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The number of academic S&E publications increased from 271 treatment quadriceps pain generic bimat 3ml overnight delivery,502 to 307 symptoms 8 days after conception order bimat mastercard,413 between these years medicine you can take during pregnancy purchase 3 ml bimat with visa, rising from 70 treatment xanax withdrawal 3ml bimat for sale. Trends in non-academic sectors include the following (Appendix Table 5-41): · · Industry publications reached a high of 33,498 in 2005 and then declined to 24,565, or 6. Federal government publications grew in the early 2000s, peaking at 22,580 in 2012 and declining to 19,556 in 2016, accounting for 4. As noted previously, life sciences (biological sciences, medical sciences, and other life sciences) dominate the research portfolios of U. The dominance of life sciences is especially pronounced in the nonprofit sector, with 86. The exception to the life sciences focus is the research portfolio of industry (28. Note(s) Articles refer to publications from a selection of journals, books, and conference proceedings in S&E from Scopus. Collaborative S&E research facilitates knowledge transfer and sharing among individuals, institutions, and nations. Between 2006 and 2016, international collaboration increased; domestic-only collaboration held steady as a share of the total, and single-institution authorship declined (Figure 5-24). Articles with multiple institutions are counts of articles with two or more institutional addresses. Articles with multiple domestic institutions only are counts of articles with more than one institutional address within a single region, country, or economy. Over the period 2006­16, the share of publications produced in collaboration with other U. The share of academic publications coauthored with foreign institutions increased from 24. Note(s) Article counts are from a selection of journals, books, and conference proceedings in S&E from Scopus. Articles are classified by their year of publication and are assigned to a sector on the basis of the institutional address(es) listed in the article. The sum of articles coauthored with various sectors could exceed the total number of articles coauthored with another sector or foreign sector because of articles coauthored by multiple sectors. Science and Engineering Indicators 2018 International Collaboration the percentage of worldwide publications produced with international collaboration-that is, by authors with institutional addresses from at least two countries-rose from 16. This increase in part reflects increasing global capabilities in R&D and an expanding pool of trained researchers, as well as improvements in communications technology. These collaborations may also reflect the strengthening of a network of international scholars who increasingly collaborate with each other (Wagner, Park, and Leydesdorff 2015). Finally, the research challenges of climate change, food, water, and energy security are fundamentally global, rather than national, in scope, thereby calling for international research collaboration (Royal Society 2011). Although these factors affect the overall trend, the patterns of international scientific collaboration also reflect wider relationships among countries, including linguistic and historical factors, as well as geographic, economic, and cultural relations (Glдnzel and Schubert 2005; Narin, Stevens, and Whitlow 1991). Percentages of international collaboration, by field the increase in international coauthorship occurs in every broad field of science. Astronomy is the most international field, with more than half of its publications internationally coauthored (54. Geosciences, mathematics, biological sciences, and physics also have percentages of international collaboration above the average of 24. Factors influencing variations among fields include the existence of formal international collaborative programs and the use of costly research equipment. However, even fields with relatively low percentages of international collaboration have experienced increases in collaboration between 2006 and 2016. Articles with international collaboration are counts of articles with institutional addresses from more than one country or economy. Science and Engineering Indicators 2018 International collaboration, by region, country, or economy Countries vary widely in the proportion of their internationally coauthored S&E publications. Countries with large populations or communities of researchers may have high rates of domestic coauthorship because of the large pool of potential domestic coauthors in their field.

Ludwigia glandulosa Walter Cylindric-fruit Seedbox G5 S1 E Onagraceae (Evening Primrose Family) Taxnote: Maryland plants are ssp symptoms 8 days after ovulation purchase generic bimat on-line. Cons/Econote: Occurring in Maryland at its northern range limit and collected as early as 1890 treatment hyperthyroidism buy bimat visa. Ludwigia hirtella Rafinesque Hairy Ludwigia G5 S1 E Onagraceae (Evening Primrose Family) Cons/Econote: A species of pine savannas to our south medicine man pharmacy bimat 3ml low price. Maryland stations occur in artificially maintained habitats that mimic its natural habitat medicine 3 times a day order bimat without a prescription. Habitat: Open, wet meadows (powerlines), road shoulders and other clearings in sandy/peaty soil. Lupinus perennis Linnaeus Sundial Lupine G5 S2 T Fabaceae (Legume Family) Cons/Econote: Threatened by habitat loss and under decline at most stations with several small populations now extirpated. Frye (2012) demonstrated a dramatic effect of browsing white-tailed deer on fruit and seed production. The Service is managing and in some cases restoring connectivity between populations in Worcester County as breeding habitat for the globally rare Frosted Elfin (Callophyrs irus). Habitat: Dry sandy soils of inland dunes and sand ridge woodlands, sandy powerline meadows, dry rocky slopes and outcrops. Lycopodiella caroliniana (Linnaeus) Pichi Sermolli see Pseudolycopodiella caroliniana (Linnaeus) Holub Lycopodiella inundata (Linnaeus) Holub Bog Clubmoss G5 S2 Lycopodiaceae (Clubmoss Family) Syn: Lycopodium innundatum Linnaeus Cons/Econote: Circumboreal, ranging south along the Appalachians. Largely restricted to the Allegheny Plateau but with a few oddly disjunct occurrences. Lycopodium tristachyum Pursh see Diphasiastrum tristachyum (Pursh) Holub S1 E Lycopus amplectens Rafinesque Sessile-leaf Bugleweed G5 Lamiaceae (Mint Family) Cons/Econote: Endangered by habitat loss, chiefly by woody succession of open, boggy habitats. Lygodium palmatum (Bernhardi) Swartz Climbing Fern G4 S2 T Lygodiaceae (Climbing Fern Family) Cons/Econote: Well-documented by historical collections (pre-1900) from areas where the species is no longer extant, suggestive of a long-term decline in the range and abundance of this species. Currently comprising a few zones of local frequency but otherwise scattered, isolated and generally with low population sizes. Lysimachia hybrida Michaux Lowland Loosestrife G5 S2 T Primulaceae (Primrose Family) Cons/Econote: Threatened by habitat loss and displacement by invasive species. Lysimachia lanceolata Walter Lanceleaf Loosestrife Primulaceae (Primrose Family) Habitat: Riverside prairie scour bars, moist depressions in rich woods. Lysimachia thyrsiflora Linnaeus Water Loosestrife G5 S1 Primulaceae (Primrose Family) Cons/Econote: Circumboreal, south to Maryland at a single station (see Steury et al. X E Lythrum alatum Pursh Winged Loosestrife G5 S1 E Lythraceae (Loosestrife Family) Cons/Econote: Maryland stations are small (~30 plants each) and their occurrence in any given year is unpredictable. Magnolia tripetala (Linnaeus) Linnaeus Umbrella Magnolia G5 S3 Magnoliaceae (Magnolia Family) Cons/Econote: Occurring predominately in Piedmont forests and near the northern range limit for the species, the native within-State range is somewhat obscured by naturalized garden escapes (see also Riefner & Hill 1983). Global Rank State State Federal Rank Status Status G5 S2 E Malaxis unifolia Michaux Green Adders-mouth Orchid G5 S2 Orchidaceae (Orchid Family) Cons/Econote: Perhaps declining; many Maryland records are approaching historical dates (last observed 30 years before present). Habitat: A broad range of habitats from swamp forests and acidic seeps to sandy upland forests under pines. S3 Rosaceae (Rose Family) Syn: Pyrus angustifolia Aiton Cons/Econote: Noted by Hill (1986) as widespread on Assateague Island and collected by E. The species occurs sporadically and with uncertain nativity at many locations (old farmsteads, field hedgerows, etc. Habitat: Maritime shrub thickets, field edges, old fields and farmsteads, hedgerows, roadsides. Unfortunately, this species now contends with multiple invasive species that are aggressive competitors. Low population sizes are reported for most stations and few are protected; however, the number of stations has steadily increased in recent years. S1S2 E Apocynaceae (Dogbane Family) Cons/Econote: this species occurs in naturally disturbed lowlands. Maryland populations are invariably small and their occurrence is temporal, such that the number of occupied sites changes over years. Habitat: Bedrock scour and terrace woodlands in rich alluvium, upland forests, barrens, glades, clearings, and roadsides over limestone or shale substrates. Matteuccia struthiopteris (Linnaeus) Todaro Ostrich Fern G5 S2S3 Onocleaceae (Sensitive Fern Family) Taxnote: Maryland plants are var.

Here medicine school buy genuine bimat on line, equal weight is given to health and life expectancy medications excessive sweating discount 3 ml bimat fast delivery, that is medicine hat college cheap bimat uk, one year in full health is given the same value as two years lived in 50 per cent of full health (whatever this means) symptoms and diagnosis order 3 ml bimat free shipping. What is measured here are the years of life expected to be lived in full health, in full quality or without disability. First, what exactly should be represented on the y-axis, that is, what are the relevant qualitative individual outcomes? And second, once this has been decided, how should the scale be calibrated, for example, what level of health should count as full health, or as 50 per cent of full health? Such a view would imply that few people are in full health, and that public health should try to benefit people who are very healthy (but below the maximum). Such a view would also make it quite difficult to make trade-offs between health and longevity. The question is really how we should value different improvements in health from a public health perspective, a question that is analogous to the question how we should value different life years depending on when during the life cycle they occur. Only then does it make sense to say that we ought to maximize the area below the curve. Each improvement in health of a certain magnitude is equally valuable (from a public health perspective), regardless of where on the scale it occurs. Once a certain level of health has been attained, a further improvement is worth nothing from a public health perspective. Public health should do nothing for those people who have reached this level (and who can be expected to stay on this level). Improvements beyond acceptable health still have value, but they are worth less (from a public health perspective) than improvements below this level. Let us now return to the first question, that is, what exactly should be represented on the y-axis. The perhaps most natural answer to this question (an answer that has been taken for granted in the above) is health. There are several views of what health is, however, one of which is the absence of disorders or maladies (that is, diseases, injuries and defects). To suggest that public health should promote health in this sense is to suggest that it should aim at preventing disease and injury. Chapter 2: Health, disease and the goal of public health 29 To prevent disease and injury this is obviously a plausible goal of public health. Or alternatively put, what conditions should be categorized as disorders, mental or somatic? Disorders as internally caused undesirable conditions It is generally assumed that disorders are physical or mental states or processes (for example, underlying anatomical or physiological pathologies or abnormalities) that typically manifest themselves in different kinds of undesirable symptoms. First, there is the view that the concept of disorder (particularly mental disorder) is a purely evaluative concept, that is, that there is really no need for a factual component (Wakefield, 1992). Second, it has been argued that the concept is a purely factual or scientific concept, that the presence of the right kind of internal cause is not just necessary for disorder, but also sufficient (Boorse, 1975). The presence of a machine-fault is not just necessary for disorder, but also sufficient, and it is often assumed that the presence of such an 14 15 the main reason why the question is best phrased in terms of disorder rather than in terms of illness or disease is that the most practically relevant category is a broader category that also includes injury, retardation, and so on. The practically important thing is obviously how we distinguish disorder from non-disorder, and not how we draw the line between for example, disease and injury, or between illness and disease. This rudimentary conceptual theory of disorder offers us truth conditions for disorder statements, that is, it tells us under what conditions a disorder is present. This leaves it open what kind of thing a disorder is, however, for example, whether it is (1) the condition that is caused by an underlying dysfunction (or the like), that is, some kind of syndrome, (2) the internal cause that produces the symptomatic manifestations or (3) the whole complex, that is, the underlying pathology plus the symptoms. Third, it has been suggested that the value component and the factual component should be supplemented by a third component, for example, the idea that a disorder is, by definition, a condition that health professionals treat, or a condition that (we think) should be treated by health professionals or by medical means (Reznek, 1987). That is, it seems reasonable to accept the general idea that disorders are undesirable conditions immediately caused by internal states and processes. This assumption gives rise to two questions: (1) How should the evaluative content of the concept of disorder (its value component) be characterized? The value component: harm and other bad things With the possible exception of a few machine-fault theorists and a number of physicians, it is generally agreed that we have to rely on value judgments to distinguish disorders from other conditions. To clarify this, we need to know more than to what extent attributions of disorder are dependent on values. In particular, we have to know what kind of evaluations we have to rely on to identify the class of disorder. Disorders typically involve some kind of harm to the individual who has the disorder, for example, distress or disability.

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Describe the clinical features of ocular hypotony medications 1 order bimat 3 ml online, recognize and know how to treat common and uncommon etiologies (eg medicine 0025-7974 buy 3ml bimat overnight delivery, choroidal detachment medications available in mexico proven 3ml bimat, leaking trabeculectomy bleb) treatment 7 february discount bimat american express. Describe the features of and know how to evaluate and treat or when to refer the primary infantile, developmental (eg, aniridia, Axenfeld-Rieger), and juvenile glaucomas. Describe and know how to apply specific medical treatments in advanced glaucoma cases. Describe the principles, indications, and complications of laser treatment of more advanced or complex glaucoma (eg, repeat procedures). Describe the more advanced surgical treatment of glaucoma: (eg, trabeculectomy, combined cataract and trabeculectomy, glaucoma drainage devices, and cyclodestructive procedures), including indications, techniques, and complications. Describe use of antimetabolites and antiangiogenic agents and potential complications from their use. Recognize glaucoma surgical complications, their etiologies, and options for treatment. Describe and treat intraocular infections resulting from filtering blebs or other glaucoma procedures. Describe new nonpenetrating glaucoma surgery techniques: principles, techniques, advantages, limitations, and complications. Perform laser peripheral iridotomy for more advanced glaucoma (eg, monocular patient, acute angle closure, hazy cornea). Perform laser treatments (eg, argon laser trabeculoplasty, iridoplasty) for more advanced glaucoma cases (eg, repeat treatments, monocular patient). Perform cyclophotocoagulation for more advanced cases (eg, prior surgery, monocular patient). Manage and treat medically and/or surgically a flat anterior chamber as appropriate. Perform small incision phaco/intraocular lens surgery combined with trabeculectomy, at the same or different sites. Very Advanced Level Goals: Subspecialist Subspecialist equivalent: a glaucoma subspecialist must be able to perform flawless gonioscopy; interpret the most difficult discs; diagnose and treat unusual and rare glaucomas; devise management algorithms throughout care, foreseeing alternatives and potential complications; perform surgery and manage complications of surgery in high-risk glaucoma cases; prepare a thorough consultation letter with instructions for management and future potential difficulties; and teach these skills to residents and general ophthalmologists. List the main population-based studies in glaucoma prevalence, incidence, and risk factors (eg, Baltimore Eye Survey, Blue Mountains Eye Study, Barbados Eye Study, Rotterdam Eye Study, Thessaloniki Eye Study, Latinos Eye Study, Singapore Malay Eye Study). Describe and critically discuss results of the above-mentioned studies on glaucoma prevalence, incidence, and risk factors. Describe use of other tonometers (eg, ocular response analyzer, dynamic contour tonometry, pneumotonometer). Describe mechanisms of ganglion cell damage and potential pathways for neuroprotection. Describe and know specific medical and surgical treatments in the most complex and most advanced glaucoma cases (eg, refractory glaucoma, monocular patients, noncompliant patients). Describe and know the specific management of complications related to the surgical intervention of the most complex and most advanced glaucomas. Medical and surgical management of hypotony from overfiltration, bleb leak, choroidals, and other causes. Perform advanced techniques for revisions of glaucoma surgery blebs (eg, sliding flap, free graft, amniotic membrane) and manage complications. Perform trabeculectomy revisions, glaucoma drainage device surgery, and manage complications. Describe the typical features, evaluation, and management of the most common optic neuropathies (eg, infectious, demyelinating, ischemic, inflammatory, hereditary, toxic, nutritional, compressive, infiltrative). Describe the typical features, evaluation, and management of the most common ocular motor neuropathies (eg, third, fourth, sixth nerve palsy). Describe the typical features of cavernous sinus syndrome and superior orbital fissure syndrome. Describe the typical features, evaluation, and management of the most common efferent pupillary abnormalities (eg, Horner syndrome, third nerve palsy, tonic pupil, light-near dissociation). Describe the typical features and evaluation of the most common visual field defects (eg, optic nerve, optic chiasm, optic radiation, occipital cortex). Describe the differential diagnosis, evaluation, and management of congenital optic nerve abnormalities (eg, optic pit, disc coloboma, papillorenal syndrome, morning glory syndrome, tilted disc, optic nerve hypoplasia, myelinated nerve fiber layer, melanocytoma, disc drusen, Bergmeister papilla). Describe the features of simple supranuclear and internuclear palsies (eg, internuclear ophthalmoplegia, vertical gaze palsy). Describe the signs and symptoms of giant cell arteritis and the indications for performing a temporal artery biopsy.

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