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Telehealth services complement in-person neurologic care. The American Academy of Neurology supports patient access to telehealth services regardless of location, coverage for telehealth services by all subscriber benefits and insurance, equitable provider reimbursement, simplified state licensing requirements easing access to virtual care, and expanding telehealth research and quality initiatives. The roles and responsibilities of providers should be clearly delineated in telehealth service models.

Parking Management Units (PMU) at the vast majority of university campuses in the United States represent a self-sustaining auxiliary unit. Given the decline in state financial support for many higher education institutions, PMUs are increasingly being pressured to maximize revenue while at the same time managing what is very often perceived by users as a public good. Maximization of revenue requires a clear understanding of price sensitivity across target markets. This is especially true in instances where substitutable products offered by a single purveyor exist, such as different types of parking permits offered by a single institution. The primary objective of this research is to assess the price sensitivity of various target markets with respect to university parking at a mid-sized, state-funded university located in the Inland Northwest of the United States (University of Idaho). Utilizing data collected from a conjoint survey of administrators, faculty, staff, and students, price sensitivity is assessed by estimating the demand function for various types of parking permits. Furthermore, the degree of substitutability between various permits types is evaluated by calculating cross-price elasticity of demand. Results from this research can provide managers with insight regarding the pricing dynamics in a university parking setting and allow for more efficient pricing of parking permits. Keywords: campus parking, conjoint analysis, higher education, pricing strategy, INTRODUCTION Campus parking has long been a pressing issue for universities, both domestically and internationally (Bennett, 1956, 1958; Forman, 1971; Meng, Du, Li, & Wong, 2018; Mooney, 1993; Narragon, Dessouky, [...]

Neuromuscular ultrasound has become an integral part of the diagnostic workup of neuromuscular disorders at many centers. Despite its growing utility, uniform standard scanning techniques do not currently exist. Scanning approaches for similar diseases vary in the literature creating heterogeneity in the studies as reported in several meta‐analysis. Moreover, neuromuscular ultrasound experts including the group in this study have different views with regards to technical aspects, scanning protocols, and the parameters that should be assessed. Establishing standardized neuromuscular scanning protocols is essential for the development of the subspeciality to ensure uniform clinical and research practices. Therefore, we aimed to recommend consensus‐based standardized scanning techniques and protocols for common neuromuscular disorders using the Delphi approach. A panel of 17 experts participated in the study, which consisted of three consecutive electronic surveys. The first survey included voting on six scanning protocols addressing the general scanning technique and five common categories of suspected neuromuscular disorders. The subsequent surveys focused on refining the protocols and voting on new steps, rephrased statements, or areas of non‐agreement. A high degree of consensus was achieved on the general neuromuscular ultrasound scanning technique and the scanning protocols for focal mononeuropathies, brachial plexopathies, polyneuropathies, amyotophic lateral sclerosis, and muscle diseases. In this study, a group of neuromuscular ultrasound experts developed six consensus‐based neuromuscular ultrasound scanning protocols that may serve as references for clinicians and researchers. The standardized protocols could also aid in achieving high‐quality uniform neuromuscular ultrasound practices. See Editorial on pages 341–344 in this issue. [ABSTRACT FROM AUTHOR]

Smoke from forest fires is a serious and increasing land management concern. However, a paucity of information exists that is specific to public perceptions of smoke. This study used conjoint analysis, a multivariate technique, to evaluate how four situational factors (i.e., smoke origin, smoke duration, health impact, and advanced warning) influence public tolerance of smoke in the northern Rocky Mountains and south-central United States. Separate analyses were performed for subgroups, based on community type, level of fire preparedness, demographics, and smoke experience, to explore potential differences among managerially relevant populations. Origin of the smoke and advanced public warning were commonly the most important factors influencing public tolerance of smoke. A comparison of our conjoint approach with a univariate rating technique is also discussed. Findings from this research will help fire managers understand public tolerance of smoke from forest fires, inform forest management, and enhance public communication strategies. Key words: tolerance, preference, warning, fire, public, health. La fumee produite par les feux de foret est une preoccupation serieuse et grandissante en amenagement du territoire. Cependant, il existe peu d'information specifique au sujet de la perception de la fumee par le public. Dans cette etude nous avons eu recours a l'analyse conjointe, une technique d'analyse multivariee, pour evaluer de quelle facon quatre facteurs conjoncturels (c.-a-d. origine de la fumee, duree de la fumee, impact sur la sante et alertes precoces) influencent la tolerance du public a la fumee dans les Rocheuses du Nord et le centre-sud des Etats-Unis. Des analyses distinctes ont ete effectuees pour des sousgroupes sur la base du type de communaute, de l'etat de preparation en cas de feu, des caracteristiques demographiques et de l'experience face a la fumee pour explorer les differences potentielles parmi les populations pertinentes du point de vue de l'amenagement. L'origine de la fumee et les alertes precoces etaient communement les facteurs qui influencaient le plus la tolerance du public a la fumee. Une comparaison de notre approche conjointe avec la technique de cotation univariee fait egalement l'objet d'une discussion. Les resultats de cette etude aideront les gestionnaires du feu a comprendre la tolerance du public a la fumee produite par les feux de foret, a informer les amenagistes forestiers et a ameliorer les strategies de communication avec le public. [Traduit par la Redaction] Mots-cles: tolerance, preference, avertissement, feu, public, sante., Introduction Smoke from forest fires can result in public controversy and impair forest management when it disperses over residential, commercial, recreational, and transportation areas. Many North Americans are experiencing impacts [...]

This study uses the Engle-Granger cointegration method to examine the correlation relationship among prices of North American softwood lumber species, wood-based panel prices, and US single-family housing starts. The methodology employed is identical to that used by US petitioners in the latest round of the Canada--United States softwood lumber trade dispute, whereby petitioners argued that all North American species of softwood lumber were considered to be nearly perfect substitutes for one another. Tests for nonstationarity using the augmented Dickey-Fuller unit root test, as well as our cointegration results, confirm petitioners' results. We find evidence of a long-term cointegrating relationship among the prices of North American softwood lumber species. However, we found no clear evidence of nearly perfect substitutability among different North American softwood lumber species. Additional analysis reveals that a long-run equilibrium relationship also exists between North American softwood lumber species and four types of wood-based panel products, as well as US single-family housing starts. Given that the price movements of different wood-based panel products and single-family housing starts are highly correlated with the price movement of North American softwood lumber species, we fail to conclude that North American softwood lumber species can be claimed as nearly perfect substitutes. Furthermore, we find that the petitioners' analysis is deficient in that it does not account for the fact that cointegration in prices among North American species of softwood lumber can be caused by common demand-side factors, such as residential construction activity. Ce travail utilise la methode de co-integration de Engler-Granger pour etudier la relation de correlation entre le prix des differentes especes nord-americaines de bois d'ceuvre resineux, le prix des panneaux derives du bois et les mises en chantier de maisons unifamiliales aux Etats-Unis. La methodologie utilisee est identique a celle des requerants americains lors des dernieres negociations dans le differend entre le Canada et les Etats-Unis an sujet du bois d'ceuvre resineux. Les requerants americains soutenaient que toutes les especes nord-americaines de bois d'ceuvre pouvaient etre considerees comme des substituts presque parfaits. Nous avons des indices qu'il y a une relation de co-integration a long terme entre le prix des especes nord-americaines de bois d'ceuvre resineux. D'autres analyses revelent qu'il existe un equilibre a long terme entre les especes nord-americaines de bois d'ceuvre resineux et quatre types de panneaux derives du bois, de meme qu' avec les mises en chantier de maisons unifamiliales aux Etats-Unis. Etant donne que les fluctuations du prix de differents panneaux derives du bois et les mises en chantier de maisons unifamiliales aux Etats-Unis sont etroitement correlees avec les fluctuations du prix des especes nord-americaines de bois d'ceuvre resineux, nous arrivons a la conclusion que les differentes especes nord-americaines de bois d'ceuvre resineux ne peuvent etre considerees comme des substituts presque parfaits. De plus, nous constatons que 'analyse des requerants americains est incomplete parce qu'elle ne tient pas compte du fait que la co-integration des prix chez les especes nord-americaines de bois d'ceuvre resineux pent etre due a des facteurs couramment associes a la demande tels que l' activity dans le secteur de la construction residentielle. [Traduit par la Redaction], Introduction The United States is the world's largest producer of industrial wood products, manufacturing approximately 34.52 x [10.sup.9] board feet (1000 board feet = 2.36 [m.sup.3]) of softwood lumber in [...]

Abstract: Using a mail questionnaire targeted at 500 softwood sawmills in the United States and Canada, firm innovativeness was assessed using three methods: (1) current technology, (2) self-evaluation, and (3) [...]

Over the past 20 years, four significant and contentious softwood lumber trade disputes have taken place between the United States and Canada. The US International Trade Commission (USITC), relying on aggregate market assessments using elasticity of demand estimation and cointegration methods, has ruled that all North American softwood lumber species are perfectly fungible. The objective of this study is to disaggregate the US softwood lumber market by estimating cross-price elasticity of demand for North American softwood lumber species and species groups in three major end-use markets (floor framing, roof framing, and wall framing products) using a discrete choice preference model. Specifically, this study utilizes a choice-based conjoint model to estimate species and species group preferences, market shares, and price-demand relationships for North American softwood lumber. Research results are compared with published aggregate market cross-price elasticity of demand estimates, such as those relied upon by USITC, to determine whether North American softwood lumber species and species groups are perfectly fungible in the three largest softwood lumber end-use markets. Results demonstrate that distinct differences exist in the substitutability between North American species and species groups of softwood lumber. The results provide notable implications in future USITC trade analyses of the US- Canadian softwood lumber trade issue. Au cours des 20 dernieres annees, quatre litiges importants et controverses entre les Etats-Unis et le Canada sont survenus au sujet du commerce du bois d'oeuvre resineux. La Commission du commerce international des Etats- Unis (USITC), s'appuyant sur l'estimation de l'elasticite de la demande du marche global et des methodes de cointegration, a etabli que les essences de bois resineux nord-americain etaient parfaitement substituables. L'objectif de cette etude est de desagreger le marche americain du bois de sciage resineux en estimant les elasticites-prix croisees de la demande pour les essences de bois d'oeuvre resineux nord-americain et les groupes d'essences dans trois marches importants de produits finis (charpentes de plancher, de toiture et des murs) a l'aide d'un modele des choix discrets. Specifiquement, cette etude utilise un modele conjoint base sur les choix pour estimer les preferences des essences et des groupes d'essences, les parts de marche et la relation entre le prix et la demande pour le bois d'oeuvre resineux nord-americain. Les resultats de la recherche sont compares a d'autres estimations des elasticites-prix croisees de la demande, telles que celles qui ont [Traduit par la Redaction], Introduction The United States represents Canada's largest bilateral trade partner, with one of Canada's most important exports to the United States being softwood lumber. According to the Canadian Department of [...]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1552-6569.2006.00061.x Byline: Steven J. Shook (1), Rishi Gupta (1), Nirav A. Vora (1), Andrew L. Tievsky (1), Irene Katzan (1), Derk W. Krieger (1) Keywords: Brain ischemia; cerebrovascular accident; diffusion magnetic resonance imaging; hydroxymethylglutaryl (HMG)-CoA reductase inhibitors; retrospective studies; risk factors; treatment outcome Abstract: ABSTRACT Background. Studies have shown an association between HMG-CoA reductase inhibitors (statins) and improved stroke outcomes, possibly secondary to neuroprotective properties. Objective. To assess whether patients taking statins prior to ischemic stroke have smaller infarcts on magnetic resonance imaging (MRI), adjusting for other relevant clinical factors. Design. We retrospectively reviewed the Cleveland Clinic Foundation (CCF) Neurology Inpatient Database from June 2002 through June 2004. Demographics, medications, stroke subtype, diffusion-weighted imaging (DWI) infarct volume, admission NIHSS, and hours to MRI were collected. Patients with a nonlacunar middle cerebral artery (MCA) territory infarct and MRI less than 48 hours from symptom onset were included (n= 143). A multivariable linear regression model was constructed to determine independent predictors of smaller infarct volume. Results. A total of 143 patients were studied, including 38 patients taking statins at the time of their stroke. In univariate analysis, patients using statins were significantly more likely to have a history of hyperlipidemia, atrial fibrillation, and coronary artery disease and to be using coumadin, antiplatelet drugs, and angiotensin-converting enzyme inhibitors. Patients on statins had a tendency toward smaller infarcts in univariate analysis (median 25.4 cm.sup.3 vs. 15.5 cm.sup.3, P= 0.054). In multivariable linear regression analysis statin use, patient age, and TIA within the prior 4 weeks were independently associated with smaller DWI volumes; vessel occlusion on vascular imaging, and cardioembolic stroke subtype with larger infarct size. Conclusions. Statin use prior to the onset of nonlacunar MCA infarction was associated with a smaller infarct volume independent of other factors. Further studies utilizing both clinical and radiologic outcomes will be required to confirm these findings. Author Affiliation: (1)From the Department of Neurology, The Cleveland Clinic Foundation, Cleveland, OH (SS); Department of Neurology, Section of Stroke and Neurocritical Care, Cleveland, OH (NV, IK, DK); Department of Neurology, Stroke Institute, University of Pittsburgh Medical Center, Pittsburgh, PA (NV); and Department of Radiology, Section of Neuroradiology, Cleveland, OH (AT), Department of Neurology, Division of Cerebrovasoular Diseases and Neuroendovascular Services, Michigan State University, East Lansing, MI (RG). Article History: Received March 14, 2006, and in revised form July 19, 2006. Accepted for publication July 25, 2006. Article note: Address correspondence to Derk W. Krieger, MD, PhD, Department of Neurology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, S-90, Cleveland, OH 44195. E-mail: krieged@ccf.org.

The SerH locus of Tetrahymena thermophila is one of several paralogous loci with genes encoding variants of the major cell surface protein known as the immobilization antigen (i-ag). The locus is highly polymorphic, raising questions concerning functional equivalency and selective forces acting on its multiple alleles. Here, we compare the sequences and expression of SerH1, SerH3, SerH4, SerH5, and SerH6. The precursor i-ags are highly similar. They are rich in alanine, serine, threonine, and cysteine and they share nearly identical ER translocation and GPI addition signals. The locations of the 39 cysteines are highly conserved, particularly in the 3.5 central, imperfect tandem repeats in which 8 periodic cysteines punctuate alternating short and long stretches of amino acids. Hydrophobicity patterns are also conserved. Nevertheless, amino acid sequence identity is low, ranging from 60.7 to 82.9%. At the nucleotide level, from 9.7 to 26.7% of nucleotide sites are polymorphic in pairwise comparisons. Expression of each allele is regulated by temperature-sensitive mRNA stability. H mRNAs are stable at 36 [degrees]. The H5 mRNA, which is less affected by temperature, has a different arrangement of the putative mRNA destabilization motif AUUUA. Statistical analysis of SerH genes indicates that the multiple alleles are neutral. Significantly low ratios of the rates of nonsynonymous to synonymous amino acid substitutions suggest that the multiple alleles are subject to purifying (negative) selection enforcing constraints on structure.

Introduction/Aims: The purpose of this literature review is to develop an evidence‐based guideline for the use of neuromuscular ultrasound in the diagnosis of ulnar neuropathy at the elbow (UNE). The proposed research question was: "In patients with suspected UNE, does ulnar nerve enlargement as measured with ultrasound accurately identify those patients with UNE?" Methods: A systematic review and meta‐analysis was performed, and studies were classified according to American Academy of Neurology criteria for rating articles for diagnostic accuracy. Results: Based on Class I evidence in four studies, it is probable that neuromuscular ultrasound measurement of the ulnar nerve at the elbow, either of diameter or cross‐sectional area (CSA), is accurate for the diagnosis of UNE. Recommendation For patients with symptoms and signs suggestive of ulnar neuropathy, clinicians should offer ultrasonographic measurement of ulnar nerve cross‐sectional area or diameter to confirm the diagnosis and localize the site of compression (Level B). [ABSTRACT FROM AUTHOR]