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This article argues that the well-known debate about the obligatory nature of the evening prayer, attributed to tannaitic authorities in both the Palestinian and Babylonian Talmuds, is in fact a Babylonian invention. The article documents the significant evidence that the evening prayer was assumed to be obligatory in tannaitic and early amoraic texts and then argues that the literary context of the debate in both Talmuds strongly suggests Babylonian origins for the debate. Dating the debate is more complex, but it seems relatively unlikely that this represents a pre-amoraic Babylonian tradition. Finally, the article considers the motivation for such a development in amoraic Babylonia and suggests that antiquarian interest in the temple may be the likeliest avenue to pursue.
Honduras Has Emerged as a cocaine transshipment point between Colombia and the United States. One informed source suggests that as much as fifty tons of cocaine have moved through the country during the last fifteen months. This paper examines the politics of drug trafficking in Honduras. Special attention is given to the relations between drug trafficking and the Honduran political environment, the emergence of a new “powder elite, ” and the manner in which US and Honduran authorities are addressing these problems.
One of the hemisphere's poorest countries by almost all standards of development, Honduras has a population of about 4.5 million people and an area the size of Tennessee. Unlike neighboring Guatemala and El Salvador where a national oligarchy has enhanced its wealth through an extensive coffee industry, Honduras first emerged in the international economy through its foreign-owned banana enterprises which still are a leading source of foreign exchange.
This study examined the association and directionality of effect between mental wellbeing and depressive symptoms in Australian adolescents. Data were collected on two occasions 21 months apart. At Time 1, 1,762 10- to 14-year-old adolescents from a range of socio-economic status areas participated. At Time 2 (T2), 1,575 participated again. On both occasions, the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS) and the Children's Depression Inventory 2 (CDI 2) were administered via online survey. Cross-lagged, longitudinal path analyses demonstrated a negative association between earlier symptoms of depression and later positive mental wellbeing, and that the reverse was also true, though weaker. The model accounted for 20% of the variance in males’ T2 CDI 2 depressive symptom scores (26% for females) and 21% of the variance in males’ T2 SWEMWBS mental wellbeing scores (23% for females). Depressive symptomatology and mental wellbeing were highly correlated, but symptoms of depression were more strongly associated with later mental wellbeing than vice versa. This has implications for educational psychologists, teachers, health professionals, and policy makers seeking to reduce depressive symptoms or promote mental wellbeing. Focusing solely on the promotion of mental wellbeing, without intervening to reduce symptoms of depression, may limit the potential outcomes that might be achieved.
Needle thoracostomy is the prehospital treatment for tension pneumothorax. Sufficient catheter length is necessary for procedural success. The authors of this study determined minimum catheter length needed for procedural success on a percentile basis.
A meta-analysis of existing studies was conducted. A Medline search was performed using the search terms: needle decompression, needle thoracentesis, chest decompression, pneumothorax decompression, needle thoracostomy, and tension pneumothorax. Studies were included if they published a sample size, mean chest wall thickness, and a standard deviation or confidence interval. A PubMed search was performed in a similar fashion. Sample size, mean chest wall thickness, and standard deviation were found or calculated for each study. Data were combined to create a pooled dataset. Normal distribution of data was assumed. Procedural success was defined as catheter length being equal to or greater than the chest wall thickness.
The Medline and PubMed searches yielded 773 unique studies; all study abstracts were reviewed for possible inclusion. Eighteen papers were identified for full manuscript review. Thirteen studies met all inclusion criteria and were included in the analysis. Pooled sample statistics were: n=2,558; mean=4.19 cm; and SD=1.37 cm. Minimum catheter length needed for success at the 95th percentile for chest wall size was found to be 6.44 cm.
A catheter of at least 6.44 cm in length would be required to ensure that 95% of the patients in this pooled sample would have penetration of the pleural space at the site of needle decompression, and therefore, a successful procedure. These findings represent Level III evidence.
ClemencyBM, TanskiCT, RosenbergM, MayPR, ConsiglioJD, LindstromHA. Sufficient Catheter Length for Pneumothorax Needle Decompression: A Meta-Analysis. Prehosp Disaster Med. 2015;30(3):15
Across 366 California hospitals, we identified hospital-level characteristics predicting increased hospital-associated Clostridium difficile infection (HA-CDI) rates including more licensed beds, teaching and long-term acute care (LTAC) hospitals, and polymerase chain reaction testing. Adjustment for these characteristics impacted rankings in 24% of teaching hospitals, 13% of community hospitals, and 11% of LTAC hospitals.
In recent years, there has been a surge in the study of ritual impurity and its relationship to immorality (or, perhaps more accurately, prohibited activity) in biblical literature and early Judaism. Yet relatively scant attention has been paid to one of the most important topics pertaining to impurity—the menstrual laws of Leviticus (the laws of [niddah]) and their development in early Jewish texts. The niddah laws are uniquely important because they appear both in the context of ritual-impurity legislation (Leviticus 12 and Leviticus 15) and in the context of legislation concerning prohibited acts (Lev 18:19 and Lev 20:18). Or, to put it another way: biblical menstrual laws comprise both impurity and prohibition elements.
Treatment of Staphylococcus aureus colonization before surgery reduces risk of surgical site infection (SSI). The regimen of nasal mupirocin ointment and topical chlorhexidine gluconate is effective, but cost and patient compliance may be a barrier. Nasal povidone-iodine solution may provide an alternative to mupirocin.
We conducted an investigator-initiated, open-label, randomized trial comparing SSI after arthroplasty or spine fusion in patients receiving topical chlorhexidine wipes in combination with either twice daily application of nasal mupirocin ointment during the 5 days before surgery or 2 applications of povidone-iodine solution into each nostril within 2 hours of surgical incision. The primary study end point was deep SSI within the 3 months after surgery.
In the modified intent-to-treat analysis, a deep SSI developed after 14 of 855 surgical procedures in the mupirocin group and 6 of 842 surgical procedures in the povidone-iodine group (P = .1); S. aureus deep SSI developed after 5 surgical procedures in the mupirocin group and 1 surgical procedure in the povidone-iodine group (P = .2). In the per protocol analysis, S. aureus deep SSI developed in 5 of 763 surgical procedures in the mupirocin group and 0 of 776 surgical procedures in the povidone-iodine group (P = .03).
Nasal povidone-iodine may be considered as an alternative to mupirocin in a multifaceted approach to reduce SSI.
Due to rising rates of obesity globally, the present study aimed to examine differences in overweight and underweight prevalence in Western Australian schoolchildren in 2008 compared with 2003.
Cross-sectional study at two time points; using two-stage stratified sampling, primary and secondary schools in both metropolitan and non-metropolitan Western Australia; sample selected was representative of the State's population figures.
Seventeen primary and thirteen secondary (2008) and nineteen primary and seventeen secondary (2003) schools. Government and non-government funded schools in metropolitan and non-metropolitan (regional/rural) Western Australia were recruited.
Height and weight were measured for 1708 (961 primary and 747 secondary) students in 2008 and 1694 (876 primary and 817 secondary) students in 2003.
Overweight and obesity prevalence in primary students was similar in 2008 (22·9 %) to 2003 (23·2 %; P > 0·05). In secondary girls overweight and obesity prevalence dropped from 23·1 % (2003) to 15·9 % (2008; P = 0·002). Secondary boys showed a slight decrease in overweight and obesity prevalence; however, this was not statistically significant (P = 0·102). Higher proportions of underweight in primary girls were observed in 2008 (9·9 %) compared with 2003 (4·2 %; P < 0·001) and in secondary girls in 2008 (9·4 %) compared with 2003 (5·5 %; P < 0·001).
Prevalence of overweight and obesity in Western Australian primary students was stable; however, it declined in secondary students. Both primary and secondary girls showed an increase in underweight prevalence. Public health interventions are needed for the high percentage of youth still overweight, whereas the observed increase in underweight girls warrants attention and further investigation.
It is likely that there are substantial subconscious effects of organizations’ efforts to associate their products with sport via sponsorships, but most research methods are unable to capture these effects. The present study employed a novel projective technique to explore children's implicit associations between popular sports and a range of sports sponsors.
Children participated in an activity using magnets bearing the logos of numerous sports and sponsors. They were invited to arrange the magnets on a whiteboard without being advised that the activity related to sponsorship.
Perth, Western Australia.
Children (n 164) aged 5–12 years.
Three-quarters (76 %) of the children aligned at least one correct sponsor magnet with the relevant sport. Just over half the children (54 %) correctly matched the most popular sport (an Australian Football League team) with its relevant sponsor (a fast-food chain).
Given the unstructured nature of the projective task, the results provide some support for the argument that sports sponsorship can effectively reach child audiences. This is of concern given the current extent of sponsorship by alcohol and fast-food companies.
This chapter is an atlas of digital mammography intended to introduce the reader to the appearance of various benign and malignant entities as they may appear on digital imaging. Cases 1–17 were contributed by Robert D. Rosenberg, and cases 18–34 are from Michael N. Linver.
Dr. Rosenberg’s practice switched from film-screen mammography to computed radiographic technique using Fuji equipment with 50 mm pixel size, and approximately two years later switched again to Hologic direct digital radiographic technique with a 70 mm pixel size. Therefore, his digital images are a combination of these two image types. When it makes a difference which type of image is being shown, the Fuji computed radiographic images are designated as CR images, and the Hologic direct digital radiographic images as DR images.
Dr. Linver’s practice moved from film-screen mammography directly to Hologic direct digital mammography with a 70 mm pixel size, so all of his digital mammography images are obtained with that equipment.
The infrared- and Raman-active vibrational modes of C60 were measured in the various structural states of Rb1C60. According to earlier studies, Rb1 C60 has an f cc structure at temperatures above ∼ 100°C, a linear chain polymer orthorhombic structure when slowly cooled, and an as yet undetermined structure when very rapidly cooled (“quenched”). We show that the spectra obtained in the polymer state are consistent with each C60 molecule having bonds to two diametrically opposite neighbors. In the quenched state, we find evidence for further symmetry breaking, implying a lower symmetry structure than the polymer state. The spectroscopic data of the quenched phase are shown to be consistent with Rb2(C60)2, a dimerization of C60.
Electromigration tests have been performed on single-crystal Al lines which were predamaged by rows of submicrometer-depth indentations made using a nanoindentation device. Indentations were placed close to each other so that their plastic deformation zones overlapped. During subsequent electromigration testing at 280°C and I to 2 MA/cm2, no damage was observed in non-indented single-crystal lines, while the indented lines showed electromigrationinduced voids at the cathode-side ends of the indented areas, and hillocks at the anode-side ends. The voids grew and moved away from the indentations towards the cathode. Fhe electromigration damage morphology of the indented lines indicates that the mechanical damage generates a local fast diffusion path in the single-crystal lines, which is believed to be due to dislocation core diffusion. A minimum indentation row length was observed, below which no void formed. This electromigration behavior is found to be phenomenologically similar to that of polygranular clusters in near-bamboo lines.
The continued shrink of interconnect structures is requiring new materials to be introduced into back-end of the line (BEOL) devices at an increasing rate. These new materials must provide a performance benefit from the previous generation with the recent focus on reducing the effective dielectric constant of the integrated structures. This reduction may occur not only by changing the intralevel dielectric but also by changing the capping layer/diffusion barrier on the chemicalmechanically polished (CMP'd) Cu surface. However, changing this material may alter the reliability of the device structure due to a change in the Cu/cap interface bonding. Another consequence of the decrease in minimum feature size in interconnects is that commonly practiced techniques, such as sputtered liner and Cu seed, may not be extendable to future generations. Accordingly, the focus of this paper is on identifying basic relationships between interfacial chemistry and interfacial adhesion and illustrating how those relationships can be used to address some of the issues that may pose problems in future technologies.
It is now apparent that future generations of fast electronics and compact sensors may need to rely increasingly on integrated optical components. But integration of electronics and photonics in today's IC's is challenging. Silicon, the ubiquitous electronic material, is neither ideally suited for most photonic functions nor readily integrated with most of the common photonic materials, such as GaAs. The approach we describe here relies on GaN-based films, which can be grown directly on silicon substrates and hence can be potentially integrated with state-of-the-art Si-based electronics. We have demonstrated the fabrication of GaN structures on silicon wafers ranging in overall size from sub-micron to several millimeters, all containing highly accurate individual features on the nm scale. As proof of concept, we have fabricated GaN optical waveguides and photonic crystals containing optical cavities by patterning GaN membranes grown directly on Si wafers. Our optical cavities were designed to have resonant modes within the spectral region of the broad defect-induced luminescence of GaN. We have measured sharp resonant features associated with these cavities by optically pumping above the GaN band edge, and have compared the data to numerical simulations of the spectra. Our results to date demonstrate the feasibility of fabricating high-quality GaN photonic structures directly on Si wafers, thereby providing a possible path to achieving true integration of electronics and photonics in future generations of IC's.
Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as “dual purpose” substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.
(Disaster Med Public Health Preparedness. 2010;4:318-325)