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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)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Lazarus Colloredo and Joannes Baptista Colloredo (1617 – after 1646) were Italian conjoined twins who toured in 17th-century Europe. They were born in Genoa, Italy.
The upper body of Joannes Baptista (named after John the Baptist) and his left leg stuck out of his mobile brother. He did not speak and kept his eyes closed and mouth open all the time and was thus a parasitic twin. According to a later account by Copenhagen anatomist Thomas Bartholinus, if someone pushed the breast of Joannes Baptista, he moved his hands, ears and lips.
To make a living, Lazarus toured around Europe and visited at least Basel, Switzerland and Copenhagen, Denmark before he arrived in Scotland in 1642 and later visited the court of Charles I of England.
They also visited Gdańsk, Turkey and Denmark, and toured Germany and Italy in 1646.
Contemporary accounts described Lazarus as courteous and handsome but for his brother who just dangled before him. When Lazarus was not exhibiting himself, he covered his brother with his cloak to avoid unnecessary attention.
Later accounts claim that Lazarus married and sired several children, none with his condition. His engraved portrait depicts him in a costume of a courtier of the period of the House of Stuart.
The brothers' exact date of death is unknown.
Mary and Eliza Chulkhurst (or Chalkhurst), commonly known as the Biddenden Maids, were a pair of conjoined twins supposedly born in Biddenden, Kent, England, in the year 1100. They are said to have been joined at both the shoulder and the hip, and to have lived for 34 years. It is claimed that on their death they bequeathed five plots of land to the village, known as the Bread and Cheese Lands. The income from these lands was used to pay for an annual of food and drink to the poor every Easter. Since at least 1775, the dole has included Biddenden cakes, hard biscuits imprinted with an image of two conjoined women.
Although the annual distribution of food and drink is known to have taken place since at least 1605, no records exist of the story of the sisters prior to 1770. Records of that time say that the names of the sisters were not known, and early drawings of Biddenden cakes do not give names for the sisters; it is not until the early 19th century that the names "Mary and Eliza Chulkhurst" were first used.
Edward Hasted, the local historian of Kent, has dismissed the story of the Biddenden Maids as a folk myth, claiming that the image on the cake had originally represented two poor women and that the story of the conjoined twins was "a vulgar tradition" invented to account for it, while influential historian Robert Chambers accepted that the legend could be true but believed it unlikely. Throughout most of the 19th century little research was carried out into the origins of the legend. Despite the doubts among historians, in the 19th century the legend became increasingly popular and the village of Biddenden was thronged with rowdy visitors every Easter. In the late 19th century historians investigated the origins of the legend. It was suggested that the twins had genuinely existed but had been joined at the hip only rather than at both the hip and shoulder, and that they had lived in the 16th rather than the 12th century.
In 1907, the Bread and Cheese Lands were sold for housing, and the resulting income allowed the annual dole to expand considerably, providing the widows and pensioners of Biddenden with cheese, bread and tea at Easter and with cash payments at Christmas. Biddenden cakes continue to be given to the poor of Biddenden each Easter, and are sold as souvenirs to visitors.
In Chinese alchemy, elixir poisoning refers to the toxic effects from elixirs of immortality that contained metals and minerals such as mercury and arsenic. The official "Twenty-Four Histories" record numerous Chinese emperors, nobles, and officials who ironically died from taking elixirs in order to prolong their lifespans. The first emperor to die from elixir poisoning was likely Qin Shi Huang (d. 210 BCE) and the last was Yongzheng (d. 1735). Despite common knowledge that immortality potions could be deadly, fangshi and Daoist alchemists continued the elixir-making practice for two millennia.
Aposthia is a rare congenital condition in humans, in which the foreskin of the penis is missing.
Toward the end of the nineteenth century, E. S. Talbot claimed that aposthia among Jews was evidence for the now-discredited Lamarckian theory of evolution. In his work, ""The Variation of Animals and Plants under Domestication"", Charles Darwin also mentioned cases of "born circumcised" babies as "conclusive evidence" for the now-discredited blending inheritance.
It is likely that the cases he described were actually hypospadias, a condition in which the urinary meatus is on the underside of the penis. Neither condition has been shown to have a higher frequency in Jews or Muslims.
Islamophobia is an intense fear or hatred of, or prejudice against, the Islamic religion or Muslims, especially when seen as a geopolitical force or the source of terrorism.
The term was first used in the early 20th century and it emerged as a neologism in the 1970s, then it became increasingly salient during the 1980s and 1990s, and it reached public policy prominence with the report by the Runnymede Trust's Commission on British Muslims and Islamophobia (CBMI) entitled "Islamophobia: A Challenge for Us All" (1997). The introduction of the term was justified by the report's assessment that "anti-Muslim prejudice has grown so considerably and so rapidly in recent years that a new item in the vocabulary is needed".
The causes and characteristics of Islamophobia are still debated. Some commentators have posited an increase in Islamophobia resulting from the September 11 attacks, some from multiple terror attacks in Europe and the United States, while others have associated it with the increased presence of Muslims in the United States and in the European Union. Some people also question the validity of the term. The academics S. Sayyid and Abdoolkarim Vakil maintain that Islamophobia is a response to the emergence of a distinct Muslim public identity globally, the presence of Muslims is in itself not an indicator of the degree of Islamophobia in a society. Sayyid and Vakil maintain that there are societies where virtually no Muslims live but many institutionalized forms of Islamophobia still exist in them.
The etymology of English elixir derives from Medieval Latin "", from Arabic ("al-ʾiksīr"), probably from Ancient Greek ("xḗrion" "a desiccative powder for wounds"). "Elixir" originated in medieval European alchemy meaning "A preparation by the use of which it was sought to change metals into gold" (elixir stone or philosopher's stone) or "A supposed drug or essence with the property of indefinitely prolonging life" (elixir of life). The word was figuratively extended to mean "A sovereign remedy for disease. Hence adopted as a name for quack medicines" (e.g., Daffy's Elixir) and "The quintessence or soul of a thing; its kernel or secret principle". In modern usage, "elixir" is a pharmaceutical term for "A sweetened aromatic solution of alcohol and water, serving as a vehicle for medicine" ("Oxford English Dictionary", 2nd ed., 2009). Outside of Chinese cultural contexts, English "elixir poisoning" usually refers to accidental contamination, such as the 1937 Elixir sulfanilamide mass poisoning in the United States.
"Dān" 丹 "cinnabar; vermillion; elixir; alchemy" is the keyword for Chinese immortality elixirs. The red mineral cinnabar ("dānshā" 丹砂 lit. "cinnabar sand") was anciently used to produce the pigment vermilion ("zhūhóng" 朱紅) and the element mercury ("shuǐyín" 水銀 "watery silver" or "gǒng" 汞).
According to the "ABC Etymological Dictionary of Old Chinese", the etymology of Modern Standard Chinese "dān" from Old Chinese "*tān" (< *"tlan" ?) 丹 "red; vermillion; cinnabar", "gān" 矸 in "dāngān" 丹矸 from *"tân-kân" (< *"tlan-klan" ?) "cinnabar; vermillion ore", and "zhān" from *"tan" 旃 "a red flag" derive from Proto-Kam-Sui *"h-lan" "red" or Proto-Sino-Tibetan *"tja-n" or *"tya-n" "red". The *"t-" initial and *"t-" or *"k-" doublets indicate that Old Chinese borrowed this item. (Schuessler 2007: 204).
Although the word "dan" 丹 "cinnabar; red" frequently occurs in oracle script from the late Shang Dynasty (ca. 1600-1046 BCE) and bronzeware script and seal script from the Zhou Dynasty (1045-256 BCE), paleographers disagree about the graphic origins of the logograph 丹 and its ancient variants 𠁿 and 𠕑. Early scripts combine a 丶 dot or ⼀ stroke (depicting a piece of cinnabar) in the middle of a surrounding frame, which is said to represent:
- "jǐng" 井 "well" represents the mine from which the cinnabar is taken" ("Shuowen Jiezi")
- "the crucible of the Taoist alchemists" (Léon Wieger )
- "the contents of a square receptacle" (Bernhard Karlgren)
- "placed in a tray or palette to be used as red pigment" (Wang Hongyuan 王宏源)
- "mineral powder on a stretched filter-cloth" (Needham and Lu).
Many Chinese elixir names are compounds of "dan", such as "jīndān" 金丹 (with "gold") meaning "golden elixir; elixir of immortality; potable gold" and "xiāndān" 仙丹 (with "Daoist immortal") "elixir of immortality; panacea", and "shéndān" 神丹 (with "spirit; god") "divine elixir". "Bùsǐ zhī yào" 不死之藥 "drug of deathlessness" was another early name for the elixir of immortality. Chinese alchemists would "liàndān" 煉丹 (with "smelt; refine") "concoct pills of immortality" using a "dāndǐng" 丹鼎 (with "tripod cooking vessel; cauldron") "furnace for concocting pills of immortality". In addition, the ancient Chinese believed that other substances provided longevity and immortality, notably the "língzhī" 靈芝 ""Ganoderma" mushroom".
The transformation from chemistry-based "waidan" 外丹 "external elixir/alchemy" to physiology-based "neidan" 內丹 "internal elixir/alchemy" gave new analogous meanings to old terms. The human body metaphorically becomes a "ding" "cauldron" in which the adept forges the Three Treasures (essence, life-force, and spirit) within the "jindan" Golden Elixir within the "dāntián" 丹田 (with "field") "lower part of the abdomen".
In early China, alchemists and pharmacists were one in the same. Traditional Chinese Medicine also used less concentrated cinnabar and mercury preparations, and "dan" means "pill; medicine" in general, for example, "dānfāng" 丹方 semantically changed from "prescription for elixir of immortality" to "medical prescription". "Dan" was lexicalized into medical terms such as " dānjì" 丹劑 "pill preparation" and "dānyào" 丹藥 "pill medicine".
The Chinese names for immortality elixirs have parallels in other cultures and languages, for example, Indo-Iranian "soma" or "haoma", Sanskrit "amrita", and Greek "ambrosia".
The medical condition of being overweight or obesity is defined as "abnormal or excessive fat accumulation that may impair health". It is measured through the Body Mass Index (BMI), defined as a person's weight, in kilograms, divided by the square of the person's height, in meters. If an individual has a BMI of 25–29, he or she is overweight. Having a BMI of 30 or more means an individual is obese. The greater the BMI, the greater the risk of chronic diseases as a result of obesity. These diseases include cardiovascular diseases, diabetes, musculoskeletal disorders, cancer, and premature death.
One reason that poverty produces such high rates of fistula cases is the malnutrition that exists in such areas. Lack of money and access to proper nutrition, as well as vulnerability to diseases that exist in impoverished areas because of limited basic health care and disease prevention methods, cause inhabitants of these regions to experience stunted growth. Sub-Saharan Africa is one such environment where the shortest women have on average lighter babies and more difficulties during birth when compared with full-grown women. This stunted growth causes expectant mothers to have skeletons unequipped for proper birth, such as an underdeveloped pelvis. This weak and underdeveloped bone structure increases the chances that the baby will get stuck in the pelvis during birth, cutting off circulation and leading to tissue necrosis. Because of the correlation between malnutrition, stunted growth, and birthing difficulties, maternal height can at times be used as a measure for expected labor difficulties.
According to tradition Mary and Eliza Chulkhurst, or Chalkhurst, were born to relatively wealthy parents in Biddenden, Kent, in the year 1100. The pair were said to be conjoined at both the shoulder and the hip. They grew up conjoined, and are said to have "had frequent quarrels, which sometimes terminated in blows". At the age of 34, Mary Chulkhurst died suddenly. Doctors proposed to separate the still-living Eliza from her sister's body but she refused, saying "as we came together we will also go together", and died six hours afterwards. In their wills, the sisters left five pieces of land in the Biddenden area comprising around in total to the local church, with the income from these lands (claimed to have been 6 guineas per annum at the time of their death) to provide an annual dole of bread, cheese and beer to the poor every Easter. Henceforward, the lands were to be known as the Bread and Cheese Lands.
Obesity in North Africa and the Middle East is a notable health issue. In 2005, the World Health Organization measured that 1.6 billion people were overweight and 400 million were obese. It estimates that by the year 2015, 2.3 billion people will be overweight and 700 million will be obese. The Middle East, including the Arabian Peninsula, Eastern Mediterranean, Turkey and Iran, and North Africa, are no exception to the worldwide increase in obesity. Subsequently, some call this trend the New World Syndrome. The lifestyle changes associated with the discovery of oil and the subsequent increase in wealth is one contributing factor.
Urbanization has occurred rapidly and has been accompanied by new technologies that promote sedentary lifestyles. Due to accessibility of private cars, television, and household appliances, the population as a whole is engaging in less physical activity. The rise in caloric and fat intake in a region where exercise is not a defining part of the culture has added to the overall increased percentages of overweight and obese populations. In addition, women are more likely to be overweight or obese due to cultural norms and perceptions of appropriate female behavior and occupations inside and outside of the home.
High levels of poverty also lead to low levels of education among impoverished women concerning maternal health. This lack of information in combination with obstacles preventing rural women to easily travel to and from hospitals lead many to arrive at the birthing process without prenatal care. This can cause a development of unplanned complications that may arise during home births, in which traditional techniques are used. These techniques often fail in the event of unplanned emergencies, leading women to go to hospital for care too late, desperately ill, and therefore vulnerable to the risks of anesthesia and surgery that must be used on them. In a study of women who had prenatal care and those who had unbooked emergency births, “the death rate in the booked-healthy group was as good as that in many developed countries, [but] the death rate in the unbooked emergencies was the same as the death rate in England in the 16th and 17th centuries.” In this study, 62 unbooked emergency women were diagnosed with obstetric fistulae out of 7,707 studied, in comparison to three diagnosed booked mothers out of 15,020 studied. In addition, studies find that education is associated with lower desired family size, greater use of contraceptives, and increased use of professional medical services. Educated families are also more likely to be able to afford health care, especially maternal healthcare.
The causes of childhood obesity can be based on both a combination of individual choices and socio-environmental adaptions with genetic factors playing an important role also.
Genetics, according to the Australian Health Survey plays a primary role in determining obesity. In 2011/2012 it was recorded that 90% of the Australian population had inherited their obese tendencies due to the epigenetic modifications of their mothers during pregnancy. Interchanging closely with the genetic factor, the environment and individual temptations are also highlighted as contributing causes to the worldwide epidemic. The genetic configuration influences the tendencies to become overweight, and diet and physical activity determines to what extent those tendencies are elaborated.
Though heart disease is not exclusive to the poor, there are aspects of a life of poverty that contribute to its development. This category includes coronary heart disease, stroke and heart attack. Heart disease is the leading cause of death worldwide and there are disparities of morbidity between the rich and poor. Studies from around the world link heart disease to poverty. Low neighborhood income and education were associated with higher risk factors. Poor diet, lack of exercise and limited (or no) access to a specialist were all factors related to poverty, though to contribute to heart disease.
Both low income and low education were predictors of coronary heart disease, a subset of cardiovascular disease. Of those admitted to hospital in the United States for heart failure, women and African Americans were more likely to reside in lower income neighborhoods. In the developing world, there is a 10 fold increase in cardiac events in the black and urban populations.
Poverty and disease are tied closely together, with each factor aiding the other. Many diseases that primarily affect the poor serve to also deepen poverty and worsen conditions. Poverty also significantly reduces people's capabilities making it more difficult to avoid poverty related diseases.
The majority of diseases and related mortality in poor countries is due to preventable, treatable diseases for which medicines and treatment regimes are readily available. Poverty is in many cases the single dominating factor in higher rates of prevalence of these diseases. Poor hygiene, ignorance in health-related education, non-availability of safe drinking water, inadequate nutrition and indoor pollution are factors exacerbated by poverty.
Just the big three PRDs — TB, AIDS/HIV and Malaria — account for 18% of diseases in poor countries. The disease burden of treatable childhood diseases in high-mortality, poor countries is 5.2% in terms of disability-adjusted life years but just 0.2% in the case of advanced countries.
In addition, infant mortality and maternal mortality are far more prevalent among the poor. For example, 98% of the 11,600 daily maternal and neonatal deaths occur in developing countries.
There is most likely a link between children's linear growth and household sanitation practices. The ingestion of high quantities of fecal bacteria by young children through putting soiled fingers or household items in the mouth leads to intestinal infections. This affect children's nutritional status by diminishing appetite, reducing nutrient absorption, and increasing nutrient losses.
The diseases recurrent diarrhoea and intestinal worm infections (helminthiasis) which are both linked to poor sanitation have been shown to contribute to child stunting. The evidence that a condition called environmental enteropathy also stunts children is not conclusively available yet, although the link is plausible and several studies are underway on this topic. Environmental enteropathy is a syndrome causing changes in the small intestine of persons and can be brought on due to lacking basic sanitary facilities and being exposed to faecal contamination on a long-term basis.
Research on a global level has found that the proportion of stunting that could be attributed to five or more episodes of diarrhoea before two years of age was 25%. Since diarrhoea is closely linked with water, sanitation and hygiene (WASH), this is a good indicator for the connection between WASH and stunted growth. To what extent improvements in drinking water safety, toilet use and good handwashing practices contribute to reduce stunting depends on the how bad these practices were prior to interventions.
In summary, key policy interventions for the prevention of stunting are:
- Improvement in nutrition surveillance activities to identify rates and trends of stunting and other forms of malnutrition within countries. This should be done with an equity perspective, as it is likely that stunting rates will vary greatly between different population groups. The most vulnerable should be prioritized. The same should be done for risk factors such as anemia, maternal under-nutrition, food insecurity, low birth-weight, breastfeeding practices etc. By collecting more detailed information, it is easier to ensure that policy interventions really address the root causes of stunting.
- Political will to develop and implement national targets and strategies in line with evidence-based international guidelines as well as contextual factors.
- Designing and implementing policies promoting nutritional and health well-being of mothers and women of reproductive age. The main focus should be on the 1000 days of pregnancy and first two years of life, but the pre-conception period should not be neglected as it can play a significant role in ensuring the fetus and baby's nutrition.
- Designing and implementing policies promoting proper breastfeeding and complementary feeding practice (focusing on diet diversity for both macro and micronutrients). This can ensure optimal infant nutrition as well as protection from infections that can weaken the child's body. Labor policy ensuring mothers have the chance to breastfeed should be considered where necessary.
- Introducing interventions addressing social and other health determinants of stunting, such as poor sanitation and access to drinking water, early marriages, intestinal parasite infections, malaria and other childhood preventable disease (referred to as “nutrition-sensitive interventions”), as well as the country's food security landscape. Interventions to keep adolescent girls in school can be effective at delaying marriage with subsequent nutritional benefits for both women and babies. Regulating milk substitutes is also very important to ensure that as many mothers as possible breastfeed their babies, unless a clear contraindication is present.
- Broadly speaking, effective policies to reduce stunting require multisectoral approaches, strong political commitment, community involvement and integrated service delivery.
Lazarus syndrome, (the Lazarus heart) also known as autoresuscitation after failed cardiopulmonary resuscitation, is the spontaneous return of circulation after failed attempts at resuscitation. Its occurrence has been noted in medical literature at least 38 times since 1982. It takes its name from Lazarus who, as described in the New Testament of The Bible, was raised from the dead by Jesus.
Occurrences of the syndrome are extremely rare and the causes are not well understood. One hypothesis for the phenomenon is that a chief factor (though not the only one) is the buildup of pressure in the chest as a result of cardiopulmonary resuscitation (CPR). The relaxation of pressure after resuscitation efforts have ended is thought to allow the heart to expand, triggering the heart's electrical impulses and restarting the heartbeat. Other possible factors are hyperkalemia or high doses of epinephrine.
Heat-related illnesses from occupational heat stress have several risk factors. Some of these factors include high temperatures, humidity, radiant heat sources, limited air movement, metabolic heat from physical exertion of energy, not drinking enough fluids, personal protective equipment and clothing, physical condition and health problems, medications, pregnancy, lack of acclimatization, advanced age, having a previous heat-related illness and others.
The Lazarus phenomenon raises ethical issues for physicians, who must determine when medical death has occurred, resuscitation efforts should end, and postmortem procedures such as autopsies and organ harvesting may take place.
Medical literature has recommended observation of a patient's vital signs for five to ten minutes after cessation of resuscitation before certifying death.
Heat alert programs should be developed for implementation when hotter than normal temperatures, or a heat wave occurs.
The symptoms of autophobia vary by case. However, there are some symptoms that a multitude of people with this disease suffer from. An intense amount of apprehension and anxiety when you are alone or think about situations where you would be secluded is one of the most common indications that a person is autophobic. People with this disorder also commonly believe that there is an impending disaster waiting to occur whenever they are left alone. For this reason, autophobes go to extreme lengths to avoid being in isolation. However, people with this disease often do not need to be in "physical" isolation to feel abandoned. Autophobes will often be in a crowded area or group of people and feel as though they are completely secluded.
There has also been some connection to autophobia being diagnosed in people who also suffer from borderline personality disorders.
Below is a list of other symptoms that are sometimes associated with autophobia:
- Mental symptoms:
- Fear of fainting
- A disability to concentrate on anything other than the disease
- Fear of losing your mind
- Failure to think clearly
- Emotional symptoms:
- Stress over up-coming times and places where you may be alone
- Fear of being secluded
- Physical symptoms:
- Lightheadedness, dizziness
- Sweating
- Shaking
- Nausea
- Cold and hot flashes
- Numbness or tingling feelings
- Dry mouth
- Increased heart rate
The proximal causes of fiddler’s neck are friction and pressure, but both repetitive shearing stress and occlusion with consequent trapping of sweat give rise to progressive damage. This damage along with poor hygiene predisposes the area to local infection, and such infection can progress to scarring and other long-term effects. Hot weather is reported to exacerbate fiddler’s neck, as are tiredness, playing emotional music, and playing in smaller groups where individual stress is higher. Type I hypersensitivity reactions may also be involved, particularly to rosewood and ebony in the chinrest and tailpiece, as well as to varnish of the instrument body when chinrests are not used and to rosin deposits on the instrument and on chin cloths. Nickel or other metal allergies are common causes if the chin rest has a metal clip that comes into constant contact with the skin. Rosin exposure in particular may lead to abietic acid dermatitis.
Autophobia is a form of anxiety that can cause a minor to extreme feeling of danger or fear when alone. There is not a specific treatment to cure autophobia as it affects each person differently. Most sufferers are treated with psychotherapy in which the amount of time that they are alone is slowly increased. There are no conclusive studies currently that support any medications being used as treatment. If the anxiety is too intense medications have been used to aid the patient in a continuation of the therapy.
It is not uncommon for sufferers to be unaware that they have this anxiety and to dismiss the idea of seeking help. Much like substance abuse, autophobia is mental and physical and requires assistance from a medical professional. Medication can be used to stabilize symptoms and inhibit further substance abuse. Group and individual therapy is used to help ease symptoms and treat the phobia.
In mild cases of autophobia, treatment can sometimes be very simple. Therapists recommend many different remedies to make patients feel as though they are not alone even when that is the case, such as listening to music when running errands alone or turning on the television when at home, even if it is just for background noise. Using noise to interrupt the silence of isolated situations can often be a great help for people suffering from autophobia.
However, it is important to remember that just because a person may feel alone at times does not mean that they have autophobia. Most people feel alone and secluded at times; this is not an unusual phenomenon. Only when the fear of being alone beings to interrupt how a person lives their daily life does the idea of being autophobic become a possibility.
The diagnostic criteria for Dorian Gray syndrome are:
- Signs of dysmorphophobia
- Arrested development (inability to mature)
- Using at least two different medical-lifestyle products and services:
- Hair-growth restoration (e.g. finasteride)
- Antiadiposita to lose weight (e.g. orlistat)
- Anti-impotence drugs (e.g. sildenafil)
- Anti-depressant drugs (e.g. fluoxetine)
- Cosmetic dermatology (e.g. laser resurfacing)
- Cosmetic surgery (e.g. a face-lift, liposuction)