bluuebunny/crossref_metadata_2025 huggingface dataset:
Skepticism and Nihilism
Authors: Unger Peter
Published: November 2023

My main aim in this paper is to help foster a positive attitude toward a thesis of radical nihilism. According to this thesis, none of the things which, it seems, are most commonly alleged to exist do in fact exist: neither rocks nor stones, not tables nor chairs nor even people; perhaps most importantly, neither you nor I exist. The positive attitude toward this thesis is that it is worthy of serious consideration. The recommended attitude is that it should be seriously considered, at least, whether this thesis may not be perferable to its denial. Thus taken as a ‘‘working hypothesis’’, this attitude continues, the thesis may provide a first step to developing a more adequate way of thinking. To be sure, if we stay within our ordinary thinking, the nihilistic thesis means commitment to paradox for us. Thus the paradoxical character of some things just said. But that may mean no relevant refutation of the thesis, or of our arguments on its behalf. Rather, it might direct us to abandon common sense entirely, in our philosophical thinking. Perhaps new beginnings for understanding may then be sought so that such paradox may be properly avoided.
Agitation and Pain
Authors: Wijdicks Eelco F M
Published: November 2023

Rapid administration of a sedative may seem appropriate in patients with an acute neurologic illness who are agitated and uncomfortable. It may not only provide proper anxiolysis but may also reduce oxygen consumption and mute the hyperdynamic stress response. In addition, pulling of intravascular and bladder catheters and endotracheal and nasogastric tubes, a danger to the patient, may be prevented.
Craniotomy and Biopsy
Authors: Wijdicks Eelco F M
Published: November 2023

Both elective and emergency craniotomy are unchallenged indications for admission to a neurologic-neurosurgical intensive care unit. We may have a tendency to overestimate small risks but the probability of a major complication after elective craniotomy is rare, and such a complication is unlikely to contribute to overall morbidity. In many patients with planned craniotomy, stay in the NICU is precautionary and brief.
Gastrointestinal Complications
Authors: Wijdicks Eelco F M
Published: November 2023

Gastrointestinal discomfort is not often voiced by patients with acute brain injury. Impaired level of consciousness often precludes an adequate history of abdominal pain, and, in trauma, there may be distracting injuries. Often, only significant laboratory changes, such as a decrease in hematocrit, point to a gastrointestinal complication. This chapter summarizes the important principles of recognition and management of acute conditions in the gastrointestinal tract complicating acute neurologic illness. Bowel care in spinal cord injury, which is complicated because of neurogenic bowel disorder, receives attention here.
Philosophy of the Environment
Authors: Nelson William M
Published: November 2023

Let us put chemical usage in context. There is justifiably a concern over the adverse effects of chemicals on human health and the environment. The source of chemicals may be industrial, commercial, or adventitious. Environmental quality is a concern in the United States and throughout the world. This concern is important today. Our world has heightened environmental awareness, fueled by public interest groups and the media. Public awareness is growing of the processes involved in the use, manufacturing, and effect of many chemicals on the environment, including the generation of waste, the disruption of ecosystems, and the depletion of natural resources. Current patterns of chemical development threaten to exceed the limits of sustainability in terms of resource utilization and waste management, and also pose potential threats to global climate, vegetation, and agriculture. According to the U.S. Environmental Protection Agency (EPA), about 123 billion tons of industrial wastes are generated annually in the United States, and more than a third of this is hazardous waste. This presents a challenge to the chemical industry. Although the EPA has striven to reduce the impact of toxic chemicals, the efforts have focused primarily on exposure-based approaches. Within the United States, the Pollution Prevention Act of 1990 introduced a new era in regulatory philosophy and policy. The emphasis became the prevention of toxic substances at their source. Green chemistry aims at accomplishing pollution prevention through the design of safer chemicals and the use of more environmentally friendly chemical processes.
Visionaries and Eclectics
Authors: Stokes W Royal
Published: November 2023

Of the several times that I have caught Don Byron in performance, one of the most enjoyable was in the mid-199os when, in the Smithsonian’s Baird Auditorium, he and a half-dozen of his musical associates offered selections from his CD Bug Music, which features the recorded music of Raymond Scott, John Kirby, and small group Duke Ellington. I went backstage with my brother Bill after the concert and presented Byron a copy of my recently published Swing Era New York: The Jazz Photographs of Charles Peterson, inscribing it to him on the spot and then opening it to photographs of Scott, Kirby, and Ellington. He thanked me warmly for the gift.
Editorial Introduction Place in Mind and Mind in Place
Authors: Graham George , Valentine Elizabeth R
Published: November 2023

Ullin Thomas (U. T.) Place can justifiably be described as the pioneer of the modern identity theory of mind, according to which mental processes can be identified with processes that go on in the brain. He was the author of the first of the trilogy of papers1 that established the theory as a defensible philosophical position. Place offered at least two estimations of his paper’s impact. One is humble; the other is uncharacteristically immodest. The one (Place 1988; chapter 7, this volume) is that his paper was an ancestor of the materialism that has become an establishment view in contemporary philosophy of mind. The other (Place 2002; chapter 1, this volume) is that the paper marked a watershed in philosophical discussions of the mind-body problem whose impact was comparable to that of Descartes’s Meditations. In our judgment there is no doubt that the paper constituted a watershed, helping to set the agenda in the philosophy of mind for the next half century. So its impact has been much more than just ancestral, if less than the volcanic force among philosophers of mind of the Meditations.
From Mystical Experience to Biological Consciousness A Pilgrim’s Progress?
Authors: Graham George , Valentine Elizabeth R
Published: November 2023

The story I shall tell is a piece of autobiography. But it is not, as you might sup­ pose, a record of my own mystical experiences. For I do not claim to have had any. It is rather a record of a thought process that led from a childhood interest in religion, through an adolescent interest in mystical experience as a psycho­ logical phenomenon, to the publication forty years ago in the British Journal of Psychology for 1956 of a paper titled “Is consciousness a brain process?” In that paper, as I say in the abstract, “The thesis that consciousness is a process in the brain is put forward as a reasonable scientific hypothesis, not to be dis­ missed on logical grounds alone” (Place, 1956, p. 44). It is widely accepted that that paper marks a watershed in philosophical discussion of the mind-body problem, one whose impact, though confined to discussions of that particular issue by professional philosophers in the English-speaking world, ranks in the magnitude of its effect with that of Descartes’s Meditations more than three hundred years earlier.
The Infallibility of Our Knowledge of Our Own Beliefs
Authors: Graham George , Valentine Elizabeth R
Published: November 2023

It would seem to be the case that if I assert a proposition of the form ‘I believe that p’, I cannot be mistaken. The proposition of the form, “I believe that p,” may be false; but if it is, it must be the case that I am lying. Why should this be? On what Ryle (1949) in The Concept of Mind called “the official doctrine,” the infallibility of my knowledge of my own beliefs is explained on the assumption that a belief is a private inner state that I and only I can inspect. The objection to this theory is that if it were true, our knowledge of our own beliefs would be in­ corrigible in the sense that no one else is able to inspect my beliefs and thus correct any error I may have made in reporting them; but it would not be infallible, because there is no reason in principle why I should not make a mistake through careless introspection even though I am the only person who is in a position to correct it.
How Tuned Out Are They?
Authors: Mindich David T Z
Published: November 2023

In late 2001, I was interviewed on CNN about how young people are following the news in the wake of the September 11 terrorist attacks. Miles O’Brien, the anchor, mentioned that there was an upward “trend” in news consumption among young people and he backed it up with the following statistic from the Pew Research Center for the People & the Press: Two months after the terrorist attacks, 61 percent of people under 30 were following the news of the terrorist attacks “closely.” Anyone in America on September 11 and during the days that followed knows that almost everyone was glued to their televisions. But, as I told O’Brien that day, Pew’s findings painted a mixed picture about how young people consume news.
Marriage
Authors: Frier Bruce W , McGinn Thomas A J
Published: November 2023

In a famous and much debated fragment, the late classical jurist Modestinus describes Roman marriage as “the union of a male and a female in a complete life partnership, the sharing of divine and human law” (D. 23.2.1: Nuptiae sunt coniunctio maris et feminae et consortium omnis vitae, divini et humani iuris communicatio). This august description, however, scarcely isolates Roman marriage as a distinct historical phenomenon. At best, Modestinus may be thought to identify an abiding cultural ideal rather than the real Roman marriage that emerges from legal and literary sources. Marriage is usually considered the most fundamental building block of human societies, and it is certainly the most persistent. But its configuration, and in particular its legal configuration, has varied extremely widely through the ages. Modestinus emphasizes above all the alliance between husband and wife, and their subsequent companionship. But even a quick glance at Roman literary sources will suggest that close spousal interrelationships were only one part of the picture, and in some respects not even the most important part. In the Roman world, as in human societies generally, marriage as an institution was deeply saturated with numerous social meanings and uses, which potentially conflict with one another in particular circumstances. First, a wedding between two individuals often served to create a link between their families; and if one or both of the new spouses were in the power of patres familias, a father’s heavy presence is also often detectable in the immediate background of a marriage ceremony. Second, the arrangements leading to a marriage could have major property implications for the two families, since a bride usually required a dowry; and more generally the issue of a couple’s maintenance was important to their marriage’s ultimate success. Third, the two families, as well as the public at large, might take an active interest in the marriage at least to the extent that procreation, and hence the renewal of a population, was regarded as an intrinsic and important aspect of marriage.
A Citizen’s Guide to Ecology
Authors: Slobodkin Lawrence B
Published: November 2023

The earth is continuously changing and evolving yet it is unclear how environmental changes will affect us in years to come. What changes are inevitable? What changes, if any, are beneficial? And what can we do as citizens of this planet to protect it and our future generations? Larry Slobodkin, one of the leading pioneers of modern ecology, offers compelling answers to these questions in A Citizen's Guide to Ecology. He provides many insights into ecology and the processes that keep the world functioning. This important guide introduces observations that underlie arguments about all aspects of the natural environment--including both global and local issues. To clarify difficult concepts, Slobodkin uses lake, ocean, and terrestrial ecosystems to explain ecological energy flows and relationships on a global scale. The book presents a clear and current understanding of the ecological world, and how individual citizens can participate in practical decisions on ecological issues. It tackles such issues as global warming, ecology and health, organic farming, species extinction and adaptation, and endangered species. An excellent introduction and overview, A Citizen's Guide to Ecology helps us to understand what steps we as humans can take to keep our planet habitable for generations to come. "This beautifully written book brings together careful observation, personal reflection, and theoretical understanding to explain the major environmental problems that confront us. Dr. Slobodkin's superb and sweeping work invites us to contemplate a great many facts and a few large values to motivate a clear and compelling response to losses of biodiversity, the problem of invasive species, global warming, and other environmental concerns."--Mark Sagoff, School of Public Affairs, University of Maryland
Why Does Culture Increase Human Adaptability?
Authors: Boyd Robert , Richerson Peter J
Published: November 2023

Culture has made the human species a spectacular ecological success. Since the first appearance of tools and other evidences of culture in the archaeological record, the human species has expanded its range from part of Africa to the entire world, increased in numbers by many orders of magnitude, exterminated competitors and prey species, and radically altered the earth’s biota.
Why Culture Is Common, but Cultural Evolution Is Rare
Authors: Boyd Robert , Richerson Peter J
Published: November 2023

Cultural variation is common in nature. In creatures as diverse as rats, pigeons, chimpanzees, and octopuses, behavior is acquired through social learning. As a result, the presence of a particular behavior in a population makes it more likely that individuals in the next generation will acquire the same behavior, which, in turn, results in persistent differences between populations that are not due to genetic or environmental differences.
Simple Models of Complex Phenomena: The Case of Cultural Evolution
Authors: Boyd Robert , Richerson Peter J
Published: November 2023

A great deal of the progress in evolutionary biology has resulted from the deployment of relatively simple theoretical models. Staddon’s, Smith’s, and Maynard Smith’s contributions illustrate this point. Despite their success, simple models have been subjected to a steady stream of criticism. The complexity of real social and biological phenomena is compared to the toy like quality of the simple models used to analyze them and their users charged with unwarranted reductionism or plain simplemindedness.
Organization of the Endocrine System
Authors: Ojeda Sergio R , Griffin James E
Published: November 2023

The evolutionary appearance of multicellular organisms dictated the necessity of establishing coordinating systems to regulate and integrate the function of the different cells. Two basic regulatory mechanisms developed to perform this delicate function: the nervous system and the endocrine system. Whereas the former employs electrochemical signals to send commands to peripheral organs and to receive information from them, the latter performs its regulatory function by producing chemical agents that, in general, are transported by the bloodstream to the target organs.
Genes and Hormones
Authors: White Perrin C
Published: November 2023

Much of the knowledge presented in the following chapters has been gained using molecular genetic techniques to analyze the structure, synthesis, regulation, and effects of hormones. This chapter provides an overview of some of the relevant techniques and associated concepts.
Feeling and Facing Fear
Authors: Schneider Pat , Elbow Peter
Published: November 2023

Writing is talking. It is hunkering down around the cave fire at night and telling about the day. And however it may be disguised, fear is close to the center of the first stories we will want to tell. We will tell about the hunt, the animal at the mouth of the cave, the fear that made the mother’s arms strong as she protected the child; the wild boar, how it turned and faced the hunter. And as we try to tell our tales, fear will rise. At times, fear keeps us from writing at all, or keeps us from writing as truly, clearly, and brilliantly as we might. Fear has good reason for being; understanding it can make all the difference.
The Form Your Writing Takes
Authors: Schneider Pat , Elbow Peter
Published: November 2023

This chapter is not intended as a thorough examination of various forms—that would take many books! Rather, it is an invitation to the writer who has worked in one form, and perhaps has not experimented much with a range of forms. I am offering only brief observations and some suggestions of where to go for more information, in the hope that it might be helpful as ideas for further writing practice, or as enticements toward experimentation.
Trout Cod (Muccullochella macquariensis) in the Murray River, Southeast Australia: Prioritizing Rehabilitation Efforts
Authors: Nicol Simon , Todd Charles
Published: November 2023

Trout cod (Muccullochella macquariensis Cuvier) were formerly distributed over a substantial proportion of the Murray-Darling Basin in eastern Australia (Douglas et al. 1994). In the last 50 years they have undergone a dramatic contraction in range and are now classified as critically endangered (Australian Society for Fish Biology 2001). At present only two breeding populations are known: a naturally occurring population in a 200-km reach of the Murray River below Lake Mulwala, and a translocated population in an 8-km reach of Seven Creeks below Polly McQuinns Weir (Richardson and Ingram 1989, Ingram et al. 1990). Alteration or destruction of habitat is widely recognized as a major cause of decline in fish native to Australia (Cadwallader 1978; Koehn and O’Connor 1990a, 1990b; Lintermans 1991). In combination with angling pressure, it is thought to be the primary threat to remaining populations (Douglas et al. 1994). Fish habitat has been degraded in the Murray-Darling Basin by the construction of instream barriers to fish passage, alteration of flow regimes and water extraction, reduction in water quality, loss of floodplain habitat, and the removal of instream physical habitat such as woody debris and pools (Lawrence 1991). Large woody debris from trees that have fallen into a river is an important habitat attribute for many Australian freshwater fish species (Treadwell et al. 1999), including trout cod (Koehn and Nicol 1998). The reach of the Murray River where trout cod still occur is large, deep, and slow flowing; has a sand, silt, and clay substrate; and contains abundant large woody debris (Australian Capitol Territory Government 1999). There has been little removal of large woody debris in this reach (Department of Land and Water Resources, unpublished records) in contrast to areas where trout cod no longer occur (Treadwell et al. 1999).
Houston Toad (Bufo houstonensis) in Bastrop County, TexasNeed for Protecting Multiple Subpopulations
Authors: Hatfield Jeff S , Price Andrew H , Diamond David D , True C Diane
Published: November 2023

The Houston toad (Bufo houstonensis) was listed as an endangered species in 1970 under the U.S. Endangered Species Act and is currently found in nine counties in east-central Texas (U.S. Fish and Wildlife Service 2003). This species is thought to require habitat consisting of deep sandy soils among pine (Pinus) or oak (Quercus) woodlands. The reasons for its decline are believed to be habitat loss, habitat fragmentation, competition and hybridization with other species of Bufo (Hillis et al. 1984), and competition or predation by introduced species (e.g., fire ants, Solenopsis invicta). Bastrop County, Texas, is believed to support the largest remaining population of the Houston toad. Because this area (and nearby Austin) is undergoing significant development, habitat loss and fragmentation are major concerns, especially because of the effect of roads on some amphibian populations (Hels and Buchwald 2001). Currently, two relatively large, forested tracts of land within Bastrop County, separated by a minimum distance of 2222 m, contain breeding populations of the Houston toad (Figure 26.1). Although it is unknown whether either area will be able to support this species indefinitely, it is clear that management actions within and between these areas may make extinction less likely. For example, maintaining corridors for dispersal between these two areas might be beneficial for the long-term maintenance of this species in Bastrop County, although this option may be difficult because there is a two-lane highway separating these areas.
Skeptical Linguistic Essays
Authors: Postal Paul M
Published: November 2023

Paul Postal is a distinguished Research Professor at New York University whose specialties are syntactic theory, English syntax, and the foundations of linguistics. This volume consists of an introduction and two groups of essays, each with a connecting theme. The first, positive group, contains five previously unpublished studies of English syntax. These include a long study of so-called ‘locative inversion’, two investigations related to raising to non-subject status, an argument for the existence of a hitherto ignored nominal grammatical category and a study of vulgar negative polarity items. Each investigation of specific English details is argued to have significant theoretical consequences. The link between them is that each chapter reveals how much of even a well-studied language remains mysterious. Part One ends with a new theoretical essay that argues in a novel fashion for the controversial conclusion that it is literally impossible for a natural language to have a generative grammar due to a variety of theoretically neglected phenomena including so-called direct speech and metalinguistic uses. The second, negative group of papers, contains seven essays each of which seeks to show that aspects of contemporary linguistic activity are in part contaminated by elements of what is called ‘junk linguistics’. Postal uses the term to denote work which advances proposals, puts forward claims and asserts deep results which, he argues, can only be accepted by ignoring serious standards of inquiry and scholarship. The fact that much of this work is nonetheless currently considered not only serious but prestigious reveals, Postal says, the problem to exist at the core of the field, not its periphery. These chapters include long, detailed studies of the strong crossover phenomenon and English passive structures as well as documentation of “junk linguistic” aspects in National Science Foundation refereeing, work on the foundations of linguistics, and even in widespread terminological usages. The negative section final chapter briefly lists personal suggestions for dealing with this problem.
First Encounters
Authors: Pais Abraham
Published: November 2023

On September 19, 1946, a week after I had arrived in the United States for the first time, a meeting of the American Physical Society began, held in the building of the Engineering Societies in Midtown Manhattan. From the minutes of that meeting: “Many guests from overseas were present . . . over a thousand people attended.” I had been asked to give an invited paper at this gathering of physicists, the biggest I had ever seen.
University Studies
Authors: Pais Abraham
Published: November 2023

In September 1922 Oppenheimer entered Harvard College, majoring in chemistry. In high school he had been called Bob. Now he became Robert. “At Harvard I did a great deal; the maximum number of courses you could take was six but I audited two or three more in my third year . . . the free availability of the whole library . . . got me reading very widely.
Atomic Politics in the Early Postwar Years
Authors: Pais Abraham
Published: November 2023

Here and there in the preceding I have recorded snippets of Oppenheimer’s opinions and activities regarding political aspects of atomic energy: his first correspondence with the secretary of war and his reply on accepting the certificate of appreciation for the work in Los Alamos, from the secretary of war; his credo; and his involvement with the May-Johnson and the McMahon proposals, as well as his appointment to the GAC. I recall a few dates mentioned earlier.
In Which The Excrement Hits The Ventilator
Authors: Pais Abraham
Published: November 2023

Replying to Strauss’s message, Robert agreed to meet with him at 3:30 PM December 21 at Strauss’s office in AEC headquarters, where the two men were joined by Kenneth Nichols, the Commission’s general manager.
No Final Judgment
Authors: Pais Abraham
Published: November 2023

After the verdict, Oppenheimer later told a reporter, one option was to seek to show “that what was put out as a final judgment about me wasn’t the final judgment.”
Bridging Health Care’s Divides
Authors: Charon Rita
Published: November 2023

Narrative medicine is a very practical undertaking. It arises from the day-in, day-out events of the doctor’s or nurses’ office—right there off the crowded waiting room, the desk drawers filled with prescription blanks and rubber hammers, the gauze and the scalpels and the needles and the betadine, the telephones ringing and the computer screens filled with lab test results. Or it arises in the anonymous hospital room, strangers overhearing, through the green cloth curtain, a doctor telling a patient bad news, sad news, news of defeat, and sometimes—though it seems rarely—news of success and cure. Here, relative strangers meet—one prepared to deploy clinical knowledge and the other prepared for the worst.
The Patient, the Body, and the Self
Authors: Charon Rita
Published: November 2023

A 51-year-old man came to see me with diarrhea and abdominal pain. A successful writer of nonfiction, he had been physically healthy except for a completely resolved sports injury of some years ago. He had suffered through a major depression about 20 years ago, had undergone intensive long-term psychotherapy, and was now not clinically depressed. When he experienced persistent left upper quadrant abdominal pain and developed a dramatic change in his bowel habits, he came to the quick and irrevocable decision that he had pancreatic cancer. A rapid loss of around eight pounds confirmed this medical suspicion in his own mind.
Power, Lady, and Linguistic Politeness in Language and Woman’s Place
Authors: Holmes Janet
Published: November 2023

Robin Lakoff is undoubtedly the linguist who has most profoundly influenced the direction of language and gender research worldwide —most especially perhaps in its infancy, with her groundbreaking article (1973) and book Language and Womans Place (LWP) (1975). But even thirty years later, as this volume testifies, she continues to contribute insightfully and incisively to the field. LWP addressed two fundamental dimensions of the interaction of language and gender, namely the language used by and about women, dimensions which have continued to attract the attention of researchers and which have increasingly been regarded as simply different facets of one issue —the role of language in the construction of gender identity (see Holmes 2001).
“Women’s Language’’ and Martha Stewart: From a Room of One’s Own to a Home of One’s Own to a Corporation of One’s Own
Authors: Davies Catherine Evans
Published: November 2023

Whereas recent research on gender and language has typically abstracted away from the gendered individual to attempt to generalize about the linguistic behavior of the social category, especially about the occurrence of selected linguistic features, a more comprehensive treatment of gendered style, inspired by Robin Lakoffs work in Language and Womans Place (LWP) (1975), also exists within the tradition of interactional sociolinguistics (e.g., Tannen 1996). Meanwhile, Barbara Johnstone (1996, 1999) has drawn our attention to the linguistic individual (see also Bean & Johnstone, this volume).
Strabismus Surgery
Authors: Buckley Edward G , Plager David A , Repka Michael X , Wilson M Edward
Published: November 2023

A concise, readable description of the best current surgical strategies and examination techniques in the treatment of strabismus, this book comprehensively covers the management of esotropia, exotropia, oblique muscle dysfunction, dissociated strabismus complex, paralytic strabismus, restrictive strabismus, and nystagmus, along with a chapter on reoperation strategies.
Nystagmus Surgery
Authors: Repka Michael X
Published: November 2023

The decision to treat surgically a patient with nystagmus is a serious one. Such a plan is undertaken after considering each of the patient’s symptoms and informing the patient and family of the likelihood of improvement. Three symptoms lead the ophthalmologist to consider surgical correction of nystagmus: anomalous head posture, decreased vision, and oscillopsia. Surgery may also be performed for strabismus at the same operation.
The History of Cerebral Trauma
Authors: rose F Clifford
Published: November 2023

A murder committed over 1 million years ago provides the first evidence of brain injury. At that time, the human’s predecessor was a semierect hominid now named Australopithecus africanus. A damaged skull from this species found in South Africa revealed two posterior fractures close together that fit the condyles of an antelope humerus discovered nearby, which was therefore presumed to be the instrument used for the clubbing to death from behind. Such fractured skulls have been found in later hominids who walked more erectly (Homo erectus), such as Java man (more than 300,000 years ago), Peking man (more than 100,000 years ago), and Neanderthal man (more than 40,000 years ago). “The literature of trepanation is large, well over 1000 references.” “Not all holes in skulls were made by human hands and these have been grouped as pseudo-trephination. The earliest known trephined skulls date from 10,000 bc and were found in North Africa.
Low-Back Pain and Sciatica: Evaluation and Treatment
Authors: Howard James F
Published: November 2023

Unquestionably, the patient with low-back pain often is a diagnostic challenge for the physician irrespective of whether the physician is a neurologist, neurosurgeon, orthopedist, physiatrist, internist, or generalist.

This is due, in part, to the fact that the patient’s complaint is a symptom, not a clinical sign or diagnosis, and the anatomical substrates for causing the problem are myriad (Fig. 16.1). The etiologies are diverse, if not legion, and there is poor correlation with symptoms, laboratory study findings, and pathological findings. This accounts for the fact that in 85% of patients with acute low-back pain and in 50% of patients with chronic low-back pain, no diagnosis is ever established.64,156,209 Further the problem may be complicated by other factors, resulting in an exaggeration of symptoms by nonphysiological processes (psychological, remunerative, occupational, etc.).
Electrodiagnostic Studies in the Evaluation of Peripheral Nerve Injuries
Authors: Katirji Bashar
Published: November 2023

Injuries to peripheral nerves are most prevalent in young adults between the age of 18 and 35 years and result in substantial disability. These lesions are much more common during wartime, but they also often accompany civilian trauma that results from motor vehicle accidents, motorcycle accidents, industrial accidents, and gunshot or knife wounds.12,13,15 Traumatic nerve injuries may be direct (such as with stab wounds) or indirect (such as with radial neuropathy following humeral fracture). Also, a significant percentage of peripheral nerve injuries encountered in clinical practice are iatrogenic, occurring in the setting of surgical or radiological procedures, needle injuries, and, occasionally, following medical therapy, such as with the use of anticoagulation.
Chronic Regional Pain Syndrome I/II
Authors: Schwartzman Robert J , Vorobeychik Yakov
Published: November 2023

It is clear that the process may be sympathetically maintained (usually early in the course), sympathetically independent, or never have many sympathetic signs or symptoms. It frequently spreads contralaterally and may generalize to affect the entire body. It may be dissociated in that a patient may have pain, autonomic and motor dysfunction, or any combination of signs ipsilaterally and only the movement disorder or autonomic dysregulation contralaterally.87 The process clearly affects both the peripheral (PNS) and central nervous systems (CNS).41 This has been demonstrated by changes in magnetic resonance imaging (MRI) magnetoencephalography, and quantitative sensory testing in both the CNS and PNS.25,44 A sustaining nociceptive barrage appears to be necessary to maintain the abnormal state of central painprojecting neurons.37 Deep somatic and articular pain is frequently prominent. Some genetic evidence for susceptibility to the illness has been presented.55,56 Patients are depressed due to their severe pain. They do not differ from other patients with chronic pain, and there is no psychological profile for these patients.
Iatrogenic Nerve Injuries
Authors: Wilbourn Asa J
Published: November 2023

The concept that healers could accidentally produce medical disorders in the course of diagnosing or treating their patients was recognized as early as 1700 B.C. Nonetheless, the term iatrogenic (from Greek: iatros = healer; genic = origin) was not used until the early twentieth century. By the 1970s, its meaning had been expanded considerably, so that it encompassed any type of adverse event experienced by any patient, caused by any health care provider, via either commission or omission.
Introduction
Authors: Gibson Rosalind S
Published: November 2023

Nutritional assessment procedures were first used in surveys designed to describe the nutritional status of populations on a national basis. The methods used were initially described following a conference held in 1932 by the Health Organization of the League of Nations. In 1955, the Interdepartmental Committee on Nutrition for National Defense (ICNND) was organized to assist low-income countries in assessing the nutritional status of their populations and to identify problems of malnutrition and the ways in which they could be solved. The ICNND teams conducted medical nutrition surveys in 24 countries. A comprehensive manual was then produced (ICNND, 1963), with the intention of standardizing both the methods used for the collection of nutrition survey data and the interpretation of the results.
Evaluation of nutrient intakes and diets
Authors: Gibson Rosalind S
Published: November 2023

Dietary intake data resulting from nutritional assessment systems have been severely criticized in the past because both random and systematic errors occur in measuring intakes of food and calculating their nutrient content. The data are also frequently misinterpreted. This is particularly unfortunate because the careful evaluation of food and nutrient-intake data has important applications, provided that the limitations of the methods are clearly understood.
Anthropometric reference data
Authors: Gibson Rosalind S
Published: November 2023

Anthropometric reference data comes from local or international sources. Local reference data should be compiled from measurements made on well-nourished, healthy individuals, selected from a local elite group; the group should be ethnically and genetically representative of the population to be investigated. Such data may be preferred where ethnic and genetic factors influencing growth potential predominate, or where it is felt that international reference data, derived from populations with needlessly high energy intakes, are inappropriate.
The Use of Portfolios to Assess Professionalism
Authors: Fryer-Edwards Kelly , Pinsky Linda E , Robins Lynne
Published: November 2023

On Scrubs, a popular 1V sit-com about medical residents, there is a scene in which a patient seeks reassurance from an intern. “Are you a good doctor?” she asks. “Too soon to tell,” he replies in an eager and earnest manner. The intern faces a dilemma faced by most medicine trainees. His goal is to become a good doctor, but his medical school experience has been limited to course grades and fairly general evaluations with which to assess his progress. His eagerness to become a good doctor may even interfere with his professional development because personal insecurity compounded by institutional pressures may encourage him to pretend he knows things he has not yet learned and to hide his deficiency from others. The medical student’s teachers may be unable to distinguish what he already knows and what he still needs to learn. He realizes that he is supposed to be a “lifelong learner,” but trained in neither thorough and honest self-assessment nor goal setting, he responds by thinking he should just do more nontargeted learning such as reading a textbook from cover to cover.
Faith and Reason, the Perpetual War: Ruminations of a Fool
Authors: Shapiro Stewart
Published: November 2023

In the spirit of this volume, let me begin with a short, autobiographical note. We’ll get to some philosophy or, better, meta-philosophy, after that. I still remember the moment when the last remnants of my religious faith died. One day in February of 1984, I was driving and listening to a radio news story about David Vetter, otherwise known as the “bubble-boy.” The announcer said that he had been born, twelve years before, with a condition, known as severe combined immune deficiency (scid), that robbed him of the usual defenses against infectious diseases. Since any infection would prove fatal, David lived in a sterile environment, a plastic bubble. He had no physical contact with any living organism. Eventually, the defense was breached, and his doctors had to enter the bubble. David then hugged his mother for the first time, and died a short time later, thus prompting the news story that day.
On Becoming a Heretic
Authors: Curley Edwin
Published: November 2023

When I was a child, I did what children do: I accepted the view of the world that the more vocal adults around me taught me to accept. My mother—and my maternal grandmother, who had lived with us from my infancy—were Episcopalians. They saw to it that I went to the Episcopal church and Sunday school, and rejoiced when I became an acolyte. For a while my mother cherished the hope that I might become a minister. My father, whose mother’s attempt to raise him as a Christian Scientist had alienated him from organized religion, was an agnostic. But for a long time I did not know this. In the interest of family harmony, he kept quiet about religious matters until many years later, after my mother had died.
Epilogue: The Value of Genetic Diagnosis-Applying Knowledge about Etiology to Prevention and Treatment
Authors: Smith Moyra
Published: November 2023

In this chapter, we will consider why a genetic diagnosis is useful. Much of the research in human genetics has been motivated primarily by the perception that certain genetic disorders cause suffering and severely impact life quality. Research activities are stimulated by the perception that it may be possible to prevent this suffering through an understanding of the cause and natural history of the disorder. It is clear this understanding evolves through research on individuals with disabilities and their families.
Mouse Models for Genetic Susceptibility to Infection in Humans
Authors: Fortin Anny , Buschman Ellen , Skamene Emil
Published: November 2023

Over the last several years, there has been a remarkable increase in the availability of new genomic strategies for analysis of complex traits in both human populations and mouse models. The advances in genome mapping, scanning, and analysis have been particularly valuable in the field of infectious diseases, leading to the cloning of a human gene for susceptibility to leprosy (Mira et al., 2003, 2004). In the mouse, the advent of genome scanning and new genetic strains has led to the identification of resistance=susceptibility loci for a large number of viral, bacterial, and eukaryotic pathogens. In the mammalian host, genetic control of resistance to infection (encompassing both innate and acquired immune phases) is regarded as a complex phenotype. In order to identify genes influencing host response to infection, the infectious process can be strategically divided into four stages: exposure to the pathogen, establishment of infection, progression of infection to disease, and clinical manifestation of the disease. Within these stages, the most important points of possible genetic control are likely to act during the innate and acquired phases of immunity.
MHC Class I Polypeptide-Related Sequence A and B (MICA and MICB) Genes
Authors: Bahram Seiamak
Published: November 2023

The prime relevance of the so-called classical MHC class I genes in fighting infectious diseases is established beyond doubt (Segal and Hill 2003). These highly polymorphic, ubiquitously expressed, b2-microglobulin linked molecules (HLA-A,-B and -C in man, H2-K1,-D1, and -L in mouse) present short, endogenously produced peptide antigens (derived from degradation of intracellular proteins, including viruses and certainbacteria) to the ab T-cell receptor (TCR) of CD8+ cytotoxic T lymphocytes (CTLs) (Bjorkman and Parham 1990). These CTLs consequently eliminate the infected cells and, in case of most infections, thereby stop further microbial diffusion. The hallmark of these classical MHC class I genes is their staggering number of alleles (see chapter 4). This diversity is most important at the population level, conferring on the species a capacity to resist an epidemic=pandemic, because there are likely certain group of individuals that harbor particular disease-resistant combinations of these HLA alleles (Robinson et al. 2003). This high level of diversity within these classical HLA molecules contrasts with the significantly lower number of alleles identified for the socalled nonclassical MHC I genes (HLA-E, -F, and -G in humans and H-2QTM in mice): 5 for HLA-E, 2 for HLA-F and 15 for HLA-G (Radosavljevic and Bahram 2003). Again, this makes sense because these molecules either do not interact with peptides or interact with only a restricted set of them and hence do not need a large allelic repertoire for this purpose.
Killer Immunoglobulin-Like Receptor and Related Genes
Authors: Martin Maureen P , Dorak M Tevfik , Carrington Mary
Published: November 2023

Natural killer (NK) cells are an important component of the innate immune system; they participate in early responses against infected or transformed cells by production of cytokines and direct cytotoxicity (Bancroft 1993; Biron et al. 1999; Cooper et al. 2001; French and Yokoyama 2003; Robertson and Ritz 1990; Trinchieri 1989). The importance of NK cells in antiviral immunity is evidenced by the report of an NK-cell– deficient individual with otherwise normal B and T cells who suffered from recurrent herpesvirus infections (Biron et al. 1989). Other studies have also implicated NK cells in the pathogenesis of viral infections, including cytomegalovirus (CMV), Epstein-Barr virus, herpes simplex virus (HSV), hepatitis B, hepatitis C (HCV), and HIV-1, as well as a variety of intracellular bacteria and protozoan parasites (reviewed in Bancroft 1993; Biron et al. 1999; See et al. 1997). Thus, it is clear that NK cells, key components of the innate immune system, are essential in limiting pathogens during the early phases of a primary infection before the adaptive immune system is able to respond.
Diseases Due to Encapsulated Bacteria
Authors: Kotb Malak
Published: November 2023

In addition to epidemiological and socioeconomic differences that influence susceptibility to certain bacterial infections, host genetic variability contributes importantly to the substantial differences in their occurrence and course. The same bacteria cause a spectrum of clinical manifestations from asymptomatic infection in some to fatal disease in others. Studying the immune response and differences in genetic makeup of susceptible and resistant individuals can provide insight into disease mechanisms and a deeper understanding of the network of interactive pathways that lead either to eradication of infection or to serious host-mediated pathological consequences. This knowledge can guide the development of diagnostic and therapeutic advances.
Schubert’s Moment musical in F Minor, D. (Op. 94), No. 3
Authors: Schenker Heinrich
Published: November 2023

The beautiful blossoms of all the diminutions are contained, as in a bud, in this very turn figure; it even provides impetus for the Urlinie ( 3 –4 –3 –2 –1)—truly a secret of becoming that only the organically creating fantasy of a genius has the power to bring forth, to express.
Schumann’s Scenes of Childhood, Op. 15, No. 1“Of Foreign Lands and Peoples”
Authors: Schenker Heinrich
Published: November 2023

A harmonically supported 5 is lowered to 3 in bars 3– 1 (see Fig. 1a): this is the first section of the little three-part song form. lingers in bars 9–14, which represent the middle section. The neighbor note (4) aids the expansion here, and by its upward stepwise motion also signals the ascent 3 –4 –5 (compare Kontrapunkt i, p. 240/p. 178, and ii, p. 15 [recte: 74]/pp. 74 –75). The third section, bars 15 – 22, is a repetition of the first.
Bowel Management: Constipation, Diarrhea, Obstruction, and Ascites
Authors: Economou Denice Caraccia
Published: November 2023

Constipation affects 2% to 10% of the general population, but the incidence may be as high as 20% to 50% in older or ill persons. Constipation is a major problem in cancer patients, with as many as 70% to 100% of cancer patients having this distressing symptom.2,4 The use of opioids for pain is a contributory factor to constipation, and this side effect is the principal reason for their discontinuation. Constipation is common and yet undertreated by both physicians and nurses.
Pruritus, Fever, and Sweats
Authors: Rhiner Michelle , Slatkin Neal E
Published: November 2023

Pruritus, derived from the Latin word prurire, which means “to itch,” is a common and poorly understood symptom of both localized and systemic disorders (Table 17-1). The difficulties of defining the clinical characteristics of pruritus are in part related to the ambiguities of the available terminology and difficulties in quantifying this subjective disorder. “Itch,” while describing the actual experience of sensory discomfort, is sometimes confused with scratching, the response used to relieve the discomfort. The literature is also less than clear on the distinction between itching and pruritus.1,2 “Itch” is probably best reserved to describe the actual sensory discomfort that may arise in response to a fleeting stimulus or a pathological disorder.3 The term “pruritus,” is generally used to refer to a pathological condition in which the sensations of itch are intense and often generalized and trigger repeated scratching in an attempt to relieve the discomfort. Quantification of itch intensity, which is necessary for both clinical management and intervention studies, usually relies on the same 0-to-10 scale used to rate pain and other subjective symptoms. An assessment can also be made of “itch behaviors,” such as rubbing and scratching, or the physical manifestations of these behaviors, such as the severity and distribution of scratch-induced excoriation.