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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
Ronnie and Donnie Galyon (born October 28, 1951) are two American conjoined twins. According to the 2009 "Guinness World Records", the Galyons are the oldest living set of conjoined twins in the world, and, as of 29 October 2014, possess the world record for the longest-lived conjoined twins in history.
They were born at St. Elizabeth Hospital in Dayton, Ohio, on 28 October 1951, to Wesley and Eileen Galyon; Eileen was not expecting twins. They were joined from the sternum to the groin and shared a set of organs, so they could not be separated. Local schools deemed the twins a distraction and they were subsequently never formally educated, resulting in their lifelong functional illiteracy.
With nine children to support, their father Wesley decided to take the twins on the road as a sideshow attraction. The boys were exhibited in sideshows throughout the US and later in Latin America. Their tours made them celebrities and provided an income with which they supported their family. The twins also tried to join the Army, but were ranked 4F.
In 1991, after three decades in entertainment, the pair retired and moved into their first independent home in Dayton, Ohio, in a house purchased with sideshow earnings. They were active in the community and lived a largely normal life by means of a custom double wheelchair. Although retired from show business, the twins made numerous television appearances. They appeared on "The Jerry Springer Show" in 1997, a Discovery Channel documentary in 1998 and a Channel Five documentary in 2009.
In 2009, Ronnie suffered a life-threatening infection in his lungs, which quickly endangered both twins. After their hospitalization, they required round-the-clock care. Their younger brother Jim and his wife Mary, who lived in the same town, were unable to bring the twins into their home as it was not handicap accessible, until an outpouring of donations and volunteers from the local community assisted in building a special addition to the home. On December 22, 2010, TLC premiered "The World's Oldest Conjoined Twins Move Home," which documented the building process as well as the twins' recovery and their return to the community.
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.
Islamophobia in the United Kingdom refers to a set of discourses, behaviours and structures which express feelings of anxiety, fear, hostility and rejection towards Islam and/or Muslims in the United Kingdom. Islamophobia can manifest itself through discrimination in the workforce, negative coverage in the media, and violence against Muslims.
As of 2017, acid attacks, arson attacks against mosques and vehicle ramming have statistically risen against Muslims, predominately in England and Scotland.
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".
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.
The Dorian Gray syndrome arises from the concurring and overlapping clinical concepts of the narcissistic personality, dysmorphophobia, and paraphilia. Psychodynamically, the man afflicted with DGS presents an interplay among his narcissistic tendencies ("timeless beauty"), his arrested development (inability to psychologically mature), and his use of "medical lifestyle" products and services — hair restoration, drugs (for impotence, weight-loss, and mood modification), laser dermatology, and plastic surgery — in order to remain young.
Although the DGS patient displays diagnostic features of said mental disorders, the syndrome describes a common, underlying psychodynamics of mental illness, which is characterized by narcissistic defences against time-dependent maturation, expressed by actively seeking the timeless beauty of youth. The article "Das Dorian Gray syndrom" (2005) reported that approximately 3.0 per cent of the population of Germany present features of the Dorian Gray syndrome.
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)
Obesity in Mexico is a relatively recent phenomenon, having been widespread since the 1980s with the introduction of processed food into much of the Mexican food market. Prior to that, dietary issues were limited to under and malnutrition, which is still a problem in various parts of the country. Following trends already ongoing in other parts of the world, Mexicans have been foregoing traditional whole grains and vegetables in favor of a diet with more animal products, more fat, and more sugar much of which is a consequence of processed food. It has seen dietary energy intake and rates of overweight and obese people rise with seven out of ten at least overweight and a third clinically obese.
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.
Until the late 20th century, dietary issues in Mexico were solely a question of undernutrition or malnutrition, generally because of poverty and distribution issues. For this reason, obesity was associated with wealth and health, the latter especially in children. Despite changes in the Mexican diet and food distribution, malnutrition still remains problematic in various parts of the country.
A brainstem stroke syndrome is a condition involving a stroke of the brainstem. Because of their location, they often involve impairment both of the cranial nuclei and of the long tracts.
A person may have vertigo, dizziness and severe imbalance without the hallmark of most strokes – weakness on one side of the body. The symptoms of vertigo, dizziness or imbalance usually occur together; dizziness alone is not a sign of stroke. Brainstem stroke can also cause diplopia, slurred speech and decreased level of consciousness. A more serious outcome is locked-in syndrome.
Obesity is defined as the excessive accumulation of fat and is predominately caused when there is an energy imbalance between calorie consumption and calorie expenditure. Childhood obesity is becoming an increasing concern worldwide and Australia alone, recognizes that 1 in 4 children are either overweight or obese.
For Australians aged between 4 and 17 years, obesity is a very concerning condition as once gained it is favourably harder to be liberated from. Short-term effects on children can mean a decrease in their psychological well-being (stigmatisation and poor self-esteem) as well as physical deteriorations such as sleep apnea, breathlessness and cardiovascular disease. With an increase risk of adult obesity being associated with childhood obesity there are numerous long-term effects that can ultimately hinder the life expectancy of individuals including the development of serious diseases.
In order to combat the worldwide epidemic of childhood obesity it is imperative that the issue is addressed in its early stages. The main preventative measures to be implemented include increasing physical exercise, dietary knowledge and decreasing sedentary behaviours.
Stunted growth, also known as stunting and nutritional stunting, is a reduced growth rate in human development. It is a primary manifestation of malnutrition (or more precisely undernutrition) and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother. The definition of stunting according to the World Health Organisation (WHO) is for the "height for age" value to be less than two standard deviations of the WHO Child Growth Standards median.
As of 2012 an estimated 162 million children under 5 years of age, or 25%, were stunted in 2012. More than 90% of the world's stunted children live in Africa and Asia, where respectively 36% and 56% of children are affected. Once established, stunting and its effects typically become permanent. Stunted children may never regain the height lost as a result of stunting, and most children will never gain the corresponding body weight. Living in an environment where many people defecate in the open due to lack of sanitation, is an important cause of stunted growth in children, for example in India.
Occupational heat stress is the net load to which a worker is exposed from the combined contributions of metabolic heat, environmental factors, and clothing worn which results in an increase in heat storage in the body. Heat stress can result in heat-related illnesses, such as heat stroke, hyperthermia, heat exhaustion, heat cramps or heat rashes. Although heat exhaustion is less severe, hyperthermia is a medical emergency and requires emergency treatment, which if not provided can even lead to death.
Heat stress causes illness but also may account for an increase in workplace accidents, and a decrease in worker productivity. Worker injuries attributable to heat include those caused by: sweaty palms, fogged-up safety glasses, and dizziness. Burns may also occur as a result of accidental contact with hot surfaces or steam. In United States, occupational heat stress in becoming more significant as the average temperatures increase but remains overlooked. There are few studies and regulations regarding heat exposure of workers.
Diseases of poverty is a term sometimes used to collectively describe diseases, disabilities, and health conditions that are more prevalent among the poor than among wealthier people. In many cases poverty is considered the leading risk factor or determinant for such diseases, and in some cases the diseases themselves are identified as barriers to economic development that would end poverty. Diseases of poverty are often co-morbid and ubiquitous with malnutrition.
These diseases triggered in part by poverty are in contrast to so-called "diseases of affluence", which are diseases thought to be a result of increasing wealth in a society.
Antisocial personality disorder is defined by a pervasive and persistent disregard for morals, social norms, and the rights and feelings of others. Individuals with this personality disorder will typically have no compunction in exploiting others in harmful ways for their own gain or pleasure and frequently manipulate and deceive other people, achieving this through wit and a facade of superficial charm or through intimidation and violence. They may display , think lowly and negatively of others, and lack remorse for their harmful actions and have a callous attitude to those they have harmed. Irresponsibility is a core characteristic of this disorder: they can have significant difficulties in maintaining stable employment as well as fulfilling their social and financial obligations, and people with this disorder often lead exploitative, unlawful, or parasitic lifestyles.
Those with antisocial personality disorder are often impulsive and reckless, failing to consider or disregarding the consequences of their actions. They may repeatedly disregard and jeopardize their own safety and the safety of others and place themselves and others in danger. They are often aggressive and hostile and display a disregulated temper and can lash out violently with provocation or frustration. Individuals are prone to substance abuse and addiction, and the abuse of various psychoactive substances is common in this population. These behaviors lead such individuals into frequent conflict with the law, and many people with ASPD have extensive histories of antisocial behavior and criminal infractions stemming back before adulthood.
Serious problems with interpersonal relationships are often seen in those with the disorder. Attachments and emotional bonds are weak, and interpersonal relationships often revolve around the manipulation, exploitation, and abuse of others. While they generally have no problems in establishing relationships, they may have difficulties in sustaining and maintaining them. Relationships with family members and relatives are often strained due to their behavior and the frequent problems that these individuals may get into.
Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder thought to occur as a result of repetitive, prolonged trauma involving harm or abandonment by a caregiver or other interpersonal relationships with an uneven power dynamic. C-PTSD is associated with sexual, emotional or physical abuse or neglect in childhood, intimate partner violence, victims of kidnapping and hostage situations, indentured servants, victims of slavery, sweatshop workers, prisoners of war, victims of bullying, concentration camp survivors, and defectors of cults or cult-like organizations. Situations involving captivity/entrapment (a situation lacking a viable escape route for the victim or a perception of such) can lead to C-PTSD-like symptoms, which include prolonged feelings of terror, worthlessness, helplessness, and deformation of one's identity and sense of self.
Some researchers argue that C-PTSD is distinct from, but similar to PTSD, somatization disorder, dissociative identity disorder, and borderline personality disorder, with the main distinction being that it distorts a person's core identity, especially when prolonged trauma occurs during childhood development . It was first described in 1992 by Judith Herman in her book "Trauma & Recovery" and an accompanying article. Though peer-reviewed journals have published papers on C-PTSD, the category is not yet adopted by either the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders", 5th Edition (DSM-5), or in the World Health Organization's (WHO) "International Statistical Classification of Diseases and Related Health Problems", 10th Edition (ICD-10). However, it is proposed for the ICD-11, to be finalized in 2018.
The diagnosis of PTSD was originally developed for adults who had suffered from a single event trauma, such as rape, or a traumatic experience during a war. However, the situation for many children is quite different. Children can suffer chronic trauma such as maltreatment, family violence, and a disruption in attachment to their primary caregiver. In many cases, it is the child's caregiver who caused the trauma. The diagnosis of PTSD does not take into account how the developmental stages of children may affect their symptoms and how trauma can affect a child’s development.
The term developmental trauma disorder (DTD) has also been suggested. This developmental form of trauma places children at risk for developing psychiatric and medical disorders. Bessel van der Kolk explains DTD as numerous encounters with interpersonal trauma such as physical assault, sexual assault, violence or death. It can also be characterized by subjective events like betrayal, defeat or shame.
Repeated traumatization during childhood leads to symptoms that differ from those described for PTSD. Cook and others describe symptoms and behavioural characteristics in seven domains:
- "Attachment" – "problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to others' emotional states"
- "Biology" – "sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems"
- "Affect or emotional regulation" – "poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes"
- "Dissociation" – "amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events"
- "Behavioural control" – "problems with impulse control, aggression, pathological self-soothing, and sleep problems"
- "Cognition" – "difficulty regulating attention, problems with a variety of 'executive functions' such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with 'cause-effect' thinking, and language developmental problems such as a gap between receptive and expressive communication abilities."
- "Self-concept" – "fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self".
Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may include depression, infertility, social isolation, and poverty
Risk factors include obstructed labor, poor access to medical care, malnutrition, and teenage pregnancy. The underlying mechanism is poor blood flow to the affected area for a prolonged period of time. Diagnosis is generally based on symptoms and may be supported by use of methylene blue.
Obstetric fistulas are almost entirely preventable with appropriate use of cesarean section. Treatment is typically by surgery. If treated early the use of a urinary catheter may help with healing. Counselling may also be useful. An estimated 2 million women in sub-Saharan Africa, Asia, the Arab region, and Latin America have the condition with about 75,000 new cases developing a year. It occurs very rarely in the developed world. It is considered a disease of poverty.
While antisocial personality disorder is a mental disorder diagnosed in adulthood, it has its precedent in childhood. The DSM-5's criteria for ASPD require that the individual have conduct problems evident by the age of 15. Persistent antisocial behavior as well as a lack of regard for others in childhood and adolescence is known as conduct disorder and is the precursor of ASPD. About 25-40% of youths with conduct disorder will be diagnosed with ASPD in adulthood.
Conduct disorder (CD) is a disorder diagnosed in childhood that parallels the characteristics found in ASPD and is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated. Children with the disorder often display impulsive and aggressive behavior, may be callous and deceitful, and may repeatedly engage in petty crime such as stealing or vandalism or get into fights with other children and adults. This behavior is typically persistent and may be difficult to deter with threat or punishment. Attention deficit hyperactivity disorder (ADHD) is common in this population, and children with the disorder may also engage in substance abuse." CD is differentiated from oppositional defiant disorder (ODD) in that children with ODD do not commit aggressive or antisocial acts against other people, animals, and property, though many children diagnosed with ODD are subsequently rediagnosed with CD.
Two developmental courses for CD have been identified based on the age at which the symptoms become present. The first is known as the "childhood-onset type" and occurs when conduct disorder symptoms are present before the age of 10 years. This course is often linked to a more persistent life course and more pervasive behaviors, and children in this group express greater levels of ADHD symptoms, neuropsychological deficits, more academic problems, increased family dysfunction, and higher likelihood of aggression and violence. The second is known as the "adolescent-onset type" and occurs when conduct disorder develops after the age of 10 years. Compared to the childhood-onset type, less impairment in various cognitive and emotional functions are present, and the adolescent-onset variety may remit by adulthood. In addition to this differentiation, the DSM-5 provides a specifier for a callous and unemotional interpersonal style, which reflects characteristics seen in psychopathy and are believed to be a childhood precursor to this disorder. Compared to the adolescent-onset subtype, the childhood onset subtype, especially if callous and unemotional traits are present, tends to have a worse treatment outcome.
Some common psychological consequences that people with a fistula face are the despair from losing their child, the humiliation from their smell, and inability to perform their family roles. Additionally, a fear of developing another fistula in future pregnancies exists.
Combined drug intoxication (CDI), also known as multiple drug intake (MDI) or lethal polydrug/polypharmacy intoxication, is an unnatural cause of human death. CDI is often confused with drug overdose, but it is a completely different phenomenon. It is distinct in that it is due to the simultaneous use of multiple drugs, whether the drugs are prescription, over-the-counter, recreational, or some other combination. Alcohol can exacerbate the symptoms and may directly contribute to increased severity of symptoms. The reasons for toxicity vary depending on the mixture of drugs. Usually, most victims die after using two or more drugs in combination that suppress breathing, and the low blood oxygen level causes brain death.
The CDI/MDI phenomenon seems to be becoming more common in recent years. In December 2007, according to Dr. John Mendelson, a pharmacologist at the California Pacific Medical Center Research Institute, deaths by combined drug intoxication were relatively "rare" ("one in several million"), though they appeared then to be "on the rise". In July 2008, the Associated Press and CNN reported on a medical study showing that over two decades, from 1983 to 2004, such deaths have soared. It has also become a prevalent risk for older patients.
XXYY syndrome is a sex chromosome anomaly in which males have an extra X and Y chromosome. Human cells usually contain two sex chromosomes, one from the mother and one from the father. Usually, females have two X chromosomes (XX) and males have one X and one Y chromosome (XY). The appearance of at least one Y chromosome with a properly functioning SRY gene makes a male. Therefore, humans with XXYY are genotypically male. Males with XXYY syndrome have 48 chromosomes instead of the typical 46. This is why XXYY syndrome is sometimes written as 48,XXYY syndrome or 48,XXYY. It is estimated that XXYY affects one in every 18,000–40,000 male births.
Growth stunting is identified by comparing measurements of children's heights to the World Health Organization 2006 growth reference population: children who fall below the fifth percentile of the reference population in height for age are defined as stunted, regardless of the reason. The lower than fifth percentile corresponds to less than two standard deviations of the WHO Child Growth Standards median.
As an indicator of nutritional status, comparisons of children's measurements with growth reference curves may be used differently for populations of children than for individual children. The fact that an individual child falls below the fifth percentile for height for age on a growth reference curve may reflect normal variation in growth within a population: the individual child may be short simply because both parents carried genes for shortness and not because of inadequate nutrition. However, if substantially more than 5% of an identified child population have height for age that is less than the fifth percentile on the reference curve, then the population is said to have a higher-than-expected prevalence of stunting, and malnutrition is generally the first cause considered.