Acupuncture is a popular alternative therapy worldwide and is generally safe. However, serious acupuncture-related complications can occur. Intracranial complications caused by a migrated acupuncture ...needle are extremely rare. Herein we report a surgical case of intracranial acupuncture needle migration and discuss the key technical aspects of the procedure. We additionally performed a review of the relevant literature. A 55-year-old woman presented with migration of a broken acupuncture needle via the posterior cervical skin. Computed tomography (CT) showed that the needle migrated intra- and extradurally via the atlanto-occipital junction. CT angiography revealed that the needle tail was located adjacent to the right distal horizontal loop of the vertebral artery. Meanwhile, the needle tip was positioned in the premedullary cistern adjacent to the medulla oblongata via the right lateral medullary cistern. Emergent surgical removal was conducted. Intradural exploration was required as the needle was not found in the epidural space. The needle penetrated the adventitia of the right intradural vertebral artery. We failed to pull out the needle toward the epidural space. After the needle was completely pulled into the intradural space, it was successfully removed without bleeding complication. Postoperative CT showed no evidence of residual needle fragment. The patient was discharged home without any sequelae. To the best of our knowledge, this is the first case of penetrating vertebral artery injury caused by radiologically confirmed acupuncture needle migration. An intracranially migrated needle should be removed urgently to prevent further migration causing brainstem, cranial nerve, and vessel injuries. The surgical strategy should be selected according to needle location and direction.
The technological revolution has been taking place and rapidly changing many activities in social life, and especially in businesses. The benefits of the technological revolution led to changes in ...policies for businesses and therefore require businesses to change to adapt. In operations, choosing appropriate policies plays a decisive role in the development of enterprises in production and business, optimizing production activities and dominating the market. Conducting a survey of 310 typical enterprises in Vietnam with stable production and business activities, using estimated regression analysis via SPSS software, the regression results show that the factors that influence the decision of the policy choices are: external groups, administrator influence, employee quality, and legal environment.
Normative circular and dimensional models are the dominant structures for the organization of vocational interests in the scientific literature. However, it is increasingly recognized that not all ...individuals' interest configurations can be adequately represented by normative models. Adopting a person-centered, multidimensional perspective on vocational interests, the current study seeks to identify distinct profiles of interests based on RIASEC data that integrate interest configurations that align with and deviate from normal circular and dimensional structures. We also test the replicability of the profile structure, examine the likelihood of STEM degree choice as a function of profile membership, and investigate core personality predictors of interest profile membership. Latent profile analyses revealed six profiles of vocational interests, representing distinct combinations of the RIASEC interests (i.e., social-dominant, disinterested, high realistic-dominant, investigative-dominant, ambivalent, and conventional-dominant), which replicated entirely across independent subsamples. Furthermore, the profiles differed on the likelihood of STEM degree choice, with the conventional-dominant profile evincing the highest probability of choice and the social-dominant profile evincing the lowest probability of choice. Finally, results revealed that the Big-Five personality traits were differentially related to interest profile membership, largely in line with vocational interest theory. The present findings constitute novel evidence that a person-centered framework for the representation of interest configurations can accommodate both people's adherence to and deviations from normative structures for the organization of interests. The findings also underpin the use of all available interest information on individuals, rather than reliance on the two or three highest interest dimensions, to inform educational and vocational decision-making.
•Latent profiles of vocational interests were identified.•The profiles replicated across subsamples.•Big-Five personality dimensions differentiated the profiles.•Profile membership was associated with the probability of STEM major choice.
Previous studies on sex differences in out-of-hospital cardiac arrest (OHCA) had limited scope and yielded conflicting results. We aimed to provide a comprehensive overall view on sex differences in ...care utilization, and outcome of OHCA.
We performed a population-based cohort-study, analysing all emergency medical service (EMS) treated resuscitation attempts in one province of the Netherlands (2006-2012). We calculated odds ratios (ORs) for the association of sex and chance of a resuscitation attempt by EMS, shockable initial rhythm (SIR), and in-hospital treatment using logistic regression analysis. Additionally, we provided an overview of sex differences in overall survival and survival at successive stages of care, in the entire study population and in patients with SIR. We identified 5717 EMS-treated OHCAs (28.0% female). Women with OHCA were less likely than men to receive a resuscitation attempt by a bystander (67.9% vs. 72.7%; P < 0.001), even when OHCA was witnessed (69.2% vs. 73.9%; P < 0.001). Women who were resuscitated had lower odds than men for overall survival to hospital discharge OR 0.57; 95% confidence interval (CI) 0.48-0.67; 12.5% vs. 20.1%; P < 0.001, survival from OHCA to hospital admission (OR 0.88; 95% CI 0.78-0.99; 33.6% vs. 36.6%; P = 0.033), and survival from hospital admission to discharge (OR 0.49, 95% CI 0.40-0.60; 33.1% vs. 51.7%). This was explained by a lower rate of SIR in women (33.7% vs. 52.7%; P < 0.001). After adjustment for resuscitation parameters, female sex remained independently associated with lower SIR rate.
In case of OHCA, women are less often resuscitated by bystanders than men. When resuscitation is attempted, women have lower survival rates at each successive stage of care. These sex gaps are likely explained by lower rate of SIR in women, which can only partly be explained by resuscitation characteristics.
Previous studies reported that autistic adolescents and adults tend to exhibit extensive choice switching in repeated experiential tasks. However, a recent meta-analysis showed that this switching ...effect was non-significant across studies. Furthermore, the relevant psychological mechanisms remain unclear. We examined the robustness of the extreme choice-switching phenomenon, and whether it is driven by a learning impairment, feedback-related aspects (e.g., avoiding losses), or alternatively a different information sampling strategy.
We recruited an online sample of 114 US participants (57 autistic adults and 57 non-autistic). All participants performed the Iowa Gambling task, a four-option repeated choice task. Standard task blocks were followed by a trial block with no feedback.
The findings replicate the extreme choice switching phenomenon (Cohen's d = 0.48). Furthermore, the effect was found with no difference in average choice rates denoting no learning impairment, and was even observed in trial blocks with no feedback (d = 0.52). There was no evidence that the switching strategy of autistic individuals was more perseverative (i.e., that similar switching rates were used in subsequent trial blocks). When adding the current dataset to the meta-analysis, the choice switching phenomenon is significant across studies, d = 0.32.
The findings suggest that the increased choice switching phenomenon in autism may be robust and that it represents a distinct information sampling strategy and not poor implicit learning (or a bias in the sensitivity to losses). Such extended sampling may underlie some of the phenomena previously attributed to poor learning.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
When choosing between delayed or uncertain outcomes, individuals discount the value of such outcomes on the basis of the expected time to or the likelihood of their occurrence. In an integrative ...review of the expanding experimental literature on discounting, the authors show that although the same form of hyperbola-like function describes discounting of both delayed and probabilistic outcomes, a variety of recent findings are inconsistent with a single-process account. The authors also review studies that compare discounting in different populations and discuss the theoretical and practical implications of the findings. The present effort illustrates the value of studying choice involving both delayed and probabilistic outcomes within a general discounting framework that uses similar experimental procedures and a common analytical approach.
The purpose of this study was to preliminarily develop novel self-administered measures to assess nutrition security and choice in dietary characteristics. Measures were piloted in a convenience ...sample of households at risk for food insecurity in the United States. The survey included the new measures, construct validation variables (household food security, self-reported general health, and dietary variables), and demographic questions. Exploratory factor analysis was used to assess dimensionality, internal (Cronbach's alpha (CA)), and construct validity were assessed (Spearman's correlation). Multivariate logistic regression models were used to assess added utility of the new measures beyond food security measurement. Finally, brief screener versions of the full measures were created. Participants in the analytic sample (n = 380) averaged 45 years old, 71% experiencing food insecurity, 42% with high school diploma or less, 78% were women, and racially/ethnically diverse. Scores for the Household Nutrition Security (CA = 0.85; Mean = 2.58 (SD = 0.87)), Household Healthfulness Choice (CA = 0.79; Mean = 2.47 (SD = 0.96)), and Household Dietary Choice (CA = 0.80; Mean = 2.57 (SD = 0.90)) were positively associated with food security (0.401–0.657), general health (0.194–0.290), fruit and vegetable intake frequency (0.240–0.280), and “scratch-cooked” meal intake (0.328–0.350), and negatively associated with “processed” meal intake (−0.162 to −0.234) and an external locus of nutrition control (−0.343 to −0.366). Further, findings show that the new measures are useful for assessing risk for poor dietary and health outcomes even after controlling for household food security status and sample characteristics. These findings are encouraging and support reliability, construct validity, and utility of these new measures. Following further testing, such as Confirmatory Factor Analysis in future samples, these measures may be used in various applications to contribute to a better understanding of households' limitations for accessing healthful foods and foods that meet their preferences.
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