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Background The aim is to develop and test the utility of an event-initiated, team-based check list to optimize the response to bleeding during laparoscopic HPB surgery. Methods To build a checklist for managing bleeding events, we conducted a systematic review. Using nominal group technique (NGT), a checklist consisting of four domains was developed. Following team-based training of anesthesia and surgical staff, the checklist was implemented. HPB cases before and after implementation of the checklist were compared for adverse outcomes, bleeding complications, and transfusions. Results NGT identified four domains: Communicate Control, Expose, and Repair under which the checklist was organized. Supplemental Video for a detailed review of how each domain was applied to a specific case example. We compared 169 HPB cases before to 53 cases after implementation. We found a significant decrease in mean EBL (from 518 ± 852.8 to 151.5 ± 221.7 ml (P = 0.001)) for cases performed after implementation of the checklist and a trends toward less volume of pRBC transfused (2.7 ± 2.5 vs 2.3 ± 1.7 units/per patient, P = 0.611) and transfusion rates (22% vs 11%, P = 0.703). Conclusion An event-initiated, team-based response to an adverse bleeding event during laparoscopic HPB surgery correlates with positive effects on bleeding management, and transfusion rates.

Scientific novelty drives the efforts to invent new vaccines and solutions during the pandemic. First-time collaboration and international collaboration are two pivotal channels to expand teams' search activities for a broader scope of resources required to address the global challenge, which might facilitate the generation of novel ideas. Our analysis of 98,981 coronavirus papers suggests that scientific novelty measured by the BioBERT model that is pre-trained on 29 million PubMed articles, and first-time collaboration increased after the outbreak of COVID-19, and international collaboration witnessed a sudden decrease. During COVID-19, papers with more first-time collaboration were found to be more novel and international collaboration did not hamper novelty as it had done in the normal periods. The findings suggest the necessity of reaching out for distant resources and the importance of maintaining a collaborative scientific community beyond nationalism during a pandemic., Comment: 19 pages, 3 figures

Friction stir welding (FSW) was used to join cast Ti–6Al–4V hemisphere and cylinder parts to produce a spacecraft propellant tank with reduced costs and lead time compared to conventional manufacturing. As a potential source for failure, the weld was inspected for residual stresses using three different methods: non-destructive neutron and X-ray diffraction as well as destructive hole drilling. The results showed lower residual stresses in the friction stir weld compared to results from conventional welding techniques such as electron beam welding or tungsten inert gas welding. In the hoop direction, a typical M-shaped residual stress profile centered around the weld was observed for both neutron and X-ray diffraction. According to the acquired data, the peak residual stresses (tensile) were measured in the heat-affected zone, up to a maximum of ~ 200 MPa. The results from the three different techniques generally compared well with each other, considering the rather significant differences between the methods.

Abstract: This chapter analyzes the implications of the unexpected 2020-2021 COVID-19 pandemic for work and retirement in the United states. The pandemic induced the greatest loss of jobs in the shortest period of time in U.S. history. A slow economic recovery would surely have endangered work longer/retire later policies that seek to adjust the finances of Social Security retirement to an aging population. Boosted by the huge CARES (March 2020) and ARPA (April 2021) rescue packages, the early recovery from the COVID-19 recession was faster and stronger than the recovery from the 2007-2009 Great Recession. Even so, the pandemic greatly altered the job market, with workers suffering from long COVID having difficulty returning to work and more workers working from home. In its immediate effect and potential long-run impact, the pandemic recession/recovery is a wake-up call to the danger that shocks from the natural world pose to work and retirement. Realistic planning for the future of work and retirement should go beyond analyzing socioeconomic trends to analyzing expected unexpected changes from the natural world as well.

Firms hire workers to undertake tasks and activities associated with particular occupations, which makes occupations a fundamental unit in economic analyses of the labor market. Using a unique dataset on pay in identically defined occupations in developing and advanced countries, we find that in most countries occupational skill premia narrowed substantially from the 1950s to the 1980s, then widened through the 2000s, creating a U-shaped pattern of change. The narrowing was due in part to the huge worldwide increase in the supply of educated workers. The subsequent widening was due in part to the weakening of trade unions and a shift in demand to more skilled workers associated with rising trade. The data indicate that supply, demand, and institutional forces are all drivers of occupational skill premia, ruling out simple single factor explanations of change. The paper concludes with a call for improving the collection of occupational wage data to understand future changes in the world of work.

Using a panel survey, the authors investigate how the welfare of rural-urban migrant workers in China is affected by trade union presence at the workplace. Controlling for individual fixed effects, they find the following. Relative to workers from workplaces without union presence or with inactive unions, both union-covered non-members and union members in workplaces with active unions earn higher monthly income, are more likely to have a written contract, be covered by social insurances, receive fringe benefits, express work-related grievances through official channels, feel more satisfied with their lives, and are less likely to have mental health problems.

The relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.

In this paper, we examine how two regionally implemented environmental initiatives in China have impacted the innovation ability of Chinese-listed firms. The regional implementation of these policies, with non-policy regions serving as controls, offers researchers the perfect conditions for a natural experiment. Using research and development (R&D) expenditures and patents as a proxy for innovativeness, we compare the record of innovation of firms inside the policy zones with firms outside the policy zones. We use a Difference-In-Difference-In-Differences (DIDID) method to eliminate endogeneity and take the quality of the patents into account by incorporating sub-items. Results show only one of the regulations had a positive effect and that low quality patents account for most of the innovation. We conclude that reasonably designed environmental regulations, when implemented regionally in competitive industries, do improve Chinese firms' innovation ability in line with the Porter Hypothesis. The results help us derive some useful policy implications regarding innovation.

This paper measures aggregate changes in job characteristics in the United States from 2005 to 2015 and decomposes those changes into components representing shifts within occupations and changes in occupational employment shares. Per our title, within-occupation changes dominate, raising doubts about the ability of projections based on expected changes in the occupational composition of employment to capture the likely future of work. Indeed, our data show only weak relationships between automatability, repetitiveness, and other job attributes and changes in occupational employment. The results suggest that analysts give greater attention to within-occupation impacts of technology in assessing the future of work.

The Child-Turcotte-Pugh (CTP) and the MELD (Model for End-Stage Liver Disease) scores were designed to predict the outcome of decompressive therapy for portal hypertension. They were prospectively validated to predict mortality risk in patients with a wide spectrum of liver disease etiology and severity. Unlike the CTP score, the MELD score was derived from prospectively gathered data. Its calculation was based on serum bilirubin, serum creatinine, international normalized ratio (INR) and etiology of liver disease. Instituting a continuous disease severity score that de-emphasizes waiting time resulted in better categorization of waiting patients and enhanced transparency. The US instituted the MELD system in 2002 and soon thereafter, MELD-based liver allocation was adopted throughout the world including Latin America. The most significant impact of MELD-based policies has been the reduction of waiting-list mortality. In the years after implementation of the MELD system, several options have been proposed to improve the MELD score's accuracy. Adding serum sodium (MELD-Na) increased the accuracy of the score in predicting waiting list mortality, thus completing the original MELD score as a prognostic model in liver allocation. On the 20th anniversary of the creation of MELD score we present a brief account of its development, its use to stratify patients on the waiting list for liver transplantation as well as its adoption as liver allocation system .