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Researchers explore future economic and climate scenarios using global economic and integrated assessment models to understand long-term interactions between human development and global environmental changes. However, differences in trade modeling approaches are an important source of uncertainty in these types of assessments, particularly for regional projections. In this study, we modified the Global Change Analysis Model (GCAM) to include a novel logit-based Armington trade structure, to examine two approaches to modeling trade: (1) an approach that represents segmented regional markets (SRM), and (2) an approach that represents integrated world markets (IWM). Our results demonstrate that assuming IWM, i.e., homogeneous product modeling and neglecting economic geography, could lead to lower cropland use (i.e., by 115 million hectares globally) and terrestrial carbon fluxes (i.e., by 25%) by the end of the century under the default GCAM scenario, compared with the logit-based Armington SRM structure. The results are highly heterogeneous across regions, with more pronounced regional trade responses driven by global market integration. Our study highlights the critical role that assumptions about future trade paradigms play in global economic and integrated assessment modeling. The results imply that closer harmonization of trade modeling approaches and trade parameter values could increase the convergence of regional results among models in model intercomparison studies.

Purpose of review Sinusitis is an illness that is often successfully treated by primary care physicians. Recurrent or chronic rhinosinusitis, however, can be frustrating for patients as well as primary care and subspecialty providers. The present review details the approach to recurrent or chronic sinusitis. We give a broad overview of the workup of chronic rhinosinusitis, focusing on immune deficiency, an often overlooked but clinically important aspect of the sinusitis workup. Recent findings Immune deficiency is prevalent in patients with recurrent or chronic sinus disease. An immunologic workup, as well as a workup for other chronic treatable diseases, should be undertaken before sinus surgery or in patients who have been unresponsive to surgery. This approach can enhance visualization during surgery, minimize postoperative complications, improve surgical outcomes, and possibly obviate the need for surgery altogether. Summary Elucidating the cause of recurrent or refractory sinus disease can be challenging. Allergic disease should be evaluated and treated early in the process. An immunologic evaluation should be performed and uncommon causes of sinus inflammation should be addressed later in the course to reduce inflammation either to avoid surgery or improve surgical outcomes.

Long QT syndrome can present with neurological manifestations, including syncope and seizure-like activity. These patients often receive an initial neurologic evaluation, including electroencephalography (EEG). Our previous retrospective study suggested an increased prevalence of prolonged corrected QT interval (QTc) measured during the EEG of patients with syncope. The aim of the current study is to assess the accuracy of the EEG QTc reading compared with the nonsimultaneous 12-lead electrocardiography (ECG) in children with syncope. Abnormal QTc was defined as ≥450 ms in boys, ≥460 ms in girls. Forty-two children were included. There was no significant correlation between QTc readings in the EEG and ECG. EEG failed to identify 2 children with prolonged QTc in the ECG and overestimated the QTc in 3 children with normal QTc in the ECG. This study suggests that interpretation of the QTc segment during an EEG is limited. Further studies with simultaneous EEG and 12-lead ECG are warranted.

The object of this study is to quantify the very low frequency (i.e., −β. The peak magnitude squared of the coherence near 0.4 Hz was 0.82 ± 0.08, but the apparent linear coherence fell off quickly at lower frequencies so that it was close to zero for frequencies