Real Estate Speculation as a Source of Banking and Currency Instability: Lessons from the Asian Crisis

A central feature of the Asian currency crisis was the vast prior capital inflow into the region, and the later rapid reversal of that movement. In seeking to explain why this outflow of capital took place and was so devastating for the countries concerned, various writers have laid blame upon a combination of connected lending, poor bank supervision, moral hazard and “crony capitalism”. Our emphasis is different. Much of the capital inflow financed a vast over-expansion of commercial real estate development. Plunging real estate values accompanied by severe difficulties in the banking and financial sector have been common occurrences across the region. The argument is that large international portfolio capital flows mediated by banks will usually lead to rapidly appreciating asset prices which will result in banking/currency crises.

Machine learning models based on routinely sampled blood tests can predict the presence of malignancy amongst patients with suspected musculoskeletal malignancy.

This study explores the possibility of using routinely taken blood tests in the diagnosis and triage of patients with suspected musculoskeletal malignancy. A retrospective study was performed on results of patients who had presented for assessment to a regional musculoskeletal tumour unit. Blood results of patients with a histologically confirmed diagnosis between 2010 and 2020 were retrieved. 33 distinct blood tests were available for model forming. Results were standardised by calculating z-scores. Data were split into a training set (70%) and a test set (30%). The training set was balanced by resampling underrepresented classes. The random forest algorithm performed best and was selected for model forming. Receiver operating characteristic curves were used to find the optimum threshold. Models were calibrated and performance metrics evaluated with confusion tables. 2371 patients formed the study population. 1080 had a malignant diagnosis in one of three categories: sarcoma, metastasis, or haematological malignancy. 1291 had a benign condition. Metastasis could be predicted with an accuracy of 79% (AUC 87%, sensitivity 79%, specificity 80% NPV 91%). Haematological malignancy accuracy 79% (AUC 81%, sensitivity 77%, specificity 79%, NPV 97%). Sarcoma accuracy 64% (AUC 73%, sensitivity 76%, specificity 61%, NPV 88%) and all malignancy accuracy 74% (AUC 80%, sensitivity 72%, specificity 75%, NPV 76%). Routinely performed blood tests can be useful in triage of musculoskeletal tumours and can be used to predict presence of musculoskeletal malignancy. [Abstract copyright: Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Speculative behavior in vacant land development: evidence for real options in Malaysia

The development of vacant land may be seen from a real options perspective—owners of vacant land have the incentive to delay developing the land and keep their options open (keep the lands undeveloped) if they believe that future development will yield higher value. We investigate whether there is speculative behavior with regard to vacant land development in Malaysia. Using samples of 254 vacant plots of lands and 3,681 houses in Selangor, Malaysia, we find that the option premium for vacant lands ranges from 8% to 20% across all areas in Selangor. We posit that the higher option premium for vacant lands is the result of a higher level of speculation by landowners. We also find that, while the option value increases, the intrinsic value reduces the market price of the vacant land. Our findings are indicative of speculative behavior by the owners of vacant land in Malaysia

Transtendinous repair of partial articular sided supraspinatus tears is associated with higher rates of stiffness and significantly inferior early functional scores than tear completion and repair: a systematic review

Introduction: Transtendon repair (TTR) and tear completion and repair (TCR) are common repair techniques for partial thickness rotator cuff tears (PTRCTs). Previous systematic reviews have not demonstrated any advantage of either but have not specifically addressed early recovery. Aim: To compare the outcomes of these two techniques in treating PTRCTs with respect to post-operative stiffness, delay in functional recovery and re-tear rates. Material and methods: A systematic review of the Medline and EMBASE database was performed in accordance with the PRISMA guidelines. Both cases series and comparative studies reporting functional outcomes, post-operative stiffness or re-tear rate after either TTR or TCR for PTRCTs were included. Results: The search strategy identified 21 studies (n = 797); 4 comparative studies (n = 214), 15 TTR (n = 511) and 2 TCR case series (n = 72). All four comparative studies included were randomised controlled trials. One RCT reported early outcomes and demonstrated significantly slower recovery in the TTR group at 3 months (ASES p = 0.037, Constant score p = 0.019 and pain p = 0.001). Similarly, data from the case series suggested that the rate of post-operative stiffness was higher in the TTR group. All comparative studies demonstrated no significant difference at final follow up in terms of pain, range of motion or functional score. Discussion: The results of this systematic review suggest that transtendinous repairs are associated with more pain and worse function during the first 3 months. This suggests that tear completion and repair should be the preferred option, as comparative studies do not demonstrate any long-term advantage of transtendinous repair. Type of study: Systematic review Level of proof: Level II evidence

Acromioclavicular joint augmentation at the time of coracoclavicular ligament reconstruction fails to improve functional outcomes despite significantly improved horizontal stability

Purpose: Acromioclavicular joint reconstruction is a well-established and frequently performed procedure. Recent scientific and commercial interest has led to a drive to develop and perform surgical techniques that more reliably restore horizontal stability in order to improve patient outcomes. The aim of this systematic review was to evaluate the biomechanical evidence for procedures directed at restoring horizontal stability and determine whether they are associated with superior clinical results when compared to well-established procedures. Methods: A review of the online databases Medline and EMBASE was conducted in accordance with the PRISMA guidelines on the 23rd December 2017. Biomechanical and clinical studies reporting either static or dynamic horizontal displacement following acromioclavicular joint reconstruction (Coracoclavicular reconstruction or Weaver-Dunn) were included. In addition, biomechanical and clinical studies reporting outcomes after additional augmentation of the acromioclavicular joint were included. The studies were appraised using the Methodological index for non-randomised studies tool. Results: The search strategy identified 18 studies eligible for inclusion: six biomechanical and 12 clinical studies. Comparative biomechanical studies demonstrated that acromioclavicular augmentation provided significantly increased horizontal stability compared to the coracoclavicular reconstruction and Weaver–Dunn procedure. Comparative clinical studies demonstrated no significant differences between coracoclavicular reconstruction with and without acromioclavicular augmentation in terms of functional outcomes (American Shoulder and Elbow Surgeon and Constant score), complication or revision rates. However, one comparative study did demonstrate an improvement in Taft (p = 0.018) and Acromioclavicular Joint Instability scores (p = 0.0001) after acromioclavicular augmentation. Conclusion: In conclusion, coracoclavicular reconstruction with augmentation of the acromioclavicular joint has been shown to provide improved horizontal stability in both biomechanical and clinical studies compared to isolated coracoclavicular reconstruction. However, comparative studies have shown no clinical advantage with respect to American Shoulder and Elbow Surgeon or Constant scores and, therefore, the results of this systematic review do not support acromioclavicular augmentation in routine clinical practice. Level of evidence: IV