Predicting Future Sources of Mass Toxic Tort Litigation

The authors describe the efforts of an expert working group to identify potential sources, over the next five to ten years, of future mass litigation and report on the group\u27s consensus conclusions

US News and World Report Cancer Hospital Rankings: Do They Reflect Measures of Research Productivity?

Context: Prior research has faulted the US News and World Report hospital specialty rankings for excessive reliance on reputation, a subjective measure of a hospital's performance.Objective: To determine whether and to what extent reputation correlates with objective measures of research productivity among cancer hospitals.Design: A retrospective observational study.Setting: Automated search of NIH Reporter, BioEntrez, BioMedline and Clinicaltrials.gov databases.Participants: The 50 highest ranked cancer hospitals in 2013's US News and World Report Rankings.Exposure: We ascertained the number of NCI funded grants, and the cumulative funds received by each cancer center. Additionally, we identified the number of phase I, phase II, and phase III studies published and indexed in MEDLINE, and registered at clinicaltrials.gov. All counts were over the preceding 5 years. For published articles, we summed the impact factor of the journals in which they appeared. Trials were attributed to centers on the basis of the affiliation of the lead author or study principal investigator.Main Outcome: Correlation coefficients from simple and multiple linear regressions for measures of research productivity and a center's reputation.Results: All measures of research productivity demonstrated robust correlation with reputation (mean r-squared  = 0.65, median r-squared = 0.68, minimum r-squared = .41, maximum r-squared = 0.80). A multivariable model showed that 93% of the variation in reputation is explained by objective measures.Conclusion: Contrary to prior criticism, the majority of reputation, used in US News and World Rankings, can be explained by objective measures of research productivity among cancer hospitals.</p

International Portfolio Diversification: Short-Term Financial Assets and Gold

Using a continuous-time finance-theoretic framework, this paper presents the optimal portfolio rule of an international investor who consumes N national composite goods and who holds N domestic-currency-denominated assets with known nominal interest rates in an environment where prices of goods, assets and exchange rates follow geometric Brownian motion. It is shown that the currency portfolio rule described in Macedo (1982a) is applicable to the case where there are N assets with a known price and one asset, gold, with a random rice in terms of the numeraire. Under these assumptions, it is found that the optimal portfolio of an investor consuming goods from all major industrialized countries (according to their weight in total trade) would be dominated in March 1981 by long positions in U.S. dollars (25%), yen (17%), D. marks (16%), French francs (15%) and pounds sterling (10%). An investor consuming only U.S. goods, by contrast, would hold 96% of his optimal portfolio in U.S. dollars. Because of the covariance of exchange rates and gold, the exclusion of the latter generates substantial reshuffling. The analysis of the evolution of portfolios over time shows that shares changed dramatically at the beginning of the period and did not begin to approach their March 1981 values until the end of 1975. In the case of the yen and the pound there were oscillations throughout the period. With respect to the dollar share in the optimal portfolio of the U.S. and international investor, it is found that, in the period between late 1974 and mid-1976, a period in which the dollar is considered to have been "strong", a large decline in its optimal share took place.

Lobato v. Taylor.

Abstract Forthcoming

Results at 24 months from the prospective, randomized, multicenter Investigational Device Exemption trial of ProDisc-C versus anterior cervical discectomy and fusion with 4-year follow-up and continued access patients.

BackgroundCervical total disk replacement (TDR) is intended to address pain and preserve motion between vertebral bodies in patients with symptomatic cervical disk disease. Two-year follow-up for the ProDisc-C (Synthes USA Products, LLC, West Chester, Pennsylvania) TDR clinical trial showed non-inferiority versus anterior cervical discectomy and fusion (ACDF), showing superiority in many clinical outcomes. We present the 4-year interim follow-up results.MethodsPatients were randomized (1:1) to ProDisc-C (PDC-R) or ACDF. Patients were assessed preoperatively, and postoperatively at 6 weeks and 3, 6, 12, 18, 24, 36, and 48 months. After the randomized portion, continued access (CA) patients also underwent ProDisc-C implantation, with follow-up visits up to 24 months. Evaluations included Neck Disability Index (NDI), Visual Analog Scale (VAS) for pain/satisfaction, and radiographic and physical/neurologic examinations.ResultsRandomized patients (103 PDC-R and 106 ACDF) and 136 CA patients were treated at 13 sites. VAS pain and NDI score improvements from baseline were significant for all patients (P &lt; .0001) but did not differ among groups. VAS satisfaction was higher at all time points for PDC-R versus ACDF patients (P = .0499 at 48 months). The percentage of patients who responded yes to surgery again was 85.6% at 24 months and 88.9% at 48 months in the PDC-R group, 80.9% at 24 months and 81.0% at 48 months in the ACDF group, and 86.3% at 24 months in the CA group. Five PDC-R patients (48 months) and no CA patients (24 months) had index-level bridging bone. By 48 months, approximately 4-fold more ACDF patients required secondary surgery (3 of 103 PDC-R patients [2.9%] vs 12 of 106 ACDF patients [11.3%], P = .0292). Of these, 6 ACDF patients (5.6%) required procedures at adjacent levels. Three CA patients required secondary procedures (24 months).ConclusionsOur 4-year data support that ProDisc-C TDR and ACDF are viable surgical options for symptomatic cervical disk disease. Although ACDF patients may be at higher risk for additional surgical intervention, patients in both groups show good clinical results at longer-term follow-up

Single-object Imaging and Spectroscopy to Enhance Dark Energy Science from LSST

Single-object imaging and spectroscopy on telescopes with apertures ranging from ~4 m to 40 m have the potential to greatly enhance the cosmological constraints that can be obtained from LSST. Two major cosmological probes will benefit greatly from LSST follow-up: accurate spectrophotometry for nearby and distant Type Ia supernovae will expand the cosmological distance lever arm by unlocking the constraining power of high-z supernovae; and cosmology with time delays of strongly-lensed supernovae and quasars will require additional high-cadence imaging to supplement LSST, adaptive optics imaging or spectroscopy for accurate lens and source positions, and IFU or slit spectroscopy to measure detailed properties of lens systems. We highlight the scientific impact of these two science drivers, and discuss how additional resources will benefit them. For both science cases, LSST will deliver a large sample of objects over both the wide and deep fields in the LSST survey, but additional data to characterize both individual systems and overall systematics will be key to ensuring robust cosmological inference to high redshifts. Community access to large amounts of natural-seeing imaging on ~2-4 m telescopes, adaptive optics imaging and spectroscopy on 8-40 m telescopes, and high-throughput single-target spectroscopy on 4-40 m telescopes will be necessary for LSST time domain cosmology to reach its full potential. In two companion white papers we present the additional gains for LSST cosmology that will come from deep and from wide-field multi-object spectroscopy.Comment: Submitted to the call for Astro2020 science white paper

Hybrid approach for pulmonary atresia with intact ventricular septum: Early single center results and comparison to the standard surgical approach

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106725/1/ccd25181.pd

Impact of vulvovaginal health on postmenopausal women: A review of surveys on symptoms of vulvovaginal atrophy

Several recent, large-scale studies have provided valuable insights into patient perspectives on postmenopausal vulvovaginal health. Symptoms of vulvovaginal atrophy, which include dryness, irritation, itching, dysuria, and dyspareunia, can adversely affect interpersonal relationships, quality of life, and sexual function. While approximately half of postmenopausal women report these symptoms, far fewer seek treatment, often because they are uninformed about hypoestrogenic postmenopausal vulvovaginal changes and the availability of safe, effective, and well-tolerated treatments, particularly local vaginal estrogen therapy. Because women hesitate to seek help for symptoms, a proactive approach to conversations about vulvovaginal discomfort would improve diagnosis and treatment

Irregular behaviour of class numbers and Euler-Kronecker constants of cyclotomic fields: the log log log devil at play

Kummer (1851) and, many years later, Ihara (2005) both posed conjectures on invariants related to the cyclotomic field $\mathbb Q(\zeta_q)$ with $q$ a prime. Kummer's conjecture concerns the asymptotic behaviour of the first factor of the class number of $\mathbb Q(\zeta_q)$ and Ihara's the positivity of the Euler-Kronecker constant of $\mathbb Q(\zeta_q)$ (the ratio of the constant and the residue of the Laurent series of the Dedekind zeta function $\zeta_{\mathbb Q(\zeta_q)}(s)$ at $s=1$). If certain standard conjectures in analytic number theory hold true, then one can show that both conjectures are true for a set of primes of natural density 1, but false in general. Responsible for this are irregularities in the distribution of the primes. With this survey we hope to convince the reader that the apparently dissimilar mathematical objects studied by Kummer and Ihara actually display a very similar behaviour.Comment: 20 pages, 1 figure, survey, to appear in `Irregularities in the Distribution of Prime Numbers - Research Inspired by Maier's Matrix Method', Eds. J. Pintz and M. Th. Rassia