Protein misfolding disorders are an emerging complex group of chronic and progressive entities driven by structural transitions in the native state of specific proteinaceous components and the generation of polymeric aggregates that assemble into poorly soluble tissue deposits. In all these disorders, through mechanistic pathways still poorly understood, soluble proteins normally found in biological fluids change their conformation and form insoluble structures that accumulate as intra- and extracellular aggregates or as fibrillar deposits. The group comprises a wide range of diseases encompassing disorders that are either (i) localized to the central nervous system (CNS) and particularly associated with cerebrovascular compromise, neuronal vulnerability, and neurodegeneration; (ii) restricted to other individual organs, where their presence correlate with a specific organ dysfunction(s), e.g. the pancreas in type II diabetes or the heart in familial amyloidotic cardiomyopathy; or (iii) affecting multiple organs, as in the case of systemic amyloidosis. The group of disorders affecting the CNS, which is the focus of this book, is quite heterogeneous and, as illustrated in Table 1.1, includes conditions with dissimilar clinical manifestations — ranging from cognitive decline and dementia to severe motor deficits or to recurrent episodes of cerebral hemorrhage — as well as disease-specific pathology .
In order to provide useful diagnostic information for clinical management, a fneneedle aspiration (FNA) sample of a thyroid nodule should be representative of the underlying lesion. Real-time ultrasound guidance for thyroid FNA is recommended to confrm needle placement in the nodule. It is worth emphasizing that cellularity /adequacy is dependent not only on the technique of the aspirator but also on the inherent nature of the lesion (e.g., solid vs. cystic). High-quality specimens require profcient collection combined with excellent slide preparation, processing, and staining. In general, the adequacy of a thyroid FNA is defned by both the quantity and quality of the cellular and colloid components. Historically, the terms “nondiagnostic” and “inadequate/unsatisfactory” have been used interchangeably by many but not all pathologists: some have interpreted the terms to mean different things . An unsatisfactory specimen is always nondiagnostic, but some technically satisfactory specimens may also be considered “nondiagnostic,” that is, showing nonspecifc features not conclusively representative of a particular entity. At the 2007 NCI Thyroid State of the Science conference, the terms “nondiagnostic (ND)” and “unsatisfactory (UNS)” were equated and recommended for the category that conveys an inadequate/insuffcient sample . In this application, these terms are synonymous, and the laboratory should choose the one it prefers and use it exclusively for this category. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is a ﬂexible framework, however, and can be modifed by the laboratory to suit the needs of its providers.
A 4-year-old boy with no past medical history presented to the emergency room with a 4-day history of progressive weakness and sleepiness. His parents initially noticed drooling followed by weakness and diffculty walking. On the day of admission, he was noted to have asymmetry of the face and left-sided arm and leg weakness. In addition, he had altered mental status alternating between lethargy and aggressive behaviors. There was no history of recent illness, immunization, or trauma. No family history of autoimmune disorders was reported. Upon admission he was lethargic with intermittent irritability but responded to simple commands. There were no meningeal signs. His cranial nerve examination showed ﬂattening of the nasolabial fold on the left side. There was no afferent pupillary defect. He demonstrated left-sided weakness of the upper and lower extremities with an ipsilateral extensor plantar response. Strength in the right arm and leg was normal. Due to the weakness, the patient had diffculty performing fnger-to-nose testing on the left and was unable to walk. No sensory defcits were noted, and there was no truncal or appendicular ataxia.
The internal milieu of the brain is isolated from solutes and cells in the bloodstream, creating an immunologically and pharmacologically “privileged” compartment owing to the BBB. The BBB is a highly organized and strictly regulated multicellular system, creating physical, chemical, and metabolic barriers, which has at its heart the CEC. These closely apposed cells are integrated functionally and metabolically with pericytes, astrocytes, and neurons to regulate blood ﬂow and exchange of materials via transporters, pores, and channels normally protecting the brain with disturbances during acute and chronic inﬂammatory responses.
In this chapter, the neuroanatomical overlap in the distribution of orexin and endocannabinoid systems, as well as the functional interaction between leptindriven synaptic rewiring of orexinergic neurons and the orexin receptor-mediated activation of 2-arachidonoylglycerol synthesis, will be presented in the context of their role in the regulation of appetite, reward, sleep/wake, and analgesia. This chapter attempts to piece together what is known about this important cross talk and points out its potential therapeutic implications.
A CVA is a very serious and sudden occurrence. This is thus a specifc symptom of this CNS disorder, in contrast to dementia, Parkinson’s, and MS, which are characterized by their progressive course. Over the last few decades, the care for CVA patients has improved enormously, and much expertise has been gained in terms of insights into the impairments that result from a CVA. The experience thus gained can be transposed to the other CNS disorders described in this book. There are, namely, many commonalities, and this provides the opportunity to place neurorehabilitation in a broader perspective. This chapter lists the symptoms that may be an indicator for the occurrence of a CVA, which is followed by the description of the symptomatology after a cerebrovascular accident (CVA). Given that patients are permitted direct access to physiotherapy in the Netherlands, the physiotherapist must be able to recognize symptoms at an early stage. This chapter also examines the causes and risk factors of a CVA. When these are recognized, it is possible to take specifc actions that reduce the chance of a CVA.
The textile industry plays an important role in creating Taiwan’s foreign exchange income. The vast majority of textile enterprises are traditional, labor-intensive small- edium enterprises. Over the recent years, with the increasing consciousness of people’s environmental protection around the world and the pressure of competition on the international markets, many textile ompanies are forced to pay close attention to the environmental protection. In view of this trend, the textile industry hopes the implementation of a green information system help to investigate the extent of business process improvement after implementing the system and key factors for success with an aim to effectively reduce cost, expand business opportunities, and march toward globalization. In this study, a case study approach is adopted to conduct an on-site survey on one enterprise in the upstream, mid-stream and downstream supply hains respectively. The business management cost is increased at the very beginning of the green supply chain introduction. However, the business process is improved after the mplementation of Internet interface. The green supply chain brings external effects: the romotion of corporate image, an increase of customer value and loyalty, reduction of customer complaints, and product conformity to global standards. It also generates internal effects: enhanced supply chain integration (for instance, increased information availability, process efficiency and supply chain partnership), the increase of sales revenue, procurement efficiency, and competitiveness.
The adoption of Information and Communication Technologies (ICT) in environmental management has become a significant demand nowadays with the rapid growth of environmental information. This paper presents a prototype Environmental Management Information System (EMIS) that was developed to provide a systematic way of managing environmental data and human resources of an environmental organization. The system was designed using programming languages, a Database Management System (DBMS) and other technologies and programming tools and combines information from the relational database in order to achieve the principal goals of the environmental organization. The developed application can be used to store and elaborate information regarding: human resources data, environmental projects, observations, reports, data about the protected species, environmental measurements of pollutant factors or other kinds of analytical measurements and also the financial data of the organization. Furthermore, the system supports the visualization of spatial data structures by using geographic information systems (GIS) and web mapping technologies. This paper describes this prototype software application, its structure, its functions and how this system can be utilized to facilitate technology-based environmental management and decision-making process
Specific expert systems are used for supporting, speeding-up and adding precision to in silico experimentation in many domains. In particular, many experimentalists exhibit a growing interest in workflow management systems for making a pipeline of experiments. Unfortunately, these type of systems does not integrate a systematic approach or a support component for the workflow composition/reuse. For this reason, in this paper we propose a knowledge-based hybrid architecture for designing expert systems that are able to support experiment management. This architecture defines a reference cognitive space and a proper ontology that describe the state of a problem by means of three different perspectives at the same time: procedural, declarative and workflow-oriented. In addition, we introduce an instance of our architecture, in order to demonstrate the features of the proposed work. In particular, we model a bioinformatics case study, according to the proposed hybrid architecture guidelines, in order to explain how to design and integrate required knowledge into an interactive system for composition and running of scientific workflows.
This paper presents a method of applying the International Organization for Standardization (ISO) Network Management Model to the Boardman-Sauser Distinguishing Characteristics ofSystem ofSystems (SoS). The ISO model defines five conceptual areas for managingnetworks: Performance, Configuration, Accounting, Fault, and Security. This model is both a standard and primary means for understanding the major functions of network management. The Boardman-Sauser characteristics of . Autonomy, Belonging, Connectivity, Diversity, and Emergence are used to recognize a SoS. These characteristics represent the fundamental “building blocks” ofSoS management. In this paper the five functional areas of network management are analyzed and mapped to each of the five “building blocks” of SoS management to create a SoS Operational Management Matrix (SoSOMM). The matrix will serve as a foundation for extracting network management ‘best practices’ into the realm of SoS management. The proposed method will increase the overall effectiveness ofSoS management practices.