Double bubbles in the three-torus

13 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200113 pages, 4 figures. Prepared on behalf of the participants in the Clay Mathematics Institute Summer School on the Global Theory of Minimal Surfaces, held at the Mathematical Sciences Research Institute in Berkeley, California, Summer 200

Improving the early diagnosis of early nodular melanoma: can we do better?

Introduction: Cutaneous melanoma is the sixth most common malignant cancer in the USA. Among different subtypes of melanoma, nodular melanoma (NM) accounts about 14% of all cases but is responsible for more than 40% of melanoma deaths. Early diagnosis is the best method to improve melanoma prognosis. Unfortunately, early diagnosis of NM is particularly challenging given that patients often lack identifiable risk factors such as many moles or freckles. Moreover, early NM may mimic a range of benign skin lesions that are not routinely excised or biopsied in every day practice. For this reason, specific clinical and skin imaging clues have been proposed to improve early detection of NM.Areas covered: The review discusses about the noninvasive tools to diagnose thin melanoma, particularly NM. Expert commentary: Currently, dermatologists present a wide opportunity of diagnostic tools. Current data suggest that the early diagnosis of NM is a major challenge as the majority of early NM are symmetric, roundish, and lack specific pattern. Another promising strategy is based on recent data suggesting that artificial intelligence based on deep convolutional neural networking is able to outperform average dermatologist. Further research is necessary to validate the performance of this method in the real world and in the clinical setting

Pseudo ainhum and facial malformation secondary to Streeter's dysplasia

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Machine Learning Framework for the Sustainable Maintenance of Building Facilities

The importance of sustainable building maintenance is growing as part of the Sustainable Building concept. The integration and implementation of new technologies such as the Internet of Things (IoT), smart sensors, and information and communication technology (ICT) into building facilities generate a large amount of data that will be utilized to better manage the sustainable building maintenance and staff. Anomaly prediction models assist facility managers in informing operators to perform scheduled maintenance and visualizing predicted facility anomalies on building information models (BIM). This study proposes a Machine Learning (ML) anomaly prediction model for sustainable building facility maintenance using an IoT sensor network and a BIM model. The suggested framework shows the data management technique of the anomaly prediction model in the 3D building model. The case study demonstrated the framework’s competence to predict anomalies in the heating ventilation air conditioning (HVAC) system. Furthermore, data collected from various simulated conditions of the building facilities was utilized to monitor and forecast anomalies in the 3D model of the fan coil. The faults were then predicted using a classification model, and the results of the models are introduced. Finally, the IoT data from the building facility and the predicted values of the ML models are visualized in the building facility’s BIM model and the real-time monitoring dashboard, respectively

Slip length of the tribo system steel-polyalphaolefin-steel determined by a novel tribometer

Nowadays sealing systems are commonly designed by means of hydrodynamic and elastohydrodynamic theories. Although the analytical as well as the computational approaches have improved in meaning full manner since the last decades: For small sealing gaps, in the order of micrometers and below, a discrepancy between experimental investigated and theoretically predicted leakage flows occur. As a cause for the discrepancy a breakdown of the no slip boundary condition is suspected. Since in small sealing gaps the continuum hypothesis is violated and molecular effects have to be considered. One fundamental quantity to take molecular affects into account is the slip length. Within this paper a new measurement apparatus to evaluate the slip length for hydraulic applications is presented. The adjustable gaps between two planar surfaces are in the order of magnitude of 1 μm. In a first step the slip length for the system steel-oil –steel is investigated at three different temperatures: 18°C, 22°C and 25°C. The measured slip lengths are in the order of magnitude of ~100 nm

Perceived barriers to pediatrician and family practitioner participation in pediatric clinical trials: Findings from the Clinical Trials Transformation Initiative.

Despite legislation to stimulate pediatric drug development through clinical trials, enrolling children in trials continues to be challenging. Non-investigator (those who have never served as a clinical trial investigator) providers are essential to recruitment of pediatric patients, but little is known regarding the specific barriers that limit pediatric providers from participating in and referring their patients to clinical trials. We conducted an online survey of pediatric providers from a wide variety of practice types across the United States to evaluate their attitudes and awareness of pediatric clinical trials. Using a 4-point Likert scale, providers described their perception of potential barriers to their practice serving as a site for pediatric clinical trials. Of the 136 providers surveyed, 52/136 (38%) had previously referred a pediatric patient to a trial, and only 17/136 (12%) had ever been an investigator for a pediatric trial. Lack of awareness of existing pediatric trials was a major barrier to patient referral by providers, in addition to consideration of trial risks, distance to the site, and time needed to discuss trial participation with parents. Overall, providers perceived greater challenges related to parental concerns and parent or child logistical barriers than study implementation and ethics or regulatory barriers as barriers to their practice serving as a trial site. Providers who had previously been an investigator for a pediatric trial were less likely to be concerned with potential barriers than non-investigators. Understanding the barriers that limit pediatric providers from collaboration or inhibit their participation is key to designing effective interventions to optimize pediatric trial participation

THE ANALYSIS OF DECISION-MAKING PROCESS WITH 7P (A Quantitative-Descriptive Research of The Consumers of Happy Puppy Seturan Yogyakarta and Hello FKTV Yogyakarta)

Decision is the result of selecting one out of two or more options or available alternatives (Schiffman and Kanuk, 2000). As for other activities, decision-making can also be applied for choosing the right karaoke house to get entertainment. This paper is a quantitative-descriptive research of decision-making process of the consumers of Hello FKTV Yogyakarta and Happy Puppy Seturan, whose data are obtained from questionnaires spread to 30 consumers of Happy Puppy Seturan and Hello FKTV Yogyakarta who have come at least twice to both karaoke houses. Afterwards, the data are then analyzed using one of the marketingcommunication theories, which is Solomon’s consumer decision making process. The theory presumes that there are four steps in the process of consumer’s decision making process—problem/ need recognition,information search, evaluation of alternatives, and product choice. At the stage of evaluation of alternative, there is a paradigm called 7P, which tries to see a product or service from the viewpoint of marketing from seven different angles—product, price, place, promotion, people, process, and physical evidence. The 7P becomes the indicator to see and compare various alternatives which become the consideration of consumers in searching for information. It is then concluded that consumers fulfill their needs for karaoke by spending small amount of money through the utilization of discount voucher provided by Happy Puppy Seturan and Hello FKTV. Consumers give positive evaluation concerning the price or karaoke-room rental and the song collections. But other aspect such as foods and beverages are still evaluated negatively by the consumers, because of the tasteless of foods and the unaffordable price. Most of the consumers get the information concerning Happy Puppy Seturan and Hello FKTV form their friends and only small portion of the consumers seek for the information via social media. Promotion through social media can be one of the effective strategies to attract consumers, especially college students

Differences between international recommendations on breastfeeding in the presence of HIV and the attitudes and counselling messages of health workers in Lilongwe, Malawi

BACKGROUND: To prevent postnatal transmission of HIV in settings where safe alternatives to breastfeeding are unavailable, the World Health Organization (WHO) recommends exclusive breastfeeding followed by early, rapid cessation of breastfeeding. Only limited data are available on the attitudes of health workers toward this recommendation and the impact of these attitudes on infant feeding counselling messages given to mothers. METHODS: As part of the Breastfeeding, Antiretroviral, and Nutrition (BAN) clinical trial, we carried out an in-depth qualitative study of the attitudes, beliefs, and counselling messages of 19 health workers in Lilongwe, Malawi. RESULTS: Although none of the workers had received formal training, several reported having counseled HIV-positive mothers about infant feeding. Health workers with counselling experience believed that HIV-infected mothers should breastfeed exclusively, rather than infant formula feed, citing poverty as the primary reason. Because of high levels of malnutrition, all the workers had concerns about early cessation of breastfeeding. CONCLUSION: Important differences were observed between the WHO recommendations and the attitudes and practices of the health workers. Understanding these differences is important for designing effective interventions

Endocrine dysfunction in patients operated on for non-pituitary intracranial tumors

Objective: Hypopituitarism frequently follows pituitary neurosurgery (NS) and/or irradiation. However, the frequency of hypothalamic–pituitary dysfunction after NS of non-pituitary intracranial tumors is unclear. The aim of this study was to assess the presence of endocrine alterations in patients operated on for intracranial tumors. Design: This is a retrospective study. Methods: We studied 68 consecutive adult patients (28 female, 40 male, age 45.0 ± 1.8 years; body mass index (BMI): 26.5 ± 0.6) with intracranial tumors who underwent NS only (n = 17) or in combination with radiotherapy (RT) and/or chemotherapy (CT) (n = 51). In all subjects, basal endocrine parameters and the GH response to GHRH + arginine test (using BMI-dependent cut offs) were evaluated. Results: In 20.6% of the patients, peripheral endocrinopathy related to CT and/or RT was present. Hypopituitarism was found in 38.2% of the patients. Total pituitary hormone, multiple pituitary hormone, and isolated pituitary hormone deficits were present in 16.2, 5.8, and 16.2% respectively. The most common pituitary deficits were, in decreasing order: LH/FSH 29.4%, GH 27.9%, ACTH 19.1%, TSH 17.7%, and diabetes insipidus 4.4%. Hyperprolactinemia was present in 13.2%. The prevalence of hypopituitarism was higher in patients who underwent NS only and with tumors located closely to the sella turcica, but a substantial proportion of patients with tumors not directly neighboring the sella also showed hypopituitarism. Conclusions: Hypopituitarism frequently occurs after NS for intracranial tumors. Also, exposure of these patients to CT and/or RT is frequently associated with peripheral endocrinopathies. Thus, endocrine evaluation and follow-up of patients treated for intracranial tumors should be performed on a regular basis

Adaptation and delivery of a motivational interviewing-based counseling program for persons acutely infected with HIV in Malawi: Implementation and lessons learned

Objective: Individuals diagnosed with acute HIV infection (AHI) are highly infectious and require immediate HIV prevention efforts to minimize their likelihood of transmitting HIV to others. We sought to explore the relevance of Motivational Interviewing (MI), an evidence-based counseling method, for Malawians with AHI. Methods: We designed a MI-based intervention called “Uphungu Wanga” to support risk reduction efforts immediately after AHI diagnosis. It was adapted from Options and SafeTalk interventions, and refined through formative research and input from Malawian team members and training participants. We conducted qualitative interviews with counselors and participants to explore the relevance of MI in this context. Results: Intervention adaptation required careful consideration of Malawian cultural context and the needs of people with AHI. Uphungu Wanga's content was relevant and key MI techniques of topic selection and goal setting were viewed positively by counselors and participants. However, rating levels of importance and confidence did not appear to help participants to explore behavior change as intended. Conclusion: Uphungu Wanga may have provided some added benefits beyond “brief education” standard of care counseling for Malawians with AHI. Practice implications: MI techniques of topic selection and goal setting may enhance prevention education and counseling for Malawians with AHI