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David Paul Appell, a resident of Miami, has an illustrious record in journalism, including scores of travel articles for major magazines, and long stints as a top editor of important travel magazines. This new edition of his previous \"Miami and Key West\" has been brought thoroughly up-to-date, including close attention to towns along the route to Key West, and to the continuing growth of Miami and Miami Beach in art galleries, museums, nightspots, and remarkable restaurants. As a fervent admirer of south Florida, he brings both color and practicality to this Easy Guide.

Purpose: Down Syndrome (DS) is a genetic impairment has comorbidities such as Congenital Heart Disease (CHD). Pulmonary Atrial Hypertension (PAH) is a complication of CHD in these patients; however, there are no sufficient documents about the prevalence of PAH in CHD-DS patients in Iran. The purpose of this study is to investigate the prevalence of (PAH) in CHD-DS patients.   Method: This is a cross-sectional study that conducted on CHD-DS patients referred to Imam Reza hospital, Mashhad, Iran (April 2015- February 2016). The comparison group includes non-DS (NDS) children with CHD. Both groups were same in terms of age and gender. Echocardiography was run for all patients to determine CHD types and pulmonary arterial pressure (PAP).   Results: the cohort of 77 patients (including 47 in DS group and 30 in comparison group) was studied. It was observed that 66% of the DS group and 56.7% of the NDS group were female (P=0.412). The average age of case and comparison group were 15.1±25.83 and 36.6±44.17 month, respectively (p=0.108). Most of the CHD-DS patients (63.8%) had multiple heart disease. The most common impairments among the DS-CHD group were Ventricular Septal Defect (VSD), Atrial Septal Defect (ASD), and Patent Ductus Arteriosus (PDA).48.9% of the DS patients and 23.3% of NDS group had developed PAH which demonstrates a significant higher rate among DS patients (p=0.025).   Conclusions: Our findings denote higher prevalence of PAH among CHD-DS patients. Such an observation is a meaningful warning for the studied patients to take necessary medical therapies in order to prevent complications and irreversible pulmonary vascular disease.

Advances in control techniques for vibrational quantum states in molecules present new challenges for modelling such systems, which could be amenable to quantum simulation methods. Here, by exploiting a natural mapping between vibrations in molecules and photons in waveguides, we demonstrate a reprogrammable photonic chip as a versatile simulation platform for a range of quantum dynamic behaviour in different molecules. We begin by simulating the time evolution of vibrational excitations in the harmonic approximation for several four-atom molecules, including H 2 CS, SO 3 , HNCO, HFHF, N 4 and P 4 . We then simulate coherent and dephased energy transport in the simplest model of the peptide bond in proteins— N -methylacetamide—and simulate thermal relaxation and the effect of anharmonicities in H 2 O. Finally, we use multi-photon statistics with a feedback control algorithm to iteratively identify quantum states that increase a particular dissociation pathway of NH 3 . These methods point to powerful new simulation tools for molecular quantum dynamics and the field of femtochemistry. By mapping vibrations in molecules to photons in waveguides, the vibrational quantum dynamics of various molecules are simulated using a photonic chip.

An introduction to the life and career of the singer/songwriter Alicia Keys.

Stingless bees (Meliponini) are a ubiquitous and diverse element of the pantropical melittofauna, and have significant cultural and economic importance. This review outlines their diversity, and provides identification keys based on external morphology, brief accounts for each of the recognized genera, and an updated checklist of all living and fossil species. In total there are currently 605 described extant species in 45 extant genera, and a further 18 extinct species in nine genera, seven of which are extinct. A new fossil genus, Adactylurina Engel, gen. nov. , is also described for a species in Miocene amber from Ethiopia. In addition to the systematic review, the biology of stingless bees is summarized with an emphasis on aspects related to their nesting biology and architecture.

Not until she was 16 did Stella Arnold learn the full truth about her father, how handsome, charming James turned out to be a cold-blooded, psychotic extortionist, racketeer and killer. Knowing now what her father was capable of, she decides to study psychology and the criminal mind, and to further her education in America. In the spring of 1962 she flies to Boston where, being beautiful, bright and fashionably English, she becomes someone of huge fascination and on every invitation list. Then comes an invitation one summer weekend to the home of the Kennedys. Stella quickly becomes part of the inner Kennedy circle as they party through the hot summer nights. Both brothers, JFK and Bobby, make their moves on her but she firmly, charmingly, repels them. Further south, on the Florida Keys, a killer is on the loose. The case, unsolved, begins to rock America, and with her specialist knowledge of psychopaths, Stella is co-opted by the police investigation and prepares to fly south ...

BackgroundAlmost 1/3 of incident pulmonary TB (PTB) cases in England start treatment >4 months after symptom onset.1 Leicester, a high incidence TB area (>40 cases/100,000 population) provides a centralised rapid access tuberculosis (RATB) pathway for suspected TB cases from primary and secondary care, facilitating urgent assessment. To expedite diagnosis, radiologists can assign urgent referral codes, such as the TB code, to streamline referrals to appropriate multidisciplinary teams.AimWe investigated the accuracy of radiology reports for diagnosing PTB and the impact of reporting codes and keywords on time to PTB notification in patients referred to the RATB service.MethodsWe assessed CXR reports of 1124 patients referred to the RATB service at University Hospitals of Leicester (Jan 2019–Dec 2023) for inclusion of TB or other urgent referral codes - lung cancer code (RAL), GPCTFU (GP CT follow-up), XRCCT (urgent CT follow-up) and TB keywords (TB*, tubercul*, mycobac*), and the intervals between CXR request, report and TB diagnosis.ResultsThere were 216 cases (19.2%) of PTB among the 1124 patients referred to RATB service. CXRs were performed promptly (median same-day), but median reporting times varied by requesting source - 2 days (A&E), 2 days (primary care), 6 days (inpatient), 11 days (outpatient) (p<0.001). Urgent codes or TB keywords were reported in 138 (63.9%) of the PTB cases. Interestingly, 22 PTB cases (10.2%) had reports containing TB keywords but no referral code assigned, and 41 cases (21.2%) had other abnormalities reported but no link to TB diagnosis was made. The diagnostic performance of different codes and TB keywords is noted in table 1. Inclusion of the RATB code or inclusion of TB keywords was associated with a significantly shorter median notification delay than non-coded cases (9 vs. 46.5 days (p<0.001)).Abstract M38 Table 1Effect of CXR coding and reporting of TB keywords on time to TB notification CXR CODING CATEGORIES IN PATIENT REFERRALS TO RATB Variable RATB coded RAL, GPCTFU or XRCCT urgent codes applied (RATB excluded) Non-urgent X-ray follow-up code (RATB and urgent codes excluded) Non-coded scans including TB keywords Non-coded scans with no TB keywords Number of CXRs in category (% total CXRs) 308(27.4) 103(9.2) 19(1.7) 79(7.0) 615(54.7) Number of PTB cases in the category (% of given category) 93(30.2) 23(22.3) 4(21.1) 22(27.8) 74(12.0) Sensitivity (%) [95% CI ] 43.1[36.4–49.9] 10.6[6.9–15.5] 1.9[0.5–4.7] 10.2[6.5–15.0] 34.3[28.0–41.0] Specificity (%) [95% CI ] 76.3[73.4–79.1] 91.2[89.2–93.0] 98.3[97.3–99.1] 93.7[91.9–95.2] 40.4[37.2–43.7] Median days from CXR report to PTB notification (IQR) 9(6–15) 29(11–45) 51.5(29–63) 10(5.5 – 24.5) 46.5(15–78) ConclusionAccurate reporting and inclusion of a TB code on CXR reports is a key driver of accelerated PTB diagnosis for RATB pathways. However, the code was applied to only a subset of cases, suggesting TB-related CXR changes lack specificity. These data provide a useful reference for evaluating AI-driven approaches to CXR reporting and coding for TB.Referencehttps://www.gov.uk/government/publications/tuberculosis-in-england-2023-report-data-up-to-end-of-2022/tb-treatment-and-outcomes-england-2022

In 1935 on the Florida Key of Matacumbe, thirteen-year-old Jake makes new friends during an idyllic summer, only to have everything change when a hurricane threatens the island.

People who are more avoidant of pathogens are more politically conservative, as are nations with greater parasite stress. In the current research, we test two prominent hypotheses that have been proposed as explanations for these relationships. The first, which is an intragroup account, holds that these relationships between pathogens and politics are based on motivations to adhere to local norms, which are sometimes shaped by cultural evolution to have pathogen-neutralizing properties. The second, which is an intergroup account, holds that these same relationships are based on motivations to avoid contact with outgroups, who might pose greater infectious disease threats than ingroup members. Results from a study surveying 11,501 participants across 30 nations are more consistent with the intragroup account than with the intergroup account. National parasite stress relates to traditionalism (an aspect of conservatism especially related to adherence to group norms) but not to social dominance orientation (SDO; an aspect of conservatism especially related to endorsements of intergroup barriers and negativity toward ethnic and racial outgroups). Further, individual differences in pathogen-avoidance motives (i.e., disgust sensitivity) relate more strongly to traditionalism than to SDO within the 30 nations.