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PPS

The Prospective Payment System (PPS) is a fixed-price reimbursement framework established by the U.S. () in 1983 to pay hospitals for inpatient services based on diagnosis-related groups (DRGs), shifting from retrospective cost-based reimbursements to prospectively set rates intended to incentivize efficiency and contain expenditures. Designed primarily to address rapid Medicare cost inflation exceeding 15% annually in the late , PPS grouped cases into over 400 DRGs, with payments adjusted for factors like hospital wage indices and teaching status, but excluding outlier cases to mitigate extreme financial risks. While empirical analyses confirm PPS achieved its core goal of decelerating inpatient spending growth—reducing Medicare's per-diem costs by promoting shorter lengths of stay and operational efficiencies without broad evidence of widespread mortality increases—critics have highlighted causal risks of "DRG creep" (upcoding diagnoses for higher payments) and incentives for cost-shifting to non-Medicare s or premature discharges, potentially compromising care quality in under-resourced facilities. Subsequent refinements, including expansions to outpatient, skilled nursing, and home health sectors, have sustained cost controls amid ongoing debates over whether bundled payments truly align with causal determinants of health outcomes or merely mask systemic inefficiencies in volume-driven care models.

In correspondence

Post-postscript

A post-postscript, abbreviated as PPS or P.P.S., refers to an additional notation appended after an initial postscript (P.S.) in a letter or document, originating from the Latin post postscriptum, meaning "after what has been written after." This convention allows for the inclusion of further supplementary information without altering the preceding content. In historical formal , particularly prior to widespread digital editing tools, PPS provided a practical means to convey secondary afterthoughts, avoiding the labor of recopying the entire missive or first . It emerged as a logical extension of the P.S., which itself addressed overlooked points post-signature, reflecting the constraints of manual writing and transcription processes. Contemporary usage persists in digital formats like emails and memos, where PPS functions as a low-formality for final clarifications or reiterations, though it appears less commonly than P.S. due to easier inline revisions. Its persistence underscores a stylistic preference for sequential emphasis on ancillary details.

In politics and government

Parliamentary Private Secretary

A (PPS) is a backbench selected to serve as an unpaid aide to a in the and comparable systems across nations. The position functions primarily as the minister's liaison with parliamentary colleagues, conveying departmental perspectives to backbenchers and relaying grassroots concerns to the . PPSs undertake administrative tasks such as organizing ministerial schedules, supporting constituency engagements, and defending policies in informal debates, but they hold no authority, salary premium, or right to speak officially for the department. This arrangement ensures ministers receive unfiltered parliamentary intelligence while preserving separation from formal policymaking. The role traces its informal origins to the early 18th century, with possible precedents under in the 1730s, though systematic appointments emerged in the amid expanding ministerial workloads. By the , PPSs became integral to operations, numbering around 40-50 per government as of recent administrations, often assigned to senior ministers including the . Proximity to power has enabled subtle influence, as evidenced by former PPSs like , who leveraged the experience to advance to higher offices, demonstrating the position's value as a conduit for refinement through backbench feedback. Critics argue the role fosters , with ministers appointing loyalists—typically from their —who must align votes with the , potentially eroding backbench and enabling undue informal sway over ministerial decisions. A highlighted risks to parliamentary , suggesting PPSs prioritize cohesion over constituent . Counterarguments emphasize tangible benefits in governance efficiency, such as streamlined communication during high-stakes periods; for instance, PPSs aided ministerial overload management in post-1945 Labour governments implementing reforms, where their liaison duties accelerated legislative alignment without documented . Empirical patterns show most PPS tenures (averaging 1-2 years) yield career progression for capable holders while maintaining ministerial autonomy, underscoring causal utility in resource-constrained s over systemic favoritism.

Polish Socialist Party

The Polish Socialist Party (PPS), known in Polish as Polska Partia Socjalistyczna, was established on , 1892, in by Polish socialist exiles, including figures like Ignacy Daszyński and Bolesław Limanowski, as a Marxist-influenced organization advocating workers' rights and national independence from Russian, Prussian, and Austrian partitions. Operating illegally in Russian-controlled , it organized strikes, underground education, and , drawing on proletarian mobilization to challenge imperial rule, though its early activities yielded limited immediate gains amid severe repression, including mass arrests following the 1905 Revolution. In 1906, the PPS fractured at its ninth congress into the revolutionary PPS-Revolutionary Faction (also called the Old Faction, led by ) and the more orthodox Marxist PPS-Left (Young Faction), primarily over tactics: the former prioritized armed struggle against Tsarist authorities via the Combat Organization, which executed over 1,000 attacks, including assassinations of officials and bombings from 1904 to 1908, aiming to provoke reprisals that would radicalize Poles toward . These operations, while contributing to the erosion of control—exemplified by disruptions during the 1905-1907 Revolution—also involved internal purges, such as the 1906 liquidation of suspected spies within the party, resulting in civilian casualties and heightened counter-terrorism that temporarily crippled the movement, with Piłsudski himself imprisoned until 1910. The PPS-Revolutionary Faction's militancy directly informed Piłsudski's later formation of Polish Legions in , which fought alongside and played a causal role in Poland's 1918 restoration by demonstrating military viability and pressuring exhausted empires, though the violence's net effect included alienating moderates and sustaining cycles of rather than broad societal transformation. During the interwar (1918-1939), the unified PPS emerged as a major force, securing parliamentary seats—peaking at 40 in 1928—and pushing legislation for an eight-hour workday, , and union rights through alliances with agrarian groups, though economic data shows these reforms correlated with modest wage growth ( rose ~20% from 1928-1937) amid persistent rural poverty and industrial strikes exceeding 1 million participants annually by . Piłsudski's 1926 coup marginalized the party, associating it with opposition to his regime, yet it maintained influence in urban centers like and via the Polish Trade Unions Association. In , PPS activists formed the underground PPS-WRN (Freedom, Equality, Independence), integrating into the Polish Home Army with sabotage operations against Nazis, including intelligence relays to Allies, but suffering heavy losses—estimated at 10-15% of pre-war membership executed or deported—without altering occupation dynamics decisively. Post-1945, under Soviet-imposed communism, the PPS faced absorption into the (PZPR) via a 1948 merger, where its 500,000 members were outnumbered by communists, enabling Stalinist consolidation: independent socialists were purged through show trials (e.g., executions of leaders like Mieczysław Niedziałkowski's successors), and suppressed amid land collectivization that reduced agricultural output by 20-30% in the early . This alignment, driven by PPS-Left influences and coercion, facilitated one-party rule until 1989, contrasting the party's pre-war anti-Bolshevism and yielding empirical failures like chronic shortages and repression documented in declassified archives. Revived in 1990 as a democratic socialist entity, the PPS has since polled under 2% in national elections (e.g., 1.1% in 2019 vote), marginalized by market reforms' success—GDP per capita tripling from 1990-2020—and voter rejection of state-socialist legacies, positioning it as a for expansion without significant policy impact. Critics attribute its decline to unresolved tensions between nationalist roots and ideological rigidity, where early terrorism's short-term disruptions aided independence but long-term fostered factionalism, and post-war compromises entrenched over adaptive .

Party of Progress and Socialism

The Party of Progress and Socialism (PPS; Arabic: حزب التقدم والاشتراكية, ḥizb at-taqaddum wa-ash-shiyākīyah; French: Parti du Progrès et du Socialisme) is a left-wing political party in Morocco with roots in the Moroccan Communist Party, which was established in 1943 and banned in 1952 following independence. The PPS was founded on August 23, 1974, under the leadership of Ali Yata as a legal reconstitution of communist and progressive factions, adopting a platform of socialism, secularism, and nationalism while retaining Marxist ideological foundations. It has participated in opposition alliances and governing coalitions, such as the 1998 "alternance" government led by the Socialist Union of Popular Forces (USFP), where it held ministerial positions focused on social issues. Historically, the PPS critiqued the Moroccan monarchy's authority during the and , aligning with broader leftist movements amid periods of political detention and exile for its leaders, though it moderated its stance over time to engage in parliamentary politics. Following the 2011 Arab Spring protests and subsequent constitutional , which expanded parliamentary powers modestly while preserving monarchical dominance, the PPS endorsed the reforms but operated primarily in opposition to the Islamist Justice and Development Party (PJD)-led coalitions formed after the November 2011 elections, securing limited seats (18 out of 395 in the ). By 2021, under a new excluding the PJD, the PPS joined the government, taking roles in agriculture and amid efforts to stabilize post-pandemic recovery. The party's platform advocates state-led , expansion of social welfare programs, and labor protections, including pushes for adjustments and union rights during its governmental tenures, such as in the late 1990s when it contributed to initial steps toward social security enhancements. However, empirical outcomes under mixed governments involving PPS influence show constrained progress: 's annual GDP growth averaged 2.5-3.5% from 1998-2011, below regional peers like at times, coinciding with persistent state controls that delayed dynamism. rates declined from approximately 15% in 2007 to 6% by 2014 per surveys, but reductions stalled amid uneven implementation, with rural areas lagging and vulnerability affecting over 20% of the population by 2020. scandals implicating public officials, including in social spending sectors, have undermined such initiatives, with systemic graft estimated to erode 7% of GDP annually, though not uniquely tied to PPS governance. These patterns reflect causal limits of interventionist policies in a monarchy-centric system, where royal oversight often prioritizes stability over radical redistribution.

In education

Portland Public Schools

Portland Public Schools (PPS) is Oregon's largest , founded in 1851 as the state's first system and serving over 40,000 students across more than 80 schools from pre-kindergarten through grade 12 in the city of . The district operates as an urban PK-12 system funded primarily through the Oregon State School Fund and local property taxes, including a voter-approved local option at $1.99 per $1,000 of assessed value renewed in 2024 to support operations and programs. Enrollment has trended downward for over a decade, dropping from peaks near 80,000 students in the mid-1960s due to demographic shifts, lower birth rates, and increasing parental choice for charter or private alternatives, with recent capture rates at 69% for high schools and 75% for elementary schools. In the 1970s, PPS implemented desegregation measures including one-way busing of Black students from inner-city neighborhoods to predominantly white schools on the city's east side, following community activism and federal pressures to address de facto segregation, though these policies drew criticism for isolating minority students in unfamiliar environments without reciprocal integration or sufficient support staff representation. Recent initiatives have emphasized STEM education integration and recovery from pandemic-related learning losses, with small gains in grades 3-8 proficiency on state assessments—1.5 percentage points in English language arts and 2 points in math—but overall scores remain below 2018-2019 pre-pandemic levels, where statewide proficiency hovered around 44% across subjects. The district's four-year cohort graduation rate stood at 84% for the class of 2024, a slight decline from 84.5% the prior year and trailing the state average of 81.8%, with subgroup disparities evident in lower rates for underserved populations. Achievement gaps persist, particularly between white students and students of color, as shown in fall 2024 testing data mirroring prior years' patterns of lower proficiency in reading and math for , , and Native American subgroups, amid broader state figures where only 42.4% of elementary and middle schoolers met standards in core subjects. Funding challenges have intensified, with a projected $40 million shortfall for the 2025-26 school year driven by stagnant state allocations, enrollment drops reducing per-pupil revenue, and rising personnel and operational costs, necessitating cuts despite a $2 billion overall budget approval in May 2025. Discipline policies have faced scrutiny for incorporating race as a primary criterion in decisions, favoring approaches over suspensions, which critics argue exacerbates classroom disruptions and unequal treatment, as evidenced by disproportionate exclusion rates by ethnicity in 2021-22 data where small cohorts showed variability but overall patterns raised equity concerns.

In business and finance

Prospective Payment System

The (PPS) is a reimbursement methodology adopted by the U.S. program to pay healthcare providers fixed rates in advance for specified services, primarily to incentivize efficiency and contain escalating costs. For inpatient hospital services, Prospective Payment System (IPPS) was implemented on October 1, 1983, under the Social Security Amendments, replacing retrospective cost-based s with payments bundled by Diagnosis-Related Groups (DRGs), which classify patient cases based on diagnosis, procedures, age, sex, and comorbidities. This shift aimed to curb 's rapid inpatient spending growth, which had averaged over 15% annually in the late 1970s, by transferring financial risk to providers who could retain savings from shorter stays or efficient care but faced losses from overruns. The IPPS model expanded beyond hospitals to other Medicare-covered services, influencing subsequent prospective systems for skilled nursing facilities (implemented 1998), home health agencies (2000), outpatient departments, and long-term care hospitals, each adapting DRG-like bundling to provider-specific metrics. Empirical data indicate IPPS achieved initial cost controls, with inpatient expenditures per case stabilizing post-1983 after prior double-digit inflation, and average hospital lengths of stay declining by approximately 25% in the first few years through operational efficiencies like reduced ancillary services. However, these savings—estimated in billions over decades relative to pre-PPS trends—came with trade-offs, as fixed payments encouraged "quicker and sicker" discharges, where patients were released earlier but in poorer condition, correlating with elevated post-discharge impairment and potential shifts in costs to other payers or uncompensated care. Critics argue PPS distorted care incentives, prioritizing volume control over comprehensive treatment and contributing to higher readmission rates, with early evidence showing upticks in Medicare patients returning within 30 days due to inadequate stabilization. To mitigate such quality concerns, reforms like the Hospital Readmissions Reduction Program (HRRP), enacted under the 2010 Affordable Care Act and effective October 1, 2012, imposed payment reductions—up to 3% of base IPPS amounts—on hospitals exceeding risk-adjusted 30-day readmission benchmarks for conditions like heart failure, pneumonia, and acute myocardial infarction. HRRP has linked to modest readmission declines (about 0.5-1% nationally) and Medicare savings exceeding $2 billion by 2018, though penalties totaling nearly $1.9 billion by 2017 disproportionately affected safety-net hospitals serving complex, low-income populations, raising equity issues without fully resolving underlying discharge planning gaps. Overall, while PPS demonstrably restrained per-case inflation, causal analyses suggest persistent challenges in balancing fiscal discipline with sustained patient outcomes, as evidenced by ongoing adjustments in payment weights and quality metrics.

In manufacturing

Production Planning and Control System

A Production Planning and Control System (PPCS) is an integrated set of processes and software tools designed to optimize manufacturing operations by coordinating scheduling, , , and execution in environments. It evolved from early methods like systems in the mid-20th century, advancing significantly with the introduction of (MRP) in the 1960s and 1970s, which automated bill-of-materials explosion and dependent demand calculations using mainframe computers. By the 1980s, MRP expanded into (MRP II), incorporating closed-loop feedback for and control, addressing limitations in earlier systems by integrating financial and operational data. This progression enabled real-time adjustments to production variables, though traditional implementations relied on hierarchical databases that could constrain flexibility in dynamic settings. Core functionalities of PPCS include based on master production schedules, capacity requirements planning to balance workloads across machines and labor, and to minimize stockouts or excess holding costs through techniques like models. These features facilitate routing optimization and progress monitoring, often leveraging (ERP) modules for data integration. Empirical studies demonstrate benefits such as reduced manufacturing lead times through synchronized process sequencing, with case analyses showing improvements via elimination of non-value-adding delays in multi-stage production. In practice, PPCS implementation has lowered operational waste and enhanced on-time delivery rates by aligning material flows with production rhythms, particularly in sectors requiring precise sequencing. In the , PPCS has proven effective when hybridized with Just-In-Time () principles, where MRP-driven planning feeds into pull-based sequencing to support mixed-model assembly lines and sequenced supplier deliveries. This , as seen in ERP-supported JIT environments, reduces buffers while maintaining throughput, enabling responsiveness to fluctuating orders without excess capacity idling. However, challenges persist, including high upfront implementation costs for software customization and , often exceeding initial projections due to complexities with systems. Traditional PPCS can exhibit rigidity in volatile markets, struggling with frequent disruptions like variability or short demands, as fixed routings and static assumptions limit adaptability without advanced tools. Despite these drawbacks, successes in stable, high-volume settings underscore causal links between disciplined planning and efficiency gains, provided empirical validation through pilot testing precedes full rollout.

In aviation

Precision Positioning Service

The Precision Positioning Service (PPS) is a component of the U.S. (GPS) that delivers highly accurate positioning, velocity, and timing data to authorized users, predominantly the , via encrypted signals on both L1 (1575.42 MHz) and (1227.60 MHz) carrier frequencies. Unlike the Standard Positioning Service (), which relies on the coarser C/A-code for civilian access, PPS employs the longer Precision (P(Y)) code—encrypted since modernization efforts—for superior , anti-jamming resistance, and ionospheric error correction through dual-frequency processing. This enables typical horizontal positioning accuracies of approximately 1 meter or better under nominal conditions, compared to SPS's 3-5 meters without augmentations. PPS originated as part of GPS's foundational design in the 1970s, but its full potential was obscured for civilians by , a deliberate error introduced in 1990 to limit accuracy to around 100 meters; was discontinued on May 2, 2000, by presidential directive, aligning closer to PPS levels while preserving PPS's security features. Formal performance standards for PPS were first publicly detailed in February 2007, specifying signal-in-space user range error (SIS URE) of 0.82 meters (95% probability), supporting sub-meter navigation in operational scenarios. Subsequent GPS modernization, including the rollout of the military M-code signal starting with Block III satellites in 2018, further bolsters PPS with enhanced anti-spoofing and power levels for contested environments. In aviation, PPS facilitates precision navigation for U.S. military aircraft and unmanned aerial vehicles (UAVs), enabling instrument approaches, autonomous drone operations, and low-visibility landings with centimeter-level accuracy when integrated with inertial systems or ground aids. For instance, it underpins systems like the Joint Precision Approach and Landing System (JPALS), deployed since the early 2000s for carrier-based operations, where sub-meter errors are critical for safe recovery in adverse conditions. Following the September 11, 2001, attacks, PPS's secure signals gained emphasis in aviation security protocols, supporting resilient positioning amid heightened threats to air traffic control and military flights, though civilian aviation relies primarily on SPS augmented by Wide Area Augmentation System (WAAS) for similar precision without encryption access. PPS offers distinct advantages over in , including mandatory dual-frequency operation for real-time ionospheric compensation—reducing errors to centimeters in post-processed modes—and robust against denial-of-service attacks, vital for operations in electronically contested airspace. However, its U.S.-controlled nature raises concerns over systemic dependencies, as disruptions or could impair reliant on GPS derivatives, with historical vulnerabilities demonstrated in military exercises. Export restrictions under (ITAR) further limit PPS-equipped receivers to approved allies, constraining broader adoption and prompting critiques of over-centralization in navigation infrastructure.

In military technology

PPS submachine gun

The was developed by Soviet designer Alexei Sudayev in 1942 during the siege of Leningrad as a lightweight, low-cost for infantry and partisans, chambered in the cartridge. The initial PPS-42 variant prioritized stamped sheet metal fabrication over machined parts to accelerate production under resource constraints, using roughly half the raw materials and one-third the machine time compared to the earlier PPSh-41. Approximately 46,000 PPS-42 units were manufactured at Factory 209 in 1943 before refinements led to the PPS-43, of which over one million were produced across Soviet factories by May 1945, enabling widespread issuance amid the Nazi invasion. The PPS-43 featured blowback operation with an , a 35-round curved box magazine, folding metal stock, and a cyclic rate of 600-900 rounds per minute, weighing about 3 kg unloaded for maneuverability in and . Its design emphasized simplicity—requiring just 2.7 man-hours and 6.2 kg of material per unit—facilitating equivalence to German MP40 output but at lower cost and with fewer skilled laborers, as stamped construction avoided complex milling. was limited to 100-200 meters due to the pistol cartridge's , suiting close-quarters suppression but hindering precision beyond that, which aligned with Soviet doctrinal reliance on volume fire in massed assaults rather than individual marksmanship. In combat, the PPS equipped frontline troops and partisans during 1943-1945 offensives, providing automatic fire advantages in like Stalingrad's aftermath and , where its compactness aided house-to-house tactics. Reliability stemmed from rugged, minimalistic internals tolerant of dirt and cold—outperforming the MP40, which jammed more readily in —though prolonged exposure to heavy fouling could affect any open-bolt SMG without maintenance. Criticisms included vulnerability to accuracy degradation in sustained bursts and unsuitability for open terrain, reflecting broader Soviet prioritization of quantity in human-wave operations over weapon sophistication. Postwar, surplus PPS stocks proliferated through Soviet aid to allies, with examples captured from Chinese units during the (1950-1953) and employed by North Vietnamese and forces in the (1955-1975), often alongside local copies like the Chinese Type 53. This dissemination supported proxy conflicts but highlighted the design's obsolescence against emerging assault rifles, as its pistol round lacked penetration against modern or vehicles. Finnish forces adapted captured PPS-43s as the M44 variant for their needs, underscoring its influence on wartime expedient manufacturing.

In science and technology

Packets per second

Packets per second (PPS) measures the rate at which a , such as a router, switch, or , can process, forward, or inspect packets, typically expressed in packets per second or millions of packets per second (Mpps). This metric evaluates the packet-handling capacity of and software, independent of packet size or content, and is essential for assessing performance under varying traffic conditions. Unlike , which quantifies volume in bits per second (bps), PPS focuses on the of discrete packet events, where smaller packets can generate higher PPS demands even at lower overall throughput. In , for example, the theoretical maximum PPS for minimum-sized 64-byte frames (including Ethernet headers but excluding interframe gaps and preamble) is approximately 1.488 Mpps, calculated as 1,000,000,000 bps divided by the effective on-wire bits per packet (roughly 672 bits accounting for overhead). This limit arises because processing each packet incurs fixed costs like header inspection and forwarding decisions, making PPS a key constraint for devices handling fragmented or short-packet traffic, such as in VoIP or scenarios. Exceeding this capacity can lead to packet drops, increased latency, or device overload, particularly in stateful inspections where connection tracking scales with packet volume rather than bytes. PPS benchmarking is crucial for evaluating equipment resilience against distributed denial-of-service (DDoS) attacks, especially protocol-layer floods measured in PPS rather than Gbps, as these exploit packet-processing exhaustion over volume. Notable examples include a 2020 attack peaking at 809 Mpps mitigated by Akamai, targeting routers and firewalls with amplified packet rates from reflection protocols like DNS or NTP. In load testing, high PPS simulates real-world bursts from applications with frequent small packets, revealing bottlenecks in CPU-bound forwarding paths. Tools like Pktgen, a kernel-based packet generator, enable precise PPS stress tests by producing customizable traffic streams up to line rates on high-speed interfaces, while iPerf primarily assesses throughput but can indirectly inform PPS via mode with small payloads. Advancements in networks and amplify PPS requirements due to the proliferation of low-latency, real-time applications like autonomous vehicles and industrial automation, which generate bursts of small, frequent packets from massive device endpoints. Insufficient PPS handling in these environments can degrade by introducing or drops, necessitating hardware with multi-Gpps forwarding rates and optimized software for efficient packet parsing.

Polyphenylene sulfide

Polyphenylene sulfide (PPS) is a high-performance characterized by its repeating -[C6H4-S]- units, forming a linear chain that imparts exceptional thermal stability and rigidity. First synthesized in low molecular weight form in by Friedel and Crafts, commercial-scale production became viable through a polycondensation process developed by chemists Edmonds and Hill at , patented in 1967 and commercialized under the Ryton brand in 1972. This advancement enabled PPS to serve as a semicrystalline material suitable for injection molding, , and , distinguishing it from earlier, less processable variants. PPS exhibits a melting point of approximately 280°C and continuous use temperatures up to 240°C, maintaining mechanical integrity under prolonged exposure to heat without significant degradation. Its chemical inertness resists attack from acids, bases, solvents, and fuels even at elevated temperatures, while inherent flame retardancy achieves V-0 ratings without additives. Mechanically, unfilled PPS offers tensile strength around 60-80 and low water absorption (less than 0.05%), ensuring dimensional stability in humid or environments. The primary synthesis route involves polycondensation of p-dichlorobenzene with in a polar solvent like N-methylpyrrolidone at temperatures exceeding 250°C, yielding high molecular weight after purification and . Commercial production often incorporates fillers such as fibers (up to 40% by weight) or minerals to enhance and reduce warpage, as pure PPS exhibits high melt viscosity requiring specialized processing equipment. Global output has expanded, with the market valued at roughly USD 1.8 billion in 2023 and projected to reach USD 3.2 billion by 2032 at a 6.6% CAGR, driven by demand in and lightweighting trends. In automotive applications, PPS compounds form seals, pump impellers, fuel system components, and electrical connectors, leveraging resistance to oils, coolants, and temperatures up to 200°C under the hood. Electronics utilize PPS for insulators, coil bobbins, and surface-mount device housings due to its low dielectric constant (around 3.0) and high insulation resistance. Compared to polyether ether ketone (PEEK), PPS provides similar chemical resistance and lower cost (typically 30-50% less per kg), but inferior continuous service temperature (260°C for PEEK) and impact toughness, with notched Izod values of 0.4-1.5 ft-lb/in versus PEEK's 1.5-2.2 ft-lb/in. These trade-offs position PPS as a cost-effective choice for demanding yet non-extreme conditions, though its processing demands high shear rates and precise control to mitigate defects like flash or voids.

Post-polio syndrome

Post-polio syndrome (PPS) refers to the emergence of new neuromuscular symptoms, including muscle weakness, fatigue, and atrophy, in individuals who previously recovered from acute paralytic poliomyelitis, typically occurring 15 to 40 years after the initial infection following a period of functional stability. This condition affects an estimated 25 to 50 percent of polio survivors, though prevalence estimates vary up to 74 percent based on self-reported late-onset symptoms in cohort studies. PPS is not a recurrence of the poliovirus but arises from the progressive failure of surviving motor neurons that had compensated for earlier neuronal loss during the acute phase. Common symptoms include progressive and fatigability, often in previously affected limbs but sometimes in unaffected areas, alongside generalized , joint and (), sleep disturbances, cold intolerance, , and respiratory difficulties in severe cases. These manifestations can lead to decreased physical , with longitudinal studies documenting average declines of 6 percent in walking capacity and 14 percent in self-reported over 10 years among affected individuals. Symptoms typically worsen gradually, influenced by factors such as greater initial from and comorbidities like aging or overuse of compensatory muscles. The involves chronic and reinnervation processes initiated by poliovirus-induced destruction of anterior horn cells, followed by of remaining axons to maintain function; over decades, this leads to exhaustion and dropout, exacerbated by normal aging-related neuronal attrition. Empirical evidence from and muscle studies supports this mechanism, showing enlarged s vulnerable to attrition rather than or immune-mediated damage. PPS is distinct from dysimmune conditions, as cerebrospinal fluid analyses and immunological markers do not indicate active . Diagnosis relies on clinical criteria: a history of confirmed paralytic , a stable recovery phase of at least 15 years, and new symptoms not attributable to other disorders, confirmed via exclusion of comorbidities through , imaging, and electrophysiological tests. No specific exists, but longitudinal monitoring distinguishes PPS progression from expected age-related decline, with studies refuting claims of over-diagnosis by demonstrating verifiable neuromuscular deterioration over 5 to 10 years. There is no curative for PPS; management focuses on symptom palliation and functional preservation through techniques, such as paced activity and assistive devices like or ventilatory support for respiratory involvement. emphasizing non-fatiguing exercises and pharmacological interventions for pain (e.g., analgesics or antidepressants) provide modest relief, while avoiding strenuous rehabilitation prevents exacerbation. involves slow progression, with most individuals maintaining independence but requiring adaptive strategies; global polio campaigns have drastically reduced new cases of initial poliomyelitis—and thus potential PPS—by eradicating wild in all but two countries as of 2023.

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