Alien Registration- Barnaby, Murray D. (Bucksport, Hancock County)

https://digitalmaine.com/alien_docs/19267/thumbnail.jp

Monitoring the performance of residents during training in off-pump coronary surgery.

OBJECTIVE: Control charts (eg, cumulative sum charts) plot changes in performance with time and can alert a surgeon to suboptimal performance. They were used to compare performance of off-pump coronary artery bypass surgery between a consultant and four resident surgeons and to compare performance of off-pump coronary artery bypass surgery and conventional coronary artery bypass grafting within surgeons. METHODS: Data were analyzed for consecutive patients undergoing coronary artery bypass grafting who were operated on by one consultant or one of four residents. Conversions were analyzed by intention to treat. Perioperative death or one or more of 10 adverse events constituted failure. Predicted risks of failure for individual patients were derived from the study population. Variable life-adjusted displays and risk-adjusted sequential probability ratio test charts were plotted. RESULTS: Data for 1372 patients were analyzed; 769 of the procedures were off-pump coronary artery bypass operations (56.0%). The consultant operated on 382 patients (293 off-pump, 76.7%), and the residents operated on 990 (474 off-pump, 47.9%). Patients operated on by residents tended to be older, more obese, more likely to require an urgent operation, and more likely to need a circumflex artery graft but less likely to have triple-vessel disease. There were 7 conversions (consultant 5, residents 2). The overall failure rate was 8.5% (9.2% for consultant's operations and 8.2% for residents' operations), including 10 deaths (0.7%). Predicted and observed risks of failure were similar for all five surgeons. After 100 off-pump coronary artery bypass operations, performance was the same or better for the residents as for the consultant. For all surgeons, performance was the same or better for off-pump as for conventional coronary artery bypass grafting. CONCLUSIONS: Off-pump coronary artery bypass surgery can be safely taught to cardiothoracic residents. Implementation of continuous performance monitoring for residents is practicable

Using simulation to develop business strategy skills of entrepreneurs - Some reflections on a pilot

It is recognized that the value of entrepreneurship education and the recruitment of practising entrepreneurs for such learning programmes can be problematic. This raises an important and challenging issue for universities when they are increasingly being asked to develop the leadership and management capabilities of entrepreneurs. In this account of practice, the authors explore the role for business simulation in the development of existing entrepreneurs’ and small business leaders’ strategic decision-making skills. The article describes and reflects on a pilot business simulation course, considering the challenges in the planning, the engagement of entrepreneurs and the delivery of the programme. It provides insights into the value of introducing this form of learning experience and exposes the significant challenges associated with engaging small business leaders

Phenomenology of a Pseudo-Scalar Inflaton: Naturally Large Nongaussianity

Many controlled realizations of chaotic inflation employ pseudo-scalar axions. Pseudo-scalars \phi are naturally coupled to gauge fields through c \phi F \tilde{F}. In the presence of this coupling, gauge field quanta are copiously produced by the rolling inflaton. The produced gauge quanta, in turn, source inflaton fluctuations via inverse decay. These new cosmological perturbations add incoherently with the "vacuum" perturbations, and are highly nongaussian. This provides a natural mechanism to generate large nongaussianity in single or multi field slow-roll inflation. The resulting phenomenological signatures are highly distinctive: large nongaussianity of (nearly) equilateral shape, in addition to detectably large values of both the scalar spectral tilt and tensor-to-scalar ratio (both being typical of large field inflation). The WMAP bound on nongaussianity implies that the coupling, c, of the pseudo-scalar inflaton to any gauge field must be smaller than about 10^{2} M_p^{-1}.Comment: 45 pages, 7 figure

MATHEMATICAL FORMULAS FOR CALCULATING NET RETURNS FROM PARTICIPATION IN GOVERNMENT PROGRAMS, CRP, AND CROP INSURANCE ALTERNATIVES

The purpose of this report is to provide a revised version of the publication, "Mathematical Formulas for Calculating Net Returns from Participation in Government Commodity Programs including Marketing Loans" (Williams and Barnaby, 1994). The change in design of the government commodity programs and development of several crop insurance alternatives has been significant since the previous paper was published. The formulas for calculating net returns incorporate provisions from the Farm Security and Rural Investment Act of 2002 and several crop insurance designs developed in the 1990s. Individuals conducting research or education programs will be able to use this revision for reference when estimating net returns for producers under current commodity program and crop insurance plan provisions.Agricultural Finance,

Integrating Clinical Staging and Phenomenological Psychopathology to Add Depth, Nuance, and Utility to Clinical Phenotyping: A Heuristic Challenge

Psychiatry has witnessed a new wave of approaches to clinical phenotyping and the study of psychopathology, including the National Institute of Mental Health’s Research Domain Criteria, clinical staging, network approaches, the Hierarchical Taxonomy of Psychopathology, and the general psychopathology factor, as well as a revival of interest in phenomenological psychopathology. The question naturally emerges as to what the relationship between these new approaches is – are they mutually exclusive, competing approaches, or can they be integrated in some way and used to enrich each other? In this opinion piece, we propose a possible integration between clinical staging and phenomenological psychopathology. Domains identified in phenomenological psychopathology, such as selfhood, embodiment, affectivity, etc., can be overlaid on clinical stages in order to enrich and deepen the phenotypes captured in clinical staging (‘high resolution’ clinical phenotypes). This approach may be useful both ideographically and nomothetically, in that it could complement diagnosis, enrich clinical formulation, and inform treatment of individual patients, as well as help guide aetiological, prediction, and treatment research. The overlaying of phenomenological domains on clinical stages may require that these domains are reformulated in dimensional rather than categorial terms. This integrative project requires assessment tools, some of which are already available, that are sensitive and thorough enough to pick up on the range of relevant psychopathology. The proposed approach offers opportunities for mutual enrichment: clinical staging may be enriched by introducing greater depth to phenotypes; phenomenological psychopathology may be enriched by introducing stages of severity and disorder progression to phenomenological analysis

Experimental Analysis of Proton-Induced Displacement and Ionization Damage Using Gate-Controlled Lateral PNP Bipolar Transistors

The electrical characteristics of proton-irradiated bipolar transistors are affected by ionization damage to the insulating oxide and displacement damage to the semiconductor bulk. While both types of damage degrade the transistor, it is important to understand the mechanisms individually and to be able to analyze them separately. In this paper, a method for analyzing the effects of ionization and displacement damage using gate-controlled lateral PNP bipolar junction transistors is described. This technique allows the effects of oxide charge, surface recombination velocity, and bulk traps to be measured independently