cssi/SciSciGPT-SciSciNet huggingface dataset:
Painful breast lumps in nursing mothers.

Identifying and treating plugged ducts, mastitis, and abscess.Editor's note: AJN has revised this column to provide you with the latest evidence-based interventions to manage your patients' symptoms. If there's a topic you'd like us to address, please e-mail us and let us know.Keywordsbreast abscess
Application of combined technique of hair implanter and automatic hair transplant system in hair transplantation

Objective To investigate the application of hair transplantation to treat the baldness, low density of eyebrow, loss of pubic hair. Methods A strip of scalp was harvested from the occipital area between external ears. The strip was divided into narrow sliver, from which a series of micrograft of 1~3 hairs and minigraft of 4~5 hairs were dissected under surgical loupes(2×). The micrografts were planted by means of hair implanter to restore the hairline, eyebrow and pubic hair. In other recipient area of the bald patients, holes were made using motor-driven punch with a diameter of 1.5mm. The minigrafts were then inserted into the holes by means of implanting hand tool of the automated hair transplant system. Results From Oct 2001 to Jan 2004, 43 male pattern hair loss patients, 5 cicatrical alopecia patients, 3 pubic hair loss patients and 5 patients with sparse eyebrows were treated using hair transplantation. All of the patients were satisfied with the appearance. The survival rate of the hair grafts reached about 90%. Conclusion Hair transplantation by means of the combination of hair implanter and automatic hair transplant system according to different recipient areas can obtain good results.
Clinical observation of the effect of xinmaitong tablet on hypertension

OBJECTIVE To observe the clinical therapeutic effect of Xinmaitong on hypertension. METHODS 200 primary hypertension patients were assigned to Xinmaitong group and Nimodipine group randomly. Compare the effective rate between two groups after 6 weeks' therapy. RESULTS The degree of decreasing blood pressure of Xinmaitong group was obviously higher than Nimodipine group, there was significant difference between them (P < 0.05). CONCLUSIONS The effect to therapy hypertension of Xinmaitong is better than Nimodipine, and there is no obvious adverse effect.
History of homeopathy and social history of medicine: the story of a successful marriage

The Institute for the History of Medicine (IGM) was established in 1980 by the Robert Bosch Foundation, in Stuttgart, Germany, on the basis of a collection of documents and other small objects belonging to Samuel Hahnemann, the founder of homeopathy. However, since its very inception, its directors considered that the history of homeopathy also had a role to play in the larger picture of the history of medicine. On the other hand, the history of homeopathy was not restricted to the account of the development of ideas and careers of practitioners, but it would benefit significantly by approaching it from the perspective of social history, including the study of institutions, patients’ views, lay supporting societies and publications. This paper presents a review of this project as assessed by an analysis of recent publications that, taken as a whole, reflect the historiographical contribution of researchers at IGM.
Real-Time Vehicle Tracking in Aerial Video Using Hyperspectral Features

Vehicle tracking from a moving aerial platform poses a number of unique challenges including the small number of pixels representing a vehicle, large camera motion, and parallax error. This paper considers a multi-modal sensor to design a real-time persistent aerial tracking system. Wide field of view (FOV) panchromatic imagery is used to remove global camera motion whereas narrow FOV hyperspectral image is used to detect the target of interest (TOI). Hyperspectral features provide distinctive information to reject objects with different reflectance characteristics from the TOI. This way the density of detected vehicles is reduced, which increases tracking consistency. Finally, we use a spatial data based classifier to remove spurious detections. With such framework, parallax effect in non-planar scenes is avoided. The proposed tracking system is evaluated in a dense, synthetic scene and outperforms other state-of-theart traditional and aerial object trackers.
Complicitous Housewives during the Argentine Dictatorship: Reconstructing a Tenebrous Past in Lo que nosotras sabíamos by María Inés Krimer

AbstractLo que nosotras sabiamos by Maria Ines Krimer portrays life in a cement-producing village in Argentina during the dictatorship. The narrative voice—nosotras— is that of wives of company managers who are reconstructing their memories and in the process seek the reasons behind the suicide of a woman in the village. There are references to ominous occurrences related to the dictatorship, and we discover that behind the appearance of normality lurks the sordid reality of a society complicit with the abuses of power. This study will consider how Lo que nosotras sabiamos fuses elements of the genero negro with a memory narrative to reproduce a discourse of social actors who—through their prejudices, their alliance with power, and veil of secrecy—served to legitimize State terror. Recent work by memory theorists helps us understand how memory discourses function to enable individuals to come to terms with painful experiences and denounce human rights violations. However, in the case of the narrators, who...
A 3-bit 20GS/s interleaved flash analog-to-digital converter in SiGe technology

A 3-bit analog-to-digital converter (ADC) for software defined radio applications that can work at a sampling rate of 20 GS/s is presented in this paper. In order to operate at Ku-band, two flash current mode logic (CML) ADCs are time-interleaved to achieve a 20 GHz sampling rate. A 3-bit current-steering digital-to-analog converter (DAC) is also designed for testing the high-speed ADC. The ADC-DAC RFIC is implemented in a 0.12 mum SiGe technology and occupies an area of 1.5 times 1.7 mm2. The total power consumption for the entire ADC-DAC chip is 2.36 W with a 4.2 V power supply. The ADC-DAC RFIC is packaged in a 44-pin CLLC package and achieves a peak spurious free dynamic range (SFDR) of 30.5 dBc and a peak effective number of bits (ENOB) of 2.8 bits at a 20 GS/s sampling rate.
Media entrepreneurship programs: Emerging isomorphic patterns

ABSTRACTThis study examines if the area of media entrepreneurship education has developed similarities as a way to build legitimacy. This study uses institutional isomorphism to examine the likelihood, and reasons, that similarities may be emerging from separate media entrepreneurship programs. This study conducts in-depth, open-ended telephone interviews with program heads of media entrepreneurship programs across the United States. Overall, the interviews indicated isomorphic practices are emerging from media entrepreneurship programs, with the programs displaying similar coercive, normative and mimetic processes in the attempt to legitimize the emerging area of media entrepreneurship. The findings indicate that isomorphism has emerged within media entrepreneurship programs, and that media entrepreneurship is becoming a legitimized “industry” within media management and economics and journalism fields.
Dietary self-selection and rules of compromise by fifth-instar Vanessa cardui

We examined dietary self-selection and rules of compromise for protein (P) and digestible carbohydrate (C) intake by fifth-instar Vanessa cardui L. (Lepidoptera: Nymphalidae: Nymphalini). We presented six fat-free diet pairs to larvae in a choice trial to determine the ‘intake target’. In addition, we fed larvae seven fat-free single diets differing in dietary nutrient ratio in no-choice trials to determine the rules of compromise they exhibit when constrained to a singular, sub-optimal dietary source. In choice trials, caterpillars regulated nutrient intake to a ratio of 1 protein to 1.09 carbohydrate (1P:1.09C), exhibiting tighter regulation of protein than of carbohydrate. Furthermore, larvae from different diet pair treatments did not differ in pupal mass or stadium duration. In no-choice experiments, larvae reduced consumption on increasingly protein-biased diets and increased consumption on increasingly carbohydrate-biased diets, relative to a 1P:1C ratio diet. Differences in carbohydrate consumption were much greater between no-choice treatments than differences in protein consumption. Dietary nutrient ratio affected pupal mass when accounting for initial larval mass. Pupal mass decreased as nutrient ratio was shifted off of 1P:1C, but to a greater extent when the ratio was skewed toward carbohydrate. Stadium duration increased as nutrient ratio diverged from 1P:1C, being more pronounced when shifted toward carbohydrate than toward protein. Regulation to near 1P:1C is consistent with results found for other Lepidoptera, and the rule of compromise exhibited by V. cardui is consistent with that expected for a generalist herbivore.
Electrochemical reduction of terbuthylazine under acidic conditions and structural determination of post-electrolysis product with the aid of GC/MS, IR, and 1H NMR spectroscopy

Abstract Terbuthylazine ( N - t -butyl-6-chloro- N ′-ethyl-1,3,5-triazine-2,4-diamine) is an important chloro- s -triazine herbicide that is used to prevent the growth of weeds during the production of a variety of crops in several European nations. The compound is also used as an algaecide to inhibit the growth of algae in water-cooling ponds and towers in the United States. These compounds can undergo electrochemical reduction under acidic conditions. Reduction pathways for several chloro- s -triazine herbicides have been proposed based on a variety of electrochemical, chromatographic, and spectroscopic techniques. There was general agreement in the literature that protonated forms of these compounds undergo a 4-electron reduction. The proposed reactions were elimination of the chloro group, elimination of an alkyl or alkylamino group, and reduction of the s -triazine ring. The present paper describes an electrochemical study of terbuthylazine with subsequent analyses of the post-electrolysis product by means of GC/MS, IR, and 1 H NMR spectroscopy. This work provides evidence for a 4-electron reduction involving elimination of the chloro group and reduction of the s -triazine ring.
High-Intensity Cigarette Smoking Is Associated With Incident Diabetes Mellitus In Black Adults: The Jackson Heart Study.

BackgroundPrevious reports on whether smoking is associated with insulin resistance and diabetes mellitus have yielded inconsistent findings. We aimed to evaluate the relationship between cigarette...
Examining the Link Between Perfectionism and Psychological Maladjustment: Social Problem Solving as a Buffer

An integrative model in which perfectionism and social problem solving were hypothesized to have additive and interactive effects in predicting psychological maladjustment (viz., depressive symptoms and suicide ideation) was proposed and tested in a sample of 371 college students. Results of hierarchical regression analyses indicated that social problem solving added significant incremental validity in predicting scores on measures of depressive symptoms and suicide ideation beyond what was accounted for by perfectionism. Moreover, a significant Perfectionism × Social Problem Solving interaction was found in predicting each of the maladjustment measures after accounting for the influences of both perfectionism and social problem solving. These results are taken to provide preliminary support for an additive and interactive prediction model of psychological maladjustment involving perfectionism and social problem solving.
Varicocele Related Testicular Atrophy and its Predictive Effect Upon Fertility

Varicoceles are the most common reversible cause of male factor infertility, yet approximately 80% of men with varicoceles are fertile. Therefore, it is unclear whether all adolescents should undergo prophylactic varicocelectomy to prevent future infertility or whether a subgroup of patients who are at increased risk for future infertility can be identified and treated. Testicular size discrepancy or hypotrophy of the testis associated with a unilateral varicocele has been suggested as an indication for prophylactic varicocelectomy in adolescents. We examined 946 men attending a urological clinic for complaints other than infertility to determine whether testis size discrepancy was predictive of infertility in men with left varicoceles. A left varicocele was detected on physical examination in 211 men, of whom 173 (82%) had been able to father children and 38 (18%) had never fathered children. A group of 630 men without palpable varicoceles served as controls, including 528 (84%) with a history of fertility. Testicular size was measured using an orchidometer and the average testicular volume difference was obtained by subtracting left from right testicular volume. The mean testicular volume difference for the fertile men without varicoceles (1.6 +/- 0.3 ml.) was significantly lower than the fertile men with varicoceles (3.1 +/- 0.4 ml.) (p < 0.05) and infertile men with varicoceles (2.5 +/- 0.6 ml.) (p < 0.05). There was no significant difference between fertile and infertile men with varicoceles. This study confirms prior reports that the majority of men with left varicoceles are able to father children and that varicoceles cause significant ipsilateral testicular atrophy/hypotrophy. However, we were unable to demonstrate a correlation between loss of testicular volume and fertility status in men with left varicoceles. Further study is needed to identify the clinical parameters predictive of future infertility in adolescents with varicoceles.
Effective Interpersonal Listening in the Personal Selling Environment: Conceptualization, Measurement, and Nomological Validity

The purpose of this research was to develop and validate a measure of the degree to which salespeople practice effective listening. After defming and discussing the construct, the development of a paper-and-pencil self-report measure of interpersonal listening in the personal selling context (lLPS) is described. Following the procedure used by Spiro and Weitz (1990), the validity of the measure was assessed via a mail questionnaire with a sample of 604 salespeople from a variety of firms and industries. Both performance and sales experience were significantly correlated with the ILPS scale. There were no significant relationships between ILPS and gender, age, or industry type. The 14-item ILPS scale that emerged from the purification process was shown to have acceptable reliability estimates, as well as evidence of face, convergent, and nomological validity. Managerial implications and directions for future research are presented.
Nutritional Support in Hospitalized Patients with Diabetes Mellitus

Inpatient diabetes management is becoming more important in recent years. Given the ever-increasing rates of diabetes incidence in the general population, it is no surprise that 20–30% of the patients admitted to the hospital have a diagnosis of diabetes. Therefore, the treatment of hyperglycemia is becoming a more important aspect of inpatient care. Although it has been shown that prevention of hyperglycemia reduces morbidity, mortality, and length of stay, optimal inpatient glycemic goals remain controversial. The comprehensive inpatient management of diabetes includes optimization of feeding, whether nutrition is administered enterally, parenterally, or as a combination of these two methods. This requires the physician to recognize the patient’s clinical status, and take into account the different aspects of the patient’s illness in order to properly provide the right composition of nutrition. Furthermore, it is of utmost importance to select the right regimen of hypoglycemic agents in the prevention of hyperglycemia.
Self-organizing circuits of model neurons

Activity can affect the growth patterns of neurons as well as modifying their membrane and synaptic conductances. Most models of activity-dependent plasticity have concentrated on one of these aspects, most commonly synaptic plasticity. We construct and study a model in which all three forms of plasticity are present. Starting from random initial conditions, an array of these model cells can develop spontaneously into a highly coupled circuit displaying a complex pattern of activity. Although all the model cells are described by identical equations, they differentiate within these circuits and individually show a variety of intrinsic characteristics.
Shared decision-making in the BREATHE asthma intervention trial: A research protocol.

Aim To evaluate the preliminary effectiveness of the BRief Evaluation of Asthma THerapy intervention, a 7-min primary care provider-delivered shared decision-making protocol that uses motivational interviewing to address erroneous asthma disease and medication beliefs. Design A multi-centre masked two-arm group-randomized clinical trial. Methods This 2-year pilot study is funded (September 2016) by the National Institute of Nursing Research. Eight providers will be randomized to one of two arms: the active intervention (N = 4) or a dose-matched attention control (N = 4). Providers will deliver the intervention to which they were randomized to 10 Black adult patients with uncontrolled asthma (N = 80). Patients will be followed three months postintervention to test the preliminary intervention effects on asthma control (primary outcome) and on medication adherence, lung function, and asthma-related quality of life (secondary outcomes). Discussion This study will evaluate the preliminary impact of a novel shared decision-making intervention delivered in a real world setting to address erroneous disease and medication beliefs as a means of improving asthma control in Black adults. Results will inform a future, large-scale randomized trial with sufficient power to test the intervention's effectiveness. Impact Shared decision-making is an evidence-based intervention with proven effectiveness when implemented in the context of labour- and time-intensive research protocols. Medication adherence is linked with the marked disparities evident in poor and minority adults with asthma. Addressing this requires a novel multifactorial approach as we have proposed. To ensure sustainability, shared decision-making interventions must be adapted to and integrated into real-world settings. Trial registration Registered at clincialtrials.gov as NCT03036267 and NCT03300752.
Purposeful interprofessional team intervention improves relational coordination among advanced heart failure care teams.

Effective delivery of healthcare is highly interdependent within and between interprofessional (IP) care teams and the patients they serve. This is particularly true for complex health conditions s...
Hypercomplex number approach to Schwinger's quantum source theory

The hypercomplex numbers associated with the Dirac-Clifford algebra, are applied to the spin−0, −1/2, and −1 structures for Schwinger's source theory of quantum electrodynamics. The generalizations to 5-vectors and 5-space relativity are introduced. The anticommuting numbers, associated with Fermi-Dirac statistics, are examined in some detail. The hyper-complex number formulation is suitable for curved space quantum computations.
"The Present of California May Prove the Likeness of the Future of British Columbia”: Transnational Anti-Chinese Policies Before the Exclusion Era, 1850-1885

This study illuminates the various ways in which California and British Columbia borrowed, copied, and swapped anti-Chinese policy initiatives at the local, state, and provincial levels prior to the passage of the United States’ Chinese Exclusion Act (1882) and the Canadian Chinese Immigration Act (1885). The Chinese Exclusion Act and Chinese Immigration Act became historical benchmarks in their respective countries, ending open border traditions and making race a qualification of entry. Yet these national policies were reactions to highly localized concerns in California and British Columbia, a state and province uniquely bound together by geography, political isolation, migration patterns, and economic relationships. While prior scholars have noted the influence of Californians and British Columbians in passing national anti-Chinese restrictions, such analysis has ignored the transnational exchange occurring prior to the enactment of national policies.
Learning Effective Loss Functions Efficiently.

We consider the problem of learning a loss function which, when minimized over a training dataset, yields a model that approximately minimizes a validation error metric. Though learning an optimal loss function is NP-hard, we present an anytime algorithm that is asymptotically optimal in the worst case, and is provably efficient in an idealized "easy" case. Experimentally, we show that this algorithm can be used to tune loss function hyperparameters orders of magnitude faster than state-of-the-art alternatives. We also show that our algorithm can be used to learn novel and effective loss functions on-the-fly during training.
Expanding ethics curriculum resources: American College of Epidemiology's syllabus collection project.

Abstract This commentary provides an update on the evolution of the American College of Epidemiology's online and open-source collection of ethics syllabi in epidemiology and public health. Begun in 2011, the syllabus-collection project anticipated the Council on Education for Public Health's accreditation requirement calling for “the development of ethical practice” and identifying a need to “demonstrate our commitment to ethical dealings.” The Ethics Committee of the American College of Epidemiology continued the project in 2018 seeking to acquire as many syllabi as possible for the repository; all 180 Council on Education for Public Health–accredited schools and programs were contacted and asked to share syllabi that addressed ethical and related issues. The overarching goal was to support institutions that have not yet introduced ethics into public health and epidemiology curricula. In total, 45 new syllabi were collected in 2018 and collated with the 38 acquired in 2011; 83 syllabi have been compiled from 52 accredited entities. Having a readily available on-line resource to support institutions and faculty seeking to introduce or improve the presentation of ethics in public health and epidemiology curricula is believed to be an important contribution to public health science and pedagogy.
Cost-Reliability Tradeoffs in Fusing Unreliable Computational Units

We investigate fusing several unreliable computational units that perform the same task. We model an unreliable computational outcome as an additive perturbation to its error-free result in terms of its fidelity and cost. We analyze reliability of replication-based strategies that distribute cost across several unreliable units and fuse their outcomes. When the cost is a convex function of fidelity, the optimal replication-based strategy in terms of incurred cost while achieving a target mean-square error level may fuse several unreliable computational units. For concave and linear costs, a single more reliable unit incurs lower cost compared to fusion of several lower cost and less reliable units while achieving the same mean-square error level. We show how our results give insight into problems from theoretical neuroscience and circuits.
Weight Dysregulation, Positive Energy Balance, and Binge Eating in Eating Disorders

Determinants of binge eating are usually understood in terms of cognitive, behavioral, and affective disturbances. However, many of those with eating disorders (EDs) experienced elevated premorbid weights, lost substantial weight as their disorder developed and/or are currently at low weight. We review evidence that these three aspects of weight regulation are related to binge eating, to loss of control eating in the absence of objective binge eating and/or to positive energy balance and weight gain over time (an outcome that is greatly feared in those with EDs). Thus, there appear to be powerful reciprocal influences between psychological and biological aspects of binge eating but until recently only the psychological features have been incorporated into models of ED psychopathology and treatment. Further, several studies have shown that weight suppression is also related to eating symptoms in nonclinical groups, which indicates that elevated weight suppression can accelerate weight regain and have other negative impacts in the absence of an ED. In sum, the impact of weight history on the perpetuation of EDs indicates that treatment researchers should consider this impact as they try to improve treatment outcomes.
Bond characteristics and modeling of near-surface mounted CFRP in concrete

Abstract This paper presents the direct pull-out test results of twenty-four concrete joint specimens using near-surface mounted (NSM) carbon fiber-reinforced polymer (CFRP) rods and strips. Investigated in the study was the effect on the bond strength and local bond characteristics due to different cross-sectional shape (rod vs. strip) and surface treatment of NSM reinforcement (roughened, sand-coated, sand-coated and spirally wound), adhesive type, and concrete strength. Specimens using CFRP rods with sand-coated and spirally wound surface condition outperformed others in terms of load-carrying capacity and local bond strength. Increasing the strength of epoxy adhesive or concrete had positive influence on the bond behavior. The observed post-debonding residual bond stress was confirmed to contribute to the load-carrying capacity of the joint. The proposed analytical model based on a proper trilinear local bond stress-slip law (representing the distinctive linear elastic, softening and debonding stages) provided good agreement with the experimental data.
The myth of a food crisis

Abstract A key assertion in many discussions on global agriculture is the prediction of a potential future global food production deficit: the challenge of “feeding the 10 billion.” The crisis narrative has in many ways been led by the UN’s Food and Agriculture Organization (FAO), whose quantitative modeling of the food system has predicted a 70% increase (now 60%) in the annual total of food needed by 2050. By examining the assumptions underlying its modeling, however, this chapter shows that FAO and other modelers have consistently underestimated actual and potential global food supplies and overestimated food demand. For example, FAO’s latest model underreports potential rice yields by approximately 7 billion persons’ worth of food. In all, this chapter estimates that, since they all use similar assumptions, at least 12.5 billion persons’ worth of food has been left out of current food models. Thus current models imply quantitative scarcity where none exists.
Periprosthetic Tibial Fractures After Total Knee Arthroplasty: Early and Long-Term Clinical Outcomes.

Abstract Background Although periprosthetic fractures are increasing in prevalence, evidence-based guidelines for the optimal treatment of periprosthetic tibial fractures (PTx) are lacking. Thus, the purpose of this study is to assess the clinical outcomes in PTx after a total knee arthroplasty (TKA) which were treated with different treatment options. Methods A retrospective review was performed on a consecutive series of 34 nontumor patients treated at 2 academic institutions who experienced a PTx after TKA (2008-2016). Felix classification was used to classify fractures (Felix = I-II-III; subgroup = A-B-C) which were treated by closed reduction, open reduction/internal fixation, revision TKA, or proximal tibial replacement. Patient demographics and surgical characteristics were collected. Failure of treatment was defined as any revision or reoperation. Independent t-tests, one-way analysis of variance, chi-squared analyses, and Fisher’s exact tests were conducted. Results Patients with Felix I had more nonsurgical complications when compared to Felix III patients (P = .006). Felix I group developed more postoperative anemia requiring transfusion than Felix III group (P = .009). All fracture types had >30% revision and >50% readmission rate with infection being the most common cause. These did not differ between Felix fracture types. Patients who underwent proximal tibial replacement had higher rate of postoperative infection (P = .030), revision surgery (P = .046), and required more flap reconstructions (P = .005). Conclusion PTx after a TKA is associated with high revision and readmission rates. Patients with Felix type I fractures are at higher risk of postoperative nonsurgical complications and anemia requiring transfusion. Fractures treated with proximal tibial replacement are more likely to develop postoperative infections and undergo revision surgery.
Functional magnetic resonance brain imaging of imagined walking to study locomotor function after stroke.

Abstract Objective Imagined walking has yielded insights into normal locomotor control and could improve understanding of neurologic gait dysfunction. This study evaluated brain activation during imagined walking in chronic stroke. Methods Ten persons with stroke and 10 matched controls completed a walking test battery and a magnetic resonance imaging session including imagined walking and knee extension tasks. Brain activations were compared between tasks and groups. Associations between activations and composite gait score were also calculated, while controlling for lesion load. Results Stroke and worse gait score were each associated with lesser overall brain activation during knee extension but greater overall activation during imagined walking. During imagined walking, the stroke group significantly activated the primary motor cortex lower limb region and cerebellar locomotor region. Better walking function was associated with less activation of these regions and greater activation of medial superior frontal gyrus area 9. Conclusions Compared with knee extension, imagined walking was less sensitive to stroke-related deficits in brain activation but better at revealing compensatory changes, some of which could be maladaptive. Significance The identified associations for imagined walking suggest potential neural mechanisms of locomotor adaptation after stroke, which could be useful for future intervention development and prognostication.
International Bonds and the Currency Risk: How Do Macro- shocks Affect Returns?

The currency translation risk borne by international investors and the riskiness of returns on long-term bonds both play a role in determining a country's cost of capital. For the U.S. investor, excess returns on German, Japanese, and U.K. bonds have been positively correlated with the respective excess local currency return (1978-1992). For investors who measure their performance in the currencies of these countries, the comparable correlation between U.S. bonds and a position in U.S. dollars has been negative. A traditional sticky-price model is used to explore the responses of a country's excess bond and currency returns to money growth and demand shocks. This model is ambiguous in its predictions of the resulting bond and currency return correlations. However, the macroeconomic variables in the model as well as variables shown to forecast bond and currency returns, are analyzed in VAR systems. Return innovations produced by the VAR systems are decomposed into their fundamental macroeconomic components. The effects of shocks to the fundamental components are traced through the system to determine the underlying causes of observed correlations between the bond and currency returns.
Paramedic-performed Prehospital Point-of-care Ultrasound for Patients with Undifferentiated Dyspnea: A Pilot Study.

Introduction: Thoracic ultrasound is frequently used in the emergency department (ED) to determine the etiology of dyspnea, yet its use is not widespread in the prehospital setting. We sought to investigate the feasibility and diagnostic performance of paramedic acquisition and assessment of thoracic ultrasound images in the prehospital environment, specifically for the detection of B-lines in congestive heart failure (CHF).Methods: This was a prospective observational study of a convenience sample of adult patients with a chief complaint of dyspnea. Paramedics participated in a didactic and hands-on session instructing them how to use a portable ultrasound device. Paramedics assessed patients for the presence of B-lines. Sensitivity and specificity for the presence of bilateral B-lines and any B-lines were calculated based on discharge diagnosis. Clips archived to the ultrasound units were reviewed and paramedic interpretations were compared to expert sonologist interpretations.Results: A total of 63 paramedics completed both didactic and hands-on training, and 22 performed ultrasounds in the field. There were 65 patients with B-line findings recorded and a discharge diagnosis for analysis. The presence of bilateral B-lines for diagnosis of CHF yielded a sensitivity of 80.0% (95% confidence interval [CI], 51.4-94.7%) and specificity of 72.0% (95% CI, 57.3-83.3), while presence of any B-lines was 93.3% sensitive (95% CI, 66.0-99.7%), and 50% specific (95% CI, 35.7-64.2%) for CHF. Paramedics archived 117 ultrasound clips of which 63% were determined to be adequate for interpretation. Comparison of paramedic and expert sonologist interpretation of images showed good inter-rater agreement for detection of any B-lines (k = 0.60; 95% CI, 0.36-0.84).Conclusion: This observational pilot study suggests that prehospital lung ultrasound for B-lines may aid in identifying or excluding CHF as a cause of dyspnea. The presence of bilateral B-lines as determined by paramedics is reasonably sensitive and specific for the diagnosis of CHF and pulmonary edema, while the absence of B lines is likely to exclude significant decompensated heart failure. The study was limited by being a convenience sample and highlighted some of the difficulties related to prehospital research. Larger funded trials will be needed to provide more definitive data.
Diagnosis and Treatment of Unruptured Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage

Unruptured intracranial aneurysms (UIAs) are commonly acquired vascular lesions that form an outpouching of the arterial wall due to wall thinning. The prevalence of UIAs in the general population is 3.2%. In contrast, an intracranial aneurysm may be manifested after rupture with classic presentation of a thunderclap headache suggesting aneurysmal subarachnoid hemorrhage (SAH). Previous consensus suggests that although small intracranial aneurysms (<7 mm) are less susceptible to rupture, aneurysms larger than 7 mm should be treated on a case-by-case basis with consideration of additional risk factors of aneurysmal growth and rupture. However, this distinction is outdated. The PHASES score, which comprises data pooled from several prospective studies, provides precise estimates by considering not only the aneurysm size but also other variables, such as the aneurysm location. The International Study of Unruptured Intracranial Aneurysms is the largest observational study on the natural history of UIAs, providing the foundation to the current guidelines for the management of UIAs. Although SAH accounts for only 3% of all stroke subtypes, it is associated with considerable burden of morbidity and mortality. The initial management is focused on stabilizing the patient in the intensive care unit with close hemodynamic and serial neurologic monitoring with endovascular or open surgical aneurysm treatment to prevent rebleeding. Since the results of the International Subarachnoid Aneurysm Trial, treatment of aneurysmal SAH has shifted from surgical clipping to endovascular coiling, which demonstrated higher odds of survival free of disability at 1 year after SAH. Nonetheless, aneurysmal SAH remains a public health hazard and is associated with high rates of disability and death.
Social anxiety and risky Marijuana use: The role of underutilization of protective behavioral strategies.

Abstract Social anxiety is a common mental health problem that increases the risk of experiencing cannabis-related problems. In fact, social anxiety more than quadruples the risk of developing cannabis use disorder, yet it is inconsistently related to more cannabis use. Inconsistent findings may be due to lack of attention to protective behavioral strategies (PBS) among socially anxious cannabis users. PBS are cognitive-behavioral strategies to reduce cannabis use and related problems. Yet socially anxious persons may be less likely to use PBS for a variety of reasons (e.g., fear of negative evaluation for engaging in behaviors to reduce use), leading to heavier or more frequent use and related problems. The current study examined the mediating role of PBS in the relationships of social anxiety with past-month cannabis use and related problems among current (past-month) cannabis users (N = 102). Social anxiety was significantly positively related to past-month cannabis problems, but not directly related to cannabis use. Social anxiety was significantly negatively related to PBS. Social anxiety was indirectly (via PBS) related to more frequent use, greater peak use, and more cannabis problems. Serial mediation analyses indicated that social anxiety was indirectly related to more cannabis problems via the serial effects of PBS and cannabis use variables. Findings suggest that socially anxious persons may be vulnerable to heavier cannabis use and more cannabis problems due to PBS underutilization. Treatment implications are discussed.
Necrotizing Autoimmune Myopathy: Comparison of Clinical Features and Treatment Outcomes among Different Etiologies (S17.002)

OBJECTIVE: To characterize the clinical, serological and electrophysiological features of adult patients with necrotizing autoimmune myopathy (NAM), compare etiological subgroups, and determine predictors of clinical outcome. BACKGROUND: NAM is an immune-mediated myopathy characterized clinically by subacute weakness, and pathologically by necrotic muscle fibers with absent or minimal inflammation. NAM is associated with statin medications, connective tissue disease (CTD), cancer, and autoantibodies (e.g., signal recognition particle [SRP]-IgG). Limited data are available on treatment outcomes. DESIGN/METHODS: Retrospective review of clinical, electrophysiological, serological, and pathological findings of patients diagnosed with NAM between 2004 and 2013. Patients were divided into 4 groups: Statin-associated, paraneoplastic, CTD-associated, and idiopathic. RESULTS: Sixty-three patients were included (mean age 59.9 years). Proximal lower limb weakness predominated (73[percnt]). Distal weakness (41[percnt]), dysphagia (35[percnt]) and respiratory involvement (37[percnt]) were common. Twenty-two (35[percnt]) were receiving statins at onset. Three patients had CTD and 6 had cancer. Mean presenting CK value was 7,051 U/L. The idiopathic group was significantly younger. Myotonic discharges were more common in the statin-associated group. Fourteen of 53 tested patients were SRP-IgG positive (26[percnt]). Facial weakness was more common in SRP-IgG-positive patients, while neck weakness and myotonic discharges were less common. Monotherapy with prednisone or IVIG was insufficient to control disease in 78[percnt]. Clinical relapse occurred in 50[percnt] during medication taper or discontinuation. Predictors of good outcome were male sex, mild weakness at onset, and treatment with 2 or more immunosuppressants within 3 months of symptom onset. CONCLUSIONS: NAM is usually idiopathic and often accompanied by SRP-IgG; statin therapy is a common association. SRP-IgG detection did not predict clinical outcome. Treatment with corticosteroids or IVIG alone did not control disease in most patients. Early aggressive immunotherapy promotes better outcome. Relapse risk is high during medication taper. Disclosure: Dr. Kassardjian has nothing to disclose. Dr. Lennon stands to receive royalty payments for commercial assays to detect of Aquaporin 4-specific Autoantibody. Dr. Milone has nothing to disclose.
Suprasegmental Constraints on Segmental Representation: Research Involving Speech Production

Publisher Summary This chapter discusses the relation between segmental and suprasegmental representation, an interesting and worthwhile question to pursue. The segment is primary and merely constrained by the prosodies is a view that has dominated phonetics and phonology from their beginnings and only now is beginning to be replaced widely by more balanced approaches. There has recently been a great increase in the activity devoted to discovering information about, and developing descriptive systems for, such suprasegmental phonological constructs as the syllable, the word, accent, tone, intonation, and rhythm. The chapter presents a brief review of the variety of ways segmental structure has been seen as dependent on higher levels of structure and process.
Re-Inventing the Wheel: The Re-Creation of Documents in a Bumble-Bee Organization

However, participants in an on-going study of knowledge communication practices have a strong tendency to re-create existing documents from scratch, despite the fact that sometimes multiple documents that serve the same purpose already exist in the organization’s archive. While at first this behavior seems wasteful, examination of their practices indicate that participants often have good reasons for re-creating documents. These include (a) empowerment, (b) learning, (c) personalization, (d) customization, and (e) simplification.
Interventional pulmonology procedures in the pediatric population.

Summary Introduction Advanced training in interventional pulmonology (IP) includes a multidisciplinary approach to a wide variety of pathologic conditions affecting different age groups. The role of the interventional pulmonologist in the pediatric patient population has not been described. We report our experience of the care of pediatric patients by IP at an academic institution. Methods A retrospective review of inpatient and outpatient IP procedures from 2008 to 2011 was performed. All patients' less than 21 years of age at the time of their procedure were identified. Data regarding age, procedure performed, pre-operative diagnosis, results, and complications were collected. Results Thirty-five patients younger than the age of 21, with 14 of these patients being under the age of 18, were identified. Fifty-six procedures were performed on the entire cohort, 30 as inpatient procedures and 26 as outpatient procedures. There were no deaths or major complications related to any procedure. Discussion We identified a cohort of pediatric patients that were able to successfully undergo diagnostic and therapeutic procedures under the direction of an experienced IP team. Cases included the evaluation and management of both malignant and benign complex airway and pleural diseases. There was no major morbidity or mortality related to our procedures, demonstrating an ability to safely evaluate and manage complex airway and pleural disease in the pediatric population. Pediatr Pulmonol. 2014; 49:597–604. © 2013 Wiley Periodicals, Inc.
The Mind's Staircase: Exploring the Conceptual Underpinnings of Children's Thought and Knowledge

Contents: Part I:Introduction. R. Case, General and Specific Views of the Mind, its Structure, and its Development. R. Case, A Neo-Piagetian Approach to the Issue of Cognitive Generality and Specificity. R. Case, Advantages and Limitations of the Neo-Piagetian Position. Part II:The Role of Central Conceptual Structures in the Development of Children's Logico-Mathematical Thought. Z. Marini, Synchrony and Asynchrony in the Development of Children's Scientific Reasoning. S. Griffin, R. Case, R. Sandieson, Synchrony and Asynchrony in the Acquisition of Children's Everyday Mathematical Knowledge. A.M. Capodilupo, A Neo-Structural Analysis of Children's Response to Instruction in the Sight-Reading of Musical Notation. R. Case, R. Sandieson, Testing for the Presence of a Central Quantative Structure: Use of the Transfer Paradigm. Part III:The Role of Central Conceptual Structures in the Development of Children's Social and Emotional Thought. J. Goldberg-Reitman, Young Girls' Conception of Their Mothers' Role: A Neo- Structural Analysis. M. Bruchkowsky, The Development of Empathic Cognition in Middle and Early Childhood. A. McKeough, A Neo-Structural Analysis of Children's Narrative and its Development. S. Griffin, Young Children's Awareness of Their Inner World: A Neo-Structural Analysis of the Development of Intrapersonal Intelligence. A. McKeough, Testing for the Presence of a Central Social Structure: Use of the Transfer Paradigm. Part IV:The Role of Central Conceptual Structures in the Development of Children's Spatial Thought. S. Dennis, Stage and Structure in the Development of Children's Spatial Representations. D.T. Reid, Horizontal and Vertical Structure: Stages and Substages in Children's Motor Development. Part V:Cross-Domain Synchrony and Asynchrony in the Acquisition of Different Central Conceptual Structures. R. Case, S. Griffin, A. McKeough, Y. Okamoto, Parallels in the Development of Children's Social, Numerical, and Spatial Thought. J. Crammond, Analyzing the Basic Cognitive-Developmental Processes of Children with Specific Types of Learning Disability. M. Porath, Stage and Structure in the Development of Children with Various Types of "Giftedness." T.A. Fiati, Cross-Cultural Variation in the Structure of Children's Thought. Part VI:Conclusion. R. Case, The Mind and its Modules: Toward a Multi-Level View of the Development of Human Intelligence.
Magnetic Fields and Activity of the Sun and Stars: An Overview

I review recent work on the observation and theory of solar and stellar magnetic field activity and its relation to stellar activity, with particular emphasis on those aspects relevant to the problem of activity of red dwarf stars.
Globalization and the Race to the Bottom in Developing Countries: Globalization and the productive welfare state: case study of South Korea

The following three chapters illustrate the findings from the previous portion of the book by selecting one representative from each cluster: a protective welfare state (India); a productive welfare state (South Korea); and a weak dual welfare state (Brazil). These case studies are intended as heuristic devices, rather than another hard test of the hypotheses in this book. The purpose of the case illustrations is to provide a more nuanced and detailed look at the primary research finding: as international market demands systematically affect government policy decisions in developing countries, distinct institutional arrangements governing the distribution of welfare persist and, as a consequence, middle-class labor groups are the ones most directly hurt by race to the bottom pressures. The country overviews essentially provide greater in-depth analysis of how national social policy configurations are structuring responses to globalization. The addition of the case study analysis allows a more applied understanding of the consequences of globalization in terms of cutbacks (RTB) and institutional changes. In addition, they permit consideration of the role of other factors not emphasized in the quantitative analysis, such as democracy. One caveat should be kept in mind as the case studies unfold in the following chapters. Because the causal linkages have been empirically verified in the earlier chapters, I take on the broad panorama of each country's political economy and related social welfare strategies in a swift, bold, and unrestrained manner.