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1
Levine, Jerome I. Medications that increase sensitivity to light: A 1990 listing. [Rockville, Md.?]: U.S. Dept. of Health and Human Services, Public Health Service, Food and Drug Administration, Center for Devices and Radiological Health, 1991.
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2
Angus, Douglas E. Consumer sensitivity to increases in the price of magazine subscriptions. [Ottawa]: Coopers & Lybrand Consulting Group, 1986.
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3
Monteleone, Erminio, and Mario Bertuccioli, eds. Secondo Convegno Nazionale della Società Italiana di Scienze Sensoriali. Florence: Firenze University Press, 2009. http://dx.doi.org/10.36253/978-88-8453-872-7.
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Over the last decade there has been a growing interest in sensory science in Italy. This has clearly resulted in an increase in the number of researchers engaged in this sector and the number of companies that exploit sensory evaluations for product innovation and enhancement and in quality control. In Italy, in the sphere of the valorisation of prestige foodstuffs there is an increasing sensitivity towards the adoption of strict methods for describing the sensory properties of the products and ascertaining compliance with defined sensory standards. The Società Italiana di Scienze Sensoriali has played a decisive role in activating and guiding this development. Pursuing this approach, in 2008 the Society organised the 2nd National Convention as an occasion for exchange among professionals working in the field of sensory science.
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Yobbi, D. K. Testing the sensitivity of pumpage to increases in surficial aquifer system heads in the Cypress Creek well-field area, West-Central Florida: An optimization technique. Tallahassee, Fla: U.S. Dept. of the Interior, U.S. Geological Survey, 2002.
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5
Hilgers, Lance Jay. Improved methods which increase the reliability and sensitivity of polymerase chain reaction. 1993.
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6
Cejas, Ivette, and Alexandra L. Quittner. Effects of Family Variables on Spoken Language in Children with Cochlear Implants. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190880545.003.0005.
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This chapter reviews the effects of family variables on spoken language in the largest, longitudinal multisite study of the effects of cochlear implants on young deaf children’s development. Data published to date on 188 deaf and 97 hearing children indicate that parents report high levels of context-specific parenting stress and less sensitivity during parent–child interactions and use fewer higher-level language techniques. Children’s language was related to higher rates of behavior problems, which were associated with higher parenting stress. After implantation, children made impressive gains in spoken language, and these were directly related to maternal sensitivity and use of facilitative language techniques. Our results indicated that cochlear implantation should be accompanied by parenting interventions that increase sensitivity and use of higher-level language strategies and foster a stronger parent–child relationship.
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How, Poh Choo, Pachida Lo, Marjorie Westervelt, and Hendry Ton. Refugees and Immigrants. Edited by Hunter L. McQuistion. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190610999.003.0023.
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The number of refugees and immigrants continues to increase each year. These populations may experience migration-related trauma and stress that increase the risk for mental illness(es). Perspectives about mental illness, its expression, and treatments often differ significantly between immigrants/refugees and their providers. Therefore, psychiatric evaluation requires sensitivity to the patients’ cultural context and perspectives, including the specific stressors associated with being a migrant. Interpreters can be helpful as cultural brokers in the process of forming a collaborative explanatory model and treatment plan. The latter should include psychosocial approaches to help patients identify areas of resiliency and foster post-traumatic growth, as well as social integration and acculturation to the dominant culture while maintaining affiliation with their original culture. This will increase the probability of positive mental health outcomes.
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Wilton, Niall, Brian J. Anderson, and Bruno Marciniak. Anatomy, physiology, and pharmacology in paediatric anaesthesia. Edited by Jonathan G. Hardman and Neil S. Morton. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0069.
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Anaesthesia for children is tempered by changes that occur during both growth and development. Drug dose is affected by size and clearance maturation processes as well as the changing body composition that occurs with age. All organ systems undergo these maturation changes and most are complete within the first few years of life. Normal physiological variables in infancy and childhood are quite different from adults. The central nervous, cardiovascular, and respiratory systems are particularly important. Cerebral immaturity and plasticity impacts sensitivity to drugs, pain responses, and behaviour and increases potential harm from apoptosis with anaesthesia. The heart undergoes a transition from fetal to adult circulation during the first few weeks of life. Undiagnosed congenital defects are not uncommon. The neonate is very susceptible to conditions that trigger an increase in pulmonary vascular resistance, with reversion to fetal circulatory patterns. Respiratory anatomy and mechanics affect the propensity to apnoea, airway maintenance, artificial ventilation modalities, uptake of inhalational agents, and tracheal tube sizes. Metabolic rate and oxygen requirements increase with decreasing age. This physiology influences diverse aspects that include the rate of desaturation during apnoea, hypoglycaemia during starvation, cardiac output, drug metabolism, fluid requirements, and heat production or loss.
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Stoneley, Sarah, and Simon Rinald. Sensory loss. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0047.
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Sensory disturbance can either be a complete loss (anaesthesia) or a reduction (hypoaesthesia) in the ability to perceive the sensory input. Dysaesthesia is an abnormal increase in the perception of normal sensory stimuli. Hyperalgesia is an increased sensitivity to normally painful stimuli, and allodynia is the perception of usually innocuous stimuli as painful. A complete loss of sensation is likely to be due to a central nervous system problem, while a tingling/paraesthesia (large fibre) or burning/temperature (small fibre) sensation is likely due to an acquired peripheral nervous system problem. Shooting, electric-shock-like pains suggest radicular pathology, a tight-band spinal cord dysfunction. Positive sensory symptoms are usually absent in inherited neuropathies, even in the context of significant deficits on examination. This chapter describes the clinical approach to patients with sensory symptoms. Common patterns of sensory loss and their causes are described.
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Räisänen, Jouni. Future Climate Change in the Baltic Sea Region and Environmental Impacts. Oxford University Press, 2017. http://dx.doi.org/10.1093/acrefore/9780190228620.013.634.
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The warming of the global climate is expected to continue in the 21st century, although the magnitude of change depends on future anthropogenic greenhouse gas emissions and the sensitivity of climate to them. The regional characteristics and impacts of future climate change in the Baltic Sea countries have been explored since at least the 1990s. Later research has supported many findings from the early studies, but advances in understanding and improved modeling tools have made the picture gradually more comprehensive and more detailed. Nevertheless, many uncertainties still remain.In the Baltic Sea region, warming is likely to exceed its global average, particularly in winter and in the northern parts of the area. The warming will be accompanied by a general increase in winter precipitation, but in summer, precipitation may either increase or decrease, with a larger chance of drying in the southern than in the northern parts of the region. Despite the increase in winter precipitation, the amount of snow is generally expected to decrease, as a smaller fraction of the precipitation falls as snow and midwinter snowmelt episodes become more common. Changes in windiness are very uncertain, although most projections suggest a slight increase in average wind speed over the Baltic Sea. Climatic extremes are also projected to change, but some of the changes will differ from the corresponding change in mean climate. For example, the lowest winter temperatures are expected to warm even more than the winter mean temperature, and short-term summer precipitation extremes are likely to become more severe, even in the areas where the mean summer precipitation does not increase.The projected atmospheric changes will be accompanied by an increase in Baltic Sea water temperature, reduced ice cover, and, according to most studies, reduced salinity due to increased precipitation and river runoff. The seasonal cycle of runoff will be modified by changes in precipitation and earlier snowmelt. Global-scale sea level rise also will affect the Baltic Sea, but will be counteracted by glacial isostatic adjustment. According to most projections, in the northern parts of the Baltic Sea, the latter will still dominate, leading to a continued, although decelerated, decrease in relative sea level. The changes in the physical environment and climate will have a number of environmental impacts on, for example, atmospheric chemistry, freshwater and marine biogeochemistry, ecosystems, and coastal erosion. However, future environmental change in the region will be affected by several interrelated factors. Climate change is only one of them, and in many cases its effects may be exceeded by other anthropogenic changes.
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Klapwijk, Eduard T., Wouter van den Bos, and Berna Güroğlu. Neural Mechanisms of Criminal Decision Making in Adolescence. Edited by Wim Bernasco, Jean-Louis van Gelder, and Henk Elffers. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780199338801.013.12.
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Adolescence is a time of change in which there is an increase and peak in criminal behavior. This chapter discusses the neurocognitive mechanisms underlying criminal decision making in adolescents. First, it provides a brief overview of the neural basis of decision making in typically developing adolescents. Second, it discusses studies that examine decision-making processes in delinquent and antisocial adolescents compared to their typically developing peers. The chapter focuses on executive functioning and empathy, and it is concluded that delinquent and antisocial adolescents mainly display affective deficits. This is manifested in risky and impulsive decisions and in impaired sensitivity to the distress and perspectives of other people. Finally, the chapter argues that future research on criminal decision making in adolescence could benefit from focusing on subgroups of offenders and from including environmental factors such as peer influence in experimental designs.
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Gonzalez-Albarrán, Olga, and Luis M. Ruilope. The kidney and control of blood pressure. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0210.
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The kidneys can be at the root of the development of arterial hypertension or they can participate in the maintenance of hypertension and its sequels. Renal alterations interfering with the regulation of sodium homeostasis or facilitating the generation of vasoconstrictors, particularly angiotensin II, are involved in the dysregulation of arterial blood pressure that underlies the development of arterial hypertension. The biology of angiotensin is described in detail.The kidneys are also the mediator of hypertension in such examples as renal ischaemia and hyperaldosteronism. The role of renal nerves, and renal depressor substances, are also described.Transplantation experiments in animals and observations in human transplantation, as well as some primary gene defects, show the importance of renal mechanisms in hypertension. Once kidneys have been damaged, they often contribute to an increase in arterial pressure. Salt sensitivity is probably a major part of the mechanism, but it is mediated by multiple pathways.
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Huotari, Mikko, and Jürgen Rüland. Context, Concepts, and Comparison in Southeast Asian Studies. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190846374.003.0005.
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This chapter argues that the value of comparative area studies (CAS) depends on some original frame of reference, here the field of Southeast Asian studies. We trace the evolution of this field in view of research on other world regions and general methodological debates. The chapter also highlights the role of CAS in overcoming increasingly rigid methodological divides over such core issues as context-sensitivity and the challenges of comparative research practice. We outline a methodologically pluralist framework of area studies comparisons. This requires methodological bridges between mainstream disciplines and area studies as well as innovative approaches to conceptual problems associated with comparing different regions and cultures. In the process, CAS can also increase attention to non-Western regions, which sometimes get short shrift in theory building in the social sciences. Thus, CAS is in a particularly strong position to mediate the ongoing internationalization and “de-Westernization” of global knowledge.
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Golper, Thomas A., Andrew A. Udy, and Jeffrey Lipman. Drug dosing in acute kidney injury. Edited by William G. Bennett. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0364.
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Drug dosing in acute kidney injury (AKI) is one of the broadest topics in human medicine. It requires an understanding of markedly altered and constantly changing physiology under many disease situations, the use of the drugs to treat those variety of diseases, and the concept of drug removal during blood cleansing therapies. Early in AKI kidney function may be supraphysiologic, while later in the course there may be no kidney function. As function deteriorates other metabolic pathways are altered in unpredictable ways. Furthermore, the underlying disorders that lead to AKI alter metabolic pathways. Heart failure is accompanied by vasoconstriction in the muscle, skin and splanchnic beds, while brain and cardiac blood flow proportionally increase. Third spacing occurs and lungs can become congested. As either kidney or liver function deteriorates, there may be increased or decreased drug sensitivity at the receptor level. Acidosis accompanies several failing organs. Protein synthesis is qualitatively and quantitatively altered. Sepsis affects tissue permeability. All these abnormalities influence drug pharmacokinetics and dynamics. AKI is accompanied by therapeutic interventions that alter intrinsic metabolism which is in turn complicated by kidney replacement therapy (KRT). So metabolism and removal are both altered and constantly changing. Drug management in AKI is exceedingly complex and is only beginning to be understood. Thus, we approach this discussion in a physiological manner. Critically ill patients pass through phases of illness, sometimes rapidly, other times slowly. The recognition of the phases and the need to adjust medication administration strategies is crucial to improving outcomes. An early phase involving supraphysiologic kidney function may be contributory to therapeutic failures that result in the complication of later AKI and kidney function failure.
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Gutiérrez, Orlando M. Fibroblast growth factor 23, Klotho, and phosphorus metabolism in chronic kidney disease. Edited by David J. Goldsmith. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0119.
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Fibroblast growth factor 23 (FGF23) and Klotho have emerged as major hormonal regulators of phosphorus (P) and vitamin D metabolism. FGF23 is secreted by bone cells and acts in the kidneys to increase urinary P excretion and inhibit the synthesis of 1,25 dihydroxyvitamin D (1,25(OH)2D) and in the parathyroid glands to inhibit the synthesis and secretion of parathyroid hormone. Phosphorus excess stimulates FGF23 secretion, likely as an appropriate physiological adaptation to maintain normal P homeostasis by enhancing urinary P excretion and diminishing intestinal P absorption via lower 1,25(OH)2D. The FGF23 concentrations are elevated early in the course of chronic kidney disease (CKD) and may be a primary initiating factor for the development of secondary hyperparathyroidism in this setting. Klotho exists in two forms: a transmembrane form and a secreted form, each with distinct functions. The transmembrane form acts as the key co-factor needed for FGF23 to bind to and activate its cognate receptor in the kidneys and the parathyroid glands. The secreted form of Klotho has FGF23-independent effects on renal P and calcium handling, insulin sensitivity, and endothelial function. Disturbances in the expression of Klotho may play a role in the development of altered bone and mineral metabolism in early CKD. In addition, abnormal circulating concentrations of both FGF23 and Klotho have been linked to excess cardiovascular disease, suggesting that both play an important role in maintaining cardiovascular health.
16
Grimaldi, Stephanie J., and Emily R. Stern. Sensory Processing and Intolerance in OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0011.
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Patients with obsessive-compulsive disorder (OCD) often exhibit abnormal sensitivity to sensory stimuli and a reduced ability to screen out stimuli that most do not find bothersome. This chapter reviews evidence documenting increased sensitivity to external sensory stimuli (auditory, olfactory, tactile) and reduced sensory gating in patients with OCD. In some individuals such sensitivity can present as a primary symptom. Many patients with OCD also experience sensations that appear to be “internally generated,” including not-just-right experiences, incompleteness, and physical urges; this is the focus of the second half of the chapter. These sensations, termed “sensory phenomena,” cause significant distress and impairment in daily functioning and may require different treatments than fear-based obsessions. The chapter concludes with a brief discussion of directions for future research that may provide further insight into the nature of sensory symptoms as well as potential treatments.
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Carpenter, Gregory, and Meenal Patil. Gender Differences in Pain. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0005.
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Epidemiologic and clinical findings demonstrate that women are at increased risk for chronic pain, experience greater pain-related distress, and show heightened sensitivity for pain compared to men. There are differences in analgesic responses to pain and to both opioid and non-opioid medications as well as for endogenous analgesic processes. Many stress-related disorders, such as fibromyalgia and chronic pain, are more prevalent in women. Studies of experimentally induced pain show that women exhibit greater pain sensitivity, enhanced pain facilitation, and reduced pain inhibition compared to men. Mechanisms that implicated in the underlying sex differences include biological involvement of estrogen and progesterone versus testosterone. Sex-related differences in pain may also reflect differences in the endogenous opioid system. Other mechanisms include steroid action differences in adulthood, modulation of various biological systems such as the cardiovascular and inflammatory pathways, and sociocultural differences
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Beattie, R. Mark, Anil Dhawan, and John W.L. Puntis. Coeliac disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569862.003.0033.
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Who to investigate 234How to investigate 236Diagnosis 238Treatment 240Follow-up and support 242Coeliac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten which is present in wheat, barley, and rye. It occurs in genetically susceptible children and adults. The classical presentation is with chronic diarrhoea, abdominal distension, and failure to thrive. The widespread availability of antibody screening has considerably changed the clinical spectrum of cases seen. The testing of children with less classical symptoms and screening of children at high risk has brought increasing recognition of the varied presentation and increased prevalence of this now very common condition....
19
Hester, Rebecca J. Culture in Medicine: An Argument Against Competence. Edinburgh University Press, 2018. http://dx.doi.org/10.3366/edinburgh/9781474400046.003.0031.
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For the last few decades cultural competence has been celebrated as the curricular response to a variety of political and social challenges in healthcare. These challenges include the persistence of race- and ethnicity-based health disparities, breakdowns in communication between the patient and provider, and issues of cultural difference around delivery and acceptance of healthcare. Commonly defined as ‘a set of congruent behaviors, attitudes, and policies that come together in a system, agency or among professionals and enable that system, agency or those professions to work effectively in cross-cultural situations’, cultural competence is meant to engender increased sensitivity, humility and awareness with regard to cultural diversity in the clinical context.
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Mc Ardle, Brian A., Jennifer M. Renaud, Robert A. deKemp, and Rob S. B. Beanlands. Role of PET in Diagnosis and Risk Assessment in Patients with Known or Suspected CAD. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199392094.003.0020.
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Cardiac PET enables evaluation of multiple aspects of myocardial perfusion, metabolism, cell signaling and function that are of value both for diagnosis and prognostication in patients with known or suspected CAD and its use has increased in the past three decades. PET myocardial perfusion imaging (MPI) offers several technological advantages over SPECT including; higher photon energy, higher count sensitivity, more consistent attenuation correction and the ability to measure myocardial blood flow in absolute terms. These result in faster imaging times, lower patient radiation exposure and increased diagnostic accuracy. However the availability of PET MPI remains limited, predominantly due to expense. Efforts are underway to expand the use of PET MPI beyond larger centers, with lower-cost scanners and more widely available radiotracers. In this chapter we describe the latest advances in PET camera technology and image reconstruction as well as potential image artifacts specific to PET MPI. We go on to discuss diagnostic accuracy and prognostic value of PET MPI as well as its role in clinical practice.
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Adelman, Ronald D., Michele G. Greene, and Milagros D. Silva. Communication challenges with the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198736134.003.0052.
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The significant growth in the elderly population brings with it increased utilization of healthcare resources. Effective geriatric medical care requires effective communication and consideration of the challenges to communication in all stages of the continuum through health and disease. Given the often-negative perceptions of the elderly and the great heterogeneity of this population, it is imperative that health professionals assess each older patient as an individual. The impact of a cancer diagnosis and treatment, as well as a terminal illness, has a powerful effect on the lives of older people. Health professionals who care for the elderly with sensitivity to their personhood, their medical status, and psychosocial needs will have a profound influence on the quality of older patients’ lives.
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Pessoa, Luiz. Attention, Motivation, and Emotion. Edited by Anna C. (Kia) Nobre and Sabine Kastner. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199675111.013.001.
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The first part of the chapter describes effects of motivation on attention at the behavioural and physiological levels. For example, reward increases detection sensitivity (dprime) in both endogenous attention and exogenous attention tasks, enhances stimulus coding, and influences the filtering of task-irrelevant stimuli. These recent findings are surprising insofar as traditional psychological models have described motivation as a fairly unspecific ‘force’. The results reviewed are far from global. Instead they reflect specific mechanisms that are manifested selectively both at behavioural and neural levels. The second part of the chapter describes the role of attention when emotion-laden visual stimuli are processed. When one considers the bulk of the evidence, emotional processing is revealed to be capacity-limited. Yet, emotional processing is prioritized relative to that of neutral items.
23
Loades, Anne. Anglican Spirituality. Edited by Mark Chapman, Sathianathan Clarke, and Martyn Percy. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199218561.013.10.
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By virtue of its historical origins as well as its commitment to fundamental doctrines such as the Trinity, and the transformation of perspective as a result of ecumenism and the continuation of the Anglican Communion worldwide, Anglicans draw on an extraordinary range of resources both old and new. Reflection on scripture, saints both pre- and post-Reformation, and the willingness of present-day Christians to lay bare their own engagement with God result in a rich and demanding range of possibilities. The impact of liturgical reforms and revisions post Vatican II have resulting in the reordering of places and spaces for worship, increased sensitivity to ‘sacramentalism’ very broadly construed, attention to the arts in all their complexity, and in some cases in serious re-engagement with political and social life.
24
Brodsky, Beth S. Meeting the Clinical Challenges of Managing Borderline Personality Disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199997510.003.0020.
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Individuals diagnosed with borderline personality disorder (BPD) are high utilizers of mental health treatment and comprise a large percentage of both inpatient and outpatient psychiatric populations. Not only do they exhibit extreme interpersonal sensitivity and are quick to feel invalidated, rejected, and abandoned, they also present clinically with very challenging symptoms that have contributed to a stigmatization of the BPD diagnosis and the misconception that BPD is not treatable. Recently developed BPD-specific evidence-based psychotherapies incorporating theoretical and technical modifications to “treatment as usual” contribute to the destigmatization of the BPD diagnosis and to increased effectiveness in clinical management of the disorder. This chapter reviews the conceptualizations and interventions that facilitate the capacity for mental health providers to maintain an empathic therapeutic stance toward and positive engagement with BPD patients in order to keep patients engaged with and making progress toward their goals in treatment.
25
Armstrong, Bruce K., Claire M. Vajdic, and Anne E. Cust. Melanoma. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0057.
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Melanoma is a cancer of melanocytes, cells that produce the brown-black skin pigment melanin. Melanocytes originate in cells of the neural crest and migrate during embryogenesis, principally to the epidermis, eyes, and some mucous membranes (mouth, nose, esophagus, anus, genitourinary organs, and conjunctiva). Cutaneous melanoma afflicts mainly fair-skinned people of European origin, among whom sun exposure is the major cause. Five-year relative survival can exceed 90%. Invasive cutaneous melanoma in US whites occurs mostly on the trunk (34%), and upper limbs and shoulders (26%). Melanoma incidence rates have been increasing predominantly in European-origin populations. Ultraviolet (UV) radiation, from the sun or artificial tanning devices, probably both initiates and promotes melanoma. Nevi are markers of increased melanoma risk and direct precursors in some cases; nevus-prone people may require only modest sun exposure to initiate melanoma. Other risk factors include family history and sun sensitivity.
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Dickerman, Anna L., Yesne Alici, William Breitbart, and Harvey Max Chochinov. Palliative Care and Spiritual Care of Persons with HIV and AIDS. Edited by Mary Ann Cohen, Jack M. Gorman, Jeffrey M. Jacobson, Paul Volberding, and Scott Letendre. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199392742.003.0041.
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The meaning and role of palliative and spiritual care have evolved over the last decades, along with the dramatically changing clinical picture of AIDS. Although advances in antiretroviral therapy and medical interventions have allowed persons with HIV/AIDS and access to care to live longer and healthier lives, many persons in the United States and throughout the world continue to die of AIDS. There is an increased need for a comprehensive, multidisciplinary approach to care including psychosocial and family support. Curative, palliative, and spiritual care should be integrated, without dichotomizing curative and palliative approaches, in order to meet the challenges of AIDS throughout the course of illness. This chapter reviews basic concepts of palliative and spiritual care, as well as specific challenges facing clinicians involved in HIV palliative care. Finally, issues such as bereavement, demoralization, dignity, meaning, cultural sensitivity, doctor–patient communication, and psychiatric contributions to physical symptom control are reviewed.
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Arsenault, Elizabeth Grimm. Geneva Convention Compliance in Iraq and Afghanistan. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780199379774.003.0005.
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US compliance with the Geneva Conventions in Iraq and Afghanistan appeared to vary with the particular subject matter and battle space. In military operations during the last decade, the United States assessed the legality of virtually every proposed target to avoid the intentional targeting of civilians. Legal specialists also, however, flagrantly overlooked Common Article 3’s minimum prescription that all captured individuals have the right to be treated humanely. This variation in compliance is explained by the shift in mission objectives: When the United States approached these conflicts as purely counterterror operations, the goal was to disrupt the enemy. However, under the population-centric counterinsurgency mission, noncompliance with the Geneva Conventions equated to mission failure. The shift from counterterrorism to counterinsurgency increased US sensitivity to civilian casualties and the operational consequences of detainee abuse. By adapting practice to comply with the Conventions, the people became the prize in the war on terror.
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Nutt, David J., and Liam J. Nestor. Conclusion and overview. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198797746.003.0013.
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Substance addiction is a chronic relapsing disorder. It is the manifestation of the long-term pharmacological actions of substances on the receptor mechanisms of the brain’s neural circuitry. There are different neurotransmitter systems (e.g. dopamine, GABA, opioids) and even appetite hormones, acting within this neural circuitry in addiction, but their collective roles in the disorder remain equivocal. Importantly, disturbances to these systems may also pre-date addiction, which leads people to initiate substance abuse (e.g. stress, reward sensitivity). People may also be at an increased risk of initiating substance abuse due to age (e.g. adolescence), where there is an imbalance in the maturation of neural circuits. The pharmacokinetics of addictive drugs also plays a significant role in their abuse potential. Addiction is a recurrent disorder that is difficult to cure. Treatments that possess efficacy in aiding people to remain abstinent and stabilize their lives are the best courses of treatment for addiction disorders.
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Byrne, Maria, Pauline M. Ross, Symon A. Dworjanyn, and Laura Parker, eds. Larval Ecology in the Face of Changing Climate—Impacts of Ocean Warming and Ocean Acidification. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198786962.003.0017.
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Ocean warming and acidification are major climate change stressors for marine invertebrate larvae, and their impacts differ between habitats and regions. In many regions species with pelagic propagules are on the move, exhibiting poleward trends as temperatures rise and ocean currents change. Larval sensitivity to warming varies among species, influencing their invasive potential. Broadly distributed species with wide developmental thermotolerances appear best able to avail of the new opportunities provided by warming. Ocean acidification is a multi-stressor in itself and the impacts of its covarying stressors differ among taxa. Increased pCO2 is the key stressor impairing calcification in echinoid larvae while decreased mineral saturation is more important for calcification in bivalve larvae. Non-feeding, non-calcifying larvae appear more resilient to warming and acidification. Some species may be able to persist through acclimatization/adaptation to produce resilient offspring. Understanding the capacity for adaptation/acclimatization across generations is important to predicting the future species composition of marine communities.
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Lopez, Berenice, and Patrick J. Twomey. Biochemical investigation of rheumatic diseases. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0062.
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It is important for rheumatologists to have an understanding of biochemical tests including an awareness of their limitations. The biological variability of an analyte both within and between individuals, the limitations of the measurement technology, the sensitivity of laboratory internal quality control and external quality assurance procedures, as well as interlaboratory variations in practices including sample collection procedures, may all impact on the interpretation of a result. Biochemical tests are often requested to monitor organ-specific dysfunction arising as an adverse consequence of pharmacotherapy or as a component of a systemic rheumatic disease, although dysfunction may also reflect infection or coincidental pathology. Patients with rheumatic diseases are at high risk of renal and hepatic disease. Serum creatinine and its derivative estimated glomerular filtration rate (eGFR) are the most readily available surrogate markers of GFR and are used to assess renal impairment and monitor its course. However, the use of creatinine alone lacks sensitivity and a substantial loss of function must occur before creatinine levels are increased. Additional biochemical screening for kidney damage can be performed by assessment of glomerular integrity, including proteinuria or albuminuria and haematuria. A wide spectrum of rheumatic diseases can affect the liver with various degrees of involvement and hepatic pathology. These often present with cholestatic or hepatitic biochemical profiles. The medical management of rheumatic diseases also involves medications that are hepatotoxic, and routine monitoring of liver function is recommended. This approach is not problem-free and may be improved by quantitative determinations of non-invasive markers of liver fibrosis in the future. Together with imaging techniques, biochemical tests play an important role in the assessment and differential diagnosis of metabolic bone disease.
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Kane, David, and Philip Platt. Ultrasound. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199642489.003.0067.
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Musculoskeletal ultrasound (MSUS) is rapidly becoming a standard part of many rheumatologists' daily clinical practice. MSUS is safe, increasingly widely available, relatively low cost, non-invasive, and hence very acceptable to the patient. Current problems with availability of training, mentoring, and accreditation procedures need to be overcome for MSUS to reach its full potential for rheumatologists. MSUS is capable of improving clinical diagnosis and the accuracy of intervention. MSUS is more sensitive than clinical examination in the detection of synovitis and effusion and is capable of rapid targeted assessment of widely spaced joints coupled with clinical correlation. MSUS has advantages over other imaging modalities; the ability to display dynamic real-time movement makes it the imaging modality of choice for tendon problems. It is significantly more sensitive than plain radiology in the demonstration of early erosive changes, and although its sensitivity is less than that of MRI for the detection of erosions it is far more practical, timely, and available. The combination of sensitivity in detection of synovitis, tenosynovitis, and erosions makes it an ideal imaging modality in the context of an early arthritis clinic. Power Doppler has been shown to be an effective way of evaluating synovitis and hence is of value in early diagnosis and monitoring of inflammatory arthritides. The accuracy of placement of local injection therapies is enhanced by MSUS, and it significantly increases the diagnostic success rate of aspiration of joints and bursas. The flexibility of ultrasound as a tool for rheumatologists is shown by its application in the assessment of vasculitides, peripheral nerve pathology, salivary glands, and skin lesions.
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Kane, David, and Philip Platt. Ultrasound. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199642489.003.0067_update_002.
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Musculoskeletal ultrasound (MSUS) is rapidly becoming a standard part of many rheumatologists’ daily clinical practice. MSUS is safe, increasingly widely available, relatively low cost, non-invasive, and hence very acceptable to the patient. Current problems with availability of training, mentoring, and accreditation procedures need to be overcome for MSUS to reach its full potential for rheumatologists. MSUS is capable of improving clinical diagnosis and the accuracy of intervention. MSUS is more sensitive than clinical examination in the detection of synovitis and effusion and is capable of rapid targeted assessment of widely spaced joints coupled with clinical correlation. MSUS has advantages over other imaging modalities; the ability to display dynamic real-time movement makes it the imaging modality of choice for tendon problems. It is significantly more sensitive than plain radiology in the demonstration of early erosive changes, and although its sensitivity is less than that of MRI for the detection of erosions it is far more practical, timely, and available. The combination of sensitivity in detection of synovitis, tenosynovitis, and erosions makes it an ideal imaging modality in the context of an early arthritis clinic. Power Doppler has been shown to be an effective way of evaluating synovitis and hence is of value in early diagnosis and monitoring of inflammatory arthritides. The accuracy of placement of local injection therapies is enhanced by MSUS, and it significantly increases the diagnostic success rate of aspiration of joints and bursas. The flexibility of ultrasound as a tool for rheumatologists is shown by its application in the assessment of vasculitides, peripheral nerve pathology, salivary glands, and skin lesions.
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Giannitsis, Evangelos, and Hugo A. Katus. Biomarkers in acute coronary syndromes. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0036.
Full textAbstract:
Biomarker testing in the evaluation of a patient with acute chest pain is best established for cardiac troponins that allow the diagnosis of myocardial infarction, risk estimation of short- and long-term risk of death and myocardial infarction, and guidance of pharmacological therapy, as well as the need and timing of invasive strategy. Newer, more sensitive troponin assays have become commercially available and have the capability to detect myocardial infarction earlier and more sensitively than standard assays, but they are hampered by a lack of clinical specificity, i.e. the ability to discriminate myocardial ischaemia from myocardial necrosis not related to ischaemia such as myocarditis, pulmonary embolism, or decompensated heart failure. Strategies to improve clinical specificity (including strict adherence to the universal myocardial infarction definition and the need for serial troponin measurements to detect an acute rise and/or fall of cardiac troponin) will improve the interpretation of the increasing number of positive results. Other biomarkers of inflammation, activated coagulation/fibrinolysis, and increased ventricular stress mirror different aspects of the underlying disease activity and may help to improve our understanding of the pathophysiological mechanisms of acute coronary syndromes. Among the flood of new biomarkers, there are several novel promising biomarkers, such as copeptin that allows an earlier rule-out of myocardial infarction in combination with cardiac troponin, whereas MR-proANP and MR-proADM appear to allow a refinement of cardiovascular risk. GDF-15 might help to identify candidates for an early invasive vs conservative strategy. A multi-marker approach to biomarkers becomes more and more attractive, as increasing evidence suggests that a combination of several biomarkers may help to predict individual risk and treatment benefits, particularly among troponin-negative subjects. Future goals include the acceleration of rule-in and rule-out of patients with suspected acute coronary syndrome, in order to shorten lengths of stay in the emergency department, and to optimize patient management and the use of health care resources. New algorithms using high-sensitivity cardiac troponin assays at low cut-offs alone, or in combination with additional biomarkers, allow to establish accelerated rule-out algorithms within 1 or 2 hours.
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Giannitsis, Evangelos, and Hugo A. Katus. Biomarkers in acute coronary syndromes. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0036_update_001.
Full textAbstract:
Biomarker testing in the evaluation of a patient with acute chest pain is best established for cardiac troponins that allow the diagnosis of myocardial infarction, risk estimation of short- and long-term risk of death and myocardial infarction, and guidance of pharmacological therapy, as well as the need and timing of invasive strategy. Newer, more sensitive troponin assays have become commercially available and have the capability to detect myocardial infarction earlier and more sensitively than standard assays, but they are hampered by a lack of clinical specificity, i.e. the ability to discriminate myocardial ischaemia from myocardial necrosis not related to ischaemia such as myocarditis, pulmonary embolism, or decompensated heart failure. Strategies to improve clinical specificity (including strict adherence to the universal myocardial infarction definition and the need for serial troponin measurements to detect an acute rise and/or fall of cardiac troponin) will improve the interpretation of the increasing number of positive results. Other biomarkers of inflammation, activated coagulation/fibrinolysis, and increased ventricular stress mirror different aspects of the underlying disease activity and may help to improve our understanding of the pathophysiological mechanisms of acute coronary syndromes. Among the flood of new biomarkers, there are several novel promising biomarkers, such as copeptin that allows an earlier rule-out of myocardial infarction in combination with cardiac troponin, whereas MR-proANP and MR-proADM appear to allow a refinement of cardiovascular risk. GDF-15 might help to identify candidates for an early invasive vs conservative strategy. A multi-marker approach to biomarkers becomes more and more attractive, as increasing evidence suggests that a combination of several biomarkers may help to predict individual risk and treatment benefits, particularly among normal-troponin subjects. Future goals include the acceleration of rule-in and rule-out of patients with suspected acute coronary syndrome, in order to shorten lengths of stay in the emergency department, and to optimize patient management and the use of health care resources. New algorithms using high-sensitivity cardiac troponin assays at low cut-offs alone, or in combination with additional biomarkers, allow to establish accelerated rule-out algorithms within 1 or 2 hours.
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Giannitsis, Evangelos, and Hugo A. Katus. Biomarkers in acute coronary syndromes. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199687039.003.0036_update_002.
Full textAbstract:
Biomarker testing in the evaluation of a patient with acute chest pain is best established for cardiac troponins that allow the diagnosis of myocardial infarction, risk estimation of short- and long-term risk of death and myocardial infarction, and guidance of pharmacological therapy, as well as the need and timing of invasive strategy. Newer, more sensitive troponin assays have become commercially available and have the capability to detect myocardial infarction earlier and more sensitively than standard assays, but they are hampered by a lack of clinical specificity, i.e. the ability to discriminate myocardial ischaemia from myocardial necrosis not related to ischaemia such as myocarditis, pulmonary embolism, or decompensated heart failure. Strategies to improve clinical specificity (including strict adherence to the universal myocardial infarction definition and the need for serial troponin measurements to detect an acute rise and/or fall of cardiac troponin) will improve the interpretation of the increasing number of positive results. Other biomarkers of inflammation, activated coagulation/fibrinolysis, and increased ventricular stress mirror different aspects of the underlying disease activity and may help to improve our understanding of the pathophysiological mechanisms of acute coronary syndromes. Among the flood of new biomarkers, there are several novel promising biomarkers, such as copeptin that allows an earlier rule-out of myocardial infarction in combination with cardiac troponin, whereas MR-proANP and MR-proADM appear to allow a refinement of cardiovascular risk. GDF-15 might help to identify candidates for an early invasive vs conservative strategy. A multi-marker approach to biomarkers becomes more and more attractive, as increasing evidence suggests that a combination of several biomarkers may help to predict individual risk and treatment benefits, particularly among normal-troponin subjects. Future goals include the acceleration of rule-in and rule-out of patients with suspected acute coronary syndrome, in order to shorten lengths of stay in the emergency department, and to optimize patient management and the use of health care resources. New algorithms using high-sensitivity cardiac troponin assays at low cut-offs alone, or in combination with additional biomarkers, allow to establish accelerated rule-out algorithms within 1 or 2 hours.
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Sklar, Larry A., ed. Flow Cytometry for Biotechnology. Oxford University Press, 2005. http://dx.doi.org/10.1093/oso/9780195183146.001.0001.
Full textAbstract:
Flow cytometry is a sensitive and quantitative platform for the measurement of particle fluorescence. In flow cytometry, the particles in a sample flow in single file through a focused laser beam at rates of hundreds to thousands of particles per second. During the time each particle is in the laser beam, on the order of ten microseconds, one or more fluorescent dyes associated with that particle are excited. The fluorescence emitted from each particle is collected through a microscope objective, spectrally filtered, and detected with photomultiplier tubes. Flow cytometry is uniquely capable of the precise and quantitative molecular analysis of genomic sequence information, interactions between purified biomolecules and cellular function. Combined with automated sample handling for increased sample throughput, these features make flow cytometry a versatile platform with applications at many stages of drug discovery. Traditionally, the particles studied are cells, especially blood cells; flow cytometry is used extensively in immunology. This volume shows how flow cytometry is integrated into modern biotechnology, dealing with issues of throughput, content, sensitivity, and high throughput informatics with applications in genomics, proteomics and protein-protein interactions, drug discovery, vaccine development, plant and reproductive biology, pharmacology and toxicology, cell-cell interactions and protein engineering.
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Clarke, Andrew. Metabolism. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780199551668.003.0008.
Full textAbstract:
Metabolism is driven by redox reactions, in which part of the difference in potential energy between the electron donor and acceptor is used by the organism for its life processes (with the remainder being dissipated as heat). The key process is intermediary metabolism, by which the energy stored in reserves (glycogen, starch, lipid, protein) is transferred to ATP. In aerobic respiration the electrons released from reserves are passed to oxygen, which is thereby reduced to water. Not all ATP regeneration involves oxygen as the final electron acceptor, and not all oxygen is used for ATP regeneration, but oxygen consumption is often the simplest and most practical way to measure the rate of intermediary metabolism and the errors in doing so are believed to be small. The costs of existence, as estimated by resting metabolism, represent only a part (~ 25%) of the daily energy expenditure of organisms. The costs of the organism’s ecology (growth, reproduction, movement and so on) are additional to existence costs. Resting metabolic rate increases with cell temperature, indicating that it costs more energy to maintain a warm cell than it does a cool or cold cell. The temperature sensitivity of resting metabolism is highly conserved across organisms.
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Gao, Yanhong, and Deliang Chen. Modeling of Regional Climate over the Tibetan Plateau. Oxford University Press, 2017. http://dx.doi.org/10.1093/acrefore/9780190228620.013.591.
Full textAbstract:
The modeling of climate over the Tibetan Plateau (TP) started with the introduction of Global Climate Models (GCMs) in the 1950s. Since then, GCMs have been developed to simulate atmospheric dynamics and eventually the climate system. As the highest and widest international plateau, the strong orographic forcing caused by the TP and its impact on general circulation rather than regional climate was initially the focus. Later, with growing awareness of the incapability of GCMs to depict regional or local-scale atmospheric processes over the heterogeneous ground, coupled with the importance of this information for local decision-making, regional climate models (RCMs) were established in the 1970s. Dynamic and thermodynamic influences of the TP on the East and South Asia summer monsoon have since been widely investigated by model. Besides the heterogeneity in topography, impacts of land cover heterogeneity and change on regional climate were widely modeled through sensitivity experiments.In recent decades, the TP has experienced a greater warming than the global average and those for similar latitudes. GCMs project a global pattern where the wet gets wetter and the dry gets drier. The climate regime over the TP covers the extreme arid regions from the northwest to the semi-humid region in the southeast. The increased warming over the TP compared to the global average raises a number of questions. What are the regional dryness/wetness changes over the TP? What is the mechanism of the responses of regional changes to global warming? To answer these questions, several dynamical downscaling models (DDMs) using RCMs focusing on the TP have recently been conducted and high-resolution data sets generated. All DDM studies demonstrated that this process-based approach, despite its limitations, can improve understandings of the processes that lead to precipitation on the TP. Observation and global land data assimilation systems both present more wetting in the northwestern arid/semi-arid regions than the southeastern humid/semi-humid regions. The DDM was found to better capture the observed elevation dependent warming over the TP. In addition, the long-term high-resolution climate simulation was found to better capture the spatial pattern of precipitation and P-E (precipitation minus evapotranspiration) changes than the best available global reanalysis. This facilitates new and substantial findings regarding the role of dynamical, thermodynamics, and transient eddies in P-E changes reflected in observed changes in major river basins fed by runoff from the TP. The DDM was found to add value regarding snowfall retrieval, precipitation frequency, and orographic precipitation.Although these advantages in the DDM over the TP are evidenced, there are unavoidable facts to be aware of. Firstly, there are still many discrepancies that exist in the up-to-date models. Any uncertainty in the model’s physics or in the land information from remote sensing and the forcing could result in uncertainties in simulation results. Secondly, the question remains of what is the appropriate resolution for resolving the TP’s heterogeneity. Thirdly, it is a challenge to include human activities in the climate models, although this is deemed necessary for future earth science. All-embracing further efforts are expected to improve regional climate models over the TP.