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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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The Number of the Beast (, "Arithmos tou Thēriou") is a term in the Book of Revelation, of the New Testament, that is associated with the Beast of Revelation in chapter 13. In most manuscripts of the New Testament and in English translations of the Bible, the number of the beast is 666. Papyrus 115 (which is the oldest preserved manuscript of the "Revelation" ), as well as other ancient sources like "Codex Ephraemi Rescriptus", give the Number of the Beast as 616 (), not 666; critical editions of the Greek text, such as the Novum Testamentum Graece, note 616 as a variant.
Poena cullei (from Latin 'penalty of the sack') under Roman law was a type of death penalty imposed on a subject who had been found guilty of parricide. The punishment consisted of being sewn up in a leather sack, sometimes with an assortment of live animals, and then being thrown into water. The punishment may have varied widely in its frequency and precise form during the Roman period. For example, the earliest fully documented case is from ca. 100 BCE, although scholars think the punishment may have developed about a century earlier (earlier than that, murderers, including parricides, would be handed over to the aggrieved family for punishment, rather than punishment being enacted by Roman state officials). Inclusion of live animals in the sack is only documented from Early Imperial times, and at the beginning, only snakes are mentioned. At the time of Emperor Hadrian (2nd century CE), the most well known form of the punishment was documented, where a cock, a dog, a monkey and a viper were inserted in the sack. However, at the time of Hadrian "poena cullei" was made into an optional form of punishment for parricides (the alternate being thrown to the beasts in the arena). During the 3rd century CE up to the accession of Emperor Constantine, "poena cullei" fell out of use; Constantine revived it, now with only serpents to be added in the sack. Well over 200 years later, Emperor Justinian reinstituted the punishment with the four animals, and "poena cullei" remained the statutory penalty for parricides within Byzantine law for the next 400 years, when it was replaced with the punishment for parricides to be burnt alive instead.
"Poena cullei" gained a revival of sorts in late medieval and early modern Germany, with late cases of being drowned in a sack along with live animals being documented from Saxony in the first half of the 18th century.
The phenomenon known as Beatlemania originated in the United Kingdom, birthplace of the Beatles, when the band first realised enormous popularity there in 1963. Returning in 1962 from a highly formative two-year residency in Germany, the Beatles achieved a commercial breakthrough with their second UK single release, "Please Please Me" early in 1963, but gained "Superstar" status with the release of "She Loves You" later that year. There followed an almost non-stop series of concerts and tours, attended with feverish enthusiasm across the UK, for the whole of the following year. The Beatles' popularity in the UK came to exceed even that of the notable American artists Tommy Roe, Chris Montez and Roy Orbison, whose UK chart success at the time did not keep them from being overshadowed by the Beatles during their 1963 nationwide tours with the lower-billed band — an achievement previously unknown for a UK act.
With intense media interest in the Beatles during 1963, the year was also taken up with TV shows, press interviews and a weekly radio show. Despite these demands the band found time for many sessions in the recording studio, releasing two albums and four singles during the year. 1963 was also the year when Lennon's son Julian was born.
By the end of 1963, Beatlemania would begin to spread internationally. The single "I Want to Hold Your Hand" entered the US charts on 18 January 1964, selling one-and-a-half million copies in under three weeks, and the following month the Beatles made their first visit to America. The great interest in the Beatles brought about a major change in US attitudes to popular music and marked the start of the phenomenon known as the British Invasion.
The distinction between Hua () and Yi (), also known as Sino–barbarian dichotomy, is an ancient Chinese concept that differentiated a culturally defined "China" (called Hua, Huaxia 華夏, or Xia 夏) from cultural or ethnic outsiders (Yi "barbarians"). Although Yi is often translated as "barbarian", other translations of this term in English include "foreigners",
"ordinary others" "wild tribes", and "uncivilized tribes."
The Hua–Yi distinction asserted Chinese superiority, but implied that outsiders could become "Hua" by adopting Chinese values and customs.
Juche (; ; ), usually left untranslated, or translated as "self-reliance", is the official state ideology of North Korea, described by the government as Kim Il-sung's "original, brilliant and revolutionary contribution to national and international thought". It postulates that "man is the master of his destiny", that the North Korean masses are to act as the "masters of the revolution and construction", and that by becoming self-reliant and strong a nation can achieve true socialism.
Kim Il-sung (1912–1994) developed the ideology, originally viewed as a variant of Marxism–Leninism until it became distinctly "Korean" in character, whilst incorporating the historical materialist ideas of Marxism–Leninism and strongly emphasising the individual, the nation state and its sovereignty. Consequently, "Juche" was adopted into a set of principles that the North Korean government has used to justify its policy decisions from the 1950s onwards. Such principles include moving the nation towards claimed ""jaju"" (independence), through the construction of ""jarip"" (national economy) and an emphasis upon ""jawi"" (self-defence), in order to establish socialism.
The Practice is firmly rooted in the ideals of sustainability through agricultural independence and a lack of dependency.
The "Juche" ideology has been criticized by many scholars and observers as a mechanism for sustaining the totalitarian rule of the North Korean regime, and justifying the country's heavy-handed isolationism and oppression of the North Korean people. It has also been described as a form of Korean ethnic nationalism, but one which promotes the Kim family as the saviours of the "Korean Race" and acts as a foundation of the subsequent personality cult surrounding them.
Anti-Chinese sentiment in the United States has existed since the late 18th century. Its origins have been traced to the American merchants, missionaries, and diplomats who sent home from China "relentlessly negative" reports of the people they encountered there. These attitudes were transmitted to Americans who never left North America, triggering talk of the Yellow Peril, and continued through the Cold War during McCarthyism. Modern anti-Chinese sentiment is the result of China's rise as a major world power. Anti-Chinese sentiment or sinophobia is a broad opposition or hostility to the people, policies, culture, or politics of China.
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.
, sometimes referred to as , is a neurological syndrome caused by severe mercury poisoning. Symptoms include ataxia, numbness in the hands and feet, general muscle weakness, loss of peripheral vision, and damage to hearing and speech. In extreme cases, insanity, paralysis, coma, and death follow within weeks of the onset of symptoms. A congenital form of the disease can also affect fetuses in the womb.
Minamata disease was first discovered in Minamata city in Kumamoto prefecture, Japan, in 1956. It was caused by the release of methylmercury in the industrial wastewater from the Chisso Corporation's chemical factory, which continued from 1932 to 1968. This highly toxic chemical bioaccumulated in shellfish and fish in Minamata Bay and the Shiranui Sea, which, when eaten by the local populace, resulted in mercury poisoning. While cat, dog, pig, and human deaths continued for 36 years, the government and company did little to prevent the pollution. The animal effects were severe enough in cats that they came to be named as having "dancing cat fever".
As of March 2001, 2,265 victims had been officially recognised as having Minamata disease (1,784 of whom had died) and over 10,000 had received financial compensation from Chisso. By 2004, Chisso Corporation had paid $86 million in compensation, and in the same year was ordered to clean up its contamination. On March 29, 2010, a settlement was reached to compensate as-yet uncertified victims.
A second outbreak of Minamata disease occurred in Niigata Prefecture in 1965. The original Minamata disease and Niigata Minamata disease are considered two of the four big pollution diseases of Japan.
Anti-Catholicism (also referred to as Catholicophobia or Catholico- phobia) is hostility towards Catholics or opposition to the Catholic Church, its clergy and its adherents.
After the Protestant Reformation and until at least the late 20th Century, the majority of Protestant states (especially the United Kingdom and the United States) made anti-Catholicism and opposition to the Pope and Catholic rituals major political themes, with anti-Catholic sentiment at times leading to violence and religious discrimination against Catholic individuals (often derogatorily referred to in Anglophone Protestant countries as "papists" or "Romanists"). Historically, Catholics in Protestant countries were frequently suspected of conspiring against the state in furtherance of papal interests or to establish a political hegemony under the "Papacy", with Protestants sometimes questioning Catholic individuals' loyalty to the state and suspecting Catholics of ultimately maintaining loyalty to the Vatican rather than maintaining loyalty to their domiciled countries. In majority Protestant countries with large scale immigration, such as the United States and Australia, suspicion or discrimination of Catholic immigrants often overlapped or conflated with nativism, xenophobia, and ethnocentric or racist sentiments (i.e. anti-Italianism, anti-Irish sentiment, Hispanophobia, anti-Quebec sentiment, anti-Polish sentiment).
In the Early modern period, in the face of rising secular powers in Europe, the Catholic Church struggled to maintain its traditional religious and political role in primarily Catholic nations. As a result of these struggles, there arose in some majority Catholic countries a hostile attitude towards the considerable political, social, spiritual and religious power of the Pope and the clergy in the form of anti-clericalism.
Coffin birth, also known as postmortem fetal extrusion, is the expulsion of a nonviable fetus through the vaginal opening of the decomposing body of a deceased pregnant woman as a result of the increasing pressure of intra-abdominal gases. This kind of postmortem delivery occurs very rarely during the decomposition of a body. The practice of chemical preservation, whereby chemical preservatives and disinfectant solutions are pumped into a body to replace natural body fluids (and the bacteria that reside therein), have made the occurrence of "coffin birth" so rare that the topic is rarely mentioned in international medical discourse.
Typically during the decomposition of a human body, naturally occurring bacteria in the organs of the abdominal cavity (such as the stomach and intestines) generate gases as by-products of metabolism, which causes the body to swell. In some cases, the confined pressure of the gases can squeeze the uterus (the womb), even forcing it downward, and it may and be forced out of the body through the vaginal opening (a process called "prolapse"). If a fetus is contained within the uterus, it could therefore be expelled from the mother's body through the vaginal opening when the uterus turns inside-out, in a process that, to outward appearances, mimics childbirth. The main differences lie in the state of the mother and fetus and the mechanism of delivery: in the event of natural, live childbirth, the mother's contractions encourage the infant to emerge from the womb; in a case of coffin birth, built-up gas pressure within the putrefied body of a pregnant woman pushes the dead fetus from the body of the mother.
Cases have been recorded by medical authorities since the 16th century, though some archaeological cases provide evidence for its occurrence in many periods of human history. While cases of postmortem fetal expulsion have always been rare, the phenomenon has been recorded under disparate circumstances and is occasionally seen in a modern forensic context when the body of a pregnant woman lies undisturbed and undiscovered for some time following death. There are also cases whereby a fetus may become separated from the body of the pregnant woman about the time of death or during decomposition, though because those cases are not consistent with the processes described here, they are not considered true cases of postmortem fetal extrusion.
Interpreting the identity and the number of the beast usually falls into three categories:
1. Using gematria to calculate the number of a world leader’s name, in order to match it with the number of the beast.
2. Associating the number of the beast as the duration of the beast’s reign
3. Corresponding symbolism for the Antichrist and antichristian power.
The symptoms of this disease include:
- Severe pruritus
- Pain
- Inflammation and swelling
- Lesions and ulcerations, with black dots in the center
Left untreated, secondary infections, such as bacteremia, tetanus, and gangrene, can occur.
In all cases, tungiasis by itself only caused morbidity, though secondary infection may lead to mortality. The life cycle section presents the Fortaleza stages from the flea’s developmental perspective. It should be noted that the discussion is specific to symptoms of human infection. The clinical presentation in humans follows the Fortaleza Classification as the stage of infection will determine the symptoms present. The following discussion will give an overview of the symptoms beginning in stage 2 because patients are not likely to present themselves at the early stages of infection, mostly because the flea’s burrowing is usually not felt. This may be due to a keratolytic enzyme secreted during stage 1.
The patient with a single flea may present as early as stage 2 when, though the erythema is barely perceptible, a boring pain and the curious sensation of pleasant itching occur. This inflammatory reaction is the initial immunological response to the infestation. Heavily infested patients may not notice a stage 2 infection due to the other fleas’ causing irritation as well. Feces may be seen, but this is more common in the 3rd stage.
Around the third day after penetration, erythema and skin tenderness are felt, accompanied by pruritus (severe itching) and a black furuncular nodule surrounded by a white halo of stretched skin caused by the expansion of the flea. Fecal coils may protrude from the center of the nodule where the flea’s anus is facing upward. They should be washed off quickly as the feces may remain in the skin unless removed. During this 3a substage, pain can be severe, especially at night or, if the nodule is on the foot, while walking. Eggs will also begin to be released and a watery secretion can be observed. The radical metamorphosis during the 3rd to 6th day after penetration, or neosomy, precedes the formation of a small caldera-like rim rampart as a result of the increased thickness of the flea’s chitin exoskeleton. During the caldera formation, the nodule shrinks a bit and it looks as if it is beginning to dry out; this takes 2 weeks and comprises substage 3b.
At the third week after penetration and substage 4a, the eggs’ release will have stopped and the lesion will become smaller and more wrinkled. As the flea is near death, fecal and water secretion will stop altogether. Pain, tenderness, and skin inflammation will still be present. Around the 25th day after penetration, the lesion looks like a black crust and the flea’s carcass is removed by host repair mechanisms and the skin begins to heal. With the flea gone, inflammation may still persist for a while.
Although patients would not present within the 5th stage of tungiasis as the flea would be dead and no longer in the body, this stage is characterized by the reorganization of the skin (1–4 weeks) and a circular residue of 5–10 mm in diameter around the site in penetration. An intraepithelial abscess, which developed due to the presence of the flea, will drain and later heal. Although these disease residues would persist for a few months, tungiasis is no longer present.
In severe cases, ulcers are common, as well as complete tissue and nail deformation. A patient may be unable to walk due to severe pain if too many of the lesions are present in the feet. Suppuration (pus formation), auto-amputation of digits (via ainhum), and chronic lymphedema may also be seen.
If the patient is not vaccinated, tetanus is often a complication due to secondary infection. Gangrene is another common complication of severe infestation and superinfection. Staphylococcus aureus and Wolbachia endobacteria can be transmitted by the chigoe flea, as well as nearly 150 other different pathogens. For these reasons, the chigoe flea should be removed as soon as possible.
The cause of postmortem fetal extrusion is not completely understood, as the event is neither predictable nor replicable under experimental conditions. Evidence has accumulated opportunistically and direct observation is serendipitous. While it is possible that more than one cause can produce the same result, there is an accepted hypothesis, based on established research in the fields of biochemistry and forensic taphonomy, and further supported by observational research, that accounts for the taphonomic mechanisms that would result in the most often encountered cases of postmortem extrusion of a non-viable fetus.
Typically, as a dead body decomposes, body tissues become depleted of oxygen and the body begins to putrefy; anaerobic bacteria in the gastrointestinal tract proliferate and as a result of increased metabolic activity, release gases such as carbon dioxide, methane, and hydrogen sulfide. These bacteria secrete exoenzymes to break down body cells and proteins for ingestion which thus weakens organ tissues. Increasing pressure forces the diffusion of excessive gases into the weakened tissues where they enter the circulatory system and spread to other parts of the body, causing both torso and limbs to become bloated. These decompositional processes weaken the structural integrity of organs by separating necrotizing tissue layers. Bloating usually begins from two to five days after death, depending on external temperature, humidity, and other environmental conditions. As the volume of gas increases, the pressure begins to force various body fluids to exude from all natural orifices. It is at this point during the decomposition of a pregnant body that amniotic membranes become stretched and separated, and intraabdominal gas pressure may force the and prolapse of the uterus, which would result in the expulsion of the fetus through the vaginal canal. It has been observed that the bodies of multiparous women are more likely to spontaneously expel the fetus during decomposition than those who died during their first pregnancy, because of the more elastic nature of the cervix.
Symptoms of an ingrown nail include pain along the margins of the nail (caused by hypergranulation that occurs around the aforementioned margins), worsening of pain when wearing tight footwear, and sensitivity to pressure of any kind, even the weight of bedsheets. Bumping of an affected toe can produce sharp and even excruciating pain as the tissue is punctured further by the nail. By the very nature of the condition, ingrown nails become easily infected unless special care is taken early to treat the condition by keeping the area clean. Signs of infection include redness and swelling of the area around the nail, drainage of pus and watery discharge tinged with blood. The main symptom is swelling at the base of the nail on the ingrowing side (though it may be both sides).
Onychocryptosis should not be confused with a similar nail disorder, convex nail, nor with other painful conditions such as involuted nails, nor with the presence of small corns, callus or debris down the nail sulci (grooves on either side).
Tungiasis (also known as "nigua", "pio" and "bicho de pie", or "pique" or sand flea disease) is an inflammatory skin disease caused by infection with the female ectoparasitic "Tunga penetrans" (also known as chigoe flea, jigger, nigua or sand flea), found in the tropical parts of Africa, the Caribbean, Central and South America, and India. "Tunga penetrans" is the smallest known flea, measuring 1 mm across. It is also known in Latin America as the "nigua" and "bicho de pie" (Spanish) or "bicho de pé" (Portuguese), literally ""foot bug"". "Tunga penetrans" is a member of the genus "Tunga", which comprises 13 species.
Tungiasis causes skin inflammation, severe pain, itching, and a lesion at the site of infection that is characterized by a black dot at the center of a swollen red lesion, surrounded by what looks like a white halo. Desquamation of the skin is always seen, especially after the flea expands during hypertrophy.
As of 2009, tungiasis is present worldwide in 88 countries with varying degrees of incidence. This disease is of special public health concern in highly endemic areas such as Nigeria, Trinidad and Tobago, and Brazil, where its prevalence, especially in poor communities, has been known to approach 50%.
The chigoe flea is properly classified as a member of the order Siphonaptera as it is a flea. Although commonly referred to as chiggers, true chiggers are mites which are minute arachnids. Mites penetrate the skin and feed on skin cells that are broken down by an enzyme they secrete from their mouthparts, but they do not lay eggs in the host as "T. penetrans" does. Moreover, in mites, the adult and the larval forms both feed on other animals. This is not the case with "T. penetrans", as only the adults feed on mammals and it is only the female that stays attached to the host.
"Tunga penetrans" is also known by the following names: chigoe flea, sand flea, nigua, chigger flea, jigger flea, bicho de pé, pico, sikka, kuti, and piqui, among many others.
Factors that predispose to face presentation are prematurity, macrosomia, anencephaly and other malformations, cephalopelvic disproportion, and polyhydramnios. In an uncomplicated face presentation duration of labor is not altered. Perinatal losses with face presentation occur with traumatic version and extraction and midforceps procedures Duff indicates that the prevalence of face presentations is about 1/500–600., while Benedetti et al. found it to be 1/1,250 term deliveries.
Face presentations are classified according to the position of the chin (mentum):
- Left Mento-Anterior (LMA), Left Mento-Posterior (LMP), Left Mento-Transverse (LMT);
- Right Mento-Anterior (RMA), Right Mento-Posterior (RMP), Right Mento-Transverse (RMT);
The main contributor to onychocryptosis is footwear, particularly ill-fitting shoes with inadequate toe-box room and tight stockings that apply pressure to the top or side of the foot. Other factors may include the damp atmosphere of enclosed shoes, which soften the nail-plate and cause swelling on the epidermal keratin (eventually increasing the convex arch permanently), genetics, trauma and disease. Improper cutting of the nail may cause the nail to cut into the side-fold skin from growth and impact, whether or not the nail is truly "ingrown". The nail bends inwards or upwards depending on the angle of its cut. If the cutting tool, such as scissors, is at an attitude in which the lower blade is closer to the toe than the upper blade, the toenail will tend to grow upwards from its base, and vice versa. The process is visible along the nail as it grows, appearing as a warp advancing to the end of the nail. The upper corners turn more easily than the center of the nail tip. Holding the tool at the same angle for all nails may induce these conditions; as the nail turns closer to the skin, it becomes harder to fit the lower blade in the right attitude under the nail. When cutting a nail, it is not just the correct angle that is important, but also how short it is cut. A shorter cut will bend the nail more, unless the cut is even on both top and bottom of the nail.
Causes may include:
- Shoes causing a bunching of the toes in the developmental stages of the foot (frequently in people under 21), which can cause the nail to curl and dig into the skin. This is particularly the case in ill-fitting shoes that are too narrow or too short, but any toed shoes may cause an ingrown nail.
- Poor nail care, including cutting the nail too short, rounded off at the tip or peeled off at the edges instead of being cut straight across.
- Broken toenails.
- Trauma to the nail plate or toe, which can occur by dropping objects on or stubbing the toenail, or by the nail protruding through the shoe (as during sports or other vigorous activity), can cause the flesh to become injured and the nail to grow irregularly and press into the flesh.
- Predisposition, such as abnormally shaped nail beds, nail deformities caused by diseases or a genetic susceptibility, increases the chance of an ingrown nail, but the ingrowth cannot occur without pressure from a shoe.
- A bacterial infection, treatable with antibiotics.
One study compared patients with ingrown toenails to healthy controls and found no difference in the shape of toenails between those of patients and of the control group. The study suggested that treatment should not be based on the correction of a non-existent nail deformity. Ingrown toenails are caused by weight-bearing (activities such as walking, running, etc.) in patients that have too much soft skin tissue on the sides of their nail. Weight bearing causes this excessive amount of skin to bulge up along the sides of the nail. The pressure on the skin around the nail results in the tissue being damaged, resulting in swelling, redness and infection. Many treatments are directed at the nail itself and often include partial or full removal of the healthy nail. However, failure to treat the cutaneous condition can result in a return of the ingrowth and a deformity or mutilation of the nail.
While some consider the brow presentation as an intermediate stage towards the face presentation, others disagree. Thus Bhal et al. indicated that both conditions are about equally common (1/994 face and 1/755 brow positions), and that prematurity was more common with face while postmaturity was more common with brow positions.
Following the Beatles' Hamburg period, the band had returned from Germany to the UK and were . Their new manager, Brian Epstein, had made efforts to smarten the band up, encouraging them to wear suits instead of jeans and leather jackets, and to refrain from swearing, smoking, drinking or eating onstage, or stopping and starting songs when they felt like it: Epstein had seen the band's potential and was attempting to transform the Beatles into a serious commercial proposition. He had started to approach record companies, but this had not led to any interest in the band.
When diagnosing allochiria, it is important to consider the sensory and the motor aspects of the problem. In absence of knowledge there are a number of ways in which the various symptoms may be overlooked or misinterpreted and as the condition goes frequently unrecognized. One rare example in medicine that causes a wrong diagnosis of allochiria is due to the unawareness of a few simple facts than to any failure in judgment. It is evident that the details of the sensory symptoms get overlooked when testing a patient's localizing capacity. The observer neglects to inquire expressly as to the side to which the sensation is referred. This is evident when patients with allochiria show no fault in sensorial perception and localization. However, even if the patient mentions the wrong side, it is sometimes being just regarded as a slip of the tongue and matter may not be pursued any further. Looking at the motor aspect of allochiria, the symptoms again are described in a misleading way because the symptoms are less obvious. Unless motor manifestations are carefully analyzed, they may be interpreted as clumsiness or weakness. Moreover, when patients complained of weakness and awkwardness of right side—examinations apparently confirmed that the truth of this statement and defect was marked as acts consciously performed and was present only in relation to such acts. If a patient says that he cannot tell on which side the certain stimulus is applied—existence of allochiria is confirmed, provided that sensibility is intact.
Common relevant features of acrocephalosyndactyly are a high-arched palate, pseudomandibular prognathism (appearing as mandibular prognathism), a narrow palate, and crowding of the teeth.
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.
Allochiria (from the Greek meaning "other hand") is a neurological disorder in which the patient responds to stimuli presented to one side of their body as if the stimuli had been presented at the opposite side. It is associated with spatial s, usually symmetrical, of stimuli from one side of the body (or of the space) to the opposite one. Thus a touch to the left side of the body will be reported as a touch to the right side, which is also known as somatosensory allochiria. If the auditory or visual senses are affected, sounds (a person's voice for instance) will be reported as being heard on the opposite side to that on which they occur and objects presented visually will be reported as having been presented on the opposite side. Often patients may express allochiria in their drawing while copying an image. Allochiria often co-occurs with unilateral neglect and, like hemispatial neglect, the disorder arises commonly from damage to the right parietal lobe.
Allochiria is often confused with alloesthesia, also known as false allochiria. True allochiria is a symptom of dyschiria and unilateral neglect. Dyschiria is a disorder in the localization of sensation due to various degrees of dissociation and cause impairment in one side causing the inability to tell which side of the body was touched.
A breech birth occurs when a baby is born bottom first instead of head first. Around 3-5% of pregnant women at term (37–40 weeks pregnant) will have a breech baby.
Most babies in the breech position are born by a caesarean section because it is seen as safer than being born vaginally.
As most breech babies are delivered by caesarean section in developed countries, doctors and midwives may lose the skills required to safely assist women giving birth to a breech baby vaginally. Delivering all breech babies by caesarean section in developing countries may be very difficult to implement or even impossible as there are not always resources available to provide this service.
All acrocephalosyndactyly syndromes show some level of limb anomalies, so it can be hard to tell them apart. However, the typical hand deformities in patients with Apert Syndrome distinguish it from the other syndromes.
The hands in patients with Apert syndrome always show four common features:
1. a short thumb with radial deviation
2. complex syndactyly of the index, long and ring finger
3. symbrachyphalangism
4. simple syndactyly of the fourth webspace
The deformity of the space between the index finger and the thumb may be variable. Based on this first webspace, we can differentiate three different types of handdeformation:
- Type I: Also called a "spade hand". The most common and least severe type of deformation. The thumb shows radial deviation and clinodactyly, but is separated from the index finger. The index, long and ring finger are fused together in the distal interphalangeal joints and form a flat palm. During the embryonic stage, the fusion has no effect on the longitudinal growth of these fingers, so they have a normal length. In the fourth webspace, we always see a simple syndactyly, either complete or incomplete.
- Type II: Also called a "spoon" or "mitten" hand. This is a more serious anomaly since the thumb is fused to the index finger by simple complete or incomplete syndactyly. Only the distal phalanx of the thumb is not joined in the osseous union with the index finger and has a separate nail. Because the fusion of the digits is at the level of the distal interphalangeal joints, a concave palm is formed. Most of the time, we see complete syndactyly of the fourth webspace.
- Type III: Also called the "hoof" or "rosebud" hand. This is the most uncommon but also most severe form of hand deformity in Apert syndrome. There is a solid osseous or cartilaginous fusion of all digits with one long, conjoined nail. The thumb is turned inwards and it is often impossible to tell the fingers apart. Usually proper imaging of the hand is very difficult, due to overlap of bones, but physical examination alone is not enough to measure the severity of deformation