Arthur L M Swislocki1,2, Jan Krouwer3, Joseph J Ravera4,5. 1. Medical Service, Department of Veterans Affairs, Northern California Health Care System, Sacramento, CA. 2. Department of Internal Medicine, University of California, Davis School of Medicine, Sacramento, CA. 3. Krouwer Consulting, Sherborn, MA. 4. Division of Emergency Medicine, Department of Surgery, University of Vermont Medical Center, Burlington, VT. 5. Department of Surgery, University of Vermont Larner College of Medicine, Burlington, VT.