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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)
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Treatment is primarily symptomatic involving wound management of skin lesions and aggressive supportive therapy when renal compromise occurs. Some UK dogs with Alabama rot have been successfully treated since 2013. A webinar on Alabama rot by the Royal Veterinary College on 11 February 2015 was tutored by David Walker of Anderson Moores Veterinary Specialists.
The following treatments, while once recommended, are considered of no use or harmful, including tourniquets, incisions, suction, application of cold, and application of electricity. Cases in which these treatments appear to work may be the result of dry bites.
- Application of a tourniquet to the bitten limb is generally not recommended. There is no convincing evidence that it is an effective first-aid tool as ordinarily applied. Tourniquets have been found to be completely ineffective in the treatment of "Crotalus durissus" bites, but some positive results have been seen with properly applied tourniquets for cobra venom in the Philippines. Uninformed tourniquet use is dangerous, since reducing or cutting off circulation can lead to gangrene, which can be fatal. The use of a compression bandage is generally as effective, and much safer.
- Cutting open the bitten area, an action often taken prior to suction, is not recommended since it causes further damage and increases the risk of infection; the subsequent cauterization of the area with fire or silver nitrate (also known as "infernal stone") is also potentially threatening.
- Sucking out venom, either by mouth or with a pump, does not work and may harm the affected area directly. Suction started after three minutes removes a clinically insignificant quantity—less than one-thousandth of the venom injected—as shown in a human study. In a study with pigs, suction not only caused no improvement but led to necrosis in the suctioned area. Suctioning by mouth presents a risk of further poisoning through the mouth's mucous tissues. The well-meaning family member or friend may also release bacteria into the person's wound, leading to infection.
- Immersion in warm water or sour milk, followed by the application of snake-stones (also known as "la Pierre Noire"), which are believed to draw off the poison in much the way a sponge soaks up water.
- Application of a one-percent solution of potassium permanganate or chromic acid to the cut, exposed area. The latter substance is notably toxic and carcinogenic.
- Drinking abundant quantities of alcohol following the cauterization or disinfection of the wound area.
- Use of electroshock therapy in animal tests has shown this treatment to be useless and potentially dangerous.
In extreme cases, in remote areas, all of these misguided attempts at treatment have resulted in injuries far worse than an otherwise mild to moderate snakebite. In worst-case scenarios, thoroughly constricting tourniquets have been applied to bitten limbs, completely shutting off blood flow to the area. By the time the person finally reached appropriate medical facilities their limbs had to be amputated.
Until the advent of antivenom, bites from some species of snake were almost universally fatal. Despite huge advances in emergency therapy, antivenom is often still the only effective treatment for envenomation. The first antivenom was developed in 1895 by French physician Albert Calmette for the treatment of Indian cobra bites. Antivenom is made by injecting a small amount of venom into an animal (usually a horse or sheep) to initiate an immune system response. The resulting antibodies are then harvested from the animal's blood.
Antivenom is injected into the person intravenously, and works by binding to and neutralizing venom enzymes. It cannot undo damage already caused by venom, so antivenom treatment should be sought as soon as possible. Modern antivenoms are usually polyvalent, making them effective against the venom of numerous snake species. Pharmaceutical companies which produce antivenom target their products against the species native to a particular area. Although some people may develop serious adverse reactions to antivenom, such as anaphylaxis, in emergency situations this is usually treatable and hence the benefit outweighs the potential consequences of not using antivenom. Giving adrenaline (epinephrine) to prevent adverse effect to antivenom before they occur might be reasonable where they occur commonly. Antihistamines do not appear to provide any benefit in preventing adverse reactions.
In 1973 it was proven for the first time that polyester degrades when disposed in bioactive material such as soil. Polyesters are water resistant and can be melted and shaped into sheets, bottles, and other products, making certain plastics now available as a biodegradable product. Following that discovery, polyhydroxylalkanoates (PHAs) were produced directly from renewable resources by microbes. They are approximately 95% cellular bacteria and can be manipulated by genetic strategies. The composition and biodegradability of PHAs can be regulated by blending them with other natural polymers. In the 1980s the company ICI Zenecca commercialized PHAs under the name Biopol. It was used for the production of shampoo bottles and other cosmetic products. Consumers were willing to pay more for this product because it was natural and biodegradable, a response which had not occurred before.
Now biodegradable technology has become a highly developed market with applications in product packaging, production and medicine. Biodegradable technology is concerned with the manufacturing science of biodegradable materials. It imposes science-based mechanisms of plant genetics into contemporary industral processes. Scientists and manufacturing corporations can help impact climate change by developing a use of plant genetics that would mimic some technologies. By looking to plants, such as biodegradable material harvested through photosynthesis, waste and toxins can be minimized.
Oxo-biodegradable technology, which has further developed biodegradable plastics, has also emerged. Oxo-biodegradation is defined by CEN (the European Standards Organisation) as "degradation resulting from oxidative and cell-mediated phenomena, either simultaneously or successively." Whilst sometimes described as "oxo-fragmentable," and "oxo-degradable" these terms describe only the first or oxidative phase and should not be used for material which degrades by the process of oxo-biodegradation defined by CEN: the correct description is "oxo-biodegradable."
By combining plastic products with very large polymer molecules, which contain only carbon and hydrogen, with oxygen in the air, the product is rendered capable of decomposing in anywhere from a week to one to two years. This reaction occurs even without prodegradant additives but at a very slow rate. That is why conventional plastics, when discarded, persist for a long time in the environment. Oxo-biodegradable formulations catalyze and accelerate the biodegradation process but it takes considerable skill and experience to balance the ingredients within the formulations so as to provide the product with a useful life for a set period, followed by degradation and biodegradation.
Biodegradable technology is especially utilized by the bio-medical community. Biodegradable polymers are classified into three groups:
medical, ecological, and dual application, while in terms of origin they are divided into two groups: natural and synthetic. The Clean Technology Group is exploiting the use of supercritical carbon dioxide, which under high pressure at room temperature is a solvent that can use biodegradable plastics to make polymer drug coatings. The polymer (meaning a material composed of molecules with repeating structural units that form a long chain) is used to encapsulate a drug prior to injection in the body and is based on lactic acid, a compound normally produced in the body, and is thus able to be excreted naturally. The coating is designed for controlled release over a period of time, reducing the number of injections required and maximizing the therapeutic benefit. Professor Steve Howdle states that biodegradable polymers are particularly attractive for use in drug delivery, as once introduced into the body they require no retrieval or further manipulation and are degraded into soluble, non-toxic by-products. Different polymers degrade at different rates within the body and therefore polymer selection can be tailored to achieve desired release rates.
Other biomedical applications include the use of biodegradable, elastic shape-memory polymers. Biodegradable implant materials can now be used for minimally invasive surgical procedures through degradable thermoplastic polymers. These polymers are now able to change their shape with increase of temperature, causing shape memory capabilities as well as easily degradable sutures. As a result, implants can now fit through small incisions, doctors can easily perform complex deformations, and sutures and other material aides can naturally biodegrade after a completed surgery.
Biodegradation is the disintegration of materials by bacteria, fungi, or other biological means.
The term is often used in relation to: biomedicine, waste management, ecology, and the bioremediation of the natural environment. It is now commonly associated with environmentally-friendly products, capable of decomposing back into natural elements.
Although often conflated, "biodegradable" is distinct in meaning from: "compostable". While biodegradable simply means "can be consumed by microorganisms", "compostable" makes the further specific demand that the object break down under composting conditions.
Organic material can be degraded aerobically (with oxygen) or anaerobically (without oxygen). Decomposition of biodegradable substances may include both biological and abiotic steps.
Biodegradable matter is generally organic material that provides a nutrient for microorganisms. These are so numerous and diverse that a huge range of compounds can be biodegraded, including hydrocarbons (oils), polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and pharmaceutical substances.
Microorganisms secrete biosurfactant, an extracellular surfactant, to enhance this process.
In pet rabbits, myxomatosis can be misdiagnosed as pasteurellosis, a bacterial infection which can be treated with antibiotics. By contrast, there is no treatment for rabbits suffering from myxomatosis, other than palliative care to ease the suffering of individual animals, and the treatment of secondary and opportunistic infections, in the hopes the treated animal will survive. In practice, the owner is often urged to euthanize the animal to end its suffering.
Salicylic acid — The treatment of warts by keratolysis involves the peeling away of dead surface skin cells with keratolytic chemicals such as salicylic acid or trichloroacetic acid. These are available in over-the-counter products or, in higher concentrations, may need to be prescribed by a physician. A 12-week daily treatment with salicylic acid has been shown to lead to a complete clearance of warts in 10–15% of the cases.
Formic acid — Topical formic acid is a common treatment for plantar warts, which works by being applied over a period of time causing the body to reject the wart.
Immunotherapy — Intralesional injection of antigens (mumps, "candida" or trichophytin antigens USP) is a new wart treatment which may trigger a host immune response to the wart virus, resulting in wart resolution. It is now recommended as a second-line therapy.
Liquid nitrogen — This, and similar cryosurgery methods, is a common surgical treatment which acts by freezing the external cell structure of the warts, destroying the live tissue.
Electrodesiccation and surgical excision, which may produce scarring.
Laser surgery — This is generally a last resort treatment, as it is expensive and painful, but may be necessary for large, hard-to-cure warts.
Cauterization — This may be effective as a prolonged treatment. As a short-term treatment, cauterization of the base with anesthetic can be effective, but this method risks scars or keloids. Subsequent surgical removal is unnecessary, and risks keloids and recurrence in the operative scar.
Lucio's phenomenon is treated by anti-leprosy therapy (dapsone, rifampin, and clofazimine), optimal wound care, and treatment for bacteremia including antibiotics. In severe cases exchange transfusion may be helpful.
A remedy, which can work within hours, perhaps by countering constipation, is to feed green pea to affected fish. Fish surgeons can also adjust the buoyancy of the fish by placing a stone in the swim bladder or performing a partial removal of the bladder.
The Control of Vibration at Work Regulations 2005, created under the Health and Safety at Work etc. Act 1974. is the legislation in the UK that governs exposure to vibration and assists with preventing HAVS occurring.
Good practice in industrial health and safety management requires that worker vibration exposure is assessed in terms of acceleration amplitude and duration. Using a tool that vibrates slightly for a long time can be as damaging as using a heavily vibrating tool for a short time. The duration of use of the tool is measured as trigger time, the period when the worker actually has their finger on the trigger to make the tool run, and is typically quoted in hours per day. Vibration amplitude is quoted in metres per second squared, and is measured by an accelerometer on the tool or given by the manufacturer. Amplitudes can vary significantly with tool design, condition and style of use, even for the same type of tool.
In the UK, Health and Safety Executive gives the example of a hammer drill which can vary from 6m/s² to 25m/s². HSE publishes a list of typically observed vibration levels for various tools, and graphs of how long each day a worker can be exposed to particular vibration levels. This makes managing the risk relatively straightforward. Tools are given an Exposure Action Value (EAV, the time which a tool can be used before action needs to be taken to reduce vibration exposure) and an Exposure Limit Value (ELV, the time after which a tool may not be used).
In the United States, the National Institute for Occupational Safety and Health published a similar database where values for sound power and vibrations for commonly found tools from large commercial vendors in the United States were surveyed. Further testing is underway for more and newer tools.
The effect of legislation in various countries on worker vibration limits has been to oblige equipment providers to develop better-designed, better-maintained tools, and for employers to train workers appropriately. It also drives tool designers to innovate to reduce vibration. Some examples are the easily manipulated mechanical arm (EMMA) and the suspension mechanism designed into chainsaws.
A simpler system, known as re-active monitoring, may be used by, for example, monitoring rates of usage of consumable items. Such a system was introduced by Carl West at a fabrication workshop in Rotherham, England. In this system, the vibration levels of the angle grinding tools in use was measured, as was the average life of a grinding disk. Thus by recording numbers of grinding disks used, vibration exposure may be calculated.
The number of cases in the US is not known, but a Hampshire veterinary practice reported on 24 March 2015 that there had been 103 suspected cases in the UK, including 52 deaths confirmed by postmortem examination.
Toxic oil syndrome or simply toxic syndrome (Spanish: "síndrome del aceite tóxico" or "síndrome tóxico") is a musculoskeletal disease most famous for a 1981 outbreak in Spain which killed over 600 people and was likely caused by contaminated colza oil. Its first appearance was as a lung disease, with unusual features; though the symptoms initially resembled a lung infection, antibiotics were ineffective. The disease appeared to be restricted to certain geographical localities, and several members of a family could be affected, even while their neighbours had no symptoms. Following the acute phase, a range of other chronic symptoms was apparent.
A number of treatments are available. The most successful non-invasive procedure is cognitive behavioural therapy (CBT), which attempts to alleviate the anxiety felt by sufferers.
In extreme cases a surgical procedure known as endoscopic transthoracic sympathicotomy (ETS) is available. Pioneered by surgeons in Sweden, this procedure has recently become increasingly controversial due to its many potential adverse effects. Patients who have undergone the procedure frequently complain of compensatory sweating and fatigue, with around 5% reconsidering getting the treatment. ETS is now normally only considered in extreme cases where other treatments have been ineffective.
The conclusion of the Joint WHO/CISAT Scientific Committee for the Toxic Oil Syndrome from 2002, that oil was the cause for TOS, is based only on epidemiological evidence, since up to now, experimental studies performed in a variety of laboratory animals have failed to reproduce the symptoms of human TOS. None of the "in vivo" or "in vitro" studies performed with toxic-oil-specific components, such as fatty acid anilides, and esters of 3-(N-phenylamino)-1,2-propanediol (abbreviated as PAP), have provided evidence that these markers are causally involved in the pathogenesis of TOS.
Specifically, three possible causative agents of TOS are PAP (3-(N-phenylamino)-1,2-propanediol), the 1,2-dioleoyl ester of PAP (abbreviated OOPAP), and the 3-oleoyl ester of PAP (abbreviated OPAP). These three compounds are formed by means of similar chemical processes, and oil that contains one of the three substances is likely to contain the other two. Oil samples that are suspected to have been ingested by people who later developed TOS often contain all three of these contaminants (among other substances), but are most likely to contain OOPAP. However, when these three substances were given to laboratory animals, OOPAP was not acutely toxic, PAP was toxic only after injection, but not after oral administration, and OPAP was toxic only after injection of high doses. Therefore, none of these three substances is thought to cause TOS. Similar results were obtained after administration of fatty acid anilides.
The fact that the first cases of the syndrome were located in Madrid, near the U.S. military base in Torrejón de Ardoz, and the secrecy surrounding the huge investigations, spread the idea of a conspiracy. Several of those affected by the TOS claim they never consumed that oil. Although the oil was mainly sold on street markets, a considerable percentage of the patients was upper class. Another theory suggests the toxic reaction was triggered by organophosphate poisoning (e. g., from pesticide residues in tomatoes) and covered up by the Spanish government and the WHO.
Flacherie (literally: "flaccidness") is a disease of silkworms, caused by silkworms eating infected or contaminated mulberry leaves. Flacherie infected silkworms look weak and can die from this disease. Silkworm larvae that are about to die from Flacherie are a dark brown.
There are two kinds of flacherie: essentially, infectious (viral) flacherie and noninfectious ("bouffee") flacherie. Both are technically a lethal diarrhea.
Bouffée flacherie is caused by heat waves ("bouffée" means "sudden heat spell" in French).
Viral flacherie is ultimately caused by infection with "Bombyx mori" infectious flacherie virus (BmIFV, Iflaviridae), "Bombyx mori" densovirus (BmDNV, Parvoviridae) or "Bombyx mori" cypovirus 1 (BmCPV-1, Reoviridae). This either alone or in combination with bacterial infection destroys the gut tissue. Bacterial pathogens contributing to infectious flaccherie are "Serratia marcescens", and species of "Streptococcus" and "Staphylococcus" in the form known as thatte roga.
Louis Pasteur, who began his studies on silkworm diseases in 1865, was the first one able to recognize that mortality due to viral flacherie was caused by infection. (Priority, however, was claimed by Antoine Béchamp.) Richard Gordon described the discovery: "The French silk industry was meanwhile plummeting from a 130 million to an 8 million francs annual income, because the silkworms had all caught "pébrine," black pepper disease…He [Pasteur] went south from Paris to Alais, and rewarded them by discovering the silkworm epidemic to be inflicted by some sort of living microbe…Pasteur threw in another disease, "flâcherie," silkworm diarrhoea. The cures for both were culling the insects which showed the peppery spots — the peasants bottled the silkworm moths in brandy, for display to the experts — and rigorous hygiene of the mulberry leaf."
The drug tafamidis has completed a phase II/III 18-month-long placebo controlled clinical trial
and these results in combination with an 18-month follow-on study demonstrated that Tafamidis or Vyndaqel slowed progression of FAP, particularly when administered to patients early in the course of FAP. This drug is now approved by the European Medicines Agency.
The US Food and Drug Administration's Peripheral and Central Nervous System Drugs Advisory Committee rejected the drug in June 2012, in a 13-4 vote. The committee stated that there was not enough evidence supporting efficacy of the drug, and requested additional clinical trials.
Treatment is usually debridement and excision, with amputation necessary in many cases. Water-soluble antibiotics (such as penicillin) alone are not effective because they do not penetrate ischaemic muscles sufficiently to be effective. Penicillin is effective against C. perfringens. When gas gangrene occurs in such regions as the abdominal cavity, the patient can be treated in a hyperbaric chamber. which contains a pressurized oxygen-rich atmosphere. The oxygen saturates the infected tissues and thereby prevents the growth of the obligately anaerobic clostridia. The growth of C. perfringens is inhibited when the availability of oxygen is equivalent to a partial pressure of around 9–10 kPa (compare to 4–5 kPa in venous blood under normal conditions, with 11–13 kPa in arteries and 21 kPa in air at sea level), so if the treatment is started early, this condition can mostly be cured.
In the absence of a liver transplant, FAP is invariably fatal, usually within a decade. The disadvantage of liver transplantation is that approximately 10% of the subjects die from the procedure or complications resulting from the procedure, which is a form of gene therapy wherein the liver expressing wild type and mutant TTR is replaced by a liver only expressing wild type TTR. Moreover, transplanted patients must take immune suppressants (drugs) for the remainder of their life, which can lead to additional complications. In late 2011, the European Medicines Agency approved the transthyretin kinetic stabilizer Tafamidis or Vyndaqel discovered by Jeffery W. Kelly and developed by FoldRx pharmaceuticals (acquired by Pfizer in 2010) for the treatment of FAP based on clinical trial data. Tafamidis (20 mg once daily) slowed the progression of FAP over a 36-month period and importantly reversed the weight loss and muscle wasting associated with disease progression.
The type of injury dictates the treatment; however, surgery is a common treatment. Catheterization is usually a part of treatment for penis injuries; when the urethra is intact, urethral catheterization may be used, but if it has been injured, suprapubic catheterization is used. Some injuries, including animal bites, are also treated with antibiotics, irrigation, and rabies prophylaxis.
Like other forms of epilepsy, abdominal epilepsy is treated with anticonvulsant drugs, such as phenytoin. Since no controlled studies exist, however, other drugs may be equally effective.
Blight refers to a specific symptom affecting plants in response to infection by a pathogenic organism. It is a rapid and complete chlorosis, browning, then death of plant tissues such as leaves, branches, twigs, or floral organs. Accordingly, many diseases that primarily exhibit this symptom are called blights. Several notable examples are:
- Late blight of potato, caused by the water mold "Phytophthora infestans" (Mont.) de Bary, the disease which led to the Great Irish Famine
- Southern corn leaf blight, caused by the fungus "Cochliobolus heterostrophus" (Drechs.) Drechs, anamorph "Bipolaris maydis" (Nisikado & Miyake) Shoemaker, incited a severe loss of corn in the United States in 1970.
- Chestnut blight, caused by the fungus "Cryphonectria parasitica" (Murrill) Barr, has nearly completely eradicated mature American chestnuts in North America.
- Fire blight of pome fruits, caused by the bacterium "Erwinia amylovora" (Burrill) Winslow "et al.", is the most severe disease of pear and also is found in apple and raspberry, among others.
- Bacterial leaf blight of rice, caused by the bacterium "Xanthomonas oryzae" (Uyeda & Ishiyama) Dowson.
- Early blight of potato and tomato, caused by species of the ubiquitous fungal genus "Alternaria"
- Leaf blight of the grasses
On leaf tissue, symptoms of blight are the initial appearance of lesions which rapidly engulf surrounding tissue. However, leaf spot may, in advanced stages, expand to kill entire areas of leaf tissue and thus exhibit blight symptoms.
Blights are often named after their causative agent, for example Colletotrichum blight is named after the fungi "Colletotrichum capsici", and Phytophthora blight is named after the water mold "Phytophthora parasitica".
Swim bladder disease, also called swim bladder disorder or flipover, is a common ailment in aquarium fish. The swim bladder is an internal gas-filled organ that contributes to the ability of a fish to control its buoyancy, and thus to stay at the current water depth without having to waste energy in swimming. A fish with swim bladder disorder can float nose down tail up, or can float to the top or sink to the bottom of the aquarium.
Surgical repair is performed. Reconstruction or ligation of aberrant right subclavian artery by sternotomy/by neck approach.