Hepatocellular Carcinoma Screening With Computed Tomography Using the Arterial Enhancement Fraction With Radiologic-Pathologic Correlation.

OBJECTIVE The aim of this study was to investigate the performance of the arterial enhancement fraction (AEF) in multiphasic computed tomography (CT) acquisitions to detect hepatocellular carcinoma (HCC) in liver transplant recipients in correlation with the pathologic analysis of the corresponding liver explants. MATERIALS AND METHODS Fifty-five transplant recipients were analyzed: 35 patients with 108 histologically proven HCC lesions and 20 patients with end-stage liver disease without HCC. Six radiologists looked at the triphasic CT acquisitions with the AEF maps in a first readout. For the second readout without the AEF maps, 3 radiologists analyzed triphasic CT acquisitions (group 1), whereas the other 3 readers had 4 contrast acquisitions available (group 2). A jackknife free-response reader receiver operating characteristic analysis was used to compare the readout performance of the readers. Receiver operating characteristic analysis was used to determine the optimal cutoff value of the AEF. RESULTS The figure of merit (θ = 0.6935) for the conventional triphasic readout was significantly inferior compared with the triphasic readout with additional use of the AEF (θ = 0.7478, P < 0.0001) in group 1. There was no significant difference between the fourphasic conventional readout (θ = 0.7569) and the triphasic readout (θ = 0.7615, P = 0.7541) with the AEF in group 2. Without the AEF, HCC lesions were detected with a sensitivity of 30.7% (95% confidence interval [CI], 25.5%-36.4%) and a specificity of 97.1% (96.0%-98.0%) by group 1 looking at 3 CT acquisition phases and with a sensitivity of 42.1% (36.2%-48.1%) and a specificity of 97.5% (96.4%-98.3%) in group 2 looking at 4 CT acquisition phases. Using the AEF maps, both groups looking at the same 3 acquisition phases, the sensitivity was 47.7% (95% CI, 41.9%-53.5%) with a specificity of 97.4% (96.4%-98.3%) in group 1 and 49.8% (95% CI, 43.9%-55.8%)/97.6% (96.6%-98.4%) in group 2. The optimal cutoff for the AEF was 50%. CONCLUSION The AEF is a helpful tool to screen for HCC with CT. The use of the AEF maps may significantly improve HCC detection, which allows omitting the fourth CT acquisition phase and thus making a 25% reduction of radiation dose possible.

Perception of co-speech gestures in aphasic patients: A visual exploration study during the observation of dyadic conversations

Background: Co-speech gestures are part of nonverbal communication during conversations. They either support the verbal message or provide the interlocutor with additional information. Furthermore, they prompt as nonverbal cues the cooperative process of turn taking. In the present study, we investigated the influence of co-speech gestures on the perception of dyadic dialogue in aphasic patients. In particular, we analysed the impact of co-speech gestures on gaze direction (towards speaker or listener) and fixation of body parts. We hypothesized that aphasic patients, who are restricted in verbal comprehension, adapt their visual exploration strategies. Methods: Sixteen aphasic patients and 23 healthy control subjects participated in the study. Visual exploration behaviour was measured by means of a contact-free infrared eye-tracker while subjects were watching videos depicting spontaneous dialogues between two individuals. Cumulative fixation duration and mean fixation duration were calculated for the factors co-speech gesture (present and absent), gaze direction (to the speaker or to the listener), and region of interest (ROI), including hands, face, and body. Results: Both aphasic patients and healthy controls mainly fixated the speaker’s face. We found a significant co-speech gesture x ROI interaction, indicating that the presence of a co-speech gesture encouraged subjects to look at the speaker. Further, there was a significant gaze direction x ROI x group interaction revealing that aphasic patients showed reduced cumulative fixation duration on the speaker’s face compared to healthy controls. Conclusion: Co-speech gestures guide the observer’s attention towards the speaker, the source of semantic input. It is discussed whether an underlying semantic processing deficit or a deficit to integrate audio-visual information may cause aphasic patients to explore less the speaker’s face. Keywords: Gestures, visual exploration, dialogue, aphasia, apraxia, eye movements

Penalty Enhancement for Hate Crimes: An Economic Analysis

The issue of bias-motivated crimes has attracted consderable attention in recent years. In this paper, we develop an economic framework to analyze penalty enhancements for bias-motivated crimes. We extend the standard model by introducing two different groups of potential victims of crime, and assume that a potential offender's benefits from a crime depend on the group to which the victim belongs. We begin with the assumption that the harm to an individual victim from a bias-motivated crime is identical to that from an equivalent non-hate crime. Nonetheless, we derive the result that a pattern of crimes disproportionately targeting an identifiable group leads to greater social harm. This conclusion follows both from a model where disparities in groups' victimization probabilities lead to social losses due to fairness concerns, as well as a model where potential victims have the opportunity to undertake socially costly victimization avoidance activities. In particular, penalty enhancements can reduce the incentives for avoidance activity, and thereby protect the networks of profitable interactions that link members of different groups. We also argue that those groups that are covered by hate crime statutes tend to be those whose characteristics make it especially likely that penalty enhancement is socially optimal. Finally, we consider a number of other issues related to hate crimes, including teh choice of sanctions from behind a Rawlsian 'veil of ignorance' concerning group identity.

A Dynamic Analysis: the Smile and Display of Dentition during Speech

The objective of this retrospective study is to follow up on a previous Dynamic Smile Analysis and videographically analyze and develop averages for soft tissue norms with respect to the display of dentition during speech. These values would then be compared cross-sectionally across different age groups to see whether changes attributable to the aging process could be seen. A secondary objective was to compare averages for soft tissue norms in the display of dentition during speech to averages for soft tissue norms in the display of dentition during the smile. Materials and Method: Records from a previous study in which video equipment was used to capture video for 26 1 subjects were re-evaluated to find appropriate frames to analyze for speech. Two frames for each subject were selected; one frame representing the maximal display of maxillary incisors during speech and the second representing the widest transverse display of dentition during speech. After excluding 40 subjects the data for the remaining 221 subjects was analyzed. These averages were then compared to averages attained in the previous study to compare the display of the dentition during speech to the display of the dentition during smile. Results: On average, a difference in 1.29 mm was seen in the display of the maxillary incisors during speech at maximal display and during the smile. An average of 7.23 mm of maxillary incisors is readily visible during maximum display of maxillary incisors during speech, as compared to 8.52 mm during the smile. The constructed smile index was also smaller when measured during the speech when compared to the smile index by an average of 2.58 units. Conclusion: This study helps to establish age-related dynamic norms for the display of dentition during speech. The dynamic measures indicate that the display of dectition is greater, on average, during the smile than at speech.

Assessment of English Language Learners Seeking a Graduate Degree in Speech Language Pathology

A shortage of bilingual/bicultural speech language pathologists may reflect a problem with recruitment and retention of bilingual/bicultural students. The purpose of the present study was to survey graduate training programs in speech language pathology to determine typical policies and practices concerning students who apply and are admitted as ELLs. With a growing number of ELL children needing services from a bilingual SLP, it seems that little is being done to address the issue. The problem may be with the reluctance of programs to not only accept ELL students, but there also seems to be a disinclination for any sort of training program to be established for these ELL students. Clinic directors were asked to complete a survey about ELLs seeking clinical training in speech language pathology. In particular, we were interested in obtaining information about whether clinical training programs a) provided opportunities for ELL to participate in clinic, b) assessed the English skills of these students, and c) provided remediation if these students English skills were judged to be less than proficient.

Speech delivered in the Reichstag, May 21st., 1935 : approved translation

by Adolf Hitler

America's state health departments and the enhancement of health communication through podcasting

Perhaps it was foreshadowing the influence emerging technologies would have on health when the term "podcast" beat out "bird flu" for the 2005 word of the year, an honor given by The New Oxford American Dictionary. From medical school courses to medical journal summaries, podcasting has found a niche in the health field and with studies showing a high proportion of people using the Internet to seek health information, it is imperative that the online information be accurate and easily accessible. With the responsibility of health departments to reach out to their respective communities with effective health communication strategies, this study assessed the proportion of 50 states' and the District of Columbia's health departments utilizing podcasting as a tool for health communication. Additionally, to assess any trends, the prevalence of podcasting was compared to select state demographic characteristics (age, sex, and median income), the organization of the health department (freestanding or super-agency), and the respective United Health Foundation 2007 health ranking. ^ Prevalence data were collected from each state health department's website to find evidence of podcasting to any extent. If a podcast was present, characteristics including creator, release frequency, and transcript were further assessed. The study found that 51% (26/51) of all health departments were utilizing podcasts in some capacity and almost 20% (5/26) of these had created their own podcasts. The most common use of podcasting was to link to outside podcast resources, most notably, the Centers for Disease Control's podcast series. No significant associations were found between the state-specific variables and the podcasting outcomes; however, higher percentages of young adults in some states suggest potential podcasting opportunities for targeting these known podcast users with age-specific health messages. Another recommendation is a future assessment of local health departments' use of podcasting as their smaller, more defined target audiences may be a more efficient use of podcasting as a health communication tool. Additionally, there is a need for evaluations of podcasts' overall effectiveness as a health communication tool to (1) reach a target audience; and (2) convey a specific health message. In conclusion, the findings from this project illuminate the extent of podcast influence in states' and the District of Columbia's health departments as a health communication tool; however evaluations of effectiveness are imperative for future studies.^

Performance enhancement of large industrial wastewater stabilization ponds

A 6-month-long, bench-scale simulation of an industrial wastewater stabilization pond (WSP) system was conducted to evaluate responses to several potential performance-enhancing treatments. The industrial WSP system consists of an anaerobic primary (1ry) WSP treating high-strength wastewater, followed by facultative secondary (2ry) and aerobic tertiary (3ry) WSPs in series treating lower-strength wastewater. The 1ry WSP was simulated with four glass aquaria which were fed with wastewater from the actual WSP system. The treatments examined were phosphorus supplementation (PHOS), phosphorus supplementation with pH control (PHOS+ALK), and phosphorus supplementation with pH control and effluent recycle (PHOS+ALK+RCY). The supplementary phosphorus treatment alone did not yield any significant change versus the CONTROL 1ry model pond. The average carbon to phosphorus ratio of the feed wastewater received from the WSP system was already 100:0.019 (i.e., 2,100 mg/l: 0.4 mg/l). The pH-control treatments (PHOS+ALK and PHOS+ALK+RCY) produced significant results, with 9 to 12 percent more total organic carbon (TOC) removal, 43 percent more volatile organic acid (VOA) generation, 78 percent more 2-ethoxyethanol and 14 percent more bis(2-chloroethyl)ether removal, and from 100- to 10,000-fold increases in bacterial enzyme activity and heterotrophic bacterial numbers. Recycling a 10-percent portion of the effluent yielded less variability for certain physicochemical parameters in the PHOS+ALK+RCY 1ry model pond, but overall there was no statistically-detectable improvement in performance versus no recycle. The 2ry and 3ry WSPs were also simulated in the laboratory to monitor the effect and fate of increased phosphorus loadings, as might occur if supplemental phosphorus were added to the 1ry WSP. Noticeable increases in algal growth were observed at feed phosphorus concentrations of 0.5 mg/l; however, there were no significant changes in the monitored physicochemical parameters. The effluent phosphorus concentrations from both the 2ry and 3ry model ponds did increase notably when feed phosphorus concentrations were increased from 0.5 to 1.0 mg/l. ^

Communication and enhancement of Italian cultural heritage by Google

Tras liderar la investigación e indización de la información por cerca de una década, el motor de búsqueda Google se ha convertido en un sistema económico que influye nuestro mundo contemporáneo, contribuyendo grandemente a la transformación de nuestro mundo en un único globo virtual. En años recientes, Google ha comenzado a ofrecer a los usuarios globales aplicaciones o software que son usados para nuestra herencia cultural. Este software se resalta aquí en su potencial, desde un punto de vista económico, cultural y turístico. Tratamos de describir lo más importante del software de Google (como Google Maps, Google Street View, Google Earth, Google SketchUp, Google Books y Google Art Project), con el mayor y más evidente impacto en los sectores culturales y turísticos. Este ensayo muestra la digitalización y promoción de la herencia cultural italiana en Google, a través de sus programas informáticos (por ejemplo, Google Street View que ha llevado al uso de vistas tridimensionales remotas de algunos de los más importantes monumentos y sitios arqueológicos de Italia; el uso de Google SketchUp ha llevado al diseño de reconstrucción tridimensional del histórico centro de la ciudad de L'Aquila, devastada luego del terremoto de abril de 2009 y nunca reconstruida), y a través de diversos programas asociados específicos con el Ministerio Italiano de Cultura

Communication and enhancement of Italian cultural heritage by Google

Tras liderar la investigación e indización de la información por cerca de una década, el motor de búsqueda Google se ha convertido en un sistema económico que influye nuestro mundo contemporáneo, contribuyendo grandemente a la transformación de nuestro mundo en un único globo virtual. En años recientes, Google ha comenzado a ofrecer a los usuarios globales aplicaciones o software que son usados para nuestra herencia cultural. Este software se resalta aquí en su potencial, desde un punto de vista económico, cultural y turístico. Tratamos de describir lo más importante del software de Google (como Google Maps, Google Street View, Google Earth, Google SketchUp, Google Books y Google Art Project), con el mayor y más evidente impacto en los sectores culturales y turísticos. Este ensayo muestra la digitalización y promoción de la herencia cultural italiana en Google, a través de sus programas informáticos (por ejemplo, Google Street View que ha llevado al uso de vistas tridimensionales remotas de algunos de los más importantes monumentos y sitios arqueológicos de Italia; el uso de Google SketchUp ha llevado al diseño de reconstrucción tridimensional del histórico centro de la ciudad de L'Aquila, devastada luego del terremoto de abril de 2009 y nunca reconstruida), y a través de diversos programas asociados específicos con el Ministerio Italiano de Cultura

Communication and enhancement of Italian cultural heritage by Google

Tras liderar la investigación e indización de la información por cerca de una década, el motor de búsqueda Google se ha convertido en un sistema económico que influye nuestro mundo contemporáneo, contribuyendo grandemente a la transformación de nuestro mundo en un único globo virtual. En años recientes, Google ha comenzado a ofrecer a los usuarios globales aplicaciones o software que son usados para nuestra herencia cultural. Este software se resalta aquí en su potencial, desde un punto de vista económico, cultural y turístico. Tratamos de describir lo más importante del software de Google (como Google Maps, Google Street View, Google Earth, Google SketchUp, Google Books y Google Art Project), con el mayor y más evidente impacto en los sectores culturales y turísticos. Este ensayo muestra la digitalización y promoción de la herencia cultural italiana en Google, a través de sus programas informáticos (por ejemplo, Google Street View que ha llevado al uso de vistas tridimensionales remotas de algunos de los más importantes monumentos y sitios arqueológicos de Italia; el uso de Google SketchUp ha llevado al diseño de reconstrucción tridimensional del histórico centro de la ciudad de L'Aquila, devastada luego del terremoto de abril de 2009 y nunca reconstruida), y a través de diversos programas asociados específicos con el Ministerio Italiano de Cultura

Enhancement of photosynthetic carbon assimilation efficiency by phytoplankton in the future coastal ocean

A mesocosm experiment was conducted to evaluate the effects of future climate conditions on photosynthesis and productivity of coastal phytoplankton. Natural phytoplankton assemblages were incubated in field mesocosms under the ambient condition (present condition: ca. 400 ppmv CO2 and ambient temp.), and two future climate conditions (acidification condition: ca. 900 ppmv CO2 and ambient temp.; greenhouse condition: ca. 900 ppmv CO2 and 3 °C warmer than ambient). Photosynthetic parameters of steady-state light responses curves (LCs; measured by PAM fluorometer) and photosynthesis-irradiance curves (P-I curves; estimated by in situ incorporation of 14C) were compared to three conditions during the experiment period. Under acidification, electron transport efficiency (alpha LC) and photosynthetic 14C assimilation efficiency (alpha) were 10% higher than those of the present condition, but maximum rates of relative electron transport (rETRm,LC) and photosynthetic 14C assimilation (PBmax) were lower than the present condition by about 19% and 7%, respectively. In addition, rETRm,LC and alpha LC were not significantly different between and greenhouse conditions, but PBmax and alpha of greenhouse conditions were higher than those of the present condition by about 9% and 30%, respectively. In particular, the greenhouse condition has drastically higher PBmax and alpha than the present condition more than 60% during the post-bloom period. According to these results, two future ocean conditions have major positive effects on the photosynthesis in terms of energy utilization efficiency for organic carbon fixation through the inorganic carbon assimilation. Despite phytoplankton taking an advantage on photosynthesis, primary production of phytoplankton was not stimulated by future conditions. In particular, biomass of phytoplankton was depressed under both acidification and greenhouse conditions after the the pre-bloom period, and more research is required to suggest that some factors such as grazing activity could be important for regulating phytoplankton bloom in the future ocean.