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When the Diagnosis Is Multiple Sclerosis: Help, Hope, and Insights from an Affected Physician - Original PDF
نویسندگان: خلاصه: THE NAME , “MULTIPLE SCLEROSIS ” I have a very hard time with the name of this illness—“multiple sclerosis.” It has such a horrific sound to it. Even after seven years, I rarely say the words multiple sclerosis aloud. I much prefer the more appealing sound of MS. In speaking to others with multiple sclerosis (MS), I have learned that I am not alone with this preference. At the time I was diagnosed, I was somewhat familiar with this illness, hav- ing intermittently cared for multiple sclerosis patients in the hospital. Most of the patients I had seen were diagnosed with MS in the 1970s or 1980s, a time when medication for relapse prevention was not yet available. Others, who were frequently in the hospital, had a variant of MS called “primary progressive multiple sclerosis,” which can lead to significant disability fairly quickly. As a physician, I thought their situations were so very sad, as many patients had developed poor functioning of their arms, legs, bladder, or speech. I rarely had the opportunity to see the MS patients who had very little disability, since they were seen in the outpatient setting. So when I finally had it con- firmed, that yes, these bizarre symptoms I had been having were in fact due to multiple sclerosis, I conjured up the worst possible images of what might happen to me. While many of you may not have had the opportunity to meet patients with more advanced stages of MS, I suspect that your reaction to the diagnosis of MS may have been quite similar to mine. Many people still carry an image of multiple sclerosis as an illness that picks an individual out of the prime of his or her life, and leaves that person wheelchair bound and severely disabled. Fortunately, for the majority of women and men who are newly diagnosed with relapsing–remitting MS in the new millennium, this is not an inevitable outcome. And yet, while we know that medications now exist to prevent relapses, this knowledge does not necessarily make the initial journey any 2 When the Diagnosis Is Multiple Sclerosis easier. We did not sign up for this club. We did not ask to play this game. The anger, the grief, and the uncertainty about the future can be overwhelming. Give yourself time. It will be possible to feel in control again.
Adaptive Optics for Vision Science Principles Practices Design and Applications - Original PDF
نویسندگان: خلاصه: The high transverse resolution of retinal imaging systems equipped with adaptive optics provides a unique opportunity to record these eye move- ments with very high accuracy. Putnam et al. showed that it is possible to record the retinal location of a fixation target on discrete trials with an error at least 5 times smaller than the diameter of the smallest foveal cones [63]. We used this capability to measure the standard deviation of fixation positions FIGURE 1.7 Images of the cone mosaics of 10 subjects with normal color vision, obtained with the combined methods of adaptive optics imaging and retinal densi- tometry. The images are false colored so that blue, green, and red are used to repre- sent the S, M, and L cones, respectively. (The true colors of these cones are yellow, purple, and bluish-purple). The mosaics illustrate the enormous variability in L/M cone ratio. The L/M cone ratios are (A) 0.37, (B) 1.11, (C) 1.14, (D) 1.24, (E) 1.77, (F) 1.88, (G) 2.32, (H) 2.36, (I) 2.46, (J) 3.67, (K) 3.90, and (L) 16.54. The proportion of S cones is relatively constant across eyes, ranging from 3.9 to 6.6% of the total population. Images were taken either 1° or 1.25° from the foveal center. For two of the 10 subjects, two different retinal locations are shown. Panels (D) and (E) show images from nasal and temporal retinas, respectively, for one subject; (J) and (K) show images from nasal and temporal retinas for another subject. Images (C), (J), and (K) are from Roorda and Williams [52]. All other images were made by Heidi Hofer. (See insert for a color representation of this figure.) (From Williams and Hofer [57]. Reprinted with permission from The MIT Press.) across discrete fixation trials, obtaining values that ranged from 2.1 to 6.3 arcmin, with an average of 3.4 arcmin, in agreement with previous studies [63, 64]. Interestingly, the mean fixation location on the retina was displaced from the location of highest foveal cone density by an average of about 10 arcmin (as shown in Fig. 1.8), indicating that cone density alone does not drive the location on the retina selected for fixation. This method may have interesting future applications in studies that require the submicron registra- tion of stimuli with respect to the retina or delivering light to retinal features as small as single cells. Whereas the method developed by our group can only record eye position on discrete trials, Scott Stevenson and Austin Roorda have shown that it is possible to extract continuous eye movement records from video-rate images obtained with an adaptive optics scanning laser ophthalmoscope (AOSLO) [66]. Eye movements cause local warping of the image within single video frames as well as translation between frames. The warping and translation information in the images can be used to recover a record of the eye move- ments that is probably as accurate as any method yet devised. This is illus- trated in Figure 1.9, which compares the eye movement record from the AOSLO with that from a Dual Purkinje Eye Tracker. The noise in the AOSLO trace is on the order of a few arc seconds compared to about a minute of arc for the Dual Purkinje Eye Tracker. Note also the greatly reduced overshoot following a saccade in the AOSLO trace. These overshoots are thought to be partly artifacts caused by lens wobble following the saccade and do not reflect the true position of the retinal image. The AOSLO is not susceptible to this artifact because it tracks the retinal position directly rather than relying on reflections from the anterior optics.
Killing Hope_ US Military and CIA Interventions Since World War II. Part 1-Zed Books Ltd (2003) - Original PDF
نویسندگان: خلاصه: Introduction A Brief History of the Cold War and Anti-communism Our fear that communism might someday take over most of the world blinds us to the fact that anti- communism already has. —Michael Parenti1 It was in the early days of the fighting in Vietnam that a Vietcong officer said to his American prisoner: "You were our heroes after the War. We read American books and saw American films, and a common phrase in those days was "to be as rich and as wise as an American". What happened?"2 An American might have been asked something similar by a Guatemalan, an Indonesian or a Cuban during the ten years previous, or by a Uruguayan, a Chilean or a Greek in the decade subsequent. The remarkable international goodwill and credibility enjoyed by the United States at the close of the Second World War was dissipated country-by-country, intervention-by-intervention. The opportunity to build the war- ravaged world anew, to lay the foundations for peace, prosperity and justice, collapsed under the awful weight of anti-communism. The weight had been accumulating for some time; indeed, since Day One of the Russian Revolution. By the summer of 1918 some 13,000 American troops could be found in the newly-born Union of Soviet Socialist Republics. Two years and thousands of casualties later, the American troops left, having failed in their mission to "strangle at its birth" the Bolshevik state, as Winston Churchill put it.3 The young Churchill was Great Britain's Minister for War and Air during this period. Increasingly, it was he who directed the invasion of the Soviet Union by the Allies (Great Britain, the US, France, Japan and several other nations) on the side of the counter-revolutionary "White Army". Years later, Churchill the historian was to record his views of this singular affair for posterity: Were they [the Allies] at war with Soviet Russia? Certainly not; but they shot Soviet Russians at sight. They stood as invaders on Russian soil. They armed the enemies of the Soviet Government. They blockaded its ports, and sunk its battleships. They earnestly desired and schemed its downfall. But war—shocking! Interference—shame! It was, they repeated, a matter of indifference to them how Russians settled their own internal affairs. They were impartial—Bang!4 What was there about this Bolshevik Revolution that so alarmed the most powerful nations in the world? What drove them to invade a land whose soldiers had recently fought alongside them for over three years and suffered more casualties than any other country on either side of the World War? The Bolsheviks had had the audacity to make a separate peace with Germany in order to take leave of a war they regarded as imperialist and not in any way their war, and to try and rebuild a terribly weary and devastated Russia. But the Bolsheviks had displayed the far greater audacity of overthrowing a capitalist- feudal system and proclaiming the first socialist state in the history of the world. This was uppityness writ incredibly large. This was the crime the Allies had to punish, the virus which had to be eradicated lest it spread to their own people. 6 The invasion did not achieve its immediate purpose, but its consequences were nonetheless profound and persist to the present day. Professor D.F. Fleming, the Vanderbilt University historian of the Cold War, has noted: For the American people the cosmic tragedy of the interventions in Russia does not exist, or it was an unimportant incident long forgotten. But for the Soviet peoples and their leaders the period was a time of endless killing, of looting and rapine, of plague and famine, of measureless suffering for scores of millions— an experience burned into the very soul of a nation, not to be forgotten for many generations, if ever. Also for many years the harsh Soviet regimentations could all be justified by fear that the capitalist powers would be back to finish the job. It is not strange that in his address in New York, September 17, 1959, Premier Khrushchev should remind us of the interventions, "the time you sent your troops to quell the revolution", as he put it.5 In what could be taken as a portent of superpower insensitivity, a 1920 Pentagon report on the intervention reads: "This expedition affords one of the finest examples in history of honorable, unselfish dealings ... under very difficult circumstances to be helpful to a people struggling to achieve a new liberty."6 History does not tell us what a Soviet Union, allowed to develop in a "normal" way of its own choosing, would look like today. We do know, however, the nature of a Soviet Union attacked in its cradle, raised alone in an extremely hostile world, and, when it managed to survive to adulthood, overrun by the Nazi war machine with the blessings of the Western powers. The resulting insecurities and fears have inevitably led to deformities of character not unlike that found in an individual raised in a similar life- threatening manner. We in the West are never allowed to forget the political shortcomings (real and bogus) of the Soviet Union; at the same time we are never reminded of the history which lies behind it. The anti-communist propaganda campaign began even earlier than the military intervention. Before the year 1918 was over, expressions in the vein of "Red Peril", "the Bolshevik assault on civilization", and "menace to world by Reds is seen" had become commonplace in the pages of the New York Times. During February and March 1919, a US Senate Judiciary Subcommittee held heatings before which many "Bolshevik horror stories" were presented. The character of some of the testimony can be gauged by the headline in the usually sedate Times of 12 February 1919: DESCRIBE HORRORS UNDER RED RULE. R.E. SIMONS AND W.W. WELSH TELL SENATORS OF BRUTALITIES OF BOLSHEV1KI— STRIP WOMEN IN STREETS—PEOPLE OF EVERY CLASS EXCEPT THE SCUM SUBJECTED TO VIOLENCE BY MOBS
A devil's chaplain: reflections on hope, lies, science, and love - Original PDF
نویسندگان: خلاصه: The first essay in this volume, A Devil's Chaplain (1.1), has not previously been published. The title, borrowed by the book, is explained in the essay itself. The second essay, What is True? (1.2), was my contribution to a symposium of that name, in Forbes ASAP magazine. Scientists tend to take a robust view of truth and are impatient of philosophical equivocation over its reality or importance. It's hard enough coaxing nature to give up her truths, without spectators and hangers-on strewing gratuitous obstacles in our way. My essay argues that we should at least be consistent. Truths about everyday life are just as much - or as little - open to philosophical doubt as scientific truths. Let us shun double standards. At times I fear turning into a double standards bore. It started in child- hood when my first hero, Doctor Dolittle (he returned irresistibly to mind when I read the Naturalist's Voyage of my adult hero, Charles Darwin), raised my consciousness, to borrow a useful piece of feminist jargon, about our treatment of animals. Non-human animals I should say, for, of course, we are animals. The moral philosopher most justly credited with raising today's consciousness in this direction is Peter Singer, lately moved from Australia to Princeton. His The Great Ape Project aims towards granting the other great apes, as near as is practically possible, civil rights equivalent to those enjoyed by the human great ape. When you stop and ask yourself why this seems so immediately ridiculous, the harder you think, the less ridiculous it seems. Cheap cracks like 'I suppose you'll need reinforced ballot-boxes for gorillas, then?' are soon dispatched: we give rights, but not the vote, to children, lunatics and Members of the House of Lords. The biggest objection to the GAP is 'Where will it all end? Rights for oysters?' (Bertrand Russell's quip, in a similar context). Where do you draw the line? Gaps in the Mind (1.3), my own contribution to the GAP book, uses an evolutionary argument to show that we should not be in the business of drawing lines in the first place. There's no law of nature that says boundaries have to be clear-cut.
Medieval Naval Warfare, 1000–1500 - Original PDF
نویسندگان: خلاصه: How were medieval navies organised, and how did powerful rulers use them? Medieval Naval Warfare, 1000–1500 provides a wealth of information about the strategy and tactics of these early fleets and the extent to which the possibilities of sea power were understood and exploited.
Digital Signal Processing: A Student Guide - Original PDF
نویسندگان: خلاصه: Digital Signal Processing (DSP) is concerned with the use of programmable digital hardware and software (digital systems) to perform mathematical operations on a sequence of discrete numbers (a digital signal). Such processing is needed to facilitate the extraction of information embedded in the signal.
Diagnostic Radiology Physics: A Handbook For Teachers And Students - Original PDF
نویسندگان: خلاصه: This book is dedicated to students and teachers involved in programmes that train professionals for work in diagnostic radiology. It teaches the essential physics of diagnostic radiology and its application in modern medicine. As such, it is useful to graduate students in medical physics programmes, residents in diagnostic radiology and advanced students in radiographic technology programmes.
Davidson’s Self-assessment in Medicine - Original PDF
نویسندگان: خلاصه: This book has been built around modern educational principles and utilises a contemporary assessment style, in line with current undergraduate and postgraduate teaching. It is designed to help and support students in their final undergraduate years and in the early years after qualification. The style is compatible with that used in modern postgraduate examinations across the world.آیا کتاب مورد نظر هنوز بر روی سایت قرار نگرفته است؟ جای نگرانی نیست! کافی است بر روی گزینه سفارش کتاب کلیک کرده و درخواست خود را ثبت کنید. در کمتر از چند ساعت کتاب شما را آماده خواهیم کرد.