A Comparative Research on the Variations of PPP Contracts: Availability Payment PPP vs. Concession PPP

It is fair to say that the research on Public Private Partnership (PPP), in particular, on its risk-return profiles, is rare, despite the fact that this form of infrastructure financing has been on the rise during the last two decades in a diverse set of countries. This study aims to fill that gap by offering a comparative study on the two frequently-employed PPP contracts in Korea and other countries - Availability Payment (AP) PPP contracts vs. Concession (C) PPP contracts - with respect to ex post (or realized during the operational stage) risk-adjusted return characteristics. To that end, we compiled an unique project-level data set that covers the performance indicators of those PPP projects initiated during 1995 to 2014 in Korea both at-contract as well as at-operation stages, and applied a three-factor CAPM model to estimate the alpha and beta for those two types of PPP contracts. Our empirical results indicate that: ceteris paribus, AP-PPP entails a higher market-driven risk to the private partners; the systematic risk factors caused by the size and by the book-to-market-ratio have statistically significant effects on the ex post returns; and, the ex post excess returns are shown to be not significant, neither statistically nor economically. Based on our findings, we discuss welfare implications of PPP contracts out of their systematic risk characteristics documented

Fine-Dusty: Gamification of Particulate Matter Risk Communication

With the increasing severity of particulate matter problems, the current media have begun to deal with this issue. Yet awareness of the problem is still very low among many people. In this study, we applied gamification methods to risk information communication to overcome the limitations of information from the previous particulate matter media. Via a design science research methodology and design process of the gamification, user needs regarding risk communication were defined and gamification was identified as a promising design alternative. Attributes of information design extracted from user research were implemented to guide the game elements. Effectiveness of the gamified application was evaluated through presurvey and postsurvey using remote unmoderated user testing. Based on self-determination theory, the relationship between game elements and required information design aspects, the effect of game elements on user motivation was evaluated. As a result, the effect of using the particulate matter game application was verified to bring affordance and internal and external motivation to users. In the case of internal motivation, autonomy was affected but competence and relatedness were not. Furthermore, the gamification application influenced users’ reduction action, knowledge of the problem, and empowerment regarding particulate matter after using the prototype

A New Risk Evaluation Model for Safety Management on an Entire Ship Route

In this paper, we introduce a new risk evaluation model for evaluating the navigation safety zone for an entire ship route. This model considers a new algorithm to determine the navigational safety zone in real-time, and also takes the navigation officers’ perception while navigating a ship into consideration. The risk quantification has been developed using a questionnaire and incorporated into the new model. A simulation was carried out for the Osaka bay area in order to verify the usefulness of the proposed model. A new approach was employed to monitor the level of navigation safety along a ship route. The entire ship route is divided into small sections as a gridded matrix. The level of navigation safety can be quantified by means of a safety index on the basis of the ship’s navigation data within a specified distance range. The results show that the comparison between risks identified for different sections across the entire ship route is easy, which helps determine the navigational safety zone quickly. This model is expected to be able to serve as a new tool for managing safety throughout an entire ship route area in real-time in order to support the port safety authority or vessel traffic service center

Pneumonia after Kidney Transplantation in Children

Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6–12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children

Moyamoya disease in a 3-year-old boy presenting with a focal motor seizure provoked by hyperventilation

A previously healthy, 3-year-old boy presented to the emergency department with an afebrile focal motor seizure. He was found crying and having a seizure 30 minutes earlier. During this seizure, he was jerking his head and right extremities. Subsequent magnetic resonance imaging showed acute infarction in the bilateral frontal lobes, chiefly in the left. After hospitalization, conventional angiography demonstrated bilateral stenosis of the distal internal carotid arteries with development of lenticulostriate collaterals, which confirmed the diagnosis of moyamoya disease. It is vital to recognize focal motor seizures and situations related to hyperventilation in children with a seizure, which imply a structural lesion and a provoked cerebral ischemia in preexisting moyamoya disease, respectively

Mutations of Different Molecular Origins Exhibit Contrasting Patterns of Regional Substitution Rate Variation

Transitions at CpG dinucleotides, referred to as “CpG substitutions”, are a major mutational input into vertebrate genomes and a leading cause of human genetic disease. The prevalence of CpG substitutions is due to their mutational origin, which is dependent on DNA methylation. In comparison, other single nucleotide substitutions (for example those occurring at GpC dinucleotides) mainly arise from errors during DNA replication. Here we analyzed high quality BAC-based data from human, chimpanzee, and baboon to investigate regional variation of CpG substitution rates

Alum Adjuvant Enhances Protection against Respiratory Syncytial Virus but Exacerbates Pulmonary Inflammation by Modulating Multiple Innate and Adaptive Immune Cells

Respiratory syncytial virus (RSV) is well-known for inducing vaccine-enhanced respiratory disease after vaccination of young children with formalin-inactivated RSV (FI-RSV) in alum formulation. Here, we investigated alum adjuvant effects on protection and disease after FIRSV immunization with or without alum in comparison with live RSV reinfections. Despite viral clearance, live RSV reinfections caused weight loss and substantial pulmonary inflammation probably due to high levels of RSV specific IFN-γ+IL4-, IFN-γ-TNF-α+, IFN-γ+ TNF-α- effector CD4 and CD8 T cells. Alum adjuvant significantly improved protection as evidenced by effective viral clearance compared to unadjuvanted FI-RSV. However, in contrast to unadjuvanted FI-RSV, alum-adjuvanted FI-RSV (FI-RSV-A) induced severe vaccine- enhanced RSV disease including weight loss, eosinophilia, and lung histopathology. Alum adjuvant in the FI-RSV-A was found to be mainly responsible for inducing high levels of RSV-specific IFN-γ-IL4+, IFN-γ-TNF-α+ CD4+ T cells, and proinflammatory cytokines IL-6 and IL-4 as well as B220+ plasmacytoid and CD4+ dendritic cells, and inhibiting the induction of IFN-γ+CD8 T cells. This study suggests that alum adjuvant in FI-RSV vaccines increases immunogenicity and viral clearance but also induces atypical T helper CD4+ T cells and multiple inflammatory dendritic cell subsets responsible for vaccine-enhanced severe RSV disease

The Metagenomics and Metadesign of the Subways and Urban Biomes (MetaSUB) International Consortium inaugural meeting report

The Metagenomics and Metadesign of the Subways and Urban Biomes (MetaSUB) International Consortium is a novel, interdisciplinary initiative comprised of experts across many fields, including genomics, data analysis, engineering, public health, and architecture. The ultimate goal of the MetaSUB Consortium is to improve city utilization and planning through the detection, measurement, and design of metagenomics within urban environments. Although continual measures occur for temperature, air pressure, weather, and human activity, including longitudinal, cross-kingdom ecosystem dynamics can alter and improve the design of cities. The MetaSUB Consortium is aiding these efforts by developing and testing metagenomic methods and standards, including optimized methods for sample collection, DNA/RNA isolation, taxa characterization, and data visualization. The data produced by the consortium can aid city planners, public health officials, and architectural designers. In addition, the study will continue to lead to the discovery of new species, global maps of antimicrobial resistance (AMR) markers, and novel biosynthetic gene clusters (BGCs). Finally, we note that engineered metagenomic ecosystems can help enable more responsive, safer, and quantified cities

Biobanking for glomerular diseases: a study design and protocol for KOrea Renal biobank NEtwoRk System TOward NExt-generation analysis (KORNERSTONE)

Abstract Backgrounds Glomerular diseases, a set of debilitating and complex disease entities, are related to mortality and morbidity. To gain insight into pathophysiology and novel treatment targets of glomerular disease, various types of biospecimens linked to deep clinical phenotyping including clinical information, digital pathology, and well-defined outcomes are required. We provide the rationale and design of the KOrea Renal biobank NEtwoRk System TOward Next-generation analysis (KORNERSTONE). Methods The KORNERSTONE, which has been initiated by Korea Centres for Disease Control and Prevention, is designed as a multi-centre, prospective cohort study and biobank for glomerular diseases. Clinical data, questionnaires will be collected at the time of kidney biopsy and subsequently every 1 year after kidney biopsy. All of the clinical data will be extracted from the electrical health record and automatically uploaded to the web-based database. High-quality digital pathologies are obtained and connected in the database. Various types of biospecimens are collected at baseline and during follow-up: serum, urine, buffy coat, stool, glomerular complementary DNA (cDNA), tubulointerstitial cDNA. All data and biospecimens are processed and stored in a standardised manner. The primary outcomes are mortality and end-stage renal disease. The secondary outcomes will be deterioration renal function, remission of proteinuria, cardiovascular events and quality of life. Discussion Ethical approval has been obtained from the institutional review board of each participating centre and ethics oversight committee. The KORNERSTONE is designed to deliver pioneer insights into glomerular diseases. The study design allows comprehensive, integrated and high-quality data collection on baseline laboratory findings, clinical outcomes including administrative data and digital pathologic images. This may provide various biospecimens and information to many researchers, establish the rationale for future more individualised treatment strategies for glomerular diseases. Trial registration NCT03929887