Bilateral Morgagni Hernia: A Unique Presentation of a Rare Pathology

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Michael Leshen

2016-01-01

Full Text Available Morgagni hernia is an unusual congenital herniation of abdominal content through the triangular parasternal gaps of the anterior diaphragm. They are commonly asymptomatic and right-sided. We present a case of a bilateral Morgagni hernia resulting in delayed growth in a 10-month-old boy. The presentation was unique due to its bilateral nature and its symptomatic compression of the mediastinum. Diagnosis was made by 3D reconstructed CT angiogram. The patient underwent medical optimization until he was safely able to tolerate laparoscopic surgical repair of his hernia. Upon laparoscopy, the CT findings were confirmed and the hernia was repaired.

Bilateral widespread mechanical pain hypersensitivity as sign of central sensitization in patients with cluster headache.

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Fernández-de-Las-Peñas, César; Ortega-Santiago, Ricardo; Cuadrado, María L; López-de-Silanes, Carlos; Pareja, Juan A

2011-03-01

To investigate bilateral widespread pressure pain hyperalgesia in deep tissues over symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with cluster headache (CH). Central sensitization is claimed to play a relevant role in CH. No study has previously searched for widespread pressure hyperalgesia in deep tissues over both symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with CH. Sixteen men (mean age: 43 ± 11 years) with CH in a remission phase and 16 matched controls were recruited. Pressure pain thresholds (PPTs) were bilaterally measured over the supra-orbital (V1), infra-orbital (V2), mental (V3), median (C5), radial (C6), and ulnar (C7) nerves, C5-C6 zygapophyseal joint, mastoid process, and tibialis anterior muscle by an assessor blinded to the subjects' condition. The results showed that PPT levels were significantly decreased bilaterally in patients with CH as compared with healthy controls (all sites, P < .001). A greater degree of sensitization over the mastoid process (P < .001) and a lower degree of sensitization over the tibialis anterior muscle (P < .01) was found. Our findings revealed bilateral widespread pressure pain hypersensitivity in patients with CH confirming the presence of central sensitization mechanisms in this headache condition. © 2010 American Headache Society.

Ovarian Artery Embolization in Patients With Collateral Supply to Symptomatic Uterine Leiomyomata

International Nuclear Information System (INIS)

Scheurig-Muenkler, C.; Poellinger, A.; Wagner, M.; Hamm, B.; Kroencke, T. J.

2011-01-01

Purpose: To evaluate the safety and outcome of ovarian artery embolization (OAE) in patients with collateral supply to symptomatic uterine leiomyomata. Materials and Methods: Thirteen patients with relevant leiomyoma perfusion by way of enlarged ovarian arteries underwent additional OAE during the same (N = 10) or a second procedure (N = 3). Uterine artery embolization (UAE) was performed bilaterally in 10 and unilaterally in 2 patients with a single artery. One patient had no typical uterine arteries but bilaterally enlarged ovarian arteries, prompting bilateral OAE. OAE was accomplished with coil embolization in one and particle embolization in 12 patients. Symptoms before therapy and clinical outcome were assessed using a standardized questionnaire. Contrast-enhanced magnetic resonance (MR) imaging after embolization was available in 11 of 13 patients and was used to determine the percentage of fibroid infarction. Results: UAE and OAE were technically successful in all patients. One patient experienced prolonged irritation at the puncture site. Median clinical follow-up time was 16 months (range 4–37). Ten of 13 patients showed improvement or complete resolution of clinical symptoms. One patient reported only slight improvement of her symptoms. These women presented with regular menses. Two patients (15%), 47 and 48 years, both with unilateral OAE, reported permanent amenorrhea directly after embolization. Their symptoms completely resolved. Seven patients showed complete and 4 showed >90% fibroid infarction after embolization therapy. Conclusions: OAE is technically safe and effective in patients with ovarian artery collateral supply to symptomatic uterine leiomyomata. The risk of permanent amenorrhea observed in this study is similar to the reported incidence after UAE.

Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

International Nuclear Information System (INIS)

Cho, Bong Hae; Jung, Yun Hoa

2013-01-01

This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

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Cho, Bong Hae; Jung, Yun Hoa [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

2013-03-15

This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

Symptomatic ovarian steroid cell tumor not otherwise specified in a post-menopausal woman

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Neha Sood

2016-06-01

Full Text Available Steroid cell tumor not otherwise specified (NOS is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years, in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL. Radiologic studies were consistent with bilateral adrenal adenomas. Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion. A diagnostic and therapeutic bilateral salpingooophorectomy confirmed steroid cell tumor NOS of the left ovary. Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level. Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging.

Tachyons without paradoxes

International Nuclear Information System (INIS)

Barrowes, S.C.

1977-01-01

Tachyon paradoxes, including causality paradoxes, have persisted within tachyon theories and left little hope for the existence of observable tachyons. A way is presented to solve the causality paradoxes, along with two other paradoxes, by the introduction of an absolute frame of reference in which a tachyon effect may never precede its cause. Relativity for ordinary matter is unaffected by this, even if the tachyons couple to ordinary particles. Violations of the principle of relativity due to the absolute frame would appear only in the case of free tachyons

Paradoxical Reaction to Alprazolam in an Elderly Woman with a History of Anxiety, Mood Disorders, and Hypothyroidism

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Daniel Kirkpatrick

2016-01-01

Full Text Available With less than 1% of patients who use benzodiazepines being affected, paradoxical responses to benzodiazepines are rare. In this case report, we outline the course of an 80-year-old female who developed a paradoxical response to benzodiazepines. Significant medical and psychiatric history includes anxiety, mood disorder, hypothyroidism, bilateral mastectomy, goiter removal, and triple bypass. The patient presented with mental status changes, anxiety, motor restlessness, and paranoia. Over time, a temporal relationship between the severity of the patient’s motor agitation and intake of alprazolam was observed. As doses of alprazolam were decreased, her motor agitation became less severe. In addition to motor agitation, the patient also demonstrated increased aggressiveness, a subjective feeling of restlessness, and increased talkativeness. As her dose of alprazolam decreased, many of the patient’s symptoms were observed to decrease. This case report also discusses theories regarding the pathophysiology of paradoxical reactions to benzodiazepines, known risk factors, and appropriate treatment.

Simultaneous bilateral anterior cruciate ligament reconstruction: Cost comparison and functional results

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Matjaž Sajovic

2014-04-01

Full Text Available Background: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL deficiency remains controversial. The purpose was to evaluate cost and mid-term functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft.Methods: We compared the mid-term outcome of 7 patients (14 knees who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients.Results: The median duration of hospital stay was 4 nights (range 3 to 5 for the bilateral group and 2 nights (range, 1 to 4 for the control group. The duration of rehabilitation process in patients from the control group with unilateral ACL reconstruction was one week shorter (9 versus 8 weeks. In the bilateral group, the median Lysholm score was 96 (range 85–100 and in the control group, the median score was 93 (range 81–100. The median time to return to full-time work and to full sports was 9 weeks and 7 months for the simultaneous bilateral group and 8 weeks and 6 months for the unilateral group. Six patients (86 % in the bilateral group and 17 patients (81 % in the control group were still performing at their pre-injury level of activity. The Health Insurance Institute of Slovenia saves EUR 2,925 when we perform simultaneous bilateral ACL reconstruction instead of two stage ACL reconstruction.Conclusions: Mid-term clinical results suggested that simultaneous bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting with symptomatic bilateral ACL deficient knees, one stage bilateral ACL reconstruction is reproducible, cost effective, and does not compromise functional results.

Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

International Nuclear Information System (INIS)

Bratby, M.J.; Walker, W.J.

2009-01-01

Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

Uterine artery embolisation for symptomatic adenomyosis-Mid-term results

Energy Technology Data Exchange (ETDEWEB)

Bratby, M.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom); Walker, W.J. [Radiology Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX (United Kingdom)], E-mail: wjwalker@doctors.org.uk

2009-04-15

Purpose: To evaluate the role of uterine artery embolisation (UAE) in the treatment of adenomyosis. Materials and methods: 27 women with symptomatic adenomyosis diagnosed on magnetic resonance imaging (MRI) underwent UAE between 1998 and 2004. Clinical evaluation using a standardised questionnaire was made at regular intervals after embolisation to assess patient outcome. Results: The diagnosis of adenomyosis was confirmed histologically by transvaginal biopsy in 5 women. There were 14 women with associated uterine fibroids. Diffuse adenomyosis was identified in 18 women. A focal adenomyoma was present in another 8 women. In 1 patient adenomyosis was not classified. All patients except one underwent bilateral uterine artery embolisation. There was an initial favourable clinical response, with improvement of menorrhagia in 79% (13/16) of patients at 12 months. Follow-up data was available on a total of 14 patients at 2 and 3 years after embolisation. 45.5% (5/11) reported a deterioration in menorrhagia symptoms at 2 years. Conclusion: UAE for symptomatic adenomyosis is effective in the short-term but there is a high rate of recurrence of clinical symptoms 2 year following treatment.

Is the EPR paradox really a paradox?

OpenAIRE

Tartaglia, A.

1998-01-01

The EPR paradox and the meaning of the Bell inequality are discussed. It is shown that considering the quantum objects as carrying with them ''instruction kits'' telling them what to do when meeting a measurement apparatus any paradox disappears. In this view the quantum state is characterized by the prescribed behaviour rather than by the specific value a parameter assumes as a result of an interaction.

[Bilateral Pallidotomy for Tardive Dystonia:A Case Report].

Science.gov (United States)

Kohara, Kotaro; Taira, Takaomi; Horisawa, Shiro; Hanada, Tomoko; Kawamata, Takakazu

2017-11-01

Tardive dystonia is a movement disorder related to the use of dopamine-receptor-blocking drugs. Several reports have shown that deep brain stimulation of the globus pallidus internus(GPi-DBS)is effective in treating tardive dystonia. However, a few reports demonstrated the efficacy of ablation of the GPi(pallidotomy). We herein report a case of tardive dystonia successfully treated with bilateral pallidotomy. A 32-year-old man developed severe tardive dystonia 10 years after the chronic use of antipsychotic drugs. Withdrawal of the drugs and botulinum toxin injections were ineffective. The patient underwent bilateral pallidotomy for tardive dystonia because of rejection of the implanted DBS devices. Significant improvement was observed, with a 95% decrease in the Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS)movement score, and no severe adverse events occurred. Symptomatic relief persisted for nine months. Pallidotomy is a feasible and efficacious procedure for tardive dystonia treatment without the use of hardware implantations.

Generalized Hardy's Paradox

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Jiang, Shu-Han; Xu, Zhen-Peng; Su, Hong-Yi; Pati, Arun Kumar; Chen, Jing-Ling

2018-01-01

Here, we present the most general framework for n -particle Hardy's paradoxes, which include Hardy's original one and Cereceda's extension as special cases. Remarkably, for any n ≥3 , we demonstrate that there always exist generalized paradoxes (with the success probability as high as 1 /2n -1) that are stronger than the previous ones in showing the conflict of quantum mechanics with local realism. An experimental proposal to observe the stronger paradox is also presented for the case of three qubits. Furthermore, from these paradoxes we can construct the most general Hardy's inequalities, which enable us to detect Bell's nonlocality for more quantum states.

Mobile compression devices and aspirin for VTE prophylaxis following simultaneous bilateral total knee arthroplasty.

Science.gov (United States)

Nam, Denis; Nunley, Ryan M; Johnson, Staci R; Keeney, James A; Barrack, Robert L

2015-03-01

Recently, Levy et al questioned the effectiveness of mobile compression devices (MCDs) as the sole method of thromboprophylaxis following simultaneous bilateral total knee arthroplasty (TKA). This study's purpose was to assess if the addition of aspirin to MCDs improves venous thromboembolism (VTE) prevention following simultaneous bilateral TKA. Ninety-six patients (192 TKAs) were retrospectively reviewed: 47 patients received MCDs for 10 days and aspirin for 6 weeks postoperatively based on a risk stratification protocol, while 49 patients received warfarin for 4 weeks postoperatively. One symptomatic VTE was noted in the warfarin cohort, while one patient in the MCD/aspirin cohort and three patients in the warfarin cohort were readmitted within 3 months of surgery. In appropriately selected patients, MCDs with aspirin shows promise in VTE prevention following simultaneous bilateral TKA. Copyright © 2014 Elsevier Inc. All rights reserved.

The quercetin paradox

International Nuclear Information System (INIS)

Boots, Agnes W.; Li, Hui; Schins, Roel P.F.; Duffin, Rodger; Heemskerk, Johan W.M.; Bast, Aalt; Haenen, Guido R.M.M.

2007-01-01

Free radical scavenging antioxidants, such as quercetin, are chemically converted into oxidation products when they protect against free radicals. The main oxidation product of quercetin, however, displays a high reactivity towards thiols, which can lead to the loss of protein function. The quercetin paradox is that in the process of offering protection, quercetin is converted into a potential toxic product. In the present study, this paradox is evaluated using rat lung epithelial (RLE) cells. It was found that quercetin efficiently protects against H 2 O 2 -induced DNA damage in RLE cells, but this damage is swapped for a reduction in GSH level, an increase in LDH leakage as well as an increase of the cytosolic free calcium concentration. To our knowledge, this is the first study that indicates that the quercetin paradox, i.e. the exchange of damage caused by quercetin and its metabolites, also occurs in living lung cells. Following depletion of GSH in the cells by BSO pre-treatment, this quercetin paradox becomes more pronounced, confirming that the formation of thiol reactive quercetin metabolites is involved in the quercetin paradox. The quercetin paradox in living cells implies that the anti-oxidant directs oxidative damage selectively to thiol arylation. Apparently, the potential toxicity of metabolites formed during the actual antioxidant activity of free radical scavengers should be considered in antioxidant supplementation

Paradoxes in probability theory

CERN Document Server

Eckhardt, William

2013-01-01

Paradoxes provide a vehicle for exposing misinterpretations and misapplications of accepted principles. This book discusses seven paradoxes surrounding probability theory.  Some remain the focus of controversy; others have allegedly been solved, however the accepted solutions are demonstrably incorrect. Each paradox is shown to rest on one or more fallacies.  Instead of the esoteric, idiosyncratic, and untested methods that have been brought to bear on these problems, the book invokes uncontroversial probability principles, acceptable both to frequentists and subjectivists. The philosophical disputation inspired by these paradoxes is shown to be misguided and unnecessary; for instance, startling claims concerning human destiny and the nature of reality are directly related to fallacious reasoning in a betting paradox, and a problem analyzed in philosophy journals is resolved by means of a computer program.

Paradoxes and Innovation in Family Firms

DEFF Research Database (Denmark)

Ingram, Amy E.; Lewis, Marianne W.; Barton, Sid

2016-01-01

thinkers are more likely to manage these tensions and fuel innovative behavior. Leveraging family business and organizational paradox literatures, this multi-stage exploratory study develops measures of paradoxical tensions and paradoxical thinking in family firms, and tests these propositions. Findings...... indicate that paradoxical tensions may stymie innovative behavior, but that leaders' paradoxical thinking is positively related to innovative behavior....

Paradoxes in Practice

DEFF Research Database (Denmark)

Madsen, Charlotte Øland; Schulze, Pernille; Larsen, Mette Vinther

The purpose of this paper is to explore how paradoxes unfold in management practices and how moments of relational dialogic, self-reflexive learning can transform these paradoxes into new understandings of the complexities of organizing and management. We work with paradox, not as a label...... to explore ‘the flux of reality from within’ with the managers. We therefore draw on Bakhtin’s ideas regarding ongoing centripetal (monologic) and centrifugal (dialogic) forces of language and aim to demonstrate how working with language and the awareness of the embodied embedded practices at the same time...

Ultrasound -a useful complementary tool to mammography in assessment of symptomatic breast diseases

International Nuclear Information System (INIS)

Fatima, S.T.; Zahur, Z.; Jeilani, A.; Hussain, S.J.A.

2015-01-01

Breast cancer is the most common female malignancy worldwide. Pakistan has the highest incidence rate of breast cancer than any other Asian population. The purpose of the study was to evaluate the worth of sono-mammography in diagnosis of symptomatic breast diseases by comparing it with mammogram. Methods: In this cross-sectional validation study, 45 subjects with mean age of 45+-12.07 were included. Majority of the patients presented with complaint of breast lump. After complete history and clinical examination, all the patients had high resolution ultrasound of bilateral breasts and axilla followed by bilateral mammography. Histopathology was taken as gold standard in this study. The exclusion criteria were pregnancy and patients having direct clinical signs of breast malignancy. Results: Based on histopathology, out of 45 patients with breast symptoms, 12 patients had benign lesions, whereas 32 patients were diagnosed as the cases of breast cancers. Finally one patient did not have biopsy proven final diagnosis. Sensitivity and specificity of ultrasound were calculated to be 100% and 67% as compared to sensitivity and specificity of 90.6% and 91.7% for that of mammography. Conclusions: Ultrasound is a useful complementary tool to mammography in assessment of symptomatic breast diseases since it helps in characterization and localization of breast lesions seen on mammogram and it is not limited by dense breasts. Also it should be the considered as initial imaging technique for assessment of palpable breast lumps. (author)

Embolia paradojal inminente Impending paradoxical embolism

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Miguel A. Veltri

2006-12-01

Full Text Available La presencia de un trombo venoso atrapado en un defecto interauricular e insinuándose en las cavidades izquierdas configura una forma extremadamente inusual de enfermedad tromboembólica denominada embolia paradojal inminente. Presentamos el caso de un varón de 71 años, sometido 10 días antes a adenomectomía prostática, que consultó por disnea y mareos. Se le diagnosticó tromboembolismo pulmonar bilateral por tomografía axial computada helicoidal. Se lo anticoaguló con heparina sódica y se le realizó un ecocardiograma transesofágico que mostró un trombo que atravesaba el foramen oval y se alojaba en la aurícula izquierda. No presentaba signos clínicos de embolización sistémica. Se realizó la embolectomía quirúrgica y cierre del defecto auricular. El paciente falleció.An intracardiac thrombus traversing a patent foramen ovale is a very infrequent but potentially catastrophic complication of the thromboembolic disease. It is named "impending paradoxical embolism". We report the case of a 71 year old Caucasian male warded in ten days after a prostatectomy because of bilateral pulmonary embolism. Diagnosis was confirmed by HCT scan and the patient received anticoagulation with heparin. A transesophageal ecocardiogram disclosed a thrombus traversing foramen ovale into the left atrium. Surgical embolectomy was performed, but the patient died shortly after surgery.

The Oxygen Paradox, the French Paradox, and age-related diseases.

Science.gov (United States)

Davies, Joanna M S; Cillard, Josiane; Friguet, Bertrand; Cadenas, Enrique; Cadet, Jean; Cayce, Rachael; Fishmann, Andrew; Liao, David; Bulteau, Anne-Laure; Derbré, Frédéric; Rébillard, Amélie; Burstein, Steven; Hirsch, Etienne; Kloner, Robert A; Jakowec, Michael; Petzinger, Giselle; Sauce, Delphine; Sennlaub, Florian; Limon, Isabelle; Ursini, Fulvio; Maiorino, Matilde; Economides, Christina; Pike, Christian J; Cohen, Pinchas; Salvayre, Anne Negre; Halliday, Matthew R; Lundquist, Adam J; Jakowec, Nicolaus A; Mechta-Grigoriou, Fatima; Mericskay, Mathias; Mariani, Jean; Li, Zhenlin; Huang, David; Grant, Ellsworth; Forman, Henry J; Finch, Caleb E; Sun, Patrick Y; Pomatto, Laura C D; Agbulut, Onnik; Warburton, David; Neri, Christian; Rouis, Mustapha; Cillard, Pierre; Capeau, Jacqueline; Rosenbaum, Jean; Davies, Kelvin J A

2017-12-01

A paradox is a seemingly absurd or impossible concept, proposition, or theory that is often difficult to understand or explain, sometimes apparently self-contradictory, and yet ultimately correct or true. How is it possible, for example, that oxygen "a toxic environmental poison" could be also indispensable for life (Beckman and Ames Physiol Rev 78(2):547-81, 1998; Stadtman and Berlett Chem Res Toxicol 10(5):485-94, 1997)?: the so-called Oxygen Paradox (Davies and Ursini 1995; Davies Biochem Soc Symp 61:1-31, 1995). How can French people apparently disregard the rule that high dietary intakes of cholesterol and saturated fats (e.g., cheese and paté) will result in an early death from cardiovascular diseases (Renaud and de Lorgeril Lancet 339(8808):1523-6, 1992; Catalgol et al. Front Pharmacol 3:141, 2012; Eisenberg et al. Nat Med 22(12):1428-1438, 2016)?: the so-called, French Paradox. Doubtless, the truth is not a duality and epistemological bias probably generates apparently self-contradictory conclusions. Perhaps nowhere in biology are there so many apparently contradictory views, and even experimental results, affecting human physiology and pathology as in the fields of free radicals and oxidative stress, antioxidants, foods and drinks, and dietary recommendations; this is particularly true when issues such as disease-susceptibility or avoidance, "healthspan," "lifespan," and ageing are involved. Consider, for example, the apparently paradoxical observation that treatment with low doses of a substance that is toxic at high concentrations may actually induce transient adaptations that protect against a subsequent exposure to the same (or similar) toxin. This particular paradox is now mechanistically explained as "Adaptive Homeostasis" (Davies Mol Asp Med 49:1-7, 2016; Pomatto et al. 2017a; Lomeli et al. Clin Sci (Lond) 131(21):2573-2599, 2017; Pomatto and Davies 2017); the non-damaging process by which an apparent toxicant can activate biological signal

Bilateral inferior vena cava filter insertion in a patient with duplication of the infrarenal vena cava.

LENUS (Irish Health Repository)

Leong, S

2010-06-19

BACKGROUND: Inferior vena cava (IVC) filter insertion is a commonly performed procedure for indications such as recurrent pulmonary emboli or contraindication to anticoagulation. Symptomatic duplication of the IVC is exceedingly rare with only a handful of cases being described in the literature. AIM: We report an unusual case of a patient with symptomatic duplication of the IVC. RESULT: A 53-year-old woman presented at our hospital for resection of a cerebral metastasis from a non-small cell lung cancer following a recent diagnosis of bilateral lower limb deep venous thrombosis. This required perioperative reversal of anticoagulation and IVC filter insertion. Conventional venography performed during filter insertion documented the existence of a duplicated IVC. CONCLUSION: We present a case of a symptomatic duplication of the IVC requiring filter insertion. We review the developmental anatomy of the IVC along with the diagnostic findings and management strategies available.

Antiparticle in Light of Einstein-Podolsky-Rosen Paradox and Klein Paradox

OpenAIRE

Ni, Guang-jiong; Guan, Hong; Zhou, Weimin; Yan, Jun

2000-01-01

The original version of Einstein-Podolsky-Rosen (EPR) paradox and the Klein paradox of Klein-Gordon (KG) equation are discussed to show the necessity of existence of antiparticle with its wavefunction being fixed unambiguously. No concept of "hole" is needed.

Uterine artery embolization with Pingyangmycin lipiodol emulsion for treatment of symptomatic uterine fibroids

International Nuclear Information System (INIS)

Li Yanhao; Liu Biao; Zeng Qingle; Jiang Zhongpu; Chen Yong; Huang Weilang; Shen Qi; Zhao Zhongqing

2000-01-01

Objective: To evaluate the effectiveness and side effects of uterine arterial embolization with Pingyangmycin(a homogenous bleomycin) lipiodol emulsion(PLE) for symptomatic uterine fibroids. Methods: Uterine arterial embolization with PLE was performed in 25 patients. The improvement of symptoms and uterine size changes were followed up in 3-18 months(mean 6 months) after the procedure. Results: All but 2 cases were successfully treated bilaterally. Super-selective angiography showed enlargement of uterine artery, accompanied by tortuous branches. The uterine size was increased. The uterus itself was significantly stained and emptied slowly. Coagulation necrosis was found in resected fibroids after embolization in 3 patients. One month after the procedure, a mean 40% reduction of uterine volume was obtained in 18 followed-up cases. The clinical symptoms were relieved significantly. The main side effects were hypogastric pain(13/25),which was intense in 6 cases. Conclusion: Uterine arterial embolization with PLE is a good non-surgical therapy in symptomatic uterine fibroids with mild side effects

Botulinum toxin injections for new onset bilateral vocal fold motion impairment in adults.

Science.gov (United States)

Ekbom, Dale C; Garrett, C Gaelyn; Yung, Katherine C; Johnson, Felicia L; Billante, Cheryl R; Zealear, David L; Courey, Mark S

2010-04-01

Review of clinical experience and results using botulinum toxin type A (BTX) for the management of adult patients with respiratory compromise due to new onset bilateral vocal fold motion impairment (BVFMI). Retrospective case series. The records of 11 patients from two institutions with respiratory compromise due to bilateral vocal fold motion impairment were reviewed. Age, sex, etiology of motion impairment, subjective response to BTX injections, changes in pulmonary function studies pre- and postinjection when available, the dosage of botulinum toxin required to achieve response, the number of injections per patient, and complications were reported. All patients were over 18 years old. There were three male and eight female subjects. The etiology of BVFMI was due to previous anterior cervical surgery in nine patients and prolonged intubation in two. Ten patients reported symptomatic improvement and returned for an average of nine injections over the 10-year period of study. The most common interval between injections was 3 months. In all patients the dose required to achieve symptomatic improvement was at least 2.5 mouse units injected into each vocal fold. One patient without relief of symptoms had bilateral cricoarytenoid joint fixation. Complications were limited to moderate dysphagia in one patient and breathy dysphonia in all patients. BTX injection into the vocal folds provides temporary relief of symptoms in airway obstruction in adult patients with BVFMI. Patients require an average of 2.5 units of botulinum injection into each vocal fold and have an average length of response of 3 months. BTX injection may be used as a form of temporary relief of airway obstruction in patients wishing to avoid ablative surgery or tracheotomy.

Multisetting Greenberger-Horne-Zeilinger paradoxes

Science.gov (United States)

Tang, Weidong; Yu, Sixia; Oh, C. H.

2017-01-01

The Greenberger-Horne-Zeilinger (GHZ) paradox provides an all-versus-nothing test for the quantum nonlocality. In most of the GHZ paradoxes known so far each observer is allowed to measure only two alternative observables. Here we present a general construction for GHZ paradoxes in which each observer measures more than two observables given that the system is prepared in the n -qudit GHZ state. By doing so we are able to construct a multisetting GHZ paradox for the n -qubit GHZ state, with n being arbitrary, which is genuine n -partite; i.e., no GHZ paradox exists when restricted to a subset of a number of observers for a given set of Mermin observables. Our result fills up the gap of the absence of a genuine GHZ paradox for the GHZ state of an even number of qubits, especially the four-qubit GHZ state as used in GHZ's original proposal.

Treatment of symptomatic pelvic varices by ovarian vein embolization

International Nuclear Information System (INIS)

Capasso, Patrizio; Simons, Christine; Trotteur, Genevieve; Dondelinger, Robert F.; Henroteaux, Denis; Gaspard, Ulysse

1997-01-01

Purpose. Pelvic congestion syndrome is a common cause of chronic pelvic pain in women and its association with venous congestion has been described in the literature. We evaluated the potential benefits of lumboovarian vein embolization in the treatment of lower abdominal pain in patients presenting with pelvic varicosities. Methods. Nineteen patients were treated. There were 13 unilateral embolizations, 6 initial bilateral treatments and 5 treated recurrences (a total of 30 procedures). All embolizations were performed with either enbucrilate and/or macrocoils, and there was an average clinical and Doppler duplex follow-up of 15.4 months. Results. The initial technical success rate was 96.7%. There were no immediate or long-term complications. Variable symptomatic relief was observed in 73.7% of cases with complete responses in 57.9%. All 8 patients who had partial or no pain relief complained of dyspareunia. The direct relationship between varices and chronic pelvic pain was difficult to ascertain in a significant number of clinical failures. Conclusion. Transcatheter embolization of lumboovarian varices is a safe technique offering symptomatic relief of pelvic pain in the majority of cases. The presence of dyspareunia seemed to be a poor prognostic factor, indicating that other causes of pelvic pain may coexist with pelvic varicosities

[A case of Crow-Fukase syndrome with respiratory failure due to bilateral diaphragmatic paralysis].

Science.gov (United States)

Namekawa, Michito; Muramatsu, Shin-ichi; Hashimoto, Ritsuo; Kawakami, Tadataka; Fujimoto, Ken-ichi; Nakano, Imaharu

2002-07-01

A 62-year-old man with well-controlled diabetes mellitus developed numbness of the bilateral feet and hands, followed by subacutely progressive weakness and amyotrophy of extremities. He became bed-ridden state, and dyspnea also appeared, so he was referred to our hospital. Physical examination revealed a lean man, with dark-reddish skin pigmentation, crabbed fingers, bilateral pretibial pitting edema, and bristles in extremities. Thoracoabdominal paradoxical respiration was observed and pulmonary vesicular sounds was decreased markedly in the both lungs. Laboratory data revealed hypoproteinemia, abnormalities of endocrine system, but M-protein was not detected. Serum vascular endothelial growth factor level was quite high. Chest radiography revealed elevation of the bilateral diaphragm, the % vital capacity (%VC) was 24%, and arterial blood gas analysis showed marked hypoxia with hypercapnia. These findings suggested that his respiratory failure was induced by bilateral diaphragmatic paralysis caused by bilateral phrenic nerve palsy due to Crow-Fukase syndrome. He became somnolent because of hypercapnic narcosis, so non-invasive positive pressure ventilation (NIPPV) was started. We treated him with intravenous immunoglobulin and oral corticosteroids therapies, and after these therapies, his symptoms were remarkably recovered and NIPPV became unnecessary soon. The most frequent causes of respiratory failure in Crow-Fukase syndrome are pleural effusion and pulmonary hypertension, and only two cases of this syndrome with respiratory failure caused by bilateral diaphragmatic paralysis were reported until now. When the patients with Crow-Fukase syndrome complain of dyspnea, we should take the diaphragmatic paralysis into consideration, which may be improved by appropriate therapies.

Tachyons and causal paradoxes

International Nuclear Information System (INIS)

Maund, J.B.

1979-01-01

Although the existence of tachyons is not ruled out by special relativity, it appears that causal paradoxes will arise if there are tachyons. The usual solutions to these paradoxes employ some form of the reinterpretation principle. In this paper it is argued first that, the principle is incoherent, second, that even if it is not, some causal paradoxes remain, and third, the most plausible ''solution,'' which appeals to boundary conditions of the universe, will conflict with special relativity

Bilateral and pseudobilateral tonsilloliths: Three dimensional imaging with cone-beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Misirlioglu, Melda; Adisen, Mehmet Zahit; Yardimci, Selmi [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kirikkale University, Kirikkale (Turkmenistan); Nalcaci, Rana [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara (Turkmenistan)

2013-09-15

Tonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs. The sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm{sup 3} of the segmented three dimensional models were obtained. CBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to 302.5mm{sup 3}. The patients with bilaterally multiple and large calcifications were found to be symptomatic. The cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies.

Cannabinoid Hyperemesis Syndrome: Case Report of a Paradoxical Reaction with Heavy Marijuana Use

Directory of Open Access Journals (Sweden)

Benjamin Cox

2012-01-01

Full Text Available Cannabinoid hyperemesis syndrome (CHS is a rare constellation of clinical findings that includes a history of chronic heavy marijuana use, severe abdominal pain, unrelenting nausea, and intractable vomiting. A striking component of this history includes the use of hot showers or long baths that help to alleviate these symptoms. This is an underrecognized syndrome that can lead to expensive and unrevealing workups and can leave patients self-medicating their nausea and vomiting with the very substance that is causing their symptoms. Long-term treatment of CHS is abstinence from marijuana use—but the acute symptomatic treatment of CHS has been a struggle for many clinicians. Many standard medications used for the symptomatic treatment of CHS (including ondansetron, promethazine, and morphine have repeatedly been shown to be ineffective. Here we present the use of lorazepam as an agent that successfully and safely treats the tenacious symptoms of CHS. Additionally, we build upon existing hypotheses for the pathogenesis of CHS to try to explain why a substance that has been used for thousands of years is only now beginning to cause this paradoxical hyperemesis syndrome.

Quantum paradoxes and physical reality

International Nuclear Information System (INIS)

Van der Merwe, Alwyn; Selleri, Franco

1990-01-01

This book is devoted to the most fundamental themes of quantum physics: acausality, wave-particle duality, Einstein-Podolsky-Rosen (EPR) paradox, and so on. These are matters of growing interest for physicists. Several paradoxes have plagued quantum physics since its beginnings, the easiest of which to solve are the paradoxes of completeness (Schroedinger's cat, Wigner's friend, de Broglie's box, etc.). At a deeper level is the paradox of wave-particle duality whose solution probably requires the Einstein-de Broglie picture of atomic systems. The most difficult of them all is the EPR paradox (incompatibility between local realism and quantum theory). The book shows that experimental research can, in principle, solve paradoxes such as EPR and wave-particle duality but that the experiments performed on Bell-type inequalities have instead left the conceptual situation fundamentally unmodified. For a fair understanding of the Einstein-de Broglie and of the Bohr-Heisenberg ideas, an 'internal' lecture of physics is not enough. Such 'external' elements as individual biographies, history of culture, and philosophical preconceptions prove also to be important. (author). refs.; figs.; tabs

Electromagnetic reaction paradox

International Nuclear Information System (INIS)

Aspden, H.

1984-01-01

Alternative explanations for free-electron diamagnetism appear paradoxical and inconsistent with the reactive induction properties of magnetic materials. It is shown that the paradox can be eliminated by a generalized definition of the magnetic field with interesting spin-off consequences, including a justification for the anomalous doubling of the positron's effective mass in a free-electron environment

Reduction in incidence of lymphocele following extraperitoneal radical prostatectomy and pelvic lymph node dissection by bilateral peritoneal fenestration.

Science.gov (United States)

Stolzenburg, Jens-Uwe; Wasserscheid, Johanna; Rabenalt, Robert; Do, Minh; Schwalenberg, Thilo; McNeill, Alan; Constantinides, Costantinos; Kallidonis, Panagiotis; Ganzer, Roman; Liatsikos, Evangelos

2008-12-01

In our series of 1,900 endoscopic extraperitoneal radical prostatectomies (EERPE) the incidence of symptomatic lymphocele following simultaneous pelvic lymph node dissection (PLND) is between 3 and 14% depending on the extent of lymph node dissection. We report the impact of bilateral peritoneal fenestration after completion of extraperitoneal prostatectomy and PLND on the incidence of lymphocele, postoperative pain and complications. A total of 100 consecutive patients undergoing EERPE and extended PLND were allocated into two groups. In Group A (n = 50) a 4-6 cm incision was performed bilaterally over the external iliac vessels down to the obturator fossa after completion of the main procedure. In Group B (n = 50) no peritoneal incisions were made. The postoperative assessment protocol included a visual analogue pain scale administered three times daily for 6 days, analgesia requirement, and ultrasound examination on 4th and 8th days, and 3 months postoperatively. CRP and leucocyte counts were measured on 1st and 2nd postoperative days. Complications were recorded according to our standard protocol using the Clavien classification. Three patients (6%) in Group A were found to have lymphoceles, none of which were symptomatic. Significantly more patients in Group B developed a lymphocele, (n = 16, 32%, P < 0.001) of which a significant number were symptomatic (n = 7, 14%, P < 0.001) and required laparoscopic fenestration. No significant difference was observed between the pain score in either group. Mean pain scores were 3.4 versus 3.8 at 6 h, and 0.8 versus 1.1 at 6 days, respectively. No difference in analgesia requirement, serum inflammatory markers and return to normal bowel activity was observed between the groups. This study demonstrates that peritoneal fenestration significantly reduces the incidence of both symptomatic and asymptomatic lymphocele, without an increase in postoperative morbidity. As symptomatic lymphocele is one of the most common

Radwaste paradox

International Nuclear Information System (INIS)

Carter, L.J.

1983-01-01

The Paradox Basin is one of the places where the US Department of Energy is looking for a site for a deep-mined repository for high-level radioactive waste. This seems appropriately symbolic because the geologic disposal problem has increasingly taken on the aspect of a political and technical conundrum, replete with real or seeming contradictions and paradoxes. A central paradox is that, while the concept of sequestering long-lived wastes in mined repositories is attractive intuitively, the very efforts made to confirm the suitability of particular rock formations give rise to further uncertainties. The new law contemplates repository construction will start as early as 1989. Experience so far at the several sites suggests that the technical and political questions tend to proliferate rather than diminish as more becomes known about the geology and hydrology. The following sites were discussed: the Hanford basalt; the Nevada tuff; and salt beds and salt domes (Utah, Texas, Mississippi). (DP)

Comment on the extinct paradox

International Nuclear Information System (INIS)

Levine, D.M.

1983-11-01

The extinction paradox is a contradiction between geometrical optics results which predict that at high frequencies the scattering cross section of an object should equal its geometrical cross section and rigorous scattering theory which shows that at high frequencies the scattering cross section approaches twice the geometrical cross section of the object. Confusion about the reason for this paradox persists today even though the nature of the paradox was correctly identified many years ago by Brillouin. The resolution of the paradox is restated and illustrated with an example, and then the implications to the interpretation of scattering cross sections are identified

The three-box paradox revisited

International Nuclear Information System (INIS)

Ravon, Tamar; Vaidman, Lev

2007-01-01

The classical three-box paradox of Kirkpatrick (2003 J. Phys. A: Math. Gen. 36 4891) is compared to the original quantum three-box paradox of Aharonov and Vaidman (1991 J. Phys. A: Math. Gen. 24 2315). It is argued that the quantum three-box experiment is a 'quantum paradox' in the sense that it is an example of a classical task which cannot be accomplished using classical means, but can be accomplished using quantum devices. It is shown that Kirkpatrick's card game is analogous to a different game with a particle in three boxes which does not contain paradoxical features

The Simpson's paradox unraveled

DEFF Research Database (Denmark)

Hernán, Miguel A; Clayton, David; Keiding, Niels

2011-01-01

Background In a famous article, Simpson described a hypothetical data example that led to apparently paradoxical results. Methods We make the causal structure of Simpson’s example explicit. Results We show how the paradox disappears when the statistical analysis is appropriately guided by subject......-matter knowledge. We also review previous explanations of Simpson’s paradox that attributed it to two distinct phenomena: confounding and non-collapsibility. Conclusion Analytical errors may occur when the problem is stripped of its causal context and analyzed merely in statistical terms....

Quantum paradoxes and physical reality

Energy Technology Data Exchange (ETDEWEB)

Van der Merwe, Alwyn (Denver Univ., CO (USA). Dept. of Physics) (ed.); Selleri, Franco (Bologna Univ. (Italy). Ist. di Fisica)

1990-01-01

This book is devoted to the most fundamental themes of quantum physics: acausality, wave-particle duality, Einstein-Podolsky-Rosen (EPR) paradox, and so on. These are matters of growing interest for physicists. Several paradoxes have plagued quantum physics since its beginnings, the easiest of which to solve are the paradoxes of completeness (Schroedinger's cat, Wigner's friend, de Broglie's box, etc.). At a deeper level is the paradox of wave-particle duality whose solution probably requires the Einstein-de Broglie picture of atomic systems. The most difficult of them all is the EPR paradox (incompatibility between local realism and quantum theory). The book shows that experimental research can, in principle, solve paradoxes such as EPR and wave-particle duality but that the experiments performed on Bell-type inequalities have instead left the conceptual situation fundamentally unmodified. For a fair understanding of the Einstein-de Broglie and of the Bohr-Heisenberg ideas, an 'internal' lecture of physics is not enough. Such 'external' elements as individual biographies, history of culture, and philosophical preconceptions prove also to be important. (author). refs.; figs.; tabs.

Paradoxical embolism: computed tomography demonstration

International Nuclear Information System (INIS)

Kaye, J.; Hayward, M.

2001-01-01

Paradoxical emboli are rare and often presumptively diagnosed. A case of paradoxical embolism, in which both the arterial and venous emboli were documented on CT, is described. While paradoxical emboli are not infrequently diagnosed clinically on a presumptive basis, it is rare to document them with imaging such as CT which, in the present case, confirmed the diagnosis. Copyright (2001) Blackwell Science Pty Ltd

An American Paradox

International Nuclear Information System (INIS)

Jamieson, D.

2006-01-01

This paper explores the paradox that while Americans generally identify themselves as environmentalists, they show little willingness to voluntarily restrain their behavior or to support specific fiscal policies that would result in increased levels of environmental protection. I explore the role of values in the explanation of this paradox, and discuss some of the difficulties involved in studying values and their role in human behavior

Assessment of 'on-treatment platelet reactivity' and relationship with cerebral micro-embolic signals in asymptomatic and symptomatic carotid stenosis.

Science.gov (United States)

Kinsella, Justin A; Oliver Tobin, W; Tierney, Sean; Feeley, Timothy M; Egan, Bridget; Coughlan, Tara; Ronan Collins, D; O'Neill, Desmond; Harbison, Joseph A; Doherty, Colin P; Madhavan, Prakash; Moore, Dermot J; O'Neill, Sean M; Colgan, Mary-Paula; Saqqur, Maher; Murphy, Raymond P; Moran, Niamh; Hamilton, George; McCabe, Dominick J H

2017-05-15

The relationship between on-treatment platelet reactivity and cerebral micro-embolic signals (MES) is unknown, and has not been previously simultaneously assessed in asymptomatic and symptomatic carotid stenosis patients. Consecutive eligible patients with ≥50% asymptomatic or recently symptomatic carotid stenosis (≤4weeks following TIA/ischaemic stroke) were recruited to this pilot study. Symptomatic patients were followed up to the 'late' phase (≥3months) following symptom onset or carotid intervention; longitudinal data were analysed from symptomatic patients with data available at both time-points. Platelet function/reactivity was assessed with the PFA-100® to measure collagen-ADP (C-ADP) and collagen-epinephrine (C-EPI) closure times in citrate-anticoagulated whole blood. Bilateral simultaneous 1-hour transcranial Doppler ultrasound (TCD) monitoring of the middle cerebral arteries was performed to classify patients as MES +ve or MES -ve. 31 patients with ≥50% asymptomatic and 46 with early symptomatic carotid stenosis or occlusion were included. 35 symptomatic patients were followed up to the late phase (23 following carotid intervention). Prevalence of 'high on-treatment platelet reactivity' (HTPR) on the C-EPI cartridge did not differ between asymptomatic and symptomatic patients overall, but was lower in 'symptomatic post-intervention' than asymptomatic patients on aspirin monotherapy (10% vs. 50%; p=0.03). The prevalence of HTPR on the C-EPI cartridge decreased between the early and late phases in symptomatic patients (63% vs. 34%; p=0.017), including those on aspirin monotherapy (p=0.016). There were no significant differences in HTPR status between asymptomatic vs. early or late symptomatic MES +ve or MES -ve patients. Carotid interventional treatment, presumably in combination with resolution of the acute phase response, may decrease the prevalence of HTPR in patients with recently symptomatic carotid stenosis over time. Preliminary subgroup

Black Hole Paradoxes

International Nuclear Information System (INIS)

Joshi, Pankaj S.; Narayan, Ramesh

2016-01-01

We propose here that the well-known black hole paradoxes such as the information loss and teleological nature of the event horizon are restricted to a particular idealized case, which is the homogeneous dust collapse model. In this case, the event horizon, which defines the boundary of the black hole, forms initially, and the singularity in the interior of the black hole at a later time. We show that, in contrast, gravitational collapse from physically more realistic initial conditions typically leads to the scenario in which the event horizon and space-time singularity form simultaneously. We point out that this apparently simple modification can mitigate the causality and teleological paradoxes, and also lends support to two recently suggested solutions to the information paradox, namely, the ‘firewall’ and ‘classical chaos’ proposals. (paper)

Einstein and the twin paradox

International Nuclear Information System (INIS)

Pesic, Peter

2003-01-01

Einstein was the first to discuss and resolve the 'twin paradox', which in 1905 he did not consider paradoxical and treated as a consequence of lack of simultaneity. He maintained this view until at least 1914. However, in 1918 Einstein brought forward arguments about accelerated frames of reference that tended to overshadow his initial resolution. His earlier arguments were gradually rediscovered during the subsequent controversy about this 'paradox'

Managing operational paradoxes

International Nuclear Information System (INIS)

Olson, J.; Baker, K.; Thurber, J.

1992-01-01

The economic, regulatory, and social environment of commercial nuclear power has changed dramatically in the last 10 yr. In addition to the increased regulatory pressure resulting from the Three Mile Island incident and other factors, nuclear utilities have experienced increasing financial pressure from state public utility commissions and investors. To successfully manage nuclear power plants in today's environment requires different skills and strategies than were required 10 yr ago. External pressures on the utility and plant organization have created a series of operational paradoxes unmatched in the history of commercial nuclear power. This paper is based on a synthesis of findings and observations from a series of studies conducted by the authors over the past 10 yr. The authors identify a series of specific paradoxes facing managers of nuclear power plants and suggest several strategies for managing these paradoxes

Five paradox on energy system management

International Nuclear Information System (INIS)

Frisch, J.R.

1995-01-01

Five paradox are detailed on energy management: internationalization of energy questions but always regional management is present, short term problems must be solved but without forgetting long term problems in environment, the third paradox is : we have time but we are in a hurry, we have reserves but ten, twenty or thirty years are necessary to adapt our energy system; the fourth paradox is : we cannot manage energy by managing only energy, for example : finances system development and environment importance. The last and fifth paradox is : the market, yes, but state too, as regulative force

Extending Cantor Paradox

OpenAIRE

Leon, Antonio

2008-01-01

The inconsistencies involved in the foundation of set theory were invariably caused by infinity and self-reference; and only with the opportune axiomatic restrictions could them be obviated. Throughout history, both concepts have proved to be an exhaustible source of paradoxes and contradictions. It seems therefore legitimate to pose some questions concerning their formal consistency. This is just the objective of this paper. Starting from an extension of Cantor's paradox that suggests the in...

Symptomatic knee disorders in floor layers and graphic designers. A cross-sectional study

Directory of Open Access Journals (Sweden)

Jensen Lilli

2012-09-01

Full Text Available Abstract Background Previous studies have described an increased risk of developing tibio-femoral osteoarthritis (TF OA, meniscal tears and bursitis among those with a trade as floor layers. The purpose of this study was to analyse symptomatic knee disorders among floor layers that were highly exposed to kneeling work tasks compared to graphic designers without knee-demanding work tasks. Methods Data on the Knee injury and Osteoarthritis Outcome Score (KOOS were collected by questionnaires. In total 134 floor layers and 120 graphic designers had a bilateral radiographic knee examination to detect TF OA and patella-femoral (PF OA. A random sample of 92 floor layers and 49 graphic designers had Magnetic Resonance Imaging (MRI of both knees to examine meniscal tears. Means of the subscales of KOOS were compared by analysis of variance. The risk ratio of symptomatic knee disorders defined as a combination of radiological detected knee OA or MRI-detected meniscal tears combined with a low KOOS score was estimated by logistic regression in floor layers with 95% confidence interval (CI and adjusted for age, body mass index, traumas, and knee-straining sports activities. Symptomatic knee OA or meniscal tears were defined as a combination of low KOOS-scores and radiographic or MRI pathology. Results Symptomatic TF and medial meniscal tears were found in floor layers compared to graphic designers with odds ratios 2.6 (95%CI 0.99-6.9 and 2.04 (95% CI 0.77-5.5, respectively. There were no differences in PF OA. Floor layers scored significantly lower on all KOOS subscales compared to graphic designers. Significantly lower scores on the KOOS subscales were also found for radiographic TF and PF OA regardless of trade but not for meniscal tears. Conclusions The study showed an overall increased risk of developing symptomatic TF OA in a group of floor layers with a substantial amount of kneeling work positions. Prevention would be appropriate to reduce the

Explaining the harmonic sequence paradox.

Science.gov (United States)

Schmidt, Ulrich; Zimper, Alexander

2012-05-01

According to the harmonic sequence paradox, an expected utility decision maker's willingness to pay for a gamble whose expected payoffs evolve according to the harmonic series is finite if and only if his marginal utility of additional income becomes zero for rather low payoff levels. Since the assumption of zero marginal utility is implausible for finite payoff levels, expected utility theory - as well as its standard generalizations such as cumulative prospect theory - are apparently unable to explain a finite willingness to pay. This paper presents first an experimental study of the harmonic sequence paradox. Additionally, it demonstrates that the theoretical argument of the harmonic sequence paradox only applies to time-patient decision makers, whereas the paradox is easily avoided if time-impatience is introduced. ©2011 The British Psychological Society.

The core paradox.

Science.gov (United States)

Kennedy, G. C.; Higgins, G. H.

1973-01-01

Rebuttal of suggestions from various critics attempting to provide an escape from the seeming paradox originated by Higgins and Kennedy's (1971) proposed possibility that the liquid in the outer core was thermally stably stratified and that this stratification might prove a powerful inhibitor to circulation of the outer core fluid of the kind postulated for the generation of the earth's magnetic field. These suggestions are examined and shown to provide no reasonable escape from the core paradox.

Immunoglobulin G4-related sclerosing disease manifesting as bilateral tonsillar hypertrophy on MRI images: A case report

Energy Technology Data Exchange (ETDEWEB)

Park, Mee Hyun; Woo, Ji Young; Lee, Yul; Yoon, Dae Young; Hong, Hye Sook; Hong, Min Eui [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

2016-02-15

Immunoglobulin G4-related sclerosing disease (IgG4-SD) is currently recognized as a distinct systemic disease involving various organs. We reported the imaging findings of a case of pathologically confirmed IgG4-SD involving bilateral palatine tonsils. CT and MRI showed diffuse enlargement of both palatine tonsils with homogeneous contrast enhancement. Focal contour bulging was noted in the right palatine tonsil. Lesions appeared as isointense on T1-weighted and slightly hyperintense on T2-weighted MRI images, as compared with muscle. The T2-weighted MRI image showed a striated pattern in both tonsils. Despite its rare occurrence, IgG4-SD should be included in the differential diagnoses of patients with symptomatic bilateral tonsillar hypertrophy that is non-responsive to medication.

Immunoglobulin G4-related sclerosing disease manifesting as bilateral tonsillar hypertrophy on MRI images: A case report

International Nuclear Information System (INIS)

Park, Mee Hyun; Woo, Ji Young; Lee, Yul; Yoon, Dae Young; Hong, Hye Sook; Hong, Min Eui

2016-01-01

Immunoglobulin G4-related sclerosing disease (IgG4-SD) is currently recognized as a distinct systemic disease involving various organs. We reported the imaging findings of a case of pathologically confirmed IgG4-SD involving bilateral palatine tonsils. CT and MRI showed diffuse enlargement of both palatine tonsils with homogeneous contrast enhancement. Focal contour bulging was noted in the right palatine tonsil. Lesions appeared as isointense on T1-weighted and slightly hyperintense on T2-weighted MRI images, as compared with muscle. The T2-weighted MRI image showed a striated pattern in both tonsils. Despite its rare occurrence, IgG4-SD should be included in the differential diagnoses of patients with symptomatic bilateral tonsillar hypertrophy that is non-responsive to medication

A collagen-fibrin patch for the prevention of symptomatic lymphoceles after pelvic lymphadenectomy in women with gynecologic malignancies: A randomized clinical trial.

Science.gov (United States)

Grimm, Christoph; Polterauer, Stephan; Helmy-Bader, Samir; Zikan, Michal; Cibula, David; Heitz, Florian; Harter, Philipp; Giese, Arnd; Reinthaller, Alexander; Tempfer, Clemens

2018-04-01

To evaluate the efficacy of a collagen-fibrin patch for the prevention of symptomatic lymphoceles after pelvic lymphadenectomy in women with gynecologic malignancies. In a multicenter, randomized, clinical trial, 164 women with pelvic lymphadenectomy were allocated either to bilateral pelvic application of two collagen-fibrin patches or no intervention. Main outcome was efficacy, defined as reduction of symptomatic lymphocele rate diagnosed within four weeks after surgery. Secondary outcomes were asymptomatic lymphoceles and subsequent interventions. Sample size was based on the assumption that application of a collagen-fibrin patch reduces the prevalence of symptomatic lymphoceles by at least 66%. The study was single-blinded, i.e., patients and primary outcome assessors, but not surgeons, were blinded to the treatment allocation. A total of 75 women were randomized to the intervention and 89 to the control group. All women received the allocated intervention. In total, 42 (27.4%) lymphoceles and 8 (5.2%) symptomatic lymphoceles were observed. Symptomatic lymphoceles were observed in 5/68 (7.4%) women in the intervention group and 3/85 (3.5%) women in the control group (p = 0.47). Asymptomatic lymphoceles were observed in 16 (23.5%) women in the intervention group compared to 18 (21.2%) in the control group (p = 0.85). In a multivariate logistic regression model, no independent risk factor for the development of a symptomatic lymphocele was ascertained. Intraoperative application of collagen-fibrin patches to the pelvic side walls does not reduce the incidence of symptomatic lymphoceles in women with gynecologic malignancies undergoing pelvic lymphadenectomy. Copyright © 2018. Published by Elsevier Inc.

From the BMI paradox to the obesity paradox: the obesity-mortality association in coronary heart disease.

Science.gov (United States)

Antonopoulos, A S; Oikonomou, E K; Antoniades, C; Tousoulis, D

2016-10-01

Despite a strong association between body weight and mortality in the general population, clinical evidence suggests better clinical outcome of overweight or obese individuals with established coronary heart disease. This finding has been termed the 'obesity paradox', but its existence remains a point of debate, because it is mostly observed when body mass index (BMI) is used to define obesity. Inherent limitations of BMI as an index of adiposity, as well as methodological biases and the presence of confounding factors, may account for the observed findings of clinical studies. In this review, our aim is to present the data that support the presence of a BMI paradox in coronary heart disease and then explore whether next to a BMI paradox a true obesity paradox exists as well. We conclude by attempting to link the obesity paradox notion to available translational research data supporting a 'healthy', protective adipose tissue phenotype. © 2016 World Obesity. © 2016 World Obesity.

Paradoxical cerebral air embolism

International Nuclear Information System (INIS)

Lopez-Negrete, L.; Garcia-Lozano, J.; Sanchez, J. L.; Sala, J.

2000-01-01

We present a fatal case of intracranial air embolism produced by the passage of intravenous air to the arteries owing to the existence of a patent foremen ovale associated with pulmonary hypertension, which permitted a right-left shunt (paradoxical embolism). The pathophysiological mechanisms of pneumcephalus and paradoxical embolism are discussed and the pertinent literature is reviewed. (Author) 6 refs

Middle ground approach to paradox: Within- and between-culture examination of the creative benefits of paradoxical frames.

Science.gov (United States)

Leung, Angela K-Y; Liou, Shyhnan; Miron-Spektor, Ella; Koh, Brandon; Chan, David; Eisenberg, Roni; Schneider, Iris

2018-03-01

Thriving in increasingly complex and ambiguous environments requires creativity and the capability to reconcile conflicting demands. Recent evidence with Western samples has suggested that paradoxical frames, or mental templates that encourage individuals to recognize and embrace contradictions, could produce creative benefits. We extended the timely, but understudied, topic by studying the nuances of for whom and why creative advantages of paradoxical frames emerge. We suggest that people endorsing a middle ground approach are less likely to scrutinize conflict and reconcile with integrative solutions, thus receiving less creative benefits of paradoxical frames. Five studies that examined individual and cultural differences in middle ground endorsement support our theory. Study 1 found that paradoxical frames increased creativity, but failed to replicate that experienced conflict mediated the relationship in a Taiwanese sample. In both within- and between-culture analysis, we showed that the creative advantages of thinking paradoxically and experiencing conflict emerged among individuals who endorse lower (vs. higher) levels of middle ground (Study 2) and among Israelis whose culture predominantly endorses middle ground strategy less, but not among Singaporeans whose culture predominantly endorses middle ground more (Study 3). Study 4 further demonstrated the causal role of middle ground in the paradox-conflict-creativity link. To answer "why," Study 5 situationally induced integrative complex thinking that sets distinctions and forms syntheses among contradictory elements, and found that low endorsers of middle ground performed more creatively when they engaged integrative complex thinking to cope with paradoxes. This program of studies offers important insights on harnessing paradoxical experiences to catalyze creativity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Bilateral cochlear implantation in a patient with bilateral temporal bone fractures.

Science.gov (United States)

Chung, Jae Ho; Shin, Myung Chul; Min, Hyun Jung; Park, Chul Won; Lee, Seung Hwan

2011-01-01

With the emphasis on bilateral hearing nowadays, bilateral cochlear implantation has been tried out for bilateral aural rehabilitation. Bilateral sensorineural hearing loss caused by head trauma can get help from cochlear implantation. We present the case of a 44-year-old man with bilateral otic capsule violating temporal bone fractures due to head trauma. The patient demonstrated much improved audiometric and psychoacoustic performance after bilateral cochlear implantation. We believe bilateral cochlear implantation in such patient can be a very effective tool for rehabilitation. Copyright © 2011 Elsevier Inc. All rights reserved.

What Paradox?

DEFF Research Database (Denmark)

Holt, Robin; Zundel, Mike

2017-01-01

This chapter investigates the relationship between paradox and the logical typing of classes and members. Class-based thinking affords efficiency in communication and the progressive, additive development of knowledge, but also creates fissures, shortcuts, truncations, and delimitations that gene......This chapter investigates the relationship between paradox and the logical typing of classes and members. Class-based thinking affords efficiency in communication and the progressive, additive development of knowledge, but also creates fissures, shortcuts, truncations, and delimitations...... that emphasizes interconnectedness and interdependency, which Gregory Bateson calls “grace”: the successful integration of smaller with wider arcs of awareness. This is developed here into a method for studying organizational phenomena using the example of an organizational routine, arguing that this may be one...

Bilateral segmental regression of the carotid and vertebral arteries with rete compensation in a Western patient

Energy Technology Data Exchange (ETDEWEB)

Mahadevan, J.; Batista, L.; Alvarez, H.; Lasjaunias, P. [Service de Neuroradiologie Diagnostique et Therapeutique, Hopital de Bicetre, 94275 Le Kremlin Bicetre, 94275, Le Kremlin Bicetre (France); Bravo-Castro, E. [Instituto De Neurocirugia Asenjo, c/Jose Manuel Infante, Santiago (Chile)

2004-06-01

We report a case of symptomatic symmetrical, bilateral absence of the cavernous internal carotid (ICA) and transdural vertebral artery (VA) segments with formation of a rete mirabile. There have been similar reports in Asian patients; ours is the first in the Western population. A 29- year-old woman presented with recurrent temporary blindness and an episode of minor subarachnoid haemorrhage. Angiography demonstrated absence of the C5 and C6 segments of the ICA and the C1/2 segments of the VA bilaterally, with typical carotid rete mirabile formation to reconstitute the distal flow. Comparative anatomy and embryology show retia in several species and point to their secondary origin. The anomalies of the ICA cannot be called agenesis but rather absence since they are likely to result from perinatal disappearance of the artery rather its failure to develop. (orig.)

Bilateral pial synangiosis in a child with PHACE syndrome.

Science.gov (United States)

Jack, Andrew S; Chow, Michael M; Fiorillo, Loretta; Chibuk, Thea; Yager, Jerome Y; Mehta, Vivek

2016-01-01

The acronym PHACE has been used to denote a constellation of abnormalities: posterior fossa anomalies, facial hemangiomas, arterial anomalies, cardiac anomalies, and eye abnormalities. Approximately 30% of patients with large facial hemangiomas have PHACE syndrome, with the vast majority having intracranial arteriopathy. Few reports characterize neurological deterioration from this intracranial arteriopathy, and even fewer report successful treatment thereof. The authors report on a case of a child with PHACE syndrome who presented with an ischemic stroke from a progressive intracranial arteriopathy and describe her successful treatment with bilateral pial synangiosis. An 8-month old girl diagnosed with PHACE syndrome was found to have bilateral internal carotid artery stenosis. Although initially asymptomatic, a few months after diagnosis she suffered a right frontal and parietal stroke. MRI and cerebral angiography investigations demonstrated progressive intracranial arterial stenosis and occlusion. The patient then underwent indirect cerebral revascularization surgery. At 2-year follow-up, she exhibited clinical improvement with persistent speech and motor developmental delay. Follow-up MRI and cerebral angiography showed no new ischemic events and robust extensive vascular collateralization from surgery. PHACE syndrome is an uncommon disease, and affected patients often have cerebral arteriopathy. Although the underlying natural history of cerebral arteriopathy in PHACE remains unclear, cerebral revascularization may represent a potential therapy for symptomatic patients.

Optical tweezers and paradoxes in electromagnetism

International Nuclear Information System (INIS)

Pfeifer, Robert N C; Nieminen, Timo A; Heckenberg, Norman R; Rubinsztein-Dunlop, Halina

2011-01-01

The widespread application of optical forces and torques has contributed to renewed interest in the fundamentals of the electromagnetic force and torque, including long-standing paradoxes such as the Abraham–Minkowski controversy and the angular momentum density of a circularly polarized plane wave. We discuss the relationship between these electromagnetic paradoxes and optical tweezers. In particular, consideration of possible optical tweezers experiments to attempt to resolve these paradoxes strongly suggests that they are beyond experimental resolution, yielding identical observable results in all cases

Bilateral posterior tarsal tunnel syndrome caused by accessory flexor digitorum longus; case report and surgical technique.

Science.gov (United States)

Schmidt-Hebbel, A; Elgueta, J; Villa, A; Mery, P; Filippi, J

To present a case report of bilateral posterior tarsal tunnel syndrome (PTTS) caused by an accessory flexor digitorum longus (AFDL), including the surgical technique and a review of the literature. Twenty-nine year old male diagnosed with bilateral PTTS, refractory to conservative management, with 53 points on the preoperative AOFAS score. MR of both ankles showed an AFDL within the tarsal tunnel, in close relationship to the posterior tibial nerve. Bilateral tarsal tunnel decompression and AFDL resection was performed. There were no post-operative complications. At 6 months after surgery, the patient had no pain and had 87 points on the AOFAS score. The PTTS is an entrapment neuropathy of the posterior tibial nerve or one of its terminal branches. A rare cause is the presence of an AFDL, and its resection is associated with good clinical results. Careful scar tissue resection and neurolysis is recommended. Knowing the normal pathway and anatomical variability of the posterior tibial nerve and its branches is essential to avoid iatrogenic injury. In our case report, MR and intraoperative findings identified a bilateral FDLA in close relationship to the common flexor digitorum, an unusual finding, with few reports in current literature. Careful tarsal tunnel decompression and AFDL resection in our patient with bilateral symptomatic PTTS has good clinical results and no complications, particularly when diagnosed and treated early. Copyright © 2015 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Another paradox involving the second law of thermodynamics

International Nuclear Information System (INIS)

Sheehan, D.P.

1996-01-01

Recently a paradox has been posed that appears to challenge the second law of thermodynamics in a plasma blackbody environment [D. P. Sheehan, Phys. Plasmas 2, 1893 (1995)]. In this paper another, related paradox is posed in an unmagnetized Q plasma. Laboratory experiments simulating some necessary conditions for the paradoxical system corroborate theoretical predictions and fail to resolve the paradox in favor of the second law. copyright 1996 American Institute of Physics

Differences in muscle activities during shoulder elevation in patients with symptomatic and asymptomatic rotator cuff tears: analysis by positron emission tomography.

Science.gov (United States)

Shinozaki, Nobuhisa; Sano, Hirotaka; Omi, Rei; Kishimoto, Koshi N; Yamamoto, Nobuyuki; Tashiro, Manabu; Itoi, Eiji

2014-03-01

Differences in muscle activity patterns between patients with symptomatic and asymptomatic full-thickness rotator cuff tears have not yet been fully clarified. The purpose of this study was to investigate the muscle activity pattern by use of positron emission tomography (PET) in patients with symptomatic and asymptomatic rotator cuff tears. Ten shoulders of 9 patients with full-thickness rotator cuff tears were divided into 2 groups by a numerical pain rating scale (0-10), symptomatic (≥2) and asymptomatic (0 or 1), with 5 shoulders each. Scaption exercise of bilateral arms (200 repetitions in 10 minutes) with a weight of 0.25 kg each was performed before and after injection of fluorodeoxyglucose. After PET examination, the standardized uptake value of each muscle was calculated to quantify its activity and compared between the two groups. The activity of the anterior and middle deltoid was significantly decreased in the symptomatic group compared with the asymptomatic group (anterior deltoid, P = .02; middle deltoid, P = .03). In contrast, the activity of the superior trapezius was significantly increased in the symptomatic group compared with the asymptomatic group (P = .02). In patients with a symptomatic tear, the deltoid activity was decreased and the trapezius activity was increased. It is likely that they might have moved the painful glenohumeral joint less and instead moved the painless scapulothoracic joint more during the prescribed exercise. We conclude that patients with painful rotator cuff tears use the parascapular muscles more than those without pain do during arm elevation. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Yule-Simpson's Paradox in Research

Science.gov (United States)

Goltz, Heather Honore; Smith, Matthew Lee

2010-01-01

Yule (1903) and Simpson (1951) described a statistical paradox that occurs when data is aggregated. In such situations, aggregated data may reveal a trend that directly contrasts those of sub-groups trends. In fact, the aggregate data trends may even be opposite in direction of sub-group trends. To reveal Yule-Simpson's paradox (YSP)-type…

Identification and Assessment of Paradoxical Ventricular Wall Motion Using ECG Gated Blood Pool Scan - Comparison of cine Loop , Phase Analysis and Paradox Image -

International Nuclear Information System (INIS)

Lee, Jae Tae; Kim, Gwang Weon; Lee, Kyu Bo; Chung, Byung Chun; Whang, Kee Suk; Chae, Sung Chul; Paek, Wee Hyun; Cheon, Jae Eun; Lee, Hyong Woo; Chung, Jin Hong

1990-01-01

Sixty-four patients with paradoxical ventricular wall motion noticed both in angiocardiography or 2-dimensional echocardiography were assessed by ECG gated blood pool scan (GBPS). Endless cine loop image, phase and amplitude images and paradox image obtained by visual inspection of each cardiac beat or Fourier transformation of acquired raw data were investigated to determine the incremental value of GBPS with these processing methods for identification of paradoxical ventricular wall motion. The results were as follows:1) Paradoxical wall motions were observed on interventricular septum in 34 cases, left ventricular free wall in 26 and right ventricular wall in 24. Underlying heart diseases were is chemic (23 cases) valvular(9), congenital heart disease (12), cardiomyopathy (5), pericardial effusion(5), post cardiac surgery(3), corpulmonale (2), endocarditis (l) and right ventricular tumor(l). 2) Left ventricular ejection fractions of patients with paradoxical left ventricular wall motion were significantly lower than those with paradoxical septal motion (p <0.005). 3) The sensitivity of each processing methods for detecting paradoxical wall motion was 76.9% by phase analysis, 74.6% by endless cine loop mapping and 68.4% by paradox image manipulation respectively. Paradoxial motions visualized only in phase, paradox or both images were appeared as hypokinesia or akinesia in cine loop image. 4) All events could be identified by at least one of above three processing methods, however only 34 cases (48.4%) showed the paradoxical motions in all of the three images. By these findings, we concluded that simultaneous inspection of all above three processing methods-endless cine loop, phase analysis and paradox image is necessary for accurate identification and assessment of paradoxical ventricular wall motion when performing GBPS.

Identification and Assessment of Paradoxical Ventricular Wall Motion Using ECG Gated Blood Pool Scan - Comparison of cine Loop , Phase Analysis and Paradox Image -

Energy Technology Data Exchange (ETDEWEB)

Lee, Jae Tae; Kim, Gwang Weon; Lee, Kyu Bo; Chung, Byung Chun; Whang, Kee Suk; Chae, Sung Chul; Paek, Wee Hyun; Cheon, Jae Eun [Kyungpook National University School of Medicine, Daegu (Korea, Republic of); Lee, Hyong Woo; Chung, Jin Hong [Yeongnam National University College of Medicine, Daegu (Korea, Republic of)

1990-07-15

Sixty-four patients with paradoxical ventricular wall motion noticed both in angiocardiography or 2-dimensional echocardiography were assessed by ECG gated blood pool scan (GBPS). Endless cine loop image, phase and amplitude images and paradox image obtained by visual inspection of each cardiac beat or Fourier transformation of acquired raw data were investigated to determine the incremental value of GBPS with these processing methods for identification of paradoxical ventricular wall motion. The results were as follows:1) Paradoxical wall motions were observed on interventricular septum in 34 cases, left ventricular free wall in 26 and right ventricular wall in 24. Underlying heart diseases were is chemic (23 cases) valvular(9), congenital heart disease (12), cardiomyopathy (5), pericardial effusion(5), post cardiac surgery(3), corpulmonale (2), endocarditis (l) and right ventricular tumor(l). 2) Left ventricular ejection fractions of patients with paradoxical left ventricular wall motion were significantly lower than those with paradoxical septal motion (p <0.005). 3) The sensitivity of each processing methods for detecting paradoxical wall motion was 76.9% by phase analysis, 74.6% by endless cine loop mapping and 68.4% by paradox image manipulation respectively. Paradoxial motions visualized only in phase, paradox or both images were appeared as hypokinesia or akinesia in cine loop image. 4) All events could be identified by at least one of above three processing methods, however only 34 cases (48.4%) showed the paradoxical motions in all of the three images. By these findings, we concluded that simultaneous inspection of all above three processing methods-endless cine loop, phase analysis and paradox image is necessary for accurate identification and assessment of paradoxical ventricular wall motion when performing GBPS.

Man Is a Paradox

Institute of Scientific and Technical Information of China (English)

王茂娟

2009-01-01

In the poem "Always", the author Pablo Neruda employs the first person narration to incisively reveal the paradoxical traits in human nature by exploring man in relation to love. "I" play a role shifting from a calm narrator to a furious one, and the last recovering to a mild one, which offers a multiple visual angle to observe humanity. In sum, by means of continuous changes of my inner feelings in the poem, Pablo Neruda reveals the paradoxical humanity .

Body mass index and outcome after revascularization for symptomatic carotid artery stenosis

Science.gov (United States)

Greving, Jacoba P.; Hendrikse, Jeroen; Algra, Ale; Kappelle, L. Jaap; Becquemin, Jean-Pierre; Bonati, Leo H.; Brott, Thomas G.; Bulbulia, Richard; Calvet, David; Eckstein, Hans-Henning; Fraedrich, Gustav; Gregson, John; Halliday, Alison; Howard, George; Jansen, Olav; Roubin, Gary S.; Brown, Martin M.; Mas, Jean-Louis; Ringleb, Peter A.

2017-01-01

Objective: To determine whether the obesity paradox exists in patients who undergo carotid artery stenting (CAS) or carotid endarterectomy (CEA) for symptomatic carotid artery stenosis. Methods: We combined individual patient data from 2 randomized trials (Endarterectomy vs Angioplasty in Patients with Symptomatic Severe Carotid Stenosis and Stent-Protected Angioplasty vs Carotid Endarterectomy) and 3 centers in a third trial (International Carotid Stenting Study). Baseline body mass index (BMI) was available for 1,969 patients and classified into 4 groups: 120 days after randomization). This outcome was compared between different BMI strata in CAS and CEA patients separately, and in the total group. We performed intention-to-treat multivariable Cox regression analyses. Results: Median follow-up was 2.0 years. Stroke or death occurred in 159 patients in the periprocedural (cumulative risk 8.1%) and in 270 patients in the postprocedural period (rate 4.8/100 person-years). BMI did not affect periprocedural risk of stroke or death for patients assigned to CAS (ptrend = 0.39) or CEA (ptrend = 0.77) or for the total group (ptrend = 0.48). Within the total group, patients with BMI 25–<30 had lower postprocedural risk of stroke or death than patients with BMI 20–<25 (BMI 25–<30 vs BMI 20–<25; hazard ratio 0.72; 95% confidence interval 0.55–0.94). Conclusions: BMI is not associated with periprocedural risk of stroke or death; however, BMI 25–<30 is associated with lower postprocedural risk than BMI 20–<25. These observations were similar for CAS and CEA. PMID:28446644

Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome

International Nuclear Information System (INIS)

Sarma, Asha; Shyn, Paul B.; Vivian, Mark A.; Ng, Ju-Mei; Tuncali, Kemal; Lorch, Jorchen H.; Zaheer, Sarah N.; Gordon, Michael S.; Silverman, Stuart G.

2015-01-01

Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: One was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements

Single-Session CT-Guided Percutaneous Microwave Ablation of Bilateral Adrenal Gland Hyperplasia Due to Ectopic ACTH Syndrome

Energy Technology Data Exchange (ETDEWEB)

Sarma, Asha, E-mail: ashasarma@gmail.com; Shyn, Paul B., E-mail: pshyn@partners.org [Brigham and Women’s Hospital, Department of Radiology (United States); Vivian, Mark A. [University of Manitoba, Department of Radiology (Canada); Ng, Ju-Mei [Brigham and Women’s Hospital, Department of Anesthesiology (United States); Tuncali, Kemal [Brigham and Women’s Hospital, Department of Radiology (United States); Lorch, Jorchen H. [Dana Farber Cancer Institute, Department of Medicine (United States); Zaheer, Sarah N.; Gordon, Michael S. [Brigham and Women’s Hospital, Department of Endocrinology (United States); Silverman, Stuart G. [Brigham and Women’s Hospital, Department of Radiology (United States)

2015-10-15

Bilateral adrenalectomy is currently the only available treatment for adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (ectopic ACTH syndrome) that is refractory to pharmacologic therapy. We describe two patients with refractory ectopic ACTH syndrome who were treated with CT-guided percutaneous microwave ablation of both hyperplastic adrenal glands in a single session: One was not a surgical candidate, and the other had undergone unsuccessful surgery. Following the procedure, both patients achieved substantial decreases in serum cortisol, symptomatic improvement, and decreased anti-hypertensive medication requirements.

Quantum Zeno and anti-Zeno paradoxes

Indian Academy of Sciences (India)

Abstract. Continuous observation of a time independent projection operator is known to prevent change of state (the quantum Zeno paradox). We discuss the recent result that generic continuous measurement of time dependent projection operators will in fact ensure change of state: an anti-Zeno paradox.

Bosonic analog of the Klein paradox

International Nuclear Information System (INIS)

Wagner, R. E.; Ware, M. R.; Su, Q.; Grobe, R.

2010-01-01

The standard Klein paradox describes how an incoming electron scatters off a supercritical electrostatic barrier that is so strong that it can generate electron-positron pairs. This fermionic system has been widely discussed in textbooks to illustrate some of the discrepancies between quantum mechanical and quantum field theoretical descriptions for the pair creation process. We compare the fermionic dynamics with that of the corresponding bosonic system. We point out that the direct counterpart of the Pauli exclusion principle (the central mechanism to resolve the fermionic Klein paradox) is stimulated emission, which leads to the resolution of the analogous bosonic paradox.

Three Paradoxes of the Future Prediction

Directory of Open Access Journals (Sweden)

D. V. Pivovarov

2012-01-01

Full Text Available The paper is devoted to the issue of predicting the future. While creating the future image of the mankind as a whole, and Russia in particular, extrapolated some 50 or 100 years ahead, such cultural forms as religion, philosophy, education and art make their significant impact. However, philosophy plays a special role of critical methodology in coordinating the futurological efforts. It works as a tuning fork that tunes up the orchestra of various sciences and other forms of social consciousness. Being dialectical, philosophers find out and analyze the contradictions – paradoxes, antinomies, and aporias - involved in such activities as prophesizing, prognosticating, predicting and foreseeing. On the basis of the retrospective analysis, the author considers the most significant paradoxes facing the futurologists engaged in predicting the general course of historic events; the paradoxes being denoted as follows: the antinomy of academic ignorance, paradox of newness and paradox of an emergent effect. The analysis results in conclusion that the large-scale, long-term «scientific predictions of the future», claiming to be the truth and pretending for historical value and accuracy, are impossible or at least doubtful. Nevertheless, global prognoses are highly valued, widely discussed and always in demand in society due to the purposeful human intellect. 

Three Paradoxes of the Future Prediction

Directory of Open Access Journals (Sweden)

D. V. Pivovarov

2015-02-01

Full Text Available The paper is devoted to the issue of predicting the future. While creating the future image of the mankind as a whole, and Russia in particular, extrapolated some 50 or 100 years ahead, such cultural forms as religion, philosophy, education and art make their significant impact. However, philosophy plays a special role of critical methodology in coordinating the futurological efforts. It works as a tuning fork that tunes up the orchestra of various sciences and other forms of social consciousness. Being dialectical, philosophers find out and analyze the contradictions – paradoxes, antinomies, and aporias - involved in such activities as prophesizing, prognosticating, predicting and foreseeing. On the basis of the retrospective analysis, the author considers the most significant paradoxes facing the futurologists engaged in predicting the general course of historic events; the paradoxes being denoted as follows: the antinomy of academic ignorance, paradox of newness and paradox of an emergent effect. The analysis results in conclusion that the large-scale, long-term «scientific predictions of the future», claiming to be the truth and pretending for historical value and accuracy, are impossible or at least doubtful. Nevertheless, global prognoses are highly valued, widely discussed and always in demand in society due to the purposeful human intellect. 

Increased platelet activation in early symptomatic versus asymptomatic carotid stenosis and relationship with microembolic status: Results from the Platelets And Carotid Stenosis (PACS) Study.

LENUS (Irish Health Repository)

Kinsella, Ja

2013-04-26

BACKGROUND: Cerebral microembolic signals (MES) may predict increased stroke risk in carotid stenosis. However, the relationship between platelet counts or platelet activation status and MES in symptomatic versus asymptomatic carotid stenosis has not been comprehensively assessed. SETTING: University teaching hospitals. METHODS: This prospective, pilot observational study assessed platelet counts and platelet activation status, and the relationship between platelet activation and MES in asymptomatic versus early (≤4 weeks after TIA\\/stroke) and late phase (≥3 months) symptomatic moderate or severe (≥50%) carotid stenosis patients. Full blood count measurements were performed, and whole blood flow cytometry was used to quantify platelet surface activation marker expression (CD62P and CD63) and circulating leucocyte-platelet complexes. Bilateral simultaneous transcranial Doppler ultrasound monitoring of the middle cerebral arteries was performed for 1 hour to classify patients as MES-positive or MES-negative. RESULTS: Data from 31 asymptomatic patients were compared with 46 symptomatic patients in the early phase, and 35 of these patients followed up to the late phase after symptom onset. The median platelet count (211 vs. 200 x 10(9) \\/L; p=0.03) and the median% lymphocyte-platelet complexes were higher in early symptomatic than asymptomatic patients (2.8 vs. 2.4%, p=0.001). The% lymphocyte-platelet complexes was higher in early symptomatic than asymptomatic patients with ≥70% carotid stenosis (p=0.0005), and in symptomatic patients recruited within 7 days of symptom onset (p=0.028). Complete TCD data were available in 25 asymptomatic and 31 early phase symptomatic, and 27 late phase symptomatic patients. 12% of asymptomatic versus 32% of early phase symptomatic (p=0.02) and 19% of late phase symptomatic patients (p=0.2) were MES-positive. Early symptomatic MES-negative patients had a higher% lymphocyte-platelet complexes than asymptomatic MES

Adiposopathy and Obesity Paradox

Directory of Open Access Journals (Sweden)

Indriyanti Rafi Sukmawati

2013-04-01

Full Text Available BACKGROUND: Obesity has reached global epidemic proportions in both adults and children and is associated with numerous comorbidities, including hypertension, type 2 diabetes mellitus (T2DM, dyslipidemia and major cardiovascular diseases (CVD. CONTENT: Adiposity may cause adipocyte and adipose tissue anatomic and functional abnormalities, termed adiposopathy (adipose-opathy or "sick fat," that result in endocrine and immune derangements. Adiposopathy may directly contribute to CVD through pericardiac and perivascular effects on the myocardium and blood vessels. Adiposopathy may also indirectly contribute to CVD through promoting or worsening major CVD risk factors such as T2DM, high blood pressure, and dyslipidemia. Despite this adverse association, numerous studies have documented an obesity paradox in which overweight and obese people with established CVD, including hypertension, heart failure, coronary heart disease, and peripheral arterial disease, have a better prognosis compared with nonoverweight/nonobese patients. These paradoxical findings are made less paradoxical when the pathogenic potential of excessive body fat is assessed based on adipose tissue dysfunction rather than simply on increased fat mass alone. SUMMARY: Adiposopathy is defined as pathological adipose tissue function that may be promoted and exacerbated by fat accumulation (adiposity and sedentary lifestyle in genetically susceptible patients. Adiposopathy is a root cause of some of the most common metabolic diseases observed in clinical practice, including T2DM, hypertension and dyslipidemia. KEYWORDS: adiposopathy, adiposity, obesity paradox, adipocyte dysfunction, adipose hypertrophy, adipose hyperplasia.

Use of informed consent with therapeutic paradox.

Science.gov (United States)

Farkas, M M

1992-01-01

Debate persists in the literature and among clinicians about the ethical appropriateness of paradoxical interventions. It has been suggested that informed consent with therapeutic paradox would alleviate ethical concerns of deception, manipulation, harm to the client, and withholding of information from the client in therapy. The purpose of this study was to explore health care consumer reactions to the benefits and risks of therapeutic paradox as stated in a consent for treatment form. The study explored the responses of 32 medical patients to a hypothetical consent for treatment form for therapeutic paradox. Data were collected in a brief semistructured interview after subjects read the hypothetical consent form. Utilizing a case study, the investigator then offered an example of a successful paradoxical intervention and additional subject comments were solicited. Content analysis of the responses was made. Health care consumers had mixed responses to the consent form. While the consent form served as an obstacle for some consumers, many were willing to sign the consent form and accept treatment even though they had internal reservations and questions. Appropriateness of the consent form format is discussed.

Negative freedom and the liberal paradoxes

NARCIS (Netherlands)

van Hees, M.V.B.P.M

In their game-theoretic formulations, the liberal paradoxes of Amartya Sm and Alan Gibbard show a tension between freedom on the one hand, and Pareto optimality and stability on the other. This article examines what happens to the liberal paradoxes if a negative conception of freedom is used. Given

Simpson’s Paradox in Psychological Science: A Practical Guide

Directory of Open Access Journals (Sweden)

Rogier eKievit

2013-08-01

Full Text Available The direction of an association at the population-level may be reversed within the subgroups comprising that population—a striking observation called Simpson’s paradox. When facing this pattern, psychologists often view it as anomalous. Here, we argue that Simpson’s paradox is more common than conventionally thought, and typically results in incorrect interpretations – potentially with harmful consequences. We support this claim by drawing on empirical results from cognitive neuroscience, behavior genetics, psychopathology, personality psychology, educational psychology, intelligence research, and simulation studies. We show that Simpson’s Paradox is most likely to occur when inferences are drawn across different levels of explanation (e.g., from populations to subgroups, or subgroups to individuals. We propose a set of statistical markers indicative of the paradox, and offer psychometric solutions for dealing with the paradox when encountered—including a toolbox in R for detecting Simpson’s Paradox. We show that explicit modeling of situations in which the paradox might occur not only prevents incorrect interpretations of data, but also results in a deeper understanding of what data tell us about the world.

Consciousness and the "Causal Paradox"

OpenAIRE

Velmans, Max

1996-01-01

Viewed from a first-person perspective consciousness appears to be necessary for complex, novel human activity - but viewed from a third-person perspective consciousness appears to play no role in the activity of brains, producing a "causal paradox". To resolve this paradox one needs to distinguish consciousness of processing from consciousness accompanying processing or causing processing. Accounts of consciousness/brain causal interactions switch between first- and third-person perspectives...

Second Parrondo's Paradox in Scale Free Networks

OpenAIRE

Toyota, Norihito

2012-01-01

Parrondo's paradox occurs in sequences of games in which a winning expectation value of a payoff may be obtained by playing two games in a random order, even though each game in the sequence may be lost when played individually.Several variations of Parrondo's games apparently with the same paradoxical property have been introduced by G.P. Harmer and D. Abbott; history dependence, one dimensional line, two dimensional lattice and so on. I have shown that Parrondo's paradox does not occur in s...

A Paradoxical Approach to Vocational Indecision.

Science.gov (United States)

Lopez, Frederick G.

1983-01-01

Describes a case study in which a paradoxical intervention was effectively used in treating a vocationally indecisive college student and his overly involved father. The quality of the father-son interaction improved as the student's anxiety decreased. Implications for the use of paradox in other situations are discussed. (Author/JAC)

New Paradoxes of Risky Decision Making

Science.gov (United States)

Birnbaum, Michael H.

2008-01-01

During the last 25 years, prospect theory and its successor, cumulative prospect theory, replaced expected utility as the dominant descriptive theories of risky decision making. Although these models account for the original Allais paradoxes, 11 new paradoxes show where prospect theories lead to self-contradiction or systematic false predictions.…

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

OpenAIRE

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare en...

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures.

Science.gov (United States)

Gulbahar, Gultekin; Kaplan, Tevfik; Turker, Hasan Bozkurt; Gundogdu, Ahmet Gokhan; Han, Serdar

2015-01-01

First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

Virtue Acquisition: The Paradox of Striving

Science.gov (United States)

Snow, Nancy

2016-01-01

Aristotelian-inspired accounts of virtue acquisition stress guided practice and habituated action to develop virtue. This emphasis on action can lead to the "paradox of striving". The paradox occurs when we try too hard to act well and thereby spoil our efforts. I identify four forms of striving--forcing, impulsivity, overthinking, and…

Family Fathers Lost in Theatre Paradox

DEFF Research Database (Denmark)

Kuhlmann, Annelis

2008-01-01

Diderot's influence on theatre is well known through The Paradox of Acting (Paradoxe sur le comédien). However, Diderot also wrote a few drames bourgeois, among which is The Family Father (Le Père de famille), which still in Diderot's days was edited in Copenhagen in French, and which in Danish...

[Bilateral cochlear implants].

Science.gov (United States)

Müller, J

2017-07-01

Cochlear implants (CI) are standard for the hearing rehabilitation of severe to profound deafness. Nowadays, if bilaterally indicated, bilateral implantation is usually recommended (in accordance with German guidelines). Bilateral implantation enables better speech discrimination in quiet and in noise, and restores directional and spatial hearing. Children with bilateral CI are able to undergo hearing-based hearing and speech development. Within the scope of their individual possibilities, bilaterally implanted children develop faster than children with unilateral CI and attain, e.g., a larger vocabulary within a certain time interval. Only bilateral implantation allows "binaural hearing," with all the benefits that people with normal hearing profit from, namely: better speech discrimination in quiet and in noise, as well as directional and spatial hearing. Naturally, the developments take time. Binaural CI users benefit from the same effects as normal hearing persons: head shadow effect, squelch effect, and summation and redundancy effects. Sequential CI fitting is not necessarily disadvantageous-both simultaneously and sequentially fitted patients benefit in a similar way. For children, earliest possible fitting and shortest possible interval between the two surgeries seems to positively influence the outcome if bilateral CI are indicated.

Paradox, reprimand and extinction in adults with mental handicap.

Science.gov (United States)

Wood, V E; Chamove, A S

1991-08-01

To assess the efficacy of paradoxical directives, levels of challenging behaviour during 2 weeks of paradox, reprimand and extinction were compared with baseline levels in four adults with mental handicaps attending a day centre. Paradox was the most effective procedure for reducing the frequency and severity of challenging behaviour by an average of over 70% by the end of 2 weeks and up to 90% in certain subjects; extinction was least effective. Paradox was most effective with more defiant subjects, when staff rated treatment success as low, when improvement using extinction and reprimand was poorest, and in reducing aggressive behaviour. The present authors suggest the overjustification effect offers an explanation for the effects of paradox.

New paradoxes in intertemporal choice

Directory of Open Access Journals (Sweden)

Li-Lin Rao

2011-02-01

Full Text Available Similar to research on risky choice, the traditional analysis of intertemporal choice takes the view that an individual behaves so as to maximize the discounted sum of all future utilities. The well-known Allais paradox contradicts the fundamental postulates of maximizing the expected value or utility of a risky option. We describe a violation of the law of diminishing marginal utility as well as an intertemporal version of the Allais paradox.

Paradoxical therapy in conversion disorder

OpenAIRE

ATAOĞLU, Ahmet

1998-01-01

Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour, such as performing complusive ritual or bringing on a conversion attack. In this study paradoxical intention (PI) was used with to half of the patients with conversion disorders, while the other half were treated with diazepam in order to examine the efficiency of the PI versus diazepam in conversion disorder. Patients treated with PI appeared to have a greater improvement r...

A Rare Entity: Bilateral First Rib Fractures Accompanying Bilateral Scapular Fractures

Directory of Open Access Journals (Sweden)

Gultekin Gulbahar

2015-01-01

Full Text Available First rib fractures are scarce due to their well-protected anatomic locations. Bilateral first rib fractures accompanying bilateral scapular fractures are very rare, although they may be together with scapular and clavicular fractures. According to our knowledge, no case of bilateral first rib fractures accompanying bilateral scapular fractures has been reported, so we herein discussed the diagnosis, treatment, and complications of bone fractures due to thoracic trauma in bias of this rare entity.

Pediatric intracerebral hemorrhage: acute symptomatic seizures and epilepsy.

Science.gov (United States)

Beslow, Lauren A; Abend, Nicholas S; Gindville, Melissa C; Bastian, Rachel A; Licht, Daniel J; Smith, Sabrina E; Hillis, Argye E; Ichord, Rebecca N; Jordan, Lori C

2013-04-01

Seizures are believed to be common presenting symptoms in neonates and children with spontaneous intracerebral hemorrhage (ICH). However, few data are available on the epidemiology of acute symptomatic seizures or the risk for later epilepsy. To define the incidence of and explore risk factors for seizures and epilepsy in children with spontaneous ICH. Our a priori hypotheses were that younger age at presentation, cortical involvement of ICH, acute symptomatic seizures after presentation, ICH due to vascular malformation, and elevated intracranial pressure requiring urgent intervention would predict remote symptomatic seizures and epilepsy. Prospective cohort study conducted between March 1, 2007, and January 1, 2012. Three tertiary care pediatric hospitals. Seventy-three pediatric subjects with spontaneous ICH including 20 perinatal (≥37 weeks' gestation to 28 days) and 53 childhood subjects (>28 days to Acute symptomatic seizures (clinically evident and electrographic-only seizures within 7 days), remote symptomatic seizures, and epilepsy. Acute symptomatic seizures occurred in 35 subjects (48%). Acute symptomatic seizures as a presenting symptom of ICH occurred in 12 perinatal (60%) and 19 childhood (36%) subjects (P = .07). Acute symptomatic seizures after presentation occurred in 7 children. Electrographic-only seizures were present in 9 of 32 subjects (28%) with continuous electroencephalogram monitoring. One-year and 2-year remote symptomatic seizure-free survival rates were 82% (95% CI, 68-90) and 67% (95% CI, 46-82), respectively. One-year and 2-year epilepsy-free survival rates were 96% (95% CI, 83-99) and 87% (95% CI, 65-95), respectively. Elevated intracranial pressure requiring acute intervention was a risk factor for seizures after presentation (P = .01; Fisher exact test), remote symptomatic seizures, and epilepsy (P = .03, and P = .04, respectively; log-rank test). Presenting seizures are common in perinatal and childhood ICH. Continuous

Thermoeconomic diagnosis and entropy generation paradox

DEFF Research Database (Denmark)

Sigthorsson, Oskar; Ommen, Torben Schmidt; Elmegaard, Brian

2017-01-01

In the entropy generation paradox, the entropy generation number, as a function of heat exchanger effectiveness, counter-intuitively approaches zero in two limits symmetrically from a single maximum. In thermoeconomic diagnosis, namely in the characteristic curve method, the exergy destruction...... to the entropy generation paradox, as a decreased heat exchanger effectiveness (as in the case of an operation anomaly in the component) can counter-intuitively result in decreased exergy destruction rate of the component. Therefore, along with an improper selection of independent variables, the heat exchanger...... increases in case of an operation anomaly in a component. The normalised exergy destruction rate as the dependent variable therefore resolves the relation of the characteristic curve method with the entropy generation paradox....

Symptomatic Autism in Childhood and Adolescence

Science.gov (United States)

Easson, William M.

1971-01-01

The frequency of symptomatic autism in children with severe perceptual or intellectual handicaps is noted and early diagnosis and treatment urged to permit healthy child development. Highlighted are some common causes leading to symptomatic autism. (KW)

On Hardy's paradox, weak measurements, and multitasking diagrams

International Nuclear Information System (INIS)

Meglicki, Zdzislaw

2011-01-01

We discuss Hardy's paradox and weak measurements by using multitasking diagrams, which are introduced to illustrate the progress of quantum probabilities through the double interferometer system. We explain how Hardy's paradox is avoided and elaborate on the outcome of weak measurements in this context. -- Highlights: → Hardy's paradox explained and eliminated. → Weak measurements: what is really measured? → Multitasking diagrams: introduced and used to discuss quantum mechanical processes.

A longitudinal study of the bilateral benefit in children with bilateral cochlear implants.

Science.gov (United States)

Asp, Filip; Mäki-Torkko, Elina; Karltorp, Eva; Harder, Henrik; Hergils, Leif; Eskilsson, Gunnar; Stenfelt, Stefan

2015-02-01

To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization. Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing. Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data. For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization. A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

Paradox in a non-linear capacitated transportation problem

Directory of Open Access Journals (Sweden)

Dahiya Kalpana

2006-01-01

Full Text Available This paper discusses a paradox in fixed charge capacitated transportation problem where the objective function is the sum of two linear fractional functions consisting of variables costs and fixed charges respectively. A paradox arises when the transportation problem admits of an objective function value which is lower than the optimal objective function value, by transporting larger quantities of goods over the same route. A sufficient condition for the existence of a paradox is established. Paradoxical range of flow is obtained for any given flow in which the corresponding objective function value is less than the optimum value of the given transportation problem. Numerical illustration is included in support of theory.

A Krein quantization approach to Klein paradox

International Nuclear Information System (INIS)

Payandeh, Farrin; Fathi, Mohsen; Mohammad Pur, Toradj; Moghaddam, Zahra Gh.

2013-01-01

In this paper we first introduce the famous Klein paradox. Afterwards by proposing the Krein quantization approach and taking the negative modes into account, we will show that the expected and exact current densities could be achieved without confronting any paradox. (authors)

The paradoxes of the interaction-free measurements

International Nuclear Information System (INIS)

Vaidman, L.; Tel Aviv Univ.

2001-01-01

Interaction-free measurements introduced by Elitzur and Vaidman (1993) allow finding infinitely fragile objects without destroying them. Paradoxical features of these and related measurements are discussed. The resolution of the paradoxes in the framework of the Many-Worlds Interpretation is proposed. (orig.)

The clock paradox as a cosmological problem

International Nuclear Information System (INIS)

Fu, K.Y.

1975-01-01

In this paper the clock paradox is discussed within the framework of the general theory of relativity. It is shown that in general the aging asymmetry exists. It is also argued that the clock paradox, according to Mach's principle, is essentially a cosmological problem. (author)

The paradox of scientific expertise

DEFF Research Database (Denmark)

Alrøe, Hugo Fjelsted; Noe, Egon

2011-01-01

Modern societies depend on a growing production of scientific knowledge, which is based on the functional differentiation of science into still more specialised scientific disciplines and subdisciplines. This is the basis for the paradox of scientific expertise: The growth of science leads to a f...... cross-disciplinary research and in the collective use of different kinds of scientific expertise, and thereby make society better able to solve complex, real-world problems.......Modern societies depend on a growing production of scientific knowledge, which is based on the functional differentiation of science into still more specialised scientific disciplines and subdisciplines. This is the basis for the paradox of scientific expertise: The growth of science leads...... to a fragmentation of scientific expertise. To resolve this paradox, the present paper investigates three hypotheses: 1) All scientific knowledge is perspectival. 2) The perspectival structure of science leads to specific forms of knowledge asymmetries. 3) Such perspectival knowledge asymmetries must be handled...

Ending the myth of the St Petersburg Paradox

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Robert Vivian

2013-09-01

Full Text Available Nicolas Bernoulli suggested the St Petersburg game, nearly 300 years ago, which is widely believed to produce a paradox in decision theory. This belief stems from a long standing mathematical error in the original calculation of the expected value of the game. This article argues that, in addition to the mathematical error, there are also methodological considerations which gave rise to the paradox. This article explains these considerations and why because of the modern computer, the same considerations, when correctly applied, also demonstrate that no paradox exists. Because of the longstanding belief that a paradox exists it is unlikely the mere mathematical correction will end the myth. The article explains why it is the methodological correction which will dispel the myth.

Greenberger-Horne-Zeilinger paradoxes from qudit graph states.

Science.gov (United States)

Tang, Weidong; Yu, Sixia; Oh, C H

2013-03-08

One fascinating way of revealing quantum nonlocality is the all-versus-nothing test due to Greenberger, Horne, and Zeilinger (GHZ) known as the GHZ paradox. So far genuine multipartite and multilevel GHZ paradoxes are known to exist only in systems containing an odd number of particles. Here we shall construct GHZ paradoxes for an arbitrary number (greater than 3) of particles with the help of qudit graph states on a special kind of graphs, called GHZ graphs. Furthermore, based on the GHZ paradox arising from a GHZ graph, we derive a Bell inequality with two d-outcome observables for each observer, whose maximal violation attained by the corresponding graph state, and a Kochen-Specker inequality testing the quantum contextuality in a state-independent fashion.

Temperature relaxation and the Kapitza boundary resistance paradox

OpenAIRE

Brink, Alec Maassen van den; Dekker, H.

1994-01-01

The calculation of the Kapitza boundary resistance between dissimilar harmonic solids has since long (Little [Can. J. Phys. 37, 334 (1959)]) suffered from a paradox: this resistance erroneously tends to a finite value in the limit of identical solids. We resolve this paradox by calculating temperature differences in the final heat-transporting state, rather than with respect to the initial state of local equilibrium. For a one-dimensional model we thus derive an exact, paradox-free formula fo...

A Dichotomic Analysis of the Surprise Examination Paradox

OpenAIRE

Franceschi, Paul

2002-01-01

This paper presents a dichotomic analysis of the surprise examination paradox. In section 1, I analyse the surprise notion in detail. I introduce then in section 2, the distinction between a monist and dichotomic analysis of the paradox. I also present there a dichotomy leading to distinguish two basically and structurally different versions of the paradox, respectively based on a conjoint and a disjoint definition of the surprise. In section 3, I describe the solution to SEP corresponding to...

Contralateral paradoxical response to chemotherapy in tuberculous ...

African Journals Online (AJOL)

Pleural effusions may occur as a complication of primary tuberculosis or an established pulmonary or extrapulmonary infection. New formation or expansion of a tuberculous lesion during chemotherapy is referred to as paradoxical response. Paradoxical response has been described to occur weeks or months after starting ...

Unveiling consumer's privacy paradox behaviour in an economic exchange.

Science.gov (United States)

Motiwalla, Luvai F; Li, Xiao-Bai

2016-01-01

Privacy paradox is of great interest to IS researchers and firms gathering personal information. It has been studied from social, behavioural, and economic perspectives independently. However, prior research has not examined the degrees of influence these perspectives contribute to the privacy paradox problem. We combine both economic and behavioural perspectives in our study of the privacy paradox with a price valuation of personal information through an economic experiment combined with a behavioural study on privacy paradox. Our goal is to reveal more insights on the privacy paradox through economic valuation on personal information. Results indicate that general privacy concerns or individual disclosure concerns do not have a significant influence on the price valuation of personal information. Instead, prior disclosure behaviour in specific scenario, like with healthcare providers or social networks, is a better indicator of consumer price valuations.

Postoperative Stiffness Requiring Manipulation Under Anesthesia Is Significantly Reduced After Simultaneous Versus Staged Bilateral Total Knee Arthroplasty.

Science.gov (United States)

Meehan, John P; Monazzam, Shafagh; Miles, Troy; Danielsen, Beate; White, Richard H

2017-12-20

For patients with symptomatic bilateral knee arthritis, it is unknown whether the risk of developing stiffness requiring manipulation under anesthesia postoperatively is higher or lower for those undergoing simultaneous bilateral total knee arthroplasty (TKA) compared with those having staged bilateral TKA. Therefore, we undertook this study to evaluate the risk of requiring manipulation under anesthesia in staged versus simultaneous bilateral TKA as well as patients undergoing unilateral TKA. We utilized the California Patient Discharge Database, which is linked with the California Emergency Department, Ambulatory Surgery, and master death file databases. Using a literature-based estimate of the number of patients who failed to undergo the second stage of a staged bilateral TKA, replacement cases were randomly selected from patients who had unilateral TKA and were matched on 8 clinical characteristics of the patients who had staged bilateral TKA. Hierarchical multivariate logistic regression was performed to determine the risk-adjusted odds of manipulation in patients undergoing unilateral TKA, staged bilateral TKA, and simultaneous bilateral TKA using yearly hospital TKA volume as a random effect. Adjustment was made to allow fair comparison of the outcome at 90 and 180 days of follow-up after staged compared with simultaneous bilateral TKA. During the time period from 2005 through 2013, the cumulative incidence of manipulation within 90 days was 2.14% for unilateral TKA (4,398 events per 205,744 patients), 2.11% for staged bilateral TKA (724 events per 34,352 patients), and 1.62% for simultaneous bilateral TKA (195 events per 12,013 patients). At 180 days of complete follow-up, the cumulative incidence of manipulation was 3.07% after unilateral TKA (6,313 events per 205,649 patients), 2.89% after staged bilateral TKAs (957 events per 33,169 patients), and 2.29% after simultaneous bilateral TKA (267 events per 11,653 patients). With multivariate analyses used to

The Lindley paradox in optical interferometry

International Nuclear Information System (INIS)

Mauri, Camillo; Paris, Matteo G.A.

2016-01-01

The so-called Lindley paradox is a counterintuitive statistical effect where the Bayesian and frequentist approaches to hypothesis testing give radically different answers, depending on the choice of the prior distribution. In this paper we address the occurrence of the Lindley paradox in optical interferometry and discuss its implications for high-precision measurements. In particular, we focus on phase estimation by Mach–Zehnder interferometers and show how to mitigate the conflict between the two approaches by using suitable priors. - Highlights: • We address the occurence of Lindley paradox in interferometry and discuss its implications for high-precision measurements. • We show how to mitigate the conflict between Bayesian and frequentist approach to interferometry using suitable priors. • Our results apply to calibration of homodyne detectors for quantum tomography.

Mathematical fallacies and paradoxes

CERN Document Server

Bunch, Bryan

1982-01-01

Stimulating, thought-provoking analysis of the most interesting intellectual inconsistencies in mathematics, physics, and language, including being led astray by algebra (De Morgan's paradox). 1982 edition.

On the Mathematics of the Jeffreys-Lindley Paradox

OpenAIRE

Villa, Cristiano; Walker, Stephen

2015-01-01

This paper is concerned with the well known Jeffreys-Lindley paradox. In a Bayesian set up, the so-called paradox arises when a point null hypothesis is tested and an objective prior is sought for the alternative hypothesis. In particular, the posterior for the null hypothesis tends to one when the uncertainty, i.e. the variance, for the parameter value goes to infinity. We argue that the appropriate way to deal with the paradox is to use simple mathematics, and that any philosophical argumen...

Paradoxical response to dexamethasone and spontaneous hypocortisolism in Cushing's disease

Science.gov (United States)

Lila, Anurag R; Sarathi, Vijaya; Bandgar, Tushar R; Shah, Nalini S

2013-01-01

Paradoxical response to dexamethasone and spontaneous development of hypocortisolism are rare features of Cushing's disease. We report a 13-year-old boy with Cushing's disease owing to a pituitary macroadenoma. On initial evaluation, he had partial suppression of serum cortisol by dexamethasone. He developed transient hypocortisolism after first adenomectomy, but the disease recurred after 1 year. Repeat evaluation showed recurrent hypercortisolism and paradoxical response to dexamethasone. He underwent second surgery and, postoperatively, hypercostisolism persisted even after 2 years of surgery. Repeat evaluations after 8 years of second surgery revealed persistent hypocortisolism despite residual tumour of same size and similar plasma adrenocorticotropic hormone (ACTH) levels. We have also shown that the paradoxical increase in serum cortisol was preceded by a paradoxical increase in ACTH. The paradoxical response persisted despite hypocortisolism. This patient with Cushing's disease had two very rare features: paradoxical response to dexamethasone and spontaneous development of hypocortisolism. PMID:23365169

Paradoxes of maternal mourning.

Science.gov (United States)

Brice, C W

1991-02-01

It has been customary to conceptualize mourning as a phasic or stage phenomenon (Lindemann 1944; Parkes 1972; Bowlby 1980; Knapp 1986). Such a conceptualization has proved to be of tremendous didactic value, especially in terms of succinctly organizing and communicating the major affects, behaviors, and reactions of mourning. It is, however, my belief, based upon clinical experience with many forms of bereavement, that the phenomenon of mourning is not comprised of clearly delineated stages and phases. I have come to conceptualize the phenomenon of mourning the death of a loved person as involving the bereaved's struggle with a series of more or less unresolvable paradoxes rather than as a progression through stages that possess relatively distinct and predictable beginning and ending points. The specific paradoxes encountered by a bereaved person differ, of course, in accordance with the relationship that was lost (mother, father, spouse, child, or sibling), the developmental stage of the bereaved (childhood, adolescence, adulthood, or maturity), the type of death (sudden or prolonged), and the cause of death (illness, murder, suicide, or accident). In this paper, I will address those paradoxes that seem specific to maternal mourning - that is, to mothers who are mourning the death of a child.

Does evaporation paradox exist in China?

Directory of Open Access Journals (Sweden)

Z. T. Cong

2009-03-01

Full Text Available One expected consequence of global warming is the increase in evaporation. However, lots of observations show that the rate of evaporation from open pans of water has been steadily decreasing all over the world in the past 50 years. The contrast between expectation and observation is called "evaporation paradox". Based on data from 317 weather stations in China from 1956 to 2005, the trends of pan evaporation and air temperature were obtained and evaporation paradox was analyzed. The conclusions include: (1 From 1956 to 2005, pan evaporation paradox existed in China as a whole while pan evaporation kept decreasing and air temperature became warmer and warmer, but it does not apply to Northeast and Southeast China; (2 From 1956 to 1985, pan evaporation paradox existed narrowly as a whole with unobvious climate warming trend, but it does not apply to Northeast China; (3 From 1986 to 2005, in the past 20 years, pan evaporation paradox did not exist for the whole period while pan evaporation kept increasing, although it existed in South China. Furthermore, the trend of other weather factors including sunshine duration, windspeed, humidity and vapor pressure deficit, and their relations with pan evaporation are discussed. As a result, it can be concluded that pan evaporation decreasing is caused by the decreasing in radiation and wind speed before 1985 and pan evaporation increasing is caused by the decreasing in vapor pressure deficit due to strong warming after 1986. With the Budyko curve, it can be concluded that the actual evaporation decreased in the former 30 years and increased in the latter 20 year for the whole China.

Bilateral bone conduction devices: improved hearing ability in children with bilateral conductive hearing loss.

Science.gov (United States)

Dun, Catharina A J; Agterberg, Martijn J H; Cremers, Cor W R J; Hol, Myrthe K S; Snik, Ad F M

2013-01-01

The aim of the study was to investigate whether children with bilateral conductive hearing loss benefit from their second device (i.e., the bilateral bone conduction device [BCD]). Speech recognition in noise was assessed in 10 children fitted with bilateral BCDs during childhood. Speech recognition was measured in 2 conditions with both BCDs active. Spatial resolution was tested with the Minimum Audible Angle test in the bilateral and monaural listening conditions. Children demonstrated an improvement in speech recognition when speech was presented from the front and noise was presented from the right-hand side as compared with both speech and noise being presented from the front. The minimum audible angle decreased from 57° in the best monaural condition to 13° in the bilateral condition. The audiological outcomes demonstrate the advantage of bilateral BCD fitting in children with bilateral conductive hearing loss.

Linear perspective and framing in the vista paradox

DEFF Research Database (Denmark)

Costa, Marco; Bonetti, Leonardo

2017-01-01

The vista paradox is the illusion in which an object seen through a frame appears to shrink in apparent size as the observer approaches the frame. In four studies, we tested the effect of framing and fixating on the target object. The first two studies assessed the vista paradox in a large scale...... inserted within five frames differing in size. In the fourth study linear perspective was added to the images. The results showed that both frame size and linear perspective cues were critical factors for the vista paradox illusion....

Paradoxical facilitation of working memory after basolateral amygdala damage.

Directory of Open Access Journals (Sweden)

Barak Morgan

Full Text Available Working memory is a vital cognitive capacity without which meaningful thinking and logical reasoning would be impossible. Working memory is integrally dependent upon prefrontal cortex and it has been suggested that voluntary control of working memory, enabling sustained emotion inhibition, was the crucial step in the evolution of modern humans. Consistent with this, recent fMRI studies suggest that working memory performance depends upon the capacity of prefrontal cortex to suppress bottom-up amygdala signals during emotional arousal. However fMRI is not well-suited to definitively resolve questions of causality. Moreover, the amygdala is neither structurally or functionally homogenous and fMRI studies do not resolve which amygdala sub-regions interfere with working memory. Lesion studies on the other hand can contribute unique causal evidence on aspects of brain-behaviour phenomena fMRI cannot "see". To address these questions we investigated working memory performance in three adult female subjects with bilateral basolateral amygdala calcification consequent to Urbach-Wiethe Disease and ten healthy controls. Amygdala lesion extent and functionality was determined by structural and functional MRI methods. Working memory performance was assessed using the Wechsler Adult Intelligence Scale-III digit span forward task. State and trait anxiety measures to control for possible emotional differences between patient and control groups were administered. Structural MRI showed bilateral selective basolateral amygdala damage in the three Urbach-Wiethe Disease subjects and fMRI confirmed intact functionality in the remaining amygdala sub-regions. The three Urbach-Wiethe Disease subjects showed significant working memory facilitation relative to controls. Control measures showed no group anxiety differences. Results are provisionally interpreted in terms of a 'cooperation through competition' networks model that may account for the observed paradoxical

The happiness paradox

NARCIS (Netherlands)

Bollen, Johan; Gonçalves, Bruno; Leemput, van de Ingrid; Ruan, Guangchen

2017-01-01

Most individuals in social networks experience a so-called Friendship Paradox: they are less popular than their friends on average. This effect may explain recent findings that widespread social network media use leads to reduced happiness. However the relation between popularity and happiness is

The Hydrostatic Paradox.

Science.gov (United States)

Wilson, Alpha E.

1995-01-01

Presents an example demonstrating the quantitative resolution of the hydrostatic paradox which is the realization that the force due to fluid pressure on the bottom of a vessel can be considerably greater or considerably less than the weight of the fluid in the vessel. (JRH)

The "Paradox of Interdisciplinarity" in Australian Research Governance

Science.gov (United States)

Woelert, Peter; Millar, Victoria

2013-01-01

This paper identifies what can be called the "paradox of interdisciplinarity" (Weingart 2000) in Australian higher education research governance and explores some of its constitutive dimensions. In the Australian context, the paradox of interdisciplinarity primarily concerns the proliferation of a programmatic discourse of…

Nonoperative treatment of symptomatic spondylolysis.

Science.gov (United States)

Kurd, Mark F; Patel, Deepan; Norton, Robert; Picetti, George; Friel, Brian; Vaccaro, Alexander R

2007-12-01

Symptomatic spondylolysis resulting from a stress fracture of the pars interarticularis is a cause of low back pain in the juvenile and adolescent patient. Treatment is conservative in the majority of cases. To analyze the outcome of patients with symptomatic isthmic spondylolysis treated nonoperatively with a custom fit thoracolumbar orthosis and activity cessation for 3 months followed by an organized physical therapy program. Retrospective case series. Four hundred thirty-six juvenile and adolescent patients with spondylolysis. Pain improvement, hamstring flexibility, range of motion, resolution of back spasms, and return to previous activities. Retrospective review of 436 juvenile and adolescent patients with symptomatic spondylolysis confirmed by single-photon emission computed tomography or computed tomography. Clinical outcomes were assessed through patient history and physical examination. Ninety-five percent of patients achieved excellent results according to a modified Odom's Criteria. The remaining 5% of patients achieved good results as they required occasional nonsteroidal anti-inflammatory drugs to relieve pain. Back spasms were resolved and hamstring tightness and range of motion returned to normal in all patients. All patients returned to their preinjury activity level. No patients went on to surgery. Symptomatic juvenile and adolescent patients with an isthmus spondylolysis may be effectively managed with a custom fit thoracolumbar orthosis brace and activity cessation for approximately 3 months followed by an organized physical therapy program.

Paradox image: a noninvasive index of regional left-ventricular dyskinesis

International Nuclear Information System (INIS)

Holman, B.L.; Wynne, J.; Idoine, J.; Zielonka, J.; Neill, J.

1979-01-01

The paradox image, a functional image of regional dyskinesis derived from the equilibrium (gated) radionuclide ventriculogram, was constructed by subtracting the background-corrected end-diastolic frame from the background-corrected end-systolic frame. In 11 patients showing dyskinesis by contrast ventriculography, the percentage of left-ventricular picture elements containing paradox ranged from 3.6 to 55.6% (21.44% +- 4.45 s.e.m.). In 11 patients with normokinesis and in eight patients with hypookinesis by contrast ventriculography, the left-ventricular picture elements demonstrating paradox were less than 1.1% in all cases. In nine patients with akinesis, the percentage of left-ventricular picture elements containing paradox was 2.05% +- 0.96 s.e.m. and was less than 2% in seven patients. There was also an excellent agreement between the location of dyskinesis on the paradox image and that by contrast ventriculography. The paradox image is a sensitive indicator of left-ventricular dyskinesis and should be useful in the evaluation of patients with suspected left-ventricular asynergy

Einstein-Podolsky-Rosen paradox and quantum steering in pulsed optomechanics

Science.gov (United States)

He, Q. Y.; Reid, M. D.

2013-11-01

We describe how to generate an Einstein-Podolsky-Rosen (EPR) paradox between a mesoscopic mechanical oscillator and an optical pulse. We find two types of paradox, defined by whether it is the oscillator or the pulse that shows the effect Schrödinger called “steering”. Only the oscillator paradox addresses the question of mesoscopic local reality for a massive system. In that case, EPR's “elements of reality” are defined for the oscillator, and it is these elements of reality that are falsified (if quantum mechanics is complete). For this sort of paradox, we show that a thermal barrier exists, meaning that a threshold level of pulse-oscillator interaction is required for a given thermal occupation n0 of the oscillator. We find there is no equivalent thermal barrier for the entanglement of the pulse with the oscillator or for the EPR paradox that addresses the local reality of the optical system. Finally, we examine the possibility of an EPR paradox between two entangled oscillators. Our work highlights the asymmetrical effect of thermal noise on quantum nonlocality.

Cognitive bias in symptomatic and recovered agoraphobics.

Science.gov (United States)

Stoler, L S; McNally, R J

1991-01-01

Symptomatic agoraphobics, recovered agoraphobics, and normal control subjects completed a series of sentence stems that had either ambiguous or unambiguous meanings, and had either a potentially threatening or a nonthreatening connotation. The written completions made by subjects to these stems were classified as indicating either a biased (i.e. threat-related) or unbiased interpretation of the meaning of the stem, and if a biased interpretation was made, whether the subject indicated efforts at adaptive coping with the perceived threat. Results indicated that symptomatic agoraphobics exhibited strong biases for interpreting information as threatening, relative to normal control subjects. Moreover, recovered agoraphobics resembled symptomatic agoraphobics more than normal control subjects, thus indicating that cognitive biases may persist following cessation of panic attacks and reductions in avoidance behavior. However, recovered agoraphobics also exhibited tendencies to cope adaptively with perceived threats whereas symptomatic agoraphobics did not.

Simpson's paradox in psychological science: a practical guide

NARCIS (Netherlands)

Kievit, R.A.; Frankenhuis, W.E.; Waldorp, L.J.; Borsboom, D.

2013-01-01

The direction of an association at the population-level may be reversed within the subgroups comprising that population—a striking observation called Simpson's paradox. When facing this pattern, psychologists often view it as anomalous. Here, we argue that Simpson's paradox is more common than

Pervasive Technologies and the Paradoxes of Multimodal Digital Communication

Directory of Open Access Journals (Sweden)

Sandra Petroni

2014-12-01

Full Text Available Contemporary societies are greatly challenged by paradoxes in all facets of life. Digital communication encodes and produces meaning by making use of these contradictory relations. In this contribution, three digital paradoxes will be presented. The first paradox is grounded in the process of remediation in digital settings which mirrors a contradictory double logic. Digital culture, in fact, wants both to multiply its media and to eliminate all traces of mediation. The second antinomy has its origins in the new concept of linguistic entropy: a structured information disorder that is regulated by usability and multimodality. In accordance with the second paradox, the third one stems from further processes that are framing, a multimodal resource, and linking, a hypertextual resource.

The Tolman-Regge antitelephone paradox: Its solution by tachyon mechanics

International Nuclear Information System (INIS)

Recami, E.

The possibility of solving (at least 'in microphysics') all the ordinary causal paradoxes devised for Tachyons is not yet widely recognized; on the contrary, the effectiveness of the Stuckelberg-Feynman 'switching principle' is often misunderstood. It is therefore shown in details and rigorously how to solve the oldest causal paradox, originally proposed by Tolman, which is the Kernel of so many further tachyon paradoxes. The key to the solution is a careful application of Tachyon Kinematics. Which can be unambiguously derived from Special Relativity. A systematic, thorough analysis of all tachyon paradoxes is going to appear elsewhere. (Author) [pt

Nietzsche et les paradoxes de la force

Directory of Open Access Journals (Sweden)

Arnaud François

2011-06-01

Full Text Available According to this paper, the Nietzschean notion of force actually consists of a number of paradoxes, which I seek to formulate through the philosophical problems they pose. These paradoxes revolve around this fundamental paradox: on the one hand, force is able to rise and fall, but precisely how could such an increase and such a decrease be designed, as far as only what is given once for all can accept quantitative determinations? I come to draw two methods to answer this question (contrariety between two positive forces, reactivity of one force against the other, which suggest two ways of posing the biological and medical problems today, related to the notions of health and disease, in the scope of which Nietzsche has encountered it.

The Surprise Examination Paradox and the Second Incompleteness Theorem

OpenAIRE

Kritchman, Shira; Raz, Ran

2010-01-01

We give a new proof for Godel's second incompleteness theorem, based on Kolmogorov complexity, Chaitin's incompleteness theorem, and an argument that resembles the surprise examination paradox. We then go the other way around and suggest that the second incompleteness theorem gives a possible resolution of the surprise examination paradox. Roughly speaking, we argue that the flaw in the derivation of the paradox is that it contains a hidden assumption that one can prove the consistency of the...

Unveiling consumer’s privacy paradox behaviour in an economic exchange

Science.gov (United States)

Li, Xiao-Bai

2015-01-01

Privacy paradox is of great interest to IS researchers and firms gathering personal information. It has been studied from social, behavioural, and economic perspectives independently. However, prior research has not examined the degrees of influence these perspectives contribute to the privacy paradox problem. We combine both economic and behavioural perspectives in our study of the privacy paradox with a price valuation of personal information through an economic experiment combined with a behavioural study on privacy paradox. Our goal is to reveal more insights on the privacy paradox through economic valuation on personal information. Results indicate that general privacy concerns or individual disclosure concerns do not have a significant influence on the price valuation of personal information. Instead, prior disclosure behaviour in specific scenario, like with healthcare providers or social networks, is a better indicator of consumer price valuations. PMID:27708687

Bilateral breast carcinoma: results with breast conservation therapy and a comparison with bilateral mastectomy

International Nuclear Information System (INIS)

Kim, David H.; Haffty, Bruce G.

1996-01-01

Purpose: To assess outcome of patients with bilateral breast carcinoma treated with bilateral breast conserving surgery with radiation therapy (CS+RT) and to compare their outcome to (1) patients with unilateral disease treated with CS+RT and (2) patients of comparable stage treated with bilateral mastectomy. Methods and Materials: The charts of all patients with the diagnosis of breast cancer treated with CS+RT at our facilities prior to 1993 were reviewed to identify patients with bilateral disease. A total of 50 patients identified as having bilateral breast cancer conservatively treated(BCT) served as the index population. Out of the 50 patients, 23 presented with synchronous bilateral breast cancer and 27 presented with metachronous bilateral breast cancer. A group of 984 patients with unilateral breast cancer (UCT) treated with CS+RT during the same time interval served as the first control group. A second control group was comprised of 42 patients with early stage bilateral breast cancer presenting during the same time interval treated with bilateral mastectomy (BMAST). Patients who had locally advanced disease in either breast or those patients treated exclusively for lobular carcinoma in situ in either breast were excluded from the analysis. Of the 42 BMAST patients, 33 presented with synchronous disease and nine presented with metachronous disease. Local-regional relapse rates were calculated from the date of treatment of each breast. Overall survival and distant relapse rates were calculated from the date of treatment of the second breast cancer diagnosed. Survival curves were calculated via the life table method and statistical comparisons between curves were performed using the log rank statistic. Chi square analysis was used to detect differences between categorical variables. Results: As of December 1995, the median follow-up of the bilateral conservatively treated patient population was 9.4 years. No statistically significant differences were noted

MR imaging of symptomatic osteochondromas with pathological correlation

International Nuclear Information System (INIS)

Mehta, M.; Knapp, T.; White, L.M.; Wunder, J.S.; Bell, R.S.

1998-01-01

Objective. To demonstrate the value of MR imaging in the diagnosis and differentiation of the various symptomatic complications of osteochondromas, providing pathological correlation with emphasis on the usefulness of MR imaging as a single imaging modality in these patients. Design. We retrospectively reviewed all MR examinations of clinically symptomatic osteochondromas (30 patients) performed at our institution between March 1990 and October 1997. Patients. Thirty patients had clinically symptomatic osteochondromas during the study period. Twenty patients were male and 10 were female. There were five cases of multiple osteochondromatosis. Pathological correlation was available in 24 patients. Results and conclusion. Symptomatic complications included fracture (7%), osseous deformity limiting range of motion (23%), vascular injury (7%), neurological compromise (10%), bursa formation (27%) and malignant transformation (27%). MR imaging was able to diagnose or suggest the etiology for the clinical symptomatology in all cases, demonstrating that it is an ideal imaging modality in the diagnostic evaluation of symptomatic complications of osteochondromas and often avoids the need for further imaging. (orig.)

Symptomatic unruptured cerebral aneurysms. Features and surgical outcome

International Nuclear Information System (INIS)

Date, Isao

2010-01-01

Development of less invasive imaging studies, such as magnetic resonance angiography, has increased the chances that unruptured cerebral aneurysms are found. The rupture risk of 'symptomatic' aneurysms is higher than for 'asymptomatic' aneurysms; so 'symptomatic' aneurysms are more often surgically treated. Many reviews examine 'asymptomatic' unruptured cerebral aneurysms, but few evaluate 'symptomatic' aneurysms. The author has treated many patients with symptomatic unruptured cerebral aneurysms and found that improved cranial nerve signs can be expected if the surgical treatment is performed before the symptoms become irreversible; the critical period is approximately 3 months. It is important to suppress the pulsation of the aneurysms compressing the cranial nerves; both a clipping procedure and endovascular coiling are effective. Cranial nerve signs are more commonly the symptoms of unruptured cerebral aneurysms, but large to giant aneurysms can also be the causes of hemiparesis, hydrocephalus, epilepsy, or even cerebral infarction. This review summarizes the features and surgical outcome of symptomatic unruptured cerebral aneurysms. (author)

Proper-time quantum-mechanics and the Klein paradox

International Nuclear Information System (INIS)

Thaller, B.

1981-01-01

Scattering at high potential-steps is treated in the framework of relativistic proper-time theory. No paradox arises in contrast to Dirac's wavemechanics (''Klein's paradox''); pair creation may happen with a certain probability and may be described as a scattering process with ordinary quantum-mechanical methods. (author)

Time symmetry and interpretation of quantum mechanics. [Paradoxes

Energy Technology Data Exchange (ETDEWEB)

de Beauregard, O.C.

1976-10-01

A drastic resolution of the quantum paradoxes is proposed, combining (I) von Neumann's postulate that collapse of the state vector is due to the act of observation, and (II) my reinterpretation of von Neumann's quantal irreversibility as an equivalence between wave retardation and entropy increase, both being ''factlike'' rather than ''lawlike'' (Mehlberg). This entails a coupling of the two de jure symmetries between (I) retarded and (II) advanced waves, and between Aristotle's information as (I) learning and (II) willing awareness. Symmetric acceptance of cognizance as a source of retarded waves, and of will as a sink of advanced waves, is submitted as a central ''paradox'' of the Copernican or Einsteinian sort, out of which new light is shed upon previously known paradoxes, such as the EPR paradox, Schroedinger's cat, and Wigner's friend. Parapsychology is thus found to creep into the picture.

Temperature relaxation at the Kapitza-boundary-resistance paradox

NARCIS (Netherlands)

Maassen van den Brink, A.; Dekker, H.

1995-01-01

The calculation of the Kapitza boundary resistance between dissimilar harmonic solids has for a long time [W. A. Little, Can. J. Phys. 37, 334 (1959)] presented a paradox: this resistance erroneously tends to a finite value in the limit of identical solids. We resolve this paradox by calculating

Un théoricien paradoxal

Directory of Open Access Journals (Sweden)

Jacques Dubois

2009-08-01

Full Text Available Professeur de littérature française à Paris-VIII et psychanalyste, Pierre Bayard a publié en quinze ans une dizaine d’ouvrages critiques dans la collection « Paradoxe » des éditions de Minuit. À croire que cette collection a été créée à sa seule intention tant chacun de ses livres inverse radicalement un principe bien établi et pousse le paradoxe jusqu’à ses ultimes conséquences, voire jusqu’à l’absurde. L’exemple le plus flagrant est ce Comment parler des livres que l’on n’a pas lus ?, qui, ...

A Resolution of the Paradox of Enrichment

Science.gov (United States)

Feng, Z. C.; Li, Y. Charles

2015-06-01

The paradox of enrichment was observed by Rosenzweig [1971] in a class of predator-prey models. Two of the parameters in the models are crucial for the paradox. These two parameters are the prey's carrying capacity and prey's half-saturation for predation. Intuitively, increasing the carrying capacity due to enrichment of the prey's environment should lead to a more stable predator-prey system. Analytically, it turns out that increasing the carrying capacity always leads to an unstable predator-prey system that is susceptible to extinction from environmental random perturbations. This is the so-called paradox of enrichment. Our resolution here rests upon a closer investigation on a dimensionless number H formed from the carrying capacity and the prey's half-saturation. By recasting the models into dimensionless forms, the models are in fact governed by a few dimensionless numbers including H. The effects of the two parameters: carrying capacity and half-saturation are incorporated into the number H. In fact, increasing the carrying capacity is equivalent (i.e. has the same effect on H) to decreasing the half-saturation which implies more aggressive predation. Since there is no paradox between more aggressive predation and instability of the predator-prey system, the paradox of enrichment is resolved. The so-called instability of the predator-prey system is characterized by the existence of a stable limit cycle in the phase plane, which gets closer and closer to the predator axis and prey axis. Due to random environmental perturbations, this can lead to extinction. We also further explore spatially dependent models for which the phase space is infinite-dimensional. The spatially independent limit cycle which is generated by a Hopf bifurcation from an unstable steady state, is linearly stable in the infinite-dimensional phase space. Numerical simulations indicate that the basin of attraction of the limit cycle is riddled. This shows that spatial perturbations can

Paradox Lost? No, Paradox Found! Reply to Tomasello and Akhtar (2003).

Science.gov (United States)

Naigles, Letitia R.

2003-01-01

Asserts that the posited paradox between infancy and toddlerhood language was not eliminated by Tomasello and Akhtar's appeal to infants' robust statistical learning abilities. Maintains that scrutiny of their studies supports the resolution that abstracting linguistic form is easy for infants and that toddlers find it difficult to integrate…

Repair of pars defects by segmental transverse wiring for athletes with symptomatic spondylolysis: relationship between bony union and postoperative symptoms.

Science.gov (United States)

Hioki, Akira; Miyamoto, Kei; Sadamasu, Aya; Nozawa, Satoshi; Ogawa, Hiroyasu; Fushimi, Kazunari; Hosoe, Hideo; Shimizu, Katsuji

2012-04-20

Retrospective study of surgery for spondylolysis patients. To assess clinical outcome of bony union using multislice computed tomography after segmental wiring fixation. How bony union affects surgical outcome of spondylolysis repair is unclear. Forty-four athletes with symptomatic spondylolysis (33 men and 11 women; mean age, 24.2 ± 5.4 years) who underwent segmental wiring fixation were evaluated retrospectively at a mean follow-up of 85 ± 17 months. The level of spondylolysis was L5 in 42 cases, and both L4 and L5 in 2 cases, giving a total of 46 operative levels of vertebrae. Bony union using axial and sagittal reconstruction images of computed tomography, the Japanese Orthopaedic Association (JOA) score for back pain, and complications were reviewed. State of bony union was classified as bilateral union, unilateral union, or nonunion. The total score and the improvement ratio of the JOA score were compared among the 3 groups. Bilateral bony union was obtained in 29 cases (31 of 46 vertebrae, 67.4%). Six cases (13%) showed unilateral union, and 9 cases (19.6%) showed nonunion. JOA score increased significantly after surgery in all groups, average improvement rate was 78.9% in the bilateral group, 63.6% in the unilateral group, and 29.8% in the nonunion group; differences among the 3 groups were significant (P spondylolysis repair.

Spin entanglement, decoherence and Bohm's EPR paradox.

Science.gov (United States)

Cavalcanti, E G; Drummond, P D; Bachor, H A; Reid, M D

2009-10-12

We obtain criteria for entanglement and the EPR paradox for spin-entangled particles and analyse the effects of decoherence caused by absorption and state purity errors. For a two qubit photonic state, entanglement can occur for all transmission efficiencies. In this case, the state preparation purity must be above a threshold value. However, Bohm's spin EPR paradox can be achieved only above a critical level of loss. We calculate a required efficiency of 58%, which appears achievable with current quantum optical technologies. For a macroscopic number of particles prepared in a correlated state, spin entanglement and the EPR paradox can be demonstrated using our criteria for efficiencies eta > 1/3 and eta > 2/3 respectively. This indicates a surprising insensitivity to loss decoherence, in a macroscopic system of ultra-cold atoms or photons.

Bilateral herpes zoster

OpenAIRE

Singh K; Bajaj A; Dwivedi N; Merchery A

1993-01-01

A case of bilateral herpes zoster of lumbosacral region is reported in association with diabetes mellitus in a 55 years old female. The case is of interest due to bilateral distribution which is rare and sacral region involvement which is quite uncommon.

Factors associated with symptomatic vulvovaginal candidiasis: a ...

African Journals Online (AJOL)

Background: Symptomatic vulvovaginal candidiasis (VVC) is one of the most common problems leading women to seek advice in primary healthcare facilities. Aim: The aim of this study is to describe the associations between some hypothesized factors and the presence of symptomatic VVC. Subjects and Methods: An ...

Linear optics implementation of weak values in Hardy's paradox

International Nuclear Information System (INIS)

Ahnert, S.E.; Payne, M.C.

2004-01-01

We propose an experimental setup for the implementation of weak measurements in the context of the gedanken experiment known as Hardy's paradox. As Aharonov et al. [Y. Aharonov, A. Botero, S. Popescu, B. Reznik, and J. Tollaksen, Phys. Lett. A301, 130 (2002)] showed, these weak values form a language with which the paradox can be resolved. Our analysis shows that this language is indeed consistent and experimentally testable. It also reveals exactly how a combination of weak values can give rise to an apparently paradoxical result

Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy

NARCIS (Netherlands)

Puar, T.; Engels, M.; Herwaarden, A.E. van; Sweep, F.C.; Hulsbergen-van de Kaa, C.A.; Kamphuis-van Ulzen, K.; Chortis, V.; Arlt, W.; Stikkelbroeck, N.; Claahsen-van der Grinten, H.L.; Hermus, A.R.M.M.

2017-01-01

Context: Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare. Patient: We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years

The nuclear paradox

International Nuclear Information System (INIS)

Eibenschutz, J.

1989-01-01

In this work it is discussed the nuclear paradox. One side, the nuclear power is important for technological development, on the other hand, it has been frequently questioned by society. It is pointed out as well, that many other factors are more dangerous to man such as environment polution. (A.C.A.S.)

Einstein-Podolsky-Rosen paradox and measurement of quantum system

OpenAIRE

Kladko, Konstantin

1999-01-01

Einstein-Podolsky-Rosen (EPR) paradox is considered in a relation to a measurement of an arbitrary quantum system . It is shown that the EPR paradox always appears in a gedanken experiment with two successively joined measuring devices.

Bilateral herpes zoster

Directory of Open Access Journals (Sweden)

Singh K

1993-01-01

Full Text Available A case of bilateral herpes zoster of lumbosacral region is reported in association with diabetes mellitus in a 55 years old female. The case is of interest due to bilateral distribution which is rare and sacral region involvement which is quite uncommon.

Paradoxical perception of surfaces in the Shepard tabletop illusion

Science.gov (United States)

Tyler, Christopher W

2011-01-01

The Shepard tabletop illusion, consisting of different perspective embeddings of two identical parallelograms as tabletops, affords a profound difference in their perceived surface shapes. My analysis reveals three further paradoxical aspects of this illusion, in addition to its susceptibility to the ‘inverse perspective illusion’ of the implied orthographic perspective of the table images. These novel aspects of the illusion are: a paradoxical slant of the tabletops, a paradoxical lack of perceived depth, and a paradoxical distortion of the length of the rear legs. The construction of the illusion resembles scenes found in ancient Chinese scroll paintings, and an analysis of the source of the third effect shows that the interpretation in terms of surfaces can account for the difference in treatment of the filled-in versus open forms in the Chinese painting from more than 1000 years ago. PMID:23145230

Phenotypic and imaging features of FLNA-negative patients with bilateral periventricular nodular heterotopia and epilepsy.

Science.gov (United States)

Fallil, Zianka; Pardoe, Heath; Bachman, Robert; Cunningham, Benjamin; Parulkar, Isha; Shain, Catherine; Poduri, Annapurna; Knowlton, Robert; Kuzniecky, Ruben

2015-10-01

Periventricular nodular heterotopia (PVNH) is a malformation of cortical development due to impaired neuronal migration resulting in the formation of nodular masses of neurons and glial cells in close proximity to the ventricular walls. We report the clinical characteristics of the largest case series of FLNA-negative patients with seizures and bilateral periventricular heterotopia. Participants were recruited through the Epilepsy Phenome/Genome Project (EPGP), a multicenter collaborative effort to collect detailed phenotypic data and DNA on a large number of individuals with epilepsy, including a cohort with symptomatic epilepsy related to PVNH. Included subjects had epilepsy, and MRI confirmed bilateral PVNH. Magnetic resonance imaging studies were visually and quantitatively reviewed to investigate the topographic extent of PVNH, symmetry, and laterality. We analyzed data on 71 patients with bilateral PVNH. The incidence of febrile seizures was 16.6%. There was at least one other family member with epilepsy in 36.9% of this population. Developmental delay was present in 21.8%. Focal onset seizures were the most common type of seizure presentation (79.3%). High heterotopia burden was strongly associated with female gender and trigonal nodular localization. There was no evidence for differences in brain volume between PVNH subjects and controls. No relationship was observed between heterotopic volume and gender, developmental delay, location of PVNH, ventricular or cerebellar abnormalities, laterality of seizure onset, age at seizure onset, and duration of epilepsy. A direct correlation was observed between high heterotopia burden, female gender, and trigonal location in this large cohort of FLNA-negative bilateral PVNH patients with epilepsy. Quantitative MRI measurements indicated that this correlation is based on the diffuse nature of the heterotopic nodules rather than on the total volume of abnormal heterotopic tissue. Copyright © 2015 Elsevier Inc. All

The effect of 'Candidatus Liberibacter asiaticus' infection on the proteomic profiles and nutritional status of pre-symptomatic and symptomatic grapefruit (Citrus paradisi) plants.

Science.gov (United States)

Nwugo, Chika C; Lin, Hong; Duan, Yongping; Civerolo, Edwin L

2013-04-11

Huanglongbing (HLB) is a highly destructive citrus disease which threatens citrus production worldwide and 'Candidatus Liberibacter asiaticus' (Las), a non-culturable phloem-limited bacterium, is an associated causal agent of the disease. To better understand the physiological and molecular processes involved in host responses to Las, 2-DE and mass spectrometry analyses, as well as ICP spectroscopy analysis were employed to elucidate the global protein expression profiles and nutrient concentrations in leaves of Las-infected grapefruit plants at pre-symptomatic or symptomatic stages for HLB. This study identified 123 protein spots out of 191 spots that showed significant changes in the leaves of grapefruit plants in response to Las infection and all identified spots matched to 69 unique proteins/peptides. A down-regulation of 56 proteins including those associated with photosynthesis, protein synthesis, and metabolism was correlated with significant reductions in the concentrations of Ca, Mg, Fe, Zn, Mn, and Cu in leaves of grapefruit plants in response to Las infection, particularly in symptomatic plants. Oxygen-evolving enhancer (OEE) proteins, a PSI 9 kDa protein, and a Btf3-like protein were among a small group of proteins that were down-regulated in both pre-symptomatic and symptomatic plants in response to Las infection. Furthermore, a Las-mediated up-regulation of 13 grapefruit proteins was detected, which included Cu/Zn superoxide dismutase, chitinases, lectin-related proteins, miraculin-like proteins, peroxiredoxins and a CAP 160 protein. Interestingly, a Las-mediated up-regulation of granule-bound starch synthase was correlated with an increase in the K concentrations of pre-symptomatic and symptomatic plants. This study constitutes the first attempt to characterize the interrelationships between protein expression and nutritional status of Las-infected pre-symptomatic or symptomatic grapefruit plants and sheds light on the physiological and molecular

Bilateral breast carcinoma

International Nuclear Information System (INIS)

Kim, Eung Jo; Oh, Ki Keun

1990-01-01

We evaluate 311 breast cancer patients admitted to Yong Dong Severance Hospital Between October 1st 1985 and July 31th 1989, and were able to obtain the following conclusions. 1) There were 14(4.5%) bilateral breast cancers among the 311 confirmed breast cancers. 2) Among the bilateral breast cancers, 5(31%) were synchronous and 9(69%) metachronous. 3) Average interval between the first and the second breast cancer in metachronous cancers was 3.8 year(1-15 years). 4) Bilateral breast cancer was most prevalent in the fifth decade (6/14) with the mean age of 47 years. 5) Film mammogram and sonomammogram showed findings of typical breast malignancies. There was no additional specific findings for each cancer in bilateral breast cancers which was different from unilateral cancers. Therefor, in the patients with unilateral breast cancer, possibility of the second lesion in the contralateral side must be considered and a close follow up observation should be done for at least 3 years

A SECOND CASE OF BILATERAL RHEGMATOGENOUS RETINAL DETACHMENTS REPAIRED WITH SIMULTANEOUS BILATERAL PNEUMATIC RETINOPEXY.

Science.gov (United States)

Rubin, Uriel; De Jager, Cornelis; Zakour, Moayed; Gonder, J Thomas

2017-01-01

To present a case of a patient with simultaneous bilateral retinal detachments treated successfully with bilateral pneumatic retinopexy. Case report. This is a case of an otherwise healthy 49-year-old woman with no remarkable ocular history that presented with simultaneous phakic superior bilateral rhegmatogenous retinal detachments. Treatment on the day of presentation included laser retinopexy of the inferior lattice degeneration in the left eye and bilateral intravitreal injection of 0.4 cc of 100% C3F8 gas preceded by topical anesthesia. After 48 hours, both retinas were completely reattached, and bilateral laser retinopexy was performed to the superior tears. After a review of the literature, the authors could find only two reported cases of simultaneous bilateral retinal detachments treated successfully with pneumatic retinopexy. This is not only a cost-effective procedure but also allows treatment when there is no immediate operating room availability or a when a quick referral for surgery is not possible.

An Applet for the Investigation of Simpson's Paradox

Science.gov (United States)

Schneiter, Kady; Symanzik, Jurgen

2013-01-01

This article describes an applet that facilitates investigation of Simpson's Paradox in the context of a number of real and hypothetical data sets. The applet builds on the Baker-Kramer graphical representation for Simpson's Paradox. The implementation and use of the applet are explained. This is followed by a description of how the applet has…

An alternative resolution to the Mansuripur paradox

Science.gov (United States)

Redfern, Francis

2016-04-01

In 2013 an article published online by the journal Science declared that the paradox proposed by Masud Mansuripur was resolved. This paradox concerns a point charge-Amperian magnetic dipole system as seen in a frame of reference where they are at rest and one in which they are moving. In the latter frame an electric dipole appears on the magnetic dipole. A torque is then exerted upon the electric dipole by the point charge, a torque that is not observed in the at-rest frame. Mansuripur points out this violates the relativity principle and suggests the Lorentz force responsible for the torque be replaced by the Einstein-Laub force. The resolution of the paradox reported by Science, based on numerous papers in the physics literature, preserves the Lorentz force but depends on the concept of hidden momentum. Here I propose a different resolution based on the overlooked fact that the charge-magnetic dipole system contains linear and angular electromagnetic field momentum. The time rate of change of the field angular-momentum in the frame through which the system is moving cancels that due to the charge-electric dipole interaction. From this point of view hidden momentum is not needed in the resolution of the paradox.

An alternative resolution to the Mansuripur paradox

International Nuclear Information System (INIS)

Redfern, Francis

2016-01-01

In 2013 an article published online by the journal Science declared that the paradox proposed by Masud Mansuripur was resolved. This paradox concerns a point charge-Amperian magnetic dipole system as seen in a frame of reference where they are at rest and one in which they are moving. In the latter frame an electric dipole appears on the magnetic dipole. A torque is then exerted upon the electric dipole by the point charge, a torque that is not observed in the at-rest frame. Mansuripur points out this violates the relativity principle and suggests the Lorentz force responsible for the torque be replaced by the Einstein–Laub force. The resolution of the paradox reported by Science, based on numerous papers in the physics literature, preserves the Lorentz force but depends on the concept of hidden momentum. Here I propose a different resolution based on the overlooked fact that the charge-magnetic dipole system contains linear and angular electromagnetic field momentum. The time rate of change of the field angular–momentum in the frame through which the system is moving cancels that due to the charge-electric dipole interaction. From this point of view hidden momentum is not needed in the resolution of the paradox. (paper)

Symptomatic Non-parasitic benign hepatic cyst: Evaluation of ...

African Journals Online (AJOL)

HussamHassan

Rarely, however, the cysts become symptomatic and are then best treated surgically. The optimal surgical treatment is debatable. ... the liver, including multiple cysts arising in the ..... aspiration and ethanol sclerosis of a large, symptomatic,.

The nature of quantum paradoxes

International Nuclear Information System (INIS)

Tarozzi, G.; Van der Merwe, A.

1988-01-01

The nature of Quantum Paradoxes provides an exhaustive general view of the most recent studies and research carried out by Italian scientists and philosophers of science in the field of the foundations of quantum physics, employing a critical stance and an alternative to the orthodox Copenhagen interpretation. During the last twenty years the Italians have produced a remarkable amount of work on the quantum-mechanical theory of measurement, the interpretation of the wave-function, the axiomatization of quantum formalism, Bell-type theorems and realistic local theories, thus creating one of the most advanced contributions to the problems of understanding Nature and clarifying the origin of the quantum paradoxes. (author). refs.; figs.; tabs

Klein paradox and vacuum polarization

International Nuclear Information System (INIS)

Damour, T.

1977-01-01

This contribution reviews some of the methods which can be used when studying quantum fields in a given stationary classical external field. The attention is mainly directed towards cases where real pair creation can occur in such a stationary background. The paradigm of this situation is the Klein paradox. This paradox is best approached by the introduction of some energy diagrams whose direct extension to black holes physics has proven to be very useful. Finally processes of real pair creation around a Kerr-Newman (charged and rotating) black hole and their feedback on the geometry are briefly discussed. It is also shown how the Hawking process can be recovered in this approach. (Auth.)

On Hardy's paradox, weak measurements, and multitasking diagrams

Energy Technology Data Exchange (ETDEWEB)

Meglicki, Zdzislaw, E-mail: gustav@indiana.edu [Indiana University, Office of the Vice President for Information Technology, 601 E. Kirkwood Ave., Room 116, Bloomington, IN 47405-1223 (United States)

2011-07-04

We discuss Hardy's paradox and weak measurements by using multitasking diagrams, which are introduced to illustrate the progress of quantum probabilities through the double interferometer system. We explain how Hardy's paradox is avoided and elaborate on the outcome of weak measurements in this context. -- Highlights: → Hardy's paradox explained and eliminated. → Weak measurements: what is really measured? → Multitasking diagrams: introduced and used to discuss quantum mechanical processes.

A Simple Explanation of the Classic Hydrostatic Paradox

Science.gov (United States)

Kontomaris, Stylianos-Vasileios; Malamou, Anna

2016-01-01

An interesting problem in fluid mechanics, with significant educational importance, is the classic hydrostatic paradox. The hydrostatic paradox states the fact that in different shaped containers, with the same base area, which are filled with a liquid of the same height, the applied force by the liquid on the base of each container is exactly the…

Intimate partner violence against women and the Nordic paradox.

Science.gov (United States)

Gracia, Enrique; Merlo, Juan

2016-05-01

Nordic countries are the most gender equal countries in the world, but at the same time they have disproportionally high prevalence rates of intimate partner violence (IPV) against women. High prevalence of IPV against women, and high levels of gender equality would appear contradictory, but these apparently opposite statements appear to be true in Nordic countries, producing what could be called the 'Nordic paradox'. Despite this paradox being one of the most puzzling issues in the field, this is a research question rarely asked, and one that remains unanswered. This paper explores a number of theoretical and methodological issues that may help to understand this paradox. Efforts to understand the Nordic paradox may provide an avenue to guide new research on IPV and to respond to this major public health problem in a more effective way. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bilateral spontaneous thrombosis of the pampiniform plexus; A rare etiology of acute scrotal pain: A case report and review of literature

Directory of Open Access Journals (Sweden)

Ktari Kamel

2018-03-01

Full Text Available Introduction: Acute testicular pain is frequent in urology. If torsion of the spermatic cord and orchiepididymites are usual, thrombosis of the pampiniform plexus is a very uncommon clinical entity. We present an unusual case and review the literature to explore potential etiologies and therapeutic strategies. Observation: A rare case of bilateral thrombosis of the pampiniform plexus occurred in a 39 year-old male.The diagnosis was confirmed with doppler sonographie and Computer Tomography. Urethral infection and protein C deficiency were found as associated factors. The treatment was conservative with good result. Conclusions: Anatomical factors are probably responsible for almost exclusive involvement of the left side. However, coagulation abnormalities and retroperitoneal tumors or absence of inferior vena cava must be sought especially in cases of right side or bilateral thrombosis of the pampiniform plexus. The management of pampiniform plexus thrombosis remains non surgical based on symptomatic treatment with good clinical and radiological evolution. Keywords: Thrombosis, Varicocele, Pain, Thrombophilia

The Black Star: Lived Paradoxes in the Poetry of Paul Celan

Directory of Open Access Journals (Sweden)

Dorit Lemberger

2017-12-01

Full Text Available Celan’s poetry is deemed universal and experimental, and its main characteristic is to “explore possibilities of sense-making.” His poetry is also acknowledged to be the apex of Jewish post-Holocaust poetry, contending with existentialist questions such as the existence God in the Holocaust and the possibility of restoring Jewish identity. In this paper I will examine how Celan uses paradoxes in his poetry to create atheistic and skeptical expressions. The technique of paradox expresses the concurrent existence of two contradictory possibilities; the article will present three types of paradox typical of Celan’s poetry: (1 the affirmation and denial of the existence of God; (2 the mention of rituals from Jewish tradition, while voiding them of their conventional meaning; (3 the use of German, specifically, for the reconstitution of Jewish identity. My main argument is that paradox in Celan’s work creates a unique voice of atheism and skepticism, since it preserves the ideas that it rejects as a source for fashioning meaning. In order to explore how Celan constructs paradox, I will use Wittgenstein’s resolutions of the paradoxes that emerge from the use of language, and I will show how they illuminate Celan’s use of this technique. The article will examine three Wittgensteinian methods of resolving the paradoxes that Celan employs in his oeuvre: highlighting, containing, and dissolving.

Time symmetry and the Einstein paradox

International Nuclear Information System (INIS)

Costa de Beauregard, O.

1977-01-01

The characteristic difference between the paleoquantal calculation (addition of partial probabilities) and the neoquantal one (addition of partial amplitudes) for the correlation of photon polarizations in cascade transitions is derived in terms of elementary trigonometry. This deliberate use of simple formulae aims at a transparent rendering of the change in paradigm required by the so-called EPR paradox (which is truly the 1927 Einstein paradox), namely that 1) the two photons do not possess polarizations of their own when leaving the source C, but borrow one later, when interacting with the analysers L and N; 2) the die is thus not cast at C, but later, at L and N; 3) the correlation between the measurements at L and N is tied through C, in their common past. The tight connection between this ''Einstein nonseparability'' and the nonlocality in Feynman's ''theory of positrons'' is demonstrated through an analysis of the e + e - annihilation into two photons. Thus the Einstein paradox corresponds, in the ''new wavelike probability calculus'', to the Loschmid and Zermelo sort of paradox in the old probability calculus. That is, it contrasts the intrinsic time symmetry existing at the elementary level to the factlike macroscopic time asymmetry. The discussion deliberately by-passes the hidden-variable problem, the model in this being Einstein's by-passing of the mechanical aether when proposing special relativity. It is believed today, like in 1905, the problem is tayloring the wording after the (operationally good) mathematics. Moreover, that the change in paradigm, which is needed, comes through a victory of formalism over modelism. (author)

Navigating Instructional Dialectics: Empirical Exploration of Paradox in Teaching

Science.gov (United States)

Thompson, Blair; Rudick, C. Kyle; Kerssen-Griep, Jeff; Golsan, Kathryn

2018-01-01

Navigating contradiction represents an integral part of the teaching process. While educational literature has discussed the paradoxes that teachers experience in the classroom, minimal empirical research has analyzed the strategies teachers employ to address these paradoxes. Using relational dialectics as a theoretical framework for understanding…

Mimesis, fiction, paradoxes

Directory of Open Access Journals (Sweden)

Françoise Lavocat

2010-04-01

Full Text Available Les théories contemporaines de la fiction, comme les poétiques de la Renaissance, privilégient une conception de la mimesis fondée sur la vraisemblance : la démonstration du profit cognitif et moral de la fiction passe toujours par une définition de l’imitation (de quelque façon qu’on la définisse fondée sur la rationalité. L’auteur de cet article examine tout d’abord le statut des contradictions et de l’impossible chez quelques théoriciens actuels (principalement J.-M. Schaeffer, M.-L. Ryan, L. Doležel et poéticiens du 16e siècle (L. Castelvetro et F. Patrizi. Sont ensuite étudiées la forme et la fonction que prend l’impossible dans trois fictions narratives de la Renaissance. L’hypothèse majeure qui est défendue est que ces paradoxes permettent de penser le non-existant, dans la continuité de la scolastique médiévale et en relation avec une problématique religieuse, sérieuse ou parodique. Par là même, et en raison de leur auto-référentialité constitutive, les paradoxes inscrivent dans la fiction une réflexion sur elle-même qui n’a rien d’une apologie. La pensée de la fiction s’articule en définitive de façon bien différente dans les théories et dans les fictions elles-mêmes.Like Renaissance poetics, contemporary theories of fiction do favour a conception of mimesis based on likelihood. In order to underscore the benefits of fiction, in terms of cognition or ethics, both ancient and present-day authors usually identify imitation (however this is understood as a kind of rationality. The aim of this article is to question the status of contradictions and impossibilities, first in current theories of fiction (J-M Schaeffer, M.-L. Ryan, L. Doležel, then in two sixteenth century comments of Aristotle (by L. Castelvetro and F. Patrizi. In the following steps, forms and functions of the impossible are studied in three narratives of the Renaissance. The main hypothesis here is the following: in

New physics and paradox

International Nuclear Information System (INIS)

Van der Spuy, E.

1983-01-01

Conflict between the finite and infinite in theoretical physics often results in paradox. By measuring phenomena for which such conflict exists, physicists may be able to discover in each case the basis of the conflict and thus may eventually reformulate physical laws

A Zeno-like paradox in linear interaction

International Nuclear Information System (INIS)

Weiss, J.

1998-01-01

The so-called Zeno-like paradox of infinite regressions and progressions connected by light cones, typical to particle dynamics of direct-interaction (ADD) theory, is examined for linear AAD interaction. It is shown that the paradox is resolved via convenient evaluating integral expressions which determine conserved quantities of Lorentz group to exhibit integral-free forms. As a result the formalism is also permitted to emerge the field confinement as one of substantial properties of linear interaction. (author)

Spin entanglement, decoherence and Bohm's EPR paradox

OpenAIRE

Cavalcanti, E. G.; Drummond, P. D.; Bachor, H. A.; Reid, M. D.

2007-01-01

We obtain criteria for entanglement and the EPR paradox for spin-entangled particles and analyse the effects of decoherence caused by absorption and state purity errors. For a two qubit photonic state, entanglement can occur for all transmission efficiencies. In this case, the state preparation purity must be above a threshold value. However, Bohm's spin EPR paradox can be achieved only above a critical level of loss. We calculate a required efficiency of 58%, which appears achievable with cu...

A Resolution of the Paradox of Enrichment

OpenAIRE

Feng, Z. C.; Li, Y. Charles

2011-01-01

The paradox of enrichment was observed by M. Rosenzweig in a class of predator-prey models. Two of the parameters in the models are crucial for the paradox. These two parameters are the prey's carrying capacity and prey's half-saturation for predation. Intuitively, increasing the carrying capacity due to enrichment of the prey's environment should lead to a more stable predator-prey system. Analytically, it turns out that increasing the carrying capacity always leads to an unstable predator-p...

Increased platelet count and reticulated platelets in recently symptomatic versus asymptomatic carotid artery stenosis and in cerebral microembolic signal-negative patient subgroups: results from the HaEmostasis In carotid STenosis (HEIST) study.

Science.gov (United States)

Murphy, S J X; Lim, S T; Kinsella, J A; Murphy, D; Enright, H M; McCabe, Dominick J H

2018-02-23

The pathophysiological mechanisms responsible for the disparity in stroke risk between asymptomatic and symptomatic carotid stenosis patients are not fully understood. The functionally important reticulated platelet fraction and reticulocytes could play a role. We performed a prospective, multi-centre, observational analytical study comparing full blood count parameters and platelet production/turnover/activation markers in patients with asymptomatic versus recently symptomatic moderate (≥ 50-69%) or severe (≥ 70-99%) carotid stenosis. Data from 34 asymptomatic patients were compared with 43 symptomatic patients in the 'early phase' (≤ 4 weeks) and 37 of these patients in the 'late phase' (≥ 3 months) after TIA/ischaemic stroke. Reticulated platelets were quantified by whole blood flow cytometry and reticulated platelets and red cell reticulocytes by 'automated assays' (Sysmex XE-2100™). Bilateral simultaneous transcranial Doppler ultrasound monitoring classified patients as micro-embolic signal (MES)+ve or MES-ve. Mean platelet count was higher in early (216 × 10 9 /L; P = 0.04) and late symptomatic (219 × 10 9 /L; P = 0.044) than asymptomatic patients (194 × 10 9 /L). Mean platelet volume was higher in early symptomatic than asymptomatic patients (10.8 vs. 10.45 fl; P = 0.045). Automated assays revealed higher % reticulated platelet fractions in early (5.78%; P < 0.001) and late symptomatic (5.11%; P = 0.01) than asymptomatic patients (3.48%). Red cell reticulocyte counts were lower in early (0.92%; P = 0.035) and late symptomatic (0.93%; P = 0.036) than asymptomatic patients (1.07%). The automated % reticulated platelet fraction was also higher in early symptomatic than asymptomatic MES-ve patients (5.7 vs. 3.55%; P = 0.001). The combination of increased platelet counts and a shift towards production of an increased population of larger, young, reticulated platelets could contribute to a higher risk of first or recurrent

Does highly symptomatic class membership in the acute phase predict highly symptomatic classification in victims 6 months after traumatic exposure?

Science.gov (United States)

Hansen, Maj; Hyland, Philip; Armour, Cherie

2016-05-01

Recently studies have indicated the existence of both posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) subtypes but no studies have investigated their mutual association. Although ASD may not be a precursor of PTSD per se, there are potential benefits associated with early identification of victims at risk of developing PTSD subtypes. The present study investigates ASD and PTSD subtypes using latent class analysis (LCA) following bank robbery (N=371). Moreover, we assessed if highly symptomatic ASD and selected risk factors increased the probability of highly symptomatic PTSD. The results of LCA revealed a three class solution for ASD and a two class solution for PTSD. Negative cognitions about self (OR=1.08), neuroticism (OR=1.09) and membership of the 'High symptomatic ASD' class (OR=20.41) significantly increased the probability of 'symptomatic PTSD' class membership. Future studies are needed to investigate the existence of ASD and PTSD subtypes and their mutual relationship. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bilateral acute retinal necrosis associated with bilateral uveal effusion in an immunocompetent patient: A challenging association

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S Bala Murugan

2018-01-01

Full Text Available Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes.

Women's understanding of the "Nice guy paradox": a phenomenological study

OpenAIRE

2010-01-01

M.A. The Nice Guy Paradox is a provocative perception that is commonly expressed within society and the mass media. According to this perception, nice guys are less successful in their relationships with women than other men. The Nice Guy Paradox causes much frustration and confusion for self-proclaimed nice guys. In addition, the implications of this perception may negatively influence the way in which men relate to women. For instance, the Nice Guy Paradox implies that if men want to be ...

The Banach-Tarski paradox

CERN Document Server

Wagon, Stan

1985-01-01

The Banach-Tarski paradox is a most striking mathematical construction: it asserts that a solid ball may be taken apart into finitely many pieces that can be rearranged using rigid motions to form a ball twice as large as the original. This volume explore

38 CFR 4.26 - Bilateral factor.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Bilateral factor. 4.26... DISABILITIES General Policy in Rating § 4.26 Bilateral factor. When a partial disability results from disease... disability. The bilateral factor will be applied to such bilateral disabilities before other combinations are...

Separating models, ideas, and data to avoid a paradox : Rejoinder to Humphry

NARCIS (Netherlands)

Sijtsma, K.; Emons, W.H.M.

2013-01-01

This article is a rejoinder to Humphry’s (2013) comment on Sijtsma (2012). Sijtsma argued that the Rasch paradox does not exist but Humphry replies that the Rasch paradox can occur provided the measurement procedure is precise enough. The rejoinder argues that the debates about the Rasch paradox

Evaluation of Paradoxical Septal Motion Following Cardiac Surgery with Gated Cardiac Blood Pool Scan

International Nuclear Information System (INIS)

Shin, Seong Hae; Chung, June Key; Lee, Myung Chul; Cho, Bo Youn; Koh, Chang Soon; Suh, Kyung Phil

1985-01-01

The development of paradoxical interventricular septal motion is a common consequence of cardiopulmonary bypass operation. The reason for this postoperative abnormal septal motion is not clear. 41 patients were studied preoperatively and postoperatively with radionuclide blood pool scan to evaluate the frequency of development of paradoxical septal motion with right ventricular volume overload before surgery and the frequency of development of paradoxical septal motion after cardiac surgery with cardiopulmonary bypass, and to evaluate the change of EF related to the development of paradoxical septal motion after cardiac surgery. The results were as follows; 1) 7 of 41 patients with right ventricular volume overload (that is 17%) showed paradoxical septal motion before surgery. But 13 of 34 patients (that is 42%) had paradoxical septal motion after cardiac surgery with cardiopulmonary bypass. So open heart surgery with cardiopulmonary bypass related the development of paradoxical septal motion after surgery. 2) EF significantly decreased in patients who developed paradoxical septal motion after surgery, whereas the EF did not change in the patients who retained normal interventricular septal motion after surgery. So paradoxical septal motion usually reflected some diminution of left ventricular function, immediately after cardiac surgery.

Evaluation of Paradoxical Septal Motion Following Cardiac Surgery with Gated Cardiac Blood Pool Scan

Energy Technology Data Exchange (ETDEWEB)

Shin, Seong Hae; Chung, June Key; Lee, Myung Chul; Cho, Bo Youn; Koh, Chang Soon; Suh, Kyung Phil [Seoul National University College of Medicine, Seoul (Korea, Republic of)

1985-03-15

The development of paradoxical interventricular septal motion is a common consequence of cardiopulmonary bypass operation. The reason for this postoperative abnormal septal motion is not clear. 41 patients were studied preoperatively and postoperatively with radionuclide blood pool scan to evaluate the frequency of development of paradoxical septal motion with right ventricular volume overload before surgery and the frequency of development of paradoxical septal motion after cardiac surgery with cardiopulmonary bypass, and to evaluate the change of EF related to the development of paradoxical septal motion after cardiac surgery. The results were as follows; 1) 7 of 41 patients with right ventricular volume overload (that is 17%) showed paradoxical septal motion before surgery. But 13 of 34 patients (that is 42%) had paradoxical septal motion after cardiac surgery with cardiopulmonary bypass. So open heart surgery with cardiopulmonary bypass related the development of paradoxical septal motion after surgery. 2) EF significantly decreased in patients who developed paradoxical septal motion after surgery, whereas the EF did not change in the patients who retained normal interventricular septal motion after surgery. So paradoxical septal motion usually reflected some diminution of left ventricular function, immediately after cardiac surgery.

Diagnosis and management with botulinum toxin in 11 cases of laryngeal synkinesis.

Science.gov (United States)

Lekue, Asier; García-López, Isabel; Santiago, Susana; Del Palacio, Antonio; Gavilán, Javier

2015-09-01

Laryngeal synkinesis is a vocal fold movement disorder produced by a misdirected reinnervation after a recurrent laryngeal nerve injury. Its symptoms differ greatly between patients, requiring diverse therapeutical approaches. We aim to describe our experience in the diagnosis and treatment of different laryngeal synkinesis presentations. 11 patients diagnosed between 2011 and 2014 in a tertiary referral center with laryngeal synkinesis confirmed by laryngeal electromyography were included in our study. All medical records and laryngoscopic and electromyographic data were reviewed retrospectively. Four patients had previous unilateral vocal fold palsy and seven had a bilateral palsy with different degrees of clinical involvement. All of them showed paradoxical movements during inhalation in videofibrolaryngoscopic examination. Laryngeal electromyography confirmed the diagnosis of laryngeal synkinesis. Dyspnea was the main presentation symptom. Three patients with mild symptoms were not treated. Patients with unilateral vocal fold immobility were successfully treated with periodic botulinum toxin injections. Patients with bilateral immobility had a good initial response to botulinum toxin, although in some of them, a posterior cordectomy had to be finally performed. In conclusion, laryngeal synkinesis is a heterogeneous clinic entity that appears in patients with unilateral or bilateral vocal fold paralysis. Videofibrolaryngoscopy and laryngeal electromyography are essential to a correct diagnosis. Botulinum toxin injections are the main treatment for symptomatic cases, even if in bilateral palsy cases more aggressive treatments are often required.

Disability reconsidered: the paradox of physical therapy.

Science.gov (United States)

Roush, Susan E; Sharby, Nancy

2011-12-01

The purposes of this perspective article are: (1) to explore models of disability from the perspective of the academic discipline of disability studies (DS), (2) to consider the paradox of improving functional capacities while valuing disability as diversity, (3) to identify how physical therapy's use of the International Classification of Functioning, Disability and Health (ICF) disablement model intersects with various disability models, and (4) to apply this broader understanding of disability to physical therapist practice, education, and research. The DS literature has been critical of rehabilitation professionals, particularly targeting the medical model of disability. In contrast, advocates for a social model of disability recognize disability as diversity. It is paradoxical for physical therapy to simultaneously work to ameliorate disability while celebrating it as diversity. The ICF biopsychosocial disablement model offers a mechanism to practice within this paradox and suggests that it is no longer sufficient to conceptualize disability as a purely individual matter that requires attention in isolation from the impact of the larger society.

Identifying Quantum Structures in the Ellsberg Paradox

Science.gov (United States)

Aerts, Diederik; Sozzo, Sandro; Tapia, Jocelyn

2014-10-01

Empirical evidence has confirmed that quantum effects occur frequently also outside the microscopic domain, while quantum structures satisfactorily model various situations in several areas of science, including biological, cognitive and social processes. In this paper, we elaborate a quantum mechanical model which faithfully describes the Ellsberg paradox in economics, showing that the mathematical formalism of quantum mechanics is capable to represent the ambiguity present in this kind of situations, because of the presence of contextuality. Then, we analyze the data collected in a concrete experiment we performed on the Ellsberg paradox and work out a complete representation of them in complex Hilbert space. We prove that the presence of quantum structure is genuine, that is, interference and superposition in a complex Hilbert space are really necessary to describe the conceptual situation presented by Ellsberg. Moreover, our approach sheds light on `ambiguity laden' decision processes in economics and decision theory, and allows to deal with different Ellsberg-type generalizations, e.g., the Machina paradox.

The Amazon's energetic paradox

International Nuclear Information System (INIS)

Silva, Marcos Vinicius Miranda da; Bermann, Celio

1999-01-01

The main energy sources in Amazon region are hydroelectric, biomass, and natural gas. Although abundance of these resources, the energy consumption in this region is one of the most low of Brazil. The article overviews this paradox. In this context, economical, geopolitical, and technical aspects are presented

Reinterpretaion of the friendship paradox

Science.gov (United States)

Fu, Jingcheng; Wu, Jianliang

The friendship paradox (FP) is a sociological phenomenon stating that most people have fewer friends than their friends do. It is to say that in a social network, the number of friends that most individuals have is smaller than the average number of friends of friends. This has been verified by Feld. We call this interpreting method mean value version. But is it the best choice to portray the paradox? In this paper, we propose a probability method to reinterpret this paradox, and we illustrate that the explanation using our method is more persuasive. An individual satisfies the FP if his (her) randomly chosen friend has more friends than him (her) with probability not less than 1/2. Comparing the ratios of nodes satisfying the FP in networks, rp, we can see that the probability version is stronger than the mean value version in real networks both online and offline. We also show some results about the effects of several parameters on rp in random network models. Most importantly, rp is a quadratic polynomial of the power law exponent γ in Price model, and rp is higher when the average clustering coefficient is between 0.4 and 0.5 in Petter-Beom (PB) model. The introduction of the probability method to FP can shed light on understanding the network structure in complex networks especially in social networks.

The Paradox of Openness

DEFF Research Database (Denmark)

Laursen, Keld; Salter, Ammon

2014-01-01

To innovate, firms often need to draw from, and collaborate with, a large number of actors from outside their organization. At the same time, firms need also to be focused on capturing the returns from their innovative ideas. This gives rise to a paradox of openness—the creation of innovations of...... or collaborate with competitors. We explore the implications of these findings for the literature on open innovation and innovation strategy.......To innovate, firms often need to draw from, and collaborate with, a large number of actors from outside their organization. At the same time, firms need also to be focused on capturing the returns from their innovative ideas. This gives rise to a paradox of openness—the creation of innovations...... often requires openness, but the commercialization of innovations requires protection. Based on econometric analysis of data from a UK innovation survey, we find a concave relationship between firms’ breadth of external search and formal collaboration for innovation, and the strength of the firms...

Pregnancy following bilateral salpingectomy

DEFF Research Database (Denmark)

Oturai, Annette Bang

2008-01-01

This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy...... was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy Udgivelsesdato: 2008/4/21...

Bernstein's paradox of entangled quantum states

International Nuclear Information System (INIS)

Belinsky, A V; Chirkin, A S

2013-01-01

Bernstein's classical paradox of a regular colored-faced tetrahedron, while designed to illustrate the subtleties of probability theory, is strongly flawed in being asymmetric. Faces of tetrahedron are nonequivalent: three of them are single-colored, and one is many-colored. Therefore, even prior to formal calculations, a strong suspicion as to the independence of the color resulting statistics arises. Not so with entangled quantum states. In the schematic solutions proposed, while photon detection channels are completely symmetric and equivalent, the events that occur in them turn out to be statistically dependent, making the Bernstein paradox even more impressive due to the unusual behavior of quantum particles not obeying classical laws. As an illustrative example of the probability paradox, Greenberger–Horne–Zeilinger multiqubit states are considered. (methodological notes)

Where Was Everybody? Olaf Stapledon and the Fermi Paradox

Science.gov (United States)

Baxter, S.

In 1948 Olaf Stapledon gave an address to the BIS in which he summarised his vision of mankind's cosmic future: `One can imagine some sort of cosmical community of worlds ...' One might ask, however, since the universe is vastly older than mankind, why races on other worlds have not already built such a community. This is a `Fermi Paradox' question. The Paradox is based on the observation that there has been time for extraterrestrial intelligence to arise and colonise the Galaxy many times over, yet we see no sign of such endeavours. In this paper Stapledon's novels are retrospectively analysed from the point of view of the Fermi Paradox. In Last and First Men (1930) humanity is forever isolated because life and mind are rare in the Galaxy, and interstellar distances are too large ever to be traversed. These are classic candidate Fermi `solutions'. The `solution' implicit in Star Maker (1937) might be criticised in that it posits that humanity lives at a special epoch, with the cosmically transforming development of interstellar travel occurring a `mere' ten billion years after mankind, in a universe supposedly ~200bn years old. Stapledon died in 1950, the year the Paradox was formulated, and was probably unaware of the Paradox. However to apply retrospectively Fermi thinking to Stapledon's cosmologies is to gain a new insight into the author's philosophy.

Quantum Bayesian networks with application to games displaying Parrondo's paradox

Science.gov (United States)

Pejic, Michael

Bayesian networks and their accompanying graphical models are widely used for prediction and analysis across many disciplines. We will reformulate these in terms of linear maps. This reformulation will suggest a natural extension, which we will show is equivalent to standard textbook quantum mechanics. Therefore, this extension will be termed quantum. However, the term quantum should not be taken to imply this extension is necessarily only of utility in situations traditionally thought of as in the domain of quantum mechanics. In principle, it may be employed in any modelling situation, say forecasting the weather or the stock market---it is up to experiment to determine if this extension is useful in practice. Even restricting to the domain of quantum mechanics, with this new formulation the advantages of Bayesian networks can be maintained for models incorporating quantum and mixed classical-quantum behavior. The use of these will be illustrated by various basic examples. Parrondo's paradox refers to the situation where two, multi-round games with a fixed winning criteria, both with probability greater than one-half for one player to win, are combined. Using a possibly biased coin to determine the rule to employ for each round, paradoxically, the previously losing player now wins the combined game with probabilitygreater than one-half. Using the extended Bayesian networks, we will formulate and analyze classical observed, classical hidden, and quantum versions of a game that displays this paradox, finding bounds for the discrepancy from naive expectations for the occurrence of the paradox. A quantum paradox inspired by Parrondo's paradox will also be analyzed. We will prove a bound for the discrepancy from naive expectations for this paradox as well. Games involving quantum walks that achieve this bound will be presented.

Symptomatic relapse of HIV-associated cryptococcal meningitis in ...

African Journals Online (AJOL)

Objectives. Cryptococcal meningitis is the most common cause of adult meningitis in southern Africa. Much of this disease burden is thought to be due to symptomatic relapse of previously treated infection. We studied the contribution of inadequate secondary fluconazole prophylaxis to symptomatic relapses of cryptococcal ...

Galileo's kinematical paradox and the role of resistive forces

International Nuclear Information System (INIS)

Aguiar, C E; Soares, V; Tort, A C

2014-01-01

We discuss Galileo's kinematical ‘paradox’ taking into account the effects of sliding friction and of resistive forces proportional to velocity. We show that sliding friction eliminates the paradox but still allows for very simple synchronous curves. Perhaps surprisingly, Galileo's paradox is preserved when the resistive force is proportional to velocity. (paper)

Bilateral Arterial Embolization of the Prostate Through a Single Prostatic Artery: A Case Series

Energy Technology Data Exchange (ETDEWEB)

Amouyal, Gregory, E-mail: gregamouyal@hotmail.com; Pellerin, Olivier, E-mail: olivier.pellerin@aphp.fr; Giudice, Costantino Del, E-mail: costantino.delgiudice@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France); Déan, Carole, E-mail: carole.dean@aphp.fr [Assistance Publique - Hôpitaux de Paris, Interventional Radiology Department, Hôpital Européen Georges Pompidou (France); Thiounn, Nicolas, E-mail: nicolas.thiounn@aphp.fr; Sapoval, Marc, E-mail: marc.sapoval2@aphp.fr [Université Paris Descartes - Sorbonne - Paris - Cité, Faculté de Médecine (France)

2017-05-15

Peri-prostatic shunts are frequent during PAE, carrying the risk of non-target embolization of penis/corpus cavernosum or rectum but also the potential advantage to irrigate the contralateral lobe. Sometimes, bilateral embolization is impossible, carrying the risk of limited clinical success. The possibility to reach contralateral prostatic territory from the ipsilateral prostatic artery (PA) and embolize it via peri/intra-prostatic anastomoses could be of interest in this situation. We describe a series of three consecutive patients (among 89 consecutive patients treated by PAE for symptomatic BPH) who underwent successful embolization of both prostatic lobes through catheterization of a PA on only one side. All patients had clinical success after a mean follow-up of 3.3 months. Dosimetry of these three procedures indicates that there may be radiation dose savings.

Bilateral persistent hyperplastic primary vitreous

Directory of Open Access Journals (Sweden)

Jain Tarun

2009-01-01

Full Text Available A case of bilateral persistent hyperplastic primary vitreous (PHPV in a 3-month-old male infant, who had bilateral leukokoria, is presented. The child was referred for imaging with a clinical suspicion of retinoblastoma. Gray-scale ultrasound evaluation revealed an echogenic band in the posterior segment of both globes, extending from the posterior surface of the lens capsule to the optic disc. Doppler examination revealed the presence of arterial flow in the band in both globes. Associated echogenic hemorrhage was also seen, which was confirmed by computed tomography. Most cases of PHPV are sporadic and unilateral, and bilateral PHPV is rare. The imaging features in this case suggest the diagnosis of bilateral PHPV and differentiate it from retinoblastoma. This entity, although infrequent, should be considered in the differential diagnosis while evaluating bilateral leukokoria.

Energy flow in a bound electromagnetic field: resolution of apparent paradoxes

International Nuclear Information System (INIS)

Kholmetskii, A L; Yarman, T

2008-01-01

In this paper, we present a resolution of apparent paradoxes formulated in (Kholmetskii A L 2006 Apparent paradoxes in classical electrodynamics: the energy-momentum conservation law for a bound electromagnetic field Eur. J. Phys. 27 825-38; Kholmetskii A L and Yarman T 2008 Apparent paradoxes in classical electrodynamics: a fluid medium in an electromagnetic field Eur. J. Phys. 29 1127) and dealing with the energy flux in a bound electromagnetic field

Consistent resolution of some relativistic quantum paradoxes

International Nuclear Information System (INIS)

Griffiths, Robert B.

2002-01-01

A relativistic version of the (consistent or decoherent) histories approach to quantum theory is developed on the basis of earlier work by Hartle, and used to discuss relativistic forms of the paradoxes of spherical wave packet collapse, Bohm's formulation of the Einstein-Podolsky-Rosen paradox, and Hardy's paradox. It is argued that wave function collapse is not needed for introducing probabilities into relativistic quantum mechanics, and in any case should never be thought of as a physical process. Alternative approaches to stochastic time dependence can be used to construct a physical picture of the measurement process that is less misleading than collapse models. In particular, one can employ a coarse-grained but fully quantum-mechanical description in which particles move along trajectories, with behavior under Lorentz transformations the same as in classical relativistic physics, and detectors are triggered by particles reaching them along such trajectories. States entangled between spacelike separate regions are also legitimate quantum descriptions, and can be consistently handled by the formalism presented here. The paradoxes in question arise because of using modes of reasoning which, while correct for classical physics, are inconsistent with the mathematical structure of quantum theory, and are resolved (or tamed) by using a proper quantum analysis. In particular, there is no need to invoke, nor any evidence for, mysterious long-range superluminal influences, and thus no incompatibility, at least from this source, between relativity theory and quantum mechanics

A new explanation of the extinction paradox

International Nuclear Information System (INIS)

Berg, M.J.; Sorensen, C.M.; Chakrabarti, A.

2011-01-01

This work presents a new explanation for the extinction paradox and shows that the canonical explanations are incorrect. This paradox refers to the large size limit of a particle's extinction cross section. It is called a paradox because the geometrical optics approximation, which should be valid in this limit, predicts a cross section that is half of the true value. The new explanation is achieved by formulating the scattered wave in terms of an integral over the particle's surface where the seemingly unrelated Ewald-Oseen theorem appears in the formulation. By expressing the cross section in terms of this surface integral, the Ewald-Oseen theorem is analytically connected to the cross section. Several illustrations are used to reveal the significance of this connection: The paradox is seen to be a consequence of the requirement that the incident wave be canceled within the particle by secondary radiation from its own internal field. Following this, the canonical explanations are examined to reveal serious problems. In the process, the same asymptotic extinction behavior is shown to occur for small highly refractive dielectric particles, and thus is not just a large particle size or small wavelength effect as is often stated. The traditional explanations cannot account for this behavior while the new one actually predicts it. All in all, this work constitutes a fundamental reworking of 60 years of accepted understanding for the cause of the asymptotic behavior of the extinction cross section.

Design principles of paradoxical signaling in the immune system

Science.gov (United States)

Hart, Yuval

A widespread feature of cell-cell signaling systems is paradoxical pleiotropy: the same secreted signaling molecule can induce opposite effects in the responding cells. For example, the cytokine IL-2 can promote proliferation and death of T-cells. The role of such paradoxical signaling remains unclear. We suggest that this mechanism provides homeostatic concentration of cells, independent of initial conditions. The crux of the paradoxical mechanism is the combination of a positive and a negative feedback loops creating two stable states - an OFF state and an ON state. Experimentally, we found that CD4 + cells grown in culture with a 30-fold difference in initial concentrations reached a homeostatic concentration nearly independent of initial cell levels (ON-state). Below an initial threshold, cell density decayed to extinction (OFF-state). Mathematical modeling explained the observed cell and cytokine dynamics and predicted conditions that shifted cell fate from homeostasis to the OFF-state. We suggest that paradoxical signaling provides cell circuits with specific dynamical features that are robust to environmental perturbations.

The green paradox of the economics of exhaustible resources

International Nuclear Information System (INIS)

Cairns, Robert D.

2014-01-01

The green paradox states that an increasing tax on emissions of carbon dioxide, consonant with the expected increase in their marginal damages, may induce oil producers to shift their production toward the present and thereby to exacerbate the problem of climatic change. The model is based on Hotelling models of resource use that do not take the natural and technical features of oil production into account. Natural features include the decline of production through time according to a decline curve. Technical features include the requirement to sink investment in productive capacity. A model of a profit-maximizing firm indicates that, if these features are taken into account, the prediction of the green paradox is unlikely. - Highlights: • The green paradox is a direct application of Hotelling′s rule from the economics of exhaustible resources. • Hotelling′s analysis was a profound contribution to economic thought but evidence for it is weak. • Hotelling-style analysis assumes incorrectly that production can be rearranged at will among time periods. • Technological and geological features of oil production make the prediction of the green paradox unlikely

Idiopathic bilateral male breast abscess.

Science.gov (United States)

Sinha, Rajan Kumar; Sinha, Mithilesh Kumar; Gaurav, Kumar; Kumar, Amar

2014-03-10

A 38-year-old man presented with bilateral breast swelling, along with pain and redness for 7 days. Bilateral axillary nodes were also palpable; which were multiple and discrete. A provisional diagnosis of bilateral breast abscess was made with suspicion of underlying malignancy. Incision and drainage through subareolar incision was performed and the adjoining tissue was excised and sent for histopathological examination.

Traversing boundaries: thrombus in transit with paradoxical embolism

Directory of Open Access Journals (Sweden)

Varun Miriyala

2016-09-01

Full Text Available A 72-year-old male is diagnosed with paradoxical embolus after he presented with concurrent deep vein thrombosis, stroke, and multiple arterial emboli in the presence of a patent foramen ovale (PFO. Paradoxical embolus requires the passage of a thrombus from the venous into the arterial circulation through a right-to-left shunt leading to systemic embolism. But, despite the high incidence of PFO (27.3% across all age groups by autopsy, paradoxical embolism (PDE is uncommon, representing <2% of all arterial emboli. We present a case report where a thrombus has been directly observed passing through the PFO during an echocardiogram study; thus, clearly delineating the true cause of multiple thromboemboli and stoke in our patient. Subsequent Transesophageal Echocardiography (TEE also interestingly showed the thrombus in transit in the aorta and pulmonary artery.

Athletic participation in children with symptomatic spondylolysis in the New York area.

Science.gov (United States)

Ladenhauf, Hannah N; Fabricant, Peter D; Grossman, Eric; Widmann, Roger F; Green, Daniel W

2013-10-01

The purpose of this study was to assess athletic activities associated with spondylolysis in children and adolescents in a New York metropolitan tertiary referral center. We retrospectively evaluated 137 consecutive cases of symptomatic spondylolysis presenting to one of two pediatric orthopedic spine surgeons. Ten patients who did not participate in any organized athletics were excluded, leaving 127 children for analysis. Data regarding spondylolysis and athletic participation were gathered for analysis. One hundred and twenty-seven patients were analyzed (mean age, 13.9 ± 2.2 yr). All patients had initial x-rays, with nearly all obtaining further advanced level imaging to confirm the diagnosis of spondylolysis. Magnetic resonance imaging was obtained in 42.5% of cases, limited computed tomography scan in 29.1% of cases, and single-photon emission computed tomography scan in 23.6% of cases. The most common location of spondylolysis was at the L5 level (74%), of which 43.6% were bilateral. Of the overall cohort, 2.4% had spondylolysis at multiple levels. The most common athletic activities associated with spondylolysis in this cohort were soccer (19.3%), basketball (17.2%), and lacrosse (9.4%). Although previous reports have implicated participation in various sports in the development of symptomatic spondylolysis in children, lacrosse and baseball have rarely been associated with spondylolysis. We found that in the New York metropolitan area, soccer, basketball, lacrosse, baseball, tennis, and football were most commonly associated with spondylolysis. Therefore, we emphasize consideration of spondylolysis in these children if they present with low back pain. These results may be used to counsel parents and young athletes about the possibility of spondylolysis as an etiology of lumbar back pain and in educating coaches, teachers, school nurses, and primary care providers.

Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

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Satoru Kodama

2012-01-01

Full Text Available Inverted papilloma (IP is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM. The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS should be selected, and ESS, including EMM, is a good first choice of the treatment for IP.

Bilateral Endoscopic Medial Maxillectomy for Bilateral Inverted Papilloma

Science.gov (United States)

Kodama, Satoru; Kawano, Toshiaki; Suzuki, Masashi

2012-01-01

Inverted papilloma (IP) is a benign tumor of the nasal cavity and paranasal sinuses that is unilateral in most cases. Bilateral IP, involving both sides of the nasal cavity and sinuses, is extremely rare. This paper describes a large IP that filled in both sides of the nasal cavity and sinuses, mimicking association with malignancy. The tumor was successfully treated by bilateral endoscopic medial maxillectomy (EMM). The patient is without evidence of the disease 24 months after surgery. If preoperative diagnosis does not confirm the association with malignancy in IP, endoscopic sinus surgery (ESS) should be selected, and ESS, including EMM, is a good first choice of the treatment for IP. PMID:22953103

Mechanical paradox: the uphill roller

International Nuclear Information System (INIS)

Cortes, Emilio; Cortes-Poza, D

2011-01-01

We analyse in detail the dynamics of a mechanical system which is a rigid body with the geometry of a double cone. This double cone is apparently able to spontaneously roll uphill along inclined rails. The experiment has been known for some centuries, and because of its peculiar behaviour, it has been named 'mechanical paradox'. Although this instrument is well known today, we have not found in the literature a dynamical study like the one we are presenting. A deeper analysis of this mechanical object will allow us to go further than explaining the apparent paradox in the system; it will show interesting features of the dynamics that are not evident or intuitive. In this work, we follow a complete study of the geometry, the kinematic variables and the Lagrangian dynamics of the problem for any set of the angular parameters and initial values, and obtain as a result a full description of the dynamic variables of this mechanical device. In addition to studying the dynamics of the system with the angles that yield the typical paradoxical behaviour, we study carefully what we call the constant potential geometry regime, where the centre of mass maintains its height, and found in this particular case some features of the dynamics which are not common in rolling objects. We believe that this work can offer the student good material to review some fundamental concepts of analytical mechanics.

Computerized videokeratoscopy contact lens software for RGP fitting in a bilateral postkeratoplasty patient: a clinical case report.

Science.gov (United States)

Szczotka, L B; Reinhart, W

1995-01-01

Computerized videokeratoscopy systems now allow interactive rigid gas permeable (RGP) fitting evaluation using fluorescein pattern simulations through updated software programs. We used Computed Anatomy's Topographic Modeling System-1 (TMS-1) Custom Design Contact Lens Program successfully to refit a symptomatic bilateral post-penetrating keratoplasty patient. No trial lenses were used. For each eye the base curve, optic zone size, and edge lift were chosen from the optimal fluorescein pattern designed and titrated on the TMS-1 unit. Lens powers were based on the patient's previous lenses and overrefraction. Dispensed lenses provided a clinically acceptable fit, good comfort, and maximal visual acuity, and no adjustments were necessary. Corneal videokeratoscopy can be successfully employed to titrate an RGP fit, even on irregular corneas.

The eight paradoxes of nuclear information

International Nuclear Information System (INIS)

Timbal-Duclaux, Louis

1977-01-01

As it now develops, the nuclear debate is essentially characterized by its technical, mythical and polemical fields. Due to the interrelation between these three characteristics, paradox tends to multiply, either on the requesters for information side or from those who answer it. As many problems the people or organizations, such as E.D.F. for example, have to cope with as there are parties in this debate. These different paradoxes are analyzed together with some means which permits a suitable answer to be found. To conclude it is noted that if the nuclear fear is mostly imaginary passional, irrational, the problem is not to ignore these characteristics but to 'give them a statute' [fr

A Paraconsistentist Approach to Chisholm's Paradox

Directory of Open Access Journals (Sweden)

Marcelo Esteban Coniglio

2009-12-01

Full Text Available The Logics of Deontic (InConsistency (LDI’s can be considered as the deontic counterpart of the paraconsistent logics known as Logics of Formal (InConsistency. This paper introduces and studies new LDI’s and other paraconsistent deontic logics with different properties: systems tolerant to contradictory obligations; systems in which contradictory obligations trivialize; and a bimodal paraconsistent deontic logic combining the features of previous systems. These logics are used to analyze the well-known Chisholm’s paradox, taking profit of the fact that, besides contradictory obligations do not trivialize in LDI’s, several logical dependencies of classical logic are blocked in the context of LDI’s, allowing to dissolve the paradox.

Fermi's paradox: The last challenge for copernicanism?

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Ćirković M.M.

2009-01-01

Full Text Available We review Fermi's paradox (or the 'Great Silence' problem, not only arguably the oldest and crucial problem for the Search for ExtraTerrestrial Intelligence (SETI, but also a conundrum of profound scientific, philosophical and cultural importance. By a simple analysis of observation selection effects, the correct resolution of Fermi's paradox is certain to tell us something about the future of humanity. Already more than three quarters of century old puzzle and a quarter of century since the last major review paper in the field by G. David Brin has generated many ingenious discussions and hypotheses. We analyze the often tacit methodological assumptions built in various answers to this puzzle and attempt a new classification of the numerous solutions proposed in an already huge literature on the subject. Finally, we consider the ramifications of various classes of hypotheses for the practical SETI projects. Somewhat paradoxically, it seems that the class of (neocatastrophic hypotheses gives, on the balance, the strongest justification to optimism regarding our current and near-future SETI efforts.

Vegetarian diet as a risk factor for symptomatic gallstone disease.

Science.gov (United States)

McConnell, T J; Appleby, P N; Key, T J

2017-06-01

Previous small studies have shown either no difference or a lower risk of symptomatic gallstone disease in vegetarians than in non-vegetarians. This study examined the incidence of symptomatic gallstone disease in a cohort of British vegetarians and non-vegetarians, and investigated the associations between nutrient intake and risk of symptomatic gallstone disease. The data were analysed from 49 652 adults enroled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, one-third of whom were vegetarian. The linked databases of hospital records were used to identify incident cases. Risk by diet group was estimated using Cox proportional hazards models. Further analysis quantified risk by intakes of selected macronutrients. There were 1182 cases of symptomatic gallstone disease during 687 822 person-years of follow-up (mean=13.85 years). There was a large significant association between increasing body mass index (BMI) and risk of developing symptomatic gallstone disease (overall trend Pvegetarians had a moderately increased risk compared with non-vegetarians (HR: 1.22; 95% CI: 1.06-1.41; P=0.006). Although starch consumption was positively associated with gallstones risk (P=0.002 for trend), it did not explain the increased risk in vegetarians. There is a highly significant association of increased BMI with risk of symptomatic gallstone disease. After adjusting for BMI, there is a small but statistically significant positive association between vegetarian diet and symptomatic gallstone disease.

Laying the ghost of twin paradox

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Popović Marko

2009-01-01

Full Text Available Someone's true age is not written in his ID, but in his biomarkers. Aging process is not caused by time passing, but by thermodynamically laws. Entropy, extent of metabolic reaction, and temperature are Lorentz invariant, so these facts make twin paradox impossible because there is no way for one twin to age slower than the other even if the time in his frame is dilated. Entropy is the function of state, not time. So as much as standard thermodynamics concerns, the path between two points in space is equivalent to the path between two states. Whether the point B is reached by moving faster using the longer way (with time dilatation, or slower by using shortcut (without time dilatation, the state of the system after completing the road should be the same. This is supported by the fact that when two twins reach the same space-time point (point B in which the state parameters are the same. If we use entropy as an age parameter, then both twins have the same entropy value and are exactly the same biological age. Therefore, the twin paradox is a logical mistake based on wrong first premise. Bergson symmetry is not necessary any more to explain the impossibility of twin paradox.

Dovetailing talent management and diversity management: The exclusion-inclusion paradox

NARCIS (Netherlands)

Daubner, D.; Vinkenburg, C.J.; Jansen, Paul

2017-01-01

Purpose The purpose of this paper is to adopt a paradox lens for dovetailing the human resource management sub-domains of talent management (TM) and diversity management (DM), in the attempt to create closer alignment between the two. Design/methodology/approach The authors review paradox theory, TM

The Neutrosophic Logic View to Schrodinger's Cat Paradox, Revisited

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Florentin Smarandache

2008-07-01

Full Text Available The present article discusses Neutrosophic logic view to Schrodinger's cat paradox. We argue that this paradox involves some degree of indeterminacy (unknown which Neutrosophic logic can take into consideration, whereas other methods including Fuzzy logic cannot. To make this proposition clear, we revisit our previous paper by offering an illustration using modified coin tossing problem, known as Parrondo's game.

Paradoxes in virtual team knowledge communication and trust building

DEFF Research Database (Denmark)

Petersen, Nils Braad

2012-01-01

This thesis proposal presents paradoxes within current trust and knowledge management literatures as a lens for understanding challenges in virtual teams working across organisational and geographic boundaries. By exposing contradictions within current virtual team research, the author proposes...... a need for a different, multi-level, multi-theoretical approach to virtual team research in order to overcome the paradoxes. A moderate constructionist research position building on Critical Realism is proposed. To situate the project within current literatures, trust, knowledge management and virtual...... team literatures are reviewed. These are used to support the paradoxes used as a lens for understanding. A research design is presented building on interviews, documentary analysis and observations analysed using Social Network Analysis and James Gee’s framework for discourse analysis. Finally...

The Colombian Left: A Paradoxical Past; A Promising Future?

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Charles Bergquist

2017-07-01

Full Text Available The essay explores the paradoxical history of the left in Colombia: how and why one of the weakest lefts in Latin America brought about the strongest and most lasting Marxist insurrection in the hemisphere in the decades following the Cuban Revolution. The article argues that the terms of this paradox are related, that the historic weakness of the left partly explains the force and longevity of revolutionary guerrillas, and that said paradox helps clarify not only the failure of several attempts to achieve a negotiated settlement of the armed conflict, but also the negative vote in the October 2016 plebiscite. Finally, it envisions a more promising future for the country’s left, provided that a lasting peace is consolidated.

The klein paradox as a many particle problem

International Nuclear Information System (INIS)

Bongaarts, P.J.M.; Ruijsenaars, S.N.M.

1976-01-01

A mathematically rigorous analysis of the Klein paradox is given in the many-particle formulation of the Dirac theory. This paradox was meant as an example demonstrating the negative energy problems of the single particle Dirac equation. However, it is shown that this problem does not disappear in the second quantized version of the Dirac theory. It corresponds with a situation which cannot be described properly within the framework of a field theory with an external potential

Bilateral, independent juvenile nasopharyngeal angiofibroma

DEFF Research Database (Denmark)

Mørkenborg, Marie-Louise; Frendø, M; Stavngaard, T

2015-01-01

BACKGROUND: Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating...... from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning...... embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. CONCLUSION: This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral...

Paradoxes in carcinogenesis: New opportunities for research directions

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Kramer Barnett S

2007-08-01

Full Text Available Abstract Background The prevailing paradigm in cancer research is the somatic mutation theory that posits that cancer begins with a single mutation in a somatic cell followed by successive mutations. Much cancer research involves refining the somatic mutation theory with an ever increasing catalog of genetic changes. The problem is that such research may miss paradoxical aspects of carcinogenesis for which there is no likely explanation under the somatic mutation theory. These paradoxical aspects offer opportunities for new research directions that should not be ignored. Discussion Various paradoxes related to the somatic mutation theory of carcinogenesis are discussed: (1 the presence of large numbers of spatially distinct precancerous lesions at the onset of promotion, (2 the large number of genetic instabilities found in hyperplastic polyps not considered cancer, (3 spontaneous regression, (4 higher incidence of cancer in patients with xeroderma pigmentosa but not in patients with other comparable defects in DNA repair, (5 lower incidence of many cancers except leukemia and testicular cancer in patients with Down's syndrome, (6 cancer developing after normal tissue is transplanted to other parts of the body or next to stroma previously exposed to carcinogens, (7 the lack of tumors when epithelial cells exposed to a carcinogen were transplanted next to normal stroma, (8 the development of cancers when Millipore filters of various pore sizes were was inserted under the skin of rats, but only if the holes were sufficiently small. For the latter paradox, a microarray experiment is proposed to try to better understand the phenomena. Summary The famous physicist Niels Bohr said "How wonderful that we have met with a paradox. Now we have some hope of making progress." The same viewpoint should apply to cancer research. It is easy to ignore this piece of wisdom about the means to advance knowledge, but we do so at our peril.

On Johnson's Paradox: Hypothesis Verification

Science.gov (United States)

Noble, Clyde E.

1975-01-01

When H. M. Johnson argued that all inductive reasoning is based on the fallacy of affirming the consequent and cannot therefore establish the 'truth' of scientific hypotheses, he posed a paradox for strict empiricists. Author examined Johnson's argument. (Editor/RK)

Occipital lobe infarction: a rare presentation of bilateral giant cavernous carotid aneurysms: a case report.

Science.gov (United States)

Vanikieti, Kavin; Poonyathalang, Anuchit; Jindahra, Panitha; Cheecharoen, Piyaphon; Chokthaweesak, Wimonwan

2018-02-02

Cavernous carotid aneurysm (CCA) represents 2-9% of all intracranial aneurysms and 15% of internal carotid artery (ICA) aneurysms; additionally, giant aneurysms are those aneurysms that are > 25 mm in size. Bilateral CCAs account for 11-29% of patients and are commonly associated with structural weaknesses in the ICA wall, secondary to systemic hypertension. CCAs are considered benign lesions, given the low risk for developing major neurologic morbidities (i.e., subarachnoid hemorrhage, cerebral infarction, or carotid cavernous fistula). Moreover, concurrent presentation with posterior circulation cerebral infarction is even rarer, given different circulation territory from CCA. Here, we report on a patient with bilateral giant CCAs who presented with both typical and atypical symptoms. An 88-year-old hypertensive woman presented with acute vertical oblique binocular diplopia, followed by complete ptosis of the right eye. Ophthalmic examination showed dysfunction of the right third, fourth, and sixth cranial nerves. Further examination revealed hypesthesia of the areas supplied by the ophthalmic (V1) and maxillary (V2) branches of the right trigeminal nerve. Bilateral giant cavernous carotid aneurysms, with a concurrent subacute right occipital lobe infarction, were discovered on brain imaging and angiogram. Additionally, a prominent right posterior communicating artery (PCOM) was revealed. Seven months later, clinical improvement with stable radiographic findings was documented without any intervention. Dysfunction of the third, fourth, and sixth cranial nerves, and the ophthalmic (V 1 ) and maxillary (V 2 ) branches of the trigeminal nerves, should necessitate brain imaging, with special attention given to the cavernous sinus. Despite unilateral symptomatic presentation, bilateral lesions cannot be excluded solely on the basis of clinical findings. CCA should be included in the differential diagnosis of cavernous sinus lesions. Although rare, ipsilateral

Introduction, Copyright's Paradox

OpenAIRE

Netanel, Neil

2008-01-01

The United States Supreme Court famously labeled copyright “the engine of free expression” because it provides a vital economic incentive for much of the literature, commentary, music, art, and film that makes up our public discourse. Yet today’s greatly expanded copyright law often does the opposite—it can be used to quash news reporting, political commentary, church dissent, historical scholarship, cultural critique, and artistic expression. In Copyright’s Paradox, Neil Weinstock ...

BILATERAL SINGLE SESSION URETEROSCOPY FOR URETERAL ...

African Journals Online (AJOL)

Objectives: To determine the feasibility, safety and success rate of bilateral single session rigid retrograde ureteroscopy (URS) for bilateral ureteral calculi. Patients and Methods: Thirty-five patients underwent bilateral single session ureteroscopic calculus removal. Results: Out of 70 renal units in 35 patients treated, ...

Urinary Prothrombin Fragment 1+2 in relation to Development of Non-Symptomatic and Symptomatic Venous Thromboembolic Events following Total Knee Replacement

DEFF Research Database (Denmark)

Borris, Lars Carl; Breindahl, Morten; Rud-Lassen, Michael

2011-01-01

Prothrombin fragment 1+2 is excreted in urine (uF1+2) as a result of in vivo thrombin generation and can be a marker of coagulation status after an operative procedure. This study compared uF1+2 levels in patients with symptomatic and non-symptomatic venous thromboembolism (VTE) after total knee...... replacement (TKR) and in event-free sex- and age-matched controls. Significantly higher median uF1+2 levels were seen in the VTE patients on days 1, 3, and the day of venography (mostly day 7) after TKR compared with controls. The uF1+2 levels tended to be high in some patients with symptomatic VTE; however...

The mean, the median, and the St. Petersburg paradox.

Science.gov (United States)

Hayden, Benjamin Y; Platt, Michael L

2009-06-01

The St. Petersburg Paradox is a famous economic and philosophical puzzle that has generated numerous conflicting explanations. To shed empirical light on this phenomenon, we examined subjects' bids for one St. Petersburg gamble with a real monetary payment. We found that bids were typically lower than twice the smallest payoff, and thus much lower than is generally supposed. We also examined bids offered for several hypothetical variants of the St. Petersburg Paradox. We found that bids were weakly affected by truncating the gamble, were strongly affected by repeats of the gamble, and depended linearly on the initial "seed" value of the gamble. One explanation, which we call the median heuristic , strongly predicts these data. Subjects following this strategy evaluate a gamble as if they were taking the median rather than the mean of the payoff distribution. Finally, we argue that the distribution of outcomes embodied in the St. Petersburg paradox is so divergent from the Gaussian form that the statistical mean is a poor estimator of expected value, so that the expected value of the St. Petersburg gamble is undefined. These results suggest that this classic paradox has a straightforward explanation rooted in the use of a statistical heuristic.

Einstein, Podolsky, and Rosen paradox in atomic, nuclear, and particle physics

CERN Document Server

Afriat, Alexander

1999-01-01

This text is the first exhaustive treatise on the Einstein, Podolsky, and Rosen (EPR) Paradox - the incompatibility, at empirical level, between local realism and the existing quantum theory The volume collates all the data and thought on the Paradox, from its original formulation in 1935, to some very recent theoretical developments The authors devote an entire chapter to the EPR Paradox for pairs of neutral kaons In addition, their text provides 6 different proofs of Bell's Theorem, about 150 references to the literature, and 74 illustrations

Managing paradoxical tensions during the implementation of Lean capabilities for improvement

DEFF Research Database (Denmark)

Maalouf, Malek Miguel; Gammelgaard, Britta

2016-01-01

Purpose: – Through the identification and investigation of the organisational paradoxes in lean, the purpose of this paper is to deepen the understanding of lean implementation intricacies, and contribute to sustaining lean in companies. Design/methodology/approach: – Case study based on semi...... also points to a range managerial responses used for dealing with the three paradoxes and facilitating lean transformation. Research limitations/implications: – This is a theory development paper which increases the understanding regarding the role of the organisational paradoxes in facilitating...

Acute Bilateral Superior Branch Vestibular Neuropathy

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Dario A. Yacovino

2018-05-01

Full Text Available The rapid onset of a bilateral vestibular hypofunction (BVH is often attributed to vestibular ototoxicity. However, without any prior exposure to ototoxins, the idiopathic form of BVH is most common. Although sequential bilateral vestibular neuritis (VN is described as a cause of BVH, clinical evidence for simultaneous and acute onset bilateral VN is unknown. We describe a patient with an acute onset of severe gait ataxia and oscillopsia with features compatible with acute BVH putatively due to a bilateral VN, which we serially evaluated with clinical and laboratory vestibular function testing over the course of 1 year. Initially, bilateral superior and horizontal semicircular canals and bilateral utricles were impaired, consistent with damage to both superior branches of each vestibular nerve. Hearing was spared. Only modest results were obtained following 6 months of vestibular rehabilitation. At a 1-year follow-up, only the utricular function of one side recovered. This case is the first evidence supporting an acute presentation of bilateral VN as a cause for BVH, which would not have been observed without critical assessment of each of the 10 vestibular end organs.

On the extinction paradox, the finiteness of resources, and the nature of probability

International Nuclear Information System (INIS)

Munera, H.

1991-01-01

A talk by Lewins is discussed. Lewins addressed the subject of randomness in nature, and some implications for nuclear reactors. In particular, Lewins described the extinction paradox: a critical ''reactor is self-sustaining in the mean, nevertheless it will shut down with certainty!'' According to Lewins, the paradox arises because the idealized chain process leaves out the fact that resources are always finite (ie, the number of initial neutrons is finite, and the amount of fissile atoms in a reactor depends upon Avogadro's number). This explanation, however, only implies that the model used to reach the paradox is too naive to represent a real reactor (indeed, Lewins immediately explains more realistic models), but the paradox still remains in the context of the idealized chain reaction. Two ways of explaining the paradox are considered. (author)

A Hydrostatic Paradox Revisited

Science.gov (United States)

Ganci, Salvatore

2012-01-01

This paper revisits a well-known hydrostatic paradox, observed when turning upside down a glass partially filled with water and covered with a sheet of light material. The phenomenon is studied in its most general form by including the mass of the cover. A historical survey of this experiment shows that a common misunderstanding of the phenomenon…

A paradox in the global description of the multiverse

Energy Technology Data Exchange (ETDEWEB)

Bousso, Raphael [Center for Theoretical Physics, Department of Physics, University of California, Berkeley, CA 94720-7300 (United States); Freivogel, Ben [Center for Theoretical Physics, Department of Physics, University of California, Berkeley, CA 94720-7300 (United States)

2007-06-15

We use an argument by Page to exhibit a paradox in the global description of the multiverse: the overwhelming majority of observers arise from quantum fluctuations and not by conventional evolution. Unless we are extremely atypical, this contradicts observation. The paradox does not arise in the local description of the multiverse, but similar arguments yield interesting constraints on the maximum lifetime of metastable vacua.

A paradox in the global description of the multiverse

International Nuclear Information System (INIS)

Bousso, Raphael; Freivogel, Ben

2007-01-01

We use an argument by Page to exhibit a paradox in the global description of the multiverse: the overwhelming majority of observers arise from quantum fluctuations and not by conventional evolution. Unless we are extremely atypical, this contradicts observation. The paradox does not arise in the local description of the multiverse, but similar arguments yield interesting constraints on the maximum lifetime of metastable vacua

The Schroedinger's paradox and the tranformation of quantum systems

International Nuclear Information System (INIS)

Bitsakis, E.I.

1980-01-01

The Schroedinger's paradox is analysed, as an illustration of certain weaknesses of the Copenhagen's interpretation of quantum mechanics and of the limits of the quantum-mechanical description of phenomena. A realistic approach of the paradox indicates the necessity of a theory that would permit not only the calculation of probabilities, but also the description of physical processes, as taking place in space and time

On the present status of the Klein Paradox

International Nuclear Information System (INIS)

Wergeland, H.

1980-01-01

Klein's paradox is a solution of Dirac's equation which implies that electrons may penetrate an electrostatic potential barrier even when their kinetic energy is lower than the barrier. Since the barrier is infinitely broad this is not a case of tunneling. A number of treatments of the paradox, by Sauter, Hylleraas, Jenssen and others are discussed, and the Boundary Value Problem is treated at some length. Examples are presented with an infinitely broad barrier and with a barrier of finite breadth. (JIW)

Testing the Transivity Explanation of the Allais Paradox

DEFF Research Database (Denmark)

Groes, Ebbe; Jacobsen, Hans Jørgen; Sloth, Birgitte

1999-01-01

This paper uses a two-dimensional version of a standard common consequence experiment to test the intransitivity explanation of Allais-paradox-type violations of expected utility theory. We compare the common consequence effect of two choice problems differing only with respect to whether...... intransitivity as an explanation of the Allais Paradox. The question whether violations of expected utility are mainly due to intransitivity or to violation of independence is important since it is exactly on this issue the main new decision theories differ...

Paradoxical Personality and Academic Achievement in College Students From Buenos Aires

Directory of Open Access Journals (Sweden)

Agustín Freiberg Hoffmann

2015-11-01

Full Text Available This paper presents a study on paradoxical personality, defined as a distinctive feature in creative persons, developed with 350 college students from Buenos Aires. Goals aimed at describing and analysing possible significant differences of paradoxical traits in students from diverse majors representing seven different fields of study, and examining the relationship between each bipolar trait and academic achievement. The sample was composed of 7 groups (n = 50 by group representing fields of study typically offered in public universities, Biology, Computer Science, Engineering, Law, Nutrition, Psychology, and History of Art. Analyses by career provided descriptive information about students of these majors, concerning their paradoxical personality profiles. Correlational studies verified significant associations between academic achievement and most paradoxical traits in majors such as Computer Science, Nutrition and Psychology. Results are discussed regarding practical outcomes and teaching programs.

Paradoxical self-esteem and selectivity in the processing of social information.

Science.gov (United States)

Tafarodi, R W

1998-05-01

Paradoxical self-esteem is defined as contrasting levels of self-liking and self-competence. Consideration of the social and motivational implications of this uncommon form of self-esteem suggests that heightened selectivity in the processing of social information may be behind its persistence. Two experiments were conducted to confirm the prediction of heightened selectivity in paradoxicals. As expected, those paradoxically low in self-liking were more negatively biased in their memory for personality feedback (Study 1) and interpretation of valuatively ambiguous phrases (Study 2) than were their counterparts who shared the same low self-liking but were also low in self-competence. Symmetrical with this result, those paradoxically high in self-liking exhibited a heightened positive bias relative to those who were high in both self-liking and self-competence. The findings are discussed in relation to attitudes and motivation.

A history of the Allais paradox.

Science.gov (United States)

Heukelom, Floris

2015-03-01

This article documents the history of the Allais paradox, and shows that underneath the many discussions of the various protagonists lay different, irreconcilable epistemological positions. Savage, like his mentor von Neumann and similar to economist Friedman, worked from an epistemology of generalized characterizations. Allais, on the other hand, like economists Samuelson and Baumol, started from an epistemology of exact descriptions in which every axiom was an empirical claim that could be refuted directly by observations. As a result, the two sides failed to find a common ground. Only a few decades later was the now so-called Allais paradox rediscovered as an important precursor when a new behavioural economic subdiscipline started to adopt the epistemology of exact descriptions and its accompanying falsifications of rational choice theory.

Killing Mosquitoes and Keeping Practice: Teacher Education as Sustaining Paradox

Science.gov (United States)

Keiser, David Lee

2013-01-01

The moral and ethical charge of teaching and teacher education includes sustaining equanimity and paradox, and maintaining poise amongst contradicting policies and interests. This paper draws upon the wisdom of the Tao Te Ching to address some paradoxes in education and teacher preparation. Specifically, the article looks at four chapters of the…

Bilateral Testicular Tumors Resulting in Recurrent Cushing Disease After Bilateral Adrenalectomy.

Science.gov (United States)

Puar, Troy; Engels, Manon; van Herwaarden, Antonius E; Sweep, Fred C G J; Hulsbergen-van de Kaa, Christina; Kamphuis-van Ulzen, Karin; Chortis, Vasileios; Arlt, Wiebke; Stikkelbroeck, Nike; Claahsen-van der Grinten, Hedi L; Hermus, Ad R M M

2017-02-01

Recurrence of hypercortisolism in patients after bilateral adrenalectomy for Cushing disease is extremely rare. We present a 27-year-old man who previously underwent bilateral adrenalectomy for Cushing disease with complete clinical resolution. Cushingoid features recurred 12 years later, with bilateral testicular enlargement. Hormonal tests confirmed adrenocorticotropic hormone (ACTH)-dependent Cushing disease. Surgical resection of the testicular tumors led to clinical and biochemical remission. Gene expression analysis of the tumor tissue by quantitative polymerase chain reaction showed high expression of all key steroidogenic enzymes. Adrenocortical-specific genes were 5.1 × 105 (CYP11B1), 1.8 × 102 (CYP11B2), and 6.3 × 104 (MC2R) times higher than nonsteroidogenic fibroblast control. This correlated with urine steroid metabolome profiling showing 2 fivefold increases in the excretion of the metabolites of 11-deoxycortisol, 21-deoxycortisol, and total glucocorticoids. Leydig-specific genes were 4.3 × 101 (LHCGR) and 9.3 × 100 (HSD17B3) times higher than control, and urinary steroid profiling showed twofold increased excretion of the major androgen metabolites androsterone and etiocholanolone. These distinctly increased steroid metabolites were suppressed by dexamethasone but unresponsive to human chorionic gonadotropin stimulation, supporting the role of ACTH, but not luteinizing hormone, in regulating tumor-specific steroid excess. We report bilateral testicular tumors occurring in a patient with recurrent Cushing disease 12 years after bilateral adrenalectomy. Using mRNA expression analysis and steroid metabolome profiling, the tumors demonstrated both adrenocortical and gonadal steroidogenic properties, similar to testicular adrenal rest tumors found in patients with congenital adrenal hyperplasia, suggesting the presence of pluripotent cells even in patients without congenital adrenal hyperplasia. Copyright © 2017 by the Endocrine Society

New loophole for the EPR paradox

OpenAIRE

Feldmann, Michel

1999-01-01

We exhibit a classical model free from any paradox which exactly simulates the spin EPR test. We conclude that Bell's inequality violation is a strictly classical phenomenon, contrary to a general belief.

On Aerts' overlooked solution to the EPR paradox

OpenAIRE

de Bianchi, Massimiliano Sassoli

2018-01-01

The Einstein-Podolsky-Rosen (EPR) paradox was enunciated in 1935 and since then it has made a lot of ink flow. Being a subtle result, it has also been largely misunderstood. Indeed, if questioned about its solution, many physicists will still affirm today that the paradox has been solved by the Bell-test experimental results, which have shown that entangled states are real. However, this remains a wrong view, as the validity of the EPR ex-absurdum reasoning is independent from the Bell-test e...

Scientific progress despite irreproducibility: A seeming paradox.

Science.gov (United States)

Shiffrin, Richard M; Börner, Katy; Stigler, Stephen M

2018-03-13

It appears paradoxical that science is producing outstanding new results and theories at a rapid rate at the same time that researchers are identifying serious problems in the practice of science that cause many reports to be irreproducible and invalid. Certainly, the practice of science needs to be improved, and scientists are now pursuing this goal. However, in this perspective, we argue that this seeming paradox is not new, has always been part of the way science works, and likely will remain so. We first introduce the paradox. We then review a wide range of challenges that appear to make scientific success difficult. Next, we describe the factors that make science work-in the past, present, and presumably also in the future. We then suggest that remedies for the present practice of science need to be applied selectively so as not to slow progress and illustrate with a few examples. We conclude with arguments that communication of science needs to emphasize not just problems but the enormous successes and benefits that science has brought and is now bringing to all elements of modern society.

Investigating the loss of work productivity due to symptomatic leiomyoma.

Science.gov (United States)

Hasselrot, Klara; Lindeberg, Mia; Konings, Peter; Kopp Kallner, Helena

2018-01-01

Leiomyoma affects up to 50% of fertile women, leading to morbidity such as bleeding or pain. The effect of symptomatic leiomyoma on the productivity of employed women is understudied. The present study investigates productivity loss in a Swedish setting in women with symptomatic leiomyoma compared to healthy women. Women seeking care for leiomyoma and heavy menstrual bleeding (HMB) were recruited at nine Swedish sites. Healthy controls with self-perceived mild to normal menstruation were recruited at routine visits. Cases and controls were employed without option to work from home. After recruitment, all women reported the work productivity and activity impairment (WPAI) questionnaire, the pictorial blood assessment chart (PBAC) and pain on the visual analog scale (VAS). Women with symptomatic leiomyoma (n = 88) missed more working time during menses compared to asymptomatic controls (n = 34): 7.6 vs 0.2% p = 0.003. The proportion of impairment while working was also significantly higher in women with symptomatic leiomyoma (43.8 vs 12.1% p100). Symptomatic leiomyoma leads to loss of working hours as well as loss of productivity during working hours, and affects women in other daily activities. Increased awareness of the impact of leiomyomas on women's lives is needed, and timely and appropriate management of the symptomatic leiomyomas could improve work productivity and quality of life.

The Paradox of Analogy

Directory of Open Access Journals (Sweden)

David Botting

2012-03-01

Full Text Available I will show that there is a type of analogical reasoning that instantiates a pattern of reasoning in confirmation theory that is considered at best paradoxical and at worst fatal to the entire syntactical approach to confirmation and explanation. However, I hope to elaborate conditions under which this is a sound (although not necessarily strong method of reasoning.

Paradoxes of unstable electron

International Nuclear Information System (INIS)

Okun, L.B.; Zeldovich, Ya.B.

1978-01-01

The hypothesis that electron is unstable - when it is consistent with the vanishing mass of the photon- leads to a number of paradoxical statements. The lifetime of the electron is determined by emission of a huge number of longitudinal photons and exponentially depends on the amount of emitted energy. This suggests to discuss searches for charge nonconservation in experiments with high energy particles

Art's Pedagogical Paradox

Science.gov (United States)

Kalin, Nadine M.

2014-01-01

This article contributes to conversations concerning art education futures through engaging alternative relations between art, education, and democracy that mobilize education as art projects associated with the "pedagogical turn" as sites of liminality and paradox. An analysis of the art project, Pedagogical Factory, is used to outline…

The Paradox of Modern Suffering

DEFF Research Database (Denmark)

Dræby, Anders

The Paradox of Suffering in modern western Culture In non-western cultures and pre-modern western cultures suffering is considered the normal state of life. Corrispondingly the suffering of oneself and that of other people form a central focus to most religions, their practices and philosophies...

O paradoxo de Chalmers Chalmers' paradox

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Gustavo Leal-Toledo

2009-01-01

Full Text Available O Argumento dos Zumbis proposto por Chalmers, ao contrário de defender o dualismo, bane as qualia para um "mundo" onde elas não podem influenciar o julgamento que fazemos sobre nós mesmos. Por este motivo, pelo próprio argumento, podemos ser um zumbi e não saber. A isso Chalmers chamou de The Paradox of Phenomenal Judgment. O problema é que ele aceita tal paradoxo como parte de sua própria teoria. No entanto, este movimento filosófico não é aceitável e este paradoxo mina a teoria de Chalmers por dentro mostrando que o argumento dos zumbis é, na verdade, um argumento contra o dualismo. Chalmers tenta resolver este problema com uma série de argumentos que tem como base o fato de que a consciência é um bruto explanandum indubitável. No entanto, tal tentativa fracassa por uma série de razões que mostram que mesmo se ele estivesse correto, ainda poderíamos ser um zumbi e não saber.The Zombie Argument proposed by Chalmers, instead of working as a defense of dualism, banishes qualia to a 'world' where they cannot influence our judgments about ourselves. For this reason, according to the argument itself, we may be all zombies and not know it. This is what Chalmers called The Paradox of Phenomenal Judgment. The problem is that he accepts this paradox as part of his theory. This philosophical move, however, is not acceptable, for the paradox undermines Chalmers' theory, by showing that the zombie argument is, actually, an argument against dualism. Chalmers tries to solve this problem with many arguments based on the status of consciousness as brute indubitable explanandum. However, this attempt is a failure by a series of reasons showing that, even if he were right, we could still be zombies and not know it.

Bolzano's Approach to the Paradoxes of Infinity: Implications for Teaching

Science.gov (United States)

Waldegg, Guillermina

2005-01-01

In this paper we analyze excerpts of "Paradoxes of the Infinite", the posthumous work of Bernard Bolzano (1781-1848), in order to show that Georg Cantor's (1845-1918) approach to the problem of defining actual mathematical infinity is not the most natural. In fact, Bolzano's approach to the paradoxes of infinity is more intuitive, while remaining…

Globalization and Religion in Historical Perspective: A Paradoxical Relationship

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Luke M. Herrington

2013-03-01

Full Text Available Religion has long been a driving force in the process of globalization. This idea is not controversial or novel thinking, nor is it meant to be. However, the dominant reasoning on the subject of globalization, expressed by authors like Thomas Friedman, places economics at the center of analysis, skewing focus from the ideational factors at work in this process. By expanding the definition of globalization to accommodate ideational factors and cultural exchange, religion’s agency in the process can be enabled. Interestingly, the story of religion and globalization is in some ways the history of globalization, but it is riddled with paradoxes, including the agent-opponent paradox, the subject of this article. Religion and globalization have a co-constitutive relationship, but religious actors are both agents of globalization and principals in its backlash. While some actors might benefit from a mutually reinforcing relationship with globalization, others are marginalized in some way or another, so it is necessary to expose the links and wedges that allow for such a paradox. To that end, the concepts of globalization and religious actors must be defined, and the history of the agent-opponent paradox, from the Buddhists of the Silk Road to the Jubilee campaign of 2000, must be elucidated.

The mean, the median, and the St. Petersburg paradox

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Benjamin Y. Hayden

2009-06-01

Full Text Available The St.~Petersburg Paradox is a famous economic and philosophical puzzle that has generated numerous conflicting explanations. To shed empirical light on this phenomenon, we examined subjects' bids for one St.~Petersburg gamble with a real monetary payment. We found that bids were typically lower than twice the smallest payoff, and thus much lower than is generally supposed. We also examined bids offered for several hypothetical variants of the St.~Petersburg Paradox. We found that bids were weakly affected by truncating the gamble, were strongly affected by repeats of the gamble, and depended linearly on the initial ``seed'' value of the gamble. One explanation, which we call the extit{median} extit{heuristic}, strongly predicts these data. Subjects following this strategy evaluate a gamble as if they were taking the median rather than the mean of the payoff distribution. Finally, we argue that the distribution of outcomes embodied in the St.~Petersburg paradox is so divergent from the Gaussian form that the statistical mean is a poor estimator of expected value, so that the expected value of the St.~Petersburg gamble is undefined. These results suggest that this classic paradox has a straightforward explanation rooted in the use of a statistical heuristic.

ACUTE NEUROINFECTIONS AND SYMPTOMATIC EPILEPSY IN CHILDREN: CAUSAL RELATIONSHIP (review

Directory of Open Access Journals (Sweden)

E. Yu. Gorelik

2017-01-01

Full Text Available Convulsions in case of acute neuroinfections can both complicate the disease course and transfer to symptomatic epilepsy which is one of the most important medical and social problems. The review article presents the data on epidemiology of convulsive disorder and symptomatic epilepsy in case of neuroinfections in children. There are considered the current immune and biochemical aspects of epileptogenesis in case of infectious pathology. There is given the information on neurophysiological and radial features of symptomatic epilepsy developed in case of neuroinfections of different etiology. There is underlined the practical significance of timely complex etio-pathogenetic therapy for neuroinfections complicated by convulsion that allows to reduce the frequency of symptomatic epilepsy development. There are presented the data on the results of transcranial magnetic stimulation in case of refractory epilepsy.

MR Imaging in symptomatic osteochondromas

International Nuclear Information System (INIS)

Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha

1998-01-01

The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs

The Klein paradox: a new treatment

International Nuclear Information System (INIS)

Truebenbacher, E

2015-01-01

The Dirac equation requires a treatment of the step potential that differs fundamentally from the traditional treatment, because the Dirac plane waves, besides momentum and spin, are characterized by a quantum number with the physical meaning of sign of charge. Since the Hermitean operator corresponding to this quantum number does not commute with the step potential, the time displacement parameter used in the ansatz of the stationary state does not have the physical meaning of energy. Therefore there are no paradoxal values of the ‘energy’. The new solution of the Dirac equation with a step potential is obtained. This solution, again, allows for phenomena of the Klein paradox type, but in addition it contains a positron amplitude localized at the threshold point of the step potential. (paper)

Klein paradox in the Breit equation

International Nuclear Information System (INIS)

Krolikowski, W.; Turski, A.; Rzewuski, J.

1979-01-01

We demonstrate that in the Breit equation with a central potential V(r) having the property V(r 0 )=E there appears a Klein paradox at r=r 0 . This phenomenon, besides the previously found Klein paradox at r→infinite appearing if V(r)→infinite at r→infinite, seems to indicate that in the Breit equation valid in the single-particle theory the sea of particle-antiparticle pairs is not well separated from the considered two-body configuration. We conjecture that both phenomena should be absent from the Salpeter equation which is consistent with the hole theory. We prove this conjecture in the limit of m( 1 )→infinite and m( 2 )→infinite, where we neglect the terms approx. 1/m( 1 ) and 1/m( 2 ). (orig./WL) [de

Clinical analysis of 34 cases symptomatic epilepsy secondary to cerebrovascular disease

International Nuclear Information System (INIS)

Zeng Mingyu; Liu Chunfeng

2000-01-01

Objective: To investigate the relation between cerebrovascular disease and symptomatic epilepsy. Method: 786 patients suffered cerebrovascular disease were retrospectively analyzed. Result: The occurrence rate of Secondary to Cerebrovascular Disease symptomatic epilepsy Secondary to Cerebrovascular Disease was 4.3%. Those older than 60 are prone to develop Acrodynia symptomatic epilepsy. Generalized epileptic seizure were often seen. Secondary to Cerebrovascular Disease epilepsy die to cortical lesion are more easily seem than subcortical lesion. Early epilepsy is more than late epilepsy. Conclusion: The cause of symptomatic epilepsy after cerebrovascular disease is not same in different types and course of CVD. Those who developed epilepsy particularly epilepsy continua would have bad prognosis

Moving towards a geocentric, polycultural theory of organizational paradox

OpenAIRE

Keller, J.; Lewis, M. W.

2016-01-01

Purpose\\ud This paper comments on “Global implications of the indigenous epistemological system from the east” (Li, 2016), which provides an indigenous Chinese perspective on organizational paradox. Li introduces Yin-Yang balancing as an epistemological system that can help scholars examine and practitioners manage paradoxes. In this commentary, the purpose of this paper is to discuss the merits of Yin-Yang balancing and how this approach and other indigenous theories might enrich organizatio...

The incidence of symptomatic malrotation post gastroschisis repair.

LENUS (Irish Health Repository)

Abdelhafeez, A

2011-12-01

Gastroschisis is known to be associated with abnormal bowel rotation. Currently, the broadly accepted practice is not to perform Ladd\\'s procedure routinely at the time of closure of gastroschisis defects. However the incidence of symptomatic malrotation and volvulus post gastroschisis repair is unknown; this incidence is important in view of the current practice of bedside gastroschisis closure. This study examined the incidence of symptomatic malrotation and volvulus following gastroschisis repair.

Chronic Illness as a Source of Happiness: Paradox or perfectly normal?

NARCIS (Netherlands)

Hoppe, S.

2013-01-01

In this paper I analyse the relation between happiness and chronic illness from the perspective of medical anthropology and disability studies. By looking at the disability paradox I deconstruct society’s view of people with a disability. I argue that the disability paradox is problematic as it

Game theory and non-linear dynamics: the Parrondo Paradox case study

International Nuclear Information System (INIS)

Arena, P.; Fazzino, S.; Fortuna, L.; Maniscalco, P.

2003-01-01

In this paper a new research topic is explored on the role of chaos in a particular game problem: the Parrondo Paradox. In the original formulation of this paradox, it has been proved that two separate losing games can be combined following a random or periodic strategy in order to have a resulting winning game. In this paper, three key points will be dealt with. The first one regards the introduction of a strategy based on various chaotic time series: this could improve the gain in the classical two games Parrondo problem. The second one concerns with the introduction of a third loosing game based on the history of the game and not on the capital as in the classical Parrondo two games Problem. Finally, the Parrondo Paradox has been generalized for N games and an algorithm has been proposed in order to investigate through an optimization approach the region of probability parameter space in which Parrondo Paradox can occur

Small-Gauge Pars Plana Vitrectomy for the Management of Symptomatic Posterior Vitreous Detachment after Phacoemulsification and Multifocal Intraocular Lens Implantation: A Pilot Study from the Pan-American Collaborative Retina Study Group

Science.gov (United States)

Navarro, Rodrigo M.; Machado, Leonardo M.; Maia, Ossires; Wu, Lihteh; Farah, Michel E.; Magalhaes, Octaviano; Arevalo, J. Fernando; Maia, Mauricio

2015-01-01

Purpose. To determine the efficacy of 23-gauge pars plana vitrectomy (PPV) for symptomatic posterior vitreous detachment (PVD) on visual acuity (VA) and quality after multifocal intraocular lenses (IOLs). Methods. In this prospective case series, patients who developed symptomatic PVD and were not satisfied with visual quality due to floaters and halos after multifocal IOL implantation underwent PPV. Examinations included LogMAR uncorrected visual acuity (UCVA), intraocular pressure, biomicroscopy, and indirect ophthalmoscopy at baseline and 1, 7, 30, and 180 days postoperatively. Ultrasonography and aberrometry were performed. The Visual Functioning Questionnaire 25 (VFQ-25) was administered preoperatively and at 30 days postoperatively. Both the postoperative UCVA and questionnaire results were compared to preoperative findings using the Wilcoxon test. Results. Sixteen eyes of 8 patients were included. VA significantly improved from 0.17 to 0.09 postoperatively (P = 0.017). All patients reported improvement of halos, glare, and floaters. VFQ-25 scores significantly improved in general vision (P = 0.023), near activities (P = 0.043), distance activities (P = 0.041), mental health (P = 0.011), role difficulties (P = 0.042), and driving (P = 0.016). Conclusion. PPV may increase UCVA and quality of vision in patients with bilateral multifocal IOLs and symptomatic PVD. Larger studies are advised. PMID:26504590

Salt disposal: Paradox Basin, Utah

International Nuclear Information System (INIS)

1983-04-01

This report presents the findings of a study conducted for the National Waste Terminal Storage (NWTS) Program. Permanent disposal options are examined for salt resulting from the excavation of a waste repository in the bedded salt deposits of the Paradox Basin of southeastern Utah. The study is based on a repository salt backfill compaction of 60% of the original density which leaves a total of 8 million tons of 95% pure salt to be disposed of over a 30-year period. The feasibility, impacts, and mitigation methods are examined for five options: commercial disposal, permanent onsite surface disposal, permanent offsite disposal, deepwell injection, and ocean and Great Salt Lake disposal. The study concludes the following: Commercial marketing of all repository salt would require a subsidy for transportation to major salt markets. Permanent onsite surface storage is both economically and technically feasible. Permanent offsite disposal is technically feasible but would incur additional transportation costs. Selection of an offsite location would provide a means of mitigating impacts associated with surface storage at the repository site. Deepwell injection is an attractive disposal method; however, the large water requirement, high cost of development, and poor performance of similar operating brine disposal wells eliminates this option from consideration as the primary means of disposal for the Paradox Basin. Ocean disposal is expensive because of high transportation cost. Also, regulatory approval is unlikely. Ocean disposal should be eliminated from further consideration in the Paradox Basin. Great Salt Lake disposal appears to be technically feasible. Great Salt Lake disposal would require state approval and would incur substantial costs for salt transportation. Permanent onsite disposal is the least expensive method for disposal of all repository salt

Bilateral tension pneumothorax related to acupuncture.

Science.gov (United States)

Tagami, Rumi; Moriya, Takashi; Kinoshita, Kosaku; Tanjoh, Katsuhisa

2013-06-01

We report on a patient with a rare case of bilateral tension pneumothorax that occurred after acupuncture. A 69-year-old large-bodied man, who otherwise had no risk factors for spontaneous pneumothorax, presented with chest pressure, cold sweats and shortness of breath. Immediately after bilateral pneumothorax had been identified on a chest radiograph in the emergency room, his blood pressure and percutaneous oxygen saturation suddenly decreased to 78 mm Hg and 86%, respectively. We confirmed deterioration in his cardiopulmonary status and diagnosed bilateral tension pneumothorax. We punctured his chest bilaterally and inserted chest tubes for drainage. His vital signs promptly recovered. After the bilateral puncture and drainage, we learnt that he had been treated with acupuncture on his upper back. We finally diagnosed a bilateral tension pneumothorax based on the symptoms that appeared 8 h after the acupuncture. Because the patient had no risk factors for spontaneous pneumothorax, no alternative diagnosis was proposed. We recommend that patients receiving acupuncture around the chest wall must be adequately informed of the possibility of complications and expected symptoms, as a definitive diagnosis can be difficult without complete information.

Bilateral, independent juvenile nasopharyngeal angiofibroma: case report.

Science.gov (United States)

Mørkenborg, M-L; Frendø, M; Stavngaard, T; Von Buchwald, C

2015-10-01

Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning and surgical strategy. A 21-year-old male presented with increasing bilateral nasal obstruction and discharge. Examination revealed tumours bilaterally and imaging demonstrated non-contiguous tumours. Pre-operative angiography showed strictly ipsilateral vascular supplies requiring bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated. This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery.

Authority as paradox: the transformations of Don Quijote.

Science.gov (United States)

Priel, Beatriz

2006-12-01

The author's contention is that the analysand's temporary attribution of authority to the analyst is inherent in the analytic situation; this is seen as a transitional and paradoxical form of authority pertaining neither to internal nor external reality, but dwelling in the analytic third. The author proposes a conceptualization of psychoanalytic authority as a form of aesthetic authority according to Gadamer's definitions. While the scientific and hermeneutic codes for the understanding of authority in psychoanalysis assume that the main issue at stake is the delimitation of the objectivity or the subjectivity of the analyst's knowledge, this aesthetic perspective centres on the analysand's attribution of a claim of truth to analytic interpretations, and on the experience of recognition. The experience of recognition of a possible truth is particular and context-bound, as well as self-transformational. A reading of three episodes from Cervantes's The history of Don Quixote de la Mancha illuminates the transitional and paradoxical character of aesthetic authority within a transformational dialogue. These episodes are read as dramatizations of different positions vis-à-vis the paradoxical authority that characterizes transformational dialogues.

Paradoxical sphincter contraction is rarely indicative of anismus.

Science.gov (United States)

Voderholzer, W A; Neuhaus, D A; Klauser, A G; Tzavella, K; Müller-Lissner, S A; Schindlbeck, N E

1997-08-01

Anismus is thought to be a cause of chronic constipation by producing outlet obstruction. The underlying mechanism is paradoxical contraction of the anal sphincter or puborectalis muscle. However, paradoxical sphincter contraction (PSC) also occurs in healthy controls, so anismus may be diagnosed too often because it may be based on a non-specific finding related to untoward conditions during the anorectal examination. To investigate the pathophysiological importance of PSC found at anorectal manometry in constipated patients and in patients with stool incontinence. Digital rectal examination and anorectal manometry were performed in 102 chronically constipated patients, 102 patients with stool incontinence, and in 18 controls without anorectal disease. In 120 of the 222 subjects defaecography was also performed. Paradoxical sphincter contraction was defined as a sustained increase in sphincter pressure during straining. Anismus was assumed when PSC was present on anorectal manometry and digital rectal examination and the anorectal angle did not widen on defaecography. Manometric PSC occurred about twice as often in constipated patients as in incontinent patients (41.2% versus 25.5%, p anismus is rare.

The Merger Paradox and R&D

OpenAIRE

MIYAGIWA, Kaz; WAN, Jiangyun(Yunyun)

2015-01-01

The merger paradox is revisited in the presence of cost-reducing R&D in Cournot oligopoly. Two cases are found, in which merger is profitable without satisfying the 80-percent threshold requirement of Salant et al (1983).

Symptomatic Tarlov Cysts: Surgical Treatment by Subcutaneous Infusion Port.

Science.gov (United States)

Huang, Ying; Zhu, Tong; Lin, Hongyi; Li, Jing; Zeng, Tao; Lin, Jian

2018-05-01

The treatment of Tarlov cysts is challenging and difficult. The objective of our study was to describe the security and efficacy of the subcutaneous infusion port for drainage of symptomatic Tarlov cysts. The authors executed a retrospective review of data from 5 symptomatic Tarlov cysts patients who were treated using a subcutaneous infusion port from June 2014 to July 2017. Numerical Rating Scale scores and the Japanese Orthopedic Association scores of back pain were analyzed. Complications and adverse effects on postoperative days 1, 7, 14, and 28 were also analyzed. The mean follow-up was 12.6 months. Five adults (3 females and 2 males) who had been symptomatic received a subcutaneous infusion port. After treatment, all patients experienced pain relief and pain alleviation lasted from 1 day to 3 years without complications and adverse effects. A subcutaneous infusion port is a useful treatment option for symptomatic Tarlov cysts. When the patients' symptoms returned and the cysts repressurized, we quickly and simply drained the cysts by using the infusion port. Copyright © 2018 Elsevier Inc. All rights reserved.

"Paradox fikce" a emoce ve sportovních filmech

OpenAIRE

Sýkora, Matěj

2013-01-01

This bachelor thesis deals with the paradox of fiction and emotion of recipients of sports films. The work is divided into four main chapters. The first two aim to define the key terms fiction (the fictional world) and emotion. The third chapter briefly summarizes the most important theories dealing with the paradox of fiction (Radford and Weston, Walton, etc.) and offers an outline of a possible solution to the problem following neurobiological explorations of Antonio Damasio and selected co...

Bilateral internal laryngoceles mimicking asthma

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Elif A Aksoy

2013-01-01

Full Text Available Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

Educating geographers in an era of the anthropocene: paradoxical natures - paradoxical cultures

DEFF Research Database (Denmark)

Grindsted, Thomas Skou

2015-01-01

Geographical imaginations are vital to make sense of challenges to sustainability which are produced and distributed across scale. Yet, a number of studies find that geography has been reluctant to integrate sustainability issues in its curricula. Geography is particularly interesting and can con...... of this finding is significant across disciplines. Thus, scholars and students should learn to go beyond the geopolitics of education in order to transcend the paradoxical-culture-natures identified...

MCM Paradox: Abundance of Eukaryotic Replicative Helicases and Genomic Integrity.

Science.gov (United States)

Das, Mitali; Singh, Sunita; Pradhan, Satyajit; Narayan, Gopeshwar

2014-01-01

As a crucial component of DNA replication licensing system, minichromosome maintenance (MCM) 2-7 complex acts as the eukaryotic DNA replicative helicase. The six related MCM proteins form a heterohexamer and bind with ORC, CDC6, and Cdt1 to form the prereplication complex. Although the MCMs are well known as replicative helicases, their overabundance and distribution patterns on chromatin present a paradox called the "MCM paradox." Several approaches had been taken to solve the MCM paradox and describe the purpose of excess MCMs distributed beyond the replication origins. Alternative functions of these MCMs rather than a helicase had also been proposed. This review focuses on several models and concepts generated to solve the MCM paradox coinciding with their helicase function and provides insight into the concept that excess MCMs are meant for licensing dormant origins as a backup during replication stress. Finally, we extend our view towards the effect of alteration of MCM level. Though an excess MCM constituent is needed for normal cells to withstand stress, there must be a delineation of the threshold level in normal and malignant cells. This review also outlooks the future prospects to better understand the MCM biology.

Service Recovery Paradox In Indian Banking Industry: An Empirical Investigation

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Arunesh Garg

2013-10-01

Full Text Available The present study examines existence of service recovery paradox in Indian banking industry. The study is taken up in the tri-city of Chandigarh, Panchkula and Mohali. The respondents are catego- rized into failure and no-failure groups on the basis of their service experience. Failure group consti- tutes those respondents who have experienced service recovery, and has been further divided into five sub-groups ranging from service recovery++ (service recovery better than expected to service recovery- - (service recovery worse than expected. Service recovery paradox is examined by com- paring service recovery++ group with no-failure group. The study shows evidence for existence of service recovery paradox in relation to satisfaction. It has been concluded that for service recovery paradox to exist, recovery effort has to be exceptionally good and much better than expectation level of the customer. The study suggests that service managers should take service failure as an opportunity to appease customers by providing a much better than expected recovery experience. However, organizations should not plan to create service failure situations because if they falter on imparting the recovery, customer satisfaction may be influenced negatively.

Relationship between human cytomegalovirus transcription and symptomatic apical periodontitis in Iran.

Science.gov (United States)

Yazdi, K A; Sabeti, M; Jabalameli, F; Eman eini, M; Kolahdouzan, S A; Slots, J

2008-12-01

Apical periodontitis of endodontic origin may develop as a result of cooperative interactions among herpesviruses, specific pathogenic bacteria and tissue-destructive inflammatory mediators. This study sought to identify the presence of Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) transcripts in symptomatic and asymptomatic periapical lesions of individuals living in Iran. Fifty endodontic patients (28 with symptomatic periapical lesions and 22 with asymptomatic periapical lesions) were included in the study. In each study subject, a microbiological periapical sample was collected using a curette in conjunction with periapical surgery. A reverse transcription-polymerase chain reaction assay was used to identify transcripts of EBV and HCMV. Human cytomegalovirus transcript was detected in 15 of the 28 (53.6%) symptomatic and in six of the 22 (27.3%) asymptomatic periapical study lesions (significant difference between symptomatic and asymptomatic lesions; P = 0.03, chi-square test). Epstein-Barr virus transcript was identified in one symptomatic and in two asymptomatic periapical lesions. This study establishes that HCMV transcription is common in apical periodontitis and is most frequent in symptomatic lesions. The high frequency of active herpesvirus infections in severe apical periodontitis changes the pathogenic paradigm of the disease and may also have preventive and therapeutic implications.

A CASE REPORT OF THE PATIENT WITH EXTRAOVARIAN PRIMARY PERITONEAL CARCINOMA AFTER BILATERAL SALPINGO-OOPHORECTOMY THIRTEEN YEARS AGO

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Drago Sredanović

2018-02-01

Full Text Available Abstract: We present a rare case of extraovarian primary peritoneal carcinoma in 65-year-old female with a history of total abdominal hysterectomy and bilateral salpingo-oophorectomy for larger symptomatic leiomyoma 13 years ago. In October 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adenocarcinoma and significantly elevated serum Ca-125 was 500 U/ml. Clinical examinations were performed, but could not identify a unique origin of disease. Background: Aproximatly 3.2 % to 21 % of extraovarian primary peritoneal carcinoma patients have a history bilateral oophorectomy for benign disease or prophylaxis – family history of ovar- ian carcinoma.1 Patients and methods: A 65-year old woman with a history of total abdominal hysterectomy and bileteral salpin- go-oophorectomy was operated for larger symptomatic leiomyoma 13 years ago. In Octobre 2005 the patient had abdominal swelling, ascites with positive cytology peritonal adeno- carcinoma and significantly elevated serum Ca-125 was 500 U/ml. Radiologic imaging, gastroscopy, colonoscopy, mammography were performed, but couldn`t identify a unique origin of disease. Patient was treated for two years at the Oncology Institute Ljubljana. Significantly elevated serum Ca-125 and citology with immunohistochemical analysis pre- sented correct diagnosis of extraovarian primary peritoneal carcinoma. The patient was treated with combination systemic chemotherapy (Paclitaxel and Carboplatin with initial good response. In year 2006 and 2007 because of the progression of disease, the treatment was repeated with adjuvant chemotherapy. Conclusions: Look like in other similar cases we have confirmed our disease with three cytologic punction procedures, with significant elevated valves of Ca-125 and with several other directed proce- dures.1–3 Our patient has survived the characteristic critical period for this form of cancer of 7 to 27.8 months because of well orientated

Simultaneous and staged bilateral total hip arthroplasty

DEFF Research Database (Denmark)

Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik

2013-01-01

Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

Adaptationism fails to resolve Fermi's paradox

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Ćirković Milan M.

2005-01-01

Full Text Available One of the most interesting problems in the nascent discipline of astrobiology is more than half-century old Fermi's paradox: why, considering extraordinary young age of Earth and the Solar System in the Galactic context, don't we perceive much older intelligent communities or signposts of their activity? In spite of a vigorous research activity in recent years, especially bolstered by successes of astrobiology in finding extrasolar planets and extremophiles, this problem (also known as the "Great Silence" or "astrosociological" paradox remains as open as ever. In a previous paper, we have discussed a particular evolutionary solution suggested by Karl Schroeder based on the currently dominant evolutionary doctrine of adaptationism. Here, we extend that discussion with emphasis on the problems such a solution is bound to face, and conclude that it is ultimately quite unlikely. .

Bilateral spontaneous hemotympanum: Case report

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Economou Nicolas C

2006-10-01

Full Text Available Abstract Background The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. Case presentation A 72-year-old male presented with acute deterioration of hearing. In the patient's medical history aortic valve replacement 1 year before presentation was reported. Since then he had been administered regularly coumarinic anticoagulants, with INR levels maintained between 3.4 and 4.0. Otoscopy revealed the presence of bilateral hemotympanum. The audiogram showed symmetrical moderately severe mixed hearing loss bilaterally, with the conductive component predominating. Tympanograms were flat bilaterally with absent acoustic reflexes. A computerized tomography scan showed the presence of fluid in the mastoid and middle ear bilaterally. Treatment was conservative and consisted of a 10-day course of antibiotics, anticongestants and temporary interruption of the anticoagulant therapy. After 3 weeks, normal tympanic membranes were found and hearing had returned to previous levels. Conclusion Anticoagulant intake should be included in the differential diagnosis of hemotympanum, because its detection and appropriate treatment may lead to resolution of the disorder.

The periodontal pain paradox: Difficulty on pain assesment in dental patients (The periodontal pain paradox hypothesis

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Haryono Utomo

2006-12-01

Full Text Available In daily dental practice, the majority of patients’ main complaints are related to pain. Most patients assume that all pains inside the oral cavity originated from the tooth. One particular case is thermal sensitivity; sometimes patients were being able to point the site of pain, although there is neither visible caries nor secondary caries in dental radiograph. In this case, gingival recession and dentin hypersensitivity are first to be treated to eliminate the pain. If these treatments failed, pain may misdiagnose as pulpal inflammation and lead to unnecessary root canal treatment. Study in pain during periodontal instrumentation of plaque-related periodontitis revealed that the majority of patients feel pain and discomfort during probing and scaling. It seems obvious because an inflammation, either acute or chronic is related to a lowered pain threshold. However, in contrast, in this case report, patient suffered from chronic gingivitis and thermal sensitivity experienced a relative pain-free sensation during probing and scaling. Lowered pain threshold which accompanied by a blunted pain perception upon periodontal instrumentation is proposed to be termed as the periodontal pain paradox. The objective of this study is to reveal the possibility of certain factors in periodontal inflammation which may involved in the periodontal pain paradox hypothesis. Patient with thermal hypersensitivity who was conducted probing and scaling, after the relative pain-free instrumentation, thermal hypersensitivity rapidly disappeared. Based on the successful periodontal treatment, it is concluded that chronic gingivitis may modulate periodontal pain perception which termed as periodontal pain paradox

Qualities and Inequalities in Online Social Networks through the Lens of the Generalized Friendship Paradox.

Science.gov (United States)

Momeni, Naghmeh; Rabbat, Michael

2016-01-01

The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their activities and influence in online social networks. Using these measures we analyse the prevalence of the generalized friendship paradox over Twitter and we report high levels of prevalence (up to over 90% of nodes). We contend that this prevalence of the friendship paradox and its generalized version arise because of the hierarchical nature of the connections in the network. This hierarchy is nested as opposed to being star-like. We conclude that these paradoxes are collective phenomena not created merely by a minority of well-connected or high-attribute nodes. Moreover, our results show that a large fraction of individuals can experience the generalized friendship paradox even in the absence of a significant correlation between degrees and attributes.

Qualities and Inequalities in Online Social Networks through the Lens of the Generalized Friendship Paradox.

Directory of Open Access Journals (Sweden)

Naghmeh Momeni

Full Text Available The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their activities and influence in online social networks. Using these measures we analyse the prevalence of the generalized friendship paradox over Twitter and we report high levels of prevalence (up to over 90% of nodes. We contend that this prevalence of the friendship paradox and its generalized version arise because of the hierarchical nature of the connections in the network. This hierarchy is nested as opposed to being star-like. We conclude that these paradoxes are collective phenomena not created merely by a minority of well-connected or high-attribute nodes. Moreover, our results show that a large fraction of individuals can experience the generalized friendship paradox even in the absence of a significant correlation between degrees and attributes.

MR Imaging in symptomatic osteochondromas

Energy Technology Data Exchange (ETDEWEB)

Kim, Soo Young; Kim, Jee Young; Kim, Sang Heum; Chun, Kyung Ah; Park, Young Ha [Catholic University of Korea, Seoul (Korea, Republic of)

1998-06-01

The purpose of this study is to assess the MR findings of symptomatic osteochondromas. We evaluated 31 patients who between July, 1994 and May, 1997 underwent MR imaging for symptomatic osteochondroma. Fourteen were males and 17 were females, and their ages ranged from 8 to 49 (mean, 23) years. Using T1WI, T2WI and gadolinium-DTPA-enhanced T1WI, images were analysed according to signal intensity in the osseous component of the osteochondroma, thickness of the cartilage cap, and associated change in surrounding soft tissue. Clinical manifestation included a palpable mass or tendency to grow (n=22) and pain on movement (n=9). Complications were of three types : that which followed change in the osseous component of the tumor, associated change in surrounding soft tissue, and malignant transformation. In the osseous component, bone marrow edema or contusion was seen in 21 cases (67.7%), and in two (65%), fracture was observed. In surrounding soft tissue, muscle impingement was seen in 21 cases (67.7%), bursitis was in 7 cases (22.6 %), tenosynovitis in seven (22.6 %), and vascular compression in five (16.1 %). In three cases (9.7%), transformation to chondrosarcoma had occurred; two of these were derived from osteochondromatosis and one from a single osteochondroma. The thickness of the cartilage cap was as follow : < 5 mm (n=16), 5-10 mm (n=12), and > 10 mm (n=3). In patients with symptomatic osteochondroma, MR imaging is useful for detecting both complications and malignant transformation. (author). 21 refs., 1 tab., 6 figs.

The Obesity Paradox in Kidney Disease: How to Reconcile It With Obesity Management

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Kamyar Kalantar-Zadeh

2017-03-01

Full Text Available Obesity, a risk factor for de novo chronic kidney disease (CKD, confers survival advantages in advanced CKD. This so-called obesity paradox is the archetype of the reverse epidemiology of cardiovascular risks, in addition to the lipid, blood pressure, adiponectin, homocysteine, and uric acid paradoxes. These paradoxical phenomena are in sharp contradistinction to the known epidemiology of cardiovascular risks in the general population. In addition to advanced CKD, the obesity paradox has also been observed in heart failure, chronic obstructive lung disease, liver cirrhosis, and metastatic cancer, as well as in elderly individuals. These are populations in whom protein−energy wasting and inflammation are strong predictors of early death. Both larger muscle mass and higher body fat provide longevity in these patients, whereas thinner body habitus and weight loss are associated with higher mortality. Muscle mass appears to be superior to body fat in conferring an even greater survival. The obesity paradox may be the result of a time discrepancy between competing risk factors, that is, overnutrition as the long-term killer versus undernutrition as the short-term killer. Hemodynamic stability of obesity, lipoprotein defense against circulating endotoxins, protective cytokine profiles, toxin sequestration of fat mass, and antioxidation of muscle may play important roles. Despite claims that the obesity paradox is a statistical fallacy and a result of residual confounding, the consistency of data and other causality clues suggest a high biologic plausibility. Examining the causes and consequences of the obesity paradox may help uncover important pathophysiologic mechanisms leading to improved outcomes in patients with CKD.

Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography

International Nuclear Information System (INIS)

Plumb, Andrew A.; Pathiraja, Fiona; Taylor, Stuart A.; Halligan, Steve; Nickerson, Claire; Wooldrage, Katherine; Atkin, Wendy S.; Burling, David

2016-01-01

The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations. Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression. Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm 3 , p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02). Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients. (orig.)

Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography

Energy Technology Data Exchange (ETDEWEB)

Plumb, Andrew A.; Pathiraja, Fiona; Taylor, Stuart A.; Halligan, Steve [University College London, Centre for Medical Imaging, London (United Kingdom); Nickerson, Claire [Fulwood House, Public Health England, Sheffield (United Kingdom); Wooldrage, Katherine; Atkin, Wendy S. [Imperial College London, Department of Surgery and Cancer, London (United Kingdom); Burling, David [St Mark' s Hospital, Intestinal Imaging Centre, Harrow (United Kingdom)

2016-12-15

The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations. Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression. Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm{sup 3}, p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02). Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients. (orig.)

Silicosis with bilateral spontaneous pneumothorax

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Fotedar Sanjay

2010-01-01

Full Text Available Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax.The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

Arthroscopic treatment of symptomatic type D medial plica

OpenAIRE

Uysal, Mustafa; Asik, Mehmet; Akpinar, Sercan; Ciftci, Feyyaz; Cesur, Necip; Tandogan, Reha N.

2007-01-01

We aimed to review the results of subtotal arthroscopic resection of symptomatic type D medial plica. We retrospectively evaluated 23 knees with symptomatic type D medial plica in 22 patients without other intra-articular pathology. All patients complained of chronic knee pain that had not been alleviated by medical treatment or physical therapy. In only three (13%) of the patients studied was the plica diagnosed pre-operatively with magnetic resonance imaging. The type D medial plicae in our...

Governance and Developing Asia: Concepts, Measurements, Determinants, and Paradoxes

OpenAIRE

Quibria, M.G.

2014-01-01

Recent years have seen the emergence of a considerable volume of literature on governance and its role in economic and social development of a country. This paper provides a critical review of the literature. This review brings into the open a number of serious conceptual, measurement, and data issues as well as the existence of an Asian governance paradox - i.e., a general disjunction between growth and governance in most Asian economies. This paradox seems to suggest that much of the curren...

Extensitivity of entropy and modern form of Gibbs paradox

International Nuclear Information System (INIS)

Home, D.; Sengupta, S.

1981-01-01

The extensivity property of entropy is clarified in the light of a critical examination of the entropy formula based on quantum statistics and the relevant thermodynamic requirement. The modern form of the Gibbs paradox, related to the discontinuous jump in entropy due to identity or non-identity of particles, is critically investigated. Qualitative framework of a new resolution of this paradox, which analyses the general effect of distinction mark on the Hamiltonian of a system of identical particles, is outlined. (author)

Symptomatic Cerebral Vasospasm and Delayed Cerebral Ischemia Following Transsphenoidal Resection of a Craniopharyngioma.

Science.gov (United States)

Ricarte, Irapuá Ferreira; Funchal, Bruno F; Miranda Alves, Maramélia A; Gomes, Daniela L; Valiente, Raul A; Carvalho, Flávio A; Silva, Gisele S

2015-09-01

Vasospasm has been rarely described as a complication associated with craniopharyngioma surgery. Herein we describe a patient who developed symptomatic vasospasm and delayed cerebral ischemia after transsphenoidal surgery for a craniopharyngioma. A 67-year-old woman became drowsy 2 weeks after a transsphenoidal resection of a craniopharyngioma. A head computed tomography (CT) was unremarkable except for postoperative findings. Electroencephalogram and laboratory studies were within the normal limits. A repeated CT scan 48 hours after the initial symptoms showed bilateral infarcts in the territory of the anterior cerebral arteries (ACA). Transcranial Doppler (TCD) showed increased blood flow velocities in both anterior cerebral arteries (169 cm/second in the left ACA and 145 cm/second in the right ACA) and right middle cerebral artery (164 cm/second) compatible with vasospasm. A CT angiography confirmed the findings. She was treated with induced hypertension and her level of consciousness improved. TCD velocities normalized after 2 weeks. Cerebral vasospasm should be considered in the differential diagnosis of patients with altered neurologic status in the postoperative period following a craniopharyngioma resection. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Colloquium: The Einstein-Podolsky-Rosen paradox: From concepts to applications

International Nuclear Information System (INIS)

Reid, M. D.; Drummond, P. D.; Bowen, W. P.; Cavalcanti, E. G.; Lam, P. K.; Bachor, H. A.; Andersen, U. L.; Leuchs, G.

2009-01-01

This Colloquium examines the field of the Einstein, Podolsky, and Rosen (EPR) gedanken experiment, from the original paper of Einstein, Podolsky, and Rosen, through to modern theoretical proposals of how to realize both the continuous-variable and discrete versions of the EPR paradox. The relationship with entanglement and Bell's theorem are analyzed, and the progress to date towards experimental confirmation of the EPR paradox is summarized, with a detailed treatment of the continuous-variable paradox in laser-based experiments. Practical techniques covered include continuous-wave parametric amplifier and optical fiber quantum soliton experiments. Current proposals for extending EPR experiments to massive-particle systems are discussed, including spin squeezing, atomic position entanglement, and quadrature entanglement in ultracold atoms. Finally, applications of this technology to quantum key distribution, quantum teleportation, and entanglement swapping are examined.

Colloquium: The Einstein-Podolsky-Rosen paradox: From concepts to applications

Energy Technology Data Exchange (ETDEWEB)

Reid, M. D.; Drummond, P. D.; Bowen, W. P.; Cavalcanti, E. G.; Lam, P. K.; Bachor, H. A.; Andersen, U. L.; Leuchs, G. [ARC Centre of Excellence for Quantum-Atom Optics and Centre for Atom Optics and Ultrafast Spectroscopy, Swinburne University of Technology, P.O. Box 218, Melbourne, Victoria 3122 Australia (Australia); School of Physical Sciences, University of Queensland, Brisbane, Queensland 4072 (Australia); Centre for Quantum Dynamics, Griffith University, Brisbane, Queensland 4111 (Australia); ARC Centre of Excellence for Quantum-Atom Optics, Building 38, The Australian National University, Canberra, Australian Capital Territory 0200 (Australia); Department of Physics, Technical University of Denmark, Building 309, 2800 Lyngby (Denmark); Max-Planck Institute for the Science of Light and Department of Physics, Universitaet Erlangen-Nuernberg, D-91058 Erlangen (Germany)

2009-10-15

This Colloquium examines the field of the Einstein, Podolsky, and Rosen (EPR) gedanken experiment, from the original paper of Einstein, Podolsky, and Rosen, through to modern theoretical proposals of how to realize both the continuous-variable and discrete versions of the EPR paradox. The relationship with entanglement and Bell's theorem are analyzed, and the progress to date towards experimental confirmation of the EPR paradox is summarized, with a detailed treatment of the continuous-variable paradox in laser-based experiments. Practical techniques covered include continuous-wave parametric amplifier and optical fiber quantum soliton experiments. Current proposals for extending EPR experiments to massive-particle systems are discussed, including spin squeezing, atomic position entanglement, and quadrature entanglement in ultracold atoms. Finally, applications of this technology to quantum key distribution, quantum teleportation, and entanglement swapping are examined.

Colloquium: The Einstein-Podolsky-Rosen paradox: From concepts to applications

Science.gov (United States)

Reid, M. D.; Drummond, P. D.; Bowen, W. P.; Cavalcanti, E. G.; Lam, P. K.; Bachor, H. A.; Andersen, U. L.; Leuchs, G.

2009-10-01

This Colloquium examines the field of the Einstein, Podolsky, and Rosen (EPR) gedanken experiment, from the original paper of Einstein, Podolsky, and Rosen, through to modern theoretical proposals of how to realize both the continuous-variable and discrete versions of the EPR paradox. The relationship with entanglement and Bell’s theorem are analyzed, and the progress to date towards experimental confirmation of the EPR paradox is summarized, with a detailed treatment of the continuous-variable paradox in laser-based experiments. Practical techniques covered include continuous-wave parametric amplifier and optical fiber quantum soliton experiments. Current proposals for extending EPR experiments to massive-particle systems are discussed, including spin squeezing, atomic position entanglement, and quadrature entanglement in ultracold atoms. Finally, applications of this technology to quantum key distribution, quantum teleportation, and entanglement swapping are examined.

Geologic appraisal of Paradox basin salt deposits for water emplacement

Science.gov (United States)

Hite, Robert J.; Lohman, Stanley William

1973-01-01

Thick salt deposits of Middle Pennsylvanian age are present in an area of 12,000 square miles in the Paradox basin of southeast Utah and southwest Colorado. The deposits are in the Paradox Member of the Hermosa Formation. The greatest thickness of this evaporite sequence is in a troughlike depression adjacent to the Uncompahgre uplift on the northeast side of the basin.The salt deposits consist of a cyclical sequence of thick halite units separated by thin units of black shale, dolomite, and anhydrite. Many halite units are several hundred feet thick and locally contain economically valuable potash deposits.Over much of the Paradox basin the salt deposits occur at depths of more than 5,000 feet. Only in a series of salt anticlines located along the northeastern side of the basin do the salt deposits rise to relatively shallow depths. The salt anticlines can be divided geographically and structurally into five major systems. Each system consists of a long undulating welt of thickened salt over which younger rocks are arched in anticlinal form. Locally there are areas along the axes of the anticlines where the Paradox Member was never covered by younger sediments. This allowed large-scale migration of Paradox strata toward and up through these holes in the sediment cover forming diapiric anticlines.The central or salt-bearing cores of the anticlines range in thickness from about 2,500 to 14,000 feet. Structure in the central core of the salt anticlines is the result of both regional-compression and flowage of the Paradox Member into the anticlines from adjacent synclines. Structure in the central cores of the salt anticlines ranges from relatively undeformed beds to complexly folded and faulted masses, in which stratigraphic continuity is undemonstrable.The presence of thick cap rock .over many of the salt anticlines is evidence of removal of large volumes of halite by groundwater. Available geologic and hydrologic information suggests that this is a relatively slow

Paradoxical reaction to the treatment of tuberculosis uncovering previously silent meningeal disease Reação paradoxal ao tratamento da tuberculose revelando doença meníngea previamente silenciosa

Directory of Open Access Journals (Sweden)

Walter A. Eyer-Silva

2002-02-01

Full Text Available The development of paradoxical clinical worsening following initiation of tuberculosis treatment may complicate the clinical course of both HIV-infected and uninfected patients. We report a severe manifestation of the so called paradoxical reaction to the treatment of tuberculosis that unmasked previously silent meningeal disease in a 34-year-old HIV-infected male patient.O desenvolvimento de piora clínica paradoxal como resposta ao início do tratamento da tuberculose pode complicar a evolução de pacientes com e sem infecção pelo HIV. Apresentamos uma grave manifestação da chamada reação paradoxal ao tratamento da tuberculose, que revelou doença meníngea previamente silenciosa em um paciente HIV-positivo de 34 anos.

Bilateral Keratectasia 34 Years after Corneal Transplant

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Xavier Valldeperas

2010-07-01

Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

The Teacher's Paradox

Science.gov (United States)

Lilyquist, J. Gary

1998-06-01

New findings suggest that the way in which schools conduct their business is blocking our educational system from improving at a rate required to meet society's needs. A ground theory developed by exploring six organizational dimensions: external and internal environment cultures, leadership, strategy, structure, and results, verified the existence of the teacher's paradox. Implications suggest educational reformers must rethink approaches to school improvement by work within cultural boundaries. The forth coming book, "Are schools really like this?" presents "The Balance Alignment Model and Theory" to improve our schools using system thinking.

A boy with bilateral SUNA

DEFF Research Database (Denmark)

Vuković Cvetković, Vlasta; Jensen, Rigmor Højland

2017-01-01

secondary causes should be searched for vigorously if there are bilateral symptoms. Despite a number of therapeutic trials, effective management for the majority of SUNA patients is not available at present. Management of SUNA is often difficult. Case We report the case of a young boy with bilateral SUNA...

Perspectives on Games, Computers, and Mental Health: Questions about Paradoxes, Evidences, and Challenges

OpenAIRE

Desseilles, Martin

2016-01-01

In the field of mental health, games and computerized games present questions about paradoxes, evidences, and challenges. This perspective article offers perspectives and personal opinion about these questions, evidences, and challenges with an objective of presenting several ideas and issues in this rapidly developing field. First, games raise some questions in the sense of the paradox between a game and an issue, as well as the paradox of using an amusing game to treat a serious pathology. ...

Progressive paradoxical sleep deprivation impairs partial memory following learning tasks in rats

Institute of Scientific and Technical Information of China (English)

Chunmin Zhu; Xiangrong Yao; Weisheng Zhang; Yanfeng Song; Yiping Hou

2008-01-01

BACKGROUND: Complex learning tasks result in a greater number of paradoxical sleep phases, which can improve memory. The effect of paradoxical sleep deprivation, induced by "flower pot" technique, on spatial reference memory and working memory require further research. OBJECTIVE: To observe the effect of progressive paradoxical sleep deprivation in rats, subsequent to learning, on memory using the Morris Water Maze. DESIGN, TIME AND SETTING: Controlled observation experiment. The experiment was performed at the Laboratory of Neurobiology, Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Lanzhou University from December 2006 to October 2007. MATERIALS: Twenty-eight, male, Wistar rats, 3-4 months old, were provided by the Experimental Animal Center of Lanzhou University. The Morris Water Maze and behavioral analyses system was purchased from Genheart Company, Beijing, China. METHODS: All animals, according to a random digits table, were randomly divided into paradoxical sleep deprivation, tank control, and home cage control groups. Paradoxical sleep deprivation was induced by the "flower pot" technique for 72 hours, housing the rats on small platforms over water. Rats in the "tank control" and "home cage control" groups were housed either in a tank with large platforms over the water or in normal cages without paradoxical sleep deprivation. MAIN OUTCOME MEASURES: Morris Water Maze was employed for task learning and spatial memory testing. Rats in all groups were placed at six random starting points each day for four consecutive days. Each placement was repeated for two trials; the first trial represented reference memory and the second working memory. Rats in the first trial were allowed to locate the submerged platform within 120 seconds. Data, including swimming distance, escape latency, swimming velocity, percentage of time in correct quarter, and memory scores were recorded and analyzed automatically by behavioral analyses

Einstein-Podolsky-Rosen paradox in single pairs of images.

Science.gov (United States)

Lantz, Eric; Denis, Séverine; Moreau, Paul-Antoine; Devaux, Fabrice

2015-10-05

Spatially entangled twin photons provide a test of the Einstein-Podolsky-Rosen (EPR) paradox in its original form of position (image plane) versus impulsion (Fourier plane). We show that recording a single pair of images in each plane is sufficient to safely demonstrate an EPR paradox. On each pair of images, we have retrieved the fluctuations by subtracting the fitted deterministic intensity shape and then have obtained an intercorrelation peak with a sufficient signal to noise ratio to safely distinguish this peak from random fluctuations. A 95% confidence interval has been determined, confirming a high degree of paradox whatever the considered single pairs. Last, we have verified that the value of the variance of the difference between twin images is always below the quantum (poissonian) limit, in order to ensure the particle character of the demonstration. Our demonstration shows that a single image pattern can reveal the quantum and non-local behavior of light.

Teaching Quantum Physics without Paradoxes

Science.gov (United States)

Hobson, Art

2007-01-01

Although the resolution to the wave-particle paradox has been known for 80 years, it is seldom presented. Briefly, the resolution is that material particles and photons are the quanta of extended spatially continuous but energetically quantized fields. But because the resolution resides in quantum field theory and is not usually spelled out in…

Micro-Macro Paradoxes of Entrepreneurship

DEFF Research Database (Denmark)

Søgaard, Villy

2008-01-01

Artiklen tager afsæt i det såkaldte micro-macro paradox fra Aids-Efficiency litteraturen og argumenterer for, at en tilsvarende problemstilling bør inddrages i vurderingen af f.eks. de beskæftigelsesmæssige konsekvenser af entrepreneuriel virksomhed. Den påviser også i en gennemgang af litteratur...

Bilateral juvenile nasopharyngeal angiofibroma: report of a case.

Science.gov (United States)

Wu, Edward C; Chark, Davin W; Bhandarkar, Naveen D

2014-07-01

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA. Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management. The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth. The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary. © 2014 ARS-AAOA, LLC.

Simpson’s Paradox in the interpretation of “leaky pipeline” data

Directory of Open Access Journals (Sweden)

Walton Paul H.

2016-12-01

Full Text Available The traditional ‘leaky pipeline’ plots are widely used to inform gender equality policy and practice. Herein, we demonstrate how a statistical phenomenon known as Simpson’s paradox can obscure trends in gender ‘leaky pipeline’ plots. Our approach has been to use Excel spreadsheets to generate hypothetical ‘leaky pipeline’ plots of gender inequality within an organisation. The principal factors, which make up these hypothetical plots, can be input into the model so that a range of potential situations can be modelled. How the individual principal factors are then reflected in ‘leaky pipeline’ plots is shown. We find that the effect of Simpson’s paradox on leaky pipeline plots can be simply and clearly illustrated with the use of hypothetical modelling and our study augments the findings in other statistical reports of Simpson’s paradox in clinical trial data and in gender inequality data. The findings in this paper, however, are presented in a way, which makes the paradox accessible to a wide range of people.

Paradoxical response to dexamethasone and spontaneous hypocortisolism in Cushing's disease

OpenAIRE

Lila, Anurag R; Sarathi, Vijaya; Bandgar, Tushar R; Shah, Nalini S

2013-01-01

Paradoxical response to dexamethasone and spontaneous development of hypocortisolism are rare features of Cushing's disease. We report a 13-year-old boy with Cushing's disease owing to a pituitary macroadenoma. On initial evaluation, he had partial suppression of serum cortisol by dexamethasone. He developed transient hypocortisolism after first adenomectomy, but the disease recurred after 1 year. Repeat evaluation showed recurrent hypercortisolism and paradoxical response to dexamethasone. H...

Fault-tolerant Greenberger-Horne-Zeilinger paradox based on non-Abelian anyons.

Science.gov (United States)

Deng, Dong-Ling; Wu, Chunfeng; Chen, Jing-Ling; Oh, C H

2010-08-06

We propose a scheme to test the Greenberger-Horne-Zeilinger paradox based on braidings of non-Abelian anyons, which are exotic quasiparticle excitations of topological states of matter. Because topological ordered states are robust against local perturbations, this scheme is in some sense "fault-tolerant" and might close the detection inefficiency loophole problem in previous experimental tests of the Greenberger-Horne-Zeilinger paradox. In turn, the construction of the Greenberger-Horne-Zeilinger paradox reveals the nonlocal property of non-Abelian anyons. Our results indicate that the non-Abelian fractional statistics is a pure quantum effect and cannot be described by local realistic theories. Finally, we present a possible experimental implementation of the scheme based on the anyonic interferometry technologies.

Experimental test of the irreducible four-qubit Greenberger-Horne-Zeilinger paradox

Science.gov (United States)

Su, Zu-En; Tang, Wei-Dong; Wu, Dian; Cai, Xin-Dong; Yang, Tao; Li, Li; Liu, Nai-Le; Lu, Chao-Yang; Żukowski, Marek; Pan, Jian-Wei

2017-03-01

The paradox of Greenberger-Horne-Zeilinger (GHZ) disproves directly the concept of EPR elements of reality, based on the EPR correlations, in an all-versus-nothing way. A three-qubit experimental demonstration of the GHZ paradox was achieved nearly 20 years ago, followed by demonstrations for more qubits. Still, the GHZ contradictions underlying the tests can be reduced to a three-qubit one. We show an irreducible four-qubit GHZ paradox, and report its experimental demonstration. The bound of a three-setting-per-party Bell-GHZ inequality is violated by 7 σ . The fidelity of the GHZ state was around 81 % , and an entanglement witness reveals a violation of the separability threshold by 19 σ .

A Canadian paradox: Tommy Douglas and eugenics.

Science.gov (United States)

Shevell, Michael

2012-01-01

Tommy Douglas is an icon of Canadian 20th Century political history and is considered by many as the "Father" of Medicare, a key component of our national identity. Throughout his career, he was associated at both the provincial and federal levels with progressive causes concerning disadvantaged populations. In his sociology Master's thesis written in the early 1930's, Douglas endorsed eugenic oriented solutions such as segregation and sterilization to address what was perceived to be an endemic and biologically determined problem. At first glance, this endorsement of eugenics appears to be paradoxical, but careful analysis revealed that this paradox has multiple roots in religion, political belief, historical exposure and our own desire to view our collective history in a favourable light.

Rotating model for the equivalence principle paradox

International Nuclear Information System (INIS)

Wilkins, D.C.

1975-01-01

An idealized system is described in which two inertial frames rotate relative to one another. When a (scalar) dipole is locally at rest in one frame, a paradox arises as to whether or not it will radiate. Fluxes of energy and angular momentum and the time development of the system are discussed. Resolution of the paradox involves several unusual features, including (i) radiation by an unmoving charge, an effect discussed by Chitre, Price, and Sandberg, (ii) different power seen by relatively accelerated inertial observers, and (iii) radiation reaction due to gravitational backscattering of radiation, in agreement with the work of C. and B. DeWitt. These results are obtained, for the most part, without the complications of curved space--time

Steering, Entanglement, Nonlocality, and the EPR Paradox

Science.gov (United States)

Wiseman, Howard; Jones, Steve; Andrew, Doherty

2007-06-01

The concept of steering was introduced by Schroedinger in 1935 as a generalization of the EPR paradox for arbitrary pure bipartite entangled states and arbitrary measurements by one party. Until now, it has never been rigorously defined, so it has not been known (for example) what mixed states are steerable (that is, can be used to exhibit steering). We provide an operational definition, from which we prove (by considering Werner states and Isotropic states) that steerable states are a strict subset of the entangled states, and a strict superset of the states that can exhibit Bell-nonlocality. For arbitrary bipartite Gaussian states we derive a linear matrix inequality that decides the question of steerability via Gaussian measurements, and we relate this to the original EPR paradox.

Six psychotropics for pre-symptomatic & early Alzheimer's (MCI, Parkinson's, and Huntington's disease modification

Directory of Open Access Journals (Sweden)

Edward C Lauterbach

2016-01-01

Full Text Available The quest for neuroprotective drugs to slow the progression of neurodegenerative diseases (NDDs, including Alzheimer's disease (AD, Parkinson's disease (PD, and Huntington's disease (HD, has been largely unrewarding. Preclinical evidence suggests that repurposing quetiapine, lithium, valproate, fluoxetine, donepezil, and memantine for early and pre-symptomatic disease-modification in NDDs may be promising and can spare regulatory barriers. The literature of these psychotropics in early stage and pre-symptomatic AD, PD, and HD is reviewed and propitious findings follow. Mild cognitive impairment (MCI phase of AD: salutary human randomized controlled trial findings for low-dose lithium and, in selected patients, donepezil await replication. Pre-symptomatic AD: human epidemiological data indicate that lithium reduces AD risk. Animal model studies (AMS reveal encouraging results for quetiapine, lithium, donepezil, and memantine. Early PD: valproate AMS findings show promise. Pre-symptomatic PD: lithium and valproate AMS findings are encouraging. Early HD: uncontrolled clinical data indicate non-progression with lithium, fluoxetine, donepezil, and memantine. Pre-symptomatic HD: lithium and valproate are auspicious in AMS. Many other promising findings awaiting replication (valproate in MCI; lithium, valproate, fluoxetine in pre-symptomatic AD; lithium in early PD; lithium, valproate, fluoxetine in pre-symptomatic PD; donepezil in early HD; lithium, fluoxetine, memantine in pre-symptomatic HD are reviewed. Dose- and stage-dependent effects are considered. Suggestions for signal-enhancement in human trials are provided for each NDD stage.

Calcium paradox and calcium entry blockers

NARCIS (Netherlands)

Ruigrok, T.J.C.; Slade, A.M.; Nayler, W.G.; Meijler, F.L.

1984-01-01

Reperfusion of isolated hearts with calcium-containing solution after a short period of calcium-free perfusion results in irreversible cell damage (calcium paradox). This phenomenon is characterized by an excessive influx of calcium into the cells, the rapid onset of myocardial contracture,

Bilateral complex regional pain syndrome following spinal cord injury and bilateral calcaneus fracture

Directory of Open Access Journals (Sweden)

Ahmet Boyacı

2013-09-01

Full Text Available Complex regional pain syndrome (CRPS is a disease affectingone or more extremities, characterized by spontaneouspain, allodynia, hyperpathia and hyperalgesia.CRPS is separated into Type 1 and Type 2. CRPS whichdevelops after a nociceptive event is labeled as Type 1and when it develops following peripheral nerve damage,Type 2. Although the pathogenesis is not fully understood,peripheral and central sensitivity are held responsible.Bilateral lower extremity involvement is extremely rare.However, it should be borne in mind that it can develop intraumatic injuries which occur in more than one area anddiagnosis and commencement of a rehabilitation programshould be made in the early period. The case is presentedhere of bilateral Type 1 CRPS developing after incompletespinal cord injury and bilateral calcaneus fracture. JClin Exp Invest 2013; 4 (3: 360-363Key words: complex regional pain syndrome, calcaneusfracture, spinal cord injury

Introducing the Levinthal's Protein Folding Paradox and Its Solution

Science.gov (United States)

Martínez, Leandro

2014-01-01

The protein folding (Levinthal's) paradox states that it would not be possible in a physically meaningful time to a protein to reach the native (functional) conformation by a random search of the enormously large number of possible structures. This paradox has been solved: it was shown that small biases toward the native conformation result…

Mechanical Paradox: The Uphill Roller

Science.gov (United States)

Cortes, Emilio; Cortes-Poza, D.

2011-01-01

We analyse in detail the dynamics of a mechanical system which is a rigid body with the geometry of a double cone. This double cone is apparently able to spontaneously roll uphill along inclined rails. The experiment has been known for some centuries, and because of its peculiar behaviour, it has been named "mechanical paradox". Although this…

The Paradox of Painful Art

Science.gov (United States)

Smuts, Aaron

2007-01-01

Many of the most popular genres of narrative art are designed to elicit negative emotions: emotions that are experienced as painful or involving some degree of pain, which people generally avoid in their daily lives. Traditionally, the question of why people seek out such experiences of painful art has been presented as the paradox of tragedy, and…

The Paradoxes of Liberalism

DEFF Research Database (Denmark)

Thompson, Grahame

2011-01-01

Jakob Vestergaard has produced one of the most telling analyses of the international financial architecture by deploying a broadly Foucauldian framework that invokes a novel description of neo-liberal governance, one organized around discipline, conditional exceptions and the pursuit of a ‘proper...... economy’. This review both welcomes but challenges some of Vestergaard's analysis. In so doing it explores further the paradoxes of liberalism and the fate of sovereignty in the current international context....

ADHD, Multimodal Treatment, and Longitudinal Outcome: Evidence, Paradox, and Challenge.

Science.gov (United States)

Hinshaw, Stephen P; Arnold, L Eugene

2015-01-01

Given major increases in the diagnosis of attention-deficit hyperactivity disorder (ADHD) and in rates of medication for this condition, we carefully examine evidence for effects of single versus multimodal (i.e., combined medication and psychosocial/behavioral) interventions for ADHD. Our primary data source is the Multimodal Treatment Study of Children with ADHD (MTA), a 14-month, randomized clinical trial in which intensive behavioral, medication, and multimodal treatment arms were contrasted with one another and with community intervention (treatment-as-usual), regarding outcome domains of ADHD symptoms, comorbidities, and core functional impairments. Although initial reports emphasized the superiority of well-monitored medication for symptomatic improvement, reanalyses and reappraisals have highlighted (a) the superiority of combination treatment for composite outcomes and for domains of functional impairment (e.g., academic achievement, social skills, parenting practices); (b) the importance of considering moderator and mediator processes underlying differential patterns of outcome, including comorbid subgroups and improvements in family discipline style during the intervention period; (c) the emergence of side effects (e.g., mild growth suppression) in youth treated with long-term medication; and (d) the diminution of medication's initial superiority once the randomly assigned treatment phase turned into naturalistic follow-up. The key paradox is that whereas ADHD clearly responds to medication and behavioral treatment in the short term, evidence for long-term effectiveness remains elusive. We close with discussion of future directions and a call for greater understanding of relevant developmental processes in the attempt to promote optimal, generalized, and lasting treatments for this important and impairing neurodevelopmental disorder.

Time travel paradoxes, path integrals, and the many worlds interpretation of quantum mechanics

International Nuclear Information System (INIS)

Everett, Allen

2004-01-01

We consider two approaches to evading paradoxes in quantum mechanics with closed timelike curves. In a model similar to Politzer's, assuming pure states and using path integrals, we show that the problems of paradoxes and of unitarity violation are related; preserving unitarity avoids paradoxes by modifying the time evolution so that improbable events become certain. Deutsch has argued, using the density matrix, that paradoxes do not occur in the 'many worlds interpretation'. We find that in this approach account must be taken of the resolution time of the device that detects objects emerging from a wormhole or other time machine. When this is done one finds that this approach is viable only if macroscopic objects traversing a wormhole interact with it so strongly that they are broken into microscopic fragments

Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.

Science.gov (United States)

Malham, Gregory M; Limb, Rebecca J; Claydon, Matthew H; Brazenor, Graeme A

2013-12-01

Painful L5/S1 pseudoarthrosis has been previously managed with posterior excision and/or lumbar fusion. To our knowledge, the anterior approach for L5/S1 pseudoarthrectomy in the treatment of Bertolotti's syndrome has not been described. We present two patients with severe symptomatic L5/S1 pseudoarthroses that were successfully excised via an anterior retroperitoneal approach with 2 year clinical and radiological follow-up. The literature regarding surgical treatments for Bertolotti's syndrome is reviewed. The technique for an anterior retroperitoneal approach is described. This approach has been safe and effective in providing long term symptomatic relief to our two patients. Further studies comparing the outcomes of anterior versus posterior pseudoarthrectomy will guide the management of this condition. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Chinese Classroom Paradox: A Cross-Cultural Comparison of Teacher Controlling Behaviors

Science.gov (United States)

Zhou, Ning; Lam, Shui-Fong; Chan, Kam Chi

2012-01-01

Chinese classrooms present an intriguing paradox to the claim of self-determination theory that autonomy facilitates learning. Chinese teachers appear to be controlling, but Chinese students do not have poor academic performance in international comparisons. The present study addressed this paradox by examining the cultural differences in…

Obesity and poverty paradox in developed countries.

Science.gov (United States)

Żukiewicz-Sobczak, Wioletta; Wróblewska, Paula; Zwoliński, Jacek; Chmielewska-Badora, Jolanta; Adamczuk, Piotr; Krasowska, Ewelina; Zagórski, Jerzy; Oniszczuk, Anna; Piątek, Jacek; Silny, Wojciech

2014-01-01

Obesity is a civilization disease and the proportion of people suffering from it continues to grow, especially in the developed countries. Number of obese people in Europe has increased threefold over the last 20 years. The paradox of obesity and poverty relationship is observed especially in the developed and developing countries. In developing countries, along with economic development and income growth, the number of people with overweight and obesity is increasing. This paradox has a relationship with both the easy availability and low cost of highly processed foods containing 'empty calories' and no nutritional value. To date, this paradox has been described in the United States and the United Kingdom, although many European countries are also experiencing high percentages of obese people. Among the reasons for the growing obesity in the population of poor people are: higher unemployment, lower education level, and irregular meals. Another cause of obesity is low physical activity, which among the poor is associated with a lack of money for sports equipment. Due to the large rate of deaths caused by diseases directly linked to obesity, the governments of many countries implement prevention programmes of overweight and obesity. These programmes are based primarily on educating the public about a healthy lifestyle based on healthy eating, daily physical activity and avoiding alcohol and cigarettes.

Obesity and poverty paradox in developed countries

Directory of Open Access Journals (Sweden)

Wioletta Żukiewicz-Sobczak

2014-09-01

Full Text Available Obesity is a civilization disease and the proportion of people suffering from it continues to grow, especially in the developed countries. Number of obese people in Europe has increased threefold over the last 20 years. The paradox of obesity and poverty relationship is observed especially in the developed and developing countries. In developing countries, along with economic development and income growth, the number of people with overweight and obesity is increasing. This paradox has a relationship with both the easy availability and low cost of highly processed foods containing ‘empty calories’ and no nutritional value. To date, this paradox has been described in the United States and the United Kingdom, although many European countries are also experiencing high percentages of obese people. Among the reasons for the growing obesity in the population of poor people are: higher unemployment, lower education level, and irregular meals. Another cause of obesity is low physical activity, which among the poor is associated with a lack of money for sports equipment. Due to the large rate of deaths caused by diseases directly linked to obesity, the governments of many countries implement prevention programmes of overweight and obesity. These programmes are based primarily on educating the public about a healthy lifestyle based on healthy eating, daily physical activity and avoiding alcohol and cigarettes.

Resolving the Innovation Diffusion Paradox in Mobile App Stores

DEFF Research Database (Denmark)

Xiong, Bingqing; Tan, Chee-Wee; Wang, Weiquan

2017-01-01

to the abundance of apps and multitudinous promotional information. To this end, this study proposes branding as a strategy to tackle the innovation diffusion paradox. Specifically, we construct a research model that posits consumers’ brand awareness as an antecedent affecting their brand association and quality......The growing number of apps released on a daily basis has contributed to an innovation diffusion paradox whereby the frequency and intensity by which innovations are crowdsourced are stymieing their own diffusion. In mobile app stores, consumers are often constrained in their selection due...

Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

Directory of Open Access Journals (Sweden)

Sultan Şevik Eliçora

2015-01-01

Full Text Available Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis.

Chronic Illness as a Source of Happiness: Paradox or perfectly normal?

Directory of Open Access Journals (Sweden)

S. Hoppe

2013-11-01

Full Text Available In this paper I analyse the relation between happiness and chronic illness from the perspective of medical anthropology and disability studies. By looking at the disability paradox I deconstruct society’s view of people with a disability. I argue that the disability paradox is problematic as it ignores the views of people with a disability. Moreover, such a paradox reinforces the idea that living with a chronic illness or disability is a devastating experience and that happiness and disability are mutally exclusive realities. Based on empiric examples of people who suffer from Multiple Sclerosis I demonstrate that people with a chronic illness can experience happiness in spite of illness, but also as a consequence of it. 

Paradoxical hypotension during dobutamine infusion for myocardial perfusion scintigraphy

International Nuclear Information System (INIS)

Erguen, E.L.; Caner, B.; Atalar, E.; Karanfil, A.; Tokgoezoglu, L.

1998-01-01

Dobutamine as a predominant beta-1 agonist increases heart rate and myocardial contractility and at sufficient high doses, it also increases systolic blood pressure. This study was undertaken to describe instances of paradoxical hypotension during dobutamine infusion for Tl-201 myocardial perfusion SPECT study and the relationship between scintigraphic findings and hypotension occurred during dobutamine infusion. Methods: In 201 consecutive patients unable to perform adequate exercise, dobutamine Tl-201 myocardial SPECT was performed. Dobutamine was infused starting from 10 μg/kg/min increasing to 40 μ/kg/min. Paradoxical hypotension was defined as a decrease in systolic blood pressure ≥ 20 mmHg compared with baseline study. Paradoxical hypotension was observed in 40 patients (Group A) out of 201 (19.9%) while no significant change in systolic blood pressure was detected in the remaining 161 patients (Group B). Mean maximum fall in systolic blood pressure was 39±18 mmHg (range: 20-90). In 33 of 40 patients (83%) with paradoxical hypotension, scintigraphy was normal compared to 131 (81%) of the remaining 161 patients. In patients of Group A, angiography, echocardiography and tilt table tests were performed in 13, 11 and 6 patients respectively. Nine of 13 angiographic evaluations (69%), 10 of 11 echocardiographic evaluations (91%), all of the tilt table tests were normal. Additionally, all of the patients of Group A were clinically followed up at least 6 months after the myocardial perfusion scintigraphy. None of the patients had a cardiac event except one patient during the follow-up period. Conclusion: Paradoxical hypotension during dobutamine infusion for myocardial scintigraphy is not an uncommon finding and up to 19.9% patients may develop such hypotension. To maximize test safety, precautions should be taken during dobutamine myocardial stress test, since remarkable decrease in systolic blood pressure may occur. Unlike hypotension occurring with exercise

Widespread hypermetabolism in symptomatic and asymptomatic episodes in Kleine-Levin syndrome.

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Yves Dauvilliers

Full Text Available BACKGROUND: No reliable biomarkers are identified in KLS. However, few functional neuroimaging studies suggested hypoactivity in thalamic and hypothalamic regions during symptomatic episodes. Here, we investigated relative changes in regional brain metabolism in Kleine-Levin syndrome (KLS during symptomatic episodes and asymptomatic periods, as compared to healthy controls. METHODS: Four drug-free male patients with typical KLS and 15 healthy controls were included. 18-F-fluorodeoxy glucose positron emission tomography (PET was obtained in baseline condition in all participants, and during symptomatic episodes in KLS patients. All participants were asked to remain fully awake during the whole PET procedure. RESULTS: Between state-comparisons in KLS disclosed higher metabolism in paracentral, precentral, and postcentral areas, supplementary motor area, medial frontal gyrus, thalamus and putamen during symptomatic episodes, and decreased metabolism in occipital and temporal gyri. As compared to healthy control subjects, KLS patients in the asymptomatic phase consistently exhibited significant hypermetabolism in a wide cortical network including frontal and temporal cortices, posterior cingulate and precuneus, with no detected hypometabolism. In symptomatic KLS episodes, hypermetabolism was additionally found in orbital frontal and supplementary motor areas, insula and inferior parietal areas, and right caudate nucleus, and hypometabolism in the middle occipital gyrus and inferior parietal areas. CONCLUSION: Our results demonstrated significant hypermetabolism and few hypometabolism in specific but widespread brain regions in drug-free KLS patients at baseline and during symptomatic episodes, highlighting the behavioral state-dependent nature of changes in regional brain activity in KLS.

The Policy Maker's Anguish: Regulating Personal Data Behavior Between Paradoxes and Dilemmas

Science.gov (United States)

Compañó, Ramón; Lusoli, Wainer

Regulators in Europe and elsewhere are paying great attention to identity, privacy and trust in online and converging environments. Appropriate regulation of identity in a ubiquitous information environment is seen as one of the major drivers of the future Internet economy. Regulation of personal identity data has come to the fore including mapping conducted on digital personhood by the OECD; work on human rights and profiling by the Council of Europe andmajor studies by the European Commission with regard to self-regulation in the privacy market, electronic identity technical interoperability and enhanced safety for young people. These domains overlap onto an increasingly complex model of regulation of individuals' identity management, online and offline. This chapter argues that policy makers struggle to deal with issues concerning electronic identity, due to the apparently irrational and unpredictable behavior of users when engaging in online interactions involving identity management. Building on empirical survey evidence from four EU countries, we examine the first aspect in detail - citizens' management of identity in a digital environment. We build on data from a large scale (n = 5,265) online survey of attitudes to electronic identity among young Europeans (France, Germany, Spain, UK) conducted in August 2008. The survey asked questions about perceptions and acceptance of risks, general motivations, attitudes and behaviors concerning electronic identity. Four behavioral paradoxes are identified in the analysis: a privacy paradox (to date well known), but also a control paradox, a responsibility paradox and an awareness paradox. The chapter then examines the paradoxes in relation of three main policy dilemmas framing the debate on digital identity. The paper concludes by arguing for an expanded identity debate spanning policy circles and the engineering community.

R&D ADMINISTRATION IN THE HIGH TECHNOLOGY INDUSTRY: HOW TO MANAGE A PARADOX

Directory of Open Access Journals (Sweden)

Nobuiuki Costa Ito

2010-10-01

Full Text Available The competitive environment of the knowledge age is getting more complex, dynamic, and fast-moving each day. The high tech industry is intensively tied to its effects and demands for innovation, so the field of Research and Development must act strategically, generating innovations and granting success and sustainability to the business. However, there is a paradox in R&D which may lay traps and obstacles disguised by the busy day-to-day activity of the organization. The purpose of this paper is to point out directions that managers may take to cope with these contradictions in R&D administration. The R&D paradox is rooted in the conflict between exploitation, achieved by continual improvement through incremental innovation, and by exploration, which seeks new opportunities in the creation of new technologies through disruptive innovations. These two sides of the paradox demand different, and sometimes even divergent, organizations. Top management leadership is crucial for the acceptance and balancing of the contradictions created by this paradox, and can align exploitation/exploration through distributive and integrative decisions and transform companies into truly ambidextrous organizations.    Key-words:  Research & Development. Innovation. Paradox. Ambidextrous organizations. Strategy. 

Paradoxical motion of interventricular septum on Tc-99m MIBI gated SPECT study

International Nuclear Information System (INIS)

Ergun, E.L.; Erbas, B.; Beylergil, V.; Demirturk, O.S.; Pasaoglu, I.

2004-01-01

After uncomplicated cardiac surgery, abnormal motion of the interventricular septum is frequently observed. The interventricular septum has often been found to display dyskinetic, or paradoxical motion by echocardiographic studies. This study was undertaken to describe instances of paradoxical motion of interventricular septum on Tc-99m MIBI gated SPECT studies in patients after coronary artery by pass graft surgery. Tc-99m MIBI gated SPECT in conjunction with stress myocardial perfusion SPECT was performed in 18 patients who had history of cardiac bypass graft surgery. Paradoxical motion of the interventricular septum was defined visually from Tc-99m MIBI gated SPECT. Perfusion of the interventricular septum was examined from myocardial perfusion images in the same study. Paradoxical motion of the interventricular septum was observed in 4 patients (22%). The interventricular septum was normally perfused in all patients. It was concluded that paradoxical motion of the interventricular septum in patients who had a history of cardiac by-pass graft surgery is not an uncommon finding and it can be observed with gated SPECT. The exact mechanism of this phenomenon is not well-known. A normal perfusion in interventricular wall helps to discriminate this situation from a real abnormality. (author)

Zeno's paradox in quantum cellular automata

Energy Technology Data Exchange (ETDEWEB)

Groessing, G [Atominst. der Oesterreichischen Universitaeten, Vienna (Austria); Zeilinger, A [Inst. fuer Experimentalphysik, Univ. Innsbruck (Austria)

1991-07-01

The effect of Zeno's paradox in quantum theory is demonstrated with the aid of quantum mechanical cellular automata. It is shown that the degree of non-unitarity of the cellular automaton evolution and the frequency of consecutive measurements of cellular automaton states are operationally indistinguishable. (orig.).

Zeno's paradox in quantum cellular automata

International Nuclear Information System (INIS)

Groessing, G.; Zeilinger, A.

1991-01-01

The effect of Zeno's paradox in quantum theory is demonstrated with the aid of quantum mechanical cellular automata. It is shown that the degree of non-unitarity of the cellular automaton evolution and the frequency of consecutive measurements of cellular automaton states are operationally indistinguishable. (orig.)

MODELING PARADOXES IN NOVICE AND EXPERT DESIGN

DEFF Research Database (Denmark)

Dorst, Kees; Hansen, Claus Thorp

2011-01-01

In their ICED09 paper ‘Problem formulation as a discursive activity’, the authors have used an extensive educational case study to explore a framework for describing design as a discursive activity, centered around the paradoxical nature of the problem situation. The ‘working definition’ for para......In their ICED09 paper ‘Problem formulation as a discursive activity’, the authors have used an extensive educational case study to explore a framework for describing design as a discursive activity, centered around the paradoxical nature of the problem situation. The ‘working definition...... at play in a design situation, and extract themes that can lead to reformulation of the problem as well as the creation of innovative solutions. This behaviour is compared to the ways of working of novice designers (students) in the original case study....

Bilateral optic neuropathy in acute cryptococcal meningitis

Institute of Scientific and Technical Information of China (English)

Qi Zhe Ngoo; Li Min Evelyn Tai; Wan Hazabbah Wan Hitam; John Tharakan

2016-01-01

We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had som-nolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous flu-conazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

The Einstein-Podolsky-Rosen paradox

International Nuclear Information System (INIS)

Roy, S.M.

1980-01-01

The celebrated arguments of Einstein, Podolsky and Rosen claiming that quantum mechanics cannot be a complete theory are reviewed. Recent research climaxed by Bell's theorem shows that Einstein's locality or ''no telepathy'' postulate conflicts with quantum theory. It adds a new dimension to the paradox by catapulting the problem from the domain of metaphysics into that of experimental physics. (auth.)

Time and situatedness Merleau-Ponty,s Response to McTaggart,s Paradox

Directory of Open Access Journals (Sweden)

Claudio Javier Cormick

2014-12-01

Full Text Available The article seeks to establish a relationship that has not yet been explored satisfactorily between Merleau-Ponty᾿s phenomenology of time and a central issue of analytical “theory of time”: McTaggart᾿s paradox. By clarifying the authentic meaning of Merleau-Ponty᾿s “subjectivism” regarding time, against Priest᾿s interpretation (1998, the article points out a convergence between the phenomenological approach and Michael Dummett᾿s theses developed in response to the abovementioned paradox. A “situational” solution to the paradox is attempted on the basis of Dummett᾿s ideas and Bimbenet᾿s interpretation of Merleau-Ponty᾿s “perspectivism”.

Continuous-variable Einstein-Podolsky-Rosen paradox with traveling-wave second-harmonic generation

International Nuclear Information System (INIS)

Olsen, M.K.

2004-01-01

The Einstein-Podolsky-Rosen paradox and quantum entanglement are at the heart of quantum mechanics. Here we show that single-pass traveling-wave second-harmonic generation can be used to demonstrate both entanglement and the paradox with continuous variables that are analogous to the position and momentum of the original proposal

Corporal punishment contestations, paradoxes and implications for ...

African Journals Online (AJOL)

Corporal punishment contestations, paradoxes and implications for school leadership: A case study of two South African high schools. ... South African Journal of Education. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current ...

Some reflections on the Renewal-theory paradox in queueing theory

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Robert B. Cooper

1998-01-01

Full Text Available The classical renewal-theory (waiting time, or inspection paradox states that the length of the renewal interval that covers a randomly-selected time epoch tends to be longer than an ordinary renewal interval. This paradox manifests itself in numerous interesting ways in queueing theory, a prime example being the celebrated Pollaczek-Khintchine formula for the mean waiting time in the M/G/1 queue. In this expository paper, we give intuitive arguments that “explain” why the renewal-theory paradox is ubiquitous in queueing theory, and why it sometimes produces anomalous results. In particular, we use these intuitive arguments to explain decomposition in vacation models, and to derive formulas that describe some recently-discovered counterintuitive results for polling models, such as the reduction of waiting times as a consequence of forcing the server to set up even when no work is waiting.

Bilateral renal calculi

Science.gov (United States)

Sreenevasan, G

1974-01-01

Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

FLOWING BILATERAL FILTER: DEFINITION AND IMPLEMENTATIONS

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Maxime Moreaud

2015-06-01

Full Text Available The bilateral filter plays a key role in image processing applications due to its intuitive parameterization and its high quality filter result, smoothing homogeneous regions while preserving the edges of the objects. Considering the image as a topological relief, seeing pixel intensities as peaks and valleys, we introduce a way to control the tonal weighting coefficients, the flowing bilateral filter, reducing "halo" artifacts typically produced by the regular bilateral filter around a large peak surrounded by two valleys of lower values. In this paper we propose to investigate exact and approximated versions of CPU and parallel GPU (Graphical Processing Unit based implementations of the regular and flowing bilateral filter using the NVidia CUDA API. Fast implementations of these filters are important for the processing of large 3D volumes up to several GB acquired by x-ray or electron tomography.

Bilateral cochlear implantation: current concepts, indications, and results.

Science.gov (United States)

Basura, Gregory J; Eapen, Rose; Buchman, Craig A

2009-12-01

The optimal treatment for bilateral hearing loss continues to evolve as cochlear implant (CI) and hearing aid technologies advance, as does our understanding of the central auditory system. Ongoing discussions continue on the validity and feasibility of bilateral CI in terms of performance, justification of need, medical/surgical safety concerns, and economics. The purpose of this review article is to provide an update on the advantages and disadvantages of bilateral CI and to provide a discussion on timing (simultaneous vs. sequential), technology (bimodal vs. binaural) and feasibility. Binaural advantages are found in both adult and pediatric bilateral CI recipients, the greatest being the head shadow effect and improvements in localization and loudness summation. This theoretically offers an advantage over their unilateral implanted counterparts in terms of improved sound localization and enhanced speech perception under noisy conditions. Most investigators agree that bilateral stimulation during critical periods of development is paramount for optimizing auditory functioning in children. Currently, bilateral CI is widely accepted as a safe and effective means of bilateral auditory stimulation.

MRI of symptomatic shoulders

International Nuclear Information System (INIS)

Kikukawa, Kenshi; Segata, Tateki; Kunitake, Katsuhiko; Morisawa, Keizo; Harada, Masataka; Hirano, Mako

2004-01-01

The purpose of this study was to determine the prevalence of cuff tear and acromioclavicular joint (ACJ) osteoarthrosis by magnetic resonance imaging (MRI) evaluation in symptomatic shoulders. MRI was performed on 124 shoulders in 115 patients whose age ranged from 16 to 83 years (average: 58.0 years). There were 74 men (79 shoulders) and 41 women (45 shoulders). The patients were divided into three groups according to age; A group (10 shoulders: 16-29 years), B group (43 shoulders: 30-59 years), and C group (71 shoulders: 60-83 years). Rotator cuff tears and ACJ osteoarthrosis were graded on scales 0 to 3 (normal, increased signal intensity, incomplete, complete), and 1 to 4 (none, mild, moderate, severe), respectively. There was a significant difference in the severity of the cuff tears and the ACJ osteoarthrosis with respect to age. Twenty percent of the shoulders were graded incomplete or complete cuff tears in group A, 88% in group B, and 93% in group C. No shoulders were graded moderate or severe ACJ changes in group A, 63% in group B, and 93% in group C. There was a definite correlation between the cuff tears and ACJ osteoarthrosis. MRI of the symptomatic shoulders indicated well correlation between the rotator cuff tears and ACJ osteoarthrosis. (author)

six six six paradox : [luuletused] / Triin Tasuja

Index Scriptorium Estoniae

Tasuja, Triin

2008-01-01

Sisu: six six six paradox ; cat stevens ; "vahel tundub, et mu ümber..." ; sääse ; Salaalaealised ; kolkalapsed ; longin mööda lumiseid tänavaid ; punkrock dekadents ; "Igast kirjaneitsist..." ; "mina olengi see saikochick..."

Achondroplasia Associated with Bilateral Keratoconus

Directory of Open Access Journals (Sweden)

Ammar M. Al Mahmood

2012-01-01

Full Text Available We report a rare case of bilateral keratoconus in association with achondroplasia. A 26-year-old male, with a known case of achondroplasia, complained of bilateral gradual deterioration in vision for the past few years. Slit lamp biomicroscopy showed bilateral central corneal protrusion and stromal thinning at the apex consistent with keratoconus. a trial of hard contact lens fitting failed to improve VA in the left eye (LE. Right eye (RE improved to 20/25. The patient underwent penetrating keratoplasty (PKP in his LE. Twenty-seven months postoperatively, uncorrected visual acuity (UCVA was 20/30. Ophthalmologists should be aware that patients with achondroplasia who complain of poor vision should be suspected of having keratoconus once other more common conditions are ruled out.

Seismicity of the Paradox Basin and the Colorado Plateau interior

International Nuclear Information System (INIS)

Wong, I.G.

1984-04-01

National Waste Terminal Storage Program site qualification criteria require that a nuclear waste repository be located so that ground motion associated with the maximum credible and maximum probable earthquakes or other earthquake-associated effects will not have an unacceptable adverse impact on system performance. To determine whether a potential repository site located in the Paradox salt formation in the Paradox Basin of southeastern Utah satisfies these criteria, seismological studies were undertaken by Woodward-Clyde Consultants (WCC) in March 1978. These studies included: (1) analysis of historical seismicity; (2) analysis of contemporary seismicity and tectonics of both the Paradox Basin and surrounding Colorado Plateau, including an extensive program of microearthquake monitoring; (3) evaluation of the Paradox Basin crustal structure; (4) evaluation of mining-induced seismicity; and (5) characterization of design-related earthquake-induced ground motions pertinent to a potential repository site through studies of attentation and subsurface ground motions. A detailed discussion of the results of the seismological studies performed through December 1980 is contained in WCC (1982). The purpose of this topical report is to update and summarize the studies on the local, regional, and mining-induced seismicity conducted through December 1982. The limitations of any interpretations are also discussed and additional information that remains to be acquired is identified. 56 references, 45 figures, 4 tables

Bilateral Complex Regional Pain Syndrome after Fracture of Bilateral Tibia and Fibula

Directory of Open Access Journals (Sweden)

Senem Şaş

2017-04-01

Full Text Available Complex regional syndrome type 1 (CRPS-1 is a painful clinical condition. It occurs after a painful event and characterized by allodynia, hyperalgesia, edema, abnormalities in skin blood flow and abnormal sudomotor activity. When CRPS-1 is associated with nerve injury, it is defined as CRPS-2. Central and peripheral theory are responsible in etiopathogenesis of CRPS-1. Generally it occurs in the injured limb. But, it may ocur in the opposite extremities. In this article, we present a case developing bilateral CRPS-1 after bilateral tibia and fibula fracture by reviewing current literatüre.

The role of causal reasoning in understanding Simpson's paradox, Lord's paradox, and the suppression effect: covariate selection in the analysis of observational studies

Directory of Open Access Journals (Sweden)

Arah Onyebuchi A

2008-02-01

Full Text Available Abstract Tu et al present an analysis of the equivalence of three paradoxes, namely, Simpson's, Lord's, and the suppression phenomena. They conclude that all three simply reiterate the occurrence of a change in the association of any two variables when a third variable is statistically controlled for. This is not surprising because reversal or change in magnitude is common in conditional analysis. At the heart of the phenomenon of change in magnitude, with or without reversal of effect estimate, is the question of which to use: the unadjusted (combined table or adjusted (sub-table estimate. Hence, Simpson's paradox and related phenomena are a problem of covariate selection and adjustment (when to adjust or not in the causal analysis of non-experimental data. It cannot be overemphasized that although these paradoxes reveal the perils of using statistical criteria to guide causal analysis, they hold neither the explanations of the phenomenon they depict nor the pointers on how to avoid them. The explanations and solutions lie in causal reasoning which relies on background knowledge, not statistical criteria.

[Five paradoxes in health promotion].

Science.gov (United States)

López-Dicastillo, Olga; Canga-Armayor, Navidad; Mujika, Agurtzane; Pardavila-Belio, Miren Idoia; Belintxon, Maider; Serrano-Monzó, Inmaculada; Pumar-Méndez, María J

The World Health Organization states that health promotion is a key strategy to improve health, and it is conceived as a global process of enabling people to increase control over, and to improve, their health. Health promotion does not focus solely on empowering individuals dealing with their knowledge, attitudes and skills, but it also takes political, social, economic and environmental aspects influencing health and wellbeing into account. The complexity of applying these concepts is reflected in the five paradoxes in health promotion; these arise in between the rhetoric in health promotion and implementation. The detected paradoxes which are described herein involve the patient versus the person, the individual versus the group, disease professionals versus health professionals, disease indicators versus health indicators, and health as an expense versus health as an investment. Making these contradictions explicit can help determine why it is so complex to put the concepts related to health promotion into practice. It can also help to put forward aspects that need further work if health promotion is to put into practice. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

The paradox of strategic environmental assessment

Energy Technology Data Exchange (ETDEWEB)

Bidstrup, Morten, E-mail: bidstrup@plan.aau.dk; Hansen, Anne Merrild, E-mail: merrild@plan.aau.dk

2014-07-01

Strategic Environmental Assessment (SEA) is a tool that can facilitate sustainable development and improve decision-making by introducing environmental concern early in planning processes. However, various international studies conclude that current planning practice is not taking full advantage of the tool, and we therefore define the paradox of SEA as the methodological ambiguity of non-strategic SEA. This article explores causality through at three-step case study on aggregates extraction planning in Denmark, which consists of a document analysis; a questionnaire survey and follow-up communication with key planners. Though the environmental reports on one hand largely lack strategic considerations, practitioners express an inherent will for strategy and reveal that their SEAs in fact have been an integrated part of the planning process. Institutional context is found to be the most significant barrier for a strategy and this suggests that non-strategic planning setups can prove more important than non-strategic planning in SEA practice. Planners may try to execute strategy within the confinements of SEA-restricted planning contexts; however, such efforts can be overlooked if evaluated by a narrow criterion for strategy formation. Consequently, the paradox may also spark from challenged documentation. These findings contribute to the common understanding of SEA quality; however, further research is needed on how to communicate and influence the strategic options which arguably remain inside non-strategic planning realities. - Highlights: • International studies conclude that SEAs are not strategic. = The paradox of SEA. • Even on the highest managerial level, some contexts do not leave room for strategy. • Non-strategic SEA can derive from challenged documentation. • Descriptive and emergent strategy formation can, in practice, be deemed non-strategic.

The paradox of strategic environmental assessment

International Nuclear Information System (INIS)

Bidstrup, Morten; Hansen, Anne Merrild

2014-01-01

Strategic Environmental Assessment (SEA) is a tool that can facilitate sustainable development and improve decision-making by introducing environmental concern early in planning processes. However, various international studies conclude that current planning practice is not taking full advantage of the tool, and we therefore define the paradox of SEA as the methodological ambiguity of non-strategic SEA. This article explores causality through at three-step case study on aggregates extraction planning in Denmark, which consists of a document analysis; a questionnaire survey and follow-up communication with key planners. Though the environmental reports on one hand largely lack strategic considerations, practitioners express an inherent will for strategy and reveal that their SEAs in fact have been an integrated part of the planning process. Institutional context is found to be the most significant barrier for a strategy and this suggests that non-strategic planning setups can prove more important than non-strategic planning in SEA practice. Planners may try to execute strategy within the confinements of SEA-restricted planning contexts; however, such efforts can be overlooked if evaluated by a narrow criterion for strategy formation. Consequently, the paradox may also spark from challenged documentation. These findings contribute to the common understanding of SEA quality; however, further research is needed on how to communicate and influence the strategic options which arguably remain inside non-strategic planning realities. - Highlights: • International studies conclude that SEAs are not strategic. = The paradox of SEA. • Even on the highest managerial level, some contexts do not leave room for strategy. • Non-strategic SEA can derive from challenged documentation. • Descriptive and emergent strategy formation can, in practice, be deemed non-strategic

The paradox of imperfect duty in Kant's moral philosophy: A problem in 'applying' ethics'

Directory of Open Access Journals (Sweden)

Richter Phillip

2015-01-01

Full Text Available The Applied Ethics debate has not yet sufficiently clarified what application of ethics exactly is. The issue of application is considered to be especially problematic in Kantian ethics or in discourse ethics. This article describes the concept of applying ethics in Kant. In discussing the duty of helping others and the theory of its application in Metaphysics of Morals it is shown that a strict separation of justification and application in ethical theory results in the paradox of imperfect duty. The paradox says that the duty to help others would be fulfilled without ever being fulfilled in action. To overcome the paradox it is necessary to form submaximes of helping, which are not arbitrarily but instructed by a theory of casuistry. This casuistry, if it is considered as a doctrine of application in Kantian ethics, can overcome the paradox of imperfect duty. However, the casuistry can overcome this paradox only if it is understood as a philosophy of prudence, which can be found in Aristotle or Descartes.

Bilateral tension pneumothorax after acupuncture.

Science.gov (United States)

Mohammad, Nurashikin

2018-04-19

Acupuncture is an ancient complementary medicine which is currently used worldwide. Many serious adverse events have been reported which include a spectrum of mild-to-fatal complications. However, the level of awareness with regard to complications is still low both to physicians and patients. We report a 63-year-old who presented with acute shortness of breath 2 hours after having had acupuncture. On examination, there was absent breath sound heard on the left lung and slightly reduced breath sound on the right lung. She had type 1 respiratory failure. Urgent chest radiograph confirmed bilateral pneumothorax which was more severe on the left with tension pneumothorax and mediastinal shift. Chest tubes were inserted bilaterally after failed needle aspiration attempts. Subsequently, the pneumothoraces resolved, and she was discharged well. The bilateral pneumothoraces caused by acupuncture were curable but could have been potentially fatal if diagnosis was delayed. This case report adds to the limited current literature on the complications of acupuncture leading to bilateral pneumothoraces. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

Science.gov (United States)

Ramakers, Geerte G J; Kraaijenga, Véronique J C; Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Van Zanten, Gijsbert A; Grolman, Wilko

2017-01-01

There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). This study is a secondary analysis as part of a multicenter randomized controlled trial. Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total

Hydraulic bilateral construction robot; Yuatsushiki bilateral kensetsu robot

Energy Technology Data Exchange (ETDEWEB)

Maehata, K.; Mori, N. [Kayaba Industry Co. Ltd., Tokyo (Japan)

1999-05-15

Concerning a hydraulic bilateral construction robot, its system constitution, structures and functions of important components, and the results of some tests are explained, and the researches conducted at Gifu University are described. The construction robot in this report is a servo controlled system of a version developed from the mini-shovel now available in the market. It is equipped, in addition to an electrohydraulic servo control system, with various sensors for detecting the robot attitude, vibration, and load state, and with a camera for visualizing the surrounding landscape. It is also provided with a bilateral joy stick which is a remote control actuator capable of working sensation feedback and with a rocking unit that creates robot movements of rolling, pitching, and heaving. The construction robot discussed here, with output increased and response faster thanks to the employment of a hydraulic driving system for the aim of building a robot system superior in performance to the conventional model designed primarily for heavy duty, proves after tests to be a highly sophisticated remotely controlled robot control system. (NEDO)

Bilateral pallidotomy for generalized dystonia Palidotomia bilateral para distonias generalizadas

Directory of Open Access Journals (Sweden)

Hélio A. G. Teive

2001-06-01

Full Text Available OBJECTIVE: To evaluate the efficacy and safety of bilateral pallidotomies in five patients with generalized dystonia. BACKGROUND: Generalized dystonias are frequently a therapeutic challenge, with poor responses to pharmacological treatment. GPi (globus pallidus internus pallidotomies for Parkinson's disease ameliorate all kinds of dyskinesias/dystonia, and recent studies reported a marked improvement of refractory dystonias with this procedure. METHODS: Five patients with generalized dystonias refractory to medical treatment were selected; one posttraumatic and four idiopathic. The decision to perform bilateral procedures was based on the predominant axial involvement in these patients. Dystonia severity was assessed with the Burke-Fahn-Marsden Dystonia Scale (BFM. Simultaneous procedures were performed in all but one patient, who had a staged procedure. They were reevaluated with the same scale (BFM by an unblinded rater at 1, 2, 3, 30, 60, 90, 120 and 180 days post-operatively. RESULTS: The four patients with idiopathic dystonia showed a progressive improvement up to three months; the patient with posttraumatic dystonia relapsed at three months. One patient had a marked improvement, being able to discontinue all the medications. A mean decrease in the BFM scores of 52,58% was noted. One patient had a trans-operative motor seizure followed by a transient hemiparesis secondary to rack hemorrhage; other was lethargic up to three days after the procedure. CONCLUSIONS: Our results show that bilateral GPi pallidotomies may be a safe and effective approach to medically refractory generalized dystonias; it can also be speculated that the posttraumatic subgroup may not benefit with this procedure.As distonias generalizadas são freqüentemente um desafio terapêutico, com pobres respostas aos tratamentos farmacológicos. As cirurgias estereotáxicas, como a palidotomia, têm sido utilizadas com êxito no tratamento da doença de Parkinson e estudos

Simultaneous bilateral elbow dislocation with bilateral medial epicondyle fractures in a 13-year-old female gymnast with hyperlaxity

Science.gov (United States)

Bauer, Stefan; Dunne, Ben; Whitewood, Colin

2012-01-01

Bilateral simultaneous elbow dislocations are extremely rare and have only been described in 12 cases. In the paediatric population unilateral elbow dislocations are rare with 3–6% of all elbow injuries and there are only few studies describing this injury exclusively in children. There is only one case report of a paediatric patient who sustained a simultaneous bilateral elbow dislocation with medial epicondyle fractures. We present a second paediatric case of simultaneous bilateral elbow dislocation with associated displaced bilateral medial epicondyle fractures in a gymnast with joint hyperlaxity (3 of 5 Wynne-Davies criteria) treated with closed reduction and short-term immobilisation (3 weeks). The patient returned to full trampoline gymnastics between 4 and 5 months postinjury and made an uneventful recovery. PMID:23234820

The dissolver paradox as a coupled fast-thermal reactor

International Nuclear Information System (INIS)

Lutz, H.F.; Webb, P.S.

1993-05-01

The dissolver paradox is treated as coupled fast-thermal reactors. Each reactor is sub-critical but the coupling is sufficient to form a critical system. The practical importance of the system occurs when the fast system by itself is mass limited and the thermal system by itself is volume limited. Numerous 1D calculations have been made to calculate the neutron multiplication parameters of the separate fast and thermal systems that occur in the dissolver paradox. A model has been developed to describe the coupling between the systems. Monte Carlo calculations using the MCNP code have tested the model

THE EUROPEAN UNION’S BILATERAL APPROACH

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Ludmila BORTA

2014-12-01

Full Text Available The EU is a world economic power and a major trading partner for most countries. All the time, this region has been interested and has acted towards a free and fair trade. The decrease and even the elimination of tariff and non-tariff barriers in the world trade are among the main objectives of the EU strategy for international trade. At the moment, the elusive outcome of the WTO Doha Round has led to the proliferation of bilateral trade agreements worldwide. Although the EU remains committed to further development of the multilateral trading system, however, the EU still has appealed also to the development of bilateral trade relations. The aim of this paper is to illustrate the current bilateral dimension of the common commercial policy of the EU. In conclusion, to describe this bilateral approach of the EU we are using one word, namely “diversity”.

A case of bilateral tubal pregnancy

Directory of Open Access Journals (Sweden)

Ayano Funamizu

2017-11-01

Full Text Available Bilateral tubal pregnancy is very rare and occurs in only 1 out of every 200,000 spontaneous pregnancies. In this case, a 29-year-old woman with a history of primary infertility underwent treatment with human menopausal gonadotropin (hMG-human chorionic gonadotropin (hCG, and became pregnant. A gestational sac (GS was not detected in the uterus and transvaginal ultrasonography (USG revealed GS with fetal heartbeat in the left adnexa at 7 weeks and 6 days of gestation. The patient underwent laparoscopic surgery and ultimately, bilateral tubal pregnancy was diagnosed. Consequently, bilateral fallopian tube resection was performed. Afterwards, she conceived by assisted reproductive technology (ART and delivered vaginally. This case suggests that even if a GS is found in one fallopian tube by USG, it is important to evaluate the other fallopian tube carefully. Keywords: bilateral tubal pregnancy, ectopic pregnancy, human menopausal gonadotropin, laparoscopy

Bilateral sarkoidose i glandula parotis

DEFF Research Database (Denmark)

Hahn, Pernille; Krogdahl, Annelise; Godballe, Christian

2012-01-01

We describe an unusual case of sarcoidosis in which the patient presented with a bilateral swelling of the parotid salivary glands and no other manifestation of the disease. Sarcoidosis is a multisystem granulomatous disorder of unknown cause in which there may be multiple exocrine involvement......, including the salivary glands. This case emphasises the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling....

MODERN VIEWS ON BILATERAL BREAST CANCER

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Ye. A. Fesik

2014-01-01

Full Text Available Presented modern literature data on the features of the pathogenesis, course, clinical and morphological expression and tumor characteristics, parameters and nodal metastasis of hematogenous bilateral breast cancer. Highlight the results of domestic and foreign studies in recent years to determine the prognostic factors and recurrence of synchronous and metachronous bilateral breast cancer. It was revealed that the frequency of bilateral breast tumor lesions varies widely, ranging from 0.1 to 20%, with metachronous tumors recorded significantly higher (69.6% than the synchronous (22.7%. The probability of occurrence of metachronous breast cancer is higher in women with a family history, as well as if they have a gene mutation BRCA-1. Found that the most common histological type of breast tumor with bilateral lesions is invasive ductal. However, the incidence of invasive lobular cancer and non-invasive lobular cancer is slightly higher among synchronous bilateral cancer compared with unilateral disease. Studies have shown that in a double-sided synchronous breast cancer tumor, as a rule, has a lower degree of differentiation, and the higher the expression level of estrogen receptors and progesterone receptors. Relevance of the issue because the identification of patterns in the study of lymphatic and hematogenous features bilateral metastasis of mammary tumors provides a basis for speculation about the differences in the progression of neoplastic disease in these groups and is a cause for further detailed research in this area to identify and evaluate the prognosis and also the choice of tactics of such patients.

Should symptomatic menopausal women be offered hormone therapy?

Science.gov (United States)

Lobo, Rogerio A; Bélisle, Serge; Creasman, William T; Frankel, Nancy R; Goodman, Neil E; Hall, Janet E; Ivey, Susan Lee; Kingsberg, Sheryl; Langer, Robert; Lehman, Rebecca; McArthur, Donna Behler; Montgomery-Rice, Valerie; Notelovitz, Morris; Packin, Gary S; Rebar, Robert W; Rousseau, MaryEllen; Schenken, Robert S; Schneider, Diane L; Sherif, Katherine; Wysocki, Susan

2006-01-01

Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.

The house economist and the eating paradox.

Science.gov (United States)

Woods, Stephen C

2002-04-01

An important observation of the experiments of George Collier is that animals normally prefer to maintain their body weight by eating a large number of small meals each day. However, as the effort to obtain access to food increases, the animals adapt by changing to a schedule of eating a small number of large meals each day. A strong implication of this is that there is a hidden cost to eating large meals, and this is the basis of the eating paradox that states that although food is a necessary commodity, the act of ingesting it poses certain metabolic problems for animals. Experiments on cephalic insulin secretion, conditioned insulin secretion and meal feeding are discussed to make the point that the economy demonstrated by rats in Collier's paradigm is dictated in part by predictions of the eating paradox. Copyright 2002 Elsevier Science Ltd.

Some human performance paradoxes of nuclear operations

International Nuclear Information System (INIS)

Otway, H.J.; Misenta, R.

1980-01-01

Roughly once a year, an abnormal situation with emergency potential may suddenly break the calm monotony of nuclear-power plant operation. The operating crew, perhaps under-stimulated by monitoring largely automatic processes, may then be expected to make correct inferences and decisions about complex phenomena. However, under stress, the operators may resort to using their 'best-learned responses', inappropriate to the real situation. Recent events at Three Mile Island prompted a variety of suggestions intended to improve operator performance, eg higher qualifications, more pay, or enhanced status. The authors stress the paradoxes of nuclear operation, conclude that some 'intuitively obvious' suggestions might have the opposite effect to that intended, and explore the possibility of introducing frequent, realistic emergency drills. Even this approach raises paradoxes - perhaps the role of the operator should be eliminated, or redefined to allow less human intervention in emergencies. (author)

A paradox for traffic dynamics in complex networks with ATIS

International Nuclear Information System (INIS)

Zheng Jianfeng; Gao Ziyou

2008-01-01

In this work, we study the statistical properties of traffic (e.g., vehicles) dynamics in complex networks, by introducing advanced transportation information systems (ATIS). The ATIS can provide the information of traffic flow pattern throughout the network and have an obvious effect on path routing strategy for such vehicles equipped with ATIS. The ATIS can be described by the understanding of link cost functions. Different indices such as efficiency and system total cost are discussed in depth. It is found that, for random networks (scale-free networks), the efficiency is effectively improved (decreased) if ATIS is properly equipped; however the system total cost is largely increased (decreased). It indicates that there exists a paradox between the efficiency and system total cost in complex networks. Furthermore, we report the simulation results by considering different kinds of link cost functions, and the paradox is recovered. Finally, we extend our traffic model, and also find the existence of the paradox

Towards an Einstein–Podolsky–Rosen paradox between two macroscopic atomic ensembles at room temperature

International Nuclear Information System (INIS)

He, Q Y; Reid, M D

2013-01-01

Experiments have reported the entanglement of two spatially separated macroscopic atomic ensembles at room temperature (Krauter et al 2011 Phys. Rev. Lett. 107 080503; Julsgaard et al 2001 Nature 413 400). We show how an Einstein–Podolsky–Rosen (EPR) paradox is realizable with this experiment. Our proposed test involves violation of an inferred Heisenberg uncertainty principle, which is a sufficient condition for an EPR paradox. This is a stronger test of nonlocality than entanglement. Our proposal would enable the first definitive confirmation of quantum EPR paradox correlations between two macroscopic objects at room temperature. This is a necessary intermediate step towards a nonlocal experiment with causal measurement separations. As well as having fundamental significance, the realization of an atomic EPR paradox could provide a resource for novel applications in quantum technology. (paper)

Towards an Einstein-Podolsky-Rosen paradox between two macroscopic atomic ensembles at room temperature

Science.gov (United States)

He, Q. Y.; Reid, M. D.

2013-06-01

Experiments have reported the entanglement of two spatially separated macroscopic atomic ensembles at room temperature (Krauter et al 2011 Phys. Rev. Lett. 107 080503; Julsgaard et al 2001 Nature 413 400). We show how an Einstein-Podolsky-Rosen (EPR) paradox is realizable with this experiment. Our proposed test involves violation of an inferred Heisenberg uncertainty principle, which is a sufficient condition for an EPR paradox. This is a stronger test of nonlocality than entanglement. Our proposal would enable the first definitive confirmation of quantum EPR paradox correlations between two macroscopic objects at room temperature. This is a necessary intermediate step towards a nonlocal experiment with causal measurement separations. As well as having fundamental significance, the realization of an atomic EPR paradox could provide a resource for novel applications in quantum technology.

Postoperative lumbar MR imaging with contrast enhancement. Comparison between symptomatic and asymptomatic patients

International Nuclear Information System (INIS)

Grane, P.; Tullberg, T.; Rydberg, J.; Lindgren, L.

1995-01-01

Contrast-enhanced MR imaging of the spine after surgery for lumbar disk herniation almost always shows pathologic changes. To investigate to what extent these changes are correlated to patients' actual clinical symptoms, we compared the postoperative MR findings in 19 asymptomatic patients with 42 symptomatic patients (43 levels). The asymptomatic patients underwent MR examination one year after surgery. Twenty-six of the symptomatic patients underwent MR one year of less after surgery, and in 16 patients (17 levels) MR was performed more than one year after surgery. Sixteen percent of the asymptomatic and 42% of the symptomatic patients had disk herniation at the level of previous surgery. Most of the herniated disks were found in the symptomatic patients less than one year after surgery. The amount of epidural scar tissue, displacement and thickening of nerve roots, and compression of the dural sac were also studied. Disk herniation as a probable cause of recurrent sciatica was a common finding among symptomatic patients examined one year or less after surgery. In comparing asymptomatic patients and symptomatic patients with more than one year between surgery and MR examination, no significant radiologic differences, including disk herniation, were found. (orig.)

Postoperative lumbar MR imaging with contrast enhancement. Comparison between symptomatic and asymptomatic patients

Energy Technology Data Exchange (ETDEWEB)

Grane, P. [Dept. of Neuroradiology, Karolinska Hospital, Stockholm (Sweden); Tullberg, T. [Dept. of Orthopaedics, St. Goeran`s Hospital, Stockholm (Sweden); Rydberg, J. [Dept. of Radiology, St. Goeran`s Hospital, Stockholm (Sweden); Lindgren, L. [Dept. of Neurosurgery, Karolinska Hospital, Stockholm (Sweden)

1995-05-01

Contrast-enhanced MR imaging of the spine after surgery for lumbar disk herniation almost always shows pathologic changes. To investigate to what extent these changes are correlated to patients` actual clinical symptoms, we compared the postoperative MR findings in 19 asymptomatic patients with 42 symptomatic patients (43 levels). The asymptomatic patients underwent MR examination one year after surgery. Twenty-six of the symptomatic patients underwent MR one year of less after surgery, and in 16 patients (17 levels) MR was performed more than one year after surgery. Sixteen percent of the asymptomatic and 42% of the symptomatic patients had disk herniation at the level of previous surgery. Most of the herniated disks were found in the symptomatic patients less than one year after surgery. The amount of epidural scar tissue, displacement and thickening of nerve roots, and compression of the dural sac were also studied. Disk herniation as a probable cause of recurrent sciatica was a common finding among symptomatic patients examined one year or less after surgery. In comparing asymptomatic patients and symptomatic patients with more than one year between surgery and MR examination, no significant radiologic differences, including disk herniation, were found. (orig.).

Identity paradoxes

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Đurić Jelena

2010-01-01

Full Text Available The article considers paradoxical nature of identity that emerges from: 1 the very concept of identity whose abstract generality unites various and even opposite features; 2 the processual nature of reality that is easier to express in the poetical metaphors or abstract principles than in unambiguous conceptual networks; 3 the oppose relationship between being and knowledge, mind and matter, subject and object, self and personality. Entangled in the labyrinth which evade efforts to be conceptually defined, the modern thinking of identity moves towards abandoning the idea of “self” on behalf of the “ego” and towards the misapprehension of identity as being identical. This corresponds to the “time of the lost spirit” stretched between the simultaneous need to find an identity and to give it up.

Bilateral microperc in a severe kyphoscoliosis

OpenAIRE

Dağgülli, Mansur; Penbegül, Necmettin; Dede, Onur; Utanğaç, Mehmet Mazhar

2016-01-01

Percutaneous nephrolithotomy is the standard modality for large renal calculi in normal and abnormal renal anatomic situations. This case report describes a 57-year-old male patient who presented with bilateral kidney stones and severe kyphoscoliosis. He had successfully been treated with a bilateral microperc technique.

A case of bilateral trench foot.

Science.gov (United States)

Parsons, S L; Leach, I H; Charnley, R M

1993-12-01

A case of severe bilateral trench foot is presented in a patient who lived rough for 3 weeks without removing his boots. Non-operative management yielded no clinical improvement and bilateral below-knee amputation was necessary. Histology revealed subcutaneous and muscle necrosis with secondary arterial thrombosis.

Ceratite bilateral por Acanthamoeba: relato de caso Bilateral Acanthamoeba keratitis: case report

Directory of Open Access Journals (Sweden)

Wilson Nahmatallah Obeid

2003-12-01

Full Text Available A ceratite por Acanthamoeba é uma infecção ocular grave que, apesar dos recentes progressos no diagnóstico e tratamento, ainda provoca prolongada morbidade e perda da acuidade visual. Relatamos um caso de ceratite bilateral por Acanthamoeba em usuário de lentes de contato, que é o primeiro caso descrito na literatura brasileira.Acanthamoeba keratitis is a severe ocular infection which even with recent progress in diagnosis and treatment still causes long morbidity and loss of visual acuity. We describe a case of bilateral Acanthamoeba keratitis in a user of contact lenses, which is the first case discussed in Brazilian literature.

Silent myocardial ischemia in patients with symptomatic intracranial atherosclerosis: associated factors.

Science.gov (United States)

Arenillas, Juan F; Candell-Riera, Jaume; Romero-Farina, Guillermo; Molina, Carlos A; Chacón, Pilar; Aguadé-Bruix, Santiago; Montaner, Joan; de León, Gustavo; Castell-Conesa, Joan; Alvarez-Sabín, José

2005-06-01

Optimization of coronary risk evaluation in stroke patients has been encouraged. The relationship between symptomatic intracranial atherosclerosis and occult coronary artery disease (CAD) has not been evaluated sufficiently. We aimed to investigate the prevalence of silent myocardial ischemia in patients with symptomatic intracranial atherosclerosis and to identify factors associated with its presence. From 186 first-ever transient ischemic attack or ischemic stroke patients with intracranial stenoses, 65 fulfilled selection criteria, including angiographic confirmation of a symptomatic atherosclerotic stenosis and absence of known CAD. All patients underwent a maximal-stress myocardial perfusion single-photon emission computed tomography (SPECT). Lipoprotein(a) [Lp(a)], C-reactive protein, and homocysteine (Hcy) levels were determined before SPECT. Stress-rest SPECT detected reversible myocardial perfusion defects in 34 (52%) patients. Vascular risk factors associated with a pathologic SPECT were hypercholesterolemia (P=0.045), presence of >2 risk factors (P=0.004) and high Lp(a) (P=0.023) and Hcy levels (P=0.018). Ninety percent of patients with high Lp(a) and Hcy levels had a positive SPECT. Existence of a stenosed intracranial internal carotid artery (ICA; odds ratio [OR], 7.22, 2.07 to 25.23; P=0.002) and location of the symptomatic stenosis in vertebrobasilar arteries (OR, 4.89, 1.19 to 20.12; P=0.027) were independently associated with silent myocardial ischemia after adjustment by age, sex, and risk factors. More than 50% of the patients with symptomatic intracranial atherosclerosis and not overt CAD show myocardial perfusion defects on stress-rest SPECT. Stenosed intracranial ICA, symptomatic vertebrobasilar stenosis and presence of high Lp(a) and Hcy levels may characterize the patients at a higher risk for occult CAD.

Battling Arrow's Paradox to Discover Robust Water Management Alternatives

Science.gov (United States)

Kasprzyk, J. R.; Reed, P. M.; Hadka, D.

2013-12-01

This study explores whether or not Arrow's Impossibility Theorem, a theory of social choice, affects the formulation of water resources systems planning problems. The theorem discusses creating an aggregation function for voters choosing from more than three alternatives for society. The Impossibility Theorem is also called Arrow's Paradox, because when trying to add more voters, a single individual's preference will dictate the optimal group decision. In the context of water resources planning, our study is motivated by recent theoretical work that has generalized the insights for Arrow's Paradox to the design of complex engineered systems. In this framing of the paradox, states of society are equivalent to water planning or design alternatives, and the voters are equivalent to multiple planning objectives (e.g. minimizing cost or maximizing performance). Seen from this point of view, multi-objective water planning problems are functionally equivalent to the social choice problem described above. Traditional solutions to such multi-objective problems aggregate multiple performance measures into a single mathematical objective. The Theorem implies that a subset of performance concerns will inadvertently dictate the overall design evaluations in unpredictable ways using such an aggregation. We suggest that instead of aggregation, an explicit many-objective approach to water planning can help overcome the challenges posed by Arrow's Paradox. Many-objective planning explicitly disaggregates measures of performance while supporting the discovery of the planning tradeoffs, employing multiobjective evolutionary algorithms (MOEAs) to find solutions. Using MOEA-based search to address Arrow's Paradox requires that the MOEAs perform robustly with increasing problem complexity, such as adding additional objectives and/or decisions. This study uses comprehensive diagnostic evaluation of MOEA search performance across multiple problem formulations (both aggregated and many

Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation

Directory of Open Access Journals (Sweden)

Geerte G. J. Ramakers

2017-11-01

Full Text Available ImportanceThere is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.ObjectiveTo investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years.Study designThis study is a secondary analysis as part of a multicenter randomized controlled trial.MethodsThirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI and Tinnitus Questionnaire (TQ.ResultsThe prevalence of preoperative tinnitus was 42% (16/38. One year after bilateral implantation, there was a median difference of −8 (inter-quartile range (IQR: −28 to 4 in THI score and −9 (IQR: −17 to −9 in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group

Qualities and Inequalities in Online Social Networks through the Lens of the Generalized Friendship Paradox

OpenAIRE

Momeni, Naghmeh; Rabbat, Michael

2016-01-01

The friendship paradox is the phenomenon that in social networks, people on average have fewer friends than their friends do. The generalized friendship paradox is an extension to attributes other than the number of friends. The friendship paradox and its generalized version have gathered recent attention due to the information they provide about network structure and local inequalities. In this paper, we propose several measures of nodal qualities which capture different aspects of their act...

Paradoxes of photoconductive target and optical control of secondary ion yield

International Nuclear Information System (INIS)

Rokakh, A. G.; Matasov, M. D.

2010-01-01

This study of the photoconductivity of semiconductors, in particular, cadmium chalcogenides as materials for targets of vacuum image converters followed the path of overcoming paradoxes. The concepts developed by the classics of photoelectricity also help to understand the paradoxes of the new secondary-ion photoelectric effect, especially, its spectral characteristic. The optical channel of secondary ion yield control via a photoconductive target opens the way to a new branch of nanotechnology, i.e., optoionics.

Bilateral agenesis of the anterior cruciate ligament: MRI evaluation

Energy Technology Data Exchange (ETDEWEB)

Bedoya, Maria A.; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Radiology Department, Philadelphia, PA (United States); McGraw, Michael H. [Hospitalof theUniversityof Pennsylvania, Divisionof Orthopaedics, Philadelphia, PA (United States); Wells, Lawrence [The Children' s Hospital of Philadelphia, Division of Orthopaedics, Philadelphia, PA (United States)

2014-09-15

Bilateral agenesis of the anterior cruciate ligament (ACL) is extremely rare. We describe a 13-year-old girl who presented with bilateral knee pain without history of trauma; she has two family members with knee instability. Magnetic resonance imaging showed bilateral absence of the ACL, and medial posterior horn meniscal tears. Bilateral arthroscopic partial meniscectomy and anterior cruciate ligament reconstruction was performed. (orig.)

Staged bilateral carotid endarterectomy

DEFF Research Database (Denmark)

Schroeder, T; Sillesen, H; Engell, Hans Christian

1986-01-01

In a series of 56 staged bilateral carotid endarterectomies, new neurologic symptoms developed in 5% and 20% following the first and second procedure, respectively. All complications were transient or minor. The incidence of postendarterectomy hypertension was significantly higher following...... the second procedure, when operations were staged less than 3 weeks apart. A correlation between these hypertensive episodes and the occurrence of new neurologic symptoms could not be shown. However, as this correlation has been proved in several other reports, bilateral carotid endarterectomy is advised...... to be staged at least 3 weeks apart. In addition, a conservative attitude towards contralateral asymptomatic lesions is proposed....

Prognosis of asymptomatic and symptomatic, undiagnosed COPD in the general population in Denmark

DEFF Research Database (Denmark)

Çolak, Yunus; Afzal, Shoaib; Nordestgaard, Børge G.

2017-01-01

Background: COPD can be diagnosed early using spirometry, but spirometry use is only recommended in symptomatic smokers, even though early stages of COPD can be asymptomatic. We investigated the prognosis of individuals with asymptomatic and symptomatic, undiagnosed COPD in the general population...... of COPD are needed. Funding:The Danish Lung Association, the Danish Cancer Society, Herlev and Gentofte Hospital, Copenhagen University Hospital, and University of Copenhagen.......Background: COPD can be diagnosed early using spirometry, but spirometry use is only recommended in symptomatic smokers, even though early stages of COPD can be asymptomatic. We investigated the prognosis of individuals with asymptomatic and symptomatic, undiagnosed COPD in the general population......%) were at high risk of having COPD. 3699 (11%) of these participants met the COPD criteria and 2903 (78%) were undiagnosed, of whom 2052 (71%) were symptomatic. During a median follow-up of 6·1 years (IQR 4·9), we recorded 800 exacerbations, 2038 cases of pneumonia, and 2789 deaths in the 32 518...

Political Animals: The Paradox of Ecofeminist Politics.

Science.gov (United States)

Sandilands, Catriona

1994-01-01

Analyzes the paradox between the careful work of rigorous political analysis and philosophy and a desire for mystery and the experience of awe and wildness that demands putting aside careful reasoning and the sensing of nature in an altogether different way. (LZ)

Reinnervation of bilateral posterior cricoarytenoid muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis.

Directory of Open Access Journals (Sweden)

Meng Li

Full Text Available OBJECTIVE: To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. METHODS: Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. RESULTS: Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05. No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. CONCLUSIONS: Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity.

Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

Science.gov (United States)

Zheng, Hongliang; Chen, Donghui; Zhu, Minhui; Wang, Wei; Liu, Fei; Zhang, Caiyun

2013-01-01

Objective To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA) muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. Methods Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. Results Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P 0.05). No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. Conclusions Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity. PMID:24098581

The matchmaking paradox: a statistical explanation

International Nuclear Information System (INIS)

Eliazar, Iddo I; Sokolov, Igor M

2010-01-01

Medical surveys regarding the number of heterosexual partners per person yield different female and male averages-a result which, from a physical standpoint, is impossible. In this paper we term this puzzle the 'matchmaking paradox', and establish a statistical model explaining it. We consider a bipartite graph with N male and N female nodes (N >> 1), and B bonds connecting them (B >> 1). Each node is associated a random 'attractiveness level', and the bonds connect to the nodes randomly-with probabilities which are proportionate to the nodes' attractiveness levels. The population's average bonds-per-nodes B/N is estimated via a sample average calculated from a survey of size n (n >> 1). A comprehensive statistical analysis of this model is carried out, asserting that (i) the sample average well estimates the population average if and only if the attractiveness levels possess a finite mean; (ii) if the attractiveness levels are governed by a 'fat-tailed' probability law then the sample average displays wild fluctuations and strong skew-thus providing a statistical explanation to the matchmaking paradox.

Perspectives on the quantum Zeno paradox

Science.gov (United States)

Itano, Wayne M.

2009-11-01

As of October 2006, there were approximately 535 citations to the seminal 1977 paper of Misra and Sudarshan that pointed out the quantum Zeno paradox (more often called the quantum Zeno effect). In simple terms, the quantum Zeno effect refers to a slowing down of the evolution of a quantum state in the limit that the state is observed continuously. There has been much disagreement as to how the quantum Zeno effect should be defined and as to whether it is really a paradox, requiring new physics, or merely a consequence of "ordinary" quantum mechanics. The experiment of Itano, Heinzen, Bollinger, and Wineland, published in 1990, has been cited around 347 times and seems to be the one most often called a demonstration of the quantum Zeno effect. Given that there is disagreement as to what the quantum Zeno effect is, there naturally is disagreement as to whether that experiment demonstrated the quantum Zeno effect. Some differing perspectives regarding the quantum Zeno effect and what would constitute an experimental demonstration are discussed.

Perspectives on the quantum Zeno paradox

International Nuclear Information System (INIS)

Itano, Wayne M

2009-01-01

As of October 2006, there were approximately 535 citations to the seminal 1977 paper of Misra and Sudarshan that pointed out the quantum Zeno paradox (more often called the quantum Zeno effect). In simple terms, the quantum Zeno effect refers to a slowing down of the evolution of a quantum state in the limit that the state is observed continuously. There has been much disagreement as to how the quantum Zeno effect should be defined and as to whether it is really a paradox, requiring new physics, or merely a consequence of 'ordinary' quantum mechanics. The experiment of Itano, Heinzen, Bollinger, and Wineland, published in 1990, has been cited around 347 times and seems to be the one most often called a demonstration of the quantum Zeno effect. Given that there is disagreement as to what the quantum Zeno effect is, there naturally is disagreement as to whether that experiment demonstrated the quantum Zeno effect. Some differing perspectives regarding the quantum Zeno effect and what would constitute an experimental demonstration are discussed.

R and D Policies, Carbon Tax and Green Paradox

International Nuclear Information System (INIS)

Bermudez Neubauer, Mauricio; Grimaud, Andre; Rouge, Luc

2016-01-01

We study an economy in which a final good is produced by two sectors. One uses a non-renewable and polluting resource, the other a renewable and clean resource. A specific type of research is associated with each sector. The public authorities levy a carbon tax and simultaneously subsidise both research sectors. We study the impact of such a policy scheme on the rate of resource extraction and emissions. In the clean sector, the research subsidy and the carbon tax have opposite effects. If the tax creates a green paradox, the subsidy moderates it; if the tax slows resource extraction, then the subsidy generates a green paradox

[Declining birth rates as a cause of unemployment? Some remarks on the Gunther paradox].

Science.gov (United States)

Wagner, A

1980-01-01

Gunther (1931) regarded the fact that a diminishing future labor force due to lack of demand leads to increasing unemployment at the present time as a paradox. The presumed connection between declining birth rates and rising unemployment in contrast to a rising birth rate and declining unemployment in a transition period of about 15-20 years is called a Guenther paradox. The author tries to explain the Guenther paradox by means of a macrodemoeconomic model with disequilibrium on the labor market. Clearly there is a relationship between birth rate and unemployment. (author's)

MRI features of bilateral parotid haemangiomas of infancy

International Nuclear Information System (INIS)

Andronikou, Savvas; Jadwat, Saaleeha; McHugh, Kieran; Linward, Jane

2003-01-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

MRI features of bilateral parotid haemangiomas of infancy

Energy Technology Data Exchange (ETDEWEB)

Andronikou, Savvas; Jadwat, Saaleeha [Institute of Child Health, University of Cape Town, Klipfontein Road, Rondebosch, 7700, Cape Town (South Africa); McHugh, Kieran; Linward, Jane [Department of Radiology, Great Ormond Street Hospital for Children, London, WC1N 3JH (United Kingdom)

2003-04-01

The aim of this article is to report the MRI features of bilateral parotid haemangiomas of infancy and highlight the diagnostic and prognostic value of MRI especially with regard to those lesions that may cause respiratory compromise. Retrospective review of MRI scans in six infants with bilateral parotid haemangiomas. The bilateral haemangiomas were symmetrical in all but one patient. On T1-weighted images the masses were isointense to muscle and on T2 they were hyperintense with numerous small vessels giving a septated appearance. There was vivid enhancement with gadolinium in all cases. In three patients, deep bilateral extensions were demonstrated involving the parapharyngeal spaces resulting in respiratory compromise which required tracheostomy. Bilateral parotid haemangiomas are rare, but when present may have deep extensions, which can result in respiratory compromise requiring tracheostomy. (orig.)

Bilateral electric energy contracts: return and risk

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Gunn, Laura K.; Silva, Elisa B.; Correia, Paulo B. [State University of Campinas (UNICAMP), SP (Brazil). College of Mechanical Engineering

2009-07-01

In Brazil electricity is traded through three segments: the spot market that balances offer and demand, with prices calculated by a cost-based computational model; the regulated market , where prices are settled in public auctions, and the free market for bilateral contracts. As spot and regulated market prices are public information, a seller is able to calculate his opportunity price to trade a bilateral contract in the free market by using the non-arbitrage principle. Thus, the seller searches the price of a bilateral contract in the free market that balances his/her revenues with the value expected in case it were negotiated in the regulated and the spot market. Besides the expected revenue, the seller may also consider the CVaR to measure the risk of her/his bilateral contract in the free market. So this paper develops a binomial lattice approach to price bilateral contracts in the free market, considering the seller's opportunity of negotiations in both regulated and spot markets, and measuring the contract risk directly. (author)

The social dominance paradox.

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Cook, Jennifer Louise; den Ouden, Hanneke E M; Heyes, Cecilia M; Cools, Roshan

2014-12-01

Dominant individuals report high levels of self-sufficiency, self-esteem, and authoritarianism. The lay stereotype suggests that such individuals ignore information from others, preferring to make their own choices. However, the nonhuman animal literature presents a conflicting view, suggesting that dominant individuals are avid social learners, whereas subordinates focus on learning from private experience. Whether dominant humans are best characterized by the lay stereotype or the animal view is currently unknown. Here, we present a "social dominance paradox": using self-report scales and computerized tasks, we demonstrate that socially dominant people explicitly value independence, but, paradoxically, in a complex decision-making task, they show an enhanced reliance (relative to subordinate individuals) on social learning. More specifically, socially dominant people employed a strategy of copying other agents when the agents' responses had a history of being correct. However, in humans, two subtypes of dominance have been identified: aggressive and social. Aggressively dominant individuals, who are as likely to "get their own way" as socially dominant individuals but who do so through the use of aggressive or Machiavellian tactics, did not use social information, even when it was beneficial to do so. This paper presents the first study of dominance and social learning in humans and challenges the lay stereotype in which all dominant individuals ignore others' views. The more subtle perspective we offer could have important implications for decision making in both the boardroom and the classroom. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quantum Zeno paradox and decay of the 235m U isomer in matter

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Panov, A.D.

1995-01-01

The known quantum Zeno paradox is considered from microscopic viewpoint as applied to observation of nuclear decay. It is shown that some phenomena, related with this paradox can produce sufficient effect on the constant of 235m U isomer decay during its implantation in metallic matrices. 43 refs., 3 figs

Bilateral Traumatic Globe Luxation with Optic Nerve Transection

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Levent Tok

2014-12-01

Full Text Available Purpose: The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods: A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results: Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion: Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia.

Bilateral Traumatic Globe Luxation with Optic Nerve Transection

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Tok, Levent; Tok, Ozlem Yalcin; Argun, Tugba Cakmak; Yilmaz, Omer; Gunes, Alime; Unlu, Elif Nisa; Sezer, Sezgin; Ibisoglu, Seda; Argun, Mehmet

2014-01-01

Purpose The purpose of this study was to document clinical findings and management of a patient with bilateral globe luxation and optic nerve transection. Materials and Methods A 25-year-old female patient was admitted to the emergency department with bilateral traumatic globe luxation following a motor vehicle accident. Results Visual acuity testing showed no light perception. The right pupil was dilated and bilaterally did not react to light. The globes were bilaterally intact. A computed tomography scan revealed Le Fort type II fractures, bilateral optic nerve transection and disruption of all extraocular muscles. The globes of the patient were bilaterally reduced into the orbit. However, the patient developed phthisis bulbi in the right eye at month 3. Conclusion Globe luxation presents a dramatic clinical picture, and may lead to the development of severe complications due to the concomitance of complete optic nerve dissection and multiple traumas. Even if the luxated globe is repositioned into the orbit, there is still an increased risk of the development of phthisis due to ischemia. PMID:25606034

A neural network to predict symptomatic lung injury

International Nuclear Information System (INIS)

Munley, M.T.; Lo, J.Y.

1999-01-01

A nonlinear neural network that simultaneously uses pre-radiotherapy (RT) biological and physical data was developed to predict symptomatic lung injury. The input data were pre-RT pulmonary function, three-dimensional treatment plan doses and demographics. The output was a single value between 0 (asymptomatic) and 1 (symptomatic) to predict the likelihood that a particular patient would become symptomatic. The network was trained on data from 97 patients for 400 iterations with the goal to minimize the mean-squared error. Statistical analysis was performed on the resulting network to determine the model's accuracy. Results from the neural network were compared with those given by traditional linear discriminate analysis and the dose-volume histogram reduction (DVHR) scheme of Kutcher. Receiver-operator characteristic (ROC) analysis was performed on the resulting network which had Az=0.833±0.04. (Az is the area under the ROC curve.) Linear discriminate multivariate analysis yielded an Az=0.813±0.06. The DVHR method had Az=0.521±0.08. The network was also used to rank the significance of the input variables. Future studies will be conducted to improve network accuracy and to include functional imaging data. (author)

Service Recovery Paradox In Indian Banking Industry: An Empirical Investigation

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Arunesh Garg

2013-11-01

Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The present study examines existence of service recovery paradox in Indian banking industry. The study is taken up in the tri-city of Chandigarh, Panchkula and Mohali. The respondents are categorized into failure and no-failure groups on the basis of their service experience. Failure group constitutes those respondents who have experienced service recovery, and has been further divided into five sub-groups ranging from service recovery++ (service recovery better than expected to service recovery- - (service recovery worse than expected. Service recovery paradox is examined by comparing service recovery++ group with no-failure group. The study shows evidence for existence of service recovery paradox in relation to satisfaction. It has been concluded that for service recovery paradox to exist, recovery effort has to be exceptionally good and much better than expectation level of the customer. The study suggests that service managers should take service failure as an opportunity to appease customers by providing a much better than expected recovery experience. However, organizations should not plan to create service failure situations because if they falter on imparting the recovery, customer satisfaction may be influenced negatively. Keywords: Banking, service failure, customer satisfaction, recommendation intention, service recovery, recovery paradox. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso

Achieving symptomatic remission in out-patients with schizophrenia--a naturalistic study with quetiapine.

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Wobrock, T; Köhler, J; Klein, P; Falkai, P

2009-08-01

Symptomatic remission was defined as a score of mild or less on each of eight key schizophrenia symptoms on the Positive and Negative Syndrome Scale (PANSS-8). To evaluate the symptomatic remission criterion in clinical practice and to determine predictors for achieving symptomatic remission, a 12-week non-interventional study (NIS) with quetiapine was conducted in Germany. For the comparison of patients with and without symptomatic remission, sociodemographic and clinical variables of 693 patients were analyzed by logistic regression for their predictive value to achieve remission. Four hundred and four patients (58.3%) achieved symptomatic remission after 12 weeks' treatment with quetiapine. Remission was significantly predicted by a low degree of PANSS-8 total score, PANSS single items blunted affect (N1), social withdrawal (N4), lack of spontaneity (N6), mannerism and posturing (G5), and low disease severity (CGI-S) at baseline. Predictors of non-remission were older age, diagnosis of schizophrenic residuum, multiple previous episodes, longer duration of current episode, presence of concomitant diseases, and alcohol abuse. This study demonstrated that the majority of schizophrenia out-patients achieved symptomatic remission after 12 weeks treatment and confirms the importance of managing negative symptoms in order to achieve disease remission.

The concept of symptomatic epilepsy and the complexities of assigning cause in epilepsy.

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Shorvon, Simon

2014-03-01

The concept of symptomatic epilepsy and the difficulties in assigning cause in epilepsy are described. A historical review is given, emphasizing aspects of the history which are relevant today. The historical review is divided into three approximately semicentenial periods (1860-1910, 1910-1960, 1960-present). A definition of symptomatic epilepsy and this is followed by listing of causes of symptomatic epilepsy. The fact that not all the causes of idiopathic epilepsy are genetic is discussed. A category of provoked epilepsy is proposed. The complexities in assigning cause include the following: the multifactorial nature of epilepsy, the distinction between remote and proximate causes, the role of nongenetic factors in idiopathic epilepsy, the role of investigation in determining the range of causes, the fact that not all symptomatic epilepsy is acquired, the nosological position of provoked epilepsy and the view of epilepsy as a process, and the differentiation of new-onset and established epilepsy. The newly proposed ILAE classification of epilepsy and its changes in terminologies and the difficulties in the concept of acute symptomatic epilepsy are discussed, including the inconsistencies and gray areas and the distinction between idiopathic, symptomatic, and provoked epilepsies. Points to be considered in future work are listed. Copyright © 2013 Elsevier Inc. All rights reserved.

Temporal dynamics of host molecular responses differentiate symptomatic and asymptomatic influenza a infection.

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Yongsheng Huang

2011-08-01

Full Text Available Exposure to influenza viruses is necessary, but not sufficient, for healthy human hosts to develop symptomatic illness. The host response is an important determinant of disease progression. In order to delineate host molecular responses that differentiate symptomatic and asymptomatic Influenza A infection, we inoculated 17 healthy adults with live influenza (H3N2/Wisconsin and examined changes in host peripheral blood gene expression at 16 timepoints over 132 hours. Here we present distinct transcriptional dynamics of host responses unique to asymptomatic and symptomatic infections. We show that symptomatic hosts invoke, simultaneously, multiple pattern recognition receptors-mediated antiviral and inflammatory responses that may relate to virus-induced oxidative stress. In contrast, asymptomatic subjects tightly regulate these responses and exhibit elevated expression of genes that function in antioxidant responses and cell-mediated responses. We reveal an ab initio molecular signature that strongly correlates to symptomatic clinical disease and biomarkers whose expression patterns best discriminate early from late phases of infection. Our results establish a temporal pattern of host molecular responses that differentiates symptomatic from asymptomatic infections and reveals an asymptomatic host-unique non-passive response signature, suggesting novel putative molecular targets for both prognostic assessment and ameliorative therapeutic intervention in seasonal and pandemic influenza.

Paradoxical response during antituberculous treatment for abdominal tuberculosis

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Kim, Ji Young; Kwon, Jung Hyeok; Kim, Mi Jeong; Chang, Hyuk Won; Hwang, Jae Seok; Cho, Kwang Bum; Park, Kyung Sik; Jang, Byoung Kuk; Chung, Woo Jin [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

2006-12-15

The purpose of our study was to evaluate clinical and CT findings of paradoxical response during treatment for abdominal tuberculosis. Authors reviewed the patient records of 138 patients with abdominal tuberculosis during a recent 6-year period and we selected 11 patients with a paradoxical response. The CT findings and pathologic findings of the initial lesions and new lesions were reviewed. The intervals between initiation of therapy and the detection of new lesions, improvement of new lesion and the final follow-up were evaluated. At the initial presentation, we identified tuberculous peritonitis in 8 patients, tuberculous lymphadenitis in 3 patients and ileocolic tuberculosis in two patients. New lesions were identified at 2-10 months (mean: 3.8 months) after the initiation of therapy and following improvement of the initial lesions. The new lesions were perihepatic caseous abscess (n=4), hepatic tuberculoma (n=3), hepatic caseous abscess (n=1), tuberculous lymphadenitis (n=3), ileocolic tuberculosis (n=3), and splenic tuberculoma (n=1). Improvement of new lesions was noted at 4-14 months (mean: 7.6 months). At the final follow-up of seven patients, the new lesions disappeared and four patients still had small residual lesions. New lesions that develop in a patient with initial improvement should be considered a paradoxical response that will ultimately improve with continuation of the original medication.

Paradoxical response during antituberculous treatment for abdominal tuberculosis

International Nuclear Information System (INIS)

Kim, Ji Young; Kwon, Jung Hyeok; Kim, Mi Jeong; Chang, Hyuk Won; Hwang, Jae Seok; Cho, Kwang Bum; Park, Kyung Sik; Jang, Byoung Kuk; Chung, Woo Jin

2006-01-01

The purpose of our study was to evaluate clinical and CT findings of paradoxical response during treatment for abdominal tuberculosis. Authors reviewed the patient records of 138 patients with abdominal tuberculosis during a recent 6-year period and we selected 11 patients with a paradoxical response. The CT findings and pathologic findings of the initial lesions and new lesions were reviewed. The intervals between initiation of therapy and the detection of new lesions, improvement of new lesion and the final follow-up were evaluated. At the initial presentation, we identified tuberculous peritonitis in 8 patients, tuberculous lymphadenitis in 3 patients and ileocolic tuberculosis in two patients. New lesions were identified at 2-10 months (mean: 3.8 months) after the initiation of therapy and following improvement of the initial lesions. The new lesions were perihepatic caseous abscess (n=4), hepatic tuberculoma (n=3), hepatic caseous abscess (n=1), tuberculous lymphadenitis (n=3), ileocolic tuberculosis (n=3), and splenic tuberculoma (n=1). Improvement of new lesions was noted at 4-14 months (mean: 7.6 months). At the final follow-up of seven patients, the new lesions disappeared and four patients still had small residual lesions. New lesions that develop in a patient with initial improvement should be considered a paradoxical response that will ultimately improve with continuation of the original medication

Bilateral adrenal masses: a single-centre experience

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Nilesh Lomte

2016-05-01

Full Text Available Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015. Results The most common aetiology was pheochromocytoma (40%, followed by tuberculosis (27.1%, primary adrenal lymphoma (PAL (10%, metastases (5.7%, non-functioning adenomas (4.3%, primary bilateral macronodular adrenal hyperplasia (4.3%, and others (8.6%. Age at presentation was less in patients with pheochromocytoma (33 years and tuberculosis (41 years compared with PAL (48 years and metastases (61 years (P<0.001. The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54% and abdominal pain (29%, whereas tuberculosis presented with adrenal insufficiency (AI (95%. The presenting symptoms for PAL were AI (57% and abdominal pain (43%, whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm followed by pheochromocytoma (4.8cm, metastasis (4cm and tuberculosis (2.1cm (P<0.001. Biochemically, most patients with pheochromocytoma (92.8% had catecholamine excess. Hypocortisolism was common in tuberculosis (100% and PAL (71.4% and absent with metastases (P<0.001. Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.

Bilateral adrenal masses: a single-centre experience

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Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

2016-01-01

Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015). Results The most common aetiology was pheochromocytoma (40%), followed by tuberculosis (27.1%), primary adrenal lymphoma (PAL) (10%), metastases (5.7%), non-functioning adenomas (4.3%), primary bilateral macronodular adrenal hyperplasia (4.3%), and others (8.6%). Age at presentation was less in patients with pheochromocytoma (33 years) and tuberculosis (41 years) compared with PAL (48 years) and metastases (61 years) (P<0.001). The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54%) and abdominal pain (29%), whereas tuberculosis presented with adrenal insufficiency (AI) (95%). The presenting symptoms for PAL were AI (57%) and abdominal pain (43%), whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm) followed by pheochromocytoma (4.8cm), metastasis (4cm) and tuberculosis (2.1cm) (P<0.001). Biochemically, most patients with pheochromocytoma (92.8%) had catecholamine excess. Hypocortisolism was common in tuberculosis (100%) and PAL (71.4%) and absent with metastases (P<0.001). Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies. PMID:27037294

Vitamin paradox in obesity: Deficiency or excess?

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Zhou, Shi-Sheng; Li, Da; Chen, Na-Na; Zhou, Yiming

2015-08-25

Since synthetic vitamins were used to fortify food and as supplements in the late 1930s, vitamin intake has significantly increased. This has been accompanied by an increased prevalence of obesity, a condition associated with diabetes, hypertension, cardiovascular disease, asthma and cancer. Paradoxically, obesity is often associated with low levels of fasting serum vitamins, such as folate and vitamin D. Recent studies on folic acid fortification have revealed another paradoxical phenomenon: obesity exhibits low fasting serum but high erythrocyte folate concentrations, with high levels of serum folate oxidation products. High erythrocyte folate status is known to reflect long-term excess folic acid intake, while increased folate oxidation products suggest an increased folate degradation because obesity shows an increased activity of cytochrome P450 2E1, a monooxygenase enzyme that can use folic acid as a substrate. There is also evidence that obesity increases niacin degradation, manifested by increased activity/expression of niacin-degrading enzymes and high levels of niacin metabolites. Moreover, obesity most commonly occurs in those with a low excretory reserve capacity (e.g., due to low birth weight/preterm birth) and/or a low sweat gland activity (black race and physical inactivity). These lines of evidence raise the possibility that low fasting serum vitamin status in obesity may be a compensatory response to chronic excess vitamin intake, rather than vitamin deficiency, and that obesity could be one of the manifestations of chronic vitamin poisoning. In this article, we discuss vitamin paradox in obesity from the perspective of vitamin homeostasis.

Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125

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Védi André Serges Loué

2013-01-01

Full Text Available Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs’ syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs’ syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices.

[Symptomatic remission and its relationship to social functioning in Tunisian out-patients with schizophrenia].

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El Gharbi, I; Chhoumi, M; Mechri, A

2017-11-28

The concept of symptomatic and functional remission represents an important challenge in the care of the mentally ill, particularly in patients with schizophrenia. Operational criteria for symptomatic remission in schizophrenia have been proposed by Andreasen et al. (2005). Over the last decade, these criteria have been widely validated; however few studies have been conducted outside developed countries. Moreover, the association of symptomatic remission with functional outcome has not yet been established in developing countries including Tunisia, as there may be variability in the social and familial environment. To determine the frequency and associated factors of symptomatic remission in a sample of Tunisian out-patients with schizophrenia and to explore the relationship between symptomatic remission and some indicators of social functioning. A cross-sectional study was carried-out on 115 out-patients with schizophrenia (87 males, 28 females, mean age=37.56±10.2 years) in the psychiatry department of the university hospital in Monastir (Tunisia). Nearly all of the patients (98.26%) had been hospitalized at least once in a psychiatric unit. The last hospitalization dated back to 39 months on average (range=6 months to 16 years). Symptomatic remission was assessed by the eight core items of the positive and negative syndrome scale (PANSS). These are the items P1 "Delusions"; P3 "Hallucinatory behavior" and G9 "Unusual thought content" for the positive dimension, the items P2 "Conceptual disorganization" and G5 "Mannerism and disorders of posture" for the disorganization dimension and the items N1 "Blunted affect", N4 "Social withdrawal" and N6 "Lack of spontaneity and flow of conversation" for the negative dimension. A score of mild or less on all eight-core symptoms constitutes symptomatic remission. This symptom level should have been maintained for six months. The social functioning was assessed by the Social and Occupational Functioning Assessment Scale

The Paradox and Fog of Supervision: Site for the Encounters and Growth of Praxis, Persons and Voices

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Cherry, Nita

2012-01-01

Purpose: Several paradoxes have been presented in the literature as inherent in supervision of doctoral students. The purpose of this paper is to explore these paradoxes and offer the concept of praxis as a way of effectively engaging with complex and paradoxical dimensions of supervision, rather than denying or avoiding them.…

The MedDRA paradox.

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Merrill, Gary H

2008-11-06

MedDRA (the Medical Dictionary for Regulatory Activities Terminology) is a controlled vocabulary widely used as a medical coding scheme. However, MedDRA's characterization of its structural hierarchy exhibits some confusing and paradoxical features. The goal of this paper is to examine these features, determine whether there is a coherent view of the MedDRA hierarchy that emerges, and explore what lessons are to be learned from this for using MedDRA and similar terminologies in a broad medical informatics context that includes relations among multiple disparate terminologies, thesauri, and ontologies.

Paradoxical embolization via a patent foramen ovale following acute pulmonary embolism

International Nuclear Information System (INIS)

Thomas, D.V.; Bynevelt, V.; Price, R.

2005-01-01

The foramen ovale is usually obliterated following establishment of the adult circulation but remains patent in 25% of individuals. This potential communication between the venous and arterial circulations can allow thromboembolic material to bypass the lungs and enter the systemic circulation. We report two cases of paradoxical embolization through a patent foramen ovale following acute large pulmonary embolism (PE) and discuss the factors that predispose to paradoxical embolization following PE Copyright (2005) Blackwell Publishing Asia Pty Ltd

Change in left ventricular systolic function in patients with ST elevation myocardial infarction: Evidence for smoker's paradox or pseudo-paradox?

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Burak Acar

2016-11-01

Conclusion: True or persistent ‘smoker's paradox’ does not appear to be relevant among STEMI patients undergoing p-PCI. The ‘smoker's paradox’ is in fact a pseudo-paradox. Further studies with larger numbers may be warranted.

Paradoxical undressing associated with subarachnoid hemorrhage in a non-hypothermia case?

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Descloux, Emilienne; Ducrot, Kewin; Scarpelli, Maria Pia; Lobrinus, Alexander; Palmiere, Cristian

2017-09-01

Paradoxical undressing is a phenomenon characterizing some fatal hypothermia cases. The victims, despite low environmental temperatures, paradoxically remove their clothes due to a sudden feeling of warmth. In this report, we describe a case of suspected paradoxical undressing in a non-hypothermia case. The victim, a 51-year-old Caucasian man, was found dead wearing only sneakers and socks. All other clothing was found in his car. Postmortem investigations allowed the hypothesis of hypothermia to be ruled out and revealed the presence of a ruptured cerebral aneurysm that caused a subarachnoid hemorrhage, the latter responsible for the death. The absence of any elements suggesting a voluntary undressing or any third party's DNA profile or involvement along with the possibility that the subarachnoid hemorrhage might have determined a hypothalamic injury, somehow rendered conceivable the hypothesis of an inappropriate feeling of warmth due to hemorrhage-induced dysregulation of the hypothalamic temperature-regulating centers.

Bilateral Tubal Pregnancy without Known Risk Factor

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Hyacinthe Zamané

2017-01-01

Full Text Available Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy.

Clinical meaning of hot uptake on bone scan in symptomatic accessory navicular bones

International Nuclear Information System (INIS)

Chong, Ari; Ha, Jung Min; Lee, Jun Young

2016-01-01

We analyzed clinical factors related to uptake on a Tc-99 m HDP bone scan of the accessory navicular (AN). We retrospectively reviewed patients who had been examined by an orthopedic surgeon and underwent bone scan due to suspected symptomatic AN. A three-point grading system was used to evaluate uptake on bone scan. Relationships between grade, symptoms, age, gender, symptom duration, and bone size were analyzed. In total, 73 ANs (30 asymptomatic, 43 symptomatic) were enrolled. The majority of asymptomatic ANs had no uptake but some had grade 1 (n = 8) or 2 (n = 2) uptake. All asymptomatic ANs with uptake remained asymptomatic during follow-up. For the asymptomatic ANs, larger bones showed a higher grade. With a cut-off value of size ≤6.8 mm, there is no chance of uptake. All symptomatic ANs showed uptake on bone scan. For symptomatic ANs, larger size and shorter pain duration were related to a higher grade. Age, gender, and left-/right-sideness were not related to grade. Multiple regressions revealed that only uptake grade, not size or symptom duration, was the significant risk factor for a symptomatic AN. With a cut-off value of grade <1, a symptomatic AN could be ruled out with a negative predictive value of 100 %. Bone scanning is useful for symptomatic ANs with a high negative predictive value. Higher grade is related to larger size and shorter pain duration. For asymptomatic ANs, grade was related to size but did not predict symptom development

Clinical meaning of hot uptake on bone scan in symptomatic accessory navicular bones

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Chong, Ari; Ha, Jung Min; Lee, Jun Young [Chosun University Hospital, Gwangju (Korea, Republic of)

2016-12-15

We analyzed clinical factors related to uptake on a Tc-99 m HDP bone scan of the accessory navicular (AN). We retrospectively reviewed patients who had been examined by an orthopedic surgeon and underwent bone scan due to suspected symptomatic AN. A three-point grading system was used to evaluate uptake on bone scan. Relationships between grade, symptoms, age, gender, symptom duration, and bone size were analyzed. In total, 73 ANs (30 asymptomatic, 43 symptomatic) were enrolled. The majority of asymptomatic ANs had no uptake but some had grade 1 (n = 8) or 2 (n = 2) uptake. All asymptomatic ANs with uptake remained asymptomatic during follow-up. For the asymptomatic ANs, larger bones showed a higher grade. With a cut-off value of size ≤6.8 mm, there is no chance of uptake. All symptomatic ANs showed uptake on bone scan. For symptomatic ANs, larger size and shorter pain duration were related to a higher grade. Age, gender, and left-/right-sideness were not related to grade. Multiple regressions revealed that only uptake grade, not size or symptom duration, was the significant risk factor for a symptomatic AN. With a cut-off value of grade <1, a symptomatic AN could be ruled out with a negative predictive value of 100 %. Bone scanning is useful for symptomatic ANs with a high negative predictive value. Higher grade is related to larger size and shorter pain duration. For asymptomatic ANs, grade was related to size but did not predict symptom development.

Chasing our tails: psychological, institutional and societal paradoxes in natural resource management, sustainability, and climate change in Australia.

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Browne, A L; Bishop, B J

2011-06-01

Natural Resource Management (NRM) and Ecologically Sustainable Development (ESD) have been guiding frameworks in Australia for a number of decades. Recently, NRM and ESD have become central to climate change mitigation. In this paper, we explore the psychological paradoxes that function within climate change settings, with particular attention devoted to the way that research and development reinforces these paradoxes by advocating for participatory forms of inquiry. Paradox emerges in NRM at psychological, institutional, and organisational levels. Paradoxes are also features of different forms of democracy such as neoliberal and participatory democracy. Although NRM, ESD and climate change are often conceptualised as distinct issue domains, these policy areas are fundamentally interconnected in both theory and in practice. This interconnection between these policy and research settings, reflections on paradox, and the experience of incorporating community psychology into the paradoxical settings of NRM and climate change are captured in this paper.

Obesity paradox and risk of sudden death in heart failure results from the MUerte Subita en Insuficiencia cardiaca (MUSIC) study.

Science.gov (United States)

Gastelurrutia, Paloma; Pascual-Figal, Domingo; Vazquez, Rafael; Cygankiewicz, Iwona; Shamagian, Lillian Grigorian; Puig, Teresa; Ferrero, Andreu; Cinca, Juan; de Luna, Antoni Bayes; Bayes-Genis, Antoni

2011-01-01

among patients with heart failure (HF), body mass index (BMI) has been inversely associated with mortality, giving rise to the so-called obesity paradox. The aim of this study was to examine the relationship between BMI and two modes of cardiac death: pump failure death and sudden death. nine hundred seventy-nine patients with mild to moderate chronic symptomatic HF from the MUSIC (MUerte Subita en Insuficiencia Cardiaca) Study, a prospective, multicenter, and longitudinal study designed to assess risk predictors of cardiac mortality, were followed up during a median of 44 months. Independent predictors of death were identified by a multivariable Cox proportional hazards model. higher BMI emerged as an independent predictor of all-cause mortality (hazard ratio [HR] = 0.94, 95% confidence interval [CI] = 0.91-0.97, P = .0003) and pump failure death (HR = 0.93, 95% CI = 0.88-0.98, P = .004). Sudden death accounted for 45% of deaths in obese patients, 53% in overweight patients, and 37% in lean patients. No significant relationship between BMI and sudden death was observed (HR = 0.97, 95% CI = 0.92-1.02, P = .28). The only independent predictors of sudden death were prior history of myocardial infarction (HR = 1.89, 95% CI = 1.23-2.90, P = .004), hypertension (HR = 1.66, 95% CI = 1.05-2.63, P = .03), left ventricular ejection fraction (HR = 0.88, 95% CI = 0.79-0.96, P = .006), and N-terminal pro-B-type natriuretic peptide (HR = 1.01, 95% CI = 1.00-1.02, P = .048). the obesity paradox in HF affects all-cause mortality and pump failure death but not sudden death. The risk of dying suddenly was similar across BMI categories in this cohort of ambulatory patients with HF.

[Bilateral torticollis].

Science.gov (United States)

Kustos, T; Magdics, M

1993-12-19

Bilateral torticollis is a very rare form of a well known deformity i.e. muscular torticollis. This malformation might present a differential diagnostic problem both for orthopaedic surgeons and ophthalmologists, as well as, for neurologists. In agreement with the literature, the role of an injury during labour or defective embriogenesis is suggested to play a part.

TNF blockade induces a dysregulated type I interferon response without autoimmunity in paradoxical psoriasis.

Science.gov (United States)

Conrad, Curdin; Di Domizio, Jeremy; Mylonas, Alessio; Belkhodja, Cyrine; Demaria, Olivier; Navarini, Alexander A; Lapointe, Anne-Karine; French, Lars E; Vernez, Maxime; Gilliet, Michel

2018-01-02

Although anti-tumor necrosis factor (TNF) agents are highly effective in the treatment of psoriasis, 2-5% of treated patients develop psoriasis-like skin lesions called paradoxical psoriasis. The pathogenesis of this side effect and its distinction from classical psoriasis remain unknown. Here we show that skin lesions from patients with paradoxical psoriasis are characterized by a selective overexpression of type I interferons, dermal accumulation of plasmacytoid dendritic cells (pDC), and reduced T-cell numbers, when compared to classical psoriasis. Anti-TNF treatment prolongs type I interferon production by pDCs through inhibition of their maturation. The resulting type I interferon overexpression is responsible for the skin phenotype of paradoxical psoriasis, which, unlike classical psoriasis, is independent of T cells. These findings indicate that paradoxical psoriasis represents an ongoing overactive innate inflammatory process, driven by pDC-derived type I interferon that does not lead to T-cell autoimmunity.

Prevalence of significant bacteriuria among symptomatic and ...

African Journals Online (AJOL)

2013-06-10

Jun 10, 2013 ... bacteriuria in symptomatic and asymptomatic sickle cell patients in Lagos. Materials and Methods: .... over 65 years, treatment with immunosuppressive drugs, the presence of .... toxemia of pregnancy.[7,13] A positive urine ...

Illustrations of the twin paradox

International Nuclear Information System (INIS)

Rebhan, E.

1985-01-01

In order to provide a more intuitive understanding of the twin paradox, several illustrations of this are presented. In one of these, each of the twins is equipped with a lamp whose monochromatic light can be observed by the other. In other illustrations the travelling twin uses an Einstein train instead of a space ship, all the cars of the train and all stations along the route of the train being equipped with clocks. (author)

Bilateral optic neuropathy in acute cr yptococcal meningitis

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Qi Zhe Ngoo

2016-11-01

Full Text Available We reported a case of cryptococcal meningitis presenting with bilateral optic neuropathy in an immunocompetent patient. A 64-year-old Malay gentleman with no medical comorbidities presented with acute bilateral blurring of vision for a week, which was associated with generalised throbbing headache and low grade fever. He also had somnolence and altered consciousness. Visual acuity in both eyes was no perception of light with poor pupillary reflexes. Extraocular muscle movements were normal. Anterior segments were unremarkable bilaterally. Fundoscopy revealed bilateral optic disc swelling. CT scan of the brain showed multifocal infarct, but no meningeal enhancement or mass. Cerebrospinal fluid opening pressure was normal, while its culture grew Cryptococcus neoformans. A diagnosis of cryptococcal meningitis with bilateral optic neuropathy was made. Patient was treated with a six-week course of intravenous fluconazole and started concomitantly on a fortnight's course of intravenous amphotericin B. After that, his general condition improved, but there was still no improvement in his visual acuity. On reviewing at two months post-initiation of treatment, fundi showed bilateral optic atrophy. Bilateral optic neuropathy secondary to cryptococcal meningitis was rare. The prognosis was guarded due to the sequelae of optic atrophy. Anti-fungal medication alone may not be sufficient to manage this condition. However, evidence for other treatment modalities is still lacking and further clinical studies are required.

Neglected simultaneous bilateral femoral neck fractures secondary to narcotic drug abuse treated by bilateral one-staged hemiarthroplasty: a case report

Directory of Open Access Journals (Sweden)

Vahedi Ehsan

2010-06-01

Full Text Available Abstract Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, anti-epileptic medications, seizure, etc. A 28-year-old addict man referred to us with a 10-year history of narcotic drug abuse and history of 8 months bilateral groin pain. He admitted with displaced bilateral femoral neck fracture. Because of long duration of this condition and osteonecrosis revealed on bone scan, one-staged bilateral hip hemiarthroplasty was done. A good function was noted after surgery to 4-month follow up. Up to now, have not be founded in the literature that a case of bilateral femoral neck fracture associated with narcotic drug abuse. Because of negative effects of opium or smoking on bone tissues, a simple bone pain should aware us about the risk of stress or fatigue fracture.

Symptomatic Raccoon Dogs and Sarcoptic Mange Along an Urban Gradient.

Science.gov (United States)

Saito, Masayuki U; Sonoda, Yoichi

2017-06-01

We quantitatively evaluated the effects of landscape factors on the distribution of symptomatic raccoon dogs with sarcoptic mange along an urban gradient. We used 246 camera traps (182 traps from April 2005 to December 2006; 64 traps from September 2009 to October 2010) to record the occurrence of asymptomatic and symptomatic raccoon dogs at 21 survey sites along an urban-rural gradient in the Tama Hills area of Tokyo. Each occurrence was explained in terms of the surrounding forest, agricultural, and grassland areas and additional factors (i.e., seasonal variations and survey methods) at various spatial scales using a generalized additive mixed model (GAMM). In our analysis, a 1000-m radius was identified as the important spatial scale for asymptomatic and symptomatic raccoon dog occurrence. The peak of the predicted occurrence probability of asymptomatic raccoon dogs appeared in the intermediate forest landscape as opposed to non-forest and forest landscapes. However, a high occurrence probability of symptomatic raccoon dogs was detected in non-forest and intermediate forest landscapes (i.e., urban and suburban) as opposed to a forest landscape, presumably because of animals occurring at much higher densities in more urbanized areas. Therefore, our results suggest that human-modified landscapes play an important role in the high occurrence of sarcoptic mange in raccoon dogs.

PPI, paradoxes and Plato: who's sailing the ship?

Science.gov (United States)

Ives, Jonathan; Damery, Sarah; Redwod, Sabi

2013-03-01

Over the last decade, patient and public involvement (PPI) has become a requisite in applied health research. Some funding bodies demand explicit evidence of PPI, while others have made a commitment to developing PPI in the projects they fund. Despite being commonplace, there remains a dearth of engagement with the ethical and theoretical underpinnings of PPI processes and practices. More specifically, while there is a small (but growing) body of literature examining the effectiveness and impact of PPI, there has been relatively little reflection on whether the concept/practice of PPI is internally coherent. Here, the authors unpick a 'paradox' within PPI, which highlights a tension between its moral and pragmatic motivations and its implementation. The authors argue that this 'professionalisation paradox' means we need to rethink the practice, and purpose, of PPI in research.

Executive functioning during full and partial remission (positive and negative symptomatic remission) of schizophrenia.

Science.gov (United States)

Braw, Yoram; Benozio, Avi; Levkovitz, Yechiel

2012-12-01

Despite the upsurge of research regarding cognitive impairment in schizophrenia we still lack adequate understanding of the executive functioning of patients in symptomatic remission. Moreover, the cognitive functioning of patients in partial remission has not been studied previously although they comprise a significant proportion of schizophrenia patients. The current study therefore examined the executive functioning of patients in full symptomatic remission and for the first time assessed two sub-groups of patients in partial remission. Executive functioning of five groups was compared; symptomatic patients, patients in positive symptomatic remission, negative symptomatic remission, full symptomatic remission (SP, PSR, NSR, and FSR; N=101) and healthy controls (N=37). A graded cognitive profile was evident between the groups. SP patients exhibited widespread executive dysfunction while the performance of FSR patients was comparable to that of the healthy controls. Both PSR and NSR patients had working memory deficits, with PSR patients showing additional deficits in cognitive planning. The findings are encouraging, tentatively suggesting intact executive functioning among patients in full symptomatic remission. The graded cognitive profile of the patient groups strengthens earlier findings indicating the significant role of negative symptoms in determining executive dysfunction in schizophrenia. The findings point toward potential targets for therapeutic efforts and emphasize the need for further research of sub-groups of schizophrenia patients in partial remission. Copyright © 2012 Elsevier B.V. All rights reserved.

Bilateral sacrospinous vault fixation with tailored synthetic mesh arms: clinical outcomes at one year.

Science.gov (United States)

Geoffrion, Roxana; Hyakutake, Momoe T; Koenig, Nicole A; Lee, Terry; Cundiff, Geoffrey W

2015-02-01

Bilateral sacrospinous fixation with tailored mesh arms (bSSVF) uses polypropylene mesh to suspend the vault to the sacrospinous ligaments bilaterally with minimal tension, recreating nulliparous midline anatomy. It can be used with uterine conservation. Our primary objective was to determine objective cure rate at one year following bSSVF compared with a control group undergoing abdominal sacrocolpopexy (ASC). Secondary objectives were to compare symptoms, quality of life, sexual function, pain, and global satisfaction before and after surgery and between bSSVF and ASC groups at one year. This prospective cohort study enrolled patients with symptomatic prolapse who chose to undergo bSSVF or ASC. Baseline demographics were obtained. Prolapse quantification, validated symptom questionnaire scores, and McGill pain scores were obtained at baseline, six weeks, and one-year postoperatively. Global satisfaction was recorded. The primary outcome measure was the difference in cure rate (vault stage ≤ 1) between groups. Fifty patients were recruited: 30 underwent bSSVF and 17 ASC. Forty-three patients were available for one-year follow-up. Baseline data were similar. There was no difference in vault stage between bSSVF and ASC groups at one year. Five women who underwent bSSVF had cervical elongation, and four of these were classified as POP recurrence. Women who underwent bSSVF had more anterior recurrences but fewer postoperative complications, shorter hospital stay, and less use of narcotics than controls. Questionnaire scores were similar at one year. All respondents felt subjective improvement after either surgical procedure. Objective and subjective cure rates are comparable after bSSVF and ASC. Hysteropexy may cause cervical elongation that merits further research.

The Equality Paradox of Deliberative Democracy: Evidence from a National Deliberative Poll

DEFF Research Database (Denmark)

Hansen, Kasper Møller

2010-01-01

and openly without any procedural restrictions. At the same time, however it is argued that arguments referring to the common good and public interest should and will be emphasized in a deliberative process, which favors participants accustomed to this kind of reasoning, thus, compromising political equality...... the citizens' capabilities to form reasoned and reflective opinions based on the common good rather than self-interest. The focus on the normative potential of deliberation has to a large extent neglected deliberations' many pitfalls and contradictions. One of the most troubling paradoxes in deliberative...... democracy is the equality paradox. The equality paradox of deliberation relates to the idea that deliberative democrats advocate the importance of securing that the deliberative process fulfills political equality as the participants in the deliberative process are able to express their views freely...

Bilateral Wilms' tumor

International Nuclear Information System (INIS)

Malcolm, A.W.; Jaffe, N.; Folkman, M.J.; Cassady, J.R.

1980-01-01

Twenty children with bilateral Wilms' tumor were presented to the Children's Hospital Medical Center and Children's Cancer Research Foundation, Sidney Farber Cancer Institute, and Joint Center for Radiation Therapy (CHMC-CCRF, SFCI, JCRT) from January 1, 1956 to December 31, 1976. Of these 20, 16 had simultaneous and 4 had metachronous disease on presentation. All patients were treated with surgery, radiation and chemotherapy. Of the 16 patients with simultaneous disease, 10 (63%) are alive and free of disease 12+ to 175+ months post diagnosis and treatment, with median follow-up of 121 months. There were no long-term survivors in the metachronous group; all were dead of disease within 21 months from initial presentation of original tumor. With these data we relate prognosis to extent of disease and discuss a general approach to the management of bilateral Wilms' tumor

Paradoxical psychotherapy in a case of transvestism.

Science.gov (United States)

Cliffe, M J

1987-09-01

Paradoxical psychotherapy succeeded in removing the compulsive element and reducing the guilt attached to transvestism in a male transvestite patient. Cross-dressing at home became acceptable to him and the temptation to cross-dress in public ended. Data suggested three independent motivational systems in this patient.

Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

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Ines Mack

2017-06-01

Full Text Available Cytomegalovirus (CMV is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy. Diagnosis was confirmed by CMV PCR from amniotic fluid and fetal MR imaging. The newborn presented with typical cCMV symptoms including jaundice, hepatosplenomegaly, cholestasis, petechiae, small head circumference, and sensorineural hearing loss, the most common neurologic sequela. CMV was detected in infant blood and urine by PCR, and intravenous ganciclovir was initiated and continued orally for 6 weeks totally. Apart from persisting right-sided deafness, the child exhibited normal neurological development up through the last follow-up at 4.5 years. To date, the most effective strategy to prevent vertical CMV transmission is hygiene counseling for women of childbearing age, which, in our case, and in concordance with recent literature, applies to seronegative, as well as seropositive, women. Once an expecting mother shows seroconversion or signs of an active CMV infection, there are no established procedures to reduce the risk of transmission, or therapeutic options for the fetus with signs of infection. After birth, symptomatic infants can be treated with ganciclovir to inhibit viral replication and improve hearing ability and neurodevelopmental outcome. A comprehensive review of the literature, including our case study, reveals the most current and significant diagnostic and treatment options available. In conclusion, the triad

Outcome of endovascular treatment in symptomatic intracranial vascular stenosis

Energy Technology Data Exchange (ETDEWEB)

Suh, Dae Chul; Kim, Sang Joon; Lee, Duk Hee; Kim, Won; Choi, Choong Gon; Lee, Jeong Hyun; Kwon, Sun Uck; Kim, Jong Sung [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Hyun Jeong [Daejeon Catholic Hospital, Daejeon (Korea, Republic of)

2005-03-15

The outcome evaluation for the revascularization of intracranial vascular stenoses has not been fully described due to the highly technical nature of the procedure. We report here on the early and late clinical outcome of angioplasty and/or stenting of symptomatic severe intracranial vascular stenoses at a single institute. Since 1995, we have treated 35 patients with symptomatic intracranial vascular stenosis (more than 70% stenosis, mean stenosis: 78.6% {+-} 6.2%). Angioplasty (n = 19) was performed for the horizontal segment of the middle cerebral artery (M1) (n = 16) and the basilar artery (BA) (n = 1), the intradural vertebral artery (VA) (n = 1), and the cavernous internal carotid artery (ICA) (n = 1). Stenting (n = 16) was performed for the cavernous or petrous ICAs (n = 9), the intradural VA (n = 3), BA (n = 2), and M1 (n = 2) artery. We assessed the angiographic success (defined as residual stenosis < 50%) rate, the periprocedural complications during the 30-day periprocedural period, the symptomatic recurrence and restenosis during a mean 22-month follow-up (FU) period. The Kaplan-Meier estimate of the cumulative even-free rate of the major cerebrovascular events, i.e. death, stroke or restenosis, was also done. Angiographic success was achieved in 97% of our patients (34/35). There were four procedure-related complications (11%) including a death and a minor stroke. During the mean 22-month FU, the asymptomatic restenosis rate was 9% and the symptomatic restenosis rate was 6% in the target lesion and 9% in all the vascular territories. The Kaplan-Meier estimate was 70.6% (95% confidence interval = 46.5-94.7) after 33 month of FU. In addition to a high angiographic success rate and an acceptable periprocedural complication rate, intracranial angioplasty and/or stenting revealed a relatively low symptomatic recurrence rate. Hemorrhage is a rare, but the physician must aware that potentially fatal periprocedural complications can occur.

The effect of congruence in patient and therapist alliance on patient's symptomatic levels.

Science.gov (United States)

Zilcha-Mano, Sigal; Snyder, John; Silberschatz, George

2017-05-01

The ability of alliance to predict outcome has been widely demonstrated, but less is known about the effect of the level of congruence between patient and therapist alliance ratings on outcome. In the current study we examined whether the degree of congruence between patient and therapist alliance ratings can predict symptomatic levels 1 month later in treatment. The sample consisted of 127 patient-therapist dyads. Patients and therapists reported on their alliance levels, and patients reported their symptomatic levels 1 month later. Polynomial regression and response surface analysis were used to examine congruence. Findings suggest that when the congruence level of patient and therapist alliance ratings was not taken into account, only the therapist's alliance served as a significant predictor of symptomatic levels. But when the degree of congruence between patient and therapist alliance ratings was considered, the degree of congruence was a significant predictor of symptomatic levels 1 month later in treatment. Findings support the importance of the level of congruence between patient and therapist alliance ratings in predicting patient's symptomatic levels.

Resolution of a cosmological paradox using concepts from general relativity theory

International Nuclear Information System (INIS)

Silverman, A.N.

1986-01-01

According to the big bang theory, the universe began about 15 billion years ago and has been continually expanding ever since. If certain elementary physical concepts are naively applied to this cosmological theory, it can lead to a paradox in which distant astronomical objects seem to have lain at distances from the Earth larger than the possible size of the universe. The paradox is resolved by using concepts from general relativity theory. These concepts may appear startling to some readers

Problems and paradoxes of the Lifshitz theory

International Nuclear Information System (INIS)

Klimchitskaya, G L

2009-01-01

The problems and paradoxes of the Lifshitz theory in application to real dielectric and semiconductor materials are reviewed. It is shown that the inclusion of drift current of conduction electrons into the model of dielectric response results in contradictions with both thermodynamics and experimental data of different experimental groups. Physical reasons why the problems and paradoxes arise are analyzed and found to be connected with the violation of basic applicability condition of the Lifshitz theory, the thermal equilibrium. A recent alternative approach to the resolution of the problems based on the inclusion of screening effects and diffusion current is considered and demonstrated to be thermodynamically and experimentally inconsistent. It is argued that the inclusion of the diffusion current leads to an even deeper violation of thermal equilibrium. Phenomenologically, the Lifshitz theory with role of drift and diffusion currents neglected is shown to be free of problems and in agreement with both thermodynamics and all available experimental data.

Fermi's Paradox - The Last Challenge For Copernicanism?

Directory of Open Access Journals (Sweden)

Ćirković, M. M.

2009-06-01

Full Text Available We review Fermi's paradox (or the "Great Silence" problem, not only arguably the oldest and crucial problem for the Search for ExtraTerrestrial Intelligence (SETI, but also a conundrum of profound scientific, philosophical and cultural importance. By a simple analysis of observation selection effects, the correct resolution of Fermi's paradox is certain to tell us something about the future of humanity. Already more than three quarters of century old puzzle -- and a quarter of century since the last major review paper in the field by G. David Brin -- has generated many ingenious discussions and hypotheses. We analyze the often tacit methodological assumptions built in various answers to this puzzle and attempt a new classification of the numerous solutions proposed in an already huge literatureon the subject. Finally, we consider the ramifications of variousclasses of hypotheses for the practical SETI projects. Somewhatparadoxically, it seems that the class of (neocatastrophichypotheses gives, on the balance, the strongest justification tooptimism regarding our current and near-future SETI efforts.

Simultaneous bilateral patellar tendon rupture ?

OpenAIRE

Moura, Diogo Lino; Marques, Jos? Pedro; Lucas, Francisco Manuel; Fonseca, Fernando Pereira

2016-01-01

Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a s...

Bone resorptive activity in symptomatic and asymptomatic apical lesions of endodontic origin.

Science.gov (United States)

Salinas-Muñoz, M; Garrido-Flores, M; Baeza, M; Huamán-Chipana, P; García-Sesnich, J; Bologna, R; Vernal, R; Hernández, M

2017-11-01

The aim of this study is to assess the levels and diagnostic accuracy of a set of bone resorption biomarkers, including TRAP-5, RANKL, and OPG in symptomatic and asymptomatic apical lesions and controls. Apical tissues from symptomatic and asymptomatic apical periodontitis patients and periodontal ligaments from healthy teeth extracted for orthodontic reasons were processed for tissue homogenization and the levels of TRAP-5, RANKL, and OPG were determined by multiplex assay. Marker levels were analyzed by Kruskal Wallis test, and diagnostic accuracy was analyzed with ROC curves. Higher levels of RANKL, OPG, and RANKL/OPG ratio were determined in both types of apical lesions compared to healthy periodontal ligament, whereas higher TRAP-5 levels were found only in symptomatic apical lesions (p apical lesions versus healthy controls (AUC = 0.69, p asymptomatic apical periodontitis (AUC = 0.71, p Apical lesions showed higher RANKL and OPG levels than healthy tissues. TRAP-5 levels were the highest in symptomatic apical lesions, suggesting that these represent a progressive state, and showed diagnostic potential. Clinically symptomatic apical periodontitis might represent biologically progressive apical lesions based on TRAP5 levels. TRAP5 has diagnostic potential to identify these lesions, representing a candidate prognostic biomarker.

Can Virtue Be Taught and How? Confucius on the Paradox of Moral Education

Science.gov (United States)

Huang, Yong

2011-01-01

In this paper I shall first examine an apparent paradox in Confucius' view on whether everyone is perfectible through education: on the one hand, he states that education should be provided to all, on the other hand, he says that common people cannot be made to know things. To understand this apparent paradox, I shall argue that education for…

Paradoxical upgrading reaction in extra-pulmonary tuberculosis: association with vitamin D therapy

OpenAIRE

Barr, D.A.; Coussens, A.K.; Irvine, S.; Ritchie, N.D.; Herbert, K.; Choo-Kang, B.; Raeside, D.; Bell, D.J.; Seaton, R.A.

2017-01-01

SETTING: Glasgow, Scotland, UK.\\ud \\ud BACKGROUND: Paradoxical reactions in tuberculosis (TB) are a notable example of our incomplete understanding of host-pathogen interactions during anti-tuberculosis treatment.\\ud \\ud OBJECTIVES: To determine risk factors for a TB paradoxical reaction, and specifically to assess for an independent association with vitamin D use.\\ud \\ud DESIGN: Consecutive human immunodeficiency virus (HIV) negative adult patients treated for extra-pulmonary TB were identif...

Maxillary arch width in unoperated adult bilateral cleft lip and alveolus and complete bilateral cleft lip and palate.

NARCIS (Netherlands)

Latief, B.S.; Lekkas, C.; Kuijpers, M.A.R.

2010-01-01

OBJECTIVES: To study maxillary arch width in adult patients with bilateral cleft lip and alveolus (BCLA) or with complete bilateral cleft lip and palate (BCLP), who have not had any surgery. SETTING AND SAMPLING POPULATION: Eighteen patients with BCLA, 13 patients with BCLP, and 24 controls from

On a paradox of probability theory

International Nuclear Information System (INIS)

Stuart, C.I.J.M.

1989-01-01

Costa de Beauregard's proposal concerning physical retrocausality has been shown to fail on two crucial points. However, it is argued that his proposal still merits serious attention. The argument arises from showing that his proposal reveals a paradox involving relations between conditional probabilities, statistical correlations and reciprocal causalities of the type exhibited by cooperative dynamics in physical systems. 4 refs. (Author)

Common iliac vein stenosis and risk of symptomatic pulmonary embolism: an inverse correlation.

Science.gov (United States)

Chan, Keith T; Popat, Rita A; Sze, Daniel Y; Kuo, William T; Kothary, Nishita; Louie, John D; Hovsepian, David M; Hwang, Gloria L; Hofmann, Lawrence V

2011-02-01

To test the hypothesis that a common iliac vein (CIV) stenosis may impair embolization of a large deep venous thrombosis (DVT) to the lungs, decreasing the incidence of a symptomatic pulmonary embolism (PE). Between January 2002 and August 2007, 75 patients diagnosed with unilateral DVT were included in a single-institution case-control study. Minimum CIV diameters were measured 1 cm below the inferior vena cava (IVC) bifurcation on computed tomography (CT) images. A significant stenosis in the CIV ipsilateral to the DVT was defined as having either a diameter 4 mm or less or a greater than 70% reduction in lumen diameter. A symptomatic PE was defined as having symptoms and imaging findings consistent with a PE. The odds of symptomatic PE versus CIV stenosis were assessed using logistic regression models. The associations between thrombus location, stenosis, and symptomatic PE were assessed using a stratified analysis. Of 75 subjects, 49 (65%) presented with symptomatic PE. There were 17 (23%) subjects with a venous lumen 4 mm or less and 12 (16%) subjects with a greater than 70% stenosis. CIV stenosis of 4 mm or less resulted in a decreased odds of a symptomatic PE compared with a lumen greater than 4 mm (odds ratio [OR] 0.17, P = .011), whereas a greater than 70% stenosis increased the odds of DVT involving the CIV (OR 7.1, P = .047). Among patients with unilateral DVT, those with an ipsilateral CIV lumen of 4 mm or less have an 83% lower risk of developing symptomatic PE compared with patients with a CIV lumen greater than 4 mm. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Jevons' Paradox revisited: The evidence for backfire from improved energy efficiency

International Nuclear Information System (INIS)

Sorrell, Steve

2009-01-01

Beginning with William Stanley Jevons in 1865, a number of authors have claimed that economically justified energy-efficiency improvements will increase rather than reduce energy consumption. 'Jevons Paradox' is extremely difficult to test empirically, but could have profound implications for energy and climate policy. This paper summarises and critiques the arguments and evidence that have been cited in support of Jevons' Paradox, focusing in particular on the work of Len Brookes and Harry Saunders. It identifies some empirical and theoretical weaknesses in these arguments, highlights the questions they raise for economic orthodoxy and points to some interesting parallels between these arguments and those used by the 'biophysical' school of ecological economics. While the evidence in favour of 'Jevons Paradox' is far from conclusive, it does suggest that economy-wide rebound effects are larger than is conventionally assumed and that energy plays a more important role in driving productivity improvements and economic growth than is conventionally assumed

Bilateral Arthrodesis of the Ankle Joint: Self-Reported Outcomes in 35 Patients From the Swedish Ankle Registry.

Science.gov (United States)

Henricson, Anders; Kamrad, Ilka; Rosengren, Björn; Carlsson, Åke

Bilateral ankle arthrodesis is seldom performed, and results concerning the outcome and satisfaction can only sparsely be found in published studies. We analyzed the data from 35 patients who had undergone bilateral ankle arthrodesis in the Swedish Ankle Registry using patient-reported generic and region-specific outcome measures. Of 36 talocrural arthrodeses and 34 tibio-talar-calcaneal arthrodeses, 6 ankles (9%) had undergone repeat arthrodesis because of nonunion. After a mean follow-up period of 47 ± 5 (range 12 to 194) months, the mean scores were as follows: self-reported foot and ankle score, 33 ± 10 (range 4 to 48); the EuroQol Group's EQ-5D ™ score, 0.67 ± 0.28 (range -0.11 to 1), the EuroQol Group's visual analog scale score, 70 ± 19 (range 20 to 95), 36-item Short Form Health Survey (SF-36) physical domain, 39 ± 11 (range 16 to 58); and SF-36 mental domain, 54 ± 14 (range 17 to 71). Patients with rheumatoid arthritis seemed to have similar self-reported foot and ankle scores but possibly lower EQ-5D ™ and SF-36 scores. Those with talocrural arthrodeses scored higher than did those with tibio-talar-calcaneal arthrodeses on the EQ5D ™ and SF-36 questionnaires (p = .03 and p = .04). In 64 of 70 ankles (91%), the patients were satisfied or very satisfied with the outcome. In conclusion, we consider bilateral ankle arthrodesis to be a reasonable treatment for symptomatic hindfoot arthritis, with high postoperative mid-term satisfaction and satisfactory scores on the patient-reported generic and region-specific outcome measures, when no other treatment option is available. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Bilateral ovarian tumour in a young girl | Govindarajan | African ...

African Journals Online (AJOL)

Bilateral ovarian tumour in a girl presents the dilemma of conservative versus aggressive approach towards these tumours. When faced with suspicious tumour and complete replacement of the ovaries bilaterally, bilateral oophorectomy is a viable option, though the certain possibility of infertility and lifelong hormonal ...

Bilateral elastofibroma dorsi: A case report

OpenAIRE

Molini, L.; Ciortan, E.; Bianchi, S.

2010-01-01

Elastofibroma dorsi is a rare pseudotumoral lesion located in the periscapular region. Ultrasound can be used to evaluate its dimensions, margins, and internal structure. In the presence of bilateralism, diagnosis can be made on the basis of clinical and sonographic findings. The authors present a case of bilateral elastofibroma dorsi in which the clinical and ultrasound diagnosis was confirmed by magnetic resonance imaging.

Optimal Treatment of Symptomatic Hemorrhoids

OpenAIRE

Song, Seok-Gyu; Kim, Soung-Ho

2011-01-01

Hemorrhoids are the most common anorectal complaint, and approximately 10 to 20 percent of patients with symptomatic hemorrhoids require surgery. Symptoms of hemorrhoids, such as painless rectal bleeding, tissue protrusion and mucous discharge, vary. The traditional therapeutic strategies of medicine include surgical, as well as non-surgical, treatment. To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients. Othe...

MR imaging of the Achilles tendon: overlap of findings in symptomatic and asymptomatic individuals

International Nuclear Information System (INIS)

Haims, A.H.; Schweitzer, M.E.; Patel, R.S.

2000-01-01

Objective: To differentiate MR imaging characteristics of symptomatic as compared with asymptomatic Achilles tendons.Design: 1.5 T MR images of 94 feet (88 patients) with ''abnormal'' MR examinations were retrospectively evaluated and clinically correlated. Two masked, independent observers systematically evaluated for intratendon T2 signal, tendon thickness, presence of peritendonitis, retrocalcaneal bursal fluid volume, pre-Achilles edema, bone marrow edema at the Achilles insertion, and tears (interstitial, partial, complete). These findings were correlated with symptoms (onset and duration) and physical examination results (tenderness, palpable defects, increased angle of resting dorsiflexion).Results: Of the 94 ankles, 64 ankles (32 females, 29 males) were clinically symptomatic. No relationship between Achilles tendon disorders and age or gender was identified. Asymptomatic Achilles tendons frequently demonstrated mild increased intratendon signal (21/30), 0.747 cm average tendon thickness, peritendonitis (11/30), pre-Achilles edema (12/30), and 0.104 ml average retrocalcaneal bursal fluid volume. Symptomatic patients had thicker tendons (0.877 cm), greater retrocalcaneal fluid volume (0.278 ml), more frequent tears (23/64), a similar frequency of peritendonitis (22/64) but less frequent pre-Achilles edema (18/64). Sixty-four percent of the Achilles tendon tears were interstitial. Except for two interstitial tears in control patients, the majority of Achilles tears were in symptomatic patients (14/16). Only symptomatic tendons demonstrated partial or complete tendon tears. In addition, calcaneal edema was found almost exclusively in actively symptomatic patients. Thicker tendons were associated more often with chronic symptoms and with tears. When present in symptomatic patients, peritendonitis was usually associated with acute symptoms. The presence of pre-Achilles edema, however, did not distinguish acute from chronic disorders.Conclusion: There is

Unusual Presentation of Recurrent Pyogenic Bilateral Psoas Abscess Causing Bilateral Pulmonary Embolism by Iliac Vein Compression

OpenAIRE

Ijaz, Mohsin; Sakam, Sailaja; Ashraf, Umair; Marquez, Jose Gomez

2015-01-01

Patient: Male, 47 Final Diagnosis: Bilateral psoas abscess • acute lower extremity deep vein thrombosis • bilateral pulmonary embolism Symptoms: Progressive left leg swelling • productive cough with whitish sputum • right flank pain Medication: Antibiotics and anticoagulation Clinical Procedure: CT-guided percutaneous drain placement Specialty: Internal Medicine/Critical Care Objective: Unusual presentation Background: Psoas abscesses are a known cause of back pain, but they have not been rep...

Bilateral acute iris transillumination: Case report

Directory of Open Access Journals (Sweden)

Cumali Degirmenci

2016-04-01

Full Text Available Bilateral acute iris transillumination (BAIT is a recently defined disease characterized with bilateral acute, severe pigment dispersion of iris and pupil sphincter paralysis. The etiopathogenesis of the disease is unknown, but antibiotics such as moxifloxacin, clarithromycin, viral infections, and fumigation therapies were considered as probable etiologic factors. A 33-year-old female was referred to our clinic for acute iridocyclitis refractory to azathioprine, colchicum and corticosteroid treatments. Ophthalmic examination revealed bilateral pigment dispersion, significant iris transillumination, heavy pigment deposition in iridocorneal angle, and elevated intraocular pressure. Upon systemic evaluation she was found to have bacterial urinary tract infection. BAIT is an important cause of pigment dispersion and clinicians must be vigilant for this condition to avoid unnecessary diagnostic tests and treatment.

Making Games Not Work: Paradoxes Embedded in Game-Based Training and Concepts for Overcoming Them

Science.gov (United States)

Jones, Phillip N.; Cuper, Taryn

2010-01-01

An interest in game-based training solutions is natural. All one has to do is watch someone fully engaged in a modern game to see the potential of harnessing that attention for training. However, the reality of game-based training has not fully satisfied these expectations. This paper explains two paradoxes that must be overcome for games to support training. These paradoxes are a result of the realities of the basic human condition clashing with the requirements of learning theory. 80th paradoxes arise from the concept of "engagement" that is central to games. The first comes from a more robust definition of engagement, which is the condition of Flow or Optimal Experience. Flow is the state game developers want to see in users. One aspect of Flow is loss of sense of self as the individual becomes immersed in the experience. The paradox arises because this loss of self directly contradicts the learning requirement of self-reflection. The second paradox comes from theories of play, which state in part that play requires a level of individual freedom. The contradiction arises when game-based play must be harnessed to an organizational training program or regimen. The paper will discuss these paradoxes in the context of an effort to design a game-based training modality to train combat medics and will close with a review of compensating strategies identified by the designers. The paper will provide information important to anyone interested in conceptualizing and designing game-based training.

Infectious mononucleosis presenting as bilateral acute dacryocystitis.

Science.gov (United States)

Atkinson, P L; Ansons, A M; Patterson, A

1990-01-01

A case of infectious mononucleosis presenting as bilateral acute dacryocystitis in a 7-year-old girl is reported. Acute dacryocystitis is uncommon in this age group, and an underlying systemic illness should be suspected particularly when it is bilateral. Images PMID:2275940

Similarity in Bilateral Isolated Internal Orbital Fractures.

Science.gov (United States)

Chen, Hung-Chang; Cox, Jacob T; Sanyal, Abanti; Mahoney, Nicholas R

2018-04-13

In evaluating patients sustaining bilateral isolated internal orbital fractures, the authors have observed both similar fracture locations and also similar expansion of orbital volumes. In this study, we aim to investigate if there is a propensity for the 2 orbits to fracture in symmetrically similar patterns when sustaining similar trauma. A retrospective chart review was performed studying all cases at our institution of bilateral isolated internal orbital fractures involving the medial wall and/or the floor at the time of presentation. The similarity of the bilateral fracture locations was evaluated using the Fisher's exact test. The bilateral expanded orbital volumes were analyzed using the Wilcoxon signed-rank test to assess for orbital volume similarity. Twenty-four patients with bilateral internal orbital fractures were analyzed for fracture location similarity. Seventeen patients (70.8%) had 100% concordance in the orbital subregion fractured, and the association between the right and the left orbital fracture subregion locations was statistically significant (P < 0.0001). Fifteen patients were analyzed for orbital volume similarity. The average orbital cavity volume was 31.2 ± 3.8 cm on the right and 32.0 ± 3.7 cm on the left. There was a statistically significant difference between right and left orbital cavity volumes (P = 0.0026). The data from this study suggest that an individual who suffers isolated bilateral internal orbital fractures has a statistically significant similarity in the location of their orbital fractures. However, there does not appear to be statistically significant similarity in the expansion of the orbital volumes in these patients.

Results of surgical excision of urethral prolapse in symptomatic patients.

Science.gov (United States)

Hall, Mary E; Oyesanya, Tola; Cameron, Anne P

2017-11-01

Here, we present the clinical presentation and surgical outcomes of women with symptomatic urethral prolapse presenting to our institution over 20 years, and seek to provide treatment recommendations for management of symptomatic urethral prolapse and caruncle. A retrospective review of medical records from female patients who underwent surgery for symptomatic urethral prolapse from June 1995 to August 2015 was performed. Surgical technique consisted of a four-quadrant excisional approach for repair of urethral prolapse. A total of 26 patients were identified with a mean age of 38.8 years (range 3-81). The most common presentations were vaginal bleeding, hematuria, pain, and dysuria. All patients underwent surgical excision of urethral prolapse via a standard approach. Follow-up data was available in 24 patients. Six patients experienced temporary postoperative bleeding, and one patient required placement of a Foley catheter for tamponade. One patient experienced temporary postoperative urinary retention requiring Foley catheter placement. Three patients had visible recurrence of urethral prolapse, for which one later underwent re-excision. Surgical excision of urethral prolapse is a reasonable treatment option in patients who have tried conservative management without relief, as well as in those who present with severe symptoms. Possible complications following excision include postoperative bleeding and recurrence, and patients must be counseled accordingly. In this work, we propose a treatment algorithm for symptomatic urethral prolapse. © 2017 Wiley Periodicals, Inc.

Bilateral locked facets in the thoracic spine

NARCIS (Netherlands)

M.H.A. Willems; Braakman, R. (Reinder); B. van Linge (Bert)

1984-01-01

textabstractTwo cases of traumatic bilateral locked facets in the thoracic spine are reported. Both patients had only minor neurological signs. They both made a full neurological recovery after surgical reduction of the locked facets. Bilateral locked facets are very uncommon in the thoracic spine.

Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction

International Nuclear Information System (INIS)

Doody, O.; Adam, W. R.; Foley, P. T.; Lyon, S. M.

2009-01-01

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

Social Capital and Human Mortality: Explaining the Rural Paradox with County-Level Mortality Data

Science.gov (United States)

Yang, Tse-Chuan; Jensen, Leif; Haran, Murali

2011-01-01

The "rural paradox" refers to standardized mortality rates in rural areas that are unexpectedly low in view of well-known economic and infrastructural disadvantages there. We explore this paradox by incorporating social capital, a promising explanatory factor that has seldom been incorporated into residential mortality research. We do so while…

Recurrent Bilateral Breast Abscesses after Sternotomy

Directory of Open Access Journals (Sweden)

Hamza Cinar

2012-01-01

Full Text Available Median sternotomy is the most commonly used incision in cardiothoracic procedures. Development of breast abscess after sternotomy is a very rare situation. We present a case of sternal wound infection with recurrent bilateral breast abscess after sternotomy. Our case is the first and only case in the literature due to the presence of sternal wound infection with recurrent bilateral breast abscess after sternotomy.

Bilateral agreements

International Nuclear Information System (INIS)

Anon.

2004-01-01

The bilateral agreements concern Brazil with United States relative to the co operation in nuclear energy, Germany with Russian Federation relative to the elimination and disposal of nuclear weapons; The multilateral agreements concerns the signature of the Protocols to amend the Paris and Brussels Conventions, the multilateral nuclear environmental programme in the Russian Federation, the status of Conventions in the field of nuclear energy. (N.C.)

Cajetan of Thiene on the Logic of Paradox

Czech Academy of Sciences Publication Activity Database

Hanke, Miroslav

2016-01-01

Roč. 13, č. 1 (2016), s. 71-95 ISSN 1214-8407 R&D Projects: GA ČR GP13-08389P Institutional support: RVO:67985955 Keywords : Cajetan of Thiene * logical operators * semantic paradoxes * scholastic logic Subject RIV: AA - Philosophy ; Religion

Symptomatic heterotopic suprarenal splenic tissue

International Nuclear Information System (INIS)

Heider, J.; Kreft, B.; Winter, P.

1998-01-01

We report on a 33-year-old man with symptomatic heterotopic suprarenal splenic tissue. Heterotopic splenic tissue can often be found after posttraumatic splenectomy. It is a result of autotransplantation induced by trauma (splenosis). Additionally it can grow during embryogenic development. Such an accessory spleen is found in 10-44% of all autopsies. In this case report the patient was treated by resection due to increasing flank pain and suspected neoplasm. (orig.) [de

The great silence science and philosophy of Fermi's paradox

CERN Document Server

Cirkovic, Milan M

2018-01-01

The Great Silence explores the multifaceted problem named after the great Italian physicist Enrico Fermi and his legendary 1950 lunchtime question "Where is everybody?" In many respects, Fermi's paradox is the richest and the most challenging problem for the entire field of astrobiology and the Search for ExtraTerrestrial Intelligence (SETI) studies. This book shows how Fermi's paradox is intricately connected with many fields of learning, technology, arts, and even everyday life. It aims to establish the strongest possible version of the problem, to dispel many related confusions, obfuscations, and prejudices, as well as to offer a novel point of entry to the many solutions proposed in existing literature. Cirkovic argues that any evolutionary worldview cannot avoid resolving the Great Silence problem in one guise or another.

Privacy Awareness: A Means to Solve the Privacy Paradox?

Science.gov (United States)

Pötzsch, Stefanie

People are limited in their resources, i.e. they have limited memory capabilities, cannot pay attention to too many things at the same time, and forget much information after a while; computers do not suffer from these limitations. Thus, revealing personal data in electronic communication environments and being completely unaware of the impact of privacy might cause a lot of privacy issues later. Even if people are privacy aware in general, the so-called privacy paradox shows that they do not behave according to their stated attitudes. This paper discusses explanations for the existing dichotomy between the intentions of people towards disclosure of personal data and their behaviour. We present requirements on tools for privacy-awareness support in order to counteract the privacy paradox.

Bilateral Simultaneous Macular Infarction with Spontaneous Visual ...

African Journals Online (AJOL)

To report the rare and dramatic event of bilateral macular infarction in a sickle cell hemoglobinopathy (SS genotype) patient, resulting in bilateral severe reduction in visual acuity. Without any intervention, the patient's vision gradually improved over the follow‑up period. Central visual field defects however persisted.

Noise reduction with complex bilateral filter.

Science.gov (United States)

Matsumoto, Mitsuharu

2017-12-01

This study introduces a noise reduction technique that uses a complex bilateral filter. A bilateral filter is a nonlinear filter originally developed for images that can reduce noise while preserving edge information. It is an attractive filter and has been used in many applications in image processing. When it is applied to an acoustical signal, small-amplitude noise is reduced while the speech signal is preserved. However, a bilateral filter cannot handle noise with relatively large amplitudes owing to its innate characteristics. In this study, the noisy signal is transformed into the time-frequency domain and the filter is improved to handle complex spectra. The high-amplitude noise is reduced in the time-frequency domain via the proposed filter. The features and the potential of the proposed filter are also confirmed through experiments.

Prognosis of synchronous bilateral breast cancer

DEFF Research Database (Denmark)

Holm, Marianne; Tjønneland, Anne; Balslev, Eva

2014-01-01

Currently, no consistent evidence-based guidelines for the management of synchronous bilateral breast cancer (SBBC) exist and it is uncertain how presenting with SBBC affects patients' prognosis. We conducted a review of studies analyzing the association between SBBC and prognosis. The studies...... that reported adjusted effect measures were included in meta-analyses of effect of bilaterality on breast cancer mortality. From 57 initially identified records 17 studies from 11 different countries including 8,050 SBBC patients were included. The quality of the studies varied but was generally low with small...... sample sizes, and lack of consistent, detailed histo-pathological information. When doing meta-analysis on the subgroup of studies that provided adjusted effect estimates on breast cancer mortality (nine studies including 3,631 SBBC cases), we found that bilaterality in itself had a negative impact...

Seventy Years of the EPR Paradox

Science.gov (United States)

Kupczynski, Marian

2006-11-01

In spite of the fact that statistical predictions of quantum theory (QT) can only be tested if large amount of data is available a claim has been made that QT provides the most complete description of an individual physical system. Einstein's opposition to this claim and the paradox he presented in the article written together with Podolsky and Rosen in 1935 inspired generations of physicists in their quest for better understanding of QT. Seventy years after EPR article it is clear that without deep understanding of the character and limitations of QT one may not hope to find a meaningful unified theory of all physical interactions, manipulate qubits or construct a quantum computer.. In this paper we present shortly the EPR paper, the discussion, which followed it and Bell inequalities (BI). To avoid various paradoxes we advocate purely statistical contextual interpretation (PSC) of QT. According to PSC a state vector is not an attribute of a single electron, photon, trapped ion or quantum dot. A value of an observable assigned to a physical system has only a meaning in a context of a particular physical experiment PSC does not provide any mental space-time picture of sub phenomena. The EPR paradox is avoided because the reduction of the state vector in the measurement process is a passage from a description of the whole ensemble of the experimental results to a particular sub-ensemble of these results. We show that the violation of BI is neither a proof of the completeness of QT nor of its non-locality. Therefore we rephrase the EPR question and ask whether QT is "predictably "complete or in other words does it provide the complete description of experimental data. To test the "predictable completeness" it is not necessary to perform additional experiments it is sufficient to analyze more in detail the existing experimental data by using various non-parametric purity tests and other specific statistical tools invented to study the fine structure the time-series.

Bilateral Medial Medullary Infarction with Nondominant Vertebral Artery Occlusion.

Science.gov (United States)

Zhang, Lei; Zhang, Gui-lian; Du, Ju-mei; Ma, Zhu-lin

2015-09-01

Bilateral medial medullary infarction (MMI) is a rare stroke subtype. Here, we report a case with bilateral MMI caused by nondominant vertebral artery occlusion confirmed by brain digital subtraction angiography and magnetic resonance imaging basi-parallel-anatomical-scanning. We highlight that anterior spinal arteries could originate from a unilateral vertebral artery (VA). Radiologists and neurologists should pay attention to the nondominant VA as bilateral MMI may be induced by occlusion of nondominant VA that supplies the bilateral anteromedial territories of the medulla. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Tachyon kinematics and causality: a systematic thorough analysis of the tachyon causal paradoxes

International Nuclear Information System (INIS)

Recami, E.

1987-01-01

The chronological order of the events along a spacelike path is not invariant under Lorentz transformations, as is well known. This led to an early conviction that tachyons would give rise to causal anomalies. A relativistic version of the Stueckelberg-Feynman switching procedure (SWP) has been invoked as the suitable tool to eliminate those anomalies. The application of the SWP does eliminate the motions backwards in time, but interchanges the roles of source and detector. This fact triggered the proposal of a host of causal paradoxes. Till now, however, it has not been recognized that such paradoxes can be sensibly discussed (and completely solved, at least in microphysics) only after the tachyon relativistic mechanics has been properly developed. They start by showing how to apply the SWP, both in the case of ordinary special relativity and in the case with tachyons. Then they carefully exploit the kinetics of the tachyon exchange between two (ordinary) bodies. Being finally able to tackle the tachyon causality problem, they successively solve the paradoxes of: (i) Tolman-Regge, (ii) Pirani, (iii) Edmonds, and (iv) Bell. Finally, they discuss a further, new paradox associated with the transmission of signals by modulated tachyon beams

Proposed demonstration of the Einstein-Poldosky-Rosen paradox using trapped electrons

International Nuclear Information System (INIS)

Martins, Ana M.

2002-01-01

Correlations of the type discussed by Einstein, Poldosky, and Rosen in their original 1935 paradox may be generated between the positions and the momenta of two electrons confined in two spatially separated Penning traps when they are allowed to be coupled for a certain time interval. An experimental demonstration of the paradox could be done using the accurate techniques of manipulation and measurement of confined charged particles. The basic ideas presented in this paper might be extended in order to enable quantum information transfer of continuous variables between massive particles

EXERTIONAL RHABDOMYOLYSIS OF THE BILATERAL ADDUCTOR MAGNUS

Directory of Open Access Journals (Sweden)

Tolga Saka

2007-12-01

Full Text Available We present a case study of a person (63 year-old man, who has been using statins for 18 years, with rhabdomyolysis of the bilateral adductor muscles associated with strenuous and prolonged eccentric exercises (hiking in a hot environment. Clinical examination showed predominantly on the right side muscle swelling and palpational pain of the bilateral adductor muscle groups and bilateral tibial edema. His serum creatine kinase (CK level was 12218 IU/L. T2-weighted magnetic resonance (MR images showed a high signal intensity in the bilateral adductor muscles of the hip. The patient did not develop complications and returned to his previous performance level in 30 days following adequate hydration and resting of the affected muscles. Strenuous eccentric exercise should be avoided during the course of statin use and clinicians should be aware of present observations when considering the significance of acute CK elevations in patients on statin treatment

Bilateral nasolabial cysts associated with recurrent dacryocystitis.

Science.gov (United States)

Kyrmizakis, Dionysios E; Lachanas, Vassilios A; Benakis, Antonios A; Velegrakis, George A; Aslanides, Ioannis M

2005-05-01

Nasolabial cysts are rare, nonodontogenic, soft-tissue, developmental cysts occurring inferior to the nasal alar region. They are thought to arise from remnants of the nasolacrimal ducts and they are frequently asymptomatic. We report a rare case of bilateral nasolabial cysts accompanied by bilateral chronic dacryocystitis. A 48-year-old woman suffering from bilateral chronic dacryocystitis was referred to our department for endonasal dacryocystorhinostomy. She had undergone external dacryocystorhinostomy on the left side a few years earlier. Physical examination and computed tomography scan revealed nasolabial cysts bilaterally inferior to the nasal alar region. The cysts were removed via a sublabial approach and endoscopic dacryocystorhinostomy was performed on the right side. Ten months after surgery, the patient was asymptomatic. There may be a correlation, due to embryological reasons, between the presence of nasolabial cysts and the presence of chronic dacryocystitis. Both can be corrected surgically, under the same anaesthesia, without visible scar formation.