Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Therapeutic approaches for GIDC differ from those used on adults and have included behavior therapy, psychodynamic therapy, group therapy, and parent counseling. Proponents of this intervention seek to reduce gender dysphoria, make children more comfortable with their bodies, lessen ostracism, and reduce the child's psychiatric comorbidity. The majority of therapists currently employ these techniques. "Two short term goals have been discussed in the literature: the reduction or elimination of social ostracism and conflict, and the alleviation of underlying or associated psychopathology. Longer term goals have focused on the prevention of transsexualism and/or homosexuality."
Individual therapy with the child seeks to identify and resolve underlying factors, including familial factors; encourage identification by sex assigned at birth; and encourage same-sex friendships. Parent counseling involves setting limits on the child's cross-gender behavior; encouraging gender-neutral or sex-typical activities; examining familial factors; and examining parental factors such as psychopathology. Longtime researchers of gender identity disorder, Kenneth Zucker and Susan Bradley, state that it has been found that boys with gender identity disorder often have mothers who to an extent reinforced behavior more stereotypical of young girls. They also note that children with gender identity disorder tend to come from families where cross-gender role behavior was not explicitly discouraged. However, they also acknowledge that one could view these findings as merely indicative of the fact that parents who were more accepting of their child's cross-gender role behavior are also more likely to bring their children to a clinical psychiatrist as opposed to parents who are less accepting of cross-gender role behavior in their children (Bradley, Zucker, 1997). " Proponents acknowledge limited data on GIDC: "apart from a series of intrasubject behaviour therapy case reports from the 1970s, one will find not a single randomized controlled treatment trial in the literature" (Zucker 2001). Psychiatrist Domenico Di Ceglie opines that for therapeutic intervention, "efficacy is unclear," and psychologist Bernadette Wren says, "There is little evidence, however, that any psychological treatments have much effect in changing gender identity although some treatment centres continue to promote this as an aim (e.g. Zucker, & Bradley, 1995)." Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."
Transvestism is the practice of dressing and acting in a style or manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional or ceremonial reasons.
Though coined as late as the 1910s, the phenomenon is not new. It was referred to in the Hebrew Bible. The word has undergone several changes of meaning since it was first coined and is still used in a variety of senses. Today, the term "transvestite" is commonly considered outdated and derogatory, with the term "cross-dresser" used as a more appropriate replacement. This is because the term "transvestite" was historically used to diagnose medical disorders, including mental health disorders, and transvestism was viewed as a disorder, but the term "cross-dresser" was coined by the transgender community. In some cases, however, the term "transvestite" is seen as more appropriate for use by members of the transgender community instead of by those outside of the transgender community, and some have reclaimed the word.
Some people experience sexual excitement from the look or feel of a women's bra. The attraction may be to the look or feel of the material, such as lace, or how it looks on a person. Some people get excitement from removing a bra.
Some people experience sexual excitement from the look or feel of articles made of silk or satin fabric. Such interest is usually directed towards the person wearing silk or satin, but it can also be directed towards the garment itself, or to the feel of the garment when worn.
The attraction can be to the physical properties of the garment, such as softness, smoothness, drape and shine, and to its association with elegance, glamour, romance and opulence.
The principal materials which are considered erotic are charmeuse silk (silk woven so that it has a sheen) and satins (such as acetate satin and rayon satin), but other materials with similar properties, such as spandex and polyester are also admired.
Males with late onset gender dysphoria "frequently" display transvestic fetishism.
Some male transvestic fetishists collect women's clothing, e.g. panties, nightgowns, babydolls, bridal gowns, slips, brassieres, and other types of nightwear, lingerie, stockings, pantyhose, shoes, and boots, items of a distinct feminine look and feel. They may dress in these feminine garments and take photographs of themselves while living out their fantasies.
According to DSM-IV, this fetishism was limited to heterosexual men; however, DSM-5 does not have this restriction, and opens it to women and men with this interest, regardless of their sexual orientation.
There are two key criteria before a psychiatric diagnosis of "transvestic fetishism" is made:
1. Individuals must be sexually aroused by the act of cross-dressing.
2. Individuals must experience significant distress or impairment – socially or occupationally – because of their behavior.
Transvestic fetishism is a psychiatric diagnosis applied to those who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal, and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association. (Sexual arousal in response to donning sex-typical clothing is homeovestism.)
Therapeutic intervention for GIDC came under renewed scrutiny in May 2008, when Kenneth Zucker was appointed to the DSM-5 committee on GIDC. According to MSNBC, "The petition accuses Zucker of having engaged in 'junk science' and promoting 'hurtful theories' during his career." Zucker is accused by LGBT activists of promoting "gender-conforming therapies in children" and "treating children with GID with an eye toward preventing adult homosexuality or transsexuality." Zucker "rejects the junk-science charge, saying that there 'has to be an empirical basis to modify anything' in the DSM. As for hurting people, 'in my own career, my primary motivation in working with children, adolescents and families is to help them with the distress and suffering they are experiencing, whatever the reasons they are having these struggles. I want to help people feel better about themselves, not hurt them.'" However, opponents continue to argue that the diagnosis "harms the very children it purports to help".
The DSM-5 change to "gender dysphoria" was endorsed by transgender activists and allies as a way to lessen stigma but maintain a diagnostic route to trans-specific medical care. However, Lev states that the diagnosis of gender dysphoria continues to pathologize transgender experiences.
Andre Crawford (born March 20, 1962) is an American convicted serial killer, who killed 11 women between 1993 and 1999. Many of the women were prostitutes or drug addicts. He also had sex with their corpses.
Crawford had been placed in foster care as an infant after authorities found him living alone in squalor and after his mother admitted leaving him unattended for long periods of time. As a child he had lived with a foster family. As an adult, he became a transient, living in vacant buildings in Chicago.
He was accused of the murder of Evandry Harris, Patricia Dunn, Rhonda King, Angel Shatteen, Shaquanta Langley, Sonja Brandon, Nicole Townsend, Cheryl Cross, Tommie Dennis, Sheryl Johnson and Constance Bailey. He was linked by DNA to seven of the victims, and confessed to all 11 murders. He was convicted in December 2009. A 12th woman was attacked and left for dead on Thanksgiving 1997, but survived.
Hubert Geralds, Jr., 34, was convicted in 1997 of murdering six women in Chicago’s Englewood neighborhood. The first victim was Rhonda King. Under interrogation by police, he confessed to all six murders. In 1998 he was sentenced to death. In 2000 prosecutors moved to vacate the conviction for the King murder, because DNA linked her death to Andre Crawford. Geralds remained on death row for the other five murders, however.
Mme L. reports that “1, 2, 3 are children without fixed personalities; they play together. 4 is a good peaceful woman, absorbed by down-to-earth occupations and who takes pleasure in them. 5 is a young man, ordinary and common in his tastes and appearance, but extravagant and self-centered. 6 is a young man of 16 or 17, very well brought up, polite, gentle, agreeable in appearance, and with upstanding tastes; average intelligence; orphan. 7 is a bad sort, although brought up well; spiritual, extravagant, gay, likeable; capable of very good actions on occasion; very generous. 8 is a very dignified lady, who acts appropriately, and who is linked with 7 and has much influence on him. She is the wife of 9. 9 is the husband of 8. He is self-centred, maniacal, selfish, thinks only about himself, is grumpy, endlessly reproaching his wife for one thing or another; telling her, for example, that he would have been better to have married a 9, since between them they would have made 18 – as opposed to only 17 with her… 10, and the other remaining numerals, have no personifications”.
Cakins (1893) describes a case for whom “T’s are generally crabbed, ungenerous creatures. U is a soulless sort of thing. 4 is honest, but… 3 I cannot trust… 9 is dark, a gentleman, tall and graceful, but politic under his suavity” .
For synesthete MT “I [is] a bit of a worrier at times, although easy-going; J [is] male; appearing jocular, but with strength of character; K [is] female; quiet, responsible…” .
More recently AP has reported that February is “an introverted female”, while F is a “[male] dodgy geezer”. Similarly, May is reported to be “soft-spoken” and “girly” while M is an “old lady [who] natter[s] a lot”, and while August is “a boy among girls”, A is a female “mother type” (; ).
Ordinal-linguistic personification (OLP, or personification for short) is a form of synesthesia in which ordered sequences, such as ordinal numbers, days, months and letters are associated with personalities and/or genders (). Although this form of synesthesia was documented as early as the 1890s (; ) researchers have, until recently, paid little attention to this form (see History of synesthesia research).
People with positive cultures for "Streptococcus pyogenes" should be treated with penicillin as long as allergy is not present. The use of antibiotics will not alter cardiac involvement in the development of rheumatic fever. Some suggest the use of benzathine benzylpenicillin.
Monthly injections of long-acting penicillin must be given for a period of five years in patients having one attack of rheumatic fever. If there is evidence of carditis, the length of therapy may be up to 40 years.
Another important cornerstone in treating rheumatic fever includes the continual use of low-dose antibiotics (such as penicillin, sulfadiazine, or erythromycin) to prevent recurrence.
The management of rheumatic fever is geared toward the reduction of inflammation with anti-inflammatory medications such as aspirin or corticosteroids. Individuals with positive cultures for strep throat should also be treated with antibiotics.
Aspirin is the drug of choice and should be given at high doses.
One should watch for side effects like gastritis and salicylate poisoning. In children and teenagers, the use of aspirin and aspirin-containing products can be associated with Reye's syndrome, a serious and potentially deadly condition. The risks, benefits, and alternative treatments must always be considered when administering aspirin and aspirin-containing products in children and teenagers. Ibuprofen for pain and discomfort and corticosteroids for moderate to severe inflammatory reactions manifested by rheumatic fever should be considered in children and teenagers.
The side effects of penicillin can be altered by taking other medications at the same time. Taking oral contraceptives along with penicillin may lower the effects of the contraceptive. When probenecid is used concurrently with penicillin, kidney excretion of probenecid is increase resulting in higher blood levels of penicillin in the circulation. In some instances, this would be intended therapeutic effect. In other instances, this is an unintended side effect. Neomycin can lower the absorption of penicillin from the gastrointestinal tract resulting in lower than expected levels of penicillin in the circulation. This side effect may result in an ineffective therapeutic effect of penicillin. When methotrexate is administered with penicillin, toxicity may occur related to methotrexante.
Until more molecular and clinical studies are performed there will be no way to prevent the disease. Treatments are directed towards alleviating the symptoms. To treat the disease it is crucial to diagnose it properly. Orthopedic therapy and fracture management are necessary to reduce the severity of symptoms. Bisphosphonate drugs are also an effective treatment.
Dapsone is an effective treatment in most people. Itching is typically reduced within 2–3 days. However, dapsone treatment has no effect on any intestinal damage that might be present.
Therefore, a strict gluten-free diet must also be followed, and this will usually be a lifelong requirement. This will reduce any associated intestinal damage and the risk of other complications. After some time on a gluten-free diet, the dosage of dapsone can usually be reduced or even stopped, although this can take many years.
Dapsone is an antibacterial, and its role in the treatment of DH, which is not caused by bacteria, is poorly understood. It can cause adverse effects on the blood, so regular blood monitoring is required.
Dapsone is the drug of choice. For individuals with DH unable to tolerate dapsone for any reason, alternative treatment options may include the following:
- colchicine
- lymecycline
- nicotinamide
- tetracycline
- sulfamethoxypyridazine
- sulfapyridine
When penicillin is used at high doses hypokalemia, metabolic acidosis, and hyperkalemia can occur. Developing hypernatremia after administering high doses of penicillin can be a serious side effect.
The skin should be cleaned and kept dry, and topical antibiotics can be applied to the area. Systemic antibiotics are not needed.
Control relies on prompt detection, isolation and treatment of affected cattle. Footpaths should be kept as dry as possible and slurry build-up should be avoided. Regular footbaths should be organised, using formalin, copper sulphate or a thymol-based disinfectant. In 2013, a safer and alternative to chemicals for hoof baths called Thymox Technology was proven, through field testing, to kill the main bacteria causing digital dermatitis.
Viet Nguyen (, February 25, 1981 – October 6, 2007) and Duc Nguyen (, born February 25, 1981) were a pair of conjoined twins born in Vietnam and surgically separated in 1988. Viet died in 2007 of natural causes.
Viet and Duc were born on February 25, 1981, in Kon Tum Province, Tây Nguyên, Vietnam. Viet was the elder and Duc was the younger of the two brothers. Their relatives claim that "the reason they became conjoined twins is the influence of Agent Orange that the U.S. military used as a defoliant during the Vietnam War". His mother was farming in the area doused with Agent Orange a year after the Vietnam War had ended. She also drank water from a well in that area. After that, Viet and Duc were born. On October 4, 1988, Viet and Duc were separated in the hospital in Ho Chi Minh City with the help of the Japanese Red Cross after Viet went into a coma.
Duc first entered junior high school, then dropped out and learned computer programming in a school. Now, he works at a hospital in Ho Chi Minh City. On December 16, 2006, he married Nguyen Thanh Tuyen in Ho Chi Minh City.
Viet's health problems continued after the separation, and he died due to liver failure and pneumonia on October 6, 2007, at the age of 26.
It is essential that a child with strabismus is presented to the ophthalmologist as early as possible for diagnosis and treatment in order to allow best possible monocular and binocular vision to develop. Initially, the patient will have a full eye examination to identify any associated pathology, and any glasses required to optimise acuity will be prescribed – although infantile esotropia is not typically associated with refractive error. Studies have found that approximately 15% of infantile esotropia patients have accommodative esotropia. For these patients, antiaccommodative therapy (with spectacles) is indicated before any surgery as antiaccommodative therapy fully corrects their esotropia in many cases and significantly decreases their deviation angle in others.
Amblyopia will be treated via occlusion treatment (using patching or atropine drops) of the non-squinting eye with the aim of achieving full alternation of fixation. Management thereafter will be surgical. As alternative to surgery, also botulinum toxin therapy has been used in children with infantile esotropia. Furthermore, as accompaniment to ophtalmologic treatment, craniosacral therapy may be performed in order to relieve tension ("see also:" Management of strabismus).
According to a Cochrane review of 2012, controversies remain regarding type of surgery, non-surgical intervention and age of intervention.
The aims of treatment are as follows:
The elimination of any amblyopia
A cosmetically acceptable ocular alignment
long term stability of eye position
binocular cooperation.
Intensive cardiac care and immunosuppressives including corticosteroids are helpful in the acute stage of the disease. Chronic phase has, mainly debility control and supportive care options.
Non-surgical therapies include:
- Shoe modifications: wearing shoes that have a wide toe box, and avoiding those with pointed toes or high heels.
- Oral nonsteroidal anti-inflammatory drugs may help in relieving the pain and inflammation.
- Injections of corticosteroid are commonly used to treat the inflammation.
- Bunionette pads placed over the affected area may help reduce pain.
- An ice pack may be applied to reduce pain and inflammation.
Surgery is often considered when pain continues for a long period with no improvement in these non-surgical therapies.
Though there have been ample attempts to rehabilitate patients with pure alexia, few have proven to be effective on a large scale. Most rehabilitation practices have been specialized to a single patient or small patient group. At the simplest level, patients seeking rehabilitation are asked to practice reading words aloud repeatedly. This is meant to stimulate the damaged system of the brain. This is known as multiple oral re-reading (MOR) treatment. This is a text-based approach that is implemented in order to prevent patients from LBL reading. MOR works by reading aloud the same text repeatedly until certain criteria are reached. The most important criteria for a pure alexic patient is reading at an improved rate. The treatment aims to shift patients away from the LBL reading strategy by strengthening links between visual input and the associated orthographic representations. This repetition supports the idea of using top-down processing initially minimize the effects peripheral processing which were demonstrated in the study above. From here, the goal is to increasing bottom-up processing. This will hopefully aid in word recognition and promote interactive processing of all available information to support reading. 'The supported reading stimulation from MOR has a rehabilitative effect so that reading rate and accuracy are better for untrained text, and word-form recognition improves as evidenced by a reduced word-length effect.' These tactics have seen quite good success.
Another tactic that has been employed is the use of cross modal therapy. In this therapy, patients are asked to trace the words in which they are trying to read aloud. There has been success using cross modal therapy such as kinaesthetic or motor-cross cuing therapy, but tends to be a more feasible approach for those on the slower reading end of the spectrum.
The disease used to be uniformly fatal, with a 5-year survival rate between 10 and 35%. As a result, treatment was radical surgery. New multidrug chemotherapy regimens with or without radiation therapy are now used in combination with less radical surgery with good results, although outcome data are not yet available.