The anomaly of the CMB power with the latest Planck data

The lack of power anomaly is an unexpected feature observed at large angular scales in the CMB maps by the COBE, WMAP and Planck satellites. This signature, which consists in a missing of power with respect to that predicted by the $\Lambda$CDM model, might hint at a new cosmological phase before the standard inflationary era. The main point of this paper is taking the latest Planck polarisation data into account to investigate how CMB polarisation improves the understanding of this feature. With this aim, we apply to the last Planck data, both PR3 (2018) and PR4 (2020) releases, a new class of estimators able to evaluate this anomaly considering temperature and polarisation data both separately and in a jointly way. This is the first time that the PR4 dataset is used to study this anomaly. In order to critically evaluate this feature, taking into account the residuals of known systematic effects present in the Planck datasets, we analyse the cleaned CMB maps using different combinations of sky masks, harmonic range and binning on the CMB multipoles. Our analysis shows that the estimator based only on temperature data confirms the presence of a lack of power with a lower-tail-probability (LTP), depending on the component separation method, $\leq 0.33\%$ and $\leq 1.76\%$, for PR3 and PR4 respectively. To our knowledge the $LTP \leq 0.33\%$ for the PR3 dataset is the lowest one present in the literature obtained from Planck 2018 data considering the Planck confidence mask. We find significant differences between these two datasets when polarisation is taken into account. However, we also show that for the PR3 dataset the inclusion of the subdominant polarisation information provides estimates which are less likely accepted in a $\Lambda$CDM cosmological model than the only-temperature analysis on the whole harmonic-range considered

The education direction of the ACLS training program

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30978/1/0000651.pd

Assessing uncertainty in outsourcing clinical services at tertiary health centers

When tertiary health centers face capacity constraint, one feasible strategy to meet service demand is outsourcing clinical services to qualified community providers. Clinical outsourcing enables tertiary health centers to meet the expectations of service timeliness and provides good opportunities to collaborate with other health care providers. However, outsourcing may result in dependence and loss of control for the tertiary health centers. Other parties involved in clinical outsourcing such as local partners, patients, and payers may also encounter potential risks as well as enjoy benefits in an outsourcing arrangement. Recommendations on selecting potential outsourcing partners are given to minimize the risks associated with an outsourcing contract. Copyright © 2006 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56139/1/858_ftp.pd

Education in adult advanced cardiac life support training programs: Changing the paradigm

To develop a consensus for change in the educational aspects of the Advanced Cardiac Life Support (ACLS) Training Program, the American Heart Association appointed panel members to engage in a consensus process. At a preconference meeting held in the fall of 1991, panel members received broad input from experts in adult education, experienced ACLS educators, and resuscitation scientists. The panel then developed a statement based on the preconference discussions and presented it at the National Conference on CPR and Emergency Cardiac Care held in February 1992. The conference's recommendations and the process that led to them are described in this paper.The key conclusions of the consensus process are as follows. The purpose of ACLS programs is the education of health professionals whose jobs include the management of patients in arrest or near-arrest. The goal of each ACLS course is to have each participant succeed in acquiring the skills and knowledge required for resuscitation. Aspects of the course which threaten failure or raise anxiety should be minimized or eliminated. ACLS course directors are strongly encouraged to design courses whose content and presentation are best suited to the training, experience, and needs of the course participants. Flexibility is strongly encouraged. Evaluation (testing) should be used primarily for its educational value, to help both learners and instructors identify areas needing improvement. The problem learner should be identified as early as possible and should receive intensive remediation to achieve the goal of every participant acquiring the targeted skills and knowledge. Because skill retention is variable, rescuers should practice skills frequently in regular refresher sessions. At a minimum, retraining every two years is strongly recommended.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30977/1/0000650.pd

Comparison of adrenergic agonists for the treatment of ventricular fibrillation and pulseless electrical activity

The primary role of epinephrine for the treatment of ventricular fibrillation (VF) and pulseless electrical activity (PEA) is to increase blood flow to the myocardium and central nervous system and ultimately improve survival. However, despite the administration of epinephrine, survival following VF or PEA is low. In an attempt to improve outcome from VF and PEA, alternative adrenergic agonists (methoxamine, phenylephrine, norepinephrine) which have different pharmacological properties than epinephrine have been evaluated. In order to determine the role of alternative adrenergic agonists for the treatment of VF and PEA this paper will compare the pharmacological properties and pharmacodynamic effects of these drugs to epinephrine. Specifically, receptor physiology along with the effects of adrenergic agonists on coronary perfusion pressure, survival, myocardial oxygen demand, and cerebral blood flow will be discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31146/1/0000043.pd

The minimum scale of grooving on a recently ruptured limestone fault

AbstractFaults have grooves that are formed by abrasion and wear during slip. Recent observations indicate that this grooving is only a large‐scale feature, indicating brittle behavior has a length scale limit. The connection between this scale and earthquake behavior remains limited because no examples exist from a proven seismogenic fault. Here, we address this problem and analyze differences in this scale between lithologies to further our understanding of the underlying mechanics. This study uses samples from the Mt. Vettoretto fault collected after the Norcia earthquake of 2016. We imaged fault topography with a white light interferometer and 10 μm resolution structure from motion and then calculated a Monte Carlo version of root mean square roughness. We found a minimum scale of grooving of ~100 μm. In comparing this fault to the Corona Heights fault, we find that this minimum grooving scale is consistent with predictions based on material properties

Nominal GDP Targeting and the Zero Lower Bound: Should We Abandon Inflation Targeting?

I compare nominal GDP level targeting to flexible inflation targeting in a small New Keynesian model subject to the zero lower bound on nominal policy rates. First, I study the performance of optimal discretionary policies. I find that, for a standard calibration, inflation targeting under discretion leaves the economy open to a deflationary trap. Nominal GDP level targeting under discretion, by contrast, provides a firm nominal anchor to the economy. Second, I study simple policy rules and the role of smoothing in the rules. With smoothing, a Taylor-type rule performs as well as a nominal GDP level rule. These result suggest that inflation targeting should not be ditched. Still, it can be improved significantly, by using policy rate smoothing to anchor inflation firmly

Architecture and permeability structure of the Sibillini Mts. Thrust and influence upon recent, extension-related seismicity in the central Apennines (Italy) through fault-valve behavior

The central Apennines are a fold-thrust belt currently affected by post-orogenic ex-tensional seismicity. To constrain the influ-ence that the inherited thrust-related struc-tures exert on the present seismic behavior of the belt, we provide the high-resolution structural and hydraulic characterization of one of the most external exposed thrust fault systems of the central Apennines, the Sibil-lini Mts. Thrust Front (STF). We integrate structural mapping, multiscale structural analysis, and in situ air permeability on the brittle structural facies of the thrust zone. We also performed K-Ar dating of selected fault rocks to better constrain structural in-heritance. The STF is defined by a complex, similar to 300-m-thick deformation zone involving Meso-Cenozoic marl and limestone that re-sults from the accommodation of both seis-mic and aseismic slip during shortening. Permeability measurements indicate that the low permeability (10-2 divided by 10-3 D) of the marly rich host rock diminishes within the thrust zone, where the principal slip surfaces and associated S-C structures represent efficient hydraulic barriers (permeability down to similar to 3 x 10-10 D) to sub-vertical fluid flow. Field data and K-Ar dating indicate that the STF began its evolution ca. 7 Ma (early Messin-ian). We suggest that the studied thrust zone may represent a barrier for the upward migration of deep fluids at the hypocentral depth of present-day extensional earth-quakes. We also speculate on the influence that similar deformation zones may have at depth on the overall regional seismotectonic pattern by causing transient fluid overpres-sures and, possibly, triggering cyclic exten-sional earthquakes on normal faults prone to slip while crosscutting the earlier thrust zones (as per a classic fault valve behavior). This mechanism may have controlled the ori-gin of the 2016-2017 central Apennines dev-astating earthquakes

AEducaAR, Anatomical Education in Augmented Reality: A Pilot Experience of an Innovative Educational Tool Combining AR Technology and 3D Printing

Gross anatomy knowledge is an essential element for medical students in their education, and nowadays, cadaver-based instruction represents the main instructional tool able to provide three-dimensional (3D) and topographical comprehensions. The aim of the study was to develop and test a prototype of an innovative tool for medical education in human anatomy based on the combination of augmented reality (AR) technology and a tangible 3D printed model that can be explored and manipulated by trainees, thus favoring a three-dimensional and topographical learning approach. After development of the tool, called AEducaAR (Anatomical Education with Augmented Reality), it was tested and evaluated by 62 second-year degree medical students attending the human anatomy course at the International School of Medicine and Surgery of the University of Bologna. Students were divided into two groups: AEducaAR-based learning (“AEducaAR group”) was compared to standard learning using human anatomy atlas (“Control group”). Both groups performed an objective test and an anonymous questionnaire. In the objective test, the results showed no significant difference between the two learning methods; instead, in the questionnaire, students showed enthusiasm and interest for the new tool and highlighted its training potentiality in open-ended comments. Therefore, the presented AEducaAR tool, once implemented, may contribute to enhancing students’ motivation for learning, increasing long-term memory retention and 3D comprehension of anatomical structures. Moreover, this new tool might help medical students to approach to innovative medical devices and technologies useful in their future careers