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Jeffrey A Brinker, M.D.

Jeffrey A Brinker, M.D.

  • Professor of Medicine
  • Joint Appointment in Radiology and Radiological Science


High school class schedules are (essentially buy generic skelaxin 400 mg spasms near heart, a measure of mental randomly assigned to purchase genuine skelaxin spasms side of head students order skelaxin from india muscle relaxant herbs, and alertness) and body temperature starts therefore, students have core classes at to increase upon waking and, with the various times of day. Since time-of-day for exception of a dip after noon, most high school classes is assigned by continues to rise until about 8:00 P. In addition, left-handed children term memory (as cited in Sjosten-Bell, perform better in afternoon hours. Researchers also suggest gifted people do Studies show higher arousal benefits long better in afternoons, and children who have term memory more than in short-term difficulty in reading would perform better in memory (Millar et al. In multiple Biorhythm cycles oscillate in a steady wave studies when compared to material learned and last 23 to 33 days. Basic plasma in morning hours, material originally learned hormone levels due to circadian rhythms in afternoons show advantages for long term promote arousal from a low level in early recall (as cited in Millar et al. According to the Mayo Clinic, shown in several studies to be influenced by more than 100 human functions are time-of-day of instruction. These studies impacted by hormone changes due to show an increase in reading achievement for biorhythms and circadian cycles (as cited in students is more likely if students receive Klein 2004). These physiological and instruction in afternoon rather than biochemical changes in a person express instruction in early morning. This is themselves in daily fluctuations affecting because reading comprehension entails time-of-day for learning and recall. Reading comprehension is a hours giving humans best processing of process relying on long-term memory. Linear reasoning, numeric comprehension found beginning readers manipulation, arithmetic skills, who received afternoon reading instruction mathematical concepts and language generally achieve at higher levels. The functions such as grammar and vocabulary study showed first period instruction was are all related to left hemisphere functions. This study was performed over a Nevertheless, most right-handed people period of one school year in reading show left hemisphere dominance. Research achievement differences based on the has shown right-handed students perform Comprehensive Test of Basic Skills. Davis? better in morning and tenth graders had (1987b) second study with eighth grade increased concentration during morning students in English confirmed those who hours (Klein, 2001). In afternoon hours allowing for processing of 2004, Klein found learning achievement for visual information and long-term memory middle school students in literature was best (Klein, 2001). He then found levels of attention for tenth Davis? (1987b) second study looked at grade students were lowest in afternoon and time-of-day effect on mathematics highest in morning. He examined time-of-day was correlated with perceived levels of effects on instruction of 80 eighth grade attention. For the academic subjects were being studied during school year, students were assigned to either different times of day in this study. The could have been more interesting or favored mathematics instructor was unchanged in which would explain their attention level both of these mathematics classes. Also, the self-assessed Comprehensive Test of Basic Skills was questionnaires were filled out for only one used as a pretest and again as a posttest nine day. Davis found the fact that shifted to different times-of-day depending there was no apparent difference in on more attention-grabbing classroom achievement between morning and activities and lessons on one particular day. Davis students perform better during a particular concluded possibly mathematics entails a optimal time of day. Goldstein, Hahn, balance of short-term memory and long term Hasher, Wiprzycka, and Zelazo (2007) memory therefore does not fall into a short found approximately a six-point difference term memory or long-term memory task. This suggests during three different time periods in a day student learning is influenced by teachers? (morning, mid-morning and afternoon) over time-of-day preferences as well as a three week period. Results found a slight trend performing at a preferred time-of-day would toward students performing best in morning. Students significance between student scores on who preferred morning and intermediate quizzes and time-of-day assessed. However, scores for students grade students, Klein (2001) examined preferring morning and intermediate times mathematics aptitude and levels of attention. Effects of time-of-day influence on reduction of truancy resulted of instruction on beginning reading from matching the time preferences of achievement. Journal of Educational students with their English course period Research, 80(3), 138-140. If time is viewed as a Time of day, intellectual performance, resource and can be influenced to support and behavioral problems in morning high quality instruction, preferred time-of versus evening type adolescents: Is day is much more likely to result in there a synchrony effect? British Journal of Therefore, there is a need for research Educational Technology, 39(3), 555 showing optimal time-of-day for particular 558. Personalized best time-of-day for certain core subjects as Learning, Educational Leadership, a whole. Research brief hours and mathematics during morning learning time and student achievement. Attention, scholastic day of instruction on class achievement for achievement and timing of lessons. An analysis of the schedules for improved attention and relationships among academic achievement. Scandinavian Journal of achievement in mathematics and Educational Research, 48(4), 441-450. An analysis of the preferences of third, fourth, fifth, and relationships among academic sixth grade students (St. Johns achievement, attendance, and the University, New York), (Doctoral learning style time preferences of Dissertation).

It is also the only integer greater than unity such that the sum of the squares from 1 to order 400 mg skelaxin fast delivery muscle relaxant juice itself is a square 400mg skelaxin mastercard spasms from catheter. According to purchase 400 mg skelaxin visa muscle relaxant 8667 Euclid, given two line segments the shorter one can always be marked off a nite number of times on the longer length either evenly or until a length shorter than its own length remains and the process cannot continue. A more algebraic version of the division algorithm, one more appropriate for our use, is stated in the next theorem. In order to show that q and r are unique, suppose that there are two other integers u, v such that a? One of the most important consequences of the division algorithm is the fact that for any positive integer n. If we restrict our attention to division by the integer 2, the division algorithm implies that every integer is even or odd, that is, can be written in the form 2k or 2k? If we restrict ourselves to division by the integer 3, the division algorithm implies that every integer is of the form 3k,3k? Using this fact, Theon of Smyrna claimed that every square is divisible by 3 or becomes so when 1 is subtracted from it. That is, according to the division algorithm, the only remainders possible when dividing by 7 are 0, 1, 2, 3, 4, 5, and 6. Since q2 is even, q must be even, contradicting the assumption that p and q have no p? In 1737, the irrationality of e, the base of the natural logarithm, was established by Euler. Lambert was self-educated and made signi?cant con tributions to physics, mathematics, and cartography. He developed the transverse Mercator projection by projecting onto a cylinder tangent to a meridian. In non-Euclidean geometry, a Lambert quadrilateral is a four-sided gure having three right angles. However, there are occasions when it is useful to consider other bases, in particular base 2. Representing integers in bases other than base 10 is useful if such representations are unique, which we establish with the next result. Ifq2 > b,we continue the process, obtaining a decreasing sequence of positive integers q1. An elementary version of the game of nim consists of two players and a single pile of matches. Players move alternately, each player is allowed to take up to half the number of matches in the pile, and the player who takes the last match loses. A player can force a win by leaving 2n A 1 matches in the pile, where n is a positive integer. For example, if there were 73 matches in the pile a player attempting to force a win would remove 10 matches leaving 73 A 10? In 1901, using properties of binary representations, Charles Bouton of Harvard developed several winning strategies for a more advanced version of nim where several piles of matches were involved and where players who moved alternately were allowed to remove matches from but a single pile on each move. True or false (if false give a counterexample): (a) if ajbc, then either ajb or ajc, (b) if aj(b? Show that the number of positive divisors of a positive integer is odd if and only if the integer is a square. In an 1883 edition of the Educational Times, Emma Essennell of Coventry, England, showed for any integer n, n5 A n is divisible by 30, and by 240 if n is odd. Prove that if a is a positive proper divisor of the positive integer b, then a < ba2. For any positive integer n, show that there is a one-to-one correspon 58 Divisibility p? Given a scale with a single pan, determine the least number of weights and precisely the values of the weights necessary in order to weigh all integral weights in kilograms from 1 kilogram to 40 kilograms. A number n is called a Niven number, named for Ivan Niven, a number theorist at the University of Oregon, if it is divisible by the sum of its digits. Kennedy showed that it is not possible to have more than 20 consecutive Niven numbers. Let Sd(n, b), the extended digital sum of the integer n expressed in base b > 2, represent sd(n, b) summed over the digits of n. However, if one of them is nonzero, the number of common divisors of a and b is nite. We denote the largest common divisor of a and b by gcd(a, b) and, following standard convention, call it the greatest common divisor of a and b. It follows straightforwardly from the de?nition that d is the greatest common divisor of a and b if and only if 2. As pointed out in [Schroeder], physiological studies have shown that, with few exceptions, the brain, upon being presented with two harmoni cally related frequencies, will often perceive the greatest common divisor of the two frequencies as the pitch. For example, if presented with frequencies of 320 hertz and 560 hertz the brain will perceive a pitch of 80 Hz. One of the most important properties of the greatest common divisor of two numbers is that it is the smallest positive integer that can be expressed as a linear combination of the two numbers. Proof Let T represent the set of all linear combinations of a and b that are positive, that is, T? Since e divides both a and b and d is the greatest common divisor of a and b, it follows that e < d. Note that all entries are multiples of 7 and the least positive linear combination is 7. Suppose d is the greatest common divisor and a and b, x and y are integers 60 Divisibility Table 2.

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Example 2: Patient has an infiltrating duct tumor in the upper outer quadrant (C504) of the right breast and another infiltrating duct carcinoma in the lower inner (C503) quadrant of the right breast order online skelaxin muscle relaxant 2. Example 2: Excision of the right axillary nodes reveals metastatic infiltrating duct carcinoma purchase discount skelaxin on line muscle relaxant vs painkiller. If a tumor is metastatic and the primary site is unknown skelaxin 400 mg online muscle relaxant non drowsy, code the primary site as unknown (C809). Although angiosarcoma actually originates in the lining of the blood vessels, an angiosarcoma originating in the breast has a poorer prognosis than many other breast tumors. Code the primary site to the location of the transplanted organ when a malignancy arises in a transplanted organ, i. For information about organ or tissue transplants, see the section Determining Multiple Primaries c. For additional information about hematopoietic-related transplants, refer to the Hematopoietic and Lymphoid Neoplasm Coding Manual and Database 13. When the medical record does not contain enough information to assign a primary a. Schema Discriminator 1: Occult Head and Neck Lymph Nodes is used to discriminate between these cases and other uses of C760. Sarcomas may also arise in the walls of hollow organs and in the viscera covering an organ. Code the organ of origin as the primary site when leiomyosarcoma arises in an organ. Coding Instructions for Hematopoietic and Lymphoid Neoplasms (9590/3-9992/3) See the Hematopoietic and Lymphoid Neoplasm Coding Manual and Database for instructions on coding the primary site for hematopoietic and lymphoid neoplasms. Code Description 0 Not a paired site 1 Right: origin of primary 2 Left: origin of primary 3 Only one side involved, right or left origin unspecified 4 Bilateral involvement at time of diagnosis, lateral origin unknown for a single primary; or both ovaries involved simultaneously, single histology; bilateral retinoblastomas; bilateral Wilms tumors 5 Paired site: midline tumor (effective with 01/01/2010 dx) 9 Paired site, but no information concerning laterality Coding Instructions 1. Code laterality using codes 1-9 for all sites listed in the table: Sites for Which Laterality Codes Must Be Recorded a. Laterality may be coded for sites other than those required; for example, thyroid 3. Assign code 3 if the laterality is not known but the tumor is confined to a single side of the paired organ Example: Pathology report: Patient has a 2 cm carcinoma in the upper pole of the kidney. Code laterality as 3 because there is documentation that the disease exists in only one kidney, but it is unknown if the disease originated in the right or left kidney. Both ovaries involved simultaneously with a single histology, or epithelial histologies (8000-8799) b. Example 2: Patient has a midline meningioma of the cerebral meninges (C700, laterality 5). There is no statement that only one side of the paired organ is involved Example 1: Admitting history says patient was diagnosed with lung cancer based on positive sputum cytology. Note that there is an effective date for assigning laterality for some of the sites. For example: Code 2 may be assigned for a tumor originating in the left lobe of thyroid. The best method could occur at any time throughout the entire course of the disease. Note: the codes and instructions for hematopoietic and lymphoid neoplasms are different from the codes for solid tumors. See the section Codes for Hematopoietic and Lymphoid Neoplasms for hematopoietic and lymphoid neoplasms diagnostic confirmation codes. Codes for Solid Tumors Microscopically Confirmed Code Description 1 Positive histology 2 Positive cytology 4 Positive microscopic confirmation, method not specified Not Microscopically Confirmed Code Description 5 Positive laboratory test/marker study 6 Direct visualization without microscopic confirmation 7 Radiology and other imaging techniques without microscopic confirmation 8 Clinical diagnosis only (other than 5, 6, or 7) Confirmation Unknown Code Description 9 Unknown whether or not microscopically confirmed; death certificate only Coding Instructions for Solid Tumors 1. Always code the procedure with the lower numeric value when presence of cancer is confirmed with multiple diagnostic methods. Examination of cells (rather than tissue) including but not limited to: sputum smears, bronchial brushings, bronchial washings, prostatic secretions, breast secretions, gastric fluid, spinal fluid, peritoneal fluid, pleural fluid, urinary sediment, cervical smears, or vaginal smears b. Paraffin block specimens from concentrated spinal, pleural, or peritoneal fluid 5. Assign code 4 when there is information that the diagnosis of cancer was microscopically confirmed, but the type of confirmation is unknown 6. Note: For tests and tumor markers that may be used to help diagnose cancer, see. Assign code 8 when the case was diagnosed by any clinical method not mentioned in preceding codes. The new codes, new terms, and codes with changes to behavior are available at: If the only pathologic specimen is from a metastatic site, code the appropriate histology code and the malignant behavior code (/3). The exception is with in situ breast cancer; code as non-invasive (/2) in the presence of isolated tumor cells or if cells are artifactually displaced from a previous procedure. In Situ Clinical evidence alone cannot identify the behavior as in situ; a behavior code of /2 (in situ) must be based on pathologic examination. Example: Pathology from mastectomy: Large mass composed of intraductal carcinoma with a single focus of invasion. Re-code the behavior as malignant (/3) when metastases are attributed to a tumor originally thought to be in situ.

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The week gains its power from the whole number 7 purchase skelaxin 400 mg fast delivery spasms rib cage, and not from the jumble of names in which the week is clothed best skelaxin 400mg spasms just below sternum. The seven-day cycle is the closest whole number that corresponds to purchase 400mg skelaxin mastercard spasms kidney area the four phases of the moon, which, as whole numbers, are also seven days each. In fact, the fixed 7-day cycle only makes sense within the context of the Thirteen Moon calendar with its 28-day cycles divisible by four and seven, creating the annual cycle of fifty-two perfect weeks-plus the Day Out of Time, ensuring a perpetual harmony. Was the Babylonian naming of these days-with only one name a reference to the moon-meant to be a cover-up of some earlier knowledge, a knowledge both more purely lunar and harmonic, such as the Thirteen Moon calendar? What would really happen if there were a Day Out of Time, no day of the week or month at all? Since 1993, sixty years after the failure of the League of Nations to enact calendar reform, the Thirteen Moon Calendar Change Peace Movement has made certain that the the Adventof the Noosphere. All the while, the Gregorian world has arrogantly plunged blindly forward, locked into its mechanistically chaotic timing sensibility, only to receive the mortal wound of the Inevitable Event, causing it to fall through the seams of its own making, the technosphere. A Day Out of Time, it seems, might be a relief to a world now consumed by chaos, barbarism, and war. He sends down from the sky water for your drink and to grow trees for your benefit. With it He grows for you crops, olives, date palms, grapes, and all kinds of fruits. And He commits, in your service, the night and the day, as well as the sun and the moon. Who will take the message of the advent of the noosphere to the statesmen and the politicians that they may take heed and note that what is occurring is not really in their control at all, but is the climax of a phenom enal process known as biogeochemical combustion? And who will declare that this climax will inevitably shake all the towers to their foundations and level the moun tains of industry to a flat plain from which the noosphere will manifest as the equal ity of telepathy for all? This book, and this ninth chapter in particular, is like a long meditation, a vision, inspired by the dark tragedy of the Inevitable Event. As a vision, these thoughts are both those of one solitary individual, albeit a noospheric chip, and the continuation of the vision of that ancient seer, Pacal Votan. Could it be that Pacal Votan in his time knowledge rehearsed all these words, these thoughts, this entire vision itself? On the sarcophagus lid of Pacal Votan is a cross, not the cross of death as in Chris tianity, but the cross oflife, a tree, a cosmic tree. The head at each end represents the galactic vision that sees equally into the past and the future. This is what is meant by the advent of the noosphere, the mind of time on Earth, the mental envelope of planetary con 188. The Advent of the Noosphere sciousness arising from the grave crisis of the biosphere through which we are now passing at this very moment. Because we are now defining the noosphere does not mean that the noosphere was not known to those ancient Mayan time scientists like Pacal Votan, especially if the noosphere is defined as the mind of time on Earth. How many such rehearsals would be necessary before some thing was finally learned? Knowing the nature of the synchronic order of time, someone like Pacal Votan, obviously one of the most singular of all personalities of the Mayan world, would have possessed a consciousness like the two-headed galactic band, the consciousness of ga lactic memory. In the zuvuya of galactic consciousness, peering into the deep past is peering at the present from the future. This is possible in the radial time of the fourth dimension freed from the strict linear construct of past-and-future-time. From some higher state of mind, from a mind and consciousness identified completely with the galaxy, this has all been foreseen, this has all been written in a book. Now we who are in this present state of end-time consciousness are being asked to self-reflect. We are being asked if we can manage to hold the noospheric lens steady enough to see that the technosphere had to end, and that the technosphere could only end by the means by which it maintained all of the biosphere in its control, by terror itself. Yes, we are all a bit like the frog at the bottom of the well whose vision and perception of the universe is circumscribed by what the opening of the well allows it to see. The well is the technosphere, both as a planetary apparatus and as a belief system. And what do they think of their lost star children, many of whom now believe it is childish to think that we came from the stars? This being so, we could receive telepathic messages from the star people-if we were ready for it and knew precisely why, when, and how such communication occurs. In fact, as we have said earlier, the noosphere is the region on Earth for the receipt and transmission of messages of cosmic consciousness. This being so, the future of human evolution, of Homo noosphericus, would be nothing less than to become a medium of cosmic con sciousness, adapting to the expanded measure of Noospheric Earth Time, traveling back to the stars but through the superior knowledge of the actual laws of time. In writing this book, I have only a sense of duty, of responsibility to expand the vision of my fellow earthlings from the technosphere to the noosphere. In the Law of Time there are no arbitrary distinctions between reason and art, science and proph ecy. This book is as much an exposi tion of matters generally not thought about, as it is a personal testament and vision. In that regard this text is a portion of a broadcast transduced and received by me functioning as a noospheric chip, on behalf of the biosphere-noosphere transition. In the tomb lid ofPacal Votan are impressed all the frequencies of this broadcast transmission called Time and the Technosphere. He left his body in that tomb, a jade mask being the actual impression of his face.

TheRorschach Inkblot Test is a projective measure of personality in which the respondent indicates his or her thoughts about a series of 10 symmetrical inkblots (Figure 11 order on line skelaxin spasms left upper quadrant. The sketches are shown to cheap 400mg skelaxin visa infantile spasms 6 weeks individuals purchase skelaxin online pills muscle spasms 72885, who are asked to tell a story about what is happening in the picture. Trained coders read the stories and use them to develop a personality profile of the respondent. Other popular projective tests include those that ask the respondent to draw pictures, such as the [30] Draw-A-Person test (Machover, 1949), and free association tests in which the respondent quickly responds with the first word that comes to mind when the examiner says a test word. Another approach is the use of anatomically correct? dolls that feature representations of the male and female genitals. Investigators allow children to play with the dolls and then try to determine on the basis of the play if the children may have been sexually abused. The advantage of projective tests is that they are less direct, allowing people to avoid using their defense mechanisms and therefore show their true? personality. The idea is that when people view ambiguous stimuli they will describe them according to the aspects of personality that are most important to them, and therefore bypass some of the limitations of more conscious responding. Despite their widespread use, however, the empirical evidence supporting the use of projective [31] tests is mixed (Karon, 2000; Wood, Nezworski, Lilienfeld, & Garb, 2003). The projective tests often fail to distinguish between people with psychological disorders and those without or to correlate with other measures of personality or with behavior. Psychology in Everyday Life: Leaders and Leadership One trait that has been studied in thousands of studies is leadership, the ability to direct or inspire others to achieve goals. Trait theories of leadership are theories based on the idea that some people are simply natural leaders? [32] because they possess personality characteristics that make them effective (Zaccaro, 2007). Consider Bill Gates, the founder of the Microsoft Corporation, shown in Figure 11. Research has found that being intelligent is an important characteristic of leaders, as long as the leader communicates [33] to others in a way that is easily understood by his or her followers (Simonton, 1994, 1995). Other research has found that people with good social skills, such as the ability to accurately perceive the needs and goals of the group [34] members and to communicate with others, also tend to make good leaders (Kenny & Zaccaro, 1983). Some have considered this in terms of charisma (Sternberg & Lubart, 1995; Sternberg, [35] 2002). Charismatic leadersare leaders who are enthusiastic, committed, and self-confident; who tend to talk about the importance of group goals at a broad level; and who make personal sacrifices for the group. Charismatic leaders express views that support and validate existing group norms but that also contain a vision of what the group could or should be. Charismatic leaders use their referent power to motivate, uplift, and inspire others. Another trait-based approach to leadership is based on the idea that leaders take either transactional or transformational leadership styles with their subordinates (Bass, 1999; Pieterse, Van [37] Knippenberg, Schippers, & Stam, 2010). Transformational leaders, on the other hand, are more like charismatic leaders?they have a vision of where the group is going, and attempt to stimulate and inspire their workers to move beyond their present status and to create a new and better future. In still other cases, different types of leaders may perform differently in different situations. Leaders whose personalities lead them to be more focused on fostering harmonious social relationships among the members of the group, for instance, are particularly effective in situations in which the group is already functioning well and yet it is important to keep the group members engaged in the task and committed to the group outcomes. Leaders who are more task-oriented and directive, on the other hand, are more effective when the group is not functioning well and [38] needs a firm hand to guide it (Ayman, Chemers, & Fiedler, 1995). One of these approaches, known as physiognomy, has been validated by current research. This is in part because people tend to see more traits in other people than they do in themselves. Despite their widespread use, however, the empirical evidence supporting the use of projective tests is mixed. Accuracy and awareness in the perception and categorization of male sexual orientation. Female sexual orientation is perceived accurately, rapidly, and automatically from the face and its features. The five-factor model and personality disorder empirical literature: A meta-analytic review. On predicting some of the people some of the time: the search for cross-situational consistencies in behavior. Toward a unified theory of personality: Integrating dispositions and processing dynamics within the cognitive-affective processing system. The rank-order consistency of personality traits from childhood to old age: A quantitative review of longitudinal studies. The clinical interpretation of the Thematic Apperception Test, Rorschach, and other clinical data: A reexamination of statistical versus clinical prediction. Personality projection in the drawing of the human figure (A method of personality investigation). Transformational and transactional leadership and innovative behavior: the moderating role of psychological empowerment. Describe the strengths and limitations of the psychodynamic approach to explaining personality. Identify the major contributions of the humanistic approach to understanding personality. In this section we will consider two major theories of the origin of personality: psychodynamic andhumanistic approaches. Psychodynamic Theories of Personality: the Role of the Unconscious One of the most important psychological approaches to understanding personality is based on the theorizing of the Austrian physician and psychologist Sigmund Freud (1856?1939), who founded what today is known as the psychodynamic approach to understanding personality. Many people know about Freud because his work has had a huge impact on our everyday thinking about psychology, and the psychodynamic approach is one of the most important approaches to [1] psychological therapy (Roudinesco, 2003; Taylor, 2009). Freud is probably the best known of all psychologists, in part because of his impressive observation and analyses of personality (there are 24 volumes of his writings).


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