How can I compare Shakespeare's play Macbeth to its screen version by Rupert Goold?

First, you can examine the role played by the Weird Sisters in each.  In the play, they only appear in a few select scenes; however, in Goold's film, the sisters are much more pervasive and active.  For example, they show up in the scene where the captain speaks to Duncan to tell him about Macbeth's bravery in the field.  In this scene, they appear as nurses who then kill the captain when no one is watching.  Further, they appear in Macbeth's kitchen, helping to prepare the foods for the dinner with Duncan, and they reappear as servants at the dinner party where Banquo's ghost shows up.  They seem a great deal more evil, even more malicious than they do in the play, and their influence on Macbeth feels that much more omnipresent. 

Second, you could discuss the way the play has been updated in the film adaptation.  Instead of being set in Scotland in the eleventh century, the movie takes place in what seems like a twentieth century totalitarian country like Communist Russia or Nazi Germany.  This makes it feel somewhat more understandable to a modern audience, as we are a great deal more familiar with the way this symbolism and propaganda looks than we could be with Scotland of a millennium ago.  

Who was the 280-pound colonel who turned his bookstore over to his brother so he could fight the British during the Revolutionary War?

The man you are looking for is Henry Knox, whom I consider to be one of the most inspirational figures from the Revolutionary War. Prior to the American Revolution, Knox operated a bookstore, but he was very interested in military history and had read a number of books on the subject. When war broke out, he formed a friendship with George Washington and eventually became Washington's chief artillery officer.

One of Knox's most notable actions during the war was managing the transport of more than 60 tons of cannons and mortar from Fort Ticonderoga in New York to Boston. This feat was astounding due to its extreme difficulty; the cannons had to be hauled by oxen through snowy mountains and over icy rivers. This artillery battery gave Washington the upper hand in Boston.

Following the American Revolution, Henry Knox continued to play an important role in American military affairs. President Washington appointed him as the first U.S. Secretary of War under the Constitution.

Did the Supreme Court declare the national bank constitutional?

The Supreme Court considered the constitutionality of the Bank of the United States in McCulloch v. Maryland (1819). In this landmark case, which involved the question of whether states had the power to tax branches of the national bank, the Court ruled that the bank was constitutional. Chief Justice John Marshall ruled that the power to create a national bank was implied by the powers to tax, print and coin money, and borrow money on the credit of the United States. These powers were expressly delegated to Congress in the Constitution. This case settled the constitutionality of the Bank of the United States, but it emerged again in the 1830s when President Andrew Jackson, an inveterate opponent of the bank, vetoed a bill that rechartered it. But it also dramatically expanded the scope of federal authority by empowering Congress to pass laws under the Necessary and Proper, or "elastic" clause in Article I, Section 6 of the Constitution.

What are some metaphors in Tangerine by Edward Bloor?

The most important metaphor is vision (and blindness, and degrees of blindness). Paul's family acts as if he's blind, but he's not! His eyes are injured, and he has to wear those thick glasses, but Paul really can see okay. Otherwise, how could he play soccer? Metaphorically speaking, it's actually Paul's parents who are blind. They ignore (fail to see) the reality of their older son's cruelty and his crimes. All they can "see" is Erik's football talent, and they've fooled themselves into thinking that the cause of Paul's eye injury was that the young boy stared into the sun during an eclipse. Which isn't true! Paul starts to see the truth of how his eyes were injured, and it's a truth to which his parents are blind. Toward the end of the story, we find out exactly what happened: Erik violently attacked Paul, spraying paint into his eyes. Fortunately, by the end of the story, the parents' eyes are "opened" to Erik's true nature.

Speaking of the eclipse, that's another important metaphor in the story. You know how in an eclipse, one object passes in front of another, blocking out your vision of it? The same thing is going on with the two brothers in the family. Erik is the older one, the football star who gets all his parents' attention. Paul just kind of tags along. Erik eclipses Paul, and Paul has to linger unseen in Erik's shadow.

Lastly, let's consider the sinkhole. Whenever you have a sudden natural disaster in a story, it's worth taking a look at it as something more than a plot device. Yes, the sinkhole is the reason that Paul gets to change schools. But it could also be a metaphor for Paul's despair. Think about how dejected Paul felt at his first school, when his IEP prevented him from being on the soccer team. He was so sad that it was like he was being pulled into the ground, away from light and happiness. And then, the sinkhole happened. It'd be a coincidence in real life, but in a novel like this one, it's probably a metaphor.

You might look at the sinkhole, the eclipse, and the blindness, and say, "Wait, aren't these symbols and not metaphors?"

It depends on how you define these terms, and they do overlap. But in general, if you've found something that represents something else in a work of literature, and you want to know if your object or event is a symbol or a metaphor, a good test is to examine what's being represented. Does your object or event represent:

A. a specific thing going on in that particular story?

or 

B. a general, abstract idea?

If it's A, then it's better to call your object or event a metaphor. If it's B, then your object or event is better referred to as a symbol. 

In the case of the sinkhole, the eclipse, and the vision/blindness, I'll call these metaphors because they represent specific other things going on in the story, and not necessarily bigger, abstract ideas (like fairness, acceptance, discrimination, and so on).

How might you expand on the following statements about Shakespeare's Romeo and Juliet?1. Romeo and Juliet is a cautionary tale about the...

1. For this topic you’re being asked to consider how human emotions cause the central tragedy of Romeo and Juliet. Throughout the play, characters react quickly and violently to emotions, without considering whether or not these are lasting feelings or rational decisions.

• In Act III, Scene i, Mercutio fights Tybalt in a moment of rage. Disgusted at Romeo’s reluctance to fight Tybalt, Mercutio says “O calm, dishonouable, vile submission!” immediately before picking a fight with Tybalt himself. Mercutio equates “calm” with dishonorable and vile, and therefore, by his warped notion of rage-based honor, picks a fight with Tybalt which results in his death. Now, angry at Mercutio’s murder, Romeo, who has just vowed to not hurt Tybalt for Juliet’s sake, says that “fier-ey’d fury be my conduct now.” With only rage and no reason to guide his actions, Romeo fights and kills Tybalt, causing the Prince to banish him from the city, separating him from Juliet.


• Romeo quickly resolves to kill himself upon hearing of Juliet’s death from Balthasar in Act V, Scene i. Notably, this is not the first time we see Romeo making such a plan. After killing Tybalt, the stage directions for Act III, Scene ii note that Romeo draws his sword, meaning to harm himself. Friar Lawrence scolds Romeo for a pattern of behavior that Romeo evidences throughout the play:

“Thy wild acts denote

The unreasonable fury of a beast.”

Friar Lawrence notes that Romeo very quickly jumps to a conclusion of death in his despair and barely listens to what Lawrence has to say. Every time the Friar attempts to talk to Romeo reasonably about his banishment within the scene, Romeo bursts into a long speech bemoaning his fate. According to Lawrence, Romeo is wild, desperate, a madman, and a beast in his behavior. Romeo is so emotional he cannot stop to listen or think logically. So in Act V, Scene iii, Romeo notices that Juliet does not appear to be dead, observing,

“Beauty’s ensign yet

Is crimson in thy lips and in thy cheeks.”

He even asks “Why art thou yet so fair?” Romeo kills himself minutes after stating that Juliet doesn’t really seem dead, unable to reason with his strong feelings.

• Of course, this pattern also affects the overall plot of the play. The play’s Prologue explains Romeo and Juliet cannot be together in the first place because of an “ancient grudge,” a “continuance of their parents’ rage.” Although no real logic is given for why the two families must fight, characters like Tybalt, Romeo, and Mercutio act and react quickly on a rage that isn’t even their own. The strong emotions of the two families ultimately lead to the end of each family’s line, with the youngest Capulets and the Montagues slain as the result of a long held hatred.

2. This topic states that although the lovers are described as “star crossed,” much of the play’s tragedy hinges on the actions of one person. As the prompt doesn’t name which person’s actions you ought to consider, I’ll give you an argument for Friar Lawrence.

• As Juliet is only 13 years old, Nurse is silly and unreliable,  and Romeo, as discussed in the last section, is not really capable of rational thought, Friar Lawrence is the only adult involved in their relationship and the plan to fake Juliet’s death. Lawrence actually pushes the romance in Act II, Scene iii, believing

“this alliance may so happy prove,

To turn your households’ rancor to pure love.”

However well-intentioned, Friar Lawrence decides to support the relationship just after he chides Romeo for being being in love with Juliet so quickly after being in love with Rosaline. He notes that

“young men’s love, then, lies

Not truly in their hearts but in their eyes.”

Friar Lawrence knows that Romeo is emotional and fickle, but decides that possible peace between the households warrants his assistance in this relationship.

• Friar Lawrence then chooses to withhold all that he knows from both Romeo and Juliet’s parents. As we see in Act I, Scene v, Capulet doesn’t mind that Romeo is in his house, telling Tybalt he’s heard that Romeo’s “a virtuous and well-govern’d youth.” It’s possible that the Capulets and Montagues might have been able to move past the “ancient grudge” mentioned in the prologue for their children’s sakes, but Friar Lawrence doesn’t tell anyone what’s occurred until after Romeo and Juliet are already dead. He seems to realize this was a mistake as he says in Act V, Scene iii, his explanation works

“both to impeach and purge

Myself condemned and myself excused.”

What he means is that, although he hasn’t outright killed Romeo and Juliet, he’s been very involved in the circumstances that lead to their deaths.

• Friar Lawrence doesn’t adequately assess how emotional and prone to self-harm Romeo and Juliet are. Friar Lawrence knows that Juliet and Romeo have both expressed suicidal tendencies when they are presented with problems (Romeo in Act III, Scene ii, and Juliet in Act IV, Scene i), yet he entrusts Friar John with his letter to Romeo, explaining the plan. Friar John does not understand the significance of the letter, and the choice seems doubly strange when Romeo makes it evident in Act V, Scene i that he expected the Friar to send any correspondence through Balthasar, asking “Hast thou no letters to me from the friar?” When Balthasar responds in the negative, Romeo proceeds with his plan to go to Juliet and kill himself. Then in Act V, Scene iii, Romeo is dead, Paris is dead, and the Friar arrives and attempts to urge Juliet to come away with him to a nunnery. Juliet is still confused, asking where Romeo is. By this point, the Friar ought to know better than to answer as he does. Instead of insisting that Juliet come to him before explaining, the Friar tells Juliet the worst news first, saying

“Thy husband in thy bosom there lies dead;

And Paris too.”

Juliet, who has already threatened to kill herself over Romeo, quickly takes her own life. Friar Lawrence’s lack of knowledge when it comes to the emotions of those involved in his plans ends up costing many lives, and his actions are what allow the events of the play to take place. He alone can reveal all at the end of the play, finally telling the Capulets and the Montagues the information that could have allowed them to avoid so much bloodshed.

3. Romeo and Juliet explores lust, fascination, and love through “love” as experienced by two young people. Romeo and Juliet’s discourse on love, both separately and together in the balcony scene, reveals the play’s ongoing preoccupation with what love means and how it is truly experienced.

• As discussed in the first topic, Romeo is fickle and emotional. The play begins with Romeo claiming to be madly in love with Rosaline in Act I, Scene i. The problem, however, is as easily resolved as Benvolio suggests:

“By giving liberty to unto thine eyes;

Examine other beauties.”

Romeo is absorbed and fascinated in his love for Rosaline, able to think of little else. However when Romeo sees Juliet, Rosaline is forgotten, an inconsistency that Friar Lawrence calls him out on in Act II, Scene iii. Romeo’s fickleness in love raises the issue of love vs. lust or fascination. Is Romeo really in love with Juliet, a girl he barely knows? His soliloquy in the garden in Act II, Scene ii focuses on her body:

“See how she leans her cheek upon her hand!

O, that I were a glove upon that hand,

That I might touch that cheek!”

Romeo’s focus on the tactile and physical in his love for Juliet suggests that his “love” might be more lustful and shallow.

• Juliet, on the other hand, is more philosophical. While Romeo soliloquizes about Juliet’s physicality, Juliet wants to consider the core of Romeo’s being, rejecting physicality and easy categorization in the process:

“Thou art thyself though, not a Montague.

What’s a Montague? It is neither hand, nor foot,

Nor arm, nor face.”

Juliet’s love, therefore, is not lustful, and is possibly more mature and more like what we would consider “real” love, as opposed to lust or fascination.

• When Romeo and Juliet talk on the balcony in Act II, Scene ii, their conversation reveals love’s multifaceted nature. Juliet first considers their love in archetypal terms, or as role play, saying she knows what “thou wilt say” but recognizing that lovers prove false, and that she herself may be called upon to deceive:

“I’ll frown, be perverse, and say thee nay,

So thou wilt woo.”

However, as she has already admitted to loving Romeo, she realizes she’s already messed up the pattern of pursuit and rejection. By making Juliet and Romeo unable to participate in standard lovers role play, Shakespeare could be indicating that their love is more genuine than love that adheres to convention. Romeo quickly adopts highly romantic speech, swearing by the moon that he loves her, but this is not satisfactory for Juliet. Juliet points out the bad logic of his choice; the moon is “inconstant” and “changes.” Again, Juliet approaches love philosophically and as a result of her consideration can see their love is “too rash, too unadvis’d.” Through this scene, Shakespeare indicates that the audience must truly consider Romeo and Juliet’s relationship beyond flowery speech, preset roles, and lust. Instead of being satisfied with telling a love story, Shakespeare asks audiences to define love as they watch two teenagers act on an emotional impulse that closely resembles it. 

What is the relationship between childbirth and infectious disease?

Definition

Pregnancy and childbirth present unique challenges to the physiology of
both the pregnant woman and her fetus (or newborn after birth) and significantly
affect the body’s immune system’s ability to combat infection.
The immune system considers a growing fetus to be a foreign object. To
prevent an “attack” by this “object,” the pregnant woman’s immune system
self-modulates, resulting in a condition of immunosuppression that exposes her and
her fetus to infections that would not pose a threat to healthy, nonpregnant women.

In addition, the developing immunity of the fetus does not effectively protect against
disease. Maternal IgG antibodies (proteins that fight infection, also called
immunoglobulins) cross the placenta to provide protection, but IgM (immunoglobulin
M) antibodies do not. The function of disease-fighting white blood cells and
complement-protein activity (another form of immune protection) are decreased.
Threats to the fetus include bacterial, viral, and other pathogens
inside and outside the genital tract. Some of these cause serious infection in
both the pregnant woman and the fetus, while others threaten only the pregnant
women or only the fetus. Modes of transmission vary too.

Congenital infections, which occur during pregnancy, cross the placenta to
infect a growing fetus and may result in abnormal development, fetal disease, or
fetal death. These include the TORCH agents, an acronym that has been used to
describe the most common congenital infections. Intrapartum infections are passed during labor and delivery as the
fetus travels through the infected birth canal. Examples of these infections
include many of the sexually transmitted diseases (STDs)
and group B Streptococcus. Postpartum infections occur after
delivery and most often involve the genitourinary tract of the mother. In the
past, these infections were known as childbirth fever and were once leading causes
of morbidity and mortality. However, with the widespread use of improved sterile
techniques and of antibiotics, incidence has decreased dramatically. In
addition, some microbes (such as human immunodeficiency virus and
cytomegalovirus) can infect the newborn through
breast-feeding; other infections are acquired during the postdelivery hospital
stay, an infection known as nosocomial.

Threats to the Fetus and the Newborn

Many infectious agents are able to cross the placenta during pregnancy and cause congenital infection, whether these agents originate in the genitourinary system or elsewhere in the body. Some organisms that cause little or no clinical illness in the pregnant woman can present significant danger to the developing fetus; these organisms are teratogenic (they cause birth defects). In utero transmission of infection can occur at any time before birth, and the period of greatest risk varies by organism. TORCH is the acronym that has been used for these common organisms in the past, but as more and more organisms belonging to the “other” category are identified, the term has lost favor. The original purpose of the TORCH designation was to group infections with similar patterns of transmission and presentation. TORCH includes Toxoplasma, coxsackie virus, human parvovirus, hepatitis B, syphilis, Epstein-Barr virus, varicella zoster virus (or chickenpox; a primary infection during pregnancy is considered a medical emergency), LCMV (lymphocytic choriomeningitis), parvovirus B19, rubella virus, cytomegalovirus (CMV), HIV, and herpes simplex virus.

The agents responsible for congenital infection carry significant risk of morbidity and mortality and can cause neurological damage, blindness, deafness, cardiac defects, intrauterine growth restriction, skin lesions, and a host of other abnormalities. HIV, one of the congenital agents recently added to the foregoing list, is now known to be a major cause of infant mortality worldwide. Influenza, including H1N1 (swine flu), is a growing significant threat. Many of these organisms can also be transmitted during passage through the birth canal if they are present at the time of delivery.

Routine maternal screening for serologic evidence of organisms causing congenital infection during pregnancy is commonplace in many parts of the world, but its use as a diagnostic tool is controversial in the United States because of overuse and a lack of consistent interpretation of results. Screening is limited to cases in which exposure is known or suspected or in which symptoms are present. (Syphilis is a notable exception, and it is routinely screened for.)

Symptoms of infection in the newborn cover a broad range and are often nonspecific. Fever, hypothermia, vomiting, rash, and decreased muscle tone may indicate infectious illness, and many congenital infections acquired during gestation are accompanied by abnormalities specific to the organism involved. When a diagnosis is confirmed, the organism identified determines the availability of treatment for mother and newborn. Antiviral medications, intravenous gammaglobulin (IVIg), and antibiotics are mainstays of treatment.

Listeriosis is a less common but devastating cause of fetal infection. Maternal
infection comes from eating contaminated food. The organism crosses the placenta
to cause amnionitis (infection of the amniotic sac); the infant mortality rate for
this infection is almost 50 percent. Prevention through avoidance of high-risk
foods is the mainstay treatment, but infection can sometimes be treated with
antibiotics (with limited success).

The most common cause of life-threatening infection in the newborn is group B Streptococcus (GBS), which affects both mother and child. GBS is a beta-hemolytic gram-positive coccus that is often found in normal vaginal flora. Intrapartum transmission to the newborn occurs during delivery and can be the result of ascending infection after the rupture of membranes or of direct contact in the vaginal canal. Infection can cause severe illness and death.

Infants with GBS infection will present with either early-onset or late-onset disease, depending on the time between delivery and onset of symptoms. Early-onset disease occurs before seven days of age and includes symptoms of sepsis, pneumonia, or meningitis. Newborns who become ill between age seven and eighty-nine days have late-onset disease, which typically manifests as generalized bacteremia and meningitis. Common sequelae for those who survive the infection are vision loss, neurologic damage, and developmental delay.

Up to 30 percent of pregnant girls and women are colonized with GBS, but less
than 1 percent of these cases have symptoms of disease. Therefore, the
Centers for
Disease Control and Prevention (CDC) recommends GBS screening
by vaginal and rectal cultures for all pregnant females who are between
thirty-five and thirty-seven weeks gestation. New mothers with positive or unknown
culture results are treated with antibiotic prophylaxis (most often with
penicillin G), and their newborns are closely observed for signs and symptoms of
disease. The incidence of early-onset disease has decreased dramatically since
screening and prophylaxis became routine, but the frequency of late-onset disease
remains stable.

Other causes of intrapartum disease transmission include sexually transmitted
organisms such as chlamydia and gonorrhea, so the CDC recommends
routine screening of all women early in pregnancy. Antibiotic treatment can
prevent infant disease. Bacteria colonizing the vagina and rectum of the pregnant
woman, bacteria including gram-positives, gram-negatives, aerobes, and anaerobes,
can overgrow and cause infection of the fetus or newborn; these bacteria can also
cause preterm labor and delivery. The index of suspicion required to seek
diagnosis and treatment should be low.

The degree of risk associated with congenital, intrapartum, and postpartum infections in the newborn is highly correlated with gestational age. The immune function of premature infants is less mature than that of term infants, with decreased white-cell function, antibody production, and complement activity. Premature infants spend more time in the hospital and undergo invasive procedures, exposing them to nosocomial (hospital acquired) infection.

Threats During and After Pregnancy

In spite of the immune suppression that is a hallmark of forty weeks of pregnancy, the most serious infectious disease dangers for the pregnant woman-mother are from intrapartum and postpartum events (during and immediately following birth). Historically, childbirth fever from genital tract infection following delivery has been a leading cause of maternal morbidity and mortality. The traumatic nature of vaginal or cesarean delivery predisposes to the local spread of colonized bacteria, and though the incidence has decreased significantly with the widespread use of improved hygiene and of antibiotics, obstetric infection still accounts for more than 12 percent of maternal deaths.

Puerperal or postpartum infection is a bacterial
infection that occurs during or after childbirth. Most of
these infections begin in the genitourinary tract and infect the uterus and
surrounding areas soon after delivery. In some cases, however, organisms may be
carried through the blood to seed other parts of the body or may occur through
breast-feeding. Vaginal delivery carries an infection risk of 1 to 3 percent,
while the risk after cesarean delivery may be as high as 20 percent. Other factors making
infection more likely include repeated vaginal examinations during labor, early
rupture of membranes and early internal fetal monitoring, postpartum hemorrhage,
retained placental fragments, prolonged labor, young age, and low socioeconomic
group.

Postpartum infection is typically diagnosed when a fever greater than 100.4°
Fahrenheit (38° Celsius) is present for two of ten days following delivery. Endometritis (infection of the uterine lining) is the most
common site, followed by postcesarean wound infections, perineal cellulitis
(infection of perineal tissue), mastitis (breast infection), urinary tract infections (UTIs), and septic phlebitis
(infection of pelvic blood clots). Maternal death rates because of infection are
approximately 0.6 deaths per 100,000 live births.

Symptoms may include fever, low abdominal and uterine pain, heavy malodorous lochia (bloody discharge that follows delivery), chills, and general malaise. Those with a UTI may have pain on voiding and nausea and vomiting. Those who received general anesthesia for cesarean delivery may present with symptoms of pneumonia, and wound infections may develop swelling and drainage. Breast infection, which can occur when nipples become sore and cracked, allowing bacteria to enter, manifests as a breast that appears red, warm, swollen, and painful (often after the immediate postpartum period but before six weeks after delivery).

Diagnosis is based on observation of symptoms, physical examination, and the
results of bacterial cultures and blood studies. If left untreated, severe
complications of postpartum infection can occur and include peritonitis
(infection of the abdominal lining), septic embolism (infected blood clots that
travel to lungs and other areas of the body), and septic shock.
Treatment generally includes intravenous antibiotics for forty-eight hours or
more, sometimes followed by a course of oral medication after hospital
discharge.

Colonization with group B Streptococcus during pregnancy is a cause of maternal UTI, amnionitis, endometritis, and fetal loss. Rarely, it can cause pelvic abscess, meningitis, and endocarditis. Clinical diagnosis of infection is difficult because few pregnant women who carry GBS develop signs and symptoms of disease. The current screening and treatment approach, which is delayed until thirty-five to thirty-seven weeks gestation, just before delivery, does not address the incidence of maternal GBS disease during pregnancy. Several vaccines to prevent GBS colonization and disease are in development; routine vaccination would decrease risk significantly.

UTI is a common problem for women, and the risk is exacerbated during pregnancy. The proximity of the (short) urethra to the vagina and anus, compounded by (in the pregnant woman) a weakened immune system and by stasis caused by a growing fetus crowding the urinary system, make frequent UTIs a common complaint. Responsible organisms include Escherichia coli, Klebsiella, Enterobacter, Enterococcus, GBS, staph species, and Proteus.

Infection may be symptomatic or asymptomatic, and both are clinically important
to the health of the mother and newborn. Asymptomatic infection is more likely to
lead to acute pyelonephritis (kidney infection), which is a common reason
for hospitalization in pregnant women. The severity of infection varies, but it
can progress to generalized urosepsis and is associated with low neonatal birth
weight and prematurity. Because so many of these infections are asymptomatic, it
is recommended that all pregnant women be screened by urine culture during early
pregnancy and treated with antibiotics if indicated.

Bacterial
vaginosis is a condition caused by the overgrowth of
colonizing bacteria of the vagina. Normal vaginal flora varies depending on the pH
of the vagina, and overgrowth is polymicrobial. It may be asymptomatic or may
present with burning and discharge. The organisms can ascend and infect the
amniotic membranes, causing premature labor. It is estimated that 40 percent of
these pregnancies will go on to have preterm labor. Therefore, the CDC recommends
that females at risk for premature labor (prior preterm delivery or high-risk
pregnancy) be screened for bacterial vaginosis and treated if indicated.

All antimicrobial medications cross the placenta and expose the fetus to
possible adverse effects, so they should be used with caution. Most commonly
prescribed antibiotics are safe for use during pregnancy and include
penicillins, cephalosporins, nitrofurantoin, and macrolides,
but some have been associated with birth defects and disorders (tetracyclines) and increased toxicity (sulfonamides).

Impact

Infections associated with childbirth affect pregnant girls and women and their
fetuses and newborns worldwide. Infections can occur from the time the fertilized
egg is implanted up to and beyond the moment of delivery, sometimes with
devastating results. Expanded prenatal care, improved hygiene, aseptic
technique, and the use of antibiotics have made death from
childbed fever rare in the developed world, but congenital and perinatal
infections continue to take a toll, especially in developing countries.

Infection is understood to be a major cause of preterm birth and may account for 25 to 40 percent of events that result in maternal and fetal (and newborn) morbidity and mortality; infections also add to the rapidly rising cost of health care. The development of vaccines to protect newborns and mothers from disease is ongoing.

Bibliography

Campos, Bonnie C., and Jennifer Brown. Protect Your Pregnancy. New York: McGraw-Hill, 2003. A pregnancy guide with a special focus on at-risk pregnancies. Reviews how to recognize signs and symptoms of pregnancy complications and explores preexisting and developing medical conditions that can lead to premature delivery, among other topics.

Cunningham, F. Gary, et al. Williams Obstetrics. 23d ed. New York: McGraw-Hill, 2010. The bible of obstetrics theory and practice.

Forsgren, M. “Prevention of Congenital and Perinatal Infections.” Eurosurveillance 14 (2009). Available at http://www.eurosurveillance.org/viewarticle.aspx?articleid=19131. A scholarly look at what can be done to prevent infection, now and in the future.

Newell, Marie-Louise, and James McIntyre. Congenital and Perinatal Infections: Prevention, Diagnosis, and Treatment. New York: Cambridge University Press, 2000. A comprehensive examination of infections associated with childbirth for medical professionals and educated general readers.

Thornton, C. A. “Immunology of Pregnancy.” Proceedings of the Nutrition Society 69 (2010): 357-365. An advanced article on the significance of maternal diet and nutrition in healthy fetal development.

What benefits did the participants gain from the Atlantic Slave Trade?

With the exception of a few minor players in Africa, the slave trade was inherently negative for Africa. Some local rulers benefited from collaboration with slave traders and made a great profit off of the Atlantic Slave Trade. Aside from these few profiteers, the slave trade was excessively negative on the continent of Africa. For this reason, discussion of the advantages of the slave trade should focus on the New World.

Listing the advantages of the slave trade, it should not be interpreted as any sort of endorsement for the slave trade itself. Making humans an economic commodity is reprehensible by any measure. Having said that, the slave trade was very important to the economic development of the colonies in the New World. There was a severe labor shortage in the Americas and slaves from Africa filled this void. Slaves were vital to the colonial economies that were establishing cash crops to acquire capital. The slave trade was extremely important to the acquisition of wealth in the colonies. It can be stated the Transatlantic Slave Trade was the catalyst for capitalism and industrialism in Europe and the Americas. As an example, the steady and cheap supply of cotton from the American South to Britain was an important component in the success of the early textile factories in Great Britain.  The profit from the cotton trade was invested in technologies that helped the United States industrialize.  

Why is Scout's ham costume significant in the novel To Kill a Mockingbird by Harper Lee?

There are several reasons as to why Scout's ham costume is significant in the novel To Kill a Mockingbird. During Maycomb's Halloween festival, Mrs. Grace Merriweather composes a pageant in which the children dress up as the county's agricultural products. Scout dresses up like a ham, and her cumbersome costume is made out of chicken wire and fabric. Aside from providing comic relief to the story, Scout's perception of Bob Ewell's attack is altered because her costume blocks her vision. Scout is unable to see who saved them during the attack, and Boo Radley's heroics are not obvious to the reader. This allows Harper Lee to build tension before revealing Boo's involvement. In addition to heightening the mood and tension of the story, Scout's ham costume prevents Bob's knife from stabbing her. When Sheriff Tate examines her crushed ham costume, he shows Atticus the clean line in the fabric from Bob's knife. Scout's ham costume protects her during the attack and saves her life.

How can I write a good thesis statement about King Lear?

King Lear is a very complicated play. It has two plots and many characters. Lear has three daughters and Gloucester has two sons. Lear's three daughters all have husbands. There are other characters who have substantial parts. The action takes place over a fairly long time period and covers a large part of England. You should not try to think of a thesis or a thesis statement that would cover the whole play. Less is more. You would do well to pick one character you like or dislike and focus on him or her. You have to form an opinion before you can present a thesis. How do you feel about the play? How do you feel about the characters. 

A possible thesis that comes to mind is this. It would seem that Gloucester is punished for his adulterous behavior in conceiving his bastard son Edmund by having Edmund become the cause of all his suffering. Gloucester thinks he is a very fine fellow in having produced a child out of wedlock. He would like to think of himself as an impetuous romantic lover. He appears to be bragging about it to Kent in the opening scene. He does not understand that all our actions have consequences. 

I think you could find a thesis in almost any of the characters. For instance, what do you think of the way Cordelia answered her father Lear when he asked her to tell him how much she loved him? Was she being wise. Did she have to be so uncompromisingly honest and sacrifice a full one-third of England?

What about the Fool? Is the Fool really funny? Did you laugh at any of his jokes? Do you think Shakespeare really intended the jokes to be funny? I think Shakespeare did not want the jokes to be funny because he didn't want the audience to seem to be laughing at poor King Lear.

You need a thesis before you can write a thesis statement. You need to find your thesis inside your own mind. These written assignments are handed out in college to get people to think. The graders appreciate honest thinking. 

What is the social commentary of the story "The Ones Who Walk Away from Omelas"?

In Le Guin's story "The Ones Who Walk Away from Omelas," social commentary is made as the author raises questions about the extent of the responsibility of a society to its members.

Interestingly, this story has the alternate title "Variations on a Theme by William James." In her allegorical tale, Le Guin takes aim at James's philosophy of Pragmatism, which holds that

....an ideology or proposition is true if it works satisfactorily, that the meaning ["truth"] of a proposition is to be found in the practical consequences of accepting it.[http://www.iep.utm.edu/pragmati/]

In Omelas, which appears to be an idyllic community, its happiness is formed upon what the narrator calls

...a just discrimination of what is necessary, what is neither necessary nor destructive, and what is destructive.

However, this "just discrimination" is later revealed to be composed of the confinement in a narrow subterranean cell of a young being so dehumanized and so deprived of intellectual stimulation that "it" cannot know joy: "It has been afraid too long ever to be free of fear." This scapegoat absorbs all the ills of the society, allowing everyone else an idyllic life.

When some of the inhabitants learn of this miserable creature who bears the ills of their society, they are disturbed by this knowledge. These people walk away from Omelas, while others do nothing, believing this situation is pragmatic. Further, they reason that the child's existence is necessary "for the good of others" and the contentment of all the other residents in the community.

One historical application of this concept of pragmatism and the use of the scapegoat is that used by Nazism, which held in part that many of the ills of Germany's economic depression and its society were due to the presence and social and economic influence of Jews and other "undesirable" people. Thus, in order to practically solve the country's problems, these negative influences had to be removed for the greater good of the German people.

Certainly, in her allegory of Omelas, Le Guin hints at history and raises the moral question of whether any individual, ethnic group, religious group, etc. should be sacrificed for the greater good, or whether a society should not take moral responsibility for all its people. Indeed, it is a question of lasting significance.

Bottom is the only "mortal" to interact with the fairies in A Midsummer Night's Dream. Why might this be so?

Bottom has a fanciful nature and Puck thinks he deserves a lesson because of his arrogance.

There are really two reasons that Bottom is the only one who interacts with the fairies. One is that Bottom is already a fellow with a big imagination. The other is that he is supremely arrogant, in a clumsy sort of way. In other words, he is perfect as the butt of Puck’s joke.

Puck sees the craftsmen practicing their play and decides that they are too close to the fairies. He observes them and notices Bottom’s antics. From the beginning, he wants to play every part, he overacts, and he is generally full of himself.

I will move storms, I will condole in some
measure. To the rest: yet my chief humour is for a
tyrant: I could play Ercles rarely, or a part to
tear a cat in, to make all split. (Act 1, Scene 2) 

All of this is happening in the middle of a war between Titania and Oberon, the queen and king of the fairies.  Oberon instructs Puck to help him get revenge on Titania, who is causing trouble because of her continued possession of a changeling they both seem to want.

Puck decides to have some fun with Bottom and Titania.  First, he exchanges Bottom’s head for that of an ass (a donkey). This terrifies the rest of the craftsmen. Then he uses his love potion to make Titania fall in love with Bottom. The fairies all have fun with Bottom until Oberon decides enough is enough and reveals his trick. 

OBERON

There lies your love.

TITANIA

How came these things to pass?
O, how mine eyes do loathe his visage now! (Act 4, Scene 1)

The trick is all the better because it was played on Bottom, the arrogant and silly weaver. Bottom could see all of the fairies when he was with Titania, but he was just conceited enough to go along with it. Once Titania came out of her spell, the fairies had no need for Bottom anymore.

In The Omnivores Dilemma, Pollan comes to the conclusion that "industrial organics" is a contradiction in terms. Why?

The term "industrial organics" is contradictory on two levels-- both in the literal meaning of the phrase and in its implications as an agricultural practice.

First, let's address the meaning of the phrase. Industrial refers to that which is entirely made and controlled by man. Typically, we use the word when we talk about machinery or mass-scale production of goods. In contrast, organic refers to that which is produced naturally, without human intervention. When we talk about organic food, specifically, we are referring to foods produced with as little intervention from humans as possible. "Organic" has come to refer to foods produced without pesticides, but as Pollan notes in his book, there is a lot of variety in the actual practice of organic agriculture.

The phrase "industrial organics" is an oxymoron because industrial and organic agriculture are at odds with one another in terms of how much human intervention is involved in producing foods. We can certainly refer to the mass-scale production of pesticide-free fruits and vegetables as "industrial organic," but this is disingenuous to what organic agriculture is really about. The movement in favor of organic agriculture has grown in response to the drawbacks of industrial agriculture-- environmental degradation, pesticide toxicity, and reduced diversity, to name a few. To advocate for industrial organic agriculture may seem a better choice but is essentially swapping one evil for another.

As I mentioned above, industrial organic agriculture has some practical issues. Any two farmers could be adhering to very different practices in raising crops they call organic. Without standardization of what it means to raise organic produce, the premise of mass-scale production isn't really feasible. Even with standards of organic agriculture in place, the degree of human intervention necessary to raise produce on a massive scale creates a system that is inherently industrialized. This brings us back to the original issue-- organic and industrial agriculture are two very different means of production.

What issues do voters consider important in the 2016 election?

According to a recent survey by Gallup, a respected polling organization, the four top issues of concern to both self-identifying Democrats and Republicans in the 2016 Presidential election are the economy, terrorism, jobs and healthcare. Although people with different political perspectives disagree on how best to address these problems, most people polled agree that these issues are important areas of ongoing concern. The recent terrorist attack in Brussels is likely to cause a spike in voter concern over terrorism.

There are five issues that are significantly more important to Republican leaning voters than to Democratic leaning ones. They are immigration, the federal budget deficit, taxes, foreign affairs, and the size of the federal government. Democrats, on the other hand, show greater concern than Republicans for education and income inequality.

Some issues that seem controversial but are actually not the top priorities for voters of either party include gun policy, banking regulation, gay marriage, abortion, and climate change.

A survey by Pew Research confirms these conclusions, listing as the top issues of interest to most voters the economy, healthcare, and terrorism, with the federal budget deficit, immigration, and the environment also being considered very important by over half the respondents. 

What quotes show that Roger is a victim of Jack?

Roger is not a victim of Jack but is in full agreement with Jack's methods and uses them to inspire his own brutal conduct. Early in the story after Maurice and Roger finish their stint as fire-tenders, they head to the beach. Roger immediately terrorizes the littluns on the beach, destroying their sand castles. While Maurice exhibits a sense of conscience for making one of the boys cry, Roger doesn't. He proceeds to tease Henry by throwing stones at him from behind a tree, aiming to miss. When Jack shows Roger the face and body paint, "Roger understood and nodded gravely."

During the sow hunt, Roger pushes past Jack and inserts his spear into the sow's rectum, driving it further and further in. Jack selects Roger to be one of the boys to steal fire from the others, and Roger doesn't object. During Jack's feast, "Roger became the pig, grunting and charging at Jack, who side-stepped." This is not the action of a victim, but rather a partner. When Jack makes plans to steal fire again, this time Piggy's glasses, Roger volunteers to go with him.

When Roger comes to Castle Rock and sees that Jack has created a defense that would "send the rock thundering down to the neck of land," Roger approves, saying, "He's a proper chief, isn't he?" Later, when Ralph and Piggy come to Castle Rock, Jack is away hunting, and Roger is manning the defenses of the camp. He begins throwing stones at the twins, "aiming to miss." But then "some source of power began to pulse in Roger's body." Later he begins zinging rocks very close to Ralph's head. When Roger sends the rock down on Piggy, it is from his own "sense of delirious abandonment," not from Jack's order. When Roger sees Jack merely prodding the captured Samneric, he declares, "That's not the way," and evidently causes the twins actual physical harm, causing them to tell Ralph, "He's a terror." In the final hunt for Ralph, it is Roger who has "sharpened a stick on both ends," presumably in order to kill Ralph the way he killed the sow. Throughout the story, Roger's acts of cruelty are the result of his own choices, not a submission to Jack's influence. 

What is hypotension?

Causes and Symptoms

The body has a complex system for regulating blood pressure, which ensures adequate blood flow to each organ and tissue. The sympathetic and parasympathetic branches of the autonomic nervous system, various hormones produced by the adrenal and pituitary glands, the kidneys, the heart, and local mechanisms in all parts of the body control the amount of blood in the vessels, how much blood is squeezed out of the heart with each beat, and how much blood is available to any body system at a given time. A failure in any of these regulatory areas can cause the blood pressure to become too low for the person to function normally.

Normal blood pressure varies depending on the demands put on the body, how fit a person is, and the age of the individual. For most adults, 120/80 is considered normal; however, the top number (systolic pressure) can be as low as 90 and the bottom number (diastolic) as low as 60 and still be considered normal. When the blood pressure is lower than about 90/60 and the individual develops symptoms related to the low pressure, then that individual is diagnosed with hypotension. Low blood pressure by itself is not unhealthy, especially in athletic people, but when the flow of blood to the organs of the body is inadequate, symptoms develop. They include rapid heartbeat, light-headedness or dizziness, weakness, and possibly fainting. Other symptoms vary with the cause of the low blood pressure.

Low blood pressure associated with insufficient blood flow to the body organs can cause kidney failure, strokes, and heart attacks. Orthostatic hypotension is low blood pressure and its associated symptoms that are most pronounced when a person goes from lying or sitting to standing.

Specific causes of hypotension include adverse drug reactions, diseases such as diabetes that damage the autonomic nervous system, hormone-producing tumors, fever, heart disease, dehydration, hemorrhage, excessive heat, alcohol use, heart attack, heart trauma, abnormal heart rhythms, overwhelming infection, anaphylaxis, burns, vomiting, and diarrhea.

Treatment and Therapy

The treatment of hypotension is primarily aimed at removing the underlying cause—for example, discontinuing a drug that causes blood vessels to dilate or wearing elastic stockings to improve blood flow back to the heart. If the low blood pressure is severe enough, then supportive treatment with fluids, oxygen, and other modalities may be required.

Bibliography

American Medical Association. American Medical Association Family Medical Guide. 4th rev. ed. Hoboken: Wiley, 2004. Print.

"Hypotension." MedlinePlus, 20 Feb. 2011. Web.

Komaroff, Anthony, ed. Harvard Medical School Family Health Guide. New York: Free, 2005. Print.

"Low Blood Pressure." American Heart Association, 4 Apr. 2012. Web.

"Low Blood Pressure (Hypotension)." Mayo Clinic, 19 May 2011. Web.

Stoppard, Miriam. Family Health Guide. London: DK, 2006. Print.

Voyatzis, Diane. "Orthostatic Hypotension." Health Library, 25 Mar. 2013. Web.

In Fahrenheit 451, what is the official slogan of the firemen?

In Montag’s society, the firemen do not put out fires.  They start fires to burn books.  Montag explains the firemen’s official slogan to Clarisse, a teenager from his neighborhood who wonders at the way things are and does not just accept them.  She asks him if he ever reads the books he burns, and he tells her that it is against the law. 

"It's fine work. Monday burn Millay, Wednesday Whitman, Friday Faulkner, burn 'em to ashes, then burn the ashes. That's our official slogan." (Part I)

In fact, the firemen have passed the rumor that things have always been this way.  Firemen never put out fires, they just started them in order to get rid of the books society outlawed.  Before Clarisse asked him the question, Montag never really thought much about it, shown in this echange with Clarisse:

"No. Houses have always been fireproof, take my word for it."

"Strange. I heard once that a long time ago houses used to burn by accident and they needed firemen to stop the flames." (Part I) 

Montag laughs at this, and Clarisse asks him why he laughs.  She also asks him why he answers her questions immediately without thinking.  Montag has been brainwashed like all of the other firemen to give rote answers to questions like these.  He is not supposed to doubt his work. 

Before this conversation with Clarisse, Montag never really stopped to think.  He did not think about his job or the history of firemen.  It really gets to the root of his society, because the reason why they banned books is to keep everyone happy and comfortable so they never questioned or thought about these subjects.  After this conversation, Montag does begin to question.  He even steals a book to see what all of the fuss is about, and his life is never the same. 

Why hadn't the sniper eaten since morning?

The text of the story answers that question in the sentence following the detail about him not eating.  The story tells readers that the sniper had not eaten, because he was too excited to eat.  

He was eating a sandwich hungrily. He had eaten nothing since morning. He had been too excited to eat.

Unfortunately, the story does not elaborate on why the sniper was so excited.  One possible reason that he had been so excited is because he was excited about his current position.  He's on a rooftop, which means that he is firing from a concealed, elevated location.  He has a good firing position, which is likely exciting for a sniper. 

I also believe that the sniper might excited at the prospect of violence.  The sniper is thrilled at the power that he holds.  The text says that the sniper is used to killing.  

They [his eyes] were deep and thoughtful, the eyes of a man who is used to looking at death.

More importantly though is the detail in the sentence just prior to the sentence explaining that the sniper has seen a lot of death.  

His face was the face of a student, thin and ascetic, but his eyes had the cold gleam of the fanatic.

The word fanatic carries a lot of meaning.  It connotes passion and pleasure, which tells me that the sniper is a man who loves doing his job—or perhaps fighting for his cause.  The sniper is too excited to eat because he knows he has work to do later that day.  

How does Pavel die or get hurt in The Boy in the Striped Pajamas?

In Chapter 13, Bruno mentions that Pavel is looking extremely tired and thin while he serves dinner. Pavel can barely stand upright with his back against the wall as Bruno's family eats. Bruno also notices that Pavel's hands shake while he carries the dinner plates. It is obvious to the reader that Pavel is suffering from malnutrition and lack of medical attention at Auschwitz. Towards the end the meal, Bruno's father asks Pavel to refill his glass, which Pavel typically does without being told. After Pavel fills the Commandant's glass, he turns to refill Lieutenant Kotler's glass, but ends up dropping the bottle of wine. The wine spills all over Kotler's uniform, and Kotler loses his temper. Boyne does not explicitly state what happens to Pavel, but it is suggested that Lieutenant Kotler beats Pavel unmercifully. Bruno begins to cry, and Gretel turns pale after witnessing Pavel's severe beating. Bruno also mentions that his father did not stop Kotler from beating Pavel. Pavel is not mentioned in the novel again after the incident, which suggests that he died due to the extensive injuries he suffered from Lieutenant Kotler's beating.

What is herpes simplex infection?

Definition

Herpes simplex infection is a sore or blister caused by the herpes simplex
virus (HSV) that can occur on the face or the genital area.
The blisters contain fluid that harbors the virus.

Causes

Herpes simplex infection is caused when the virus is transmitted by
person-to-person contact or by contact with contaminated items. HSV type 1 usually
causes cold sores or blisters on the lips, while HSV type 2 is usually the cause
of genital
herpes. Kissing, oral sex, or other sexual acts may transmit
the virus. Sharing infected items (fomites), such as lipstick, dishes, and towels,
may also cause infection. Pregnant women may infect their fetuses during a vaginal
birth.

Risk Factors

Exposure to someone with an active infection and contact with contaminated items are risk factors for infection with HSV. Newborns and persons who are stressed or who have a weak immune system are more at risk. Previous infection with herpes simplex is a risk factor in future infections. Unprotected sex is a risk factor for genital herpes.

Symptoms

The presence of small, painful blisters that are filled with fluid is the primary symptom of infection with HSV. A tingling or painful sensation may occur before blister development. Blister development may take a few weeks after exposure to the virus.

Screening and Diagnosis

There is no recommended routine screening test for the HSV. For
cold
sores, diagnosis is usually made based on symptoms. A
physician will ask about previous cold sores, current stress levels, tingling or
pain before the blister developed, and exposure to others with cold sores. For
genital herpes, a herpes viral culture of the fluid in the blister may be used in
addition to the physician’s examination. A herpesvirus
antigen test involves the use of a microscope to find markers on cells that
indicate infection. A polymerase chain reaction test can be used with fluids from
sores, blood, or spinal fluid to look for genetic material and can determine if
the virus is type 1 or type 2.

Treatment and Therapy

Outbreaks of herpes simplex infection may occur several times a year. Cold sores usually will clear up on their own or with over-the-counter treatments. Persons who have frequent cold sores, an impaired immune system, a cold sore that does not heal, or severe symptoms including pain, should contact a doctor. Oral antiviral drugs may be prescribed by the doctor if outbreaks are severe. Cold or warm cloths applied to the blister may ease the pain.

Genital herpes requires a visit to a physician. There is no treatment that can cure genital herpes, but medication is available to treat outbreaks and to suppress the virus.

Prevention and Outcomes

One should not share personal items with persons who have visible cold sores, should refrain from eating and drinking from shared plates and cups, and should use good handwashing technique. Genital herpes can be transmitted even when blisters are not present, so one should abstain from sexual contact when blisters are visible. Latex condoms, when correctly used, may reduce the risk of herpes simplex infection, but they cannot eliminate infection.

Bibliography

Gordon, Sara C., et al. “Viral Infections of the Mouth.” Available at http://emedicine.medscape.com/article/1079920-overview.

James, S. H., and R. J. Whitley. “Treatment of Herpes Simplex Virus Infections in Pediatric Patients: Current Status and Future Needs.” Clinical Pharmacology and Therapeutics 88 (2010): 720-724.

Kane, Melissa, and Tatyana Gotovkina. “Common Threads in Persistent Viral Infections.” Journal of Virology 84 (2010): 4116-4123.

Khare, Manjiri. “Infectious Disease in Pregnancy.” Current Obstetrics and Gynaecology 15 (2005): 149-156.

What are three examples of how people are afraid of what they don't know throughout the novel To Kill a Mockingbird?

There are several examples of people fearing what they do not know or understand throughout the novel To Kill a Mockingbird. The most obvious example of individuals fearing the unknown is the way the children view the mysterious Boo Radley at the beginning of the novel. They believe the negative rumors that portray Boo Radley to be the "malevolent phantom" who commits small crimes throughout the community. In reality, Boo Radley is simply a reclusive, shy individual who has fallen victim to his father's religious fanaticism.

During Atticus' closing remarks of the trial, he speaks about the "evil assumption" that all black men are essentially immoral beings, which is the predominant view held by Maycomb's citizens. The citizens of Maycomb fear the black community because they do not understand that race has nothing to do with a person's character or morals. They hold prejudiced beliefs and stereotype the entire black community instead of attempting to understand the differences in each other's culture.

In Chapter 24, Mrs. Grace Merriweather displays her fear about foreign cultures and tribes in Africa. She is culturally ignorant and does not understand the Mrunas' society, values, and beliefs. She concludes that there is nothing but sin and squalor on the continent of Africa, instead of approaching the Mrunas' culture with an open mind.

What is the significance of Matt not knowing what "gift" means in the book Gathering Blue?

In Lois Lowry's book Gathering Blue, the fact that Matt does not know what "gift" means is significant is because it demonstrate Matt's background and upbringing (or, rather, the lack of it.) By showing where Matt come from, the author highlights the transformation Matt goes through to become the type of person he is at the end of Gathering Blue and in its sequel, The Messenger.

Matt and Kira, who is the main character in Gathering Blue, live in a village in primitive conditions. The villagers have to work very hard to survive, to provide food and maintain shelter for themselves and their families. While sometimes they have to cooperate and work together to accomplish some tasks for everyone's benefit, ultimately the people in the village view each other as competitors, if not enemies - if one gets more, the other one gets less.

Matt comes from particularly impoverished section of the village, the Fen. Kira was raised by a loving mother who put her needs first, but in the Fen, even the parents compete with their children for food. There, the children are a burden, and relationships such as friendship are non-existent. Therefore, Matt has no clue what a "gift" is - he has never seen anyone giving to another without expecting something in return; he does not even know that such a concept exists. However, when Kira explains it to him, he is fascinated.

Because of the friendship that develops between Matt and Kira, who looks out for him, Matt's emotional needs, which he did not know he had, become fulfilled. Eventually, Matt travels all the way through the forest to look for another village where, he heard, "they know how to make blue" -  to bring Kira "the blue" as a gift.

What is ornithine transcarbamylase deficiency?

Risk Factors

There are no known risk factors for OTC deficiency. As an X-linked defect, the incidence in males is higher than in females; however, heterozygous females may be affected.

Etiology and Genetics

Ornithine transcarbamylase, found primarily in liver mitochondria, is an early enzyme in the urea cycle. In this cycle, ammonia, produced by the degradation of proteins and the subsequent deamination of their constituent amino acids, is converted to urea, which can be safely eliminated. When ornithine transcarbamylase is missing, carbamyl phosphate, formed in part from ammonia released by deamination of amino acids, cannot combine with ornithine. As carbamyl phosphate concentrations rise in the liver, ammonia is released into the circulatory system.

The gene coding for ornithine transcarbamylase is located on the short arm of the X chromosome at position p21.1. As with all X-linked genes, since males have only a single X chromosome, alleles on this X are expressed whether they are dominant or recessive. Females have two X chromosomes and thus can be heterozygous for X-linked genes. More than three hundred different mutations of the ornithine transcarbamylase gene are known. Males who inherit an X chromosome that leads to little or no enzyme activity have severe early-onset symptoms with high morbidity and mortality. Most males with late-onset symptoms have mutations that lead to enzymes with lowered activity ranging from 26 to 74 percent of normal.

Expression of the OTC deficiency phenotype in females is quite variable and depends on both the pattern of X chromosome inactivation in the liver and the type of mutation inherited. If a female is heterozygous for a normal and a deficient OTC allele, then her liver is a mosaic, since one X chromosome is randomly inactivated in each cell. If, in a heterozygous female’s liver, the majority of cells have the normal X turned off, then she will show more symptoms of her OTC deficient allele. If, on the other hand, more of the OTC deficient X chromosomes are turned off, then she may have few if any symptoms. Females thus can vary from being severely affected to being asymptomatic.

The estimated incidence of early-onset OTC deficiency is 1 in 80,000 live births. When male late-onset OTC deficiency and variable female expression are included, estimates run as high as 1 in 20,000 live births.

Symptoms

The primary symptom of OTC deficiency is hyperammonemia. In early-onset OTC deficiency, as the excess ammonia reaches the central nervous system, lethargy, anorexia, and a general failure to thrive are often the first readily apparent symptoms. These are followed by disorientation, seizures, combativeness, somnolence, coma, and finally death. In those that survive, mental retardation is common. Many of these same symptoms, sometimes less severe, are seen in late-onset OTC deficiency. Often symptoms appear after stressors such as infections, surgery, and high-protein meals. Because of mosaicism, symptoms in female heterozygotes vary widely. Symptoms can be as severe as in affected males, or can be quite minor. In some women, the only symptom is migraine headaches after eating meals rich in protein. Some asymptomatic women show hyperammonemia during pregnancy or shortly after childbirth.

Screening and Diagnosis

The primary diagnostic characteristic of OTC deficiency is the demonstration of hyperammonemia. In addition, elevated urinary output of orotic acid can be used to identify patients and sometimes asymptomatic carriers. Levels of OTC can be measured in the fetus for prenatal diagnosis. Genetic counseling is recommended for families in which this disease has occurred.

Treatment and Therapy

Several treatment options are available to prevent or lessen the severity of the hyperammonemia. First, a patient needs to be on a very low protein diet, which must be maintained for life. Deviation from the diet, especially during infancy, childhood, and adolescence, can lead to coma and death. Sodium benzoate, arginine, and sodium phenylacetate may be administered intravenously and citrulline may be taken orally to reduce ammonia levels in the blood. Hemodialysis can be used on comatose patients with extremely high ammonia levels and liver transplant can also be an effective treatment.

Prevention and Outcomes

Symptoms can be lessened by diet and medication but the disease itself cannot be prevented. Unfortunately, unless the disease is diagnosed prenatally, some nervous system damage usually occurs before diagnosis. Without treatment, the early-onset disease is lethal in infancy. With treatment, children can survive longer but often succumb at an early age because the correct balance of diet and medication is difficult to maintain. Late-onset OTC deficiency can often be managed with dietary restrictions since many late-onset patients are not completely enzyme-deficient; however, late-onset deficiency can lead to sudden death when ammonia levels rise sharply.

Bibliography

Arranz, J. A., et al. “The Relationship of OTC Structure to Disease Severity.” Journal of Inherited Metabolic Disease 30 (2007): 217–26. Print.

Nightengale, Scott, et al. "Late-Onset Ornithine Transcarbamylase Deficiency Presenting with Asymptomatic Liver Dysfunction." Journal of Pediatric Gastroenterology and Nutrition 58.6 (2014): e55–e57. Print

Rush, Eric T., et al. "Late-Onset Ornithine Transcarbamylase Deficiency: An Under Recognized Cause of Metabolic Encephalopathy." SAGE: Open Medical Case Reports 2 (July 2014): 1–4. Print.

Tuchman, M., et al. “The Molecular Basis of OTC Deficiency.” European Journal of Pediatrics 159 Suppl. 3 (2000): S196–98. Print.

Wilemon, Tom. "Weight-loss Surgery Triggered Rare Genetic Wasting Disorder." USA Today. Gannett, 15 May 2012. Web. 4 Aug. 2014.

Wilken, B. “Management of Patients with OTC Deficiency.” Molecular Genetics and Metabolism 81 Suppl 1 (2004): S86–91. Print.

What is an anti-inflammatory diet?

Overview

Numerous evidence-based research studies in the twenty-first century support
the use of anti-inflammatory diets for the treatment and prevention of chronic
degenerative diseases. These studies examined dietary properties that included raw
versus processed, organic versus commercially grown, and natural versus
genetically modified. The studies also looked at the dietary effects of herbs and
spices, fruits and vegetables, nuts and seeds, grains and legumes, minerals and
vitamins, and phytochemicals and polyunsaturated fatty acids such as
omega-3.

Mechanism of Action

There are few direct or indirect pathways (based on the specific inflammatory
biomarkers) that explain how the anti-inflammatory diet works. The
eicosanoid-related anti-inflammatory pathway is typical for foods with high
omega-3 fatty acid content. This pathway decreases levels of arachidonic acid and
inflammatory mediators such as cytokines, related prostaglandins, and
related metabolites. This process also decreases the activities of inflammatory
cells in the immune system.

Food with active phytochemicals (for example, resveratol and epigallocatechin galate) works through an inhibitory effect on nuclear transcription (for example, nuclear transcription factor) and through a signaling process.

Therapeutic Uses

Based on recent research studies, the anti-inflammatory diet could be used as a
therapy for chronic degenerative diseases that have chronic inflammation as a
common denominator. These diseases include diabetes,
cardiovascular diseases, obesity, and certain cancers, as well
as arthritis, osteoporosis, and other immune system
disorders.

Scientific Evidence

Evidence-based research shows that an anti-inflammatory diet is beneficial in
treating many chronic degenerative disease conditions. A 2003 double-blind,
cross-over study included sixty-eight persons with a diagnosis of rheumatoid
arthritis. Participants were divided into two groups for
eight months of observation. One group was on a regular Western diet, and the
other group was on an anti-inflammatory diet with specific regulations on
arachidonic acid (low intake). Both groups received placebo or fish oil capsules
for three months. Persons on the anti-inflammatory diet, but not those on the
typical Western diet, showed improvements in tender and swollen joints and showed
even higher improvements when fish oil was added. The basic anti-inflammatory diet
can augment the beneficial effects of any single, added anti-inflammatory food
component.

In a 2010 double-blind, placebo-controlled, crossover study with a treatment
period of five weeks, thirty-six healthy overweight persons received what was
called an anti-inflammatory dietary mix (AIDM), which included green tea extract,
resveratol (grape extract), vitamin C, vitamin E
(alpha-tocopherol), tomato extract, and omega-3 fatty acid. All of these food
components are described as anti-inflammatory by human and animal research
studies. Serum and urine inflammatory biomarkers were measured. The AIDM brought
about a decrease in inflammation and in oxidative stress (a
marker for risk of inflammation) and changes in lipid metabolism (with a decrease
of triglycerides and with improvement of endothelial function).

In a 2010 single-blind, randomized study, thirty-five persons diagnosed with
obesity and metabolic syndrome were put on either an anti-inflammatory
diet (consisting of green tea or green tea extract) or no diet for eight weeks.
The group on green tea beverages or green tea extract showed lower
interleukin (one of the biomarkers for inflammation)
levels.

Safety Issues

No adverse side effects have been reported with the use of the anti-inflammatory diet. Beneficial changes in bowel habits can occur in the beginning, however.

Bibliography

Adam, O., et al. “Anti-inflammatory Effects of a Low Arachidonic Acid Diet and Fish Oil in Patients with Rheumatoid Arthritis.” Rheumatology International 23, no. 1 (2003): 27-36.

Bakker, G. C. M., et al. “An Anti-inflammatory Dietary Mix Modulates Inflammation and Oxidative and Metabolic Stress in Overweight Men: A Nutrigenomic Approach.” American Journal of Clinical Nutrition 91 (2010): 1044-1059.

Basu, A., et al. “Green Tea Minimally Affects Biomarkers of Inflammation in Obese Subjects with Metabolic Syndrome.” Nutrition, June, 2010.

Calder, P. C., et al. “Polyunsaturated Fatty Acids, Inflammation, and Immunity.” European Journal of Clinical Nutrition 56, suppl. 3 (2002): S14-S19.

Dandona, P., et al. “The Anti-inflammatory and Potential Anti-atherogenic Effect of Insulin: A New Paradigm.” Diabetologia 45 (2002): 924-930.

Libby, P. “Inflammatory Mechanisms: The Molecular Basis of Inflammation and Disease.” Nutrition Reviews 65, no. 12 (2007): 140-146.

Roberts, C. K., et al. “Effects of a Short-Term Diet and Exercise Intervention on Inflammatory/Anti-inflammatory Properties of HDL in Overweight/Obese Men with Cardiovascular Risk Factors.” Journal of Applied Physiology 101 (2006): 1727-1732.

What does Jem first find in the knothole of the oak tree in Harper Lee's To Kill a Mockingbird?

In Chapter 4 of Harper Lee's To Kill a Mockingbird, Scout is the first to find something in the knothole of an oak tree on the Radley lot. After that, walking home together, Scout and Jem jointly find another item in the knothole.

Walking home from school by herself soon before the start of summer, Scout sees some tinfoil shining in the knothole. When she goes to investigate, she discovers "two pieces of chewing gum minus their outer wrappers" and crams them in her mouth as quickly as possible. When she tells Jem about her discovery, he is aghast that she chewed the gum and reminds her, "Don't you know you're not supposed to even touch the trees over there? You'll get killed if you do!" (Ch. 4). Though Scout disagrees that there is any danger in her chewing the gum, she eventually obediently gargles for Jem.

Later, while walking home together on the last day of school, Scout and Jem both simultaneously see some more tinfoil shining in the knothole of the oak tree, as we can tell when Jem says, "I see it, Scout! I see it—" (Ch. 4). Disregarding his own advice, "Jem looked around, reached up, and gingerly pocketed a tiny shiny package." Once the children get home, they find they are holding a small jewelry box wrapped in "chewing-gum wrappers." Inside of the box are two very polished pennies dated 1906. Jem realizes they are somebody's treasures and must have been stored in the tree for safekeeping. He plans to hold on to them until they can find out who they belong to once school starts up again.

Identify two groups that brought about an end to the Byzantine Empire; describe what they each did.

The Byzantine Empire faced a number of threats from different fronts. The Byzantine Empire was engaged in long-running conflicts with both the Bulgarian and Serbian Empires. However, the two groups that played a major role in its decline were the crusaders or the Catholics of the Western Roman Empire and the Turks who later formed the Ottoman Empire.

The conflict between the Byzantine Empire and the Western Roman Empire revolved around religious differences. The Byzantine Empire identified with Orthodox Christianity while the Western Empire identified with Catholicism. These differences led to the sacking of Constantinople by the crusaders of the Western Empire resulting in the growing enmity between the two groups. These conflicts drained resources that would have otherwise been used in the growth and development of the Byzantine Empire.

Losses suffered by the Byzantine Empire made the region vulnerable to attacks by the Turks. The Turks took the opportunity to annex Byzantine lands. The Empire was forced to seek help from the Western Empire. However, the condition to renounce Orthodoxy for Catholicism was unpopular among the Byzantine people, who rejected the condition. This delayed the help from the Western Empire, and by the time compromises were made, it was too late, and the Empire fell to the Turks who later united to form the Ottoman Empire.

How did the Spanish-American War affect American society?

The Spanish-American War had far-reaching effects on American society. With the victory, the United States acquired colonies in Guam, Puerto Rico, and the Philippines. This spurred a great debate about America's participation in imperialism. Many believed that the United States was hypocritical in fighting against Spanish imperialism only to take on colonies of their own. The Philippines, led by Emilio Aguinaldo, resisted American colonial rule which resulted in a bloody three-year conflict in the Pacific.

The Spanish-American War also created a sort of folk hero out of Theodore Roosevelt. His heroics in Cuba, which were greatly exaggerated, made him a legitimate political force in the United States. This led him to be selected as William McKinley's vice president in 1900. He would become president when McKinley was assassinated and continued to push for American expansion. The war also pointed to a need to create a canal in Panama to connect the oceans for military purposes. This was pushed forward by Roosevelt as he was instrumental in the construction of the Panama Canal as President of the United States.

The Spanish-American War also transformed the American press. The coverage of the War was very popular on the home front and a number journalists became powerful as a result (Joe Pulitzer and William Randolph Hearst are the most obvious examples.) The Spanish-American War marked the birth of the newspaper as a major popular media form.

What is hematuria?

Causes and Symptoms

Hematuria can present as bloody urine that is visible to the naked eye, or it can be subtle, detectable only by microscopic analysis. The source of the blood can be from any part of the urinary system, including the kidneys, bladder, and urethra. Hematuria can be accompanied by a variety of symptoms, or it can be completely asymptomatic.

The presentation, source, and symptoms of hematuria are functions of its broad range of causes. Possibly the most common cause of hematuria is a urinary tract infection
(UTI), which includes infections of the kidney (pyelonephritis), bladder (cystitis), and urethra (urethritis). UTIs generally are caused by bacteria such as Escherichia coli and are accompanied by symptoms such as fever, pain with urination, and urinary frequency or urgency.

Another common cause of hematuria is kidney stones (nephrolithiasis). Stones are most commonly composed of calcium and can present with severe pain, nausea, and vomiting.

Hematuria can also be the presenting symptom of innocent causes such as benign familial hematuria (a mild inherited condition), benign prostatic hyperplasia
(BPH or enlarged prostate, a common condition in middle-aged and elderly men), medication, and exercise. In other situations, it can be the first sign of life-threatening problems such as bladder or kidney cancer and trauma.

Treatment and Therapy

The therapeutic options for treating hematuria depend on its cause. For a UTI, treatment can be a course of oral antibiotics, or it may require hospitalization and intravenous antibiotics in the case of a severe infection. In the case of kidney stones, the stones will usually pass on their own, but in some cases interventions such as surgery or lithotripsy (breaking up the stones) are necessary to clear the obstruction.

If the cause is benign familial hematuria or exercise, then reassurance may be all the treatment that is required. BPH may also be treated with reassurance and lifestyle change, or medication and surgical intervention may be initiated to help reduce the size of the prostate. If medication is the cause of hematuria, the condition may be self-limited, or a patient may be advised to change or stop the medication.

Cancers of the bladder and kidneys are treated with chemotherapy, radiation, surgery, immunotherapy, or a combination of these options, depending on the type and severity of the cancer. Hematuria as a sign of trauma to the kidneys is treated based on careful consideration of various options, and treatment may include surgery.

Bibliography

"Blood in Urine (Hematuria)." Mayo Clinic, September 1, 2011.

Domino, Frank, ed. The Five-Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2006.

Kilmartin, Angela, ed. The Patient’s Encyclopaedia of Urinary Tract Infection, Sexual Cystitis, and Interstitial Cystitis. London: Angela Kilmartin, 2002.

Lopez, Ralph. “The Kidneys.” In The Teen Health Book: A Parents’ Guide to Adolescent Health and Well-Being, edited by Kate Kelly. New York: W. W. Norton, 2003.

Shannon, Diane W. "Blood in Urine (Hematuria—Adult)." Health Library, January 10, 2013.

U.S. Department of Health and Human Services. "Hematuria: Blood in the Urine." National Kidney and Urologic Diseases Information Clearinghouse, April 16, 2012.

In Fahrenheit 451 by Ray Bradbury, how does Mildred feel about Guy owning books?

After Beatty's visit to their home in Part One of Fahrenheit 451, Montag reveals his hidden stash of books to Mildred. Her reaction is a combination of shock and intense fear, as we see in the text:

Mildred backed away as if she were suddenly confronted by a pack of mice that had come up out of the floor. He could hear her breathing rapidly and her face was paled out and her eyes were fastened wide. 

Mildred then (unsuccessfully) tries to set fire to one of Montag's books by burning it in the incinerator. In doing this, she literally rejects his ownership of books and makes very clear that she has no interest in sharing his hobby.

As the plot develops, Montag's books become a source of major concern and anxiety for Mildred: she is terrified that the authorities will find out that Montag has books in his possession and that the firemen will destroy her home. This fear then transforms into a need for self-preservation: eventually, she reports Montag and his books to Captain Beatty and then disappears off into the city. 

What was the significance of the Declaration of Independence right after it was approved?

Right after the Declaration of Independence was approved and adopted by the Second Continental Congress, we were a free and independent nation. We no longer were following British rules, policies, or laws. We were free to make our own laws and make our own agreements with other countries. The issuing of the Declaration of Independence was to inform the world that we were independent and that these countries should feel free to make agreements with us. We wanted these countries to recognize that we were an independent nation.

The adopting of the Declaration of Independence also meant that we were going to be fighting Great Britain for our independence. The British weren’t going to allow us to declare our independence and become independent without fighting them for our independence. We needed to be prepared for a war, and possibly a long war, with Great Britain. We had to win this war to really confirm our independence from Great Britain.

Adopting the Declaration of Independence also meant we had to develop a plan of government for the country. While the Second Continental Congress operated like a form of government, we needed an official plan for a new government. This was eventually done when the new plan of government was established under the Articles of Confederation.

The adopting of the Declaration of Independence had several significant and immediate effects for the former colonies.

What is the inciting incident in Animal Farm?

If I understand what you mean by inciting incident, which I am interpreting as the specific incident or precipitating event that brings the plot of the novel into being, that incident would be as follows. The animals have been underfed and neglected by Farmer Jones and his men because Farmer Jones has taken to drinking too heavily and his men are dishonest. On Midsummer's Eve, he goes out and has a drunken binge. Meanwhile, his men go rabbiting. The animals are unfed, hungry and fed up. A hungry cow breaks into the store shed and all the animals begin to eat. When Farmer Jones and his men come in with whips to restore order, the animals rebel. They fight back. So the inciting incident is Farmer Jones and the men coming in to whip the hungry animals and chase them away from the food stores. This brings Animal Farm into being for the following reasons: first, Farmer Jones and his men are chased off the farm, second, when Mrs. Jones sees what is happening she packs her bag and leaves, along with Moses. Third, the animals burn everything that reminds them of the humans, such as the whips and the ribbons they would braid in the horses' manes. More importantly, it is at this point that they adopt the Seven Commandments of Animalism and rename the farm Animal Farm, from which the book gets its title. From this point forward, all the action will revolve around the animals' experiment in running the farm themselves. 

What is allomorphy?

In linguistics, a morpheme is the minimal unit of meaning in a language. Morphemes include words (roots) and affixes (postfixes, prefixes, infixes, etc.). An allomorph is a variant of a morpheme. 

So when we look at a word like 'cats', we actually have two morphemes used together to signify multiples members of Felis catus (please note that in the examples below I am using phonemic notation for the sounds of the morphemes, but due to the constraints of this format, I am not using IPA for the vowel sounds; instead, I am using English spelling conventions for the vowel sounds even though the forms  enclosed in // should be read as phonemic representations):

{CAT}+{pl} = /kat/ + /-s/ = 'cats'

So, we can see that '-s' is a morpheme that is used to make nouns plural in English. However, it is not the only form of the plural in English. Consider the word 'dogs':

{DOG} + {pl} = /dog/ + /-z/ = 'dogs'

With the words 'dogs', we see an allomorph of the standard English plural morpheme. It can be realized as /-s/ or as /-z/ depending on the phonetic environment of the word to which it is affixed. In an unvoiced environment, it is /-s/ whereas in a voiced environment it is /-z/.

Not all instances of allomorphy are so straightforward, however. To see two more complex situations, we need look no further than some irregular forms of the plural in English.

The plural of 'mouse' is 'mice', not *mouses. This is an umlaut plural in English. It is still the root morpheme plus the plural morpheme, but in this case the plural morpheme is realized as a change form a back vowel to a front vowel in the root:

{MOUSE}+{pl} = /mais/

The change of the back vowel in /mous/ to a front vowel in /mais/ is an allomorph of the English plural morpheme. Another allomorph of the English plural is a null change, as in deer:

{DEER}+{pl} = /deer/

The null change is an allomorph of the English plural morpheme even though there is no actual change to the root word. The reason for this is that morphemes are abstract units of meaning, and they exist even if an allomorph of the morpheme is phonologically null.

What had broken Madame Schachter’s spirit?

Like Moshe the Beadle, Madame Schächter attempts to warn the Jews of Sighet about the horrors to come. Moshe described the atrocities he witnessed in the forest of Galicia. Madame Schächter is a prophetess, describing the flames of the furnaces at the death camps. While on the train to Auschwitz she becomes hysterical, calling out that she sees fire. Three times she warns them of the flames, but when they look outside there is nothing but darkness. To keep her quiet the men beat her, tie her up and put a gag in her mouth. Even this brutality does not dissuade her, and the fourth time she cries out the flames of the crematoria actually come into view as the train pulls into the station at Birkenau, the reception center for Auschwitz. Her spirit is not broken until they arrive and her warnings prove to be true. After her last outburst Wiesel says, "she had become dumb, indifferent, absent, and had gone back to her corner." He sees her for the last time as they depart from the train.