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BACKGROUND AND OBJECTIVE: To characterize treatment patterns for retinal vein occlusion (RVO)-related macular edema (ME) in routine clinical practice and its impact on long-term best-corrected visual acuity (BCVA) and central subfield thickness (CST). PATIENTS AND METHODS: Retrospective study of 365 eyes with branch RVO (BRVO) or central/hemi-RVO (CRVO/HRVO)-related ME between 2003 and 2020. Regression analysis identified factors associated with maintenance injection interval (MII). Subgroup analysis compared outcomes between different MIIs. RESULTS: 51.3% of BRVO patients received injections ≤q8 weeks, 26.4% received injections q8-12 weeks, and 22.3% received injections >q12 weeks. 45.2% of CRVO/HRVO patients received injections ≤q8 weeks, 32.1% received injections q8-12 weeks, and 22.6% received injections >q12 weeks. Age, diabetes, and baseline CST were found to predict MII. There was no significant difference in BCVA and CST at baseline, 12, or 24 months in all MII groups in BRVO and CRVO/HRVO. CONCLUSION: There exists a significant heterogeneity in anti-VEGF treatment frequency for RVO-associated ME in routine clinical practice. [ Ophthalmic Surg Lasers Imaging Retina 2022;53:626–633.]

The distance-inclination degeneracy limits gravitational-wave parameter estimation of compact binary mergers. Although the degeneracy can be partially broken by including higher-order modes or precession, these effects are suppressed in binary neutron stars. In this work, we implement a new parametrization of the tidal effects in the binary neutron-star waveform, exploiting the binary Love relations, that breaks the distance-inclination degeneracy. The binary Love relations prescribe the tidal deformability of a neutron star as a function of its source-frame mass in an equation-of-state insensitive way and, thus, allows direct measurement of the redshift of the source. If the cosmological parameters are assumed to be known, the redshift can be converted to a luminosity distance, and the distance-inclination degeneracy can thus be broken. We implement this new approach, studying a range of binary neutron-star observing scenarios using Bayesian parameter estimation on synthetic data. In the era of the third-generation detectors, for observations with signal-to-noise ratios ranging from 6 to 167, we forecast up to an $\sim70\%$ decrease in the $90\%$ credible interval of the distance and inclination and up to an $\sim50\%$ decrease in that of the source-frame component masses. For edge-on systems, our approach can result in moderate ($\sim50\%$) improvement in the measurements of distance and inclination for binaries with a signal-to-noise ratio as low as 10. This prescription can be used to better infer the source-frame masses and, hence, refine population properties of neutron stars, such as their maximum mass, impacting nuclear astrophysics. When combined with the search for electromagnetic counterpart observations, the work presented here can be used to put improved bounds on the opening angle of jets from binary neutron-star mergers., 19 pages, 13 figures, text and references updated, v2 matches version published in PRD

Heart failure with mildly reduced ejection fraction (HFmrEF) has been classified using various definitions since its first mention in the literature in 2014. This group was most recently defined in the Universal Definition and Classification of Heart Failure (HF) as HF with a left ventricular ejection fraction of 41% to 49%. An increasing emphasis has been placed on HFmrEF over the past several years, with many recent publications suggesting that common therapies used in HF with reduced ejection fraction provide benefit in this population as well. Patients with HFmrEF comprise approximately one-quarter of all patients with HF. The lack of authoritative guidance concerning pharmacotherapeutic approaches in these patients leaves a significant portion of HF patients without an evidence-based approach. Although it remains unclear if HFmrEF is simply a transitional state from preserved to reduced ejection fraction, or a distinct phenotype requiring medical optimization, there are clear cardiovascular benefits to managing this subset appropriately. This publication was created to help serve as a resource for clinicians on this evolving subset of HF and aid in preventing the progression of this disease state through improved therapy optimization. The objective of this article is to briefly discuss the epidemiology and pathophysiology of HFmrEF and review the pharmacology and clinical application of therapies for the management of HFmrEF.

Purpose The purpose of this study was to develop a novel swine model of recurrent gastrointestinal bleeding that could potentially be utilized for the study of provocative mesenteric angiography. Methods Animal experiments were approved by the Institutional Animal Care and Use Committee. The superior mesenteric artery was catheterized via percutaneous transfemoral access. Via laparotomy, multiple small incisions were created in the small bowel wall of four swine. After hemostasis was achieved, varying amounts of thrombolytics were infused into the superior mesenteric artery via a 5 french catheter. The number of incisions with observable rebleeding and interval until rebleeding were ascertained. Results In a test animal, active extravasation was confirmed to be detectable on digital subtraction angiography at a small bowel incision site. After tissue plasminogen activator (tPA) administration into the superior mesenteric artery, rebleeding from the incisions was visually observed in 11 of 30 small bowel incisions (37%). Provoked bleeding occurred at a median of 6 minutes (mean: 5 minutes and 52 seconds) after completion of tPA injection with a range of approximately 1 to 10 minutes. Conclusion This pilot study proposes a feasible model for provocative mesenteric angiography in swine.

Gravitational wave observations have great potential to reveal new information about the fundamental nature of gravity, but extracting that information can be difficult. One popular technique is the parametrized inspiral test of general relativity (a realization of the parametrized post-Einsteinian framework), where the gravitational waveform, as calculated in Einstein's theory as a series expansion in the orbital velocity, is parametrically deformed at a given set of orders in velocity. However, most current approaches usually only analyze the data while considering a single, specific modification at a time. Are then constraints placed with a single modification robust to our ignorance of higher post-Newtonian order corrections? We show here that for a wide class of theories, specifically those that admit a post-Newtonian expansion, single-parameter tests are indeed robust. In particular, through a series of full Bayesian parameter estimation studies on several different sets of synthetic data, we show that single-parameter constraints are not degraded but rather are improved by the inclusion of multiple parameters, provided one includes information about the mathematical structure of the series. We then exemplify this with a specific theory of gravity, shift-symmetric scalar Gauss-Bonnet theory, where the waveform has been calculated to higher post-Newtonian orders than leading. We show that the inclusion of these higher order terms strengthens single-parameter constraints, instead of weakening them, and that the strengthening is very mild. This analysis therefore provides strong evidence that single-parameter post-Einsteinian tests of general relativity are robust to ignorance of high post-Newtonian order terms in the general relativistic deformations., Comment: 22 pages, 11 figures, updated with additional figure and small corrections to reflect the published version

The authors have requested that this preprint be removed from Research Square.

Gravitational-wave cosmology began in 2017 with the observation of the gravitational waves emitted in the merger of two neutron stars, and the coincident observation of the electromagnetic emission that followed. Although only a $30\%$ measurement of the Hubble constant was achieved, future observations may yield more precise measurements either through other coincident events or through cross correlation of gravitational-wave events with galaxy catalogs. Here, we implement a new way to measure the Hubble constant without an electromagnetic counterpart and through the use of the binary Love relations. These relations govern the tidal deformabilities of neutron stars in an equation-of-state insensitive way. Importantly, the Love relations depend on the component masses of the binary in the source frame. Since the gravitational-wave phase and amplitude depend on the chirp mass in the observer (and hence redshifted) frame, one can in principle combine the binary Love relations with the gravitational-wave data to directly measure the redshift, and thereby infer the value of the Hubble constant. We implement this approach in both real and synthetic data through a Bayesian parameter estimation study in a range of observing scenarios. We find that for the LIGO/Virgo/KAGRA design sensitivity era, this method results in a similar measurement accuracy of the Hubble constant to those of current-day, dark-siren measurements. For third generation detectors, this accuracy improves to $\lesssim 10\%$ when combining measurements from binary neutron star events in the LIGO Voyager era, and to $\lesssim 2\%$ in the Cosmic Explorer era., accepted in PRD

The Campbell University Drug Information Center supports health professionals by providing responses to drug-related inquiries. An inquiry was received by the Drug Information Center for a comprehensive list of oral solutions which should be protected from light. In investigating this request for information, a list of light-sensitive oral prescription drug products published in Hospital Pharmacy in 2009 was identified. This discovery highlighted the need for both an updated list and one which distinguished oral solid products and oral liquid products. The purpose of this project was to update the previously published list and to distinguish between oral solid and liquid dosage forms. The process of updating this list entailed several professional resources. A list of all oral products was obtained and then sorted to clearly identify which products were available in oral solid dosage form only, oral liquid dosage form only, and both dosage forms. Once delineated, the product labels for each medication were scoured for language indicating the product is light sensitive.

Objective. The purpose of this study was to determine whether the addition of standardized patients or the addition of interprofessional student teams with standardized patients to the use of a simulated electronic health record improved student knowledge retention and perceptions. Methods. This was a prospective cohort study assessing three cohorts of first-year student pharmacists in pharmacy skills laboratory activities that occurred in 2018, 2019, and 2021. The primary objective of the study was to compare knowledge retention of the case material between groups at one month. Each year, an element of simulated experience was added onto the previous year’s case. In 2018, students completed the case using only the electronic health record web application. In 2019, the previous year’s experience was combined with an objective structured clinical examination (OSCE) with standardized patients. In 2021, the 2019 experience was supplemented with student physician assistants. Case scores and student perceptions were also compared between groups. Results. Of the 260 potential participants, 238 students were included in the primary analysis. Results showed that with the addition of interprofessional team-based care and standardized patients, significant improvement was demonstrated in knowledge retention assessments at one month. Mean knowledge retention assessment scores for the 2018, 2019, and 2021 groups were 63.8%, 71.7%, and 76.1%, respectively. Significant improvement was also found in student perceptions. Conclusion. Adding standardized patients and interprofessional team-based care to a pharmacy skills laboratory that uses a simulated electronic health record significantly improved student knowledge retention and perceptions.

Gravitational wave observations of compact binaries allow us to test general relativity (and modifications thereof) in the strong and highly-dynamical field regime of gravity. Here we confront two extensions to general relativity, dynamical Chern-Simons and Einstein-dilaton-Gauss-Bonnet theories, against the gravitational wave sources from the GWTC-1 and GWTC-2 catalogs by the LIGO-Virgo Collaboration. By stacking the posterior of individual events, we strengthen the constraint on the square root of the coupling parameter in Einstein-dilaton-Gauss-Bonnet gravity to $\sqrt{\alpha_{\rm \tiny EdGB}} < 1.7$ km, but we are unable to place meaningful constraints on dynamical Chern-Simons gravity. Importantly, we also show that our bounds are robust to (i) the choice of general-relativity base waveform model, upon which we add modifications, (ii) unknown higher post-Newtonian order terms in the modifications to general relativity, (iii) the small-coupling approximation, and (iv) uncertainties on the nature of the constituent compact objects., Comment: 17 pages, 12 figures; Updated to reflect the version published in PRD

A 43-year-old woman presented with postpartum haemorrhage necessitating uterine artery embolisation. Prior to embolisation, angiography demonstrated the presence of a persistent sciatic artery (PSA). Due to the possibility of embolic particles inadvertently traveling to the lower extremity via this variant arterial pathway, care was taken to only embolise the uterine artery. PSAs are uncommon but important vascular pathways to screen for during pelvic intervention and are associated with other genitourinary anomalies.

Background and purpose In order to develop practice-ready pharmacists as mandated by the Accreditation Council for Pharmacy Education Accreditation Standards, exposing students to health information technologies used in clinical practice, like electronic health records (EHRs), is imperative. While the benefits of using EHRs have been described in the literature, limited information or guidance exists on how these tools can incorporate various activities and topics to be implemented throughout an entire curriculum. The purpose of this report is to describe the curriculum-wide implementation of a simulated EHR software, including the novel learning experiences and costs incurred by the college. Educational activity and setting The EHR was implemented in various courses across the pharmacy school curriculum in the first, second, and third professional years. Findings During the final year of implementation, the EHR platform was utilized in each of the three didactic years of the pharmacy program. Twenty-two faculty members created cases using the EHR platform. These cases were used across 16 courses and were accessed by students 7191 times during the implementation process. The cost per use of the EHR platform was approximately half that of the most frequently used electronic learning database used in the program. Summary In the three years since its inception, the EHR has been highly utilized as evidenced by the overall number of experiences for students, the variety of experiences, and the number of faculty who used the EHR in their course.

Objective. Interprofessional team-based care has become the standard for practicing clinical pharmacists. However, it is difficult to simulate every aspect of this environment in the didactic curriculum. The purpose of this study was to determine if the addition of standardized patients (SP) or interprofessional student teams with SPs, to the use of a simulated electronic health record (EHR) improved student knowledge retention and perceptions.Methods. This was a prospective cohort study assessing three cohorts of first-year student pharmacists in pharmacy skills laboratory activities that occurred in 2018, 2019, and 2021. The primary objective of the study was to compare knowledge retention at 1-month related to the case material between groups. Each year an element of simulated experience was added onto the previous year's case. In 2018, students completed the case using the EHR web application only. In 2019, an objective structured clinical examination (OSCE) with SPs was combined with the previous year's experience. In 2021, student physician assistants were added to the 2019 experience. Case scores and student perceptions were also compared between groups.Results. Of the 260 potential participants, 238 students were included in the primary analysis. Significant improvement was demonstrated in one-month knowledge retention assessments with the addition of interprofessional team-based care and SPs. Mean knowledge retention assessment scores were 63.8%, 71.7%, and 76.1% respectively. There was also significant improvement in student perceptions.Conclusion. The addition of SPs and interprofessional team-based care to a pharmacy skills laboratory that utilizes a simulated EHR significantly improved student knowledge retention and perceptions.

This paper evaluates the effectiveness of the Counseling on Access to Lethal Means (CALM) suicide prevention program. CALM trains mental health providers how to counsel suicidal individuals and those who support them on mean restriction during times of crisis. Pre/post/3-month follow-up assessments measured knowledge of lethal means, confidence and comfort in discussing means restriction (self-efficacy), and future intentions to counsel clients on means restriction. Change in the number of clients receiving lethal means counseling was also assessed. All constructs increased significantly at posttest. Confidence and counseling intentions were sustained at follow-up and significantly more clients received means counseling in the 3 months following the CALM training. Knowledge and comfort levels decreased at follow-up but not to pre-training levels. CALM is effective at increasing mental health professionals' comfort, knowledge, and frequency of talking about means restriction with clients. an effective means restriction training program. A template to assess clients for suicidality and lethal means access and booster sessions are recommended to further sustain effects.

Gravitational wave observations of compact binary mergers are already providing stringent tests of general relativity and constraints on modified gravity. Ground-based interferometric detectors will soon reach design sensitivity and they will be followed by third-generation upgrades, possibly operating in conjunction with space-based detectors. How will these improvements affect our ability to investigate fundamental physics with gravitational waves? The answer depends on the timeline for the sensitivity upgrades of the instruments, but also on astrophysical compact binary population uncertainties, which determine the number and signal-to-noise ratio of the observed sources. We consider several scenarios for the proposed timeline of detector upgrades and various astrophysical population models. Using a stacked Fisher matrix analysis of binary black hole merger observations, we thoroughly investigate future theory-agnostic bounds on modifications of general relativity, as well as bounds on specific theories. For theory-agnostic bounds, we find that ground-based observations of stellar-mass black holes and LISA observations of massive black holes can each lead to improvements of 2-4 orders of magnitude with respect to present gravitational wave constraints, while multiband observations can yield improvements of 1-6 orders of magnitude. We also clarify how the relation between theory-agnostic and theory-specific bounds depends on the source properties., Comment: 45 pages, 28 figures, 7 tables. v3: matches version published in Physical Review D; v4: corrected an error in the parameter definitions on the bottom of page 11, corrected the units of several parameters in Table II, the caption of Table II, and in Fig. 11, and adjusted the labels of several figures in Sec. VIB to improve clarity

Evidence-based medicine (EBM) has been positively accepted by clinicians; however, there are barriers to practicing EBM that create gaps between EBM and current clinical practice. A pharmacist-led drug information (DI) service initiative was established to overcome common barriers to practicing EBM. The service utilizes technology and a collaborative model among otherwise independent academic DI centers to provide efficient high-quality service to health care professionals. It was piloted at a large health care system with positive user satisfaction. The unique technological collaborative has shown several benefits, including increased efficiency and peer learning among DI pharmacists.

STUDY DESIGN Randomized controlled trial. OBJECTIVE To compare radiation exposure between ultra-low radiation imaging (ULRI) with image enhancement and standard-dose fluoroscopy for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA Although the benefits of MIS are lauded by many, there is a significant amount of radiation exposure to surgeon and operating room personnel. Our goal with this work was to see if by using ultra-low dose radiation settings coupled with image enhancement, this exposure could be minimized. METHODS An institutional review board approved, prospective, internally randomized controlled trial was performed comparing ultra-low dose settings coupled with image enhancement software to conventional fluoroscopic imaging. In this study, each patient served as their own control, randomly assigning one side of MIS-TLIF for cannulation and K-wire placement using each imaging modality. Further, the case was also randomly divided into screw placement and cage placement/final images to allow further comparisons amongst patients. Radiation production from the C-arm fluoroscope and radiation exposure to all operating room personnel were recorded. RESULTS Twenty-four patients were randomly assigned to undergo a single level MIS-TLIF. In no case was low radiation imaging abandoned, and no patient had a neurologic decline or required hardware repositioning. Everyone in the operating room-the physician, scrub nurse, circulator, and anesthesiologist-all benefited with 61.6% to 83.5% reduction in radiation exposure during cannulation and K-wire placement to screw insertion aided by ULRI. In every case but the anesthesiologist dose, this was statistically significant (P

Patient: Female, 56 Final Diagnosis: Fixed-drug eruption Symptoms: — Medication: Metformin Clinical Procedure: Discontinued metformin Specialty: Family Medicine Objective: Unusual or unexpected effect of treatment Background: A fixed-drug eruption (FDE) is a reaction characterized by cutaneous lesions that appear due to exposure to a particular drug. Barbiturates, carbamazepine, sulfamethoxazole, and tetracyclines have all been associated with causation of FDEs. Although these drugs are more commonly associated with FDEs, any introduction of a medication has the potential to result in a FDE. Metformin, a commonly used medication to improve glycemic control, has been reported to cause dermatologic reactions in some case reports, but only a single previously documented case report discusses the potential of metformin-associated FDE. Case Report: We describe a 56-year-old woman who developed a FDE with multiple exposures to metformin. Upon each exposure, small, round, erythematic lesions developed on the palms of the hands and soles of the feet; these lesions resolved each time after discontinuation of metformin. According to the Naranjo scale, there is a definite association between metformin and FDE in this case (score of 8). Conclusions: This report contributes to the limited documented literature on metformin-induced FDE. Clinicians should be made aware of possible FDEs associated with this commonly used medication.

Gravitational waves can probe fundamental physics, leading to new constraints on the mass of the graviton. Previous tests, however, have neglected the effect of screening, which is typically present in modified theories that predict a non-zero graviton mass. We here study whether future gravitational wave observations can constrain the graviton mass when screening effects are taken into account. We first consider model-independent corrections to the propagation of gravitational waves due to screened massive graviton effects. We find that future observation can place constraints on the screening radius and the graviton mass of ${\cal{O}}(10^{2})$--${\cal{O}}(10^{4})$ Mpc and ${\cal{O}}(10^{-22})$--${\cal{O}}(10^{-26})$ eV respectively. We also consider screening effects in two specific theories, ghost-free massive gravity and bigravity, that might not realize these types of propagation modifications, but that do provide analytic expressions for screening parameters relevant to our analysis allowing for more concrete results. However, the constraints we are able to place are small. The reason for this is that second- and third-generation detectors are sensitive to graviton masses that lead to very small screening radii in these particular models. The effect of screening, however, can become important as constraints on the graviton mass are improved through the stacking of multiple observations in the near future., 11 pages, 5 figures

The purpose of this study was to assess the technical feasibility of ultrasound-guided endovascular creation of a percutaneous extraluminal arterial bypass graft without a surgically created arterial anastomosis. Nine swine were utilized for this IACUC-approved study using a carotid bypass model in swine. Using sonographic guidance, percutaneous access was obtained to the proximal and distal common carotid artery. A self-expanding stent graft was advanced through the proximal carotid access site, tunneled subcutaneously, then advanced through the distal carotid access site, and deployed. The stent grafts were monitored weekly for patency using ultrasound. Angiography was performed at 4 weeks to evaluate for graft patency. Gross pathologic analysis was performed on the explanted stent grafts. In eight out of the nine swine (89%), percutaneous extraluminal bypass graft creation was technically successful, with brisk flow through the stent graft to the distal circulation, complete exclusion of the bypassed segment of carotid artery, and no extravasation. The technical failure was due to stent graft maldeployment. Of the six swine evaluated for patency, four grafts were patent at the 4-week end point. Both occluded stent grafts were due to extraluminal extrusion of one end, likely related to neck movement and growth in neck length. The percutaneous arterial bypass technique had a high technical success rate and a graft patency rate of 67% at 4 weeks, with early occlusions possibly related to limitations of the animal model.

The nuclear transcription factors NF-kappaB/Rel have been shown to function as key regulators of either cell death or survival in neuronal cells. Here, we investigated whether selective activation of diverse NF-kappaB/Rel family members might lead to distinct effects on neuron viability. In both cultured rat cerebellar granule cells and mouse hippocampal slices, we examined NF-kappaB/Rel activation induced by two opposing modulators of cell viability: 1) interleukin-1beta (IL-1beta), which promotes neuron survival and 2) glutamate, which can elicit toxicity. IL-1beta produced a prolonged stimulation of NF-kappaB/Rel factors by inducing both IkappaBalpha and IkappaBbeta degradation. Glutamate produced a delayed and transient activation of NF-kappaB/Rel, which was associated with a brief loss of IkappaBalpha. Moreover, IL-1beta activated the p50, p65, and c-Rel subunits of NF-kappaB/Rel, whereas glutamate activated only the p50 and p65 proteins. The inhibition of NF-kappaB/Rel protein expression by antisense oligonucleotides in cerebellar granule cells showed that p65 was involved in glutamate-mediated cell death, whereas c-Rel was essential for IL-1beta-preserved cell survival. Furthermore, the depletion of c-Rel in cultured neurons as well as in the hippocampus from the c-Rel(-/-) mouse converted the IL-1beta effect into toxicity. These findings suggest that, within a single neuron, the balance between cell death and survival in response to external stimuli may rely on the activation of distinct NF-kappaB/Rel proteins.

Adult female dogs were immunized with 0.5 mg bovine luteinizing hormone receptor (LH-R) encapsulated in a silastic subdermal implant and subsequently with four intramuscular booster injections of 0.1 mg LH-R each. Circulating LH-R antibody was detected in the sera 3 weeks post-implant. The appearance of LH-R antibody was associated with a decline in the serum progesterone concentrations to a range of 0-0.5 ng/ml until day 365 in the immunized dogs in comparison with a range of 5-10 ng in the control animals, suggesting a lack of ovulation and corpus luteum function in immunized dogs. The immunized dogs did not show signs of 'standing heat' and failed to ovulate when induced by LH-RH challenge. Serum oestradiol levels, however, remained in the range of 30-40 pg/ml in both the immunized and the control dogs. With the decline in the antibody titres, the hormonal profile and vaginal cytology returned to a fertile state and the dogs exhibited signs of 'standing heat', as well as vaginal bleeding. Dogs immunized with LH-R did not show any serious metabolic, local or systemic adverse effects. The hypothalamic--pituitary gonadal axis remained intact as indicated by little difference in pituitary LH levels between control and immunized animals, and by the release of LH by LH-RH challenge. These studies demonstrate that active immunization of female dogs with LH-R could immunomodulate ovarian function to cause a reversible state of infertility. It may be postulated that, due to extensive interspecies homology, a recombinant LH receptor-based immunocontraceptive vaccine may also be effective in other vertebrates.

The management of ordnance and explosives (O/E) at military installations has traditionally been based on the premise that worker and community safety are paramount. While the Department of Defense (DOD) has a well-defined collection of safety regulations and guidance documents for O/E recovery operations, the status of these operations with respect to federal and state environmental laws is somewhat complex. The U.S. Environmental Protection Agency's (EPA's) Military Munitions Rule, promulgated in 1997, defined when these items were legally considered to become a solid, potentially hazardous waste. The DOD/EPA document titled Unexploded Ordnance (UXO) Management Principles, dated March 7, 2000, clarified some of the complexities. Ordnance and explosives recovery operations at Rocky Mountain Arsenal (RMA), a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) site in Colorado, present a unique application of existing rules. CERCLA allows for the substantive elements of applicable or relevant and appropriate regulations to be invoked in the conduct of response operations. This article addresses how a risk-based approach has been developed to handle emergency scenarios involving O/E discovered in the process of a CERCLA response action. RMA personnel have taken the Resource Conservation and Recovery Act (RCRA) emergency response authorities, the Military Munitions Rule, and Departments of Army and Defense regulations and guidance and crafted a set of emergency response protocols that incorporate relevant regulations, protect human health and the environment, and satisfy the regulatory agencies. This article represents the approach taken at RMA and does not necessarily represent a valid approach at other installations. It is intended to provide readers with information and references that may be useful in developing their own set of site-specific procedures. It should be noted that the DOD is reviewing and potentially revising materials referenced in this article. The approach described in this article may require amendment when modifications to DOD policy are made. © 2002 Wiley Periodicals, Inc.

One of the IACUC’s principal roles is to ensure that animals used in research, testing, and teaching are used humanely by trained staff. Although IACUC review of proposals describing planned animal activity is an important mechanism for meeting this role, observation of animal use provides the most direct assurance that these goals are attained. At some institutions, animals are never removed from the animal facility as all activities are performed within animal holding or procedure rooms. Nevertheless, it is common for animals to be transported from the animal facility to an investigator’s laboratory for experimental use. While animal resource personnel can readily observe the appropriateness of activities conducted within the animal facility, this task becomes signicantly more difcult, especially at large institutions, when animal research is conducted in an investigator’s laboratory.

The study attempted to integrate the cognitive content-specificity and tripartite literatures to create a more holistic model of the emotional, physiological, and cognitive phenomenology of depression and anxiety. In addition, the constructs of hopelessness and worry were used to clarify ambiguous findings in the cognitive content-specificity research and to identify possible cognitive correlates of high NA and low PA. The results from 124 clients at a university counseling center supported this attempt at integrating these literatures. Overall, there was good evidence that worry is a cognitive correlate of high NA. Consequently, we view worry and high NA as features of a constellation of correlated indices that are shared with both depressed and anxious mood states. Alternatively, the results also support the position that hopelessness is a cognitive correlate of low PA. These features—low PA and hopelessness—define correlated indices that help discriminate depressed from anxious states. We view this integration of the cognitive and emotional literatures as providing evidence for a comprehensive map of the emotional and cognitive phenomenology in depression and anxiety.

As more U.S. Department of Defense (DOD) Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation sites approach closure, the importance of properly conducting CERCLA five-year reviews will increase.Relatively few DOD sites have been subject to a five-year review so far, and less than a handful have been subject to a five-year review under the U.S. Environmental Protection Agency's (EPA's) new guidance. Since these reviews are required to occur at certain sites into the indefinite future, conducting them properly from the outset is critical. The assumptions and decisions made in conducting the first five-year review at a given site set the precedent for future five-year reviews, and mistakes made in format or content may be perpetuated in subsequent five-year reviews. This article provides a detailed accounting of how one of the DOD's largest cleanup sites, Rocky Mountain Arsenal, conducted its first five-year review in accordance with the new EPA guidance. It provides a lesson in cooperation among the DOD; the U.S. Fish and Wildlife Service; Shell Oil Company; local, state, and federal regulators; and the public. This article simplifies the complex process of conducting a five-year review at a large cleanup site and clarifies objectives. Finally, the article provides recommendations to help other facilities properly conduct a five-year review the first time so the process is simpler in the future. © 2001 John Wiley & Sons, Inc.

A review and meta-analysis was conducted to evaluate the empirical evidence for the cognitive content-specificity hypothesis. The cognitive content-specificity hypothesis is a component of Aaron Beck's cognitive theory of emotional disorders (A.T. Beck, 1976) in which he postulates that affective states can be discriminated on the basis of unique cognitive content. The majority of investigations of this hypothesis have involved the assessment of self-reported cognitive features associated with anxious and depressive symptomatology. Across the 13 studies meeting the inclusion criteria, all effect sizes, even divergent relationships, were significantly different from zero indicating that depressive and anxious cognitive content shared significant variance with both depression and anxiety. More specific effect-size contrasts indicted that depressive cognitive content did display significant specificity, being more strongly related to depression than anxiety. Finally, the cognitive content measures were found to be highly correlated. These findings are generally inconsistent with the cognitive content-specificity hypothesis. Theoretical and psychometric recommendations are offered to address these issues in future cognitive content-specificity research.

As more data gathering, analysis, and tracking tasks are outsourced the need for multiple contractors and military personnel to input, update, access, store, and track Mormation is becoming critical to efficient functioning and managing of environmental projects and programs at military installations. This paper presents two case studies detailing the way two organizations--the Rocky Mountain Arsenal (RMA) in Colorado, and the 611th Air Support Group (611 ASG) in Alaska--are managing complex data using web-based technology. RMA is involved in one of the largest environmental cleanup programs in the Department of Defense. As such, large volumes of environmental data and documents must be generates stored, and tracked. Often these documents are prepared by multiple contractors and are reviewed by several parties or groups. To manage environmental information and to ensure that it meets compliance requirements more efficiently, RMA has developed an electronic document tracking and distribution system. This system allows access to up-to-date information, including a detailed review of all pertinent regulatory and other requirements at RMA. The dynamic system includes milestones, review deadlines, submission deadlines, and other requirements for managing the environmental program. The 611 ASG manages more than 30 remote installations in Alaska, many of which are operated bymore » contractor personnel. These installations contain hundreds of buildings that are constantly being modified because of exposure to harsh arctic climates; some of them have been determined to be eligible for the National Register of Historic Places. To meet regulatory requirements for cultural resources management as well as engineering requirements for upkeep of buildings, a database was developed to store and analyze building data. The database has a web-based interface that allows anyone with the correct access codes to input new data, modify existing data, or query the database using a number of standard reports. This system allows the 611 ASG to centrally manage its building information while also permitting installation contractors to update and use data through the Internet from their remote locations.« less

The dimensionality of career indecisiveness has continually eluded researchers for several years. These measures have been either purely theoretical or purely empirical, neglecting the other domain. A relatively new instrument, the Career Decision Difficulties Questionnaire (CDDQ), is based on a taxonomy of decision-making difficulties. This study assesses the reliability and construct validity of the CDDQ, along with differences between decided and undecided groups. The sample included 268 university students. Convergent validity was assessed using the Career Decision Scale (CDS). Discriminant validity was assessed using measures of anxiety and social desirability. The CDDQ showed convergence with the CDS, and discriminated against both anxiety and social desirability. Differences between groups were statistically significant on most decision making difficulty scales. The results provide support for the reliability and validity of the CDDQ, suggesting that this measure may be useful in attempting to understand the multidimensionality of career indecisiveness and further assist in the development of a more comprehensive and accurate theoretical perspective of the construct of career indecisiveness.

Objective—To determine the effect of immunization with bovine luteinizing hormone receptor (LH-R) on ovarian function of cats. Animals—9 adult female domestic cats. Procedure—7 cats were immunized with 0.5 mg of LH-R encapsulated in a silastic subdermal implant (3 × 10 mm); 2 served as control cats. Receptors had 80% specific binding to 125I-human chorionic gonadotropin with a binding capacity of 2,682 pM/mg. Cats received booster injections of LH-R. Cats were induced to ovulate with luteinizing hormone (LH) releasing hormone on day 345. Samples of venous blood and vaginal cells were collected through day 395. Observation of estrus behavior continued until day 516. Serum concentrations of estradiol, progesterone, thyroid gland hormones, LH, and LH-R antibody were determined. Results—LH-R antibody was detected in the sera of immunized cats within 21 days after implantation. Detection of LH-R antibody was associated with suppression of serum progesterone to ≤ 0.5 ng/mL during the study period, compared with concentrations of 5 to 10 ng/mL in control cats. Immunized cats did not display signs of estrus. Release of LH after administration of LH releasing hormone indicated an intact hypothalamic-pituitary axis but poor corpus luteum function. Serum estradiol concentrations remained between 30 to 40 pg/mL in immunized and control cats. With the decrease antibody titers, hormone concentrations returned to a pattern consistent with that during fertility. Conclusions and Clinical Relevance—Active immunization with LH-R suppressed corpus luteum function in cats. The effect was reversible. An LH-R-based antifertility vaccine may have clinical application in other vertebrates. (Am J Vet Res 2003;64:292–298)

We recently identified commercial mouse serum as the source of introduction of ectromelia virus, the causative agent of mousepox, a rare and devastating murine virus, into our institution. The serum was not intended to be used in vivo; however, media supplemented with the serum was inadvertently used to feed cells that were subsequently inoculated into mice. Fortunately, we were able to contain and eliminate the virus before it spread throughout our institutional colonies. We have determined that the contaminated serum, which was obtained late last year, originated in China. The serum was imported as a batch of at least 43 liters and was filtered (0.2 μ) by the distributor. The serum has been distributed to major suppliers throughout the United States and has or may be sold as is or further processed to obtain a variety of serum-derived products. The identification of the serum source, the size of the lot from which it originated, and the distribution throughout the country by many vendors raises concerns about the potential risk to our domestic mouse colonies. Further, as tens of thousands of mice are needed to generate this quantity of serum, and considering the lack of testing of imported material for mousepox and other agents of potential concern, the likelihood is that serum contaminated with mousepox may continue to be distributed. The last major mousepox outbreak in the United States occurred in the late 1970s and early 1980s at the U.S. National Institutes of Health and a number of academic institutions. Tens of thousands of mice had to be destroyed at a cost of millions of dollars and lost research. If an outbreak of this magnitude occurs again, the impact could be considerably more devastating, as many of the gene-targeted murine models produced and used are maintained at a single institution and are irreplaceable. This incident serves as a reminder of the importance of testing all biologics, including tumors and cell lines, of rodent origin or that have been passaged in rodents, for contamination with adventitious agents. It also raises the question of whether governmental oversight of this process is sufficient to protect a critical resource.

Gate-level simulators are usually thought of in terms of their benefits to logic designers, while behavioral simulators are considered to be the province of system architects. However, the behavioral modeling capabilities of a multilevel gate/behavioral simulator significantly enhanced the performance and accuracy of what are essentially gate-level simulations. The Behave simulator is a multilevel simulator that can simulate circuits at several levels of abstraction?behavioral level, gate level, or a mixture. Zero delay and rank order capability are also available in Behave and can be used to advantage. For example, in a simulation of an array multiplier involving 10,000 vectors, the time decreased from 16 hours to 38 minutes, simply because the elements were rank ordered. This range of processing is possible because of the flexibility in software for general-purpose CPUs.