Stigma against patients with functional neurological disorder (FND) presents obstacles to diagnosis, treatment, and research. The lack of biomarkers and the potential for symptoms to be misunderstood, invalidated, or dismissed can leave patients, families, and healthcare professionals at a loss. Stigma exacerbates suffering and unmet needs of patients and families, and can result in poor clinical management and prolonged, repetitive use of healthcare resources. Our current understanding of stigma in FND comes from surveys documenting frustration experienced by providers and distressing healthcare interactions experienced by patients. However, little is known about the origins of FND stigma, its prevalence across different healthcare contexts, its impact on patient health outcomes, and optimal methods for reduction. In this paper, we set forth a research agenda directed at better understanding the prevalence and context of stigma, clarifying its impact on patients and providers, and promoting best practices for stigma reduction.

Introduction: Kussmaul's sign, the absence of a drop in JVP or a paradoxical increase in JVP on inspiration, can be elicited clinically as an indicator of right ventricular myocardial infarction (RVMI). RVMI poses unique diagnostic and management challenges. It complicates 30-50% of inferior MI and is associated with increased mortality when compared to inferior MI without RV involvement. Early recognition allows maintenance of preload by avoiding use of nitroglycerin, diuretic and narcotic medication, and treatment with fluids and vasopressors. We reviewed the evidence for Kussmaul's sign for diagnosis of RVMI. Methods: We conducted a librarian assisted search using PubMed, Medline, Embase, the Cochrane database, relevant conference abstracts from 1965 to October 2019. No restrictions for language or study type were imposed. All studies with patients presenting with acute myocardial infarction were reviewed. Two independent reviewers extracted data from relevant studies. Studies were combined when similar study populations were present. Study quality was assessed using the QUADAS-2 tool. Random effects meta-analysis was performed using metaprop in Stata for the 3 reference standards combined. Subset analysis for each of the 3 reference standards was completed. Results: We identified 122 studies: 10 were selected for full text review. Eight studies had comparable populations with a total of 469 consecutive patients admitted to the coronary care unit with acute inferior myocardial infarction and were included in the analysis. Prevalence of RVMI was 36% (CI 95% 31.8–40.5). References standards for the diagnosis of RVMI included echocardiography, 16 lead ECG and haemodynamic studies. A gold standard for diagnosis of RVMI is lacking and thus the reference standards were combined. Kussmaul's sign had a sensitivity of 69.3% (CI 95% 46.3 - 85.5, I2- 86.7%), specificity of 95.1% (CI 95% 75.6 - 99.2, I2- 89.3%) and LR + 14.1 (CI 95% 2.6-73.2). Subset analysis of echocardiography, ECG and haemodynamic studies revealed sensitivity of 45%, 77% and 82% (I2- 62%, N/A, 70%) respectively and specificity of 92%, 84% and 92% (I2- 86%, N/A, 86%). Conclusion: Kussmaul's sign is specific for acute right ventricular myocardial infarction and may serve as an important clinical sign of right ventricular dysfunction requiring preload preserving management.

Three-day-old soybean (Glycine max (L.) Merr., ‘Hawkeye 63′) hypocotyl segments (0.5 to 1.5 cm below the cotyledons) were utilized to evaluate the effects of the antagonistic interaction of S-ethyl dipropylthiocarbamate (EPTC) and (2,4-dichlorophenoxy)acetic acid (2,4-D) on growth and nucleic acid synthesis. EPTC inhibited growth and RNA synthesis in soybean tissue. The addition of 2,4-D with EPTC was antagonistic to EPTC inhibition of growth and caused an increase in total RNA synthesis. Analysis of soybean tissue nucleic acids by methylated-albumin-kieselguhr(MAK) column chromatography showed that EPTC inhibited ribosomal-RNA (r-RNA), DNA like RNA (D-RNA), and tenaciously-bound-RNA (TB-RNA) synthesis. The combination of 2,4-D with EPTC caused an increase in D-RNA and TB-RNA synthesis compared to the EPTC treatment alone. The 2,4-D-enhanced synthesis of D-RNA and TB-RNA in the presence of EPTC appears to be the basis of the antagonism between EPTC and 2,4-D. Preliminary analysis of r-RNA indicated that EPTC preferentially inhibited the synthesis of 18S r-RNA more than 25S r-RNA and that 2,4-D had no effect on this selective inhibition.

An antagonistic interaction between S-ethyl dipropylthiocarbamate (EPTC) and (2,4-dichlorophenoxy)acetic acid (2,4-D) was observed on sorghum (Sorghum vulgare Pers.) and corn (Zea mays L.) after 21 days growth in soil incorporated treatments. Increasing the 2,4-D concentration increased the antagonism to EPTC. The antagonistic interaction was also observed on sorghum grown in solution culture. The antagonistic interaction occurred when the site of uptake was restricted to either the root or shoot zone of sorghum. Uptake studies with 14C-EPTC indicated that 2,4-D does not interfere with uptake or subsequent movement of 14C radioactivity within sorghum plants. Respiration of sorghum treated with the combination EPTC-2,4-D appeared to be normal. Respiration of EPTC-treated plants was inhibited.

Yellow nutsedge control with rust (Puccinia canaliculata (Schw.) Lagerh.) collected in Salisbury, MD., was evaluated alone or in combination with pebulate at 1.7 or 3.3 kg ai ha-1 in transplanted tomato. Foliar applications of urediniospores in mid-June did not affect the yellow nutsedge population; however, tuber biomass was reduced 32%. In July, yellow nutsedge infection was manifest as an increase of phytotoxicity from 2.3 to 4.1 (0 to 10) and of disease incidence increase from 3 to 37%. Pebulate, 3.3 kg ha-1 reduced the yellow nutsedge population and ground cover by 79 and 90%, respectively, in June, with a 48% reduction of both tuber population and biomass in September. Tomato yields were not increased by rust or pebulate treatments. Marketable tomato yield was increased 46% by handweeding. Yellow nutsedge control was not enhanced by the combination treatments of pebulate followed by rust inoculation.

Total weed density increased after 1 yr of no-tillage and after 2 yr of conventional tillage in a 4-yr experiment with repeated assignment of the same treatment to the same plots. Large crabgrass, goosegrass, and carpetweed densities were higher in the no-tillage compared with the conventional-tillage treatment in at least 1 yr whereas common lambsquarters density was greater in the conventional-tillage treatment the last year of the experiment. Within the no-tillage treatment, rye or hairy vetch residue reduced total weed density an average of 78% compared to the treatment without cover crop when cover crop biomass exceeded 300 g m–2 and when residue covered more than 90% of the soil. Goosegrass, stinkgrass, and carpetweed densities were reduced by cover crop residue in at least 1 yr whereas large crabgrass was unaffected. Common lambsquarters density increased where rye was grown as a cover crop prior to conventional tillage. Despite differences in weed density among treatments, weed biomass was equivalent in all treatments during the last 2 yr.

Soybean (Glycine max (L.) Merr., ‘Hawkeye 63′) seedling segments from the zone of elongation and corn (Zea mays L., ‘Pioneer 3306) seedling segments were utilized to evaluate the antagonistic interaction of S-ethyl dipropylthiocarbamate (EPTC) and (2,4-dichlorophenoxy)-acetic acid (2,4-D). EPTC inhibited growth of the soybean and corn tissue, and 2,4-D in combination with EPTC caused an increase in growth compared to EPTC alone. The 2,4-D-enhanced growth in the presence of EPTC was due to an antagonism of the EPTC inhibition. Inhibition of soybean tissue growth by S-ethyl diisobutylthiocarbamate (butylate) also was antagonized by 2,4-D. Preincubation of soybean tissue in EPTC for 4 hr prior to the addition of 2,4-D did not prevent 2,4-D enhancement of growth. Conversely, the rate of growth was inhibited when EPTC was added after 4 hr of 2,4-D-enhanced growth. The addition of uridine to the incubation media with EPTC did not decrease the EPTC-inhibition of soybean tissue growth. This indicated that EPTC did not inhibit the synthesis of pyrimidine precursors. EPTC vapor losses from the incubation media reduced the inhibitory effect of EPTC to soybean tissue. Also, a growth reduction occurred when the amount of soybean tissue per unit of EPTC was increased.

This paper explores the complexities of how to get our families who are often in a chaotic state of surviving (emotionally, psychologically, and physiologically) to the point where they can process psychoeducation, develop parenting skills, and implement strategies to care for children in enduring ways and to feel successful in their everyday lives. This exploration led us to ponder two questions:

1. 1. What are “good” working relationships?

2. 2. How do these relationships benefit the families we work with?

Computed tomography (CT) is an important tool in clinical diagnostic imaging enabling three-dimensional anatomic imaging at high spatial resolution with short scan times. However, X-ray attenuation differences in physiological fluids and soft tissues are relatively small, requiring the use of contrast agents to achieve sufficient imaging contrast. Recent advances in energy-sensitive X-ray detectors have made spectral (color) CT commercially feasible by unmixing the energy-dependent attenuation profile of different materials and will potentially enable molecular imaging in CT. In order to leverage these capabilities for diagnostic imaging, we are developing a spectral library of nanoparticle contrast agents with K-shell absorption edges spaced at least 10 keV apart. The objective of this study was to demonstrate the ability of spectral CT to simultaneously detect up to three different contrast agents and unmixed their signals to create color images. Gadolinium oxide (Gd), hafnium oxide (Hf) and gold (Au) were chosen due to exhibiting K-edges spaced 10-20 keV apart. Core-shell nanoparticles of each composition were synthesized by various methods to have a core diameter of 15-20 nm and were coated with a silica shell at least 2-4 nm in thickness to create a common platform for surface functionalization. The contrast agents were imaged in a soft tissue equivalent phantom using source-side method for spectral CT imaging. The source-side approach utilized monochromatic synchrotron radiation at the Argonne National Laboratory which, while not clinically applicable, served as a gold standard due to providing the highest spectral resolution. The nanoparticles designed for this study have broad applications in biomedical imaging due to their modular assembly, potential for enabling multi-modal detection, and surface functionalization with biomolecules (e.g., antibodies, peptides or enzymes) for active targeting.

This article examines the consequences of increased party system fragmentation for oppositions, their respective governments and representation more generally, focusing on 18 established democracies. Two of the findings presented here suggest that there is reason to be concerned about the future of parliamentary representation in established democracies. Firstly, an increasing proportion of votes now go to parties that do not receive a proportionate share of legislative representation, implying that a growing degree of organized opposition is extra-parliamentary. Secondly, the findings show that parliamentary oppositions have generally become more fragmented than their respective governments. This suggests that the composition of governments may not be keeping up with current trends in electoral preferences and, in some cases, that governmental majorities have become smaller and more tenuous. Thus, the overall picture is one of a growing and increasingly fragmented opposition, against a smaller and relatively cohesive government.

In the lead-up to the Square Kilometre Array (SKA) project, several next-generation radio telescopes and upgrades are already being built around the world. These include APERTIF (The Netherlands), ASKAP (Australia), e-MERLIN (UK), VLA (USA), e-EVN (based in Europe), LOFAR (The Netherlands), MeerKAT (South Africa), and the Murchison Widefield Array. Each of these new instruments has different strengths, and coordination of surveys between them can help maximise the science from each of them. A radio continuum survey is being planned on each of them with the primary science objective of understanding the formation and evolution of galaxies over cosmic time, and the cosmological parameters and large-scale structures which drive it. In pursuit of this objective, the different teams are developing a variety of new techniques, and refining existing ones. To achieve these exciting scientific goals, many technical challenges must be addressed by the survey instruments. Given the limited resources of the global radio-astronomical community, it is essential that we pool our skills and knowledge. We do not have sufficient resources to enjoy the luxury of re-inventing wheels. We face significant challenges in calibration, imaging, source extraction and measurement, classification and cross-identification, redshift determination, stacking, and data-intensive research. As these instruments extend the observational parameters, we will face further unexpected challenges in calibration, imaging, and interpretation. If we are to realise the full scientific potential of these expensive instruments, it is essential that we devote enough resources and careful study to understanding the instrumental effects and how they will affect the data. We have established an SKA Radio Continuum Survey working group, whose prime role is to maximise science from these instruments by ensuring we share resources and expertise across the projects. Here we describe these projects, their science goals, and the technical challenges which are being addressed to maximise the science return.