American Diagnostic Radiology Moves Offshore: Is this Field Riding the Internet Wave into a Regulatory Abyss?

Recent trends in the American workplace are suggesting that outsourcing is becoming more commonplace, and currently no job or its work product may be safe from outsourcing. American blue-collar workers are certainly not surprised by these trends because they have experienced outsourcing related job losses since the early 1970s. Even those white-collar jobs traditionally considered immune to outsourcing pressures, such as those held by medical specialists, are now threatened. Most workers know outsourcing as a process whereby a domestic firm transfers some portion of their work product or a job to a different firm that resides either onshore in America or offshore in some foreign land. The transferring domestic firm contracts with one of these firms, intending to make that new firm its outside supplier. Although most transferring firms see outsourcing as a positive business experience, some work transfers have both intended and unintended consequences. Some transfers may produce a net loss of jobs within the affected sector. Others may create a downward pressure on wage earnings of the affected worker, especially in labor intensive areas, such as those in manufacturing. In still others, workers may even experience personal stresses, such as increased anxiety or fear that are related to their worries over impending or future job losses. These personal stressors may also place an additional burden on affected workers by compelling them to make fewer demands on their managers. Some workers may come to believe that issuing fewer demands will translate into a greater likelihood that they will keep their jobs. Unfortunately, their beliefs may be misguided

American Diagnostic Radiology Moves Offshore: Is this Field Riding the Internet Wave into a Regulatory Abyss?

Recent trends in the American workplace are suggesting that outsourcing is becoming more commonplace, and currently no job or its work product may be safe from outsourcing. American blue-collar workers are certainly not surprised by these trends because they have experienced outsourcing related job losses since the early 1970s. Even those white-collar jobs traditionally considered immune to outsourcing pressures, such as those held by medical specialists, are now threatened. Most workers know outsourcing as a process whereby a domestic firm transfers some portion of their work product or a job to a different firm that resides either onshore in America or offshore in some foreign land. The transferring domestic firm contracts with one of these firms, intending to make that new firm its outside supplier. Although most transferring firms see outsourcing as a positive business experience, some work transfers have both intended and unintended consequences. Some transfers may produce a net loss of jobs within the affected sector. Others may create a downward pressure on wage earnings of the affected worker, especially in labor intensive areas, such as those in manufacturing. In still others, workers may even experience personal stresses, such as increased anxiety or fear that are related to their worries over impending or future job losses. These personal stressors may also place an additional burden on affected workers by compelling them to make fewer demands on their managers. Some workers may come to believe that issuing fewer demands will translate into a greater likelihood that they will keep their jobs. Unfortunately, their beliefs may be misguided

“Just Scanning Around” with Diagnostic Medical Ultrasound: Should States Regulate the Non-Diagnostic Uses of this Technology?

Recent advances in medical imaging have provided physicians with more accurate diagnostic information, which has allowed them to tailor their therapies to reduce health care costs. These recent advances have caused the New England Journal of Medicine to hail diagnostic medical imaging as one of the greatest contributions to medicine in last thousand years. Yes, modern diagnostic imaging plays a major role in medicine, especially in the case of diagnostic imaging technology. One reason this technology has assumed such a prominent position worldwide is the usage of higher sound intensities by its manufacturers for better image quality. A recent survey shows diagnostic medical ultrasound is responsible for nearly one-quarter of all the worlds imaging studies. Unfortunately, all of their success has led some entrepreneurs to seek an economic advantage by offering consumers increased access to this relative inexpensive technology. Although the FDA classifies ultrasound systems as devices, which require physician involvement, some entrepreneurs have chosen to offer access to these systems and their services without involving physicians. Tom Cruise brought the issues related to the nondiagnostic uses of this technology to national attention when announced his purchase of one of these systems for home use. Because such practices may violate the prudent use of this technology, as intended by its manufacturers, state-based legislative efforts may be needed to protect consumers from abuse. This article identifies the current nondiagnostic services that may pose a potential health risks to consumers, and it explains the science underlying those risks. It also reviews the existing federal and state regulations, and shows why all stake holders have a vested interest increased legislation that mandate increased control of this technology

Kinetic stability of Chapman-Enskog plasmas

In this paper, we investigate the kinetic stability of classical, collisional plasma - that is, plasma in which the mean-free-path $\lambda$ of constituent particles is short compared to the length scale $L$ over which fields and bulk motions in the plasma vary macroscopically, and the collision time is short compared to the evolution time. Fluid equations are typically used to describe such plasmas, since their distribution functions are close to being Maxwellian. The small deviations from the Maxwellian distribution are calculated via the Chapman-Enskog (CE) expansion in $\lambda/L \ll 1$, and determine macroscopic momentum and heat fluxes in the plasma. Such a calculation is only valid if the underlying CE distribution function is stable at collisionless length scales and/or time scales. We find that at sufficiently high plasma $\beta$, the CE distribution function can be subject to numerous microinstabilities across a wide range of scales. For a particular form of the CE distribution function arising in magnetised plasma, we provide a detailed analytic characterisation of all significant microinstabilities, including peak growth rates and their associated wavenumbers. Of specific note is the discovery of several new microinstabilities, including one at sub-electron-Larmor scales (the 'whisper instability') whose growth rate in some parameter regimes is large compared to other instabilities. Our approach enables us to construct the kinetic stability maps of classical, two-species collisional plasma in terms of $\lambda$, the electron inertial scale $d_e$ and $\beta$. This work is of general consequence in emphasising the fact that high-$\beta$ collisional plasmas can be kinetically unstable; for strongly magnetised CE plasmas, the condition for instability is $\beta > L/\lambda$. In this situation, the determination of transport coefficients via the standard CE approach is not valid.Comment: 182 pages total (99 main text, remaining appendices), 31 figure

Efficient micromirror confinement of sub-TeV cosmic rays in galaxy clusters

Recent observations suggest a stronger confinement of cosmic rays (CRs) in certain astrophysical systems than predicted by current CR-transport theories. We posit that the incorporation of microscale physics into CR-transport models can account for this enhanced CR confinement. We develop a theoretical description of the effect of magnetic microscale fluctuations originating from the mirror instability on macroscopic CR diffusion. We confirm our theory with large-dynamical-range simulations of CR transport in the intracluster medium (ICM) of galaxy clusters and kinetic simulations of CR transport in micromirror fields. We conclude that sub-TeV CR confinement in the ICM is far more effective than previously anticipated on the basis of Galactic-transport extrapolations.Comment: Utilizes PIC and MHD simulations, complemented by deep learning for data analysis. Currently under journal review. Comments welcome

In Vivo Analysis of Trypanosoma cruzi Persistence Foci at Single-Cell Resolution.

Infections with Trypanosoma cruzi are usually lifelong despite generating a strong adaptive immune response. Identifying the sites of parasite persistence is therefore crucial to understanding how T. cruzi avoids immune-mediated destruction. However, this is a major technical challenge, because the parasite burden during chronic infections is extremely low. Here, we describe an integrated approach involving comprehensive tissue processing, ex vivo imaging, and confocal microscopy, which allowed us to visualize infected host cells in murine tissue with exquisite sensitivity. Using bioluminescence-guided tissue sampling, with a detection level of 200 parasites, which we term mega-nests. In contrast, during the acute stage, when the total parasite burden is considerably higher and many cells are infected, nests containing >50 parasites are rarely found. In C3H/HeN mice, but not BALB/c mice, we identified skeletal muscle as a major site of persistence during the chronic stage, with most parasites being found in large mega-nests within the muscle fibers. Finally, we report that parasites are also frequently found in the skin during chronic murine infections, often in multiple infection foci. In addition to being a site of parasite persistence, this anatomical reservoir could play an important role in insect-mediated transmission and have implications for drug development.IMPORTANCE Trypanosoma cruzi causes Chagas disease, the most important parasitic infection in Latin America. Major pathologies include severe damage to the heart and digestive tract, although symptoms do not usually appear until decades after infection. Research has been hampered by the complex nature of the disease and technical difficulties in locating the extremely low number of parasites. Here, using highly sensitive imaging technology, we reveal the sites of parasite persistence during chronic-stage infections of experimental mice at single-cell resolution. We show that parasites are frequently located in smooth muscle cells in the circular muscle layer of the colon and that skeletal muscle cells and the skin can also be important reservoirs. This information provides a framework for investigating how the parasite is able to survive as a lifelong infection, despite a vigorous immune response. It also informs drug development strategies by identifying tissue sites that must be accessed to achieve a curative outcome

Polygenic prediction of educational attainment within and between families from genome-wide association analyses in 3 million individuals

We conduct a genome-wide association study (GWAS) of educational attainment (EA) in a sample of ~3 million individuals and identify 3,952 approximately uncorrelated genome-wide-significant single-nucleotide polymorphisms (SNPs). A genome-wide polygenic predictor, or polygenic index (PGI), explains 12–16% of EA variance and contributes to risk prediction for ten diseases. Direct effects (i.e., controlling for parental PGIs) explain roughly half the PGI’s magnitude of association with EA and other phenotypes. The correlation between mate-pair PGIs is far too large to be consistent with phenotypic assortment alone, implying additional assortment on PGI-associated factors. In an additional GWAS of dominance deviations from the additive model, we identify no genome-wide-significant SNPs, and a separate X-chromosome additive GWAS identifies 57

Impacts of climate change on plant diseases – opinions and trends

There has been a remarkable scientific output on the topic of how climate change is likely to affect plant diseases in the coming decades. This review addresses the need for review of this burgeoning literature by summarizing opinions of previous reviews and trends in recent studies on the impacts of climate change on plant health. Sudden Oak Death is used as an introductory case study: Californian forests could become even more susceptible to this emerging plant disease, if spring precipitations will be accompanied by warmer temperatures, although climate shifts may also affect the current synchronicity between host cambium activity and pathogen colonization rate. A summary of observed and predicted climate changes, as well as of direct effects of climate change on pathosystems, is provided. Prediction and management of climate change effects on plant health are complicated by indirect effects and the interactions with global change drivers. Uncertainty in models of plant disease development under climate change calls for a diversity of management strategies, from more participatory approaches to interdisciplinary science. Involvement of stakeholders and scientists from outside plant pathology shows the importance of trade-offs, for example in the land-sharing vs. sparing debate. Further research is needed on climate change and plant health in mountain, boreal, Mediterranean and tropical regions, with multiple climate change factors and scenarios (including our responses to it, e.g. the assisted migration of plants), in relation to endophytes, viruses and mycorrhiza, using long-term and large-scale datasets and considering various plant disease control methods

Mapping Helminth Co-Infection and Co-Intensity: Geostatistical Prediction in Ghana

Urinary schistosomiasis and hookworm infections cause considerable morbidity in school age children in West Africa. Severe morbidity is predominantly observed in individuals infected with both parasite types and, in particular, with heavy infections. We investigated for the first time the distribution of S. haematobium and hookworm co-infections and distribution of co-intensity of these parasites in Ghana. Bayesian geostatistical models were developed to generate a national co-infection map and national intensity maps for each parasite, using data on S. haematobium and hookworm prevalence and egg concentration (expressed as eggs per 10 mL of urine for S. haematobium and expressed as eggs per gram of faeces for hookworm), collected during a pre-intervention baseline survey in Ghana, 2008. In contrast with previous findings from the East Africa region, we found that both S. haematobium and hookworm infections are highly focal, resulting in small, localized clusters of co-infection and areas of high co-intensity. Overlaying on a single map the co-infection and the intensity of multiple parasite infections allows identification of areas where parasite environmental contamination and morbidity are at its highest, while providing an evidence base for the assessment of the progress of successive rounds of mass drug administration (MDA) in integrated parasitic disease control programs