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This comprehensive analysis addresses the United States' alarming lack of preparedness to respond effectively to a massive disaster as evidenced by Hurricane Katrina. First, a timeline of problematic response events during and after Hurricane Katrina orients readers to some of the specific problems encountered at different levels of government. Second, a list of the "Dirty Dozen"--12 major failures that have occurred in prior disasters, which also contributed to inadequate response during and after Hurricane Katrina--is presented. Third, this article encourages expanding psychology's role beyond the treatment of trauma to encompass disaster planning and mitigation efforts from a broader public health perspective. Finally, areas for important interdisciplinary research in human behavior that will influence our nation's overall preparedness for future catastrophes are identified, and ways psychologists can become personally involved beyond treating casualties are discussed.

Sport specialisation is becoming increasingly common among youth and adolescent athletes in the USA and many have raised concern about this trend. Although research on sport specialisation has grown significantly, numerous pressing questions remain pertaining to short-term and long-term effects of specialisation on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialise at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritise pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesising and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence and identifies key research priorities to help guide researchers conducting research on youth sport specialisation. Our goals are to help improve the quality and relevance of research on youth sport specialisation and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth. [ABSTRACT FROM AUTHOR]

Objective: The impact, positive or negative, of youth sport specialisation (YSS) on short-term and long-term performance is not fully understood; however, the desire to maximise performance goals is generally considered the primary reason children and adolescents specialise at a young age. We performed a systematic review of original research to establish the association of YSS and task-focused or career-focused performance outcomes.Design: Systematic review.Data Sources: Databases searched include PubMed, EMBASE, Cochrane, CINAHL and SPORTDiscus.Eligibility Criteria: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify peer-reviewed research articles published in English between 1 January 1990 and 31 December 2018 that reported original findings on the association of YSS and performance outcomes. Studies without an explicit measure of sport specialisation, for example, volume measures without measuring sport specialisation, were excluded.Results: Twenty-two articles were included in the final review; 15 addressed career performance outcomes and 7 considered task performance outcomes. All identified studies were cross-sectional or retrospective in design. The proportion of elite athletes who specialised early ranged between 7% and 85%, depending on sport and definition of specialisation. Elite athletes often specialised between the ages of 14 and 15 compared with their non-elite or semi-elite peers who typically specialised prior to 13 years. In addition, neuromuscular control, anterior reach asymmetry and physical task outcomes did not differ by specialisation status.Conclusion: The volume and methodological rigour of published research in this field are limited. Our review suggests that YSS is not required to achieve success at elite levels. YSS also does not appear to improve task-related performance (eg, anterior reach, neuromuscular control) outcomes for specialised athletes when compared with non-specialised athletes during childhood and adolescence. [ABSTRACT FROM AUTHOR]

Introduction: Characterization of the clinical and economic impact of opioid-related adverse drug events (ORADEs) after total knee arthroplasty (TKA) may guide provider and hospital system approach to managing postoperative pain after TKA. Our analysis quantifies the rate of potential ORADEs after TKA, the impact of potential ORADEs on length of stay (LOS) and hospital revenue, as well as their association with specific patient risk factors and comorbid clinical conditions.Methods: We conducted a retrospective study using the Centers for Medicare and Medicaid Services administrative database to analyze Medicare discharges involving two knee replacement surgery diagnosis-related groups (DRGs) in order to identify potential ORADEs. The impact of potential ORADEs on mean hospital LOS and hospital revenue was analyzed.Results: The potential ORADE rate in patients who underwent TKA was 25,523 out of 316,858 records analyzed (8.0%). The mean LOS for patients who experienced a potential ORADE was 1.04 days longer than those without an ORADE. The mean hospital revenue per day with a potential ORADE was $1334 (USD) less than without an ORADE. Potential ORADEs were significantly associated with poor patient outcomes such as pneumonia, septicemia, and shock.Conclusion: Potential ORADEs in TKA are associated with longer hospitalizations, decreased hospital revenue, and poor patient outcomes. Certain risk factors may predispose patients to experiencing an ORADE, and thus perioperative pain management strategies that reduce the frequency of ORADEs particularly in at-risk patients can improve patient satisfaction and increase hospital revenue following TKAs. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and debilitating complications of cancer treatment. Due to a lack of effective management options for patients with CIPN, the National Cancer Institute (NCI) sponsored a series of trials aimed at both prevention and treatment. A total of 15 such studies were approved, evaluating use of various neuro-modulatory agents which have shown benefit in other neuropathic pain states. Aside from duloxetine, none of the pharmacologic methods demonstrated therapeutic benefit for patients with CIPN. Despite these disappointing results, the series of trials revealed important lessons that have informed subsequent work. Some examples of this include the use of patient-reported symptom metrics, the elimination of traditional--yet unsubstantiated--practice approaches, and the discovery of molecular genetic predictors of neuropathy. Current inquiry is being guided by the results from these large-scale trials, and as such, stands better chance of identifying durable solutions for this treatment-limiting toxicity. [ABSTRACT FROM AUTHOR]

Exercise-based preventive training programs are designed to improve movement patterns associated with lower extremity injury risk; however, the impact of these programs on general physical fitness has not been evaluated. The purpose of this study was to compare fitness scores between participants in a preventive training program and a control group. 1068 freshmen from a US Service Academy were cluster-randomized into either the intervention or control group during 6 weeks of summer training. The intervention group performed a preventive training program, specifically the Dynamic Integrated Movement Enhancement (DIME), which is designed to improve lower extremity movement patterns. The control group performed the Army Preparation Drill (PD), a warm-up designed to prepare Soldiers for training. Main outcome measures were the Army Physical Fitness Test (APFT) raw and scaled (for age and sex) scores. Independent t-tests were used to assess between-group differences. Multivariable logistic regression models were used to control for the influence of confounding variables. DIME group participants completed the APFT 2- mile run 20 seconds faster compared to the PD group (p<0.001) which corresponded with significantly higher scaled scores (p<0.001). APFT push-up scores were significantly higher in the DIME group (p=0.041) but there were no significant differences in APFT sit-up scores. The DIME group had significantly higher total APFT scores compared to the PD group (p<0.001). Similar results were observed in multivariable models after controlling for sex and BMI. Committing time to the implementation of a preventive training program does not appear to negatively affect fitness test s [ABSTRACT FROM AUTHOR]

Abstract: Time series of geocenter coordinates were determined with data of two global navigation satellite systems (GNSSs), namely the U.S. GPS (Global Positioning System) and the Russian GLONASS (Global’naya Nawigatsionnaya Sputnikowaya Sistema). The data was recorded in the years 2008–2011 by a global network of 92 permanently observing GPS/GLONASS receivers. Two types of daily solutions were generated independently for each GNSS, one including the estimation of geocenter coordinates and one without these parameters. A fair agreement for GPS and GLONASS was found in the geocenter x- and y-coordinate series. Our tests, however, clearly reveal artifacts in the z-component determined with the GLONASS data. Large periodic excursions in the GLONASS geocenter z-coordinates of about 40cm peak-to-peak are related to the maximum elevation angles of the Sun above/below the orbital planes of the satellite system and thus have a period of about 4 months (third of a year). A detailed analysis revealed that the artifacts are almost uniquely governed by the differences of the estimates of direct solar radiation pressure (SRP) in the two solution series (with and without geocenter estimation). A simple formula is derived, describing the relation between the geocenter z-coordinate and the corresponding parameter of the SRP. The effect can be explained by first-order perturbation theory of celestial mechanics. The theory also predicts a heavy impact on the GNSS-derived geocenter if once-per-revolution SRP parameters are estimated in the direction of the satellite’s solar panel axis. Specific experiments using GPS observations revealed that this is indeed the case. Although the main focus of this article is on GNSS, the theory developed is applicable to all satellite observing techniques. We applied the theory to satellite laser ranging (SLR) solutions using LAGEOS. It turns out that the correlation between geocenter and SRP parameters is not a critical issue for the SLR solutions. The reasons are threefold: The direct SRP is about a factor of 30–40 smaller for typical geodetic SLR satellites than for GNSS satellites, allowing it in most cases to not solve for SRP parameters (ruling out the correlation between these parameters and the geocenter coordinates); the orbital arc length of 7 days (which is typically used in SLR analysis) contains more than 50 revolutions of the LAGEOS satellites as compared to about two revolutions of GNSS satellites for the daily arcs used in GNSS analysis; the orbit geometry is not as critical for LAGEOS as for GNSS satellites, because the elevation angle of the Sun w.r.t. the orbital plane is usually significantly changing over 7 days. [Copyright &y& Elsevier]

In many jurisdictions, law enforcement officials may conduct a warrantless search of the contents of an arrestee's cell phone incident to an arrest. The judicial precedent for this policy dates back to the early 1990s when courts equated early mobile technology, such as pagers and first generation cell phones, to physical containers capable of storing a limited number of calls or messages. Supreme Court precedent had long permitted the warrantless search of such containers incident to arrest. However, due to advancements in technology, mobile devices, such as smart phones, now have the capacity to hold a larger amount of personal information, including text messages, diaries, pictures, videos, financial information, and medical records. Because this information may increase an arrestee's expectation of privacy in the contents of a cell phone, an analogy to a finite physical container may no longer be appropriate. In recognition of this change, two courts now require law enforcement officials to have a warrant to search the contents of an arrestee's cell phone incident to arrest. This Note surveys how courts have dealt with changing mobile technology in the context of a search incident to arrest and analyzes the jurisdictional split. It also addresses the expectations of privacy in today's mobile technology and suggests that courts use a function-based approach when determining what information stored in a mobile device may be viewed without a warrant and what information necessarily requires a warrant. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females were 2.23 times (95% CI: 1.19, 4.20) more likely to develop PFPS compared with males. While not statistically significant, the prevalence of PFPS at study enrollment tended to be higher in females (15%) than in males (12%) ( P=0.09). Females at the USNA are significantly more likely to develop PFPS than males. Additionally, at the time of admission to the academy, the prevalence of PFPS was not significantly different between genders. [ABSTRACT FROM AUTHOR]

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Factors hypothesized to impact Asian American responses to counseling were tested as mediators and moderators of perceived counselor credibility and working alliance. Asian and European American college students (N = 182) were assigned randomly to view simulated directive or nondirective therapy approaches. Mediation analyses examined whether ethnic group differences in initial perceptions were accounted for by therapist understandability and previous therapy experiences. Moderation analyses examined whether expectations for directive therapy, ambiguity tolerance, and resistance influenced initial perceptions across directive and nondirective counseling. Asian Americans rated the counseling approaches significantly less favorably than Europeans Americans. A significant mediation effect was found for therapist understandability, whereas a significant moderation effect was found for expectation for directive therapy on initial perceptions of counselor credibility. [ABSTRACT FROM AUTHOR]

Examines both the political approval requirements and Utah Senate Bill 24 and concludes that an outright ban of low-level radioactive waste (LLRW) and some political approval requirements are unconstitutional under the Supremacy Clause in the U.S. Event that triggered Congress to enact the Low-Level Radioactive Waste Policy Act; Complexity of the scheme that governs the LLRW regulation; Impact of federal law on state statutes that ban LLRW disposal.

This article presents information on the judgment given in the Supreme Court case--United States v. Watts. In United States a Watts, the United States Supreme Court addressed whether sentencing courts, when determining a convicted defendant's sentence, may consider conduct relating to charges of which the defendant was acquitted. This Note argues that the Court's decision also ignored important constitutional considerations. The use of acquitted conduct in sentencing raises due process arid double jeopardy concerns that deserved far more careful analysis than they received. The fundamental differences between uncharged and acquitted conduct which trigger these constitutional concerns should have been noted and discussed. Determination of an offender's sentence typically begins with a recommended sentence from the probation department. The probation department includes its recommendation in the pre-sentence investigation report it prepares in which it describes the circumstances of the offense and the history of the offender.

The article announces the winners of the Molecules Best Paper Award 2013 in the U.S., including Thomas J. Schmidt, Reto Brun, and Holger Trojan.

Reports that a marker has unveiled on August 21, 2002 in Washington to commemorate the collection of original samples of Pacific Yew which led to discovery of anti-cancer compound Taxol by Mansukh Wani and Monroe Wall at Research Triangle Institute. Information on the marker; Display of portrait of Wall in the ceremony; Fellowships in natural product research provided to honor Wall and Wani.

Editorial. Comments on the contributions of Kenneth I. Howard to the clinical psychology research in the United States. Publication of studies in the Journal of Clinical Psychology periodical; Emphasis on quality/data-based clinical utility research; Plans for special therapy techniques series.

Presents an obituary for psychotherapist Kenneth I. Howard who died on October 19, 2000 in Chicago, Illinois. Cause of death; Career highlights; Contributions to psychology; Family and educational background.

Despite aggressive prevention programs and strategies, nontraumatic exertional sudden death events in military training continue to prove a difficult challenge for the Department of Defense. In November 2014, the 559th Medical Group at Joint Base San Antonio-Lackland, Texas, hosted a working group on sudden exertional death in military training. Their objectives were three-fold: (1) determine best practices to prevent sudden exertional death of military trainees, (2) determine best practices to establish safe and ethical training environments for military trainees with sickle cell trait, and (3) develop field-ready algorithms for managing military trainees who collapse during exertion. This article summarizes the major findings and recommendations of the working group. [ABSTRACT FROM AUTHOR]

Study Objective: This study aimed to assess the impact of data-driven didactic sessions on metrics including fund of knowledge, resident confidence in clinical topics, and stress in addition to American Board of Anesthesiology In-Training Examination (ITE) percentiles.Design: Observational mixed-methods study.Setting: Classroom, video-recorded e-learning.Subjects: Anesthesiology residents from two academic medical centers.Interventions: Residents were offered a data-driven didactic session, focused on lifelong learning regarding frequently asked/missed topics based on publicly-available data.Measurements: Residents were surveyed regarding their confidence on exam topics, organization of study plan, willingness to educate others, and stress levels. Residents at one institution were interviewed post-ITE. The level and trend in ITE percentiles were compared before and after the start of this initiative using segmented regression analysis.Results: Ninety-four residents participated in the survey. A comparison of pre-post responses showed an increased mean level of confidence (4.5 ± 1.6 vs. 6.2 ± 1.4; difference in means 95% CI:1.7[1.5,1.9]), sense of study organization (3.8 ± 1.6 vs. 6.7 ± 1.3;95% CI:2.8[2.5,3.1]), willingness to educate colleagues (4.0 ± 1.7 vs. 5.7 ± 1.9;95% CI:1.7[1.4,2.0]), and reduced stress levels (5.9 ± 1.9 vs. 5.2 ± 1.7;95% CI:-0.7[-1.0,-0.4]) (all p < 0.001). Thirty-one residents from one institution participated in the interviews. Interviews exhibited qualitative themes associated with increased fund of knowledge, accessibility of high-yield resources, and domains from the Kirkpatrick Classification of an educational intervention. In an assessment of 292 residents from 2012 to 2020 at one institution, there was a positive change in mean ITE percentile (adjusted intercept shift [95% CI] 11.0[3.6,18.5];p = 0.004) and trajectory over time after the introduction of data-driven didactics.Conclusion: Data-driven didactics was associated with improved resident confidence, stress, and factors related to wellness. It was also associated with a change from a negative to positive trend in ITE percentiles over time. Future assessment of data-driven didactics and impact on resident outcomes are needed. [ABSTRACT FROM AUTHOR]

Sport specialization is becoming increasingly common among youth and adolescent athletes in the United States and many have raised concern about this trend. Although research on sport specialization has grown significantly, numerous pressing questions remain pertaining to short- and long-term effects of specialization on the health and well-being of youth, including the increased risk of overuse injury and burnout. Many current elite athletes did not specialize at an early age. Methodological and study design limitations impact the quality of current literature, and researchers need to prioritize pressing research questions to promote safe and healthy youth sport participation. The American Medical Society for Sports Medicine hosted a Youth Early Sport Specialization Summit in April 2019 with the goal of synthesizing and reviewing current scientific knowledge and developing a research agenda to guide future research in the field based on the identified gaps in knowledge. This statement provides a broad summary of the existing literature, gaps and limitations in current evidence, and identifies key research priorities to help guide researchers conducting research on youth sport specialization. Our goals are to help improve the quality and relevance of research on youth sport specialization and to ultimately assure that opportunities for healthy and safe sport participation continue for all youth. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the association between injury history at enrollment and incident lower extremity (LE) injury during cadet basic training among first-year military cadets. Methods: Medically treated LE injuries during cadet basic training documented in the Defense Medical Surveillance System were ascertained in a prospective cohort study of three large US military academies from 2005 to 2008. Both acute injuries (International Classification of Disease, Ninth Revision, codes in the 800-900s, including fracture, dislocations, and sprains/strains) and injury-related musculoskeletal injuries (International Classification of Disease, Ninth Revision, codes in the 700s, including inflammation and pain, joint derangement, stress fracture, sprain/strain/rupture, and dislocation) were included. Risk ratio (RR) and 95% confidence interval (CI) were computed using multivariate log-binomial models stratified by gender. Results: During basic training, there were 1438 medically treated acute and 1719 musculoskeletal-related LE injuries in the 9811 cadets. The most frequent LE injuries were sprains/strains (73.6% of acute injuries) and inflammation and pain (89.6% of musculoskeletal-related injuries). The overall risk of incident LE injury was 23.2% (95% CI = 22.3%-24.0%). Cadets with a history of LE injury were at increased risk for incident LE injury. This association was identical in males (RR = 1.74, 95%CI= 1.55-1.94) and females(RR= 1.74,95% CI= 1.52-1.99). In site-specific analyses, strong associations between injury history and incident injury were observed for hip, knee ligament, stress fracture, and ankle sprain. Injury risk was greater (P < 0.01) for females (39.1%) compared with males (18.0%). The elevated injury risk in females (RR = 2.19,95% CI = 2.04-2.36) was independent of injury history (adjusted RR = 2.09, 95% CI = 1.95-2.24). Conclusion: Injury history upon entry to the military is associated with the incidence of LE injuries sustained during cadet basic training. Prevention programs targeted at modifiable factors in cadets with a history of LE injury should be considered. [ABSTRACT FROM AUTHOR]

Abstract: The natural tetracyclic schweinfurthins are potent and selective inhibitors of cell growth in the National Cancer Institute’s 60-cell line screen. An interest in determination of their cellular or molecular target has inspired our efforts to prepare both the natural products and analogues. In this paper, chemical synthesis of analogues modified in different olefinic positions, and preliminary results from studies of their biological activity, are reported. [Copyright &y& Elsevier]

The article presents an analysis of the disaster preparedness and management of the United States based on the government's response to Hurricane Katrina in 2005 as well as the role of psychologists in disaster planning to provide mitigation efforts and clinical care to disaster victims using psychological principles. It discusses several failures of the government's response to Hurricane Katrina which include the lack of efficient communication, poor coordination plans, and the ambiguous authority relationships. The authors believe on the significance of psychology in establishing an interdisciplinary approach that will respond to the emergence of natural disasters and address disaster management.

ABSTRACTWe report clinical and genetic characteristics of seven juvenile hemochromatosis (JH) patients (six females, one male) in two unrelated kinships from the southeastern U.S. All had severe iron overload. Mean age at diagnosis was 20 ± 5 years (range 8–23 years). In six patients, the mean age at onset of signs and symptoms attributable to iron overload was 15 ± 2 years (12–18 years); an 8-year-old girl had no symptoms. Six of the seven patients had hypogonadotrophic hypogonadism, two had severe cardiomyopathy, seven had hepatomegaly, two had hepatic cirrhosis, and five had hyperpigmentation. Two of four siblings with JH also had Hashimoto thyroiditis. One patient with severe cardiomyopathy improved with therapeutic phlebotomy, medical therapy for congestive heart failure, and a permanent pacemaker; the other died before phlebotomy was initiated. Estimates of average daily iron absorption before phlebotomy-induced iron depletion were 2.3, 3.1, and 1.7 mg in a male and two females, respectively. Both parents of four siblings with JH were heterozygous at two Ch1q loci (D1S1156, D1S2344); each of the four affected siblings was homozygous at both loci. An unaffected sib was heterozygous at D1S1156. One patient was heterozygous for HFE H63D, five others did not have HFE C282Y or H63D, and one was unavailable for testing. We conclude that JH occurs in the southeastern U.S. It is likely that JH allele(s) in at least one of the present kinships occur(s) on Ch1q, and presumably this represents a mutation(s) of the same gene localized to Ch1q in Italian and Greek JH kindreds. The present cases do not have HFE genotypes typical of hemochromatosis diagnosed in adults. Hashimoto thyroiditis, linked to Ch6p in many kinships, did not segregate with JH alleles on Ch1q in the present kinship. [Copyright &y& Elsevier]

Gaucher disease is the most common sphingolipid storage disease but genotype only broadly predicts phenotype. The 1604G→A (1604A;R496H) mutation has been described as having a low incidence among Ashkenazi Jews. The purpose of this study was to ascertain phenotypic expression and prevalence of this mutation among patients with Gaucher disease and among healthy Ashkenazi Jews. Patients in two Gaucher clinics (in the United States and Israel) and from an international Gaucher registry were assessed for frequency and phenotype expression; 200 healthy Ashkenazi Jews were screened as well. Molecular analysis was performed by standard methods. In the Gaucher clinic with mostly Jewish patients, the gene frequency was 1.68% compared with 0.38% in the international registry with mostly non-Jewish patients. Among Ashkenazi Jewish controls, no alleles with 1604A were identified. There was a marked overrepresentation of severe alleles in patients carrying the 1604A mutation, suggesting that many patients who are compound heterozygotes for 1604A are not diagnosed as having Gaucher disease because their disease is presumably so mild as to evade detection. In view of its rarity and mild expression, the inclusion of the 1604A mutation in the standard kit for screening for Gaucher disease is unnecessary. [Copyright &y& Elsevier]

Background: Acute pericarditis is the most common presentation of pericardial diseases. Although generally benign, complications such as constrictive pericarditis, cardiac tamponade, and recurrence can occur., Research Question: What are the clinical factors associated with adverse outcomes in acute pericarditis?, Study Design and Methods: We used an informatics-based search engine to search for International Classification of Diseases codes related to pericardial disease between January 1, 2009 and November 14, 2018 and then extracted clinical information, including only patients meeting the European Society of Cardiology criteria for acute pericarditis. We then evaluated the predictive value of clinical characteristics for adverse outcomes (cardiac tamponade, constrictive pericarditis, failure of therapy, recurrences, or death)., Results: We identified 240 patients with a first episode of pericarditis (51 [34-62] years, 56% males and 50% white). Pericarditis was determined to be idiopathic in 126 (53%) cases and related to cardiac injury in 79 (33%). During a median follow-up time of 179 (20-450) days, 82 (34%) patients experienced at least one adverse outcome. Subacute presentation was an independent predictor of adverse outcomes. Patients with postcardiac injury pericarditis had a lower incidence in the composite of failure of treatment and recurrence (13% vs 26%; P = .022) compared with patients with idiopathic pericarditis. Troponin I measurements were obtained in 167 patients (70%). Elevated troponin I levels were associated with lower incidence of recurrences (4% vs 17%; P = .024) and of the composite outcome (13% vs 36%; P = .004)., Interpretation: Acute pericarditis is associated with at least one adverse outcome in 34% of patients. Subacute presentation and idiopathic etiology are associated with higher incidence of adverse outcomes, whereas elevated troponin I levels identify a group with reduced risk of recurrences., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)