bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a New Module of the FACE-Q for Children and Young Adults with Diverse Conditions Associated with Visible and/or Functional Facial Differences
Authors: Longmire Natasha , Wong Riff Karen , O'Hara Justine , Aggarwala Shivani , Allen Gregory , Bulstrode Neil , Forrest Christopher , French Brooke , Goodacre Timothy , Marucci Damian , Norris Jonathan , Panchapakesan Vivek , Piplani Bhoomika , Pusic Andrea , Vercruysse Herman , Klassen Anne
Published: September 2017

Appearance and facial function are concepts not well addressed in current pediatric patient-reported outcome measures (PROM) for facial conditions. We aimed to develop a new module of the FACE-Q for children/young adults with facial conditions that include ear anomalies, facial paralysis, skeletal conditions, and soft tissue conditions. Semi-structured and cognitive interviews were conducted with patients aged 8–29 years recruited from craniofacial centers in Canada, USA, UK, and Australia. Interviews were used to elicit new concepts and to obtain feedback on CLEFT-Q scales hypothesized to be relevant to other facial conditions. Interview data were recorded, transcribed, and coded. Experts were emailed and invited to provide feedback via Research Electronic Data Capture (REDCap). Eighty-four participants and 43 experts contributed. Analysis led to the development of a conceptual framework and 14 new scales that measure appearance, facial function, health-related quality of life, and adverse effects of treatment. In addition, 12 CLEFT-Q scales were determined to have content validity for use with other facial conditions. Expert input led to minor changes to scales and items. This new FACE-Q module for children/young adults is being field-tested internationally. Once finalized, we anticipate this PROM will be used to inform clinical practice and research studies.
Facial Layers and Facial Fat Compartments: Focus on Midcheek Area
Authors: Polselli Roberto , Bertossi Dario , East Charles , Gerbault Olivier , Saban Yves
Published: September 2017

Facial cosmetic procedures are doubtless in constant augmentation directly related to fillers and botulinum toxin injections. Many articles are published in the literature to warn about the complications of these aesthetic procedures. The need for a clear anatomic classification and review of deeper ultrastructural studies on adipose tissues in the midface area are obvious. This study aims: (1) To present midface anatomy of clinical relevance in a practical way for surgeons and cosmetologists. (2) To analyze the facial fasciae related to the fat compartments. (3) To show pictures of anatomic dissections of these anatomic structures. (4) To suggest an anatomic classification. The authors analyzed the facial anatomic layers and the facial fat compartments through facial anatomical dissections and experience in the field of facial surgical and cosmetic procedures. The authors propose a dynamic three-dimensional concept of facial layers related to muscle actions and facial fat compartmentalization in the midcheek area. A “lip–lid” superficial system associated with the malar fat pad represents the first layer; two deeper lip levator systems stratification explains the deep fat compartments as an anatomic division related to fasciae extensions. Facial grooves and segments correspond to these systems action. Moreover, the importance of ultrastructural studies has been underlined.
Intra-Articular Injections of Autologous Conditioned Serum to Treat Pain from Meniscal Lesions
Authors: Strümper Rudolf
Published: September 2017

Routine use of biological therapies is in its early stages. Techniques involve stem cells, platelet preparations, recombinant growth factors and autologous conditioned serum, often combined with surgery. The objective of this case analysis was to document effects of intra-articular autologous conditioned serum injections in outpatients with knee pain associated with meniscal defects. Autologous conditioned serum was prepared from patients’ blood by centrifugal separation from cellular components using a specialized device (EOT®II, Orthokine). Outpatients (n=47) with heterogeneous knee meniscus lesions (76.6% traumatic knee injury) were injected once weekly (average 5.2 applications). Average age was 48.6 years (range 21–79). Oxford Knee Score and structural changes with the MRI Boston Leeds Osteoarthritis Knee Score were documented at baseline and 6 months. All analyses were performed retrospectively.

In 83% patients, surgery was avoided during the 6-month observation period. Oxford Knee Score improved significantly from 29.1–44.3 (p<0.001; best possible score=48). Structural findings on MRI, measured by Boston Leeds Osteoarthritis Knee Score, showed significant improvement at 6 months (0.82–0.71, p<0.001). This retrospective study implies that intra-articular autologous conditioned serum injection may be an effective treatment option for knee pain associated with meniscal lesions. Controlled studies of autologous conditioned serum treatment for meniscal lesions are advocated.
Comparison of 1 mg versus 2 mg Dexamethasone Suppression Test in Patients with Obesity
Authors: Urwyler Sandrine , Cupa Nina , Christ-Crain Mirjam
Published: September 2017

In this study, we compared the 2 mg dexamethasone suppression test (DST) with the gold-standard 1 mg DST in obese patients in order to reduce the false-positive rate for Cushing’s syndrome (CS). The primary endpoint was the comparison of serum cortisol levels after 1 mg versus 2 mg DST in patients with a BMI >30 kg/m2 and at least one additional feature of the metabolic syndrome. Secondary endpoints were comparison of salivary cortisol and ACTH levels, respectively. Fifty-four obese patients were included. Median serum cortisol levels after 1 mg DST and 2 mg DST were similar [28 nmol/l (20; 36) vs. 28 nmol/l (20; 38), p=0.53]. Salivary cortisol was 8.2 nmol/l (4.7; 11.7) after the 1 mg DST vs. 6.7 nmol/l (4.2; 9.5) after the 2 mg test, p=0.09. ACTH levels were higher after the 1 mg DST compared to the 2 mg DST [10.0 pg/ml (7.6; 10.7) vs. 5.0 pg/ml (5.0; 5.1), p<0.0001]. The false positive rate after the 1 mg DST was 14.8% (n=8) and was reduced to 11.1% (n=6) after the 2 mg DST. All non-suppressors (n=8) had type 2 diabetes and most of them took a medication interacting with cytochrome P450 3A4 (CYP3A4). In individuals with obesity, the 2 mg DST was not superior to the 1 mg DST in regard to serum cortisol levels. However, in some patients, particularly with poorly controlled diabetes or medication interacting with CYP3A4 and without adequate suppression after the 1 mg DST, the 2 mg DST might prove helpful to reduce the false-positive rate for CS.

ClinicalTrials.gov Number: NCT02227420
Production of carbon clusters C3 to C12 with a cryogenic buffer-gas beam source
Authors: Straatsma C. J. E. , Fabrikant M. I. , Douberly G. E. , Lewandowski H. J.
Published: September 2017

Cryogenic buffer-gas beam sources are capable of producing intense beams of a wide variety of molecules and have a number of advantages over traditional supersonic expansion sources. In this work, we report on a neon matrix isolation study of carbon clusters produced with a cryogenic buffer-gas beam source. Carbon clusters created by laser ablation of graphite are trapped in a neon matrix and detected with a Fourier-transform infrared spectrometer in the spectral range 4000–1000 cm−1. Through a study of carbon cluster production as a function of various system parameters, we characterize the behavior of the buffer-gas beam source and find that approximately 1011–1012 of each cluster is produced with each pulse of the ablation laser. These measurements demonstrate the usefulness of cryogenic buffer-gas beam sources for producing molecular beams of clusters.
Velocity space degrees of freedom of plasma fluctuations
Authors: Mattingly Sean , Skiff Fred
Published: September 2017

We present the first measurements of a plasma velocity-space cross-correlation matrix. A singular value decomposition is applied to this inherently Hermitian matrix, and the relation between the eigenmodes and the plasma kinetic fluctuation modes is explored. A generalized wave admittance is introduced for these eigenmodes.
Thermal and electrical properties of silicon nitride substrates
Authors: Dow Hwan Soo , Kim Woo Sik , Lee Jung Woo
Published: September 2017

This work presents the results of studies on the thermal and electrical properties of sintered silicon nitride to investigate the effects of non-oxide additives. With regard to electrical transport properties, a high electrical resistivity of 1014 ∼ 1015 Ωcm at 323 K was observed with Si3N4 substrates. Typical electrical resistivity and thermal conductivity values of the Si3N4 substrates were 1015 Ωcm and 90 W/mK at room temperature, respectively. Based on the results of XPS measurement, it is suggested that the addition of Nb significantly improved oxygen gettering by the phases of Nb2O5. Based on the analysis of the thermal conductivity of Si3N4 substrates, it appears that the interaction between oxygen and Nb in Si3N4, enhanced the thermal conduction rate of Si3N4.
Nonlocal adiabatic theory. I. The action distribution function
Authors: Bénisti Didier
Published: September 2017

In this paper, we address the motion of charged particles acted upon by a sinusoidal electrostatic wave, whose amplitude and phase velocity vary slowly enough in time for neo-adiabatic theory to apply. Moreover, we restrict to the situation when only few separatrix crossings have occurred, so that the adiabatic invariant, I, remains nearly constant. We insist here on the fact that I is different from the dynamical action, I. In particular, we show that I depends on the whole time history of the wave variations, while the action is usually defined as a local function of the wave amplitude and phase velocity. Moreover, we provide several numerical results showing how the action distribution function, f(I), varies with time, and we explain how to derive it analytically. The derivation is then generalized to the situation when the wave is weakly inhomogeneous.
Measuring translation literality
Authors: Carl Michael , Schaeffer Moritz
Published: September 2017

Tirkkonen-Condit (2005: 407–408) argues that “It looks as if literal translation is [the result of] a default rendering procedure”. As a corollary, more literal translations should be easier to process, and less literal ones should be associated with more cognitive effort. In order to assess this hypothesis, we operationalize translation literality as 1. the word-order similarity of the source and the target text and 2. the number of possible different translation renderings. We develop a literality metric and apply it on a set of manually word and sentence aligned alternative translations. Drawing on the monitor hypothesis (Tirkkonen-Condit 2005) and a model of shared syntax (Hartsuiker et al. 2004) we develop a model of translation effort based on priming strength: shared combinatorial nodes and meaning representations are activated through automatized bilingual priming processes where more strongly activated nodes lead to less effortful translation production. The theoretical framework explains the observed production- and reading times and justifies our literality metric.
Bridging the gap between language acquisition and sociolinguistics
Authors: De Vogelaer Gunther , Chevrot Jean-Pierre , Katerbow Matthias , Nardy Aurélie
Published: September 2017

Despite repeated calls for in-depth research, the acquisition of patterns of sociolinguistic variation has long been an underinvestigated topic both in sociolinguistics and in language acquisition research. With the exception of a few exploratory studies, most notably Labov (1964), it has long been rare for sociolinguistic research to focus on non-adults, whereas most research on language acquisition tended to take place in a sociolinguistic vacuum (see, e.g. Mills 1985: 142 and Labov 1989: 96 for statements to this effect). Over the last few years, however, the situation seems to be changing. Two reasons may be given for this: first, and quite trivially perhaps, technical advancements are making it possible to gather, store and explore data in cheap and efficient ways, providing researchers with the necessary data to conduct empirically sound research on the topic. And second, parallel to a paradigm shift from rule-based to usage-based conceptions of grammar, linguistic variation has moved into the centre of the attention of theoretical linguistics. As a result, the acquisition of variation can now be considered an ‘emergent topic’ in research on language variation in general.

The aim of this book is to offer a state-of-the-art of current research on the topic, thereby focusing on two particular objectives: (1) the acquisition of sociolinguistic variation presents itself as an interesting research topic for sociolinguists and psycholinguists working on acquisition, but also for a broad range of other sub-disciplines of linguistics, including historical linguistics, dialectology, and for researchers working in different theoretical frameworks. This book aims at bridging the gap between these disciplines and frameworks and allowing an interdisciplinary perspective on the topic; and (2) in order to enable cross-linguistic comparison, the book wants to bring together research carried out in different sociolinguistic constellations, as most obviously found in different language areas or different countries.
Child acquisition of sociolinguistic variation
Authors: Cornips Leonie
Published: September 2017

The main questions of this paper are whether children acquire adults’ variable V1-V2/V2-V1 word order in the perfective two-verb cluster simultaneously with a rigid V1-V2 word order in the modal two-verb cluster from start of the acquisition process. The experimental results show that children acquire variable word orders following rigid ones confirming Labov’s (1989) expectation that children have to acquire grammatical properties before acquiring stylistic and sociolinguistic constraints. It is, however, not possible to disentangle whether the struggle with the variable word orders in the perfective cluster is due to grammatical reasons only or in combination with the fact that this type of variation reveals no significant social stratification among the adults.
Language acquisition in bilectal environments
Authors: Leivada Evelina , Grohmann Kleanthes K.
Published: September 2017

The linguistic reality of Cyprus is diglossic between the local variety of Cypriot Greek and the official language Standard Modern Greek. One of the better studied differences between the two varieties is clitic placement in syntactic environments where one requires enclisis and the other proclisis. This paper discusses the findings of two studies on the acquisition of object clitics so as to (i) explore the connection between bidialectalism and metalinguistic awareness and (ii) argue that competing motivations are relevant for the linguistic development in diglossic environments. Framed as the Socio-Syntax of Development Hypothesis, the process of constructing a socio-syntactic repertoire captures competing motivations by assuming that the linguistic development of Greek Cypriot children primarily involves the need to resolve linguistic accommodation and adjust to the “high” variety.
HiCapTools: a software suite for probe design and proximity detection for targeted chromosome conformation capture applications
Authors: Anil Anandashankar , Spalinskas Rapolas , Åkerborg Örjan , Sahlén Pelin
Published: September 2017

Folding of eukaryotic genomes within nuclear space enables physical and functional contacts between regions that are otherwise kilobases away in sequence space. Targeted chromosome conformation capture methods (T2C, chi-C and HiCap) are capable of informing genomic contacts for a subset of regions targeted by probes. We here present HiCapTools, a software package that can design sequence capture probes for targeted chromosome capture applications and analyse sequencing output to detect proximities involving targeted fragments. Two probes are designed for each feature while avoiding repeat elements and non-unique regions. The data analysis suite processes alignment files to report genomic proximities for each feature at restriction fragment level and is isoform-aware for gene features. Statistical significance of contact frequencies is evaluated using an empirically derived background distribution. Targeted chromosome conformation capture applications are invaluable for locating target genes of disease-associated variants found by genome-wide association studies. Hence, we believe our software suite will prove to be useful for a wider user base within clinical and functional applications.

Availability

https://github.com/sahlenlab/HiCapTools.

Supplementary information

Supplementary data are available at Bioinformatics online.
Pathophysiology of Qi and Vital Substances
Authors: Yang Jingduan , Monti Daniel A.
Published: September 2017

This chapter describes clinical syndromes of various types of abnormalities in Qi and vital substances, such as deficiency of Yuan Qi, Zong Qi, Ying Qi, Wei Qi, Blood, Fluid, and Essences. It also describes conditions where there is excess Qi or Blood due to stagnations or stasis, such as Liver Qi Stagnation and Heart Blood Stasis. This chapter also discusses sunken Qi due to extreme Zong Qi deficiency and Rebellious Qi (Qi moving toward the opposite direction of normal) such as Rebellious Stomach Qi, due to disturbed Qi flow by various types of pathogenic energies. The abnormalities of Qi and vital substances in each internal organ are also discussed in details that lay a solid foundation for formulating a clinical diagnosis.
Pathophysiology of Energetic Channels
Authors: Yang Jingduan , Monti Daniel A.
Published: September 2017

Continuing the discussion of the human energetic anatomy that forms the basis of ancient Chinese medicine and acupuncture, this chapter describes the energetic networks (Jing Luo) known as meridians. To make a diagnosis using the Jing Luo, this chapter describes in detail those abnormalities that can happen that affect the function of 12 principal channels (Zheng Jing) and 8 extra channels (Qi Jing Ba Mai) and cause clinical symptoms such as pain in an area with a blocked flow of energy and dysfunction of the organs that depend on the integrity of their energy channels. These abnormalities resemble the manifestation of internal organ dysfunction described in Chapter 7.
Acupuncture Points of Six Principal Yang Channels
Authors: Yang Jingduan , Monti Daniel A.
Published: September 2017

This chapter describes in detail the location, energetic function, and special features of each point in six principal Yang channels: Large Intestine, Small Intestine, San Jiao, Stomach, Gallbladder, and Bladder. It emphasizes that the unique features of each point come from its association with specific organs and five elements in addition to its connection with other energy channels. The clinical indications for mental and physical dysfunctions due to channel blockages and organ energetic imbalance are only some examples of the clinical use of these points. After reading this chapter, the practitioner should be able to expand his or her usage based on the features and functions of these points.
Point Selection and Combination
Authors: Yang Jingduan , Monti Daniel A.
Published: September 2017

This chapter teaches systematically how acupuncture points are selected and combined to achieve therapeutic goals: balance Yin and Yang, normalize organ function, open blocked energy flows, and eliminate external and internal pathogenic energies. The special features of acupuncture points are discussed in categories: Ashi points, Five-Shu point, Xi point, Yuan points, Luo point, back Shu Pints, front Mu point, eight converging points for special organs, eight converging points for extra channels, six converging points for Yang organs, and meeting points. It discusses in detail how these points are combined locally and distally based on their location and the involvement of channels and organs.
Summary of medically important viruses
Authors: Matthews Philippa C.
Published: September 2017

This chapter provides a brief summary of a traditional classification system for medically important viruses. The primary focus is on organisms that are significant causes of disease in the tropics and subtropics.
Systemic protozoal infection
Authors: Matthews Philippa C.
Published: September 2017

This chapter consists of short notes, diagrams, maps, and tables to summarize human systemic protozoal infections, namely malaria, American trypanosomiasis and African trypanosomiasis, leishmaniasis, and toxoplasmosis. For ease of reference, each topic is broken down into sections, including classification, epidemiology, microbiology, pathophysiology, clinical syndromes, diagnosis, treatment, and prevention.
Lice, fleas, mites, and ticks
Authors: Matthews Philippa C.
Published: September 2017

This chapter summarizes the entomology of medically significant vectors and nuisance biters, using diagrams to summarize characteristic features and life cycles, and maps to show geographical distribution where relevant. It includes mosquitoes, lice, fleas, mites, ticks, sandflies, tsetse flies, triatomene bugs, and blackflies. For each of these, a list of the disease-causing agent(s) that might be transmitted is included, with cross-reference to other relevant sections of the book.
Snake bite
Authors: Matthews Philippa C.
Published: September 2017

This chapter provides an overview of snake bite with diagrams, pictures, and tables to summarize clinical effects and approach to management.
Analysing matched or paired data
Authors: Peacock Janet L. , Kerry Sally M. , Balise Raymond R.
Published: September 2017

Chapter 8 covers analysing matched or paired data, and includes the paired t test, non-Normal data, matched case-control data, and cohort data. It describes the use of data transformations and how results are interpreted when data are paired. It includes how to calculate 95% confidence intervals for estimates. The chapter includes analyses using Stata, SAS, SPSS, and R.
Survival analysis
Authors: Peacock Janet L. , Kerry Sally M. , Balise Raymond R.
Published: September 2017

Chapter 11 covers survival analysis, and includes Kaplan–Meier estimates, and the logrank test. Cox regression is used to do multifactorial analyses with results reported as adjusted hazard ratios. The chapter includes analyses using Stata, SAS, SPSS, and R.
Resuscitation
Authors: Banerjee Ashis , Oliver Clara
Published: September 2017

Resuscitation is a key aspect of emergency medicine. This chapter focuses on current resuscitation for adults in line with recent updates from the Resuscitation Council. Completion of an advanced life support (ALS) course is mandatory for emergency medicine trainees. This chapter is not merely an ALS manual, instead focusing on the practical aspects of answering short-answer questions (SAQ). ALS scenarios are commonly examined in the objective structured clinical examination (OSCE) part of the Fellowship of the Royal College of Emergency Medicine (FRCEM) and the SAQ paper focuses on the theory behind resuscitation. In addition, this chapter focuses on the peri-arrest situation and post-resuscitation care. This chapter provides an insight into the pathophysiology of peri-arrest arrhythmias and shock which the SAQ exam may focus on.
Respiratory emergencies
Authors: Banerjee Ashis , Oliver Clara
Published: September 2017

Difficulty in breathing is both a common presenting complaint and a major acute presentation in the emergency department (ED). This chapter covers the common causes of breathlessness. It focuses on the management and diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in line with the British Thoracic Society guidelines, which may commonly appear as a short-answer question (SAQ). In addition, this chapter covers the pathophysiology of T2RF and its management, including the indications and contraindications for non-invasive ventilation. Another common topic examined in the SAQ paper is acid-base disturbances. This chapter includes a section on the indications and interpretation of arterial blood gas analysis.
Renal emergencies
Authors: Banerjee Ashis , Oliver Clara
Published: September 2017

The Royal College of Emergency Medicine (RCEM) curriculum covers knowledge on the assessment and management of a patient presenting with oliguria which are commonly examined in the short-answer question (SAQ) paper. This chapter covers the definition, diagnosis, and management of an individual presenting with an acute kidney injury (AKI) in line with up-to-date national guidelines. A detained knowledge of the pathophysiology of acute kidney injury is not required; however, the key aspects are summarized in this chapter. In addition, a knowledge of end-stage renal failure and renal replacement therapy is required for the SAQ paper; this chapter covers the indications for renal replacement therapy and the associated complications.
Haematology and oncological emergencies
Authors: Banerjee Ashis , Oliver Clara
Published: September 2017

This chapter covers both the common haematological and oncological emergencies that may present to the emergency department. It includes an overview of blood group type including transfusion reactions, as well haemoglobinopathies such as sickle cell disease. There is also a section on bleeding disorders and their associated management. In addition, this chapter also covers common oncological emergencies which may present to the emergency department. The chapter is subdivided by type of oncological emergency to aid revision; metabolic, cardiovascular, and neurological, the latter of which includes metastatic spinal cord compression and the management of raised intracranial pressure related to cerebral metastases.
Legal aspects of emergency medicine
Authors: Banerjee Ashis , Oliver Clara
Published: September 2017

A basic understanding of the legal aspects of emergency medicine is required for the Intermediate FRCEM examination, which can easily be assessed in the short-answer question (SAQ) paper. This chapter covers consent as well as the mental capacity and Mental Health Act, including how to assess a patient’s capacity. In addition, this chapter also covers safeguarding issues, which is a requirement for all emergency medicine physicians, as well as confidentiality. In addition, included in this chapter is a summary of General Medical Council (GMC) guidance on driving and reporting patients to the Driver and Vehicle Licensing Agency (DVLA), as well as end-of-life care and do not resuscitate orders.
Psychiatric aspects of pain management
Authors: Trestman Robert L.
Published: September 2017

Chronic pain differs from acute pain in many ways. First, by definition, it has become enduring and goes beyond the expected period of healing, whether post-trauma, post-surgery, or as part of a degenerative or progressive disease. The typical time frame used for defining chronic pain is defined as pain that persists beyond a six month window. Another characteristic that distinguishes chronic from acute pain is the emotional element of perceived suffering. This component of chronic pain becomes important in the assessment and subsequent treatment of chronic pain. Chronic pain management in a correctional setting is very challenging due to a host of factors. First, the majority of people being treated have a history of substance abuse disorders. Further, as a whole, the population of incarcerated adults has a disproportionate prevalence of significant chronic medical and psychiatric conditions. Finally, access to illicit drugs is limited, if not completely eliminated in correctional settings, shifting the environmental demand characteristics to prescription medication misuse. This chapter addresses issues of the psychiatric assessment and management of chronic pain in correctional settings. Information is provided regarding the factors to be elicited in a chronic pain interview, the methods used to assess chronic pain, and the assessment factors appropriate to integrate into a management plan. The methods used to manage chronic pain, including close coordination with a treatment team, cognitive behavioral interventions, and pharmacological management are presented. Tracking treatment outcomes from a psychiatric perspective in the correctional setting are then discussed.
Pharmacotherapy for substance use disorders within correctional facilities
Authors: Wakeman Sarah E. , Rich Josiah D.
Published: September 2017

Drug addiction treatment is increasingly complex. Only 5% of prisons and 34% of jails offer any detoxification services, and only 1% of jails offer methadone for opioid withdrawal. Even fewer facilities offer medication assisted therapy (MAT) for alcohol or substance use disorders despite the tremendous evidence base supporting the use of medications to treat addiction. Untreated opioid dependence both within corrections and in the community is associated with HIV, Hepatitis C, crime, and death by overdose. Substantial evidence argues that these risks are reduced through long-term treatment with agonist medications such as methadone and buprenorphine. Only a minority of prisoners receive any addiction treatment while incarcerated. Those that do are usually offered behavioral interventions, which when used alone have extremely poor outcomes. Although there are limited studies on the outcomes of drug treatment during incarceration, there are nearly 50 years of evidence documenting the efficacy of methadone given in the community in reducing opioid use, drug-related health complications, overdose, death, criminal activity, and recidivism. Buprenorphine is similarly an effective, safe, and cost-effective long-term treatment for opioid dependence that reduces other opioid use and improves health and quality of life outcomes. There is a growing role for MAT in jails, and to a lesser degree in prisons for the treatment of alcohol and opiate dependence. This chapter presents the current state of evidence based practice in correctional MAT models.
International perspectives and practice differences
Authors: Thomson Lindsay D. G.
Published: September 2017

Across the developed world, services for those with mental disorder in prison have been established but are seldom equivalent to those found in the community. Prisoners are largely the socio-economically deprived with high rates of mental disorder. They have often been victimized. Prisons are our new asylums. In the United States three times as many mentally ill people are in prison than in psychiatric hospital. It is essential that whatever our geographical location, we learn from other jurisdictions and other systems. Rates of imprisonment, organization of psychiatric services, and location of treatment of mentally disordered offenders all vary; and it is easy to fall into the trap of assuming that the system with which you are familiar is the right one. There are major differences across the world in terms of rates of imprisonment, place of treatment of acutely ill prisoners, and the structure of our mental health services in prisons. Those requiring hospital care should be transferred out of prison for this. Independence of health services from correctional services would promote the development of the former. One challenging issue for correctional psychiatry in some jurisdictions is capital punishment and psychiatrists ethically should have no role in executions and be aware of the ethical stance of the World Psychiatric Association. This chapter examines correctional psychiatry in an international context and explores similarities and differences in our practices, and the cultural, political, and economic background to these.
Control as a Defining Characteristic of Torture
Authors: Reyes Hernán , Bașoğlu Metİn
Published: September 2017

An analysis of the Kubark interrogation techniques clearly demonstrates that they are specifically designed to induce helplessness in detainees by enhancing the unpredictability and uncontrollability of captivity stressors. By providing examples of how various aspects of life in captivity (e.g., deprivation of sleep, food, personal hygiene, medical care, social contact, communication with the outside world, and other basic needs) can be manipulated to maximize helplessness, the Kubark manual lends support to a learning theory formulation of torture as “helplessness under the control of others.” It also demonstrates that “severe mental pain or suffering” is caused by the cumulative helplessness effects of all aspects of life in captivity and not just the captors’ “intentional” behaviors during discrete interrogation sessions.
The Meaning of Psychological Trauma
Authors: McNally Richard J.
Published: September 2017

The concept of trauma is integral to the diagnosis of posttraumatic stress disorder (PTSD) because exposure to a stressor qualifying as “traumatic” is a prerequisite for diagnosing someone with the disorder. Yet clarifying the meaning of trauma and specifying what kinds of stressors count as “traumatic” is no easy task. Indeed, many people who experience unquestionably traumatic events (e.g., combat) do not develop PTSD, whereas others who experience seemingly less severe stressors do suffer from symptoms of PTSD. Moreover, stressors triggering PTSD can vary across cultures and within a culture throughout history. Debates about trauma have relevance to whether interrogation practices now falling under the rubric of cruel, inhumane, or degrading treatment (CIDT) constitute torture. This chapter reviews the arguments and scientific evidence on the meaning and measurement of psychological trauma and shows how these findings can clarify the conceptualization of CIDT, its psychiatric consequences, and whether it qualifies as torture.
Oligodendroglial tumours
Authors: Wick Wolfgang , Watts Colin , Mehta Minesh P.
Published: September 2017

Concepts of diagnosis and treatment of oligodendroglial tumours have changed through clinical and translational studies over recent years. Diagnosis is now based on histopathological and integrated molecular information. The latter includes mutations in isocitrate dehydrogenase and the co-deletion of 1p/19q in the tumour tissue. In parallel, the long-term evaluation of large randomized trials performed in Europe and North America led to the current standard of a more aggressive chemoradiation regimen with procarbazine, CCNU (lomustine), and vincristine to optimize progression-free and overall survival. The future directions are delineated, which are aiming at further definition of prognostic and predictive subgroups, based on clinical, molecular, and imaging parameters, integrating immunotherapeutic concepts, as well as a closer look at patient-centred outcomes in upcoming trials.
Tumours of the haematopoietic system
Authors: Batchelor Tracy T. , Abla Oussama , Chen Zhong-ping , Shrieve Dennis C. , Issa Samar
Published: September 2017

‘Tumours of the haematopoietic system’ examines the epidemiology, the pathogenesis, and the clinical features of adult and childhood primary central nervous system lymphomas (PCNSLs), extranodal forms of non-Hodgkin lymphoma, as well as the histiocytoses included in the World Health Organization (WHO) classification of central nervous system (CNS) tumours. It reviews these features in the most common PCNSL, primary central nervous system diffuse large B-cell lymphoma, as well as the other rare histopathological PCNSL variants including lymphomatoid granulomatosis, T-cell lymphoma, anaplastic large T-cell lymphoma, natural killer/T-cell lymphoma, low-grade lymphoma, mucosa-associated lymphoid tissue (MALT) of the dura, and Hodgkin lymphoma. The chapter also discusses clinical and anatomical PCNSL variants including vitreoretinal lymphoma, leptomeningeal lymphoma, intramedullary spinal cord lymphoma, intravascular lymphoma, and PCNSL in the immunocompromised host. It also reviews the CNS presentations of Langerhans cell histiocytosis and the following non-Langerhans cell histiocytoses: Erdheim–Chester disease, Rosai–Dorfman disease, juvenile xanthogranuloma, and histiocytic sarcoma. It is written for specialists and non-specialists managing these various conditions.
Familial tumour syndromes: von Hippel–Lindau disease
Authors: Kanno Hiroshi , Steinbach Joachim P.
Published: September 2017

Von Hippel–Lindau (VHL) disease, an autosomal dominant familial tumour syndrome, is often associated with haemangioblastoma of the central nervous system. In the presence of oxygen, VHL protein serves to prevent the accumulation of hypoxia-inducible factor (HIF) protein by targeting it to the proteasomal pathway, while biallelic inactivation of the VHL gene blocks degradation of HIF and leads to constitutive activation of the HIF pathway although oxygen is present. HIF-target genes are involved in angiogenesis, proliferation, and metabolism enabling tumour growth. Haemangioblastoma is a highly vascularized, begin tumour commonly associated with a cyst, but it is linked with neurological morbidity and mortality based on its location and multiplicity. Haemangioblastoma in VHL is diagnosed according to symptoms and signs, past and family histories, laboratory data, neuroradiological findings, pathological findings, and genetic testing. Surgical treatment is usually the most recommended therapy for haemangioblastomas, and using well-defined microsurgical techniques, the majority can be resected safely.
Metastatic tumours: spinal cord, plexus, and peripheral nerve
Authors: Schiff David , Sherman Jonathan , Brown Paul D.
Published: September 2017

Systemic cancers produce substantial neurological morbidity when they spread to the spinal epidural space, producing epidural spinal cord compression—a neurological emergency. Less often, metastases spread directly to spinal cord parenchyma to manifest as intramedullary spinal cord metastasis or result in peripheral nerve dysfunction via compression of the brachial, lumbosacral, or, rarely, the cervical plexus. This chapter reviews the clinical manifestations and risk factors for development of these entities, the diagnostic approach, management options including the role of surgery, radiation (including stereotactic body radiation therapy), and chemotherapy, as well as the neurological prognosis.
Chest medicine
Authors: Wilkinson Ian B. , Raine Tim , Wiles Kate , Goodhart Anna , Hall Catriona , O’Neill Harriet
Published: September 2017

This chapter explores chest medicine, including respiratory health, bedside tests in chest medicine, further investigations in chest medicine, pneumonia, bronchiectasis, cystic fibrosis (CF), lung tumours, fungi and the lung, asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), respiratory failure, pulmonary embolism (PE), pneumothorax, pleural effusion, obstructive sleep apnoea syndrome, cor pulmonale, sarcoidosis, interstitial lung disease (ILD), extrinsic allergic alveolitis (EAA), idiopathic pulmonary fibrosis (IPF), and industrial dust diseases.
Renal medicine
Authors: Wilkinson Ian B. , Raine Tim , Wiles Kate , Goodhart Anna , Hall Catriona , O’Neill Harriet
Published: September 2017

This chapter discusses renal medicine, including urine, urinary tract infection (UTI), acute kidney injury (AKI), chronic kidney disease (CKD), renal replacement therapy (RRT), transplantation, glomerulonephritis, nephrotic syndrome, renal manifestations of systemic disease, renal tubule: disorders and diuretics, tubulointerstitial nephropathy and nephrotoxins, and inherited kidney disease.
Emergencies
Authors: Wilkinson Ian B. , Raine Tim , Wiles Kate , Goodhart Anna , Hall Catriona , O’Neill Harriet
Published: September 2017

This chapter explores cardiovascular, respiratory, gastrointestinal, neurological, and endocrinological emergencies, including headache, breathlessness, chest pain, coma, Glasgow Coma Scale (GCS), shock, sepsis, anaphylactic shock, acute coronary syndrome with ST-elevation, acute coronary syndrome without ST-elevation, severe pulmonary oedema, cardiogenic shock, broad complex tachycardia, narrow complex tachycardia, bradycardia, acute severe asthma, acute exacerbations of COPD, pneumothorax, tension pneumothorax, pneumonia, pulmonary embolism (PE), acute upper GI bleeding, meningitis, encephalitis, cerebral abscess, status epilepticus, head injury, raised intracranial pressure (ICP), diabetic ketoacidosis (DKA), diabetic emergencies, thyroid emergencies, Addisonian crisis, hypopituitary coma, phaeochromocytoma emergencies, acute poisoning, poisons and their antidotes, paracetamol poisoning, salicylate poisoning, burns, hypothermia, and major disasters
References
Authors: Wilkinson Ian B. , Raine Tim , Wiles Kate , Goodhart Anna , Hall Catriona , O’Neill Harriet
Published: September 2017

This chapter presents key references on chest medicine, endocrinology, gastroenterology, renal medicine, haematology, infectious diseases, neurology, oncology and palliative care, rheumatology, surgery, clinical chemistry, radiology, practical procedures, and emergency medicine
Cognitive Impairment and Depression
Authors: Steinberg Martin , Rosenberg Paul B.
Published: September 2017

Depression, mild cognitive impairment (MCI) and dementia in the elderly can present with similar features such as cognitive complaints, loss of initiative, and difficulties with psychosocial functioning. These can be difficult to distinguish in the office setting, especially when mild in severity. The relationships between the three syndromes remains incompletely understood. Patients with MCI are at high risk for conversion to dementia. Depression may be either a risk factor for or early manifestation of MCI. Depression in late life is associated with Alzheimer’s disease (AD) and other dementias, but the causal relationship remains controversial. Depression may also increase the risk of conversion from MCI to dementia and be more strongly associated with conversion to Vascular dementia (VaD) than to AD. This book will provide guidance to clinicians in the diagnosis and management of these complex conditions in the office setting.
Preventing new sensitization and asthma onset by allergen immunotherapy: the current evidence
Authors: Wahn Ulrich
Published: September 2017

Purpose of review

Specific allergen immunotherapy is considered a key candidate for a successful preventive intervention in atopic diseases. The strong association of atopic manifestations such as rhinitis and asthma with atopic sensitizations (specific serum IgE) provide a rationale for early intervention in childhood and adolescence.

Recent findings

Currently, the documentation of the disease-modifying intervention effects is limited to the secondary prevention of asthma symptoms in children with allergic rhinoconjunctivitis. These effects appear to be rather allergen specific than nonspecific.

Documentation on disease modification including a reduction of asthma symptoms in children, particularly with grass pollen tablets has become quite robust. It is not clear up to now, if the new onset of allergic sensitizations can be modified. So far data on primary prevention are not conclusive.
Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children
Authors: Hoorweg Anne-lee J. , Pasma Wietze , van Wolfswinkel Leo , de Graaff Jurgen C.
Published: September 2017

Background

Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts.

Methods

In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques.

Results

We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%).

Conclusions

Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.
Vasculotide, an Angiopoietin-1 Mimetic, Restores Microcirculatory Perfusion and Microvascular Leakage and Decreases Fluid Resuscitation Requirements in Hemorrhagic Shock
Authors: Trieu Michelle , van Meurs Matijs , van Leeuwen Anoek L. I. , Van Slyke Paul , Hoang Van , Geeraedts Leo M. G. , Boer Christa , van den Brom Charissa E.
Published: September 2017

Background

Microcirculatory dysfunction is associated with multiple organ failure and unfavorable patient outcome. We investigated whether therapeutically targeting the endothelial angiopoietin/Tie2 system preserves microvascular integrity during hemorrhagic shock.

Methods

Rats were treated with the angiopoietin-1 mimetic vasculotide and subjected to hemorrhagic shock and fluid resuscitation. Microcirculatory perfusion and leakage were assessed with intravital microscopy (n = 7 per group) and Evans blue dye extravasation (n = 8 per group), respectively. The angiopoietin/Tie2 system was studied at protein and RNA level in plasma, kidneys, and lungs.

Results

Hemorrhagic shock significantly reduced continuously perfused capillaries (7 ± 2 vs. 11 ± 2) and increased nonperfused vessels (9 ± 3 vs. 5 ± 2) during hemorrhagic shock, which could not be restored by fluid resuscitation. Hemorrhagic shock increased circulating angiopoietin-2 and soluble Tie2 significantly, which associated with microcirculatory perfusion disturbances. Hemorrhagic shock significantly decreased Tie2 gene expression in kidneys and lungs and induced microvascular leakage in kidneys (19.7 ± 11.3 vs. 5.2 ± 3.0 µg/g) and lungs (16.1 ± 7.0 vs. 8.6 ± 2.7 µg/g). Vasculotide had no effect on hemodynamics and microcirculatory perfusion during hemorrhagic shock but restored microcirculatory perfusion during fluid resuscitation. Interestingly, vasculotide attenuated microvascular leakage in lungs (10.1 ± 3.3 µg/g) and significantly reduced the required amount of volume supplementation (1.3 ± 1.4 vs. 2.8 ± 1.5 ml). Furthermore, vasculotide posttreatment was also able to restore microcirculatory perfusion during fluid resuscitation.

Conclusions

Targeting Tie2 restored microvascular leakage and microcirculatory perfusion and reduced fluid resuscitation requirements in an experimental model of hemorrhagic shock. Therefore, the angiopoietin/Tie2 system seems to be a promising target in restoring microvascular integrity and may reduce organ failure during hemorrhagic shock.