bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duodenal and small bowel injuries
Authors: Smith Martin D. , Jennings Vicky A. , Devar John 
Published: October 2022

Abstract
Injury to the duodenum and small bowel is relatively common and occurs with both blunt and penetrating trauma. A knowledge of the mechanism of the injury is essential in determining its likelihood and extent and, most importantly, in planning management. Trauma to these two organs is often associated with other injuries and it is these (e.g. vascular injuries) that often determine the outcome. The management priority in all patients is to first stabilize them haemodynamically. Once this is achieved, investigations to determine the extent of the injury as well as the presence of associated injuries is important in developing a treatment plan. Grading the severity of the injury and the stability of the patient are important in defining this plan. Good quality cross-sectional imaging and ultrasound examination have become very important in decision-making. The role of diagnostic laparoscopy is limited. The anatomical site of the duodenum protects it from penetrating injuries and makes diagnosis particularly difficult after blunt trauma. The grading of duodenal injury must account for its intimate relationship with the head of the pancreas, although isolated duodenal injuries do occur. Most penetrating injuries of the abdomen are managed operatively, although there is some evidence to support selective conservative management. If there is good blood supply to the small bowel, primary repair will be possible except when the damage control approach is indicated (due to patient instability). Blunt trauma is much more difficult to manage as early diagnosis can be difficult and delayed diagnosis can have serious consequences. In summary, the majority of injuries to the duodenum are secondary to penetrating trauma. Most can be closed by simple techniques, which include primary repair and duodenoduodenostomy. For more complex injuries, a Roux-en-Y duodenojejunostomy is recommended. The overall management of complex pancreaticoduodenal injuries should ideally be individualized, and surgeons should have a flexible strategy and be familiar with the full range of techniques required for repair.
Clinical Course and Adulthood Outcome in Tourette Syndrome
Authors: Bloch Michael H. 
Published: October 2022

Abstract
This chapter summarizes theexisting literature on the long-term course of Tourette syndrome (TS). Ticsymptoms typically reach their worst-ever severity between ages 10–12 years.Children with tics tend to become more aware of premonitory urges and displaymore complex tics as they grow older. One-half to two-thirds of children withTS experience a significant decline of tic symptoms that roughly coincides withadolescence. There is no evidence to suggest that pharmacological or behavioraltreatments for tics affect long-term prognosis, although research examining thequestion is lacking. Comorbid attention-deficit/hyperactivity disorder symptoms,when they occur, typically precede the onset of tics, and comorbid obsessive–compulsivesymptoms (OCS) usually follow the onset of tics. The presence of OCS inadulthood is highly correlated with the persistence of tic symptoms intoadulthood and not strongly related to the presence of OCS in childhood. Poorfine motor skills are associated with the persistence of tic symptoms intoadulthood. Smaller caudate volumes are associated with the persistence of ticsymptoms into adulthood.
Health Outcomes, Health Status, and Mortality in Tourette Syndrome and Chronic Tic Disorder
Authors: de la Cruz Lorena Fernández , Mataix-Cols David 
Published: October 2022

Abstract
Current knowledge on the health status, health outcomes, and causes of mortality in Tourette syndrome (TS) and chronic tic disorder is very scarce. This chapter summarizes the available literature on the topic and highlights the strengths and weaknesses of the studies conducted to date. These previous works have suggested associations between TS and chronic tic disorder and a range of health conditions, including autoimmune disorders, common allergies and respiratory diseases, sleep difficulties, and metabolic and cardiovascular outcomes. In addition, the risk of premature mortality in tic disorders has been shown to be higher than that in the general population. Although other specific causes of death are yet to be examined in detail, deaths by suicide in TS and chronic tic disorder have been shown to be significantly higher than those in matched controls. Taken together, these results highlight the need to monitor the general health of individuals with TS or chronic tic disorders. The chapter also suggests further lines of research in this underresearched area of study.
Genetic Susceptibility in Tourette Syndrome
Authors: Abdallah Sarah B. , Fernandez Thomas V. 
Published: October 2022

Abstract
Early twin and family studies point to a significant genetic contribution to Tourette syndrome (TS). Informed by early segregation analyses in TS families pointing to a single-gene autosomal dominant inheritance pattern with partial penetrance, initial efforts at gene discovery in TS utilized parametric linkage analysis in large multigenerational families but failed to identify a single specific genetic locus. Later segregation analyses supported the current characterization of TS as a complex, genetically heterogeneous disorder. Nonparametric linkage analyses have yet to identify common TS risk alleles. Candidate gene association studies in TS have not yielded significant reproducible findings. Genome-wide association studies (GWAS) have proven valuable for identifying and replicating loci for common complex traits and disorders across the medical field. A GWAS meta-analysis of almost 5,000 cases identified a significant locus in FLT3. Polygenic risk scores, calculated from the most recent TS GWAS summary statistics, have shown correlation with tic severity and affected status in independent samples. There has been an increasing effort to evaluate the contribution of rare allele variants toward TS. Recent studies have found a greater burden of rare copy number variants in TS cases; the largest study to date identified NRXN1 and CNTN6 as TS risk genes. Identifying rare de novo single nucleotide variants and indels in more than 800 parent–child trios has so far identified six likely TS risk genes (WWC1, CELSR3, OPA1, NIPBL, FN1, and FBN2), which present an enriched function for cell polarity.
Abnormalities of Neural Microcircuits in Tourette Syndrome
Authors: Dyke Katherine , Brandt Valerie , Bäumer Tobias , Münchau Alexander 
Published: October 2022

Abstract
Transcranial magnetic stimulation (TMS) coupled with electromyography allows for extensive study of the motor system and related microcircuits. By varying TMS intensity and interval between pulses, it is possible to probe a number of physiological mechanisms. In contrast to magnetic resonance imaging approaches, TMS is less sensitive to motion. However, although data loss due to movement can be minimized in TMS studies, the impact of potential tic suppression should be considered while interpreting this work, as should the challenges of attempting to define what constitutes a rest state in TS. Complex interactions across numerous circuits, between causal and consequential adaptations and states of activation and rest, are likely and require much additional research to disentangle. In addition to being a useful tool for understanding microcircuits, forms of TMS have been explored as potential therapeutic interventions, as has transcranial direct current stimulation. The evidence for effectiveness of these treatments is mixed, and they are currently not recommended outside of experimental trails. Larger scale studies with appropriate controls are needed to better understand if and how these approaches can help reduce tics.
Neurobiology and Functional Anatomy of Tic Disorders
Authors: Greene Deanna J. , Kim Soyoung , Black Kevin J. , Schlaggar Bradley L. 
Published: October 2022

Abstract
This chapter summarizes the highly valuable contribution of magnetic resonance imaging (MRI) to the understanding of the functional anatomy of tics and related disorders. Structural MRI studies have revealed altered striatal volumes in children and adults with Tourette syndrome (TS), although results are inconsistent. Cortical thinning in sensorimotor regions has been detected in children and adults with TS, with correspondence between cortical region and types of tics. Whereas adults with TS show cortical thinning and reduced gray matter volume in prefrontal regions, suggesting a failure in neural compensation to control tics into adulthood, results from children with TS are mixed. Functional MRI (fMRI) studies examining tic-related activity suggest that the supplementary motor area is involved in the premonitory urge, whereas fMRI studies examining motor and cognitive control in TS report inconsistent findings. Functional connectivity MRI studies suggest complex differences in brain networks. This chapter discusses limitations of the existing studies and future directions, including the necessity to mitigate motion artifacts because they can cause systematic alterations in MRI measures.
Pathways from Genes to Symptoms in Tourette Syndrome
Authors: Eapen Valsamma , Perkes Iain , Golf Roxanne 
Published: October 2022

Abstract
Tourette syndrome (TS) is not a unitary condition but, rather, heterogeneous in clinical presentation, course, treatment response, and longitudinal outcomes. This chapter offers a critical commentary on the varying phenotypic presentations and the associated etiological underpinnings. Potential endophenotypes linking the genetic architecture with the clinical phenotypes are described. Gender-dependent differences in the phenotypic expression as well as the presence of commonly encountered comorbidities such as obsessive–compulsive behavior/disorder and attention-deficit/hyperactivity disorder may indicate different etiological pathways and pathogenesis. Additional factors that may influence the phenotypic expression of TS include prenatal and perinatal difficulties and immunological factors. The clinical phenotype and the severity of symptoms, as well as the associated psychopathology observed in TS, may be influenced by the nature and extent of involvement of the cortico-striato-thalamo-cortical circuitry and the unique contribution of both the genetic and nongenetic factors at play as well as the timing of events during the developmental period. Thus, there may be shared molecular genetic pathways affecting development across diagnostic boundaries mediated through neurodevelopmental genes, but the clinical phenotypic expression may be further shaped by other nongenetic factors. This chapter focuses on the pathogenetic pathways of the distinct and overlapping phenotypes of TS. Currently understood etiologies and phenotypes are discussed, as are underexplored factors in the pathogenesis. Endophenotypes are considered with respect to how they may mediate between genotype and phenotype. The chapter considers the reasons for etiological ambiguity and suggests future research directions to meet some of these challenges.
Clinical Rating Instruments in Tourette Syndrome
Authors: Cavanna Andrea Eugenio 
Published: October 2022

Abstract
The complex motor and behavioral phenotype of Tourette syndrome (TS) presents a unique challenge to measurement and clinical observations. Thorough neuropsychiatric assessments are the gold standard, although standardization and quantification of behavioral symptom severity are often difficult, posing a problem for interventional studies in particular. Different clinician-, informant-, and self-report rating instruments are available for tics and associated phenomena, for use in clinical practice and/or research settings. Some scales fall short of measuring the different dimensions of tic symptoms, such as frequency, intensity, interference, and impairment. The visible and audible nature of core TS symptoms allows direct observation of these symptoms using specific video protocols. A wide range of psychometrically validated clinician- and self-rated measures for obsessive–compulsive behavior, attention-deficit/hyperactivity disorder, and depressive and anxiety symptoms are also available for use in clinical practice and/or research settings. The use of behavioral measures with adequate psychometric indices is recommended. The potential differences between information gathered from clinicians and patients should always be taken into account. It is recommended that clinicians and researchers combine information from professionals and patients (as well as informants if possible) to ensure that the information gathered is comprehensive and accurate.
Neuropsychological Assessment in Tourette Syndrome
Authors: Murphy Tara , Czernecki Virginie , Tarnok Zsanett , Stark Daniel 
Published: October 2022

Abstract
Neuropsychological research and its clinical applications for those with Tourette syndrome (TS) are a promising area. Previous limitations in the literature are now being addressed and include factors such as controlling for the presence of co-occurring conditions, the separate study of children and adults, examination of factors such as time since onset of tics, and translation from the laboratory to the clinic. This chapter discusses the literature on the major domains of cognition and adaptive behavior in TS, with an emphasis on strengths and weaknesses. There is a focus on recent literature (published since 2012), but the chapter includes important older studies on intellectual function, language, learning and memory, attention, and executive function. Importantly, the chapter independently reports on child and adult studies and their implications. The chapter then discusses what is known about the real-world behavioral sequelae among individuals with TS, including adaptive behavior, as well as educational and employment outcomes. The chapter focuses on the potential neuropsychological mechanisms that may be playing out to impact on these areas of life. The role that neuropsychological factors have had in the understanding of outcome in interventions is also reviewed. The chapter then focuses on the clinical application of the corpus of literature on neuropsychology in TS. It discusses the importance of using the research findings along with clinical decision-making, considering cultural factors, limitations of tests, and the complexity of TS in the formulation to guide understanding and intervention for the individuals who live with the condition.
Behavioral and Cognitive–Behavioral Therapy for Tourette Disorder
Authors: McGuire Joseph , Capriotti Matthew R. , Woods Douglas W. , Piacentini John 
Published: October 2022

Abstract
Although pharmacological interventions are efficacious for reducing tic severity, they yield suboptimal symptom relief for most patients and are often associated with side effects that limit long-term tolerability. Behavioral and cognitive–behavioral therapies have demonstrated efficacy for reducing tic severity and tic-related impairment in patients with Tourette disorder. This has led numerous professional organizations to recommend behavioral therapies such as habit reversal training and the Comprehensive Behavioral Intervention for Tics as first-line treatments for Tourette disorder. This chapter provides an overview of different behavioral and cognitive–behavioral therapies for Tourette disorder and reviews the extant evidence for each therapeutic approach. The chapter highlights challenges confronting behavioral and cognitive–behavioral therapies, discusses treatment mechanisms, and identifies steps to overcome these treatment challenges.
Treatment of Psychiatric Comorbidities in Tourette Syndrome
Authors: Cardona Francesco , Rizzo Renata 
Published: October 2022

Abstract
Behavioral treatment should be recommended as initial treatment for patients with Tourette syndrome (TS) or other tic disorder and attention-deficit/hyperactivity disorder (ADHD), especially if symptoms are mild or parents refuse pharmacological treatments. Although obsessive–compulsive disorder (OCD) and TS are closely related, no clinical trials have specifically evaluated the treatment of OC symptoms in TS patients. Monotherapy with serotonin reuptake inhibitors (SRIs) or selective serotonin reuptake inhibitors (SSRIs) has been proven to be efficacious in the treatment of OCD patients, both adults and children, in the short term as well as the long term. No individual drug in these classes has demonstrated a superior efficacy to the others. However, nearly half of OCD patients do not respond completely to SSI/SSRI monotherapy, and even among the responders, few become asymptomatic. Various strategies have been proposed for OCD nonresponders: increasing doses, switching to another drug, augmentation strategies, and novel treatments. OCD patients with comorbid chronic tics or TS show a lower response rate compared to those without tics, both in term of percentage of responders and in terms of symptom reduction. An increased rate of response to antipsychotic augmentation in OCD patients with comorbid tics compared to those without has been reported in only one study. Despite the high rate and the clinical relevance of other psychiatric comorbidities (non-OCD anxiety disorders, self-injurious behaviors, and disruptive behaviors) in TS patients, only a few studies have been devoted to investigating a specific therapeutic approach in these patients.
Information and Social Support for Patients and Families
Authors: Müller-Vahl Kirsten R. 
Published: October 2022

Abstract
For the vast majority of the patients and parents, it is a relief—and not a burden—to receive the diagnosis of Tourette syndrome. However, the diagnosis process should be accompanied by detailed information about different aspects of the condition. Students with tics or Tourette syndrome face numerous academic, behavioral, and social challenges. Most of the impairment appears due to associated disorders. Comprehensive psychoeducational and functional behavioral assessments enable the school team to develop appropriate accommodations and interventions. Providing a supportive environment, nurturing the child’s strengths and talents, and providing resources and support for the parents in service of the child can help the student overcome any challenges and be successful in school.
Information and Support for Educators
Authors: Pruitt Sheryl K. , Packer Leslie E. 
Published: October 2022

Abstract
Students with tics or Tourette syndrome face numerous academic, behavioral, and social challenges. Most of the impairment appears due to associated disorders. The emergence of different symptoms and disorders over time has significant implications for educators. In many cases, a student’s symptoms or challenges will change during the school year or over summer vacation, and the accommodation plan that was appropriate and effective at one point in time may suddenly no longer be effective. Comprehensive psychoeducational and functional behavioral assessments enable the school team to develop appropriate accommodations and interventions. Providing a supportive environment, nurturing the child’s strengths and talents, and providing resources and support for the parents in service of the child can help the student overcome any challenges and achieve success in school.
Tourette Syndrome Support Organizations Around the World
Authors: Anderson Seonaid , Heijerman-Holtgrefe Annet , Hartmann Andreas 
Published: October 2022

Abstract
This chapter discusses what Tourette Syndrome patient associations (TSPAs) around the world have to offer to patients, their relatives, and professionals. What is their added value? And how can this improve the daily lives of people with Tourette syndrome? What is the current status of TSPAs around the world? An overview of the most important services and contact details of TSPAs are provided. It is possible to thereby quickly obtain a picture of the services that the organization in each country has to offer. Professionals can easily share the information and contact details with their patients and open the way to support in an accessible manner.
Basic Electronics
Authors: Misulis Karl E. , Johnson Evan M. 
Published: October 2022

Abstract
This chapter expounds on the concept of basic electronics and the progress in electronics, developed through scientific investigations and practical utility. Conductors are the most basic circuit element which could be classified by their ability to conduct charge (conductors, non-conductors, and semiconductors). Resistors, on the other hand, resist the flow of current, while capacitors are elements storing energy by separation of charge. The chapter also explains the function and significance of diodes, inductors, amplifiers, and analog filters. For neurophysiology purposes, most equipment use either disk electrodes or needle electrodes to conduct biologic signals effectively. Then, an analog-to-digital converter (ADC) could help transform the signals into digital data that would undergo analog-to-digital conversion.
Electroencephalography
Authors: Misulis Karl E. , Johnson Evan M. 
Published: October 2022

Abstract
This chapter looks into electroencephalography (EEG). EEG physics includes the basic understanding of cellular biology and physiology of excitable tissue such as neurons. Normal EEG activities consist of a wide range of activities like biophysical mechanisms of how the electrical activity is recorded as the generated EEG. Posterior dominant rhythm (PDR) and sleep spindles are examples of a wide variety of patterns illustrating EEG generation. On the other hand, abnormal EEG activities are illustrated by spikes, sharp waves, and slowing. Additionally, quantitative EEG is an umbrella term for advanced data handling allowing detection of seizure and spike, mapping, and spectral array.
Electromyography and Nerve Conduction Studies
Authors: Misulis Karl E. , Johnson Evan M. 
Published: October 2022

Abstract
This chapter discusses the methods of data acquisition via electromyography (EMG) and nerve conduction studies (NCS). Moreover, EMG and NCS are the basic components of neuromuscular diagnostics. Modern EMG equipment features fundamental elements such as recording hardware and software, stimulator, display, and storage. Thus, the digital transformation of EMG allowed for the digital manipulation of the data and improved acquisition. The chapter also expounds on the spectrum of normal and abnormal responses in NCV and EMG such as compound motor action potential (CMAP), denervation of muscle, and axonal neuropathy. It explains the sensory conductions, motor conductions, and EMG of Guillain-Barre syndrome, carpal tunnel syndrome, muscular dystrophy, and myasthenia gravis.
Ultrasound
Authors: Johnson Evan M. 
Published: October 2022

Abstract
This chapter explains the features and functions of sound. It discusses how sound and radio waves travel at different speeds as it is dependent on the medium it is traveling in. Sound waves travel continuously through a medium while being subjected to absorption before they encounter a medium with a different impedance. Moreover, ultrasound is primarily known to be the sound waves at frequencies higher than a human can hear. As an example of a technology using sound, sonography needs a controlled generation of sound to produce medical imaging. A sonography system typically consists of a computer with a monitor connected to a probe with a piezoelectric transducer.