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The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.
Methods:
This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).
Results:
Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.
Conclusion:
The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.
To determine associations of alcohol use with cognitive aging among middle-aged men.
Method:
1,608 male twins (mean 57 years at baseline) participated in up to three visits over 12 years, from 2003–2007 to 2016–2019. Participants were classified into six groups based on current and past self-reported alcohol use: lifetime abstainers, former drinkers, very light (1–4 drinks in past 14 days), light (5–14 drinks), moderate (15–28 drinks), and at-risk drinkers (>28 drinks in past 14 days). Linear mixed-effects regressions modeled cognitive trajectories by alcohol group, with time-based models evaluating rate of decline as a function of baseline alcohol use, and age-based models evaluating age-related differences in performance by current alcohol use. Analyses used standardized cognitive domain factor scores and adjusted for sociodemographic and health-related factors.
Results:
Performance decreased over time in all domains. Relative to very light drinkers, former drinkers showed worse verbal fluency performance, by –0.21 SD (95% CI –0.35, –0.07), and at-risk drinkers showed faster working memory decline, by 0.14 SD (95% CI 0.02, –0.20) per decade. There was no evidence of protective associations of light/moderate drinking on rate of decline. In age-based models, light drinkers displayed better memory performance at advanced ages than very light drinkers (+0.14 SD; 95% CI 0.02, 0.20 per 10-years older age); likely attributable to residual confounding or reverse association.
Conclusions:
Alcohol consumption showed minimal associations with cognitive aging among middle-aged men. Stronger associations of alcohol with cognitive aging may become apparent at older ages, when cognitive abilities decline more rapidly.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems.
Methods
The study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years (s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years (s.d. = 2.41)].
Results
Total depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60).
Conclusions
A history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.
No region of the world has been more affected by the various movements of the twentieth century than East Central Europe. Broadly defined as comprising the historic territories of the Czechs, Hungarians, Poles, and Slovaks, East Central Europe has been shaped by the interaction of politics, ideology, and diplomacy, especially by the policies of the Great Powers towards the east of Europe. This book addresses Czech politics in Moravia and Czech politics in Bohemia in the nineteenth century, the international politics of relief during World War I, the Morgenthau Mission and the Polish Pogroms of1919, the Hitler-Stalin Pact and its influence on Poland in 1939, Hungarian-Americans during World War II, and Polish-East German relations after World War II.
Contributors: Bruce Garver, M. B. B. Biskupski, Neal Pease, William L. Blackwood, Anna M. Cienciala, Steven Bela Vardy, and Douglas Selvage.
M. B. B. Biskupski is Professor of History at Central Connecticut State University.
Understanding the genetic and environmental contributions to measures of brain structure such as surface area and cortical thickness is important for a better understanding of the nature of brain-behavior relationships and changes due to development or disease. Continuous spatial maps of genetic influences on these structural features can contribute to our understanding of regional patterns of heritability, since it remains to be seen whether genetic contributions to brain structure respect the boundaries of any traditional parcellation approaches. Using data from magnetic resonance imaging scans collected on a large sample of monozygotic and dizygotic twins in the Vietnam Era Twin Study of Aging, we created maps of the heritability of areal expansion (a vertex-based area measure) and cortical thickness and examined the degree to which these maps were affected by adjustment for total surface area and mean cortical thickness. We also compared the approach of estimating regional heritability based on the average heritability of vertices within the region to the more traditional region-of-interest (ROI)-based approach. The results suggested high heritability across the cortex for areal expansion and, to a slightly lesser degree, for cortical thickness. There was a great deal of genetic overlap between global and regional measures for surface area, so maps of region-specific genetic influences on surface area revealed more modest heritabilities. There was greater inter-regional variability in heritabilities when calculated using the traditional ROI-based approach compared to summarizing vertex-by-vertex heritabilities within regions. Discrepancies between the approaches were greatest in small regions and tended to be larger for surface area than for cortical thickness measures. Implications regarding brain phenotypes for future genetic association studies are discussed.
Three-millimeter-wavelength spectra of a number of nearby galaxies have been obtained at the Five College Radio Astronomy Observatory (FCRAO) using a new, very broadband receiver. This instrument, which we call the Redshift Search Receiver, has an instantaneous bandwidth of 36 GHz and operates from 74 to 110.5 GHz. The receiver has been built at UMass/FCRAO to be part of the initial instrumentation for the Large Millimeter Telescope (LMT) and is intended primarily for determination of the redshift of distant, dust-obscured galaxies. It is being tested on the FCRAO 14 m by measuring the 3 mm spectra of a number of nearby galaxies. There are interesting differences in the chemistry of these galaxies.
As the focus of ecological research has broadened from site-level observations and experiments to landscape-scale studies, interest among ecologists in connectivity among habitat patches has increased (Turner et al. 1995; Wiens 1995; Gustafson and Gardner 1996; Hanski and Gilpin 1997; Haddad and Baum 1999). From a conservation perspective, concern with the maintenance of connectivity has grown as habitat loss and fragmentation continue worldwide (Rosenberg et al. 1997; de Lima and Gascon 1999; Haddad and Baum 1999). Typically, both basic and applied studies consider connectivity among patches of the same habitat type, such as a set of forest fragments embedded in a matrix of agricultural land uses. These studies, reviewed throughout this volume, focus on measuring patch isolation and examining the utility of corridors to restore connectivity among patches.
However, another type of connectivity, although less well studied and understood, is of equal importance in these complex landscapes: the connectivity among patches of different habitat types (Daily et al. 2001; Ricketts et al. 2001; Talley et al. Chapter 5). Many species require different habitat types for different resources or life-history stages. The proximity and availability of different habitat types, therefore, can affect the population dynamics and persistence of individual species and the diversity of communities. For example, bees often nest in one habitat type (e.g, tree cavities in forest) but require other types for forage (e.g., wildflower meadows).
Animal pollination is a mixed blessing for angiosperms. Animals carry pollen readily because they are mobile and large relative to pollen grains. Furthermore, animals learn to associate floral signals with the presence of food and so move between conspecific plants relatively consistently (Chittka et al., this volume; Gegear & Laverty, this volume; Giurfa, this volume; Menzel, this volume). However, animals act in their own interests, which often conflict with successful pollen transport (e.g., only about 1% of a plant's pollen production reaches stigmas; Harder 2000). Consequently, manipulation of pollinator behavior to promote cross-pollination is a prevailing theme in the evolution of floral design (form, color, nectar, and fragrance production) and display (inflorescence size and architecture).
This chapter reviews three aspects of pollinator manipulation by plants and their effects on pollen dispersal. First, because pollen dispersal for most animal-pollinated plants depends on the general responses of feeding pollinators to their foraging environment, we consider the underlying economic principles that establish the opportunities for floral manipulation. Second, we outline influences on the typical pattern of pollen dispersal among flowers for plants with granular pollen, and summarize how flower design affects this pattern (for a review of dispersal of orchid pollen, see Harder 2000). Finally, because pollination and mating success are characteristics of entire plants, rather than individual flowers, we consider how floral display affects pollinator attraction and within-plant behavior to determine pollen dispersal.
A central theme in Vygotsky's development theory is that cognitive development can be understood as the transformation of basic, biologically determined processes into higher psychological functions. According to the theory, the human child is endowed by nature with a wide range of perceptual, attentional, and memory capacities, such as the capacity to perceive contrast and movement, the capacity for eidetic memory, and arousal/habituation responses to environmental stimuli, to name a few. Such basic processes (also referred to by Vygotsky as “biological,” “natural,” or “elementary”), however, are substantially transformed in the context of socialization and education, particularly through the use of language, to constitute the higher psychological functions or the unique forms of human cognition.
Our readings of Vygotsky suggest that this “transformation” from basic to higher functions consists mostly of an increasing self-regulation of processes and capacities that are originally bound to and controlled by the concrete, immediate stimulus field. In development, the infant's eidetic, rudimentary memory processes are gradually transformed into the capacity for voluntary memory and the use of mnemonic strategies; the capacity to perceive salient stimulus features develops into the capacity for selective attention; arousal/habituation patterns develop into the capacity for vigilance, concentration, and sustained attention. The common denominators of these transformations or developmental changes are the decreasing power of immediate environmental contingencies and the increasing role of self-formulated plans and goals in the regulation of behavior and cognitive activity.