bluuebunny/crossref_metadata_2025 huggingface dataset:
Selective Antegrade Cerebral Perfusion With or Without Additional Lower Body Perfusion During Aortic Arch Reconstruction in Infants
Authors: Kulyabin Yuriy Y. , Gorbatykh Yuriy N. , Soynov Ilya A. , Zubritskiy Alexey V. , Voitov Alexey V. , Bogachev-Prokophiev Alexander V.
Published: December 2019

Background:

Aortic arch reconstruction is often challenging, especially in infants, owing to its high postoperative complication risks. This study aimed to compare the effectiveness between selective antegrade cerebral perfusion (SACP) alone and SACP in combination with continuous lower body perfusion with descending aortic cannulation (DAC) in preserving renal function, and to determine the influence of perfusion strategy on the postoperative course of infants who underwent aortic arch reconstruction.

Material and Methods:

A total of 121 infants who underwent aortic arch reconstruction between January 2008 and December 2018 were included in the analysis. Patients (median age: 29 days, range: 3-270 days) were divided into the following groups: those who underwent repair with SACP (SACP group, 79 patients) and those who underwent additional lower body perfusion (DAC group, 42 patients).

Results:

Three (7.1%) and nine (11.4%) patients died in the DAC and SACP groups, respectively ( P = .54). The SACP group had more patients requiring renal replacement therapy ( P = .002) and higher incidence of second stage acute kidney injury (AKI) development (Kidney disease improving global outcomes (KDIGO) criteria; P = .032). The SACP group had higher frequency of open chest postoperatively than the DAC group ( P = .011). The DAC group had lower vasoactive inotropic score (VIS) at the first postoperative day ( P < .001) and shorter intensive care unit length of stay ( P = .050). There was no difference in neurological complications between the groups ( P = .061). High VIS was associated with early mortality (odds ratio [OR]: 1.79 [1.33-2.41], P < .001) and AKI (OR: 1.60 [1.35-1.91], P < .001). The DAC perfusion strategy with minimal hypothermia was associated with lower risk of AKI (OR: 0.91 [0.84-0.98], P = .016).

Conclusion:

Antegrade cerebral perfusion with continuous lower body perfusion via DAC could effectively be used for improving early postoperative results among infants undergoing procedures that include aortic arch reconstruction.
Double-Outlet Right Atrium: Review of a Rare Anomaly With an Exemplary Case
Authors: Ambra Miette , Halkawt Ali Nuri , Giuseppe Pomé , Maurizio Marasini , Francesco Santini
Published: December 2019

Background:

Double-outlet right atrium (DORA) is a rare congenital cardiac defect, where the right atrium (RA) is connected to both the right ventricle (RV) and the left ventricle (LV). Double-outlet right atrium is classified into two types, each containing two subtypes: malaligned atrial septum with common or single atrioventricular (AV) valve and malaligned ventricular septum (VS) with adequate or inadequate RV. The VS type is characterized by straddling right AV valve (RAVV) with intact VS, resulting in two RAVV orifices.

Methods:

We report a case of “acquired DORA” in a 17-year-old male patient previously treated with subaortic VSD closure. At admission, we diagnosed DORA with VS malalignment and adequate RV. The patient had 2 orifices within the RAVV, connecting the RA to both the RV (via RAVV orifice 1) and the LV (via RAVV orifice 2). The latter was insufficient, with severe LV to RA shunt. A review of the literature indexed in PubMed and Scopus databases was undertaken.

Results:

The patient underwent biventricular repair through closure of the RAVV orifice 2 with a pericardial patch. Pacemaker implantation for complete AV block was necessary. Postoperative course and follow-up were regular. The literature review showed 39 cases of DORA, of which 8 had a malaligned VS and an adequate RV, as in our case.

Conclusion:

Acquired DORA is an interesting post-surgical variant of a rare congenital heart defect. Biventricular repair is a feasible and viable option, which involves closing the third AV orifice. Careful attention is required in order to avoid injury to the conduction system.
Association between body mass index (BMI) and hypertension in south Asian population: evidence from nationally-representative surveys
Authors: Hossain Fariha Binte , Adhikary Gourab , Chowdhury Ariful Bari , Shawon Md Shajedur Rahman
Published: December 2019

Background

Although there has been a well-established association between overweight-obesity and hypertension, whether such associations are heterogeneous for South Asian populations, or for different socioeconomic groups is not well-known. We explored the associations of overweight and obesity using South Asian cut-offs with hypertension, and also examined the relationships between body mass index (BMI) and hypertension in various socioeconomic subgroups.

Methods

We analysed the recent Demographic and Health Survey (DHS) data from Bangladesh, India, and Nepal, with a total of 821,040 men and women. Hypertension was defined by 2017 ACC/AHA cut-offs and by Joint National Committee 7 (JNC7) cut-offs for measured blood pressure and overweight and obesity were defined by measured height and weight. We used multiple logistic regressions to estimate the odds ratios (ORs) with 95% confidence intervals (CIs) of hypertension for overweight and obesity as well as for each 5-unit increase in BMI.

Results

The prevalence of hypertension using JNC7 cut-offs among participants increased by age in all three countries. The prevalence ranged from 17.4% in 35–44 years to 34.9% in ≥55 years in Bangladesh, from 4.6% in 18–24 years to 28.6% in 45–54 years in India, and from 3.8% in 18–24 years to 39.2% in ≥55 years in Nepal. Men were more likely to be hypertensive than women in India and Nepal, but not in Bangladesh. Overweight and obesity using both WHO and South Asian cut-offs were associated with higher odds of hypertension in all countries. For each 5 kg/m2 increase in BMI, the ORs for hypertension were 1.79 (95% CI: 1.65–1.93), 1.59 (95% CI: 1.58–1.61), and 2.03 (95% CI: 1.90–2.16) in Bangladesh, India, and Nepal, respectively. The associations between BMI and hypertension were consistent across various subgroups defined by sex, age, urbanicity, educational attainment and household’s wealth index.

Conclusions

Our study shows that the association of BMI with hypertension is stronger for South Asian populations at even lower cut-offs points for overweight and obesity. Therefore, public health measures to reduce population-level reduction in BMI in all population groups would also help in lowering the burden of hypertension.
Expansion and Impaired Mitochondrial Efficiency of Deep Subcutaneous Adipose Tissue in Recent-Onset Type 2 Diabetes
Authors: Bódis Kálmán , Jelenik Tomas , Lundbom Jesper , Markgraf Daniel F , Strom Alexander , Zaharia Oana-Patricia , Karusheva Yanislava , Burkart Volker , Müssig Karsten , Kupriyanova Yuliya , Ouni Meriem , Wolkersdorfer Martin , Hwang Jong-Hee , Ziegler Dan , Schürmann Annette , Roden Michael , Szendroedi Julia ,   GDS Study Group, Buyken A E , Belgardt B , Geerling G , Al-Hasani H , Herder C , Hwang J H , Icks A , Kotzka J , Kuss O , Lammert E , Markgraf D , Müssig K , Rathmann W , Szendroedi J , Ziegler D , Roden M
Published: December 2019

Context/Objective

Impaired adipose tissue (AT) function might induce recent-onset type 2 diabetes (T2D). Understanding AT energy metabolism could yield novel targets for the treatment of T2D.

Design/Patients

Male patients with recently-diagnosed T2D and healthy male controls (CON) of similar abdominal subcutaneous AT (SAT)-thickness, fat mass, and age (n = 14 each), underwent hyperinsulinemic-euglycemic clamps with [6,6-2H2]glucose and indirect calorimetry. We assessed mitochondrial efficiency (coupling: state 3/4o; proton leak: state 4o/u) via high-resolution respirometry in superficial (SSAT) and deep (DSAT) SAT-biopsies, hepatocellular lipids (HCL) and fat mass by proton-magnetic-resonance-spectroscopy and -imaging.

Results

T2D patients (known diabetes duration: 2.5 [0.1; 5.0] years) had 43%, 44%, and 63% lower muscle insulin sensitivity (IS), metabolic flexibility (P < 0.01) and AT IS (P < 0.05), 73% and 31% higher HCL (P < 0.05), and DSAT-thickness (P < 0.001), but similar hepatic IS compared with CON. Mitochondrial efficiency was ~22% lower in SSAT and DSAT of T2D patients (P < 0.001) and ~8% lower in SSAT vs DSAT (P < 0.05). In both fat depots, mitochondrial coupling correlated positively with muscle IS and metabolic flexibility (r ≥ 0.40; P < 0.05), proton leak correlated positively (r ≥ 0.51; P < 0.01) and oxidative capacity negatively (r ≤ −0.47; P < 0.05) with fasting free fatty acids (FFA). Metabolic flexibility correlated positively with SAT-oxidative capacity (r ≥ 0.48; P < 0.05) and negatively with DSAT-thickness (r = −0.48; P < 0.05). DSAT-thickness correlated negatively with mitochondrial coupling in both depots (r ≤ −0.50; P < 0.01) and muscle IS (r = −0.59; P < 0.01), positively with FFA during clamp (r = 0.63; P < 0.001) and HCL (r = 0.49; P < 0.01).

Conclusions

Impaired mitochondrial function, insulin resistance, and DSAT expansion are AT abnormalities in recent-onset T2D that might promote whole-body insulin resistance and increased substrate flux to the liver.
Diurnal Patterns for Cortisol, Cortisone and Agouti-Related Protein in Human Cerebrospinal Fluid and Blood
Authors: Panigrahi Sunil K , Toedesbusch Cristina D , McLeland Jennifer S , Lucey Brendan P , Wardlaw Sharon L
Published: December 2019

Context

Cortisol in blood has a robust circadian rhythm and exerts potent effects on energy balance that are mediated in part by central mechanisms. These interactions involve orexigenic agouti-related protein (AgRP) neurons that are stimulated by glucocorticoids. However, diurnal changes in brain or cerebrospinal fluid (CSF) cortisol and cortisone, which are interconverted by 11ß-HSD1, have not been characterized in humans.

Objective

To conduct a secondary analysis of existing samples to characterize diurnal changes in cortisol and cortisone in CSF and examine their relationships to changes in AgRP.

Methods

Stored CSF and plasma samples were obtained from 8 healthy subjects who served as controls for a sleep study. CSF was collected every 2h for 36h via indwelling lumbar catheter; plasma was collected every 2h.

Results

There was a diurnal rhythm for cortisol and cortisone in CSF that closely followed the plasma rhythm by 2 h with peak and nadir levels at 0900h and 0100h. The ratio of cortisol (active) to cortisone (inactive) in CSF was 48% higher at the peak versus nadir. There was a diurnal rhythm for AgRP in plasma that was out of phase with the cortisol rhythm. There was a less distinct diurnal rhythm for AgRP in CSF that oscillated with a similar phase as cortisol.

Conclusions

There is a robust diurnal rhythm for cortisol and cortisone in CSF. Diurnal changes were noted for AgRP that are related to the cortisol changes. It remains to be determined if AgRP mediates adverse metabolic effects associated with disruption of the cortisol circadian rhythm.
Hypercoagulability in Cushing Syndrome, Prevalence of Thrombotic Events: A Large, Single-Center, Retrospective Study
Authors: Suarez Maria Gabriela , Stack Madeleine , Hinojosa-Amaya Jose Miguel , Mitchell Michael D , Varlamov Elena V , Yedinak Chris G , Cetas Justin S , Sheppard Brett , Fleseriu Maria
Published: December 2019

Background

The risk of Cushing syndrome (CS) patients experiencing a thrombotic event (TE) is significantly higher (odds ratio; OR 18%) than that of the general population. However, there are currently no anticoagulation guidelines.

Methods

A retrospective, single-center, longitudinal study of patients undergoing all types of treatment—surgical (pituitary, unilateral, and bilateral adrenalectomy) and medical treatment—was undertaken. TEs were recorded at any point up until last patient follow-up; myocardial infarction (MI), deep venous thrombosis (DVT), and pulmonary embolism (PE) or stroke. Patients’ doses and complications of anticoagulation were recorded.

Results

Included were 208 patients; a total of 165 (79.3%) were women, and mean age at presentation was 44 ± 14.7 years. Thirty-nine (18.2%) patients had a TE; extremity DVT (38%), cerebrovascular accident (27%), MI (21%), and PE (14%). Of 56 TEs, 27 (48%) were arterial and 29 (52%) were venous. Patients who underwent bilateral adrenalectomy (BLA) had an odds ratio of 3.74 (95% CI 1.69-8.27) of developing a TE. Of patients with TEs, 40.5% experienced the event within the first 60 days after surgery. Baseline 24-hour urinary free cortisol levels did not differ in patients with or without TE after BLA. Of 197 patients who underwent surgery, 50 (25.38%) received anticoagulation after surgery, with 2% having bleeding complications.

Conclusions

The risk of TEs in patients with CS was approximately 20%. Many patients had more than 1 event, with higher risk 30 to 60 days postoperatively. The optimal prophylactic anticoagulation duration is unknown, but most likely needs to continue up to 60 days postoperatively, particularly after BLA.
Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population
Authors: Fatima Fasiha , Ahsan Naveed , Nasim Aliya , Alam Faiza
Published: December 2019

Background & Objective: Fetuin-A, hepatokine is responsible for instigating insulin resistance by inhibiting tyrosine kinase receptors. Our objective was to investigate the relationship of fetuin-A with dyslipidemia and insulin resistance in type-II diabetics of Pakistani population.

Methods: In this cross sectional study which was conducted at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi between October 2013 to March 2014, a total of 330 participants were selected and divided into two groups. Group-A (n = 165) normal healthy individual and Group-B (n = 165) Type-II diabetes mellitus mellitus with no comorbidities. Serum fetuin-A and insulin levels were determined by commercially prepared ELISA kits while fasting blood glucose (FBG) and lipid profile were performed by enzymatic kit method. Employing independent t-test, comparison of groups was done and correlation was achieved by using spearman correlation.

Results: The results demonstrate a significant difference in mean values of fetuin-A, lipid profile, glucose, insulin and Homoeostasis Model Assessment of Insulin resistance (HOMA-IR) in type-II diabetics when compared to normal healthy individuals (p<0.01). A positive correlation was found between serum fetuin-A levels and FBG(r= 0.495, p< 0.001), insulin(r= 0.227, p< 0.001), HOMA-IR(r= 0.336, p<0.001, triglycerides(r= 0.197, p< 0.001) and LDL-cholesterol(r= 0.170, p= 0.002), while negative correlation with HDL-cholesterol(r= -0.251, p< 0.001).

Conclusion: The study concludes that fetuin-A might be accountable for dyslipidemia and insulin resistance in type-II diabetes mellitus mellitus. So the high levels of Fetuin-A responsible for insulin resistance might alters endothelium and causes inflammation, vasoconstriction and thrombosis and ultimately atherosclerosis.

doi: https://doi.org/10.12669/pjms.36.2.1106

How to cite this:Fatima F, Ahsan N, Nasim A, Alam F. Association of fetuin-A with dyslipidemia and insulin resistance in type-II Diabetics of Pakistani population. Pak J Med Sci. 2020;36(2):64-68. doi: https://doi.org/10.12669/pjms.36.2.1106

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical effect and safety evaluation of different dosage of Rituximab combined with Cyclophosphamide in treatment of refractory immune Thrombocytopenia
Authors: Wang Zhibin , Ren Yu , Huang Weibo , Yao Haiying
Published: December 2019

Objective: To discuss clinical effect of different dosage of rituximab combined with cyclophosphamide in treatment of refractory immune thrombocytopenia (rITP).

Method: This study was conducted at Department of Hematopathology in XX Hospital from January 2016 to January 2018. In this study. Seventy-eight patients with rITP were selected as the objects, divided into observation group (39 cases) and control group (39 cases) according to random number table. Patients in the control group were treated with conventional rituximab and cyclophosphamide, while the observation group received low-dose rituximab. The same amount of cyclophosphamide was used in the two groups. The statistics of clinical effect, recurrence rate, untoward effect and Laboratory inspection of both groups were made before and after the treatment.

Results: Compared with the control group, the total occurrence rate of side effects in the observation group decreased significantly; the level of IgM and CD20+ in the observation group also decreased significantly, while. The level of IgA, IgG, CD3+ and CD4+ rose significantly (P<0.05). The differences in the level of Th1, TNF-a, IL-18 and Sc5b-9 had statistical significance before and after the treatment (P<0.05).

Conclusion: Rituximab combined with cyclophosphamide has the definite curative effect on rITP. The small dosage of rituximab combined with cyclophosphamide has higher clinical safety in the treatment.

doi: https://doi.org/10.12669/pjms.36.2.1168

How to cite this:Wang Z, Ren Y, Li M, Huang W, Yao H. Clinical effect and safety evaluation of different dosage of Rituximab combined with Cyclophosphamide in treatment of refractory immune Thrombocytopenia. Pak J Med Sci. 2020;36(2):69-74.   doi: https://doi.org/10.12669/pjms.36.2.1168

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses
Authors: Alshoabi Sultan Abdulwadoud , Binnuhaid Abdulkaleq Ayedh , Gameraddin Moawia Bushra , Alsultan Kamal Dahhan
Published: December 2019

Background & Objective: Chronic rhino sinusitis (CRS) is an inflammatory condition of the paranasal sinuses and the nasal passage lasting more than three months either with or without sinonasal polyps. This study aimed to report the common sinonasal lesions associated with CRS according to the histopathology results, to compare between clinical and histopathological diagnoses, and to compare between radiological and histopathological diagnoses of the sinonasal lesions.

Methods: A retrospective study of the electronic records of 82 patients diagnosed with CRS with nasal polyps. All patients underwent endoscopic sinus surgery and histopathological examination of surgical biopsies. The collected data were analyzed using SPSS program. Coparison between clinical and histopathological diagnoses was done. This study was conducted at Alsafwa Consultative Medical center (ACMC) in Almukalla city, Hadhramout province in Republic of Yemen.

Results: Out of 82 patients, the ages ranged from 4 to 90 years (mean: 34.48±17.74 years), and 54.88% were females. Inflammatory polyps were the most common lesion (31.4%), then allergic polyps (30.5%). Nasopharyngeal carcinoma (NPC) was reported in 9.8% of the lesions and all were unilateral. The results revealed strong compatibility between clinical and histopathological diagnoses (p<0.001, kappa= 0.215), and significant compatibility between radiological and histopathology diagnoses (p=0.007).

Conclusion: Inflammatory and allergic polyps are the most common benign bilateral lesions associated with chronic rhinosinusitis, which can be correctly diagnosed clinically in most cases. Unilateral nasal polyps have high rates of malignancies and should be check carefully by endoscopy and histopathology. Computed tomography has some pitfalls in diagnosing of fungal sinusitis.

Abbreviations: CRS: Chronic rhino sinusitis, CRSwNP: CRS with nasal polyps, CRSsNP: CRS without nasal polyp, Eos CRSwNP: CRSwNP and eosinophilic inflammation, PNS: paranasal sinuses, EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012, ACMC: Alsafwa Consultative Medical center, NECT: non-enhanced computed tomography, SPSS: Statistical Package for the Social sciences, IBM: International Business Machines, NY: New York, NPC: Nasopharyngeal carcinoma.

doi: https://doi.org/10.12669/pjms.36.2.1453

How to cite this:Alshoabi SA, Binnuhaid AA, Gameraddin MB, Alsultan KD. Histopathological analysis of sinonasal lesions associated with chronic rhinosinusitis and comparison with computed tomography diagnoses. Pak J Med Sci. 2020;36(2):146-150.  doi: https://doi.org/10.12669/pjms.36.2.1453

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Decitabine combined with CAG regimen in the treatment of elderly patients with acute myeloid leukemia
Authors: Zhao Haitao , Wang Chunyan , Yu Fengying , Guo Qingwei
Published: December 2019

Objective: To analyze the efficacy and safety of decitabine combined with CAG ((cytarabine + aclacinomycin + granulocyte colony stimulating factor)) regimen and CAG regimen alone in the treatment of elderly acute myeloid leukemia.

Methods: 96 elderly patients with acute myeloid leukemia who were admitted to our hospital from July 2015 to July 2017 were randomly divided into an observation group and a control group, 48 cases in each group. The patients in the control group were treated with CAG regimen, while the patients in the observation group were treated with decitabine on the basis of the control group. The clinical curative effect, changes of immune indicators, occurrence of adverse reactions and survival rate at different time after treatment were compared between the two groups.

Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the indicators of cellular immunity in the two groups were significantly lower than those before treatment, and the indicators of cellular immunity in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The 9-month survival rate and 1-year survival rate in the observation group were significantly higher than those in the control group (P<0.05).

Conclusion: The combination of decitabine and CAG regimen is effective in the treatment of elderly patients with acute myeloid leukemia. The therapy can fully inhibit cellular immune function and improve long-term survival rate, and its safety has a small difference with that of CAG regimen alone. It is worth clinical promotion.

doi: https://doi.org/10.12669/pjms.36.2.850

How to cite this:Zhao H, Wang C, Yu F, Guo Q. Decitabine combined with CAG regimen in the treatment of elderly patients with acute myeloid leukemia. Pak J Med Sci. 2020;36(2):141-145. doi: https://doi.org/10.12669/pjms.36.2.850

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Psychology of financial literacy of military personnel
Authors: Petrov Vladislav
Published: December 2019

The article is devoted to the problem of psychology of financially competent behavior of servicemen. The psychological etiology of financial literacy / illiteracy of the personnel of the Armed Forces of the Russian Federation is shown. The study was conducted using: 1) content analysis of information (publications, materials of official inspections, etc.) about the attitude of the personnel of law enforcement agencies to money and financial behavior; 2) expert survey; 3) psychodiagnostic examination (method "California psychological questionnaire". Experts and subjects were 67 soldiers.

The study found that financially literate / illiterate behavior is determined by a pattern of both General and specific qualities. The basis of the pattern of General qualities of a soldier with a financially competent command were such characteristics as responsibility, self-control and developed intellectual and prognostic abilities. Persons with financially illiterate behavior were distinguished by: inability to competently plan a personal budget; propensity to risky financial transactions; promiscuity and inattention to spending money; frivolous attitude to debts and loans; focus on spending money, not saving it. Thus, the more socially responsible is the behavior of the soldier, the more they demonstrate financially competent behavior.

The material of the article allows to justify the involvement of military psychologists to solve the problem of improving the financial literacy of personnel. First of all, it concerns preventive psychodiagnostics of propensity of the military personnel to financially illiterate behavior. This should be followed by the provision of psychological assistance to persons in need of it, as well as the formation of the personnel of financial responsibility and predictability, the ability to plan and control personal spending. Ultimately, the work to improve the financial literacy of military personnel will have a positive impact on overcoming the problem of deviant behavior of personnel, as a consequence, to maintain a high level of combat readiness of the Armed Forces.
Celebrating 100 years of nurse regulation
Authors: Glasper Alan , Carpenter Diane
Published: December 2019

Emeritus Professor Alan Glasper, from the University of Southampton, and Mental Health Lecturer and Nurse Historian Diane Carpenter, from the University of Plymouth, discuss the centenary of nurse regulation and consider polices and historical debates that shaped today's nursing regulator, the Nursing and Midwifery Council
Helping patients live well with a stoma for inflammatory bowel disease: directions for future research
Authors: Dibley Lesley , Burch Jennie
Published: December 2019

Lesley Dibley, Reader in Nursing Research and Education, University of Greenwich ( L.B.Dibley@greenwich.ac.uk ), and Jennie Burch, Head of Gastrointestinal Nurse Education, St Mark's Hospital, outline the need to assess patients' emotional as well as physical needs before stoma surgery for IBD
Pulmonary rehabilitation for chronic obstructive pulmonary disease: effects of a high versus low intensity programme
Authors: Bianco Jean Paul , Sciriha Anabel , Lungaro-Mifsud Stephen , Agius Tonio , Scerri Josianne , Montefort Stephen
Published: December 2019

Background/Aims

Pulmonary rehabilitation is known to facilitate improvements in chronic obstructive pulmonary disease symptoms, exercise tolerance and quality of life. Despite this, there is no consensus on the ideal programme intensity. This article aims to explore and compare the benefits of a high intensity and low intensity pulmonary rehabilitation programme.

Methods

A total of 30 patients with a diagnosis of chronic obstructive pulmonary disease were randomly and blindly allocated to either a high intensity or low intensity 12-week pulmonary rehabilitation programme.

Results

Significant improvements in functional and health-related quality of life measures were obtained in both groups. Most of the significant changes for the high intensity group were achieved by week 8. The low intensity group required a further 4 weeks of rehabilitation in order to reach a significant difference.

Conclusions

Results show that both low and high intensity pulmonary rehabilitation programmes were beneficial. However, the high intensity programme was more efficient in achieving these improvements than the low intensity group.
Physico-chemical characterization of hybridized graphene and boron-nitride layers
Authors: Martinez-Alanis Paulina Raquel , Alvarez de la Paz Antonio , Santamaria Ruben
Published: December 2019

New materials can be created by modifying matter. In this work, we characterize graphene and boronnitride (BN) layers after doping them with BN and carbon dimers, respectively, in different amounts and with different spatial distributions. We provide the energetic description, electron density features, molecular electrostatic potential maps, net charge populations, and the speeds of propagating waves on the hybridized layers. We show the possibility of designing molecular electrostatic potentials from a spatially controlled doping. A strategy is illustrated on a BN hybrid layer with the adsorption of DNA nucleic acid bases.
Politics as Tragedy: The Logic of Common Access to Social Value
Authors: Yoon Yong J.
Published: December 2019

We develop new theoretical elements of anti-commons and membership externality, which become essential in analyzing the budget politics and basic questions in public economy. The anti-commons problem arises when there exist multiple rights to exclude. We develop a model for anti-commons and analyze the fiscal commons problem. When separate majority coalitions may authorize simultaneous usage of a common resource, total value is dissipated, but the interdependencies introduced by possible membership in differing coalitions, to an extent, reduce the incentives for exploitation. The theory of rationality as prudence, exposited for individual choice, has been extended to collective choice for budget rule.
Public Deficits and Borrowing Costs: The Missing Half of Market Discipline
Authors: Heinemann Friedrich , Winschel Viktor
Published: December 2019

EMU driven interest rates’ convergence has led to a significant reduction of borrowing costs for some European governments in the second half of the nineties. The paper deals with the possible consequences for deficit behaviour. Although the impact of interest rates on deficits is a crucial element of the market discipline hypothesis, it has widely been neglected in the literature. In the theoretical part, a standard political economic model of budgetary policy (Hettich-Winer) is adapted. It turns out that borrowing costs, measured as the interest-growth-differential, and the level of public debt should be important determinants for public deficits. The econometric part tests these predictions for a panel of OECD countries. The results indicate that there is indeed a significant impact of borrowing costs on the primary surplus. This impact is characterised by a robust asymmetry: Reactions in times of increasing borrowing costs are more pronounced than in times of relaxing conditions.
Forty Years on, and Counting
Authors: Buchanan James M.
Published: December 2019

The Calculus of Consent’s aim was to construct a theory of politics from the foundations of individual rational choice. The Authors’ intention was to fill the gap in social science reflected in the continuing failure to analyze collective action through an individual choice perspective. The research program now called ‘constitutional economics’ was a natural outgrowth of the precautionary analytics of the early efforts.
Hayek, Arrow, and the Problems of Democratic Decision–Making
Authors: Boettke Peter J. , Leeson Peter T.
Published: December 2019

Both Hayek and Arrow provide arguments about the inability of the vote process to yield a coherent social choice. Hayek demonstrated that planning is incompatible with democracy; its coherence requires dictatorship. Arrow demonstrated that voting fails to produce rational social choices; social rationality can be assured only when there is a single will. In both, the substitution of a single will for the many wills is ruled as incompatible with a free society. Because market socialism relies upon either the existence of a meaningful, stable social welfare function or democratic decision-making to allocate resources, the complementary arguments of Hayek and Arrow imply that market socialism requires dictatorship to achieve coherence.
Stability of the Exchange–Rate Agreements and Public Debt Management: the Italian Experience within the EMS
Authors: Maggi Bernardo
Published: December 2019

This paper analyses the issue of the interdependence between fundamentals and expectations in the emergence of a currency crisis from both a theoretical and an empirical point of view with specific reference to the Italian case.

Theoretically, currency crises depend as much on fundamentals as on expectations, and the latter again on the critical condition of the former for the associated profit opportunity. Hence, in order to reduce the risk of a new speculative attack, an appropriate public debt management, which for its high level is the main fundamental in Italy, and fiscal policy must be adopted. These may be implemented with the evaluation of the probability associated to devaluation, which enables the policy-maker to identify the critical condition for die occurrence of the crisis. The empirical analysis also provides evidence in favour of the theory that points public budget government policy as one of the major factors in leading to a non-viable fixed exchange rate regime.
The Economics of Decentralization: A Review of the Literature and the Case of Education Provision
Authors: Gatti Roberta
Published: December 2019

This paper reviews the economic rationale for and against decentralization with particular attention to the organization and delivery of education. The paper frames the overview within the standard efficiency-equity trade off and highlights the increasingly important role of incentive mechanisms, accountability, and citizens' participation. The discussion then turns to the issues that are specific to decentralizing education, including the pros and cons of financing schools from local taxes, and a taxonomy and description of institutional arrangements around the world. A brief review of evaluation studies of decentralization reforms in education concludes the paper.
Bentham’s Economics of Legislation
Authors: Guidi Marco E. L.
Published: December 2019

This paper aims to highlight the economic dimension of Bentham's legal and political theory. Traditional assessments of the British legal and political system described judges and statesmen as 'wise legislators' who pursue the welfare of their subjects similarly to virtuous householders. Bentham's utilitarian restatement of the 'science of legislation' introduced a new notion of 'economy' intended as maximisation of pleasure and minimisation of pain. Under this label he evaluated laws and institutions according to the positive and adverse incentives they contained, and to the costs and benefits they had for individuals and for die community at large. The relationship between the economic analysis of laws, regulations and institutions and political economy is also examined in this paper.
Why do Governments Lack ‘Political Will’? An Explanation from the Transaction Cost Perspective
Authors: Karnik Ajit
Published: December 2019

This paper is concerned with the predilection of the ruling political party to promote the interests of powerful interest groups while at the same time neglecting the interests of the diffused mass of voters. We try to offer an explanation for this ‘lack of political will’ from the transaction cost perspective. We model the relationship between the ruling party and interest groups, and between the ruling party and rest of the voters as political contracts, each of which has its own transactions costs. The contract, which involves lower or reducible transaction costs will be preferred by the ruling political party.
Managerial Discretion, Incentives and Governance Rules for Non–Profit Organizations
Authors: Antonelli Maria Alessandra
Published: December 2019

This paper analyzes the effects of managerial discretion and some possible solutions in non-profit sector. It is shown how the traditional incentives’ mechanisms are modified in a non-profit setting. In particular, market, reputational and ideological incentives are considered. The analysis highlights that new governance rules are necessary. In this context a new financial model is analyzed where the competition between for-profit and non-profit firms is extended from the products level to that of private financing.
Inefficient Market Pricing: An Illusory Economic Box
Authors: Brancato Kevin , Wagner Richard E.
Published: December 2019

Welfare economics typically holds that market outcomes are Pareto efficient only if markets are competitive and average costs are constant or increasing. Otherwise, to attain market efficiency requires some regulatory implementation of a rule to equate price to marginal cost, though the ability of such a pricing rule to accomplish this is tempered by second-best considerations. In contrast to this typical claim, we explain why market prices must be Pareto efficient even in the presence of decreasing average costs. The existence of an analytical box labeled ‘inefficient pricing’ turns out to be an illusion that is generated by the imposition of a theoretical convention of price uniformity that has no basis for existence other than analytical convenience. In short, profit seeking alone is sufficient for Pareto efficiency, for Pareto inefficiency simultaneously means that firms are failing to exploit opportunities for profit, and to embrace such a failure provides a poor basis for economic modeling.
Tax Harmonization and Expenditure Competition among Self-interested Governments
Authors: Hensberg Claudia
Published: December 2019

In this paper the effect of tax harmonization on intergovernmental expenditure competition is analysed. To this end, it is assumed that self-interested governments cannot influence tax rates, since taxes are harmonized, but that they can freely choose expenditure policies and, by this, attract additional capital and broaden the assessment base of a capital tax. Hence, self-interested governments might have a financial incentive to provide for public input besides re-election oriented motivations. Since additional tax income from public input provision depends on the harmonized capital tax rate, the choice of the tax rate indirectly determines the amount of public input supplied by governments in expenditure competition.
Green Taxes in the European Union: The Illuminating Quality of Alternative Conceptual Frameworks
Authors: Ruble Isabella
Published: December 2019

This paper examines observed environmental taxes and revenue structures in die European Union in light of the two major contrasting approaches to the study of public finance. The first orientation is theoretical and views public finance as an independent field of study drawing its inspirations not only from economics, but also from politics, law and other disciplines. In the second orientation public finance is viewed as one of the many branches of economics and the task of the scholar is reduced to advising the tax authority about revenue raising strategies. The aim of this paper is to highlight the explanatory power of these contrasting approaches with respect to the observed stylized facts concerning environmental taxes in the European Union.
Economic Integration, Legitimacy and European Union Enlargement
Authors: Kyriacou Andreas P.
Published: December 2019

The enlargement of the European Union generates socio-economic costs and benefits for the citizens of new members and as such it is bound to affect their perceived legitimacy of the whole enterprise. The legitimacy of EU accession is likely to be enhanced by the inclusion of compensatory transfers and transition periods in the terms of accession, by the perception that EU membership represents the most favorable terms of exchange available and by the linking of accession to a sustained period of economic growth, a favorable movement in prices, improving relative incomes and the consolidation of a level playing field across new members.
The Moral Voter Hypothesis: Economic and Normative Aspects of Public Policy and Law within Democracies
Authors: Congleton Roger D.
Published: December 2019

This paper develops a model of self-interested norm-driven behavior and uses it to analyze public policy formation within a democracy. Many of the positive predictions of the moral voter hypothesis differ from those of narrow self-interested models of policy formation. For example, the model predicts that laws regulating conventional externalities will be more stringent (or less stringent) than can be justified by ordinary economic considerations whenever such laws affect behavior that is relevant for widely held normative theories. If voters are concerned with broad normative issues, politicians will take policy positions in part to advance voter interests in ‘virtue’ or ‘the public interest’ as voters assess it. Consequently, many of the laws adopted within a democracy will advance private normative agendas as understood by pivotal members of the electorate. In this sense, a ‘public interest’ interpretation of at least some government policies is entirely consistent with a rationalchoice- based analysis of decision making within a democracy. Criminal sentences for some crimes in the United States are consistent with the model's implications.
Campaign Expenditures under Proportional Representation and Plurality Voting
Authors: Lockard Alan A.
Published: December 2019

This article compares proportional representation and plurality voting with respect to the level of effort in the form of campaign expenditures and finds that, ceteris paribus, campaign expenditures should be higher under plurality voting.
Political and Economic Effects of Tax Competition and Deficits
Authors: Pitsoulis Athanassios , Siebel Jens Peter
Published: December 2019

In order to explain chronic budget deficits and to explore the political and economic effects we use a graphical model which combines the theories of strategic deficit, tax competition and the taming of the Leviathan. In a small open economy international tax competition builds up a constant threat of capital flight thus preventing capital from being taxed too high. A conservative government then has an incentive to leave a deficit as a result of a combined strategy. In this strategy, the desire to tie the successor's hands and the opportunity to extract an extra rent for the government are complements.
Emergence of Cooperation in Public Goods Problems
Authors: Roháč Dalibor
Published: December 2019

In this paper, we discuss several issues related to public goods provision. Unlike many Austrians, we do not think that the concept of public goods - or of collective action - is an inherently flawed idea, even though we reject the alleged welfare implications of public goods theory, as proposed by orthodox public finance literature. We then argue that the structure of a generic public goods problem is more a game of chicken or an assurance game than a prisoner's dilemma and that this has important implications with regard to the plausibility of cooperative outcomes. Namely, when the public goods problem has the weakest-link structure and can be represented as an assurance game, then the cooperative outcome will be self-enforcing. In many cases, the public goods problems can be transformed into weakest-link games or different mechanisms can be found to ensure cooperation. We also discuss the difference between a public goods problem and collusion. We assert that, unlike public goods problems, collusive agreements have the structure of a prisoner's dilemma. Overall, our paper suggests that there are reasons to be optimistic about stability and efficiency of stateless societal orders.
The Two–dimensional Model of Jury Decision Making
Authors: Holler Manfred J.
Published: December 2019

This paper discusses a two-dimensional jury model. It combines the idea of winning a maximum of votes in a voting game with utility maximization that derives from the winning proposition. The model assumes a first mover, the plaintiff, and a second-mover, the counsel of the defendant. Typically, these agents represent parties that have conflicting interests. Here they face a jury that consists of three groups of voters such that no single group has a majority of votes. Each group is characterized by homogeneous preferences on three alternatives that describe the possible outcomes. The outcome is selected by a simple majority of the jury members. The agents are interested in both gaining the support of a majority of jury members and seeing their preferred alternative selected as outcome. It will be demonstrated that equilibrium decision making can be derived for this model.
Income Inequality and Crime: An Empirical Analysis of the Italian Case
Authors: Astarita Caterina
Published: December 2019

This paper examines the relationship between income inequality and crime from an empirical perspective referring to Italy as a case study. Both static and dynamic panel data techniques are applied to a dataset drawn from 19 Italian regions for the period 1980-2004. As the key independent variable selected is the Gini index, further inequality measures are used for checking the robustness of the results. The econometric exercises suggest a negative link between inequality and crime. The finding, infrequently recognized in the relevant literature, can be supported by some broad explanations as well as by some peculiarities of the Italian case.
The Impact of French Privatization on Firms’ Performance
Authors: M’Rad Mouna , Hallara Slaheddine
Published: December 2019

The aim of this paper is to study the impact of privatization on performance. After reviewing the literature, we found some limitations and methodological problems associated with several previous studies. Therefore, we apply a methodology which takes into account die effect of die endogenous privatization decision as well as the economic and contextual variables affecting die nature of relationship between privatization and performance. The results support the positive effect of privatization on performance. They also reveal die existence of an indirect impact of the privatization decision through its determinants on performance.
Contracts of Public Works: How to Guarantee Low Prices without Reducing Quality
Authors: Lupo Mario
Published: December 2019

The legislation regarding public contracts for works, services and supplies refers to contracts through which the Public Administration entrusts compagnie for the realization of public works or suppli of goods and /or services destined to its own use. The discussion here refers specifically to contracts relating to public works. Criterions to select the best offer deal with issues of cost-efficiency and quality of tenders for public works. Another type of entrustment for the realization if infrastructures goes by the name of public-private partnership (PPP).
Intelligent frequency-shifted optofluidic time-stretch quantitative phase imaging
Authors: Wu Yunzhao , Zhou Yuqi , Huang Chun-Jung , Kobayashi Hirofumi , Yan Sheng , Ozeki Yasuyuki , Wu Yingli , Sun Chia-Wei , Yasumoto Atsushi , Yatomi Yutaka , Lei Cheng , Goda Keisuke
Published: December 2019

Optofluidic time-stretch quantitative phase imaging (OTS-QPI) is a powerful tool as it enables high-throughput (>10,000 cell/s) QPI of single live cells. OTS-QPI is based on decoding temporally stretched spectral interferograms that carry the spatial profiles of cells flowing on a microfluidic chip. However, the utility of OTS-QPI is troubled by difficulties in phase retrieval from the high-frequency region of the temporal interferograms, such as phase-unwrapping errors, high instrumentation cost, and large data volume. To overcome these difficulties, we propose and experimentally demonstrate frequency-shifted OTS-QPI by bringing the phase information to the baseband region. Furthermore, to show its boosted utility, we use it to demonstrate image-based classification of leukemia cells with high accuracy over 96% and evaluation of drug-treated leukemia cells via deep learning.