The culture of corruption: A nonparametric analysis

By using a sample of 77 countries the analysis applies several nonparametric techniques in order to reveal the link between national culture and corruption. Based on Hofstede΄s cultural dimensions and the corruption perception index, the results reveal that countries with higher levels of corruption tend to have higher power distance and collectivism values in their society.Nonparametric methods,Corruption perception index, National culture

Measuring Economic Journals' Citation Efficiency: A Data Envelopment Analysis Approach

This paper by using Data Envelopment Analysis (DEA) and statistical inference evaluates the citation performance of 229 economic journals. The paper categorizes the journals into four main categories (A to D) based on their efficiency levels. The results are then compared to the 27 “core economic journals” as introduced by Dimond (1989). The results reveal that after more than twenty years Diamonds’ list of “core economic journals” is still valid. Finally, for the first time the paper uses data from four well-known databases (SSCI, Scopus, RePEc, Econlit) and two quality ranking reports (Kiel Institute internals ranking and ABS quality ranking report) in a DEA setting and in order to derive the ranking of 229 economic journals. The ten economic journals with the highest citation performance are Journal of Political Economy, Econometrica, Quarterly Journal of Economics, Journal of Financial Economics, Journal of Economic Literature, American Economic Review, Review of Economic Studies, Journal of Econometrics, Journal of Finance, Brookings Papers on Economic Activity.Ranking journals; Data Envelopment Analysis; Indexing techniques; Nonparametric analysis.

An application of statistical interference in DEA models: An analysis of public owned university departments' efficiency

This paper uses Data Envelopment Analysis (DEA) model formulations in order to determine the performance levels of 16 departments of the University of Thessaly. Particularly, the constant returns to scale (CRS) and variable returns to scale (VRS) models have been applied alongside with bootstrap techniques in order to determine accurate performance measurements of the 16 departments. The study illustrates how the recent developments in efficiency analysis and statistical inference can be applied when evaluating institutional performance issues. The paper provides the efficient departments and the target values which need to be adopted from the inefficient departments in order to operate in the most productive scale size (MPSS). Moreover it provides bias corrected estimates alongside with their confidence intervals. The analysis indicates that there are strong inefficiencies among the departments, emphasizing the misallocation of resources or/and inefficient application of departments policy developments.University efficiency; DEA; Bootstrap techniques; Kernel density estimation, Economic research; Europe; University rankings.

A hierarchical multilevel approach in assessing factors explaining country-level climate change vulnerability

Assessing vulnerability is key in the planning of climate change adaptation policies and, more importantly, in determining actions increasing resilience across different locations. This study presents the results of a hierarchical linear multilevel modeling approach that utilizes as dependent variable the Notre Dame Global Adaptation Initiative (ND-GAIN) Climate Change Vulnerability Index and explores the relative impact of a number of macro-level characteristics on vulnerability, including GDP, public debt, population, agricultural coverage and sociopolitical and institutional conditions. A 1995–2016 annual time series that yields a panel dataset of 192 countries is employed. Findings suggest that country-level climate change vulnerability is responding (strongly) to the majority of the explanatory variables considered. Findings also confirm that less-developed countries demonstrate increased vulnerability compared to the developed ones and those in transition stages. While these results indeed warrant further attention, they provide a background for a more nuanced understanding of aspects defining country-level patterns of climate vulnerability.</jats:p

High performance management: An illustrative example of sales departments’ productivity measurement

This paper describes a conceptual approach to measure and compare productivity of resource utilization at the firm level, adapting a set of techniques known as Data Envelopment Analysis (DEA). Within this approach, the paper addresses the issues of multiple inputs and multiple outputs of the sales departments of a firm. In particular, we focus on the resource management of sales departments. The proposed measurement methodology will allow assessment of the impact of different management policies on firm performance. It is hoped that this novel approach to productivity measurement will help sales managers identify efficient practices and superior management policies, and will promote the adoption of these policies

Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB) for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options

Trends in surgical aortic valve replacement in pre- and post-transcatheter aortic valve replacement eras at a structural heart center

BackgroundThe advent of transcatheter aortic valve replacement (TAVR) has directly impacted the lifelong management of patients with aortic valve disease. The U.S. Food and Drug Administration has approved TAVR for all surgical risk: prohibitive (2011), high (2012), intermediate (2016), and low (2019). Since then, TAVR volumes are increasing and surgical aortic valve replacements (SAVR) are decreasing. This study sought to evaluate trends in isolated SAVR in the pre- and post-TAVR eras.MethodsFrom January 2000 to June 2020, 3,861 isolated SAVRs were performed at a single academic quaternary care institution which participated in the early trials of TAVR beginning in 2007. A formal structural heart center was established in 2012 when TAVR became commercially available. Patients were divided into the pre-TAVR era (2000–2011, n = 2,426) and post-TAVR era (2012–2020, n = 1,435). Data from the institutional Society of Thoracic Surgeons National Database was analyzed.ResultsThe median age was 66 years, similar between groups. The post-TAVR group had a statistically higher rate of diabetes, hypertension, dyslipidemia, heart failure, more reoperative SAVR, and lower STS Predicted Risk of Mortality (PROM) (2.0% vs. 2.5%, p &lt; 0.0001). There were more urgent/emergent/salvage SAVRs (38% vs. 24%) and fewer elective SAVRs (63% vs. 76%), (p &lt; 0.0001) in the post-TAVR group. More bioprosthetic valves were implanted in the post-TAVR group (85% vs. 74%, p &lt; 0.0001). Larger aortic valves were implanted (25 vs. 23 mm, p &lt; 0.0001) and more annular enlargements were performed (5.9% vs. 1.6%, p &lt; 0.0001) in the post-TAVR era. Postoperatively, the post-TAVR group had less blood product transfusion (49% vs. 58%, p &lt; 0.0001), renal failure (1.4% vs. 4.3%, p &lt; 0.0001), pneumonia (2.3% vs. 3.8%, p = 0.01), shorter lengths of stay, and lower in-hospital mortality (1.5% vs. 3.3%, p = 0.0007).ConclusionThe approval of TAVR changed the landscape of aortic valve disease management. At a quaternary academic cardiac surgery center with a well-established structural heart program, patients undergoing isolated SAVR in the post-TAVR era had lower STS PROM, more implantation of bioprosthetic valves, utilization of larger valves, annular enlargement, and lower in-hospital mortality. Isolated SAVR continues to be performed in the TAVR era with excellent outcomes. SAVR remains an essential tool in the lifetime management of aortic valve disease

Corruption in Privatization and Governance Regimes

(ISSN 1827-3580

Achieving a Preoperative Target HbA1c of < 69 mmol/mol in Elective Vascular and Orthopedic Surgery: A Retrospective Single Center Observational Study

Introduction Diabetes mellitus (DM) is present in 10–15% of the surgical population. It is a known risk factor for adverse postoperative outcomes. UK perioperative guidance recommends optimizing glycemic control preoperatively, aiming for a target glycated hemoglobin (HbA1c) of < 69 mmol/mol. However, real-world compliance with this guidance remains unknown. The aim of our study was to determine how many patients with DM undergoing elective orthopedic and vascular surgery had a preoperative HbA1c of < 69 mmol/mol. We also reviewed the surgical reasons for non-concordance with the recommended preoperative HbA1c target. Methods This was a retrospective observational study of 1000 consecutive patients who had been referred for elective vascular and orthopedic surgery at a large tertiary center. Data were collected on these patients, both those with and without DM, between January 2016 and February 2017. Electronic databases were used to collect information on the patients’ preoperative HbA1c concentration and to determine whether there was a resulting delay in surgery when the preoperative HbA1c target of < 69 mmol/mol was exceeded. Results Of the 1000 patients referred for surgery (500 orthopedic and 500 vascular patients) included in the study, 201 (20%) had diabetes. Among these 201 people with DM, 155 (77%) had a preoperative HbA1c < 69 mmol/mol. Among the 46 people with DM whose HbA1c exceeded the recommended target, 41 were operated on despite the high HbA1c level, and only five had their surgery deferred or canceled due to suboptimal preoperative glycemic control. Conclusions Our data shows that the majority (77% ) of people undergoing elective vascular and orthopedic surgery were able to achieve a target HbA1c of < 69 mmol/mol. The current preoperative guidance is therefore achievable in a real-life setting. However, as is stated in the national guidance, this target should only be used where it is safe to do so and a degree of clinical discretion is necessary

Prevalence of Dysglycemia Among Coronary Artery Bypass Surgery Patients with No Previous Diabetic History

<p>Abstract</p> <p>Background</p> <p>Dysglycemia is a major risk factor for atherosclerosis. In many patient populations dysglycemia is under-diagnosed. Patients with severe coronary artery disease commonly have dysglycemia and there is growing evidence that dysglycemia, irrespective of underlying history of diabetes, is associated with adverse outcome in coronary artery bypass graft (CABG) surgery patients, including longer hospital stay, wound infections, and higher mortality. As HbA1c is an easy and reliable way of checking for dysglycemia we routinely screen all patients undergoing CABG for elevations in HbA1c. Our hypothesis was that a substantial number of patients with dysglycemia that could be identified at the time of cardiothoracic surgery despite having no apparent history of diabetes.</p> <p>Methods</p> <p>1045 consecutive patients undergoing CABG between 2007 and 2009 had HbA1c measured pre-operatively. The 2010 American Diabetes Association (ADA) diagnostic guidelines were used to categorize patients with no known history of diabetes as having diabetes (HbA1c ≥ 6.5%) or increased risk for diabetes (HbA1c 5.7-6.4%).</p> <p>Results</p> <p>Of the 1045 patients with pre-operative HbA1c measurements, 40% (n = 415) had a known history of diabetes and 60% (n = 630) had no known history of diabetes. For the 630 patients with no known diabetic history: 207 (32.9%) had a normal HbA1c (< 5.7%); 356 (56.5%) had an HbA1c falling in the increased risk for diabetes range (5.7-6.4%); and 67 (10.6%) had an HbA1c in the diabetes range (6.5% or higher). In this study the only conventional risk factor that was predictive of high HbA1c was BMI. We also found a high HbA1c irrespective of history of DM was associated with severe coronary artery disease as indicated by the number of vessels revascularized.</p> <p>Conclusion</p> <p>Among individuals undergoing CABG with no known history of diabetes, there is a substantial amount of undiagnosed dysglycemia. Even though labeling these patients as "diabetic" or "increased risk for diabetes" remains controversial in terms of perioperative management, pre-operative screening could lead to appropriate post-operative follow up to mitigate short-term adverse outcome and provide high priority medical referrals of this at risk population.</p