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By L. Asam. Oglethorpe University. 2018.

Although some journals still have significantly different format requirements for references buy aricept 5mg low price symptoms detached retina, the advent of reference database software (www4) means that lists can be more easily changed to different formats cheap 5mg aricept with mastercard medicine ball exercises. Over 500 journals now use the ICMJE uniform requirements and either cite the document or make reference to it in their instructions to authors. The uniform requirements are clear and concise instructions to authors on how to prepare a manuscript for submission to a journal and which style to adopt. In the event of the acceptance of your paper for publication, the copy editor may ultimately change your style. However, regardless of publication style, many journals still require papers to be submitted according to the standard uniform requirements. Too few authors do this, but there is little point in writing a 400 word introduction when the journal has a limit for the whole article of 600 words. Richard Smith20 Although many journals require papers to be submitted according to the uniform requirements, each journal also has its own instructions to authors that are published on the journal website or in the printed copy of the journal. Sometimes the instructions are only published once or twice a year, for example, JAMA publishes its instructions to authors in January and July. The instructions to authors for many journals can be accessed via a central Medical College of Ohio website (www5). As soon as you have decided where to submit your paper, you should obtain the instructions to authors, read them carefully, make note of all of the relevant points, and then read them carefully again. In addition to requiring papers to conform to the uniform requirements, each journal often lists its own specific submission requirements. These may include the number of copies of the paper to submit, use of abbreviations, the standard dictionary to be used for spelling, the maximum length of the paper, the style for references, and so on. Any time you spend on formatting before you submit your paper to a journal is time well spent. If your paper conforms exactly to a journal’s guidelines, it is much more likely to be received favourably by the editor. This will help to ensure that your paper is processed expeditiously and that unnecessary delays are avoided. If you do not follow the guidelines, your manuscript may be returned to you before it is sent out for external peer review, thus causing unnecessary delay and wasting precious time. Some journals have a policy of returning papers that exceed the established length limits and ask authors to shorten them before they are sent out for review. Even when papers that exceed page limits are sent out for peer review, they may ultimately be rejected solely on the basis of their length and despite the scientific merit of the content. Shortening a paper so that it conforms to the limits set by a journal should not be 23 Scientific Writing too onerous. If you are having problems with word-trimming, consider whether each table needs all the information it shows, whether you have duplicated any of the information in the text and whether all of the tables and figures are absolutely essential for conveying your main results. If you have presented the same results as both categorical and continuous data analyses, one of the two approaches could probably be omitted. It is also worth considering whether all of the information in the introduction and discussion is essential for putting your work in the context of the literature. By cutting out words, sentences, and paragraphs here and there, it is always possible to reduce the length of a paper without compromising the main messages. If you are too emotionally involved with your writing to be objective about making cuts, it is probably best to enrol someone else to help you do it. Standardised reporting guidelines Writing is the only thing that, when I do it, I don’t feel I should be doing something else. The Consolidated Standards of Reporting Trials (CONSORT) guidelines were developed by an expert group of researchers, epidemiologists, journal editors, and statisticians (www6). The ICMJE recommends the use of CONSORT guidelines whenever the results of randomised controlled trials are reported. The CONSORT guidelines were first published in 1996,21 are now available on the web, and an updated version has recently been published. These studies therefore need to be reported to an exceptionally high standard so that readers can judge whether the results are reliable. They include a comprehensive checklist and a model flow chart diagram to help researchers publish the results of randomised controlled trials fully and accurately.

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This 76 Scientific Writing makes the interpretation of your data much easier than when the table is organised the other way around generic aricept 10mg on-line treatment resistant anxiety. In this case the numbers are included in the column titles but they could also be presented as the first line of the table buy aricept 10 mg medicine 5e. Inclusion of sample or group sizes helps readers to interpret the data correctly and calculate other statistics that may be of interest to them. It is not a good idea to include sample or group sizes at the base of a table. The meanings of “year 8” as the second year of secondary school and “year 9” as 12 months later are defined in the Methods section of the paper. It is better not to present the same data in both a figure and a table, and never to repeat data from figures or tables in the text. Readers do not want to be given the same information in multiple formats. Indeed, readers may get confused if a percentage of 54·7% in the table is repeated as 55% in the text. It is best to just give the results once, check that they are correct and use a format that gets your message across clearly in one go. Each table needs a title that tells the reader how to interpret the data. It is much better to have an inclusive title and detailed row and column descriptors than to put the essential information into footnotes, which should be avoided as far as possible. Readers will not want to search the text, the title, and the row and the column headings of the table before finally going to footnotes to find the information that they need before they can interpret your findings. Finally, tables should be submitted on separate pages and not incorporated into the text. It is common practice to print tables one to a page and include them at the end of the manuscript. Figures and graphics Art does not reproduce what we see; rather, it makes us see. Paul Klee (1879–1940) 78 Writing your paper Figures and graphs are essential for conveying results in a clear way. A cryptic approach is to show your most important findings as a figure, but only as long as the figure does not take up much more space than reporting the data would. The figure in which you present your main results should be totally self-explanatory and have a bold, stand-alone quality. A good figure tells the story in a single grab and stays in a reader’s mind. Such figures are often taken up by other researchers in their talks to wider audiences and thus help to promote your work. Figures that you use in talks to colleagues are often too simplified for a journal article in which all of the details must be included in the absence of any accompanying oral explanations. However, figures with too much detail become complicated and difficult to understand when the message gets lost in the graphics and the explanations. The symbols, abbreviations, hatching, line types, and bars must all be very clear and must be explained in detail without cluttering the picture. Also, the figure legend should be comprehensive so that the figure can be fully understood without recourse to reading explanatory text in the results section. Pie charts, which are often useful in oral presentations, have few applications in published journal articles. They are space greedy, the information cannot usually be used to provide an accurate comparison of results between groups, and the numbers are usually better accommodated in a table or bar graph, which takes less space. When creating a figure, always shrink the printed copy down to the size that it will be in the final copy of the journal and then examine it for legibility. Your work may have to survive a massive reduction during the publication process.

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Craig WA 5 mg aricept free shipping treatment 5th finger fracture, Risser JC proven aricept 5 mg medicine used during the civil war, Kramer WG (1955) Review of four hundred lung der arteriellen Durchblutung der Hüftgelenkpfanne. J Bone Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 158: 214–20 Joint Surg (Am) 37: 403–4 5. Darmonov AV (1996) Clinical screening for congenital dislocation dislocation of the hip. Dega W (1964) Schwierigkeiten in der chirurgischen Reposition der Hüftdysplasie. Z Orthop 128: 432–5 der veralteten kongenitalen Subluxation des Hüftgelenkes bei 7. Boeree NR, Clarke NM (1994) Ultrasound imaging and secondary Veth R (1999) Acetabular coverage of the femoral head after triple screening for congenital dislocation of the hip. J Bone Joint Surg pelvic osteotomy: no relation to outcome in 51 hips followed for (Br) 76: 525–33 8–15 years. Dias JJ, Thomas ICH, Lamont AC, Mody BS, Thompson JR (1993) gumente für ein generelles sonographisches Screening in der The reliability of ultrasonographic assessment of neonatal hips. Schweiz Rundschau Med Praxis 81: 519–23 Bone Joint Surg (Br) 75: 479–82 10. Dunn PM (1976) Perinatal observations on the etiology of con- Proc R Soc Med 41: 388 genital dislocation of the hip. Duffy C, Taylor F, Coleman L, Graham H, Nattrass G (2002) Mag- of developmental dysplasia of the hip after early supervised treat- netic resonance imaging evaluation of surgical management in ment in the Pavlik harness. Hsin J, Saluja R, Eilert RE, Wiedel JD (1996) Evaluaton of the biome- Bone Joint Surg (Br) 48: 397 chanics of the hip following a triple osteotomy of the innominate 25. J Bone Joint Surg (Am) 78: 855–62 len der Hüftdysplasie unter Spreizhosentherapie. Fettweis E (1968) Sitz-Hock-Stellungsgips bei Hüftgelenkdys- stationärer Behandlungsbeginn kindlicher Hüftgelenkluxationen 3 plasien. Klapsch W, Tschauner C, Graf R (1991) Kostendämpfung durch die durch Abduktionspolster. Wien Klin Wochenschr 91: 523 generelle sonographische Hüftvorsorgeuntersuchung. Forlin E, Choi H, Guille JT, Bowen JR, Gluttuing J (1992) Prognostic chr Kinderheilkd 139: 141–3 factors in congenital dislocation of the hip treated with closed 52. König F (1891) Bildung einer knöchernen Hemmung für den Gelen- reduction. Getz B (1918) The hip in lapps and its bearing on the problem of G (ed) Internationales Symposium über Beckenosteotomie/Pfan- congenital dislocation. Lerman J, Emans J, Millis M, Share J, Zurakowski D, Kasser J (2001) dysplasia. J Pediatr Orthop 4: 735–40 Early failure of Pavlik harness treatment for developmental hip 33. Graf R, Tschauner C, Steindl M (1987) Ist die IIa-Hüfte behan- dysplasia: clinical and ultrasound predictors. Ergebnisse einer Langsschnittuntersuchung 348–53 sonographisch kontrollierter Säuglingshüften unter dem 3. Ludloff (1908) Zur blutigen Einrenkung der angeborenen Hüftlux- sus linear scanning? Green NE, Lowery ER, Thomas R (1993) Orthopaedic aspects of screening for neonatal hip instability. Guille JT, Forlin E, Kumar J, MacEwen GD (1992) Triple osteotomy 534–8 of the innominate bone in treatment of developmental dysplasia 59. Mayo K, Trumble S, Mast J (1999) Results of periacetabular oste- of the hip. J Pediatr Orthop 12: 718–21 otomy in patients with previous surgery for hip dysplasia. Hailer NP, Soykaner L, Ackermann H, Rittmeister M (2005) Triple Orthop 363: 73–80 osteotomy of the pelvis for acetabular dysplasia: age at operation 60. Mostert A, Tulp N, Castelein R (2000) Results of Pavlik harness and the incidence of nonunions and other complications influ- treatment for neonatal hip dislocation as related to Graf’s sono- ence outcome. Myers S, Eijer H, Ganz R (1999) Anterior femoroacetabular impinge- holm T (1990) The Swedish experience with Salter’s innominate ment after periacetabular osteotomy.

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Patients with CRPS type I have decreased sympathetic out- flow but increased -adrenergic responsiveness in the affected limbs suggest- ing adrenergic supersensitivity purchase aricept 5 mg treatment quadriceps strain. Pharmacological or surgical sympathectomy can decrease pain in patients with CRPS and patients with neuropathic pain report increased pain during stress or after intradermal injection of a physiological dose of nor- epinephrine (NE) discount 5 mg aricept fast delivery treatment 20 nail dystrophy. In addition, injection of NE can rekindle pain and mechanical hyperalgesia in patients who have had a previous sympathetic block. Finally, inflammatory pain and hyperalgesia produced by topical cap- saicin is decreased by 1-adrenoceptor antagonists and increased by NE. Despite this evidence, systematic reviews have failed to demonstrate the efficacy of therapies designed to inhibit sympathetic function and question their utility [1, 2]. In fact, some investigators have challenged the validity of pharma- cological tests to establish the diagnosis of sympathetically maintained pain. The interpretation of results from diagnostic and prognostic nerve blocks for chronic pain can be challenging even for clinicians with considerable expertise. Recent studies have examined the effect of the natural stimulation of the subject’s own sympathetic nervous system on spontaneous pain and hyperalge- sia rather than the effect of pharmacological treatment such as sympathetic block or injection of NE. Sympathetic arousal increased pain and vasoconstric- tion in the affected extremity of patients with CRPS types I and II. Also, sympathetic activation increased spontaneous pain and spatial distribution of mechanical hyperalgesia in patients with CRPS type I who have sympatheti- cally maintained pain. These two investigations were the first to demon- strate that physiological activation of the sympathetic nervous system can modulate the pain experience in humans through endogenous release of NE from sympathetic nerve endings. These findings provide evidence in support of the concept of sympathetically maintained pain, or pain as the result of sympa- thetic efferent activity. Sympathetic Nervous System Dysfunction In the acute stage of CRPS type I, there is complete functional loss of cuta- neous sympathetic vasoconstrictor activity as well as decreased venous plasma levels of NE (presumably secondary to decreased postganglionic release from sympathetic terminals) confined to the affected extremity. This autonomic impairment may recover within weeks and likely reflects dysfunction within the CNS. During chronic CRPS, sympathetic vasoconstrictor neurons are still inhibited, but adrenoceptor supersensitivity in vascular tissue results in ongoing CRPS Psychological Dysfunction 97 vasoconstriction and subsequent cold skin. These vascular abnormalities are dynamic and more pronounced when examined over the entire range of the thermoregulatory cycle. Patients with acute CRPS type I also demonstrate -adrenergic supersen- sitivity of sudomotor nerves that is reversible with disease progression. Unilateral disturbances in sudomotor function determined by quantitative sudo- motor axon reflex test (QSART) and thermoregulatory sweat test (TST) also have been reported in patients with chronic CRPS. Sensory Dysfunction Sensory disturbances are common in patients with CRPS types I and II and predominantly consist of hyperalgesia, allodynia, and spontaneous pain. Quantitative sensory testing (QST) demonstrates an increase in warm percep- tion thresholds and a decrease of cold pain thresholds in patients with CRPS types I and II. Sensory impairments frequently extend beyond the affected area and may involve quadratic or hemilateral regions of the body. Motor Dysfunction Motor disturbances are prevalent in patients with CRPS types I and II and are independent of sensory and autonomic complaints. The most frequently described motor disturbance is loss of function of the affected extremity. Detailed neurological examination may detect objective evidence of isolated motor weakness, muscle atrophy, tremor, dystonia, or ataxia. Furthermore, electrodiagnostic tests such as electromyography and nerve con- duction velocity can be used to document muscle and large fiber abnormalities, respectively. Similarly, muscle power can be assessed by measuring grip force strength or by manual muscle testing. A recent study has demonstrated neurophysiological evi- dence of impairment of central sensorimotor integration in patients with CRPS type I. These motor deficits may be secondary to abnormal integration of visual and sensory inputs to the parietal cortex.

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