The ALLHAT findings fail to support the preference for calcium channel blockers, alpha-blockers, or angiotensin-converting enzyme inhibitors compared with thiazide-type diuretics in patients with the MetS, despite their more favorable metabolic profiles. This was particularly true for black participants.

BACKGROUND Pauses in chest compressions during cardiopulmonary resuscitation have been shown to correlate with poor outcomes. In an attempt to minimize these pauses, the American Heart Association recommends charging the defibrillator during chest compressions. While simulation work suggests decreased pause times using this technique, little is known about its use in clinical practice. METHODS We conducted a multicenter, retrospective study of defibrillator charging at three US academic teaching hospitals between April 2006 and April 2009. Data were abstracted from CPR-sensing defibrillator transcripts. Pre-shock pauses and total hands- off time preceding the defibrillation attempts were compared among techniques. RESULTS A total of 680 charge-cycles from 244 cardiac arrests were analyzed. The defibrillator was charged during ongoing chest compressions in 448 (65.9%) instances with wide variability across the three sites. Charging during compressions correlated with a decrease in median pre-shock pause [2.6 (IQR 1.9–3.8) vs 13.3 (IQR 8.6–19.5) s; p < 0.001] and total hands-off time in the 30 s preceding defibrillation [10.3 (IQR 6.4–13.8) vs 14.8 (IQR 11.0–19.6) s; p < 0.001]. The improvement in hands-off time was most pronounced when rescuers charged the defibrillator in anticipation of the pause, prior to any rhythm analysis. There was no difference in inappropriate shocks when charging during chest compressions (20.0 vs 20.1%; p=0.97) and there was only one instance noted of inadvertent shock administration during compressions, which went unnoticed by the compressor. CONCLUSIONS Charging during compressions is underutilized in clinical practice. The technique is associated with decreased hands-off time preceding defibrillation, with minimal risk to patients or rescuers.

Two accelerator mass spectrometry (AMS) dates obtained from samples of Zea mays from the Holding site, 11MS118, in the American Bottom near East St. Louis, Illinois, establish the presence of maize in the Mississippi Valley between 170 B.C. and A.D. 60. The dates finally establish the occurrence of Middle Woodland maize in Illinois and are the earliest dates thus far for maize east of the Mississippi River. Other reports of early Middle Woodland maize in the Midcontinent region should not be discounted unless AMS dating and other supporting information show the maize to be a contaminant at the site at which it occurs. Recent stable carbon-isotope experiments suggest that the relative contribution of maize to Middle Woodland diets is still an open question.

A decorated pottery vessel excavated at the Cahokia site in southwestern Illinois is believed to be a specimen from the southeastern United States. A megascopic and a petrographic analysis are presented to confirm a southern origin. The megascopic analysis suggests that the vessel is of Caddoan derivation. The petrographic analysis demonstrates that the paste of the vessel is not indigenous to the American Bottoms and suggests the use of weathered Tertiary shale deposits from the lower Mississippi River Valley. Both analytical procedures are required in order to assess adequately the sources of origin for suspected foreign pottery specimens in archaeological sites.

The locations of certain mounds at the Cahokia site indicate that the rate of Mississippi River channel migration in the American Bottoms in the Upper Mississippi Valley has differed from the rate of channel movement in the Lower Mississippi Valley. The American Bottoms was probably the most favorable section of the Mississippi River Valley for long-term prehistoric settlement with regard to location within the present meander belt of the river.