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In this Economic Commentary, we analyze the relationship between unemployment insurance (UI) recipiency and insurance by examining the wealth distribution of workers who have been through an unemployment spell. We focus on the net liquid wealth gap between recipients and nonrecipients of UI along the income distribution of the unemployed. Using recent data from the Survey of Income and Program Participation at the individual level, we estimate that UI recipients at the bottom half of the income distribution tend to have higher median net liquid wealth than nonrecipients, putting nonrecipients in a potentially vulnerable economic position during periods of unemployment., Introduction During times of rising unemployment or labor market deterioration, unemployment insurance (UI) is a main component of the employment safety net available to US workers. The share of UI [...]

Asset limits in means-tested transfers can allow for the distribution of scarce aid to families most in need but may offer a disincentive to beneficiaries to build savings necessary to weather economic shocks. In this Economic Commentary, we examine the net worth of transfer recipients along the income distribution and review the economic literature on the matter with a discussion of universal basic income (UBI) as a policy alternative. Using the 2018 Survey of Income and Program Participation, we document that recipients have a smaller average net worth than nonrecipients at every quintile of the income distribution. We also find that participants at the very bottom of the income distribution are in asset poverty, with an average level of assets surrounding testing thresholds. Recent research suggests that the elimination of testing limits, such as in policies similar to a UBI, could present a welfare-improving alternative to the current system, though not without large economic trade-offs., Income security programs are an important component of the social safety net in the United States. (1) They mostly consist of unemployment insurance and means-tested transfers, the latter being a [...]

Acute respiratory distress syndrome (ARDS) survivors often experience post-intensive care syndrome (PICS), is defined as new or worsened impairments in physical, cognitive and/or mental health status persisting beyond hospital discharge. These impairments negatively impact survivors’ quality of life and their return to work or usual activities. Moreover, family members are also impacted as recognized by the term, PICS-Family (PICS-F). PICS poses an increased burden on the health care system and has a negative societal impact. There are ongoing efforts to understand risk factors for PICS-related impairments; design and evaluate interventions for specific impairments (including the use of an ARDS survivorship core outcome set); and refine and evaluate ICU recovery clinics to support and treat survivors and their families.

In this Economic Commentary, we use the Current Population Survey to identify and examine the influx of young adults who moved in with their parents during the COVID-19 pandemic--the so-called [...]

The design and characterization of thin-film ribbon cables as electrical interconnects for implanted neural stimulation and recording devices are reported. Our goal is to develop flexible and extensible ribbon cables that integrate with thin-film, cortical penetrating microelectrode arrays (MEAs). Amorphous silicon carbide (a-SiC) and polyimide were employed as the structural elements of the ribbon cables and multilayer titanium/gold thin films as electrical traces. Using photolithography and thin-film processing, ribbon cables with linear and serpentine electrical traces were investigated. A cable design with an open lattice geometry was also investigated as a means of achieving high levels of extensibility while preserving the electrical function of the cables. Multichannel ribbon cables were fabricated with 50 mm lengths and metallization trace widths of 2–12 μm. The ribbon cables tolerate flexural bending to a radius of 50 μm with no change in trace impedance but tolerate less than 5% tensile elongation without trace failure. Ribbon cables with a lattice structure exhibit 300% elongation without failure. The high elongation tolerance is attributed to a lattice design that results in an out-of-plane displacement that avoids fracture or plastic deformation. Extensible ribbon cables underwent up to 50,000 tensile elongation cycles to 45% extension without failure. An electrical interconnect process using through-holes in the distal gold bond pads of the ribbon cables was used to connect to an a-SiC-based MEA. The electrical connection was created by stenciling a conductive epoxy into the through-holes, bridging metallization between the traces, and MEA. The interconnect was tested using a ribbon cable connected to an a-SiC MEA implanted acutely in rat cortex and used to record neuronal activity. These highly flexible and extensible ribbon cables are expected to accommodate large extensions and facilitate cable routing during surgical implantation. They may also reduce tethering forces on implanted electrode arrays, potentially improving chronic neural recording performance.

Among survivors of critical illness, prescription of potentially inappropriate medications (PIM) at hospital discharge is thought to be an important, modifiable patient safety concern. To date, there are little empirical data evaluating this issue.

To synthesize participant retention data and related reporting in studies evaluating post-hospital outcomes of survivors of critical illness after an intensive care unit (ICU) stay.

Bovine pericardium (BP) is widely used as a biomaterial for tissue engineering. Glutaraldehyde and formaldehyde are commonly employed in the reticulation processes to enhance the material’s resistance and preservation. In this study, we assessed the impact of long-term storage in 4% formaldehyde on the quantitative expression of immunophenotypic markers in glutaraldehyde-treated BP. Histologic and immunohistochemical analyses were performed on 2 BP patches, manufactured in 2009 and 2020, respectively. Braile Biomédica provided the BP patches. Sections of BP were stained with H&E, Weigert, and picrosirius red, followed by immunolabeling for vimentin, laminin 5, collagen I, and collagen IV using a standardized protocol. Microscopic images were captured using light and polarized microscopy, and the area of the antibody signal was quantified using Image J Software. Histologic analysis showed no autolysis or significant changes in the patches. Immunohistochemical analysis revealed a diffuse distribution of collagen I and collagen IV throughout the connective tissue of the patches. The 2020 specimen exhibited higher expression levels of collagen I (21.36%) and collagen IV (24.67%) compared with the 2009 specimen (collagen I: 15.87%; collagen IV: 12.02%). Laminin did not show reactivity in either specimen. Notably, vimentin immunopositivity differed significantly between the patches, with a larger area of expression observed in the 2020 patch (54%) compared with the 2009 patch (13%). In summary, there were no substantial differences in immunophenotypic expression between the 2009 and 2020 BP patches, except for the higher vimentin expression in the 2020 BP patch.

ABSTRACTRadiocarbon analysis is a common tool used to obtain the absolute ages of materials from archaeological contexts. This method underlies the basis of most archaeological chronologies across the globe, allowing us to better understand the temporality of past events. However, in the American Southeast, research by a small number of academic archaeologists who are interested in specific kinds of sites, time periods, and research questions drive radiocarbon dating efforts. This creates an uneven distribution of chronological and temporal frameworks that limits our interpretation of human behavior across time and space. In this report, we argue that if archaeologists want to control for time in the same way that we control for space in our interpretations of the archaeological record, radiocarbon dating must be practiced using a standardized methodology in all realms of archaeological practice – cultural resource management, academia, museums, and government agencies. To do this, archaeologists need to (1) better date individual sites and groups of related sites and (2) build an aggregate data set that more accurately reflects the reality of human behavior across time. We argue that cultural resource management, specifically, can play a key role in helping put radiocarbon analysis at the center of archaeological practice.

Many tissues in vivo contain aligned structures such as filaments, fibrils, and fibers, which expose cells to anisotropic structural and topographical cues that range from the nanometer to micrometer scales. Understanding how cell behavior is regulated by these cues during physiological and pathological processes (e.g., wound healing, cancer invasion) requires substrates that can expose cells to anisotropic cues over several length scales. In this study, we developed a novel method of fabricating micropatterns of aligned collagen fibrils of different geometry onto PDMS-coated glass coverslips that allowed us to investigate the roles of topography and confinement on corneal cell behavior. When corneal cells were cultured on micropatterns of aligned collagen fibrils in the absence of confinement, the degree of cell alignment increased from 40 ± 14 to 82 ± 5% as the size of the micropattern width decreased from 750 to 50 μm. Although the cell area (∼2500 μm2), cell length (∼160 μm), and projected nuclear area (∼175 μm2) were relatively constant on the different micropattern widths, cells displayed an increased aspect ratio as the width of the aligned collagen fibril micropatterns decreased. We also observed that the morphology of cells adhering to the surrounding uncoated PDMS was dependent upon both the size of the aligned collagen fibril micropattern and the distance from the micropatterns. When corneal cells were confined to the micropatterns of aligned collagen fibrils by a Pluronic coating to passivate the surrounding area, a similar trend in increasing cell alignment was observed (35 ± 10 to 89 ± 2%). However, the projected nuclear area decreased significantly (∼210 to 130 μm2) as the micropattern width decreased from 750 to 50 μm. The development of this method allows for the deposition of aligned collagen fibril micropatterns of different geometries on a transparent and elastic substrate and provides an excellent model system to investigate the role of anisotropic cues in cell behavior.

The environmental concern about the use of fossil fuels leads to the search for renewable alternatives. In this context, despite the recent growth of other technologies, biodiesel has remained so far as the main alternative to replace conventional diesel. Its production is quite attractive in social and environmental aspects, and it can be produced from several feedstocks. However, these feedstocks can be more or less interesting depending on region, climate, season, etc., and it is an energy policy problem, especially in continental countries like Brazil. Although several authors have used process simulation to support economic analyzes of biodiesel production from different feedstocks, the different hypothesis assumed and the different contexts where these works were inserted make not possible a fair comparison of them. Therefore, the objective of this work was to technically and economically evaluate biodiesel production in Brazil from fifteen different feedstocks. They were compared regarding the process demands required to obtain biodiesel meeting the regulatory agency standards, as well as regarding some economic results such as the investment needed on a new plant, profitability and break-even prices. The work reaffirms that the biodiesel price is highly influenced by the feedstock prices, but also demonstrates some benefits and limitations of each feedstock. With the considerations made in this work, chicken fat (biodiesel break-even price of US$ 1.375/kg), corn oil (US$ 1.446/kg) and palm oil (US$ 1.670/kg) appeared as promising alternatives for the Brazilian market.

ABSTRACTWe present the results of the 2022 excavations at the Bluff Field site (9CH160), wherein we consider the juxtaposition of Bayesian radiocarbon modeling against the current ceramic chronologies derived for the Georgia coast. New evidence from AMS radiocarbon dating and statistical modeling pushes both the timing and span of Wilmington series ceramics beyond the ranges afforded by current models. Short-lived carbonized hickory nuts from within excavation units and shovel tests returned dates that are hundreds of years later in time than the currently accepted timing for Wilmington ceramics. These ceramics contribute the largest proportion of the ceramic assemblage recovered from the site and within the levels from which we dated for chronological modeling. Our modeling of these dates that are in stratigraphic sequence calls into question not only the use history of the Wilmington ceramic series, but also the demographic history of the island that is currently predicated upon the timing of this and other ceramic styles. We recommend reinterrogating existing chronologies in order to bring the settlement chronologies for the Georgia coastal region up to present-day methodological and statistical standards.

ABSTRACTCharacterizing the depositional and temporal nature of sediments lends insight into the construction of monuments and midden accumulation. Identifying discrete deposits at Late Archaic shell rings can be challenging due to the seemingly homogenous nature of shell deposits. Data from cross-mended artifacts can help identify surfaces and determine whether deposits are contemporaneous. We present cross-mend results from the St. Catherines Shell Ring and the Sapelo Island Shell Ring complex. In both cases, we observed vertical distance between cross-mends suggesting that detailed spatial control of artifacts and cross-mend analysis can be used to understand the nature of anthropogenic deposition and postdepositional processes.

Consumers are tempted with a continuous stream of advertisements about restaurants' cheap hoagies, (1) deeply discounted menus, (2) and even frugal full-course meals. (3) Franchised fast-food eateries and full-service restaurants [...]

Historical descriptions and archaeological research provide a compelling association of the Native town of Tocobaga with the Safety Harbor site (8PI2), in Tampa Bay, Florida. The Spanish established a mission-fort at Tocobaga in 1567, but it was short-lived: responding to abuse by the colonizers, the Tocobagans killed the soldiers who had been left at the town and the Spanish burned the town in retaliation. We employ the metaphor of effacement, in its original referent to the wearing away of the surface of a coin, to describe the manner in which the colonial destruction of the town provided an opportunity for imposition of new meanings on the landscape of Tocobaga in the modern era: first as a plantation and “pleasure garden,” next as an ancient ruin and archaeological site, and later as a reform park. Archaeology is part of the effacement of the Native town—the remnants of Tocobaga were reinscribed as the type site for the Safety Harbor–period and the eponymous Mississippian-period (1010–1550) material culture complex. However, archaeology—including our recent testing—also provides a means for understanding such concepts as effacements, as well as the persistence of materiality.

Knowing one’s own behavioral state has long been theorized as critical for contextualizing dynamic sensory cues and identifying appropriate future behaviors. Ascending neurons (ANs) in the motor system that project to the brain are well positioned to provide such behavioral state signals. However, what ANs encode and where they convey these signals remains largely unknown. Here, through large-scale functional imaging in behaving animals and morphological quantification, we report the behavioral encoding and brain targeting of hundreds of genetically identifiable ANs in the adult fly, Drosophila melanogaster. We reveal that ANs encode behavioral states, specifically conveying self-motion to the anterior ventrolateral protocerebrum, an integrative sensory hub, as well as discrete actions to the gnathal ganglia, a locus for action selection. Additionally, AN projection patterns within the motor system are predictive of their encoding. Thus, ascending populations are well poised to inform distinct brain hubs of self-motion and ongoing behaviors and may provide an important substrate for computations that are required for adaptive behavior.

We study policy optimization problems for deterministic Markov decision processes (MDPs) with metric state and action spaces, which we refer to as metric policy optimization problems (MPOPs). Our goal is to establish theoretical results on the well-posedness of MPOPs that can characterize practically relevant continuous control systems. To do so, we define a special class of MPOPs called compactly restrictable MPOPs (CR-MPOPs), which are flexible enough to capture the complex behavior of robotic systems but specific enough to admit solutions using dynamic programming methods such as value iteration. We show how to arrive at CR-MPOPs using forward-invariance. We further show that our theoretical results on CR-MPOPs can be used to characterize feedback linearizable control affine systems.

Steel tubular structures from aging offshore units may experience significant corrosion in areas that are difficult to access for protection. Perforations might occur based on the extent and severity of corrosion. This type of damage can weaken the structural integrity of the unit based on the quantity of affected components. To address this, a research program was conducted to assess the efficacy of using composite materials to strengthen steel tubular members that present perforation damage due to corrosion. Material characterization was performed on composite material and steel. Experimental tests and numerical modeling were conducted to investigate the behavior of intact, damaged, and repaired states of 1:3.5 scale perforated steel tubular member samples under different load scenarios. The samples used in the studies considered different levels of damage, diameter-to-thickness, and length-to-thickness ratios, as well as different configurations of the strengthening patches of composite materials. It was found that a moderate repair thickness can recover the damaged samples’ lost strength, demonstrating the approach’s effectiveness as a feasible alternative for decreasing repair times and offshore unit risk. The research presents results from experiments, repair methodologies, and model calculations.

INSIDE THE Beltway and on op-ed pages across the United States, it has become increasingly popular to lament the demise of U.S. influence in Asia. Power transitions, resurgent Asian nationalism, [...]

Background: Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial Infections Surveillance (NNIS) System report, the U.S. pooled mean rates of central venous catheter (CVC)-related bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections were 4.0 per 1000 CVC days, 5.4 per 1000 mechanical ventilator days, and 3.9 per Foley catheter days, respectively. Objective: To ascertain the incidence of device-associated infections in the ICUs of developing countries. Design: Multicenter, prospective cohort surveillance of device-associated infection by using the CDC NNIS System definitions. Setting: 55 ICUs of 46 hospitals in Argentina, Brazil, Colombia, India, Mexico, Morocco, Peru, and Turkey that are members of the International Nosocomial Infection Control Consortium (INICC). Measurements: Rates of device-associated infection per 100 patients and per 1000 device days. Results: During 2002-2005, 21 069 patients who were hospitalized in ICUs for an aggregate 137 740 days acquired 3095 device-associated infections for an overall rate of 14.7% or 22.5 infections per 1000 ICU days. Ventilator-associated pneumonia posed the greatest risk (41% of all device-associated infections or 24.1 cases [range, 10.0 to 52.7 cases] per 1000 ventilator days), followed by CVC-related bloodstream infections (30% of all device-associated infections or 12.5 cases [range, 7.8 to 18.5 cases] per 1000 catheter days) and catheter-associated urinary tract infections (29% of all device-associated infections or 8.9 cases [range, 1.7 to 12.8 cases] per 1000 catheter days). Notably, 84% of Staphylococcus aureus infections were caused by methicillin-resistant strains, 51% of Enterobacteriaceae isolates were resistant to ceftriaxone, and 59% of Pseudomonas aeruginosa isolates were resistant to fluoroquinolones. The crude mortality rate for patients with device-associated infections ranged from 35.2% (for CVC-associated bloodstream infection) to 44.9% (for ventilator-associated pneumonia). Limitations: These initial data are not adequate to represent any entire country, and likely variations in the efficiency of surveillance and institutional resources may have affected the rates that were detected. Conclusions: Device-associated infections in the ICUs of these developing countries pose greater threats to patient safety than in U.S. ICUs. Active infection control programs that perform surveillance of infection and implement guidelines for prevention can improve patient safety and must become a priority in every country.

Glucagon is a 29--amino acid polypeptide produced in the pancreatic α-cells and secreted in response to falling glucose levels during the fasting period (1). Glucagon increases glucose production by promoting [...], Glucagon maintains glucose homeostasis during the fasting state by promoting hepatic gluconeogenesis and glycogenolysis. Hyperglucagonemia and/or an elevated glucagon-to-insulin ratio have been reported in diabetic patients and animals. Antagonizing the glucagon receptor is expected to result in reduced hepatic glucose overproduction, leading to overall glycemic control. Here we report the discovery and characterization of compound 1 (Cpd 1), a compound that inhibits binding of [sup.125]I-labeled glucagon to the human glucagon receptor with a half-maximal inhibitory concentration value of 181 ± 10 nmol/l. In CHO cells overexpressing the human glucagon receptor, Cpd 1 increased the half-maximal effect for glucagon stimulation of adenylyl cyclase with a [K.sub.DB] of 81 ± 11 nmol/l. In addition, Cpd 1 blocked glucagon-mediated glycogenolysis in primary human hepatocytes. In contrast, a structurally related analog (Cpd 2) was not effective in blocking glucagon-mediated biological effects. Real-time measurement of glycogen synthesis and breakdown in perfused mouse liver showed that Cpd 1 is capable of blocking glucagons-induced glycogenolysis in a dosage-dependent manner. Finally, when dosed in humanized mice, Cpd 1 blocked the rise of glucose levels observed after intraperitoneal administration of exogenous glucagon. Taken together, these data suggest that Cpd 1 is a potent glucagon receptor antagonist that has the capability to block the effects of glucagon in vivo.

Robotic-assisted mitral valve repair (MVR) represents a significant advancement in heart surgery by offering precision and reducing invasiveness, potentially improving patient recovery and outcomes even compared to minimally invasive MVR through right thoracotomy [1–3].

The invertibility of Toeplitz plus Hankel operators T(A)+H(B), A,B∈Ld×d∞(T)acting on vector Hardy spaces Hdp(T), 1

IMPORTANCE: Previous systematic reviews and meta-analyses have concluded that given data paucity, a comparison of reflectance confocal microscopy (RCM) with dermoscopy is complex. They recommend comparative prospective studies in a real-world setting of suspect lesions. OBJECTIVE: To test the hypothesis that RCM reduces unnecessary lesion excision by more than 30% and identifies all melanoma lesions thicker than 0.5 mm at baseline. DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial included 3165 patients enrolled from 3 dermatology referral centers in Italy between January 2017 and December 2019, with a mean (SD) follow-up of 9.6 (6.9) months (range, 1.9-37.0 months). The consecutive sample of 3165 suspect lesions determined through dermoscopy were eligible for inclusion (10 patients refused). Diagnostic analysis included 3078 patients (48 lost, 39 refused excision). Data were analyzed between April and September 2021. INTERVENTIONS: Patients were randomly assigned 1:1 to standard therapeutic care (clinical and dermoscopy evaluation) with or without adjunctive RCM. Information available guided prospective clinical decision-making (excision or follow-up). MAIN OUTCOMES AND MEASURES: Hypotheses were defined prior to study initiation. All lesions excised (baseline and follow-up) were registered, including histopathological diagnoses/no change at dermoscopy follow-up (with or without adjunctive RCM). Number needed to excise (total number of excised lesions/number of melanomas) and Breslow thickness of delayed diagnosed melanomas were calculated based on real-life, prospective, clinical decision-making. RESULTS: Among the 3165 participants, 1608 (50.8%) were male, and mean (SD) age was 49.3 (14.9) years. When compared with standard therapeutic care only, adjunctive RCM was associated with a higher positive predictive value (18.9 vs 33.3), lower benign to malignant ratio (3.7:1.0 vs 1.8:1.0), and a number needed to excise reduction of 43.4% (5.3 vs 3.0). All lesions (n = 15) with delayed melanoma diagnoses were thinner than 0.5 mm. CONCLUSIONS AND RELEVANCE: This randomized clinical trial shows that adjunctive use of RCM for suspect lesions reduces unnecessary excisions and assures the removal of aggressive melanomas at baseline in a real-life, clinical decision-making application for referral centers with RCM. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04789421

There's a ways to go yet, but the artificial retina is poised to move out of academic labs and into corporate R&D. I could see it. Just a little light. […]

The impressive growth of the stock market and the persistently low inflation rate are not translating to higher income for many trust beneficiaries. The reasons for this include the current low interest rate environment and the preference of corporations to put their earnings back to the business instead of raising stock dividends. One proposed measure to increase trust income is to allocate realized trust capital to beneficiaries in addition to the dividends and interest collected by the trustee. The pros and cons of this strategy are discussed.

Perceived health is one of the strongest determinants of subjective well-being, but it has received little attention among survivors of ARDS.

BackgroundInability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). Mismatch in an individual’s job workload and his or her functional ability, termed work ability imbalance, is negatively associated with RTW, but has not been evaluated in ARDS survivors.ObjectWe examine associations between work ability imbalance at 6 months and RTW at 6 months and 12 months, as well as the ability to sustain employment in ARDS survivors.MethodsPreviously employed participants from the ARDS Network Long-Term Outcomes Study (N=341) were evaluated. Pre-ARDS workload was determined based on the US Occupational Information Network classification. Post-ARDS functional ability was assessed using self-reported 36-Item Short Form Health Survey (SF-36) physical functioning, social functioning and mental health subscales, and Mini-Mental State Examination. ARDS survivors were categorised into four work ability imbalance categories: none, psychosocial, physical, and both psychosocial and physical.ResultsAlmost 90% of ARDS survivors had a physical and/or psychosocial work ability imbalance at both 6-month and 12-month follow-up. Compared with survivors with no imbalance at 6 months, those with both physical and psychosocial imbalance had lower odds of RTW (6 months: OR=0.33, 95% CI=0.13 to 0.82; 12 months: OR=0.22, 95% CI=0.07 to 0.65). Thirty-eight (19%) of those who ever RTW were subsequently jobless at 12 months.ConclusionInterventions aimed at rebalancing ARDS survivors’ work ability by addressing physical and psychosocial aspects of their functional ability and workload should be explored as part of efforts to improve RTW, maintain employment and reduce the financial impact of joblessness.

BackgroundPrior acute respiratory distress syndrome (ARDS) trials have identified hypoinflammatory and hyperinflammatory subphenotypes, with distinct differences in short-term outcomes. It is unknown if such differences extend beyond 90 days or are associated with physical, mental health or cognitive outcomes.Methods568 patients in the multicentre Statins for Acutely Injured Lungs from Sepsis trial of rosuvastatin versus placebo were included and assigned a subphenotype. Among 6-month and 12-month survivors (N=232 and 219, respectively, representing 243 unique survivors), subphenotype status was evaluated for association with a range of patient-reported outcomes (eg, mental health symptoms, quality of life). Patient subsets also were evaluated with performance-based tests of physical function (eg, 6 min walk test) and cognition.FindingsThe hyperinflammatory versus hypoinflammatory subphenotype had lower overall 12-month cumulative survival (58% vs 72%, p<0.01); however, there was no significant difference in survival beyond 90 days (86% vs 89%, p=0.70). Most survivors had impairment across the range of outcomes, with little difference between subphenotypes at 6-month and 12-month assessments. For instance, at 6 months, in comparing the hypoinflammatory versus hyperinflammatory subphenotypes, respectively, the median (IQR) patient-reported SF-36 mental health domain score was 47 (33–56) vs 44 (35–56) (p=0.99), and the per cent predicted 6 min walk distance was 66% (48%, 80%) vs 66% (49%, 79%) (p=0.76).InterpretationComparing the hyperinflammatory versus hypoinflammatory ARDS subphenotype, there was no significant difference in survival beyond 90 days and no consistent findings of important differences in 6-month or 12-month physical, cognitive and mental health outcomes. These findings, when considered with prior results, suggest that inflammatory subphenotypes largely reflect the acute phase of illness and its short-term impact.

The spectrum of a finite group is the set of element orders of this group. The main goal of this paper is to survey results concerning recognition of finite simple groups by spectrum, in particular, to list all finite simple groups for which the recognition problem is solved.

A new study of phytoplankton in the Detroit River follows significant changes to ecological and environmental conditions in the boundary waters and updates historical data research. Measures to remediate river health in recent years can be evaluated through analysis of the abundance and diversity of phytoplankton communities at a higher taxonomic resolution. By working with community partners to measure phytoplankton communities in the long term, water treatment plants can use the data gained to design an early‐warning system for river changes.

Intense competition is forcing many appliance manufacturers to open their research and development (R&D) operations to other companies. Some manufacturers are seeking joint venture (R&D) projects with other companies and institutions. Such joint ventures allow manufacturers to tap into new sources of funding and research methods. An analysis of the advantages and disadvantages of such joint ventures is presented., Appliance manufacturers have traditionally guarded their research and development efforts with a vengeance. But things are changing. The shroud of secrecy surrounding the industry's research and developments efforts is, to [...]

EXPRESS STOP Intrinsic aging: Numerous structural and functional changes combine to age the skin, resulting in thinning, fragility, and loss of elasticity. Circulation and innervation decrease, and the structural attachment [...]

With a 20-year experience of more than 700 parathyroidectomies, our persistent hypercalcemic postoperative failure rate of 7% has remained constant. Reasons for failure have been misdiagnosis or inability of the surgeon to detect and excise all hypersecreting glands. We have modified a commercially available immunoradiometric assay for intact parathyroid hormone (PTH) resulting in a 15-minute turnaround time. Since intact PTH has a half-life measured in minutes, whole blood samples taken 10 minutes after gland excisions were monitored intraoperatively to confirm significant changes in circulating hormone. Quantitative evidence that all hyperfunctioning parathyroid tissue had been ablated during operation was obtained in 19 to 21 patients. Less than four glands each were identified in 53% of these patients. The PTH 'quick' test correctly pointed to an inadequate excision requiring further parathyroid ablation in two patients, made bilateral neck exploration unnecessary in two patients who had previously undergone parathyroidectomy, and predicted persistent hypercalcemia in two patients with complications., Hyperparathyroidism is an glandular condition in which hyperactivity leads to excessive secretion of parathyroid hormone from of any of the four parathyroid glands. This causes resorption (removal) of calcium from bones and increased absorption of calcium by the kidneys and intestinal system. Hypercalcemia causes dysfunction of most of the body systems and can result in kidney failure, fragile and painful bones, pancreatitis, ulcers, and neurologic impairment. Techniques used to preoperatively identify the hypersecreting gland are only partially successful. Successful surgery is dependent on the surgeon's experience and his correct assessment at the time of operation. Excision of hyperfunctioning parathyroid tissue is usually based on the actual size of the glands seen. However, more than 20 percent of patients have more than one enlarged gland, which may be unrecognized at the time of surgery. Over the past 20 years, the authors have performed more than 700 operations with a consistent failure rate of about 7 percent. A technique is described for a quick test that can be performed during surgery. This technique, which modifies an already commercially available radiologic assay for intact parathyroid hormone, is performed on blood samples obtained 10 minutes after the gland is excised. The results are available within 15 minutes and confirm significant changes in circulating levels of intact parathyroid hormone. A report is presented of the test results of 21 patients who underwent surgery for hyperparathyroidism. The quick test showed that 19 of 21 patients had all hyperfunctioning parathyroid tissue removed. The test correctly identified two patients with inadequate glandular excision and who required more extensive tissue removal. For another two patients, the results of this test avoided unnecessary bilateral neck exploration. This quick test for intraoperative evaluation of parathyroid hormone levels will be helpful to the surgeon and will improve operative success rates. (Consumer Summary produced by Reliance Medical Information, Inc.)

ICU acquired infections are among the most common nosocomial infections. The pattern of antibacterial resistance is different according to regional and even ICU related factors. The infections caused by more resistant bacteria including pan drug-resistance (PDR), extensively drug-resistance (XDR) and multidrug-resistance (MDR) are associated with higher rates of mortality, reportedly. Machine learning (ML) algorithms can be useful for prediction of mortality in ICU settings. We aimed to examine different ML models to find the relation between the antibacterial resistance pattern of major ICU acquired infections with mortality in patients with ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI) and catheter associated urinary tract infection (CAUTI).

ICU acquired infections are the most common infectious causes of death. Analysis of factors associated with mortality related to these infections using machine learning (ML) algorithms can be useful for both individual risk stratification and quality of care, however, these studies are scarce in ICU settings. We aimed to examine different ML models to find the most relevant factors associated with mortality in patients with ventilator associated pneumonia (VAP), central line associated blood stream infection (CLABSI) and catheter associated urinary tract infection (CAUTI).

ABSTRACTEconomics – the socially instituted ways of managing how people value, make, exchange, and consume goods – is a major part of human culture. Yet there is comparatively little study of the economies of the pre-sixteenth-century Southeast, in spite of revealing written comments by the earliest European observers and the fact that cross-culturally in societies of comparable scale, multiple, complicated economic institutions always play a central role. Because of the Southeast’s rich environment and well-preserved material record of human culture spanning over 14,000 years, archaeology here could be contributing much more data and new theory to economic anthropology generally. As examples of this potential, we draw on existing archaeological information indicating (1) that chert in the Cahokia region was most likely obtained through market mechanisms, and (2) that ever since their origins, plazas were designed consistent with facilitating and managing exchange. We sketch two models (Market Fair and Formal Market) that may be useful for studying economic evolution. We suggest additional, practicable research questions to further our understanding of Southeastern economic structures.

Reducing dietary CP for broiler chickens below a certain threshold results in decreased growth, even when the supply of essential amino acids and glycine equivalent (Glyequi) is adequate, probably because other nonessential amino acids (neAA) are growth-limiting. Nonprotein nitrogen (NPN) might be used for the synthesis of neAA. Therefore, the effects of specific neAA and ammonium chloride (NH4Cl) supplementation on the growth and N-excretion characteristics of broiler chickens were investigated. Nine male Ross 308 broiler chickens were kept in each of 81 metabolism units from day 7 to 21 and received 1 of 9 diets in 9 replicates in a one-factorial arrangement of treatments. Two diets with different neAA concentrations, except for Glyequi, were mixed resulting in CP levels of 180 (CP180) and 160 (CP160) g/kg. In six other diets, CP160 was supplemented with either l-Ala, l-Pro, l-Asp, a mix of l-Asp and l-Asn·H2O, l-Glu, or a mix of l-Glu and l-Gln to achieve concentrations of the respective neAA as formulated in CP180. In a further diet, NH4Cl was added to CP160 to achieve the CP concentration of CP180. The ADG and gain:feed ratio (G:F) from day 7 to 21 were highest at CP180. Reduced neAA concentrations in CP160 decreased ADG and G:F. Supplementation of Asp+Asn, Glu, and Glu+Gln to CP160 increased ADG and G:F, but not to the level found for CP180. Compared with CP160, addition of Asp increased G:F but not ADG. Supplementation of Asp+Asn caused higher ADG and G:F than supplementation of Asp alone. The N-utilization efficiency was highest at CP160 and at CP160 supplemented with Ala, Pro, and Glu. Lower N-utilization efficiency was found at CP180 than at CP160, without and with supplemented neAA. The treatment containing NH4Cl presented the lowest ADG, G:F, and N-utilization efficiency. These results showed that individual supplementation of Asp+Asn, Glu, and Glu+Gln partly compensates for the growth-reducing effects of very low CP diets. Supplementation of NH4Cl as NPN source is not suitable for broiler chickens.