Measures of Excess Demand and Unemployment in Canada and the United States

La relation chômage-vacances d'emploi (C-VE) s'est déplacée vers l'extérieur entre les années 60 et le milieu des années 80 tant au Canada qu'aux États-Unis. À la fin des années 80, cette courbe s'est déplacée vers l'intérieur dans les deux pays, mais d'une façon plus accentuée aux États-Unis. Au même moment, alors que le taux de chômage était presque semblable dans les deux pays avant les années 80, il devenait constamment plus élevé au Canada au cours des années 80 et 90. Le but de cet article est de comprendre et d'expliquer la signification de ces changements et de voir s'ils peuvent contribuer à expliquer l'écart dans le taux de chômage entre les deux pays depuis les années 80. Nous examinons d'abord les fondements théoriques de la relation C-VE pour voir s'il est valide d'identifier des changements dans la courbe aux changements dans les déséquilibres structurels du marché du travail et les mouvements le long de la courbe avec les troubles au niveau collectif. Nous concluons que telle dichotomie est possible seulement si nous faisons des hypothèses restrictives. Il est possible que quelques déséquilibres structurels dans le marché du travail déplacent la courbe C-VE alors que d'autres causeront des changements le long de cette courbe. De la même façon, des troubles au niveau collectif peuvent causer des mouvements le long d'une courbe C-VE donnée, mais peuvent aussi amener un déplacement de cette courbe.Nous avons ensuite vérifié si l'utilisation d'un index « travailleur demandé » au lieu du taux de vacances d'emploi surestimerait les changements à la hausse observés dans la courbe. Nous concluons qu'il y a plusieurs raisons valides pour lesquelles l'indice « travailleur demandé » amène une tendance à la hausse plus élevée que le taux de vacances d'emploi. Cependant, même après avoir corrigé le biais à la hausse de cet indice du mieux que nous pouvions le faire, la relation « travailleur-demande » chômage continue de se déplacer vers l'extérieur.En troisième lieu, nous avons inventorié les différents facteurs structurels identifiés dans la littérature empirique comme causant des déplacements vers l'extérieur de la courbe C-VE. Nous avons trouvé des raisons structurelles pour le déplacement de la courbe des années 60 aux années 70. Cependant, nous n'avons trouvé aucun facteur structurel pour expliquer le déplacement continu de la courbe vers l'extérieur durant les années 80. En fait, sur la base des plus importants facteurs structurels, on aurait prédit un déplacement de la courbe vers l'intérieur durant cette dernière période. Quatrièmement, nous prétendons que les chocs économiques au niveau macro, qui ont créé des déséquilibres structurels peuvent expliquer les changements variables dans la courbe C-VE et les expériences de chômage au Canada et aux États-Unis. Ces deux économies ont connu une récession sérieuse au début des années 80, récession causée par une politique monétaire restrictive. Cependant, la récession fut plus sérieuse au Canada qu'aux États-Unis. Cela a causé un plus haut niveau de chômage de longue durée qui tendait à s'alimenter de lui-même et qui a accru le taux de chômage naturel au Canada durant les années 80. De plus, l'économie canadienne a été beaucoup plus sujette à des chocs macroéconomiques durant cette période. Ses taux réels d'intérêts à court terme ont varié beaucoup plus que les taux américains. Aussi le dollar canadien est devenu surévalué dans la dernière partie des années 80. Cela a eu des effets inégaux sur l'économie canadienne et a mené à un chômage structurel croissant dans un contexte où certains secteurs étaient frappés et d'autres aidés par les chocs macroéconomiques.Finalement, la croissance récente de presque quatre points de la différence de chômage entre les États-Unis et le Canada peut suggérer que l'écart dans le chômage entre les deux pays s'est accru. Nous prétendons que cet écart croissant est dû à des différences dans la réaction du chômage aux changements cycliques dans les deux économies. L'écart du chômage entre le Canada et les États-Unis s'est accru de plus de 3,5 % en 1984 alors que les deux économies se relevaient de la récession 1981-82. Mais cet écart est tombé à un peu plus de 2 % en 1989.The authors consider the reasons for the shifts in the unemployment vacancy (UV) relationship in Canada and the United States during the past two decades to see whether these shifts can explain the gap in the unemployment between the two countries which arose about 1980 and may be increasing. We find that changing structural imbalances in the labor markets by themselves cannot explain the shifts in the UV curves or the gap in the unemployment rates in the two countries. We conclude that aggregate economie shocks which create some structural imbalances are required to explain the shifts in the UV curves and the differing unemployment experiences in the two economies

NOMA Enhanced Backscatter Communication for Green IoT Networks

Backscatter communication has recently emerged as a promising technology to enable the passive sensing-based Internet-of-things (IoT) applications. In a backscatter communication network, uplink transmissions of multiple nodes are usually multiplexed in time- or frequency-domain to avoid collisions, yet it is desirable to improve the uplink capacity further. In this paper, we study a wireless-powered backscatter communication system, where the sensors use a hybrid channel access scheme by combining time division multiplexing access (TDMA) with power-domain non-orthogonal multiple access (PD-NOMA) to enhance the system performance in terms of outage probability and throughput. Our analysis shows that the proposed PD-NOMA increases both the spectrum efficiency and the throughput of the system

The Karachi intracranial stenosis study (KISS) Protocol: an urban multicenter case-control investigation reporting the clinical, radiologic and biochemical associations of intracranial stenosis in Pakistan.

Background: Intracranial stenosis is the most common cause of stroke among Asians. It has a poor prognosis with a high rate of recurrence. No effective medical or surgical treatment modality has been developed for the treatment of stroke due to intracranial stenosis. We aim to identify risk factors and biomarkers for intracranial stenosis and to develop techniques such as use of transcranial doppler to help diagnose intracranial stenosis in a cost-effective manner. Methods/Design: The Karachi Intracranial Stenosis Study (KISS) is a prospective, observational, case-control study to describe the clinical features and determine the risk factors of patients with stroke due to intracranial stenosis and compare them to those with stroke due to other etiologies as well as to unaffected individuals. We plan to recruit 200 patients with stroke due to intracranial stenosis and two control groups each of 150 matched individuals. The first set of controls will include patients with ischemic stroke that is due to other atherosclerotic mechanisms specifically lacunar and cardioembolic strokes. The second group will consist of stroke free individuals. Standardized interviews will be conducted to determine demographic, medical, social, and behavioral variables along with baseline medications. Mandatory procedures for inclusion in the study are clinical confirmation of stroke by a healthcare professional within 72 hours of onset, 12 lead electrocardiogram, and neuroimaging. In addition, lipid profile, serum glucose, creatinine and HbA1C will be measured in all participants. Ancillary tests will include carotid ultrasound, transcranial doppler and magnetic resonance or computed tomography angiogram to rule out concurrent carotid disease. Echocardiogram and other additional investigations will be performed at these centers at the discretion of the regional physicians. Discussion: The results of this study will help inform locally relevant clinical guidelines and effective public health and individual interventions

Identifying colorectal cancer caused by biallelic MUTYH pathogenic variants using tumor mutational signatures

Carriers of germline biallelic pathogenic variants in the MUTYH gene have a high risk of colorectal cancer. We test 5649 colorectal cancers to evaluate the discriminatory potential of a tumor mutational signature specific to MUTYH for identifying biallelic carriers and classifying variants of uncertain clinical significance (VUS). Using a tumor and matched germline targeted multi-gene panel approach, our classifier identifies all biallelic MUTYH carriers and all known non-carriers in an independent test set of 3019 colorectal cancers (accuracy = 100% (95% confidence interval 99.87-100%)). All monoallelic MUTYH carriers are classified with the non-MUTYH carriers. The classifier provides evidence for a pathogenic classification for two VUS and a benign classification for five VUS. Somatic hotspot mutations KRAS p.G12C and PIK3CA p.Q546K are associated with colorectal cancers from biallelic MUTYH carriers compared with non-carriers (p = 2 x 10(-23) and p = 6 x 10(-11), respectively). Here, we demonstrate the potential application of mutational signatures to tumor sequencing workflows to improve the identification of biallelic MUTYH carriers. Germline biallelic pathogenic MUTYH variants predispose patients to colorectal cancer (CRC); however, approaches to identify MUTYH variant carriers are lacking. Here, the authors evaluated mutational signatures that could distinguish MUTYH carriers in large CRC cohorts, and found MUTYH-associated somatic mutations

Persistent Expression of Hepatitis C Virus Non-Structural Proteins Leads to Increased Autophagy and Mitochondrial Injury in Human Hepatoma Cells

HCV infection is a major cause of chronic liver disease and liver cancer in the United States. To address the pathogenesis caused by HCV infection, recent studies have focused on the direct cytopathic effects of individual HCV proteins, with the objective of identifying their specific roles in the overall pathogenesis. However, this approach precludes examination of the possible interactions between different HCV proteins and organelles. To obtain a better understanding of the various cytopathic effects of and cellular responses to HCV proteins, we used human hepatoma cells constitutively replicating HCV RNA encoding either the full-length polyprotein or the non-structural proteins, or cells constitutively expressing the structural protein core, to model the state of persistent HCV infection and examined the combination of various HCV proteins in cellular pathogenesis. Increased reactive oxygen species (ROS) generation in the mitochondria, mitochondrial injury and degeneration, and increased lipid accumulation were common among all HCV protein-expressing cells regardless of whether they expressed the structural or non-structural proteins. Expression of the non-structural proteins also led to increased oxidative stress in the cytosol, membrane blebbing in the endoplasmic reticulum, and accumulation of autophagocytic vacuoles. Alterations of cellular redox state, on the other hand, significantly changed the level of autophagy, suggesting a direct link between oxidative stress and HCV-mediated activation of autophagy. With the wide-spread cytopathic effects, cells with the full-length HCV polyprotein showed a modest antioxidant response and exhibited a significant increase in population doubling time and a concomitant decrease in cyclin D1. In contrast, cells expressing the non-structural proteins were able to launch a vigorous antioxidant response with up-regulation of antioxidant enzymes. The population doubling time and cyclin D1 level were also comparable to that of control cells. Finally, the cytopathic effects of core protein appeared to focus on the mitochondria without remarkable disturbances in the cytosol

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial

Background: Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive antiplatelet therapy (combined aspirin, clopidogrel, and dipyridamole) with that of guideline-based antiplatelet therapy. Methods: We did an international, prospective, randomised, open-label, blinded-endpoint trial in adult participants with ischaemic stroke or transient ischaemic attack (TIA) within 48 h of onset. Participants were assigned in a 1:1 ratio using computer randomisation to receive loading doses and then 30 days of intensive antiplatelet therapy (combined aspirin 75 mg, clopidogrel 75 mg, and dipyridamole 200 mg twice daily) or guideline-based therapy (comprising either clopidogrel alone or combined aspirin and dipyridamole). Randomisation was stratified by country and index event, and minimised with prognostic baseline factors, medication use, time to randomisation, stroke-related factors, and thrombolysis. The ordinal primary outcome was the combined incidence and severity of any recurrent stroke (ischaemic or haemorrhagic; assessed using the modified Rankin Scale) or TIA within 90 days, as assessed by central telephone follow-up with masking to treatment assignment, and analysed by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN47823388. Findings: 3096 participants (1556 in the intensive antiplatelet therapy group, 1540 in the guideline antiplatelet therapy group) were recruited from 106 hospitals in four countries between April 7, 2009, and March 18, 2016. The trial was stopped early on the recommendation of the data monitoring committee. The incidence and severity of recurrent stroke or TIA did not differ between intensive and guideline therapy (93 [6%] participants vs 105 [7%]; adjusted common odds ratio [cOR] 0·90, 95% CI 0·67–1·20, p=0·47). By contrast, intensive antiplatelet therapy was associated with more, and more severe, bleeding (adjusted cOR 2·54, 95% CI 2·05–3·16, p<0·0001). Interpretation: Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P &lt; 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P &lt; 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

What scans we will read: imaging instrumentation trends in clinical oncology

Oncological diseases account for a significant portion of the burden on public healthcare systems with associated costs driven primarily by complex and long-lasting therapies. Through the visualization of patient-specific morphology and functional-molecular pathways, cancerous tissue can be detected and characterized non- invasively, so as to provide referring oncologists with essential information to support therapy management decisions. Following the onset of stand-alone anatomical and functional imaging, we witness a push towards integrating molecular image information through various methods, including anato-metabolic imaging (e.g., PET/ CT), advanced MRI, optical or ultrasound imaging. This perspective paper highlights a number of key technological and methodological advances in imaging instrumentation related to anatomical, functional, molecular medicine and hybrid imaging, that is understood as the hardware-based combination of complementary anatomical and molecular imaging. These include novel detector technologies for ionizing radiation used in CT and nuclear medicine imaging, and novel system developments in MRI and optical as well as opto-acoustic imaging. We will also highlight new data processing methods for improved non-invasive tissue characterization. Following a general introduction to the role of imaging in oncology patient management we introduce imaging methods with well-defined clinical applications and potential for clinical translation. For each modality, we report first on the status quo and point to perceived technological and methodological advances in a subsequent status go section. Considering the breadth and dynamics of these developments, this perspective ends with a critical reflection on where the authors, with the majority of them being imaging experts with a background in physics and engineering, believe imaging methods will be in a few years from now. Overall, methodological and technological medical imaging advances are geared towards increased image contrast, the derivation of reproducible quantitative parameters, an increase in volume sensitivity and a reduction in overall examination time. To ensure full translation to the clinic, this progress in technologies and instrumentation is complemented by progress in relevant acquisition and image-processing protocols and improved data analysis. To this end, we should accept diagnostic images as “data”, and – through the wider adoption of advanced analysis, including machine learning approaches and a “big data” concept – move to the next stage of non-invasive tumor phenotyping. The scans we will be reading in 10 years from now will likely be composed of highly diverse multi- dimensional data from multiple sources, which mandate the use of advanced and interactive visualization and analysis platforms powered by Artificial Intelligence (AI) for real-time data handling by cross-specialty clinical experts with a domain knowledge that will need to go beyond that of plain imaging