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Although only 1.3% of abortions in the United States are between 20 and 24 weeks' gestation, these procedures are associated with elevated risks of morbidity and mortality. Adequate cervical preparation before dilation and evacuation (D&E) at 20-24 weeks' gestation reduces procedural risk. For this gestational range, at least one day of cervical preparation with osmotic dilators is recommended before D&E. The use of overnight osmotic dilators alone is sufficient for most D&Es at 20-24 weeks' gestation. Dilapan-S® dilators require a shorter time to achieve maximum dilation, may be more effective than laminaria and may increase the likelihood of success on the first D&E attempt. The use of adjunctive mifepristone administered one-day pre-operatively at the time of osmotic dilator placement, should be considered because evidence demonstrates that it makes D&E subjectively easier at 20-24 weeks without increasing side effects. While older studies suggest that two-days of serial osmotic dilators provide greater dilation than one day of dilators, adjunctive mifepristone may be comparable to a second day of dilators. Adjunctive misoprostol administered on the day of D&E does not appear to affect initial cervical dilation and procedure time and compared with mifepristone is associated with more side effects, such as pain and nausea. Using overnight mifepristone and same-day misoprostol without osmotic dilators at 20-24 weeks' gestation lengthens D&E procedure time and appears to increase immediate complications, at least among less experienced providers. Some evidence shows the feasibility of same-day cervical preparation before D&E at 20-24 weeks using Dilapan-S® with adjunctive misoprostol or serial repeat dosing of misoprostol, but same-day preparation should be limited to providers with significant experience with these regimens. The Society of Family Planning recommends preoperative cervical preparation before D&E at 20-24 weeks' gestation. Further studies are needed to clarify the best means of preparing the cervix in order to minimize abortion complications and improve outcomes in this gestational range. [ABSTRACT FROM AUTHOR]

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The article discusses the study which analyses the association of measures of left ventricular (LV) dilation and systolic dysfunction in children with dilated cardiomyopathy (DCM) to the adverse outcome during transplant listing in the U.S. It notes that the LV dilation and systolic dysfunction in children rapidly progressive heart failure that result to higher mortality risk. It concludes that LV dilation has significant association to the risk of death during posttransplant in children.

Focuses on the state legislation on courts sanctions relating to dilatory actions of lawyers in Florida. Definition of the Section 57.105 statute; Provision of model forms to assist practitioners on the implementation of the statute in practice; Decision of the Fourth District Court of Appeal on the interpretation of the law.

Time is the fabric of experience – yet it is incredibly malleable in the mind of the observer: seeming to drag on, or fly right by at different moments. One of the most influential drivers of temporal distortions is attention, where heightened attention dilates subjective time. But an equally important feature of subjective experience involves not just the objects of attention, but also what information will naturally be remembered or forgotten, independent of attention (i.e., intrinsic image memorability). Here we test how memorability influences time perception. Observers viewed scenes in an oddball paradigm, where the last scene could be a forgettable "oddball" amidst memorable ones, or vice versa. Subjective time dilation occurred only for forgettable oddballs, but not memorable ones – demonstrating an oddball effect where the oddball did not differ in low-level visual features, image category, or even subjective memorability. But more importantly, these results emphasize how memory can interact with temporal experience: memorable beginnings may put people in an efficient encoding state, which may in turn influence which moments are dilated in time. [ABSTRACT FROM AUTHOR]

Background: Because nearly one-third of births in the United States are now achieved by cesarean delivery, comprising more than 1.27 million women each year, national organizations have recently published revised guidelines for the management of labor. These new guidelines stipulate that labor arrest should not be diagnosed unless ≥6 cm cervical dilatation has been reached or labor has been stimulated for at ≥6 hours.Objective: To determine the cervical dilatation and hours of labor stimulation prior to cesarean delivery for arrest of dilatation.Materials and Methods: Between January 1, 1999, andDecember 31, 2000, a prospective observational study of all primary cesarean deliveries was conducted at 13 university centers comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development, Maternal-Fetal Medicine Units Network. This secondary analysis includes all live-born, singleton, nonanomalous, cephalic gestations delivered by primary cesarean delivery at ≥37 weeks. A cesarean delivery was considered to have been performed for arrest of dilatation if the indication for the procedure was failure to progress, cephalopelvic disproportion, or failed induction. Augmentation was defined as stimulation after spontaneous labor had been previously diagnosed. Analysis included both the latent and active phases of labor. The active phase of labor was diagnosed when cervical dilatation was ≥4 cm in the presence of uterine contractions.Results: A total of 13,269 primary cesarean deliveries were available for analysis, 8,546 (65%) of which were performed for inadequate progress of labor with cervical dilatation recorded at the time of cesarean delivery. Of these cesarean deliveries for labor arrest, a total of 719 (8%) were performed in the latent phase of labor and 7827 (92%) were performed when cervical dilatation was ≥4 cm (active phase). Approximately two-thirds (n = =5876; 69%) received intrauterine pressure monitoring. A total of 5636 women (66% of those reaching the active phase of labor) had reached ≥6 cm cervical dilatation before cesarean delivery was performed. Moreover, 7440 (95%) of the 7827 women in active labor had ≥6 cm dilatation or had received labor stimulation ≥6 hours prior to cesarean delivery for arrest of dilatation.Conclusion: Women undergoing primary cesarean delivery for arrest of dilatation 15 years before the recommendations of the Obstetrics Care Consensus had received bona fide efforts to achieve adequate labor consistent with the recommendations of the Consensus. Because 95% of these women had ≥6 cm dilatation or had received labor stimulation ≥6 hours prior to cesarean delivery for arrest of dilatation, these new recommendations are unlikely to change the cesarean delivery rates. [ABSTRACT FROM AUTHOR]

The time from when an ambulance paramedic receives the 911 alarm notification until they have determined the differential diagnosis of a patient is highly stressful. During this time, there is a high demand placed on the paramedic, and they have a low level of control. Recent advances in prehospital care that place more responsibility on paramedics have exacerbated this high-stress phenomenon. Twenty paramedics from across the United States were interviewed and evaluated using descriptive phenomenology to better understand one of the most stressful moments of high-stakes decision-making that paramedics regularly face. Using descriptive phenomenology, we identified six categories in the paramedics' interview responses: pressure, overwhelm, emotional extremes (with sub-categories of adrenaline rush and time-dilation), dissociation, multi-tasking, and disconnect. This analysis of the paramedic's lived experience of this high-stress, high-stakes phenomenon provides insight into how paramedics experience the unique stress of this phenomenon. This understanding is key to elucidating the effects of this acute stress that may impact the judgment and, ultimately, the care performed by the paramedic. Both early- and late-career paramedics from thirteen different states in all regions of the United States were interviewed. Further qualitative data from paramedics from a diverse range of regions and backgrounds are essential to identify ways in which to ameliorate the negative effects of acute stress experienced by paramedics. Addressing such issues will reduce turnover and burnout among paramedics. • Paramedics face a high-stress, high-stakes phenomenon with each emergency • The phenomenon is perceived as pressure, overwhelm, multitasking, and dissociation • Emotional extremes are commonly experienced as a result of the phenomenon • This type of acute stress may be responsible for high burnout rates • Study suggests future research from a larger sample and more diverse range of paramedics [ABSTRACT FROM AUTHOR]

This article presents information on the prospects of the paper books industry. According to a report, with the arrival of the first eReaders in the publishing market, it accounted for about 20% of the U.S. book market and 12.9% in Great Britain. The author states that eBooks are revolutionising reading habits.

The article focuses on the increase in technological lawmaking in the U.S. in 2014. Topics include the development of the technology industry in the U.S., constitutional law in the U.S., and the U.S. Administrative Procedure Act (APA). Information is provided on the rate of technical innovation in the U.S. in 2014.

Abstract   Aims To study practice patterns in the management of non-obstructive dysphagia among U.S. gastroenterologists. Data source Endoscopic data repository from 100 U.S. gastroenterology practices during 1998–2003 (Clinical Outcomes Research Initiative, CORI). Methods All initial esophago-gastro-duodenoscopies (EGDs) performed in adult patients between 1998 and 2003 (n = 181,261) were evaluated for demographic data, endoscopic findings, and the occurrence of esophageal dilation. A case population of 7256 patients receiving empiric dilation for dysphagia for non-obstructive dysphagia was compared to a control population of 5764 patients with dilation for peptic strictures. Results The group of patients with empiric dilation was younger than the group of patients with peptic strictures and contained more women. Reflux symptoms and erosive esophagitis were less frequent in the empiric dilation group than in the strictures group. Empiric dilations were mostly performed using rubber bougies, whereas strictures were most frequently dilated over a guidewire. For all types of dilators, the diameters were significantly larger in empiric than stricture dilation. Repeat dilations within 1 year after the initial procedure occurred in 4% of the empiric and 13% of the stricture dilations. Conclusions Compared with the dilation of peptic strictures, empiric dilation of non-obstructive dysphagia is a more common clinical practice that is performed in a different patient population and utilizes different techniques. [ABSTRACT FROM AUTHOR]

The U.S. Geological Survey and other international agencies have collaborated to conduct laboratory and field validations of acoustic Doppler current profiler (ADCP) measurements of streamflow. Laboratory validations made in a large towing basin show that the mean differences between tow cart velocity and ADCP bottom-track and water-track velocities were -0.51 and -1.10%, respectively. Field validations of commercially available ADCPs were conducted by comparing streamflow measurements made with ADCPs to reference streamflow measurements obtained from concurrent mechanical current-meter measurements, stable rating curves, salt-dilution measurements, or acoustic velocity meters. Data from 1,032 transects, comprising 100 discharge measurements, were analyzed from 22 sites in the United States, Canada, Sweden, and The Netherlands. Results of these analyses show that broadband ADCP streamflow measurements are unbiased when compared to the reference discharges regardless of the water mode used for making the measurement. Measurement duration is more important than the number of transects for reducing the uncertainty of the ADCP streamflow measurement. [ABSTRACT FROM AUTHOR]

Since 1964, the NASA Goddard Space Flight Center (GSFC) has been using short pulse lasers to range to artificial satellites equipped with passive retroreflectors. Today, a global network of 40 satellite laser ranging (SLR) stations, under the auspices of the International Laser Ranging Service (ILRS), routinely tracks two dozen international space missions with few-millimeter precision using picosecond pulse lasers in support of Earth science. Lunar laser ranging (LLR) began in 1969, shortly after NASA's Apollo 11 mission placed the first of five retroreflector packages on the Moon. An important LLR data product has been the verification of Einstein's equivalence principle and other tests of general relativity. In 1975, the University of Maryland used a laser ranging system to continuously transfer time between two sets of atomic clocks — one set on the ground and the other in an aircraft — to observe the predicted relativistic effects of gravity and velocity on the clock rates. Two-way asynchronous laser transponders promise to extend these precise ranging and time transfer capabilities beyond the Moon to the planets, as evidenced by two successful experiments carried out in 2005 at distances of 24 and 80 million km respectively. [ABSTRACT FROM AUTHOR]

Presents a study that examined the recruitment of teachers through alternative routes to teacher certification in an effort to address teacher shortage in North Carolina through North Carolina Teachers of Excellence for All Children (NCTEACH) entry licensure program. Description of the NCTEACH program; Methodology; Investigation on alternative teacher certification; Analysis on the factors leading to attrition and retention of beginning teachers; Details of the dialogues that represent the participants of the first year of NCTEACH; Discussion on the recommendations of the participants of the program.

This paper explores the applicability of wavelet transform for the analysis of strong and weak ground motions recorded on rock at Yerba Buena Island and on dredged sandfill at nearby Treasure Island about 2 km away during the 1989 Loma Prieta earthquake in California. An interpretation of the results from this analysis is presented and discussed. The major important feature of this data set is that liquefaction occurred at the Treasure Island site during the strong shaking. The Daubechies 20-coefficient wavelet transform is utilized in this study. Results of the application of the wavelet transform can be summarized as follows: most of the energy of the earthquake at the Treasure Island site is in the frequency range of 0.58-1.77 Hz and arrives in the time interval between 11 and 15 s. For the Yerba Buena Island site, most of the energy lies within the frequency range of 1.15-3.53 Hz and arrives between 8 and 13 s. The analysis indicates that there are some large peaks at the highest resolution in the wavelet transforms at the Treasure Island site, which can be attributed to a progressive change in the stiffness characteristics of the soil. [ABSTRACT FROM AUTHOR]

Focuses on research developments of electron and atomic physics in the United States. Application of Electron Cyclotron Resonance ion sources; Measurement of Doppler effect by spectroscopic techniques; Principles of local Lorentz invariance and time-reversal invariance.

The article reports on the gamma-ray burst (GRB) detected by the Swift orbiter of the U.S. National Aeronautics and Space Administration (NASA) on April 23, 2009. It indicates that the gamma-ray has a redshift z of 8.26 which is considered as the highest redshift ever detected by NASA. It also states that the initial burst of gammas and the x-ray afterglow of GRB provide no direct measure of z.

Opinion. Discusses the general interest of college students towards science. Development of a science course that will appeal to a large number of college students who have been traumatized by high school science; Evaluation standards; Books assigned to students; Homework policy; Lecture demonstrations.