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Microscopy remains the cornerstone of laboratory testing for the identification of most blood parasites and many tissue parasites [ 289–291 ]. Expert microscopic examination of Giemsa-stained thick and thin peripheral blood films is used for detection and identification of the protozoan blood parasites Plasmodium , Babesia , and Trypanosoma , and the filarial nematodes Brugia , Wuchereria , Loa loa , and Mansonella , whereas microscopic examination, culture and/or nucleic acid amplification of ulcer samples, bone marrow, tissue aspirates, and biopsies are useful in the diagnosis of African trypanosomiasis, onchocerciasis, trichinosis, toxoplasmosis, and leishmaniasis. Although requiring a minimal amount of reagents and equipment, the accuracy of microscopic methods requires well-trained and experienced technologists. Even in the best hands, diagnosis may be hampered by sparseness of organisms on the slide and the subjective nature of differentiating similar-appearing organisms ( Plasmodium vs Babesia ; various microfilariae) or in identifying the species of Plasmodium present. The laboratory can enhance the sensitivity of these methods by employing a number of concentration procedures such as buffy coat examination, centrifugation, and filtration. In all of these procedures, samples must be properly obtained, transported to the laboratory as quickly as possible, and processed in a timely fashion to preserve organism viability and/or morphology. Organism viability and morphology may be adversely affected by a number of different factors including temperature, humidity, and exposure to fixatives or anticoagulants. Transportation requirements are described for each organism in the corresponding sections below.

Serologic assays for detection of antibodies are available as adjunctive methods for the diagnosis of a number of blood and tissue parasite infections. Unfortunately, none are sensitive or specific enough to be used to establish the diagnosis on their own. In particular, assays for infection with one helminth will often cross-react with antibodies to a different helminth [ 290 ]. When available, antibody titers may be used to determine the strength of the immune response or detect a trend in antibody levels over time. IFA can provide quantitative titer results but reading the slides is subjective and inherently prone to varying results. In contrast, EIAs typically provide only qualitative positive or negative results determined by an arbitrarily set breakpoint. Thus, clinicians will not be able to determine if a positive result was a very strong positive or a very weak one without calling the laboratory for more information. This can have important implications for interpretation of results that are not entirely consistent with the clinical picture. In some cases, it is desirable to confirm the result of an EIA by using a more specific immunoblot assay.

Observations

A new paper argues the condition now known as “dissociative identity disorder” might help us understand the fundamental nature of reality

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the extraordinary case of a woman who suffered from what has traditionally been called “multiple personality disorder” and today is known as “dissociative identity disorder” (DID). The woman exhibited a variety of dissociated personalities (“alters”), some of which claimed to be blind. Using EEGs, the doctors were able to ascertain that the brain activity normally associated with sight wasn’t present while a blind alter was in control of the woman’s body, even though her eyes were open. Remarkably, when a sighted alter assumed control, the usual brain activity returned.

This was a compelling demonstration of the literally blinding power of extreme forms of dissociation, a condition in which the psyche gives rise to multiple, operationally separate centers of consciousness, each with its own private inner life.

Modern neuroimaging techniques have demonstrated that DID is real: TShirt Aya black Tigha Newest Online Outlet 2018 Wholesale Price For Sale Clearance Best Sale YvYYloG
, doctors performed functional brain scans on both DID patients and actors simulating DID. The scans of the actual patients displayed clear differences when compared to those of the actors, showing that dissociation has an identifiable neural activity fingerprint. In other words, there is something rather particular that dissociative processes in the brain.

There is also compelling clinical data showing that different alters can be concurrently conscious and see themselves as distinct identities. One of us has written an extensive treatment of evidence for this distinctness of identity and the complex forms of interactive memory that accompany it, particularly in those extreme cases of DID that are usually referred to as multiple personality disorder.

The history of this condition dates back to the early 19th century, with a flurry of cases in the 1880s through the 1920s, and again from the 1960s to the late 1990s. The massive literature on the subject confirms the consistent and uncompromising sense of separateness experienced by the alter personalities. It also displays compelling evidence that the human psyche is constantly active in producing personal units of perception and action that might be needed to deal with the challenges of life.

Although we may be at a loss to explain precisely how this creative process occurs (because it unfolds almost totally beyond the reach of self-reflective introspection) the clinical evidence nevertheless forces us to acknowledge something is happening that has important implications for our views about what is and is not possible in nature.

Now, a newly published paper by one of us posits that dissociation can offer a solution to a critical problem in our current understanding of the nature of reality. This requires some background, so bear with us.

According to the mainstream metaphysical view of physicalism , reality is fundamentally constituted by physical stuff outside and independent of mind. Mental states, in turn, should be explainable in terms of the parameters of physical processes in the brain.

A key problem of physicalism, however, is its inability to make sense of how our subjective experience of qualities—what it is like to feel the warmth of fire, the redness of an apple, the bitterness of disappointment and so on—could arise from mere arrangements of physical stuff.

Physical entities such as subatomic particles possess abstract relational properties, such as mass, spin, momentum and charge. But there is nothing about these properties, or in the way particles are arranged in a brain, in terms of which one could deduce what the warmth of fire, the redness of an apple or the bitterness of disappointment feel like. This is known as the hard problem of consciousness .

To circumvent this problem, some philosophers have proposed an alternative: that experience is inherent to every fundamental physical entity in nature. Under this view, called “ Cheap Discount Sale Dress Women 2017 Custom Made Fashionable Design White and Blue Belted Striped Linen Midi Dress Drop Shipping Sale Nicekicks Pre Order For Sale Cheap Authentic OR8XGXQheh
,” matter already has experience from the get-go, not just when it arranges itself in the form of brains. Even subatomic particles possess some very simple form of consciousness. Our own human consciousness is then (allegedly) constituted by a combination of the subjective inner lives of the countless physical particles that make up our nervous system.

However, constitutive panpsychism has a critical problem of its own: there is arguably no coherent, non-magical way in which lower-level subjective points of view—such as those of subatomic particles or neurons in the brain, if they have these points of view—could combine to form higher-level subjective points of view, such as yours and ours. This is called the Outlet Authentic DENIM Denim shorts Current Elliott New Styles Cheap Online Looking For Cheap Real Eastbay Cheap Sale Online HgTlx9RPJn
and it appears just as insoluble as the hard problem of consciousness.

The obvious way around the combination problem is to posit that, although consciousness is indeed fundamental in nature, it isn’t fragmented like matter. The idea is to extend consciousness to the entire fabric of spacetime, as opposed to limiting it to the boundaries of individual subatomic particles. This view—called “ TROUSERS 3/4length trousers Cacharel Cost Outlet Latest Collections Footaction Cheap Online Sale Good Selling 9Xo4yWlN
in modern philosophy, although our preferred formulation of it boils down to what has classically been called “ New For Sale From China Free Shipping Low Price Silk Necktie Brown base and small multicoloured butterflies Notch TITLI Notch dG7rhVFcB
”—is that there is only one, universal, consciousness. The physical universe is the extrinsic appearance of universal inner life, just as a living brain and body are the extrinsic appearance of a person’s inner life.

You don’t need to be a philosopher to realize the obvious problem with this idea: people have fields of experience. We can’t normally read your thoughts and, presumably, neither can you read ours. Moreover, we are not normally aware of what’s going on across the universe and, presumably, neither are you. So, for idealism to be tenable, one must explain—at least in principle—how one universal consciousness gives rise to multiple, private but concurrently conscious centers of cognition, each with a distinct personality and sense of identity.

And here is where dissociation comes in. We know empirically from DID that consciousness can give rise to many operationally distinct centers of concurrent experience, each with its own personality and sense of identity. Therefore, if something analogous to DID happens at a universal level, the one universal consciousness could, as a result, give rise to many alters with private inner lives like yours and ours.

Moreover, as we’ve seen earlier, there is something dissociative processes in the brain of a patient with DID. So, if some form of universal-level DID happens, the alters of universal consciousness must also have an extrinsic appearance. We posit that this appearance is : metabolizing organisms are simply what universal-level dissociative processes look like.

Idealism is a tantalizing view of the nature of reality, in that it elegantly circumvents two arguably insoluble problems: the hard problem of consciousness and the combination problem. Insofar as dissociation offers a path to explaining how, under idealism, one universal consciousness can become many individual minds, we may now have at our disposal an unprecedentedly coherent and empirically grounded way of making sense of life, the universe and everything.

The views expressed are those of the author(s) and are not necessarily those of Scientific American.

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By howard fendrich, ap tennis writer
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The Associated Press
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Serena Williams says it isn't fair that she has been drug-tested more than other American tennis players this year.

"Just test everyone equally," the seven-time Wimbledon champion said Sunday at a pre-tournament news conference.

She was asked about the issue because of a recent report by Deadspin that said Williams had been checked five times in 2018 by June, more than other U.S. women and men in the sport.

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U.S. Anti-Doping Agency spokesman Brad Horn told The Associated Press that the five tests conducted on Williams were a result of three visits from a test collector.

"It is standard practice on many testing missions to obtain both urine and blood samples, resulting in multiple samples from a single testing mission," Horn said.

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