What is the best approach to the evaluation of resting tachycardia for an adult?

The best evidence about the diagnostic evaluation of resting tachycardias in adults is currently outlined by practice guidelines. 1 Initial evaluation includes clinical history, physical examination, and 12-lead electrocardiogram (ECG). If the initial evaluation suggests a sinus tachycardia with narrow QRS complexes and no identifiable secondary cause, a 24-hour Holter monitor is usually recommended (strength of recommendation: C, based on expert opinion)

Allocating resources fairly among group members: The medium of exchange matters

All organized groups face the fundamental problem of how to allocate resources fairly. Managers often confront this challenge when deciding whether to reward individual or team performance. Building upon recent research that demonstrates the unique norms invoked by the resource of money, we propose that what individuals' judge to be a fair allocation principle among group members systematically varies as a function of whether the resource being distributed is money versus other resources that are allocated within organizations. We review prior research examining contextual variables influencing allocation preferences and attempt to identify the different characteristics of money as a resource that might influence conceptions of fairness. In light of the existing research, we argue that an egalitarian allocation principle will be understood to be less fair when the norms of the market are invoked by the distribution of a resource that is a medium of exchange (e.g., money) rather than an in-kind good (e.g. food). We conclude by discussing the implications of identifying the unique properties of money for a wide set of literatures. This novel perspective on the role the allocation medium plays in how groups allocate resources fairly will be of interest to scholars of justice

What are appropriate screening tests for adolescents?

Screen all women of childbearing age, including adolescents, for rubella susceptibility (strength of recommendation [SOR]: B). Screen all sexually active adolescent females for chlamydia (SOR: A), gonorrhea (SOR: B), and cervical cancer (SOR: A). High-risk, sexually active adolescents should be screened for HIV and syphilis (SOR: A). Screen all adolescents at risk for tuberculosis (TB) infection (SOR: A)

What are appropriate screening tests for infants and children?

There is adequate evidence for screening neonates for hemoglobinopathies, congenital hypothyroidism, phenylketonuria (strength of recommendation [SOR]: A), and cystic fibrosis (SOR: B). Vision screening should be done for those younger than age 5 years (SOR: B). High-risk children should be tested for tuberculosis (TB) (SOR: B) and lead toxicity (SOR: B). Few data exist to guide frequency and timing of these screening tests, so the following timing recommendations are based on consensus opinion (SOR: C): test for visual acuity yearly starting at age 3 years; test for TB and lead once between the ages of 9 and 12 months, and repeat for high risk or exposure

Learning about compact binary merger: the interplay between numerical relativity and gravitational-wave astronomy

Activities in data analysis and numerical simulation of gravitational waves have to date largely proceeded independently. In this work we study how waveforms obtained from numerical simulations could be effectively used within the data analysis effort to search for gravitational waves from black hole binaries. We propose measures to quantify the accuracy of numerical waveforms for the purpose of data analysis and study how sensitive the analysis is to errors in the waveforms. We estimate that ~100 templates (and ~10 simulations with different mass ratios) are needed to detect waves from non-spinning binary black holes with total masses in the range 100 Msun < M < 400 Msun using initial LIGO. Of course, many more simulation runs will be needed to confirm that the correct physics is captured in the numerical evolutions. From this perspective, we also discuss sources of systematic errors in numerical waveform extraction and provide order of magnitude estimates for the computational cost of simulations that could be used to estimate the cost of parameter space surveys. Finally, we discuss what information from near-future numerical simulations of compact binary systems would be most useful for enhancing the detectability of such events with contemporary gravitational wave detectors and emphasize the role of numerical simulations for the interpretation of eventual gravitational-wave observations.Comment: 19 pages, 12 figure

When daily planning improves employee performance: the importance of planning type, engagement, and interruptions

Does planning for a particular workday help employees perform better than on other days they fail to plan? We investigate this question by identifying two distinct types of daily work planning to explain why and when planning improves employees’ daily performance. The first type is time management planning (TMP)—creating task lists, prioritizing tasks, and determining how and when to perform them. We propose that TMP enhances employees’ performance by increasing their work engagement, but that these positive effects are weakened when employees face many interruptions in their day. The second type is contingent planning (CP) in which employees anticipate possible interruptions in their work and plan for them. We propose that CP helps employees stay engaged and perform well despite frequent interruptions. We investigate these hypotheses using a two-week experience-sampling study. Our findings indicate that TMP’s positive effects are conditioned upon the amount of interruptions, but CP has positive effects that are not influenced by the level of interruptions. Through this study, we help inform workers of the different planning methods they can use to increase their daily motivation and performance in dynamic work environments

Exohedral Physisorption of Ambient Moisture Scales Non-monotonically with Fiber Proximity in Aligned Carbon Nanotube Arrays

Here we present a study on the presence of physisorbed water on the surface of aligned carbon nanotubes (CNTs) in ambient conditions, where the wet CNT array mass can be more than 200% larger than that of dry CNTs, and modeling indicates that a water layer >5 nm thick can be present on the outer CNT surface. The experimentally observed nonlinear and non-monotonic dependence of the mass of adsorbed water on the CNT packing (volume fraction) originates from two competing modes. Physisorbed water cannot be neglected in the design and fabrication of materials and devices using nanowires/nanofibers, especially CNTs, and further experimental and ab initio studies on the influence of defects on the surface energies of CNTs, and nanowires/nanofibers in general, are necessary to understand the underlying physics and chemistry that govern this system.National Science Foundation (U.S.) (NSF Grant No. CMMI-1130437)National Science Foundation (U.S.) (NSF Award Number ECS-0335765)United States. Army Research Office (contract W911NF-07-D-0004

Pretreatment nutritional status and response to checkpoint inhibitors in lung cancer.

Background:Checkpoint inhibitors are integral to non-small-cell lung cancer treatment. Existing data suggests that nutritional status may play a role in antitumor immunity. Materials & methods:This retrospective study of 106 non-small-cell lung cancer patients who started checkpoint inhibitors between 2014 and 2017 at our institution assessed relationship of nutritional parameters to overall survival (OS) and progression-free survival. Results:Mean age was 68.7 ± 9.2 years and 59.4% patients were male. On multivariate analysis for OS, hypoalbuminemia and significant weight loss were prognostic at p-values of 0.0005 and 0.0052, respectively. We noted a parabolic association between age and OS (p = 0.026, 0.0025). Conclusion:In our study, some malnutrition parameters were associated with decreased OS. U-shape relationship between age and OS noted here warrants further evaluation

Digging deeper: quality of patient-provider communication across Hispanic subgroups

<p>Abstract</p> <p>Background</p> <p>Recent research suggests that ethnic subgroup designation plays an important role in health-related disparities among Hispanics. Our objective was to examine the influence of Hispanics' self-reported ethnic subgroup designation on perceptions of their health care providers' communication behaviors.</p> <p>Methods</p> <p>Cross-sectional analysis of the 2005 Medical Expenditure Panel Survey (MEPS). Participants included non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged ≥18 years, reporting visiting a health care provider within the past 12 months. Six (n = 6) items were used to capture respondents' perceptions of their health care providers' communication behaviors.</p> <p>Results</p> <p>After controlling for socio-demographic covariates, compared to Other Hispanics (reference group), very few differences in perceptions of health care providers communication emerged across ethnic subgroups. Puerto Ricans were more likely to report that their health care provider "always" showed respect for what they had to say (OR = 2.16, 95% CI 1.16-4.03). Both Puerto Ricans (OR = 2.28, 95% CI 1.06-4.92) and Mexicans (OR = 1.88, 95% CI 1.02-3.46) were more likely to indicate that their health care provider "always" spent enough time with them as compared to Other Hispanics.</p> <p>Conclusions</p> <p>We observed very few differences among Hispanics respondents in their perceived quality of interactions with health care providers as a function of their ethnic subgroup designation. While our findings somewhat contradict previous research, they do suggest that other underlying factors may influence the quality of perceived interactions with health care providers.</p