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Blown off-course here by an errant trade wind, the bird Perched on a forbidding sign and preened Eurasian mites From its barred caudal feathers, onto our soil. In this Unstable [...]

The poem "Quarters" by Andrew Feld is presented. First Line: Pouring a plastic baggie's worth down the Coinstar's; Last Line: facing the open, empty future of our hands.

The poem "Post-Confessional," by Andrew Feld is presented. First Line: Yesterday I dropped and broke the fountain pwn; Last Line: He would no longer live. It was his decision.

The poem "Cascade Raptor Center: Capture," by Andrew Feld is presented. First Line: He hadn't meant to hit the bird, he said; Last Line: pre-set and loaded with music, just beneath the skin.

Endoscopy is generally safe, well tolerated, and important for both diagnosis and therapeutic interventions. Endoscopic procedures are important for the prevention of colon cancer, the control of active hemorrhage, symptomatic improvement for dysphagia, prevention of cancer in Barrett's esophagus and treatment of pancreatic and hepatobiliary disorders, etc. There has been an ongoing trend towards expansion of uses of therapeutic endoscopic procedures, including minimally invasive procedures, (such as per oral endoscopic myotomy (POEM), gastric per oral endoscopic myotomy, anti-reflux procedures, and bariatric procedures) which may offer a less invasive approach to common diseases than traditional surgical approaches, thus expanding the opportunity to help patients, including older and increasingly frail patients. There is also increased capacity of standard procedures such as colonoscopy to remove larger polyps and flat lesions, which also reduces the need for surgery (and attendant surgical complications), but with the potential for increased colonoscopic complications. Thus, advances in endoscopy come with potential costs, particularly as the complexity of the procedure and the frailty of the patient increase. Despite risk reduction interventions and endoscopic expertise, complications are essentially inevitable given the procedural volume and complexity of procedures provided by most gastroenterologists. The awareness of complications has been accompanied by increased attention for prevention and managing endoscopic complications, as well as the need for ethical disclosure of complications in a transparent manner and the development of programmatic approaches to complication management. This article will explore: (1) actions to prevent complications, (2) understanding how to manage complications that will inevitably arise, (3) understanding legal liability that may result from complications, and (4) discuss strategies to minimize liability. This article is meant for educational purposes and does not constitute specific legal advice. Please consult with your healthcare attorney for specific legal advice.

Presents the poem "Great Hill Lyric," by Andrew Feld.

Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N = 103) and without IBS (N = 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.

• The mortality from upper gastrointestinal (GI) tract bleeding has remained constant at 10% during the past 40 years. Many drugs may precipitate upper GI tract bleeding by disrupting the gastric mucosal barrier. Aspirin-induced injury to the gastric mucosa and GI tract bleeding have been documented in many studies; some of the mechanisms involved are known, but others are still being investigated. An approach to the bleeding patient is suggested; initial resuscitation, history taking, physical examination, determination of bleeding levels, and diagnostic procedures to determine the cause of bleeding are reviewed. Also described are available therapies for GI tract bleeding—gastric lavage, drug therapy, endoscopic control, electrocautery, thermal probe, tissue adhesive, and laser photocoagulation. The merits of the argon laser and the neodymium-yttrium aluminum garnet laser (both still in experimental stages) are described and compared. No pharmacologic or endoscopic therapies for upper GI tract bleeding have been proved effective.(Arch Intern Med 1981;141:322-327)

The poem "Memorial Overpass, I-94, ND" by Andrew Feld is presented. First Line: No Services, the emptiness declares, Last Line: And call "larger than life," which nothing is.

The poem "There," by Andrew Feld is presented. First Line: Sound of the air's fabric tearing apart, Last Line: There, there, Sweetie, don't cry, she said. There. There.

In this article, the editor-in-chief of the journal discusses the need for editors, editorial practices of the journal along with the role of editor and submission of articles to the journal.

An introduction is presented in which the editor highlights the literary works from the University of Washington (UW) creative writing professors and faculty members such as Linda Bierds and Maya Sonenberg.

This editorial presents an introduction to the journal in which the editor discusses the changes to the journal format such as the publication of only long poems, novellas and essays.

Presents the poem "Tongue: An Ode," by Andrew Feld. First Line: Tongue doesen' fit in: the only muscle to protrude; Last Line: of its tongue fits perfectly into the beak's stone sheath.

Presents the poem "Opium Poppies II," by Andrew Feld.

Presents the poem "Zealot," by Andrew Feld.