bluuebunny/crossref_metadata_2025_split huggingface dataset:
Downsides and DCF: Valuing Biased Cash Flow Forecasts
Authors: Ruback Richard S. 
Published: July 2011

The discounted cash flow valuation method relies on expected cash flows. But because they often ignore low‐probability downside events, the forecasts of expected cash flows that are provided by corporate managers and analysts are often excessively optimistic, or upwardly biased. As a result, such forecasts need to be adjusted when used in valuations.Whereas academics generally prefer adjustments of the cash flow forecasts, practitioners typically account for such downsides by increasing t he discount rate above the market‐based cost of capital. This article suggests that the appropriate adjustment to the DCF formula should depend on the nature of the omitted downside.The author shows that when the down side is assumed to be “temporary”— say, a large, weather‐related loss—the appropriate adjustment to the DCF formula is to reduce the forecasts by the expected downside and set the discount rate equal to the market‐based cost of capital. But when the omitted downside scenario is expected to be “permanent”—in the sense that the event reduces all subsequent future cash flows—the appropriate adjustment is to reduce the cash flows and increase the discount rate to reflect the probability that such a downside occurs.By endorsing both of these prescriptions, the author effectively acknowledges that there is a reasonable conceptual basis for both the academic approach of adjusting the forecasted cash flows and the practitioner approach of inflating the discount rate. The appropriate approach depends on the characterization of the omitted downside as either temporary or permanent.
How the U.S. Army Analyzes and Copes with Uncertainty and Risk
Authors: Jones Hugh 
Published: July 2011

In this edited transcript of a presentation at the CARE/CEASA conference, a U.S. army officer who teaches economics and finance at West Point discusses the Army's approach to managing uncertainty and risk while reflecting on his own two tours of duty in Iraq.The U.S. military makes a clear distinction between risk and uncertainty. Whereas “risks” are threats to a mission or operation that can be identified, and at least to some degree controlled or mitigated, “uncertainty” applies to unknown or ambiguous hazards that resist any application of probability theory or quantitative methods. The risk mitigation process begins with assessments of the probability and severity of a given risk followed by the development of controls designed to limit that risk. Once the controls are implemented, the process becomes a continuous feedback loop in which the controls are evaluated and, if ineffective, either adjusted or eliminated.The Army has two main ways that it tries to mitigate uncertainty: the “information‐focused” solution and the “action‐focused” solution. The information‐focused solution aims to reduce uncertainty by getting better information, and processing and disseminating it more quickly than the enemy. It also aims to avoid the illusion of precision that can come from too detailed predictions and instead plans for a worst‐case scenario as well as a most‐likely scenario. The action‐focused solution acknowledges that, no matter how good your information, some uncertainty is unavoidable, and the aim of this part of the program is to develop, train, and maintain units that can fight and win in the face of uncertainty. Much of this capability is attributed to training and a mission command framework in which intensive strategic planning (involving “the who, what, when, where and why of an undertaking”) and communication of the plan to field commanders and subordinate leaders is combined with heavy emphasis on the exercise of initiative by those field commanders and leaders.
Accounting for Sovereign Risk When Investing in Emerging Markets
Authors: Anshuman V. Ravi , Martin John , Titman Sheridan 
Published: July 2011

In theory, political risk is project‐specific and should be accounted for in the estimation of the expected investment cash flows. But in practice, the political risk associated with this type of investment is typically accounted for implicitly by adjusting the investment's required rate of return or the discount rate. As the authors discuss in the article, this approach disguises the specific assumptions being made about the risk of expropriation and so makes it difficult to assess this risk properly.While defending some aspects of current practice, the authors argue that corporate executives should consider some changes. For example, although a project analysis that is shared with the host government could incorporate a risk adjustment to the discount rate, the authors suggest that more explicit analysis of the anticipated risk of expropriation should be incorporated into the analysis of expected project cash flows. This analysis could involve making specific assumptions about the “term structure” of expropriation risk over the life of the investment.Finally, the authors note that the political risk of making investments in emerging economies can be managed to some extent. Investments can be structured in ways that reduce political risk by structuring project cash flows in ways that better align the incentives of the project sponsor and the government of the host country.
How Corporate Diversity and Size Influence Spinoffs and Other Breakups
Authors: Milano Gregory V. , Treadwell Steven C. , Hopson Frank 
Published: July 2011

In recent months, the list of large diversified companies that have decided they would be worth more as several smaller, focused companies has grown sharply. In many of these cases, it has been outside pressure from activist investors that has motivated these actions by management—and with some pretty favorable results.But what is driving these strategic actions and what is most important in determining whether breakups create value? To answer this fundamental questions, it is critical to decide whether large, diversified companies have a value recognition problem or a value creation problem. In this article, the authors present and try to integrate the findings of two separate but related research studies on business diversity and size with the aim of identifying their implications for corporate strategy and helping company executives create more value for their investors.The specific reasons for underperformance by large diverse companies vary greatly, but there are a number of potential problems discussed in this article, including organizational “distance,” capital allocation, human capital allocation, cross subsidies, and ineffective governance. Instead of waiting for activist investors to demand a breakup, executives of large diverse companies should be proactive in addressing the potential weaknesses of their organizations. Private equity firms understand how to make diversification work and many of today's executives could learn some valuable lessons from these firms. Large diverse businesses should embrace “Internal Capitalism,” a corporate culture and set of practices that emphasizes the importance of strategic decision‐making that is linked through continuous performance assessment to the corporate goals of boosting efficiency and sustainable growth.
Valuing Companies with Cash‐Flow@Risk
Authors: Bancel Franck , Tierny Jacques 
Published: July 2011

The classic DCF approach to capital budgeting—the one that MBA students in the world's top business schools have been taught for the last 30 years—begins with the assumption that the corporate investment decision is “independent of” the financing decision. That is, the value of a given investment opportunity should not be affected by how a company is financed, whether mainly with debt or with equity. A corollary of this capital structure “irrelevance” proposition says that a company's investment decision should also not be influenced by its risk management policy—by whether a company hedges its various price exposures or chooses to leave them unhedged.In this article, the authors—one of whom is the CFO of the French high‐tech firm Gemalto—propose a practical alternative to DCF that is based on a concept they call “cash‐flow@risk.” Implementation of the concept involves dividing expected future cash flow into two components: a low‐risk part, or “certainty equivalent,” and a high‐risk part. The two cash flow streams are discounted at different rates (corresponding to debt and equity) when estimating their value.The concept of cash‐flow@risk derives directly from, and is fully consistent with, the concept of economic capital that was developed by Robert Merton and Andre Perold in the early 1990s and that has become the basis of Value at Risk (or VaR) capital allocation systems now used at most financial institutions. But because the approach in this article focuses on the volatility of operating cash flows instead of asset values, the authors argue that an internal capital allocation system based on cash‐flow@risk is likely to be much more suitable than VaR for industrial companies.
Valuing an Early‐Stage Biotechnology Investment as a Rainbow Option
Authors: Brous Peter A. 
Published: July 2011

In an article published in this journal in 2003, Richard Shockley and three of his students presented a detailed valuation of an early‐stage biotechnology investment using a binomial lattice option pricing model. The article demonstrates how investments with multiple stages can be treated as “compound sequential options”—that is, as series of options in which investments in one option provide the opportunity to invest in the next in the series.In this article, the author uses the same business case analyzed by Shockley et al. to demonstrate how to value this early‐stage biotechnology investment by separately modeling the two types of risks: technology and product market. An option that has two distinct kinds of risk that develop differently over time is known as a “rainbow option.” The key adjustment to the option pricing model required to value such an option is that, instead of the standard binomial option pricing model with two outcomes at each point in time, the author uses a “quadranomial” option pricing model with four outcomes at each point in time. By distinguishing technology risks from product market risks and allowing them to develop differently over time, the author's analysis leads to a very different valuation and, indeed, a different decision about the initial investment than the one produced by Shockley's model.
Terminal Value, Accounting Numbers, and Inflation
Authors: Friedl Gunther , Schwetzler Bernhard 
Published: July 2011

In a 2008 article published in this journal, Michael Bradley and Gregg Jarrell argue that the well‐known Gordon‐Shapiro (henceforth “GS”) model for calculating terminal values does not properly account for the effects of inflation. Bradley and Jarrell suggest modifying the growth factor in the standard GS model by adding an additional term to the nominal growth rate that reflects the positive effect of inflation on the value of existing assets.In this article, the authors support the original Gordon‐Shapiro method for calculating terminal values by showing what they believe to be an oversight of the Bradley‐Jarrell critique. According to the authors, the disagreement stems from the use of fundamentally different assumptions about the effect of inflation on the capital investment required to sustain a business. Although Bradley‐Jarrell agree with the authors that intrinsic value is the discounted value of future free cash flows, their assumptions about capital investment effectively lead them to conclusions similar to those practitioners who attempt to value companies on the basis of discounted future accounting earnings. Despite much common practice, the GS model was meant to be applied to free cash flows, not accounting earnings. And for companies with substantial capital investment, the differences between accounting earnings that involve accruals and free cash flows can be very large.
Magnetic endoscopic imaging saves abdominal compression and patient pain in routine colonoscopies
Authors: DECHÊNE Alexander , JOCHUM Christoph , BECHMANN Lars P , WINDECK Susanne , GERKEN Guido , CANBAY Ali , ZÖPF Thomas 
Published: July 2011

OBJECTIVE:  Magnetic endoscope imaging (MEI) is a technique for the direct visualisation of endoscope configuration within the colon. This method may prevent loop formation by giving visual feedback of endoscope movement. This study aimed to evaluate the efficacy of MEI in improving colonoscopy performance.METHODS:  Overall 1000 consecutive patients who underwent a complete routine colonoscopy were randomized into two groups: in group A with MEI, while in group B without MEI. Sedation was performed according to local standards. In both groups time to reach the cecum, the number of positioning maneuvers and involvement of a second assistant nurse were recorded. Abdominal compression was graded from 1 to 4 according to the duration and intensity of compression was quantified using a scale from 1–3 according to compression form and patient reaction.RESULTS:  Patients were randomized (group A with MEI, n = 490; group B without MEI, n = 510) and a total colonoscopy was performed. Time to cecal intubation did not differ between the groups (507 s vs 538 s; NS). The duration of abdominal compression was significantly shorter in MEI guided colonoscopy. The intensity of abdominal compression was lower in group A and fewer turn maneuvers needed per patient. A trend towards a reduced need for assistance in MEI group was seen.CONCLUSION:  Although MEI does not generally accelerate colonoscope advancement, it significantly reduces the force and the duration of abdominal compression by assistant personnel, thus minimizing patient discomfort and decreasing the need for additional staff.
Economic burden attributable to functional bowel disorders in Iran: A cross‐sectional population‐based study
Authors: MOGHIMI‐DEHKORDI Bijan , VAHEDI Mohsen , POURHOSEINGHOLI Mohammad Amin , KHOSHKROOD MANSOORI Babak , SAFAEE Azadeh , HABIBI Manijeh , POURHOSEINGHOLI Asma , ZALI Mohammad Reza 
Published: July 2011

OBJECTIVE:  While few population‐based studies on the economic burden of functional bowel disorders (FBD) have been published from developing countries like Iran, this study aimed to estimate their direct and indirect costs for five groups of patients: irritable bowel syndrome (IBS), functional constipation (FC), unspecified‐FBD (U‐FBD), functional abdominal bloating (FAB) and functional diarrhea (FD).METHODS:  Up to 18 180 adults randomly sampled from Tehran, Iran (2006–2007) were interviewed using two questionnaires based on the Rome III criteria to detect FBD patients and to estimate their medical expenses (such as visiting the doctor, drugs, hospitalization and laboratory tests) and productivity loss in the previous 6 months. All costs were converted to dollar purchasing power parity (PPP$) to facilitate cross‐country comparisons.RESULTS:  The mean total 6‐month costs were approximately: 160, 147, 103, 96 and 42 PPP$ for IBS, FC, U‐FBD, FAB and FD, respectively. The highest proportion of drug consumption was found in IBS patients. The highest mean duration of absence from work was seen in IBS patients (2.26 days). Overall, doctor visit costs accounted for approximately 1/3 of the total costs for FBD, followed by hospitalization. A higher indirect cost of illness was found in IBS (54 PPP$), whereas it was zero in FD.CONCLUSION:  The economic burden of FBD seems to be moderately high in Iran and it imposes a relatively heavy financial burden on the Iranian national health system because of its high prevalence and its impact on quality of life, productivity and waste of resources.
Immunomodulation of inducible co‐stimulator (ICOS) in human cytokine‐induced killer cells against cholangiocarcinoma through ICOS/ICOS ligand interaction
Authors: HE Min , WANG Ying , SHI Wei Jin , WANG Shu Jun , SHA Hui Fang , FENG Jiu Xian , WANG Jian 
Published: July 2011

OBJECTIVE:  To evaluate the immunomodulation of inducible co‐stimulator (ICOS) in cytokine‐induced killer (CIK) cells against cholangiocarcinoma.METHODS:  CIK cells were generated from normal peripheral blood mononuclear cells. Methyl thiazolyl tetrazolium assay was performed to assess proliferation of CIK‐ICOS and controlled CIK cells; ELISA was used to analyze the expression of cytokines. Reverse transcription‐polymerase chain reaction and immunohistochemistry were performed to evaluate the expression of ICOS ligand (ICOSL) in CIK cells and human cholangiocarcinoma cell line QBC939 cells. The cytotoxicity of CIK cells was determined either by lactate dehydrogenase‐releasing assay in vivo or alteration of tumor size prior to and after the treatment of CIK cells in vivo.RESULTS:  CIK‐ICOS cells proliferated more and expressed higher secretion a level of interferon‐γ than the controlled CIK. These cells exhibited higher cytotoxicity against cholangiocarcinoma cell lines at all efficacy: toxicity (E:T) ratios tested than the controlled CIK cells. More importantly, the anti‐ICOSL antibody was able to attenuate the elevated cytotoxicity mediated by ICOS overexpression. When injected into cholangiocarcinoma xenografts in severe combined immunodeficiency mice, CIK‐ICOS cells survived better than the controlled CIK cells around xenografts and significantly reduced the growth rate of cholangiocarcinoma, with least volume increase and more severe necrosis of the xenografts than controlled mice treated with saline, CIK or CIK‐enhanced green fluorescent protein.CONCLUSION:  ICOS can enhance the cytotoxic effect of CIK cells against cholangiocarcinoma both in vitro and in vivo. This effect is mediated by ICOS‐augmented cytokine secretion and cell proliferation, and in part through ICOS‐ICOSL interaction.
Impacting Population Cardiovascular Health Through a Community‐Based Practice Network: Update on an ASH‐Supported Collaborative
Authors: Egan Brent M. , Laken Marilyn A. , Shaun Wagner C. , Mack Sheryl S. , Seymour‐Edwards Kim , Dodson John , Zhao Yumin , Lackland Daniel T. 
Published: July 2011

J Clin Hypertens (Greenwich). 2011;13:543–550. ©2011 Wiley Periodicals, Inc. The Hypertension Initiative began in 1999 to help transition South Carolina from a leader in cardiovascular disease (CVD) to a model of heart and vascular health. Goals were to reduce heart disease and stroke by 50% by promoting healthy lifestyles and access to effective care and medications. Continuing medical education was used to train providers, encourage physicians to become American Society of Hypertension (ASH)–certified hypertension specialists and recruit practices into the community‐based practice network (CBPN). Practice data audit with provider specific feedback is a key quality improvement tool. With ASH support, the CBPN has grown to 197 practices with approximately 1.6 million patients (approximately 700,000 hypertensives). Clinical data are obtained from electronic health records and quarterly provider feedback reports are generated. Hypertension, hypercholesterolemia, and diabetes control rose and South Carolina’s ranking improved from 51st to 35th in CVD mortality from 1995 to 2006. The Hypertension Initiative expanded to the Outpatient Quality Improvement Network (O’QUIN) to encompass comparative effectiveness research and other chronic diseases. Lessons learned include: trust enables success, addressing practice priorities powers participation, infrastructure support must be multilateral, and strategic planning identifies opportunities and pitfalls. A collaborative practice network is attainable that produces positive, sustainable, and growing impacts on cardiovascular and other chronic diseases.
Oral cancer and oral erythroplakia: an update and implication for clinicians
Authors: Villa A , Villa C , Abati S 
Published: July 2011

AbstractDespite recent advances in therapy and treatment for oral cancer, survival rates are still low. It is generally accepted that oral cancer may arise from potentially premalignant disorders. Oral erythroplakia has been identified as the one with the highest malignant transformation rates. The aim of this review was to provide detailed information on oral cancer and oral erythroplakia. Few data are available on oral erythroplakia and there is an urgent need for randomized controlled trials. Early detection and diagnosis is still the key to survival rates. Dentists and physicians may play an important role in the detection of premalignant lesions and therefore improve patients’ outcome.
A Systematic Review of Vaccinations to Reduce the Shedding of Escherichia coli O157 in the Faeces of Domestic Ruminants
Authors: Snedeker K. G. , Campbell M. , Sargeant J. M. 
Published: July 2011

SummaryThe objective of this study was to conduct a systematic review and meta‐analysis of the published literature to evaluate the efficacy of vaccines in reducing faecal shedding of Escherichia coli O157 in ruminants. A systematic search of eight databases and land‐grant university research reports using an algorithm adapted from a previous systematic review of pre‐harvest interventions against E. coli O157 was conducted to locate all reports of in vivo trials of E. coli O157 vaccines in ruminants published between 1990 and 2010. All located references were screened by two independent reviewers, and data were extracted from all relevant papers, with treatment effect measured in odds ratios. For trials with a faecal prevalence outcome that did not involve mixing of treated and untreated cattle in the same pen, efficacy was explored using random‐effects meta‐analysis. Funnel plots were used to evaluate publication bias, and random‐effects meta‐regression was performed to explore heterogeneity. The search located 20 relevant manuscripts which detailed 24 trials and 46 treatment comparisons; all but one trial involved cattle. There were 9 deliberate challenge trials (19 comparisons), and 15 natural exposure trials (27 comparisons). For Type III protein vaccines, there were 9 natural exposure trials detailing 17 comparisons, and meta‐analysis of 8 comparisons revealed that vaccine treatment resulted in a statistically significant reduction in E. coli O157 faecal prevalence [odds ratio (OR) = 0.38, 95% confidence interval (CI) = 0.29, 0.51]. Siderophore receptor and porin protein (SRP) vaccines (three trials/four comparisons) also reduced faecal prevalence (OR = 0.42, 95% CI = 0.20, 0.61); however, none of the bacterin vaccine trials (n = 3, six comparisons) resulted in a statistically significant reduction in prevalence. The results suggest that Type III protein and SRP vaccines significantly reduce faecal shedding in cattle; however, caution should be taken in interpreting the results because of the heterogeneity in the results.