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Background: Patients with anemia frequently undergo surgery, as it is unclear at what threshold clinicians should consider delaying surgery for preoperative anemia optimization. The primary objective of this study was to determine whether there is an association of varying degrees of anemia and transfusion with 30-day mortality.Methods: This is a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2013. Cohorts were analyzed based on preoperative hematocrit range—patients with: (1) no anemia, (2) hematocrit ≥33% and <36% in females or <39% in males, (3) hematocrit ≥30% and <33%, (4) hematocrit ≥27% and <30%, (5) hematocrit ≥24% and <27%, and (6) hematocrit ≥21% and less than 24%. Multivariable logistic regression was used to analyze the association of anemia and transfusion with 30-day in-hospital mortality.Results: The odds for 30-day mortality increased incrementally as the hematocrit ranges decreased, in which preoperative hematocrit between 21 and 24% had the highest odds for this outcome (odds ratio [OR] 6.50, p < 0.0001) compared to the reference group (no anemia). The use of transfusion increased the odds of mortality even further (OR 5.57, p < 0.0001). Among patients that received an intra-/postoperative transfusion, preoperative anemia was not predictive of mortality.Conclusions: Healthcare providers making preoperative clinical decisions for patients undergoing elective surgery should consider the degree of preoperative anemia and likelihood of perioperative transfusion. [ABSTRACT FROM AUTHOR]

A BSTRACT This article analyzes insurance demand under prospect theory in a simple model with two states of the world and fair insurance contracts. We argue that two different reference points are reasonable in this framework, state-dependent initial wealth or final wealth after buying full insurance. Applying the value function of Tversky and Kahneman (), we find that for both reference points subjects will either demand full insurance or no insurance at all. Moreover, this decision depends on the probability of the loss: the higher the probability of the loss, the higher is the propensity to take up insurance. This result can explain empirical evidence that has shown that people are unwilling to insure rare losses at subsidized premiums and at the same time take up insurance for moderate risks at highly loaded premiums. [ABSTRACT FROM AUTHOR]

The detection of the free precession of co-located 3He/129Xe nuclear spins (clock comparison) is used as ultra-sensitive probe for non-magnetic spin interactions, since the magnetic dipole interaction (Zeeman-term) drops out in the weighted frequency difference, i.e., Δω = ωHe- γHe/γXe·ωXe of the respective Larmor frequencies. Recent results are reported on searches for (i) short-range P- and T-violating interactions between nucleons, and (ii) Lorentz violating signatures by monitoring the Larmor frequencies as the laboratory reference frame rotates with respect to distant stars (sidereal modulation). Finally, a new experimental initiative to search for an electric dipole moment of 129Xe (CP-violation) is discussed, which strongly benefits from the long spin-coherence times obtained, reaching [ABSTRACT FROM AUTHOR]

According to the harmonic sequence paradox, an expected utility decision maker's willingness to pay for a gamble whose expected payoffs evolve according to the harmonic series is finite if and only if his marginal utility of additional income becomes zero for rather low payoff levels. Since the assumption of zero marginal utility is implausible for finite payoff levels, expected utility theory - as well as its standard generalizations such as cumulative prospect theory - are apparently unable to explain a finite willingness to pay. This paper presents first an experimental study of the harmonic sequence paradox. Additionally, it demonstrates that the theoretical argument of the harmonic sequence paradox only applies to time-patient decision makers, whereas the paradox is easily avoided if time-impatience is introduced. [ABSTRACT FROM AUTHOR]

Many public goods provide utility by insuring against hazardous events. Those public goods can have self-insurance and self-protection character. For both situations we analyze the efficient public provision level and the provision level resulting from Nash behavior in a private provision game. We consider the interaction of public goods as insurance devices with market insurance. The availability of market insurance reduces the provision level of the public good for both public and private provision, regardless of whether we consider self-insurance or self-protection. Moreover, we show that Nash behavior has always a larger impact than the availability of market insurance. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether the level of mobilization achieved and the barriers for progressing to the next mobilization level differ between nurses and physical therapists. Design: Prospective, observational study. Setting: Twenty-bed surgical intensive care unit (SICU) of the Massachusetts General Hospital. Participants: Sixty-three critically ill patients. Methods: Physical therapists and nurses performed 179 mobilization therapies with 63 patients. Outcome Measurement: Mobilization was defined as the process of enhancing mobility in the SICU, including bed mobility, edge of bed activities, transfers out of bed to a chair, and gait training; the mobilization level was measured on the SICU optimal mobilization scale, a 5-point (0-4) numerical rating scale. Results: Patients'' level of mobilization achieved by physical therapists was significantly higher compared with that achieved by nurses (2.3 ± 1.2 mean ± SD versus 1.2 ± 1.2, respectively P < .0001). Different barriers for mobilization were identified by physical therapists and nurses: hemodynamic instability (26% versus 12%, P = .03) and renal replacement therapy (12% versus 1%, P = .03) were barriers rated higher by nurses, whereas neurologic impairment was rated higher by physical therapists providers (18% versus 38%, P = .002). No mobilization-associated adverse events were observed in this study. Conclusions: This study showed that physical therapists mobilize their critically ill patients to higher levels compared with nurses. Nurse and physical therapists identify different barriers for mobilization. Routine involvement of physical therapists in directing mobilization treatment may promote early mobilization of critically ill patients. [Copyright &y& Elsevier]

Discusses the morphological characteristics, major underlying principles and molecular key players that control hair follicle (HF) development. Molecular interactions leading to HF induction; Analysis of pertinent topics and relevant issues; Implications on dermatology and molecular medicine.

Investigates the effect of chemical soil manipulation on motility, plant accumulation, and leaching of heavy metals. Risk of heavy metal leaching; Impact of elevated heavy metal concentrations in the soil on crop growth; Factors in transferring heavy metals from soils to plants.

The article provides a complete characterization of efficient risk-sharing with dual expected utility (DEU). Applications of non-expected utility models have shown that first-order risk aversion generates results that differ significantly from those of expected utility theory and lead in many cases to a better accommodation of real world data. In studying the behavior of firms, linearity in payments may in fact be an appealing feature. Under the dual theory, maximization of a linear function of profits can be entertained simultaneously with risk aversion. The analysis reveals that, also for efficient risk-sharing, DEU has quite different implications than expected utility. DEU has some interesting features. First, it is consistent with the experimental evidence, which motivated the development of non-expected utility theories and second, DEU allows for a separation of the concepts of risk aversion and decreasing marginal utility of money since the representation can accommodate risk aversion although marginal utility of money is constant.

The structures reported for the three cancerostatic all- l-cyclotetrapeptides cyclo(Pro-Leu)2, cyclo(Pro-Val)2 and cyclo(Pro-Phe)2 isolated from a tunicate seem questionable. The synthetic compounds claimed to be identical to the naturally occurring cyclotetrapeptides are in fact not cyclotetrapeptides but rather cyclooctapeptides. We have not been able to prepare the tyrosinase inhibitor cyclo(Pro-Val-Pro-Tyr). Ring closure of H-Pro-Val-Pro-Tyr-OC6F5 gave rise to 31% of cyclo(Pro-Val-Pro- d-Tyr). The same product was obtained in 53% yield from H-Pro-Val-Pro- d-Tyr-oc6F5. For the ring closure to the all- l-cyclopentapeptide cyclo(Pro-Ala-Ala-Phe-Leu), all ring closure positions have been investigated. The reaction at the nitrogen atom of leucine leads to 21% of the all- l-cyclopentapeptide. Dimers or mixtures of monomers and dimers result from reaction at all other positions. © Munksgaard 1997. [ABSTRACT FROM AUTHOR]