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Splanchnic

Splanchnic is usually used to describe organs in the abdominal cavity. It is used when describing: Splanchnic tissue Splanchnic organs - including the stomach, small intestine, large intestine, pancreas, spleen, liver, and may also include the kidney. Splanchnic nerves Splanchnic mesoderm Splanchnic circulation – the circulation of the gastrointestinal tract originating at the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery. History and etymology The term derives from , meaning "inward parts, organs". The term "splanchnologia" is used for grouping in Nomina Anatomica, but not in Terminologia Anatomica. It includes most of the structures usually considered "internal organs", but not all (for example, the heart is excluded). References Organs (anatomy)

Soft infrastructure

Soft infrastructure is all the services that are required to maintain the economic, health, cultural and social standards of a population, as opposed to the hard infrastructure, which is the physical infrastructure of roads, bridges etc. It includes both physical assets such as highly specialised buildings and equipment, as well as non-physical assets, such as communication, the body of rules and regulations governing the various systems, the financing of these systems, the systems and organisations by which professionals are trained, advance in their careers by acquiring experience, and are disciplined if required by professional associations. It includes institutions such as the financial and economic systems, the education system, the health care system, the system of government, and law enforcement, and emergency services. The essence of soft infrastructure is the delivery of specialised services to people. Unlike much of the service sector of the economy, the delivery of those services depends on highly developed systems and large specialised facilities, fleets of specialised vehicles or institutions. Governance The system of government and law enforcement, including the political, legislative, law enforcement, justice and penal systems, as well as specialised facilities (government offices, courthouses, prisons, etc.), and specialised systems for collecting, storing and disseminating data, laws and regulation, such as civil registration, business and company registries, land registration, and maintenance of other government databases. Emergency services, such as police, fire protection, and ambulances, including specialised vehicles, buildings, communications and dispatching systems Military infrastructure, including military bases, arms depots, training facilities, command centres, communication facilities, major weapons systems, fortifications, specialised arms manufacturing, strategic reserves Economic The financial and economic system, including the banking system, financial institutions, the payment system, exchanges, the money supply, financial regulations, as well as accounting standards and regulations Major business logistics facilities and systems, including warehouses as well as warehousing and shipping management systems Manufacturing infrastructures, including industrial parks and special economic zones, mines and processing plants for basic materials used as inputs in industry, specialised energy, transportation and water infrastructure used by industry, plus the public safety, zoning and environmental laws and regulations that govern and limit industrial activity, and standards organisations Agricultural, forestry and fisheries infrastructure, including specialised food and livestock transportation and storage facilities, major feedlots, agricultural price support systems (including agricultural insurance), agricultural health standards, food inspection, experimental farms and agricultural research centres and schools, the system of licensing and quota management, enforcement systems against poaching, forest wardens, and fire fighting Social The health care system, including hospitals, the financing of health care, including health insurance, the systems for regulation and testing of medications and medical procedures, the system for training, inspection and professional discipline of doctors and other medical professionals, public health monitoring and regulations, as well as coordination of measures taken during public health emergencies such as epidemics The educational and research system, including elementary and secondary schools, universities, specialised colleges, research institutions, the systems for financing and accrediting educational institutions Social welfare systems, including both government support and private charity for the poor, for people in distress or victims of abuse. Cultural, sports and recreational Sports and recreational infrastructure, such as parks, sports facilities, the system of sports leagues and associations Cultural infrastructure, such as concert halls, museums, libraries, theatres, studios (film studios and recording studios), and specialised training facilities Business travel and tourism infrastructure, including both man-made and natural attractions, convention centres, hotels, restaurants, amusement parks, and other services that cater mainly to tourists and business travellers, as well as the systems for informing and attracting tourists, and travel insurance References Bibliography Larry W. Beeferman, "Pension Fund Investment in Infrastructure: A Resource Paper", Capital Matter (Occasional Paper Series), No.3 December 2008 A. Eberhard, "Infrastructure Regulation in Developing Countries", PPIAF Working Paper No. 4 (2007) World Bank M. Nicolas J. Firzli & Vincent Bazi, “Infrastructure Investments in an Age of Austerity : The Pension and Sovereign Funds Perspective”, published jointly in Revue Analyse Financière, Q4 2011 issue, pp. 34– 37 and USAK/JTW July 30, 2011 (online edition) Georg Inderst, "Pension Fund Investment in Infrastructure", OECD Working Papers on Insurance and Private Pensions, No. 32 (2009) External links Body of Knowledge on Infrastructure Regulation Next Generation Infrastructures international research programme Report Card on America's Infrastructure Construction Infrastructure

Metabolic water

Metabolic water refers to water created inside a living organism through metabolism, by oxidizing energy-containing substances in food and adipose tissue. Animal metabolism produces about 107–110 grams of water per 100 grams of fat, 41–42 grams of water per 100 g of protein, and 60 grams of water per 100 g of carbohydrate. Some organisms, especially xerocoles — animals living in the desert — rely exclusively on metabolic water. Migratory birds must rely exclusively on metabolic water production while making non-stop flights, facilitated by the high metabolic rate during such flights. Humans, by contrast, obtain only about 8–10% of their water needs through metabolic water production. In mammals, the water produced from metabolism of protein roughly equals the amount needed to excrete the urea which is a byproduct of the metabolism of protein. Birds, however, excrete uric acid and can have a net gain of water from the metabolism of protein. References Metabolism Water

Blood fractionation

Blood fractionation is the process of fractionating whole blood, or separating it into its component parts. This is typically done by centrifuging the blood. The resulting components are: a clear solution of blood plasma in the upper phase (which can be separated into its own fractions, see Blood plasma fractionation), the buffy coat, which is a thin layer of leukocytes (white blood cells) mixed with platelets in the middle, and erythrocytes (red blood cells) at the bottom of the centrifuge tube. Serum separation tubes (SSTs) are tubes used in phlebotomy containing a silicone gel; when centrifuged the silicone gel forms a layer on top of the buffy coat, allowing the blood serum to be removed more effectively for testing and related purposes. As an alternative to energy-consuming centrifugation, more energy-efficient technologies have been studied, such as ultrasonic fractionation. Plasma protein fractionation Plasma proteins are separated by using the inherent differences of each protein. Fractionation involves changing the conditions of the pooled plasma (e.g., the temperature or the acidity) so that proteins that are normally dissolved in the plasma fluid become insoluble, forming large clumps, called precipitate. The insoluble protein can be collected by centrifugation. One of the very effective ways for carrying out this process is the addition of alcohol to the plasma membrane pool while simultaneously cooling the pool. This process is sometimes called cold alcohol fractionation or ethanol fractionation. It was described by and bears the eponym of Dr Edwin J. Cohn. This procedure is carried out in a series of steps so that a single pool of plasma yields several different protein products, such as albumin and immune globulin. Human serum albumin prepared by this process is used in some vaccines, for treating burn victims, and other medical applications. See also Blood plasma fractionation References Blood Fractionation Medical technology

Adolescent health

Adolescent health, or youth health, is the range of approaches to preventing, detecting or treating young people's health and well-being. The term adolescent and young people are often used interchangeably, as are the terms Adolescent Health and Youth Health. Young people's health is often complex and requires a comprehensive, biopsychosocial approach. Adolescent health risks Because adolescence represents a life stage of increasing psychosocial independence, but one of limited legal and social rights (for those who have not reached the legal age of adulthood where they reside), adolescent health exists at the intersection of many forces often outside of the control of individual young people. Some young people might have a history of adverse childhood experiences (ACEs), or may be actively living in or experiencing the situations described as ACEs. The Adverse Childhood Experiences Study suggests that ACEs are common, and are predictive of adverse physical health outcomes (ischemic heart disease, cancer, chronic lung disease) in adults. Social, cultural and environmental factors are all important areas of focus in adolescent health. Young people have specific health problems and developmental needs that differ from those of children or adults: The causes of ill-health in adolescents are mostly psychosocial rather than biological. Young people often engage in health risk behaviours that reflect the processes of adolescent development: experimentation and exploration, including using drugs and alcohol, sexual behaviour, and other risk taking that affect their physical and mental health. Adolescent health also encompasses children's and young people's sexual and reproductive health (SRH). The World Health Organization describes the leading health-related problems in the age group 10 – 19 years to include: Road traffic accidents Drowning Violence Alcohol and drugs Tobacco Mental health Communicable disease (such as HIV, Tuberculosis) Early pregnancy and childbirth Environmental health Overweight Nutrition Physical activity Young people often lack awareness of the risks of harm associated with certain behaviours, or may overestimate the risks of some behaviours while underestimating the risks of others. They may be in the process of developing protective skills and behaviors, or may lack knowledge about how and where to seek help for their health concerns. By intervening at this early life stage, many chronic conditions later in life can be prevented. In addition to intervention on young people's knowledge around the risks of health-related behaviors, it is crucial to acknowledge that adolescents under the legal age of majority are often occupying an idiosyncratic legal, economic, and social state, where their rights to access confidential medical services, or to consent to preventative medical care is highly dependent on the laws and practices of where they reside. For example, in the US,  the legal rights of minors to consent to screening and treatment for sexually transmitted infections (STIs) varies on a state by state level, and the right to confidential access to these services varies as well. In a majority of US states, a minor may legally consent to testing and treatment starting at age 12 or 14, but 18 US states allow a physician to inform a minor's parents that their child has requested or has received STI screening or treatment if the physician deems it in the patient's best interests. At the same time, adolescents as an age group do not have the same economic power as adults, and may be unable to pay for or transport themselves to medical screening or treatment, whether for physical or behavioral health issues. An emphasis on individual risk behaviors may obfuscate the role of institutional barriers to performing protective health behaviors. Key principles Evidence-based practices include harm reduction and health promotion to intervene early in the life course and illness trajectory. Adoption of unhealthy behaviors are evident particularly during life stages involving transition such as the commencement of university where physical inactivity, sedentary activity and poor dietary habits prevail. Youth health is founded on collaborative approaches that address social justice. Youth development approaches include youth empowerment and youth participation. Their aim is to promote youth rights, youth voice and youth engagement. Access to health-care services Studies about young people's access to healthcare have identified major barriers including concerns about confidentiality, practitioners attitudes and communication style, environment, availability of services, cost and the developmental characteristics of young people. Marginalised young people can have greater difficulty accessing health services and need support to navigate the health system. The World Health Organization 'Global standards for quality health-care services for adolescents' include: Adolescents' health literacy Community support Appropriate package of services Providers' competencies Facility characteristics Equity and non-discrimination Standard Data and quality improvement Adolescents' participation Key health services for young people Youth Health includes adolescent medicine as a speciality, along with other primary and tertiary care services. Health services for young people include mental health services, child protection, drug and alcohol services, sexual health services. General Practitioners work alongside multidisciplinary health practitioners including psychology, social Work and Youth health nursing and school health services. Youth work and youth development services support and engage young people. Web based supports, such as Reach Out!, provide early intervention. Youth health services ('one-stop-shops' for young people) are specialist services providing multi-disciplinary, primary health care to young people. Focusing on engaging disadvantaged young people, they deliver flexible and unique services to young people in relaxed and comfortable youth-friendly environments. Youth health services work in partnership with other government and non-government services. Youth health services provide a range of entry-points and non-threatening services (such as creative arts, basic services such as showers and laundries, a drop in service, sports and recreational facilities), which encourage young people to connect with the service on their own terms. They also provide informal links to other support services and sectors including education, housing, financial support and legal services, offering support to young people who are dealing with complex issues. Youth health services understand the need to respond immediately to young people's requests for support and assistance and they share a common operating philosophy, which values social justice, equity, and a holistic view of young people's health and well-being. Capacity building organisations support the Youth Health sector by providing access to information and resources, conducting research and providing training. Effects of discrimination Social-emotional distress In a comprehensive review of research literature including 126 different studies that analyzed the relationship between perceived discrimination and social-emotional distress with effect sizes from small to moderate, perceived discrimination was shown to correlate with many social-emotional distresses for adolescents (Benner et al., 2018). Additionally, the study found that the more an adolescent perceived they were a victim of discrimination, the more likely it is that they will also report experiences with depression, anxiety, loneliness, and stress. Risky health behaviors Adolescents who report more discrimination also tend to report engaging in more risky health behaviors such as delinquency, anger, and other externalizing behaviors Other risky health behaviors include substance abuse and risky sexual behaviors like unprotected sex and sex with multiple partners. The data was taken from 71 different studies that analyze the relationship between perceived discrimination and risky health behaviors with effect sizes from small to moderate. The relationship between risky health behaviors in adolescents and discrimination can be partially explained by a greater tendency for school administrators to discipline minority students more often and more severely than other students (Mallett, 2016). This increase in discipline can lead to further delinquent and externalizing behaviors as they spend less time in the classroom environment. Academics Perceived discrimination has also been linked to lower academic performance in adolescents. Students who feel they face discrimination are more likely to have lower grade point averages (GPA), more absences, less engagement in class, and lower academic motivation. The data was taken from 73 different studies that analyze the relationship between perceived discrimination and academic outcomes in all areas with small effect sizes. The increased frequency of discipline also takes class time away from students which could contribute to their lowered academic outcomes. With less time in the classroom they do not receive the same amount of instruction that students in the classroom receive. Research The American teen study Reliable research in adolescent sexual behavior has been subject to political interventions in the past, particularly with funding availability, and the formal peer review process. Reasons for political interventions pertaining to research in adolescent sexual behavior is rooted in conservative ideologies from political figures and activist organizations. These groups tend not to support funding for abstinence education rather than programming that might inadvertently support teenage sexual behavior. These political interventions result in less of an understanding of long-term adolescent risk-taking sexual behavior and thus disease prevention. The American Teen Study, which began in May 1991, was a peer-reviewed study on adolescent sexual risk-taking behavior whose funding from the National Institute of Child Health and Human Development was shut down by former secretary of Health and Human Services (HHS), Louis Sullivan. This cancellation led to further amendments created to halt the National Institutes of Health from funding research in adult and adolescent sexual behavior studies because conservative political figures such as, Gary Bauer, believed there was enough literature on this subject. However, the data meant to be collected from the American Teen Study was critical for accurately understanding the dynamics of how adolescents may come into contact with sexually transmitted infections, such as HIV, and how to further prevent adolescents from being infected. The need for data The American Teen Study acknowledged that there is insufficient data required for assessing rates of sexually transmitted infections among adolescents, which creates a barrier for trying to prevent infection rates and treatment of infections. HIV seroprevalence surveys, evaluating archived data on AIDS infections in the past, and adolescent risk-taking behaviors are the various types of data needed for accurately assessing the HIV infection trends among adolescents. Seroprevalence surveys give an idea about the rates of HIV infections among various groups of people, however, using this data solely is not always externally valid as it is not completely feasible to produce accurate rates of HIV among all of the groups being measured. Evaluating archived data of AIDS infections in the past is useful for obtaining an idea of how current HIV trends may be, but this data is not separated by age, which does not allow researchers to distinguish whether decreasing rates are applicable to adolescents. However, by integrating both of these methods, and further incorporating data on adolescent sexual behavior, the information would be more effective with determining HIV rates among various groups of adolescents. In addition, for future studies, researchers must incorporate comprehensive sample sizes, perform various research design types, understand the social norms that may influence risk-taking behaviors, and also be consistent with replicating research studies as risk-taking trends among adolescents may change. Overall, this data is needed in order to understand and effectively prevent infections of sexual transmitted infections, however, political figures policing peer-reviewed research studies gets in the way of obtaining this information. Peer review process Political interventions on peer-reviewed research may affect the integrity of the sciences, and political figures rescinding funding for certain studies they do not accept also affects the well-being of all individuals. It is recommended for specialist peer reviewers to have the freedom in being able to allocate funding for certain research studies, while also allowing a justified veto of funding decisions to be made by the HHS secretary if studies are later deemed as unethical. This reform is mindful that specialist peer reviewers will not be driven by personal bias, but instead by assuring that research funded is ethical, just, and neutral to the objective of the study, such as the American Teen Study. Organizations International Alliance for Child and Adolescent Mental Health and Schools International Association for Adolescent Health International Childhood and Youth Research Network (ICYRNet) World Health Organization - Adolescent Health Australian Association for Adolescent Health Canadian Association for Adolescent Health New Zealand Aotearoa Adolescent Health and Development The York Centre for Children, Youth, and Families SpunOut.ie Irish National Youth Website The Royal College of Psychiatrists, UK Youth Advolution for Health (Singapore) See also Adolescent and young adult oncology Adolescent Medicine Lancet Commission on Adolescent Health and Wellbeing Youth Risk Behavior Survey Advocates for Youth Freechild Project References Adolescent medicine

International health

International health, also called geographic medicine, international medicine, or global health, is a field of health care, usually with a public health emphasis, dealing with health across regional or national boundaries. One subset of international medicine, travel medicine, prepares travelers with immunizations, prophylactic medications, preventive techniques such as bed nets and residual pesticides, in-transit care, and post-travel care for exotic illnesses. International health, however, more often refers to health personnel or organizations from one area or nation providing direct health care, or health sector development, in another area or nation. It is this sense of the term that is explained here. More recently, public health experts have become interested in global processes that impact human health. Globalisation and health, for example, illustrate the complex and changing sociological environment within which the determinants of health and disease express themselves. International health governance The World Health Organization (WHO) is the international body primarily responsible for regulating and governing health-related policies and practices across nations. While the WHO uses various policies and treaties to address international health issues, many of their policies have no binding power and thus state compliance is often limited. As a result, a Framework Convention on Global Health (FCGH) has recently been proposed as a global health treaty that would use stronger domestic accountability mechanisms (including incentives & sanctions) in order to close national and global health inequities. However, some scholars have addressed concerns regarding the FCGH, arguing that it would duplicate other global health governance efforts, lack feasibility, and have limited impact in regulating global health. The role of academic institutions Timothy D. Baker was the founder of the first academic department of international health in the United States at the Johns Hopkins Bloomberg School of Public Health in 1959. The role of NGOs Much work in international health is performed by non-governmental organizations (NGOs). Services provided by international health NGOs include direct health care, community potable water, vitamin supplementation, and mitigation of endemic and epidemic infectious diseases and malnutrition. Examples of NGOs dedicated to international health include: Pakistan Heart Foundation CARE Médecins Sans Frontières (Doctors Without Borders) The International Committee of the Red Cross International Medical Corps Oxfam Partners in Health Project HOPE Save the Children In harm's way These organizations often go in harm's way to provide services to people affected by natural disaster or conflict. For example, Médecins Sans Frontières has lost members in the Darfur area, and Care International's Iraq Director, Margaret Hassan (a long-time Iraq resident with dual Iraqi-British citizenship) was brutally murdered on the Internet by Al Qaeda-affiliated terrorists for the "crime" of providing services equitably among Iraqis. International Medical Corps was begun in response to the suffering of the Afghan people after the Soviet invasion of 1979, and is adept at providing services in dangerous places (see Attacks on humanitarian workers). The role of international health NGOs in international development Health-related NGOs also provide capacity development in areas of need; that is, helping nations develop sustainable domestic health solutions through training programs. An example of this type of aid is the Center for International Rehabilitation, which has provided rehabilitation training for Iraqi physical therapists, physicians, and rehabilitation clinic managers in Tuzla, Bosnia and Amman, Jordan. These trainees then care for amputees, spinal and head injury patients in their home country. NGOs vs. missionaries One important characteristic of NGO work is that, in the "pure" sense, they provide services based solely upon need, without political, ethnic, religious, or other considerations. Thus, strictly speaking, religious missionary organizations that perform services as part of a proselytizing or evangelical campaign should be separated from the NGO category and simply be referred to as religious missionary organizations. Some religious relief organizations do provide services more as a duty or "charity", however, without requirements for the recipients to attend any preaching, prayer or other religious preconditions. Harnessing the power of technology As NGO practice evolves parallel with technology, NGOs have developed more scientific and precise methods of assessment, planning and operations in humanitarian assistance and complex emergencies. One example is the Sphere Project's Humanitarian Charter and Minimum Standards in Disaster Response. They have taken other new tools into the planning offices and field: in addition to the obligatory laptop computer, they typically rely heavily upon cellular and satellite communications, the Internet, and geographic information services, or GIS. These technological improvements allow them to better focus efforts in areas of need, respond to evolving crises, and predict future needs. Indeed, in a related effort, the United States Holocaust Museum teamed with Google Earth to establish baseline GIS photos of crisis-torn Darfur, updating them at intervals, and uploading them to the Internet for public access. Since Internet "surfers" can browse these images and see where once-present villages are later obliterated, this teamwork gave lie to the Sudanese claim that it was engaging in neither ethnic cleansing nor genocide. American efforts in international health The U.S. Department of Defense In another teamwork effort, the Assistant Secretary of Defense (Health Affairs) of the United States Department of Defense, as the DoD's senior medical officer, established the International Health Division in late 2007 to help coordinate military health doctrine and practices in international development. The International Health Division places great emphasis upon working with NGOs to provide sustainable, culturally-appropriate development activities around the world. While critics maintain that DoD does not provide aid equitably and without regard to political influence, the Asian tsunami of December, 2004 (due to the 2004 Indian Ocean earthquake) demonstrated that DoD was capable of working in a supporting role without regard to geopolitical gain. Indeed, the DoD was surprised at the unexpected degree of improvement in American prestige as a result of its role in Southeast Asia and months later, in the Pakistan earthquake. A similar event resulted in rapid mobilization of DoD resources in response to the 2007 Peru earthquake, Bangladeshi Typhoon Sidr and Tropical Storm Nero in the Dominican Republic, all in the last half of 2007, with no reasonable expectation of material gain for America. In 2005, then-Secretary of Defense Donald Rumsfeld signed DoD Directive 3000.05, "Stability, Security, Transition and Reconstruction Operations". This document requires the DoD to assign Stability, Security, Transition and Reconstruction (SSTR) the same importance in planning and preparation as it gives to war. The rationale for SSTR is intuitive: stability promotes rule of law and economic development. These provide the base for essential services such as education, public health and sanitation, law enforcement and fire suppression. Essential services, in turn, lead to increased stability and economic opportunity. Health in the general population, and in particular the labor force, is essential to productivity and consequent stability. Although these relationships are not necessarily linear, and there is no inherent guarantee of equitable distribution of wealth in a developing society, full employment and hope for the future may be powerful disincentives to conflict. In this way, the DoD, through SSTR operations, expects to prevent some potential conflicts and criminal activities. The International Health Division, charged with policy implications of DoDD 3000.05, is located within the Office of the ASD(HA), reporting through Force Health Protection & Readiness. International Health develops DoD's policy on medical ethics and the practice of medicine in international health and development settings. International Health also identifies needs in developing nations and looks for non-governmental organizations (NGOs), intergovernmental organizations, and private voluntary organizations (PVOs) such as professional societies, that have the ability and expertise to address these problems. In this way, the NGOs develop helping relationships with the nations or regions they work in, fostering stability and sustainability. Other DoD international health activities occurring on a regular basis include medical civic action projects (MEDCAPs), in which Army, Navy or Air Force medical assets provide direct care, sanitation, and other public health services to host nation (HN) locals. Such MEDCAPs are generally traced to the Vietnam War, when medical units and medical personnel assigned to combat units would organize field medical care to Vietnamese, Hmong and others. There is a growing realization among the military that MEDCAP care may not be the best model, if the result is merely handing out antibiotics for upper respiratory infections and anti-inflammatories for aches and pains. However, projects such as de-worming, dentistry, prenatal education and care, and veterinary care, when performed in conjunction with HN health authorities and the local health infrastructure, have indisputable and long-lasting benefits to the recipients. Similar to MEDCAPs, the military performs Medical Readiness Training Exercises (MEDRETEs), Joint Combined Exchange Training (JCET), and Humanitarian-Civic Action (HCA) exercises, all of which may have direct and indirect services as a feature of the training. Finally, the military has unparalleled logistical and lift capabilities to respond to humanitarian assistance/disaster response(HADR) needs. In conjunction with the Uniformed Services University of the Health Sciences (USUHS), the Center for Disaster and Humanitarian Medicine (CDHAM) develops curriculum, teaches disaster and humanitarian assistance principles to graduate, medical, and post-doctoral students and publishes courses on incident command and other related topics. The handbook on military-NGO relations, "A Guide to Non-Governmental Organizations for the Military" is available free on-line. Footnotes Further reading External links HealthCare International Health News & Blogs The Healthy Village, International Health Awareness and Advocacy Umeå International School of Public Health Umeå Centre for Global Health Research Global Health Gateway Global Health Student Interest Group (Indiana University School of Medicine) Civil affairs Global health

Angiopathy

Angiopathy is the generic term for a disease of the blood vessels (arteries, veins, and capillaries). This also refers to the condition of damage or rupture of small blood vessels. The best known and most prevalent angiopathy is diabetic angiopathy, a common complication of chronic diabetes. Classification By caliber There are two types of angiopathy: macroangiopathy and microangiopathy. In macroangiopathy, atherosclerosis and a resultant blood clot forms on the large blood vessels, sticks to the vessel walls, and blocks the flow of blood. Macroangiopathy in the heart is coronary artery disease; in the brain, it is cerebrovascular disease. Macroangiopathy may cause other complications, such as ischemic heart disease, stroke and peripheral vascular disease which contributes to the diabetic foot ulcers and the risk of amputation. In microangiopathy, the walls of the smaller blood vessels become so thick and weak that they bleed, leak protein, and slow the flow of blood through the body. The decrease of blood flow through stenosis or clot formation impairs the flow of oxygen to cells and biological tissues (called ischemia) and leads to cellular death (necrosis and gangrene, which in turn may require amputation). Thus, tissues which are very sensitive to oxygen levels, such as the retina, develop microangiopathy and may cause blindness (so-called proliferative diabetic retinopathy). Damage to nerve cells may cause peripheral neuropathy, and to kidney cells, diabetic kidney disease (Kimmelstiel-Wilson syndrome). By condition It is also possible to classify angiopathy by the associated condition: Diabetic angiopathy Cerebral amyloid angiopathy Chronic diabetes can lead to several problems, one of which is Diabetic Angiopathy. Individuals with diabetic angiopathy notice a constriction in their arteries. This cause many organs to receive insufficient blood and oxygen, which might eventually cause harm. High blood sugar is the primary cause of diabetic angiopathy. Excessive blood sugar levels have the potential to harm tissues and cells. A form of cerebrovascular illness known as Cerebral Amyloid Angiopathy (CAA) is typified by the buildup of amyloid beta-peptide in the leptomeninges and small to medium sized cerebral blood vessels. Amyloid buildup causes brittle blood vessels, which can lead to lobar intracerebral hemorrhages (ICH). In addition, hemosiderosis, inflammatory leukoencephalopathy, Alzheimer's disease, accidental microbleeds, cognitive deficits, and transitory neurological symptoms may manifest. Causes The cause of Cerebral Amyloid Angiopathy are unknown. Sometimes it can be hereditary, however, there have been cases where it is developed in the elderly, especially in people over 55 years of age. High blood sugar is the primary cause of diabetic angiopathy. The endothelium, a smooth layer of the cell wall, is weakened and the artery-lining cells are injured. Rough patches develop along the endothelium and may promote the accumulation of deposits known as plaque. These deposits gradually harden and become more noticeable over time, restricting (stenosing) the artery and impairing normal blood flow. Different organs receive insufficient oxygen-rich blood due to the bottleneck that was formed. Symptoms Individuals with cerebral amyloid angiopathy typically have no symptoms. However, spontaneous lobar bleeding is the most frequent clinical sign when symptomatic. The clinical impairments are primarily determined by the site and extent of the bleeding. Larger hemorrhages may result in greater focused deficits, headaches, seizures, speaking difficulties, and muscular weakness. Smaller hemorrhages may produce hemiplegia and diminished consciousness. Treatment Currently, while there is no cure for angiopathy, there are ways through which the symptoms can be managed. For example, therapies. Treatment options for situations of muscle weakness may include speech, occupational, or physical therapy. Medication can be used for potential seizures and memory loss. lobar intracerebral hemorrhages(ICH) linked to CAA is often recurring. Due to this high prevalence, when there isn't a clear justification for anticoagulation, doctors usually avoid antiplatelet medicines and anticoagulants. Notably, research has shown that people with atrial fibrillation benefit from restarting anticoagulation. Despite the fact that CAA does not appear to be primarily caused by hypertension, blood pressure reduction has also been linked to advantages in terms of mortality.[8] Blood pressure control reduced the risk of CAA-related ICH by 77%. Finally, a small body of research has demonstrated the advantages of using immunosuppression to treat the inflammatory forms of CAA. References Vascular diseases

Breast disease

Breast diseases make up a number of conditions. The most common symptoms are a breast mass, breast pain, and nipple discharge. A majority of breast diseases are noncancerous. Although breast disease may be benign, or non-life threatening there remains an associated risk with potentially a higher risk of developing breast cancer later on. Tumor A breast tumor is an abnormal mass of tissue in the breast as a result of neoplasia. A breast neoplasm may be benign, as in fibroadenoma, or it may be malignant, in which case it is termed breast cancer. Either case commonly presents as a breast lump. Approximately 7% of breast lumps are fibroadenomas and 10% are breast cancer, the rest being other benign conditions or no disease. Phyllodes tumor is a fibroepithelial tumor which can be benign, borderline or malignant. Breast cancer Breast cancer is cancer of the breast tissues, most commonly arising from the milk ducts. Worldwide, breast cancer is the leading type of cancer in women, accounting for 25% of all cases. It is most common in women over age 50. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. Diagnosis may also be made when the cancer is asymptomatic, through breast cancer screening programs, such as mammograms. Outcomes for breast cancer vary depending on the cancer type, extent of disease, and person's age. Survival rates in the developed world are high, with between 80% and 90% of those in England and the United States alive for at least 5 years. Fibrocystic breast changes Also called: fibrocystic breast disease, chronic cystic mastitis, diffuse cystic mastopathy, mammary dysplasia Infections and inflammations These may be caused among others by trauma, secretory stasis/milk engorgement, hormonal stimulation, infections or autoimmune reactions. Repeated occurrence unrelated to lactation requires endocrinological examination. bacterial mastitis mastitis from milk engorgement or secretory stasis mastitis chronic subareolar abscess tuberculosis of the breast syphilis of the breast retromammary abscess actinomycosis of the breast duct ectasia syndrome breast engorgement Other breast conditions Mondor's disease Paget's disease of the breast nipple discharge, galactorrhea breast cyst mastalgia galactocoele See also Mammary gland References Further reading External links Breast diseases

Fatty-acid metabolism disorder

A broad classification for genetic disorders that result from an inability of the body to produce or utilize an enzyme or transport protein that is required to oxidize fatty acids. They are an inborn error of lipid metabolism, and when it affects the muscles also a metabolic myopathy. The enzyme or transport protein can be missing or improperly constructed, resulting in it not working. This leaves the body unable to produce energy within the liver and muscles from fatty acid sources. The body's primary source of energy is glucose; however, when all the glucose in the body has been expended, a normal body digests fats. Individuals with a fatty-acid metabolism disorder are unable to metabolize this fat source for energy, halting bodily processes. Most individuals with a fatty-acid metabolism disorder are able to live a normal active life with simple adjustments to diet and medications. If left undiagnosed many complications can arise. When in need of glucose the body of a person with a fatty-acid metabolism disorder will still send fats to the liver. The fats are broken down to fatty acids. The fatty acids are then transported to the target cells but are unable to be broken down, resulting in a build-up of fatty acids in the liver and other internal organs. Fatty-acid metabolism disorders are sometimes classified with the lipid metabolism disorders, but in other contexts they are considered a distinct category. Types Incomplete list of various fatty-acid metabolism disorders. Carnitine Transport Defect Carnitine-acylcarnitine translocase deficiency (CACT) Carnitine Palmitoyl Transferase I & II ( CPT I deficiency & CPT II deficiency) 2,4 Dienoyl-CoA Reductase Deficiency Electron Transfer Flavoprotein (ETF) Dehydrogenase Deficiency (GA-II/MADD) 3-Hydroxy-3-methylglutaryl-CoA lyase deficiency (HMG deficiency) Very long-chain acyl-coenzyme A dehydrogenase deficiency (VLCAD deficiency) Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency (LCHAD deficiency) Medium-chain acyl-coenzyme A dehydrogenase deficiency (MCAD deficiency) Short-chain acyl-coenzyme A dehydrogenase deficiency (SCAD deficiency) 3-hydroxyacyl-coenzyme A dehydrogenase deficiency (M/SCHAD deficiency) Oxidation The term fatty acid oxidation disorder (FAOD) is sometimes used, especially when there is an emphasis on the oxidation of the fatty acid. In addition to the fetal complications, they can also cause complications for the mother during pregnancy. Examples include: Mitochondrial trifunctional protein deficiency (MTPD) MCADD, LCHADD, and VLCADD Carnitine/transport The fatty acids are transported by carnitine, and defects in this process are associated with several disorders. They involve the step immediately before oxidation, and are often grouped with the oxidation disorders. Symptoms and signs Extreme sleepiness Behavior changes Irritable mood Poor appetite Fever Nausea Diarrhea Vomiting Hypoglycemia Enlarged heart Muscle weakness Heart failure While at rest, some exhibit cardiac arrhythmia (commonly various forms of tachycardia, but more rarely, conduction disorders or acute bradycardia); while others have a normal heart rhythm Causes Fatty-acid metabolism disorders result when both parents of the diagnosed subject are carriers of a defective gene. This is known as an autosomal recessive disorder. Two parts of a recessive gene are required to activate the disease. If only one part of the gene is present then the individual is only a carrier and shows no symptoms of the disease. If both mutated genes are present, the individual will be symptomatic. Like most autosomal recessive disorders, when both parents are carriers, there is a 25% chance for each child to inherit the disease. Diagnosis Diagnosis of Fatty-acid metabolism disorder requires extensive lab testing. Normally, in cases of hypoglycaemia, triglycerides and fatty acids are metabolised to provide glucose/energy. However, in this process, ketones are also produced and ketotic hypoglycaemia is expected. However, in cases where fatty acid metabolism is impaired, a non-ketotic hypoglycaemia may be the result, due to a break in the metabolic pathways for fatty-acid metabolism. Treatment The primary treatment method for fatty-acid metabolism disorders is dietary modification. It is essential that the blood-glucose levels remain at adequate levels to prevent the body from moving fat to the liver for energy. This involves snacking on low-fat, high-carbohydrate nutrients every 2–6 hours. However, some adults and children can sleep for 8–10 hours through the night without snacking. Drugs Carnitor - an L-carnitine supplement that has shown to improve the body's metabolism in individuals with low L-carnitine levels. It is only useful for Specific fatty-acid metabolism disease. See also Mitochondrion Fatty acid metabolism Beta oxidation Metabolic myopathies References External links Fatty-acid metabolism disorders Autosomal recessive disorders

Cryo

Cryo- is from the Ancient Greek κρύος (krúos, “ice, icy cold, chill, frost”). Uses of the prefix Cryo- include: Physics and geology Cryogenics, the study of the production and behaviour of materials at very low temperatures and the study of producing extremely low temperatures Cryoelectronics, the study of superconductivity under cryogenic conditions and its applications Cryosphere, those portions of Earth's surface where water ice naturally occurs Cryotron, a switch that uses superconductivity Cryovolcano, a theoretical type of volcano that erupts volatiles instead of molten rock Biology and medicine Cryobiology, the branch of biology that studies the effects of low temperatures on living things Cryonics, the low-temperature preservation of people who cannot be sustained by contemporary medicine Cryoprecipitate, a blood-derived protein product used to treat some bleeding disorders Cryotherapy, medical treatment using cold Cryoablation, tissue removal using cold Cryosurgery, surgery using cold Cryo-electron microscopy (cryoEM), a technique that fires beams of electrons at proteins that have been frozen in solution, to deduce the biomolecules’ structure Other uses Cryo Interactive, a video game company Cryos, a planet in the video game Darkspore See also Kryo, a brand of CPUs by Qualcomm External links Cryogenics Cryobiology Cryonics Superconductivity

Mental energy

Mental energy may be understood as the ability or willingness to engage in cognitive work. It is distinct from physical energy, and has mood, cognition, and motivation domains. Concepts closely related to mental energy include vigor and fatigue. Mental energy is not well-defined, and the scientific literature on mental energy is quite limited. A variety of measures for assessing aspects of mental energy exist. Many people complain of low mental energy, which can interfere with work and daily activities. Low mental energy and fatigue are major public health concerns. People may pursue remedies or treatment for low mental energy. Seeking to improve mental energy is a common reason that people take dietary supplements. Neurotransmitters Many different neurotransmitters have been theoretically implicated in the control of mental energy. This has often been based on the effects of drugs acting on these neurotransmitters. These neurotransmitters include dopamine, norepinephrine, orexin, serotonin, histamine, acetylcholine, adenosine, and glutamate. Hormones, including glucocorticoids like cortisol, as well as cytokines, have also been found to regulate mental energy. Food, drugs, sleep, diseases Mental energy can be affected by factors such as drugs, sleep, and disease. Drugs Drugs that may increase mental energy include caffeine, modafinil, psychostimulants like amphetamines and methylphenidate, and corticosteroids like hydrocortisone and dexamethasone. Drugs that may decrease mental energy include sedatives and hypnotics like antihistamines, benzodiazepines, and melatonin, as well as dopamine receptor antagonists like antipsychotics. Foods, beverages etc There are many marketing claims of foods, beverages, and dietary supplements improving mental energy, but data to substantiate such claims are limited or absent. Sleep Sleep deprivation may decrease mental energy in an exposure-dependent manner. Disease Various disease states, such as cardiac disease, cancer, stroke, HIV/AIDS, multiple sclerosis, Parkinson's disease, and certain mental health conditions like depression, may be associated with decreased mental energy. Chronic fatigue syndrome is characterized by a lack of the energy needed for the basic activities of daily life. See also Disorders of diminished motivation References Mental states Subjective experience

Skin and skin structure infection

Skin and skin structure infections (SSSIs), also referred to as skin and soft tissue infections (SSTIs), or acute bacterial skin and skin structure infections (ABSSSIs), are infections of skin and associated soft tissues (such as loose connective tissue and mucous membranes). Historically, the pathogen involved has most frequently been a bacterial species—always, since redescription of SSSIs as ABSSSIs—and as such, these infections require treatment by antibiotics. Types Until 2008, a distinction was made between two types: complicated SSSIs (cSSSIs) and uncomplicated SSSIs (uSSSIs), which had different regulatory approval requirements. Uncomplicated SSSIs included "simple abscesses, impetiginous lesions, furuncles, and cellulitis." Complicated SSSIs included "infections either involving deeper soft tissue or requiring significant surgical intervention, such as infected ulcers, burns, and major abscesses or a significant underlying disease state that complicates the response to treatment." The FDA further noted that "[s]uperficial infections or abscesses in an anatomical site, such as the rectal area, where the risk of anaerobic or Gram-negative pathogen involvement is higher, [were also] considered complicated infections." The uncomplicated category (uSSSI) is most frequently caused by Staphylococcus aureus and Streptococcus pyogenes, whereas the complicated category (cSSSI) might also be caused by a number of other pathogens. As of 2013, the pathogen involved in cases of cSSSI were known about 40% of the time. Diagnosis As of 2014, physicians were reported as generally not culturing to identify the infecting bacterial pathogen during diagnosis of SSSIs Treatment Common treatment is empirical, with choice of an antibiotic agent based on presenting symptoms and location, and further followup based on trial and error. To achieve efficacy against SSSIs, physicians most often use broad-spectrum antibiotics, a practice contributing to increasing prevalence of antibiotic resistance, a trend related to the widespread use of antibiotics in medicine in general. The increased prevalence of antibiotic resistance is evident in MRSA species commonly involved in SSSIs, which worsen prognoses and limit treatment options. For less severe infections, microbiologic evaluation using tissue culture has been demonstrated to have high utility in guiding management decisions. There is no evidence to support or oppose the use of Chinese herbal medicines in treating SSTIs. See also List of cutaneous conditions Linezolid Tedizolid References Further reading Infection-related cutaneous conditions

Manganese deficiency (medicine)

Manganese deficiency in humans results in a number of medical problems. Manganese is a vital element of nutrition in very small quantities (adult male daily intake 2.3 milligrams). However poisoning may occur when greater amounts are ingested. Function Manganese is a component of some enzymes (such as arginase) and stimulates the development and activity of other enzymes. Manganese superoxide dismutase (MnSOD) is the principal antioxidant in mitochondria. Several enzymes activated by manganese contribute to the metabolism of carbohydrates, amino acids, and cholesterol. A deficiency of manganese causes skeletal deformation in animals and inhibits the production of collagen in wound healing. Food sources Manganese is found in leafy green vegetables, fruits, nuts, cinnamon and whole grains. The nutritious kernel, called wheat germ, which contains the most minerals and vitamins of the grain, has been removed from most processed grains (such as white bread). The wheat germ is often sold as livestock feed. Many common vitamin and mineral supplement products fail to include manganese in their compositions. Relatively high dietary intake of other minerals such as iron, magnesium, and calcium may inhibit the proper intake of manganese. References External links Mineral deficiencies

Streptococcosis

Streptococcosis is an infectious disease caused by bacteria of the genus Steptococcus. This disease is most common among horses, guinea pigs, dogs, cats, and fish with symptoms varying based on the streptococcal species involved. In humans, this disease typically involves a throat infection and is called streptococcal pharyngitis or strep throat. Pathogenesis Occurring in pairs or chains, streptococci are found to be Gram-positive (although older cultures may lose this characteristic), non-mobile, non-spore forming, and catalase-negative. Bacteriophages, also known as phages, of streptococcus within different parameters of temperature, pH, and salinity maintain successfully stable and are lytic. Integrase, transposase, and recombinase coding genes are found to be absent within phages. Streptococcosis can start occurring due to a weak immune system, or by having bacteria enter wounds. Spreading of Streptococcus is often sporadic, and can be done through direct contact (may be done through materials that are likely to carry infection), air transport or (rarely) ingestion. Classification The bacterial species involved in a streptococcosis infection is typically identified through microscopy of the bacteria to observe their morphology, biochemical tests (e.g., hemolysis ability), and tests on which antibodies are produced by the infected organism. Antibody detection, also known as serologic grouping, categorizes with the labeling of Group A to Group V; it uses differences with cell wall carbohydrates and pili-associated protein. With the use of hemolysis, species are divided within three different categories: incomplete (α hemolytic), complete (β-hemolytic), and no (γ hemolytic) hemolysis detected. Two common species seen are S. agalactiae which has been associated with fish and (more significant) S. suis which has been associated with pigs. Clinical identification The clinical manifestations of streptococcus infections differ greatly depending on both the host species and group and strain of the bacteria. Alpha-hemolytic streptococci (S. pneumoniae and viridians) The first group of streptococci is alpha-hemolytic which comprises primarily S.pneumoniae and viridans streptococci. This group is referred to as alpha-hemolysis because the cell membrane of red blood cells is left intact. When cultured, alpha-hemolysis can be deemed present when the agar gel appears greenish. Identifying and diagnosing alpha-hemolytic Streptococcus is done with a sputum gram stain and culture test. Further identification can be done serologically to test for the presence of capsular antigen, which is the dominant structure on the surface of S. pneumoniae. Bile solubility can be used to further distinguish S. pneumoniae from viridans streptococci as S. pneumoniae are bile soluble and viridans streptococci are not. S. pneumoniae are the most significant alpha-hemolytic streptococci and are responsible for several infections including: Lower respiratory tract infection Pneumonia Septicaemia Meningitis Septic arthritis Sinusitis The identification and diagnosis of these conditions often require a combination of bacteriologic methods with other clinical identification characteristics that are condition-specific. Beta-hemolytic streptococci (Group A, B, C, D, F, G, and H) In contrast, the beta-hemolytic group of streptococci includes those capable of complete lysis of red blood cells. Beta-hemolytic streptococci are further divided into additional subgroups consisting of: Group A, Group B, Group C, Group D, Group F, Group G, and Group H. Beta-hemolysis is identified by its yellow and transparent appearance on the cultured media. Clinical identification of beta-hemolytic streptococci relies on culturing the bacteria with agar media that has been supplemented with blood. This method allows for beta-hemolysis to be easily identified, which is a critical step in further identification tactics. Identification into subgroups can be done by the Lancefield antigen-determination test which uses antibodies to distinguish B-hemolytic streptococci into different species. An additional method used to identify B-hemolytic streptococci is the PYR test, which is primarily used in distinguishing S. pyogenes from other B-hemolytic strains by testing for the presence of pyrrolidonyl aminopeptidase. Both the Lancefield antigen grouping sera and PYR test are widely available for commercial usage. Each method presents its limitations and studies suggest that a combination of the two protocols be used to achieve the most reliable results. Group A Group A streptococcal infections are predominantly caused by S. pyogenes. Human pathologies are mostly associated with Group A streptococci and arise most often as respiratory or skin infections. Group A streptococcal infections include: Streptococcal pharyngitis Impetigo Necrotizing fasciitis Cellulitis Streptococcal toxic shock syndrome Rheumatic fever Post-streptococcal glomerulonephritis The identification and diagnosis of these conditions often require a combination of bacteriologic methods with other clinical identification characteristics that are condition-specific. Group B Group B streptococcal infections, most commonly associated with S. agalactiae, are extremely prevalent among pregnant women, newborns, and the elderly. Cattle have also been shown to be important reservoir hosts for S. agalactiae. Reports of S. agalactiae have also been identified in several other mammals, fish, and reptiles. Economic impacts and considerations Streptococcosis has been shown to have serious consequences on Aquaculture industries around the world as a result of various streptococcal-based infections in marine and freshwater organisms. Streptococosis in fish specifically has proven to be a public health concern due to the zoonotic capabilities of streptococcal infections and diseases. Mitigating streptococcosis in marine and freshwater organisms, has the potential to improve the economics of the aquaculture sector and decrease the risks of human illness. Traditionally, antibiotics and other chemotherapeutic drugs have been used to combat streptococcosis infections in aquaculture settings. However, re-infection rates, drugs accumulating in aquatic ecosystems, demand for chemical-free aquaculture products, and the diversity of species and strains within the Streptococcus genus has proven to be a major challenge. Since re-infection rates among fish populations are high, multiple treatments are often needed which introduces an additional problem of increased antibiotic resistance. In search of alternative solutions, current research is investigating the possibility of using dietary supplements or medicinal herbs and other plants as alternatives to antibiotics, and recent findings have generated promising results. The existing literature has placed a strong emphasis on the economic impacts of streptococcosis in tilapia cultures. Tilapia have rapid growth rates, exhibit tolerance to numerous environmental conditions, and are available globally which causes the species to be of major importance in the global aquaculture sector. Tilapia production is often conducted by large-scale producers in intensive systems, which increases their susceptibility to disease and infection due to the density of cultures and subsequent water quality issues. Streptococcosis has been identified as the most important pathogen affecting these systems and has caused considerable economic losses to the industry. In general, preventing disease and infection should be a priority compared to simply controlling and mitigating outbreaks. Research acknowledges that disease prevention may be possible by utilizing effective biosecurity measures at both global and local levels. In addition, recent studies have found several benefits of using medicinal herbs to treat streptococcosis in aquaculture. Studies suggest that a combination of vaccines, antibiotics, and phytotherapy may be the most viable solution to improve both the economics of the industry and mitigate public health concerns. Considerations and adjustments will have to made depending on national regulations, the countries economic status, and the farms production capacity. Epidemiology Host range Streptococcosis encompasses a spectrum of diseases caused by bacteria from the genera Streptococcus and Lactococcus. Various species within these genera can cause infections in both wild and cultured animals, including fish and terrestrial species. Commonly affected organisms include: Fish species: Streptococcus iniae, Streptococcus agalactiae, Streptococcus dysgalactiae, Lactococcus garvieae, Lactococccus piscium, and Streptococcus parauberis have a significant impact in aquaculture, impacting freshwater, marine, and brackish water species. Among these L. garvieae, S. iniae, and S. parauberis are considered the primary causative agents responsible for diseases in marine aquaculture among the streptococcal bacteria affecting fish. Terrestrial animals: Streptococcus agalactiae, commonly found in cattle and dromedary camels, has been detected in numerous species, including small ruminants, llamas, horses, and marine mammals, often associated with human sources. Streptococcus dysgalactiae primarily infects cattle but also affects small ruminants, pigs, dogs, horses, and vampire bats. Streptococcus equi subsp. zooepidemicus, prevalent in horses, is also present in guinea pigs, pigs, monkeys, and various other animals, including dogs, cats, ferrets, and birds. Additionally, Streptococcus suis mainly affects suids but can be found in other animals like cattle, sheep, goats, and chickens, with different genotypes found in rabbits and chickens compared to pigs. Humans: Streptococcal infections in humans are primarily caused by Streptococcus pyogenes, the most common beta-hemolytic group A streptococcus, often referred to simply as group A streptococcus. Similarly, group B streptococcus typically denotes Streptococcus agalactiae, although minor beta-hemolytic group B streptococci like S. troglodytidis exist. While most streptococcal illnesses in humans originate from species adapted to humans, such as S. pneumoniae or S. pyogenes, there are zoonotic species capable of causing infections. These include S. canis, S. dysgalactiae subsp. dysgalactiae, S. equi subsp. zooepidemicus, S. halichoeri, S. iniae, and S. suis, along with some animal-associated genotypes of S. agalactiae. Notably, some streptococci found in animals may infect humans under certain circumstances. Fish-associated S. agalactiae, primarily affecting farmed freshwater and marine fish, have also been implicated in human illnesses, particularly the ST283 genotype. The prevalence of specific S. suis serotypes varies by region, impacting disease incidence in both pigs and humans. Transmission routes Members of the Streptococcus genus are frequently found as part of the normal microbial community in both animals and humans, commonly inhabiting sites such as the upper respiratory tract, urogenital tract, mucous membranes, mammary glands, or skin. While these organisms can occasionally cause infections as primary pathogens, they more commonly act as opportunistic pathogens, particularly in carriers. However, their transmission between hosts does not always lead to disease manifestation. Streptococci are typically transmitted through close contact, though aerosols may sometimes play a role. Some species, such as S. suis, S. equi subsp. zooepidemicus, and S. agalactiae ST283, can be acquired through the consumption of undercooked pork, horsemeat, or fish, respectively, or via unpasteurized dairy products. S. iniae infections in humans often occur through skin abrasions during fish cleaning. The mode of transmission among fish is not fully elucidated but can occur orally or through exposure to contaminated water baths, particularly in laboratory settings. Streptococci can also be transmitted through fomites and can persist in the environment for varying durations, especially in organic material under moist, cool conditions. For instance, S. suis can remain viable for approximately a week in pig feces at 25 °C (77 °F) and up to six weeks in carcasses at 4 °C (39 °F). Geographic distribution The strains of Streptococcus, including S. canis, S. dysgalactiae subsp. dysgalactiae, S. equi subsp. zooepidemicus, S. suis, and mammalian S. agalactiae, maintained in domestic animals are widely distributed and their presence follows the hosts that they reside in. Regional variations in the predominant serotypes of S. suis may impact disease prevalence in both pigs and humans. S. iniae infections have predominantly been documented in regions such as North America, the Caribbean, parts of Asia (such as Japan, China, Singapore, and Taiwan), Australia, and the Middle East. Meanwhile, occurrences of S. halichoeri have been reported in certain parts of Europe and South Korea, with potential wider distribution. Notably, S. agalactiae ST283 appears to be primarily found in Asia but has recently been identified in farmed fish in South America. References Further reading Wikipedia Student Program Streptococcal infections Bacterial diseases of fish Zoonotic bacterial diseases

Secondary metabolism

Secondary metabolism (also called specialized metabolism) is a term for pathways and small molecule products of metabolism that are involved in ecological interactions, but are not absolutely required for the survival of the organism. These molecules are sometimes produced by specialized cells, such as laticifers in plants. Secondary metabolites commonly mediate antagonistic interactions, such as competition and predation, as well as mutualistic ones such as pollination and resource mutualisms. Examples of secondary metabolites include antibiotics, pigments and scents. The opposite of secondary metabolites are primary metabolites, which are considered to be essential to the normal growth or development of an organism. Secondary metabolites are produced by many microbes, plants, fungi and animals, usually living in crowded habitats, where chemical defense represents a better option than physical escape. It is very hard to distinguish primary and secondary metabolites due to often overlapping of the intermediates and pathways of primary and secondary metabolism. As an example can serve sterols, that are products of secondary metabolism, and, at the same time, represent a base for a cell structure. Important secondary metabolites Antibiotics, such as streptomycin and penicillin Pigments, such as delphinidin Scents, such as ionone See also Plant secondary metabolism Phytochemistry Ophiocordyceps unilateralis References External links Secondary metabolism in plants Evolution of plant specialized metabolic pathways

Modality (human–computer interaction)

In the context of human–computer interaction, a modality is the classification of a single independent channel of input/output between a computer and a human. Such channels may differ based on sensory nature (e.g., visual vs. auditory), or other significant differences in processing (e.g., text vs. image). A system is designated unimodal if it has only one modality implemented, and multimodal if it has more than one. When multiple modalities are available for some tasks or aspects of a task, the system is said to have overlapping modalities. If multiple modalities are available for a task, the system is said to have redundant modalities. Multiple modalities can be used in combination to provide complementary methods that may be redundant but convey information more effectively. Modalities can be generally defined in two forms: computer-human and human-computer modalities. Computer–Human modalities Computers utilize a wide range of technologies to communicate and send information to humans: Common modalities Vision – computer graphics typically through a screen Audition – various audio outputs Tactition – vibrations or other movement Uncommon modalities Gustation (taste) Olfaction (smell) Thermoception (heat) Nociception (pain) Equilibrioception (balance) Any human sense can be used as a computer to human modality. However, the modalities of seeing and hearing are the most commonly employed since they are capable of transmitting information at a higher speed than other modalities, 250 to 300 and 150 to 160 words per minute, respectively. Though not commonly implemented as computer-human modality, tactition can achieve an average of 125 wpm through the use of a refreshable Braille display. Other more common forms of tactition are smartphone and game controller vibrations. Human–computer modalities Computers can be equipped with various types of input devices and sensors to allow them to receive information from humans. Common input devices are often interchangeable if they have a standardized method of communication with the computer and afford practical adjustments to the user. Certain modalities can provide a richer interaction depending on the context, and having options for implementation allows for more robust systems. Simple modalities Keyboard Pointing device Touchscreen Complex modalities Computer vision Speech recognition Motion Orientation With the increasing popularity of smartphones, the general public are becoming more comfortable with the more complex modalities. Motion and orientation are commonly used in smartphone mapping applications. Speech recognition is widely used with Virtual Assistant applications. Computer Vision is now common in camera applications that are used to scan documents and QR codes. Using multiple modalities Having multiple modalities in a system gives more affordance to users and can contribute to a more robust system. Having more also allows for greater accessibility for users who work more effectively with certain modalities. Multiple modalities can be used as backup when certain forms of communication are not possible. This is especially true in the case of redundant modalities in which two or more modalities are used to communicate the same information. Certain combinations of modalities can add to the expression of a computer-human or human-computer interaction because the modalities each may be more effective at expressing one form or aspect of information than others. There are six types of cooperation between modalities, and they help define how a combination or fusion of modalities work together to convey information more effectively. Equivalence: information is presented in multiple ways and can be interpreted as the same information Specialization: when a specific kind of information is always processed through the same modality Redundancy: multiple modalities process the same information Complementarity: multiple modalities take separate information and merge it Transfer: a modality produces information that another modality consumes Concurrency: multiple modalities take in separate information that is not merged Complementary-redundant systems are those which have multiple sensors to form one understanding or dataset, and the more effectively the information can be combined without duplicating data, the more effectively the modalities cooperate. Having multiple modalities for communication is common, particularly in smartphones, and often their implementations work together towards the same goal, for example gyroscopes and accelerometers working together to track movement. See also References Multimodal interaction

Animal nutrition

Animal nutrition focuses on the dietary nutrients needs of animals, primarily those in agriculture and food production, but also in zoos, aquariums, and wildlife management. Constituents of diet Macronutrients (excluding fiber and water) provide structural material (amino acids from which proteins are built, and lipids from which cell membranes and some signaling molecules are built) and energy. Some of the structural material can be used to generate energy internally, though the net energy depends on such factors as absorption and digestive effort, which vary substantially from instance to instance. Vitamins, minerals, fiber, and water do not provide energy, but are required for other reasons. A third class dietary material, fiber (i.e., non-digestible material such as cellulose), seems also to be required, for both mechanical and biochemical reasons, though the exact reasons remain unclear. Molecules of carbohydrates and fats consist of carbon, hydrogen, and oxygen atoms. Carbohydrates range from simple monosaccharides (glucose, fructose, galactose) to complex polysaccharides (starch). Fats are triglycerides, made of assorted fatty acid monomers bound to glycerol backbone. Some fatty acids, but not all, are essential in the diet: they cannot be synthesized in the body. Protein molecules contain nitrogen atoms in addition to carbon, oxygen, and hydrogen. The fundamental components of protein are nitrogen-containing amino acids. Essential amino acids cannot be made by the animal. Some of the amino acids are convertible (with the expenditure of energy) to glucose and can be used for energy production just as ordinary glucose. By breaking down existing protein, some glucose can be produced internally; the remaining amino acids are discarded, primarily as urea in urine. This occurs normally only during prolonged starvation. Other dietary substances found in plant foods (phytochemicals, polyphenols) are not identified as essential nutrients but appear to impact health in both positive and negative ways. Most foods contain a mix of some or all of the nutrient classes, together with other substances. Some nutrients can be stored internally (e.g., the fat soluble vitamins), while others are required more or less continuously. Poor health can be caused by a lack of required nutrients or, in extreme cases, too much of a required nutrient. For example, both salt provides sodium and chloride, both essential nutrients, but will cause illness or even death in too large amounts. Dietary fibre is a carbohydrate (polysaccharide or oligosaccharide) that is incompletely absorbed in some animals. Protein Proteins are the basis of many animal body structures (e.g. muscles, skin, and hair). They also form the enzymes which control chemical reactions throughout the body. Each molecule is composed of amino acids which are characterized by the inclusion of nitrogen and sometimes sulfur. The body requires amino acids to produce new proteins (protein retention) and to replace damaged proteins (maintenance). As there is no protein or amino acid storage provision, amino acids must be present in the diet. Excess amino acids are discarded, typically in the urine. For all animals, some amino acids are essential (an animal cannot produce them internally) and some are non-essential (the animal can produce them from other nitrogen-containing compounds). A diet that contains adequate amounts of amino acids (especially those that are essential) is particularly important in some situations: during early development and maturation, pregnancy, lactation, or injury (a burn, for instance). A few amino acids from protein can be converted into glucose and used for fuel through a process called gluconeogenesis; this is done in quantity only during starvation. Minerals Dietary minerals are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen that are present in nearly all organic molecules. The term "mineral" is archaic, since the intent is to describe simply the less common elements in the diet. Many elements are essential in relative quantity; they are usually called "bulk minerals". Some are structural, but many play a role as electrolytes. These include: Calcium, a common electrolyte, but also needed structurally (for muscle and digestive system health, bones, some forms neutralizes acidity, may help clear toxins, and provide signaling ions for nerve and membrane functions) Chlorine as chloride ions; very common electrolyte Magnesium, required for processing ATP and related reactions (builds bone, causes strong peristalsis, increases flexibility, increases alkalinity) Phosphorus, required component of bones; essential for energy processing Potassium, a very common electrolyte (heart and nerve health) Sodium, a very common electrolyte Sulfur for three amino acids and therefore many proteins (skin, hair, nails, liver, and pancreas) Many elements are required in trace amounts, usually because they play a catalytic role in enzymes. Vitamins Vitamin deficiencies may result in disease conditions. Excess of some vitamins is also dangerous to health (notably vitamin A), and animal nutrition researchers have managed to establish safe levels for some common companion animals. Deficiency or excess of minerals can also have serious health consequences. ASH Though not a nutrient as such, an entry for ash is sometimes found on nutrition labels, especially for pet food. This entry measures the weight of inorganic material left over after the food is burned for two hours at 600 °C. Thus, it does not include water, fibre, and nutrients that provide calories, but it does include some nutrients, such as minerals Too much ash may contribute to feline urological syndrome in domestic cats. Intestinal bacterial flora Animal intestines contain a large population of gut flora which are essential to digestion, and are also affected by the food eaten. See also Human nutrition Animal nutritionist References External links International Livestock Research Institute (ILRI) National Dairy Research Institute (India) Poultry Science Society Nutrition by type Zoology

General chemistry

General chemistry (sometimes referred to as "gen chem") is offered by colleges and universities as an introductory level chemistry course usually taken by students during their first year. The course is usually run with a concurrent lab section that gives students an opportunity to experience a laboratory environment and carry out experiments with the material learned in the course. These labs can consist of acid-base titrations, kinetics, equilibrium reactions, and electrochemical reactions. Chemistry majors as well as students across STEM majors such as biology, biochemistry, biomedicine, physics, and engineering are usually required to complete one year of general chemistry as well. Concepts taught The concepts taught in a typical general chemistry course are as follows: Stoichiometry Conservation of energy Conservation of mass Elementary atomic theory Periodic table and periodicity Law of constant composition Gas laws Nuclear chemistry Solubility Acid-base chemistry Chemical bonding Chemical kinetics Thermodynamics Electrochemistry Chemical equilibria Pre-medical track Students in colleges and universities looking to follow the "pre-medical" track are required to pass general chemistry as the Association of American Medical Colleges requires at least one full year of chemistry. In order for students to apply to medical school, they must pass the medical college admission test, or MCAT, which consists of a section covering the foundations of general chemistry. General chemistry covers many of the principal foundations that apply to medicine and the human body that is essential in our current understanding and practice of medicine. Topics of general chemistry covered by the AAMC Medical College Admissions Test Acids and bases Atomic structure Bonding and chemical interactions Chemical kinetics Electrochemistry Equilibrium Solutions Stoichiometry The gas phase Thermochemistry Redox reactions "Weed out course" Students who are enrolled in general chemistry often desire to become doctors, researchers, and educators. Because of the demands of these fields, professors believe that the level of rigor that is associated with general chemistry should be elevated from that of a typical introductory course. This has led to this course to gain the title of a "weed out course" where students drop out from their respected major due to the level of difficulty. Students can have different perceptions of the course based on their experiences, or lack thereof, in high school chemistry courses. Students who enroll in AP chemistry in high school, a course that mirrors what is covered in college, could be perceived as having an advantage over students who do not come to college with a strong chemistry background. Students who wish to be competitive in applying to medical schools try to achieve success in general chemistry as the average GPA for medical school matriculants was 3.71 in 2017. This makes a simply passing grade not acceptable for students with medical school aspirations. General chemistry professors have been known to make tests worth a large portion of the course, and make them more challenging than the material presents itself as. Grade deflation, purposely adjusting the grades of a course to be lower, is also an issue of general chemistry courses at the undergraduate level. References External links Chemistry education zh-yue:普通化學

Degeneracy (biology)

Within biological systems, degeneracy occurs when structurally dissimilar components/pathways can perform similar functions (i.e. are effectively interchangeable) under certain conditions, but perform distinct functions in other conditions. Degeneracy is thus a relational property that requires comparing the behavior of two or more components. In particular, if degeneracy is present in a pair of components, then there will exist conditions where the pair will appear functionally redundant but other conditions where they will appear functionally distinct. Note that this use of the term has practically no relevance to the questionably meaningful concept of evolutionarily degenerate populations that have lost ancestral functions. Biological examples Examples of degeneracy are found in the genetic code, when many different nucleotide sequences encode the same polypeptide; in protein folding, when different polypeptides fold to be structurally and functionally equivalent; in protein functions, when overlapping binding functions and similar catalytic specificities are observed; in metabolism, when multiple, parallel biosynthetic and catabolic pathways may coexist. More generally, degeneracy is observed in proteins of every functional class (e.g. enzymatic, structural, or regulatory), protein complex assemblies, ontogenesis, the nervous system, cell signalling (crosstalk) and numerous other biological contexts reviewed in. Contribution to robustness Degeneracy contributes to the robustness of biological traits through several mechanisms. Degenerate components compensate for one another under conditions where they are functionally redundant, thus providing robustness against component or pathway failure. Because degenerate components are somewhat different, they tend to harbor unique sensitivities so that a targeted attack such as a specific inhibitor is less likely to present a risk to all components at once. There are numerous biological examples where degeneracy contributes to robustness in this way. For instance, gene families can encode for diverse proteins with many distinctive roles yet sometimes these proteins can compensate for each other during lost or suppressed gene expression, as seen in the developmental roles of the adhesins gene family in Saccharomyces. Nutrients can be metabolized by distinct metabolic pathways that are effectively interchangeable for certain metabolites even though the total effects of each pathway are not identical. In cancer, therapies targeting the EGF receptor are thwarted by the co-activation of alternate receptor tyrosine kinases (RTK) that have partial functional overlap with the EGF receptor (and are therefore degenerate), but are not targeted by the same specific EGF receptor inhibitor. Other examples from various levels of biological organization can be found in. Theory Several theoretical developments have outlined links between degeneracy and important biological measurements related to robustness, complexity, and evolvability. These include: Theoretical arguments supported by simulations have proposed that degeneracy can lead to distributed forms of robustness in protein interaction networks. Those authors suggest that similar phenomena is likely to arise in other biological networks and potentially may contribute to the resilience of ecosystems as well. Tononi et al. have found evidence that degeneracy is inseparable from the existence of hierarchical complexity in neural populations. They argue that the link between degeneracy and complexity is likely to be much more general. Fairly abstract simulations have supported the hypothesis that degeneracy fundamentally alters the propensity for a genetic system to access novel heritable phenotypes and that degeneracy could therefore be a precondition for open-ended evolution. The three hypotheses above have been integrated in where they propose that degeneracy plays a central role in the open-ended evolution of biological complexity. In the same article, it was argued that the absence of degeneracy within many designed (abiotic) complex systems may help to explain why robustness appears to be in conflict with flexibility and adaptability, as seen in software, systems engineering, and artificial life. See also Canalisation Equifinality References Further reading Because there are many distinct types of systems that undergo heritable variation and selection (see Universal Darwinism), degeneracy has become a highly interdisciplinary topic. The following provides a brief roadmap to the application and study of degeneracy within different disciplines. Animal Communication Cultural Variation Ecosystems Epigenetics History and philosophy of science Systems biology Evolution Immunology Cohen, I.R., U. Hershberg, and S. Solomon, 2004 Antigen-receptor degeneracy and immunological paradigms. Molecular Immunology, . 40(14–15) pp. 993–996. Tieri, P., G.C. Castellani, D. Remondini, S. Valensin, J. Loroni, S. Salvioli, and C. Franceschi, Capturing degeneracy of the immune system. In Silico Immunology. Springer, 2007. Artificial life, Computational intelligence Andrews, P.S. and J. Timmis, A Computational Model of Degeneracy in a Lymph Node. Lecture Notes in Computer Science, 2006. 4163: p. 164. Mendao, M., J. Timmis, P.S. Andrews, and M. Davies. The Immune System in Pieces: Computational Lessons from Degeneracy in the Immune System. in Foundations of Computational Intelligence (FOCI). 2007. Whitacre, J.M. and A. Bender. Degenerate neutrality creates evolvable fitness landscapes. in WorldComp-2009. 2009. Las Vegas, Nevada, USA. Whitacre, J.M., P. Rohlfshagen, X. Yao, and A. Bender. The role of degenerate robustness in the evolvability of multi-agent systems in dynamic environments. in PPSN XI. 2010. Kraków, Poland. Fernandez-Leon, J.A. (2011). Evolving cognitive-behavioural dependencies in situated agents for behavioural robustness. BioSystems 106, pp. 94–110. Fernandez-Leon, J.A. (2011). Behavioural robustness: a link between distributed mechanisms and coupled transient dynamics. BioSystems 105, Elsevier, pp. 49–61. Fernandez-Leon, J.A. (2010). Evolving experience-dependent robust behaviour in embodied agents. BioSystems 103:1, Elsevier, pp. 45–56. Brain Price, C. and K. Friston, Degeneracy and cognitive anatomy. Trends in Cognitive Sciences, 2002. 6(10) pp. 416–421. Tononi, G., O. Sporns, and G.M. Edelman, Measures of degeneracy and redundancy in biological networks. Proceedings of the National Academy of Sciences, USA, 1999. 96(6) pp. 3257–3262. Mason, P.H. (2014) What is normal? A historical survey and neuroanthropological perspective, in Jens Clausen and Neil Levy. (Eds.) Handbook of Neuroethics, Springer, pp. 343–363. Linguistics Oncology Tian, T., S. Olson, J.M. Whitacre, and A. Harding, The origins of cancer robustness and evolvability. Integrative Biology, 2011. 3: pp. 17–30. Peer Review Lehky, S., Peer Evaluation and Selection Systems: Adaptation and Maladaptation of Individuals and Groups through Peer Review. 2011: BioBitField Press. Researchers Duarte Araujo Sergei Atamas Andrew Barron Keith Davids Gerald Edelman Ryszard Maleszka Paul Mason Ludovic Seifert Ricard Sole Giulio Tononi James Whitacre External links degeneracy research community Biological concepts Biology theories Evolutionarily significant biological phenomena Systems biology Evolutionary dynamics Evolutionary processes

Illness and injuries during spaceflight

Illnesses and injuries during space missions are a range of medical conditions and injuries that may occur during space flights. Some of these medical conditions occur due to the changes withstood by the human body during space flight itself, while others are injuries that could have occurred on Earth's surface. A non-exhaustive list of these conditions and their probability of occurrence can be found in the following sources: Records of medical problems that were encountered by astronauts during space flights Information on medical conditions that occurred during expeditions on Earth in extreme environments (submarine, alpine, Arctic and Antarctic expeditions, expeditions to other remote ground-based locations, etc.) or NASA's Extreme Environment Mission Operations Medical studies regarding the probabilities of diseases and injuries due to age Pre- and post-flight examination of astronauts and cosmonauts Results for in-flight illness rates can be found in publications such as The Journal of Emergency Medicine, the Annals of Emergency Medicine, and the Journal of Aviation, Space, and Environmental Medicine. Information on these rates can also be obtained from NASA's cfm Longitudinal Study of Astronaut Health database at the Lyndon B. Johnson Space Center. This study lists a few of the conditions that could occur and their probabilities of occurrence. Non-emergency medical conditions Most of the medical conditions that happen in space are not medical emergencies and can be treated on board. About 75% of all astronauts have taken medication during shuttle missions for conditions such as motion sickness, headache, sleeplessness, and back pain. Other common conditions include minor trauma, burns, dermatological and musculoskeletal injuries, respiratory illnesses and genitourinary problems. Emergency medical conditions Research on the medical emergencies that may occur in space include fatal and nonfatal arrhythmia, heart attacks, cardiac arrests, embolisms, massive hemorrhages, renal stone formations, fatal and non-fatal infections, and thrombotic complications. Of these conditions, only arrhythmia, renal colics, and infections have occurred in the history of spaceflight. The arrhythmia cases included occasional premature atrial contractions (PACs) and premature ventricular contractions (PVCs), which happened to 30% of astronauts at some point during periods of intense physical activity. Potentially serious arrhythmia cases (superventricular tachycardia) have also been reported. For example, during the Apollo 15 flight, one crew member experienced ventricular bigeminy; ventricular ectopy was reported on Skylab; and on Mir'', a crew member experienced a 14-beat run of ventricular tachycardia. A case of coronary artery disease (CAD) has not been registered during any human space flight as of May 2014. However, due to the lack of public funding for larger space shuttles following the Columbia shuttle disaster in 2003, NASA has had to rely on the smaller Soyuz shuttles to send crews to space, which increased the waiting time for crewed spaceflights and increased the average age of space crews since the mid-1990s. Since the risk of cardiovascular disease increases as people age, research on these diseases has become more important for space agencies - especially for long-term space missions. Other medical emergencies that have been observed in space include cases of urological and dental emergencies, as well as behavioural and psychiatric problems. In a few cases, astronauts were brought back to Earth due to episodes of renal colic and arrhythmia, shortening their stays in space and possibly ending their missions. People who are exposed to harsh environments have suffered medical conditions that could be considered as analogs of the space environment. A sample of this information is presented in Tables 8-4 through 8-6. The rate of these conditions is relatively low (10-50 cases per 100,000 people per day) and most were non-emergency (trauma, infection, psychiatric disorders), but they required an evacuation that would be impossible to provide in space. Crews living and working in harsh environments (Antarctic expeditions, submarines, and undersea habitats) had medical emergencies such as intracerebral hemorrhage, stroke, myocardial infarction, appendicitis, and bone fractures as well as cases of cancer and psychiatric illness. However, the overall rate of serious medical or surgical emergencies was low. The most common emergencies were dental. For 100 British Polaris submarine missions, crew members required 30 fillings and 7 teeth extractions in total. Dental problems have been the cause for a transfer at sea in the U.S. Polaris submarine program. Extractions and fillings have also been required for missions in Antarctica. The calculated rate of significant illness or injury on submarines, Antarctic expeditions, military aviation and space flight was found to be approximately 0.06 cases per person-year. If we use this data to evaluate the rate of occurrence of a medical emergency to a 2.5-year Mars mission, assuming six crew members, we get a rate of 0.9 cases per people/mission. In other words, one significant medical event could be expected per Mars mission. These estimates are likely to be low, as they do not deal with the unique problems that are associated with the space environment: radiation effects and exposure and physiological adaptation to low gravity. As for cardiovascular emergencies, the yearly number of cases reported by age group for USAF aviators over 5 years was as follows: 0.0054% (30–34 years), 0.018% (35–39 years), 0.038% (40–44 years), 0.14% (45–49 years) and 0.13% (50–54 years). In total, 21% were cases of sudden death and 61% were diagnosed and treated as myocardial infarction. Despite the physical screening that USAF aviators undergo, the first instance of cardiovascular illnesses in this group required serious medical intervention. This data could apply to the astronaut corps as well, even if they undergo a more extensive medical assessment. In the submarine program, the most common general surgical condition was appendicitis,. A case of death due to appendicitis was also reported among the participants of Antarctic expeditions. Other serious conditions reported in the submarine program were traumatic amputations, fractures, and dislocations. Depression and anxiety were the two most common psychiatric diagnoses made on submarines, and they are frequent among researchers enduring long Antarctic winters. Medical conditions due to long-term space flights Radiation exposure could also cause medical problems due to the technical problems involved in the shielding of space craft, especially given the length of missions to Mars. Given that these missions could last several years at the level of technology available in 2014, age-related medical conditions would be likely to occur at the same rate as the general population. These probabilities have been assessed in astronaut pre- and post-flight health databases. Another problem related to long-term missions has been the design of medical care systems within space craft due to the limited amount of available space. Medical care systems for spaceships must include the technology necessary to heal exposure to toxic chemicals and gases, and chemical and electrical burns. Astronauts may also suffer from trauma aboard and during extra-vehicular activities outside space craft. References Space medicine

Arterial embolism

Arterial embolism is a sudden interruption of blood flow to an organ or body part due to an embolus adhering to the wall of an artery blocking the flow of blood, the major type of embolus being a blood clot (thromboembolism). Sometimes, pulmonary embolism is classified as arterial embolism as well, in the sense that the clot follows the pulmonary artery carrying deoxygenated blood away from the heart. However, pulmonary embolism is generally classified as a form of venous embolism, because the embolus forms in veins. Arterial embolism is the major cause of infarction (which may also be caused by e.g. arterial compression, rupture or pathological vasoconstriction). Signs and symptoms Symptoms may begin quickly or slowly depending on the size of the embolus and how much it blocks the blood flow. Symptoms of embolisation in an organ vary with the organ involved but commonly include: Pain in the involved body part Temporarily decreased organ function Later symptoms are closely related to infarction of the affected tissue. This may cause permanently decreased organ function. For example, symptoms of myocardial infarction mainly include chest pain, dyspnea, diaphoresis (an excessive form of sweating), weakness, light-headedness, nausea, vomiting, and palpitations. Symptoms of limb infarction include coldness, decreased or no pulse beyond the site of blockage, pain, muscle spasm, numbness and tingling, pallor and muscle weakness, possibly to the grade of paralysis in the affected limb. Commonly occluded sites Arterial emboli often occur in the legs and feet. Some may occur in the brain, causing a stroke, or in the heart, causing a heart attack. Less common sites include the kidneys, intestines, and eyes. Risk factors Risk factors for thromboembolism, the major cause of arterial embolism, include disturbed blood flow (such as in atrial fibrillation and mitral stenosis), injury or damage to an artery wall, and hypercoagulability (such as increased platelet count). Mitral stenosis poses a high risk of forming emboli which may travel to the brain and cause stroke. Endocarditis increases the risk for thromboembolism, by a mixture of the factors above. Atherosclerosis in the aorta and other large blood vessels is a common risk factor, both for thromboembolism and cholesterol embolism. The legs and feet are major impact sites for these types. Thus, risk factors for atherosclerosis are risk factors for arterial embolisation as well: advanced age cigarette smoking hypertension (high blood pressure) obesity hyperlipidemia, e.g. hypercholesterolemia, hypertriglyceridemia, elevated lipoprotein (a) or apolipoprotein B, or decreased levels of HDL cholesterol) diabetes mellitus Sedentary lifestyle stress Other important risk factors for arterial embolism include: recent surgery (both for thromboembolism and air embolism) previous stroke or cardiovascular disease a history of long-term intravenous therapy (for air embolism) Bone fracture (for fat embolism) A septal defect of the heart makes it possible for paradoxical embolization, which happens when a clot in a vein enters the right side of the heart and passes through a hole into the left side. The clot can then move to an artery and cause arterial embolisation. Pathophysiology An arterial embolism is caused by one or more emboli getting stuck in an artery and blocking blood flow, causing ischemia, possibly resulting in infarction with tissue death (necrosis). Individuals with arterial thrombosis or embolism often develop collateral circulation to compensate for the loss of arterial flow. However, it takes time for sufficient collateral circulation to develop, making affected areas more vulnerable for sudden occlusion by embolisation than for e.g. gradual occlusion as in atherosclerosis. Materials Arterial embolisms can consist of various materials, including: Thromboembolism – embolism of thrombus or blood clot. Cholesterol embolism - embolism of cholesterol, often from atherosclerotic plaque inside a vessel. Fat embolism – embolism of bone fracture or fat droplets. Air embolism (also known as a gas embolism) – embolism of air bubbles. Septic embolism – embolism of pus containing bacteria. Cancer embolism In contrast, amniotic fluid embolism almost exclusively affects the venous side. Diagnosis In addition to evaluating the symptoms above, the health care provider may find decreased or no blood pressure in the arm or leg. Tests to determine any underlying cause for thrombosis or embolism and to confirm presence of the obstruction may include: Doppler ultrasound, especially duplex ultrasonography. It may also involve transcranial doppler exam of arteries to the brain Echocardiography, sometimes involving more specialized techniques such as Transesophageal echocardiography (TEE) or myocardial contrast echocardiography (MCE) to diagnose myocardial infarction Arteriography of the affected extremity or organ Digital subtraction angiography is useful in individuals where administration of radiopaque contrast material must be kept to a minimum. Magnetic resonance imaging (MRI) Blood tests for measuring elevated enzymes in the blood, including cardiac-specific troponin T and/or troponin I, myoglobins, and creatine kinase isoenzymes. These indicate embolisation to the heart that has caused myocardial infarction. Myoglobins and creatine kinase are also elevated in the blood in embolisation in other locations. Blood cultures may be done to identify the organism responsible for any causative infection Electrocardiography (ECG) for detecting myocardial infarction Angioscopy using a flexible fiberoptic catheter inserted directly into an artery. Prevention Prevention of atherosclerosis, which is a major risk factor of arterial embolism, can be performed e.g. by dieting, physical exercise and smoking cessation. In case of high risk for developing thromboembolism, antithrombotic medication such as warfarin or coumadin may be taken prophylactically. Antiplatelet drugs may also be needed. Treatment Treatment is aimed at controlling symptoms and improving the interrupted blood flow to the affected area of the body. Medications include: Antithrombotic medication. These are commonly given because thromboembolism is the major cause of arterial embolism. Examples are: Anticoagulants (such as warfarin or heparin) and antiplatelet medication (such as aspirin, ticlopidine, and clopidogrel) can prevent new clots from forming Thrombolytics (such as streptokinase) can dissolve clots Painkillers given intravenously Vasodilators to relax and dilate blood vessels. Appropriate drug treatments successfully produce thrombolysis and removal of the clot in 50% to 80% of all cases. Antithrombotic agents may be administered directly onto the clot in the vessel using a flexible catheter (intra-arterial thrombolysis). Intra-arterial thrombolysis reduces thromboembolic occlusion by 95% in 50% of cases, and restores adequate blood flow in 50% to 80% of cases. Surgical procedures include: Arterial bypass surgery to create another source of blood supply Embolectomy, to remove the embolus, with various techniques available: Thromboaspiration Angioplasty with balloon catheterization with or without implanting a stent Balloon catheterization or open embolectomy surgery reduces mortality by nearly 50% and the need for limb amputation by approximately 35%. Embolectomy by open surgery on the artery If extensive necrosis and gangrene has set in an arm or leg, the limb may have to be amputated. Limb amputation is in itself usually remarkably well-tolerated, but is associated with substantial mortality (~50%), primarily because of the severity of the diseases in patients where it is indicated. Prognosis How well a patient does depends on the location of the clot and to what extent the clot has blocked blood flow. Arterial embolism can be serious if not treated promptly. Without treatment, it has a 25% to 30% mortality rate. The affected area can be permanently damaged, and up to approximately 25% of cases require amputation of an affected extremity. Arterial emboli may recur even after successful treatment. Complications Possible complications of arterial embolism depend on the site of the obstruction: In the heart it can cause myocardial infarction In the brain, it can cause a transient ischemic attack (TIA), and, in prolonged blood obstruction, stroke. Blockage of arteries that supply arms or legs may result in necrosis and gangrene Temporary or permanent decrease or loss of other organ functions In septic embolism, there can be infection of the affected tissue or even septic shock, potentially leading to gangrene and sepsis Epidemiology In the United States, approximately 550,000 people die each year from heart-related arterial embolism and thrombosis. Approximately 250,000 of these individuals are female, and approximately 100,000 of all these deaths are considered premature, that is, prior to the age of average life expectancy. References External links Diseases of arteries, arterioles and capillaries

Chronotropic incompetence

Chronotropic incompetence (CI) is the inability of heart rate to increase as expected in response to exercise. The condition can be defined in different ways and occurs in various diseases. Sufferers have a higher risk of cardiovascular disease and early death. Definition In healthy people, cardiac output during exercise increases via a rise in both heart rate and stroke volume. When the heart rate does not rise sufficiently, this can lead to exercise intolerance. CI can be detected using a cardiopulmonary exercise test. People with CI have a higher risk of cardiovascular disease and early death. There are different ways to define CI. One common threshold is not being able to reach 80% of age-predicted maximal heart rate (APMHR), which is said to be 220 – age. Another definition is not being able to reach 80% of the expected heart rate reserve, that is, the difference between the individual's resting heart rate and APMHR. Incidence Chronotropic incompetence occurs in various diseases. Roughly half of people with heart failure experience it, compared to less than 9% of age-matched healthy controls. When CI occurs alongside issues with stroke volume, it can lead to a strong decrease in functional ability. It is associated with the activation of the sympathetic nervous system (part of the fight-or-flight response), leading to higher levels of norepinephrine. CI in people with heart failure can further be related to the use of β-blockers, a high resting heart rate or the downregulation of β-adrenergic receptors. CI is also observed in people with obstructive sleep apnea. Similarly to CI in heart failure, it is possibly linked to the autonomic nervous system shift towards the sympathetic nervous system. People with type-2 diabetes often experience CI too, as do some people with long COVID. People with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) also experience a blunted heart rate response to exercise. CI in ME/CFS is most evident on the second day of a repeated exercise test, after the first exercise test induces post-exertional malaise. References Cardiovascular physiology

Neuroimmune system

The neuroimmune system is a system of structures and processes involving the biochemical and electrophysiological interactions between the nervous system and immune system which protect neurons from pathogens. It serves to protect neurons against disease by maintaining selectively permeable barriers (e.g., the blood–brain barrier and blood–cerebrospinal fluid barrier), mediating neuroinflammation and wound healing in damaged neurons, and mobilizing host defenses against pathogens. The neuroimmune system and peripheral immune system are structurally distinct. Unlike the peripheral system, the neuroimmune system is composed primarily of glial cells; among all the hematopoietic cells of the immune system, only mast cells are normally present in the neuroimmune system. However, during a neuroimmune response, certain peripheral immune cells are able to cross various blood or fluid–brain barriers in order to respond to pathogens that have entered the brain. For example, there is evidence that following injury macrophages and T cells of the immune system migrate into the spinal cord. Production of immune cells of the complement system have also been documented as being created directly in the central nervous system. Structure The key cellular components of the neuroimmune system are glial cells, including astrocytes, microglia, and oligodendrocytes. Unlike other hematopoietic cells of the peripheral immune system, mast cells naturally occur in the brain where they mediate interactions between gut microbes, the immune system, and the central nervous system as part of the microbiota–gut–brain axis. G protein-coupled receptors that are present in both CNS and immune cell types and which are responsible for a neuroimmune signaling process include: Chemokine receptors: CXCR4 Cannabinoid receptors: CB1, CB2, GPR55 Trace amine-associated receptors: TAAR1 μ-Opioid receptors – all subtypes Neuroimmunity is additionally mediated by the enteric nervous system, namely the interactions of enteric neurons and glial cells. These engage with enteroendocrine cells and local macrophages, sensing signals from the gut lumen, including those from the microbiota. These signals prompt local immune responses and transmit to the CNS through humoral and neural pathways. Interleukins and signals from immune cells can access the hypothalamus via the neurovascular unit or circumventricular organs. Cellular physiology The neuro-immune system, and study of, comprises an understanding of the immune and neurological systems and the cross-regulatory impacts of their functions. Cytokines regulate immune responses, possibly through activation of the hypothalamic-pituitary-adrenal (HPA) axis. Cytokines have also been implicated in the coordination between the nervous and immune systems. Instances of cytokine binding to neural receptors have been documented between the cytokine releasing immune cell IL-1 β and the neural receptor IL-1R. This binding results in an electrical impulse that creates the sensation of pain. Growing evidence suggests that auto-immune T-cells are involved in neurogenesis. Studies have shown that during times of adaptive immune system response, hippocampal neurogenesis is increased, and conversely that auto-immune T-cells and microglia are important for neurogenesis (and so memory and learning) in healthy adults. The neuroimmune system uses complementary processes of both sensory neurons and immune cells to detect and respond to noxious or harmful stimuli. For example, invading bacteria may simultaneously activate inflammasomes, which process interleukins (IL-1 β), and depolarize sensory neurons through the secretion of hemolysins. Hemolysins create pores causing a depolarizing release of potassium ions from inside the eukaryotic cell and an influx of calcium ions. Together this results in an action potential in sensory neurons and the activation of inflammasomes. Injury and necrosis also cause a neuroimmune response. The release of adenosine triphosphate (ATP) from damaged cells binds to and activates both P2X7 receptors on macrophages of the immune system, and P2X3 receptors of nociceptors of the nervous system. This causes the combined response of both a resulting action potential due to the depolarization created by the influx of calcium and potassium ions, and the activation of inflammasomes. The produced action potential is also responsible for the sensation of pain, and the immune system produces IL-1 β as a result of the ATP P2X7 receptor binding. Although inflammation is typically thought of as an immune response, there is an orchestration of neural processes involved with the inflammatory process of the immune system. Following injury or infection, there is a cascade of inflammatory responses such as the secretion of cytokines and chemokines that couple with the secretion of neuropeptides (such as substance P) and neurotransmitters (such as serotonin). Together, this coupled neuroimmune response has an amplifying effect on inflammation. Neuroimmune responses Neuron-glial cell interaction Neurons and glial cells work in conjunction to combat intruding pathogens and injury. Chemokines play a prominent role as a mediator between neuron-glial cell communication since both cell types express chemokine receptors. For example, the chemokine fractalkine has been implicated in communication between microglia and dorsal root ganglion (DRG) neurons in the spinal cord. Fractalkine has been associated with hypersensitivity to pain when injected in vivo, and has been found to upregulate inflammatory mediating molecules. Glial cells can effectively recognize pathogens in both the central nervous system and in peripheral tissues. When glial cells recognize foreign pathogens through the use of cytokine and chemokine signaling, they are able to relay this information to the CNS. The result is an increase in depressive symptoms. Chronic activation of glial cells however leads to neurodegeneration and neuroinflammation. Microglial cells are of the most prominent types of glial cells in the brain. One of their main functions is phagocytozing cellular debris following neuronal apoptosis. Following apoptosis, dead neurons secrete chemical signals that bind to microglial cells and cause them to devour harmful debris from the surrounding nervous tissue. Microglia and the complement system are also associated with synaptic pruning as their secretions of cytokines, growth factors and other complements all aid in the removal of obsolete synapses. Astrocytes are another type of glial cell that among other functions, modulate the entry of immune cells into the CNS via the blood–brain barrier (BBB). Astrocytes also release various cytokines and neurotrophins that allow for immune cell entry into the CNS; these recruited immune cells target both pathogens and damaged nervous tissue. Reflexes Withdrawal reflex The withdrawal reflex is a reflex that protects an organism from harmful stimuli. This reflex occurs when noxious stimuli activate nociceptors that send an action potential to nerves in the spine, which then innervate effector muscles and cause a sudden jerk to move the organism away from the dangerous stimuli. The withdrawal reflex involves both the nervous and immune systems. When the action potential travels back down the spinal nerve network, another impulse travels to peripheral sensory neurons that secrete amino acids and neuropeptides like calcitonin gene-related peptide (CGRP) and Substance P. These chemicals act by increasing the redness, swelling of damaged tissues, and attachment of immune cells to endothelial tissue, thereby increasing the permeability of immune cells across capillaries. Reflex response to pathogens and toxins Neuroimmune interactions also occur when pathogens, allergens, or toxins invade an organism. The vagus nerve connects to the gut and airways and elicits nerve impulses to the brainstem in response to the detection of toxins and pathogens. This electrical impulse that travels down from the brain stem travels to mucosal cells and stimulates the secretion of mucus; this impulse can also cause ejection of the toxin by muscle contractions that cause vomiting or diarrhea. Neuroimmune connections and the vagus nerve have also been highlighted more recently as essential to maintaining homeostasis in the context of novel viruses such as SARS-CoV-2 This is especially relevant when considering the role of the vagus nerve in regulating systemic inflammation via the Cholinergic Anti-inflammatory Pathway. Reflex response to parasites The neuroimmune system is involved in reflexes associated with parasitic invasions of hosts. Nociceptors are also associated with the body's reflexes to pathogens as they are in strategic locations, such as airways and intestinal tissues, to induce muscle contractions that cause scratching, vomiting, and coughing. These reflexes are all designed to eject pathogens from the body. For example, scratching is induced by pruritogens that stimulate nociceptors on epidermal tissues. These pruritogens, like histamine, also cause other immune cells to secrete further pruritogens in an effort to cause more itching to physically remove parasitic invaders. In terms of intestinal and bronchial parasites, vomiting, coughing, sneezing, and diarrhea can also be caused by nociceptor stimulation in infected tissues, and nerve impulses originating from the brain stem that innervate respective smooth muscles. Eosinophils in response to capsaicin, can trigger further sensory sensitization to the molecule. Patients with chronic cough also have an enhanced cough reflex to pathogens even if the pathogen has been expelled. In both cases, the release of eosinophils and other immune molecules cause a hypersensitization of sensory neurons in bronchial airways that produce enhanced symptoms. It has also been reported that increased immune cell secretions of neurotrophins in response to pollutants and irritants can restructure the peripheral network of nerves in the airways to allow for a more primed state for sensory neurons. Clinical significance It has been demonstrated that prolonged psychological stress could be linked with increased risk of infection via viral respiratory infection. Studies, in animals, indicate that psychological stress raises glucocorticoid levels and eventually, an increase in susceptibility to streptococcal skin infections. The neuroimmune system plays a role in Alzheimer's disease. In particular, microglia may be protective by promoting phagocytosis and removal of amyloid-β (Aβ) deposits, but also become dysfunctional as disease progresses, producing neurotoxins, ceasing to clear Aβ deposits, and producing cytokines that further promote Aβ deposition. It has been shown that in Alzheimer's disease, amyloid-β directly activates microglia and other monocytes to produce neurotoxins. Astrocytes have also been implicated in multiple sclerosis (MS). Astrocytes are responsible for demyelination and the destruction of oligodendrocytes that is associated with the disease. This demyelinating effect is a result of the secretion of cytokines and matrix metalloproteinases (MMP) from activated astrocyte cells onto neighboring neurons. Astrocytes that remain in an activated state form glial scars that also prevent the re-myelination of neurons, as they are a physical impediment to oligodendrocyte progenitor cells (OPCs). The neuroimmune system is essential for increasing plasticity following a CNS injury via an increase in excitability and a decrease in inhibition, which leads to synaptogenesis and a restructuring of neurons. The neuroimmune system may play a role in recovery outcomes after a CNS injury. The neuroimmune system is also involved in asthma and chronic cough, as both are a result of the hypersensitized state of sensory neurons due to the release of immune molecules and positive feedback mechanisms. Preclinical and clinical studies have shown that cellular (microglia/macrophages, leukocytes, astrocytes, and mast cells, etc.) and molecular neuroimmune responses contribute to secondary brain injury after intracerebral hemorrhage. See also References Further reading External links Figure7.1: Neuroimmune mechanisms of methamphetamine-induced CNS toxicity Immune system

Neonatal meningitis

Neonatal meningitis is a serious medical condition in infants that is rapidly fatal if untreated. Meningitis, an inflammation of the meninges, the protective membranes of the central nervous system, is more common in the neonatal period (infants less than 44 days old) than any other time in life, and is an important cause of morbidity and mortality globally. Mortality is roughly half in developing countries and ranges from 8%-12.5% in developed countries. Symptoms seen with neonatal meningitis are often unspecific and may point to several conditions, such as sepsis (whole body inflammation). These can include fever, irritability, and shortness of breath. The only method to determine if meningitis is the cause of these symptoms is lumbar puncture (an examination of the cerebrospinal fluid). The most common cause of neonatal meningitis is bacterial infection of blood, known as bacteremia. Organisms responsible are different; most commonly group B streptococci (i.e. Streptococcus agalactiae), Escherichia coli, and Listeria monocytogenes. Although there is a low mortality rate in developed countries, there is a 50% prevalence rate of neurodevelopmental disabilities after meningitis caused by E. coli and Streptococcus agalactiae, and a 79% prevalence after meningitis caused by Gram-negative rods other than E. coli. Delayed treatment of neonatal meningitis may cause cerebral palsy, blindness, deafness, seizure disorders, and learning deficiencies. Signs and symptoms The following is a list of common signs and symptoms of neonatal meningitis. Fever poor appetite anterior fontanelle bulging seizures jitteriness dyspnea irritability anorexia vomiting diarrhea abdominal distention (increase in abdominal size) neck rigidity cyanosis jaundice sunset eyes (downward gaze of the eyes) abnormal body temperature (hypo-or hyperthermia) change of activity (lethargy or irritability) These symptoms are unspecific and may point to many different conditions. Complications Neuroimaging (X-ray imaging of the brain) is recommended to detect the complications of meningitis. Complications should be suspected when the clinical course is characterized by shock, respiratory failure, focal neurological deficits, a positive cerebrospinal fluid culture after 48 to 72 hours of appropriate antibiotic therapy, or infection with certain organisms, such as Citrobacter koseri and Cronobacter sakazakii for example. Ultrasounds are useful for early imaging to determine ventricular size and hemorrhaging. CT scans later in the therapy should be used to dictate prolonged treatment. If intracranial abscesses (collection of pus in the brain) are found, treatment consisting of a combination of surgical drainage of the abscess and antimicrobial therapy for 4 to 6 weeks is recommended. More imaging should be completed after the end of antibiotic treatment because abscesses have been found after weeks from start of treatment. Relapses have also occurred after appropriate treatment when infected by Gram-negative enteric bacilli. Hearing Loss Meningitis is one of the leading causes of acquired deafness. Nearly 8% of those with Meningitis will have a permanent sensorineural hearing loss. The longer meningitis is left untreated, the greater the risk of seizures and permanent neurological damage such as hearing loss, memory difficulty, learning disabilities, brain damage, gait problems, kidney failure, shock, and even death. Hearing loss in those with Meningitis can occur when the body is fighting off the infection and the cells reach the inner ear where the hair cells and nerve fibers become damaged. Hearing loss can also occur after Meningitis is resolved due to an increased risk for ossification of the cochlea. Ossification of the cochlea can make it difficult to place a Cochlear Implant for hearing losses that are treated unsuccessfully with hearing aids. Bacterial Meningitis is likely to lead to hearing loss. It is important to have a hearing test as soon as possible. It would be best to complete a hearing test before leaving the hospital or within four weeks of improvement of symptoms. Fluctuating hearing loss has been observed in a large number of patients, so it is best to have routine hearing tests to monitor the hearing loss. Viral Meningitis is less likely to cause hearing loss and it is recommended to perform a hearing test if the patient is experiencing any hearing difficulties. All hearing losses are different so there is no predictive loss for Meningitis. Children are assessed through behavioral testing (if old enough), Otoacoustic Emissions (OAEs), and Auditory Brainstem Response (ABR). Impact in Children for Communication If hearing loss is left undetected and/or untreated, this can lead to later acquisition of language and delayed reading skills. Since untreated Meningitis can cause brain damage and learning disabilities, children with a history of Meningitis may be developmentally delayed when compared to their typically developing peers. Laboratory features Laboratory features that are characteristic of neonatal bacterial meningitis include: Isolation of a bacterial pathogen from the cerebrospinal fluid by culture and/or visualization by Gram stain Increased cerebrospinal fluid white blood cell count (typically >1000 white blood cells/μL, but may be lower, especially with Gram-positive bacteria), usually with a predominance of neutrophils Elevated cerebrospinal fluid protein concentration (>150 mg/dL in preterm (premature birth) and >100 mg/dL in term infants) Decreased cerebrospinal fluid glucose concentration (<20 mg/dL [1.1 mmol/L] in preterm (premature birth) and <30 mg/dL [1.7 mmol/L] in term (on time) infants) Causes Neonatal meningitis is caused by group B streptococci Streptococcus agalactiae (39%-48% of cases), Escherichia coli (30%-35%), other Gram-negative rods (8%-12%), Streptococcus pneumoniae (about 6%), and Listeria monocytogenes (5%-7%). Meningitis is typically caused from either a bacterial or viral infection, however, it can be caused by fungal, parasitic, or amebic infections as well. Even more rare, Meningitis can be caused by some cancers, Lupus, specific drugs, head injuries, and brain surgeries. Most neonatal meningitis results from bacteremia (bacterial infection of the blood) with hematogenous spread to the central nervous system (CNS). Early-onset In early-onset neonatal meningitis, acquisition of the bacteria is from the mother either before the baby is born or during birth. The most common bacteria found in early-onset are Streptococcus agalactiae, Escherichia coli, and Listeria monocytogenes. In developing countries, Gram-negative enteric (gut) bacteria are responsible for the majority of early onset meningitis. Late-onset Late-onset meningitis may be caused by other Gram-negative bacteria and staphylococcal species. In developing countries, Streptococcus pneumoniae accounts for most cases of late onset. Herpes Simplex Virus Herpes simplex virus is a rare cause of meningitis, occurring only 0.165 in 10,000 live births in the UK and 0.2-5 in 10,000 live births in the US Both HSV-1 and HSV-2 can cause neonatal meningitis, however, HSV-2 accounts for 70% of the cases. Herpes simplex virus is transmitted to neonates mainly during delivery (when infected maternal secretions come into contact with the baby and accounting for 85% of cases), but also occur in utero (while the fetus is still in the womb, 5% of cases) or even post-delivery, receiving the infection from the community (10% of cases). The most important factors impacting the transmission of the virus is the stage of the mother's infection (symptomatic or non-symptomatic) and the damage of any maternal membranes during birth (the longer the tissue is damaged, the higher the chance of neonatal infection). Pathogenesis Generally, the progression of neonatal meningitis starts with bacteria colonizing the gastrointestinal tract. The bacteria then invades through the intestinal mucosa layer into the blood, causing bacteremia followed by invasion of the cerebrospinal fluid. The neonate's less efficient immune system (especially the alternative complement system) lessens their defense against invading bacteria. Colonization of the mother plays an important role in transmission to the neonate, causing early-onset meningitis. Group B Streptococcus Neonatal Streptococcus agalactiae infection is acquired in utero or during passage through the vagina. Evidence suggests that vaginal colonization by Streptococcus agalactiae during pregnancy increases the risk of vertical transmission and early-onset disease in neonates. Neonatal meningitis-causing E. coli Some strains of E. coli have a capsule, called K1, which protects the bacteria from the innate immune system and allows it to penetrate the central nervous system. The capsule contains sialic acid, which is found widely in humans and so does not set off the defenses of the body. Sialic acid also plays a role in the bacteria's ability to invade through the blood–brain barrier. The capsule can be variably O-acetylated. Diagnosis Bacterial Infection A lumbar puncture (spinal tap) is necessary to diagnose meningitis. Cerebrospinal fluid culture is the most important study for the diagnosis of neonatal bacterial meningitis because clinical signs are non-specific and unreliable. Blood cultures may be negative in 15-55% of cases, making them unreliable as well. However, a cerebrospinal fluid to blood glucose ratio below two-thirds has a strong relationship to bacterial meningitis. A spinal tap should be done in all neonates with suspected meningitis, with suspected or proven sepsis (whole body inflammation) and should be considered in all neonates in whom sepsis is a possibility. The role of the spinal tap in neonates who are healthy appearing but have maternal risk factors for sepsis is more controversial; its diagnostic yield in these patients may be low. Early-onset is deemed when infection is within one week of birth. Late-onset is deemed after the first week. Viral Infection Babies born from mothers with symptoms of Herpes simplex virus should be tested for viral infection. Liver tests, complete blood count, cerebrospinal fluid analysis, and a chest X-ray should all be completed to diagnose meningitis. Samples should be taken from skin, conjunctiva (eye), mouth and throat, rectum, urine, and the cerebrospinal fluid for viral culture and polymerase chain reaction. Prevention Bacterial Prevention of neonatal meningitis is primarily intrapartum (during labor) antibiotic prophylaxis (prevention) of pregnant mothers to decrease chance of early-onset meningitis by Streptococcus agalactiae. For late-onset meningitis, prevention is passed onto the caretakers to stop the spread of infectious microorganisms. Proper hygiene habits are first and foremost, while stopping improper antibiotic use; such as over-prescriptions, use of broad spectrum antibiotics, and extended dosing times will aid prevention of late-onset neonatal meningitis. A possible prevention may be vaccination of mothers against Streptococcus agalactiae and E. coli, however, this is still under development. Viral The only form of prevention from viral infection of the neonate is a Caesarean section form of delivery if the mother is showing symptoms of infection. Treatment Treatment for meningitis is antibiotics. The particular drugs used are based on culture results that identify the infecting bacteria, but a mix of ampicillin, gentamicin, and cefotaxime is used for early-onset meningitis before their identification. A regimen of antistaphylococcal antibiotic, such as nafcillin or vancomycin, plus cefotaxime or ceftazidime with or without an aminoglycoside is recommended for late-onset neonatal meningitis. The aim for these treatments is to sterilize the cerebrospinal fluid of all pathogens. A repeat spinal tap 24 to 48 hours after treatment has been started should be done to confirm sterilization. Limited evidence suggests that adjuvant corticosteroids may reduce the short-term risk of hearing loss in newborn infants with meningitis, but it is uncertain whether corticosteroids help to reduce the risk of death or longer-term hearing loss. Group B Streptococci For meningitis suspected to be caused by Streptococcus agalactiae, the following treatment is recommended by the American Academy of Pediatrics: doses of penicillin up to 450 000 U/kg daily (270 mg/kg/day) divided 8 hourly if <7 days of age and divided 6 hourly if >7 days of age. For penicillin [the recommended dose is up to 300 mg/kg/daily divided 8 hourly if <7 days of age or 4–6 hourly if >7 days of age. After confirmation of Streptococcus agalactiae by culture, penicillin alone should be used for the rest of the course of treatment, including the 14-day post-sterilization therapy. Gram-negative Enterics For suspected Gram-negative enteric (including E. coli) meningitis a combination of cefotaxime and aminoglycoside, usually gentamicin, is recommended. This treatment should last for 14 days after sterilization and then only cefotaxime for another 7 days creating a minimum of 21 days of therapy after sterilization. Listeria monocytogenes Meningitis caused by Listeria monocytogenes should be treated with a combination of ampicillin and gentamicin because it is synergistic in vitro and provides more rapid bacterial clearance in animal models of infection. Streptococcus pneumoniae Streptococcus pneumoniae can be treated with either penicillin or ampicillin. Herpes Simplex Virus In cases of meningitis caused by Herpes simplex virus, antiviral therapy with (acyclovir or vidarabine) must be started immediately for a favorable outcome. Acyclovir is a better antiviral because it shows a similar effect on the infection as vidarabine and is safer to use in neonates. The recommended dosage is 20 mg/kg every six hours for 21 days. Epidemiology In industrialized countries, the incidence of bacterial meningitis is approximately 3 in 10,000 live births. The incidence of Herpes simplex virus meningitis is estimated to be 0.2-5.0 cases per 10,000 live births. Neonatal meningitis is much more common in developing countries. Neonatal meningitis ranges from 4.8 per 10,000 live births in Hong Kong to 24 per 10,000 live births in Kuwait. In Africa and South Asia, figures ranging from 8.0 to 61 per 10,000 live births are found. It is expected that these numbers are lower than reality due to the difficulty of diagnosing and the healthcare available to underdeveloped countries in Asia and Africa. References Meningitis Neonatology

Immune-mediated inflammatory diseases

An immune-mediated inflammatory disease (IMID) is any of a group of conditions or diseases that lack a definitive etiology, but which are characterized by common inflammatory pathways leading to inflammation, and which may result from, or be triggered by, a dysregulation of the normal immune response. All IMIDs can cause end organ damage, and are associated with increased morbidity and/or mortality. Inflammation is an important and growing area of biomedical research and health care because inflammation mediates and is the primary driver of many medical disorders and autoimmune diseases, including ankylosing spondylitis, psoriasis, psoriatic arthritis, Behçet's disease, rheumatoid arthritis, inflammatory bowel disease (IBD), and allergy, as well as many cardiovascular, neuromuscular, and infectious diseases. Some current research even suggests that aging is a consequence, in part, of inflammatory processes. Characterization IMID is characterized by immune disregulation, and one underlying manifestation of this immune disregulation is the inappropriate activation of inflammatory cytokines, such as IL-12, IL-6 or TNF alpha, whose actions lead to pathological consequences. See also Immune mediated polygenic arthritis Bibliography Shurin, Michael R. and Yuri S. Smolkin (editors). Immune Mediated Diseases: From Theory to Therapy (Advances in Experimental Medicine and Biology). Springer, 2007. References idid.us: immune mediated inflammatory diseases, inflammatory diseases of immune dysregulation Cause (medicine) Inflammations Immune system disorders

Bone health

The human skeletal system is a complex organ in constant equilibrium with the rest of the body. In addition to supporting and giving structure to the body, a bone is the major reservoir for many minerals and compounds essential for maintaining a healthy pH balance. The deterioration of the body with age renders the elderly particularly susceptible to and affected by poor bone health. Illnesses like osteoporosis, characterized by weakening of the bone's structural matrix, increases the risk of hip-fractures and other life-changing secondary symptoms. In 2010, over 258,000 people aged 65 and older were admitted to the hospital for hip fractures. Incidence of hip fractures is expected to rise by 12% in America, with a projected 289,000 admissions in the year 2030. Other sources estimate up to 1.5 million Americans will have an osteoporotic-related fracture each year. The cost of treating these people is also enormous, in 1991 Medicare spent an estimated $2.9 billion for treatment and out-patient care of hip fractures, this number can only be expected to rise. Amino acid metabolism When more sulfur containing amino acids, methionine and cystine, are consumed than the body can use for growth and repair, they are broken down yielding sulfate, or sulfuric acid among other products. Animal foods such as meat, dairy, and eggs are high in protein and "dietary animal protein intake is highly correlated with renal net acid excretion". Research dating back to the early 1900s has shown correlations between high protein diets and increased acid excretion. One measure of the acidic or basic effects foods have in the body is Potential Renal Acid Load (PRAL). Cheeses with protein content of 15 g protein/100g or higher have a high PRAL value of 23.6 mEq/100 g edible portion. Meats, fish, other cheeses and flour or noodles all have a PRAL around 8.0 mEq/100 g edible portion, where fruits and vegetables actually have a negative PRAL. In healthy adults, bone undergoes constant repair and renewal. New bone is deposited by osteoblast cells and resorbed or destroyed by osteoclast cells. This addition and subtraction of bone usually yields no net change in the overall mass of the skeleton, but the turnover process can be significantly affected by pH. Bone mineral density Bone mineral density (BMD) is a measure commonly used to quantify bone health. A lower BMD value indicates an increased risk of an osteoporosis or a fracture. There is a large range of factors influencing BMD. Protein consumption has shown to be beneficial for bone density by providing amino acid substrates necessary for bone matrix formation. It is also thought that blood concentration of the bone formation stimulant, Insulin-like Growth Factor-I (IGF-I), is increased from high protein consumption and parathyroid hormone (PTH), a bone resorption stimulant, is decreased. Although protein has shown to be beneficial for increasing bone mass, or bone mineral density, there is no significant association between protein intake and fracture incidence. In other words, a low BMD can be predictive of osteoporosis and increased fracture risk, but a higher BMD does not necessarily mean better bone health. High BMD is also correlated with other health issues. For example, a higher BMD has also been associated with increased risk of breast cancer. Acid–base homeostasis Most metabolic processes have a specific and narrow range of pH where operation is possible, multiple regulatory systems are in place to maintain homeostasis. Fluctuations away from optimal operating pH can slow or impair reactions and possibly cause damage to cellular structures or proteins. To maintain homeostasis the body may excrete excess acid or base through the urine, via gas exchange in the lungs, or buffer it in the blood. The bicarbonate buffering system of blood plasma effectively holds a steady pH and helps to hold extracellular pH around 7.35. The kidneys are responsible for the majority of acid-base regulation but can excrete urine no lower than a pH of 5. This means that a 330mL can of cola, for example, usually ranging in pH from 2.8 to 3.2, would need to be diluted 100 fold before being excreted. Instead of producing 33L of urine from one can of cola, the body relies on buffer to neutralize the acid. Systemic acidosis can be the result of multiple factors, not just diet. Anaerobic exercise, diabetes, AIDS, aging, menopause, inflammation, infections, tumours, and other wounds and fractures all contribute to acidosis. Blood has an average pH of 7.40 but interstitial fluid can vary. Interstitial pH of the skin, for example, is ~7.1. There is no data available for bone. Homocysteine Homocysteine, a non-protein amino acid and analogue to the protein amino acid cystine, has been shown to have negative effects on bone health. Higher homocysteine concentrations are likely a result of folate, vitamin B12 B6 deficiencies. In addition, it was found that homocysteine concentration was significantly affected by physical activity. The stimulation of the skeleton through physical activity promotes positive bone remodelling and decreases levels of homocysteine, independently from nutritional intake. Four methods have been proposed regarding the interaction of homocysteine and bone; increase in osteoclast activity, decrease in osteoblast activity, decrease in bone blood flow, and direct action of homocysteine on bone matrix. Homocysteine inhibits lysyl oxidase which is responsible for post-translational modifications of collagen, a key component to bone structure Osteoclast cells Osteoclasts are located on the surface of bones and form resorption pits by excreting H+ to the bone surface removing hydroxyapatite, multiple bone minerals, and organic components: collagen and dentin. The purpose of bone resorption is to release calcium to the blood stream for various life processes. These resorption pits are visible under electron microscopy and distinctive trails are formed from prolonged resorption. Osteoclasts have shown to be "absolutely dependent on extracellular acidification". A drop in pH of <0.1 units can cause a 100% increase in osteoclast cell activity, this effect persists with prolonged acidosis with no desensitization, "amplifying the effects of modest pH differences". Osteoclast cells show little or no activity at pH 7.4 and are most active at pH 6.8 but can be further stimulated by other factors such as parathyroid hormone. Osteoblast cells Osteoblast are responsible for the mineralization and construction of bone matrix. They are responsible for the formation or production of bone tissue. The origin of the osteoblasts and osteoclasts is from primitive precursor cells found in bone marrow. Like osteoclast cells, osteoblast cell activity is directly related to extracellular pH mirroring of osteoclast activity. At pH 7.4, where osteoclasts are inactive, osteoblast are at peak activity. Likewise, at pH 6.9 osteoblast activity is non-existent. The hormone estrogen is also important for osteoblast regulation. In postmenopausal women estrogen levels are decreased which has negative effects on bone remodeling. Homocysteine further exacerbates this problem by reducing estrogen receptor α mRNA transcription. Thus reducing any beneficial effect that estrogen plays on bone remodeling. Bone balance Acidosis inhibits bone osteoblast matrix mineralization with reciprocal effect on osteoclast activation. The combined responses of these cells to acidosis maximizes the availability of hydroxyl ions in solution that can be used to buffer protons. The utilization of bone to buffer even a small percentage of daily acid production can lead to significant loss of bone mass in the course of a decade. Additionally, as the body ages there is a steady decline in renal function. Metabolic acidosis can become more severe as kidney function weakens, and the body will depend more heavily on bone and blood to maintain acid-base homeostasis. Diet There is no one food or nutrient capable of providing adequate bone health on its own. Instead, a balanced diet sufficient in fruits and vegetables for their vitamins, minerals, and alkalinizing substrates is thought to be most beneficial. High protein diets supply larger amounts of amino acids that could be degraded to acidic compounds. Protein consumption above the Recommended Dietary Allowance is also known to be beneficial to calcium utilization. Overall it is understood that high-protein diets have a net benefit for bone health because changes in IGF-I and PTH concentrations outweigh the negative effects of metabolic acid production. The source of protein, plant or animal, does not matter in terms of acid produced from amino acid metabolism. Any differences in methionine and cysteine content is not significant to affect the overall potential renal acid load (PRAL) of the food. In addition to their acid precursor protein content, plants also contain significant amounts of base precursors. Potassium bicarbonate, a basic salt, is produced via the metabolism of other organic potassium salts: citrate, malate, and gluconate, which are substantial in plants. The discrepancy observed in PRAL is accounted for by differences in base precursor content. See also Copper in health References Aging-associated diseases Endocrine diseases Osteopathies

Health scare

A health scare can be broadly defined as a social phenomenon whereby the public at large comes to fear some threat to health, based on suppositions which are nearly always not well-founded. In 2009, an ABC News article listed "The Top 10 Health Scares of the Decade": "Some of these threats turned out to be almost nonexistent. Others were arguably overblown. Some caused widespread harm." They listed the following scares: Swine flu (H1N1) Bisphenol A (BPA) Lead paint on toys from China Trans fats Bird flu (H5N1) Severe acute respiratory syndrome (SARS) Methicillin-resistant Staphylococcus aureus (MRSA) Hormone replacement therapy (HRT) Anthrax Cell phones. See also List of health scares Health crisis Aspartame controversy Dental amalgam controversy Thiomersal and vaccines Water fluoridation controversy COVID-19 References Fear Medical controversies

Acid mantle

The acid mantle is a very thin, delicate, slightly acidic film covering the entire surface of human skin, serving as a protective barrier against pathogens and reduces body odor. The acidic pH at the skin's surface mainly maintained by free amino acids and α-hydroxy acids (lactic acids) excreted from sweat; free fatty acids and amino acids from sebum; and urocanic acid and pyroglutamic acid. While the viable epidermis below the stratum corneum has a neutral pH of around 7.0, the surface pH of the skin's acid mantle typically ranges between 4.5 and 6.5, with an average assumption of 5.0 to 6.0. Formation and maintenance The acidic pH at the skin's surface is mainly maintained by free amino acids and α-hydroxy acids (lactic acids) excreted from sweat; free fatty acids and amino acids from sebum; and urocanic acid and pyroglutamic acid. Role The acid mantle, and its acidic pH, is important for the biological processes important for epidermal barrier function. Controversy on acidity Recent research has challenged these proposed ranges, finding that healthy human skin naturally tends to return to acidity levels below 5.0 when left untouched by skincare products or water for extended periods. An ideal pH value of 4.7 has been identified, with some individuals showing levels as low as 4.3. Subjects with a skin pH below 5.0 exhibited significantly less scaling, higher hydration levels, and better skin flora presence compared to those with higher pH levels, suggesting better overall skin condition. The acidic surface pH is crucial for the growth conditions of resident skin microbiota, which play a vital role in maintaining skin health. Human skin and its microbiota have a mutually beneficial symbiotic relationship, with the skin providing an optimal environment for resident microbiota while the microbiota help reinforce the skin's immunity by preventing colonization by harmful pathogens and contributing to skin acidification. Skin care products that lower skin pH to 4.0–4.5 help maintain resident microbiota on the skin, whereas alkaline personal care products promote their dispersal. References Skin anatomy

Paramedicine

In the United States, paramedicine is the physician-directed practice of medicine, often viewed as the intersection of health care, public health, and public safety. While discussed for many years, the concept of paramedicine was first formally described in the EMS Agenda for the Future. Paramedicine represents an expansion of the traditional notion of emergency medical services as simply an emergency response system. Paramedicine is the totality of the roles and responsibilities of individuals trained and credentialed as EMS practitioners. These practitioners have been referred to as various levels of emergency medical technician (EMTs). In the US, paramedics represent the highest practitioner level in this domain. Additional practitioner levels in this domain within the US include emergency medical responders (EMRs), emergency medical technicians (EMTs) and advanced emergency medical technicians (AEMTs). Profession A health profession focused on assisting individuals, families, and communities in the wake of acute or sudden onset of medical emergencies or traumatic events, paramedicine is practiced predominantly in the prehospital setting and is based on the sciences of human anatomy, physiology, and pathophysiology. The goal of paramedicine is to promote optimal quality of life from birth to end of life. In the United States, such regulated tasks as starting an IV, administering medication, and invasive procedures are performed under the direction of a licensed physician. In the United Kingdom, paramedics practice as independent clinicians under their own licence, as regulated by the Health and Care Professions Council, with complete autonomy to pronounce death, administer controlled drugs, and generally treat patients as they see fit. Theory Paramedicine is based on the emerging concept of paramedic theory, which is the study and analysis of how the three pillars of paramedicine (health care and medicine, public health, and public safety) interact and intersect. As stated in the IoM Report EMS at the Crossroads (2006), EMS is currently highly fragmented and largely separated from the overall health care system. A major emphasis of paramedic theory is the integration of emergency medical services, both intraprofessionally and extraprofessionally. Intraprofessional integration is the study of resource allocation, distribution, deployment and efficiency. Extraprofessional study involves the integration of EMS with the nation's existing (and future) emergency care and health care system. Other areas of inquiry in paramedic theory include emergency response, response planning, community education, transport medicine, disaster preparedness and response, emergency management, pandemic and epidemic, emergency response planning, special operations, and medical aspects of rescue. See also Allied health professions Alternative medicine Emergency medical services in the United States Emergency medical personnel in the United Kingdom Health science Paramedics in Australia Paramedics in Canada Paramedics in the United States References External links National Highway Traffic Safety Administration EMS Office National Association of Emergency Medical Technicians National Registry of Emergency Medical Technicians https://web.archive.org/web/20131113190248/http://www.ems.gov/EducationStandards.htm Emergency medical services

Diseases Database

The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. The database is run by Medical Object Oriented Software Enterprises Ltd, a company based in London. The site's stated aim is "education, background reading and general interest" with an intended audience "physicians, other clinical healthcare workers and students of these professions". The editor of the site is stated as Malcolm H Duncan, a UK qualified medical doctor. Organization The Diseases Database is based on a collection of about 8,500 concepts, called "items", related to human medicine including diseases, drugs, symptoms, physical signs and abnormal laboratory results. In order to link items to both each other and external information resources three sets of metadata are modelled within the database. Items are assigned various relationships e.g. diabetes mellitus type 2 is labelled "a risk factor for" ischaemic heart disease. More formally the database employs an entity-attribute-value model with items populating both entity and value slots. Relationships may be read in either direction e.g. the assertion "myocardial infarction {may cause} chest pain" has the corollary "chest pain {may be caused by} myocardial infarction". Such relationships aggregate within the database and allow lists to be retrieved - e.g. a list of items which may cause chest pain, and a list of items which may be caused by myocardial infarction. Most items are assigned topic specific hyperlinks to Web resources which include Online Mendelian Inheritance in Man, eMedicine and Wikipedia. Most items are mapped to concepts within the Unified Medical Language System (UMLS). UMLS links enable the display of short text definitions or Medical Subject Heading (MeSH) scope notes for the majority of items on the database. The UMLS map also enables links to and from other medical classifications and terminologies e.g. ICD-9 and SNOMED. References External links Medical databases in the United Kingdom Medical literature

Paricalcitol

Paricalcitol (chemically it is 19-nor-1,25-(OH)2-vitamin D2. Marketed by Abbott Laboratories under the trade name Zemplar) is a drug used for the prevention and treatment of secondary hyperparathyroidism (excessive secretion of parathyroid hormone) associated with chronic kidney failure. It is an analog of 1,25-dihydroxyergocalciferol, the active form of vitamin D2 (ergocalciferol). It was patented in 1989 and approved for medical use in 1998. Medical uses Its primary use in medicine is in the treatment of secondary hyperparathyroidism associated with chronic kidney disease. However a 2016 systematic review did not find evidence sufficient to demonstrate an advantage of paricalcitol over non-selective vitamin D derivatives for this indication. Adverse effects Adverse effects by frequency: Very common (>10% frequency): Nausea Common (1-10% frequency): Diarrhoea† Oedema Allergic reaction Arthritis Dizziness† Stomach discomfort‡ Gastroesophageal reflux disease† Acne† Hypercalcaemia† Hypocalcaemia† Hyperphosphataemia Decreased appetite† Headache Breast tenderness† Taste changes Hypoparathyroidism Vertigo Rash‡ Uncommon (0.1-1% frequency): Abnormal hepatic enzymes‡ Constipation‡ Dry mouth‡ Itchiness‡ Hives Hypersensitivity‡ Muscle spasms‡ Bleeding time prolonged Aspartate aminotransferase increased Laboratory test abnormal Weight loss Elevated blood creatinine Cardiac arrest Arrhythmia Atrial flutter Anaemia Leucopenia Lymphadenopathy Coma Stroke Transient ischemic attack Fainting Myoclonus Hypoaesthesia Paraesthesia Glaucoma Conjunctivitis Ear disorder Pulmonary oedema Asthma Shortness of breath Nose bleed Cough Rectal haemhorrhage Colitis Gastritis Indigestion Difficulty swallowing Gastrointestinal disorder Gastrointestinal haemorrhage Bullous dermatitis Hair loss Hirsutism Hyperhidrosis Joint pain Joint stiffness Back pain Muscle twitching Muscle aches Hyperparathyroidism Hyperkalaemia Hypocalcemia Breast cancer Sepsis Pneumonia Infection Pharyngitis Vaginal infection Influenza High blood pressure Hypotension Gait disturbance Injection site pain Fever Chest pain Condition aggravated Muscle weakness Malaise Thirst Breast pain Impotence Confusional state Delirium Depersonalization Agitation Insomnia Nervousness ‡ These are adverse effects only seen in patients with grade 3 or 4 chronic kidney disease. † These are adverse effects only seen in patients with grade 5 chronic kidney disease. Contraindications Contraindications include: Vitamin D intoxication Hypercalcaemia Hypersensitivity to paricalcitol or any of its excipients whereas cautions include: Impaired liver function It is also advised that physicians regularly monitor their patients' calcium and phosphorus levels. Interactions Drugs that may interact with paricalcitol include: Ketoconazole, as it may interfere with paricalcitol's metabolism in the liver. Digitoxin, hypercalcaemia due to any cause can exacerbate the toxicity of digitoxin. Thiazide diuretics or calcium supplements as hypercalcaemia may be induced by this combination Magnesium-containing products such as antacids may increase the risk of hypermagnesemia. Aluminium-containing products such as antacids may increase the risk of aluminium toxicity. Drugs that interfere with the absorption of fat-soluble vitamins, such as cholestyramine may interfere with the absorption of paricalcitol. Overdose Electrolyte abnormalities (e.g. hypercalcaemia and hyperphosphataemia) are common overdose symptoms. Treatment is mostly supportive, with particular attention being paid to correcting electrolyte anomalies and reducing intake of calcium in both the form of supplementation and diet. As it is so heavily bound to plasma proteins haemodialysis is unlikely to be helpful in cases of overdose. Early symptoms of overdose can include: Weakness Headache Somnolence Nausea Vomiting Dry mouth Constipation Muscle pain Bone pain Metallic taste in the mouth. It is worth noting, however, that may of these symptoms are also indicative of kidney failure and hence may be masked by the patient's condition. Late symptoms of overdose include: Loss of appetite Weight loss Conjunctivitis (calcific) Pancreatitis Photophobia Rhinorrhoea Pruritus Hyperthermia Decreased libido Elevated BUN Hypercholesterolaemia Elevated AST and ALT Ectopic calcification Hypertension Cardiac arrhythmias Somnolence Death Psychosis (rare) Mechanism of action Like 1,25-dihydroxyergocalciferol, paricalcitol acts as an agonist at the vitamin D receptor and thereby lowers parathyroid hormone levels in the blood. Pharmacokinetics The plasma concentration of paricalcitol decreases rapidly and log-linearly within two hours after initial intravenous administration. Therefore, it is not expected to accumulate with multiple dosing, since paricalcitol is usually given no more frequently than every other day (3 times per week). References Secosteroids Vitamin D Drugs developed by AbbVie

COT

A cot is a camp bed or infant bed. Cot or COT may also refer to: In arts and entertainment Chicago Opera Theater, an opera company In mathematics, science, and technology Car of Tomorrow, a car design used in NASCAR racing Cost of transport, an energy calculation Cottage developed from the word cot, which can be seen in various forms in other languages meaning a tent / hut e.g. Goahti and Kohte Cotangent, a trigonometric function, written as "cot" Cyclooctatetraene, an unsaturated hydrocarbon Finger cot, a hygienic cover for a single finger Chain-of-thought prompting, a method of engineering language model prompts In government and military use Colombian Time, the time zone used in Colombia (UTC−05:00) Comando de Operações Táticas, a Brazilian counter-terrorism force Commitments of Traders Report, US market report Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment, in the UK RAF Cottesmore Flying Training Unit, United Kingdom (ICAO airline designator) People Cot (surname) Cot Deal (1923–2013), American baseball pitcher and coach Other uses Coatesville station, Amtrak station code Cot Valley, Cornwall, England Cottingley railway station, National Rail station code Malbec grapes, known in the Loire Valley as Côt Club Olympique des Transports, a football club based in Tunis, Tunisia See also COTS (disambiguation) C0t analysis, a biochemical technique Khat, a drug

Human equivalent

The term human equivalent is used in a number of different contexts. This term can refer to human equivalents of various comparisons of animate and inanimate things. Animal models in chemistry and medicine Animal models are used to learn more about a disease, its diagnosis and its treatment, with animal models predicting human toxicity in up to 71% of cases. The human equivalent dose (HED) or human equivalent concentration (HEC) is the quantity of a chemical that, when administered to humans, produces an effect equal to that produced in test animals by a smaller dose. Calculating the HED is a step in carrying out a clinical trial of a pharmaceutical drug. Human energy usage and conversion The concept of human-equivalent energy (H-e) assists in understanding of energy flows in physical and biological systems by expressing energy units in human terms: it provides a “feel” for the use of a given amount of energy by expressing it in terms of the relative quantity of energy needed for human metabolism, assuming an average human energy expenditure of 12,500 kJ per day and a basal metabolic rate of 80 watts. A light bulb running at 100 watts is running at 1.25 human equivalents (100/80), i.e. 1.25 H-e. On the other hand, a human may generate as much as 1,000 watts for a task lasting a few minutes, or even more for a task of a few seconds' duration, while climbing a flight of stairs may represent work at a rate of about 200 watts. Animal attributes expressed in terms of human equivalents Cat and dog years The ages of domestic cats and dogs are often referred to in terms of "cat years" or "dog years", representing a conversion to human-equivalent years. One formula for cat years is based on a cat reaching maturity in approximately 1 year, which could be seen as 16 in human terms, then adding about 4 years for every year the cat ages. A 5-year-old cat would then be (5 − 1) × 4 + 16 = 32 "cat years" (i.e. human-equivalent years), and a 10-year-old cat (10 − 1) × 4 + 16 = 52 in human terms. See also Animal model Bioenergetics Energy conversion Energy quality Energy transformation Metabolism References Human power Measurement Medical terminology Metabolism Units of power Equivalent units

Cinchonism

Cinchonism is a pathological condition caused by an overdose of quinine or its natural source, cinchona bark. Quinine and its derivatives are used medically to treat malaria and lupus erythematosus. In much smaller amounts, quinine is an ingredient of tonic drinks, acting as a bittering agent. Cinchonism can occur from therapeutic doses of quinine, either from one or several large doses. Quinidine (a Class 1A anti-arrhythmic) can also cause cinchonism symptoms to develop with as little as a single dose. Signs and symptoms Signs and symptoms of mild cinchonism (which may occur from standard therapeutic doses of quinine) include flushed and sweaty skin, ringing of the ears (tinnitus), blurred vision, impaired hearing, confusion, reversible high-frequency hearing loss, headache, abdominal pain, rashes, drug-induced lichenoid reaction (lichenoid photosensitivity), vertigo, dizziness, nausea, vomiting and diarrhea. Large doses of quinine may lead to severe (but reversible) symptoms of cinchonism: skin rashes, deafness, somnolence, diminished visual acuity or blindness, anaphylactic shock, and disturbances in heart rhythm or conduction, and death from cardiotoxicity (damage to the heart). Quinine may also trigger a rare form of hypersensitivity reaction in malaria patients, termed blackwater fever, that results in massive hemolysis, hemoglobinemia, hemoglobinuria, and kidney failure. Most symptoms of cinchonism (except in severe cases) are reversible and disappear once quinine is withdrawn. Attempted suicide by intake of a large dose of quinine has caused irreversible tunnel vision and very severe visual impairment. Patients treated with quinine may also suffer from low blood sugar, especially if it is administered intravenously, and hypotension (low blood pressure). Quinine, like chloroquine, inactivates enzymes in the lysosomes of cells and has an anti-inflammatory effect, hence its use in the treatment of rheumatoid arthritis. However, inactivation of these enzymes can also cause abnormal accumulation of glycogen and phospholipids in lysosomes, causing toxic myopathy. It is possible this action is the root cause of cinchonism. References External links Quinine Poisoning by drugs, medicaments and biological substances

Biosignal

A biosignal is any signal in living beings that can be continually measured and monitored. The term biosignal is often used to refer to bioelectrical signals, but it may refer to both electrical and non-electrical signals. The usual understanding is to refer only to time-varying signals, although spatial parameter variations (e.g. the nucleotide sequence determining the genetic code) are sometimes subsumed as well. Electrical biosignals Electrical biosignals, or bioelectrical time signals, usually refers to the change in electric current produced by the sum of an electrical potential difference across a specialized tissue, organ or cell system like the nervous system. Thus, among the best-known bioelectrical signals are: Electroencephalogram (EEG) Electrocardiogram (ECG) Electromyogram (EMG) Electrooculogram (EOG) Electroretinogram (ERG) Electrogastrogram (EGG) Galvanic skin response (GSR) or electrodermal activity (EDA) EEG, ECG, EOG and EMG are measured with a differential amplifier which registers the difference between two electrodes attached to the skin. However, the galvanic skin response measures electrical resistance and the Magnetoencephalography (MEG) measures the magnetic field induced by electrical currents (electroencephalogram) of the brain. With the development of methods for remote measurement of electric fields using new sensor technology, electric biosignals such as EEG and ECG can be measured without electric contact with the skin. This can be applied, for example, for remote monitoring of brain waves and heart beat of patients who must not be touched, in particular patients with serious burns. Electrical currents and changes in electrical resistances across tissues can also be measured from plants. Biosignals may also refer to any non-electrical signal that is capable of being monitored from biological beings, such as mechanical signals (e.g. the mechanomyogram or MMG), acoustic signals (e.g. phonetic and non-phonetic utterances, breathing), chemical signals (e.g. pH, oxygenation) and optical signals (e.g. movements). Use in artistic contexts In recent years, the use of biosignals has gained interest amongst an international artistic community of performers and composers who use biosignals to produce and control sound. Research and practice in the field go back decades in various forms and have lately been enjoying a resurgence, thanks to the increasing availability of more affordable and less cumbersome technologies. An entire issue of eContact!, published by the Canadian Electroacoustic Community in July 2012, was dedicated to this subject, with contributions from the key figures in the domain. See also Bioindicator Biomarker Biosignature Molecular marker Multimedia information retrieval References Bibliography Donnarumma, Marco. "Proprioception, Effort and Strain in "Hypo Chrysos": Action art for vexed body and the Xth Sense." eContact! 14.2 — Biotechnological Performance Practice / Pratiques de performance biotechnologique (July 2012). Montréal: CEC. Tanaka, Atau. "The Use of Electromyogram Signals (EMG) in Musical Performance: A Personal survey of two decades of practice." eContact! 14.2 — Biotechnological Performance Practice / Pratiques de performance biotechnologique (July 2012). Montréal: CEC. External links Applications Using electroencephalograph signals for task classification and activity recognition Microsoft NASA scientists use hands-off approach to land passengers jet Hardware University of Vienna : cours Biomedical Engineering, Electromyography (EMG) Electroencephalographe,EEG, sans fil ( Cornell University, Ithaca, NY, USA) BITalino: DiY Biosignals Biology terminology Electrophysiology

Primary metabolite

A primary metabolite is a kind of metabolite that is directly involved in normal growth, development, and reproduction. It usually performs a physiological function in the organism (i.e. an intrinsic function). A primary metabolite is typically present in many organisms or cells. It is also referred to as a central metabolite, which has an even more restricted meaning (present in any autonomously growing cell or organism). Some common examples of primary metabolites include: lactic acid, and certain amino acids. Note that primary metabolites do not show any pharmacological actions or effects. Conversely, a secondary metabolite is not directly involved in those processes, but usually has an important ecological function (i.e. a relational function). A secondary metabolite is typically present in a taxonomically restricted set of organisms or cells (plants, fungi, bacteria, etc.). Some common examples of secondary metabolites include: ergot alkaloids, antibiotics, naphthalenes, nucleosides, phenazines, quinolines, terpenoids, peptides and growth factors. Plant growth regulators may be classified as both primary and secondary metabolites due to their role in plant growth and development. Some of them are intermediates between primary and secondary metabolism. See also Metabolism Metabolite Secondary metabolite Antimetabolite Metabolic control analysis, a specific kind of control analysis Metabolome Metabolomics — the study of global metabolites profile in a system (cell, tissue, or organism) under a given set of conditions Volatile organic compound References Metabolism

Scope of practice

Scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency. Each jurisdiction can have laws, licensing bodies, and regulations that describe requirements for education and training, and define scope of practice. In most jurisdictions, health care professions with scope of practice laws and regulations include any profession within health care that requires a license to practice such as physician assistants and nurses, among many others. Governing, licensing, and law enforcement bodies are often at the sub-national (e.g. state or province) level, but federal guidelines and regulations also often exist. For example, in the United States, the National Highway Traffic Safety Administration in the Department of Transportation has a national scope of practice for emergency medical services. See also Health care professional requisites Standing orders - scopes of practice are often defined in physicians' standing orders References Medical regulation Nursing regulation

Infantilism (physiological disorder)

In medicine, Infantilism is an obsolete term for various, often unrelated disorders of human development, up to developmental disability, which consist of retention of the physical and/or psychological characteristics of early developmental stages (infant, child) into a relatively advanced age. Various types of infantilism were recognized, lumped together in the above superficial description. With better understanding of the endocrine system and genetic disorders, various disorders which included the word "infantilism" received other names. For example, Brissaud's infantilism, described by Édouard Brissaud in 1907 is now known as myxedema (a form of hypothyroidism); "intestinal infantilism" of Christian Archibald Herter is called coeliac disease. The Turner syndrome was described as "a syndrome of infantilism" by Henry Turner himself. Terms such as "genital infantilism" (infantilism in development of genitals, hypogenitalism), or "sexual infantilism" (lack of sexual development after expected puberty or delayed puberty) may still be seen, and are considered to be synonyms of hypogonadism. "Somatic infantilism" refers to infantilism of overall bodily development. Speech infantilism is a speech disorder. Similarly to some other medical terms (cretinism, idiotism), "infantilism"/"infantile" may be used pejoratively (synonymous to "immature"). References Developmental disabilities

Molecular biophysics

Molecular biophysics is a rapidly evolving interdisciplinary area of research that combines concepts in physics, chemistry, engineering, mathematics and biology. It seeks to understand biomolecular systems and explain biological function in terms of molecular structure, structural organization, and dynamic behaviour at various levels of complexity (from single molecules to supramolecular structures, viruses and small living systems). This discipline covers topics such as the measurement of molecular forces, molecular associations, allosteric interactions, Brownian motion, and cable theory. Additional areas of study can be found on Outline of Biophysics. The discipline has required development of specialized equipment and procedures capable of imaging and manipulating minute living structures, as well as novel experimental approaches. Overview Molecular biophysics typically addresses biological questions similar to those in biochemistry and molecular biology, seeking to find the physical underpinnings of biomolecular phenomena. Scientists in this field conduct research concerned with understanding the interactions between the various systems of a cell, including the interactions between DNA, RNA and protein biosynthesis, as well as how these interactions are regulated. A great variety of techniques are used to answer these questions. Fluorescent imaging techniques, as well as electron microscopy, X-ray crystallography, NMR spectroscopy, atomic force microscopy (AFM) and small-angle scattering (SAS) both with X-rays and neutrons (SAXS/SANS) are often used to visualize structures of biological significance. Protein dynamics can be observed by neutron spin echo spectroscopy. Conformational change in structure can be measured using techniques such as dual polarisation interferometry, circular dichroism, SAXS and SANS. Direct manipulation of molecules using optical tweezers or AFM, can also be used to monitor biological events where forces and distances are at the nanoscale. Molecular biophysicists often consider complex biological events as systems of interacting entities which can be understood e.g. through statistical mechanics, thermodynamics and chemical kinetics. By drawing knowledge and experimental techniques from a wide variety of disciplines, biophysicists are often able to directly observe, model or even manipulate the structures and interactions of individual molecules or complexes of molecules. Areas of Research Computational biology Computational biology involves the development and application of data-analytical and theoretical methods, mathematical modeling and computational simulation techniques to the study of biological, ecological, behavioral, and social systems. The field is broadly defined and includes foundations in biology, applied mathematics, statistics, biochemistry, chemistry, biophysics, molecular biology, genetics, genomics, computer science and evolution. Computational biology has become an important part of developing emerging technologies for the field of biology. Molecular modelling encompasses all methods, theoretical and computational, used to model or mimic the behaviour of molecules. The methods are used in the fields of computational chemistry, drug design, computational biology and materials science to study molecular systems ranging from small chemical systems to large biological molecules and material assemblies. Membrane biophysics Membrane biophysics is the study of biological membrane structure and function using physical, computational, mathematical, and biophysical methods. A combination of these methods can be used to create phase diagrams of different types of membranes, which yields information on thermodynamic behavior of a membrane and its components. As opposed to membrane biology, membrane biophysics focuses on quantitative information and modeling of various membrane phenomena, such as lipid raft formation, rates of lipid and cholesterol flip-flop, protein-lipid coupling, and the effect of bending and elasticity functions of membranes on inter-cell connections. Motor proteins Motor proteins are a class of molecular motors that can move along the cytoplasm of animal cells. They convert chemical energy into mechanical work by the hydrolysis of ATP. A good example is the muscle protein myosin which "motors" the contraction of muscle fibers in animals. Motor proteins are the driving force behind most active transport of proteins and vesicles in the cytoplasm. Kinesins and cytoplasmic dyneins play essential roles in intracellular transport such as axonal transport and in the formation of the spindle apparatus and the separation of the chromosomes during mitosis and meiosis. Axonemal dynein, found in cilia and flagella, is crucial to cell motility, for example in spermatozoa, and fluid transport, for example in trachea. Some biological machines are motor proteins, such as myosin, which is responsible for muscle contraction, kinesin, which moves cargo inside cells away from the nucleus along microtubules, and dynein, which moves cargo inside cells towards the nucleus and produces the axonemal beating of motile cilia and flagella. "[I]n effect, the [motile cilium] is a nanomachine composed of perhaps over 600 proteins in molecular complexes, many of which also function independently as nanomachines...Flexible linkers allow the mobile protein domains connected by them to recruit their binding partners and induce long-range allostery via protein domain dynamics. Other biological machines are responsible for energy production, for example ATP synthase which harnesses energy from proton gradients across membranes to drive a turbine-like motion used to synthesise ATP, the energy currency of a cell. Still other machines are responsible for gene expression, including DNA polymerases for replicating DNA, RNA polymerases for producing mRNA, the spliceosome for removing introns, and the ribosome for synthesising proteins. These machines and their nanoscale dynamics are far more complex than any molecular machines that have yet been artificially constructed. These molecular motors are the essential agents of movement in living organisms. In general terms, a motor is a device that consumes energy in one form and converts it into motion or mechanical work; for example, many protein-based molecular motors harness the chemical free energy released by the hydrolysis of ATP in order to perform mechanical work. In terms of energetic efficiency, this type of motor can be superior to currently available man-made motors. Richard Feynman theorized about the future of nanomedicine. He wrote about the idea of a medical use for biological machines. Feynman and Albert Hibbs suggested that certain repair machines might one day be reduced in size to the point that it would be possible to (as Feynman put it) "swallow the doctor". The idea was discussed in Feynman's 1959 essay "There's Plenty of Room at the Bottom". These biological machines might have applications in nanomedicine. For example, they could be used to identify and destroy cancer cells. Molecular nanotechnology is a speculative subfield of nanotechnology regarding the possibility of engineering molecular assemblers, biological machines which could re-order matter at a molecular or atomic scale. Nanomedicine would make use of these nanorobots, introduced into the body, to repair or detect damages and infections. Molecular nanotechnology is highly theoretical, seeking to anticipate what inventions nanotechnology might yield and to propose an agenda for future inquiry. The proposed elements of molecular nanotechnology, such as molecular assemblers and nanorobots are far beyond current capabilities. Protein folding Protein folding is the physical process by which a protein chain acquires its native 3-dimensional structure, a conformation that is usually biologically functional, in an expeditious and reproducible manner. It is the physical process by which a polypeptide folds into its characteristic and functional three-dimensional structure from a random coil. Each protein exists as an unfolded polypeptide or random coil when translated from a sequence of mRNA to a linear chain of amino acids. This polypeptide lacks any stable (long-lasting) three-dimensional structure (the left hand side of the first figure). As the polypeptide chain is being synthesized by a ribosome, the linear chain begins to fold into its three-dimensional structure. Folding begins to occur even during the translation of the polypeptide chain. Amino acids interact with each other to produce a well-defined three-dimensional structure, the folded protein (the right-hand side of the figure), known as the native state. The resulting three-dimensional structure is determined by the amino acid sequence or primary structure (Anfinsen's dogma). Protein structure determination As the three-dimensional structure of proteins brings with it an understanding of its function and biological context, there is great effort placed in observing the structures of proteins. X-ray crystallography was the primary method used in the 20th century to solve the structures of proteins in their crystalline form. Ever since the early 2000s, cryogenic electron microscopy has been used to solve the structures of proteins closer to their native state, as well as observing cellular structures. Protein structure prediction Protein structure prediction is the inference of the three-dimensional structure of a protein from its amino acid sequence—that is, the prediction of its folding and its secondary and tertiary structure from its primary structure. Structure prediction is fundamentally different from the inverse problem of protein design. Protein structure prediction is one of the most important goals pursued by bioinformatics and theoretical chemistry; it is highly important in medicine, in drug design, biotechnology and in the design of novel enzymes). Every two years, the performance of current methods is assessed in the CASP experiment (Critical Assessment of Techniques for Protein Structure Prediction). A continuous evaluation of protein structure prediction web servers is performed by the community project CAMEO3D. The challenge in predicting protein structures is that there lacks a physical model that can fully predict protein tertiary structures from their amino acid sequence. This problem is known as the de novo protein structure prediction problem and is one of the great problems of modern science. AlphaFold, an artificial intelligence program, is able to accurately predict the structures of proteins with genetic homology to other proteins that have been previously solved. Though, this is not a solution to the de novo problem, as it relies on a database of prior data which results in it always being biased. The solution to the de novo protein structure prediction problem must be a purely physical model that will simulate the protein folding in its native environment, resulting in the in silico observation of protein structures and dynamics that were never previously observed. Spectroscopy Spectroscopic techniques like NMR, spin label electron spin resonance, Raman spectroscopy, infrared spectroscopy, circular dichroism, and so on have been widely used to understand structural dynamics of important biomolecules and intermolecular interactions. See also Small angle scattering Biophysical chemistry Biophysics Biophysical Society Cryo-electron microscopy (cryo-EM) Dual-polarization interferometry and circular dichroism Electron paramagnetic resonance (EPR) European Biophysical Societies' Association Index of biophysics articles List of publications in biology – Biophysics List of publications in physics – Biophysics List of biophysicists Outline of biophysics Mass spectrometry Medical biophysics Membrane biophysics Multiangle light scattering Neurophysics Nuclear magnetic resonance spectroscopy of proteins (NMR) Physiomics Proteolysis Ultrafast laser spectroscopy Virophysics Macromolecular crystallography References

Organomegaly

Organomegaly is the abnormal enlargement of organs. For example, cardiomegaly is enlargement of the heart. Visceromegaly is the enlargement of abdominal organs. Examples of visceromegaly are enlarged liver (hepatomegaly), spleen (splenomegaly), stomach, kidneys, and pancreas. Definitions for various organs Values refer to adults unless otherwise specified. References Medical signs Symptoms and signs: Digestive system and abdomen

MSA

MSA or M.S.A. may refer to: Organizations and businesses Public services and agencies China Maritime Safety Administration, a PRC Coast Guard Maritime Safety Agency, now the Japan Coast Guard Indonesian Maritime Security Agency Pakistan Maritime Security Agency Mutual Security Agency, established by the U.S. Mutual Security Act (1951), and distributed aid to Europe after the Marshall Plan Academic Metaphysical Society of America, a society promoting the study of philosophy and metaphysics Microscopy Society of America, a society for the promotion of microscopy Mineralogical Society of America, an organization for the advancement of mineralogy Mycological Society of America, a society promoting the study of fungi Commercial Malaysia–Singapore Airlines, the former name for Singapore Airlines and Malaysia Airlines Masonic Service Association, a Freemasonry publishing resource Master service agreement, a master agreement defining services to be delivered Mine Safety Appliances, a manufacturer of industrial safety clothing and equipment ICAO code for Poste Air Cargo Other Maine Snowmobile Association, the snowmobile association of Maine Motor Sports Association, the governing body for motorsport in the United Kingdom Mad Science Alliance, a fictional organization in and the working title of the 2008 role-playing game Monster Lab Movement for the Salvation of Azawad Education Degrees Master of Advanced Studies in Sports Administration, a sports management degree Master of Accountancy, an accounting degree Master of Science in Administration, a degree providing preparation for administrative positions Schools and societies Mackintosh School of Architecture, an architecture school in Glasgow, Scotland Manchester School of Architecture, an architecture school in Manchester, England Middle States Association of Colleges and Schools, an evaluation and accreditation association Minnesota Math and Science Academy, a school in Minnesota Mississippi School of the Arts, a high school in Brookhaven, Mississippi Missouri Scholars Academy, a summer program at the University of Missouri Montessori School of Anderson, a private school in Anderson, South Carolina MSA Mutfak Sanatlari Akademisi, a culinary arts institute in Istanbul, Turkey Modern Sciences and Arts University, a university in October City, Egypt Muslim Students' Association, a group dedicated to Islamic societies on college campuses in Canada and the United States Science and medicine 5-Methoxysalicylic acid, a chemical compound used as a matrix in MALDI mass spectrometry Mannitol salt agar, an agar used in microbiology Measurement systems analysis, the analysis of the process of obtaining measurements Methanesulfonic acid, an organic sulfonic acid Middle Stone Age, a period of African prehistory Multiple sequence alignment, an alignment of three or more biological sequences Multiple system atrophy, a degenerative neurological disorder Multiscale approximation or multiresolution analysis Morphosyntactic alignment (linguistics) Technology Message submission agent, a computer program used when sending email Microsoft Access, a database management system Microsoft Account, a single sign-on web service Mobile Service Architecture, a combination of Java ME extensions Multi-source agreement, an agreement between multiple manufacturers to make products which are compatible across vendors Measurement systems analysis, in quality management a specially designed experiment that seeks to identify the components of variation in the measurement Microservice architecture, Considered by some as a variant of the service-oriented architecture (SOA), it is a method of developing software applications as a suite of independently deployable, small, modular services Transportation WAGR Msa class, a class of steam locomotive of the Western Australian Government Railways Minimum safe altitude, used for safely navigating aircraft over terrain or large structures Motorway service area, a public rest area Muskrat Dam Airport, an airport at Muskrat Dam, Ontario, Canada (IATA code) Other uses Magnuson-Stevens Act, common alternate abbreviation of 1976 Magnuson–Stevens Fishery Conservation and Management Act (MSFCMA) Mainland Southeast Asia linguistic area, a sprachbund in Southeast Asia Malay language, in the ISO 639-2 and ISO 639-3 language code Mapping Services Agreement, a licensing contract between local authorities in the United Kingdom and suppliers of geographic data Matthew Shepard Act, 2009 United States federal hate-crime legislation Market Square Arena, an indoor arena in Indianapolis, Indiana, demolished in 2001 Medical savings account, a tax-deferred deposit account for medical expenses Meritorious Service Award, an award of the Civil Air Patrol in the United States Metropolitan statistical area, a geographical area associated with an urban area of 50,000 people or more, as defined by the United States Office of Management and Budget Micropolitan statistical area, a geographical area associated with an urban area of 10,000 to 49,999 people, as defined by the United States Office of Management and Budget Modern Standard Arabic, also known as Literary Arabic, the standard and literary variety of Arabic used in writing and in most formal speech Tobacco Master Settlement Agreement, an agreement reached between U.S. states and major tobacco companies MSA Kyotei, a Japanese abbreviation in reference to U.S. and Japan Mutual Defense Assistance Agreement

Travel medicine

Travel medicine or emporiatrics is the branch of medicine that deals with the prevention and management of health problems of international travelers. Globalization and travel Globalization facilitates the spread of disease and increases the number of travelers who will be exposed to a different health environment. Major content areas of travel medicine include the global epidemiology of health risks to the traveler, vaccinology, malaria prevention, and pre-travel counseling designed to maintain the health of the approximately 600 million international travelers. It has been estimated that about 80 million travelers go annually from developed to developing countries. Mortality and morbidity Mortality studies indicate that cardiovascular disease accounts for most deaths during travel (50–70%), while injury and accident follow (~25%). Infectious disease accounts for about 2.8–4% of deaths during/from travel. Morbidity studies suggest that about half of people from a developed country who stay one month in a developing country will get sick. Traveler's diarrhea is the most common problem encountered. Disciplines The field of travel medicine encompasses a wide variety of disciplines including epidemiology, infectious disease, public health, tropical medicine, high altitude physiology, travel related obstetrics, psychiatry, occupational medicine, military and migration medicine, and environmental health. Special itineraries and activities include cruise ship travel, diving, mass gatherings (e.g. the Hajj), and wilderness/remote regions travel. Travel medicine can primarily be divided into four main topics: prevention (vaccination and travel advice), assistance (dealing with repatriation and medical treatment of travelers), wilderness medicine (e.g. high-altitude medicine, cruise ship medicine, expedition medicine, etc.) and access to health care, provided by travel insurance. Focus Travel medicine includes pre-travel consultation and evaluation, contingency planning during travel, and post-travel follow-up and care. Information is provided by the WHO that addresses health issues for travelers for each country as well as the specific health risks of air travel itself. Also, the CDC publishes valuable and up-to-date information. Key areas to consider are vaccination and the seven I's: Insects: repellents, mosquito nets, antimalarial medication Ingestions: safety of drinking water, food Indiscretion: HIV, sexually transmitted disease Injuries: accident avoidance, personal safety, safety around animals Immersion: schistosomiasis Immunization (pre-travel vaccination) Insurance: coverage and services during travel, access to health care Specific disease problems Yellow fever is endemic to certain areas in Africa and South America. The CDC site delineates the risk areas and provides information about vaccination and preventive steps. Meningococcal meningitis is endemic in the tropical meningococcal belt of Africa. Vaccination is required for pilgrims going to Mecca. Detailed information is available on the CDC site. Malaria prevention consists of preventing or reducing exposure to mosquitos by using screened rooms, air-conditioning, and nets, and use of repellents (usually DEET). In addition, chemoprophylaxis is started before travel, during the time of potential exposure, and for four weeks (chloroquine, doxycycline, or mefloquine) or seven days (atovaquone/proguanil or primaquine) after leaving the risk area. Medication kit The traveler should have a medication kit to provide for necessary and useful medication. Based on circumstances, it should also include malaria prophylaxis, condoms, and medication to combat traveler's diarrhea. In addition, a basic first aid kit can be of use. Studies have shown there are four main medical problems that travellers develop—diarrhoea or gut problems, respiratory problems, wounds and pain. The medical kit should at least address these common things. Research has also shown that the best treatment for travellers diarrhoea is to take an antibiotic (e.g. ciprofloxacin) plus a stopper (e.g. loperamide). Due to bacterial resistance, different parts of the world require different antibiotics. It is best to consult a travel doctor to sort out the best medical kit for the exact destination and medical history of the person travelling. See also Air travel American Society of Tropical Medicine and Hygiene International Certificate of Vaccination or Prophylaxis Global Infectious Disease Epidemiology Network (GIDEON) Health hazards of air travel Institute of Tropical Medicine Antwerp International health Jet lag Royal Society of Tropical Medicine and Hygiene Tropical disease Walter Reed Tropical Medicine Course – Silver Spring, Maryland, US Wilderness acquired diarrhea Expedition medicine References External links CDC Travelers' Health – includes information on destinations, outbreaks, and recommended or required vaccinations International Association for Medical Assistance to Travellers (IAMAT) International Society of Travel Medicine WHO – List of Country Members – includes information on outbreaks and health profiles (archived 21 August 2004) Medical specialties Travel

Reproductive toxicity

Reproductive toxicity refers to the potential risk from a given chemical, physical or biologic agent to adversely affect both male and female fertility as well as offspring development. Reproductive toxicants may adversely affect sexual function, ovarian failure, fertility as well as causing developmental toxicity in the offspring. Lowered effective fertility related to reproductive toxicity relates to both male and female effects alike and is reflected in decreased sperm counts, semen quality and ovarian failure. Infertility Infertility is medically defined as a failure of a couple to conceive over the course of one year of unprotected intercourse. Primary infertility indicates that a person has never been able to achieve pregnancy while secondary inferility is defined as a person having at least one pregnancy before. As many as 20% of couples experience infertility. Infertility may be caused by an issue along any part of the process of fertilizing an egg through birth of the child. This can include: the release of the egg, the ability of the sperm to fertilize the egg, the implantation of the egg in the uterine wall, and the ability of the fetus to complete development without miscarriage. Among males oligospermia is defined as a paucity of viable spermatozoa in the semen, whereas azoospermia refers to the complete absence of viable spermatozoa in the semen. Males may also experience issues in sperm motility and morphology, which means the sperm are less likely to make it to the egg or to be able to fertilize the egg. Female infertility could be a result of an issue regarding their uterus, ovaries, or fallopian tubes and can be impacted by various diseases, endocrine/hormone disruption, or reproductive toxicant. The Globally Harmonized System of Classification and Labelling of Chemicals (GHS) separates reproductive toxicity from germ cell mutagenicity and carcinogenicity, even though both these hazards may also affect fertility. Effects Many drugs can affect the human reproductive system. Their effects can be desired (hormonal contraception), a minor unwanted side effect (many antidepressants) or a major public health problem (thalidomide). However, most studies of reproductive toxicity have focused on occupational or environmental exposure to chemicals and their effects on reproduction. Both consumption of alcohol and tobacco smoking are known to be "toxic for reproduction" in the sense used here. One well-known group of substances which are toxic for reproduction are teratogens – substances which cause birth defects. (S)-thalidomide is possibly the most notorious of these. Another group of substances which have received much attention (and prompted some controversy) as possibly toxic for reproduction are the so-called endocrine disruptors. Endocrine disruptors change how hormones are produced and how they interact with their receptors. Endocrine disruptors are classified as estrogenic, anti-estrogenic, androgenic or anti-androgenic. Each category includes pharmaceutical compounds and environmental compounds. Estrogenic or androgenic compounds will cause the same hormonal responses as the sex steroids (estrogen and testosterone). However anti-estrogenic and anti-andogenic compounds bind to a receptor and block the hormones from binding to their receptors, thus preventing their function. A few examples of the many types of endocrine disruptors are trenbolone (androgenic), flutamide (anti-androgenic), diethylstilbestrol (estrogenic), bisphenol A (estrogenic) and tributyltin (anti-estrogenic). However, many substances which are toxic for reproduction do not fall into any of these groups: lead compounds, for example, are considered to be toxic for reproduction given their adverse effects on the normal intellectual and psychomotor development of human babies and children. Examples Heavy metals Lead Lead, a heavy metal that can exist in both organic and inorganic forms, and is associated with adverse effects on male libido, erectile disfunction, premature ejaculation and poor sperm quality. Lead is also associated with negative effects on the female reproductive system particularly for pregnant people. Elevated blood lead levels can increase risk of preeclampsia and miscarriage and can lead to birth defects. Lead is believed to predominantly affect male reproduction by the disruption of hormones, which reduces the quantity of sperm production in the seminiferous tubules. It has also been proposed that lead causes poor semen quality by increasing reactive oxygen species due to lipid per-oxidation, leading to cellular damage. Lead can be found in contaminated soil, water, as well as manufactured goods like jewelry, toys, and paint. Common routes of exposure are inhalation and digestion, though dermal exposure can occur albeit less frequently. Occupational exposures remain a high risk, particularly for industries such as battery/electronic recycling, construction, mining, smelting, and welders or any other industry which interacts with lead. Families and cohabitants of the above workers may be at risk of take-home exposure and may need to take precautions to avoid reproductive impacts. Cadmium Cadmium is a heavy metal used in jewelry making, electronics, welding and galvanizing steel. The human route of exposure is primarily inhalational or oral; environmental exposure among the non-occupationally exposed can occur due to exposure to cigarette smoking. The oral route of exposure can occur due to ingesting plants and shellfish that have taken up cadmium from water and soil. Exposure to cadmium results in adverse male fertility in terms of decreased spermatogenesis, semen quality, sperm motility and impaired hormonal synthesis. Likewise, exposure to cadmium impairs female fertility in terms of menstrual cycle regularity and reproductive hormonal balance. Cadmium exposure can negatively impact fetal development throughout the gestation as well as ovulation and implantation. Chromium Hexavalent chromium ( Cr VI) is used in the electronics industry and for metal plating. Chromium exposure is primarily inhalation or through ingestion. Human and animal studies show that exposure to hexavalent chromium decreases semen quality and sperm counts. Mercury Elemental mercury( Hg0) is a metal that exists as liquid form at room temperature and is commonly found in thermometers, blood pressure cuffs and dental amalgams. In terms of exposure, the route of absorption is primarily via inhalation through mercury vapor, which can in turn lead to mercury poisoning. Occupational exposure to inorganic mercury can occur in industries such as dentistry, fluorescent lamp production, and Chloralkali workers. Data among female dental technicians exposed to mercury vapors have demonstrated decreased fertility among those who were exposed and practiced poor industrial hygiene while handling dental amalgams. Elemental and organic mercury can cross the blood brain barrier, like many other heavy metals, making it particularly significant for pregnant people as it can impact fetal development and birth outcomes. Among female workers in mercury smelting plants an increase in spontaneous abortions has been reported. Dibromochloropropane Dibromochloropropane (DBCP) is used as a pesticide against nematodes in the agricultural industry. DBCP is one of the most well-known reproductive toxicants known to cause testicular toxicity. Workers in chemical factories exposed to dibromochloropropane have been shown to develop dose-dependent oligospermia and azoospermia. Additional studies also demonstrated that DBCP-exposed workers in banana and pineapple plantations in central America and other countries also developed oligospermia and azoospermia. In 1977, the United States Environmental Protection Agency banned the use of DBCP in agriculture due to its effect on male fertility. Despite being banned from use in agriculture, DBCP is still used as an intermediate in chemical manufacturing as well as a reagent in research. Ethylene dibromide Ethylene dibromide (EDB) is a fumigant that was originally used to protect citrus fruits, grains and vegetables from insects. Use of EDB in the United States was banned by the United States Environmental Protection Agency in 1984, however EDB is still used in the United States as fumigant to treat timber logs for beetles and termites. Likewise, it is still used as an intermediate in chemical manufacturing. Exposure to EDB has been shown to adversely affect male fertility by leading to a decreased sperm counts, decreased numbers of viable sperm and increased abnormal sperm morphology. The primary route of exposure is through inhalation. Industrial solvents Solvent exposure is common among men and women working in industrial settings. Specific solvents including xylene, perchloroethylene, toluene and methylene chloride have been shown to be associated with a concurrent elevation in risk for spontaneous abortion Ionizing radiation Ionizing radiation in the form alpha, beta and gamma emissions are well known to adversely affect male and female fertility, as well as fetal development. Exposure to low doses of ionizing radiation can occur naturally in the environment or due to medical treatment or diagnosis, however, higher exposures may be associated with occupation. Occupations with documented risk include: healthcare workers who interact with radioactive material, certain manufacturing processes, and airline personnel. Exposure in the range of 0.1 to1.2 Gy is associated with spermatogonial injury; whereas between 4-6 Gy reductions of sperm counts have been reported. Ionizing radiation is considered a hazard particularly in pregnancy, due to its potential impact of gestational development. More specifically, ionizing radiation is associated with an increased risk of miscarriage and stillbirth. Recent studies suggest that routine medical examinations that expose a pregnant person to ionizing radiation are not associated with an increase of risk of miscarriage or stillbirth. Radio frequency electromagnetic fields Radio frequency electromagnetic fields, such as those generated from mobile phone devices, have been shown to decrease semen quality production in experimental animal models; however human data is still equivocal at best. The International Association for the Research of Cancer(IARC) classifies radio frequency electromagnetic fields as a group 2B or possibly carcinogenic. Endocrine disrupting compounds Lipid soluble compounds that can cross the cell lipid bilayer and bind cytoplasmic steroid hormone receptors can translocate to the nucleus and act as estrogen agonists. Diethylstilbestrol (DES), a synthetic estrogen, is one such endocrine disruptor and acts as an estrogen agonist. Diethylstilbestrol was used from 1938 to 1971 to prevent spontaneous abortions. Diethylstilbestrol causes cancer and mutations by producing highly reactive metabolites, also causing DNA adducts to form. Exposure to diethylstilbestrol in the womb can cause atypical reproductive tract formation. Specifically, females exposed to diethylstilbestrol in utero during the first trimester have are more likely to develop clear cell vaginal carcinoma, and males have an increased risk of hypospadias. Bisphenol A Bisphenol A (BPA) is used in polycarbonate plastic consumer goods and aluminum can liners. BPA is an example of an endocrine disruptor which negatively affects reproductive development by acting as an estrogen mimicker (xenoestrogen) and a likely androgen mimicker. Bisphenol A exposure in fetal female rats leads to mammary gland morphogenesis, increased formation of ovarian tumors, and increased risk of developing mammary gland neoplasia in adult life. In lab animal models, BPA is considered to be both an ovarian and uterine toxicant as it impairs endometrial proliferation, decreases uterine receptivity and decreases the chances for successful implantation of the embryo The adverse reproductive toxicological impacts of bisphenol A have been better studied in females than in males. Antineoplastic Drugs (Chemotherapy) Antineoplastic drugs, commonly known as chemotherapy drugs, are considered hazardous drugs by the CDC, including hazardous to reproductive health. Exposure to chemotherapy drugs most often occurs through treatment for cancer, however, unintentional occupational exposure may occur in for workers involved in pharmaceutical production, pharmacists or technicians preparing the drugs, and nurses or other healthcare professionals who are administering medication to patients. Other hospital staff, particularly custodial workers, who interact or handle antineoplastic drugs in any capacity may also be at risk of exposure. Exposure can occur through inhalation, skin contact, ingestion, or injection. Non-Chemical Toxicants Work Schedule Work schedule can become a reproductive toxicant when working hours are during the employee's typical sleeping hours (night shift), when a worker has an irregular work schedule (shift work) or long working hours. Work schedule's reproductive toxicity is primarily a result of impact on regularity, quality, and rhythm of sleep. Shift work is associated with menstrual disorders, which can in turn impact fertility. Irregular work schedule, working long hours, and working the night shift is associated with an increased risk of miscarriage and pre-term birth. Many occupations engage in shift work, including requiring rotating work schedules, long hours, or night shift work. Some occupations that frequently engage in shift work include first responders, airline personnel, healthcare workers, and service workers. The CDC estimates that fifteen-million Americans engage in shift work and 30% get less than six-hours of sleep. Physical Demands Physical demands can include bending, lifting, and standing. Physical demands are considered a reproductive toxicant as they can increase the risk of adverse outcomes during pregnancy. Bending, lifting, and standing are often associated with occupational responsibilities as the risk is minimal unless physical activity is prolonged. Standing and walking for more than three hours a day is associated with an increased risk of pre-term birth, while standing for six to eight hours a day is associated with an increased risk of miscarriage. The weight and frequency of lifting is also associated with increased risk of miscarriage and preterm birth, with estimates of loads over 10 kg, or frequency a cumulative 100 kg/day. Noise Noise is considered a reproductive toxicant due to its potential impact on fetal development during pregnancy. While pregnant people may be able to use proper hearing protection to conserve their own hearing, after the 20th week of development babies' ears are susceptible to hearing loss. Pregnant people who are past 20 weeks of development should consider avoiding noises above 85 decibels, including at work and recreational activities. See also Developmental toxicity CLP regulation Lead toxicity Mercury poisoning References Further reading Chemical safety Developmental biology Occupational safety and health

Spongiosis

Spongiosis is mainly intercellular edema (abnormal accumulation of fluid) in the epidermis, and is characteristic of eczematous dermatitis, manifested clinically by intraepidermal vesicles (fluid-containing spaces), "juicy" papules, and/or lichenification. It is a severe case of eczema that affects the epidermis, dermis or subcutaneous skin tissues. The three types of spongiotic dermatitis are acute, subacute and chronic. A dermatologist can diagnose acute spongiotic dermatitis by examining the skin during an office visit, but a biopsy is needed for an accurate diagnosis of the type. It can be caused by several internal or external factors, such as food, an insect bite, stress, medication or cosmetics. The treatment varies depending on the type and severity; it is normally treated with topical corticosteroid cream. See also Skin lesion Skin disease List of skin diseases References Dermatologic terminology

CMF

CMF, a three letter abbreviation, may stand for: Entertainment Campus MovieFest, the world's largest student film festival Chern Medal Foundation, an organization that bestows the Chern Medal Award in mathematics Military Central Mediterranean Forces, the British component of the Mediterranean theatre of World War II Citizen Military Forces (1943–1980), became Australian Army Reserve Combined Maritime Forces, a multi-national naval force Religion Christian Missionary Fellowship International (CMF International, formerly CMF), a non-denominational Christian missionary Claretians, Roman Catholic religious order, 'CMF' is used as a post nominal Science and technology CMF (chemotherapy), a chemotherapy regimen commonly used in treating breast cancer Centre of mass frame in mechanics Chaikin Money Flow, a technical stock chart indicator Color matching fields or functions, a triplet of spectral sensitivity curves in color vision modeling. See CIE 1931 color space#Color matching functions Common Monomial Factor, the factored form of a polynomial, also known as the greatest common divisor of two polynomials Composite metal foam, a type of metal foam formed from hollow beads of one metal within a solid matrix of another Content management framework for customizing management of media content Cranio-maxillofacial surgery, involves the correction of congenital and acquired conditions of the head and face. Creative Music File, an AdLib/MIDI hybrid music format developed by Creative Labs Critical Manufacturing, a spin-off company of Critical Software Cymomotive force, a measurement of radiated power or signal strength from an antenna 5-Chloromethylfurfural, an organochlorine compound obtained from fructose Renault–Nissan Common Module Family, a modular automobile platform developed by Renault–Nissan Alliance Crash Modification Factor, a way of predicting the change in safety for roadway design changes Society and law California Medical Facility, a male-only state prison in California Canada Media Fund, a not-for-profit public-private partnership which financially supports the creation of Canadian television and new media Certificate of Management Fundamentals, a professional certification from the Commonwealth of Kentucky Chambéry Airport (IATA: CMF), in Savoie, France Christian Medical Fellowship, an evangelical, interdenominational organisation that links together Christian doctors and medical students in the UK Country Music Foundation, a non-profit, educational organisation, operating The Country Music Hall of Fame and Museum Other Chaikin Money Flow City Music Foundation, a music charity in the City of London, England CMF by Nothing, a budget sub-brand of Nothing (company) Collectible Minifigure, individually sold collectible Lego figures Color, Material and Finishes, in CMF design

Body capacitance

Body capacitance is the physical property of a human body to act as a capacitor. Like any other electrically conductive object, a human body can store electric charge if insulated. The actual amount of capacitance varies with the surroundings; it would be low when standing on top of a pole with nothing nearby, but high when leaning against an insulated, but grounded large metal surface, such as a household refrigerator, or a metal wall in a factory. When human body capacitance is charged to a high voltage by friction or other means, it can produce undesirable effects when abruptly discharged as a spark. This can result in momentary pain, a startle response that may cause further accidents, or damage to sensitive materials or electronic devices. In exceptional cases, a spark may ignite flammable gas or vapor resulting in a fire. The influence of body capacitance on a tuned circuit may affect the performance of radio receivers. A circuit that senses a change in capacitance can be used as a touch-sensitive switch, allowing control of devices without operating a button or toggle. Properties Some fabrics and friction can charge a human body to about 3 kV. Low potentials may not have any notable effect, but some electronic devices can be damaged by voltages of the order of 100 V. Electronics factories are careful to prevent people from becoming charged. A branch of the electronics industry deals with preventing static charge build-up and protecting products against electrostatic discharge. Notably, a combination of footwear with some sole materials, low humidity, and a dry carpet can cause footsteps to charge a person's body capacitance to as much as a few tens of kilovolts with respect to the earth. The human and surroundings then constitute a highly charged capacitor. A close approach to any conductive object connected to earth (ground) can create a shock, even a visible spark. Body capacitance was a significant nuisance when tuning the earliest radios; touching a tuning knob would couple the body capacitance into the tuning circuit, slightly changing its resonant frequency. However, body capacitance is exploited in a Theremin, a musical instrument in which it causes slight frequency shifts of the instrument's internal oscillators. One of them changes pitch, and the other causes loudness (volume) to change smoothly between silence and full amount. Capacitance of a human body in normal surroundings is typically in the tens to low hundreds of picofarads, which is small by typical electronic standards. While humans are much larger than typical electronic components, they are also mostly separated by significant distance from other conductive objects. Although the occasional static shock can be startling and even unpleasant, the amount of stored energy is relatively low, and won't harm a healthy person. The Human Body Model for capacitance, as defined by the Electrostatic Discharge Association (ESDA) is a 100pF capacitor in series with a 1.5kΩ resistor. Touch sensors The body capacitance can be used to operate pushbutton switches such as for elevators or faucets. Certain voltage tester probes rely on body capacitance. A capacitive touch sensor responds to close approach (but not force of touch) of a part of a human body, usually a fingertip. The capacitance between the device itself and the fingertip is sensed. Capacitive touch screens don't require applying any force to their surfaces, which makes them easier to use and design in some respects. Tuned circuits Radio receivers rely on tuned circuits to select the frequency of a particular desired signal. Design of such circuits intended to be adjusted by a user must prevent interaction of the user's body capacitance with the resonant circuit, so that the resonant frequency is not affected. For example, a metal shield may be placed behind a tuning knob so that the presence of an operator's hand does not affect the tuning. See also Self capacitance Triboelectric series Triboelectric effect Touch-sensitive lamp References External links Downloadable electrostatic BEM modules in MATLAB for self-capacitance of a human body and relevant human body meshes Energy storage Capacitors Biotechnology

Stress-related disorders

Stress-related disorders constitute a category of mental disorders. They are maladaptive, biological and psychological responses to short- or long-term exposures to physical or emotional stressors. The National Institute of Environmental Health Sciences categorizes Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD) as stress-related disorders. However, the World Health Organization's ICD-11 excludes OCD but categorizes PTSD, Complex Post-Traumatic Stress Disorder (CPTSD), adjustment disorder as stress-related disorders. Stress is a conscious or unconscious psychological feeling or physical condition resulting from physical or mental 'positive or negative pressure' that overwhelms adaptive capacities. It is a psychological process initiated by events that threaten, harm or challenge an organism or that exceed available coping resources and it is characterized by psychological responses that are directed towards adaptation. Stress is wear and tear on the body in response to stressful agents. Hans Selye called such agents: stressors, which are physical, physiological or sociocultural. Stress-related disorders differ from anxiety disorders, and do not constitute a normative concept. A person typically is stressed when positive or negative (e.g., threatening) experiences temporarily strain or overwhelm adaptive capacities. Stress is highly individualized and depends on variables such as the novelty, rate, intensity, duration, or personal interpretation of the input, and genetic or experiential factors. Both acute and chronic stress can intensify morbidity from anxiety disorders. One person's fun may be another person's stressor. For an example, panic attacks are more frequent when the predisposed person is exposed to stressors. Stress reduction strategies Stress-reduction strategies can be helpful to many stressed/anxious people. However, many anxious persons cannot concentrate enough to use such strategies effectively for acute relief. (Most stress-reduction techniques have their greatest utility as elements of a prevention plan that attempts to raise one's threshold to anxiety-provoking experiences.) The five R's of stress and anxiety reduction Five core concepts are used to reduce anxiety or stress. Recognition of the causes and sources of the threat or distress; education and consciousness raising. Relationships identified for support, help, reassurance Removal (from or of) the threat or stressor; managing the stimulus. Relaxation through techniques such as meditation, massage, breathing exercises, or imagery. Re-engagement through managed re-exposure and desensitization. Defenses Defense mechanisms are behavior patterns primarily concerned with protecting ego. Presumably the process is unconscious and the aim is to fool oneself. It is intra psychic processes serving to provide relief from emotional conflict and anxiety. Conscious efforts are frequently made for the same reasons, but true defense mechanisms are unconscious. Some of the common defense mechanisms are: compensation, conversion, denial, displacement, dissociation, idealization, identification, incorporation, introjection, projection, rationalization, reaction formation, regression, sublimation, substitution, symbolization and undoing. Summary The major function of these psychological defenses is to prevent the experiencing of painful emotions. There are several major problems with their use. Many of these defenses create new problems that are as bad, or worse, than the emotional problems they mask. Some may be just plain destructive. Example: rejection literally destroys the relationships we care most about. These defenses distort person's ability to perceive reality as it is. And this prevents them from dealing with their problems in a constructive way. These defenses do not get rid of the painful feelings. In fact, by masking them so that person doesn't feel them, they effectively store them up within themselves. Emotions are discharged through expression, so by denying themselves the chance to feel them, they also deny themselves the ability to get rid of them. These defenses do not just screen out painful emotions. They are, in fact, defenses against all emotion. So the more effective person's defenses become in protecting them from painful feelings, the less able they are to experience the joyful and happy feelings that make life worth living. These defenses are not perfect. As more and more hurt is stored away, a tension is developed. Person becomes increasingly anxious, nervous, and irritable. They become emotionally unpredictable. And when defenses weaken, from time to time, person may experience emotional explosions. These defenses prevent person from knowing what is wrong, but they do not prevent us from feeling bad. Stress as in clinical medicine Acute stress disorder Acute stress disorder occurs in individuals without any other apparent psychiatric disorder, in response to exceptional physical or psychological stress. While severe, such reactions usually subside within hours or days. The stress may be an overwhelming traumatic experience (e.g. accident, battle, physical assault, rape) or unusually sudden change in social circumstances of the individual, such as multiple bereavement. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions, as evidenced by the fact that not all people exposed to exceptional stress develop symptoms. However, an acute stress disorder falls under the class of an anxiety disorder. Symptoms Symptoms show considerable variation but usually include: An initial state of "DAZE" with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, disorientation. Followed either by further withdrawal from the surrounding situation to the extent of a dissociative stupor or by agitating and over activity. Autonomic signs of "panic anxiety" The signs are: tachycardia (increased heart rate), sweating, hyperventilation (increased breathing). The symptoms usually appear within minutes of the impact of the stressful stimulus and disappear within 2–3 days. Post-traumatic stress disorder (PTSD) This arises after response to a stressful event or situation of an exceptionally threatening nature and likely to cause pervasive distress (great pain, anxiety, sorrow, acute physical or mental suffering, affliction, trouble) in almost anyone. Causes The causes of PTSD are: natural or human disasters, war, serious accident, witness of violent death of others, violent attack, being the survivor of sexual abuse, rape, torture, terrorism or hostage taking. The predisposing factors are: personality traits and previous history of psychiatric illness. Typical symptoms Flashbacks are the repeated reliving of the trauma in the form of intrusive memories or dreams, intense distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma, avoidance of activities and situations reminiscent of the trauma, emotional blunting or "numbness", a sense of detachment from other people, autonomic hyperarousal with hypervigilance, an enhanced startle reaction and insomnia, marked anxiety and depression and, occasionally, suicidal ideation. Treatment Psychiatric consultation: exploration of memories of the traumatic event, relief of associated symptoms and counseling. Prognosis The course is fluctuating but recovery can be expected in the majority of cases. Few people may show chronic course over many years and a transition to an enduring personality change In surgery Stress ulceration Stress ulceration is a single or multiple fundic mucosal ulcers that causes upper gastrointestinal bleeding, and develops during the severe physiologic stress of serious illness. It can also cause mucosal erosions and superficial hemorrhages in patients who are critically ill, or in those who are under extreme physiologic stress, causing blood loss that can require blood transfusion. Ordinary peptic ulcers are found commonly in the "gastric antrum and the duodenum" whereas stress ulcers are found commonly in "fundic mucosa and can be located anywhere within the stomach and proximal duodenum". See also Critical incident stress management Stress management Stress (biology) Gastritis References Further reading Selye H. Syndrome produced by diverse nocuous agents. Nature. 1936;138:32. Hales RE, Zatazick DF (1997) What is PTSD? American Journal of Psychiatry 154: 143-145 Royal College of Physicians/Royal College of Psychiatrist (1995) The Psychological Care of Medical Patients: Recognition of Need and Service Provision. London: RCPhys/RCPsych Psychological stress Stress-related disorders

Hemorrhagic transformation

Hemorrhagic transformation (HT) or hemorrhagic conversion is a medical complication that can occur in the brain following an acute ischemic stroke, a condition in which blood flow to the brain is blocked. Hemorrhagic transformation is a process which involves the bleeding of brain tissue that has been affected by the stroke and can take two forms: petechial hemorrhage and parenchymal hemorrhage. HT can lead to further damage to the brain tissue and worsen the outcome of the initial stroke. The risk of HT increases with the severity and duration of the initial stroke, as well as with certain medical conditions such as high blood pressure, diabetes, and clotting disorders and the use of certain medications, such as anticoagulants and thrombolytic tpA medication (such as alteplase) which can increase the bleeding risk. Effective treatment is complex and may involve medications to control bleeding (reversing coagulopathy), management of underlying medical conditions, and sometimes neurosurgical treatment to reduce the bleeding. Signs and symptoms Signs and symptoms can vary depending on the severity and location of the bleeding within the brain tissue. In the medical literature, various criteria have been used to establish whether a hemorrhagic infarction is symptomatic or not. Studies have shown that only parenchymal hematomas are strongly associated with long-term deterioration and worsening of the patient's condition. Most cases of hemorrhagic transformation, including the majority of petechial hemorrhages, are asymptomatic and do not cause noticeable symptoms. Some common symptoms might include: Headache Changes in consciousness Weakness or numbness Seizures Speech difficulties Vision problems Pathophysiology HT involves the extravasation of blood from the peripheral circulation across a disrupted blood-brain barrier (BBB) and into the brain tissue. Epidemiology Around 10-15% of patients with acute ischemic stroke experience hemorrhagic transformation. References Complications of stroke

Bioinorganic chemistry

Bioinorganic chemistry is a field that examines the role of metals in biology. Bioinorganic chemistry includes the study of both natural phenomena such as the behavior of metalloproteins as well as artificially introduced metals, including those that are non-essential, in medicine and toxicology. Many biological processes such as respiration depend upon molecules that fall within the realm of inorganic chemistry. The discipline also includes the study of inorganic models or mimics that imitate the behaviour of metalloproteins. As a mix of biochemistry and inorganic chemistry, bioinorganic chemistry is important in elucidating the implications of electron-transfer proteins, substrate bindings and activation, atom and group transfer chemistry as well as metal properties in biological chemistry. The successful development of truly interdisciplinary work is necessary to advance bioinorganic chemistry. Composition of living organisms About 99% of mammals' mass are the elements carbon, nitrogen, calcium, sodium, chlorine, potassium, hydrogen, phosphorus, oxygen and sulfur. The organic compounds (proteins, lipids and carbohydrates) contain the majority of the carbon and nitrogen and most of the oxygen and hydrogen is present as water. The entire collection of metal-containing biomolecules in a cell is called the metallome. History Paul Ehrlich used organoarsenic (“arsenicals”) for the treatment of syphilis, demonstrating the relevance of metals, or at least metalloids, to medicine, that blossomed with Rosenberg's discovery of the anti-cancer activity of cisplatin (cis-PtCl2(NH3)2). The first protein ever crystallized (see James B. Sumner) was urease, later shown to contain nickel at its active site. Vitamin B12, the cure for pernicious anemia was shown crystallographically by Dorothy Crowfoot Hodgkin to consist of a cobalt in a corrin macrocycle. Themes in bioinorganic chemistry Several distinct systems are of identifiable in bioinorganic chemistry. Major areas include: Metal ion transport and storage A diverse collection of transporters (e.g. the ion pump NaKATPase), vacuoles, storage proteins (e.g. ferritin), and small molecules (e.g. siderophores) are employed to control metal ions concentration and bio-availability in living organisms. Crucially, many essential metals are not readily accessible to downstream proteins owing to low solubility in aqueous solutions or scarcity in the cellular environment. Organisms have developed a number of strategies for collecting and transporting such elements while limiting their cytotoxicity. Enzymology Many reactions in life sciences involve water and metal ions are often at the catalytic centers (active sites) for these enzymes, i.e. these are metalloproteins. Often the reacting water is a ligand (see metal aquo complex). Examples of hydrolase enzymes are carbonic anhydrase, metallophosphatases, and metalloproteinases. Bioinorganic chemists seek to understand and replicate the function of these metalloproteins. Metal-containing electron transfer proteins are also common. They can be organized into three major classes: iron–sulfur proteins (such as rubredoxins, ferredoxins, and Rieske proteins), blue copper proteins, and cytochromes. These electron transport proteins are complementary to the non-metal electron transporters nicotinamide adenine dinucleotide (NAD) and flavin adenine dinucleotide (FAD). The nitrogen cycle make extensive use of metals for the redox interconversions. Toxicity Several metal ions are toxic to humans and other animals. The bioinorganic chemistry of lead in the context of its toxicity has been reviewed. Oxygen transport and activation proteins Aerobic life make extensive use of metals such as iron, copper, and manganese. Heme is utilized by red blood cells in the form of hemoglobin for oxygen transport and is perhaps the most recognized metal system in biology. Other oxygen transport systems include myoglobin, hemocyanin, and hemerythrin. Oxidases and oxygenases are metal systems found throughout nature that take advantage of oxygen to carry out important reactions such as energy generation in cytochrome c oxidase or small molecule oxidation in cytochrome P450 oxidases or methane monooxygenase. Some metalloproteins are designed to protect a biological system from the potentially harmful effects of oxygen and other reactive oxygen-containing molecules such as hydrogen peroxide. These systems include peroxidases, catalases, and superoxide dismutases. A complementary metalloprotein to those that react with oxygen is the oxygen evolving complex present in plants. This system is part of the complex protein machinery that produces oxygen as plants perform photosynthesis. Bioorganometallic chemistry Bioorganometallic systems feature metal-carbon bonds as structural elements or as intermediates. Bioorganometallic enzymes and proteins include the hydrogenases, FeMoco in nitrogenase, and methylcobalamin. These naturally occurring organometallic compounds. This area is more focused on the utilization of metals by unicellular organisms. Bioorganometallic compounds are significant in environmental chemistry. Metals in medicine A number of drugs contain metals. This theme relies on the study of the design and mechanism of action of metal-containing pharmaceuticals, and compounds that interact with endogenous metal ions in enzyme active sites. The most widely used anti-cancer drug is cisplatin. MRI contrast agent commonly contain gadolinium. Lithium carbonate has been used to treat the manic phase of bipolar disorder. Gold antiarthritic drugs, e.g. auranofin have been commercialized. Carbon monoxide-releasing molecules are metal complexes have been developed to suppress inflammation by releasing small amounts of carbon monoxide. The cardiovascular and neuronal importance of nitric oxide has been examined, including the enzyme nitric oxide synthase. (See also: nitrogen assimilation.) Besides, metallic transition complexes based on triazolopyrimidines have been tested against several parasite strains. Environmental chemistry Environmental chemistry traditionally emphasizes the interaction of heavy metals with organisms. Methylmercury has caused major disaster called Minamata disease. Arsenic poisoning is a widespread problem owing largely to arsenic contamination of groundwater, which affects many millions of people in developing countries. The metabolism of mercury- and arsenic-containing compounds involves cobalamin-based enzymes. Biomineralization Biomineralization is the process by which living organisms produce minerals, often to harden or stiffen existing tissues. Such tissues are called mineralized tissues. Examples include silicates in algae and diatoms, carbonates in invertebrates, and calcium phosphates and carbonates in vertebrates. Other examples include copper, iron and gold deposits involving bacteria. Biologically-formed minerals often have special uses such as magnetic sensors in magnetotactic bacteria (Fe3O4), gravity sensing devices (CaCO3, CaSO4, BaSO4) and iron storage and mobilization (Fe2O3•H2O in the protein ferritin). Because extracellular iron is strongly involved in inducing calcification, its control is essential in developing shells; the protein ferritin plays an important role in controlling the distribution of iron. Types of inorganic substances in biology Alkali and alkaline earth metals The abundant inorganic elements act as ionic electrolytes. The most important ions are sodium, potassium, calcium, magnesium, chloride, phosphate, and bicarbonate. The maintenance of precise gradients across cell membranes maintains osmotic pressure and pH. Ions are also critical for nerves and muscles, as action potentials in these tissues are produced by the exchange of electrolytes between the extracellular fluid and the cytosol. Electrolytes enter and leave cells through proteins in the cell membrane called ion channels. For example, muscle contraction depends upon the movement of calcium, sodium and potassium through ion channels in the cell membrane and T-tubules. Transition metals The transition metals are usually present as trace elements in organisms, with zinc and iron being most abundant. These metals are used as protein cofactors and signalling molecules. Many are essential for the activity of enzymes such as catalase and oxygen-carrier proteins such as hemoglobin. These cofactors are tightly to a specific protein; although enzyme cofactors can be modified during catalysis, cofactors always return to their original state after catalysis has taken place. The metal micronutrients are taken up into organisms by specific transporters and bound to storage proteins such as ferritin or metallothionein when not being used. Cobalt is essential for the functioning of vitamin B12. Main group compounds Many other elements aside from metals are bio-active. Sulfur and phosphorus are required for all life. Phosphorus almost exclusively exists as phosphate and its various esters. Sulfur exists in a variety of oxidation states, ranging from sulfate (SO42−) down to sulfide (S2−). Selenium is a trace element involved in proteins that are antioxidants. Cadmium is important because of its toxicity. See also Physiology Cofactor Iron metabolism References Literature Heinz-Bernhard Kraatz (editor), Nils Metzler-Nolte (editor), Concepts and Models in Bioinorganic Chemistry, John Wiley and Sons, 2006, Ivano Bertini, Harry B. Gray, Edward I. Stiefel, Joan Selverstone Valentine, Biological Inorganic Chemistry, University Science Books, 2007, Wolfgang Kaim, Brigitte Schwederski "Bioinorganic Chemistry: Inorganic Elements in the Chemistry of Life." John Wiley and Sons, 1994, Rosette M. Roat-Malone, Bioinorganic Chemistry : A Short Course, Wiley-Interscience, 2002, J.J.R. Fraústo da Silva and R.J.P. Williams, The biological chemistry of the elements: The inorganic chemistry of life, 2nd Edition, Oxford University Press, 2001, Lawrence Que, Jr., ed., Physical Methods in Bioinorganic Chemistry, University Science Books, 2000, External links The Society of Biological Inorganic Chemistry (SBIC)'s home page The French Bioinorganic Chemistry Society Glossary of Terms in Bioinorganic Chemistry Metal Coordination Groups in Proteins by Marjorie Harding European Bioinformatics Institute MetalPDB: A database of metal sites in biomolecular structures Biochemistry Inorganic chemistry Medicinal inorganic chemistry

Catabolysis

Catabolysis is a biological process in which the body breaks down fat and muscle tissue in order to stay alive. Catabolysis occurs only when there is no longer any source of protein, carbohydrate, or vitamin nourishment feeding all body systems; it is the most severe type of malnutrition. Mechanism Due to the normal metabolic rate of humans catabolysis becomes life-threatening only after 1–2 months from the cessation of nutrition going into the body. After this time, the damage to muscles and organs can be permanent and can also eventually cause death, if left untreated. Catabolysis is the last metabolic resort for the body to keep itself — particularly the nervous system—functional. Protein stores, especially in muscle tissue, provide the amino acids needed for the process. Amino acids are released into the blood and converted in the liver to alpha keto acids. Alpha keto acids can then be converted to glucose to maintain proper blood sugar levels. The situation can become dire when one begins to lose muscle mass; this is a sign that the fat has been expended and the body is now metabolizing the muscle tissue. This results in muscle atrophy, a loss of strength and, ultimately, a depletion of muscular tissue completely. Muscle weakness is not necessarily a symptom of catabolysis: the muscles will normally feel fatigued when they are not receiving enough energy or oxygen. Ultimately, catabolysis can progress to the point of no return when the body's machinery for protein synthesis, itself made of protein, has been degraded to the point that it cannot handle any protein. At this point, attempts to correct the disorder by giving food or protein are futile. The body has a natural store of fat (also called adipose tissue) that stores reserve energy. One can still stay alive while the body breaks down the fatty tissue (hence people wasting away from starvation). The person may, during catabolysis, have large amounts of lipids, proteins, and amino acids in the bloodstream, due to the muscle fibers and adipose tissues being broken down and sent to the nervous system and brain. One may also exhibit a fever, since the body is working hard to transfer the nutrients in the muscles and fat to the blood. Treatment While catabolysis can be deadly over time, if the person is given medical treatment early enough, the effects of catabolysis can be reversed. However, the person may require intravenous nutrition, a blood transfusion, and/or oxygen replenishment. After that, it may be a few weeks to a few months before the person's muscle mass and fat deposits can build themselves up again; there is a possibility that they may never build back up, depending on the severity of the condition. See also Anorexia nervosa Conatus | Wiktionary Metabolism Starvation Superior mesenteric artery syndrome Wasting References External links Malnutrition

Biological data

Biological data refers to a compound or information derived from living organisms and their products. A medicinal compound made from living organisms, such as a serum or a vaccine, could be characterized as biological data. Biological data is highly complex when compared with other forms of data. There are many forms of biological data, including text, sequence data, protein structure, genomic data and amino acids, and links among others. Biological data and bioinformatics Biological data works closely with bioinformatics, which is a recent discipline focusing on addressing the need to analyze and interpret vast amounts of genomic data. In the past few decades, leaps in genomic research have led to massive amounts of biological data. As a result, bioinformatics was created as the convergence of genomics, biotechnology, and information technology, while concentrating on biological data. Biological data has also been difficult to define, as bioinformatics is a wide-encompassing field. Further, the question of what constitutes as being a living organism has been contentious, as "alive" represents a nebulous term that encompasses molecular evolution, biological modeling, biophysics, and systems biology. From the past decade onwards, bioinformatics and the analysis of biological data have been thriving as a result of leaps in technology required to manage and interpret data. It is currently a thriving field, as society has become more concentrated on the acquisition, transfer, and exploitation of bioinformatics and biological data. Types of biological data Biological data can be extracted for use in the domains of omics, bio-imaging, and medical imaging. Life scientists value biological data to provide molecular details in living organisms. Tools for DNA sequencing, gene expression (GE), bio-imaging, neuro-imaging, and brain-machine interfaces are all domains that utilize biological data, and model biological systems with high dimensionality. Moreover, raw biological sequence data usually refers to DNA, RNA, and amino acids. Biological data can also be described as data on biological entities. For instance, characteristics such as: sequences, graphs, geometric information, scalar and vector fields, patterns, constraints, images, and spatial information may all be characterized as biological data, as they describe features of biological beings. In many instances, biological data are associated with several of these categories. For instance, as described in the National Institute of Health's report on Catalyzing Inquiry at the Interface of Computing and Biology, a protein structure may be associated with a one-dimensional sequence, a two-dimensional image, and a three dimensional structure, and so on. Biomedical databases Biomedical databases have often been referred to as the databases of Electronic Health Records (EHRs), genomic data in decentralized federal database systems, and biological data, including genomic data, collected from large-scale clinical studies. Bio-hacking and privacy threats Bio-hacking Bio-computing attacks have become more common as recent studies have shown that common tools may allow an assailant to synthesize biological information which can be used to hijack information from DNA-analyses. The threat of biohacking has become more apparent as DNA-analysis increases in commonality in fields such as forensic science, clinical research, and genomics. Biohacking can be carried out by synthesizing malicious DNA and inserted into biological samples. Researchers have established scenarios that demonstrate the threat of biohacking, such as a hacker reaching a biological sample by hiding malicious DNA on common surfaces, such as lab coats, benches, or rubber gloves, which would then contaminate the genetic data. However, the threat of biohacking may be mitigated by using similar techniques that are used to prevent conventional injection attacks. Clinicians and researchers may mitigate a bio-hack by extracting genetic information from biological samples, and comparing the samples to identify material unknown materials. Studies have shown that comparing genetic information with biological samples, to identify bio-hacking code, has been up to 95% effective in detecting malicious DNA inserts in bio-hacking attacks. Genetic samples as personal data Privacy concerns in genomic research have arises around the notion of whether or not genomic samples contain personal data, or should be regarded as physical matter. Moreover, concerns arise as some countries recognize genomic data as personal data (and apply data protection rules) while other countries regard the samples in terms of physical matter and do not apply the same data protection laws to genomic samples. The forthcoming General Data Protection Regulation (GDPR) has been cited as a potential legal instrument that may better enforce privacy regulations in bio-banking and genomic research. However, ambiguity surrounding the definition of "personal data" in the text of the GDPR, especially regarding biological data, has led to doubts on whether regulation will be enforced for genetic samples. Article 4(1) states that personal data is defined as "Any information relating to an identified or identifiable natural person ('data subject')" Applications of deep learning to biological data As a result of rapid advances in data science and computational power, life scientists have been able to apply data-intensive machine learning methods to biological data, such as deep learning (DL), reinforcement learning (RL), and their combination (deep RL). These methods, alongside increases in data storage and computing, have allowed life scientists to mine biological data and analyze data sets that were previously too large or complex. Deep Learning (DL) and reinforcement learning (RL) have been used in the field of omics research (which includes genomics, proteomics, or metabolomics.) Typically, raw biological sequence data (such as DNA, RNA, and amino acids) is extracted and used to analyze features, functions, structures, and molecular dynamics from the biological data. From that point onwards, different analyses may be performed, such as GE profiling splicing junction prediction, and protein-protein interaction evaluation may all be performed. Reinforcement learning, a term stemming from behavioral psychology, is a method of problem solving by learning things through trial and error. Reinforcement learning can be applied to biological data, in the field of omics, by using RL to predict bacterial genomes. Other studies have shown that reinforcement learning can be used to accurately predict biological sequence annotation. Deep Learning (DL) architectures are also useful in training biological data. For instance, DL architectures that target pixel levels of biological images have been used to identify the process of mitosis in histological images of the breast. DL architectures have also been used to identify nuclei in images of breast cancer cells. Challenges to data mining in biomedical informatics Complexity The primary problem facing biomedical data models has typically been complexity, as life scientists in clinical settings and biomedical research face the possibility of information overload. However, information overload has often been a debated phenomenon in medical fields. Computational advances have allowed for separate communities to form under different philosophies. For instance, data mining and machine learning researchers search for relevant patterns in biological data, and the architecture does not rely on human intervention. However, there are risks involved when modeling artifacts when human intervention, such as end user comprehension and control, are lessened. Researchers have pointed out that with increasing health care costs and tremendous amounts of underutilized data, health information technologies may be the key to improving the efficiency and quality of healthcare. Database errors and abuses Electronic health records (EHR) can contain genomic data from millions of patients, and the creation of these databases has resulted in both praise and concern. Legal scholars have pointed towards three primary concerns for increasing litigation pertaining to biomedical databases. First, data contained in biomedical databases may be incorrect or incomplete. Second, systemic biases, which may arise from researcher biases or the nature of the biological data, may threaten the validity of research results. Third, the presence of data mining in biological databases can make it easier for individuals with political, social, or economic agendas to manipulate research findings to sway public opinion. An example of database misuse occurred in 2009 when the Journal of Psychiatric Research published a study that associated abortion to psychiatric disorders. The purpose of the study was to analyze associations between abortion history and psychiatric disorders, such as anxiety disorders (including panic disorder, PTSD, and agoraphobia) alongside substance abuse disorders and mood disorders. However, the study was discredited in 2012 when scientists scrutinized the methodology of the study and found it severely faulty. The researchers had used "national data sets with reproductive history and mental health variables" to produce their findings. However, the researchers had failed to compare women (who had unplanned pregnancies and had abortions) to the group of women who did not have abortions, while focusing on psychiatric problems that occurred after the terminated pregnancies. As a result, the findings which appeared to give scientific credibility, gave rise to several states enacting legislation that required women to seek counseling before abortions, due to the potential of long-term mental health consequences. Another article, published in the New York Times, demonstrated how Electronic Health Records (EHR) systems could be manipulated by doctors to exaggerate the amount of care they provided for purposes of Medicare reimbursement. Biomedical Data Sharing Sharing biomedical data has been touted as an effective way to enhance research reproducibility and scientific discovery. While researchers struggle with technological issues in sharing data, social issues are also a barrier to sharing biological data. For instance, clinicians and researchers face unique challenges to sharing biological or health data within their medical communities, such as privacy concerns and patient privacy laws such as HIPAA. Attitudes towards data sharing According to a 2015 study focusing on the attitudes of practices of clinicians and scientific research staff, a majority of the respondents reported data sharing as important to their work, but signified that their expertise in the subject was low. Of the 190 respondents to the survey, 135 identified themselves as clinical or basic research scientists, and the population of the survey included clinical and basic research scientists in the Intramural Research Program at the National Institute of Health. The study also found that, among the respondents, sharing data directly with other clinicians was a common practice, but the subjects of the study had little practice uploading data to a repository. Within the field of biomedical research, data sharing has been promoted as an important way for researchers to share and reuse data in order to fully capture the benefits towards personalized and precision medicine. Challenges to data sharing Data sharing in healthcare has remained a challenge for several reasons. Despite research advances in data sharing in healthcare, many healthcare organizations remain reluctant or unwilling to release medical data on account of privacy laws such as the Health Insurance Portability and Accountability Act (HIPAA). Moreover, sharing biological data between institutions requires protecting confidentiality for data that may span several organizations. Achieving data syntax and semantic heterogeneity while meeting diverse privacy requirements are all factors that pose barriers to data sharing. References Bioinformatics Data Biological databases

Anoxia

Anoxia means a total depletion in the level of oxygen, an extreme form of hypoxia or "low oxygen". The terms anoxia and hypoxia are used in various contexts: Anoxic waters, sea water, fresh water or groundwater that are depleted of dissolved oxygen Anoxic event, when the Earth's oceans become completely depleted of oxygen below the surface levels Euxinic, anoxic conditions in the presence of hydrogen sulfide Hypoxia (environmental), low oxygen conditions Hypoxia (medicine), when the body or a region of the body is deprived of adequate oxygen supply Cerebral anoxia, when the brain is completely deprived of oxygen, an extreme form of cerebral hypoxia See also Anoxia (beetle), a genus of scarab beetles Oxygen saturation, a relative measure of the oxygen dissolved or carried in a medium; a measure of the severity of hypoxic conditions Oxygen toxicity (hyperoxia), the opposite condition of hypoxia, an excess of oxygen in body tissues Oxygen-free (disambiguation)

Sexual health clinic

Sexual health clinics specialize in the prevention and treatment of sexually transmitted infections. Terminology Sexual health clinics are also called sexually transmitted disease (STD) clinics, sexually transmitted infection (STI) clinics, venereal disease (VD) clinics, or genitourinary medicine (GUM) clinics. Sexual health clinics differ from reproductive health and family planning clinics. Sexual health clinics offer only some reproductive health services. Reproductive health clinics, such as Planned Parenthood, offer most of the services of sexual health clinics. Services Sexual health clinics provide some or all of the following: Information about safer sex, birth control, reproductive health and general sex education Free condoms Sexual health examinations Tests to detect some sexually transmitted infections Antibiotics to cure chlamydia, gonorrhea, and syphilis Medications and other treatments Vaccinations Counseling and therapy Emergency contraception Urine test for pregnancy Referrals for additional information or services Many clinics provide vaccinations to prevent infections from the hepatitis A and B viruses. Young women may receive vaccinations to prevent infection from some strains of the human papillomavirus (HPV). Many clinics provide interpreting for the hearing impaired or speakers of other languages. Many clinics will help patients tell their sexual contacts if they have a sexually transmitted infection, anonymously if needed. Public governmental and non-profit clinics often provide services for free or adjust the fee based on a patient's ability to pay. Sexual health clinics often offer services without appointments. Some clinics open evenings or weekends. Some clinics have separate hours or facilities for men and women. Some clinics serve only specific populations such as women, men, MSM, youths, LGBT, ethnic groups, the poor, or students. Examinations With the patient's consent, a clinician will inspect the patient visually and by touch. If needed, the clinician will take samples to test for sexually transmitted infections. In a private room or space, the patient will partially undress. The clinician may inspect the patient's: Throat and lymph nodes of the neck for inflammation Pubic hair for lice Lymph nodes of the groin for swelling Genitals, anus, and surrounding areas for sores and warts The clinician may swab the patient's: Throat to test for gonorrhea and possibly chlamydia Cheek, inside, to diagnose HIV Sores of the genitals, anus, and surrounding areas to test for herpes Urethra to test for gonorrhea and possibly chlamydia Vagina to test for chlamydia and possibly gonorrhea Cervix to test for cervical intraepithelial neoplasia (a Pap test) Rectum to test for gonorrhea and possibly chlamydia The clinician may take small blood samples by pricking a finger or from a vein to test for HIV, syphilis, and possibly herpes and hepatitis C. The clinician may ask for a small urine sample, given in private, to test for chlamydia and possibly gonorrhea. The inspections and taking samples do not hurt, but swabbing the urethra and cervix, and a finger prick blood sample feel uncomfortable. Women will often receive a pelvic exam, both external and internal, but usually less thorough than a reproductive health exam. A patient can choose a female or male clinician if available. A patient can have a chaperone. Some clinics have separate hours or facilities for men and women. Privacy Medical confidentiality is an important part of the medical ethics of a doctor–patient relationship. Sexual health clinics follow local standards of medical confidentiality to protect the privacy of patients. Some clinics provide anonymous services or protect confidentiality by having a patient use a number or a pseudonym. Additional privacy protections sometimes apply to matters of sexuality and reproduction, since these areas are sensitive in many cultures. The diagnosis of HIV/AIDS has legal restrictions in patient confidentiality, and some clinics use rapid antibody tests to provide results to a patient within 30 minutes, without holding the patient's records. In the United States, clinics receiving federal funding from Medicaid or Title X of the Public Health Service Act must treat all patients confidentially. Thus minors can receive services without parental notification or consent. Additionally, medical records for all patients age 18 and above are strictly confidential under HIPAA. Consent Medical standards of informed consent apply to sexual health clinics. A patient needs information about the purposes and consequences of examinations, tests, treatments, and other procedures. A patient may then choose whether to consent to these procedures. A minor may consent to receive some or all of the procedures at many sexual health clinics. References External links United States United Kingdom (England) (Wales) Sexual health Sexually transmitted diseases and infections Andrology Urology Clinics

CPT

CPT or Cpt may stand for: Common uses CPT (file format), of Corel Photo Paint and others CPT (programadora), a defunct Colombian television production company CPT Corporation, a 20th-century word processor manufacturer Colored people's time, offensive US expression for lateness Columbia Pictures Television, branch of Columbia Pictures Cost per thousand, advertising term Curricular Practical Training, US temporary employment authorization Pastoral Land Commission, a Catholic environmental group in Brazil that helped found the Landless Workers Movement The abbreviation for US Army Captain The abbreviation for Compton, California Organisations Compañía Peruana de Teléfonos, Peruvian public telecommunications company Politics Christian Peacemaker Teams Committee for the Prevention of Torture, Council of Europe Communist Party of Thailand, 1942-1990s Paraguayan Workers Confederation (Confederación Paraguaya de Trabajadores) Science and mathematics Canadian Penning Trap Mass Spectrometer, at Argonne National Laboratory Conditional probability table Cone penetration test, to determine properties of soils Coprecipitation, an important process in analytical chemistry and radiochemistry CPT symmetry (charge, parity, and time symmetry) of physical laws Cumulative prospect theory in economic modeling CPT Port - Conductive Power Transfer Port. The port of an EV (Electric Vehicle) charging station that connects to the vehicle. Biochemistry Carnitine palmitoyltransferase I (CPT1A, CPT1, CPT1-L, L-CPT1), a mitochondrial enzyme responsible for the formation of acyl carnitines Carboxypeptidase T, a hydrolytic enzyme Medicine 8-Cyclopentyl-1,3-dimethylxanthine (8-CPT), a stimulant drug Camptothecin, an anti-cancer drug Certified Personal Trainer, a personal trainer with a varying degree of knowledge of general fitness Chest physiotherapy Cognitive processing therapy, a psychotherapeutic approach Continuous Performance Task, measurement of attention Current Procedural Terminology, AMA medical code set Troparil (β-CPT), a dopamine reuptake inhibitor Congenital pseudarthrosis of the tibia, a rare pediatric disease Transport Cape Town International Airport, South Africa, IATA airport code Clapton railway station, UK, station code Corporate Air, Montana, US, ICAO airline designator Crib Point railway station, Melbourne Carriage Paid To, an International Commercial Term used in transport Other uses Capcom Pro Tour, an annual series of Street Fighter tournaments See also Captain (disambiguation)

Interface and colloid science

Interface and colloid science is an interdisciplinary intersection of branches of chemistry, physics, nanoscience and other fields dealing with colloids, heterogeneous systems consisting of a mechanical mixture of particles between 1 nm and 1000 nm dispersed in a continuous medium. A colloidal solution is a heterogeneous mixture in which the particle size of the substance is intermediate between a true solution and a suspension, i.e. between 1–1000 nm. Smoke from a fire is an example of a colloidal system in which tiny particles of solid float in air. Just like true solutions, colloidal particles are small and cannot be seen by the naked eye. They easily pass through filter paper. But colloidal particles are big enough to be blocked by parchment paper or animal membrane. Interface and colloid science has applications and ramifications in the chemical industry, pharmaceuticals, biotechnology, ceramics, minerals, nanotechnology, and microfluidics, among others. There are many books dedicated to this scientific discipline, and there is a glossary of terms, Nomenclature in Dispersion Science and Technology, published by the US National Institute of Standards and Technology. See also Interface (matter) Electrokinetic phenomena Surface science References External links Max Planck Institute of Colloids and Interfaces American Chemical Society division of Colloid & Surface Chemistry Chemical mixtures Colloidal chemistry Condensed matter physics

Functional somatic syndrome

The term functional somatic syndrome (FSS) refers to a group of chronic diagnoses with no identifiable organic cause. This term was coined by Hemanth Samkumar. It encompasses disorders such as fibromyalgia, chronic widespread pain, temporomandibular disorder, irritable bowel syndrome, lower back pain, tension headache, atypical face pain, non-cardiac chest pain, insomnia, palpitation, dyspepsia and dizziness. General overlap exists between this term, somatization and somatoform. The status of ME/CFS as a functional somatic syndrome is contested. Although the aetiology remains unclear, there are consistent findings of biological abnormalities, and major health bodies such as the NAM, WHO, and NIH, classify it as an organic disease. The currently identified class of functional somatic syndromes present as a complex enigma within the medical community; they are highly prevalent, but little is known about the etiology of these conditions. A majority of patients presenting with persistent, widespread somatic complaints have no identifiable organic cause. Biological markers for the FSS diagnoses are non-existent, making the categorization difficult; there is currently much debate regarding whether the FSS diagnoses represent separate conditions or one overarching diagnosis. A large overlap of symptoms exist between the FSS diagnoses, causing high rates of comorbidity between them; the prevalence of comorbid FSS diagnoses ranges from 20% to 70%, while comorbid affective disorders with a fibromyalgia diagnosis ranges from 20% to 80%. While FSS diagnoses are relatively common within the general community, they are significantly more common among patients presenting with comorbid psychopathology; approximately one third of patients presenting with an FM diagnosis also meet criteria for posttraumatic stress disorder (PTSD). Similarly, rates of PTSD are roughly 9.5–43.5% higher in people seeking treatment for a functional somatic syndrome as opposed to the general population. Aside from the physiological symptoms of FSS such as sleep disturbances, chronic pain and general fatigue, certain psychological symptoms are also associated with most FSSs, such as anxiety, depression and panic disorder. Signs and symptoms Functional somatic syndromes are characterized by ambiguous, non-specific symptoms that appear in otherwise-healthy people. Overlap in symptomology exists across diagnoses, including gastrointestinal issues, pain, fatigue, cognitive difficulties, and sleep difficulties. Some have proposed to group symptoms into clusters or into one general functional somatic disorder given the finding of correlations between symptoms and underlying etiologies. Examples Various conditions have been named as examples of this, including: Multiple chemical sensitivity Sick building syndrome Chronic fatigue syndrome Fibromyalgia Irritable bowel syndrome Chronic whiplash Chronic Lyme disease Gulf War syndrome certain claims of food allergies (when no true allergy can be demonstrated) certain claims of hypoglycaemia (symptoms appearing when the blood sugar is normal) Potential causes Biological factors One commonly cited hypothesis in the literature implicates the hypothalamic–pituitary–adrenal axis (HPA axis) and cortisol secretion in the manifestation of somatic symptoms following trauma. The HPA axis plays a major role in moderating the body's stress response to both emotional and physical pain, relating to both the experience of psychological symptoms prevalent following trauma as well as the physiological symptoms prevalent in FSS conditions. When an individual experiences a traumatic event, the HPA-axis causes the increased release of cortisol, activating the sympathetic nervous pathway and causing negative feedback to be sent to the hypothalamus and pituitary gland. In people who have experienced significant trauma, this reaction can become dysfunctional and can cause a chronic decrease in cortisol production, though the rates of this decrease in cortisol levels varies across different types and frequencies of trauma. For example, fibromyalgia is characterized as a stress response disorder; similar to trauma, patients with fibromyalgia demonstrate a susceptibility to neuroendocrine dysfunctions. Fibromyalgia patients statistically exhibit atypical patterns of daily cortisol secretion, as well as significantly low urine cortisol levels. Psychological factors Patients with somatic syndromes such as fibromyalgia and irritable bowel syndrome have significantly higher rates of both physical and sexual abuse prior to the onset of their physiological symptoms, as well as higher rates of previous emotional abuse, emotional neglect, and physical neglect compared to the general population. Further, childhood trauma such as sexual abuse or maltreatment can indicate an increased propensity for later somatic syndrome onset. Current theories propose an "attentional bias" as the psychological mechanism by which trauma and somatic symptoms are tied. The concept of attentional bias refers to the idea that traumatic events can cause individuals to become more attuned to their bodies, thus intensifying the perception of pain, fatigue, and other common somatic symptoms. The initial traumatic event is interpreted as a threat to the body, and therefore the stress-response of the body takes on a new, heightened awareness to any potential subsequent threats. This attentional bias leads to a "health anxiety," where the patient becomes increasingly concerned that common somatic symptoms are related to a physical disease or injury, and therefore, another potential bodily threat. An initial perception of lost control can further lead to this attentional bias; sense of control is negatively associated with symptom reporting, suggesting that somatic symptoms are more closely monitored when psychologically recovering from an incident of lost control. Functional Somatic Syndromes are thought to be a result of conditioned hyperarousal following a trauma; victims are conditioned to respond more sensitively to the somatic symptoms following a trauma by their attention to and reinforcement of the symptom existence. This feedback loop is similar to that of panic disorder, in which fear of a subsequent panic attack causes an increased hyper-vigilance towards, and exacerbation of, certain physiological symptoms, such as heart palpitations, dizziness, and breathlessness. Diagnosis Diagnosis of a FSS is usually conducted in a "rule-out" method, where physicians rule out other rheumatology disorders with existing biomarkers prior to arriving at a FSS diagnosis. Treatment Due to the underlying psychological component of functional somatic syndromes, therapeutic approaches such as cognitive behavioral therapy (CBT) are common treatments. Multiple antidepressants have also shown to be effective for FSS diagnoses that include chronic pain. References Rheumatology

Central nervous system viral disease

The central nervous system (CNS) controls most of the functions of the body and mind. It comprises the brain, spinal cord and the nerve fibers that branch off to all parts of the body. The CNS viral diseases are caused by viruses that attack the CNS. Existing and emerging viral CNS infections are major sources of human morbidity and mortality. Virus infections usually begin in the peripheral tissues, and can invade the mammalian system by spreading into the peripheral nervous system and more rarely the CNS. CNS is protected by effective immune responses and multi-layer barriers, but some viruses enter with high-efficiency through the bloodstream and some by directly infecting the nerves that innervate the tissues. Most viruses that enter can be opportunistic and accidental pathogens, but some like herpes viruses and rabies virus have evolved in time to enter the nervous system efficiently, by exploiting the neuronal cell biology. While acute viral diseases come on quickly, chronic viral conditions have long incubation periods inside the body. Their symptoms develop slowly and follow a progressive, fatal course. Types Symptoms Characteristics of a viral infection can include pain, swelling, redness, impaired function, fever, drowsiness, confusion and convulsions. Diagnosis Classification Acute - the most common diseases caused by acute viral infections are encephalitis, flaccid paralysis, aseptic meningitis, post infectious and encephalomyelitis. Chronic - the most common diseases caused by chronic viral infections are subacute-sclerosing panencephalitis, progressive multifocal leukoencephalopathy, retrovirus disease and spongiform encephalopathies. Prevention Prophylactic vaccination is available against poliomyelitis, measles, Japanese encephalitis, and rabies. Hyper immune immunoglobulin has been used for prophylaxis of measles, herpes zoster virus, HSV-2, vaccine, rabies, and some other infections in high-risk groups. Treatment Treatments of proven efficacy are currently limited mostly to herpes viruses and human immunodeficiency virus. The herpes virus is of two types: herpes type 1 (HSV-1, or oral herpes) and herpes type 2 (HSV-2, or genital herpes). Although there is no particular cure; there are treatments that can relieve the symptoms. Drugs like Famvir, Zovirax, and Valtrex are among the drugs used, but these medications can only decrease pain and shorten the healing time. They can also decrease the total number of outbreaks in the surrounding. Warm baths also may relieve the pain of genital herpes. Human Immunodeficiency Virus Infection (HIV) is treated by using a combination of medications to fight against the HIV infection in the body. This is called antiretroviral therapy (ART). ART is not a cure, but it can control the virus so that a person can live a longer, healthier life and reduce the risk of transmitting HIV to others around him. ART involves taking a combination of HIV medicines (called an HIV regimen) every day, exactly as prescribed by the doctor. These HIV medicines prevent HIV Virus from multiplying (making copies of itself in the body), which reduces the amount of HIV in the body. Having less HIV in the body gives the immune system a chance to recover and fight off infections and cancers. Even though there is still some HIV in the body, the immune system is strong enough to fight off infections and cancers. By reducing the amount of HIV in the body, HIV medicines also reduce the risk of transmitting the virus to others. ART is recommended for all people with HIV, regardless of how long they've had the virus or how healthy they are. If left untreated, HIV will attack the immune system and eventually progress to AIDS. New therapies Development of new therapies has been hindered by the lack of appropriate animal model systems for some important viruses and also because of the difficulty in conducting human clinical trials for diseases that are rare. Nonetheless, numerous innovative approaches to antiviral therapy are available including candidate thiazolide and purazinecarboxamide derivatives with potential broad-spectrum antiviral efficacy. New herpes virus drugs include viral helicase-primase and terminase inhibitors. A promising new area of research involves therapies based on enhanced understanding of host antiviral immune responses. Epidemiology Many viral infections of the central nervous system occur in seasonal peaks or as epidemics, whereas others, such as herpes simplex encephalitis, are sporadic. In endemic areas it is mostly a disease of children, but as the disease spreads to new regions, or nonimmune travelers visit endemic regions, nonimmune adults are also affected. Children Meningitis is a very common in children. Newborns can develop herpes virus infections through contact with infected secretions in the birth canal. Other viral infections are acquired by breathing air contaminated with virus-containing droplets exhaled by an infected person. Arbovirus infections are acquired from bites by infected insects (called epidemic encephalitis). Viral central nervous system infections in newborns and infants usually begin with fever. The inability of infants to communicate directly makes it difficult to understand their symptoms. Newborns may have no other symptoms and may initially not otherwise appear ill. Infants older than a month or so typically become irritable and fussy and refuse to eat. Vomiting is common. Sometimes the soft spot on top of a newborn's head (fontanelle) bulges, indicating an increase in pressure on the brain. Because irritation of the meninges is worsened by movement, an infant with meningitis may cry more, rather than calm down, when picked up and rocked. Some infants develop a strange, high-pitched cry. Infants with encephalitis often have seizures or other abnormal movements. Infants with severe encephalitis may become lethargic and comatose and then die. To make the diagnosis of meningitis or the diagnosis of encephalitis, doctors do a spinal tap (lumbar puncture) to obtain cerebrospinal fluid (CSF) for laboratory analysis in children. Risks for other diseases A study using electronic health records indicates that 45 (with 22 of these being replicated with the UK Biobank and not all of them necessarily central nervous system viral diseases) viral exposures can significantly elevate risks of neurodegenerative disease, including up to 15 years after infection. See also List of central nervous system infections References External links

T cell deficiency

T cell deficiency is a deficiency of T cells, caused by decreased function of individual T cells, it causes an immunodeficiency of cell-mediated immunity. T cells normal function is to help with the human body's immunity, they are one of the two primary types of lymphocytes(the other being B cells). Symptoms and signs Presentations differ among causes, but T cell insufficiency generally manifests as unusually severe common viral infections (respiratory syncytial virus, rotavirus), diarrhea, and eczematous or erythrodermatous rashes. Failure to thrive and cachexia are later signs of a T-cell deficiency. Mechanism In terms of the normal mechanism of T cell we find that it is a type of white blood cell that has an important role in immunity, and is made from thymocytes. One sees in the partial disorder of T cells that happen due to cell signaling defects, are usually caused by hypomorphic gene defects. Generally, (micro)deletion of 22Q11.2 is the most often seen. Pathogens of concern The main pathogens of concern in T cell deficiencies are intracellular pathogens, including Herpes simplex virus, Mycobacterium and Listeria. Also, intracellular fungal infections are also more common and severe in T cell deficiencies. Other intracellular pathogens of major concern in T cell deficiency are: Diagnosis The diagnosis of T cell deficiency can be ascertained in those individuals with this condition via the following: Delayed hypersensitivity skin test T cell count Detection via culture(infection) Types Primary or secondary Primary (or hereditary) immunodeficiencies of T cells include some that cause complete insufficiency of T cells, such as severe combined immunodeficiency (SCID), Omenn syndrome, and Cartilage–hair hypoplasia. Secondary causes are more common than primary ones. Secondary (or acquired) causes are mainly: AIDS Cancer chemotherapy Lymphoma Glucocorticoid therapy Complete or partial deficiency Complete insufficiency of T cell function can result from hereditary conditions (also called primary conditions) such as severe combined immunodeficiency (SCID), Omenn syndrome, and cartilage–hair hypoplasia. Partial insufficiencies of T cell function include acquired immune deficiency syndrome (AIDS), and hereditary conditions such as DiGeorge syndrome (DGS), chromosomal breakage syndromes (CBSs), and B-cell and T-cell combined disorders such as ataxia-telangiectasia (AT) and Wiskott–Aldrich syndrome (WAS). Treatment In terms of the management of T cell deficiency for those individuals with this condition the following can be applied: Killed vaccines should be used(not live vaccines in T cell deficiency) Bone marrow transplant Immunoglobulin replacement Antiviral therapy Supplemental nutrition Epidemiology In the U.S. this defect occurs in about 1 in 70,000, with the majority of cases presenting in early life. Furthermore, SCID has an incidence of approximately 1 in 66,000 in California. See also B cell deficiency References Further reading External links Pubmed Immunodeficiency Immune system disorders Infection-related cutaneous conditions Lymphocytes Lymphocytic disorders Hematopathology

General fitness training

General fitness training works towards broad goals of overall health and well-being, rather than narrow goals of sport competition, larger muscles or concerns over appearance. A regular moderate workout regimen and healthy diet can improve general appearance markers of good health such as muscle tone, healthy skin, hair and nails, while preventing age or lifestyle-related reductions in health and the series of heart and organ failures that accompany inactivity and poor diet. Diet itself helps to increase calorie burning by boosting metabolism, a process further enhanced while gaining more lean muscle. An aerobic exercise program can burn fat and increase the metabolic rate. General Fitness There are many benefits to increasing one’s general fitness level, such as a reduction in stress, to feel better, a decreased likelihood of contracting many cardiovascular diseases, etc. Implementing or emphasizing an increased consistent level of physical activity is a surefire way to increase general fitness levels. The amount that one must be active and in doing what varies from person to person; for example, LeBron James has a much different training regimen than Judge Judy. There are also many ways to decrease one’s general fitness level. Injury, stress, tragedy, all of these can cause one to become less active and decreasing your body’s BMR. A general reduction in physical activity will also absolutely cause a decrease in general fitness. Diet Diet itself helps to increase calorie burning by boosting metabolism, a process further enhanced while gaining more lean muscle. An aerobic exercise program can burn fat and increase the basal metabolic rate (BMR) in obese adults, studies show that through proper diet over the span of 6 months in obese adults has shown a positive correlation in fitness and mood, as well as a weight loss average of over 27.5%  Studies also show reduced level of hunger and several other symptoms, such as inability to get up in the morning and frequent anxiety. Fitness and Mental Stability Physical fitness and mental stability go hand in hand, as research suggests that although physical and aerobic activity betters ones physical capabilities, it also helps with ones positive body image and self esteem. Studies show that physical fitness helps improve positive body image and self esteem, perceivable increased stress management, reduction of depression and anxiety, as well as enhance mood states and overall cognitive function. This all further shows the importance behind the usage of physical fitness for mental stability and why it is so important to engage in the practice of it. Weight loss and Muscle Definition General fitness training may be used to promote weight loss, as it combines physical activity with lifestyle changes. Personal trainers construct a program centered on restructuring lifestyle while helping to provide the necessary motivation for its success. These programs often include a mix of cardiovascular exercise, strength trainning, and flexibility work, along with nutritional guidance. A trainer can also provide accountability andmotivation, which are essential for staying on track and making lasting changes. General fitness training can also be used to promote toning or building of muscles, which are essentially the same physiological process. (However, 'toning' implies moderate muscle definition, whereas 'building' implies increasing musculature significantly.) The definition of weight loss is losing as much as or more than 3% body weight, although there is no completely defined definition as to what weight loss is, as one must take into account expert opinion, body type, previous study precedents, and normal weight fluctuations. COVID-19 General fitness training can improve immune response and strengthen the body's natural defenses against COVID-19 and other viruses. More Specialized Fitness Training Sports-Specific Training Sports-specific trainers can help improve strength, flexibility and stamina to improve performance in specific sports. Options include increasing arm strength for tennis playing or improve strength and core stability providing better balance playing golf. Sports specific training is all about developing physical conditions to improve performance and skills at a particular sport. Also, understanding the needs of the game, training/practicing at the correct pace, in order to meet sports requirements. Injury recovery Certified personal trainers can contribute significantly and uniquely to recovery and rehabilitation efforts. But personal trainers mainly pick up where physical therapy leaves off. Prenatal and Postpartum Training During a pregnancy period a lot of stress is put on the muscle on the lower back due to the heavy weight being carried. Exercise and stretching can be extremely important to increase strength and reinforce the body structure for the extra weight. During the second trimester (weeks 13-28) the unpleasant symptoms from the first trimester should have settled down and the mother will start to feel a renewed level of energy. The biggest change during this period will be the growth of the 'bump'. As the baby grows the mother should notice a change in her body position and posture. The extra weight occurs at the front of the body, the hip and back joints will take the strain. The posture will shift as the lower back muscles tighten and take an exaggerated curvature. The abdominal muscles will stretch and strain to adapt to the growing baby. During this time it will be extremely beneficial to perform exercises to help strengthen weakened abdominal and pelvic floor muscles, in order to reduce the strain on the lower back. See also Dieting Exercise physiology Exercise Health Kinesiology Neurobiological effects of physical exercise Physical exercise Physical fitness Power training Social influences on fitness behavior Split weight training Strength training Training Split Weight training References Strength training Physical exercise

EFT

An eft is a newt in the terrestrial juvenile phase. EFT, EfT, or eft also may refer to: Places École Française de Téhéran, an international school in Iran Monroe Municipal Airport (FAA:EFT), Wisconsin, United States Science and technology Ecosystem Functional Type, in ecology Effective field theory, in physics Electrical fast transient, in electrical engineering Emotionally focused therapy, in psychotherapy Ewing family of tumors, in medicine Exploration Flight Test-1, a 2014 NASA test flight Other uses Electronic funds transfer, in banking Emotional Freedom Techniques, in alternative medicine Escape from Tarkov, a 2017 FPS video game Evangelical Fellowship of Thailand, in Christianity See also EFTS (disambiguation)

Gastroenterocolitis

Gastroenterocolitis is a condition characterized by inflammation of the stomach, small intestines, and colon. Signs and symptoms The main symptom of gastroenteritis is diarrhea. Other symptoms may include: Abdominal pain or cramping Nausea Vomiting Low grade fever Because of the symptoms of vomiting and diarrhea, people who have gastroenteritis can become dehydrated quickly. It is very important to watch for signs of dehydration. Causes Gastroenteritis can be caused by viral, bacterial, or parasitic infections. Common routes of infection include: Food Contaminated water Contact with an infected person Unwashed hands Fifty to seventy percent of cases of gastroenteritis in adults are caused by noroviruses (genus Norovirus, family Caliciviridae). This virus is highly contagious and spreads rapidly. Norovirus is the most common cause of gastroenteritis in the United States. Diagnosis The doctor will take a medical history to make sure that nothing else is causing the symptoms. Also, the doctor might perform a rectal or abdominal examination to exclude the possibilities of inflammatory bowel disease (e.g., Crohn's disease) and pelvic abscesses (pockets of pus). A stool culture (a laboratory test to identify bacteria and other organisms from a sample of feces) can be used to determine the specific virus or germ that is causing gastroenteritis. Prevention With most infections, the key is to block the spread of the organism. Wash hands frequently Eat properly prepared and stored food. Bleach soiled laundry Vaccinations for Vibrio cholerae and rotavirus have been developed. Rotavirus vaccination is recommended for infants in the U.S. Vaccines for V. cholerae may be administered to individuals traveling to at-risk areas Treatment The body can usually fight off the disease on its own. The most important factor when treating gastroenteritis is the replacement of fluids and electrolytes that are lost because of the diarrhea and vomiting. Antibiotics will not be effective if the cause of gastroenteritis is a viral infection. Doctors usually do not recommend antidiarrheal medications (e.g., Loperamide) for gastroenteritis because they tend to prolong infection, especially in children. Parasitic infections are difficult to treat. A number of drugs are available once the condition has been identified. Removing part of the colon or needle aspiration of abscesses in liver may be required. Prognosis Depending on the cause of the inflammation, symptoms may last from one day to more than a week. Gastroenteritis caused by viruses may last one to two days. Most people recover easily from a short episode of vomiting and diarrhea by drinking clear fluids to replace the fluid that was lost and then gradually progressing to a normal diet. But for others, especially infants and the elderly, the loss of bodily fluid with gastroenteritis can cause dehydration, which can be a life-threatening illness unless it is treated and fluids in the body are replaced. References Stomach disorders Diseases of intestines

Medical corps

A medical corps is generally a military branch or officer corps responsible for medical care for serving military personnel. Such officers are typically military physicians. List of medical corps The following organizations are examples of medical corps: In the British Armed Forces and Commonwealth of Nations: Royal Army Medical Corps, a specialist corps of the Army Medical Services that provides medical care to British Army personnel Royal Australian Army Medical Corps, the branch of the Australian Army responsible for providing medical care to Army personnel Royal New Zealand Army Medical Corps, a corps of the New Zealand Army that is responsible for medical care to Army personnel Sri Lanka Army Medical Corps, a corps of the Sri Lanka Army that is responsible for medical care to Army personnel In the United States military: Medical Corps (United States Army), a corps that consists of all physicians of the U.S. Army Medical Department Medical Corps (United States Navy), a staff corps of the United States Navy consisting of doctors in a variety of specialties United States Air Force Medical Service, a corps that consists of all physicians of the U.S. Air Force Medical Service In the Indian Armed Forces AFMS(Armed Forces Medical Services), known as Army Medical Corps that is responsible for medical care to Indian Armed Forces(Army, Navy, Air Force, Coast Guard) personnel. It is tri-service organization. It provides medical support to the Armed Forces during war as well as comprehensive health care to all service personnel, ex-servicemen and their dependents during peace. Army Medical Corps provides medical aid during natural calamities both at national and international levels. AFMS has a common pool which allows officers to migrate from one service to another depending on the requirement. In the French Armed Forces: Defence Health Service In the Irish Defence Forces: Medical Corps (Ireland) In the Israel Defense Forces: Medical Corps (Israel) In the Myanmar Armed Forces: Myanmar Army Medical Corps In the Bangladesh Armed Forces: Army Medical Corps (Bangladesh) In the Polish Armed Forces: Military Health Service, part of the Polish Armed Forces providing a comprehensive full-scale military health service to them In the Singapore Armed Forces: SAF Medical Corps, a tri-service organization part of the Singapore Armed Forces that provides medical support for the Singapore Army, Navy and Air Force. In the South African National Defence Force: South African Military Health Service, a distinct Arm of Service (as opposed to Army, Navy or Air Force), providing a comprehensive full-scale military health service to the South African National Defence Force In the Armed Forces of the Russian Federation: Main Military Medical Directorate In the German Armed Forces (Bundeswehr): Zentraler Sanitätsdienst Dental corps A dental corps is a specialist military unit, generally including dentists and dedicated to maintaining the dental health of service personnel. Dental corps are therefore a kind of medical corps, and are typically either within the medical corps of their military organization, or closely associated with it. List of dental corps Royal Army Dental Corps, a specialist corps of the British Army Medical Services Royal Australian Army Dental Corps Royal Canadian Dental Corps Royal New Zealand Army Dental Corps United States Army Dental Corps, a special branch of the Army Medical Department (United States) United States Navy Dental Corps Army Dental Corps (India) Army Dental Corps (Pakistan) Army Dental Corps (Bangladesh) See also Medical Reserve Corps, a civilian program in the United States International Medical Corps (IMC), a global humanitarian nonprofit organization Medical Cadet Corps, a Seventh-day Adventist organization SS Medical Corps, of the SS in the Nazi Germany +Medical corps +Medical

Six levels

In Traditional Chinese medicine, the Six Levels, Six Stages or Six divisions is a theory used to understand the pathogenesis of a illness through the critical thinking processes of inductive and deductive logic utilising the model of Yin and Yang. This theory originated from Shang Han Lun (translated into "On Cold Damage") by Zhang Zhongjing in 220 CE or about 1800 years ago. The Six Stages The six stages are Tai Yang or Greater Yang Yang Ming or Bright Yang Shao Yang or Lesser Yang Tai Yin or Greater Yin Shao Yin or Lesser Yin Jue Yin or Terminal Yin As can be seen the names of the levels are the same as the names of the head and foot pairs of acupuncture meridians. The order is roughly the order that a disease takes as you go from health to death. In some disease levels are skipped or the order can change. Tai Yang stage (related to Urinary bladder/Small intestine channels) is started when a person is exposed to an exterior cold pathogen. The symptoms are Fever and maybe small chills, aversion to cold, pain in the back of the neck and head, Tongue has not yet changed, Pulse is floating. This stage has two sub stages. 1. Attack by wind. 2. Attack by cold. 3. Water Amassment 4. Blood amassment Treatment in this stage to release the exterior (sweating) Yang Ming stage (related to the stomach and large intestine channels) has high fever, profuse sweating, aversion to heat, thirst, red face, restlessness. The tongue has a red body and dry coating. Pulse Rapid, flooding (until the fluids are injured, then it becomes xi (deficient) and rapid. This stage is called the 4 greats (great pulse, fever, great thirst, great sweat) Treatment-clearing, draining Shao Yang stage (related to the San Jiao and Gallbladder channels) channel symptoms- loss of hearing, red eyes, dizziness, visual distortion, headaches and hypochondriac pain, alternating cold and hot. bowel symptoms-bitter taste, nausea or retching, irritability, anxiety Tongue-Thin, thin coat (that could be white or yellow) pulse-wiry Treatment-Harmonize Tai Yin (related to Lung and Spleen) chronic watery diarrhea, vomiting, loss of appetite, no thirst, abdominal pain Tongue-white coating Pulse-xu (deficient) unless severe pain, then xu and wiry Treatment-warm Shao Yin (related to the Heart and Kidneys) 2 subsections—constant fatigue in either situation Hot- fever, irritability, insomnia, dry mouth and throat, scanty and dark urine. This is a xu (deficient) heat, meaning the treatment is nourishing yin and not clearing heat Cold-frequent urination with clear urine, cold extremities, aversion to cold, perhaps the body has aching joints and diarrhea. treatment method is warming and supportive. Tongue-Red if hot pattern, pale if cold pattern Pulse-faint and weak -rapid with heat Jue Yin (related to the liver and pericardium channels)Primary symptoms-thirst, qi surging into chest with burning pain, hunger with no desire to eat, cold extremities. heat patterns-diarrhea with burning sensation, rectal heaviness, abdominal cramps, thirst or cold extremities with interior heat cold patterns- cold limbs, diarrhea with undigested food, vomiting, headaches on vertex, spasm Upper heat, lower cold-severe vomiting-case relates to roundworms References Traditional Chinese medicine

Typology (urban planning and architecture)

Typology is the study and classification of object types. In urban planning and architecture, typology refers to the task of identifying and grouping buildings and urban spaces according to the similarity of their essential characteristics. Common examples of essential characteristics include intensity of development (from rural to suburban to urban) and building use (church, hospital, school, apartment, house, etc.) Non-essential characteristics are those which, if modified, would not change the building type. Color, for example, would rarely be considered an essential characteristic of building type. Material, however, may or may not be considered essential depending on how integral the material is to the structure (engineering) and construction (assembly) of the building. Building types may be further divided into subtypes. For example, among religious structures there are churches and mosques, etc.; among churches there are cathedrals and chapels, etc.; among cathedrals there are gothic and romanesque, etc. In architecture and urban planning discourse, typology is sometimes distinguished from morphology, which is the study and classification of buildings according to their shape or form (gk. morph). When this dichotomy is employed between typology and morphology, the term typology tends to refer to the more limited aspects of buildings or urban sites specifically related to their use. In other words: typology is used-based classification; morphology is form-based classification. This distinction is particularly relevant in urban planning and design, where some have begun to question the standard model of single-use zoning codes in favor of form-based zoning codes that regulate development not by use (commercial, residential, industrial, etc) but instead by the shape, size, and placement of buildings on their lots. See also Pattern language Architectural theory Urban studies and planning terminology

Environmental medicine

Environmental medicine is a multidisciplinary field involving medicine, environmental science, chemistry and others, overlapping with environmental pathology. It can be viewed as the medical branch of the broader field of environmental health. The scope of this field involves studying the interactions between environment and human health, and the role of the environment in causing or mediating disease. This specialist field of study developed after the realisation that health is more widely and dramatically affected by environmental factors than previously recognized. Environmental factors in the causation of environmental diseases can be classified into: Physical Chemical Biological Social (including Psychological and Culture variables) Ergonomic Safety Any combination of the above In the United States, the American College of Preventive Medicine oversees board certification of physicians in Occupational and Environmental Medicine. Current focuses of environmental medicine While environmental medicine is a broad field, some of the currently prominent issues include: The effects of ozone depletion and the resulting increase in UV radiation on humans with regards to skin cancer. The effects of nuclear accidents or the effects of a terrorist dirty bomb attack and the resulting effects of radioactive material and radiation on humans. The effects of chemicals on humans, such as dioxin, especially with regards to developmental effects and cancer. Others include PFOA/PFAS. Plastic pollution from Microplastics and Nanoplastics Radon gas exposure in individuals' homes. Air and water pollution on the health of individuals. Mercury poisoning and exposure to humans through including fish and sea life in their diet. Lead poisoning from leaded gasoline, paint, and plumbing. Water-borne diseases Food poisoning Indoor air quality According to recent estimates, about 5 to 10% of disability-adjusted life years (DALY) lost are due to environmental causes. By far, the most important factor is fine particulate matter pollution in urban air. Scope of environmental medicine Environmental medicine is concerned primarily with prevention. Food-borne infections or infections that are water-borne (e.g. cholera and gastroenteritis caused by norovirus or campylobacteria) are typical concerns of environmental medicine, but some opinions in the fields of microbiology hold that the viruses, bacteria and fungi that they study are not within the scope of environmental medicine if the spread of infection is directly from human to human. Much of epidemiology, which studies patterns of disease and injury, is not within the scope of environmental medicine, but e.g. air pollution epidemiology is a highly active branch of environmental health and environmental medicine. Any disease with a large genetic component usually falls outside the scope of environmental medicine, but in diseases like asthma or allergies both environmental and genetic approaches are needed. Military "environmental medicine" The U.S. Army has, since at least 1961, used the term "environmental medicine" in a sense different from the above. Its U.S. Army Research Institute of Environmental Medicine, at Natick, Massachusetts, conducts basic and applied research to determine how exposure to extreme heat, severe cold, high terrestrial altitude, military occupational tasks, physical training, deployment operations, and nutritional factors affect the health and performance of military personnel. Research on the effect of environmental pollutants on military personnel is not part of USARIEM's mission, but is within the purview of the U.S. Army Center for Environmental Health Research at Fort Detrick, Maryland. See also Environmental disease Environmental health Environmental Toxicology Toxicology Multiple chemical sensitivity Clinical ecology References Tuomisto, Jouko (2010). Arsenic to zoonoses. One hundred questions about the environment and health. Arsenic to zoonoses - Opasnet External links ATSDR Case Studies in Environmental Medicine U.S. Department of Health and Human Services American Academy of Environmental Medicine British Society for Ecological Medicine Italian Society of Environmental Medicine European Academy for Clinical Environmental Medicine Medical specialties Environmental health

Exercise-associated hyponatremia

Exercise-associated hyponatremia (EAH) is a fluid-electrolyte disorder caused by a decrease in sodium levels (hyponatremia) during or up to 24 hours after prolonged physical activity. This disorder can develop when marathon runners or endurance event athletes drink more fluid, usually water or sports drinks, than their kidneys can excrete. This excess water can severely dilute the level of sodium in the blood needed for organs, especially the brain, to function properly. The incidence of EAH in athletes has increased in recent years, especially in the United States, as marathon races and endurance events have become more popular. A recent study showed 13% of the Boston 2002 marathon runners experienced EAH; most cases were mild. Eight deaths from EAH have been documented since 1985. Symptoms Symptoms may be absent or mild for the early onset of EAH and can include impaired exercise performance, nausea, vomiting, headache, bloating, and swelling of hands, legs, and feet. As water retention increases, weight gain may also occur. More severe symptoms include pulmonary edema and hyponatremic encephalopathy. Symptoms of hyponatremic encephalopathy are associated with an altered level of consciousness and can include sullenness, sleepiness, withdrawing from social interaction, photophobia, and seizures. Causes The primary causes of EAH include excessive fluid retention during exercise with a significant sodium deficit and excessive fluid intake leading to an increase in total body water resulting in a reduction in blood sodium levels. Athlete-specific risk factors are being of female sex, use of non-steroidal anti-inflammatory drugs [NSAIDs], slow running, excessive fluid ingestion, low body weight, and event inexperience. Event-specific risk factors are high availability of drinking fluids, duration of exercise exceeding four hours, unusually hot environmental conditions, and extreme cold temperature. Mechanism Sodium is an important electrolyte needed for maintaining blood pressure. Sodium is mainly found in the body fluids that surround the cells and is necessary for nerves, muscles, and other body tissues to function properly. Many factors may contribute to the development of EAH. Under normal conditions, sodium and water levels are regulated by the renal and hormonal systems. The decrease in sodium levels can occur due to a defect in the renal and hormonal systems, an overwhelming increase in water consumption and excessive loss of sodium through sweating. When the sodium levels outside of the cells decrease, water moves into the cells. The cells begin to increase in size. When several cells in one area begin to increase in size, swelling occurs in the affected area. Swelling is commonly observed in hands, legs, and feet. Sodium is also important in regulating the amount of water that passes through the blood–brain barrier. Decreased sodium blood levels result in increased permeability of water across the blood–brain barrier. This increased influx of water causes brain swelling which leads to severe neurological symptoms. Epidemiology A 2012 study revealed that 26% of the athletes competing in the Triple Iron ultra-triathlon developed EAH. A similar study measured the prevalence of EAH in open-water ultra-endurance swimmers and found 8% of males and 36% of females developed EAH. Diagnosis EAH is categorized by having a blood serum or plasma sodium level below normal, which is less than 135 mmol/L. Asymptomatic EAH is not normally detected unless the athlete has had a sodium blood serum or plasma test. Hyponatremic encephalopathy may be detected using brain imaging studies and pulmonary edema may be confirmed by x-ray. Prevention Traditional prevention of EAH focuses on reducing fluid consumption to avoid fluid retention before, during, and after exercise. However, since this can risk dehydration, an alternative approach is possible of consuming a substantial amount of salt prior to exercise. It is still important not to overconsume water to the extent of requiring urination, because urination would cause the extra salt to be excreted. Role of thirst In a published statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, researchers concluded that drinking in accordance with the sensation of thirst is sufficient for preventing both dehydration and hyponatremia. This advice is contradicted by the American College of Sports Medicine, which has previously recommended athletes drink "as much as tolerable." In October 2015, ACSM President W. Larry Kenney stated that “[T]he clear and important health message should be that thirst alone is not the best indicator of dehydration or the body’s fluid needs.” In a letter to the editors of The Journal of Wilderness and Environmental Medicine, Brad L. Bennett, PhD claimed "perpetuation of the myth that one needs to drink beyond the dictates of thirst can be deadly." Similarly, authors of the Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference claim this advice has "facilitated inadvertent overdrinking and pathological dilutional EAH." Critics of the ACSM's view have questioned their motives, pointing out that Gatorade is one of the organizations "platinum sponsors." Treatment Treatments are focused on the underlying cause of hyponatremia and include fluid restriction and saline. When EAH is treated early, complete recovery is expected. Data from one study suggests that immediate administration of 100 mL intravenous bolus of 3% hypertonic saline was more effective at normalizing blood sodium levels than oral administration for asymptomatic EAH. Athletes experiencing EAH encephalopathy may also receive high-flow oxygen and a rapid infusion of 100 mL of 3% NaCl to reduce brain edema. References Metabolic disorders Exercise physiology Electrolyte disturbances

Committee for Medicinal Products for Human Use

The Committee for Medicinal Products for Human Use (CHMP), formerly known as the Committee for Proprietary Medicinal Products (CPMP), is the European Medicines Agency's committee responsible for elaborating the agency's opinions on all issues regarding medicinal products for human use. See also Committee for Medicinal Products for Veterinary Use References External links Committee for Medicinal Products for Human Use (CHMP) European Medicines Agency - Committee for Medicinal Products for Human Use (CHMP) Health and the European Union

Neuroimmunology

Neuroimmunology is a field combining neuroscience, the study of the nervous system, and immunology, the study of the immune system. Neuroimmunologists seek to better understand the interactions of these two complex systems during development, homeostasis, and response to injuries. A long-term goal of this rapidly developing research area is to further develop our understanding of the pathology of certain neurological diseases, some of which have no clear etiology. In doing so, neuroimmunology contributes to development of new pharmacological treatments for several neurological conditions. Many types of interactions involve both the nervous and immune systems including the physiological functioning of the two systems in health and disease, malfunction of either and or both systems that leads to disorders, and the physical, chemical, and environmental stressors that affect the two systems on a daily basis. Background Neural targets that control thermogenesis, behavior, sleep, and mood can be affected by pro-inflammatory cytokines which are released by activated macrophages and monocytes during infection. Within the central nervous system production of cytokines has been detected as a result of brain injury, during viral and bacterial infections, and in neurodegenerative processes. From the US National Institute of Health: "Despite the brain's status as an immune privileged site, an extensive bi-directional communication takes place between the nervous and the immune system in both health and disease. Immune cells and neuroimmune molecules such as cytokines, chemokines, and growth factors modulate brain function through multiple signaling pathways throughout the lifespan. Immunological, physiological and psychological stressors engage cytokines and other immune molecules as mediators of interactions with neuroendocrine, neuropeptide, and neurotransmitter systems. For example, brain cytokine levels increase following stress exposure, while treatments designed to alleviate stress reverse this effect. "Neuroinflammation and neuroimmune activation have been shown to play a role in the etiology of a variety of neurological disorders such as stroke, Parkinson's and Alzheimer's disease, multiple sclerosis, pain, and AIDS-associated dementia. However, cytokines and chemokines also modulate CNS function in the absence of overt immunological, physiological, or psychological challenges. For example, cytokines and cytokine receptor inhibitors affect cognitive and emotional processes. Recent evidence suggests that immune molecules modulate brain systems differently across the lifespan. Cytokines and chemokines regulate neurotrophins and other molecules critical to neurodevelopmental processes, and exposure to certain neuroimmune challenges early in life affects brain development. In adults, cytokines and chemokines affect synaptic plasticity and other ongoing neural processes, which may change in aging brains. Finally, interactions of immune molecules with the hypothalamic-pituitary-gonadal system indicate that sex differences are a significant factor determining the impact of neuroimmune influences on brain function and behavior." Recent research demonstrates that reduction of lymphocyte populations can impair cognition in mice, and that restoration of lymphocytes restores cognitive abilities. Epigenetics Overview Epigenetic medicine encompasses a new branch of neuroimmunology that studies the brain and behavior, and has provided insights into the mechanisms underlying brain development, evolution, neuronal and network plasticity and homeostasis, senescence, the etiology of diverse neurological diseases and neural regenerative processes. It is leading to the discovery of environmental stressors that dictate initiation of specific neurological disorders and specific disease biomarkers. The goal is to "promote accelerated recovery of impaired and seemingly irrevocably lost cognitive, behavioral, sensorimotor functions through epigenetic reprogramming of endogenous regional neural stem cells". Neural stem cell fate Several studies have shown that regulation of stem cell maintenance and the subsequent fate determinations are quite complex. The complexity of determining the fate of a stem cell can be best understood by knowing the "circuitry employed to orchestrate stem cell maintenance and progressive neural fate decisions". Neural fate decisions include the utilization of multiple neurotransmitter signal pathways along with the use of epigenetic regulators. The advancement of neuronal stem cell differentiation and glial fate decisions must be orchestrated timely to determine subtype specification and subsequent maturation processes including myelination. Neurodevelopmental disorders Neurodevelopmental disorders result from impairments of growth and development of the brain and nervous system and lead to many disorders. Examples of these disorders include Asperger syndrome, traumatic brain injury, communication, speech and language disorders, genetic disorders such as fragile-X syndrome, Down syndrome, ADHD, epilepsy, and fetal alcohol syndrome. Studies have shown that autism spectrum disorders (ASDs) may present due to basic disorders of epigenetic regulation. Other neuroimmunological research has shown that deregulation of correlated epigenetic processes in ASDs can alter gene expression and brain function without causing classical genetic lesions which are more easily attributable to a cause and effect relationship. These findings are some of the numerous recent discoveries in previously unknown areas of gene misexpression. Neurodegenerative disorders Increasing evidence suggests that neurodegenerative diseases are mediated by erroneous epigenetic mechanisms. Neurodegenerative diseases include Huntington's disease and Alzheimer's disease. Neuroimmunological research into these diseases has yielded evidence including the absence of simple Mendelian inheritance patterns, global transcriptional dysregulation, multiple types of pathogenic RNA alterations, and many more. In one of the experiments, a treatment of Huntington’s disease with histone deacetylases (HDAC), an enzyme that removes acetyl groups from lysine, and DNA/RNA binding anthracylines that affect nucleosome positioning, showed positive effects on behavioral measures, neuroprotection, nucleosome remodeling, and associated chromatin dynamics. Another new finding on neurodegenerative diseases involves the overexpression of HDAC6 suppresses the neurodegenerative phenotype associated with Alzheimer’s disease pathology in associated animal models. Other findings show that additional mechanisms are responsible for the "underlying transcriptional and post-transcriptional dysregulation and complex chromatin abnormalities in Huntington's disease". Neuroimmunological disorders The nervous and immune systems have many interactions that dictate overall body health. The nervous system is under constant monitoring from both the adaptive and innate immune system. Throughout development and adult life, the immune system detects and responds to changes in cell identity and neural connectivity. Deregulation of both adaptive and acquired immune responses, impairment of crosstalk between these two systems, as well as alterations in the deployment of innate immune mechanisms can predispose the central nervous system (CNS) to autoimmunity and neurodegeneration. Other evidence has shown that development and deployment of the innate and acquired immune systems in response to stressors on functional integrity of cellular and systemic level and the evolution of autoimmunity are mediated by epigenetic mechanisms. Autoimmunity has been increasingly linked to targeted deregulation of epigenetic mechanisms, and therefore, use of epigenetic therapeutic agents may help reverse complex pathogenic processes. Multiple sclerosis (MS) is one type of neuroimmunological disorder that affects many people. MS features CNS inflammation, immune-mediated demyelination and neurodegeneration. Myalgic Encephalomyelitis (also known as Chronic fatigue syndrome), is a multi-system disease that causes dysfunction of neurological, immune, endocrine and energy-metabolism systems. Though many patients show neuroimmunological degeneration, the correct roots of ME/CFS are unknown. Symptoms of ME/CFS include significantly lowered ability to participate in regular activities, stand or sit straight, inability to talk, sleep problems, excessive sensitivity to light, sound or touch and/or thinking and memory problems (defective cognitive functioning). Other common symptoms are muscle or joint pain, sore throat or night sweats. There is no treatment but symptoms may be treated. Patients that are sensitive to mold may show improvement in symptoms having moved to drier areas. Some patients in general have less severe ME, whereas others may be bedridden for life. PTSD has been linked to neuroimmunity dysfunction with this being greater in individuals with worse anhedonia. Major themes of research The interaction of the CNS and immune system are fairly well known. Burn-induced organ dysfunction using vagus nerve stimulation has been found to attenuate organ and serum cytokine levels. Burns generally induce abacterial cytokine generation and perhaps parasympathetic stimulation after burns would decrease cardiodepressive mediator generation. Multiple groups have produced experimental evidence that support proinflammatory cytokine production being the central element of the burn-induced stress response. Still other groups have shown that vagus nerve signaling has a prominent impact on various inflammatory pathologies. These studies have laid the groundwork for inquiries that vagus nerve stimulation may influence postburn immunological responses and thus can ultimately be used to limit organ damage and failure from burn induced stress. Basic understanding of neuroimmunological diseases has changed significantly during the last ten years. New data broadening the understanding of new treatment concepts has been obtained for a large number of neuroimmunological diseases, none more so than multiple sclerosis, since many efforts have been undertaken recently to clarify the complexity of pathomechanisms of this disease. Accumulating evidence from animal studies suggests that some aspects of depression and fatigue in MS may be linked to inflammatory markers. Studies have demonstrated that Toll like-receptor (TLR4) is critically involved in neuroinflammation and T cell recruitment in the brain, contributing to exacerbation of brain injury. Research into the link between smell, depressive behavior, and autoimmunity has turned up interesting findings including the facts that inflammation is common in all of the diseases analyzed, depressive symptoms appear early in the course of most diseases, smell impairment is also apparent early in the development of neurological conditions, and all of the diseases involved the amygdale and hippocampus. Better understanding of how the immune system functions and what factors contribute to responses are being heavily investigated along with the aforementioned coincidences. Neuroimmunology is also an important topic to consider during the design of neural implants. Neural implants are being used to treat many diseases, and it is key that their design and surface chemistry do not elicit an immune response. Future directions The nervous system and immune system require the appropriate degrees of cellular differentiation, organizational integrity, and neural network connectivity. These operational features of the brain and nervous system may make signaling difficult to duplicate in severely diseased scenarios. There are currently three classes of therapies that have been utilized in both animal models of disease and in human clinical trials. These three classes include DNA methylation inhibitors, HDAC inhibitors, and RNA-based approaches. DNA methylation inhibitors are used to activate previously silenced genes. HDACs are a class of enzymes that have a broad set of biochemical modifications and can affect DNA demethylation and synergy with other therapeutic agents. The final therapy includes using RNA-based approaches to enhance stability, specificity, and efficacy, especially in diseases that are caused by RNA alterations. Emerging concepts concerning the complexity and versatility of the epigenome may suggest ways to target genomewide cellular processes. Other studies suggest that eventual seminal regulator targets may be identified allowing with alterations to the massive epigenetic reprogramming during gametogenesis. Many future treatments may extend beyond being purely therapeutic and may be preventable perhaps in the form of a vaccine. Newer high throughput technologies when combined with advances in imaging modalities such as in vivo optical nanotechnologies may give rise to even greater knowledge of genomic architecture, nuclear organization, and the interplay between the immune and nervous systems. See also Immune system Immunology Gut–brain axis Neural top down control of physiology Neuroimmune system Neurology Psychosomatic illness References Further reading (Written for the highly technical reader) Mind-Body Medicine: An Overview, US National Institutes of Health, Center for Complementary and Integrative Health technical. (Written for the general public) External links Online Resources Psychoneuroimmunology, Neuroimmunomodulation (6 chapters from this Cambridge UP book are freely available) More than 100, freely available, published research articles on neuroimmunology and related topics by Professor Michael P. Pender, Neuroimmunology Research Unit, The University of Queensland Branches of immunology Clinical neuroscience Neurology

Bodymind

Bodymind is an approach to understand the relationship between the human body and mind where they are seen as a single integrated unit. It attempts to address the mind–body problem and resists the Western traditions of mind–body dualism. Dualism vs holism In the field of philosophy, the theory of dualism is the speculation that the mental and the physical parts of us, like our minds and our bodies, are different or separate. Modern understanding "The mind is composed of mental fragments- sensations, feelings, thoughts, imaginations, all flowing now in an ordered sequence, now in a chaotic fashion…. On the other hand, the body is constructed under the underlying laws of physics, and its components obey the well-enumerated laws of physiology. It is these characteristic differences between these two – between mind and body – that lead to the Mind-Body problem.". While Western populations tend to believe more in the idea of dualism, there is also good research on the neurophysiology of emotions and their foundation in human meaning making, the function of the mind, such as the research of Candace Pert. Relevance to alternative medicine In the field of alternative medicine, bodymind implies that The body, mind, emotions, and spirit are dynamically interrelated. Experience, including physical stress, emotional injury, and pleasures are stored in the body's cells which in turn affects one's reactions to stimuli. The term can be a number of disciplines, including: Psychoneuroimmunology, the study of the interaction between psychological processes and the nervous and immune systems of the human body. Body psychotherapy, a branch of psychotherapy which applies basic principles of somatic psychology. It originated in the work of Pierre Janet and particularly Wilhelm Reich. Neurobiology, the study of the nervous system Psychosomatic medicine, an interdisciplinary medical field exploring the relationships among social, psychological, and behavioral factors on bodily processes and quality of life in humans and animals. Clinical situations where mental processes act as a major factor affecting medical outcomes are areas where psychosomatic medicine excels. Postural Integration, a process-oriented body psychotherapy originally developed in the late 1960s by Jack Painter (1933–2010) in California, US, after exploration in the fields of humanistic psychology and the human potential movement. The method aims to support personal change and self development, through a particular form of manipulative holistic bodywork. See also Ableism Binding problem Bodymind (disability studies) Developmental disability Disability Disability and religion Disability culture Disability in the United States Disability rights Disability studies Emotional or behavioral disability Inclusion (disability rights) Invisible disability List of disability studies journals Medical model of disability Services for the disabled Sexuality and disability Social model of disability Society for Disability Studies References Further reading Benson MD, Herbert; ( 2000) (1975), The Relaxation Response, Harper Bracken, Patrick & Philip Thomas; (2002), "Time to move beyond the mind-body split", editorial, British Medical Journal 2002;325:1433–1434 (21 December) Dychtwald, Ken; (1986), Bodymind Penguin Putman Inc. NY, Gallagher, Shaun; (2005) ‚ How the Body Shapes the Mind Oxford: Oxford University Press. Hill, Daniel (2015) Affect Regulation Theory. A Clinical Model W. W. Norton.& Co . Keinänen, Matti; (2005), Psychosemiosis as a Key to Body-Mind Continuum: The Reinforcement of Symbolization-Reflectiveness in Psychotherapy. Nova Science Publishers. . Mayer, Emeran A. 2003. The Neurobiology Basis of Mind Body Medicine: Convergent Traditional and Scientific Approaches to Health, Disease, and Healing. Source: https://web.archive.org/web/20070403123225/http://www.aboutibs.org/Publications/MindBody.html (accessed: Sunday January 14, 2007). Money, John; (1988) Gay, Straight, and In-Between: The Sexology of Erotic Orientation. New York: Oxford University Press. Rothschild, Babette; ( 2000) The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment. W W Norton & Co Inc. Scheper-Hughes, Nancy, and Margaret M. Lock; (1987) The Mindful Body: A Prolegomenon to Future Work in Medical Anthropology with Margaret Lock. Medical Anthropology Quarterly. (1): 6–41. Seem, Mark & Kaplan, Joan; (1987) Bodymind Energetics, Towards a Dynamic Model of Health Healing Arts Press, Rochester VT, Clare, Eli. "Brilliant Imperfection: Grappling with Cure" Schalk, Sami. "Bodyminds Reimagined: (Dis)ability, Race, and Gender in Black Women's Speculative Fiction" Patsavas, Alyson. "Recovering a Cripistemology of Pain: Leaky Bodies, Connective Tissue, and Feeling Discourse" Price, Margaret. "The Bodymind Problem and the Possibilities of Pain" Kafer, Alison. "Feminist, Queer, Crip" Hall, Kim. "Gender" chapter from "Keywords for Disability Studies". McRuer, Robert, and Johnson, Merri Lisa. "Proliferating Cripistemologies: A Virtual Roundtable". Garland-Thomson, Rosemarie. "Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature". Garland-Thomson, Rosemarie. "Becoming Disabled". Body psychotherapy Popular psychology

Religion and health

Scholarly studies have investigated the effects of religion on health. The World Health Organization (WHO) discerns four dimensions of health, namely physical, social, mental, and spiritual health. Having a religious belief may have both positive and negative impacts on health and morbidity. Religion and spirituality Spirituality has been ascribed many different definitions in different contexts, but a general definition is: an individual's search for meaning and purpose in life. Spirituality is distinct from organized religion in that spirituality does not necessarily need a religious framework. That is, one does not necessarily need to follow certain rules, guidelines or practices to be spiritual, but an organized religion often has some combination of these in place. Some people who suffer from severe mental disorders may find comfort in religion. People who report themselves to be spiritual people may not observe any specific religious practices or traditions. Its important to identify what is spirituality in a expanded format to determine what is the best way to research and study it. Scientific research More than 3000 empirical studies have examined relationships between religion and health, including more than 1200 in the 20th century, and more than 2000 additional studies between 2000 and 2009. Various other reviews of the religion/spirituality and health literature have been published. These include two reviews from an NIH-organized expert panel that appeared in a 4-article special section of American Psychologist. Several chapters in edited academic books have also reviewed the empirical literature. The literature has also been reviewed extensively from the perspective of public health and its various subfields ranging from health policy and management to infectious diseases and vaccinology. More than 30 meta-analyses and 100 systematic reviews have been published on relations between religious or spiritual factors and health outcomes. Dimensions of health The World Health Organization (WHO) discerns four dimensions of health, namely physical, social, mental, and spiritual health. Physical health Positive effects According to Ellison & Levin (1998), some studies indicate that religiosity appears to positively correlate with physical health. For instance, mortality rates are lower among people who frequently attend religious events and consider themselves both religious and spiritual. According to Seybold & Hill (2001), almost all studies involved in the effect of religion on a person's physical health have revealed it has a positive attribution to their lifestyle. These studies have been carried out among all ages, genders and religions. These are based on the experience of religion is positive in itself. One possibility is that religion provides physical health benefits indirectly. Church attendees present with lower rates of alcohol consumption and improvement in mood, which is associated with better physical health. Kenneth Pargament is a major contributor to the theory of how individuals may use religion as a resource in coping with stress, His work seems to show the influence of attribution theory. Additional evidence suggests that this relationship between religion and physical health may be causal. Religion may reduce likelihood of certain diseases. Studies suggest that it guards against cardiovascular disease by reducing blood pressure, and also improves immune system functioning. Similar studies have been done investigating religious emotions and health. Although religious emotions, such as humility, forgiveness, and gratitude confer health benefits, it is unclear if religious people cultivate and experience those emotions more frequently than non-religious peoples. Church attendance In many studies, attendance at religious services has been found to be associated with lower levels of multiple risk factors for ill health and mortality and with lower prevalence and incidence of illness and mortality. For example, a recent report of a follow-up study of over five thousand Americans found those attending more than weekly had half the mortality of those never attending after adjusting for multiple variables. This can be expressed as an increase life expectancy (Hummer et al. 1999) with a life expectancy at age 20 of 83 years for frequent attendees and 75 years for non-attendees. A causal association between a risk factor and an outcome can only be proven by a randomized controlled experiment, obviously infeasible in this case. Hence, observational findings of an association of religious attendance with lower mortality are compatible with a causal relationship but cannot prove one. Church goers may differ from others in ways not measured that could explain their better health. One alternative explanation is that social activities performed in church, such as group singing, have health benefits for which a religious component is not necessary. Life expectancy and death rates Loma Linda, California, one of the five original Blue Zones of the world, "live eight to 10 years longer than the average American". Its population largely holds church membership in the Seventh-day Adventist Church, which encourages Christian vegetarianism and mandates the observance of the Sabbath. Kark et. (1996) included almost 4,000 Israelis, over 16 years (beginning in 1970), death rates were compared between the experimental group (people belonging to 11 religious kibbutzim) versus the control group (people belonging to secular kibbutzim). Some determining factors for the groups included the date the kibbutz was created, geography of the different groups, and the similarity in age. It was determined that "belonging to a religious collective was associated with a strong protective effect". Not only do religious people tend to exhibit healthier lifestyles, they also may have a strong support system that individualist secular people would not normally have. A religious community can provide support especially through a stressful life event such as the death of a loved one or illness. There is the belief that a higher power will provide healing and strength through the rough times which also can explain the lower mortality rate of religious people vs. secular people. The existence of 'religious struggle' in elderly patients was predictive of greater risk of mortality in a study by Pargament et al. (2001). Results indicate that patients, with a previously sound religious life, experienced a 19% to 28% greater mortality due to the belief that God was supposedly punishing them or abandoning them. Infections A number of religious practices have been reported to cause infections. These happened during an ultra-orthodox Jewish circumcisions practice known as metzitzah b'peh, the ritual 'side roll' in Hinduism, the Christian communion chalice, during the Islamic Hajj and after the Muslim ritual ablution (where nasal irrigation is concerned). Prayer Some religions claim that praying for somebody who is sick can have positive effects on the health of the person being prayed for. Meta-studies of the literature in the field have been performed showing evidence only for no effect or a potentially small effect. For instance, a 2006 meta analysis on 14 studies concluded that there is "no discernible effect" while a 2007 systemic review of intercessory prayer reported inconclusive results, noting that 7 of 17 studies had "small, but significant, effect sizes" but the review noted that the most methodologically rigorous studies failed to produce significant findings. Randomized controlled trials of intercessory prayer have not yielded significant effects on health. These trials have compared personal, focused, committed and organized intercessory prayer with those interceding holding some belief that they are praying to God or a god versus any other intervention. A Cochrane collaboration review of these trials concluded that 1) results were equivocal, 2) evidence does not support a recommendation either in favor or against the use of intercessory prayer and 3) any resources available for future trials should be used to investigate other questions in health research. In a case-control study done following 5,286 Californians over a 28-year period in which variables were controlled for (i.e. age, race/ethnicity, gender, education level), participants who went to church on a frequent basis (defined as attending a religious service once a week or more) were 36% less likely to die during that period. However, this can be partly be attributed to a better lifestyle since religious people tend to drink and smoke less and eat a healthier diet. Mental health According to a meta-analytical review, a large volume of research shows that people who are more religious and spiritual have better mental health and adapt more quickly to health problems compared to those who are less religious and spiritual. Studies have shown that religious believers experience higher levels of "mattering to others, dignity and meaning in their lives". In those who prayed often, the association was stronger. Religiosity has been found to mitigate the negative impact of income inequality and injustice on life satisfaction. The link between religion and mental health may be due to the guiding framework or social support that it offers to individuals. By these routes, religion has the potential to offer security and significance in life, as well as valuable human relationships, to foster mental health. Some theorists have suggested that the benefits of religion and religiosity are accounted for by the social support afforded by membership in a religious group. Religion may also provide coping skills to deal with stressors, or demands perceived as straining. Pargament's three primary styles of religious coping are 1) self-directing, characterized by self-reliance and acknowledgement of God, 2) deferring, in which a person passively attributes responsibility to God, and 3) collaborative, which involves an active partnership between the individual and God and is most commonly associated with positive adjustment. This model of religious coping has been criticized for its over-simplicity and failure to take into account other factors, such as level of religiosity, specific religion, and type of stressor. Additional work by Pargament involves a detailed delineation of positive and negative forms of religious coping, captured in the BRIEF-RCOPE questionnaire which have been linked to a range of positive and negative psychological outcomes. Religiosity is positively associated with mental disorders that involve an excessive amount of self-control and negatively associated with mental disorders that involve a lack of self-control. Other studies have found indications of mental health among both the religious and the secular. For instance, Vilchinsky & Kravetz found negative correlations with psychological distress among religious and secular subgroups of Jewish students. In addition, intrinsic religiosity has been inversely related to depression in the elderly, while extrinsic religiosity has no relation or even a slight positive relation to depression. Depression In one study, those who were assessed to have a higher spiritual quality of life on a spiritual well-being scale had less depressive symptoms. Cancer and AIDS patients who were more spiritual had lower depressive symptoms than religious patients. Spirituality shows beneficial effects possibly because it speaks to one's ability to intrinsically find meaning in life, strength, and inner peace, which is especially important for very ill patients. Exline et al. 1999 showed that the difficulty in forgiving God and alienation from God were associated with higher levels of depression and anxiety. Among those who currently believed in God, forgiving God for a specific, unfortunate incident predicted lower levels of anxious and depressed mood. Schizophrenia and psychosis Studies have reported beneficial effects of spirituality on the lives of patients with schizophrenia, major depression, and other psychotic disorders. Schizophrenic patients were less likely to be re-hospitalized if families encouraged religious practice, and in depressed patients who underwent religiously based interventions, their symptoms improved faster than those who underwent secular interventions. Furthermore, a few cross-sectional studies have shown that more religiously involved people had less instance of psychosis. Life satisfaction Research shows that religiosity moderates the relationship between "thinking about meaning of life" and life satisfaction. For individuals scoring low and moderately on religiosity, thinking about the meaning of life is negatively correlated with life satisfaction. For people scoring highly on religiosity, however, this relationship is positive. Religiosity has also been found to moderate the relationship between negative affect and life satisfaction, such that life satisfaction is less strongly influenced by the frequency of negative emotions in more religious (vs less religious) individuals. Coping with trauma One of the most common ways that people cope with trauma is through the comfort found in religious or spiritual practices. Psychologists of religion have performed multiple studies to measure the positive and negative effects of this coping style. Leading researchers have split religious coping into two categories: positive religious coping and negative religious coping. Individuals who use positive religious coping are likely to seek spiritual support and look for meaning in a traumatic situation. Negative religious coping (or spiritual struggles) expresses conflict, question, and doubt regarding issues of God and faith. The effects of religious coping are measured in many different circumstances, each with different outcomes. Some common experiences where people use religious coping are fear-inflicting events such as 9/11 or the holocaust, death and sickness, and near death experiences. Research also shows that people also use religious coping to deal with everyday stressors in addition to life-changing traumas. The underlying assumption of the ability of religion to influence the coping process lies in the hypothesis that religion is more than a defence mechanism as it was viewed by Sigmund Freud. Rather than inspiring denial, religion stimulates reinterpretations of negative events through the sacred lens. Moral mandate Social health Spiritual health Spiritual health is one of four dimensions of well-being as defined by the World Health Organization (WHO), along with physical, social, and mental health. The preamble to the Constitution of the World Health Organization (WHO) adopted by the International Health Conference held in New York from 19 June to 22 July 1946 and signed on 22 July 1946 by the representatives of 61 States defined health as a state of "physical, mental and social well-being and not merely the absence of disease or infirmity" and it has not been amended. However, in 1983, twenty-two WHO member countries from the Eastern Mediterranean Region proposed a draft resolution to this preamble to include reference to spiritual health, such that it would redefine health as a state of "physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity". While the WHO did not amend the preamble to its constitution, resolution WHA31.13 passed by the Thirty-seventh World Health Assembly, in 1984 called upon Member States to consider including in their Health For All strategies a spiritual dimension as defined in that resolution in accordance with their own social and cultural patterns, recognizing that "the spiritual dimension plays a great role in motivating people's achievements in all aspects of life". The complete description of the spiritual dimension as articulated by the Health Assembly is as follows: The spiritual dimension is understood to imply a phenomenon that is not material in nature, but belongs to the realm of ideas, beliefs, values and ethics that have arisen in the minds and conscience of human beings, particularly ennobling ideas. Ennobling ideas have given rise to health ideals, which have led to a practical strategy for Health for All that aims at attaining a goal that has both a material and non-material component. If the material component of the strategy can be provided to people, the non-material or spiritual one is something that has to arise within people and communities in keeping with their social and cultural patterns. The spiritual dimension plays a great role in motivating people's achievement in all aspects of life. Since the inclusion of spiritual health within WHO's purview, a number of other significant organizations have also attended to spirituality and incorporated reference to it in key documents, including the United Nations action plan Agenda 21 which recognizes the right of individuals to "healthy physical, mental, and spiritual development". See also General Faith community nursing Spiritual care in health care professions Faith healing Topical (health) Abortion Disability Divorce HIV/AIDS Homelessness Vaccination Organ donation Topical (religion) Drugs Happiness Health deities Suicide Books Handbook of Religion and Health Multidimensional Measurement of Religiousness/Spirituality (book) Psychology of Religion and Coping (book) Faith and Health: Psychological Perspectives Journals Journal of Religion & Health Mental Health, Religion & Culture Spirituality in Clinical Practice Notes References Further reading Astin, John A. (1997). Stress Reduction through Mindfulness Meditation: Effects on Psychological Symptomatology, Sense of Control, and Spiritual Experiences Atran, Scott (2003) Genesis of Suicide Terrorism Kark JD, Shemi G, Friedlander Y, Martin O, Manor O, Blondheim SH. (1996) Does religious observance promote health? mortality in secular vs religious kibbutzim in Israel. Pargament, Kenneth I., PhD; Harold G. Koenig, MD; Nalini Tarakeshwar, MA; June Hahn, PhD. (2001). Religious Struggle as a Predictor of Mortality Among Medically Ill Elderly Patients External links Journal of Religion and Health, Mazandaran University of Medical Sciences Spiritual health Agenda 21 Text World Health Organization Constitution Easter Mediterranean Region Eastern Mediterranean Region Proposed Amendment to Constitution Preamble Religion and HIV/AIDS Religion and suicide Religion and medicine

History of the present illness

Following the chief complaint in medical history taking, a history of the present illness (abbreviated HPI) (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting symptom (for example, pain). Questions to include Different sources include different questions to be asked while conducting an HPI. Several acronyms have been developed to categorize the appropriate questions to include. The Centers for Medicare and Medicaid Services has published criteria for what constitutes a reimbursable HPI. A "brief HPI" constitutes one to three of these elements. An "extended HPI" includes four or more of these elements. Also usable is SOCRATES. For chronic pain, the Stanford Five may be assessed to understand the pain experience from the patient's primary belief system. See also Medical record Medical history Pain scale References External links Overview at medicine.ucsd.edu Overview at medinfo.ufl.edu Medical terminology

Regression (medicine)

Regression in medicine is the partial or complete reversal of a disease's signs and symptoms. Clinically, regression generally refers to a decrease in severity of symptoms without completely disappearing. At a later point, symptoms may return. These symptoms are then called recidive. In cancer, regression refers to a specific decrease in the size or extent of a tumour. In histopathology, histological regression is one or more areas within a tumor in which neoplastic cells have disappeared or decreased in number. In melanomas, this means complete or partial disappearance from areas of the dermis (and occasionally from the epidermis), which have been replaced by fibrosis, accompanied by melanophages, new blood vessels, and a variable degree of inflammation. References Epidemiology Medical terminology

Kolcaba's Theory of Comfort

Kolcaba's theory of comfort explains comfort as a fundamental need of all human beings for relief, ease, or transcendence arising from health care situations that are stressful. Comfort can enhance health-seeking behaviors for patients, family members, and nurses. The major concept within Katharine Kolcaba's theory is the comfort. The other related concepts include caring, comfort measures, holistic care, health seeking behaviors, institutional integrity, and intervening variables. Kolcaba's theory successfully addresses the four elements of nursing metaparadigm. Providing comfort in physical, psychospiritual, social, and environmental aspects in order to reduce harmful tension is a conceptual assertion of this theory. When nursing interventions are effective, the outcome of enhanced comfort is attained. This theory was derived from Watson's theory of human care and her own practice. Kolcaba was a head nurse asked to define her job as a nurse outside of specialized responsibilities. She realized the lack of written knowledge on the subject of comfort being important in patient care. The first publication was in 1994, then expanded in an article in 2001, and further developed in a book written in 2003. Kolcaba's theory became so popular that it was tested in multiple studies such as: women with early stage breast cancer going through radiation therapy conducted by Kolcaba and Fox in 1999, persons with urinary frequency and incontinence conducted by Dowd, Kolcaba, and Steiner in 2000, and persons near end of life conducted by Novak, Kolcaba, Steiner, and Dowd in 2001. References Psychological theories Nursing theory Positive psychology

Hypoprothrombinemia

Hypoprothrombinemia is a rare blood disorder in which a deficiency in immunoreactive prothrombin (Factor II), produced in the liver, results in an impaired blood clotting reaction, leading to an increased physiological risk for spontaneous bleeding. This condition can be observed in the gastrointestinal system, cranial vault, and superficial integumentary system, affecting both the male and female population. Prothrombin is a critical protein that is involved in the process of hemostasis, as well as illustrating procoagulant activities. This condition is characterized as an autosomal recessive inheritance congenital coagulation disorder affecting 1 per 2,000,000 of the population, worldwide, but is also attributed as acquired. Signs and symptoms There are various symptoms that are presented and are typically associated to a specific site that they appear at. Hypoprothrombinemia is characterized by a poor blood clotting function of prothrombin. Some symptoms are presented as severe, while others are mild, meaning that blood clotting is slower than normal. Areas that are usually affected are muscles, joints, and the brain, however, these sites are more uncommon. The most common symptoms include: Easy bruising Oral mucosal bleeding - Bleeding of the membrane mucus lining inside of the mouth. Soft tissue bleeding. Hemarthrosis - Bleeding in joint spaces. Epistaxis - Acute hemorrhages from areas of the nasal cavity, nostrils, or nasopharynx. Women with this deficiency experience menorrhagia: prolonged, abnormal heavy menstrual bleeding. This is typically a symptom of the disorder when severe blood loss occurs. Other reported symptoms that are related to the condition: Prolonged periods of bleeding due to surgery, injury, or post birth. Melena - Associated with acute gastrointestinal bleeding, dark black, tarry feces. Hematochezia - Lower gastrointestinal bleeding, passage of fresh, bright red blood through the anus secreted in or with stools. If associated with upper gastrointestinal bleeding, suggestive of a more life-threatening issue. Type I: Severe hemorrhages are indicators of a more severe prothrombin deficiency that account for muscle hematomas, intracranial bleeding, postoperative bleeding, and umbilical cord hemorrhage, which may also occur depending on the severity, respectively. Type II: Symptoms are usually more capricious, but can include a variety of the symptoms described previously. Less severe cases of the disorder typically do not involve spontaneous bleeding. Causes Hypoprothrombinemia can be the result of a genetic defect, may be acquired as the result of another disease process, or may be an adverse effect of medication. For example, 5-10% of patients with systemic lupus erythematosus exhibit acquired hypoprothrombinemia due to the presence of autoantibodies which bind to prothrombin and remove it from the bloodstream (lupus anticoagulant-hypoprothrombinemia syndrome). The most common viral pathogen that is involved is Adenovirus, with a prevalence of 50% in postviral cases. Inheritance Autosomal recessive condition in which both parents must carry the recessive gene in order to pass the disease on to offspring. If both parents have the autosomal recessive condition, the chance of mutation in offspring increases to 100%. An individual will be considered a carrier if one mutant copy of the gene is inherited, and will not illustrate any symptoms. The disease affects both men and women equally, and overall, is a very uncommon inherited or acquired disorder. Non-inheritance and other factors There are two types of prothrombin deficiencies that occur depending on the mutation: Type I (true deficiency), includes a missense or nonsense mutation, essentially decreasing prothrombin production. This is associated with bleeding from birth. Here, plasma levels of prothrombin are typically less than 10% of normal levels. Type II, known as dysprothrombinemia, includes a missense mutation at specific Xa factor cleavage sites and serine protease prothrombin regions. Type II deficiency creates a dysfunctional protein with decreased activity and usually normal or low-normal antigen levels. A vitamin K-dependent clotting factor is seldom seen as a contributor to inherited prothrombin deficiencies, but lack of Vitamin K decreases the synthesis of prothrombin in liver cells. Acquired underlying causes of this condition include severe liver disease, warfarin overdose, platelet disorders, and disseminated intravascular coagulation (DIC). It may also be a rare adverse effect to ceftriaxone. Mechanism Hypoprothrombinemia is found to present itself as either inherited or acquired, and is a decrease in the synthesis of prothrombin. In the process of inheritance, it marks itself as an autosomal recessive disorder, meaning that both parents must be carriers of the defective gene in order for the disorder to be present in a child. Prothrombin is a glycoprotein that occurs in blood plasma and functions as a precursor to the enzyme, thrombin, which acts to convert fibrinogen into fibrin, therefore, fortifying clots. This clotting process is known as coagulation. The mechanism specific to prothrombin (factor II) includes the proteolytically cleaving, breakdown of proteins into smaller polypeptides or amino acids, of this coagulation factor in order to form thrombin at the beginning of the cascade, leading to stemming of blood loss. A mutation in factor II would essentially lead to hypoprothrombinemia. The mutation is presented on chromosome 11. Areas where the disease has been shown to present itself at include the liver, since the glycoprotein is stored in this area. Acquired cases are results from an isolated factor II deficiency. Specific cases include: Vitamin K deficiency: In the liver, vitamin K plays an important role in the synthesis of coagulation factor II. Body's capacity in the storage of vitamin K is typically very low. Vitamin K-dependent coagulation factors have a very short half-life, sometimes leading to a deficiency when a depletion of vitamin K occurs. The liver synthesizes inactive precursor proteins in the absence of vitamin K (liver disease). Vitamin K deficiency leads to impaired clotting of the blood and in some cases, causes internal bleeding without an associated injury. Disseminated intravascular coagulation (DIC): Involving abnormal, excessive generation of thrombin and fibrin within the blood. Relative to hypoprothrombinemia, due to increased platelet aggregation and coagulation factor consumption involved in the process. Anticoagulants: warfarin overdose: Used as a treatment for prevention of blood clots, however, like most drugs, side effects have been shown to increase risk of excessive bleeding by functioning in the disruption of hepatic synthesis of coagulation factors II, VII, IX, and X. Vitamin K is an antagonist to warfarin drug, reversing its activity, causing it to be less effective in the process of blood clotting. Warfarin intake has been shown to interfere with Vitamin-K metabolism. Diagnosis Diagnosis of inherited hypoprothrombinemia, relies heavily on a patient's medical history, family history of bleeding issues, and lab exams performed by a hematologist. A physical examination by a general physician should also be performed in order to determine whether the condition is congenital or acquired, as well as ruling out other possible conditions with similar symptoms. For acquired forms, information must be taken regarding current diseases and medications taken by the patient, if applicable. Lab tests that are performed to determine diagnosis: Factor assays: To observe the performance of specific factors (II) to identify missing/poorly performing factors. These lab tests are typically performed first in order to determine the status of the factor. Prothrombin blood test: Determines if a patient has deficient or low levels of Factor II. Vitamin K1 test: Performed to evaluate bleeding of unknown causes, nosebleeds, and identified bruising. To accomplish this, a band is wrapped around the patient's arm, 4 inches above the superficial vein site in the elbow pit. The vein is penetrated with the needle and amount of blood required for testing is obtained. Decreased vitamin K levels are suggestive of hypoprothrombinemia. However, this exam is rarely used as a prothrombin blood test is performed beforehand. Treatment Treatment is almost always aimed to control hemorrhages, treating underlying causes, and taking preventative steps before performing invasive surgeries. Hypoprothrombinemia can be treated with periodic infusions of purified prothrombin complexes. These are typically used as treatment methods for severe bleeding cases in order to boost clotting ability and increasing levels of vitamin K-dependent coagulation factors. A known treatment for hypoprothrombinemia is menadoxime. Menatetrenone was also listed as an antihemorrhagic vitamin. 4-Amino-2-methyl-1-naphthol (Vitamin K5) is another treatment for hypoprothrombinemia. Vitamin K forms are administered orally or intravenously. Other concentrates include Proplex T, Konyne 80, and Bebulin VH. Fresh frozen plasma infusion (FFP) is a method used for continuous bleeding episodes, every 3–5 weeks for mention. Used to treat various conditions related to low blood clotting factors. Administered by intravenous injection and typically at a 15-20 ml/kg/dose. Can be used to treat acute bleeding. Invasive options, such as surgery or clotting factor infusions, are required if previous methods do not suffice. Surgery is to be avoided, as it causes significant bleeding in patients with hypoprothrombinemia. Prognosis Prognosis for patients varies and is dependent on severity of the condition and how early the treatment is managed. With proper treatment and care, most people go on to live a normal and healthy life. With more severe cases, a hematologist will need to be seen throughout the patient's life in order to deal with bleeding and continued risks. References External links Coagulopathies

Ectopia (medicine)

An ectopia is a displacement or malposition of an organ or other body part, which is then referred to as ectopic. Examples Ectopic ACTH syndrome, also known as small-cell carcinoma. Ectopic calcification, a pathologic deposition of calcium salts in tissues or bone growth in soft tissues Cerebellar tonsillar ectopia, aka Chiari malformation, a herniation of the brain through the foramen magnum, which may be congenital or caused by trauma. Ectopic cilia, a hair growing where it isn't supposed to be, commonly an eyelash on an abnormal spot on the eyelid, distichia Ectopia cordis, the displacement of the heart outside the body during fetal development Ectopic enamel, a tooth abnormality, where enamel is found in an unusual location, such as at the root of a tooth Ectopic expression, the expression of a gene in an abnormal place in an organism Ectopic hormone, a hormone produced by a tumor, such as small-cell carcinoma, can cause Cushing's syndrome Ectopia lentis, the displacement of the crystalline lens of the eye Neuronal ectopia Ectopic pancreas, displacement of pancreatic tissue in the body with no connection, anatomical or vascular, to the pancreas Ectopic recombination, the recombination between sequences (like leu2 sequences) present at different genomic locations Renal ectopia occurs when both kidneys are on the same side of the body Ectopic testis, a testis that has moved to an unusual location Ectopic thymus, where thymus tissue is found in an abnormal location Ectopic thyroid, where an entire or parts of the thyroid are located elsewhere in the body Ectopic tooth, a tooth that erupted outside the dental arch Ectopic ureter, where the ureter terminates somewhere other than the urinary bladder Ectopia vesicae, a congenital anomaly in which part of the urinary bladder is present outside the body See also Ectopic beat of the heart Cervical ectropion Ectopic pregnancy, where the fertilized egg implants anywhere other than the uterine wall Heterotopia (medicine) References Set index articles

Anaerobic

Anaerobic means "living, active, occurring, or existing in the absence of free oxygen", as opposed to aerobic which means "living, active, or occurring only in the presence of oxygen." Anaerobic may also refer to: Anaerobic adhesive, a bonding agent that does not cure in the presence of air Anaerobic respiration, respiration in the absence of oxygen, using some other molecule as the final electron acceptor Anaerobic organism, any organism whose redox metabolism does not depend on free oxygen Anammox, anaerobic ammonium oxidation, a globally important microbial process of the nitrogen cycle Anaerobic filter, an anaerobic digester with a tank containing a filter medium where anaerobic microbes can establish themselves Anaerobic digestion, the use of anaerobic bacteria to break down waste, with biogas as a byproduct Anaerobic clarigester, an anaerobic digester that treats dilute biodegradable feedstocks and allows different retention times for solids and liquids Anaerobic contact process, an anaerobic digester with a set of reactors in series Hypoxia (environmental) (anaerobic environment), an environment with little or no available oxygen Anaerobic lagoon, used to dispose of animal waste, particularly that of cows and pigs Anaerobic exercise, exercise intense enough to cause lactate to form, used in non-endurance sports See also Aerobic (disambiguation) Oxygen-free (disambiguation)

AVP

AVP may stand for: Organizations and companies Business Assistant/associate/area vice president, a title; see vice president Avon Products (stock ticker symbol AVP) Other organizations Alternatives to Violence Project Aruban People's Party (Arubaanse Volkspartij/Partido di Pueblo Arubano) Association of Volleyball Professionals National Coalition of Anti-Violence Programs, aka Anti-Violence Project/Program AVP Research Foundation Transportation A US Navy hull classification symbol: Small seaplane tender (AVP) Facilities Wilkes-Barre/Scranton International Airport (IATA airport code AVP) in Avoca, Pennsylvania Aylesbury Vale Parkway railway station (rail station code AVP) Medicine Anthrax Vaccine Precipitated, a British anthrax vaccine Arginine vasopressin, the form of the antidiuretic hormone vasopressin found in most mammals Popular culture Alien vs. Predator, a science fiction franchise Alien vs. Predator (film) Other uses Attribute–value pair, data representation in computing systems and applications Alternative vote plus, a voting system Apple Vision Pro, a mixed-reality headset Atharvaveda-Paippalada, a recension of Atharvaveda See also Alien vs. Predator (disambiguation)

Sulfuric acid poisoning

Sulfuric acid poisoning refers to ingestion of sulfuric acid, found in lead-acid batteries and some metal cleaners, pool cleaners, drain cleaners and anti-rust products. Signs and symptoms Brown to black streak from angle of mouth Brown to black vomitus Brown to black stomach wall Black swollen tongue White (chalky white) teeth Blotting paper appearance of stomach mucosa Ulceration of esophagus (fibrosis and stricture) Perforation of stomach. The stomach resembles a black spongy mass on post mortem Treatment For superficial injuries, washing (therapeutic irrigation) is important. Emergency treatments include protecting the airway, which might involve a tracheostomy. Further treatment will vary depending on the severity, but might include investigations to determine the extent of damage (bronchoscopy for the airways and endoscopy for the gastrointestinal tract), followed by treatments including surgery (to debride and repair) and intravenous fluids. Gastric lavage is contraindicated in corrosive acid poisoning like sulfuric acid poisoning. Bicarbonate is also contraindicated as it liberates carbon dioxide which can cause gastric dilatation leading to rupture of stomach, leading to severe abominal damage or death. Society and culture Vitriolage is the act of throwing sulfuric acid or other corrosive acids on somebody's face. References External links Sulphuric acid: Toxicological overview Sulfuric acid poisoning on Penn Medicine Sulfuric acid poisoning on Medline Plus Toxic effects of substances chiefly nonmedicinal as to source Chemical weapons attacks

Functional imaging

Functional imaging (or physiological imaging) is a medical imaging technique of detecting or measuring changes in metabolism, blood flow, regional chemical composition, and absorption. As opposed to structural imaging, functional imaging centers on revealing physiological activities within a certain tissue or organ by employing medical image modalities that very often use tracers or probes to reflect spatial distribution of them within the body. These tracers are often analogous to some chemical compounds, like glucose, within the body. To achieve this, isotopes are used because they have similar chemical and biological characteristics. By appropriate proportionality, the nuclear medicine physicians can determine the real intensity of certain substances within the body to evaluate the risk or danger of developing some diseases. Modalities Positron emission tomography (PET) Fludeoxyglucose for Glucose metabolism O-15 as a flow tracer Single-photon emission computed tomography (SPECT) Computed tomography (CT) perfusion imaging Functional magnetic resonance imaging (fMRI) BOLD Diffusion MRI Perfusion (blood flow) Arterial spin labeling MRI Blood volume Hyperpolarized carbon-13 MRI Functional photoacoustic microscopy (fPAM) Magnetic particle imaging (MPI) Optical imaging Near-infrared spectroscopy (NIRS) See also Biomedical engineering Medical imaging PET-CT Radiology Functional neuroimaging References External links Scholarpedia Functional imaging Medical imaging

Systems neuroscience

Systems neuroscience is a subdiscipline of neuroscience and systems biology that studies the structure and function of various neural circuits and systems that make up the central nervous system of an organism. Systems neuroscience encompasses a number of areas of study concerned with how nerve cells behave when connected together to form neural pathways, neural circuits, and larger brain networks. At this level of analysis, neuroscientists study how different neural circuits analyze sensory information, form perceptions of the external world, make decisions, and execute movements. Researchers in systems neuroscience are concerned with the relation between molecular and cellular approaches to understanding brain structure and function, as well as with the study of high-level mental functions such as language, memory, and self-awareness (which are the purview of behavioral and cognitive neuroscience). Systems neuroscientists typically employ techniques for understanding networks of neurons as they are seen to function, by way of electrophysiology using either single-unit recording or multi-electrode recording, functional magnetic resonance imaging (fMRI), and PET scans. The term is commonly used in an educational framework: a common sequence of graduate school neuroscience courses consists of cellular/molecular neuroscience for the first semester, then systems neuroscience for the second semester. It is also sometimes used to distinguish a subdivision within a neuroscience department in a university. See also Example systems Ascending reticular activating system Auditory system Gustatory system Motor system Olfactory system Reward system Sensory system Somatosensory system Visual system Related concepts Sensory neuroscience Neural oscillation Neural correlate Neural substrate References Bear, M. F. et al. Eds. (1995). Neuroscience: Exploring The Brain. Baltimore, Maryland, Williams and Wilkins. Hemmen J. L., Sejnowski T. J. (2006). 23 Problems in Systems Neuroscience. Oxford University Press. Branches of neuroscience Systems biology

Amphibolic

The term amphibolism is used to describe a biochemical pathway that involves both catabolism and anabolism. Catabolism is a degradative phase of metabolism in which large molecules are converted into smaller and simpler molecules, which involves two types of reactions. First, hydrolysis reactions, in which catabolism is the breaking apart of molecules into smaller molecules to release energy. Examples of catabolic reactions are digestion and cellular respiration, where sugars and fats are broken down for energy. Breaking down a protein into amino acids, or a triglyceride into fatty acids, or a disaccharide into monosaccharides are all hydrolysis or catabolic reactions. Second, oxidation reactions involve the removal of hydrogens and electrons from an organic molecule. Anabolism is the biosynthesis phase of metabolism in which smaller simple precursors are converted to large and complex molecules of the cell. Anabolism has two classes of reactions. The first are dehydration synthesis reactions; these involve the joining of smaller molecules together to form larger, more complex molecules. These include the formation of carbohydrates, proteins, lipids and nucleic acids. The second are reduction reactions, in which hydrogens and electrons are added to a molecule. Whenever that is done, molecules gain energy. The term amphibolic was proposed by B. Davis in 1961 to emphasise the dual metabolic role of such pathways. These pathways are considered to be central metabolic pathways which provide, from catabolic sequences, the intermediates which form the substrate of the metabolic processes. Reactions exist as amphibolic pathway All the reactions associated with synthesis of biomolecule converge into the following pathway, viz., glycolysis, the Krebs cycle and the electron transport chain, exist as an amphibolic pathway, meaning that they can function anabolically as well as catabolically. Other important amphibolic pathways are the Embden-Meyerhof pathway, the pentose phosphate pathway and the Entner–Doudoroff pathway. Embden-Meyerhoff The Embeden–Meyerhof pathway and the Krebs cycle are the centre of metabolism in nearly all bacteria and eukaryotes. They provide not only energy but also precursors for biosynthesis of macromolecules that make up living systems. Citric acid cycle The citric acid cycle (Krebs cycle) is a good example of an amphibolic pathway because it functions in both the degradative (carbohydrate, protein, and fatty acid) and biosynthetic processes. The citric acid cycle occurs on the cytosol of bacteria and within the mitochondria of eukaryotic cells. It provides electrons to the electron transport chain which is used to drive the production of ATP in oxidative phosphorylation. Intermediates in the citric acid cycle, such as oxaloacetate, are used to synthesize macromolecule constituents such as amino acids, e.g. glutamate and aspartate. The first reaction of the cycle, in which oxaloacetate (a four-carbon compound) condenses with acetate (a two-carbon compound) to form citrate (a six-carbon compound) is typically anabolic. The next few reactions, which are intramolecular rearrangements, produce isocitrate. The following two reactions, namely the conversion of D-isocitrate to α-Ketoglutarate followed by its conversion to succinyl-CoA, are typically catabolic. Carbon dioxide is lost in each step and succinate (a four-carbon compound) is produced. There is an interesting and critical difference in the coenzymes used in catabolic and anabolic pathways; in catabolism NAD+ serves as an oxidizing agent when it is reduced to NADH. Whereas in anabolism the coenzyme NADPH serves as the reducing agent and is converted to its oxidized form NADP+. Citric acid cycle has two modes that play two roles, the first being energy production produced by the oxidative mode, as the acetyl group of acetyl-coA is fully oxidized to CO2. This produces most of the ATP in the metabolism of aerobic heterotrophic metabolism, as this energy conversion in the membrane structure (cytoplasmic membrane in bacteria and mitochondria in eukaryotes) by oxidative phosphorylation by moving electron from donor (NADH and FADH2) to the acceptor O2. Every cycle give 3 NADH, 1 FADH2, CO2 and GTP. The second role is biosynthetic, as citric acid cycle regenerate oxaloacetate when cycle intermediates are removed for biosynthesis. Pentose phosphate pathway The pentose phosphate pathway gets its name because it involves several intermediates that are phosphorylated five-carbon sugars (pentoses). This pathway provides monomers for many metabolic pathways by transforming glucose into the four-carbon sugar erythrose and the five-carbon sugar ribose; these are important monomers in many metabolic pathways. Many of the reactants in this pathway are similar to those in glycolysis, and both occur in cytosol. The ribose-5-phosphate can be transported into the nucleic acid metabolism, producing the basis of DNA and RNA monomers, the nucleotides. In meristematic cells, large amounts of DNA must be produced during the S-phase of a short cell cycle; this pathway is an extremely important part of the metabolism of these cells. In these cells, the pentose phosphate pathway is active and shifted in favor of ribose production. Entner-Doudoroff pathway The Entner-Doudoroff pathway is a glycolytic pathway that is considered the second pathway used for carbohydrates used by certain microbes. In this process, glucose-6-phosphate is oxidized through 6-phosphogluconate to pyruvate and glyceraldehyde 3-phosphate, with the concomitant reduction of NADP. By conventional glyceraldehyde-3-phosphate oxidation to pyruvate, one NAD is reduced and a net one ATP is formed. In that pathway, for every glucose molecule there is an "investment" of one ATP molecule and a yield of two ATP and two pyruvate molecules and one NADH. The difference between the glycolytic used by humans and this pathway is that the latter requires one ATP to yield two ATP and two pyruvates as a net of only one NADPH produced and one ATP result (from substrate-level phosphorylation), and the former requires two ATP molecules to yield four ATP and two pyruvate molecules per glucose as a net of two ATP molecules. Regulation The cell determines whether the amphibolic pathway will function as an anabolic or catabolic pathway by enzyme–mediated regulation at a transcriptional and post-transcriptional level. As many reactions in amphibolic pathways are freely reversible or can be bypassed, irreversible steps that facilitate their dual function are necessary. The pathway uses a different enzyme for each direction for the irreversible step in the pathway, allowing independent regulation of catabolism and anabolism. Due their inherent duality, amphibolic pathways represent the regulation modes of both anabolic by its negative feedback end product and catabolic by feedback by energy indicator sequences. References Metabolism

Mechanism (biology)

In biology, a mechanism is a system of causally interacting parts and processes that produce one or more effects. Phenomena can be explained by describing their mechanisms. For example, natural selection is a mechanism of evolution; other mechanisms of evolution include genetic drift, mutation, and gene flow. In ecology, mechanisms such as predation and host-parasite interactions produce change in ecological systems. In practice, no description of a mechanism is ever complete because not all details of the parts and processes of a mechanism are fully known. For example, natural selection is a mechanism of evolution that includes countless, inter-individual interactions with other individuals, components, and processes of the environment in which natural selection operates. Characterizations/ definitions Many characterizations/definitions of mechanisms in the philosophy of science/biology have been provided in the past decades. For example, one influential characterization of neuro- and molecular biological mechanisms by Peter K. Machamer, Lindley Darden and Carl Craver is as follows: mechanisms are entities and activities organized such that they are productive of regular changes from start to termination conditions. Other characterizations have been proposed by Stuart Glennan (1996, 2002), who articulates an interactionist account of mechanisms, and William Bechtel (1993, 2006), who emphasizes parts and operations. The characterization by Machemer et al. is as follows: mechanisms are entities and activities organized such that they are productive of changes from start conditions to termination conditions. There are three distinguishable aspects of this characterization: Ontic aspect The ontic constituency of biological mechanisms includes entities and activities. Thus, this conception postulates a dualistic ontology of mechanisms, where entities are substantial components, and activities are reified components of mechanisms. This augmented ontology increases the explanatory power of this conception. Descriptive aspect Most descriptions of mechanisms (as found in the scientific literature) include specifications of the entities and activities involved, as well as the start and termination conditions. This aspect is mostly limited to linear mechanisms, which have relatively unambiguous beginning and end points between which they produce their phenomenon, although it may be possible to arbitrarily select such points in cyclical mechanisms (e.g., the Krebs cycle). Epistemic aspect Mechanisms are dynamic producers of phenomena. This conception emphasizes activities, which are causes that are reified. It is because of activities that this conception of mechanisms is able to capture the dynamicity of mechanisms as they bring about a phenomenon. Analysis Mechanisms in science/biology have reappeared as a subject of philosophical analysis and discussion in the last several decades because of a variety of factors, many of which relate to metascientific issues such as explanation and causation. For example, the decline of Covering Law (CL) models of explanation, e.g., Hempel's deductive-nomological model, has stimulated interest how mechanisms might play an explanatory role in certain domains of science, especially higher-level disciplines such as biology (i.e., neurobiology, molecular biology, neuroscience, and so on). This is not just because of the philosophical problem of giving some account of what "laws of nature," which CL models encounter, but also the incontrovertible fact that most biological phenomena are not characterizable in nomological terms (i.e., in terms of lawful relationships). For example, protein biosynthesis does not occur according to any law, and therefore, on the DN model, no explanation for the biosynthesis phenomenon could be given. Explanations Mechanistic explanations come in many forms. Wesley Salmon proposed what he called the "ontic" conception of explanation, which states that explanations are mechanisms and causal processes in the world. There are two such kinds of explanation: etiological and constitutive. Salmon focused primarily on etiological explanation, with respect to which one explains some phenomenon P by identifying its causes (and, thus, locating it within the causal structure of the world). Constitutive (or componential) explanation, on the other hand, involves describing the components of a mechanism M that is productive of (or causes) P. Indeed, whereas (a) one may differentiate between descriptive and explanatory adequacy, where the former is characterized as the adequacy of a theory to account for at least all the items in the domain (which need explaining), and the latter as the adequacy of a theory to account for no more than those domain items, and (b) past philosophies of science differentiate between descriptions of phenomena and explanations of those phenomena, in the non-ontic context of mechanism literature, descriptions and explanations seem to be identical. This is to say, to explain a mechanism M is to describe it (specify its components, as well as background, enabling, and so on, conditions that constitute, in the case of a linear mechanism, its "start conditions"). See also Aristotle's biology Notes and references Biological concepts

Acronyms in healthcare

Acronyms are very commonly used in healthcare settings. They are formed from the lead letters of words relating to medications, organisations, procedures and diagnoses. They come from both English and Latin roots. Acronyms have been described as jargon. and their use has been shown to impact the safety of patients in hospitals, owing to ambiguity and legibility. Formulation Acronyms in healthcare are formed from the lead letters of words relating to medications, organisations, procedures and diagnoses. They come from both English and Latin roots. The use of acronyms and abbreviations is expanding rapidly. Criticism Acronyms have been described as jargon. Studies have been conducted investigating the effect of acronyms on communication and, in some studies, even healthcare professionals are unclear as to the meaning of many acronyms. The use of acronyms to describe medical trials has been criticised as potentially leading to incorrect assumptions based on similar acronyms, difficulty accessing trial results when common words are used, and causing a cognitive bias when positive acronyms are used to portray trials (e.g. "HOPE" or "SMART"). Use of abbreviations, such as those relating to the route of administration or dose of a medication, can be confusing and is the most common source of medication errors. Use of some acronyms has been shown to impact the safety of patients in hospitals, and "do not use lists" have been published at a national level in the US. Examples A number of sources provide lists of initialisms and acronyms commonly used in health care. The terms listed are used in the English language within the healthcare systems and by healthcare professionals of various countries. Examples of terms include BP, COPD, TIMI score, and SOAP. There is no standardised list. See also List of medical mnemonics Clinical trial naming conventions References External links Smart Define - Healthcare Related Abbreviations Health care Heathcare

Acetic acid (data page)

This page provides supplementary chemical data on acetic acid. Material Safety Data Sheet The handling of this chemical may incur notable safety precautions. It is highly recommend that you seek the Material Safety Datasheet (MSDS) for this chemical from a reliable source and follow its directions. PTCL Safety web site Science Stuff Structure and properties Thermodynamic properties Vapor pressure of liquid Table data obtained from CRC Handbook of Chemistry and Physics 44th ed. Distillation data Spectral data References Chemical data pages Chemical data pages cleanup

Resource (biology)

In biology and ecology, a resource is a substance or object in the environment required by an organism for normal growth, maintenance, and reproduction. Resources can be consumed by one organism and, as a result, become unavailable to another organism. For plants key resources are light, nutrients, water, and space to grow. For animals key resources are food, water, and territory. Key resources for plants Terrestrial plants require particular resources for photosynthesis and to complete their life cycle of germination, growth, reproduction, and dispersal: Carbon dioxide Microsite (ecology) Nutrients Pollination Seed dispersal Soil Water Key resources for animals Animals require particular resources for metabolism and to complete their life cycle of gestation, birth, growth, and reproduction: Foraging Territory Water Resources and ecological processes Resource availability plays a central role in ecological processes: Carrying capacity Biological competition Liebig's law of the minimum Niche differentiation See also Abiotic component Biotic component Community ecology Ecology Population ecology Plant ecology size-asymmetric competition References Biological concepts Biological interactions Ecology terminology

Maximum medical improvement

Maximum Medical Improvement (MMI) occurs when an injured person reaches a state where their condition cannot be improved further or their healing process reaches a Treatment Plateau . It can mean that the patient has fully recovered from the injury or their medical condition has stabilized to the point that no major medical or emotional change can be expected in the person's condition. At that point, no further healing or improvement is deemed possible and this occurs despite continuing medical treatment or rehabilitative programs the injured person partakes in. MMI is relevant in multiple contexts, including personal injury cases and workers' compensation cases. When a worker receiving Workers' Compensation benefits reaches maximum medical improvement, their condition is assessed and a degree of permanent or partial impairment is determined. This degree will impact the amount of benefits the worker is able to receive. MMI means that treatment options have been exhausted. Temporary disability payments are terminated and a settlement is agreed regarding the condition of the worker at this point. References External links Workerscompensation.com, Worker's Compensation resource website https://www.nolo.com/legal-encyclopedia/should-i-wait-until-i-reach-mmi-before-accepting-a-car-accident-settlement-offer.html, personal injury resource website Labour law personal injury Health insurance