Irrational Expectations: Can a Regulator Credibly Commit to Removing an Unbundling Obligation?

There is a large empirical literature that investigates the effects of unbundling requirements on broadband operators' incentives to invest in infrastructure. To date, that literature has generally relied on industry-wide data as an indicator of how the representative operator reacts to the imposition of mandatory unbundling. In this paper, we present original findings on how specific firms reacted to the removal of an unbundling obligation that is, an act of "regulatory forbearance"either for an existing access technology or for a new access technology. We rely on three case studies to evaluate the impact of regulatory forbearance on specific incumbents and entrants that were directly affected by the regulator's decision. Our findings from the first case study appear to undermine the so-called "stepping stone" justification for unbundling an existing access technology (for example, the copper loop). In particular, there is a large discontinuity in the investment by entrants around the date of forbearance, in contrast to the steady movement up the ladder of investment predicted by the stepping stone hypothesis. Such a discontinuity suggests that either (1) the regulator failed to signal its deregulatory intentions to entrants, or (2) that the signal was clear but the entrant did not react according to the theory. We also find that incumbent investment increases significantly in response to forbearance from regulating a new access technology (for example, fiber loops). When forbearing from regulating an existing access technology, regulators can signal their future intentions to entrants by slowly increasing the regulated wholesale rate. In the case of forbearing from regulating a new technology, however, there is no equivalent mechanism by which regulators can signal their deregulatory intentions to incumbents. Because a regulator cannot credibly signal its commitment to industry participants, and because such a commitment is critical to the practical success of the stepping stone theory, the best policy for maximizing investment is to accelerate the date of forbearance for existing and new access technologies.Technology and Industry

Decision-Oriented Multi-Outcome Modeling for Anesthesia Patients

Anesthesia drugs have impact on multiple outcomes of an anesthesia patient. Most typical outcomes include anesthesia depth, blood pressures, heart rates, etc. Traditional diagnosis and control in anesthesia focus on a one-drug-one-outcome scenario. This paper studies the problem of real-time modeling for monitoring, diagnosing, and predicting multiple outcomes of anesthesia patients. It is shown that consideration of multiple outcomes is necessary and beneficial for anesthesia managements. Due to limited real-time data, real-time modeling in multi-outcome modeling requires low-complexity model strucrtures. This paper introduces a method of decision-oriented modeling that significantly reduces the complexity of the problem. The method employs simplified and combined model functions in a Wiener structure to contain model complexity. The ideas of drug impact prediction and reachable sets are introduced for utility of the models in diagnosis, outcome prediction, and decision assistance. Clinical data are used to evaluate the effectiveness of the method

Transmission of Mycobacterium tuberculosis in a Rural Community, Arkansas, 1945–2000

A cluster of tuberculosis cases in a rural community in Arkansas persisted from 1991 to 1999. The cluster had 13 members, 11 linked epidemiologically. Old records identified 24 additional patients for 40 linked case-patients during a 54-year period. Residents of this neighborhood represent a population at high risk who should be considered for tuberculin testing and treatment for latent tuberculosis infection

Dissecting the quinone bromide flow battery

Chemistry and Chemical Biolog

Treatment outcomes of new tuberculosis patients hospitalized in Kampala, Uganda: a prospective cohort study.

BACKGROUND: In most resource limited settings, new tuberculosis (TB) patients are usually treated as outpatients. We sought to investigate the reasons for hospitalisation and the predictors of poor treatment outcomes and mortality in a cohort of hospitalized new TB patients in Kampala, Uganda. METHODS AND FINDINGS: Ninety-six new TB patients hospitalised between 2003 and 2006 were enrolled and followed for two years. Thirty two were HIV-uninfected and 64 were HIV-infected. Among the HIV-uninfected, the commonest reasons for hospitalization were low Karnofsky score (47%) and need for diagnostic evaluation (25%). HIV-infected patients were commonly hospitalized due to low Karnofsky score (72%), concurrent illness (16%) and diagnostic evaluation (14%). Eleven HIV uninfected patients died (mortality rate 19.7 per 100 person-years) while 41 deaths occurred among the HIV-infected patients (mortality rate 46.9 per 100 person years). In all patients an unsuccessful treatment outcome (treatment failure, death during the treatment period or an unknown outcome) was associated with duration of TB symptoms, with the odds of an unsuccessful outcome decreasing with increasing duration. Among HIV-infected patients, an unsuccessful treatment outcome was also associated with male sex (P = 0.004) and age (P = 0.034). Low Karnofsky score (aHR = 8.93, 95% CI 1.88 - 42.40, P = 0.001) was the only factor significantly associated with mortality among the HIV-uninfected. Mortality among the HIV-infected was associated with the composite variable of CD4 and ART use, with patients with baseline CD4 below 200 cells/µL who were not on ART at a greater risk of death than those who were on ART, and low Karnofsky score (aHR = 2.02, 95% CI 1.02 - 4.01, P = 0.045). CONCLUSION: Poor health status is a common cause of hospitalisation for new TB patients. Mortality in this study was very high and associated with advanced HIV Disease and no use of ART

Low-cost rapid detection of rifampicin resistant tuberculosis using bacteriophage in Kampala, Uganda

BACKGROUND: Resistance to anti-tuberculosis drugs is a serious public health problem. Multi-drug resistant tuberculosis (MDR-TB), defined as resistance to at least rifampicin and isoniazid, has been reported in all regions of the world. Current phenotypic methods of assessing drug susceptibility of M. tuberculosis are slow. Rapid molecular methods to detect resistance to rifampicin have been developed but they are not affordable in some high prevalence countries such as those in sub Saharan Africa. A simple multi-well plate assay using mycobacteriophage D29 has been developed to test M. tuberculosis isolates for resistance to rifampicin. The purpose of this study was to investigate the performance of this technology in Kampala, Uganda. METHODS: In a blinded study 149 M. tuberculosis isolates were tested for resistance to rifampicin by the phage assay and results compared to those from routine phenotypic testing in BACTEC 460. Three concentrations of drug were used 2, 4 and 10 μg/ml. Isolates found resistant by either assay were subjected to sequence analysis of a 81 bp fragment of the rpoB gene to identify mutations predictive of resistance. Four isolates with discrepant phage and BACTEC results were tested in a second phenotypic assay to determine minimal inhibitory concentrations. RESULTS: Initial analysis suggested a sensitivity and specificity of 100% and 96.5% respectively for the phage assay used at 4 and 10 μg/ml when compared to the BACTEC 460. However, further analysis revealed 4 false negative results from the BACTEC 460 and the phage assay proved the more sensitive and specific of the two tests. Of the 39 isolates found resistant by the phage assay 38 (97.4%) were found to have mutations predictive of resistance in the 81 bp region of the rpoB gene. When used at 2 μg/ml false resistant results were observed from the phage assay. The cost of reagents for testing each isolate was estimated to be 1.3US$ when testing a batch of 20 isolates on a single 96 well plate. Results were obtained in 48 hours. CONCLUSION: The phage assay can be used for screening of isolates for resistance to rifampicin, with high sensitivity and specificity in Uganda. The test may be useful in poorly resourced laboratories as a rapid screen to differentiate between rifampicin susceptible and potential MDR-TB cases

High-performance Aqueous Redox Flow Battery (ARFB)

Chemistry and Chemical Biolog

Saturation magnetostriction and its low-temperature variation inferred for natural titanomaghemites: implications for internal stress control of coercivity in oceanic basalts

Highly oxidized titanomaghemite in oceanic basalts often carries remanent magnetization of high coercivity (stability), helping preserve the oceanic magnetic anomaly pattern. We study the source of this high coercivity in four oceanic basalts (from ODP sites 238, 572D, 470A and 556) containing highly oxidized titanomaghemite (titanium content parameter x ≈ 0.55 and oxidation parameter z ≈ 0.9 on average). Most of the titanomaghemite is likely in singledomain grains with uniaxial anisotropy because the ratio of saturation remanence J RS to saturation magnetization Js approaches 0.50 (JRS/JS = 0.46 on average). We show that the uniaxial anisotropy is very likely magnetostrictively controlled through internal stresses σi in the titanomaghemite grains. This allows us to use a novel indirect method to estimate the saturation magnetostriction λS of the titanomaghemite. A saturation remanence J RS is given along the axis of a cylindrical sample of each basalt. Then a small compression σ is applied repeatedly along this axis and the reversible change ∆JRS in JRS is measured. Combining equations from single-domain theory for this piezomagnetic effect and for the sample’s coercive force HC gives λS = 1.39HCJS 1/σ ∆JRS/JRS (using cgs units, or with HC in mT, J S in kA m and σ in Pa). This yields four λS estimates (with ca 50 per cent expected error) ranging from 3 × 10−6 to 10 × 10−6 and averaging 6 × 10−6. Theory for the piezomagnetic effect yields four σ i estimates averaging 2 × 108 Pa. This is similar to the internal stress magnitude thought to be responsible for the high coercivity of ball-milled single-domain titanomagnetite (x ≈ 0.6) and natural single-domain haematite. We also show that cooling to 120 ◦K causes HC J S for each oceanic basalt to vary in approximate proportion to (1− T TC)n with n between 1.9 and 2.0 (where T is temperature and T C is Curie point, both in ◦K). This implies that λS of titanomaghemite with x ≈ 0.55 and z ≈ 0.9 also varies in approximate proportion to (1− T TC)n with n near 1.9 or 2.0 on cooling to 120 ◦K (assuming that σ i remains constant on cooling). Our results support the hypothesis that coercivity (magnetic stability) is often magnetostrictively controlled by internal stresses in the highly oxidized titanomaghemites typical of oceanic basalts older than ca 10 Myr.We suggest that this hypothesis can be further tested by more extensive observation of whether cooling to 120 ◦K often causes HC J S of such basalts to vary in approximate proportion to (1 − T TC)n with n near 1.9 or 2.0