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Kiki Strike

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The Kiki Strike series, by Kirsten Miller , is a series of three novels revolving around the adventures of six girls in Manhattan, and currently consists of three books ( Inside the Shadow City , The Empress's Tomb and The Darkness Dwellers ).

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96-482: Told from Ananka Fishbein's point of view, these books describe the adventures of the Irregulars, a group of girls who join to explore an underground world beneath Manhattan called "The Shadow City." During this, they must fight against various villains and help save the city of New York numerous times. Ananka Fishbein (pronounced un-AH-nka Fish-Bean) Ananka attends a private school called Atalanta, and lives in

192-1118: A beached whale , and eight of them developed symptoms of botulism, two of them requiring mechanical ventilation . Other, much rarer sources of infection (about every decade in the US ) include garlic or herbs stored covered in oil without acidification , chili peppers , improperly handled baked potatoes wrapped in aluminum foil, tomatoes, and home-canned or fermented fish . When canning or preserving food at home, attention should be paid to hygiene, pressure, temperature, refrigeration and storage. When making home preserves, only acidic fruit such as apples, pears, stone fruits and berries should be used. Tropical fruit and tomatoes are low in acidity and must have some acidity added before they are canned. Low-acid foods have pH values higher than 4.6. They include red meats, seafood, poultry, milk, and all fresh vegetables except for most tomatoes. Most mixtures of low-acid and acid foods also have pH values above 4.6 unless their recipes include enough lemon juice, citric acid, or vinegar to make them acidic. Acid foods have

288-401: A brain scan , cerebrospinal fluid examination, nerve conduction test ( electromyography , or EMG), and an edrophonium chloride (Tensilon) test for myasthenia gravis . A definite diagnosis can be made if botulinum toxin is identified in the food, stomach or intestinal contents, vomit or feces. The toxin is occasionally found in the blood in peracute cases. Botulinum toxin can be detected by

384-450: A 2008 review the FDA added these concerns as a boxed warning . An international grassroots effort led by NeverTox to assemble the people experiencing Iatrogenic Botulism Poisoning (IBP) and provide education and emotional support serves 39,000 people through a Facebook group who are suffering from adverse events from botulinum toxin injections. Prior to the boxed warning labels that included

480-728: A better vaccine was being carried out, but the US FDA had not approved any vaccine against botulism. Botulism is generally treated with botulism antitoxin and supportive care. Illness This is an accepted version of this page A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury . Diseases are often known to be medical conditions that are associated with specific signs and symptoms . A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of

576-465: A boiling-water canner. Oils infused with fresh garlic or herbs should be acidified and refrigerated. Potatoes which have been baked while wrapped in aluminum foil should be kept hot until served or refrigerated. Because the botulism toxin is destroyed by high temperatures, home-canned foods are best boiled for 10 minutes before eating. Metal cans containing food in which bacteria are growing may bulge outwards due to gas production from bacterial growth or

672-407: A complete descending flaccid paralysis . Although constipation is usually the first symptom of infant botulism, it is commonly overlooked. Honey is a known dietary reservoir of C. botulinum spores and has been linked to infant botulism. For this reason, honey is not recommended for infants less than one year of age. Most cases of infant botulism, however, are thought to be caused by acquiring

768-425: A disclaimer that botulinum toxin injections could cause botulism, there were a series of lawsuits against the pharmaceutical firms that manufactured injectable botulinum toxin. A Hollywood producer's wife brought a lawsuit after experiencing debilitating adverse events from migraine treatment. A lawsuit on behalf of a 3-year-old boy who was permanently disabled by a botulinum toxin injection was settled in court during

864-612: A disease can alter the affected person's perspective on life. Death due to disease is called death by natural causes . There are four main types of disease: infectious diseases, deficiency diseases , hereditary diseases (including both genetic and non-genetic hereditary diseases ), and physiological diseases. Diseases can also be classified in other ways, such as communicable versus non-communicable diseases. The deadliest diseases in humans are coronary artery disease (blood flow obstruction), followed by cerebrovascular disease and lower respiratory infections . In developed countries,

960-424: A disease or other health problems. In the medical field, therapy is synonymous with the word treatment . Among psychologists, the term may refer specifically to psychotherapy or "talk therapy". Common treatments include medications , surgery , medical devices , and self-care . Treatments may be provided by an organized health care system , or informally, by the patient or family members. Preventive healthcare

1056-416: A number of positive and negative effects on the financial and other responsibilities of governments, corporations, and institutions towards individuals, as well as on the individuals themselves. The social implication of viewing aging as a disease could be profound, though this classification is not yet widespread. Lepers were people who were historically shunned because they had an infectious disease, and

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1152-493: A pH of 4.6 or lower. They include fruits, pickles, sauerkraut, jams, jellies, marmalades, and fruit butters. Although tomatoes usually are considered an acid food, some are now known to have pH values slightly above 4.6. Figs also have pH values slightly above 4.6. Therefore, if they are to be canned as acid foods, these products must be acidified to a pH of 4.6 or lower with lemon juice or citric acid. Properly acidified tomatoes and figs are acid foods and can be safely processed in

1248-422: A partly or completely genetic basis (see genetic disorder ) and may thus be transmitted from one generation to another. Social determinants of health are the social conditions in which people live that determine their health. Illnesses are generally related to social, economic, political, and environmental circumstances . Social determinants of health have been recognized by several health organizations such as

1344-492: A perfume that makes other people trust the wearer. Her parents travel a lot, and they once brought back a very strong smelling perfume that turns out to keep the rats of the shadow city at bay. Botulism Botulism is a rare and potentially fatal illness caused by botulinum toxin , which is produced by the bacterium Clostridium botulinum . The disease begins with weakness, blurred vision, feeling tired , and trouble speaking. This may then be followed by weakness of

1440-458: A person's life was shortened due to a disease. For example, if a person dies at the age of 65 from a disease, and would probably have lived until age 80 without that disease, then that disease has caused a loss of 15 years of potential life. YPLL measurements do not account for how disabled a person is before dying, so the measurement treats a person who dies suddenly and a person who died at the same age after decades of illness as equivalent. In 2004,

1536-688: A scar on her forehead from an explosion that takes place in Inside the Shadow City. Betty Bent The third Irregular to be introduced, Betty Bent is a master of disguise. Her parents are costume designers for the Metropolitan Opera, and Betty always appears in prosthetics, wigs, and costumes. She rarely shows her true face, even though she attends the Girl Scouts weekly. Betty is incredibly shy, sweet and forgiving, rarely clashing with

1632-472: A small apartment nearby that is crammed with books on every subject imaginable. Although she does not believe it, she is quite intelligent and very eccentric. She has brown hair, is described as chubby in Inside the Shadow City , and thinks of herself as very unattractive. Later in the book she is given a makeover by Betty, and finally sees herself as pretty. When asked what she would like to be when she grows up, she says she would like to study Giant Squid. At

1728-417: A variety of techniques, including enzyme-linked immunosorbent assays (ELISAs), electrochemiluminescent (ECL) tests and mouse inoculation or feeding trials. The toxins can be typed with neutralization tests in mice. In toxicoinfectious botulism, the organism can be cultured from tissues. On egg yolk medium, toxin-producing colonies usually display surface iridescence that extends beyond the colony. Although

1824-443: Is a common metaphor for addictions : The alcoholic is enslaved by drink, and the smoker is captive to nicotine. Some cancer patients treat the loss of their hair from chemotherapy as a metonymy or metaphor for all the losses caused by the disease. Some diseases are used as metaphors for social ills: "Cancer" is a common description for anything that is endemic and destructive in society, such as poverty, injustice, or racism. AIDS

1920-498: Is a way to avoid an injury, sickness, or disease in the first place. A treatment or cure is applied after a medical problem has already started. A treatment attempts to improve or remove a problem, but treatments may not produce permanent cures, especially in chronic diseases . Cures are a subset of treatments that reverse diseases completely or end medical problems permanently. Many diseases that cannot be completely cured are still treatable. Pain management (also called pain medicine)

2016-498: Is an anaerobic , Gram-positive , spore-forming rod. Botulinum toxin is one of the most powerful known toxins: about one microgram is lethal to humans when inhaled. It acts by blocking nerve function ( neuromuscular blockade ) through inhibition of the excitatory neurotransmitter acetylcholine 's release from the presynaptic membrane of neuromuscular junctions in the somatic nervous system . This causes paralysis. Advanced botulism can cause respiratory failure by paralysing

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2112-419: Is an enemy that must be feared, fought, battled, and routed. The patient or the healthcare provider is a warrior , rather than a passive victim or bystander. The agents of communicable diseases are invaders ; non-communicable diseases constitute internal insurrection or civil war . Because the threat is urgent, perhaps a matter of life and death, unthinkably radical, even oppressive, measures are society's and

2208-474: Is an expert hacker and forger. She forges birth certificates, driving licenses and illegal maps and is also known to have a talent for picking locks. She is a very elegant, Chinese, and is described as being very beautiful. She has her own nail studio, the Golden Lotus, which brings in much money. However, she makes even more, often partially illegal money from the salon because the rich clients believe that

2304-569: Is caused mainly by types A, B, E, and (rarely) F. Types C and D cause toxicity only in other animals. In October 2013, scientists released news of the discovery of type H, the first new botulism neurotoxin found in forty years. However, further studies showed type H to be a chimeric toxin composed of parts of types F and A (FA). Some types produce a characteristic putrefactive smell and digest meat (types A and some of B and F); these are said to be proteolytic ; type E and some types of B, C, D and F are nonproteolytic and can go undetected because there

2400-450: Is described as "strikingly beautiful" on many occasions. She's an excellent leader but sometimes can be cold and insensitive to the needs of the other irregulars. Her real name is 'Katarina Galatzina' but this was changed when she was poisoned by her jealous aunt Livia Galetzina, who wanted to take over the throne. Kiki is always determined to help everybody who needs help. She is clever and knows multiple languages and martial arts. She also

2496-428: Is described as a poison that can reverse wrinkles and all signs of age. She is the scientist of the group, and inventor of many clever concoctions, including several explosives ; Morlock's Miracle Mixture, a self-made substance which repels poisons when digested; and Fille Fiable a concoction used to make one seem trustworthy. DeeDee wears dreadlocks that often get singed or burnt off during her experiments. She receives

2592-422: Is experienced as a dry mouth and throat (due to decreased production of saliva), postural hypotension (decreased blood pressure on standing, with resultant lightheadedness and risk of blackouts), and eventually constipation (due to decreased forward movement of intestinal contents ). Some of the toxins (B and E) also precipitate nausea , vomiting , and difficulty with talking . The weakness then spreads to

2688-548: Is far more common in societies in which most members live until they reach the age of 80 than in societies in which most members die before they reach the age of 50. An illness narrative is a way of organizing a medical experience into a coherent story that illustrates the sick individual's personal experience. People use metaphors to make sense of their experiences with disease. The metaphors move disease from an objective thing that exists to an affective experience. The most popular metaphors draw on military concepts: Disease

2784-459: Is good friends with DeeDee Morlock . Although Luz is innocent, she has a criminal record which she is often worried about. She is very poor, and her family is said to have escaped from Cuba when she was a child. Because of this, Luz finds it difficult to trust other people and often lashes out when her shortcomings are pointed out. DeeDee Morlock DeeDee Morlock is an incredibly talented chemist, and she concocts every potion, poison, and perfume

2880-889: Is known. The most known and used classification of diseases is the World Health Organization 's ICD . This is periodically updated. Currently, the last publication is the ICD-11 . Diseases can be caused by any number of factors and may be acquired or congenital . Microorganisms , genetics, the environment or a combination of these can contribute to a diseased state. Only some diseases such as influenza are contagious and commonly believed infectious. The microorganisms that cause these diseases are known as pathogens and include varieties of bacteria, viruses, protozoa, and fungi. Infectious diseases can be transmitted, e.g. by hand-to-mouth contact with infectious material on surfaces, by bites of insects or other carriers of

2976-463: Is no strong odor associated with them. When the bacteria are under stress, they develop spores, which are inert. Their natural habitats are in the soil, in the silt that comprises the bottom sediment of streams, lakes, and coastal waters and ocean, while some types are natural inhabitants of the intestinal tracts of mammals (e.g., horses, cattle, humans), and are present in their excreta. The spores can survive in their inert form for many years. Toxin

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3072-481: Is produced by the bacteria when environmental conditions are favourable for the spores to replicate and grow, but the gene that encodes for the toxin protein is actually carried by a virus or phage that infects the bacteria. Little is known about the natural factors that control phage infection and replication within the bacteria. The spores require warm temperatures, a protein source, an anaerobic environment, and moisture in order to become active and produce toxin. In

3168-473: Is reputed to have an extensive knowledge of weaponry from her caregiver, Verushka. Kiki's cousin, Princess Sidonia, is also her nemesis, as Sidonia's mother poisoned Kiki's whole family, in an attempt to take the Pokrovian throne. Sidonia is determined to kill Kiki, because if Kiki dies, she will be next in line for the Pokrovian throne. Kiki, in turn, wants to get Sidonia's pink diamond ring so that she can use

3264-557: Is that branch of medicine employing an interdisciplinary approach to the relief of pain and improvement in the quality of life of those living with pain. Treatment for medical emergencies must be provided promptly, often through an emergency department or, in less critical situations, through an urgent care facility. Epidemiology is the study of the factors that cause or encourage diseases. Some diseases are more common in certain geographic areas, among people with certain genetic or socioeconomic characteristics, or at different times of

3360-400: Is that diseases often cannot be defined and classified clearly, especially when cause or pathogenesis are unknown. Thus diagnostic terms often only reflect a symptom or set of symptoms ( syndrome ). Classical classification of human disease derives from the observational correlation between pathological analysis and clinical syndromes. Today it is preferred to classify them by their cause if it

3456-478: The Hmong people . Sickness confers the social legitimization of certain benefits, such as illness benefits, work avoidance, and being looked after by others. The person who is sick takes on a social role called the sick role . A person who responds to a dreaded disease, such as cancer , in a culturally acceptable fashion may be publicly and privately honored with higher social status . In return for these benefits,

3552-451: The World Health Organization calculated that 932 million years of potential life were lost to premature death. The quality-adjusted life year (QALY) and disability-adjusted life year (DALY) metrics are similar but take into account whether the person was healthy after diagnosis. In addition to the number of years lost due to premature death, these measurements add part of the years lost to being sick. Unlike YPLL, these measurements show

3648-470: The acute phase ; after recovery from chickenpox, the virus may remain dormant in nerve cells for many years, and later cause herpes zoster (shingles). Diseases may be classified by cause, pathogenesis ( mechanism by which the disease is caused), or by symptoms . Alternatively, diseases may be classified according to the organ system involved, though this is often complicated since many diseases affect more than one organ. A chief difficulty in nosology

3744-809: The immune system can produce a variety of different diseases, including various forms of immunodeficiency , hypersensitivity , allergies , and autoimmune disorders . In humans, disease is often used more broadly to refer to any condition that causes pain , dysfunction , distress , social problems , or death to the person affected, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries , disabilities , disorders , syndromes , infections , isolated symptoms, deviant behaviors , and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. Diseases can affect people not only physically but also mentally, as contracting and living with

3840-462: The incubation period is the time between infection and the appearance of symptoms. The latency period is the time between infection and the ability of the disease to spread to another person, which may precede, follow, or be simultaneous with the appearance of symptoms. Some viruses also exhibit a dormant phase, called viral latency , in which the virus hides in the body in an inactive state. For example, varicella zoster virus causes chickenpox in

3936-482: The Irregulars use during their adventures. Her parents are both scientists at Columbia University. She is very clumsy and very kind. She is the daughter of a chemistry professor. She gets in a bad accident during one of the Irregulars' adventures in The Shadow City. She is first introduced at a Girl Scouts meeting, where she has just "succeeded in refining a particularly dangerous strain of botulism ", which

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4032-480: The NIH. Deposition video from that lawsuit quotes a pharmaceutical executive stating that "Botox doesn't cause botulism." The toxin is the protein botulinum toxin produced under anaerobic conditions (where there is no oxygen) by the bacterium Clostridium botulinum . Clostridium botulinum is a large anaerobic Gram-positive bacillus that forms subterminal endospores . There are eight serological varieties of

4128-588: The Public Health Agency of Canada and the World Health Organization to greatly influence collective and personal well-being. The World Health Organization's Social Determinants Council also recognizes Social determinants of health in poverty . When the cause of a disease is poorly understood, societies tend to mythologize the disease or use it as a metaphor or symbol of whatever that culture considers evil. For example, until

4224-493: The United States. Infants are susceptible to infant botulism in the first year of life, with more than 90% of cases occurring in infants younger than six months. Infant botulism results from the ingestion of the C. botulinum spores, and subsequent colonization of the small intestine. The infant gut may be colonized when the composition of the intestinal microflora (normal flora) is insufficient to competitively inhibit

4320-436: The arms (starting in the shoulders and proceeding to the forearms) and legs (again from the thighs down to the feet). Severe botulism leads to reduced movement of the muscles of respiration , and hence problems with gas exchange . This may be experienced as dyspnea (difficulty breathing), but when severe can lead to respiratory failure , due to the buildup of unexhaled carbon dioxide and its resultant depressant effect on

4416-447: The arms, chest muscles, and legs. Vomiting, swelling of the abdomen, and diarrhea may also occur. The disease does not usually affect consciousness or cause a fever . Botulism can occur in several ways. The bacterial spores which cause it are common in both soil and water and are very resistant. They produce the botulinum toxin when exposed to low oxygen levels and certain temperatures. Foodborne botulism happens when food containing

4512-412: The bacterial cause of tuberculosis was discovered in 1882, experts variously ascribed the disease to heredity , a sedentary lifestyle , depressed mood , and overindulgence in sex, rich food, or alcohol, all of which were social ills at the time. When a disease is caused by a pathogenic organism (e.g., when malaria is caused by Plasmodium ), one should not confuse the pathogen (the cause of

4608-539: The bacterium denoted by the letters A to H. The toxin from all of these acts in the same way and produces similar symptoms: the motor nerve endings are prevented from releasing acetylcholine, causing flaccid paralysis and symptoms of blurred vision, ptosis, nausea, vomiting, diarrhea or constipation, cramps, and respiratory difficulty. Botulinum toxin is broken into eight neurotoxins (labeled as types A, B, C [C1, C2], D, E, F, and G), which are antigenically and serologically distinct but structurally similar. Human botulism

4704-498: The beginning of the series, she needs to be led by Kiki Strike, but by the end, she is a leader herself. Ananka is not gifted in school (although very intelligent) because she finds school to be an utter waste of time. However, she learns much more important things, such as how to survive in dangerous situations and to look at things and see them as they were in the past. Her parents do not recognise her special talents and are instead very focused on how she does in school. Her grandfather

4800-454: The bloodstream. The consumption of honey during the first year of life has been identified as a risk factor for infant botulism; it is a factor in a fifth of all cases. The adult form of infant botulism is termed adult intestinal toxemia , and is exceedingly rare. Toxin that is produced by the bacterium in containers of food that have been improperly preserved is the most common cause of food-borne botulism. Fish that has been pickled without

4896-411: The brain. This may lead to respiratory compromise and death if untreated. Clinicians frequently think of the symptoms of botulism in terms of a classic triad: bulbar palsy and descending paralysis, lack of fever, and clear senses and mental status ("clear sensorium"). Infant botulism (also referred to as floppy baby syndrome ) was first recognized in 1976, and is the most common form of botulism in

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4992-457: The burden imposed on people who are very sick, but who live a normal lifespan. A disease that has high morbidity, but low mortality, has a high DALY and a low YPLL. In 2004, the World Health Organization calculated that 1.5 billion disability-adjusted life years were lost to disease and injury. In the developed world, heart disease and stroke cause the most loss of life, but neuropsychiatric conditions like major depressive disorder cause

5088-566: The challenge of defining them. Especially for poorly understood diseases, different groups might use significantly different definitions. Without an agreed-on definition, different researchers may report different numbers of cases and characteristics of the disease. Some morbidity databases are compiled with data supplied by states and territories health authorities, at national levels or larger scale (such as European Hospital Morbidity Database (HMDB)) which may contain hospital discharge data by detailed diagnosis, age and sex. The European HMDB data

5184-443: The container, such as bulging. Only assurance of sufficient thermal processing during production, and absence of a route for subsequent contamination, should be used as indicators of food safety. The addition of nitrites and nitrates to processed meats such as ham, bacon, and sausages reduces growth and toxin production of C. botulinum . Vaccines are under development, but they have disadvantages. As of 2017 work to develop

5280-423: The diagnosis is made by testing of a stool or enema specimen with the mouse bioassay . In people whose history and physical examination suggest botulism, these clues are often not enough to allow a diagnosis. Other diseases such as Guillain–Barré syndrome , stroke , and myasthenia gravis can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include

5376-530: The disease) with disease itself. For example, West Nile virus (the pathogen) causes West Nile fever (the disease). The misuse of basic definitions in epidemiology is frequent in scientific publications. Many diseases and disorders can be prevented through a variety of means. These include sanitation , proper nutrition , adequate exercise , vaccinations and other self-care and public health measures, such as obligatory face mask mandates . Medical therapies or treatments are efforts to cure or improve

5472-510: The disease, and from contaminated water or food (often via fecal contamination), etc. Also, there are sexually transmitted diseases . In some cases, microorganisms that are not readily spread from person to person play a role, while other diseases can be prevented or ameliorated with appropriate nutrition or other lifestyle changes. Some diseases, such as most (but not all ) forms of cancer , heart disease , and mental disorders, are non-infectious diseases . Many non-infectious diseases have

5568-444: The diseases that cause the most sickness overall are neuropsychiatric conditions , such as depression and anxiety . The study of disease is called pathology , which includes the study of etiology , or cause. In many cases, terms such as disease , disorder , morbidity , sickness and illness are used interchangeably; however, there are situations when specific terms are considered preferable. In an infectious disease,

5664-642: The documentation of results for submission to peer-reviewed journals. Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic . Epidemiologists rely on a number of other scientific disciplines such as biology (to better understand disease processes), biostatistics (the current raw information available), Geographic Information Science (to store data and map disease patterns) and social science disciplines (to better understand proximate and distal risk factors). Epidemiology can help identify causes as well as guide prevention efforts. In studying diseases, epidemiology faces

5760-403: The food inside may be foamy or have a bad odor; cans with any of these signs should be discarded. Any container of food which has been heat-treated and then assumed to be airtight which shows signs of not being so, e.g., metal cans with pinprick holes from rust or mechanical damage, should be discarded. Contamination of a canned food solely with C. botulinum may not cause any visual defects to

5856-493: The growth of C. botulinum and levels of bile acids (which normally inhibit clostridial growth) are lower than later in life. The growth of the spores releases botulinum toxin , which is then absorbed into the bloodstream and taken throughout the body, causing paralysis by blocking the release of acetylcholine at the neuromuscular junction . Typical symptoms of infant botulism include constipation, lethargy, weakness, difficulty feeding, and an altered cry, often progressing to

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5952-478: The injection site of botulinum toxin . This may include loss of strength, blurred vision, change of voice, or trouble breathing which can result in death. Onset can be hours to weeks after an injection. This generally only occurs with inappropriate strengths of botulinum toxin for cosmetic use or due to the larger doses used to treat movement disorders. However, there are cases where an off-label use of botulinum toxin resulted in severe botulism and death. Following

6048-418: The inscribed instructions to find directions to the proof that Sidonia's mother had killed her mother. Kiki has escaped to New York with her caregiver and friend Verushka Kozlova, whom she lives with. Due to the poison, unfortunately, Kiki is allergic to everything except cafe au lait and a special nutritious gruel that Veruksha prepares for her. Luz Lopez Luz Lopez is a gifted mechanic and inventor, and she

6144-471: The lives of the main six several times. She is often picked on by Oona, as she is the youngest and smallest of the Irregulars. She is first really introduced at the age eleven, but first appears in the series a seven-year-old. Iris is first mentioned in the series in the first book, as she encounters the Irregulars as they are escaping from the Shadow City. In later books, she becomes an official member. She often assisted DeeDee during experiments and has developed

6240-644: The month of Ramadan is exempted from the requirement, or even forbidden from participating. People who are sick are also exempted from social duties. For example, ill health is the only socially acceptable reason for an American to refuse an invitation to the White House . The identification of a condition as a disease, rather than as simply a variation of human structure or function, can have significant social or economic implications. The controversial recognition of diseases such as repetitive stress injury (RSI) and post-traumatic stress disorder (PTSD) has had

6336-482: The most years lost to being sick. How a society responds to diseases is the subject of medical sociology . A condition may be considered a disease in some cultures or eras but not in others. For example, obesity was associated with prosperity and abundance, and this perception persists in many African regions, especially since the beginning of the HIV/AIDS . Epilepsy is considered a sign of spiritual gifts among

6432-450: The muscles of the chest; this can progress to respiratory arrest . Furthermore, acetylcholine release from the presynaptic membranes of muscarinic nerve synapses is blocked. This can lead to a variety of autonomic signs and symptoms described above. In all cases, illness is caused by the botulinum toxin which the bacterium C. botulinum produces in anaerobic conditions and not by the bacterium itself. The pattern of damage occurs because

6528-412: The muscles supplied by the cranial nerves —a group of twelve nerves that control eye movements , the facial muscles and the muscles controlling chewing and swallowing . Double vision , drooping of both eyelids , loss of facial expression and swallowing problems may therefore occur. In addition to affecting the voluntary muscles , it can also cause disruptions in the autonomic nervous system . This

6624-754: The normal intestinal bacteria suppress development of C. botulinum . While commercially canned goods are required to undergo a "botulinum cook" in a pressure cooker at 121 °C (250 °F) for 3 minutes, and thus rarely cause botulism, there have been notable exceptions. Two were the 1978 Alaskan salmon outbreak and the 2007 Castleberry's Food Company outbreak. Foodborne botulism is the rarest form, accounting for only around 15% of cases (US) and has more frequently resulted from home-canned foods with low acid content, such as carrot juice , asparagus , green beans , beets , and corn . However, outbreaks of botulism have resulted from more unusual sources. In July 2002, fourteen Alaskans ate muktuk ( whale meat ) from

6720-477: The organism, and for this reason, honey should not be fed to children under 12 months. Treatment is with an antitoxin . In those who lose their ability to breathe on their own, mechanical ventilation may be necessary for months. Antibiotics may be used for wound botulism. Death occurs in 5 to 10% of people. Botulism also affects many other animals. The word is from Latin botulus , meaning 'sausage'. The muscle weakness of botulism characteristically starts in

6816-477: The others' strong personalities. She is very brave. She also makes the costumes, disguises, and uniforms for the group. When not in costume, Betty is described as a pretty, olive-skinned girl with a black bob haircut. Over the course of the series, she becomes good friends with Ananka Fishbien, and they go shopping together. Oona Wong The disgraced daughter of Lester Liu, the leader of the Fu Tsang gang, Oona

6912-419: The past 50 years, the proportion of patients with botulism who die has fallen from about 50% to 7% due to improved supportive care. A patient with severe botulism may require mechanical ventilation (breathing support through a ventilator) as well as intensive medical and nursing care, sometimes for several months. The person may require rehabilitation therapy after leaving the hospital. Clostridium botulinum

7008-468: The patient's moral duty as they courageously mobilize to struggle against destruction. The War on Cancer is an example of this metaphorical use of language. This language is empowering to some patients, but leaves others feeling like they are failures. Another class of metaphors describes the experience of illness as a journey: The person travels to or from a place of disease, and changes himself, discovers new information, or increases his experience along

7104-505: The protocol for fatal bovine botulism cases appears to be incineration of carcasses and withholding any potentially contaminated milk from human consumption. It is also advised that raw milk from affected cows should not be consumed by humans or fed to calves. There have been several reports of botulism from pruno wine made of food scraps in prison. In a Mississippi prison in 2016, prisoners illegally brewed alcohol that led to 31 cases of botulism. The research study done on these cases found

7200-560: The release within the nervous system of acetylcholine , a neurotransmitter, responsible for communication between motor neurons and muscle cells. All forms of botulism lead to paralysis that typically starts with the muscles of the face and then spreads towards the limbs. In severe forms, botulism leads to paralysis of the breathing muscles and causes respiratory failure . In light of this life-threatening complication, all suspected cases of botulism are treated as medical emergencies , and public health officials are usually involved to identify

7296-516: The salinity or acidity of brine that contains acetic acid and high sodium levels, as well as smoked fish stored at too high a temperature, presents a risk, as does improperly canned food. Food-borne botulism results from contaminated food in which C. botulinum spores have been allowed to germinate in low-oxygen conditions. This typically occurs in improperly prepared home-canned food substances and fermented dishes without adequate salt or acidity. Given that multiple people often consume food from

7392-421: The salon girls do not understand English. This leads them to discuss important and often money-making deals and pieces of information with their friends, most of which Oona picks up and uses to help her get more money. Oona has a gruff voice that does not match her doll-like appearance, and she is known to be cruel or mean on some occasions. Iris McLeod Once an honorary member of the Irregulars, Iris has saved

7488-474: The same source, it is common for more than a single person to be affected simultaneously. Symptoms usually appear 12–36 hours after eating, but can also appear within 6 hours to 10 days. No withdrawal periods have been established for cows affected by Botulism. Lactating cows injected with various doses of Botulinum toxin C have not resulted in detectable Botulinum neurotoxin in milk produced. Using mouse bioassays and immunostick ELISA tests , botulinum toxin

7584-402: The sick person is obligated to seek treatment and work to become well once more. As a comparison, consider pregnancy , which is not interpreted as a disease or sickness, even if the mother and baby may both benefit from medical care. Most religions grant exceptions from religious duties to people who are sick. For example, one whose life would be endangered by fasting on Yom Kippur or during

7680-641: The skin rather than the veins. Wound botulism can also come from a minor wound that is not properly cleaned out; the skin grows over the wound thus trapping the spore in an anaerobic environment and creating botulism. One example was a person who cut their ankle while using a weed eater; as the wound healed over, it trapped a blade of grass and spec of soil under the skin that lead to severe botulism requiring hospitalization and rehabilitation for months. Wound botulism accounts for 29% of cases. Isolated cases of botulism have been described after inhalation by laboratory workers. Symptoms of botulism may occur away from

7776-467: The source and take steps to prevent further cases from occurring. Botulinum toxin A and E specifically cleave the SNAP-25, whereas serotype B, D, F and G cut synaptobrevin. Serotype C cleaves both SNAP-25 and syntaxin. This causes blockade of neurotransmitter acetylcholine release, ultimately leading to paralysis. For botulism in babies, diagnosis should be made on signs and symptoms. Confirmation of

7872-505: The spores from the natural environment. Clostridium botulinum is a ubiquitous soil-dwelling bacterium. Many infant botulism patients have been demonstrated to live near a construction site or an area of soil disturbance. Infant botulism has been reported in 49 of 50 US states (all save for Rhode Island), and cases have been recognized in 26 countries on five continents. Infant botulism has no long-term side effects. Botulism can result in death due to respiratory failure. However, in

7968-412: The symptoms of mild botulism matched the symptoms severe botulism though the outcomes and progression of the disease were different. Wound botulism results from the contamination of a wound with the bacteria, which then secrete the toxin into the bloodstream. This has become more common in intravenous drug users since the 1990s, especially people using black tar heroin and those injecting heroin into

8064-826: The term "leper" still evokes social stigma . Fear of disease can still be a widespread social phenomenon, though not all diseases evoke extreme social stigma. Social standing and economic status affect health. Diseases of poverty are diseases that are associated with poverty and low social status; diseases of affluence are diseases that are associated with high social and economic status. Which diseases are associated with which states vary according to time, place, and technology. Some diseases, such as diabetes mellitus , may be associated with both poverty (poor food choices) and affluence (long lifespans and sedentary lifestyles), through different mechanisms. The term lifestyle diseases describes diseases associated with longevity and that are more common among older people. For example, cancer

8160-467: The toxin affects nerves that fire (depolarize) at a higher frequency first. Mechanisms of entry into the human body for botulinum toxin are described below. The most common form in Western countries is infant botulism. This occurs in infants who are colonized with the bacterium in the small intestine during the early stages of their lives. The bacterium then produces the toxin, which is absorbed into

8256-425: The toxin is eaten. Infant botulism instead happens when the bacterium develops in the intestines and releases the toxin. This typically only occurs in children less than one year old, as protective mechanisms against development of the bacterium develop after that age. Wound botulism is found most often among those who inject street drugs . In this situation, spores enter a wound, and in the absence of oxygen, release

8352-849: The toxin. The disease is not passed directly between people. Its diagnosis is confirmed by finding the toxin or bacteria in the person in question. Prevention is primarily by proper food preparation. The toxin, though not the spores, is destroyed by heating it to more than 85 °C (185 °F) for longer than five minutes. The clostridial spores can be destroyed in an autoclave with moist heat (120°C/ 250°F for at least 15 minutes) or dry heat (160°C for 2 hours) or by irradiation. The spores of group I strains are inactivated by heating at 121°C (250°F) for 3 minutes during commercial canning. Spores of group II strains are less heat-resistant, and they are often damaged by 90°C (194°F) for 10 minutes, 85°C for 52 minutes, or 80°C for 270 minutes; however, these treatments may not be sufficient in some foods. Honey can contain

8448-415: The trial. The family of a 7-year-old boy treated with botulinum toxin injections for leg spasms sued after the boy almost died. Several families of people who died after treatments with botulinum toxin injections brought lawsuits. One lawsuit prevailed for the plaintiff who was awarded compensation of $ 18 million; the plaintiff was a physician who was diagnosed with botulism by thirteen neurologists at

8544-430: The vegetative form of the bacteria is destroyed by boiling, the spore itself is not killed by the temperatures reached with normal sea-level-pressure boiling, leaving it free to grow and again produce the toxin when conditions are right. A recommended prevention measure for infant botulism is to avoid giving honey to infants less than 12 months of age, as botulinum spores are often present. In older children and adults

8640-454: The way. He may travel "on the road to recovery" or make changes to "get on the right track" or choose "pathways". Some are explicitly immigration-themed: the patient has been exiled from the home territory of health to the land of the ill, changing identity and relationships in the process. This language is more common among British healthcare professionals than the language of physical aggression. Some metaphors are disease-specific. Slavery

8736-503: The wild, decomposing vegetation and invertebrates combined with warm temperatures can provide ideal conditions for the botulism bacteria to activate and produce toxin that may affect feeding birds and other animals. Spores are not killed by boiling, but botulism is uncommon because special, rarely obtained conditions are necessary for botulinum toxin production from C. botulinum spores, including an anaerobic, low-salt, low-acid, low-sugar environment at ambient temperatures. Botulinum inhibits

8832-430: The year. Epidemiology is considered a cornerstone methodology of public health research and is highly regarded in evidence-based medicine for identifying risk factors for diseases. In the study of communicable and non-communicable diseases, the work of epidemiologists ranges from outbreak investigation to study design, data collection, and analysis including the development of statistical models to test hypotheses and

8928-451: Was a rat lover and invented a way to safely and effectively get rid of them, The Reverse Pied Piper (a device which the Irregulars recreate and use throughout the series). Ananka is the narrator of the series. Kiki Strike Kiki Strike is a small, albino girl who founds the Irregulars and is often considered the leader of the group. Although her platinum hair, a height of under five feet, and unhealthily pale complexion are off-putting, she

9024-402: Was detected in whole blood and serum but not in milk samples, suggesting that botulinum type C toxin does not enter milk in detectable concentrations. Cooking and pasteurization denatures botulinum toxin but does not necessarily eliminate spores. Botulinum spores or toxins can find their way into the dairy production chain from the environment. Despite the low risk of milk and meat contamination,

9120-409: Was seen as a divine judgment for moral decadence, and only by purging itself from the "pollution" of the "invader" could society become healthy again. More recently, when AIDS seemed less threatening, this type of emotive language was applied to avian flu and type 2 diabetes mellitus . Authors in the 19th century commonly used tuberculosis as a symbol and a metaphor for transcendence . People with

9216-510: Was submitted by European countries to the World Health Organization Regional Office for Europe. Disease burden is the impact of a health problem in an area measured by financial cost, mortality, morbidity, or other indicators. There are several measures used to quantify the burden imposed by diseases on people. The years of potential life lost (YPLL) is a simple estimate of the number of years that

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