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Indigenous people continue to develop methods to strengthen and empower genealogical knowledge as a means of conveying histories, illuminating current and past values, and providing important cultural frameworks for understanding their nuanced identities and worlds across time and space. Genealogies are more than simply a record of a family tree; they are a rich tapestry of ancestral links, representing a tradition of thought and connection to entities beyond the human. This article proposes an Iwi-specific methodological approach to conducting research based on the specific paradigms (ontological and epistemological) of Māori (Indigenous peoples of New Zealand) from the region of Te Awa Tupua in the North Island of Aotearoa, New Zealand. A Whanganui world view can be actioned as an operating system within research by developing a bespoke place-based methodology drawing on kōrero tuku iho (ancestral wisdom) to conduct research amongst a genealogical group with whakapapa (genealogical connection) to a distinct geographic locale. This methodological shift allows the inclusion of human research participants and more-than-human, including Te Awa Tupua (an interconnected environment around the Whanganui River) and Te Kāhui Maunga (ancestral mountains that feed the Whanganui river) as living ancestors. Whanganui ways of knowing, doing, and being underpin a worldview that situates Te Awa Tupua and tāngata (people) as inter-related beings that cannot maintain their health and wellbeing without the support of one another. [ABSTRACT FROM AUTHOR]

The reference to 'victoriati' in Bloomberg Wax Tablet 31 has been interpreted as a request for 52 Roman quinarii. This paper argues that quinarii were not available in significant enough quantities to make such a payment and that a more credible alternative is to see these 'victoriati' as a reference to local, Celtic coinage, specifically the silver issues of Epaticcus or Cunobelin. This identification, supported by recent metallurgic studies, alongside data from hoards, excavations and the Portable Antiquities Scheme, suggests a more prolonged use of Celtic coinage in Roman London than has previously been appreciated. Supplementary material is available online and provides data supporting the assertions made. [ABSTRACT FROM AUTHOR]

As Indigenous researchers we are supported and guided by an integral understanding to conduct research in accordance with our own Indigenous ethics (tikanga). By taking greater control of research methodologies and processes, we are reclaiming our ancient knowledges and ways of passing on or disseminating those knowledges. One of the less widely understood components of Māori research is around Indigenous-based, effective modes for communicating research findings to effect aspirational change for Māori. This paper explores the components of a new framework rooted in the strengths, wisdom and world views of Indigenous peoples. The TUI (Translation, Uptake and Impact) framework is designed to communicate new Māori research knowledge. This paper looks at using the TUI framework as a way to build awareness methods to engage whānau, hapū, Iwi and Māori communities, and a way to use communication to rebalance inequities. Inclusive, Māori led and Māori focused research translation thereby has the potential to contribute to more sustainable and transformative change. [ABSTRACT FROM AUTHOR]

This paper provides athlete and practitioner insights regarding a novel coping-oriented personal-disclosure mutual-sharing (COPDMS) intervention developed and administered in a youth soccer context. Participants were 18 male soccer athletes (mean age 17.29 ± 0.73 years) who belonged to the same professional academy in England. The COPDMS intervention comprised an initial sport psychology education session (Week 1), a session introducing COPDMS (Week 2), a COPDMS session (Week 4), and a follow-up session (Week 9). During the COPDMS session, athletes mutually shared personal stories and/or information about transitions as they approached a time when they would gain a professional contract or would be released from their soccer academy. Athletes communicated a range of contextually relevant demand and resource appraisals during the COPDMS session. Several athlete and practitioner insights about the COPDMS process and outcomes were provided that can guide future researchers and practitioners seeking to develop and deliver bespoke PDMS interventions in sport. [ABSTRACT FROM AUTHOR]

This article explores the connections between ghosts and medieval law. It revisits the final story from the famous Byland Abbey collection, concerning the sister of Adam de London and a disputed inheritance, and demonstrates the historicity of the people involved using legal evidence. This opens up a reading of the story in which legal ideas are central to the framing and narrative; I suggest that the ghost manifests a fear of the destruction of inheritance. I then move to argue that the law of inheritance in later medieval England was dependent on a 'spectral reasoning', in which the wishes of those who granted property to their children took on an outsized, supernatural agency. Finally, I suggest that this comparison helps to reveal not only the strangeness of inheritance as a legal concept, but also the ways in which it has continued to structure inequality into our own time. [ABSTRACT FROM AUTHOR]

Using low‐coverage whole‐genome sequencing, analysis of vocalizations, and inferences from natural history, we document a first‐generation hybrid between a rose‐breasted grosbeak (Pheucticus ludovicianus) and a scarlet tanager (Piranga olivacea). These two species occur sympatrically throughout much of eastern North America, although were not previously known to interbreed. Following the field identification of a putative hybrid, we use genetic and bioacoustic data to show that a rose‐breasted grosbeak was the maternal parent and a scarlet tanager was the paternal parent of the hybrid, whose song was similar to the latter species. These two species diverged >10 million years ago, and thus it is surprising to find a hybrid formed under natural conditions in the wild. Notably, the hybrid has an exceptionally heterozygous genome, with a conservative estimate of a heterozygous base every 100 bp. The observation that this hybrid of such highly divergent parental taxa has survived until adulthood serves as another example of the capacity for hybrid birds to survive with an exceptionally divergent genomic composition. [ABSTRACT FROM AUTHOR]

To more fully understand the belief gap hypothesis, this study examines the effect of political identity, education, and partisan media consumption on the formation of attitudes and false beliefs. Using a two-wave, nationally representative online survey of the U.S. we assess people's attitudes and beliefs toward climate change, on the one hand, and Syrian refugees, on the other. Building on previous studies, we demonstrate that the effect of one's political identity on attitudes and false beliefs is contingent upon education, which appears to widen the belief gap in consort with political identity. [ABSTRACT FROM AUTHOR]

Objective: To investigate percutaneous coronary intervention (PCI) practice in an international cohort of patients with spontaneous coronary artery dissection (SCAD). To explore factors associated with complications and study angiographic and longer term outcomes.Methods: SCAD patients (n=215, 94% female) who underwent PCI from three national cohort studies were investigated and compared with a matched cohort of conservatively managed SCAD patients (n=221).Results: SCAD-PCI patients were high risk at presentation with only 8.8% undergoing PCI outside the context of ST-elevation myocardial infarction/cardiac arrest, thrombolysis in myocardial infarction (TIMI) 0/1 flow or proximal dissections. PCI complications occurred in 38.6% (83/215), with 13.0% (28/215) serious complications. PCI-related complications were associated with more extensive dissections (multiple vs single American Heart Association coronary segments, OR 1.9 (95% CI: 1.06-3.39),p=0.030), more proximal dissections (proximal diameter per mm, OR 2.25 (1.38-3.67), p=0.001) and dissections with no contrast penetration of the false lumen (Yip-Saw 2 versus 1, OR 2.89 (1.12-7.43), p=0.028). SCAD-PCI involved long lengths of stent (median 46mm, IQR: 29-61mm). Despite these risks, SCAD-PCI led to angiographic improvements in those with reduced TIMI flow in 84.3% (118/140). Worsening TIMI flow was only seen in 7.0% (15/215) of SCAD-PCI patients. Post-PCI major adverse cardiovascular and cerebrovascular events (MACCE) and left ventricular function outcomes were favourable.Conclusion: While a conservative approach to revascularisation is favoured, SCAD cases with higher risk presentations may require PCI. SCAD-PCI is associated with longer stent lengths and a higher risk of complications but leads to overall improvements in coronary flow and good medium-term outcomes in patients. [ABSTRACT FROM AUTHOR]

Using National Lakes Assessment data, we evaluated the influence of total N (TN), total P (TP), and other variables on lake chlorophyll‐a concentrations. With simple linear regressions, high TN/TP samples biased predictions based on TN, and low TN/TP samples biased predictions based on TP. The bias problem was corrected, and correlation was improved, by splitting the dataset at the TN/TP ratio we estimated to be indicative of a balanced supply and developing separate regressions that predict chlorophyll‐a based on TP, TN, dissolved inorganic N (DIN), dissolved organic carbon (DOC), nonalgal light attenuation, depth, area, latitude, elevation, and conductivity. Both nutrients were excellent predictors, and nonalgal light attenuation was the next most influential predictor. The regression analysis suggested that a potential for P only limitation (high TN/TP, 17% of samples) or N only limitation (low TN/TP, 14% of samples) can be inferred at the extremes of the TN/TP range. However, 69% of samples had an intermediate TN/TP ratio where it is difficult to infer anything about potential nutrient limitations (biomass could be N limited, P limited, N and P co‐limited, or not limited by nutrients at all). Our results show that when developing phytoplankton response relationships using cross‐lake datasets that span a wide range of trophic states, it is important to consider whether and how biomass is influenced by confounding factors—such as differences in the relative supply of N and P—so that biomass is not underestimated or overestimated, and nutrient criteria are not under‐protective or over‐protective. [ABSTRACT FROM AUTHOR]

Background: The success of coronary artery bypass grafting surgery (CABG) is dependent on long-term graft patency, which is negatively related to early wall thickening. Avoiding high-pressure distension testing for leaks and preserving the surrounding pedicle of fat and adventitia during vein harvesting may reduce wall thickening.Methods: A single-centre, factorial randomized controlled trial was carried out to compare the impact of testing for leaks under high versus low pressure and harvesting the vein with versus without the pedicle in patients undergoing CABG. The primary outcomes were graft wall thickness, as indicator of medial-intimal hyperplasia, and lumen diameter assessed using intravascular ultrasound after 12 months.Results: Ninety-six eligible participants were recruited. With conventional harvest, low-pressure testing tended to yield a thinner vessel wall compared with high-pressure (mean difference [MD; low minus high] -0.059 mm, 95% confidence interval (CI) -0.12, +0.0039, p = .066). With high pressure testing, veins harvested with the pedicle fat tended to have a thinner vessel wall than those harvested conventionally (MD [pedicle minus conventional] -0.057 mm, 95% CI: -0.12, +0.0037, p = .066, test for interaction p = .07). Lumen diameter was similar across groups (harvest comparison p = .81; pressure comparison p = .24). Low-pressure testing was associated with fewer hospital admissions in the 12 months following surgery (p = .0008). Harvesting the vein with the pedicle fat was associated with more complications during the index admission (p = .0041).Conclusions: Conventional saphenous vein graft preparation with low-pressure distension and harvesting the vein with a surrounding pedicle yielded similar graft wall thickness after 12 months, but low pressure was associated with fewer adverse events. [ABSTRACT FROM AUTHOR]

Background: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes–ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. Methods: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. Results: A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73–0.85, p < 0.0001) and without diabetes (IRR 0.81 (95% CI: 0.78–0.85, p < 0.0001) (p int = 0.40). We observed a significant heterogeneity among centers in the population with and without diabetes (p < 0.001, respectively). The heterogeneity among centers was not related to the incidence of death due to COVID-19 in both groups of patients. Interaction was observed for Hypertension (p = 0.024) only in absence of diabetes. Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. Conclusions: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. Trial registration number: NCT 04412655. [ABSTRACT FROM AUTHOR]

Objective: To monitor hospital activity for presentation, diagnosis and treatment of cardiovascular diseases during the COVID-19) pandemic to inform on indirect effects.Methods: Retrospective serial cross-sectional study in nine UK hospitals using hospital activity data from 28 October 2019 (pre-COVID-19) to 10 May 2020 (pre-easing of lockdown) and for the same weeks during 2018-2019. We analysed aggregate data for selected cardiovascular diseases before and during the epidemic. We produced an online visualisation tool to enable near real-time monitoring of trends.Results: Across nine hospitals, total admissions and emergency department (ED) attendances decreased after lockdown (23 March 2020) by 57.9% (57.1%-58.6%) and 52.9% (52.2%-53.5%), respectively, compared with the previous year. Activity for cardiac, cerebrovascular and other vascular conditions started to decline 1-2 weeks before lockdown and fell by 31%-88% after lockdown, with the greatest reductions observed for coronary artery bypass grafts, carotid endarterectomy, aortic aneurysm repair and peripheral arterial disease procedures. Compared with before the first UK COVID-19 (31 January 2020), activity declined across diseases and specialties between the first case and lockdown (total ED attendances relative reduction (RR) 0.94, 0.93-0.95; total hospital admissions RR 0.96, 0.95-0.97) and after lockdown (attendances RR 0.63, 0.62-0.64; admissions RR 0.59, 0.57-0.60). There was limited recovery towards usual levels of some activities from mid-April 2020.Conclusions: Substantial reductions in total and cardiovascular activities are likely to contribute to a major burden of indirect effects of the pandemic, suggesting they should be monitored and mitigated urgently. [ABSTRACT FROM AUTHOR]

Background: In patients with reperfused ST-elevation myocardial infarction (STEMI) both invasive and non-invasive assessments of microvascular dysfunction, the index of microcirculatory resistance (IMR), and microvascular obstruction (MVO) by cardiovascular magnetic resonance (CMR), independently predict poor long-term outcomes. Aims: The aims of this study were to investigate whether an invasive parameter (IMR), assessed at the time of primary percutaneous intervention (PPCI), could predict the extent of MVO in proportion to infarct size (MVO index). Methods: 50 patients presenting with STEMI and TIMI flow ≤ I in the infarct related artery were prospectively recruited to the study, before undergoing PPCI. All patients underwent invasive IMR assessment at maximal hyperaemia using adenosine, and following stent insertion. CMR was performed on day 2 following STEMI, MVO was assessed both on first-pass rest perfusion (early MVO) and in the late gadolinium enhancement (LGE) images (late MVO) along with infarct size. The MVO index was calculated as the ratio of late MVO/infarct size. Differences between IMR quartiles and the MVO index were investigated. Results: The median IMR was 38.5 (range 9 to 202). The median size of late MVO was 1.9% LV (range 0 to 21.0% LV). IMR predicted late MVO (p<0.01) and as IMR increased, the MVO index increased (r = 0.70, [95% CI 0.53, 0.82], p<0.001). An IMR cut-off of 40 significantly predicted the presence of late MVO on CMR (p<0.001). Conclusion: IMR measured at the time of PPCI in acutely reperfused STEMI is associated with the presence and severity of infarct damage as measured by the MVO index. Trial registration: The Microcirculation in Acute Myocardial Infarction (MICRO-AMI). Clinicaltrials.gov . Registered 9th March 2012. [ABSTRACT FROM AUTHOR]

Background: Dual antiplatelet therapy (DAPT) with aspirin (ASP) and a P2Y12 blocker is currently standard care after percutaneous coronary intervention (PCI) with stent insertion, and aims to inhibit platelet function in order to prevent stent thrombosis. The P2Y12 blocker ticagrelor (TIC) has greater antiplatelet effect than the previously used members of this class, such as clopidogrel. In healthy volunteers, TIC is sufficient to cause strong platelet inhibition, with little additional effect from ASP. Omission of ASP may improve the safety of antiplatelet regimes by reducing bleeding. However, the effect of single antiplatelet treatment with TIC, compared to DAPT with TIC + ASP, has not been studied in detail in patients with coronary artery disease.Methods: To compare TIC with TIC + ASP, we have initiated a single centre, open-label randomised controlled trial (TEMPLATE study) in adults receiving DAPT following PCI with a sample size of 110 patients. Patients are invited to join the study when, as part of standard care, they are due to switch from DAPT (ASP + any P2Y12 blocker) to single antiplatelet treatment with ASP alone after 6-12 months. Patients are randomised to receive either TIC or TIC + ASP for 4 weeks. All patients then revert to standard care with ASP alone. Blood samples and clinical data are collected at three study visits: at baseline during treatment with ASP + any P2Y12 blocker (visit 1); approximately 4 weeks after visit 1 during treatment with either TIC or TIC + ASP (visit 2); and approximately 8 weeks after visit 1 when treatment has reverted to ASP alone (visit 3). The primary outcome is the extent of platelet inhibition, measured by light transmission aggregation, flow cytometry, flow chamber and plasma biomarker tests. The primary analysis will compare the extent of platelet inhibition between the TIC and TIC + ASP groups at visit 2, adjusted for baseline platelet reactivity. Secondary analyses will compare the extent of platelet inhibition at visit 2 with that at visit 3.Discussion: This is the first study to compare in detail the extent of platelet inhibition in patients who are receiving TIC compared with TIC + ASP. The study findings will complement larger-scale trials of the clinical efficacy and safety of TIC compared to TIC + ASP.Trial Registration: ISRCTN registry, identifier ISRCTN84335288 . Registered on 23 June 2014. [ABSTRACT FROM AUTHOR]

The article discusses jurisdiction in the England during the late Middle Ages of the 14th and 15th centuries, including in Dunwich, England, jurisdictional disputes and legal rights of the burgesses. The relationship between legal authority and English communities, including in regard to the communication of authority, is discussed.

Introduction: Academic emergency department (ED) handoffs are high-risk transfer of care events. Emergency medicine residents are inadequately trained to handle these vital transitions. We aimed to explore what modifications the I-PASS (illness severity, patient summary, action list, situation awareness and contingency plans, and synthesis by receiver) handoff system requires to be effectively modified for use in ED inter-shift handoffs. Methods: This mixed-method needs assessment conducted at an academic ED explored the suitability of the I-PASS system for ED handoffs. We conducted a literature review, focus groups, and then a survey. We sought to identify the distinctive elements of ED handoffs and discern how these could be incorporated into the I-PASS system. Results: Focus group participants agreed the patient summary should be adapted to include anticipated disposition of patient. Participants generally endorsed the order and content of the other elements of the I-PASS tool. The survey yielded several wording changes to reflect contextual differences. Themes from all qualitative sources converged to suggest changes for brevity and clarity. Most participants agreed that the I-PASS tool would be well suited to the ED setting. Conclusion: With modifications for context, brevity, and clarity, the I-PASS system may be well suited for application to the ED setting. This study provides qualitative data in support of using the I-PASS tool and concrete suggestions for how to modify the I-PASS tool for the ED. Implementation and outcome research is needed to investigate if the I-PASS tool is feasible and improves patient outcomes in the ED environment. [ABSTRACT FROM AUTHOR]

Switchgrass was co-fired with coal in an industrial scale boiler to investigate the co-firing effects on boiler performance and pollutant emissions. Comparing with firing coal alone, co-firing with switchgrass slightly lowered boiler efficiency by 0.6 to 1% under full-load and low-load conditions, respectively. Net carbon dioxide and SO2emissions were reduced with co-firing. Nitrogen oxides (NOx) emissions were similar with co-firing to firing coal alone under both high and low loading amounts of switchgrass. Varying the nitrogen content by changing switchgrass type and harvest time revealed no significant effect on NOx emission in the range of tested conditions. [ABSTRACT FROM PUBLISHER]

Introduction: The Accreditation Council for Graduate Medical Education requires that residency programs ensure resident competency in performing safe, effective handoffs. Understanding resident, attending, and nurse perceptions of the key elements of a safe and effective emergency department (ED) handoff is a crucial step to developing feasible, acceptable educational interventions to teach and assess this fundamental competency. The aim of our study was to identify the essential themes of ED-based handoffs and to explore the key cultural and interprofessional themes that may be barriers to developing and implementing successful ED-based educational handoff interventions. Methods: Using a grounded theory approach and constructivist/interpretivist research paradigm, we analyzed data from three primary and one confirmatory focus groups (FGs) at an urban, academic ED. FG protocols were developed using open-ended questions that sought to understand what participants felt were the crucial elements of ED handoffs. ED residents, attendings, a physician assistant, and nurses participated in the FGs. FGs were observed, hand-transcribed, audio- recorded and subsequently transcribed. We analyzed data using an iterative process of theme and subtheme identification. Saturation was reached during the third FG, and the fourth confirmatory group reinforced the identified themes. Two team members analyzed the transcripts separately and identified the same major themes. Results: ED providers identified that crucial elements of ED handoff include the following: 1) Culture (provider buy-in, openness to change, shared expectations of sign-out goals); 2) Time (brevity, interruptions, waiting); 3) Environment (physical location, ED factors); 4) Process (standardization, information order, tools). Conclusion: Key participants in the ED handoff process perceive that the crucial elements of intershift handoffs involve the themes of culture, time, environment, and process. Attention to these themes may improve the feasibility and acceptance of educational interventions that aim to teach and assess handoff competency. [ABSTRACT FROM AUTHOR]

The article explores the role of medieval law in the construction of material objects in relation to legal obligation, the constitution of property, and the stratification of maritime society. Emphasis is given to an analysis of court rolls from Suffolk, England which document shipwrecks and items found at sea by local mariners. Other topics include the valuation of found objects, the socioeconomic conditions of fishermen, and naming objects.

In this article, I address the use of witness testimony by medieval and early-modern historians of England. Although the idea that such evidence straightforwardly represents the thoughts and feelings of quite lowly people has long been discredited, I think that some part of this assumption still haunts the thinking of our postmodern, or cultural turn, historiography. To put it rather too bluntly: the old, empiricist quest for “real voices” in testimonies has to some extent been replaced by a contemporary quest for “real discourses.” That is to say, the utilization of testimonies by historians often seems to boil down to the careful extraction of the particular discourse under examination—gender, class, childhood—from the legal discourses acknowledged to be inherent in witness testimonies produced in law courts. Now, this is a severely reductionist account, and later I will elaborate on the varieties and subtleties of current approaches. Nonetheless, this assumption that we can simply extrapolate social discourses about “x” from the legal discourses of the depositions seems to me somewhat flawed, because it presumes that premodern witnesses were simply conduits of discourse, whose testimony was nonetheless decisively shaped by the machinations of the legal counsel. In fact, as I will argue here, medieval witnesses were quite capable of manipulating such discourses, using clichés to tell the court what they thought it wanted to hear. In the subsequent discussion, I will look in detail at two intimately related cases from the Bishop of London's consistory court to make this point more explicit. First, I will relate the basic facts of these cases: the narrative of the events and the procedure of the courts. I will then address the historiography of witness testimony in greater detail, at the same time demonstrating the way in which the examples from the consistory counter the assumptions of this historiography. I will present different ways of reading my own examples using different positions within the scholarly literature, before showing how the case upsets even the most sophisticated of such readings. Overall, I argue that as well as considering the “construction” of the testimony by lawyers and legal counsels, and the “deconstruction” of such discourses by historians, we must begin to think about the “preconstruction” of the testimony by witnesses; their own integration of legalistic ideas into the fabric of their depositions. Finally, I will conclude by considering some of the wider implications of this argument for the use of witness depositions, and for the study of “law and society” more generally in the medieval and early-modern periods. [ABSTRACT FROM PUBLISHER]

Former Green Bay Packers' coach, Vince Lombardi, is renowned for his comments on the perceived fulfillment of winning and analogy to victory on the battlefield. Lombardi also noted that if it doesn't matter who wins or loses, then why do they keep score? Sustaining its winning ethos over an extended period of time is a defining feature of the New Zealand men's national representative rugby team, commonly known as the All Blacks. Their winning record, a 75% success ratio in test matches, reflects their organizational culture, which has been developed, nurtured and sustained since their first official international in 1903. The purpose of this case study was to investigate the core values of the All Blacks that have sustained the winning culture between 1950 and 2010 from a leadership perspective. Primary data was obtained through the use of semi-structured, in-depth interviews with past and present All Black captains and coaches. Findings suggest that the key core values are the pride in the All Blacks legacy, pride in selection and pride in winning, which are also constant factors in their success. The article concludes with some reflections on the transferability of the core values identified in the paper. [ABSTRACT FROM AUTHOR]

Background: The number and functional activity of circulating progenitor cells (CPCs) is altered in diabetic patients. Furthermore, reduced CPC count has been shown to independently predict cardiovascular events. Validation of CPCs as a biomarker for cardiovascular risk stratification requires rigorous methodology. Before a standard operation protocol (SOP) can be designed for such a trial, a variety of technical issues have to be addressed fundamentally, which include the appropriate type of red blood cell lysis buffer, FMO or isotype controls to identify rare cell populations from background noise, optimal antibody dilutions and conditions of sample storage. We herein propose improvements in critical steps of CPC isolation, antigenic characterization and determination of functional competence for final application in a prospective investigation of CPCs as a biomarker of outcome following acute myocardial infarction. Methods and Findings: In this validation study, we refined the standard operating procedure (SOP) for flow cytometry characterisation and functional analysis of CPCs from the first 18 patients of the Progenitor Cell Response after Myocardial Infarction Study (ProMIS). ProMIS aims to verify the prognostic value of CPCs in patients with either ST elevation or non-ST elevation myocardial infarction with or without diabetes mellitus, using cardiac magnetic resonance imaging (MRI) for assessment of ventricular function as a primary endpoint. Results indicate crucial steps for SOP implementation, namely timely cell isolation after sampling, use of appropriate lysis buffer to separate blood cell types and minimize the acquisition events during flow cytometry, adoption of proper fluorophore combination and antibody titration for multiple antigenic detection and introduction of counting beads for precise quantification of functional CPC activity in migration assay. Conclusion and Significance: With systematic specification of factors influencing the enumeration of CPC by flow cytometry, the abundance and migration capacity of CPCs can be correctly assessed. Adoption of validated SOP is essential for refined comparison of patients with different comorbidities in the analysis of risk stratification. [ABSTRACT FROM AUTHOR]

Higher levels of religious and spiritual engagement have been shown to be associated with better adjustment in dealing with serious illness. Nevertheless, the pattern of such engagement may vary substantially among individuals. This paper presents exploratory research with the goal of identifying subgroups of individuals with non-terminal cancer who vary along multiple dimensions of religious/spiritual (R/S) involvement and well-being. Cluster analysis utilized both R/S (FACIT-Sp) and quality of life variables (e.g., FACT-G) to identify subgroups within 114 individuals (Median age = 65; 59% female) under care for cancer. Additional R/S and adjustment variables were used to explore further distinctions among these groups. Four clusters were identified: High R/S (45%), with the lowest depression; Low R /High S (25%), also with good adjustment; Negative Religious Copers (14%), with the highest depression; and Low R/S (16%), with the poorest adjustment to cancer. The results support the value of differentiating patterns of religious and spiritual engagement in relation to well-being, with implications for matching psycho-social interventions with individuals. [ABSTRACT FROM AUTHOR]

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Baited and unbaited hoop-nets commonly are used to capture catfish in lotic and lentic systems. Turtle bycatch and postcapture mortality has been problematic during catfish surveys in Missouri, USA, most recently in the Gasconade River, Gasconade and Osage counties. We evaluated 3 modified hoop-net designs that would reduce turtle bycatch without reducing catfish capture in the Gasconade River during 15 May-15 July 2006 after pilot study evaluation of 5 hoop-net designs in April 2006. We deployed modified and control-nets in blocks for 48 hours to evaluate differences in turtle and catfish catch rate, as well as abundance, size, and mortality rate of turtle bycatch. The chimney design reduced turtle bycatch by 84%when compared to the control, without decreasing the number or average size of captured flathead catfish (Pylodictis olivaris). Environmental conditions that affected turtle mortality included Secchi disc transparency, temperature, dissolved oxygen, and stream river depth. This is the first known attempt to create turtle exclusion or escapement devices for hoop-nets deployed in freshwater systems. Biologists using hoop-nets to sample aquatic vertebrates in moderate to large river systems will benefit from our study. The application of this methodology will reduce turtle bycatch mortality, especially when sampling is conducted in high water temperatures. [ABSTRACT FROM AUTHOR]

We quantified the influence of agricultural activities on environmental and biological conditions of floodplain wetlands in the upper Missouri River basin. Seasonally-flooded wetlands were characterized as low impact (non-disturbed) or high impact (disturbed) based on local land use. Biological data collected from these wetlands were used to develop a wetland condition index (WCI). Fourteen additional wetlands were sampled to evaluate the general condition of seasonally-flooded floodplain wetlands. Structural and functional attributes of macrophyte, algae, and macroinvertebrate communities were tested as candidate metrics for assessing biotic responses. The WCI we developed used six biological metrics to discriminate between disturbed and non-disturbed wetlands: 1) biomass of Culicidae larvae, 2) abundance of Chironomidae larvae, 3) macroinvertebrate diversity, 4) total number of plant species, 5) the proportion of exotic plant species, and 6) total number of sensitive diatom species. Disturbed wetlands had less taxa richness and species diversity and more exotic and nuisance (e.g., mosquitoes) species. Environmental differences between low and high impact wetlands included measures of total potassium, total phosphorus, total nitrogen, alkalinity, conductance, and sediment phosphorus concentration. Canonical analyses showed that WCI scores were weakly correlated (P = 0.057) with environmental variables in randomly selected wetlands. In addition, mean WCI score for random wetlands was higher than that for high impact wetlands, implying that floodplain wetlands were less impacted by the types of agricultural activities affecting high impact sites. Inter-year sampling of some wetlands revealed that WCI metrics were correlated in 2000 and 2001, implying that biological metrics provided useful indicators of disturbance in floodplain wetlands. [ABSTRACT FROM AUTHOR]

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving informed consent-in both face-to-face and online experiments. [ABSTRACT FROM AUTHOR]

Presents several letters to the editor related to computer software. Comments on Warren Harrison's "The Dangers of End-User Programming"; Argument pertaining to the software development; Quality of software products.