Japan and the East Asian financial crisis: patterns, motivations and instrumentalisation of Japanese regional economic diplomacy

At first sight, the East Asian financial crisis represents an instance of Japan failing the test of regional leadership - as evidenced by its abandonment of initial proposals for an Asian Monetary Fund (AMF) in the face of US and Chinese opposition in 1997. However, if a second look is taken, and one which is sensitised to the fundamental characteristics of its diplomacy, then Japan can be seen as far more effective in augmenting its regional leadership role than previously imagined. Indeed, this article demonstrates that Japanese policy-makers have resurrected, over the longer term and in different guises, AMF-like frameworks which provide a potential springboard for further regional cooperation. Hence, the aims of this article are twofold. The first is to demonstrate the overall efficacy of Japanese regional economic diplomacy, and its ability to control outcomes through steering East Asia towards enhanced monetary cooperation. The second is to explain the reasons behind Japan's distinctive policy approach towards the financial crisis and general lessons for understanding its foreign policy. The article seeks to do so by asking three fundamental questions about the 'what', 'why' and 'how' of Japan's regional role: 'what' in terms of the dominant behavioural patterns of Japan's economic diplomacy; 'why' in terms of the motivations for this behaviour; and 'how' in terms of Japan's instrumentalisation of its regional policy

Overlapping functionality of the Pht proteins in zinc homeostasis of streptococcus pneumoniae

Streptococcus pneumoniae is a globally significant pathogen that causes a range of diseases, including pneumonia, sepsis, meningitis, and otitis media. Its ability to cause disease depends upon the acquisition of nutrients from its environment, including transition metal ions such as zinc. The pneumococcus employs a number of surface proteins to achieve this, among which are four highly similar polyhistidine triad (Pht) proteins. It has previously been established that these proteins collectively aid in the delivery of zinc to the ABC transporter substrate-binding protein AdcAII. Here we have investigated the contribution of each individual Pht protein to pneumococcal zinc homeostasis by analyzing mutant strains expressing only one of the four pht genes. Under conditions of low zinc availability, each of these mutants showed superior growth and zinc accumulation profiles relative to a mutant strain lacking all four genes, indicating that any of the four Pht proteins are able to facilitate delivery of zinc to AdcAII. However, optimal growth and zinc accumulation in vitro and pneumococcal survival and proliferation in vivo required production of all four Pht proteins, indicating that, despite their overlapping functionality, the proteins are not dispensable without incurring a fitness cost. We also show that surface-attached forms of the Pht proteins are required for zinc recruitment and that they do not contribute to defense against extracellular zinc stress

The first histidine triad motif of phtd is critical for zinc homeostasis in Streptococcus pneumoniae

Streptococcus pneumoniae is the world's foremost human pathogen. Acquisition of the first row transition metal ion zinc is essential for pneumococcal colonization and disease. Zinc is acquired via the ATP-binding cassette transporter AdcCB and two zinc-binding proteins, AdcA and AdcAII. We have previously shown that AdcAII is reliant upon the polyhistidine triad (Pht) proteins to aid in zinc recruitment. Pht proteins generally contain five histidine (His) triad motifs that are believed to facilitate zinc binding and therefore play a significant role in pneumococcal metal ion homeostasis. However, the importance and potential redundancy of these motifs have not been addressed. We examined the effects of mutating each of the five His triad motifs of PhtD. The combination of in vitro growth assays, active zinc uptake, and PhtD expression studies show that the His triad closest to the protein's amino terminus is the most important for zinc acquisition. Intriguingly, in vivo competitive infection studies investigating the amino- and carboxyl-terminal His triad mutants indicate that the motifs have similar importance in colonization. Collectively, our new insights into the contributions of the individual His triad motifs of PhtD, and by extension the other Pht proteins, highlight the crucial role of the first His triad site in zinc acquisition. This study also suggests that the Pht proteins likely play a role beyond zinc acquisition in pneumococcal virulence

Aircraft Engine Technology for Green Aviation to Reduce Fuel Burn

The NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project and Integrated Systems Research Program Environmentally Responsible Aviation Project in the Aeronautics Research Mission Directorate are conducting research on advanced aircraft technology to address the environmental goals of reducing fuel burn, noise and NOx emissions for aircraft in 2020 and beyond. Both Projects, in collaborative partnerships with U.S. Industry, Academia, and other Government Agencies, have made significant progress toward reaching the N+2 (2020) and N+3 (beyond 2025) installed fuel burn goals by fundamental aircraft engine technology development, subscale component experimental investigations, full scale integrated systems validation testing, and development validation of state of the art computation design and analysis codes. Specific areas of propulsion technology research are discussed and progress to date

Cost-effectiveness of initial stress cardiovascular MR, stress SPECT or stress echocardiography as a gate-keeper test, compared with upfront invasive coronary angiography in the investigation and management of patients with stable chest pain: Mid-term outcomes from the CECaT randomised controlled trial

Objectives: To compare outcomes and cost-effectiveness of various initial imaging strategies in the management of stable chest pain in a long-term prospective randomised trial. Setting: Regional cardiothoracic referral centre in the east of England. Participants: 898 patients (69% man) entered the study with 869 alive at 2 years of follow-up. Patients were included if they presented for assessment of stable chest pain with a positive exercise test and no prior history of ischaemic heart disease. Exclusion criteria were recent infarction, unstable symptoms or any contraindication to stress MRI. Primary outcome measures: The primary outcomes of this follow-up study were survival up to a minimum of 2 years post-treatment, quality-adjusted survival and cost-utility of each strategy. Results: 898 patients were randomised. Compared with angiography, mortality was marginally higher in the groups randomised to cardiac MR (HR 2.6, 95% CI 1.1 to 6.2), but similar in the single photon emission CT-methoxyisobutylisonitrile (SPECT-MIBI; HR 1.0, 95% CI 0.4 to 2.9) and ECHO groups (HR 1.6, 95% CI 0.6 to 4.0). Although SPECT-MIBI was marginally superior to other non-invasive tests there were no other significant differences between the groups in mortality, quality-adjusted survival or costs. Conclusions: Non-invasive cardiac imaging can be used safely as the initial diagnostic test to diagnose coronary artery disease without adverse effects on patient outcomes or increased costs, relative to angiography. These results should be interpreted in the context of recent advances in imaging technology. Trial registration: ISRCTN 47108462, UKCRN 3696

Is the NICE traffic light system fit-for-purpose for children presenting with undifferentiated acute illness in primary care?

Background The National Institute of Clinical Excellence (NICE) traffic light system uses children’s symptoms and signs to categorise acute infections into red, amber and green. To our knowledge, no study has described the proportion of children with acute undifferentiated illness who fall into these categories in primary care, which is important since red and amber children are considered at higher risk of serious illness requiring urgent secondary care assessment. Aim To estimate the proportion of acutely unwell children presenting to primary care classified by the NICE traffic light system as red, amber or green, and to describe their initial management. Design and setting Secondary analysis of the Diagnosis of Urinary Tract infection in Young children prospective cohort study. Method 6797 children under 5 years presenting to 225 general practices with acute undifferentiated illness were retrospectively mapped to the NICE traffic light system by a panel of general practitioners. Results 6406 (94%) children were classified as NICE red (32%) or amber (62%) with 1.6% red and 0.3%, respectively, referred the same day for hospital assessment; and 46% and 31%, respectively, treated with antibiotics. The remaining 385 (6%) were classified green, with none referred and 27% treated with antibiotics. Results were robust to sensitivity analyses. Conclusion The majority of children presenting to UK primary care with acute undifferentiated illness meet red or amber NICE traffic light criteria,with only 6% classified as low risk, making it unfit for use in general practice. Research is urgently needed to establish as triage system suitable for general practice

Narrow heavy-hole cyclotron resonances split by the cubic Rashba spin-orbit interaction in strained germanium quantum wells

The spin-orbit interaction was found to split the cyclotron resonance of heavy holes confined in high-mobility, compressively strained germanium quantum wells. The interference between coherent spin-split cyclotron resonances was tracked on picosecond time scales using terahertz time-domain spectroscopy. Analysis in the time domain, or using a time-frequency decomposition based on the Gabor-Morlet wavelet, was necessary when the difference between cyclotron frequencies was comparable to the linewidth. The cubic Rashba spin-orbit coefficient β was determined via two methods: (i) the magnetic-field dependence of the cyclotron frequencies, and (ii) the spin-resolved subband densities. An enhanced β and spin polarization was created by tailoring the strain to enhance the spin-orbit interaction. The amplitude modulation of the narrow, interfering cyclotron resonances is a signature of spin coherences persisting for more than 10 ps

System for Centering a Turbofan in a Nacelle During Tests

A feedback position-control system has been developed for maintaining the concentricity of a turbofan with respect to a nacelle during acoustic and flow tests in a wind tunnel. The system is needed for the following reasons: Thermal and thrust loads can displace the fan relative to the nacelle; In the particular test apparatus (see Figure 1), denoted as a rotor-only nacelle (RAN), the struts, vanes, and other stator components of a turbofan engine that ordinarily maintain the required concentricity in the face of thermal and thrust loads are not present; and The struts and stator components are not present because it is necessary to provide a flow path that is acoustically clean in the sense that the measured noise can be attributed to the fan alone. The system is depicted schematically in Figure 2. The nacelle is supported by two struts attached to a two-axis traverse table located outside the wind-tunnel wall. Two servomotors acting through 100:1 gearboxes drive the table along the Y and Z axes, which are perpendicular to the axis of rotation. The Y and Z components of the deviation from concentricity are measured by four laser displacement sensors mounted on the nacelle and aimed at reflective targets on the center body, which is part of the fan assembly. The outputs of the laser displacement sensors are digitized and processed through a personal computer programmed with control software. The control output of the computer commands the servomotors to move the table as needed to restore concentricity. Numerous software and hardware travel limits and alarms are provided to maximize safety. A highly ablative rub strip in the nacelle minimizes the probability of damage in the event that a deviation from concentricity exceeds the radial clearance [<0.004 in. (<0.1 mm)] between the inner surface of the nacelle and the tips of the fan blades. To be able to prevent an excursion in excess of the tip clearance, the system must be accurate enough to control X and Y displacements to within 0.001 in. (.0.025 mm). One characteristic essential to such accuracy is sufficient rigidity in the mechanical components of the system to prevent excitation of vibrations in the strut/ nacelle subsystem. The need for such a high degree of accuracy prompted a comprehensive analysis of sources of measurement and control errors, followed by rigorous design efforts to minimize these errors. As a result, the design of the system incorporates numerous improvements in hardware, software, and operational procedures

An economic appraisal of lower extremity bypass graft maintenance

AbstractObjective: Infrainguinal graft surveillance leads to intervention on the basis of duplex-identified stenoses. We have become increasingly concerned about the high frequency with which such revisions are required to maximize graft patency and limb salvage rates. The economic implications of these procedures have not been carefully analyzed or justified. Methods: We retrospectively reviewed 155 consecutive autogenous infrainguinal bypass grafts performed for chronic leg ischemia in 141 patients. All patients were enrolled in a prospective surveillance program using color flow duplex imaging. Full economic appraisal (cost analysis, cost-effect analysis, and cost-benefit analysis) was performed for all graft surveillance and limb salvage–related interventions through use of standard accounting and valuation techniques. Results: Mean follow-up was 27 months. Five-year assisted primary patency (72%) and limb salvage rates (91%) were calculated by means of life table analysis. A total of 61 grafts required 86 revisions. Within 1 year of implantation, 36% of the grafts required revision. During this first year, the mean cost per graft enrolled was $9417. Time intervals after the initial year demonstrated a reduced annual revision rate (6$1725 per graft). The mean 5-year cost of graft maintenance ($16,318) approached that of the initial bypass graft ($19,331). The sum of the initial cost of bypass graft and 5-year graft maintenance cost ($35,649) was similar to the cost of amputation ($36,273). Grafts revised for duplex-detected stenoses (n = 46), in comparison with those revised after thrombosis (n = 15), had an improved 1-year patency (93% vs 57%; P <.01), required fewer amputations (2% vs 33%; P <.01), less frequently required multiple graft revisions (P =.06), and generated fewer expenses (at 12 months after revision, $17,688 vs$45,252, P <.01). Conclusion: The cost associated with graft maintenance is significant, particularly within the first year, and demands consideration. Revision of a duplex-identified stenosis was significantly less costly than revision after graft thrombosis. Compared with the cost of limb amputation, limb salvage–related expenses appear to be justified. (J Vasc Surg 2000;32:1-12.