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Forensic pathologists are increasingly faced with challenges when it comes to geriatric cases, due to an aging population and increased co-morbidities in the elderly. This text provides an up-to-date guide to all facets of geriatric forensic pathology, with contributions from experts from a variety of disciplines. Packed with color illustrations and case examples, chapters cover inflicted, self-inflicted and accidental trauma, as well as natural conditions leading to unexpected death. In addition, specific chapters cover a wide range of difficult and topical areas, from elder abuse, dementias and nutrition to pharmacology and toxicology issues, long-term care facilities and scene investigation. Topics such as euthanasia are also explored to provide the reader with a rich, contemporary understanding of medicolegal issues. This is an invaluable resource not only for pathologists, but also for medical practitioners and lawyers dealing with geriatric cases. The book comes packaged with online access to the text and high-resolution images.
St. Paul was a pivotal and controversial figure in the fledgling Jesus-movement of the first-century. The New Cambridge Companion to St. Paul provides an invaluable entryway into the study of Paul and his letters. Composed of sixteen essays by an international team of scholars, it explores some of the key issues in the current study of his dynamic and demanding theological discourse. The volume first examines Paul's life and the first-century context in which he and his communities lived. Contributors then analyze particular writings by comparing and contrasting at least two selected letters, while thematic essays examine topics of particular importance, including how Paul read scripture, his relation to Judaism and monotheism, why his message may have been attractive to first-century audiences, how his message was elaborated in various ways in the first four centuries, and how his theological discourse might relate to contemporary theological discourse and ideological analysis today.
Is original sin compatible with evolution? Many today believe the answer is 'No'. Engaging Aquinas's revolutionary account of the doctrine, Daniel W. Houck argues that there is not necessarily a conflict between this Christian teaching and mainstream biology. He draws on neglected texts outside the Summa Theologiae to show that Aquinas focused on humanity's loss of friendship with God - not the corruption of nature (or personal guilt). Aquinas's account is theologically attractive in its own right. Houck proposes, moreover, a new Thomist view of original sin that is consonant with evolution. This account is developed in dialogue with biblical scholarship on Jewish hamartiology and salient modern thinkers (including Kant, Schleiermacher, Barth, and Schoonenberg), and it is systematically connected to debates over nature, grace, the desire for God, and justification. In addition, the book canvasses a number of neglected premodern approaches to original sin, including those of Anselm, Abelard, and Lombard.
Although much is known about the anatomy of adult primates, particularly chimpanzees, the same cannot be said for the anatomy of young primates, especially non-hominoid primates such as lemurs and marmosets. This is the first book dedicated to newborn skeletal and dental anatomy and how it varies across primate species, which is important for interpreting adult primate skeletal form, as well as for comprehending primate and human evolution. Structured according to anatomical regions, the book includes hundreds of detailed anatomical illustrations, a color atlas illustrating entire skeletons in representative taxa, and boxes at the end of each chapter providing further detail on key aspects covered in the main text. Whilst the book is primarily a guide to comparative anatomy, it also highlights the links between development and behavior. An indispensable resource for students and researchers in the fields of biological anthropology, anatomy, primatology, growth and development, dental biology, and veterinary medicine.
Using as a starting point the work of internationally-renowned Australian scholar Sam Ricketson, whose contributions to intellectual property (IP) law and practice have been extensive and richly diverse, this volume examines topical and fundamental issues from across IP law. With authors from the US, UK, Europe, Asia, Australia and New Zealand, the book is structured in four parts, which move across IP regimes, jurisdictions, disciplines and professions, addressing issues that include what exactly is protected by IP regimes; regime differences, overlaps and transplants; copyright authorship and artificial intelligence; internationalization of IP through public and private international law; IP intersections with historical and empirical research, human rights, privacy, personality and cultural identity; IP scholars and universities, and the influence of treatises and textbooks. This work should be read by anyone interested in understanding the central issues in the evolving field of IP law.
This urgent and provocative study explores contemporary Shakespeare performance to bring a sense of theatre as technology into view. Rather than merely using technologies, the theatre's distinctively intermedial character is essential to its complex technicity; the changing function of gesture and costume, of written documents in the making of performance, of light and sound, and of the interplay of live and recorded acting complicate the sense of theatre as a medium. In a series of probing discussions, Worthen interrogates the interaction of live and mediated acting onstage, the impact of written media from the handwritten scroll to the small-screen app in acting as a technē, the work of Original Practices as an interactive modern theatre technology, the economies of theatrical immersion, and the consequences of an emerging algorithmic theatre, providing a richly theoretical reading of the stakes of theatre as an always-emerging technology.
This Handbook provides both breadth and depth regarding current approaches to the understanding, assessment, and treatment of personality disorders. The five parts of the book address etiology; models; individual disorders and clusters; assessment; and treatment. A comprehensive picture of personality pathology is supplied that acknowledges the contributions and missteps of the past, identifies the crucial questions of the present, and sets a course for the future. It also follows the changes the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) has triggered in the field of personality disorders. The editors take a unique approach where all chapters include two commentaries by experts in the field, as well as an author rejoinder. This approach engages multiple perspectives and an exchange of ideas. It is the ideal resource for researchers and treatment providers at all career stages.
Fundamental tenets of colonial historiography are challenged by showing that US capital investment into this colony did not lead to the disappearance of the small farmer. Contrary to well-established narratives, quantitative data show that the increasing integration of rural producers within the US market led to differential outcomes, depending on pre-existing land tenure structures, capital requirements to initiate production, and demographics. These new data suggest that the colonial economy was not polarized into landless Puerto Rican rural workers on one side and corporate US capitalists on the other. The persistence of Puerto Rican small farmers in some regions and the expansion of local property ownership and production disprove this socioeconomic model. Other aspects of extant Puerto Rican historiography are confronted in order to make room for thorough analyses and new conclusions on the economy of colonial Puerto Rico during the early twentieth century.
In Singapore, genome editing techniques may be applied in research but not for therapeutic (or clinical) purposes. Broadly speaking, the legal, regulatory and ethical provisions that apply to genome editing are drawn from five (at times overlapping) regulatory regimes: (i) research involving human embryos and stem cells; (ii) research involving assisted reproduction centers (and assisted reproduction services); (iii) research involving non-human animals; (iv) human biomedical research other than clinical trials; and (v) clinical trials. A human embryo may be created solely for the purposes of research (to study a genome editing technique, for instance), provided certain conditions are met and requisite approvals are obtained. Any such research should not extend beyond fourteen days from the time that the embryo was created. These requirements apply mutatis mutandis to the use of genome editing techniques to modify the genome of human oocytes and embryos. Owing to a moratorium that has been imposed, human germline genetic modification is not allowed in the clinical setting. However, it is less clear if such procedures could be applied in a clinical trial. This chapter provides an analysis of the regulatory framework and its application, as well as how it is expected to change in the foreseeable future.
In this Element, we extend our earlier treatment of biology's first law. The law says that in any evolutionary system in which there is variation and heredity, there is a tendency for diversity and complexity to increase. The law plays the same role in biology that Newton's first law plays in physics, explaining what biological systems are expected to do when no forces act, in other words, what happens when nothing happens. Here we offer a deeper explanation of certain features of the law, develop a quantitative version of it, and explore its consequences for our understanding of diversity and complexity.
Surgery and anaesthesia alter the function of the brain and its control mechanisms. In the operating room, we daily observe the effects of anaesthetic agents during induction and recovery from anaesthesia: changes in the electroencephalogram, on consciousness, muscle tone as well as in the responses to different stimulations that immediately disappear after induction, and reappear gradually when anaesthetic effects wear off. To prevent short- or long-term functional changes of the brain, the parameters of its physiological defence mechanisms must be maintained within the patient’s normal range. Failing to do so might lead to complications that can significantly alter patient outcome.
Monitoring during anaesthesia is based on the measurement of physiological signals that are recorded during surgical or other procedures requiring anaesthetic drug administration. The methods used to process these signals, calculate derived parameters and develop the different indicators of the physiological status of the patient or depth of anaesthesia are difficult to understand for anaesthesia providers without an engineering background. The present chapter aims to fill this gap by introducing the reader to the main concepts related to signal analysis commonly used to measure the response of human physiological systems under anaesthesia.
We first published on the subject of pregnancy management via fetal reduction (FR) 30 years ago . Dramatic changes have occurred in medical technology, outcomes, and patient choices – large demographic and cultural shifts that have driven the pace and direction of progress and research [2, 3].
Twin, triplet or higher order pregnancies are referred to as multiple pregnancies. The prevalence of multiple pregnancies is around 1 per 80 live births . Twins can be either dizygotic, resulting from the fertilization of two separate ova during a single ovulatory cycle, or monozygotic, resulting from a single fertilized ovum that subsequently divides into two separate individuals. Dizygotic twins are more prevalent than monozygotic twins. Higher order multiples can result from either or both processes. Monozygotic twins can either be dichorionic (1/3), monochorionic (2/3), or mono-amniotic (1/3). Which type of monozygotic twin eventually develops depends on the moment of splitting of the fertilized ovum. If the ovum splits within the first 3 days dichorionic twins develop, if the ovum splits between 4 and 8 days monochorionic/diamniotic twins develop, between 8 and 12 days mono-amniotic twins develop, and if the ovum splits after 12 days this gives rise to conjoined twins.
The fetal membranes (FM) are comprised of the amniotic membrane (AM), chorionic membrane (CM), and underlying maternal decidua. Together they provide a barrier towards ascending infection and enable amniotic fluid (AF) homeostasis. Preterm premature rupture of the membranes (PPROM) can occur spontaneously and complicates around 2% of all pregnancies, leading to preterm birth, chorioamnionitis, neonatal sepsis, limb position defects, respiratory distress syndrome, pulmonary hypoplasia, and chronic lung disease. Membrane separation is a common finding after open fetal surgery that leads to iatrogenic PPROM (iPPROM) and intrauterine infection, complicating over 30% of fetal surgeries. The subsequent associated preterm birth compromises the outcome of treatment, reducing the clinical effectiveness of fetal surgery . Spontaneous healing of the membranes does not occur after fetoscopic surgery, leaving a visible defect in the FM (Figure 50.1) that is prone to AF leakage and subsequent iPPROM . To date, there are no clinical solutions to improve healing of the FM after they rupture.
Despite advances in neonatal intensive care, prematurity remains an unsolved clinical challenge and a leading cause of infant morbidity and mortality . Approximately 6% of all live births in the USA are considered extremely preterm (delivery at less than 28 weeks’ gestation), and the incidence of prematurity has slowly risen over the past decade . Prematurity is thought to account for one-third of infant mortality , one-half of cerebral palsy, and 80% of survivors born at 22–28 weeks’ gestation will suffer at least one major co-morbidity .
Congenital renal and urinary tract anomalies are common, accounting for up to 21% of all congenital abnormalities . The reported incidence is approximately 1:250–1:1000 pregnancies  and the routine use of prenatal ultrasonography allows relatively early detection, particularly for the obstructive uropathies, which account for the majority. According to the latest UK renal registry report in 2015, ‘obstructive uropathy’ was the second leading cause (19%) of chronic renal failure in children under 16 years of age after renal dysplasia +/− reflux . The obstructions may occur within the upper or lower urinary tract, and their prognosis varies significantly, with obstructions at the level of the bladder neck being associated with the majority of neonatal mortality and renal failure. In untreated cases, perinatal mortality is high (up to 45%, often because of associated severe oligohydramnios and pulmonary hypoplasia) , and 30% of the survivors suffer from end-stage renal failure (ESRF) requiring dialysis and renal transplantation before the age of 5 . The overall chance of survival in childhood is lowest if renal support therapy or transplantation is commenced before 2 years old when compared with starting at 12–16 years old (hazard ratio [HR] of 4.1, 95% confidence interval [CI] 1.7–9.9, P = 0.002) . Therefore, in utero intervention, by the insertion of a vesicoamniotic shunt, or therapeutic treatment by fetal cystoscopy and valvular ablation, has been attempted to attenuate in utero progression of these pathologies (and their consequences) and to alter the natural history of congenital bladder neck obstruction in childhood. In this chapter, we discuss the etiology, pathophysiology, prenatal presentation and diagnosis of congenital bladder neck obstruction. Suggested algorithms for screening and the prenatal prognostic evaluation in selecting candidates for in utero therapy will be discussed.