Pennsylvania Folklife Vol. 21, No. 1

• The Fraktur of Monroe County • Minutes of the West Grove Housekeepers Association as Source Material for Folklife Studies • The Searight Tavern on the National Road: An Archaeological Study • The Brown Sugar Game in Western Pennsylvania • Bread Baking in Mifflin County, Pennsylvania: Commentary for the Documentary Film in the Encyclopaedia Cinematographica • Notes and Documents: Literature for the Allegheny Frontier: The Huntingdon Literary Museum and Monthly Miscellany (1810) • Hunting and Food-Gathering: Folk-Cultural Questionnaire No. 21https://digitalcommons.ursinus.edu/pafolklifemag/1045/thumbnail.jp

Reduction in downstream test utilization following introduction of coronary computed tomography in a cardiology practice

To compare utilization of non-invasive ischemic testing, invasive coronary angiography (ICA), and percutaneous coronary intervention (PCI) procedures before and after introduction of 64-slice multi-detector row coronary computed tomographic angiography (CCTA) in a large urban primary and consultative cardiology practice. We utilized a review of electronic medical records (NotesMD®) and the electronic practice management system (Megawest®) encompassing a 4-year period from 2004 to 2007 to determine the number of exercise treadmill (TME), supine bicycle exercise echocardiography (SBE), single photon emission computed tomography (SPECT) myocardial perfusion stress imaging (MPI), coronary calcium score (CCS), CCTA, ICA, and PCI procedures performed annually. Test utilization in the 2 years prior to and 2 years following availability of CCTA were compared. Over the 4-year period reviewed, the annual utilization of ICA decreased 45% (2,083 procedures in 2004 vs. 1,150 procedures in 2007, P < 0.01) and the percentage of ICA cases requiring PCI increased (19% in 2004 vs. 28% in 2007, P < 0.001). SPECT MPI decreased 19% (3,223 in 2004 vs. 2,614 in 2007 P < 0.02) and exercise stress treadmill testing decreased 49% (471 in 2004 vs. 241 in 2007 P < 0.02). Over the same period, there were no significant changes in measures of practice volume (office and hospital) or the annual incidence of PCI (405 cases in 2004 vs. 326 cases in 2007) but a higher percentage of patients with significant disease undergoing PCI 19% in 2004 vs. 29% in 2007 P < 0.01. Implementation of CCTA resulted in a significant decrease in ICA and a corresponding significant increase in the percentage of ICA cases requiring PCI, indicating that CCTA resulted in more accurate referral for ICA. The reduction in unnecessary ICA is associated with avoidance of potential morbidity and mortality associated with invasive diagnostic testing, reduction of downstream SPECT MPI and TME as well as substantial savings in health care dollars

Improved Quantum Multicollision-Finding Algorithm

The current paper improves the number of queries of the previous quantum multi-collision finding algorithms presented by Hosoyamada et al. at Asiacrypt 2017. Let an $l$-collision be a tuple of $l$ distinct inputs that result in the same output of a target function. In cryptology, it is important to study how many queries are required to find $l$-collisions for random functions of which domains are larger than ranges. The previous algorithm finds an $l$-collision for a random function by recursively calling the algorithm for finding $(l-1)$-collisions, and it achieves the average quantum query complexity of $O(N^{(3^{l-1}-1) / (2 \cdot 3^{l-1})})$, where $N$ is the range size of target functions. The new algorithm removes the redundancy of the previous recursive algorithm so that different recursive calls can share a part of computations. The new algorithm finds an $l$-collision for random functions with the average quantum query complexity of $O(N^{(2^{l-1}-1) / (2^{l}-1)})$, which improves the previous bound for all $l\ge 3$ (the new and previous algorithms achieve the optimal bound for $l=2$). More generally, the new algorithm achieves the average quantum query complexity of $O\left(c^{3/2}_N N^{\frac{2^{l-1}-1}{ 2^{l}-1}}\right)$ for a random function $f\colon X\to Y$ such that $|X| \geq l \cdot |Y| / c_N$ for any $1\le c_N \in o(N^{\frac{1}{2^l - 1}})$. With the same query complexity, it also finds a multiclaw for random functions, which is harder to find than a multicollision