GROWTH, YIELD AND FATTY ACIDS RESPONSE OF OENOTHERA BIENNIS TO WATER STRESS AND POTASSIUM FERTILIZER APPLICATION

Objective: The objective of this research was to study the effects of water stress treatments (40, 60, and 80 % available soil moisture, ASM) and/or potassium application (0, 0.4 and 0.8 g/pot) on growth parameters, yield and fatty acids content and composition of Oenothera biennis under greenhouse conditions.Methods: A two years pot experiment was conducted on Oenothera biennis under Egypt conditions in 2013/2014 and 2014/2015 seasons. Growth, seed yield (g/plant) and seed fixed oil content recorded at the first and second seasons. The fatty acid profile of total lipids extracted from Oenothera biennis was determined by Gas-liquid chromatography (GLC) analysis.Results: Growth characteristics (plant height, the number of branches, the number of capsules/plant and dry weights of the whole plant, root, and straw), seed yield (g/plant) and oil yield in two seasons were significantly decreased with the rise in water stress levels. Oil % was stimulated in response to water stress. Application of potassium counteracted the adverse effects of water stress. The maximum growth, seed yield and oil yield were obtained from plants irrigated with 80 % available soil moisture (ASM) plus potassium (0.8 g/pot). On the contrary, supplying plants with a water level of 40 % ASM and with potassium (0.8 g/pot) or (0.4 g/pot) gave the best result for the oil percentage in the first and second seasons, respectively. In respect to fatty acids profile, the percentage of C16:0, C18:1n9 and C22:0 acids were increased with increasing water stress while a reverse response was observed in C18:0, C18:2n6, C20:0, C18:3n6 and C20:1n9 acids. K application attenuated oil composition, where it led to a slight increase in C18:2n6 and C20:0 acids while decreased the percentages of C16:0, C18:1n9, C22:0 acids C18:0, C18:3n6 and C20:1n9 acids. Potassium rates plus 60 % ASM increased C18:0 and C18:1n9 acids while K application with both of 60 % ASM and 40 % ASM increased C18:2n6 and C20:0 acids. The C22:0 acids increased under the interaction of all irrigation treatments with (0.4 g/pot) dose of K. However, C16:0 acids increased as a result of 80 % ASM treatment with the different potassium rates. This study demonstrated the beneficial effects of K application to alleviating the adverse effects of water stress on Oenothera plants.Conclusion: Increasing irrigation levels increased the plant height, the number of branches, the number of capsules/plant, seed yield and dry weights of the whole plant, root, and straw of Oenothera biennis and the optimum irrigation level for the highest yields of these variables was 80 % ASM. Whereas, oil % decreased with increasing irrigation levels and the optimum irrigation level for the highest oil % was 40 % ASM. However, for the oil yield from plants that received 80 % ASM produced more oil yield than plants received 60 % or 40 % ASM. Application of potassium counteracted the adverse effects of water stress. Potassium fertilizer increased plant height, the number of branches, the number of capsules/plant, seed yield and dry weights of the whole plant, root, and straw of Oenothera biennis. Application of potassium could be a practical approach for enhancing the oil accumulation in Oenothera biennis. The current study provided important information about the qualitative and quantitative changes in the fatty acids profile of Oenothera biennis in relation to potassium application under water stress conditions.Keywords: Fatty acids, Oenothera biennis, Potassium fertilizer, Water stres

ACCOUNTING DISCLOSURE, FINANCIAL TRANSPARENCY, OWNERSHIP STRUCTURE AND CORPORATE GOVERNANCE: IMPLICATIONS FOR INTERNAL AND EXTERNAL WVB JORDANIAN CREDIT RISK ASSESSMENTS

UNIVERSITY OF PLYMOUTH UK School of Business Department of Accounting, Finance and Economics ABSTRACT Doctor of Philosophy Accounting disclosure, financial transparency, ownership structure and corporate governance: implications for internal and external WVB Jordanian credit risk assessments By Abdullah A.K. Al-Khawaaldah Bani Hasan (Ash-Shu’ayree As-Salafi) Creditworthiness is a quality that is important to all stakeholders of an organisation, especially bondholders. It is posited that good corporate governance practices assist the confidence that stakeholders have in an organization’s ability to generate the strong cash flows that are needed to meet financial obligations, which in turn should enhance credit risk assessments. Much research has been conducted into rating assessments, but these have largely been directed at developed markets and they have not generally been focused on the impact of good corporate governance practices and procedures. The primary focus of this research is to address this issue through an investigation into the impact of key factors upon the credit risk assessments of listed companies on the Amman Stock Exchange (ASE) in Jordan, as assessed by World'vest Base Inc. (WVB) credit risk assessment scores for Jordanian companies between 2005 and 2007 inclusively. Drawing upon insights from agency (including management disciplining and wealth redistribution hypotheses), stewardship, stakeholder, signalling, legitimacy and the diffusion of innovation theories, this thesis investigates the determinants of WVB credit risk assessments of Jordanian firms under five headings: accounting and financial aspects, market and regulatory perspectives, influence of ownership structure, financial transparency/disclosure and corporate governance factors. To achieve this, an array of modelling techniques is used in order to provide a more comprehensive picture. They include bivariate analysis, one-way analysis of variance, ordinary least square regressions for numerical scores, binary logistic regressions, and ordinal logistic regression. The results demonstrate that accounting and financial factors have a significant impact on credit risk assessments but not capital intensity. Profitability is positively associated with credit risk assessments, while leverage and loss propensity have a negative association. With respect to market and regulatory factors, size and Tobin’s Q are positively associated with credit risk assessments. By contrast type of sector and audit are not related to credit risk assessments. Foreign ownership enhances ratings, whilst institutional ownership has a negative impact. Also, insider ownership and family ownership have some importance. It was surprising to find that whilst financial transparency and disclosure variables are significantly associated positively with credit risk assessments in some models, they were generally not significant across other models. Nevertheless, the study finds empirical evidence to support a degree of association between credit risk assessments and corporate governance factors. There is also a positive association between board size and credit risk assessments, but the most important aspect of corporate governance for Jordanian firms is board expertise. The originality of this thesis also embraces the inclusion not only of externally published WVB risk assessments in the Jordanian context, but also internal numerical ratings that were made available with kind permission from the WVB agency for the purposes of this research. The question is whether there are insights that can be gained from such internal ratings that have not hitherto been made available to other researchers. The answer is in the affirmative, for role duality on the board of directors is evidently more important to WVB’s own internal numerical rating assessments than is evidenced by the WVB externally published credit risk assessments. Specifically, the significance of corporate governance (role duality) is missed by multivariate models that are based solely on externally published data. Furthermore, financial transparency and disclosure variables reveal more (albeit moderate) support for the more refined internal scores of WVB than for the external assessment ratings. Finally, family ownership is also important to WVB’s internal scores. Thus, this research has enabled deeper insights to be gained into credit risk assessment determinants within the Jordanian context.THE HASHEMIET UNIVERSITY- JORDA

Investigating and learning lessons from early experiences of implementing ePrescribing systems into NHS hospitals:a questionnaire study

Background: ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned.Methods: a descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated.Results: we obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity.Conclusions: whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activitie

Healthcare costs and utilization for Medicare beneficiaries with Alzheimer's

<p>Abstract</p> <p>Background</p> <p>Alzheimer's disease (AD) is a neurodegenerative disorder incurring significant social and economic costs. This study uses a US administrative claims database to evaluate the effect of AD on direct healthcare costs and utilization, and to identify the most common reasons for AD patients' emergency room (ER) visits and inpatient admissions.</p> <p>Methods</p> <p>Demographically matched cohorts age 65 and over with comprehensive medical and pharmacy claims from the 2003–2004 MEDSTAT MarketScan^®Medicare Supplemental and Coordination of Benefits (COB) Database were examined: 1) 25,109 individuals with an AD diagnosis or a filled prescription for an exclusively AD treatment; and 2) 75,327 matched controls. Illness burden for each person was measured using Diagnostic Cost Groups (DCGs), a comprehensive morbidity assessment system. Cost distributions and reasons for ER visits and inpatient admissions in 2004 were compared for both cohorts. Regression was used to quantify the marginal contribution of AD to health care costs and utilization, and the most common reasons for ER and inpatient admissions, using DCGs to control for overall illness burden.</p> <p>Results</p> <p>Compared with controls, the AD cohort had more co-morbid medical conditions, higher overall illness burden, and higher but less variable costs ($13,936 s.$10,369; Coefficient of variation = 181 vs. 324). Significant excess utilization was attributed to AD for inpatient services, pharmacy, ER visits, and home health care (all p < 0.05). In particular, AD patients were far more likely to be hospitalized for infections, pneumonia and falls (hip fracture, syncope, collapse).</p> <p>Conclusion</p> <p>Patients with AD have significantly more co-morbid medical conditions and higher healthcare costs and utilization than demographically-matched Medicare beneficiaries. Even after adjusting for differences in co-morbidity, AD patients incur excess ER visits and inpatient admissions.</p

The secreted triose phosphate isomerase of Brugia malayi is required to sustain microfilaria production in vivo

Human lymphatic filariasis is a major tropical disease transmitted through mosquito vectors which take up microfilarial larvae from the blood of infected subjects. Microfilariae are produced by long-lived adult parasites, which also release a suite of excretory-secretory products that have recently been subject to in-depth proteomic analysis. Surprisingly, the most abundant secreted protein of adult Brugia malayi is triose phosphate isomerase (TPI), a glycolytic enzyme usually associated with the cytosol. We now show that while TPI is a prominent target of the antibody response to infection, there is little antibody-mediated inhibition of catalytic activity by polyclonal sera. We generated a panel of twenty-three anti-TPI monoclonal antibodies and found only two were able to block TPI enzymatic activity. Immunisation of jirds with B. malayi TPI, or mice with the homologous protein from the rodent filaria Litomosoides sigmodontis, failed to induce neutralising antibodies or protective immunity. In contrast, passive transfer of neutralising monoclonal antibody to mice prior to implantation with adult B. malayi resulted in 60–70% reductions in microfilarial levels in vivo and both oocyte and microfilarial production by individual adult females. The loss of fecundity was accompanied by reduced IFNγ expression by CD4+ T cells and a higher proportion of macrophages at the site of infection. Thus, enzymatically active TPI plays an important role in the transmission cycle of B. malayi filarial parasites and is identified as a potential target for immunological and pharmacological intervention against filarial infections

Comparison of Rx-defined morbidity groups and diagnosis- based risk adjusters for predicting healthcare costs in Taiwan

<p>Abstract</p> <p>Background</p> <p>Medication claims are commonly used to calculate the risk adjustment for measuring healthcare cost. The Rx-defined Morbidity Groups (Rx-MG) which combine the use of medication to indicate morbidity have been incorporated into the Adjusted Clinical Groups (ACG) Case Mix System, developed by the Johns Hopkins University. This study aims to verify that the Rx-MG can be used for adjusting risk and for explaining the variations in the healthcare cost in Taiwan.</p> <p>Methods</p> <p>The Longitudinal Health Insurance Database 2005 (LHID2005) was used in this study. The year 2006 was chosen as the baseline to predict healthcare cost (medication and total cost) in 2007. The final sample size amounted to 793 239 (81%) enrolees, and excluded any cases with discontinued enrolment. Two different kinds of models were built to predict cost: the concurrent model and the prospective model. The predictors used in the predictive models included age, gender, Aggregated Diagnosis Groups (ADG, diagnosis- defined morbidity groups), and Rx-defined Morbidity Groups. Multivariate OLS regression was used in the cost prediction modelling.</p> <p>Results</p> <p>The concurrent model adjusted for Rx-defined Morbidity Groups for total cost, and controlled for age and gender had a better predictive R-square = 0.618, compared to the model adjusted for ADGs (R²= 0.411). The model combined with Rx-MGs and ADGs performed the best for concurrently predicting total cost (R²= 0.650). For prospectively predicting total cost, the model combined Rx-MGs and ADGs (R²= 0.382) performed better than the models adjusted by Rx-MGs (R²= 0.360) or ADGs (R²= 0.252) only. Similarly, the concurrent model adjusted for Rx-MGs predicting pharmacy cost had a better performance (R-square = 0.615), than the model adjusted for ADGs (R²= 0.431). The model combined with Rx-MGs and ADGs performed the best in concurrently as well as prospectively predicting pharmacy cost (R²= 0.638 and 0.505, respectively). The prospective models showed a remarkable improvement when adjusted by prior cost.</p> <p>Conclusions</p> <p>The medication-based Rx-Defined Morbidity Groups was useful in predicting pharmacy cost as well as total cost in Taiwan. Combining the information on medication and diagnosis as adjusters could arguably be the best method for explaining variations in healthcare cost.</p

Fundamental Reform of Payment for Adult Primary Care: Comprehensive Payment for Comprehensive Care

Primary care is essential to the effective and efficient functioning of health care delivery systems, yet there is an impending crisis in the field due in part to a dysfunctional payment system. We present a fundamentally new model of payment for primary care, replacing encounter-based imbursement with comprehensive payment for comprehensive care. Unlike former iterations of primary care capitation (which simply bundled inadequate fee-for-service payments), our comprehensive payment model represents new investment in adult primary care, with substantial increases in payment over current levels. The comprehensive payment is directed to practices to include support for the modern systems and teams essential to the delivery of comprehensive, coordinated care. Income to primary physicians is increased commensurate with the high level of responsibility expected. To ensure optimal allocation of resources and the rewarding of desired outcomes, the comprehensive payment is needs/risk-adjusted and performance-based. Our model establishes a new social contract with the primary care community, substantially increasing payment in return for achieving important societal health system goals, including improved accessibility, quality, safety, and efficiency. Attainment of these goals should help offset and justify the costs of the investment. Field tests of this and other new models of payment for primary care are urgently needed

CRISPR-Cas9 screens in human cells and primary neurons identify modifiers of C9ORF72 dipeptide-repeat-protein toxicity.

Hexanucleotide-repeat expansions in the C9ORF72 gene are the most common cause of amyotrophic lateral sclerosis and frontotemporal dementia (c9ALS/FTD). The nucleotide-repeat expansions are translated into dipeptide-repeat (DPR) proteins, which are aggregation prone and may contribute to neurodegeneration. We used the CRISPR-Cas9 system to perform genome-wide gene-knockout screens for suppressors and enhancers of C9ORF72 DPR toxicity in human cells. We validated hits by performing secondary CRISPR-Cas9 screens in primary mouse neurons. We uncovered potent modifiers of DPR toxicity whose gene products function in nucleocytoplasmic transport, the endoplasmic reticulum (ER), proteasome, RNA-processing pathways, and chromatin modification. One modifier, TMX2, modulated the ER-stress signature elicited by C9ORF72 DPRs in neurons and improved survival of human induced motor neurons from patients with C9ORF72 ALS. Together, our results demonstrate the promise of CRISPR-Cas9 screens in defining mechanisms of neurodegenerative diseases

Comparison of alternative risk adjustment measures for predictive modeling: high risk patient case finding using Taiwan's National Health Insurance claims

<p>Abstract</p> <p>Background</p> <p>Predictive modeling presents an opportunity to contain the expansion of medical expenditures by focusing on very few people. Evaluation of how risk adjustment models perform in predictive modeling in Taiwan or Asia has been rare. The aims of this study were to evaluate the performance of different risk adjustment models (the ACG risk adjustment system and prior expenditures) in predictive modeling, using Taiwan's National Health Insurance (NHI) claims data, and to compare characteristics of potentially high-expenditure subjects identified through different models.</p> <p>Methods</p> <p>A random sample of NHI enrollees continuously enrolled in 2002 and 2003 (n = 164,562) was selected. Health status measures and total expenditures derived from 2002 NHI claims data were used to predict the possibility of becoming 2003 top users. Statistics-based indicators (C-statistics, sensitivity, & Predictive Positive Value) and characteristics of identified top groups by different models (expenditures and prevalence of manageable diseases) were presented.</p> <p>Results</p> <p>Both diagnosis-based and prior expenditures models performed much better than the demographic model. Diagnosis-based models were better in identifying top users with manageable diseases; prior expenditures models were better in statistics-based indicators and identifying people with higher average expenditures. Prior expenditures status could correctly identify more actual top users than diagnosis-based or demographic models. The proportions of actual top users that could be identified by diagnosis-based models alone were much lower than that identified by prior expenditures status.</p> <p>Conclusions</p> <p>Predicted top users identified by different models have different characteristics and there is little agreement between modes regarding which groups would be potentially top users; therefore, which model to use should depend on the purpose of predictive modeling. Prior expenditures are a more powerful tool than diagnosis-based risk adjusters in terms of correctly identifying more actual high expenditures users. There is still much room left for improvement of diagnosis-based models in predictive modeling.</p

Group differences in physician responses to handheld presentation of clinical evidence: a verbal protocol analysis

<p>Abstract</p> <p>Background</p> <p>To identify individual differences in physicians' needs for the presentation of evidence resources and preferences for mobile devices.</p> <p>Methods</p> <p>Within-groups analysis of responses to semi-structured interviews. Interviews consisted of using prototypes in response to task-based scenarios. The prototypes were implemented on two different form factors: a tablet style PC and a pocketPC. Participants were from three user groups: general internists, family physicians and medicine residents, and from two different settings: urban and semi-urban. Verbal protocol analysis, which consists of coding utterances, was conducted on the transcripts of the testing sessions. Statistical relationships were investigated between staff physicians' and residents' background variables, self-reported experiences with the interfaces, and verbal code frequencies.</p> <p>Results</p> <p>47 physicians were recruited from general internal medicine, family practice clinics and a residency training program. The mean age of participants was 42.6 years. Physician specialty had a greater effect on device and information-presentation preferences than gender, age, setting or previous technical experience. Family physicians preferred the screen size of the tablet computer and were less concerned about its portability. Residents liked the screen size of the tablet, but preferred the portability of the pocketPC. Internists liked the portability of the pocketPC, but saw less advantage to the large screen of the tablet computer (F[2,44] = 4.94, p = .012).</p> <p>Conclusion</p> <p>Different types of physicians have different needs and preferences for evidence-based resources and handheld devices. This study shows how user testing can be incorporated into the process of design to inform group-based customization.</p