Ulakhan Sular provides one of the largest natural stratigraphic sections through ancient permafrost deposits in the Batagay–Betenkes region of the Yana Uplands of western Beringia, but their depositional environment, age, and paleoenvironmental significance are uncertain. To address these uncertainties, we report the results of reconnaissance observations of the stratigraphy, sedimentology, paleosols and soil-like bodies, plant and insect macrofossils, and geochronology of the permafrost deposits at the stratotype section of the Ulakhan Sular Formation. Sedimentologically, this formation is dominated by well-sorted, fine to very fine sand that contains fluvial, aeolian, and permafrost sedimentary structures consistent with deposition near the paleo-Adycha River. The fluvio-aeolian deposits have similarities and differences to periglacial fluvio-aeolian and aeolian deposits in modern arctic regions of Canada and Greenland, and Pleistocene deposits in Alaska, China, and northwest Europe. The remarkable thickness of aeolian deposits (~50 m) at Ulakhan Sular is attributed to abundant local sand sources, ample accommodation space, and intensive aeolian transport and deposition. Optically stimulated luminescence dating of quartz sand and post-infrared–infrared dating of K-feldspar sand suggests deposition of the Ulakhan Sular Formation during late Marine Oxygen Isotope Stage (MIS) 6 or MIS 5. The aeolian sand-sheet deposits are correlated with other cold-climate aeolian sand and silt (loess) deposits in Beringia and southern Siberia, indicating a regional episode of aeolian sand transport and deposition at a similar time to glaciation by the Eastern Siberian Ice Sheet.

Background: Previous studies have found that solely relying on molecular testing is likely to result in the overdiagnosis and overtreatment of C. difficile infections (CDI). Comparable outcomes have been demonstrated in patients with a positive molecular test (C. difficile PCR) result and a negative toxin immunoassay (C. difficile toxin) compared to patients without CDI by either testing Method: In 2021 Memorial Hermann Healthcare System converted from C. difficile PCR testing only to C. difficile PCR testing with reflex to C. difficile toxin if positive. A previous internal audit revealed that despite this change in testing, patients who were C. difficile PCR positive and C. difficile toxin negative were still receiving treatment. This study aimed to evaluate the impact of C. difficile reporting on the total days of therapy directed at the treatment of CDI of an 11-hospital health care system in patients who testing C. difficile PCR positive/C. difficile toxin negative. Methods: Pre-post, multicenter, retrospective, observational study conducted from January 1, 2023 through March 31, 2023 (pre-intervention) and July 1, 2023 through September 31, 2023 (post-intervention) which included hospitalized adult patients with a C. difficile test ordered within the study period. Intervention included a change in reporting of C. difficile PCR positive/C. difficile toxin negative results to display a laboratory comment. The comment notifies providers of the positive C. difficile PCR result while highlighting this probably reflects colonization with C. difficile as the C. difficile toxin is negative and treatment is rarely indicated. Results: In total, 989 C. difficile PCR were order in the pre-intervention cohort compared to 1009 in post-intervention. The overall rate of patients that received therapy directed at CDI decreased from 14% to 10% after the implementation of reporting change. Total days of therapy (DOT) also decreased by 29% from 482 to 342. Days of therapy that were administered to patients with C. difficile PCR positive/negative C. difficile toxin test decreased from 183 to 91. Conclusions: Adjusting the reporting of C. difficile results led to an overall numerical decrease of antimicrobial DOT directed at CDI treatment. In particular, among patients with a positive C. difficile PCR/C. difficile toxin negative test a 50% reduction in DOT was observed. Further data are required to assess the overall clinical impact of adjusting CDI reporting methods.

Empowering the Participant Voice (EPV) is an NCATS-funded six-CTSA collaboration to develop, demonstrate, and disseminate a low-cost infrastructure for collecting timely feedback from research participants, fostering trust, and providing data for improving clinical translational research. EPV leverages the validated Research Participant Perception Survey (RPPS) and the popular REDCap electronic data-capture platform. This report describes the development of infrastructure designed to overcome identified institutional barriers to routinely collecting participant feedback using RPPS and demonstration use cases. Sites engaged local stakeholders iteratively, incorporating feedback about anticipated value and potential concerns into project design. The team defined common standards and operations, developed software, and produced a detailed planning and implementation Guide. By May 2023, 2,575 participants diverse in age, race, ethnicity, and sex had responded to approximately 13,850 survey invitations (18.6%); 29% of responses included free-text comments. EPV infrastructure enabled sites to routinely access local and multi-site research participant experience data on an interactive analytics dashboard. The EPV learning collaborative continues to test initiatives to improve survey reach and optimize infrastructure and process. Broad uptake of EPV will expand the evidence base, enable hypothesis generation, and drive research-on-research locally and nationally to enhance the clinical research enterprise.

This article offers insights into the character and composition of world order. It does so by focusing on how world order is made and revealed through seemingly disorderly events. We examine how societies struggle to interpret and respond to disorderly events through three modes of treatment: tragedy, crisis, and scandal. These, we argue, are the dominant modes of treatment in world politics, through which an account of disorder is articulated and particular political responses are mobilised. Specifically, we argue that each mode provides a particular way of problematising disorder, locating responsibility, and generating political responses. As we will demonstrate, these modes instigate the ordering of disorder, but they also agitate and reveal the contours of order itself. We argue, therefore, that an attentiveness to how we make sense of and respond to disorder offers the discipline new opportunities for interrogating the underlying forces, dynamics, and structures that define contemporary world politics.

Focused as we are on uncovering how language works, many linguists are less cognizant of how the communicative strategies we employ in our knowledge-gathering activities impact the language users, identities, and communities we connect with and learn from. This autoethnographic essay, offered as a critical, introspective and analytical account by a U.S.-based, African American woman researcher, unfolds across three scenes of embedded ethnographic research in Micronesia and Tanzania—ocean-facing nations separated by a distance of more than 12,000 kilometers. Each scene's storytelling and dialogue—among users of Pohnpeian and Nukuoro in Micronesia, and users of Korean and Swahili in Tanzania—depicts how competing ideas about the value of marginalized languages surface within the talk of the research interview through allusions to socioracial power and linguistic capital. The essay concludes with a discussion of how a shift toward multilingual, multi-person interviewing can expand and deepen the insights of language-focused research.

Dating of ancient permafrost is essential for understanding long-term permafrost stability and interpreting palaeoenvironmental conditions but presents substantial challenges to geochronology. Here, we apply four methods to permafrost from the megaslump at Batagay, east Siberia: (1) optically stimulated luminescence (OSL) dating of quartz, (2) post-infrared infrared-stimulated luminescence (pIRIR) dating of K-feldspar, (3) radiocarbon dating of organic material, and (4) 36Cl/Cl dating of ice wedges. All four chronometers produce stratigraphically consistent and comparable ages. However, OSL appears to date Marine Isotope Stage (MIS) 3 to MIS 2 deposits more reliably than pIRIR, whereas the latter is more consistent with 36Cl/Cl ages for older deposits. The lower ice complex developed at least 650 ka, potentially during MIS 16, and represents the oldest dated permafrost in western Beringia and the second-oldest known ice in the Northern Hemisphere. It has survived multiple interglaciations, including the super-interglaciation MIS 11c, though a thaw unconformity and erosional surface indicate at least one episode of permafrost thaw and erosion occurred sometime between MIS 16 and 6. The upper ice complex formed from at least 60 to 30 ka during late MIS 4 to 3. The sand unit above the upper ice complex is dated to MIS 3–2, whereas the sand unit below formed at some time between MIS 4 and 16.

On January 28, 2021, a Special Chamber of the International Tribunal for the Law of the Sea (ITLOS) delivered a judgment in which it rejected preliminary objections raised by the Maldives in arbitral proceedings instituted by Mauritius, concerning the delimitation of the maritime boundary north of the Chagos Archipelago in the Indian Ocean.