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The objective is to demonstrate possibilities of a harpoon biopsy under ultrasound guidance for malignant neoplasms early detection using a clinical example.Clinical case. A 65-year-old patient with morphologically verified laryngeal cancer (stage II, T2N0M0) underwent radiation therapy, which resulted in a complete tumor resorption. Subsequent ultrasound detected a neoplasm in the projection of the folding section. Percutaneous harpoon biopsy was performed under ultrasound guidance because standard clinical and instrumental studies were unable to confirm the diagnosis. Histological study of the biopsy material confirmed the “relapse of larynx squamous cell carcinoma”.Conclusion. A transdermal harpoon biopsy under ultrasound guidance followed by morphological biopsy study makes it possible to diagnose the disease and determine therapeutic approach as soon as possible.

Objectives In order to improve the security of departmental information technology systems and the rationality of the financial costs of hardware solutions in such systems, it is advisable to develop a simulation model of the information technology system of an internal affairs authority (ITS ATS) connected to the Internet to determine the likelihood of damage occurring denial of service attacks. Lead and clarify for the ITS ATS a classification of modern-time complex ITS, which will allow identifying possible threats to the ITS information resource ATS based on open federal and departmental regulatory documents in connection with Internet connection. Further development of the ATS ITS model was done in the Anylogic simulation environment, which makes it possible to simulate a denial of service attack on a departmental resource and investigate the likelihood of damage occurring. The expressions from the apparatus of queuing systems are given, which allow modeling the attack and calculating the probability of damage occurrence, which is advisable to use when designing such systems in ATS. Method. Analytical and mathematical modeling using the apparatus of queuing systems. Result. A simulation model of ITS ATS is proposed, which allows to determine the probability of a destructive impact on the departmental resources of such systems. Conclusion. The direction of this study is relevant and requires further development in order to develop a methodology for assessingthe occurrence of damage in ITS ATS.

Now that the Supreme Court has upheld the constitutionality of the Patient Protection and Affordable Care Act (“PPACA”), access to medical care will sharply increase.  But the new law will do little to reign in the rapidly increasing cost of medical care in the United States.  Regulatory controls on prices or benefits, favored by some on the left, are political non-starters in today’s environment. Consumer directed health care (“CDHC”) proposals, which seek to provide patients with financial incentives to equate marginal costs and benefits at the point of treatment and is favored by many on the right, is infeasible because of the skewed distribution of health care expenses and patient bounded rationality. New approaches are desperately needed.This article proposes a government-facilitated but market-based approach to improvingefficiency in the market for medical care that I call “relative value health insurance.”  The approach would enable even boundedly-rational patients to contract for the efficientlevel of health care services ex ante through their health insurance purchase decisions.The key to facilitating efficient contracting by boundedly-rational consumers is thecreative use of comparative effectiveness research (“CER”), which the PPACA funds at a significant level for the first time. CER should be used to create public ratings ofmedical treatments on a scale of 1-10 based on their relative value, taking into accountcosts and expected benefits.  These relative value ratings would enable consumers tocontract with insurers for different levels of medical care at different prices, reflecting different cost-quality tradeoffs.After situating the concept of relative value health insurance within the context of ahealth insurance system that encourages overuse of resources and CDHC proposals that cannot mitigate the problem, the article describes the considerable benefits of relativevalue health insurance  and considers some of the formidable obstacles to making it areality.

Two parties reach an oral agreement. The first then presents a standard form contract, which the second signs without reading, or without reading carefully. When the second party later objects that the first did not perform according to the oral representations, the first party points out that the signed document includes different terms or disclaims prior representations and promises. I call this all-too-common occurrence the “Borat problem,” after litigation over the 2006 movie of that name based on this fact pattern.The Borat problem exists on the blurry border between tort and contract law. This article describes the doctrinal indeterminacy and the underlying normative problem of bilateral opportunism that has caused courts to respond to the problem in a variety of inconsistent and unsatisfying ways. It then makes the case that the costs of contracting can be minimized if parties who draft standard form contracts are required to obtain “specific assent” from their counterparts in order to contradict or disclaim prior representations, and non-drafting parties are required to satisfy a heightened evidentiary standard before being permitted to challenge the enforceability of standard form terms on the grounds of fraud or misrepresentation.

Detailed radiative transfer simulations of kilonovae are difficult to apply directly to observations; they only sparsely cover simulation parameters, such as the mass, velocity, morphology, and composition of the ejecta. On the other hand, semianalytic models for kilonovae can be evaluated continuously over model parameters, but neglect important physical details which are not incorporated in the simulations, thus introducing systematic bias. Starting with a grid of two-dimensional anisotropic simulations of kilonova light curves covering a wide range of ejecta properties, we apply adaptive learning techniques to iteratively choose new simulations and produce high-fidelity surrogate models for those simulations. These surrogate models allow for continuous evaluation across model parameters while retaining the microphysical details about the ejecta. Using a code formultimessenger inference developed by our group, we demonstrate how to use our interpolated models to infer kilonova parameters. Comparing to inferences using simplified analytic models, we recover different ejecta properties. We discuss the implications of this analysis which is qualitatively consistent with similar previous work using detailed ejecta opacity calculations and which illustrates systematic challenges for kilonova modeling. An associated data and code release provides our interpolated light-curve models, interpolation implementation which can be applied to reproduce our work or extend to new models, and our multimessenger parameter inference engine.

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