A Technological Analysis of Modified Bone from the Widows Creek Site (1JA305), Alabama

This study examines chronological and spatial changes in the distribution of modified bone attributes. Five hundred sixty-two modified bone specimens were examined from Late Archaic, Early Woodland, and Middle/Late Woodland contexts of the Widows Creek site. Each specimen was examined for raw material, manufacturing traces, manufacturing stage, and morphology. The Widows Creek material was then compared to material from Russell Cave (1JA181) and Westmoreland-Barber (40MI11) using published data. The study found that, at a general level, raw material choice varied little through time. However, distinct differences in the distribution of materials in manufacturing stages and morphological categories are present. Manufacturing stage data shows an increase in the manufacture of certain items including fishhooks and bipointed objects in the Middle Late Woodland period. Differences in settlement pattern and site function are observed when the three sites are compared

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Providing opportunities for non-engaged youth in Hong Kong.

The goal of our project was to discover effective youth employment training methods from other governments and assess their transferability to Hong Kong. We investigated programs in Germany, the Netherlands, the United Kingdom, and the United States. To understand the unemployment programmes in Hong Kong, YPTP and YWETS, we conducted interviews with programme directors, case managers, and trainees. We concluded that the initiatives in Hong Kong were effective. However, the general employment situation in Hong Kong may limit their impact

Evaluation of random number generators on FPGAs

Accurate generation of truly random bits is crucial to modern cryptography. Our project goal was to determine whether the jitter created using reconfigurable logic could be used to create a true random number generator. Our analysis suggests that the nondeterministic parts of the jitter, if manipulated correctly, can produce truly random bits. We devised two possible designs to utilize this jitter to ensure an accurate extraction of bits of nondeterministic phenomena

Research priorities for patients with peripheral arterial disease: A James Lind Alliance Priority Setting Partnership

Introduction: Peripheral arterial disease (PAD) is a common health problem associated with reduced mobility, functional capacity and quality of life. Significant research exists in the field of vascular surgery, but its relevance to the research priorities of patients/carers and clinicians/healthcare professionals is unknown. The aim of this process, conducted by the Vascular Society of Great Britain and Ireland with the James Lind Alliance (JLA), was to identify the key research priorities for PAD, from the perspective of patients/carers and clinicians/healthcare professionals.Methods: A modified JLA Priority Setting Partnership was performed in three stages: (1) a clinician/healthcare professional-led Delphi process; (2) a patient/carer-led JLA process; and (3) amalgamation of patient/carer and clinician/healthcare professional-led results for a final round of JLA-led prioritisation. The clinician/healthcare professional Delphi process surveyed vascular clinicians/healthcare professionals, inviting them to submit important research priorities for vascular surgery. This generated a list of priorities which were redistributed for interim scoring. The priorities fitted into nine specific Special Interest Groups (SIGs), one being PAD. This was followed by a patient/carer Delphi process (in association with the JLA) using a similar two-stage process. Finally, research priorities formed by these two processes were amalgamated to produce a refined list relevant to PAD. The PAD SIG then held a final JLA consensus workshop which was attended by patients/carers and clinicians/healthcare professionals, where a nominal group technique was used to produce a ranked top 10 list of research priorities specific to PAD.Results: In the clinician/healthcare professional Delphi process, 481 clinicians/healthcare professionals submitted 1,231 research priorities related to vascular conditions. Two hundred and six PAD-specific priorities were amalgamated into 17 priorities which were recirculated for scoring according to perceived importance. For patients/carers, 582 research priorities were submitted by 373 individuals, and 114 PAD specific priorities were amalgamated into 9. These were recirculated for scoring according to perceived importance. After amalgamation of both sets of priorities, 12 remained, which were discussed at the final consensus meeting, resulting in a final ranked list of 10 PAD-specific research priorities. Research priority themes included improving outcomes, maximising non-invasive therapy, education and diagnosis, and stopping/slowing down PAD and cardiovascular disease progression.Conclusions: We have identified the top 10 PAD-related research priorities from the perspective of patients/carers and clinicians/healthcare professionals. This should provide guidance for researchers, clinicians, healthcare professionals and funders to ensure that proposed PAD research is addressing priorities that are considered important to all parties

Interactome Mapping Provides a Network of Neurodegenerative Disease Proteins and Uncovers Widespread Protein Aggregation in Affected Brains.

Interactome maps are valuable resources to elucidate protein function and disease mechanisms. Here, we report on an interactome map that focuses on neurodegenerative disease (ND), connects ∼5,000 human proteins via ∼30,000 candidate interactions and is generated by systematic yeast two-hybrid interaction screening of ∼500 ND-related proteins and integration of literature interactions. This network reveals interconnectivity across diseases and links many known ND-causing proteins, such as α-synuclein, TDP-43, and ATXN1, to a host of proteins previously unrelated to NDs. It facilitates the identification of interacting proteins that significantly influence mutant TDP-43 and HTT toxicity in transgenic flies, as well as of ARF-GEP(100) that controls misfolding and aggregation of multiple ND-causing proteins in experimental model systems. Furthermore, it enables the prediction of ND-specific subnetworks and the identification of proteins, such as ATXN1 and MKL1, that are abnormally aggregated in postmortem brains of Alzheimer's disease patients, suggesting widespread protein aggregation in NDs