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1
Uchiyama, Kunio. Heterogeneous Multicore Processor Technologies for Embedded Systems. New York, NY: Springer New York, 2012.
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2
Varra, Lucia, ed. Dal dato diffuso alla conoscenza condivisa. Florence: Firenze University Press, 2012. http://dx.doi.org/10.36253/978-88-6655-177-5.
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At the present time, the tourist destination offers a stimulating laboratory for the experimentation of theoretical models and good practices on the subjects of governance, knowledge management and sustainable competition. Growing interest in the study of this territorial context gains impetus from the new approaches and tools that local administrations are starting to introduce in the phases of implementation and control of local strategies. In this respect, the Tourist Destination Observatory (OTD) represents an important innovation, offering a nerve centre for the aggregation and networking of heterogeneous data scattered over the territory as well as a model for the implementation of permanent approaches to social dialogue as prerequisites for the creation of knowledge and for an aware, shared, competitive and responsible development of the destination. The OTD can act as an efficient agent of local change, facilitating the processes of governance, and as a tool of knowledge management for the valorisation of intellectual capital. It is consequently a crucial support for the strategic repositioning of mountain resorts, which can represent valid responses to the emerging new modes of interpreting the holiday.
3
Arakawa, Fumio, Kunio Uchiyama, and Hironori Kasahara. Heterogeneous Multicore Processor Technologies for Embedded Systems. Springer, 2012.
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4
Back, Kerry E. Heterogeneous Beliefs. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780190241148.003.0021.
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There is a representative investor in a complete single‐period market if all investors have log utility or if all investors have CARA utility, even if investors have different beliefs. This extends to dynamic markets for log utility but not for CARA utility. With CARA and other LRT utility, the concept of a representative investor can be extended to include a random discounting factor that is either a supermartingale or a submartingale. If there are short sales constraints, then assets may be overpriced relative to average beliefs, because pessimistic investors are constrained from trading on their beliefs. The overpricing is an increasing function of the dispersion of beliefs. In a dynamic market with short sales constraints, prices can exceed even the values of optimistic investors (a speculative bubble).
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Alaniz, Enrique, T. H. Gindling, Catherine Mata, and Diego Rojas. Heterogeneous informality in Costa Rica and Nicaragua. 50th ed. UNU-WIDER, 2021. http://dx.doi.org/10.35188/unu-wider/2021/988-4.
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Informal work is often considered a place of employment for marginalized and vulnerable workers who have been rationed out of preferred formal work. However, informality can also be seen as a dynamic sector that budding entrepreneurs and those looking for flexible working conditions enter voluntarily. We use the methodology developed in Günther and Launov (2012) to test for the voluntary and involuntary nature of informal work in Nicaragua and Costa Rica, without making ad hoc assumptions about labour market segmentation and self-selection. We find evidence of heterogeneous informality in both Nicaragua and Costa Rica, with one informal sub-segment where most workers are voluntarily informal and another informal sub-segment where most workers are involuntarily informal. In Nicaragua, our results suggest that 44 per cent of wage employees are involuntarily informal, while 30 per cent of self-employed workers are involuntarily informal. In Costa Rica, our results suggest that 10 per cent of wage employees are involuntarily informal, and that 66 per cent of the self-employed are involuntarily informal.
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Mary, Latisha, Ann-Birte Krüger, and Andrea S. Young, eds. Migration, Multilingualism and Education. Multilingual Matters, 2021. http://dx.doi.org/10.21832/mary2941.
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This book addresses the question of how equitable and inclusive education can be implemented in heterogeneous classes where learners’ languages and cultures reflect the social reality of mass migration and everyday plurilingualism. The book brings together researchers and practitioners to address language policy and pedagogy.
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Winchester, Robert, Darren D. O’Rielly, and Proton Rahman. Genetics of psoriatic arthritis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0006.
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The psoriatic phenotype is clinically heterogeneous with psoriatic arthritis (PsA) itself being heterogeneous. Studies have consistently demonstrated that PsA has a strong genetic component and disease pathogenesis encompasses a complex interplay between genetic, immunological, and environmental factors. In this chapter, we will review the genetics of PsA including the major histocompatibility complex (MHC) region and non-MHC loci. We will detail how susceptibility genes can be grouped into barrier integrity, innate immune response, and adaptive immune response (particularly Th-17 lymphocyte signalling). We will articulate how these studies strongly support PsA as genetically different from PsV and that the genetic heterogeneity is likely attributed to different HLA susceptibility alleles within the MHC region that an individual carries. Furthermore, we will highlight new emerging technologies, in particular, next-generation sequencing, which may lead to new genetic discoveries in PsA.
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Betteridge, D. John, ed. Epidemiology of cardiovascular disease: the scale of the problem. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199543502.003.0001.
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• The epidemic of cardiovascular disease (CVD) has been and still is very dynamic and heterogeneous when comparing time trends and mortality rates in different places of the world.• Age-standardized CVD mortality rates have declined in some countries, mainly due to a better management of the essential risk factors.• Unfavourable trends in CVD incidence are found and foreseen in developing countries due to demographic and to adverse lifestyle changes.• Comprehensive CVD prevention strategies are needed to promote primary prevention and better implementation of effective preventive actions in patients with established CVD.
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Rahman, Shamima, and Mirian C. H. Janssen. Disorders of Mitochondrial Energy Metabolism. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0007.
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Mitochondrial disease can be diagnosed at every age, and the clinical presentation is very heterogeneous. In rare cases only a single organ is affected, but multisystem involvement may develop with progression of the disease. Organ systems relying most on aerobic metabolism are preferentially affected, including the central nervous system, peripheral nerves, eye, skeletal and cardiac muscle, and endocrine organs. These disorders can be classified according to whether the causative mutations affect mitochondrial DNA or nuclear DNA. Since specific treatment options are still limited, the management of mitochondrial disorders is largely supportive.
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Chong, Ji Y., and Michael P. Lerario. Progressive Quadriplegia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190495541.003.0005.
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Spinal cord ischemia most often presents as an anterior spinal artery syndrome and involves watershed regions of the spinal cord. The clinical presentation and etiologies can be heterogeneous, but cord infarcts are typically the result of aortic surgeries, systemic hypotension, vertebral artery and aortic dissections, embolus, or vascular malformations. Given that it is a rare entity, involving symptoms that can progress over minutes to hours, a diagnosis is often delayed until after conventional windows for revascularization, including thrombolysis, have passed. Magnetic resonance imaging (MRI) is usually required to confirm the diagnosis.
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Patino, Mario, and Anna M. Varughese. Osteogenesis Imperfecta. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0066.
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Osteogenesis imperfecta (OI) is a heterogeneous inherited disorder of type I collagen. Although it is most commonly known for the “brittle bones” that lead to multiple and recurrent fractures, OI has manifestations in other tissues where type I collagen is present. Moreover, the brain stem, cervical spine, and lungs can be affected indirectly due to the resultant bone abnormalities. A pre-anesthetic evaluation must review all systems and specific anesthetic considerations are necessary to reduce complications and improve outcomes of patients with OI.
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Lloyd, Peter, Sarah Doaty, and Bevra H. Hahn. Aetiopathogenesis of systemic lupus erythematosus. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739180.003.0002.
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Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of immune dysregulation, autoreactive B and T cells, and the production of a broad, heterogeneous group of autoantibodies (autoAb). The pathogenesis of lupus can be divided into three stages: 1) genetic predisposition and environmental exposures, 2) loss of tolerance, and 3) immune activation. In this chapter we will discuss the aetiopathogenesis of systemic lupus erythematosus with emphasis placed on key autoantibodies, cytokines, the innate and adaptive immune system, tolerance, NETosis, genetics and epigenetics, environmental triggers and the role of gender.
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Isaacs, Anthony, and David Isenberg. Laboratory tests and investigations. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198739180.003.0005.
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In this chapter an overview is provided of the investigations used in patients with systemic lupus erythematosus (SLE); these establish the abnormalities that can be found in each organ/system. Lupus is a very heterogeneous condition, affecting virtually every organ/system. In consequence, numerous investigations and tests are used to help make the diagnosis and define the extent of the organ/system involvement. The chapter is divided into investigations of the effects of SLE on the following systems: haematological, immunological, biochemical, renal, cardiovascular, pulmonary, gastroenterological, neurological, dermatological, and musculoskeletal. These targeted organ/system-based investigations can then be used to assess ongoing disease activity or the consequence of damage caused by previously active disease.
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Caplan, Lisa. Mediastinal Mass Biopsy. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0037.
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Anterior mediastinal masses (AMMs) comprise a heterogeneous collection of neoplasms. The mass effect of these neoplasms can compress the trachea, main stem bronchi, heart, or large vessels. Preoperative anesthetic plans should consider presenting signs, symptoms, and cardiopulmonary involvement to help risk stratify and select the proper airway technique and sedation plan. This chapter will enable readers to identify signs and symptoms that contribute to the pathophysiology of children who present with AMMs, perform a risk assessment of patient symptomatology, design a perioperative care plan, and risk stratify patients and procedures to determine appropriate anesthetic and airway techniques.
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Rosenstock, Jason B. Diagnosis and Assessment of Schizophrenia and Related Psychoses. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199331505.003.0002.
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It can be difficult assessing patients who present with psychotic symptoms. In this chapter, we will present a framework for how to make (and share) a definitive diagnose that will inform future treatment. In our approach, assessment requires both detailed cross-sectional and longitudinal components. Presentations may be heterogeneous, although diagnosis is grounded in key DSM-5 criteria, based on history and clinical assessment. Providers must rule out other psychiatric and medical conditions that can cause psychosis, before settling on a primary psychotic disorder. Finally, we must be careful when making a diagnosis of a psychotic disorder: it takes time, and when the news is delivered to patients and families, providers must be encouraging and hopeful about possibilities for recovery.
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Goodin, Robert E., and Kai Spiekermann. Extensions. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198823452.003.0003.
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The classic Condorcet Jury Theorem comes with demanding assumptions. This chapter shows that similar results can be derived if the assumptions are weakened. First, if the Competence Assumption is weakened by allowing for heterogeneous voter competence, the Asymptotic Result of the jury theorem still obtains (though the Non-asymptotic Result does only under very specific assumptions). Second, the number of alternatives can be more than two for a structurally similar jury theorem, using plurality voting. Third, different decision procedures, such as the Borda count or the Condorcet pairwise criterion, still lead to the Asymptotic Result. While the Borda count and the Condorcet pairwise criterion have a slight epistemic advantage over plurality voting, for large competent groups this difference is negligible.
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Weymark, John. Social Welfare Functions. Edited by Matthew D. Adler and Marc Fleurbaey. Oxford University Press, 2016. http://dx.doi.org/10.1093/oxfordhb/9780199325818.013.5.
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This chapter provides an introduction to the use of social welfare functions in welfare economics and social choice theory for the comparative evaluation of social alternatives. With a social welfare function, social preferences depend on individual well-beings. These well-beings are expressed in terms of either preferences or utilities. Three main approaches are considered: Bergson-Samuelson social welfare functions, Arrovian social welfare functions, and Sen’s social welfare functionals. How the measurability and comparability of utility can be modeled and how limitations on the types of utility comparisons that are possible restrict the kinds of social welfare functions that can be considered is also discussed. Extensive social choice theory is used to deal with heterogeneous opinions about how to make utility comparisons.
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Grazioli, Erica, Channa Kolb, and Bianca Weinstock-Guttman. Temporal and Clinical Course of Multiple Sclerosis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199341016.003.0010.
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The temporal and clinical course of multiple sclerosis is heterogeneous, varying among patients as well as over time in the same individual. Greater specificity in describing disease classification and course is important for conduct of clinical trials as well as prognosis for individual patients. This chapter reviews the results of recent consensus panels that have further defined the relapsing and progressive forms of multiple sclerosis through clarification of clinical relapse, subclinical relapse, active disease, and progressive disease. Clinical characteristics, conventional and nonconventional magnetic resonance imaging metrics, and immunologic and genetic biomarkers that can be used to predict disease severity and course are also discussed.
19
Brams, Steven J. Fair Division. Edited by Donald A. Wittman and Barry R. Weingast. Oxford University Press, 2009. http://dx.doi.org/10.1093/oxfordhb/9780199548477.003.0024.
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This article provides a review of the literature on fair division, which has flourished in recent years. It focuses on three different literatures in the field: the allocation of several indivisible goods, the division of a single heterogeneous good, and the division, in whole or in part, of several divisible goods. The article discusses problems that arise in allocating indivisible goods, and highlights the trade-offs that must be made when not all of the criteria of fairness can be satisfied at the same time. It also describes and provides the procedures for dividing divisible goods fairly, which is based on different criteria of fairness.
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Jackendoff, Ray. Constructions in the Parallel Architecture. Edited by Thomas Hoffmann and Graeme Trousdale. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780195396683.013.0005.
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This chapter discusses what the Parallel Architecture has taken from Construction Grammar and what it might contribute to Construction Grammar. After outlining the fundamentals of the architecture, it explains why rules of grammar should be formulated as lexical items encoded as pieces of structure: there is no hard line between words, constructions, and standard rules. The chapter also argues for a “heterogeneous” variety of Construction Grammar, which does not insist that every syntactic construction is invested with meaning. Finally, it discusses the crucial issue of semiproductivity, usually thought to be a property of morphology, showing that constructions too can be either productive or semiproductive.
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Sampaio-Barros, Percival, and Rafael Valle-Oñate. Axial spondyloarthritis in Latin America. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198734444.003.0029.
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Latin American countries are often characterized by a significant miscegenation among whites, blacks, and Amerindians. These heterogeneous populations frequently represent a challenge for the design of studies analysing the genetics, incidence, and prevalence of rheumatic diseases. In this setting, axial spondyloarthritis (axSpA) frequently shows an increased associated peripheral involvement, compared with the homogeneous population. Genetic and socioeconomic factors can be associated with this clinical presentation, although further studies are necessary to confirm this hypothesis. Regarding treatment, Latin American spondyloarthritis (SpA) patients also show a higher prescription of corticosteroids, methotrexate, and sulfasalazine than European series. This chapter presents and discusses the many aspects related to the presentation of axSpA in Latin America.
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de Bie, Robertus M. A., and Susanne E. M. Ten Holter. “My Arm Is Not Working”. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190607555.003.0011.
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Corticobasal syndrome is a clinical diagnosis based on the presence of one or more movement disorders suggestive of basal ganglia dysfunction, typically asymmetrical, with evidence of associated cortical dysfunction. This is a pathologically heterogeneous group of disorders that can share a common phenotype. Corticobasal degeneration is one of these pathologies, representing one of the rarest forms of atypical parkinsonism. When confronted with a patient with higher cortical dysfunction, specific assessment for apraxia, cortical sensory loss, and cognition is indicated. Corticobasal syndrome is currently untreatable, regardless of the nature of the underlying pathology, and in most cases progression is fast with significant disability that is typically unresponsive to levodopa.
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Levinson, Douglas F., and Walter E. Nichols. Genetics of Depression. Edited by Dennis S. Charney, Eric J. Nestler, Pamela Sklar, and Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0024.
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Major depressive disorder (MDD) is a common and heterogeneous complex trait. Twin heritability is 35%–40%, perhaps higher in severe/recurrent cases. Adverse life events (particularly during childhood) increase risk. Current evidence suggests some overlap in genetic factors among MDD, bipolar disorder, and schizophrenia. Large genome-wide association studies (GWAS) are now proving successful. Polygenic effects of common SNPs are substantial. Findings implicate genes with effects on synaptic development and function, including two obesity-associated genes (NEGR1 and OLFM4), but not previous “candidate genes.” It can now be expected that larger GWAS samples will produce additional associations that shed new light on MDD genetics.
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Blumberg, Emily A. Introduction. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199938568.003.0400.
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This chapter discusses the infections in patients receiving immunosuppressive drugs. Immunosuppressive medications are a mainstay of treatment for diverse immunologically mediated conditions. The impact of these medications on the risk for infection is variable and sometimes difficult to determine. Immunosuppressive agents can be divided into a heterogeneous set of classes with unique effects on the immune system; the risks for infections reflect the specific immunological perturbation associated with the medication. Currently, guidelines have been published recommending specific preventive measures to limit the likelihood that these immunosuppressive agents will be associated with infection. The chapter concludes that future study will be important to develop algorithms to define risk and specify appropriate preventive interventions.
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Urban, Hugh B. Purity. Edited by Michael Stausberg and Steven Engler. Oxford University Press, 2017. http://dx.doi.org/10.1093/oxfordhb/9780198729570.013.43.
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Purity is an extremely varied and heterogeneous religious ideal that lies at the critical intersection between the individual physical body, the social body, and the cosmos as a whole. At once a material and a spiritual ideal, purity overlaps partially with but far exceeds modern notions of cleanliness or hygiene; indeed, it may in some cases even contradict the latter. One can distinguish five different forms of purity, each in this chapter illustrated by one primary example: physical purity, social purity, mental purity, sexual purity, and the ritual use of impurity. There is also a variety of contemporary theoretical approaches to purity, drawn from psychology, cognitive science, cultural anthropology, gender studies, and comparative religions.
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Luqmani, Raashid. Vasculitis. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0272.
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The vasculitides are a heterogeneous group of disorders that can range from mild inflammation of blood vessels in the skin, to organ- and life-threatening diseases. The term ‘vasculitis’ is a pathological description of blood vessel wall inflammation which leads to ischaemia and infarction of the target organs. Definitions and classifications of the primary vasculitides are mainly based on the predominant calibre of the blood vessels involved but incorporate clinical, pathological, and laboratory features. The secondary vasculitides usually occur in the context of other connective tissue diseases and are not discussed further in this section. Goodpasture’s disease is not usually included in the primary vasculitides, but has compatible clinical features of pulmonary capillaritis and glomerulonephritis.
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Trifa, Mehdi, and Candice Burrier. Anesthetic Management of Anterior Mediastinal Masses in Children. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0052.
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The management of children presenting with an anterior mediastinal mass (AMM) is challenging for anesthesiologists. AMMs are a heterogeneous collection of primary or secondary, benign or malignant tumors. Severe and life-threatening complications related to airway obstruction and/or cardiovascular compression can occur in a patient with an AMM during anesthesia, even in an asymptomatic patient. It is important for the anesthesia provider to understand the pathophysiology of symptoms and complications and the current evidence regarding perioperative management of children with AMM. This chapter explores the pathophysiology of AMM symptoms and of AAM and anesthesia. Perioperative management of AMM patients, including preoperative evaluation and induction and maintenance of anesthesia, is also discussed.
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Bruce, Tricia Colleen. Conclusion. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190270315.003.0008.
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The Conclusion summarizes how personal parishes—defined not by territory but by purpose—enable the Catholic Church to respond institutionally to grassroots change and diversity in American Catholicism. Having considered parishes, boundaries, decisions, difference, fragmentation, and community, the book concludes with a handful of lessons that personal parishes offer for understanding local religion and institutional responses to diversity. Namely, this chapter explores: (1) ascription and achievement in local religion; (2) generalism and specialism in organizing diversity; (3) the future of personal parishes; and (4) the place of purpose in a heterogeneous (Catholic) America. Viewing local religion from the top shows that multiple organizational forms can be deployed to meet divergent needs, to facilitate unity, and to maintain institutional control.
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Tuck, Christopher. Land Warfare. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198790501.003.0032.
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This chapter charts the key developments in European land warfare since 1900. On the one hand, it is possible to identify overarching explanatory ideas, metanarratives, that can be used to identify continuities in development over time across Europe’s armies. These include the concept of ‘modern system’ land warfare and the ‘transformation paradigm’. However, as this chapter also shows, these two points of continuity do not mean either that European armies are homogenous, or that their conceptual assumptions are uncontested. European land warfare remains a heterogeneous phenomenon, shaped by the variety in national contexts and by contending debates on how appropriate Europe’s armies are to the actual challenges of contemporary and future armed conflict.
30
Watson, David, and Sara M. Stasik. Examining the Comorbidity Between Depression and the Anxiety Disorders From the Perspective of the Quadripartite Model. Edited by C. Steven Richards and Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.026.
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Major depression and posttraumatic stress disorder (PTSD) represent heterogeneous combinations of symptoms. Analyses focusing on these distinctive symptom dimensions can play an important role in explicating key diagnostic phenomena such as comorbidity. We review depression and PTSD from the perspective of the quadripartite model, which posits that it is important to consider two quantitative elements when analyzing the properties of symptoms: (a) the magnitude of their general distress component and (b) their level of specificity. Within both disorders, we identified certain symptoms—insomnia and appetite disturbance in the case of depression, dysphoria within PTSD—that both (a) exhibited poor diagnostic specificity and (b) provided little or no incremental information to their respective diagnoses. We therefore argue that deemphasizing these weak and nonspecific indicators and focusing primarily on more specific types of symptoms potentially can improve the diagnosis and assessment of these disorders.
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Ng, Dominic S. Familial Apolipoprotein A-I Deficiency. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0036.
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Apolipoprotein (apo) A-I is the key structural protein of high-density lipoprotein (HDL) and is necessary for sustaining the circulating level of HDL. It has also been studied extensively for its role in mediating many of the antiatherosclerotic and antithrombotic properties of HDL. More than 50 naturally occurring mutations and variants have been described, and they usually result in marked HDL deficiency in a gene-dose dependent manner. However, the propensity to develop accelerated coronary heart disease (CHD) is highly heterogeneous. Mutations resulting in inability to synthesize apo A-I tend to be associated with early CHD, while mutations resulting in structurally altered apo A-I are generally not associated. Furthermore, a number of apo A-I variants, for example apo A-I Iowa or apo A-I Helsinki, have been linked to amyloidosis, resulting in potentially serious morbid complications.
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Sonuga-Barke, Edmund J. S. Attention-Deficit/Hyperactivity Disorder. Edited by Philip David Zelazo. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199958474.013.0022.
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In this chapter I review the literature on attention-deficit/hyperactivity disorder (ADHD) with the aim of providing a developmental synthesis. In the first section I ask: What is ADHD? I conclude that it is a relatively broad construct that, although having validity as a mental disorder dimension and utility as diagnostic category, is frequently comorbid with, but can be distinguished from, other disorders, and is highly heterogeneous. In the second section I ask: What causes ADHD? I conclude that ADHD has a complex set of causes implicating multiple genetic and environmental risks (and their interaction) reflected in alterations in diverse brain systems. The causal structure of ADHD is heterogeneous, with different children displaying different etiological and pathophysiological profiles. In the third section I reflect on developmental considerations. I conclude that ADHD-type problems present in different forms throughout the lifespan from the preschool period to adulthood and that existing data suggest patterns of continuity and discontinuity that support a lifespan perspective both at the level of clinical phenotype and underlying pathophysiology. In the light of this I argue for a developmental reconceptualization of the disorder, grounded in a biopsychosocial framework that would allow the complexity and heterogeneity of the condition to be understood in terms of risk, resilience, and protective factors, as well as mediating and moderating processes. I review the implications of the developmental perspective for nosological and diagnostic formulations of the condition. In the last section I set out priorities for future research in the genetics, imaging, neuropsychology, and treatment of the condition.
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Coolen, A. C. C., A. Annibale, and E. S. Roberts. Graphs on structured spaces. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198709893.003.0010.
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This chapter moves beyond viewing nodes as homogeneous dots set on a plane. To introduce more complicated underlying space, multiplex networks (which are defined with layers of interaction on the same underlying node set) and temporal (time-dependent) networks are discussed. It shown that despite the much more complicated underlying space, many of the techniques developed in earlier chapters can be applied. Heterogeneous nodes are introduced as an extension of the stochastic block model for community structure, then extended using methods developed in earlier chapters to more general (continuous) node attributes such as fitness. The chapter closes with a discussion of the intersections and similarities between the many alternative models for capturing topological features that have been presented in the book.
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Prati, Raquel, and Olga Olevsky. Breast Cancer Staging and Treatment. Edited by Christoph I. Lee, Constance D. Lehman, and Lawrence W. Bassett. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190270261.003.0012.
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Breast carcinomas are a heterogeneous group of diseases that can be further characterized based on their histology, biomarkers, and molecular profiles. These characteristics, gathered during disease staging, provide crucial information with regard to treatment decisions. Staging has evolved from informing the operability of breast tumors to providing prognostic information, and consequently helping establish local and systemic treatment guidelines. This chapter provides a succinct overview of breast cancer staging and treatment. Topics covered include the histological classification of breast cancers, as well as classification by tumor size and location, lymph node involvement, and metastatic involvement. The topic of molecular assays for prognostic information is reviewed. Finally, current treatment paradigms, including surgery, radiation, and chemotherapy regimens for different types of breast cancer, are discussed.
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Yu, Shirley P., and David J. Hunter. Prospects for disease modification. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199668847.003.0035.
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The tremendous individual and societal burden underpin a strong rationale for the development of disease-modifying agents for osteoarthritis. Current approaches to managing the disease remain largely palliative and focused on alleviating symptoms, specifically pain and functional limitation. The chapter considers the multitude of tissues that potentially can be targeted in this heterogeneous disease of osteoarthritis and the agents that can modify these tissues. It first focuses on molecules targeting inflammatory pathways and then breaks that down by particular tissue targeted: specifically and in particular synovium, cartilage, and bone. There is widespread demonstration of the ability to modify osteoarthritis in preclinical models; however, this has not been translated to the human disease to the satisfaction of regulatory bodies at this point in time. There are a number of products currently in testing that demonstrate great promise although there remain considerable challenges to the demonstration of disease modification.
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Sokolov, Elisaveta, and K. Ray Chaudhuri. An overview of sleep dysfunction in Parkinson disease. Edited by Sudhansu Chokroverty, Luigi Ferini-Strambi, and Christopher Kennard. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199682003.003.0025.
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Disturbances in nocturnal sleep and their consequences during waking in Parkinson disease (PD) were recognized in 1817 by James Parkinson, who described sleep problems in his case series as follows: “His attendants observed, that of late the trembling would sometimes begin in his sleep, and increase until it awakened him: when he always was in a state of agitation and alarm.” Sleep disturbance in PD is complex, with a prevalence of up to 98%, and has been shown to be a key determinant of quality of life. Sleep disturbances in PD are heterogeneous, ranging from insomnia to drug-induced sleep disorders, and now can be assessed by simple validated bedside tools such as the Parkinson’s Disease Sleep Scale (PDSS). Also, sleep, contrary to previous perceptions, can be disordered not just in advanced PD, but also in the pre-motor as well as the untreated states.
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Lories, Rik. Mechanisms of bone destruction and proliferation in psoriatic arthritis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0008.
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Psoriatic arthritis is a chronic inflammatory joint disease that can affect both the peripheral and axial skeleton. The clinical presentation of psoriatic arthritis is very heterogeneous and different subforms have been described. Structural damage to the joint is a feared complication of psoriatic arthritis. The severity of joint inflammation and subsequent damage can range from mild to extreme. Over the last decade, insights into the molecular and cellular mechanisms that underlie the skeletal changes in psoriatic arthritis have gradually increased although translational validation of concepts using patient-derived materials still lags behind. Current treatment strategies directed against key mediators of inflammation appear to have good effects on joint destruction, but their short and long-term impact on new bone formation and ankylosis is still unclear. The identification of the role that key growth factors play in the latter process identifies new opportunities for therapeutic interventions.
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Miller, David, Claire Harkins, Matthias Schlögl, and Brendan Montague. The multiple voices of the corporation. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780198753261.003.0002.
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This chapter develops the central research questions of the book and lays down some of the basic assumptions we took. It is argued that corporate actors form a network of influence that reaches into every area of public life. Therefore, researching the influence of business on public policy making cannot concentrate on single actors but must emphasize the network. The chapter does so by applying classical power structure research to the digital age. The research approach is designed to allow the combination of various, very heterogeneous data sources—such as scanned material, data available online, and handcrafted structured data—into one database that can be used for network research. We conclude the chapter by taking a closer look at the sources we used to investigate the important actors within the network.
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de Vlam, Kurt. Overview of psoriatic arthritis pathogenesis. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198737582.003.0004.
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Psoriatic arthritis (PsA) is a chronic inflammatory arthritis occurring in patients with psoriasis. Some consider it as part of the heterogeneous group of diseases unified in the concept of spondyloarthritis (SpA). At least some subtypes, such as the oligoarticular and axial subtypes, can be classified as SpA. The aetiology and pathogenesis are poorly understood. An enthesitis-based model was proposed to unify skin and joint manifestation and to differentiate PsA from other rheumatic diseases such as rheumatoid arthritis and osteoarthritis. The development of PsA results from the interplay of genes, the immune response, and interaction with environmental factors. The fact that more than 80% of patients with PsA have precedent or simultaneous psoriasis suggests that the skin disease is almost a ‘condicio sine qua non’ for the development of PsA.
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Brady, Stefen, and David Hilton-Jones. Muscular dystrophies and other genetic myopathies. Edited by Hector Chinoy and Robert Cooper. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198754121.003.0006.
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Muscular dystrophies are a genetically and phenotypically heterogeneous group of progressive muscle diseases. Modern molecular genetic techniques have made it possible to clarify the genetic mutations responsible for most muscular dystrophies. Despite advances in genetics, the importance of the clinical history and physical examination has increased rather than diminished. It is only through correctly identifying the clinical features that the appropriate diagnostic investigations will be performed. Although muscular dystrophies are typically slowly progressive disorders in which muscle atrophy and weakness are the defining characteristics, diagnostic confusion with the idiopathic inflammatory myopathies (IIM) can occur, and a diagnosis of muscular dystrophy may be considered only after the failure of immunosuppressive treatment for a presumed case of IIM. This chapter reviews the various muscular dystrophies, and discusses how to differentiate between them and the IIM.
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Dean, Michael, and Karobi Moitra. Biology of Neoplasia. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780190238667.003.0002.
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The term “cancer” encompasses a large heterogeneous group of diseases that involve uncontrolled cell growth, division, and survival, culminating in local invasion and/or distant metastases. Cancer is fundamentally a genetic disease at the cellular level. Tumors occur because clones of abnormal cells acquire multiple lesions in DNA, nearly always involving mutations, chromosomal rearrangements, and extensive alteration of the epigenome. Up to 10% of cancers also involve inherited germline mutations that are moderately to highly penetrant. Cancers begin as localized growths or premalignant lesions that may regress or disappear spontaneously, or progress to a malignant primary tumor. The somatic changes that drive abnormal growth involve activating mutations of specific oncogenes, inactivation of tumor suppressor genes, and/or disruption of epigenetic controls. The latter can result from methylation or the modification of histones and other proteins that affect the remodeling of chromosomes. Numerous non-inherited factors can cause cancer by accelerating these events.
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Saugera, Valérie. From English to French. Oxford University Press, 2017. http://dx.doi.org/10.1093/acprof:oso/9780190625542.003.0003.
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The chapter presents a brief history of the contact of French with English, from 18th-century Anglomania to the global English of the turn of the 21st century, in order to contextualize the singularity of the latest contact period. It then chronicles the changes that commonly occur as donor words become new French words. These changes, illustrated with many borrowed items from the period of virtual contact (1990–2015), can be classified as grammatical shift, semantic shift, stylistic shift, and connotative shift. Beyond demonstrating that an English etymon masks heterogeneous types of French Anglicisms, an up-to-date typology shows how English morphemes are used in novel word-formation devices, such as serial bilingual compounds. The borrowing of phrases plays a marginal yet innovative role in French, including emphasis and punning, and raises the issue of typologies for borrowed/neological phrases.
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Phillips, Katherine W., Michelle Duguid, Melissa Thomas-Hunt, and Jayaram Uparna. Diversity as Knowledge Exchange: The Roles of Information Processing, Expertise, and Status. Edited by Quinetta M. Roberson. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199736355.013.0009.
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As part of an effort to understand diversity’s influence on group processes and performance, some researchers have explored diversity from an information processing perspective. This perspective suggests that because individuals in heterogeneous groups have a broader range of knowledge, skills, and abilities than homogeneous groups, they will also have greater access to a variety of task-relevant information and expertise, which can enhance group decision making. This chapter summarizes the findings of empirical research from this perspective and extends the tenets of this perspective, acknowledging the limitations of the original formulation. Included in the review is research on minority and majority influence processes and the integration of expert knowledge in groups. Finally, the chapter integrates this new information processing view with work that focuses on the effect of status differences on the processing of information in diverse environments.
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Dinopoulos, Argirios. Atypical Nonketotic Hyperglycinemia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199972135.003.0030.
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Nonketotic hyperglycinemia (NKH) or glycine encephalopathy (GE) is an autosomal recessive inborn error of glycine degradation due to a defect in the glycine cleavage system (GCS). Accumulation of glycine, particularly in the central nervous system, leads to a variety of neurological symptoms, which may be progressive in infants. Clinical symptoms in atypical NKH are heterogeneous and, according to the age of presentation, cases can be divided in three forms: neonatal, infantile, and late onset. Late-onset atypical cases display an intermittent or a chronic course and may become apparent in adulthood. Psychiatric symptoms are common, and diagnosis may be difficult due to the rarity of the disorder. The CSF/plasma glycine ratio is diagnostic but in atypical cases is usually lower than the diagnostic cut-point for classical NKH. Treatment consists of dietary measures, but no consistent outcomes have been reported.
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Tamimi, Rulla, Susan Hankinson, and Pagona Lagiou. Breast Cancer. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190676827.003.0016.
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Most of the established reproductive risk factors for breast cancer, like age at menarche or parity, are not appropriate for public health intervention. Several lines of evidence, like the associations with birthweight and early exposure to radiation, support an important influence of early-life events on subsequent breast cancer risk. The best established modifiable risk factors for the disease include postmenopausal hormone use, moderate alcohol intake, and adult weight gain. More recently, we have come to appreciate that instead of a single disease, breast cancer is rather a heterogeneous group of subtypes with different etiologies. Yet the wealth of available epidemiologic information can be synthesized into a consistent and testable, albeit still hypothetical, causal model. With our increasing knowledge on the relation between endogenous hormones and breast cancer, and the development of selective estrogen receptor modulators, as well as aromatase inhibitors, chemoprevention will likely become more common in the future.
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Richardson, Rosemary, and Isobel Davidson. The contribution of the dietitian and nutritionist to palliative medicine. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0048.
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Management of the nutritional consequences of disease and its treatment are now acknowledged as a key component of palliative care provision. Factors affecting the ability to eat and the consequent changes in body composition which occur with disease progression often initiate concern in patients and relatives alike. The role of the dietitian is to provide dietary counselling in partnership with the patient where realistic goal setting can be achieved. The evidence base for improvement in nutritional status is equivocal which may be expected in this heterogeneous population. However, achieving recommended energy intakes is viewed as achievable using this strategy but is resource intensive. Nutritional assessment allows for appropriate monitoring of sequential changes in nutritional status and should be the cornerstone of a dietitian’s role. Classifying a patient’s stage of cachexia appropriately may prove useful in identifying when dietetic interventions are likely to be of greatest benefit.
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Lopez-Arvizu, Carmen, Carmel Bogle, and Harolyn M. E. Belcher. Neurobiology of Fetal Alcohol Spectrum Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0179.
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Prenatal exposure to ethanol can result in a wide range of clinical presentations that are grouped under the term “Fetal Alcohol Spectrum Disorders” (FASD). The direct cellular teratogenic effects of ethanol on fetal neurodevelopment include damage to cell survival, proliferation, and migration mechanisms. Dysregulation of neurotransmission and alteration of genetic transcription have also been implicated in the neurotoxic effects of prenatal ethanol exposure. These deleterious events lead to brain volume reduction, corpus callosum dysgenesis, cerebellar, and other neuroanatomical anomalies that have been observed in individuals with FASD. Beyond direct ethanol-induced insults, the impact that ethanol has on maternal nutrition, metabolism, hormonal regulation, and placental physiology also adversely effects fetal development. The complex interactions between numerous neurobiological and psychosocial mechanisms that hinder optimal fetal neurodevelopment are reflected by the heterogeneous clinical presentation of FASD, including impaired growth, dysmorphic facial features, and cognitive and behavioral disorders.
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do Rosário, Maria Conceição, Marcelo Batistutto, and Ygor Ferrao. Symptom Heterogeneity in OCD. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0008.
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This chapter reviews the most relevant studies using the dimensional approach to describe the range of OCD symptomatology. Obsessive compulsive disorder (OCD) is a clinically and etiologically heterogeneous condition. This heterogeneity is problematic because it can make it difficult to interpret the results of clinical, genetic and neuroimaging studies and limits the development of more effective treatment strategies. Recently, a dimensional approach to dealing with the OCD heterogeneity has been proposed. Factor analytic studies have found from three to six obsessive compulsive symptom (OCS) dimensions (or factors), which represent groups of obsessions and compulsions that tend to co-occur. Many authors have reported that these OCS dimensions are similar in children, adolescents, and adults and are temporally stable. The usefulness and validity of this dimensional approach has been proven by studies reporting the association between the OCS dimensions and various genetic, neuroimaging and treatment response variables.
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Abatzis, Vaia T., and Edward C. Nemergut. Transsphenoidal/Pituitary Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0004.
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Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic agents should be tailored to facilitate surgical exposure, preserve cerebral perfusion and oxygenation, and provide for rapid emergence and neurological assessment. Postoperatively, careful monitoring of fluid balance and serum sodium is essential to the early diagnosis of diabetes insipidus (DI). DI is most often transient but can require medical therapy. A thorough understanding of the preoperative assessment, intraoperative management, and potential complications are fundamental to successful perioperative patient care and avoidance of morbidity and mortality.
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Holtmann, Martin, Björn Albrecht, and Daniel Brandeis. Neurofeedback. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198739258.003.0039.
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Neurofeedback of specific brain activity patterns allows perceiving and learning to gain control over these otherwise unaware neuronal processes. Neurofeedback may improve underlying neuronal deficits, and/or establish more general self-regulatory skills for compensating behavioural difficulties in other domains. Treating ADHD is the most common clinical neurofeedback application. Standard neurofeedback protocols based on electroencephalography train self-regulation of oscillatory activity in certain frequency bands (targeting theta/beta ratio) or slow cortical potential shifts. Both protocols have demonstrated promising outcomes, particularly in improving inattention symptoms, although controlled effects remain heterogeneous and often attenuated in blinded ratings. Further randomized controlled and (as far as possible) blinded evaluation studies are needed for better understanding of the mode of action and to establish robust standard training protocols for routine care. In the current state of evidence, neurofeedback can be recommended as part of a multimodal treatment of ADHD.