What is the initial approach to the treatment of shoulder pain?

There is some limited evidence supporting the use of nonsteroidal anti-inflammatory drugs (NSAIDs) in the initial treatment of shoulder pain. There is no evidence in support of most other therapies, including intra-articular or subacromial corticosteroid injection, intra-articular NSAID injection, oral corticosteroid treatment, physiotherapy, ultrasound, heat or ice therapy, laser treatment, electrotherapy, and iontophoresis (Grade of recommendation: B, based on extrapolation from systematic reviews and randomized clinical trials with inconsistent and inconclusive results

Test Bed Concept as a Means of Introducing New Technology

The rapid evolution of ultrasonic testing technology over the last ten years has found industry unable to test or apply many of the new concepts resulting from this work due to limited facility resources to adopt these advanced methods. The testing of these methods is a desirable sequence in the evolution of new ideas to production usage and in many cases would require a test bed on which to try innovative ideas. This test bed concept would provide an avenue to resolve applications problems which might otherwise overshadow the significance of technology innovations. The availability of a test vehicle with which to prove or if necessary further modify these growth ideas further benefits these accomplishments by verifying their validity and performance. In recognition of this need, a program has been undertaken to establish an advanced ultrasonic work station with the ability to function as a test system for the application of these concepts to commonly encountered inspection tasks. The present system contains all solid state instrumentation designed around the latest electronic concepts and features extensive computer interfacing with regard to both signal handling as well as command and feedback systems. The specially developed ultrasonic instrumentation contains programmable gates and interface synchronization and provides the capability to process the full R-F waveform during test. Output from the ultrasonic instrument is processed through a high speed digitizer between the instrument and the computer which is dedicated primarily to data acquisition, analysis and retention. Two~way communication linkages exist between the ultrasonic instrument and the computer as well as between the computer and the motion and position control to allow the incorporation of signal correction techniques to accommodate material attenuation, surface lens effects due to radii, etc., so that the computer can judge signal significance incorporating these corrections. Data output from the test is supplemented by graphic displays allowing the presentation of planar and rotated views with the expansion capability for the examination of selected volumes. This system is currently being applied to the evaluation of specially contoured shapes for advanced turbine engine programs in which signal characterization will play a significant part in the data analysis

Integer Polynomial Optimization in Fixed Dimension

We classify, according to their computational complexity, integer optimization problems whose constraints and objective functions are polynomials with integer coefficients and the number of variables is fixed. For the optimization of an integer polynomial over the lattice points of a convex polytope, we show an algorithm to compute lower and upper bounds for the optimal value. For polynomials that are non-negative over the polytope, these sequences of bounds lead to a fully polynomial-time approximation scheme for the optimization problem.Comment: In this revised version we include a stronger complexity bound on our algorithm. Our algorithm is in fact an FPTAS (fully polynomial-time approximation scheme) to maximize a non-negative integer polynomial over the lattice points of a polytop

A polynomial oracle-time algorithm for convex integer minimization

In this paper we consider the solution of certain convex integer minimization problems via greedy augmentation procedures. We show that a greedy augmentation procedure that employs only directions from certain Graver bases needs only polynomially many augmentation steps to solve the given problem. We extend these results to convex $N$-fold integer minimization problems and to convex 2-stage stochastic integer minimization problems. Finally, we present some applications of convex $N$-fold integer minimization problems for which our approach provides polynomial time solution algorithms.Comment: 19 pages, 1 figur

"Now he walks and walks, as if he didn't have a home where he could eat": food, healing, and hunger in Quechua narratives of madness

In the Quechua-speaking peasant communities of southern Peru, mental disorder is understood less as individualized pathology and more as a disturbance in family and social relationships. For many Andeans, food and feeding are ontologically fundamental to such relationships. This paper uses data from interviews and participant observation in a rural province of Cuzco to explore the significance of food and hunger in local discussions of madness. Carers’ narratives, explanatory models, and theories of healing all draw heavily from idioms of food sharing and consumption in making sense of affliction, and these concepts structure understandings of madness that differ significantly from those assumed by formal mental health services. Greater awareness of the salience of these themes could strengthen the input of psychiatric and psychological care with this population and enhance knowledge of the alternative treatments that they use. Moreover, this case provides lessons for the global mental health movement on the importance of openness to the ways in which indigenous cultures may construct health, madness, and sociality. Such local meanings should be considered by mental health workers delivering services in order to provide care that can adjust to the alternative ontologies of sufferers and carers

Broker Fixed: The Racialized Social Structure and the Subjugation of Indigenous Populations in the Andes

Responding to calls to return racial analysis to indigenous Latin America, this article moves beyond the prejudicial attitudes of dominant groups to specify how native subordination gets perpetuated as a normal outcome of the organization of society. I argue that a naturalized system of indirect rule racially subordinates native populations through creating the position of mestizo “authoritarian intermediary.” Natives must depend on these cultural brokers for their personhood, while maintaining this privileged position requires facilitating indigenous exploitation. Institutional structures combine with cultural practices to generate a vicious cycle in which increased village intermediary success increases native marginalization. This racialized social structure explains my ethnographic findings that indigenous villagers continued to support the same coterie of mestizos despite their regular and sometimes extreme acts of peculation. My findings about the primacy of race suggest new directions for research into indigenous studies, ethnic mobilizations, and the global dimensions of racial domination

Introduction to “Binary Binds”: Deconstructing Sex and Gender Dichotomies in Archaeological Practice

YesGender archaeology has made significant strides toward deconstructing the hegemony of binary categorizations. Challenging dichotomies such as man/woman, sex/gender, and biology/culture, approaches informed by poststructuralist, feminist, and queer theories have moved beyond essentialist and universalist identity constructs to more nuanced configurations. Despite the theoretical emphasis on context, multiplicity, and fluidity, binary starting points continue to streamline the spectrum of variability that is recognized, often reproducing normative assumptions in the evidence. The contributors to this special issue confront how sex, gender, and sexuality categories condition analytical visibility, aiming to develop approaches that respond to the complexity of theory in archaeological practice. The papers push the ontological and epistemological boundaries of bodies, personhood, and archaeological possibility, challenging a priori assumptions that contain how sex, gender, and sexuality categories are constituted and related to each other. Foregrounding intersectional approaches that engage with ambiguity, variability, and difference, this special issue seeks to “de-contain” categories, assumptions, and practices from “binding” our analytical gaze toward only certain kinds of persons and knowledges, in interpretations of the past and practices in the present

The unintended consequences of sex education: an ethnography of a development intervention in Latin America

This paper is an ethnography of a four-year, multi-disciplinary adolescent sexual and reproductive health intervention in Bolivia, Nicaragua and Ecuador. An important goal of the intervention – and of the larger global field of adolescent sexual and reproductive health – is to create more open parent-to-teen communication. This paper analyzes the project's efforts to foster such communication and how social actors variously interpreted, responded to, and repurposed the intervention's language and practices. While the intervention emphasized the goal of ‘open communication,’ its participants more often used the term ‘confianza’ (trust). This norm was defined in ways that might – or might not – include revealing information about sexual activity. Questioning public health assumptions about parent–teen communication on sex, in and of itself, is key to healthy sexual behavior, the paper explores a pragmatics of communication on sex that includes silence, implied expectations, gendered conflicts, and temporally delayed knowledge.Cuencavolumen 21, número

Integrating Signals from the T-Cell Receptor and the Interleukin-2 Receptor

T cells orchestrate the adaptive immune response, making them targets for immunotherapy. Although immunosuppressive therapies prevent disease progression, they also leave patients susceptible to opportunistic infections. To identify novel drug targets, we established a logical model describing T-cell receptor (TCR) signaling. However, to have a model that is able to predict new therapeutic approaches, the current drug targets must be included. Therefore, as a next step we generated the interleukin-2 receptor (IL-2R) signaling network and developed a tool to merge logical models. For IL-2R signaling, we show that STAT activation is independent of both Src- and PI3-kinases, while ERK activation depends upon both kinases and additionally requires novel PKCs. In addition, our merged model correctly predicted TCR-induced STAT activation. The combined network also allows information transfer from one receptor to add detail to another, thereby predicting that LAT mediates JNK activation in IL-2R signaling. In summary, the merged model not only enables us to unravel potential cross-talk, but it also suggests new experimental designs and provides a critical step towards designing strategies to reprogram T cells