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A 12-year-old boy had a three-year history of exercise-induced pain in his limbs; in particular, the shoulders, elbows, and knees were affected. For six months he had also experienced loss of strength. He noted difficulty with walking and cycling and was hardly able to climb stairs. He developed toe walking and complained about an itchy skin rash with focal depigmentation at his neck and trunk, diagnosed as eczema. He did not complain about swallowing difficulty, yet he became cachexic because his nutritional intake was lagging, and he suffered from mood swings.
Previous history was unremarkable. His parents were healthy, as was his older brother.
This chapter places the actions of the Mansfeld Regiment within the context of military pay for the Saxon army during the 1620s. Pay for individual infantrymen varied substantially, and this chapter argues that it can be used as a proxy to determine these men’s social status. Mercenary soldiers and female members of the military community could act as subcontractors in their own right, which shaped the way they found sexual partners. Pay in the Saxon army in the 1620s seems high, and was disbursed on time. Although the Saxon army was at paper strength throughout the 1620s, this massive outlay may have been one reason Saxon finances fell apart in the 1640s. Meanwhile, the Mansfeld Regiment was paid far less than the customary rate in the Saxon army, and was swindled by the Governor of Milan.
This chapter elaborates a contextualized account of Horace’s interests in nature and the nonhuman. It traces the connections in his lyric poetry between the nonhuman environment and various concepts of nature. Drawing on long-standing poetic traditions, as well as developments in Hellenistic philosophy, Horace forges a poetry in which distilled perceptions of the nonhuman world undergird insights into ethical concepts of nature by which humans should live their lives. The chapter finds in this poetics a complex form of nature poetry that usefully complicates that concept within the history of the lyric. In order to write this poetry, Horace authenticates his vatic status through claims about his own special relationship with the nonhuman environment and the gods. Horace’s special connection to the divine allows him to enjoy a privileged relationship with his nonhuman surroundings. And it is because of this status that he can command us with urgency and authority to attend to our environments. Horace represents himself as a supernatural poet of nature, whose literary achievement transcends nature even as it teaches about nature’s limits.
Constrictive pericarditis is a rare complication after cardiac surgery. It is mostly seen in adults. We report a case of constrictive pericarditis in a 3-year-old child with right ventricular dysfunction after permanent pacemaker implantation during infancy for congenital complete heart block. Suspicion of constrictive pericarditis must be kept in mind during evaluation.
In fall 1945, Lieutenant Colonel William K. Evans, the US Army’s chief civil affairs officer in Taiwan, smuggled sixty kilograms of gold bullion that he confiscated from the Japanese Tenth Area Army and offloaded it on Shanghai’s black market, returning to the United States with $108,000 in cash (worth approximately $1.5 million today). The gold was supposed to go the Chinese Nationalist government. Although US military authorities found overwhelming evidence of Evans’ guilt and had recently sentenced another colonel to ten years in prison for a nearly identical crime committed in Tokyo, Evans walked away a free man after a protracted Sino-US diplomatic struggle and two mistrials in federal court. By examining the Evans case, this chapter sheds light on the transition from extraterritoriality and formal colonialism to America’s postcolonial model of using status of forces agreements (SOFAs) to exercise jurisdiction over US forces stationed abroad.
Despite bold commitments to reduce anemia, little change in prevalence was observed over the past decade. We aimed to generate subnational maps of anemia among women of reproductive age (WRA), malaria transmission, and hemoglobinopathies to identify priority areas, but also explore their geographical overlap.
Design:
Using the most recent Demographic and Health Surveys (DHS), we first mapped anemia clusters across Sub-Sahara Africa (SSA) and identified the WCA as a major cluster. Geographic clusters with high anemia and related etiologic factors were identified using spatial statistics. Multilevel regression models were run to identify factors associated with any, moderate and severe anemia.
Settings:
West and Central African countries (n=17).
Participants:
WRA (n= 112,024) residing in 17 WCA countries.
Results:
There was a significant overlap in geographical clusters of anemia, malaria, and hemoglobinopathies, particularly in the coastal areas of the WCA region. Low birth interval (0.86 [0.77, 0.97]), number of childbirth (1.12 [1.02, 1.23]), being in the 15-19 age range (1.47 [1.09, 1.98])) were associated with increased odds of any anemia. Unimproved toilet facility and open defecation were associated with any anemia, whereas the use of unclean cooking fuel was associated with moderate/severe anemia (P<0.05). Access to health care facility, living in malaria prone areas, and hemoglobinopathies (HbC and HbS) were all associated with any, moderate or severe anemia.
Conclusion:
Interlinkages between infection, hemoglobinopathies, and nutritional deficiencies complicate the etiology of anemia in the WCA region. Without renewed efforts to integrate activities and align various sectors in the prevention of anemia, progress is likely to remain elusive.
This chapter discusses how molecular communication systems can be designed, using the various techniques described in the book. The chapter discusses system design in the context of four specific application areas: drug delivery, tissue engineering, lab-on-chip technology, and unconventional computation. In each case, the general application scenario is discussed, and specific design examples are presented.
The demands made on a modern emergency department (ED) are such that having an internal capacity to provide a range of procedural sedation is essential to its functioning. Patients arrive at every hour of the day, with pathology that may require sedation for diagnosis or treatment. The requirement for urgent action is greater than in an outpatient office or clinic, where cases are typically planned. Patients in the ED may be critically ill, or have a threat to an organ or limb that must be dealt with rapidly. Imposing on colleagues from the department of anesthesia to provide sedation for these patients is unnecessary and logistically difficult, given the after-hours and unplanned nature of these cases. Emergency physicians with training and board certification in emergency medicine have the skills to recognize these situations, and to assess the risks and benefits of procedural sedation in caring for these patients. In addition, the emergency physician has advanced airway management and resuscitation training to manage complications arising from sedation [1, 2].
Although seed trait variations and their relationship to the ecological niche have been studied extensively at the species level, they do not necessarily reflect variations at the population level. In this study, we explored the intra-specific variation in relative embryo length, seed mass and germination speed in 40 populations of Daucus carota distributed across Europe and North America. By including information on local climate conditions, we aimed to examine the impact of the geographical origin on various seed functional traits and to detect potential local adaptation. No significant difference was observed in final seed germination for European and North American seeds incubated at 20°C, nor in seed viability. In European populations, relative embryo length significantly increased with increasing seed mass, but no such relation was found in North American populations. Larger relative embryo length at dispersal resulted in increased germination speed in both European and North American populations. Populations in drier areas typically had seeds with larger relative embryo lengths. Precipitation-related climate variables showed a negative relationship with relative embryo length, indicating a reduction in relative embryo length with increased precipitation. No clear relationship between climate and seed mass was observed. We can conclude that seed functional traits of D. carota are adapted to local climate conditions, as a clear gradient was observed in the relative embryo length of D. carota, which was associated with germination speed and climate. This gradient was less pronounced in North America, which can be explained by its relatively recent introduction to the continent.
In his late twenties, a 30-year-old man reported difficulty with raising his arms and running, which had progressed over subsequent years. During his teens he had been a very good soccer player.