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The article details the Consortium for the Assessment of College Equivalancy (CACE) educational program in the U.S. The program's review team evaluates, among others, the learning experience to determine whether or not it is appropriate to the stated learning outcomes and competencies. It states that as its primary goal, CACE will leverage its members' expertise to allow them to realize their vision of higher education for adult learners.

Twenty-one warm-season heavy-rainfall events in the central United States produced by mesoscale convective systems (MCSs) that developed above and north of a surface boundary are examined to define the environmental conditions and physical processes associated with these phenomena. Storm-relative composites of numerous kinematic and thermodynamic fields are computed by centering on the heavy-rain-producing region of the parent elevated MCS. Results reveal that the heavy-rain region of elevated MCSs is located on average about 160 km north of a quasi-stationary frontal zone, in a region of low-level moisture convergence that is elongated westward on the cool side of the boundary. The MCS is located within the left-exit region of a south-southwesterly low-level jet (LLJ) and the right-entrance region of an upper-level jet positioned well north of the MCS site. The LLJ is directed toward a divergence maximum at 250 hPa that is coincident with the MCS site. Near-surface winds are light and from the southeast within a boundary layer that is statically stable and cool. Winds veer considerably with height (about 140°) from 850 to 250 hPa, a layer associated with warm-air advection. The MCS is located in a maximum of positive equivalent potential temperature θ[sub e] advection, moisture convergence, and positive thermal advection at 850 hPa. Composite fields at 500 hPa show that the MCS forms in a region of weak anticyclonic curvature in the height field with marginal positive vorticity advection. Even though surface-based stability fields indicate stable low-level air, there is a layer of convectively unstable air with maximum-θ[sub e] CAPE values of more than 1000 J kg[sup -1] in the vicinity of the MCS site and higher values upstream. Maximum-θ[sub e] convective inhibition (CIN) values over the MCS centroid site are small (less than 40 J kg[sup -1] ) while to the south convection is limited by large values of CIN (greater than 60 J kg[sup -1] ). Surface-to-500-hPa composite average relative humidity values are about 70%, and composite precipitable water values average about 3.18 cm (1.25 in.). The representativeness of the composite analysis is also examined. Last, a schematic conceptual model based upon the composite fields is presented that depicts the typical environment favorable for the development of elevated thunderstorms that lead to heavy rainfall. [ABSTRACT FROM AUTHOR]

Examines physical processes associated with heavy snowfall in South Dakota. Major synoptic features at the time of the most intense snowfall; Evidence of a warm front extending eastward ahead of the system through Missouri and two cold fronts pinwheeling southward from the center of low pressure; Prime location for upper-level divergence and synoptic-scale upward motion.

Investigates the association of comic books with the perpetuation of racial stereotypes in the U.S. Reconciliation to the contradiction between the ideology of democracy and the practice of prejudice; Foundation for stereotyped depictions of race; Representation of racial and sexual identity by the superheroes.

INTRODUCTION: We report the early results of patients treated with stapled hemorrhoidectomy, which has recently been introduced into the United States. METHODS: Sixty-eight patients with symptomatic hemorrhoids were treated at two institutions with the Proximate® HCS Hemorrhoidal Circular Stapler supplied by Ethicon Endo-Surgery. Patients were prospectively evaluated for functional recovery and postoperative pain on a 1 to 10 scale. RESULTS: There were 45 (66 percent) males and 23 (34 percent) females with a mean age of 56 years and median duration of symptoms of 5 years. The mean operative time was 22.2 minutes. The operation was performed with spinal (50 percent), local (40 percent), or general (10 percent) anesthesia and as an outpatient (56 percent) or overnight admission (44 percent). Ninety-three percent of patients remained asymptomatic with a mean follow-up of 34 weeks, whereas the remaining 7 percent required either surgical excision or rubber band ligation for persistent symptoms. There was no mortality, new incontinence, fecal impaction, or persistent pain. The total morbidity was 19 percent, with urinary retention as the most common complication (12 percent). The mean pain score decreased from 3.6 on postoperative Day 1 to 1.4 at postoperative Day 7. Ninety-nine percent of patients made a complete functional recovery by postoperative Day 7. CONCLUSIONS: Stapled hemorrhoidectomy is safe, effective, and can be performed as an outpatient procedure with local or regional anesthesia. There seems to be minimal postoperative pain and early recovery, although a benefit over traditional hemorrhoidectomy needs to be proven in a randomized trial. [ABSTRACT FROM AUTHOR]

Presents a study on the impact of deregulation on the U.S. motor carrier industry and the railroad industry during the 1980s. Disadvantages of deregulation; Percentage changes in the level of transportation rates following deregulation; Effect of deregulation on customer service quality provided by the industries; Competitive threats faced by the carriers; Need for changes in management functions of the industries.

Background: Prior efforts evaluating obesity as a risk factor for postoperative complications following proctectomy have been limited by sample size and uniform outcome classification., Methods: The ACS NSQIP was queried for patients with non-metastatic rectal adenocarcinoma who underwent elective proctectomy. After stratification by BMI classification, multivariable modeling was used to identify the effect of BMI class on adjusted risk of 30-day outcomes controlling for patient, procedure, and tumor factors., Results: Of 2241 patients identified, 33.4% had a normal BMI, 33.5% were overweight, 21.1% were obese, and 12.0% were morbidly obese. Increased risk of superficial surgical site infection (SSI) was observed in obese (OR 2.42, 95%CI:[1.36-4.29]) and morbidly obese (OR 3.29, 95%CI:[1.77-6.11]) patients when compared to normal BMI. Morbid obesity was associated with increased risk of any complication (OR 1.44, 95%CI:[1.05-1.96]). BMI class was not associated with risk adjusted odds of anastomotic leak., Conclusions: Morbid obesity is independently associated with an increased composite odds risk of short-term morbidity following elective proctectomy for cancer primarily due to increased risk of superficial SSI., Competing Interests: Declaration of competing interests The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article. Author MAS discloses consulting interests with Ethicon, Olympus, and Applied. Institutional resources provided financial support for this study and no external funding was received., (Copyright © 2020 Elsevier Inc. All rights reserved.)