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Functional popliteal artery entrapment syndrome (fPAES) is an underdiagnosed and undertreated etiology of atypical claudication. Symptoms of fPAES include deep posterior muscle cramping and pain with exercise and, unlike anatomic PAES, there are seldom vascular complications. Common noninvasive diagnostic modalities include ankle-brachial index, arterial duplex Doppler ultrasound (DUS) examination, and cross-sectional imaging such as magnetic resonance angiography (MRA). Entrapment can be difficult to reproduce during diagnostic testing, requiring provocative maneuvers. Because we believed different provocative maneuvers provide different diagnostic efficacy, we sought to optimize our diagnostic approach to fPAES.We performed a retrospective review of patients before and after optimizing our noninvasive imaging protocol comparing patients with fPAES versus other atypical claudicants with chronic compartment syndrome.Arterial DUS examination and exercise ankle-brachial index were important components of our protocol with a significant decrease in systolic posterior tibial blood pressure of -14 mm Hg after exercise, whereas nonentrapment release patients had an overall increase of 8 mm Hg (P = .006). Arterial DUS examination of the distal PA with forced plantarflexion demonstrated a trend toward an increase in the measured velocity ratio, especially in the middle and distal PA. MRA with stressed plantar flexion findings were positive in 6 of 11 patients with fPAES, with false negatives likely owing to patients' inability to maintain a provocative position for the duration of the MRA.Diagnosing fPAES is challenging owing to a lack of standardized diagnostic testing and provocative maneuvers. Different maneuvers demonstrated varying diagnostic yields for fPAES. Exercise ABIs were the most reliable vascular laboratory test to detect changes attributable to fPAES and to distinguish it from chronic compartment syndrome. Segmental PA DUS examination seems to be promising as a means of detecting PA impingement. Stress positional MRA effectively demonstrates anatomic PAES, but has a false-negative rate for fPAES.

Academic incivility is defined as behavior incongruent with the welfare of the classroom community and may take a number of forms and levels of intensity. This study seeks to determine the relationship between the Dark Triad personalities (Machiavellianism, narcissism, and psychopathy) and perceptions of appropriateness and frequency of academic incivilities. A sample of 519 university students indicated the degree to which each of 20 uncivil academic behaviors was perceived appropriate and how often students perceived those behaviors in the classroom. Factor analysis of the academic incivilities produced six factors: Low Class Engagement, Poor Class Presence, Student Retaliation, Cheating, Class Disruption, and Attempted Domination. Hierarchical linear regression analysis showed that Machiavellianism, and to a lesser extent, narcissism, predicted both perceptions that academic incivilities were appropriate and the frequency of observations of incivilities. Psychopathy had no relationship with either perceptions of appropriateness or frequency of observation.

To compare methamphetamine users who develop heart failure to those who do not and determine predictors.Patients presenting over a two-year period testing positive for methamphetamine on their toxicology screen were included. Demographics, vital signs, echocardiography and labs were compared between patients with normal versus abnormal B-type natriuretic peptide (BNP).4407 were positive for methamphetamine, 714 were screened for heart failure, and 450 (63%) had abnormal BNP. The prevalence of abnormal BNP in methamphetamine-positive patients was 10.2% versus 6.7% for those who were negative or not tested. For methamphetamine-positive patients, there was a tendency for higher age and male gender with abnormal BNP. A higher proportion of Whites and former smokers had abnormal BNP and higher heart and respiratory rates. Echocardiography revealed disparate proportions for normal left ventricular ejection fraction (LVEF) and severe dysfunction (LVEF30%), LV diastolic function, biventricular dimensions, and pulmonary arterial pressures between subgroups. For methamphetamine-positive patients with abnormal BNP, creatinine was significantly higher, but not Troponin I. Logistic regression analysis revealed predictors of abnormal BNP and LVEF30% in methamphetamine-positive patients, which included age, race, smoking history, elevated creatinine, and respiratory rate.Methamphetamine-positive patients have a significantly higher prevalence of heart failure than the general emergency department population who are methamphetamine-negative or not tested. The methamphetamine-positive subgroup who develop heart failure tend to be male, older, White, former smokers, and have higher creatinine, heart and respiratory rates. This subgroup also has greater biventricular dysfunction, dimensions, and higher pulmonary arterial pressures.

Measurements of BVOC emissions, ozone concentration and environmental parameters were carried out from May 2013 to January 2016 in a subtropical Pinus plantation in China. Isoprene and monoterpene emissions were measured using a relaxed eddy accumulation (REA) system and a gradient technique on an above-canopy tower. In 2013, isoprene comprised 21.2% of total terpenoid emissions, while α-pinene, camphene, β-pinene and limonene constituting 51.5%, 2.4%, 9.1%, and 13.0% of total emissions, respectively. Monoterpenes together were the dominant VOCs measured contributing 71.6%. α-pinene, camphene, β-pinene and limonene constituted 67.7%, 3.2%, 11.9%, 17.2% of total monoterpene emissions. Isoprene and monoterpene emissions displayed strong diurnal variations, with lower emissions in the morning and late evening, and the highest emissions around noon. BVOC peak emissions typically occurred a few hours after the noon PAR peak. Isoprene and monoterpene emissions varied with season and were the highest in summer, contributing more than half of the total annual emission, and the lowest emissions were in winter. Evident interannual variations of isoprene, monoterpenes and total BVOCs were observed. Compared to 2013, annual BVOC emissions decreased in 2015, associated with decreases of PAR, Temperature, water vapor, and an increase of all substances in gas, liquid and solid phases in the atmospheric column (e.g., S/Q, the ratio of solar scattered radiation to global radiation). Ozone concentration showed clear diurnal variation with PAR, higher around noon and lower in the early morning and late evening. Generally, there were no evident correlations between ozone concentrations and BVOC emissions, or the vertical gradients of ozone concentrations and BVOC concentrations. Under all sky conditions (including cloudy skies), no strong correlations at a high confidence level or very similar variation patterns were observed between any two following parameters, BVOC emissions, PAR, temperature, water vapor, and S/Q. The major factors controlling BVOC emissions were PAR and temperature but biomass burning smoke and phenology (pine florescence) may also play a role. The mean emission factors at standard conditions determined using the MEGAN model emission algorithms and empirical model of BVOC emissions were 0.71 and 1.19 mg m −2 h −1 for isoprene and 1.39 and 1.65 mg m −2 h −1 for total monoterpenes, respectively.

Isoprene and monoterpene emissions and environmental conditions were measured over a six month period in a Lei bamboo (Phyllostachys violascens) forest in a subtropical region in China. Isoprene and monoterpene emissions were measured using a relaxed eddy accumulation (REA) system on an above-canopy tower. From July to November of 2012, isoprene contributed 99.1% of terpenoid emissions. α-pinene, constituting 0.8% of total observed terpenoid emissions, was the only monoterpene for which a significant flux was detected. Emissions of the sesquiterpenes longifolene and α-cedrene were observed at very low rates. Isoprene and α-pinene emissions exhibited strong diurnal variations, with lower emissions in the morning and late evening, and the highest emissions around noon. BVOC peak emissions typically occurred a few hours after the noon PAR peak and coincided with the daily temperature peak. This behavior can be described reasonably well by the MEGANv2.1 biogenic emission model. During the campaign (i.e., from 7 July, 2012 to 19 Jan., 2013), the mean (and maximum) emission fluxes (mg m −2 h −1 ) were 0.95 (10.32) for isoprene, 0.010 (0.176) for α pinene, 0.001 (0.063) for longifolene, and 2.6 × 10 −4 (0.009) for α-cedrene, respectively. During the winter season, when the ground was covered by organic mulch to increase soil temperature and to increase the yield of bamboo shoot, there was no evident impact on BVOC emissions. The observed seasonal variation followed the general behavior predicted by the MEGANv2.1 model, with lower emissions associated with cooler conditions, but the magnitude of the emission decrease was greater than expected indicating driving variables are missing from the model. Emission factors, representing the emission expected for a Leaf Area Index of 5 at a temperature of 30 °C and PAR of 1500 μmol m −2 s −1 , during the peak growing season for this site were 0.008 mg m −2 h −1 for α-pinene and 3.3 mg m −2 h −1 for isoprene. The isoprene emission factor is similar to the value (3.6 mg m −2 h −1 ) for this location in the MEGANv2.1 global biogenic emission model. A second bamboo plantation, containing Moso bamboo ( Phyllostachys heterocycla ), was investigated and found to have similar isoprene and monoterpene emission rates as Lei bamboo forest. The emission data obtained in this study are the first canopy-scale flux measurements reported for bamboo plantations and demonstrate the potential importance of bamboo isoprene emissions for regional ozone and organic aerosol production.

Phenotyping has become the rate-limiting step in using large-scale genomic data to understand and improve agricultural crops. Here, the Bellwether Phenotyping Platform for controlled-environment plant growth and automated multimodal phenotyping is described. The system has capacity for 1140 plants, which pass daily through stations to record fluorescence, near-infrared, and visible images. Plant Computer Vision (PlantCV) was developed as open-source, hardware platform-independent software for quantitative image analysis. In a 4-week experiment, wild Setaria viridis and domesticated Setaria italica had fundamentally different temporal responses to water availability. While both lines produced similar levels of biomass under limited water conditions, Setaria viridis maintained the same water-use efficiency under water replete conditions, while Setaria italica shifted to less efficient growth. Overall, the Bellwether Phenotyping Platform and PlantCV software detected significant effects of genotype and environment on height, biomass, water-use efficiency, color, plant architecture, and tissue water status traits. All ∼ 79,000 images acquired during the course of the experiment are publicly available.

Academic entitlement is a well-established problem; however its causes are not well understood. This study (n = 169) investigated the role of the Dark Triad as a predictor of academic entitlement. The Dark Triad, comprised of Machiavellianism, narcissism, and psychopathy, was measured with Jonason and Webster’s (2010) concise measure, and academic entitlement was assessed with Chowning and Campbell’s (2009) academic entitlement construct (comprised of externalized responsibility and entitled expectations). Gender and psychopathy predicted externalized responsibility and narcissism predicted entitled expectations. Findings are discussed regarding the contribution of psychopathy and narcissism to academic entitlement. Also discussed is the potential learned aspect of entitlement, due to narcissism being a cause of both entitled behavior and resultant uncivil behavior that occurs when entitled behaviors fail to achieve the desired outcome.

Contributed Measurements of BVOC emissions, meteorological parameters, and solar radiation were carried out in a temperate forest, China during the summer seasons in 2010 and 2011. Terpenoid emissions were measured using the Relaxed Eddy Accumulation (REA) technique on an above-canopy tower. Isoprene contributed 79.1% and 82.0% of terpenoid emissions in 2010 and 2011 summer. The monoterpene emissions were dominated by α–pinene, contributing 6.3% and 12.2% of the total terpenoid emissions in 2010 and 2011 summer. Terpenoid emissions exhibited strong diurnal variations. Isoprene and monoterpene emissions maxima typically occurred a few hours after the noon PAR peak and coincided with the daily temperature maximum. During 2011 summer, the mean isoprene emission flux (mg m –2 h –1 ) was 0.889, mean total monoterpene emission flux was 0.143. Emission factors, representing the emission expected at a temperature of 30 °C, for this site were 0.32 mg m –2 h –1 for total monoterpenes and 4.3 mg m –2 h –1 for isoprene. The observations were used to evaluate the isoprene and monoterpene emission magnitude and variability predicted by the MEGANv2.1 model. Canopy scale isoprene and monoterpene emission factors based on these observations fall within the range of emission factors assigned to locations within 50 km of the site by the MEGANv2.1 emission model. When using the site specific landcover data for the site, the measured emission factors are 12% for isoprene and 20% for monoterpenes lower than the MEGANv2.1 emission factors. MEGANv2.1 predicts that variations in light intensity should result in significant changes in isoprene emissions during the study but this was not evident in the observations. Observed diurnal, seasonal and interannual variations in isoprene and monoterpene emissions were strongly correlated with air temperature which was the dominant driving variable for MEGANv2.1 during the study period. The observed temperature response for isoprene and monoterpenes is similar to the temperature sensitivity of the MEGANv2.1 response functions.

Total OH reactivity was measured during the Bio-hydro-atmosphere interactions of Energy, Aerosols, Carbon, H 2 O, Organics and Nitrogen-Southern Rocky Mountain 2008 field campaign (BEACHON-SRM08) held at Manitou Experimental Forest (MEF) in Colorado USA in August, 2008. The averaged total OH reactivity was 6.7 s −1 , smaller than that measured in urban (33.4 s −1 , Yoshino et al., 2012 ) and suburban (27.7 s −1 , Yoshino et al., 2006 ) areas in Tokyo in the same season, while sporadically high OH reactivity was also observed during some evenings. The total OH reactivity measurements were accompanied by observations of traces species such as CO, NO, NO y , O 3 and SO 2 and Volatile Organic Compounds (VOCs). From the calculation of OH reactivity based on the analysis of these trace species, 46.3% of OH reactivity for VOCs came from biogenic species that are dominated by 2-methyl-3-buten-2-ol (MBO), and monoterpenes. MBO was the most prominent contribution to OH reactivity of all trace species. A comparison of observed and calculated OH reactivity shows that the calculated OH reactivity is 29.5% less than the observed value, implying the existence of missing OH sinks. One of the candidates of missing OH is thought to be the oxidation products of biogenic species.

Over the past decade, new and emerging technologies in air pollution instrumentation have made it possible to involve students and citizen scientists in air pollution monitoring. Similarly, advances in data communication and transmission have made it increasingly easy to share and graphically display data. Two educational programs, the Global Ozone (GO3) Project and AQTreks, have used these advances to get air pollution monitors into the hands of thousands of students around the world and to automate data sharing. The pilot project for AQTreks, GO3 Treks, is also discussed. These educational projects began in 2009 with the GO3 Project, a stationary ground-level ozone monitoring project. In the GO3 Project, students and teachers at more than 100 schools from around the world installed ozone and weather monitoring stations at their schools with automatic uploading of their data every 15 min, resulting in more than 12 million ozone measurements along with associated weather data. Over the years, new technologies became available for students to expand their measurements from stationary to mobile platforms. Since 2016, the AQTreks educational program has been developed concurrently with the Personal Air Monitor (PAM), a mobile sensor suite paired with a smartphone app. Complementing the technology are online curricula and other resources for students and citizens to learn about air pollution and climate change. In these projects, a focus on data quality and the careful selection of monitoring technologies have resulted in scientific use of the student-collected data, including their incorporation in several research campaigns that have furthered understanding of ground-level ozone formation. This approach has demonstrated the utility of these types of educational programs both in terms of furthering scientific research and educating the next generation about air quality issues. Keywords: Citizen science, Community science, K-12 education, Air pollution, Miniaturized instruments, Sensors, Atmospheric chemistry, Mobile monitoring, Stationary monitoring

Atmospheric Environment 70 (2013) 447e453 Contents lists available at SciVerse ScienceDirect Atmospheric Environment journal homepage: www.elsevier.com/locate/atmosenv Impact of biogenic volatile organic compounds on ozone production at the Taehwa Research Forest near Seoul, South Korea So-Young Kim a , Xiaoyan Jiang b , Meehye Lee c , Andrew Turnipseed b , Alex Guenther b , Jong-Choon Kim a , Suk-Jo Lee a , Saewung Kim b, * a b c National Institute of Environmental Research, Kyungseo-Dong, Seo-gu, Incheon 404-708, South Korea National Center for Atmospheric Research, 3090 Center Green Dr., Boulder, CO 80301, USA Department of Earth and Environmental Sciences, Korea University, 145 Anam Ro, Sungbuk-Gu, Seoul 136-701, South Korea h i g h l i g h t s < We presented trace gas observation results in the suburban Seoul Metropolitan Area. < We found BVOCs are dominant OH chemical sinks. < WRF-Chem modeling results show that BVOCs are important ozone precursors. a r t i c l e i n f o a b s t r a c t Article history: Received 13 June 2012 Received in revised form 31 October 2012 Accepted 5 November 2012 The importance of biogenic volatile organic compounds (BVOCs) in understanding of air-quality and climate on regional to global scales has been highlighted in a number of modeling and observational studies. At the same time, another important emerging research topic in atmospheric chemistry is the regional and global impacts of fast growing East Asian megacities. These two research topics must be integrated in order to adequately understand and address air quality challenges emerging from Eastern Asian megacities surrounded by planted or natural forest areas. We present initial measurement results for May, June and September 2011 from the Taehwa Research Forest (TRF) which has been developed to serve as a long term observatory for investigating biosphereeatmosphere interactions at the edge of the Seoul Metropolitan Area (population of w23.5 million). The comprehensive measurement datasets of ozone and its precursors such as CO, NO x , SO 2 and VOCs shows that high ozone episodes in the suburban site could not be explained by just anthropogenic pollutants alone. In addition, isoprene (C 5 H 8 ) and monoterpenes (C 10 H 16 ) were observed as two of the most important OH chemical sinks inside of the forest canopy. In order to understand the impacts of these BVOCs on ozone and related photochemistry, we conducted model sensitivity simulations using a coupled meteorology-chemistry model (WRF-Chem) for conditions including with and without BVOC emissions. The modeling results suggest that BVOC emissions could enhance regional daytime ozone production from 5 to 20 ppbv. The observed temporal variations in ozone correspond well with the variations in BVOCs, which likely reflects the influence of BVOCs on ozone formation. These findings strongly suggest that interactions between anthropogenic pollutants and BVOCs must be understood and quantified in order to assess photochemical ozone formation in the regions surrounding East Asian megacities. O 2012 Elsevier Ltd. All rights reserved. Keywords: Tropospheric ozone BVOCs WRF-Chem Asian megacities 1. Introduction Over the past three decades, the importance of biogenic volatile organic compounds (BVOCs) for tropospheric photochemistry has * Corresponding author. Present address: Department of Earth System Science, University of California, Irvine, Irvine, CA, USA. Tel.: þ1 949 824 4531. E-mail address: saewungk@uci.edu (S. Kim). 1352-2310/$ e see front matter O 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.atmosenv.2012.11.005 been intensively studied. They are expected to have a major global role since BVOC emission is estimated to be much higher than anthropogenic volatile organic compound (AVOC) emission (Guenther et al., 2006; Goldstein and Galbally, 2007). The global dominance of BVOC is not only just in the total amount of emissions but also because BVOC reactivity with oxidants in the troposphere (e.g. hydroxyl radical (OH), ozone, and nitrate radical (NO 3 )) is usually much higher than for AVOCs. The reactivity contributions from ambient BVOC concentrations is often much higher than that

Seafood is widely considered to be either fished or farmed. In contrast to this perception, many types of seafood are produced by enterprises using a combination of techniques traditionally ascribed to either fisheries or aquaculture. Categorizing seafood as either fished or farmed obfuscates the growth potential and environmental impacts of global seafood production. To better capture seafood data, national and international record-keeping organizations should add a new hybrid category for seafood produced using both fisheries and aquaculture methods.

Popliteal entrapment syndrome, a term originally coined by Love and Whelan in 1965, is a rare form of overuse injury clinically manifest by a complex of neuromusular or ischemia symptoms in the lower extremity resulting from pathologic impingeent behind the knee. In 1879, Stuart documented an apparent relationship between opliteal artery occlusion, ischemic gangrene, and an abnormal passage of the opliteal artery medially around the medial head of the gastrocnemius muscle. Since hen, numerous congenital variations in the development and insertion of the astrocnemius and popliteus muscles have been documented as a cause for athologic impingement behind the knee. Vascular anomalies, such as aberrant geniculate branches, have also been described as unusual sources for impingement. These abnormalities, although quite rare, are associated with an increased risk of threatening lower extremity ischemia, particularly in adolescents and young adults. Focal impingement results in repetitive microtrauma to the popliteal vessels, causing chronic inflammation and subsequent occlusive or aneurysmal change. These vascular anomalies are responsible for embolic and thrombotic events that result in claudication or limb-threatening ischemia. Popliteal entrapment syndrome associated with aberrant musculotendinous impingement requires surgical intervention. Saphenous vein bypass is the most commonly performed procedure when arterial stenosis, occlusion, or aneurysm is present. If there is no significant intrinsic vascular disease associated with impingement, the retrogeniculate approach is appropriate, with resection of the offending muscle band or ligation and transection of the aberrant geniculate vessels causing impingement. The anatomic form of popliteal entrapment should always be suspected when isolated lower extremity ischemia (claudication, embolism) occurs in young adults with no evidence of cardiac or diffuse peripheral vascular disease. In 1985, a French surgeon named Rignault described an atypical form of claudication in military recruits. He documented lateral arterial impingement with stress positional

Increase of serum troponin I and ST-segment depression are objective markers of myocardial ischemia/injury. Abnormalities of the 2 indicators have been associated with supraventricular tachycardia (SVT) but their relevance for diagnosing acute coronary syndrome and the presence of coronary artery disease (CAD) in this setting have not been clarified. Therefore, we sought to evaluate the frequency of CAD based on increased troponin I and ST-segment depression during SVT. During a 5-year period, 104 patients were admitted with a diagnosis of SVT, 80 of whom had troponin I testing, and 70 of these patients could be assessed for ST-segment changes. Thirty-seven patients (48%) had increased troponin I (mean 1.54 +/- 2.7 ng/dl, normalor=0.07 ng/dl) and 46 patients (57%) had ST-segment depressionor=1.0 mm. There were no significant differences in baseline characteristics and clinical presentation of patients with and without troponin I increase or ST-segment depression. There was no difference in the diagnosis of CAD by noninvasive or invasive testing in patients with and without increased troponin I. More patients with than without ST-segment depression had evidence of CAD (22% vs none, p = 0.01), but after adjusting for covariates, ST-segment depression was not a significant predictor of CAD. In conclusion, increased troponin I and ST-segment depression are not significant markers of acute coronary syndrome in patients with SVT.

Ecosystem level ozone (O3) fluxes during four different years were examined at a subalpine forest site in the Colorado Rocky Mountains. The local mountain–valley wind system and the proximity of the Denver Metropolitan area leads to high summertime ozone episodes on many afternoons. The timing between these episodes and the ecosystem processes controlling photosynthesis during the growing season plays a critical role in determining the amount of ozone deposition. Light and vapor pressure deficit (VPD) were the most dominant environmental drivers controlling the deposition of O3 at this site through their influence on stomatal conductance. 81% of the daytime O3 uptake was predicted to occur through the stomata. Stomatal uptake decreased at high VPD and temperatures leading to an overall decrease in O3 flux; however, we did observe a non-stomatal conductance for O3 that increased slightly with temperature before leveling off at higher values. During the growing season, O3 deposition fluxes were enhanced after midday precipitation events and continued at elevated levels throughout the following night, implying a role for surface wetness. From nighttime data, evidence for both the presence of water films on the needles and non-closure of the plant stomata were observed. During the winter (nongrowing) season, the ozone deposition velocity showed a consistent dependency on the latent heat flux. Although the mechanism is unclear, it is apparent that precipitation events play a role here through their influence on latent heat flux.

A derivatization procedure using phenyl isocyanate was adapted to liquid chromatography ion trap mass spectrometry (LC-MS(n)) for confirmation and quantification of aminoglycoside residues in milk. Aminoglycoside residues were extracted from milk with acid and isolated from the matrix with a weak cation exchange solid-phase extraction cartridge. After isolating the compounds from the milk, derivatives of gentamicin, neomycin, and tobramycin were formed by reacting the drugs with phenyl isocyanate in the presence of triethylamine. The analytes were separated using a dilute formic acid/acetonitrile gradient on a reversed-phase LC column. The derivatized compounds were analyzed using positive ion electrospray LC-MS(n) with ion trap detection. Product ion spectra were generated from the derivatized protonated molecules. Specific ion transitions were evaluated for quantitative determination and qualitative confirmation of residues in milk. Using this procedure, residues were qualitatively confirmed in milk samples fortified with gentamicin and neomycin at levels ranging from 15 to 300 ng mL(-1). Gentamicin has four major components that were successfully separated and confirmed independently; for quantitative determination the peak areas from the four analogs were summed. Tobramycin was added as an internal standard for quantitation to mitigate the effects of matrix ion suppression and variable recoveries. Overall recoveries for this method ranged from 80% to 120% with relative standard deviations of less than 25%. The method detection limits are 9.8 ng mL(-1) for NEO and 12.8 ng mL(-1) for total GEN residues.

Atmospheric Environment 43 (2009) 2672–2677 Contents lists available at ScienceDirect Atmospheric Environment journal homepage: www.elsevier.com/locate/atmosenv Short communication Tethered balloon-based soundings of ozone, aerosols, and solar radiation near Mexico City during MIRAGE-MEX J.P. Greenberg * , A.B. Guenther, A. Turnipseed National Center for Atmospheric Research, Boulder, CO 80307, USA a r t i c l e i n f o a b s t r a c t Article history: Received 17 December 2008 Received in revised form 6 February 2009 Accepted 8 February 2009 A tethered balloon sampling system was used to measure vertical profiles of ozone, particles, and solar radiation in the atmospheric boundary layer on the northern edge of Mexico City, in March 2006 as part of the Megacity Impact on Regional and Global Environment-Mexico experiment. Several commercial sensors, designed for surface applications, were deployed on a tethered balloon platform. Profiles indicate that for these 3 scalars the boundary layer (surface up to 700 m) was well mixed in the period 10:00–16:00 LST. Good agreement was observed for median surface and balloon ozone and particle number concentrations. For most profiles, the surface deposition of ozone was not significant compared to median profile concentrations. Particle number concentration (0.3, 0.5, 1.0 and 5.0 m m) also showed little variation with attitude. Radiatprofiles showed a monotonic increase in diffuse radiation from the maximum altitude of profiles to the surface. Consequently, it was inferred that surface measurements of these likely were representative of lower boundary layer values during this time period. O 2009 Elsevier Ltd. All rights reserved. Keywords: Tethered balloon Boundary layer Megacity Ozone Radiation Particles 1. Introduction The MIRAGE (Megacity Impact on Regional and Global Envi- ronment)-MEX field campaign (March 2006) was designed to examine the chemical and physical transformations of gases and aerosols in the polluted outflow from Mexico City. The campaign included observations from ground stations, aircraft, and satellites. (An overview of the experiment is given in Molina et al., 2008). Surface measurements were made at three primary sites: central Mexico City (T0, Instituto Mexicano de Petroleo), the Technical University of Tecamac (T1), approximately 35 km NW of T0, and Rancho de Bisnaga (T2), approximately 70 km from T0. The sites were selected to characterize polluted MC air as it aged in transit from its source (arbitrarily set at T0). The balloon–platform profiles presented here are from the T1 site (19N42.184, 98W59.917, 2270 m asl) from 13 to 28 March 2006. The primary objective of the tethered balloon study was to deter- mine if surface measurements accurately reflected concentrations in the boundary layer, so that ground based data might be extended to characterize to the atmospheric boundary layer analysis. Vertical profiles of several variables (ozone, particles, and direct and diffuse * Corresponding author. National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307, USA. Tel.: þ1 303 497 1454; fax: þ1 303 497 1400. E-mail address: greenber@ucar.edu (J.P. Greenberg). 1352-2310/$ – see front matter O 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.atmosenv.2009.02.019 solar radiation) were made to illustrate mixing from the surface to the maximum balloon height (usually between 400 and 700 m above ground level). 2. Experiment details 2.1. Instrumentation Extensive details of tethered balloon profiling in the atmo- spheric boundary layer have been provided previously (Greenberg et al., 1999; Greenberg and Guenther, 2002). Several commercial lightweight sensors were deployed on the balloon platform. Ozone was measured by a UV absorption ozone analyzer (2B Technologies, Boulder, CO, 2.1 kg); a glass fiber filter was placed on the inlet to prevent interference of dust in the optical cell. Ten second average data are reported for each profile. The relative standard deviation of 1 min averaged data was determined experimentally to be approximately 1.3% at approximately 70 ppb. An optical particle counter (Abacus, Particle Measurement Systems, Boulder, CO, 1 kg) was also deployed. Particles numbers were counted for discrete 0.3, 0.5, 1 and 5 m m sizes; 45 s average number concentrations are reported. The reported collection efficiency is approximately 20% for 0.3 m m particles. Total (global), direct (total minus diffuse) and diffuse radiation were measured using Sunshine Sensor, Model BF3 (Delta-T Devices, Ltd., Cambridge, UK, 0.5 kg). This detector has a sensor array which requires no shadow band and need not be

Liquid chromatographic methods are presented for the quantitative and confirmatory determination of crystal violet (CV; also known as gentian violet), leucocrystal violet (LCV), brilliant green (BG), and leucobrilliant green (LBG) in catfish. LCV and LBG were oxidized to the chromic CV and BG by reaction with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone, and residues were measured as the combined CV+/-LCV and BG+/-LBG. These methods are extensions of published methods for malachite green (MG) analysis to allow simultaneous determination of MG, CV, and BG. Residues were extracted from muscle with ammonium acetate buffer and acetonitrile, and extracts cleaned up using dichloromethane partitioning and solid-phase extraction. Extracts were analyzed by liquid chromatography with visible detection (LC-VIS). The method was validated for catfish fortified with LCV over the range 0.25-10 ngg(-1) and CV at 2 ngg(-1). Average recoveries were 90.6% (+/-8.1% R.S.D., n=45) for LCV and 84.4% (+/-4.2% R.S.D., n=6) for CV. The average recovery for samples fortified with BG or LBG over the range 0.5-10 ngg(-1) was 67.2% (+/-14.8% R.S.D., n=31). CV and BG were confirmed in fish extracts by ion trap LC-mass spectrometry (LC-MS(n)) with no discharge-atmospheric pressure chemical ionization. Average LC-MS(n) recoveries were 96.5, 96.6, and 70.2% for samples fortified with CV, LCV, and BG or LBG. The limits of detection for CV, BG, and MG were in the range of 0.07-0.24 ngg(-1) (ppb) for the two different instrumental methods. This methodology was applied to the analysis of catfish treated with CV and BG.

Duplex ultrasound (US) is used to "rule out" deep venous thrombosis (DVT), but can also diagnose other causes of leg pain or swelling in Emergency Department (ED) patients. Recent literature suggests that US imaging is unnecessary among patients with low or moderate clinical probability of DVT with a normal D-dimer. We attempted to determine the incidence of clinically important incidental findings detected using venous US imaging in patients with suspected lower extremity DVT. We conducted a retrospective chart review of all ultrasounds performed by the non-invasive vascular laboratory on ED patients > 18 years old. Results were classified: normal, DVT, or incidental finding. The latter were classified as clinically significant major findings if the diagnosis led to immediate and specific treatment to prevent morbidity, or clinically significant minor findings. A total of 484 US studies were reviewed; 179 were excluded (arterial studies, penetrating trauma, upper extremity US). Findings among 305 studies were: 238 (78%) normal, 28 (9%) DVT, and 39 (12%) incidental findings. Among 39 incidental findings, 10 were clinically significant major findings and 29 clinically significant minor findings. Clinically significant major findings included: pseudoaneurysm, arterial occlusive disease, vascular graft complication, compartment syndrome, and tumor. Among 38 abnormal US studies that required immediate treatment, DVT comprised 74% (95% confidence interval 59%-85%) and important major incidental findings 26% (95% confidence interval 14%-41%). Among ED patients who underwent US to evaluate leg pain and swelling, 26% of positive studies showed clinically important findings other than DVT. Further research is needed to determine if D-dimer plus a clinical probability tool will include or exclude the patients with clinically significant major findings.

The most common drug prescribed to induce labor in the United States is oxytocin, a peptide hormone composed of nine amino acids. Oxytocin is often reconstituted in intravenous (IV) saline solutions at less than 0.05 units ml(-1) (125 ng ml(-1)) to be delivered at 1-4 drops per minute. Existing LC-UV methods for oxytocin do not have sufficient detection limits to quantitate and/or confirm oxytocin in IV solutions without sample concentration. A determinative and confirmatory method for oxytocin was developed using an LC-MS(n) ion trap instrument with an electrospray ionization (ESI) interface in positive ion mode. Separation was achieved on a C-18 column using an isocratic elution of water with 50% acetonitrile (v/v) and water with 0.05% formic acid (v/v) at a flow rate of 250 microl min(-1). Data was acquired from the selected ion monitoring (SIM) of the precursor ion (m/z 1007.3) and MS(2) scans from the collision induced dissociation of m/z 1007.3 at 30% collision energy. In this method, MS(2) full scans were utilized to obtain three structurally significant ions for the unambiguous identification of oxytocin. Calibration standards, prepared in de-ionized water from 0.006 to 0.046 units ml(-1), were linear with an R(2) value of 0.9983. The methods LOD and LOQ were 0.00084 and 0.0029 units ml(-1) (2 and 7 ng ml(-1)), respectively. This LC-MS(n) method was used to determine the amount of oxytocin in a 0.04 units ml(-1) clinical sample that was prepared in 0.9% sodium chloride IV solution.

Objectives A retrospective study was performed to identify optimal factors affecting outcomes after open revascularization for chronic mesenteric ischemia. Methods All patients who underwent open surgery for chronic mesenteric ischemia from 1987 to 2006 were reviewed. Patients with acute mesenteric ischemia or median arcuate ligament syndrome were excluded. Mortality, recurrent stenosis, and symptomatic recurrence were analyzed using logistic regression, and univariate and multivariate analysis. Results We identified 80 patients (69% women, 31% men). Mean age was 64 years (range, 31-86 years). Acute-on-chronic symptoms were present in 26%. Presenting symptoms included postprandial pain (91%), weight loss (69%), and food fear and diarrhea (25%). Preoperative imaging demonstrated severe (>70%) stenosis of the superior mesenteric artery in 75 patients (24 occluded), the celiac axis in 63 (20 occluded), and the inferior mesenteric artery in 53 (20 occluded). Multivessel disease was present in 72 patients (90%), and 40 (50%) underwent multivessel reconstruction. Revascularization was achieved by endarterectomy in 37 patients, mesenteric bypass in 29, and combined procedures in 14. Concurrent aortic reconstruction was required in 13 patients (16%). Three hospital deaths occurred (3.8%). Mean follow-up was 3.8 years (range, 0-17.2 years). One- and 5-year survival was 92.2% and 64.5%. Mortality was associated with age ( P = .019) and renal insufficiency ( P = .007), but not by clinical presentation. Symptom-free survival was 89.7% and 82.1% at 1 and 5 years, respectively. Symptoms requiring reintervention occurred in nine patients (11%) at a mean of 29 months (range, 5-127 months). Multivariate analysis showed that freedom from recurrent symptoms correlated with endarterectomy for revascularization (5.2% vs 27.6%; hazard ratio, 0.20; 95% confidence interval, 0.04-0.92; P = .02). Conclusion For open surgical candidates, endarterectomy appears to provide the most durable long-term symptom relief in patients with chronic mesenteric ischemia.

Physician reporting of lapses of consciousness (LOC) to the Department of Motor Vehicles is a controversial topic in medicine. The objective of this study was to describe current LOC reporting practices by emergency physicians (EPs) in a state with mandatory reporting requirements (California). A questionnaire describing 14 different clinical scenarios involving LOC was distributed to a diverse sample of California EPs. Clinical scenarios included new seizure, hypoglycemia, atrial fibrillation/rapid heart rate, cerebrovascular accident, micturation syncope, vasovagal syncope, hepatic encephalopathy, alcohol intoxication, closed head injury, hyperosmolar coma, methamphetamine psychosis, dementia, hyperventilation syndrome, and hypercalcemia. Emergency physicians were asked how often they would report these LOC-related conditions to the state. Simple summary statistics were calculated. The response rate was 207/340 (61%) of the forms distributed. The average number of years in Emergency Medicine practice among respondents was 12 (range 1–35), and 57% were Emergency Medicine trained. Of the 14 scenarios, only one (new-onset seizure) was reported frequently by EPs (89% reported “nearly always” or “most of the time”). The remaining 13 scenarios were rarely reported (mean of 86% for “occasionally” or “never”). Although reporting of LOC, from any cause, is mandatory in California, only new-onset seizures are frequently reported by California EPs.

CO2 transport processes relevant for estimating net ecosystem exchange (NEE) at the Niwot Ridge AmeriFlux site in the front range of the Rocky Mountains, Colorado, USA, were investigated during a pilot experiment. We found that cold, moist, and CO2rich air was transported downslope at night and upslope in the early morning at this forest site situated on a � 5% east-facing slope. We found that CO2 advection dominated the total CO2 transport in the NEE estimate at night although there are large uncertainties because of partial cancellation of horizontal and vertical advection. The horizontal CO2 advection captured not only the CO2 loss at night, but also the CO2 uptake during daytime. We found that horizontal CO2 advection was significant even during daytime especially whenturbulentmixingwas notsignificant, such as inearly morningand evening transitionperiodsand withinthe canopy. Similar processes can occur anywhere regardless of whether flow is generated by orography, synoptic pressure gradients, or surface heterogeneity as long as CO2 concentration is not well mixed by turbulence. The long-term net effect of all the CO2 budget terms on estimates of NEE needs to be investigated. # 2007 Elsevier B.V. All rights reserved.

ObjectiveAlthough the mainstay of managing acute descending thoracic aortic dissection (ADTAD) remains medical, certain patients will require emergency surgery for complications of rupture or ischemia. This study evaluates factors that affect outcome and determines which patients previously treated surgically would have been eligible for endovascular repair.MethodsA single-institution retrospective study was conducted of patients who presented with clinical signs of ADTAD that was confirmed by magnetic resonance angiography (MRA) or computed tomography (CT). All patients were admitted to the intensive care unit (ICU) and medically managed to maintain systolic blood pressure 70 years old (P = .035), and in patients who were not receiving β-blocker therapy before the onset of symptoms (P = .023). The combined overall morbidity rate was 33%, and the mortality rate was 9.6%. Morbidity in group 2 was 64% and significantly higher than the 23% in group 1 (P = .00227). The mortality rate was also higher in group 2 at 31.5% compared with group 1 at 1.6% (P = .0004). Factors affecting the overall mortality included age >70 years (P = .057), previous abdominal aortic aneurysm repair (P = .018), tobacco use (P = .039), and the presence of leg pain at initial presentation (P = .013). As determined from the review of radiologic data, 11 of 13 patients with scans available for review in group 2 could have been treated with currently available endovascular grafts.ConclusionsIntensive medical therapies are effective in preventing early mortality associated with ADTAD. Predictably, the need for emergency surgery carries a high morbidity and mortality rate. Most patients in this series requiring emergency surgery could have been candidates for endovascular therapy had it been available.

A liquid chromatography-mass spectrometry (LC-MS) method was developed to screen and confirm veterinary drug residues in raw shrimp meat. This method simultaneously monitors 18 drugs of different classes, including oxytetracycline (OTC), sulfonamides, quinolones, cationic dyes, and toltrazuril sulfone (TOLS). The homogenized shrimp meat is extracted with 5% trichloroacetic acid. The extract is further cleaned using polymer-based SPE. A 50 mm phenyl column separates the analytes, prior to analysis with an ion trap mass spectrometer interfaced with an atmospheric pressure chemical ionization source. This method is able to confirm oxytetracycline residues at 200 ng/g, toltrazuril sulfone at 50 ng/g, sulfaquinoxaline at 20 ng/g, and the other 15 drugs at 10 ng/g or lower levels. An estimate of the level of residues can also be made so that only confirmed samples above action levels will be sent for quantitation. The method is validated with both fortified and incurred samples, using multiple shrimp species as well. This multi-class method can provide a means to simultaneously monitor for a wide range of illegal drug residues in shrimp.

The avermectins—ivermectin (IVR), doramectin (DOR), eprinomectin (EPR)—and also the milbemycin moxidectin (MOX) are anthelmintic compounds that may be administered to cattle. Different ionization techniques, including atmospheric pressure photoionization (APPI), were evaluated for the detection of these residues in milk. The ionization response of these compounds using APPI was compared with that obtained by atmospheric pressure chemical ionization (APCI), a combination of APPI and APCI, and electrospray. It was found that the relative response of these drugs with different ionization protocols varied depending on the compound and the mobile phase. When monitoring negative ions, the use of the UV lamp increased the MS response. However, the best response for these compounds was obtained by operating the APCI/APPI source in the positive ion mode without any discharge current applied to the corona needle, whether the UV lamp was on or not. Using this mode of ionization, an MS–MS method was established to monitor the product ion scans of the sodiated molecular ions with an ion trap instrument. Milk fortified with these compounds (0.5–20 ng g −1 ) and milk samples from dosed animals were analyzed after isolating the residues with a simple solid phase extraction method. EPR, DOR and IVR were confirmed in all of the extracts analyzed. MOX was confirmed in all samples fortified at 5 ng g −1 or higher. Acceptable recoveries (≥60%) and relative standard deviations (R.S.D. values ≤ 20%) were observed for the residues at the following levels: EPR and IVR (1–20 ng g −1 ); DOR and MOX (5–20 ng g −1 ).

Two methods have been developed for the simultaneous determination of tetracycline, oxytetracycline, and chlortetracycline in shrimp and in whole milk. These methods were designed to simplify sample extraction and clean-up steps and to be fast and convenient for routine testing in a regulatory environment. Both methods rely on a simple extraction of the shrimp or milk matrix with succinic acid followed by isolation on a copolymeric solid phase extraction column. Chromatographic separation was achieved using a polar end-capped C8 column with an isocratic mobile phase consisting of organic acid, acetonitrile, and methanol, where 0.1% formic acid or 0.01 M oxalic acid was used as the acid. Formic acid allowed direct confirmation of the three residues by liquid chromatography–tandem mass spectrometry (LC–MS–MS). LC with ultraviolet absorbance at 370 nm resulted in the quantitation of all three tetracycline residues from shrimp and milk samples fortified at 50, 100, 200, 300, and 400 ng g −1 . Average recoveries were greater than 75% with R.S.D. values less than 10%. All three tetracycline residues were confirmed in shrimp (25–400 ng g −1 ) and milk (50–300 ng g −1 ) samples by LC–MS–MS.

Dorsalis pedis artery impingement is an extremely rare cause of foot claudication, with a single case reported in the literature. In this report, we describe the case of a 17-year-old female Irish dancer who presented with intermittent bilateral foot pain and discoloration during active plantar flexion.

The location of the Niwot Ridge Ameriflux site within the rocky mountains subjects it to airflows which are common in mountainous terrain. In this study, we examine the effects of some of these mesoscale features on local turbulent flux measurements; most notably, the formation of valley/mountain flows and mountain lee-side waves. The valley/mountain flows created local non-stationarities in the wind flow caused by the passage of a lee-side convergence zone (LCZ) in which upslope and downslope flows met in the vicinity of the measurement tower. During June–August, 2001, possible lee-side convergences were flagged for ∼26% of all half-hour daytime flux measurement periods. However, there was no apparent loss of flux during these periods. On some relatively stable, summer nights, turbulence (designated via σw), and scalar fluctuations (temperature and CO2, for example) exhibited periodicities that appeared congruent with passage of low frequency gravity waves (τ ∼ 20 min). Spectral peaks at 0.0008 Hz (20 min) in both vertical velocity and scalar spectra were observed and indicated that 25–50% of the total scalar covariances were accounted for by the low frequency waves. During some periods of strong westerly winds (predominantly in winter), large mountain gravity waves were observed to form. Typically, the flux tower resided within a region of downslope “shooting flow”, which created high turbulence, but had no detrimental effect on local flux measurements based on valid turbulence statistics and nearly complete energy budget closure. Periodically, we found evidence for re-circulating, rotor winds in the simultaneous time series of wind data from the Ameriflux tower site and a second meteorological site situated 8 km upslope and to the West. Only 14% of the half-hour time periods that we examined for a 4 month period in the winter of 2000–2001 indicated the possible existence of rotor winds. On average, energy budget closure was ∼20% less during periods with rotor occurrence compared to those without. Results from this study demonstrate that the potential exists for relatively rare, yet significant influences of mesoscale wind flow patterns on the local half-hour flux measurements at this site. Occurrence of these events could be detected through examination of normal turbulence statistical parameters.

The determination of several sulfonamide residues from shrimp tissue using size-exclusion chromatography is presented. Shrimp tissue is extracted with ethyl acetate. The extracted solution is evaporated to dryness and the re-dissolved residue is applied to a chromatographic column containing Sephadex LH-20 gel. Cleanup is performed using this size-exclusion procedure. Determination is accomplished utilizing liquid chromatography. Elution of the sulfonamides from a phenyl column is performed with a methanol: acetic acid: counter-ion mobile phase. Recovery of sulfonamide residues from shrimp range from 70 to 100%.

Ion-trap liquid chromatography–multiple mass spectrometry (LC–MS n ) has been shown to be a valuable tool for the confirmation of animal drug residues. We have taken advantage of this to update several regulatory methods for the confirmation of drug residues in aquacultured products. Here we report two such examples. First, the use of an ion-trap electrospray instrument collecting data-dependent MS 2 and MS 3 scans to yield structurally significant ions has allowed multi-residue confirmation of fluoroquinolones in salmon tissue. Ciprofloxacin, enrofloxacin, sarafloxacin, and difloxacin residues were positively identified in salmon muscle fortified at 5–80 μg kg −1 . These residues were also confirmed in extracts from incurred salmon tissue with final drug concentrations ranging from 10 to 40 μg kg −1 . The second example deals with multi-residue confirmation of phenicols using ion-trap LC–MS n . Comparisons of these methods with related confirmation procedures are discussed, as well as the optimization of MS n parameters to meet confirmation criteria. Initial efforts to use this instrument in conjunction with generic extraction methods to screen multi-class residues in shrimp tissue are also presented.

This study evaluates the clinical and economic impact of using less extensive minimal invasive aortic surgery (MIAS) for elective treatment of infrarenal aortic aneurysms (AAA) and aortoiliac occlusive disease (AIOD) in two independent surgical departments. Surgeons from two institutions conducted a prospective consecutive, nonrandomized analysis of MIAS electively performed in 80 patients. MIAS outcomes were compared with 80 consecutive elective standard open aortic procedures (40 from each institution), which were performed during the same time period. Cost analyses for MIAS and standard open repair were performed at each institution. Our results indicated that MIAS is as safe as standard open repair, is more cost-effective, and has significantly shorter hospital stays than with standard open repair.

Observations from the first submersible reconnaissance of the Blake Ridge Diapir provide the geological and ecological contexts for chemosynthetic communities established in close association with methane seeps. The seeps mark the loci of focused venting of methane from the gas hydrate reservoir, and, in one location (Hole 996D of the Ocean Drilling Program), methane emitted at the seafloor was observed forming gas hydrate on the underside of a carbonate overhang. Megafaunal elements of a chemosynthetically based community mapped onto dive tracks provide a preliminary overview of faunal distributions and habitat heterogeneity. Dense mussel beds were prominent and covered 20 � 20 m areas. The nearly non-overlapping distributions of mussels and clams indicate that there may be local (meter-scale) variations in fluid flux and chemistry within the seep site. Preliminary evidence suggests that the mussels are host to two symbiont types (sulfide-oxidizing thiotrophs and methanotrophs), while the clams derive their nutrition only from thiotrophic bacteria. Invertebrate biomass is dominated by mussels (Bathymodiolus heckerae) that reach lengths of up to 364 mm and, to a lesser extent, by small (22 mm length) vesicomyid clams (Vesicomya cf. venusta). Taking into account biomass distributions among taxa, symbiont characteristics of the bivalves, and stable-isotope analyses, the relative importance of methanotrophic vs thiotrophic bacteria in the overall nutrition of the invertebrate

Background. This article describes the diagnosis and management of chronic compartment syndrome and functional popliteal entrapment syndrome, unusual causes for claudication in young adults. Methods. A total of 276 patients (

Objectives Our purpose was to determine the safety and accuracy of immediate exercise testing in low-risk patients presenting to the emergency department (ED) with chest pain suggestive of a cardiac etiology. Background Safe, efficient management of low-risk patients presenting to the ED with chest pain is a continuing challenge. We have employed immediate exercise testing to evaluate a large, heterogeneous group of low-risk patients presenting with chest pain. Methods Patients presenting to the ED with chest pain compatible with a cardiac origin and clinical evidence of low risk on initial assessment underwent immediate exercise treadmill testing in our chest pain evaluation unit. Indicators of low clinical risk included no evidence of hemodynamic instability, arrhythmias or electrocardiographic signs of ischemia. Serial measurements of cardiac injury markers were not obtained. Results Exercise testing was performed to a sign- or symptom-limited end point in 1,000 patients (520 men, 480 women; age range 31 to 82 years) and was positive for ischemia in 13%, negative in 64% and nondiagnostic in 23% of patients. There were no adverse effects of exercise testing, and all patients with a negative exercise test were discharged directly from the ED. At 30-day follow-up there was no mortality in any of the three groups. Cardiac events in the three groups included: negative group, 1 non–Q-wave myocardial infarction (MI); positive group, 4 non–Q-wave MIs and 12 myocardial revascularizations; nondiagnostic group, 7 myocardial revascularizations. Conclusions Immediate exercise testing of patients presenting to the ED with chest pain and evidence of low clinical risk is safe and accurate for determining those who require admission and those who can be discharged to further outpatient evaluation.

J Vasc Surg 2002;35:910-5.

CPCs have been developed to meet the clinical challenge posed by the diverse group of patients presenting to the ED with findings suggestive of a coronary event. Using a protocol-driven approach, high- and low-risk patients can be identified on presentation, facilitating urgent therapy in the former and triage of the latter to more deliberate management. Most CPCs focus on low-risk patients who are being increasingly managed by accelerated diagnostic protocols. These methods comprise systematic strategies that include innovative diagnostic approaches during a 6 to 12 hour period of observation with serial ECGs, continuous monitoring and cardiac biomarker measurements. A negative evaluation is usually followed by predischarge stress testing, and positive findings mandate admission. An essential aspect of the CPC strategy is continuity of care for patients with negative cardiac evaluations. Current data indicate that management of low-risk patients with chest pain in a CPC is safe accurate, and appears to be cost-effective.

The “good soldier” syndrome, or organization citizenship behavior (OCB), is traditionally defined as extra-role behavior which serves to advance the purposes of the organization. However, these behaviors may be ethical or unethical. Implicit in the definition of OCB is some role of personal ethics: indeed, the various measures of OCB contain many items that are ethically based. This study examined the relationship between ethics and organization citizenship, and found high correlations, with “more ethical” individuals being rated higher on OCB. “More ethical” individuals were perceived to be more productive than “less ethical” workers. The differential contributions of individual citizenship behaviors to productivity among “more” and “less” ethical individuals were also identified. Results suggest that the phenomenon popularized as organizational citizenship behavior may be the manifestation of ethical behavior in the workplace. Identification of individual behaviors among those comprising the OCB phenomenon that contribute the greatest to individual productivity suggests a time difference in the results of good soldier behaviors. Some citizenship behaviors may have immediate results (e.g., obedience), while others (e.g., creativity) may require some period before benefits are realized. New areas for research are presented.