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This new era of 5G will bring together improved connectivity, cloud-based storage, and an array of connected devices and services. Extensive computing capability combined with virtual system architecture will open up a mobile internet of things (IoT). Advanced digital networks will bring together a system that connects billions of devices and sensors enabling advances in health care, education, resource management, transportation, agriculture, and many other areas. While much of this work is underway today, we will see big strides soon at the 2018 Winter Olympics. With the number of digital devices expected to rise dramatically, much of the world will be connected around the clock. I show that connected medicine will help people get quality care through improvements in imaging, diagnostics, and treatment. Rather than having computing equipment that is disparate and separate, the 5G world will allow us to enter an era where real-time health services will become the norm rather than the exception. That will bring patients closer to a science fiction concept of digital integration than ever before. West is vice president and director of Governance Studies and founding director of the Center for Technology Innovation at Brookings. Instead, it is a transformative ecosystem that includes a heterogeneous network that integrates 4G, Wi-Fi, millimeter wave, and other wireless access technologies. It combines cloud infrastructure, a virtualized network core, intelligent edge services, and a distributed computing model that derives insights from the data generated by billions of devices. According to Asha Keddy, Vice President in the Platform Engineering Group and General Manager of Next Generation and Standards at Intel, "5G is much more than a G. With 5G, we will be moving from a user centric world to one of massive machine type communications where the network will move from enabling millions to billions of devices-an era that will connect these devices intelligently and usher in the commodification of information and intelligence. By design, it will not only increase capacity, it also will enable even the smallest devices to perform high-level computations and connect quickly to processing power that is diffused throughout the system. Four factors distinguish 5G from its predecessors: connected devices, fast and intelligent networks, back-end services, and extremely low latency. These qualities enable a fully connected and interactive world with a variety of applications. This includes enhanced mobile broadband, machine-to-machine communications, artificial intelligence, and advanced digital services. Indeed, researchers estimate that this connected ecosystem will make it possible to utilize a much larger percent of digital data (35 percent) than before (5 percent). With the costs of devices and sensors coming down considerably, connectivity will be ubiquitous and unobtrusive. Rather than having to make a conscious decision to issue a computing command, people will have systems that take actions based on the predetermined preferences of that individual. A wide array of networked sensors will link appliances, home security systems, energy grids, and entertainment systems to the internet. Connecting wireless sensors throughout their appliances will turn even the tiniest of devices into minicomputers. That will help individuals harness the power of the internet for a wide variety of tasks. How 5G technology enables the health internet of things 2 Fast, intelligent networks High broadband speeds and intelligent networks will characterize the 5G network. Currently, it takes about eight minutes to download a feature movie using 4G; people will be able to do this in less than five seconds with 5G. With the billions of devices that will be online, not all data need to be moved simultaneously. Some applications require instantaneous communications, while others can transmit during off-peak hours. Having networks that automatically determine data traffic prioritization and make split-second decisions is vital to a 5G world.

There are two presentations of canine rabies, a "furious" (encephalitic) or "dumb" (paralytic) form. Both forms are invariably fatal, with the furious form causing death within a week, and the dumb form causing death within 2 weeks. The autonomic dysfunction also includes excess salivation, which can produce the "foaming at the mouth" that is often said to accompany rabies. Bat rabies differs from canine rabies not only in method of inoculation, but also in presentation. The presence of Negri bodies is variable, as non-rabid tissues have displayed inclusions that are indistinguishable from Negri bodies, while rabid tissue from animals have shown Negri bodies in only 50% of samples taken. Additionally, skin biopsy specimens may display rabies antigen within cutaneous nerves (10). As a further reminder of the importance of clinical suspicion for pediatricians, a 1990 study showed that animal bites were the fourth leading cause of accidents in children 9 years old or less. As rabies is a uniformly fatal disease once the symptomatic stage of the disease has developed, it is important to provide preexposure, and if necessary, post-exposure prophylaxis for patients. After discovering the transmissibility of rabies by nervous tissue inoculation, Pasteur determined that passage of the virus from dogs to monkeys attenuated the virus, while transmission from rabbit to rabbit increased the virulence of the strains. Booster doses of the vaccine may be given every 2 years if the antibody titers in the patient are decreased. If virucidal agents such as povidone-iodine are available, they should be used for irrigation. The efficacy of the recommended prophylaxis is evidenced by the fact that of the millions of doses administered worldwide, there have been only 13 reported failures, and all of the failures have been associated with deviation from the recommended treatment protocol. The rate of systemic allergic reaction to the rabies vaccine is approximately 11 per 10,000 vaccinations, which has resulted in a few hospitalizations, but no deaths. Additionally, rabies prophylaxis is recommended that persons traveling (for more than 30 days) into areas where rabies is endemic and medical care is limited. It is also recommended that even immunosuppressed patients receive prophylaxis if exposed to rabies. Far more effective than medical prophylaxis are the recommendations of the national working group on prevention and control of rabies in the United States. Report any animals that are acting sick or strange to local animal control authorities. True/False: Inoculation of rabies from animal to human requires a physical animal-human contact. In which of the following cases would post-exposure rabies prophylaxis be appropriate (select all appropriate): a. Which animal is most likely to transmit rabies to humans by mere contact (as opposed to a bite)? Correlation of Clinical and Neuroimaging Findings In a Case of Rabies Encephalitis. Recommendations of a national working group on prevention and control of rabies in the United States. He was diagnosed with a "viral syndrome" and given instructions for home symptomatic care. He is laying in a hospital gurney, awake and responsive, but tired and ill appearing. His skin has a maculopapular rash that blanches under pressure on the upper and lower extremities, including his palms and soles, and a few scattered macular lesions located on the upper trunk and back. Four days prior to the onset of illness, while deer hunting with friends, he noticed an engorged tick on his calf. Among the rickettsial illnesses, it is the most common and severe in the United States (1). The disease was first recognized in Idaho and Montana in the late 1800s and initially thought to be limited to the Rocky Mountain region. Though historically significant, the "Rocky Mountain" moniker is misleading relative to the current disease epidemiology. The wood tick (Dermacentor andersoni) found in the Western and Rocky Mountain States and the dog tick (Dermacentor variabilis) found east of the Rocky Mountains are the primary hosts and vectors of R.

Vйgh, "When It Rains, It Pours: Procyclical Capital Flows and Policies," in Mark Gertler and Kenneth S. League of Nations, Public Finance 1928­1935, Volume I, Numbers 1­24, (Geneva: League of Nations, 1939). League of Nations, Ragnar Nurkse, the Course and Control of Inflation, A Revue of Monetary Experience in Europe after World War I, (Geneva: League of Nations, 1946). Le Cheminant, Keith, Colonial and Foreign Central Banking System, (London: George Routledge, Ltd. Levandis, John Alexander, the Greek Foreign Debt and the Great Powers, 1821­1898, (New York: Columbia University Press, 1944). Luders, Rolf, "The Comparative Economic Performance of Chile: 1810­1995," Estudios de Economia (Chile) 25, December 1998, 217­249. Lyashchenko, Peter, History of the National Economy of Russia to the 1917 Revolution, (New York: Octagon Books, 1970). MacDonald, James, A Free Nation Deep in Debt: the Financial Roots of Democracy (New York: Farrar, Straus, and Giroux, 2003). Mamalakis, Markos, "Historical Statistics of Chile," (Westport, Conn: Greenwood Press, 1978­1982). Marichal, Carlos, A Century of Debt Crises in Latin America: From Independence to the Great Depression, 1820­1930, (Princeton: Princeton University Press, 1989). Mazower, Marc, Greece and the Inter-War Economic Crisis, (Oxford: Oxford University Press, 1991). McElderry, Andrea Lee, Shanghai Old-Style Banks 1800­1935: A Traditional Institution in a Changing Society, (Ann Arbor: Center for Chinese Studies, University of Michigan, 1976). Mizoguchi, Toshiyuki, and Mataji Umemura, Basic Economic Statistics of Former Japanese Colonies, 1895­1938, Estimates and Findings, (Tokyo: Toyo Keizai Shinposha, 1988). Neal, Larry and Marc Weidenmier, "Crises in the Global Economy from Tulips to Today: Contagion and Consequences," in Michael Bordo, Alan M. Noel, Maurer, the Power and the Money-The Mexican Financial System, 1876­1932, (Stanford: Stanford University Press, 2002). Center Sanwa Monographs on International Financial Markets (Cambridge: Cambridge University Press, 2004). Page, William, Commerce and Industry: Tables of Statistics for the British Empire from 1815, (London: Constable and Company, Ltd. Paarlberg, Don, An Analysis and History of Inflation, (Westport, Connecticut: Praeger Publishers, 1993). Pick, Franz, and Renй Sйdillot, All the Monies of the World: A Chronicle of Currency Values, (New York: Pick Publishing Corporation, 1971). Kaufman, the Risks of Sovereign Lending: Lessons from History, (New York: Salomon Brothers, 1993). Rogoff, "The Modern History of Exchange Rate Arrangements: A Reinterpretation" Quarterly Journal of Economics, Vol. An International Historical Comparison," forthcoming in American Economic Review, May 2008b. Fred, British Investment in Latin America, 1822­1949, (Minnesota: University of Minnesota Press, 1959). Sarkees, Meredith Reid, "Correlates of War Data on War: An Update to 1997," Conflict Management and Peace Science, 18/1, 123­144. Shergold, Peter, "Prices and Consumption," in Australian Historical Statistics, (Sydney: Fairfax, Syme and Weldon, 1987). Solomou, Solomos, Economic Cycles: Long Cycles and Business Cycles Since 1870 (Manchester University Press, 1998). Portfolio Investment in Latin America, 1900-1986, (Berkeley: University of California Press, 1987). Stone, Irving, the Global Export of Capital from Great Britain, 1865­1914 (New York: St. Sussman, Nathan, and Yishay Yafeh, "Contagion and Capital Market Integration in Asia: Historical and Contemporary Evidence," Mimeograph, Jerusalem, Hebrew University, July 1999. Suter, Christian, Debt Cycles in the World-Economy: Foreign Loans, Financial Crises, and Debt Settlements, 1820­1990 (Boulder: Westview Press, 1992). Tomz, Michael, Reputation and International Cooperation, Sovereign Debt Across Three Centuries, (Princeton: Princeton University Press, 2007).

With respect to public health, the first priority is to establish whether or not screening produces a net benefit in terms of mortality and/or morbidity, including quality of life. The potential risks to the patient, as well as the consequences for the medical care system. Cost- and risk-benefit analysis should include not only morbidity and mortality associated with surgery, but also the need for long-term patient compliance and the necessity for life-long medication and follow-up. For example, if people with high radiation doses are screened more frequently or intensely than individuals with lower exposure, then a false positive association between dose and thyroid disease will probably be found. In particular, the absolute rate of thyroid cancer will be increased in a screened population. This means that the excess absolute risk estimate will be overstated and may not 35 be generalizable to a non-screened population. The excess relative risk estimate would also be biased upward, if there is a correlation between thyroid dose and frequency of screening; however, if the screening was across the board for all dose groups, including the baseline group, then the excess relative risk estimate would be little affected by screening. The sparse available data generally support the notion that, once age at diagnosis is controlled for, relative risk estimates are less perturbed by screening bias than absolute risk estimates, and that the size, symptoms and aggressiveness of radiogenic and sporadic thyroid cancers are similar. Adequate information on the potential degree of confounding by screening intensity is not currently available. Conclusions (epidemiology) A great deal has already been learned about the consequences of the Chernobyl accident for thyroid cancer. There is an increased risk of thyroid cancer, especially in those exposed at young ages. The greatest risks of radiation-related thyroid cancer have been observed in those who were children or adolescents at the time of the accident and those with the highest levels of exposure to radioiodine. However, much remains to be learned, including a precise characterization of the thyroid cancer dose response that accounts for the uncertainties in dose estimation and the effects of screening for thyroid disease, an understanding of the mechanisms of radiation carcinogenesis in the thyroid gland and how those mechanisms determine the dose response, and an understanding of the role of genetic predisposition and its effect on the thyroid cancer dose response. The Chernobyl experience provides the best opportunity to learn about the effects of exposure to low doses from 131I on thyroid cancer risk. While it may not definitively settle the question of the shape of the thyroid cancer dose response at low doses and dose rates, careful epidemiological and dosimetry study should provide important evidence for radiation protection measures. There have been no published studies to date of the effects of exposure in utero and only very limited information on the effects of exposures during adulthood. It is important to consider the strengths and limitations of each study in interpreting results regarding the risk of thyroid cancer after Chernobyl. Based on studies of other populations exposed to external radiation that have had long follow-up times, it is expected that thyroid cancer risk from Chernobyl will continue for many more years, although the long-term magnitude of risk is difficult to quantify. New studies indicate that iodine deficiency and supplementation may play a role in radiationrelated thyroid cancer after Chernobyl. Further studies are needed to replicate these findings, but the role of iodine deficiency and iodine supplementation on this risk have not been adequately studied. Recommendations (epidemiology) Continued monitoring of persons exposed as children is a public health priority for the foreseeable future. For health planning purposes, continuous estimation of the predicted number of cases of thyroid cancer expected to occur in exposed populations should be based on updated estimates of risk in those populations. Investigations of the risk of thyroid cancer as a result of the Chernobyl accident should be based on analyses of radiation dose response, utilizing individualized dose estimates whenever possible. The uncertainties of these dose estimates should be carefully analysed and accounted for in the estimation of dose responses. It is recommended that there be an increased focus on the use of analytical study designs because of their suitability for deriving quantitative estimates of disease risk for individuals and for exploring modifying effects. Ecological studies, however, also should be continued, especially since they are helpful in determining how best to allocate scarce public health resources, documenting geographical and temporal variation in risk, and providing approximate risk estimates based on large numbers of cases. The development of techniques and standards for statistical analysis of radiation dose response with complex dose uncertainties is an area of active research, and analyses of the thyroid cancer dose response should capitalize on these developments. Analyzes of thyroid cancer dose responses should also take into account all available information regarding 1) methods of case detection and reporting (to account for possible biases arising from differences in case ascertainment that may be correlated with dose), and 2) potential confounding factors or dose effect modifiers such as age at exposure, age at risk, gender, stable iodine sufficiency/deficiency, and stable iodine prophylaxis around the time of the accident. Epidemiological surveillance and research in the regions currently being studied should continue. Further study will permit more sophisticated and accurate modeling of risk, perhaps with models that are less empirical, and more firmly rooted in biological mechanisms, than those currently used. It is particularly important that further surveillance and research emphasize those who were children or adolescents at the time of the Chernobyl accident, although more assessment of risk among those who were adults (especially young adults) is also needed. They will be useful not only for epidemiological studies, but also for public health purposes.