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This paper seeks to revisit the concept of power in the theoretical discourse of realism in the 21st century by taking in view the impact of information and communication technology(ICT) on international relations. The main argument is that information and communication technology has dramatically shifted the concept of power as the possession of material capabilities. The paper argues that ICT has created a double paradox for materially and technologically powerful countries by creating vulnerabilities in the hard power and soft power domain. The paper also asserts that through cyber power exists in the virtual/cyber domain, it is able to get desired outcomes in the physical domain. ICT can be used as a soft as well as a hard power multiplier. Lastly, it argues that ICT has challenged the predominant position of material power capabilities to define world order and transformed the traditional power structure.

Introduction Emotional intelligence (EI) is the skill of understanding yourself, managing yourself, understanding others, and managing relationships. Studies have begun analyzing the level of EI demonstrated by resident physicians in various specialties. Very few studies have assessed EI levels of residents in multiple specialties within one institution. The purpose of our study was to assess the EI level of all residents at our institution and to determine which variables were associated with higher EI scores. Methods In 2018, residents voluntarily participated in the study by completing two online surveys. The first survey was a de-identified survey monkey asking demographic and other training information. The second survey was an online emotional intelligence survey assessing their EI skills, the Emotional Quotient Inventory 2.0 (EQ-i 2.0). Results A total of 176 of 486 residents (36.2%) completed the study. There was no significant association between EI level and age, gender, type of medical degree, having an advanced degree, or being in a specific specialty. We found that residents who took time off before matriculating into medical school had higher overall EI scores than those who did not take time off (p = 0.02). Similarly, those who took time off before medical school scored higher in interpersonal skills (p = 0.04), empathy (p = 0.03), decision-making (p = 0.02), and impulse control (p = 0.03). Conclusion Residents who had taken time off before matriculating in medical school had higher overall EI scores and higher scores in the EI components of interpersonal skill, empathy, decision-making, and impulse control.

This Terrorism is an intentional act of violence, rational enough to generate fear amongst the target audience or society focusing upon the determination of bringing desired change in that particular society. It has been observed that terrorist organizations may prevail in the repressive regimes that they perceive as sympathetic with their ideology. However, they target the societies for terrorist operations where the basic rights of individual and legal protections exist while avoiding repressive governments when conducting operations. As terrorism is not an irrational act, targets chosen for operation are based on the assumption that after the attack, required results are achieved by the assault. The motives behind the act may be psychological, Religious or political, depending upon the nature of the activity. In the current study, all these factors are discussed in detail that may provoke an individual to become a terrorist.

Ramzan Shahid,1 Jerold Stirling,1 William Adams2 1Department of Pediatrics, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA; 2Clinical Research Office Biostatistics Core, Loyola University Chicago, Maywood, IL, USA Background: US physicians are experiencing burnout in alarming numbers. However, doctors with high levels of emotional intelligence (EI) may be immune to burnout, as they possess coping strategies which make them more resilient and better at managing stress. Educating physicians in EI may help prevent burnout and optimize their overall wellness. The purpose of our study was to determine if educational intervention increases the overall EI level of residents; specifically, their stress management and wellness scores.Participant and methods: Residents from pediatrics and med-ped residency programs at a university-based training program volunteered to complete an online self-report EI survey (EQ-i 2.0) before and after an educational intervention. The four-hour educational workshop focused on developing four EI skills: self-awareness; self-management; social awareness; and social skills. We compared de-identified median score reports for the residents as a cohort before and after the intervention.Results: Thirty-one residents (20 pediatric and 11 med-ped residents) completed the EI survey at both time intervals and were included in the analysis of results. We saw a significant increase in total EI median scores before and after educational intervention (110 vs 114, P=0.004). The stress management composite median score significantly increased (105 vs 111, P

Introduction Emotional intelligence (EI) is the skill of understanding yourself, managing yourself, understanding others, and managing relationships. Studies have begun analyzing the level of EI demonstrated by resident physicians in various specialties. Very few studies have assessed EI levels of residents in multiple specialties within one institution. The purpose of our study was to assess the EI level of all residents at our institution and to determine which variables were associated with higher EI scores. Methods In 2018, residents voluntarily participated in the study by completing two online surveys. The first survey was a de-identified survey monkey asking demographic and other training information. The second survey was an online emotional intelligence survey assessing their EI skills, the Emotional Quotient Inventory 2.0 (EQ-i 2.0). Results A total of 176 of 486 residents (36.2%) completed the study. There was no significant association between EI level and age, gender, type of medical degree, having an advanced degree, or being in a specific specialty. We found that residents who took time off before matriculating into medical school had higher overall EI scores than those who did not take time off (p = 0.02). Similarly, those who took time off before medical school scored higher in interpersonal skills (p = 0.04), empathy (p = 0.03), decision-making (p = 0.02), and impulse control (p = 0.03). Conclusion Residents who had taken time off before matriculating in medical school had higher overall EI scores and higher scores in the EI components of interpersonal skill, empathy, decision-making, and impulse control.

Objective. To identify any socioeconomic, demographic, neonatal, and perinatal factors that may be associated with failing the otoacoustic emissions (OAE) newborn hearing screen. Study Design. A retrospective chart review was performed looking at hearing screens performed on 1272 newborn infants by OAE testing. Socioeconomic, demographic, neonatal, and perinatal factors were reviewed to determine association with failing the OAE newborn hearing screen. Results. Our results demonstrate that Hispanic race was significantly associated with failing the newborn OAE hearing screen with an odds ratio of 2.54 (CI = 1.56-4.14, P = .0002). Family history of hearing loss was also significantly associated with failing the newborn hearing screen. Newborns with a family history of hearing loss were 13 times more likely to fail the newborn screen (odds ratio = 13.63, CI = 4.09-45.43, P < .0001). Conclusions. Hispanic race and family history of hearing loss are statistically significant risk factors for failing the newborn OAE hearing screen.

Objective. To determine if using an iPad as a distraction technique reduces the parent’s perception of their child’s pain and distress during immunizations. Study Design. A total of 103 parents completed a survey regarding their perception of their child’s pain during immunizations. Fifty-seven patients were in the group receiving no distraction intervention, and 46 patients were in the group that were allowed to use an iPad for distraction while receiving their vaccines. Results. Regression analysis showed that the use of iPad distraction significantly reduced the parent’s perception of their child’s level of anxiety, need for being held, and amount of crying during immunizations compared to no distraction. Conclusions. Distraction by using an iPad during immunizations reduces the parent’s perception of their child’s pain and distress. This type of distraction tool can also improve the parent’s satisfaction with the pain control provided for their child while receiving their vaccines.

Case reports are a time-honored medical tradition, and much of what we know in practice today can be traced back to individual case studies. Vandenbroucke pro-poses the potential roles of case reports include recogni-tion and description of new diseases, detection of drug side effects, study of disease mechanisms, medical edu-cation and audit, and recognition of rare manifestations of disease; and his editorial in

Background: Case reports (CRs) can be valuable contributions to medical knowledge and education. Objective assessments of publication potential and content recommendations for pediatric CRs are lacking. Methods: The “Instructions to Authors” provided by pediatric journals were assessed to determine journal characteristics, manuscript restrictions, and advice to writers. Pediatric journals referenced in the National Center for Biotechnology Information databases were identified by using the search term “pediatric.” Further inclusion criteria were: active journals; currently indexed in the PubMed, Ovid, and/or Medline databases; and English as the primary language. Results: Sixty-nine (52%) of 132 pediatric journals surveyed published CRs per their author instructions. The median 2011 impact factor for accepting journals was 1.28 (range: 0.47–5.44) compared with 2.40 (range: 0.59–5.50) for journals that did not publish CRs (P < .001). Twelve (67%) of 18 pediatric surgical specialty journals, 16 (55%) of 29 general pediatric journals, and 38 (51%) of 74 nonsurgical pediatric subspecialty journals published CRs. Sixteen journals had a separate Images section. Twenty-five (36%) of 69 journals provided no recommendations. Of the 44 journals that did provide recommendations, new insights/observations (64%) was the most common content recommendation, followed by clinical relevance (41%), novelty/rarity (39%), and instructive/educational value (32%). Conclusions: Approximately one-half of pediatric journals surveyed published CRs per their author instructions. Journals with lower impact factors were more likely to publish CRs. Many journals had specific formatting criteria. New insights and observations regarding relatively known pathology was the content criteria most often recommended.

Principal Investigator: Ramzan Shahid M.D. Co-Investigators: Kaitlyn Schneck, M.D. and Clare Zimmerman M.D. ABSTRACT BACKGROUND: Late preterm infants are at increased risk for mortality and morbidity during birth hospitalization. During the first month after birth, late preterm infants are more likely than term infants to be re-hospitalized. Most research has focused on comparing clinical outcomes of late preterm infants versus term infants. Limited studies have looked at ways to reduce the re-hospitalization and ED visit rates of …

One reason that the central nervous system of adult mammals does not regenerate after injury is that neurotrophic factors are present only in low concentrations in these tissues. Recent studies have shown that the application of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) acts to encourage the regrowth of motor and sensory fibers after spinal cord injury. Other studies have reported that the regrowth of axons after injury was enhanced by the implantation of Schwann cells, which normally secrete BDNF and NT-3. The purpose of the present study was to genetically modify Schwann cells to secrete increased amounts of BDNF or NT-3 by infection with a retroviral vector. Retroviral vectors were constructed by the ligation of BDNF or NT-3 cDNA to the LXSN vector. Viruses were generated from the plasmid forms of the vectors by transient transfection of PA317 amphotrophic retroviral packaging cells. Viruses were harvested and used to infect the human Schwann cell line designated NF-1T. Northern blot analysis of poly (A+) RNA prepared from Schwann cells that were infected with BDNF- or NT-3-containing virus showed the presence of BDNF or NT-3 mRNA. An enzyme-linked immunosorbent assay (ELISA) for BDNF and NT-3 was performed on media the cells were grown in, and on cellular extracts prepared from the BDNF- and NT-3-infected Schwann cells. The ELISA results demonstrated that the Schwann cells were secreting increased levels of immunologically active BDNF or NT-3. Immunocytochemical staining of these cells revealed the presence of these two neurotrophic factors located in perinuclear granules. These neurotrophic factor-secreting Schwann cells are currently being evaluated for their efficacy in the treatment of spinal cord injury.

Objective The purpose of this study was to determine the baseline emotional intelligence (EI) scores of Pediatric and Med-Peds Residents and to identify components of emotional intelligence that were high or low. Methods Residents from Pediatrics and Med-Peds residency programs at a university-based training program volunteered to complete an online self-report EI survey (EQ-i 2.0) in May 2015. A summary EI score report was generated for each resident by a consulting firm. De-identified score reports were compared between programs and by year of training. Results All pediatric and med-peds residents completed the survey (N=47). The median score for the group as a whole for overall emotional intelligence was higher than the national average and considered to be in the high range (110). The highest median subcomponent scores were in Impulse Control (114) and Empathy (113) and the lowest subcomponent scores were in Independence (101) and Assertiveness (102). No difference was seen between pediatric residents and medicine-pediatric residents in their total EI scores or the various components. Residents in their early years of training (PGY 1-2) compared to later years of training (PGY 3-4) showed significant differences in the component of Assertiveness (100 vs 109, p=0.002) and Empathy (115.5 vs 110, p=0.03). Conclusions As a group, Pediatric and Med-Peds residents scored lowest in areas of independence and assertiveness. While assertiveness scores improved with added years of training, empathy scores decreased. In order to improve the overall level of emotional intelligence of Pediatric and Med-Peds residents, educational interventions should focus on the areas of independence, assertiveness, and empathy.

(1) To determine whether infants born to O+ mothers who had selective cord-blood testing would have higher rates of clinically significant hyperbilirubinemia compared with those newborns who had routine cord-blood testing. (2) To determine the amount of cost savings by implementing a policy of selective cord-blood testing in newborns born to O+ mothers. We conducted a retrospective pre/post intervention chart review on all infants in the normal newborn nursery at Loyola, born to blood type O+ women between 1 April 2008 and 1 April 2009. The pre-intervention group (routine testing) included infants born within 6 months before implementation of a new policy. The post-intervention group (selective testing) included infants born within 6 months following the implementation of a new policy. Data were collected for each of these groups regarding clinically significant hyperbilirubinemia. All 250 of the infants in the routine testing group had a cord-blood type and Coombs done, whereas 42 of 164 (25%) infants in the selective group had testing done. By the end of the 6 months following the policy change, only 8% of infants were undergoing cord testing. When comparing routine vs selective testing, there was no statistically significant difference in the 24-h serum bilirubin, rate of phototherapy during the birth hospitalization, rate of readmission for hyperbilirubinemia or peak serum bilirubin level at readmission. The 92% reduction of cord-blood typing and Coombs testing would lead to a cost saving of $4100 per year to our hospital and $18 900 per year to our patients, and 95 h per year of technician time to perform these tests. When extrapolated to Illinois births in 2008, this would lead to an annual cost saving of almost $800 000 to Illinois hospitals and about $3.6 million to patients. Selective newborn cord testing of infants born to O+ mothers can decrease the use of resources and costs without increasing the risk of clinically significant hyperbilirubinemia.

Three isoforms of the alpha subunit of (Na,K)-ATPase have been identified in the rat central nervous system. Using a probe specific for the alpha 1 isoform, mRNA levels were measured from five sections of the rat spinal cord using slot blot techniques. Assigning a value of 1 to the slope obtained from the cervical section, the upper thoracic section was 2.6 times higher; the midthoracic section was 4.5 times higher; the lower thoracic section was 2.6 times higher; and the lumbar section was 1.7 times higher. The results suggest that alpha 1 isoform mRNA levels are not uniform throughout the spinal cord. In situ hybridization techniques showed that alpha 1 isoform mRNA was diffusely abundant in glial and central canal ependymal cells, while labeled neurons were localized exclusively in laterally located anterior horn neurons in cervical, thoracic, and lumbar segments and in ventromedial neurons in mid-thoracic spinal cord. Also, dorsal root ganglia neurons were extensively labeled at all segments.

Only two cases of juvenile xanthogranuloma of the larynx have been previously reported in the literature. We report a new case, which occurred in an 18-month-old girl. The patient was brought to us for treatment of stridor and respiratory distress. During examination, she was found to have a subglottic mass. The lesion was treated with laser microlaryngoscopy, which relieved the patient's respiratory distress and obviated the need for tracheotomy. Pathologic examination of the mass revealed that it was consistent with a juvenile xanthogranuloma. Juvenile xanthogranuloma is generally a benign and self-limiting disease, but complications can occur when the space that the tumor occupies causes functional impairment.