Objective Copper deficiency has been reported to cause hematological disorders. However, its clinical and hematological characteristics are not fully understood. Therefore, we investigated bedridden patients suffering from copper deficiency and tried to clarify the clinical features of hematological disorders caused by this condition.Patients and Methods Five patients with typical copper deficiency who had been dependent upon enteral nutrition for a long period of time due to various diseases were investigated. We measured hematological parameters and observed the response to copper supplementation therapy and the recovery process of hematological disorders.Results Their mean age was 82.6±10.4 years and the mean duration of enteral nutrition was 16.4±5.2 months. Their serum copper concentration was extremely decreased (range, 3 to 8 g/dl). All five patients had anemia and neutropenia. On the other hand, platelet count remained within the normal range. After copper supplementation therapy, hemoglobin concentration increased from 6.8±0.7 g/dl to 9.9±0.7 g/dl within a few months (p<0.01). Neutrophil count also increased from 750±370/ l to 3,690±1,210/ l in a few weeks (p<0.01). Mean corpuscular volume (MCV) decreased from 94.3±7.3 fl to 86.0±4.8 fl (p<0.05). Elevated serum ferritin and erythropoietin (EPO) levels were normalized after the improvement of anemia.Conclusion Bicytopenia (anemia and neutropenia) with normal platelet count is a feature of hematological disorders caused by copper deficiency. MCV tends to indicate macrocytic anemia. Serum ferritin and EPO levels are elevated. These hematological abnormalities are improved within a few months after copper supplementation therapy.

These results show that halothane causes decrease of excitatory synaptic activity, with NMDA EPSCs being more sensitive than non-NMDA EPSCs.

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This systematic literature review gathers societal vulnerability factors linking climate change and conflict from 53 existing studies. The findings reveal three main points. First, four relevant factors are missing from a previous vulnerability analysis framework proposed by Pearson and Newman: land degradation/land cover, gender, customs, and geographical conditions. Second, two factors, access to technology (e.g., for climate change adaptation) and partially democratic states, are insufficiently studied. Third, classification criteria in the previous framework need revision for accuracy. Considering these points, this study proposes a modified vulnerability analysis framework and offers five suggestions for future research directions in climate security research. First, more qualitative case studies are needed to complement the quantitative work. Second, in particular, cases where conflict was avoided or cooperation was established in high vulnerability areas need further research. Third, further research is needed on understudied factors (e.g., access to technology and partial democracy) and on factors the conventional framework cannot explain (e.g., land degradation/land cover, gender, customs, and geographical conditions). Fourth, no single vulnerability factor leads to conflict in isolation, but only in interaction; their connections must be studied. Finally, case studies are needed on vulnerability factors in countries and regions that have suffered from climate change but have not experienced conflict.

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