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Introduction: Daily use of cannabis is increasing in Australia, yet there is limited understanding of the driving behaviours within this cohort, including how they perceive and manage the risks of being apprehended for drug driving and involved in a crash after consumption. Methods: An online survey was completed by 487 Australians who reported daily cannabis use (30% medically prescribed patients, 58% male). Results: Current drug driving (i.e., driving within 4 h of consuming cannabis each week) was reported by 86% of participants. Future drug driving was anticipated by 92% of the sample. While most participants (93%) disagreed that their risk of crash increased following cannabis use, participants reported that they would drive more carefully (89%), leave greater headway (79%) and/or drive slower (51%) following cannabis consumption. Half of the sample (53%) perceived the risk of apprehension for drug driving to be likely to some extent. Strategies to reduce the likelihood of being detected were used by 25% of participants, and included using Facebook police location sites (16%), driving on back roads (6%) and/or consuming substances to mask the presence of drugs (13%). The regression analysis revealed that individuals who reported more occasions of cannabis use per day, and who perceived that cannabis does not reduce driving ability, reported a greater extent of current drug driving. Discussion and Conclusions: Interventions and education which aim to challenge this perception that 'cannabis does not reduce driving ability' may prove important for reducing drug driving among the most frequent consumers of cannabis. [ABSTRACT FROM AUTHOR]

Introduction: Incomplete anchoring of the Watchman left atrial appendage closure (LAAO) device can result in substantial device migration or device embolization (DME) requiring percutaneous or surgical retrieval. Methods: We performed a retrospective analysis of Watchman procedures (January 2016 through March 2021) reported to the National Cardiovascular Data Registry LAAO Registry. We excluded patients with prior LAAO interventions, no device released, and missing device information. In‐hospital events were assessed among all patients and postdischarge events were assessed among patients with 45‐day follow‐up. Results: Of 120 278 Watchman procedures, the in‐hospital DME rate was 0.07% (n = 84) and surgery was commonly performed (n = 39). In‐hospital mortality rate was 14% among patients with DME and 20.5% among patients who underwent surgery. In‐hospital DME was more common: at hospitals with a lower median annual procedure volume (24 vs. 41 procedures, p <.0001), with Watchman 2.5 versus Watchman FLX devices (0.08% vs. 0.04%, p =.0048), with larger LAA ostia (median 23 vs. 21 mm, p =.004), and with a smaller difference between device and LAA ostial size (median difference 4 vs. 5 mm, p =.04). Of 98 147 patients with 45‐day follow‐up, postdischarge DME occurred in 0.06% (n = 54) patients and cardiac surgery was performed in 7.4% (n = 4) of cases. The 45‐day mortality rate was 3.7% (n = 2) among patients with postdischarge DME. Postdischarge DME was more common among men (79.7% of events but 58.9% of all procedures, p =.0019), taller patients (177.9 vs. 172 cm, p =.0005), and those with greater body mass (99.9 vs. 85.5 kg, p =.0055). The rhythm at implant was less frequently AF among patients with DME compared to those without (38.9% vs. 46.9%, p =.0098). Conclusion: While Watchman DME is rare, it is associated with high mortality and frequently requires surgical retrieval, and a substantial proportion of events occur after discharge. Due to the severity of DME events, risk mitigation strategies and on‐site cardiac surgical back‐up are of paramount importance. [ABSTRACT FROM AUTHOR]

Introduction: Although atrial fibrillation (AF) ablation has become increasingly safer, rehospitalization and emergency department (ED) evaluations can occur in the postablation period. Better understanding of the frequency, causes, and predictors for hospitalization and ED evaluation after ablation are needed, particularly as same‐day discharge programs expand. Methods: The Optum Clinformatics database was used to define rates, causes, and predictors of hospital and ED care after AF ablation performed between January 2016 and May 2019. Primary outcomes were all‐cause hospital and ED care within 30 days of discharge. Independent predictors of all‐cause ED and hospital admissions care were determined via logistic regression. Results: Of the 18 848 patients in this study, the mean age was 67.5 ± 10 years, 37.9% were female, and the mean CHA2DS2‐VASc score was 3.27 ± 1.84. Within 30 days of AF ablation, 1440 of 18 848 patients (7.6%) required hospital care of which 15% had >1 admission; 7.9% required ED care of which 28.6% had >1 ED visit. The most common reasons for hospital admission (which occurred on average 12.3 days after discharge) were supraventricular tachycardia (SVT) or AF (33.2%), heart failure (12.7%), and infection (12.2%). The most common reasons for ED care were SVT/AF (15.0%), noncardiac chest pain (13.3%), and noninfectious respiratory illness (12.2%). Age, female sex, ablation in an inpatient setting, and co‐morbidities were associated with increased risk of rehospitalization. Age, female sex, patient comorbidities, and non‐use of direct oral anticoagulation were associated with increased risk of ED visit. Conclusion: Approximately 7%–8% of patients require unplanned hospitalization or ED care after AF ablation, most commonly due to SVT/AF. Predictors of unscheduled care include patient age, sex, and several patient comorbidities. This study can inform quality improvement initiatives by identifying common causes for unscheduled care. [ABSTRACT FROM AUTHOR]

Background: Despite changes inthe legality of cannabis use and the increasing prevalence of cannabis use disorder (CUD), there is little data investigating the association between CUD and inpatient atrial fibrillation (AF) hospitalizations. Methods: Using the National Inpatient Sample, we identified Atrial Fibrillation (AF) hospitalizations with and without a codiagnosis of CUD using International Classification of Diseases diagnosis codes and compared demographics, socioeconomics, comorbidities, outcomes, and trends between cohorts. Results: Between 2008 and 2018, we identified 5,155,789 admissions for AF of which 31,768 (0.6%) had a codiagnosis of CUD. The proportion of admissions with a history of CUD increased from 0.3% in 2008 to 1.0% in 2018 (p <.001). Hospital discharges of patients with CUD were significantly younger (53 vs. 72 years, p <.001), had a higher proportion of black race (CUD: 26.6% vs. 8.0%, p <.001), and had a higher proportion of income in the lowest income quartile than without a codiagnosis of CUD (CUD: 40.5% vs. 26.2%, p <.001). Conclusions: CUD is increasingly prevalent among AF hospitalizations, particularly among young patients. Codiagnosis of CUD in AF hospitalizations is also more common in underserved patients. As a result, it is important for future research to examine and understand the impact of CUD on this population, particularly in the light of changing legislation surrounding the legality of cannabis. [ABSTRACT FROM AUTHOR]

There is generally a very poor understanding of how anadromous brown trout, Salmo trutta, use marine ecosystems. In this study, we use acoustic telemetry techniques to test four alternative hypotheses for estuarine coastal habitat use by this species on a population in the Clyde, west‐central Scotland. Anadromous brown trout in their second (or more) summer feeding in the marine environment did not show patterns of estuarine use predicted from studies on other populations of this species. They did not (a) use the inner Clyde Estuary as a staging post for onward migration to open coastal waters, nor did they (b) pass through the estuary rapidly nor did they (c) make multiple incursions into freshwater. In contrast, fish utilised a very geographically constrained area of the inner estuary (<8 km in length), within which fish were highly mobile, exhibiting more activity during a flooding tide and exhibited high survivorship compared with reports from other studies. The reasons why estuarine use by anadromous brown trout in the Clyde may differ from that reported elsewhere is discussed. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is a leading cause of stroke. Oral anticoagulant (OAC) therapy can significantly reduce the risk of stroke in patients with AF, but underuse of OACs for stroke prevention continues to be a serious clinical problem, with significant deleterious impact on outcomes. We review the studies demonstrating OAC underutilization and evaluating strategies for promoting the increased use of OAC therapy for stroke prevention in nonvalvular AF (NVAF) patients, including in special patient populations. [ABSTRACT FROM AUTHOR]

What little is known about the seaward migration of Salmo salar smolt migration through standing waters indicates that it is both slow and results in high mortality rates, compared with riverine migration. This may be partly because smolts in lakes need to swim more actively and require more complex directional cues than they do in rivers. In this telemetry study of smolt migration through Loch Lomond, S. salar smolts made repeated movements in directions away from the outflowing river, which considerably increased migration time. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Worldwide, 71 million people are infected with hepatitis C virus (HCV), which, without treatment, can lead to liver failure or hepatocellular carcinoma. HCV co‐infection increases liver‐ and AIDS‐related morbidity and mortality among HIV‐positive people, despite ART. A 12‐week course of HCV direct‐acting antivirals (DAAs) usually cures HCV – regardless of HIV status. However, patents and high prices have created access barriers for people living with HCV, especially people who inject drugs (PWID). Inadequate access to and coverage of harm reduction interventions feed the co‐epidemics of HIV and HCV; as a result, the highest prevalence of HCV is found among PWID, who face additional obstacles to treatment (including stigma, discrimination and other structural barriers). The HIV epidemic occurred during globalization of intellectual property rights, and highlighted the relationship between patents and the high prices that prevent access to medicines. Indian generic manufacturers produced affordable generic HIV treatment, enabling global scale‐up. Unlike HIV, donors have yet to step forward to fund HCV programmes, although DAAs can be mass‐produced at a low and sustainable cost. Unfortunately, although voluntary licensing agreements between originators and generic manufacturers enable low‐income (and some lower‐middle income countries) to buy generic versions of HIV and HCV medicines, most middle‐income countries with large burdens of HCV infection and HIV/HCV co‐infection are excluded from these agreements. Our commentary presents tactics from the HIV experience that treatment advocates can use to expand access to DAAs. Discussion: A number of practical actions can help increase access to DAAs, including new research and development (R&D) paradigms; compassionate use, named‐patient and early access programmes; use of TRIPS flexibilities such as compulsory licences and patent oppositions; and parallel importation via buyers’ clubs. Together, these approaches can increase access to antiviral therapy for people living with HIV and viral hepatitis in low‐, middle‐ and high‐income settings. Conclusions: The HIV example provides helpful parallels for addressing challenges to expanding access to HCV DAAs. HCV treatment access – and harm reduction – should be massively scaled‐up to meet the needs of PWID, and efforts should be made to tackle stigma and discrimination, and stop criminalization of drug use and possession. [ABSTRACT FROM AUTHOR]

Hepatitis C, hepatitis B, HIV, TB and malaria are the five major causes of infectious disease death worldwide. In a breakthrough that rivals the invention of penicillin, drugs that cure hepatitis C, with minimal side effects and high success rates, have reached the market, but, in what must be one of the greatest tragedies of modern times, these life-saving medications are not being deployed on a mass scale. Pharmaceutical patents are gifted to private corporations by governments for the dual purposes of protecting R&D expenditure and encouraging innovation. Unfortunately the monopoly pricing power these patents provision currently lacks adequate checks and balances, is open to abuse, and is quite clearly being abused. The sort of legislative changes required to deliver on the original goals of pharmaceutical patents will take years or even decades to eventuate. Parallel importation of generic medication offers hope to the millions of patients with HCV unable to afford access to vastly overpriced originator medications. Doctors prescribing and monitoring patients taking generics can take comfort from the fact that the REDEMPTION trial results show, like the HIV generics that came before them, that HCV generics deliver robust clinical results. [ABSTRACT FROM AUTHOR]

The article explores the history of crime, horror, and science fiction programs in U.S. radio broadcasting that dealt with themes of death, burial, and the supernatural. Emphasis is given to topics such as the return of the dead to life, depictions of corpses, and retribution in radio programs produced by broadcasters such as Alonzo Deen Cole.

Activating mutation of K-ras and inactivation of DPC4 are two common genetic alterations that occur in the development and progression of pancreatic ductal adenocarcinomas (PDAC). A separate common event in PDAC progression is increased expression of phosphotyrosine kinase receptors (PTKRs). In our study, we examined whether activating mutations of K-ras and loss of Smad4 play a role in causing the aberrant expression of PTKRs. Immortalized human pancreas ductal cells (HPNE) were genetically modified by expressing oncogenic K-ras and/or by shRNA knockdown of Smad4. EGFR and erbB2 protein levels but not Ron or IGF-1R were substantially upregulated in HPNE cells that express K-ras [ABSTRACT FROM AUTHOR]

The inhabitants of Managua, Nicaragua have a sophisticated, often bitingly ironic, popular geography that they use to navigate the city. The Nicaraguan capital has been destroyed twice by earthquakes, ravaged by war, left to decay for lack of funds, transformed by the creative destruction of speculative capitalism and subjected to a series of ideological impositions. Few people know the official names of streets, and recent governments have not had the ability to put up signs. So a supple system of popular geography dominates, resisting and ridiculing attempts to impose an official order, and adapting to change while preserving a bottom-up sense of memory, history and place. Drawing on Allan Pred's classic account of popular geography in late nineteenth century Stockholm, I use Managua's language of spatial orientation as a window into peripheral modernity and the politics of everyday life. [ABSTRACT FROM AUTHOR]

Most of the empirical studies that analyze the impact of corruption on investment have three common features: they employ country-level data on investment, corruption is measured at the country level, and data for countries from several regions are pooled together. This paper uses firm-level data on investment and measures corruption at the firm and country level, and allows the effect of corruption to vary by region. Our dependent variable is firms' investment growth and we employ six measures of corruption from four different sources—two firm-level measures and four country-level measures. We find that the effect of corruption on investments varies significantly across regions: corruption has a negative and significant effect on investment growth for firms in Transition countries but has no significant impact for firms in Latin America and Sub-Saharan Africa. Furthermore, for Transition countries, corruption is the most important determinant of investment. [ABSTRACT FROM AUTHOR]

Background: Premature ventricular complexes (PVCs) during exercise are associated with adverse prognosis, particularly in patients with intermediate treadmill test findings. Statin use reduces the incidence of resting ventricular arrhythmias in patients with coronary artery disease; however, the relationship between statin use and exercise-induced ventricular arrhythmias has not been investigated. Methods and Results: We evaluated the association between statin use and PVCs in 1,847 heart-failure-free patients (mean age 58, 95% male) undergoing clinical exercise treadmill testing between 1997 and 2004 in the VA Palo Alto Health Care System. PVCs were quantified in beats per minute and frequent PVCs were defined as PVC rates greater than the median value (0.43 and 0.60 PVCs per minute for exercise and recovery, respectively). Propensity-adjusted logistic regression was used to evaluate the odds of developing PVCs during exercise and recovery periods associated with statin use. There were 431 subjects who developed frequent PVCs during exercise and 284 subjects had frequent recovery PVCs. After propensity score adjustment, subjects treated with statins (n = 145) had 42% lower odds of developing frequent PVCs during exercise (odds ratio [OR] 0.58, 95% confidence interval [CI] 0.37–0.93) and 44% lower odds of developing frequent PVCs during recovery (OR 0.56, 95% CI 0.30–0.94). These effects were not modified by age, prior coronary disease, hypercholesterolemia, exercise-induced angina, or exercise capacity. Conclusions: Statin use was associated with reduced odds of frequent PVCs during and after clinical exercise testing in a manner independent of associations with coronary disease or ischemia in our study population. [ABSTRACT FROM AUTHOR]

Cultures of Mycobacterium vanbaalenii strain PYR-1 in a liquid medium were exposed to the toxic environmental contaminant acridine (260 μM). After incubation for 7 d, the cultures were extracted with ethyl acetate. Metabolites were purified using high-performance liquid chromatography and analyzed by mass spectrometry and 1H nuclear magnetic resonance spectroscopy. Four metabolites, 9,10-dihydroacridine, 4-hydroxyacridine, acridine cis-1,2-dihydrodiol, and acridin-9(10H)-one, were identified. [ABSTRACT FROM AUTHOR]

The article examines the diverse representations of the historical figure of Joan of Arc. The varied use of physical imagery in depicting Joan of Arc throughout history is discussed. The events of her life and the circumstances that led to her canonization as a saint are explored. Attempts to borrow on her image as a noble woman of strength by authors, in plays, in education and religion are observed. Various drawings, illustrations, television programs and films related to Joan of Arc in a number of different cultures and countries are assessed.

Provides information on a study which investigated the impact of the case mix-adjusted reimbursement policy and market factors on the performance of nursing home care in the United States. Analysis of fixed-effects regression; Details on a decrease in excess or empty nursing home beds; Information on Medicaid residents; Methodology used to conduct the study; Results of the study.

Discusses the experiences of nonpassenger shippers and receivers, private, common and contract carriers after a year of deregulation in Florida. Overall carrier and shipper perceptions of deregulation; Comparison of carriers and shippers by regulatory preferences; Differences between the opponents and proponents of deregulation with respect to rate setting and profit levels.

The potential of 3,4,5-trichloropyridazine to induce contact sensitization was assessed in the guinea pig maximization test of Magnusson and Kligman and also in the closed patch test described by Buchler. The test material was a 1% solution of 3,4,5-trichloropyridazine in a highly refined mineral oil. The test material elicited moderate to severe irritation when diluted in mineral oil to concentrations of 15-25% and minimal irritation at concentrations of 1-3%. Both tests clearly indicated that 3,4,5-trichloropyridazine was a contact sensitizer to guinea pigs, although the response was stronger in the maximization test. Sensitization was distinguished from irritation by the use of concurrent irritation control groups. [ABSTRACT FROM AUTHOR]

The chemical ionization mass spectrometric (CIMS) analysis of doxylamine, N,N-dimethyl-2-[1-phenyl-1-(2-pyridinyl)ethoxy]ethanamine, and related compounds, using both ammonia and methane as reagent gases, is discussed. The two reagent gases did not produce the same major fragment ion for doxylamine. Mechanisms for the fragmentation of doxylamine under either ammonia or methane CIMS conditions are proposed. The mechanisms explain the observation of an m/ z 182 fragment ion for doxylamine analyzed under methane CIMS conditions and an m/ z 184 product ion detected under ammonia CIMS conditions. [ABSTRACT FROM AUTHOR]

Discusses works on the motor carrier service to the rural shipper/receivers (S/R) and the agricultural commodity S/R under regulated and unregulated environments in the United States. Effect of the Motor Carrier Act on rural and agricultural S/R; Economic arguments in the regulatory debate; Perceptions of rural S/R on the quantity of motor carrier service offered after deregulation or relaxation of regulation; Discrimination of small S/R.

It is commonly asserted that with release from economic regulations, motor carriers will eliminate or sharply reduce services to small and inconveniently located shipper/receivers. In this study the experiences of shipper/receivers under Florida deregulation are examined. Shipper/receiver experiences are compared according to firm size, community size, and proximity to major metropolitan areas or highways. The results indicate that while firm size has little bearing on service, locational factors are important. For all shipper/receiver subgroups, however, those indicating improvements greatly outnumber those reporting erosions in service. [ABSTRACT FROM AUTHOR]