On C*-algebras associated to right LCM semigroups

We initiate the study of the internal structure of C*-algebras associated to a left cancellative semigroup in which any two principal right ideals are either disjoint or intersect in another principal right ideal; these are variously called right LCM semigroups or semigroups that satisfy Clifford's condition. Our main findings are results about uniqueness of the full semigroup C*-algebra. We build our analysis upon a rich interaction between the group of units of the semigroup and the family of constructible right ideals. As an application we identify algebraic conditions on S under which C*(S) is purely infinite and simple.Comment: 31 page

C*-Algebras of algebraic dynamical systems and right LCM semigroups

We introduce algebraic dynamical systems, which consist of an action of a right LCM semigroup by injective endomorphisms of a group. To each algebraic dynamical system we associate a C*-algebra and describe it as a semigroup C*-algebra. As part of our analysis of these C*-algebras we prove results for right LCM semigroups. More precisely we discuss functoriality of the full semigroup C*-algebra and compute its K-theory for a large class of semigroups. We introduce the notion of a Nica-Toeplitz algebra of a product system over a right LCM semigroup, and show that it provides a useful alternative to study algebraic dynamical systems.Comment: 28 pages, to appear in Indiana Univ. Math.

Equilibrium states on right LCM semigroup C*-algebras

We determine the structure of equilibrium states for a natural dynamics on the boundary quotient diagram of $C^*$-algebras for a large class of right LCM semigroups. The approach is based on abstract properties of the semigroup and covers the previous case studies on $\mathbb{N} \rtimes \mathbb{N}^\times$, dilation matrices, self-similar actions, and Baumslag-Solitar monoids. At the same time, it provides new results for large classes of right LCM semigroups, including those associated to algebraic dynamical systems.Comment: 43 pages, to appear in Int. Math. Res. No

Feasibility of rapid and automated importation of 3D echocardiographic left ventricular (LV) geometry into a finite element (FEM) analysis model

BACKGROUND: Finite element method (FEM) analysis for intraoperative modeling of the left ventricle (LV) is presently not possible. Since 3D structural data of the LV is now obtainable using standard transesophageal echocardiography (TEE) devices intraoperatively, the present study describes a method to transfer this data into a commercially available FEM analysis system: ABAQUS(©). METHODS: In this prospective study TomTec LV Analysis TEE(© )Software was used for semi-automatic endocardial border detection, reconstruction, and volume-rendering of the clinical 3D echocardiographic data. A newly developed software program MVCP FemCoGen(©), written in Delphi, reformats the TomTec file structures in five patients for use in ABAQUS and allows visualization of regional deformation of the LV. RESULTS: This study demonstrates that a fully automated importation of 3D TEE data into FEM modeling is feasible and can be efficiently accomplished in the operating room. CONCLUSION: For complete intraoperative 3D LV finite element analysis, three input elements are necessary: 1. time-gaited, reality-based structural information, 2. continuous LV pressure and 3. instantaneous tissue elastance. The first of these elements is now available using the methods presented herein

Subquotients of Hecke C*-algebras

We realize the Hecke C*-algebra CQ of Bost and Connes as a direct limit of Hecke C*-algebras which are semigroup crossed products by NF, for F a finite set of primes. For each approximating Hecke C*-algebra we describe a composition series of ideals. In all cases there is a large type I ideal and a commutative quotient, and the intermediate subquotients are direct sums of simple C*-algebras. We can describe the simple summands as ordinary crossed products by actions of ZS for S a finite set of primes. When |S|=1, these actions are odometers and the crossed products are Bunce–Deddens algebras; when |S|\u3e1, the actions are an apparently new class of higher-rank odometer actions, and the crossed products are an apparently new class of classifiable AT-algebras

Interstitial lung diseases in children

Interstitial lung disease (ILD) in infants and children comprises a large spectrum of rare respiratory disorders that are mostly chronic and associated with high morbidity and mortality. These disorders are characterized by inflammatory and fibrotic changes that affect alveolar walls. Typical features of ILD include dyspnea, diffuse infiltrates on chest radiographs, and abnormal pulmonary function tests with restrictive ventilatory defect and/or impaired gas exchange. Many pathological situations can impair gas exchange and, therefore, may contribute to progressive lung damage and ILD. Consequently, diagnosis approach needs to be structured with a clinical evaluation requiring a careful history paying attention to exposures and systemic diseases. Several classifications for ILD have been proposed but none is entirely satisfactory especially in children. The present article reviews current concepts of pathophysiological mechanisms, etiology and diagnostic approaches, as well as therapeutic strategies. The following diagnostic grouping is used to discuss the various causes of pediatric ILD: 1) exposure-related ILD; 2) systemic disease-associated ILD; 3) alveolar structure disorder-associated ILD; and 4) ILD specific to infancy. Therapeutic options include mainly anti-inflammatory, immunosuppressive, and/or anti-fibrotic drugs. The outcome is highly variable with a mortality rate around 15%. An overall favorable response to corticosteroid therapy is observed in around 50% of cases, often associated with sequelae such as limited exercise tolerance or the need for long-term oxygen therapy

Alpha Rhythms in Audition: Cognitive and Clinical Perspectives

Like the visual and the sensorimotor systems, the auditory system exhibits pronounced alpha-like resting oscillatory activity. Due to the relatively small spatial extent of auditory cortical areas, this rhythmic activity is less obvious and frequently masked by non-auditory alpha-generators when recording non-invasively using magnetoencephalography (MEG) or electroencephalography (EEG). Following stimulation with sounds, marked desynchronizations can be observed between 6 and 12 Hz, which can be localized to the auditory cortex. However knowledge about the functional relevance of the auditory alpha rhythm has remained scarce so far. Results from the visual and sensorimotor system have fuelled the hypothesis of alpha activity reflecting a state of functional inhibition. The current article pursues several intentions: (1) Firstly we review and present own evidence (MEG, EEG, sEEG) for the existence of an auditory alpha-like rhythm independent of visual or motor generators, something that is occasionally met with skepticism. (2) In a second part we will discuss tinnitus and how this audiological symptom may relate to reduced background alpha. The clinical part will give an introduction into a method which aims to modulate neurophysiological activity hypothesized to underlie this distressing disorder. Using neurofeedback, one is able to directly target relevant oscillatory activity. Preliminary data point to a high potential of this approach for treating tinnitus. (3) Finally, in a cognitive neuroscientific part we will show that auditory alpha is modulated by anticipation/expectations with and without auditory stimulation. We will also introduce ideas and initial evidence that alpha oscillations are involved in the most complex capability of the auditory system, namely speech perception. The evidence presented in this article corroborates findings from other modalities, indicating that alpha-like activity functionally has an universal inhibitory role across sensory modalities

Top-Down Modulation of the Auditory Steady-State Response in a Task-Switch Paradigm

Auditory selective attention is an important mechanism for top-down selection of the vast amount of auditory information our perceptual system is exposed to. In the present study, the impact of attention on auditory steady-state responses is investigated. This issue is still a matter of debate and recent findings point to a complex pattern of attentional effects on the auditory steady state response (aSSR). The present study aimed at shedding light on the involvement of ipsilateral and contralateral activations to the attended sound taking into account hemispheric differences and a possible dependency on modulation frequency. In aid of this, a dichotic listening experiment was designed using amplitude-modulated tones that were presented to the left and right ear simultaneously. Participants had to detect target tones in a cued ear while their brain activity was assessed using MEG. Thereby, a modulation of the aSSR by attention could be revealed, interestingly restricted to the left hemisphere and 20 Hz responses: contralateral activations were enhanced while ipsilateral activations turned out to be reduced. Thus, our findings support and extend recent findings, showing that auditory attention can influence the aSSR, but only under specific circumstances and in a complex pattern regarding the different effects for ipsilateral and contralateral activations

Does Time of Day Matter for Acute Cholecystectomy in an Acute Care Surgery Model?

INTRODUCTION: Prompt cholecystectomy for acute cholecystitis is well accepted; however, whether this warrants urgent nocturnal surgery remains a matter of debate. Differences in available resources, multitasking, and sleep hygiene may affect performance. This could impact conversion rates to open surgery, operation time, bile duct injury, blood loss, complications, and hospital length of stay. Some evidence supports improved outcomes in patients who can avoid after-hour cholecystectomy. We aimed to determine if outcomes changed based on time of day for laparoscopic cholecystectomy. Our null hypothesis is that nighttime cholecystectomy is associated with worse outcomes. METHODS AND PROCEDURES: Retrospective analysis of 486 patients aged≥18 years who underwent cholecystectomy in a large, urban level 1 tertiary care center with a longstanding acute care surgery model. Demographics, procedural information, time of day of surgery, and postoperative outcomes were collected and stratified over a 4-year period from 2013-2017. Sixty five percent of the patients were female with an average age of 49.6 years and an average BMI of 32.7kg/m2. A total of 230 (47%) patients underwent laparoscopic cholecystectomy for acute cholecystitis. Almost half (45%) underwent nighttime operation defined as procedure start time between the hours of 19:00 to 07:00. RESULTS: Analysis of the 230 patients with acute cholecystitis revealed an overall conversion rate to open of 14% (n=32), bile leak (duct of Luschka or cystic) 3.5% (n=8), 30-day readmission rate of 7.4% (n=17), and length of stay of 3.9 days. Subgroup analysis of patients having nighttime cholecystectomy for cholecystitis (N=103) revealed 6.1% conversion to open, 0.9% (n=2) bile leak, 2.6% (n=6) 30-day readmission rate, and 3.43 days length of stay. Other outcomes including mortality, cardiac events, pneumonia, stroke, PE, blood loss requiring blood transfusion were not statistically significant. One patient had a common bile duct injury in the daytime group that required conversion to open and hepaticojejunostomy. CONCLUSIONS: Despite prior evidence that favors delaying cholecystectomy until daytime to avoid complications, our study did not support this. We found no difference in outcomes between daytime and nighttime cholecystectomy and conclude that cholecystectomy can safely be performed during any time of the day with similar complication rates.This may reflect the volume of experience in after-hours acute care surgery at this regional referral center.https://scholarlycommons.henryford.com/merf2019clinres/1043/thumbnail.jp