bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of the Primary Care Physician in the Assessment and Management of Polycystic Ovary Syndrome
Authors: Ee Carolyn 
Published: November 2023

AbstractPolycystic ovary syndrome (PCOS) is a complex and heterogeneous female endocrine disorder with manifestations that span the hormonal, reproductive, metabolic, and psychological. Primary care physicians (PCPs), also known as family physicians or general practitioners, play a key role in the diagnosis, assessment, and management of PCOS. This article outlines the role of the PCP in the timely and accurate diagnosis, provision of information and education, lifestyle and weight management, and management of key features such as hyperandrogenism, irregular cycles, infertility, emotional well-being, and cardiometabolic risk. PCPs play an essential role as the point of first contact for women and adolescents with or at high risk of PCOS, providers of whole-person care and continuity of care, and coordinators of care within a multidisciplinary team. Optimal management of PCOS requires equitable access to primary care. There is a need for systemic approaches to addressing barriers to provision of quality primary care, such as poor remuneration of longer consultations and low awareness of evidence-based guidelines, to women and adolescents with PCOS.
Obesity and In Vitro Fertilization
Authors: Ferrell Emily L. , Choudhry Abira A. , Schon Samantha B. 
Published: November 2023

AbstractObesity is a highly prevalent chronic disease with a significant effect on reproductive-age women. The clinical implications of obesity on fertility and pregnancy are well studied citing ovulatory dysfunction, hormonal imbalances, higher miscarriage rates, and increased maternal and neonatal risks. For this reason, many patients with obesity seek reproductive specialists to help build their families. Despite this literature base, the effect of weight loss interventions prior to assisted reproductive technology (ART) is lacking. This review aims to outline the impact of obesity on ART, specifically in vitro fertilization (IVF). Response differences to treatment protocols compared with normal weight counterparts, limitations of access to care, and the mixed results of weight-reduction strategies prior to fertility treatment will be addressed. The known data surrounding benefits of lifestyle modification, pharmacologic therapies, and surgical interventions for obesity prior to IVF are outlined and found to emphasize a need for further research to determine the optimal approach for infertility patients with obesity.
Time and cognitive development: from Vygotsky’s thinking to different notions of disability in the school environment
Authors: Ferreira Marcello , da Silva Filho Olavo Leopoldino , da Silva Nascimento Ana Bárbara , Strapasson Alexandre Betinardi 
Published: November 2023

AbstractThe perceptions about the structure of time are deeply entrenched in people’s minds. As such, they do not reveal themselves directly but are mediated by how it is possible to articulate concepts that assume these perceptions. This paper assesses how the notion of time can affect cognitive development, looking at Vygotsky’s works on defectology and other references, given that there is a gap regarding this articulation in specialized literature. For this purpose, it is argued that the notion of time often departs from an equivocal assumption of a linear time structure, influencing how we lead with disability issues in teaching and learning processes. The findings also show some consequences of such a departure in the conceptualization of deficiency, development, and time to the issue of the visibility of the so-called deficient, particularly concerning the school environment.
Modeling and formation of a single-walled carbon nanotube (SWCNT) based heterostructure for efficient solar energy: Performance and defect analysis by numerical simulation
Authors: Islam Md Ariful , Al Rafi Jobair , Uddin Muhammad Athar 
Published: November 2023

This work introduces a new highly efficient heterostructure solar cell that shows the supremacy of the single-walled carbon nanotube as an absorber layer and platinum (Pt) as a back contact. This article focuses on the most important process: optimizing the thickness and acceptor concentration of the absorber layer. Another novel fact in this work is that minorities have been included as a replica of defects and the Auger hole/electron capture coefficient, and the variations in defects have been shown with some flawless contour plots. As the whole study has been carried out using a simulator, it might not be completely realistic, but it shows outcomes close to reality. In addition, the use of minorities takes this simulation work closer to the physical one. A contemporary model—Al/ZnO/TiO2/SWCNT/SnS/Pt—has been investigated in this work for efficient performance. At the end of tuning, the input parameters are set at thickness (W) = 1.5 µm, acceptor concentration (NA) = 1 × 1020 cm−3, and defects = 1 × 1015 cm−3. Under these optimum conditions, this model has shown outstanding outcomes: VOC = 1.04 V, JSC = 41.91 mA cm−2, FF = 72.12%, and η = 31.57%. Although an efficiency of 32.86% was achieved at NA = 1 × 1021 cm−3, it is difficult to keep the acceptor concentration high in reality. Hence, the optimum value of the acceptor concentration is considered at 1 × 1020 cm−3.
A numerical simulation of high-Reynolds-number opposed impinging wall water jets in a limited field
Authors: Liang Haoran , Tang Chengyou , Xie Chunhang , Hu Ruichang , Yuan Hao 
Published: November 2023

In the impinging region of opposing jets, strong mixing and significant energy dissipation are observed, but the mixing parameters invariably change with the opposed impinging strength (OIS). In this paper, the ratio of the turbulent kinetic energy (TKE) intensity at the theoretical impinging point to the nozzle exit is defined as the opposed impinging strength. To examine the mixing properties of opposed impinging jets (OIJs) in a limited field under various OIS, a renormalization group k-ε turbulence model is employed to calculate three-dimensional OIJs under various OIS. The nozzle exit diameter is set to 0.6 m, and the inlet velocity is between 0.08 and 8 m/s, so the simulations are performed at Re between 4.8 × 104 and 4.8 × 106. This work focuses on the radial and vertical jets produced after impinging as well as the distribution of the TKE, flow field, and vortices. A thorough investigation reveals that although the OIS of the jets is primarily determined by the degree of jet development, it increases with the Reynolds number. A low OIS results in less mixing in the surrounding water and relatively unconstrained jet generation; however, it also results in limited energy extraction from the fluid. Once the OIS is high, there is more mixing in the surrounding water, and more energy is also lost during impinging. The distribution of vortices in the vortex field is not only influenced by the OIS but is also very closely related to the scale of the limited mixing field.
Women and ageing: demographic aspects
Authors: Grundy Emily 
Published: November 2023

Abstract
During the course of the twentieth century the relative size of the population aged 65 and over in England and Wales has increased threefold from just 5 per cent in 1901 to over 15 per cent in 1988.1 As a result of sex differentials in mortality, women now outnumber men from about the age of 50 and the elderly population is predominantly female. As Table 1.1 shows, in 1988 women constituted 60 per cent of the whole of the elderly population and 75 per cent of the population aged 85 and over.
Health of elderly Asian women
Authors: Ebrahim Shah 
Published: November 2023

Abstract
It is usually assumed that where a person comes from determines their ethnicity, and this simple approach has led to the census in the United Kingdom (UK) using country of birth as the only means of classifying ethnicity. The 1991 census will use such a system, but will be refined to allow separation of Bangladeshi, Pakistani, and Indians from ‘other Asians’. Without routine data collection it is very difficult to monitor the uptake of services, measure rates of disease, and determine the need for services. In part, the lack of data has arisen because of an understandable suspicion that such data might be used for the purposes of removing people from the country, and, in part, because of the notion that ‘we are all British’ and that to classify people into ethnic groups is itself a racist activity.
Preventive measures
Authors: Mehtar Shaheen 
Published: November 2023

Abstract
Disinfection and sterilization are necessary to prevent cross-infection from equipment, surfaces and skin and are used in all hospitals: Decontamination renders an article safe for handling. Disinfection is used to reduce the number of micro-organisms on an object or surface, although the disinfectants used rarely destroy all the micro-organisms they come into contact with.
Medical technology 1n China
Authors: Banta H David , Jie Chen 
Published: November 2023

Abstract
China is the most populous country in the world, with more than I billion people. During the decades following World War II, Chinese health policy focused on the control of communicable diseases, development of primary health care, and better sanitation and nutrition. Life expectancy increased from an estimated 35 years in 1949 to 69 years in 1986 (746). As a result, China is facing disease patterns typical of more developed countries, with rising rates of chronic diseases.
Smoking
Authors: Fowler Godfrey 
Published: November 2023

Abstract
Tobacco smoking has been identified by the World Health Organisation as the most important preventable cause of disease and premature death. Moreover, contrary to popular belief (which perceives lung cancer as the predominant smoking risk), much of this avoidable morbidity and mortality is cardiovascular. The proportion of males in the population in Britain who smoke reached a peak at the end of the Second World War when about two thirds of men were smoking; by the 1970s, smoking had also peaked in women, when almost half were smoking.
Hypertension
Authors: Lawrence Martin , Cruickshank Kennedy 
Published: November 2023

Abstract
It has long been recognized that high blood pressure is a major risk factor for overall mortality and for death from cardiovascular disease in particular. Untreated malignant hypertension has a mortality of over 80 per cent within a year from detection and in 1959 treatment was first shown to reduce this at least six-fold. By 1967, in the first formal controlled trial by the Veterans Administration team, the control group of 70 untreated patients with diastolic blood pressure from 115- 129 mm Hg (‘severe’ but not necessarily malignant hypertension), followed for an average of 18 months, showed major vascular events or death in 21 (30 per cent) compared with one stroke and no deaths in the actively treated group.
Exercise
Authors: Mant David , Little Paul 
Published: November 2023

Abstract
Forty years ago, Morris and his co-workers in London drew attention to the higher cardiovascular morbidity of sedentary workers within similar social groups. They asked why bus drivers should suffer more heart attacks than bus conductors, why clerks more than postmen, and they suggested that one explanation was the degree of exercise taken. This led Morris to set up the UK Civil Service Study, concerned with leisure time activity in male civil servants aged 40-64, in which those who reported involvement in vigorous exercise experienced a coronary heart disease (CHD) rate approximately one third lower than that in other men. Importantly, the benefit of vigorous exercise was apparent even within groups of men with cardiovascular risk factors such as smoking, high blood pressure and high serum cholesterol levels.
Social deprivation
Authors: Coulter Angela , Mant David 
Published: November 2023

Abstract
Socio-economic differences in life expectancy in Britain have been reported since 1921, when the first official statistics linking mortality to social class were published. Figure 9.1 shows standardized mortality ratios (SMRs) for diseases of the circulatory system by social class for the years 1979-83. There is a two-fold mortality gradient in men and almost a four-fold gradient in women between social classes I and V.
Haemostasis
Authors: Silagy Chris 
Published: November 2023

Abstract
Cigarette smoking, hypertension, and lipid abnormalities are traditionally regarded as the major risk factors associated with the development of cardiovasular disease. However, in recent years the list of other potential risk factors has grown substantially; a review in 1981 identified 246 risk factors. Two reasons may help explain this increase. Firstly, the traditional risk factors alone do not entirely account for the wide variation observed in the rate of cardiovascular disease within and between communities. Secondly, there has been a marked improvement in the understanding of the pathogenesis of cardiovascular disease.
Community-based interventions
Authors: Rayner Michael 
Published: November 2023

Abstract
There is some debate about what constitutes community-based coronary heart disease (CHD) prevention, and amongst those who would say they are involved in it there is disagreement about how it should be carried out. However, all agree that it involves activities which take place outside of traditional medical settings such as hospitals or general practitioners’ surgeries. Doctors and other health professionals may be involved but not invariably so.
Screening policy
Authors: Mant David 
Published: November 2023

Abstract
Screening can never play a major role in the prevention of heart disease in the UK. By definition, screening is selective and is therefore an inappropriate general strategy to deal with a problem which afflicts the majority of the population. If it reassures people who are identified as at average relative risk, it may even prejudice a strategy to reduce the high overall risk of the entire UK population. In these circumstances, it is very important that the scientific case for screening is well founded. It is very easy for screening to do more harm than good.
Wounds
Authors: Guly H R 
Published: November 2023

Abstract
As noted above (p. 14) the mechanism of the wounding may give valuable clues as to the type of injuries sustained. Other questions one may need to ask include the direction of a penetrating injury, the length of a blade causing a stab wound (NB the length of the track may be longer than the length of the blade due to the elasticity of the tissues), and whether there is the possibility of a foreign body (especially with thorn injuries-ask ‘did the point of the thorn come out?’).
Head injury
Authors: Guly H R 
Published: November 2023

Abstract
It is important to ask enough questions to understand fully the mechanism of the head injury. A fall on to concrete is more likely to cause a fracture than a fall on to a carpeted floor. A high velocity deceleration injury such as a road accident is likely to cause severe generalized neuronal injury whereas a blow by a hard object may fracture the skull but cause little brain injury. If the object causing the blow is small, such as a hammer, the patient may have a compound depressed fracture, the severity of which may not be appreciated if the patient never lost consciousness.
Spinal cord injury
Authors: Guly H R 
Published: November 2023

Abstract
If a patient has a spinal cord injury whether from trauma or, less commonly in an A& E setting, from a non-traumatic cause, such as an acute cord compression or a vascular problem, it is important to document the level and to determine whether the injury is complete or incomplete. By convention, the level of a cord injury is the level of the last intact segment.
Lower limb injury
Authors: Guly H R 
Published: November 2023

Abstract
It is important to establish whether a patient has walked since the accident. This may be obvious (e.g. if the patient walks into the consulting room) but a patient with a knee or hip injury will often have been asked to undress and lie on a couch before being seen by the doctor and it may be necessary to ask specifically. A patient who has walked normally or run since they injured themselves is unlikely to have a serious injury, but the ability to weight bear does not always exclude a significant fracture.
Aminoacidurias and the Fanconi syndrome
Authors: Haycock George B 
Published: November 2023

Abstract
About two-thirds of the volume of the glomerular filtrate is reabsorbed isotonically in the proximal tubule. The energy driving this process is generated from ATP by the action of Na, K ATPase in the basolateral membrane of the tubular cell, resulting in transport of three sodium (Na) ions out of the cell in exchange for two potassium (K) ions. The resulting low intracellular Na concentration creates and maintains a steep electrochemical Na gradient from the bubular fluid to the cell interior across the brush border of the apical membrane. The brush border contains a number of transport proteins, each of which facilitates diffusive entry of Na and a specific cotransportate into the cell.
Lecithin-cholesterol acyltransferase deficiency and the kidney
Authors: Harry D S , Winder A F 
Published: November 2023

Abstract
In 1935, Sperry recognized that when human serum or blood was incubated, the free cholesterol concentration fell without any change in the total cholesterol. He correctly attributed this observation to the enzymatic esterification of free cholesterol with a fatty acid coming from the hydrolysis of a fatty acid-containing compound. In the early 1960s, Glomset published several papers on the nature of the enzyme involved which he designated as lecithin-cholesterol acyl transferase (LCAT) (Glomset 1962; 1963).
Glycogen storage diseases (von Gierke’s disease)
Authors: Grunfeld Jean-Pierre 
Published: November 2023

Abstract
The glycogen storage diseases (GSDs) include over 12 separate genetic defects that affect glycogen metabolism, primarily break down in liver or muscle, or both. Indeed, liver and muscle contain abundant quantities of glycogen. Since carbohydrate metabolism in the liver is respon sible for plasma glucose homeostasis, GSDs with liver involvement are manifested by hepatome galy and hypoglycaemia. In contrast, muscle glycogen provides substrates which enable the ATP generation necessary for muscle contraction. The presenting features of GSDs that affect the muscle are cramp, exercise intolerance, and progressive muscle weakness. In occasional cases, acute rhabdomyolysis may occur in these patients, leading to myoglobinuria and acute renal failure.
von Hippel-Lindau syndrome
Authors: Neumann Hartmut P H , Laubenberger Jijrg , Wetterauer, Ulrich , Zbar Berton 
Published: November 2023

Abstract
von Rippel-Lindau syndrome (VHL) is a cancer-prone inherited disorder of adulthood involv ing many organs and organ systems (Figs 26.1 and 26.2, Table 26.1). The reported prevalence in different populations was 1: 38000-1: 53000 (Maher et al. 1991; Neumann and Wiestler 1991). The disease predominantly affects the eyes (retinal angiomatosis), central nervous system (hae mangioblastoma of the cerebellum, brainstem, and spinal cord), adrenal glands and paraganglia (phaeochromocytoma), kidneys (renal cysts, renal cell carcinoma), and pancreas (pancreatic cysts). Rare manifestations involve among other organs the epididymis (epidydimal cystade noma) and inner ear (endolymphatic sac tumour). Renal involvement by von Rippel-Lindau sysdrome is not well-known and the disease is often simply regarded as involving tumours only of the eye and the cerebellum within the same patient.
Principles of molecular biology as applied to the study of disease
Authors: Calvet James P 
Published: November 2023

Abstract
Advances in molecular biology over the past decade have created a considerable expansion in our knowledge about basic cell function, and with it an overwhelming proliferation of terms, procedures, and protocols. Despite this, however, a large number of experimental techniques in molecular biology have become standardized and are now commonplace in the laboratories of a wide range of basic and clinical investigators.
Pathogenesis of polycystic kidney disease: basement membrane and extracellular matrix
Authors: Carone Frank A , Bacallao Robert , Kanivar Yashpal S 
Published: November 2023

Abstract
Polycystic kidney disease (PKD) is a genetic or acquired disorder with progressive dilatation of multiple tubular segments and/or enlargement of glomerular capsules, accompanied by fluid accumulation, growth of non-neoplastic epithelial cells, and deranged remodelling of the extracellular matrices. This results ultimately in a certain degree of renal functional impairment, which potentially can regress to normal after removal of the inductive agent(s) in experimental animal models (Carone et al. 1994; Kanwar and Carone 1984). These localized events with seg mental dysmorphogenetic lesions are conceivably related to an aberration of one or more factors which maintain normal tubular and glomerular morphological features.
What happens to you in kidney failure?
Authors: Cameron Stewart 
Published: November 2023

Abstract
In this chapter we look at what happens to you if you have kidney failure of some degree, which may or may not be progressing, but your own kidneys are still working. Some 40-50 000 people in the UK and maybe as many as 300-400 000 in the USA are in this position. Many will be already under the care of a doctor, but quite a large proportion may not know yet that they have kidney trouble. The majority will eventually require treatment for end-stage disease, by dialysis, by kidney transplantation, or both.
Health economics and prescribing
Authors: Earl-Slater Alan 
Published: November 2023

Abstract
Primary healthcare professionals have more reason to be interested in health economics than many currently appreciate. Anyone working to improve patient wellbeing within the restrictions incurred by limited resources (time, skills, knowledge, and funds) can benefit from an understanding of health economics. The fundamental principles addressed using health economic tools and techniques, i.e. that resources are limited and that this forces choices between different courses of actions with different costs and benefits flowing from them, are not new but have always been part and parcel of medical practice.
Circles of desire: a therapeutic narrative from South Asia—translation to creolization
Authors: Jadhav Sushrut , Littlewood Roland , Raguram R 
Published: November 2023

Abstract
In summer 1985, as a junior doctor in psychiatry at the Indian National Institute of Mental Health in Bangalore, one of us (SJ) was running his out-patient clinic, clerking his patients, and discussing them with senior psychiatrists. We usually saw about 20 to 35 people over a period of four hours in a clinic shared by four residents and two consultants. People came from long distances, often with packed food as gifts for the doctors and porters, and with a determined hope for relief from their sufferings.
Basic concepts: your myth or mine?
Authors: Dickenson Donna , Fulford Bill (Kwm) 
Published: November 2023

Abstract
An important characteristic of modern mental health practice is the variety of ways in which mental distress and disorder are understood (Colombo 1997). These ‘models of disorder’ range along a spectrum from medical (or biological) conceptions of mental illness (according to which mental disorders are caused by distinct pathological lesions in the brain and hence are no different in prin ciple from bodily illnesses), through various psychological models (for exam ple, behavioural, psychoanalytic, family dynamic), to overtly moral models. According to the latter, mental disorders are, in one way or another, either problems of living for which those concerned are responsible, or labels imposed by society to justify the control of deviance.