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Objective This study aimed to evaluate the views and influence of left-handedness among obstetrics and gynecology (OBGYN) trainees and educators and to identify perceived obstacles in training by left-handed (LH) trainees. Study Design An online survey was sent to the U.S. Obstetrics and Gynecology training programs. All participants were asked questions on hand preference for various medical and nonmedical activities, as well as on demographics. Participant responses to handedness and their role as a learner or educator directed them toward further questions. Trainees were surveyed on their experience and outlook as a LH physician in OBGYN. Educators were surveyed on their experience and attitudes in working with LH trainees. LH educators were also surveyed on their experience as a LH physician, similar to the LH trainees. Chi-square or Fisher's exact analysis was used as appropriate, with p -value <0.05 considered statistically significant. Results Responses were received from 21 training programs, totaling 304 individuals. Participants included 205 learners (156 right handed and 49 left handed), and 99 faculty (82 right handed and 17 left handed). A lack of LH surgical instrument availability (93.6%) and difficulty using right-handed (RH) instruments (83%) were notable obstacles reported by LH learners. The majority of LH learners (57.4%) did not consider their handedness to be disadvantageous but did note added difficulty when training under RH mentors when compared with training under LH mentors (66%). In contrast to LH educators, RH educators endorsed added difficulty in instructing operative procedures to LH learners (32.1 vs. 13.3%, p = 0.012). Conclusion LH trainees face unique challenges during their OBGYN training. Educators would benefit from guidance on how best to manage these trainees. Educators should work to adapt surgical and procedural techniques to accommodate LH trainees. Key Points LH learners reported more difficulty in training under RH mentors. RH mentors reported increased difficulty in educating LH trainees. Neither trainees nor educators considered being LH a significant disadvantage. [ABSTRACT FROM AUTHOR]

The differential cross sections for the 12C(3He, t)12N reaction leading to formation of the 1+ (ground state), 2+ (0.96 MeV), 2− (1.19 MeV), and 1− (1.80 MeV) states of 12N are measured at E(3He) = 40 MeV. The analysis of the data is carried out within the modified diffraction model and distorted wave Born approximation. Increased rms radii have been obtained for the ground, 2− (1.19 MeV), and 1− (1.80 MeV) states. We revealed that 12B, 12N, and 12C in the isobaric analogue states with T = 1, and spin-parities 2− and 1− have increased radii and exhibit properties of neutron and proton halo states. [ABSTRACT FROM AUTHOR]

Metabolic syndrome is the nowadays problem that arose as a result of changes in lifestyle and diet. Several of the key factors of this disorder are lipid metabolism disturbances and hypertension. However, there is little known about combined influence of this factors and their contribution to the functional changes. This work is aimed to elucidate the effects of cholesterol-rich diet on major hemodynamic indices and lipid metabolism in SHR rats. The experiments were performed in 6-month old Wistar and SHR rats. Animals were fed for 8 weeks with enriched by cholesterol (3% w/w, Sigma) standard rodent rations. Cardiohemodynamics measured in vivo by Pressure-sensitive microcatheter 2F ("Millar Instruments", USA) introduced into left ventricle. Blood cholesterol profile was measured biochemically. The obtained data, paradoxically, signified that unlike the Wistar rats in SHR the major heart function parameters like Ejection fraction (31% increase), Stroke Volume (72% increase), Cardiac Output (69% increase) etc. improved after cholesterol diet. And at the same time SHR were more resistant to changes in blood lipid composition - they kept the same level of HDL and reached 46% lower LDL level than Wistar rats. Thus, chronic arterial hypertension reduces the sensitivity of rats to exogenous cholesterol. Combined influence of cholesterol and hypertension protects heart function in comparison to normotensive rats. [ABSTRACT FROM AUTHOR]

This study revisits prior research on the valuation of dividends in an accounting-based valuation framework. Using a battery of tests, we show that market value deflation is essential in market-based tests of dividend displacement and signalling because it controls for ‘stale’ information in addition to scale (size) differences across firms. For US firms, we show that after controlling for ‘stale’ information, the empirical association between dividends and market values switches from positive to negative. This switch is not explained by scale differences across firms. Further, we show that after controlling for staleness, the valuation of dividends remains positive for European firms. This result is explained by the relatively stronger association of dividends with future earnings in these settings (i.e. signalling). Lastly, our country-specific estimates of dividend valuation provide a potentially valuable index for studies aimed at examining the effects of accounting and securities regulation on information asymmetries in an international context. [ABSTRACT FROM PUBLISHER]

The article discusses the role of Afghanistan in world politics. The author examines efforts by the United States government to democratize the country, which many experts believe is hopeless. The role of the Taliban in preventing democracy from spreading throughout the country is detailed, with a specific focus on the growth of the organization during the United States' occupancy of Afghanistan. Recommendations to prevent terrorism from the International Council on Security and Development are analyzed.

Direct-drive inertial confinement fusion (ICF) is expected to demonstrate high gain on the National Ignition Facility (NIF) in the next decade and is a leading candidate for inertial fusion energy production. The demonstration of high areal densities in hydrodynamically scaled cryogenic DT or D2 implosions with neutron yields that are a significant fraction of the “clean” 1-D predictions will validate the ignition-equivalent direct-drive target performance on the OMEGA laser at the Laboratory for Laser Energetics (LLE). This paper highlights the recent experimental and theoretical progress leading toward achieving this validation in the next few years. The NIF will initially be configured for X-ray drive and with no beams placed at the target equator to provide a symmetric irradiation of a direct-drive capsule. LLE is developing the “polar-direct-drive” (PDD) approach that repoints beams toward the target equator. Initial 2-D simulations have shown ignition. A unique “Saturn-like” plastic ring around the equator refracts the laser light incident near the equator toward the target, improving the drive uniformity. LLE is currently constructing the multibeam, 2.6-kJ/beam, petawatt laser system OMEGA EP. Integrated fast-ignition experiments, combining the OMEGA EP and OMEGA Laser Systems, will begin in FY08. [ABSTRACT FROM AUTHOR]

Background: Transcatheter tricuspid valve repair (TTVr) has significantly expanded treatment options for tricuspid regurgitation (TR). However, a sizeable proportion of patients are still declined for TTVr and little is known about their clinical characteristics and cardiac morphology., Objectives: This study sought to characterize patients who screen fail for TTVr with respect to their clinical characteristics and cardiac morphology., Methods: A total of 547 patients were evaluated for TTVr between January 2016 to December 2021 from 3 centers in the United States and Germany. Clinical records and echocardiographic studies were used to assess medical history and right ventricular (RV) and tricuspid valve (TV) characteristics., Results: Median age was 80 (IQR: 74-83) years and 60.0% were female. Over half (58.1%) were accepted for TTVr. Of those who were deemed unsuitable for TTVr (41.9%), the most common exclusion reasons were anatomical criteria (56.8%). In the regression analysis, RV and right atrial size, TV coaptation gap, and tethering area were identified as independent screen failure predictors. Other rejection reasons included clinical futility (17.9%), low symptom burden (12.7%), and technical limitations (12.7%). Most of the excluded patients (71.6%) were managed conservatively with medical therapy, while a small number either proceeded to TV surgery (22.3%) or subsequently became eligible for transcatheter tricuspid valve replacement in later available clinical trials in the United States (6.1%)., Conclusions: The majority of TTVr screen failure patients are excluded due to TV, right atrial, and RV enlargement. However, a significant proportion is excluded due to clinical futility. These identifiable anatomical and clinical characteristics emphasize the importance of earlier referral and intervention of TR and the need for continued innovation of Transcatheter tricuspid valve interventions., Competing Interests: Funding Support and Author Disclosures Dr Gerçek has received research grant support from the German Heart Foundation. Dr Puthumana has received speaker honoraria from Abbott. Dr Malaisrie received research grant support and served as a consultant for Edwards Lifesciences. Dr Thomas has received consulting fees from Abbott, GE, egnite, EchoIQ, and Caption Health. Drs Rudolph and Rudolph have received research grants and speaker honoraria from Abbott and Edwards Lifesciences. Dr Pfister has received speaker honoraria and consultancy fees from Edwards Lifesciences and Abbott. Dr Davidson received research grants from Abbott and Edwards Lifesciences; served as an uncompensated consultant for Edwards Lifesciences; and received Honoria from Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2023 American College of Cardiology Foundation. All rights reserved.)