Atraumatic Back Pain Due to Quadratus Lumborum Spasm Treated by Physical Therapy with Manual Trigger Point Therapy in the Emergency Department

Manual trigger point therapy is effective for treating myofascial pain, yet it is not frequently used in emergency department (ED) settings. A 42-year-old female presented to the ED with atraumatic back pain. Her pain was thought to be myofascial, and we obtained a physical therapy consultation. Diagnosing the patient with quadratus lumborum spasm, the physical therapist treated her in the ED using manual trigger point therapy, and completely relieved her pain without requiring any medications. Manual trigger point therapy can provide non-opioid pain relief in ED patients, and physical therapists can apply this technique effectively in the ED

Simultaneous viscoelasticity and sprayability in antimicrobial acetic acid-alginate fluid gels

Acetic acid is a promising alternative to antibiotics for topical applications, particularly burn wounds, however its site specificity and retention are impaired by poor material properties. In this study, acetic acid was investigated as both the gelling agent and antimicrobial active in alginate fluid gels. The formed microstructure was found to be directly dependent on acetic acid concentration, leading to highly tuneable material properties. At clinically relevant concentrations of 2.5–5 % acetic acid, the fluid gels were elastically dominated at rest, with viscosities up to 7 orders of magnitude greater than acetic acid alone. These material properties imparted long term surface retention and microparticle barrier function, not seen with either acetic acid or alginate solutions. Most notably, sprayability was enhanced simultaneously with the increased viscosity and elasticity due to the introduction of a discretised microstructure, leading to a remarkable tenfold increase in spray coverage. Formulation was found not to inhibit antimicrobial activity, despite the less acidic pH, with common burn wound pathogens Staphylococcus aureus and Pseudomonas aeruginosa being equally susceptible to the fluid gels as to acetic acid solutions.</p

Projective simulation for artificial intelligence

We propose a model of a learning agent whose interaction with the environment is governed by a simulation-based projection, which allows the agent to project itself into future situations before it takes real action. Projective simulation is based on a random walk through a network of clips, which are elementary patches of episodic memory. The network of clips changes dynamically, both due to new perceptual input and due to certain compositional principles of the simulation process. During simulation, the clips are screened for specific features which trigger factual action of the agent. The scheme is different from other, computational, notions of simulation, and it provides a new element in an embodied cognitive science approach to intelligent action and learning. Our model provides a natural route for generalization to quantum-mechanical operation and connects the fields of reinforcement learning and quantum computation.Comment: 22 pages, 18 figures. Close to published version, with footnotes retaine

Modeling Single Electron Transfer in Si:P Double Quantum Dots

Solid-state systems such as P donors in Si have considerable potential for realization of scalable quantum computation. Recent experimental work in this area has focused on implanted Si:P double quantum dots (DQDs) that represent a preliminary step towards the realization of single donor charge-based qubits. This paper focuses on the techniques involved in analyzing the charge transfer within such DQD devices and understanding the impact of fabrication parameters on this process. We show that misalignment between the buried dots and surface gates affects the charge transfer behavior and identify some of the challenges posed by reducing the size of the metallic dot to the few donor regime.Comment: 11 pages, 7 figures, submitted to Nanotechnolog

Recombination in the Open-Ended Value Landscape of Digital Innovation

Digital innovation introduces a new open-ended value landscape to anyone seeking to generate or capture new value. To understand this landscape, we distinguish between design recombination and use recombination, explore how they play out together, and redirect the attention from products and services toward digital resources. Digital resources serve as building-blocks in digital innovation, and they hold the potential to simultaneously be part of multiple value paths, offered through design recombination and assembled through use recombination. Building on this perspective, we offer the value spaces framework as a tool for better understanding value creation and capture in digital innovation. We illustrate the framework and offer the early contours of a research agenda for information systems researchers

SCAMP:standardised, concentrated, additional macronutrients, parenteral nutrition in very preterm infants: a phase IV randomised, controlled exploratory study of macronutrient intake, growth and other aspects of neonatal care

<p>Abstract</p> <p>Background</p> <p>Infants born <29 weeks gestation are at high risk of neurocognitive disability. Early postnatal growth failure, particularly head growth, is an important and potentially reversible risk factor for impaired neurodevelopmental outcome. Inadequate nutrition is a major factor in this postnatal growth failure, optimal protein and calorie (macronutrient) intakes are rarely achieved, especially in the first week. Infants <29 weeks are dependent on parenteral nutrition for the bulk of their nutrient needs for the first 2-3 weeks of life to allow gut adaptation to milk digestion. The prescription, formulation and administration of neonatal parenteral nutrition is critical to achieving optimal protein and calorie intake but has received little scientific evaluation. Current neonatal parenteral nutrition regimens often rely on individualised prescription to manage the labile, unpredictable biochemical and metabolic control characteristic of the early neonatal period. Individualised prescription frequently fails to translate into optimal macronutrient delivery. We have previously shown that a standardised, concentrated neonatal parenteral nutrition regimen can optimise macronutrient intake.</p> <p>Methods</p> <p>We propose a single centre, randomised controlled exploratory trial of two standardised, concentrated neonatal parenteral nutrition regimens comparing a standard macronutrient content (maximum protein 2.8 g/kg/day; lipid 2.8 g/kg/day, dextrose 10%) with a higher macronutrient content (maximum protein 3.8 g/kg/day; lipid 3.8 g/kg/day, dextrose 12%) over the first 28 days of life. 150 infants 24-28 completed weeks gestation and birthweight <1200 g will be recruited. The primary outcome will be head growth velocity in the first 28 days of life. Secondary outcomes will include a) auxological data between birth and 36 weeks corrected gestational age b) actual macronutrient intake in first 28 days c) biomarkers of biochemical and metabolic tolerance d) infection biomarkers and other intravascular line complications e) incidence of major complications of prematurity including mortality f) neurodevelopmental outcome at 2 years corrected gestational age</p> <p>Trial registration</p> <p>Current controlled trials: <a href="http://www.controlled-trials.com/ISRCTN76597892">ISRCTN76597892</a>; EudraCT Number: 2008-008899-14</p

Extended Cognition Hypothesis Applied to Computational Thinking in Computer Science Education

Computational thinking is a much-used concept in computer science education. Here we examine the concept from the viewpoint of the extended cognition hypothesis. The analysis reveals that the extent of the concept is limited by its strong historical roots in computer science and software engineering. According to the extended cognition hypothesis, there is no meaningful distinction between human cognitive functions and the technology. This standpoint promotes a broader interpretation of the human-technology interaction. Human cognitive processes spontaneously adapt available technology enhanced skills when technology is used in cognitively relevant levels and modalities. A new concept technology synchronized thinking is presented to denote this conclusion. More diverse and practical approach is suggested for the computer scienceeducation.Peer reviewe

Introduction to Quantum Algorithms for Physics and Chemistry

In this introductory review, we focus on applications of quantum computation to problems of interest in physics and chemistry. We describe quantum simulation algorithms that have been developed for electronic-structure problems, thermal-state preparation, simulation of time dynamics, adiabatic quantum simulation, and density functional theory.Comment: 44 pages, 5 figures; comments or suggestions for improvement are welcom

Controlling Shareholders，Dividend Policy and Investor Protection ——Case Study on XiShui Strong Year

随着公司治理相关研究的发展，控制性股东与中小股东之间的利益冲突成为上市公司的主要代理问题。在存在控制性股东的情况下，尤其是在法律保护不完善的环境中，如何保护中小投资者的利益成为社会各界关注的焦点。股利发放原本一直被视为减少代理成本、保护外部投资者利益的一种重要方式，然而在特定的制度背景下，股利也可能成为控制性股东侵害中小股东利益的工具。在投资者权益保护不完善，大股东控制上市公司时，股利政策是否只能沦为大股东攫取私利的工具，控制性股东如何通过股利政策来侵害中小股东的利益，这是本文关注的问题。 本文以内蒙古西水股份有限公司为对象，研究其自上市以来的股利发放情况。论文以代理理论为基础，结合股利政策...With the development of corporate governance-related research, the interest conflicts between controlling shareholders and small, diversified shareholders become the main agency problem, especially in the imperfect legal protection environment. Therefore, how to protect investors’ rights attracts the attentions. Dividends have been paid as an important way to reduce agency costs. However, in uniqu...学位：管理学硕士院系专业：管理学院企业管理系_企业管理(含财务管理、市场营销、人力资源管理)学号：1762006115137

Effect of β2-adrenergic receptor stimulation on lung fluid in stable heart failure patients

Introduction: The purpose of this study was to determine 1) if stable heart-failure patients with reduced ejection fraction (HFrEF) have elevated extravascular lung water (EVLW) versus healthy control subjects, and 2) the effect of acute β2AR agonist inhalation on lung fluid balance. Methods: Twenty-two stable HFrEF patients and 18 age- and sex-matched healthy subjects were studied. Lung diffusing capacity for carbon monoxide (DLCO), alveolar-capillary conductance (DmCO), pulmonary capillary blood volume (Vc) (via rebreathe) and lung tissue volume (Vtis) (via computed tomography) were assessed before and within 30 min of administration of nebulized albuterol. EVLW was derived as Vtis – Vc. Results: Pre-albuterol, Vtis and EVLW were greater in HFrEF vs. control (998 ± 200 vs. 884 ± 123 ml, P = 0.041; 943 ± 202 vs. 802 ± 133 ml, P = 0.015, respectively). Albuterol decreased Vtis and EVLW in HFrEF (−4.6 ± 7.8%, P = 0.010; −4.6 ± 8.8%, P = 0.018) and control (−2.8 ± 4.9%, P = 0.029; −3.0 ± 5.7%, P = 0.045). There was an inverse relationship between pre-albuterol values and the pre- to post-albuterol change for EVLW (r2 = −0.264, P = 0.015) and DmCO (r2 = −0.343, P = 0.004) in HFrEF only. Conclusion: Lung fluid is elevated in stable HFrEF patients relative to healthy subjects. Stimulation of the β2ARs may cause fluid removal in HFrEF, especially in patients who exhibit greater evidence for increased lung water at baseline