Brain Wave Genereation :: essays research papers

Theory behind BrainWave Generator EEG and the brain's state EEG (Electroencephalography) technology is used to measure brain's electrical vibrations from the surface of the scalp. The resulting EEG pattern will contain frequency elements mainly below 30Hz. The frequencies are categorized into four states as follows: State Frequency range Amplitude State of mind Delta 0.5Hz - 4Hz high (up to 200uV) Deep sleep Theta 4Hz - 8Hz low (5uV - 20uV) Drowsiness (also first stage of sleep) Alpha 8Hz - 14Hz high (up to 200uV) Relaxed but alert Beta 14Hz - 30Hz low (less than 10uV) Highly alert and focused The dominant frequency in the EEG pattern determines what shall be called the current state of the brain. If the amplitude of the alpha range frequencies is highest, then the brain is said to be in the alpha stage. Note, that other frequencies still exist and it is impossible to give any "exact frequency your brain is operating on". However, later references to the brain states use the simplification of assuming that such a single frequency exists. Entraining the brain to a desired state If external stimulus is applied to the brain, it becomes possible to entrain the brain frequency from one stage to another. For example, if a person is in beta stage (highly alert) and a stimulus of 10Hz is applied to his/her brain for some time, the brain frequency is likely to change towards the applied stimulus. The effect will be relaxing to the person. This phenomenon is also called frequency following response. When the brain's state is close to the applied stimulus, entrainment works more efficiently. Thus, when doing a sweep from one frequency to another, the starting frequency should be as close to your current brain state as possible. The sweep speed should be such that your brain's state changes steadily with it, so that the difference never gets very large. In practice, it is difficult to determine your brain state without extra equipment (like EEG devices). However, you can quite safely assume that during the day your brain is in the beta stage (about 20Hz) and you can start the sweep from there. If you are already somewhat relaxed, you can use a start frequency of 15Hz or a few Hz lower. Stimulating the brain with binaural beat frequencies The easiest way of applying stimulus to the brain is via ears. Other senses could be used as well, and vision is actually used quite often (often in addition to hearing).

Memory Cost Essay

Over the past 30 years the cost of Electronics has steadily decreased. The cost of electronic storage has decreased greatly over the past 30 years as well. In this paper I will be talking about the decrease in the cost of RAM and Hard Drive Storage, how much will a 100TB HDD will cost when it becomes widely available in the future, and how much memory I will be able to buy with $100 in 10 years. In 1956, IBM created the first commercial Hard Drive called the IBM 305 RAMAC which held 5MB and cost a whopping 50 thousand dollars! Electronic storage started being more widespread during the early 1980’s, but it wasn’t until the 1990s that RAM and Hard Drive Storage begin to be cheap enough for the average person. Back in 1981 the price for one MB of Hard Drive storage space was $340! Most people couldn’t afford a computer back in the 1980’s because of the huge cost. Through the 1980’s the cost per MB fell from around $340 during 1981 then to $40 per MB i n 1988, and finally to $9 per MB in 1990. The cost of one Bit of ram in 1981 was 0.000425 cents, in 1988 it was 0.000005 cents, in 1995 it was 0.000000158 cents, in 2000 the cost per Bit was 0.000000063, and in 2013 the cost per Bit was 7.9Ãâ€"10^-10 cents. To get an understanding of how much memory will cost in the future and when 100TB hard drives will become commercially available, we have to take a look at how the price for memory has gotten cheaper over the past 10-30 years, the ever increasing amount of storage space that can be squeezed onto a hard drive platter, and take in to account the rapid growth in the technology field. According to Chris Mellor in his article (http://www.theregister.co.uk/2013/11/01/hp_memristor_2018/) technology giant HP announced that 100TB hard drives could be available as early as 2018. I firmly believe that in 4 years by 2018 there will be 100TB drives for sale to the public but they will probably be very expensive till they go into mass production. In 10 years, we will be able to buy a hard drive with a phenomenal amount of storage space. From 1990 to  2014 the price has gone down exponentially from $9 per MB to under 150 MB per Cent! If we follow that exponential trend we are looking at hard drives that can hold over 100TB that cost fewer than 100 dollars, while the RAM will decrease in price slower. In conclusion, the cost of Storage such as RAM and Hard Drives has gotten very cheap, from over $500 per MB to 5 cents per GB! We will see a continual decrease in the cost of electronic storage and an increase in the amount of storage in smaller packages. Picture Citation: http://www.aei.org/publication/chart-of-the-day-the-falling-price-of-memory/ Citations http://ns1758.ca/winch/winchest.html http://www.theregister.co.uk/2013/11/01/hp_memristor_2018/ http://www.jcmit.com/memoryprice.htm

A Christian At The Age Of 14 - 1409 Words

Author Information: (see attached resume for additional information) I became a Christian at the age of 14, partly as a result of being taught evolution in public school. Learning about evolution made me very unsettled. I reasoned that if evolution were true, then my life was a result of a series of random accidents and therefore my life had no purpose. I heard a clear gospel presentation and trusted Christ as my savior as a freshman in high school. Since that time, I have had an avid interest in the scientific evidence that proves the biblical creation account true and evolution false. I worked for 35 plus years as a hydrologist with the U.S. Geological Survey (USGS). Initially, as a research hydrologist studying the quantity and quality of river water. I later moved into water science management positions and lastly served as an executive responsible for the all the surface-water related activities of the USGS in the U.S.A. As an executive, I was also designated as the Delaware River Master. As River Master, I administered the provisions of the 1954 U.S. Supreme Court Decree allocating the waters of the Delaware River. My career with the USGS has provided me with a wealth of education and experience in all aspects fresh-water related science and science management. During my career with the USGS, I authored or co-authored about 40 scientific and lay reader reports, proceedings paper, and abstracts. Since becoming a Christian, I have had a keen interest in scientificShow MoreRelatedContemporary Christian Music Essay902 Words   |  4 Pagesin music. I went from contemporary Christian to listening to almost anything and everything. Now I listen to Christian metal, pop and rock. Contemporary Christian music now that I have discovered Christian metal and all the other genres of music sounds plain and boring I cannot stand to listen to it. Some Christian contemporary artists are Tobymac, Casting crowns, Tenth Avenue North, and Amy Grant. Some of the Christian metal bands are As I Lay dying, War of Ages, Bless the Fall, Becoming the ArchetypeRead MoreThe New Age Worldview842 Words   |  4 PagesNew Age Worldview There are many different types of worldviews in play during this day in age. One of the broadest indecisive worldviews is the New Age worldview. The New Age worldview ism to help individuals find their inner divinity. The New Age movement believes that we are all divine, therefore, we are all gods. This is great contrast with the Christian worldview who believe that there is only one true God. Although these two worldviews are very different when it comes down to â€Å"Who is God?†Read MorePresidential Debates : America s Tapestry Of Tradition1063 Words   |  5 Pagesbecome an honorable president. he must be a Christian, businessman, somewhat educated (especially in History), must be 35 years of age, a resident within the United States for 14 years, and a natural born Citizen, a term not defined in the Constitution. The lucky candidate must be a Christian because it is only through God that one can lead a nation into great prosperity. Just look at back in history when our country was once operated by Christian men. He/She must be a businessman becauseRead MoreHow Do Christians Respond When The Governing Authority Is Acting Contrary? Essay1375 Words   |  6 Pages Chapter 13 Summary: Paul continues to instruct Christians in how they should live. He begins by stating that Christians should respect and honor the governing authorities because they have been appointed by God. Also, Paul commands us to love one another. As he explains, all of the other commandments will be fulfilled by loving our neighbor. Therefore, â€Å"love is the fulfilling of the law† (13:10). Finally, Paul urges Christians to live in preparation for the day that Christ returns. ConstantlyRead MoreChristianity And The Patristic Period867 Words   |  4 Pagesits very nature since one could regard the patristic age as the authoritative or fatherly age towards Christianity. (McGrath 7) On another note, many scholars and writers had made beneficial contributions to Christianity during the patristic period, but only a few timelessly stick out for making differences that were able to change Christianity to how we perceive it in the modern world. Among the many changes that came during the pat ristic age, the most important were definitely the agreements onRead MoreNone660 Words   |  3 PagesHe may be with you forever; the Spirit of truth, whom the world cannot receive, because it does not behold Him or know Him, but you know Him because He abides with you, and will be in you. I will not leave you as orphans; I will come to you. (John 14:16-18) The Holy Spirit is not a vague, ethereal shadow, nor an impersonal force. He is a person equal in every way with God the Father and God the Son. He is considered to be the third member of the Godhead. Jesus said to His apostles... All authorityRead MoreThe Book Of Revelations Is Divided Into These Sections1081 Words   |  5 PagesThe Book of Revelations is divided into these sections: I. Prologue (1:1-3) II. Letters to the Churches of Asia (1:4-3:22) III. God and the Lamb in Heaven (4:1-5:14) IV. The Seven Seals, Trumpets, and Plagues, with Interludes (6:1-16:21) V. The Punishment of Babylon and the Destruction of Pagan Nations (17:1-20:15) VI. The New Creation (21:1-22:5) VII. Epilogue (22:6-21) (The New American Bible) The Book of Revelations is the last book of the Bible. It has several extravagant symbolisms, symbolicRead MoreThe Truth Within a Myth Essay example1177 Words   |  5 PagesGrail itself was not thoroughly explained. To Sir Thomas Malory the Grail was an object that would bring a kingdom together and promote peace. However, religious groups have other perspectives concerning the Grail. According to the most common Christian interpretations, the Holy Grail is a Chalice that touched Jesus lips during the Last Supper, and caught His blood while He was being crucified. During the crucifixion Joseph [of Arimathea] is said to have gathered the blood of the fallen ChristRead MoreWarrant The Term Elder 983 Words   |  4 Pagesâ€Å"begotten (John 1:14, 18; 3:16† and â€Å"born of God† (John 1:13; 1 John 3:9; 4:7; 5:1, 4, 18) C. Similar grammatical and stylistic structure. d. Common theme prominent in both booths such as, love, light, life, abide, darkness, eternal life, new commandment, the Word, beginning, believe 98 times in the gospel, nine times in the epistle, witness thirty eight times in the gospel, six times in the epistle. e. Evidence in both books that the author personally knew Jesus (1 John; 1:1-4 and 4:14). The author makesRead MoreTurning Men Into Fishing Is A Popular Past Time All Around The World1277 Words   |  6 Pagesworld. It has been around for many centuries, and has influenced and shaped many societies and cultures. One popular religion that fishing has a major impact on is Christianity. It is obvious that fishing is prominent in the Christian religion by looking at the famous Christian symbol, the Jesus fish. On many American cars one may find this very simple depiction of a fish on the back bumper. Another influence that fishing has in Christianity is the teachings in the bible. Many biblical stories are

THich Nhat Hanh The Creator of Engaged Buddhism Essay

Thich Nhat Hanh...The creator of engaged Buddism Thich Nhat Hanh is a Vietnamese monk and a peace activist. Thich or Thay in Vietnamese means teacher. He is an author of more than 100 books and was nominated for the nobel prize by Martin Luther King Jr. His life has since been dedicated to the work of inner transformation for the benefit of individuals and society. Nhat Hanh was born in the city of Quá º £ng Ngà £i in Central Vietnam in 1926. He was inspired to become a monk when he was seven. He saw the picture of the Buddha sitting on the grass with peace and a smile. He was impressed and had a desire to be like him. At first, his parents opposed his will because they believed that the life of a monk was difficult. When ordaining, Viemanese†¦show more content†¦In 1967, Dr. King gave a famous speech at the Riverside Church in New York City, his first to publicly question the U.S. involvement in Vietnam. It is what led Martin Luther King Jr. to nominate Nhat Hanh for a No bel Peace Prize in 1967. He said, â€Å"I do not personally know of anyone more worthy of [this prize] than this gentle monk from Vietnam. His ideas for peace, if applied, would build a monument to ecumenism, to world brotherhood, to humanity However, Although King had make a â€Å"strong requiest† to the prize committee, it was in sharp of Nobel traditions and protocol. The committee dicided to not make any award that year. Engaged Buddhism Thich Nhat Hanh combined a variety of traditional Zen teachings with the insights from Mahayana, methods from Theravada and ideas from Western psychology to offer a modern light on meditation practice. He was inspired to create Engaged Buddhism since he witnessed the suffering caused by the war and he wanted to practice Buddhism in a way that can bring help to the society. He became a leader for the Engaged Buddhism movement and promoted the individuals active role in creating changes. Engaged Buddhism means the way that people are applying knowledge and insights from dhrama teachings and meditation practice to the situation of social,

American Slavery Essay - 983 Words

Slavery, especially in America, has been an age old topic of riveting discussions. Specialist and other researchers have been digging around for countless years looking for answers to the many questions that such an activity provided. They have looked into the economics of slavery, slave demography, slave culture, slave treatment, and slave-owner ideology (p. ix). Despite slavery being a global issue, the main focus is always on American slavery. Peter Kolchin effectively illustrates in his book, American Slavery how slavery evolved alongside of historical controversy, the slave-owner relationship, how slavery changed over time, and how America compared to other slave nations around the world. Slavery evolved in many different ways†¦show more content†¦Such a dramatic switch as the one from indentured servants to slaves was not the only transformation in American slavery. Slaves underwent many integral changes as the years of servitude progressed. The slave-owner relat ionship directly represented how times changed for slaves while working. As they were brought over to America and were in culture shock, they were often treated like absolute dirt. The inferiority of slaves is illustrated as Kolchin states that â€Å"It was easy to look upon Africans in an instrumental manner: they were â€Å"savages† imported to work, and few planters expressed much interest in their lives, except for a lively concern with training them in that work or securing their obedience (p. 59).† As time progressed however, and less slaves were directly from Africa, the ideology towards slaves changed. Kolchin writes that â€Å"Slave owners were changing too: just as the slaves were becoming America-born, so, too, were the masters (p.59).† Slave owners started to look at slaves at as people instead of objects. This was a very monumental step in slavery. Slaves began to gain more freedoms from their masters. These freedoms included religious Sunda ys off, family visitations, and the ability to make money on the side. While some slaves were still met with the hardships of harsh southern slave owners beating them, as time went on, slaves became more ofShow MoreRelatedAmerican Slavery, American Freedom Essay1174 Words   |  5 PagesEdmund S. Morgan’s famous novel American Slavery, American Freedom was published by Norton in 1975, and since then has been a compelling scholarship in which he portrays how the first stages of America began to develop and prosper. Within his researched narrative, Morgan displays the question of how society with the influence of the leaders of the American Revolution, could have grown so devoted to human freedom while at the same time conformed to a system of labor that fully revoked human dignityRead MoreAmerican Slavery1079 Words   |  5 Pagespopulation increased. Planters turned to African slaves to replace the white servants, in this manner elevated the status of poor whites. There we re three structural changes: the decline of opportunity, the beginnings of natural increase, and the rise of slavery. By 1680 tobacco prices declined so much that planters earned barely enough income to recover their costs of production, and tobacco prices went below that level. But in 1740 the tobacco prices began to rise, however not having the tobacco boomRead MoreJustification of American Slavery2267 Words   |  10 Pagesearly 1600s, the majority of Indentured Servants were Native Americans. However, due to the increasing death toll of the Native American people as an result of European diseases. As a result, the percentage of indentured servants slowly shifted towards the African community as time progressed. At the time, colonialist had no problem justifying indentured servants into slavery. There were five major methods in justifying slavery. One of these methods was a biblical justification, referringRead MoreAmerican Slavery in 1600s 2755 Words   |  11 PagesAmerican Slavery Slavery became an established activity in America by 1600’s. The slaves were mostly to provide free and cheap labor. Apart from America, slavery was practiced in other parts of the world throughout history, and in fact it can be traced back to the time of the ancient civilization. With industrial revolution especially with the rise of sugar plantations, the slaves were used to grow sugar in the periods from 1100. This intensified between 1400 and 1500 when Portugal and Spain venturedRead MoreSlavery And The American Revolution2902 Words   |  12 PagesThat is the reason behind me choosing my topic on slavery in that era because it is such a wide and important topic with so much relevance and importance to creating the U.S. that we live in today not only building the foundation but creating the melting pot that the U.S. prides itself on. Within the body of this essay we will discussing many important topics on slavery including the Haitian Revolution, Brazil being the last co untry to abolish slavery, showing the difference between women and men slavesRead MoreSlavery And The American Dream1393 Words   |  6 PagesSlaves they are products of a lost mind and irresponsible love. Now when I say a slave I am not talking about someone who is the property of someone else that must obey his or her every command. I am talking about the slavery of the mind that has run like wild fire among the black community. However sad it may be, our own kind are making their children into slaves. There are few things that have had such an impact on making slaves as the topics that I am about to mention. Which all will take placeRead MoreSlavery And Circuses : The Development Of Race And American Slavery Essay1272 Words   |  6 PagesSlavery and Circuses: The Development of Race and American Slavery as a Result of Fabricated Class Divisions Imposed by the Jamestown Elite The rise of slavery in mid-seventeenth century Jamestown brought forth a new system of economic and political organization that reinforced not only the older class divisions, but also reinvigorated the already existent, but limited racial divide. From the beginning, the Virginia Company was incorporated on a disastrous union of these two forces. The failure toRead MoreSlavery : The African American Slavery2189 Words   |  9 PagesAPUSH - Steiker Period 6 Slavery 1775 - 1830 â€Å"Those who will not reason, are bigots, those who cannot, are fools, and those who dare not, are slaves, † said George Gordon Byron. Though slavery has never had a universal definition, one might describe it as the dependent labour by one person performed to another who is not of his or her family. It was thought to have come about after a dramatic labour shortage in particular areas or countries. In America, slavery has always been a highly debatedRead MoreSlavery And The Making Of American Capitalism1153 Words   |  5 PagesJose Arciga Robert Dean History 110 11.10.15 Essay Prompt The Half Has Never Been Told :Slavery and the making of American Capitalism Back when America was being shaped, tobacco was the main slave produced trade in the colonies. Plantations all across the south had a majority of the slaves from Africa brought here on ships. Forced to work for their slave owners. Tobacco wasn t the only booming business. Cotton soon came into the picture, the north was a more industrial economy, while the southRead MoreThe Hardship Of American Slavery1082 Words   |  5 PagesThe Hardship of American Slavery Jean-Jacques Rousseau once said, â€Å"Men are born free, but everywhere they are in chains.†(Mulder) Well it is the exact opposite, men are born in chains, and they will have to earn their freedom, because nothing is free in this world or there is no such thing as free lunch as they say. Bing dictionary defines the word slavery as â€Å"the state or condition of being held in involuntary servitude as the property of somebody else.† (Bing Dictionary) They were sold and purchased

The Negative Impact of Bilangual Education Free Essays

It is true that, fitting in and adapting to two different linguistic and cultural world can have lasting impacts on individuals, hence, Richard Rodriguez, in his book â€Å"Achievement of Desire†, addresses his struggles as a young boy, trying to adapt to a bilingual education and how that education alienated him from his uneducated Mexican parents. Additionally in the excerpts â€Å"How to Tame a Wild Tongue,† Gloria Anzaldua, while she mainly focuses on the language of â€Å"Mexican† people in different aspects, also mentions her strife as a bilingual student. Although these two stories are different in many ways but they both reflect the negative impact of living in the â€Å"borderlands†. We will write a custom essay sample on The Negative Impact of Bilangual Education or any similar topic only for you Order Now To better understand those cultural conflicts, it is essential to know exactly what the borderlands consist of and who spans there, but most importantly what they represent in this context. The concept of â€Å" the borderlands† informs â€Å"a variety of disciplines at the start of the twenty-first century, with many studies focusing on the boundaries where two or more disparate conceptual, social, or political entities overlap productively†(Ybarra, 1-3). However, Anzaldua’s idea of the borderlands as an active place where people can form their own identity and political resistance remains the most influential according to multiple respected scholars. Understanding the bioregional and ecological aspect of the US-Mexico borderlands, amplifies our knowledge of how colonization, exploitation, and racism impact the land and mostly the Chicanos. Furthermore, one can attribute the concept of borderlands with bilingual education with both English and Spanish being the two territories in question, as experienced by both Anzaldua and Rodriguez. In Anzaldua’s essay â€Å"How to Tame a Wild Tongue† she describes her early childhood struggles in school. One of her memories from elementary school was when she was speaking Spanish with her friends during recess, they would tell her â€Å"If you want to be American, speak ‘American’. If you don’t like it, go back to Mexico where you belong. †(Anzaldua 43). In this situation she is forced to be silent and not speak. Growing up, she was constantly told from many of her elders that she needed to speak better English, and sound more American. Anzaldua’s own mother was ashamed of the way that she spoke English, saying it sounded like a Mexican. She reflects on two speech classes that she was required to take with all other Chicano students that had only one purpose, to get rid of their accents. â€Å"In childhood we are told that our language is wrong. Repeated attacks on our native tongue diminish our sense of self. Until I can take pride in my language, I cannot take pride in myself. † (Anzaldua 45-46). Part of language includes culture identity. It is unfair for people to feel ashamed of their identity due to the way they speak. Your language is what keeps you connected to your homeland and you should not feel guilty for speaking it. One should not have to go through speech classes to correct a native accent; the accent is a part of your identity, it is part of who you are. You should not be ashamed to speak and express yourself, because you should never be judged on how you speak, but by the content of what you’re saying. From adolescence the dominants are imposing their degrading views on the subordinates. Many of the teachers that approached these students, telling them â€Å"if they want to speak Spanish go back to Mexico†, are making assumptions based on prejudice about the individuals. The constant degrading ultimately lowers their self-esteem, making it difficult for them to feel that they can overcome being a part of the subordinate group. Anzaldua however rebels against these comments. She seems hostile to the English language and to a culture that does not honor the Spanish language in general or various Spanish dialects in particular. Her general response is one of defiance, for example when she says that to attack an individual’s form of expression (in her case, speaking her Chicano Spanish dialect at school) with the intent to censor â€Å"is a violation of the First Amendment† (40). She makes it very clear that she is determined to be linguistically free despite English oppression â€Å"free to write bilingually and to switch linguistic codes without always having to translate† (41). She is determined always to have a â€Å"wild tongue. â€Å"She proves that it is okay to know more than one language and that by speaking Spanish it does not make her less of a person. It possible that she wrote her story partly in Spanish so that she could make a point that she was proud of her native language. Rodriguez suffers the same oppressions but reacted differently to them. If Rodriguez is hostile to the same culture, he does not seem to be hostile to either Spanish or English as such. Instead, he realizes that in American culture, where one language only and educational accomplishment are connected to social and material benefit, those who capture the power of language and education are more likely to obtain those benefits. But this comes at a price because obtaining those benefits usually force emotional and cultural separation from family members who lack language or educational accomplishments. Rodriguez himself admitted that â€Å"[he] cannot afford to admire his parents†¦He permits himself embarrassment at their lack of education. And to evade nostalgia for the life he has lost, he concentrates on the benefits education will bestow upon him† (Rodriguez, 15). Even Henry Staten, in his essay, remarks â€Å"how his education, which culminated in a Ph. D in English from Berkeley in 1976, gradually alienated him from his uneducated, Mexican-born parents† (Staten 8-10). In all, from both excerpts, we encounter the negative impact of bilingual education. â€Å"Rodriguez, for whom â€Å"monolingualism† in English becomes a strategy for success in U. S society, brings his personal experience to the political realm by promoting English as the sole language of public education in the U. S†¦Anzaldua, on the other hand, reflects her linguistic background with a fine toothed comb, un tangling the many strands of English and Spanish that coexist in their multilayered identity. (Ramsdell 12-16) The diversity within America is constantly growing, which in turn means American culture is frequently changing. With all of these new and foreign cultures migrating to the U. S, come many new languages. Generally, many believe that language is power, but yet, people are constantly being silenced because of their â€Å"broken English† and accent. While their politics differ widely, both Rodriguez and Anzaldua lives have been forever altered due to t heir linguistic affiliations, and most significantly by straddling on the â€Å"borderlands. † How to cite The Negative Impact of Bilangual Education, Papers

Determine Clinical Utility For Procalcitonin-Myassignmenthelp.Com

Question: Discuss About The Determine Clinical Utility For Procalcitonin? Answer: Introduction The reflective journal report is based on the article, Procalcitonin-guided diagnosis and antibiotic stewardship revisited (1). The article is the narrative review on the potential of the infection biomarker procalcitonin in infections other than the respiratory tract infections and sepsis. The aim of the article is to determine the clinical utility for procalcitonin or PCT in other infections such as Urinary tract infections, meningitis, and other superficial infections. The use of antibiotic treatment can be challenging for physicians due to ambiguity in using the conventional diagnostic markers such as C reactive protein and blood cultures in-patient suspected to have infection. The limitation pertains to the sensitivity and specificity (2). Antibiotic treatment for prolonged period has adverse consequences. In fifty per cent of the cases, the antimicrobial use has been found inappropriate and is unneeded in inpatient setting (3). It may lead to the antibiotic resistance and colla teral damage such asClostridiumdiffiicile-associated diarrhea. Recently, there is an increasing focus on the Procalcitonin, as an infection marker. Under normal circumstances it is produced by the thyroid C cells. However, in the case of bacterial infections, PCT is produced by many body tissues and it parallels to the severity of the inflammatory insult. Further, it is the prognostic indicator that the higher serum level of PCT is associated with the risk of mortality (2, 4). There is a growing body of literature on the use of PCT for the rationale use of the antibiotics. Thus, strong scientific evidence is needed to diagnose the bacteria infection using this marker, so that the antibiotic treatment can be reduced in duration when compared to other standard care. Thus, it is important to determine the efficacy of the PCT guided therapy. The benefits may include quick diagnosis, reduced hospital stay of patients even in severe sepsis and mortality (1, 3). If the clinical evidence is strong, the clinicians will be benefited. They can quickly diagnose the bacterial infections and treat on time, to prevent the clinical outcomes. The aim of the reflective journal is to summarise the selected journal article and critically evaluate the content of the research paper. Lastly, the overall summary is discussed based on the critically appraisal. Summary of article In the article by (1), the author has intended to update the clinicians on the new indications for PCT after the review published in 2011 indicating the use of prolactin in diagnosis and treatment of the lower respiratory tract infections and sepsis. This author of the article has performed a narrative review of the studies published in the period 2012-2013. The review includes various observational and interventional research and study designs. Most of the study designs selected were randomised control trials (RCT), RCT with real life (registry), meta-analysis of the RCTs, observational RCT of secondary analysis, only observational metaanalysis study, and only observational study. These chosen studies have investigated the use of the PCT in different types of infections and at different sites. The rationale for this narrative review is the inappropriate use of the antibiotics. With the emerging bacterial infections and antimicrobial resistance, there is an urgent call for intense ef forts to deal with the self-limiting nonbacterial and resolving diseases (5). There is a need of the one size fits all approach. This narrative review by (1) may add to the growing body of literature, highlighting a useful strategy for antibiotics treatment reduction. In the given article, pulmonary site, the infections covered are AECOPD, Asthma, bronchitis, community acquired immunity, and pulmonary fibrosis and upper respiratory infections. The infections related to heart studied are congestive heart failure, and endocarditis. The infections related to abdominal region covered are pancreatitis, appendicitis abdominal infections with peritonitis, and urinary tract infections. The blood related infections that are considered for determining the efficacy of PCT are Blood stream infection, Neutropenia and Severe sepsis/ shock. Some studies are included in the narrative review and deal with other infections such as arthritis, erysipelas, meningitis, and postoperative infections. Lastly, the article draws conclusion based on the results from different studies (1). Critical evaluation of the article The strength of the narrative paper is the flexibility of narratives (7). The author has focused on the broad picture of the Procalcitonin-guided diagnosis. The article has presented a comprehensive background on the chosen research area and the related gaps in this domain (1). The article contains wide range of relevant information on the Procalcitonin-guided diagnosis and its potential as infection biomarker. The strength of the study is the comprehensive details on the limitations of PCT (6). The interpretation of role of PCT is made carefully. The drawback of PCT related to suboptimal sensitivity and specificity was necessary to get idea of its clinical implication (1, 2). The literature review could have been presented in the article (1) precisely, instead of directly starting with the review (8). The article grabs the readers attention as it had clear question and focused on range of infections. The review has specified the type of the studies considered that makes easy for the readers to comprehend the methodology. It is the advantage of the study (9). However, the narrative review is limited due to lack of presentation of the search strategy, inclusion and exclusion criteria. Thus, it remains ambiguous if the researcher had personal contact with the experts (8, 10). It is not clear if all the relevant studies in the chosen time frame were considered or not. The quality of the studies chosen for narrative review does not seem to be assessed and there is no hint on the assessment of the methodological quality. This is the drawback of the study. Hence, the validity of the narrative review is doubtful although the findings address the clinical question to some extent (11). It is evident from the paper (1) that the PCT is promising in reducing the antibiotic exposure. Thus, it will be highly beneficial for the patients suffering from the critically ill sepsis, UTIs, acute heart failure, meningitis, postoperative infections and other infections. If the antibiotics treatment can be reduced with PCT, it is added an advantage (12). Highlighting this aspect is the strength of the article. The most interesting finding was the antibiotic stewardship (for respiratory infection and sepsis) by monitoring PCT kinetics. It resulted in the shorter antibiotic treatment duration in case of other infections (2). The emphasis on the PCT kinetics for antibiotic stewardship for severe infections appeared to be the effective strategy to decrease the mortality due to short duration of the antibiotic treatment by early cessation of therapy. Highlighting these findings has positive clinical implications (1). This proves to be of prognostic value related to disease severity (1 2). The results are overall combined in a systemic manner, including all the studies selected. Different infections and the role of PCT in diagnosis and treatment are well presented under individual subheadings (13). The heterogeneity of the results are however, not considered by the author (14). The reviewer does not mention the other parameters related to the PCT evaluation such as odd ratio, relative risk, or p-value. It is not clear, if it was not mentioned or if it is not applicable to this review. Thus, the presentation of the results is descriptive. The tabular representation of the PCT cut off is mentioned among other parameters (15). The strength of the results section comes from the various settings that are useful for PCT-guided therapy. The theme of recoding the PCT values on admission can be of great help to the clinicians as it was found to reduce the antibiotic treatment in low risk situation (2, 3). The author at the end of the review emphasise on the need of the comparis on between CRP and PCT in terms of the antibiotic stewardship. The review concludes with need of intense efforts to reduce the inappropriate use of the antibiotics as also mentioned in other articles in this research area (1). These additional factors can be useful and be applied as it might contribute to the change in the clinical practice. There are several limitations to the narrative review inspite of the background of the broad topic. The nature of this type of research paradigm becomes too subjective in regards to the type of studies to be included or excluded and the overall conclusion drawn (16). The selection bias may lead to misleading results. The author has not conducted the systemic review for each type of the infection in the concerned article. Only selected studies based on the PubMed search were found and some were based on the authors expertise, that makes the results of the paper very enthusiastic due to subjective weighing of the studies chosen (1). Further, there is a probability of bias, as most of the studies did not bind the patient. When large set of studies are involved, it is challenging to determine and integrate the complex interactions (17). The author of the article has presented a very less data on the CRP markers of infection. Even for the other types of infections, PCT has not been well studied. This is the weakness of the study. However, there is a significant evaluation of the PCT marker and its role in different types of infection. The results related to this have been promising inspite of the limitations. The author of the chosen article has restricted the research to a very short time period that is 2012-2016. This is the drawback as the article has chance of missing relevant data pertaining to the research topic that has been published before this time (13). It may limit the reliability of the study and the conclusions dawn (15). Overall, the results are based on the personal evaluation, beliefs, thoughts and interpretations of the author. Since, it is an expert opinion; it can be considered an evidence of lowest type. These studies are not as rigorous as they should be (16). Systematic approach may eliminate the limitation of the narrative review. Thus, the futures studies may take this rigorous approach. This approach is suggested as systematic review is the reproducible and explicit summary of the health care interventions and their effects. Further, systematic review involves two reviewers and follows a well-structured peer review protocol. Since the reviewers review the methodology, the bias is reduced. The systematic review indentifies the quality of the chosen study therefore; they are more transparent than the narrative review. Further, systematic review is considered the cornerstone of the evidence based practice as it focuses on clinical question and indentifies the best evidence (18). The narrative question has established by developing a broad question. It should start with more clear and focused question. The focused question can include the population, intervention, comparison and outcomes. It is also called as PICO question in short and is effective in finding answers more efficiently. This process decreases the element of vague and chance of getting unnecessary results (19). Summary and discussion Based on the critical appraisal of the narrative review on the Procalcitonin-guided diagnosis, and antibiotics stewardship it is evident that there is a need of finding solution that will work as all purpose strategy. There is an emerging bacterial resistance to the antibiotics. However, the prolonged use of bacteria has many adverse consequences such as collateral damage and diarrhea associated with C.difficle. Earlier, many studies have tried to determine the efficacy of the PCT in the diagnosis and treatment of the bacterial infection. However, the focus of these previous studies was mainly on respiratory tract infections and sepsis. The narrative review however highlights the clinical utility for PCT in other infections such as Urinary tract infections, meningitis, and other superficial infections. This deviation in focus was necessary for the clinicians struggling with the prolonged use of the antibiotic therapy. Based on the findings of the narrative review, there are many clinical situations where the PCT may be useful. It includes the differentiation of the bacterial and the viral respiratory tract infection. PCT will be useful in the diagnosis of the septic arthritis, renal involvement in the paediatric urinary tract infections and distinguish between the bacterial and the viral meningitis. Other clinical situation were PCT can be used include monitoring of the response to the antibacterial therapy and diagnosis of the postoperative infection (systemic secondary infection) or cases of trauma, burns ad transplants (2, 3, 5). According to (4), clinicians should not make the decisions regarding the antimicrobial therapy based on the serum level of PCT. Rather; it will be effective if PCT is placed in the clinical context of each patient scenario (1, 4). The clinicians must consider the site of possible infection, the extent of bacteria invasion and the degree of illness. Other clinical data must also be considered, pertaining to the situation. However, once the use of PCT is approved, the factors to be considered are cost. It is expensive than CRP but hold greater value for determining the cessation of antibiotics. If there is a decreased antibiotic use, the cost savings through the use of the PCT can be identified. Based on the emerging studies, it can be concluded that, PCT appears to be persuasive and is an evidence based approach to use antibiotics more rationally. This article is like an eye-opener for diagnosis of different infections using PCT. There is a need of further research to compare the effectiveness of the CRP and PCT for diagnosis of adult emergency department patients. References Sager R, Kutz A, Mueller B, Schuetz P. Procalcitonin-guided diagnosis and antibiotic stewardship revisited. BMC medicine. 2017 Jan 24;15(1):15. Schuetz P, Daniels LB, Kulkarni P, Anker SD, Mueller B. Procalcitonin: A new biomarker for the cardiologist. International journal of cardiology. 2016 Nov 15;223:390-7. Sager, R., Wirz, Y., Amin, D., Amin, A., Hausfater, P., Huber, A., Haubitz, S., Kutz, A., Mueller, B. and Schuetz, P., 2017. Are admission procalcitonin levels universal mortality predictors across different medical emergency patient populations? Results from the multi-national, prospective, observational TRIAGE study.Clinical Chemistry and Laboratory Medicine (CCLM). Mallet M, Haq M, Tripon S, Bernard M, Benosman H, Thabut D, Rudler M. Elevated procalcitonin is associated with bacterial infection during acute liver failure only when unrelated to acetaminophen intoxication. European Journal of Gastroenterology Hepatology. 2017 Jul 1;29(7):811-6. Nora D, Salluh J, Martin-Loeches I, Pvoa P. Biomarker-guided antibiotic therapystrengths and limitations. Annals of Translational Medicine. 2017 May;5(10). Elwood M. Critical appraisal of epidemiological studies and clinical trials. Oxford University Press; 2017 Mar 1. Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient?centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of advanced nursing. 2013 Jan 1;69(1):4-15. Diprose W, Verster F, Schauer C. Re-examining physical findings with point-of-care ultrasound: a narrative review. The New Zealand medical journal. 2017 Jan 27;130(1449):46. Levashina J, Hartwell CJ, Morgeson FP, Campion MA. The structured employment interview: Narrative and quantitative review of the research literature. Personnel Psychology. 2014 Mar 1;67(1):241-93. Sandelowski M. Unmixing Mixed?Methods Research. Research in Nursing Health. 2014 Feb 1;37(1):3-8. Greco T, Biondi-Zoccai G, Saleh O, Pasin L, Cabrini L, Zangrillo A, Landoni G. The attractiveness of network meta-analysis: a comprehensive systematic and narrative review. Heart, lung and vessels. 2015;7(2):133. Schuetz P, Bretscher C, Bernasconi L, Mueller B. Overview of procalcitonin assays and procalcitonin-guided protocols for the management of patients with infections and sepsis. Expert Review of Molecular Diagnostics. 2017 Jun 3;17(6):593-601. Heyvaert, M., Hannes, K., Maes, B. and Onghena, P., 2013. Critical appraisal of mixed methods studies.Journal of mixed methods research,7(4), pp.302-327. Bae JM. Narrative reviews. Epidemiology and health. 2014;36. Snilstveit B, Oliver S, Vojtkova M. Narrative approaches to systematic review and synthesis of evidence for international development policy and practice. Journal of development effectiveness. 2012 Sep 1;4(3):409-29. McGauran N, Wieseler B, Kreis J, Schler YB, Klsch H, Kaiser T. Reporting bias in medical research-a narrative review. Trials. 2010 Apr 13;11(1):37. Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD. Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatology International. 2011 Nov 1;31(11):1409. Uman LS. Systematic reviews and meta-analyses. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2011 Feb;20(1):57. Souto RQ, Khanassov V, Hong QN, Bush PL, Vedel I, Pluye P. Systematic mixed studies reviews: updating results on the reliability and efficiency of the mixed methods appraisal tool. International Journal of Nursing Studies. 2015 Jan 1;52(1):500-1.