Municipal bonds in sub-Saharan Africa: the checkered past of debt instruments in an era of incomplete decentralization

Cities across sub-Saharan Africa are faced with challenges in urban planning and service delivery due to insufficient capital for long-term investment projects. Despite the success of municipal bonds as a tool to assist in closing this financing gap in much of the rest of the world, there have been limited examples of success in this region. This study looks at the universal obstacles limiting sub-national governments from using municipal bonds as a financial instrument before examining four case studies - Johannesburg, Douala, Dakar and Kampala - to better understand their approaches to municipal bond issuance. Based on the findings from research, the thesis concludes that the chief obstacle blocking the uptake of municipal bond issuance as a means for raising funds stems from a variety of elements in the constitutional and regulatory systems in each country. This represents a significant departure from the commonly-held understandings that cities in the region are not eligible for long-term debt and are ill-managed, lack capacity, or are not viewed as creditworthy by institutional investors and other purchasers of municipal bonds. The success of municipal bond issuance appears to be contingent on strong interlinkages between central and subnational governments. This dissertation offers a critical review of the explicit and implicit powers granted to local governments under the constitutions of each of the countries, specifically the legislation that enables or prohibits municipalities from issuing bonds. Reform to the existing regulatory and legal environments across the African continent, ones that govern a financially-sustainable level of indebtedness for sub-sovereign governments, is an essential step in ensuring the future growth of Africa’s cities

Lessons Learned from Mbombela, South Africa, in Public-Private Partnerships in the Water Sector

For urban dwellers around the world, basic water services are provided by city administrations. However, in developing countries, cities lack both the human and financial resources to ensure adequate services, particularly to some of their most vulnerable populations. As a result, public entities often consider turning to the private sector for assistance, which may lead to a series of adverse and unintended consequences. The following case study describes the experiences of the South African city of Mbombela, arguably one of the most successful Public-Private Partnerships (PPPs) in the water sector in sub-Saharan Africa, through its successes and challenges

Nonparametric analysis of interval-censored failure time data

Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 26, 2010).The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file.Dissertation advisor: Dr. (Tony) Jianguo Sun.Ph.D. University of Missouri--Columbia 2008.This thesis considers the problem of treatment comparisons when only interval-censored failure time data are available. This type of data occurs frequently in clinical trials and other follow-up studies. We study several nonparametric procedures developed previously and compare them under different situations. In particular, we study the situation where the difference between the groups occurs at an early or late time period. For this problem, we generalize the log-rank tests developed for interval-censored data in Zhao and Sun (2004) and the weighted log-rank test presented in Kalbfleisch (2002). Numerical studies are conducted to evaluate the proposed test and compare it with the unweighted log-rank test, which indicate that the proposed method works well. This thesis also considerers the problem of finding an appropriate sample size to achieve a desired power. We present a simple-to-use formula to find the sample size for a prespecified power and level of significance for the case of interval-censored data. Since many researchers use missing data techniques such as imputation along with right-censored methods to analyze interval-censored data, we also compare an imputed Kaplan-Meier Estimate of the survival function to Turnbull's Self Consistent Estimate. We present a large numerical study to show that these estimates often disagree at late time points when the mean survival time is large.Includes bibliographical reference

Caudate Infarcts

Eighteen Patients Had Caudate Nucleus Infarcts (10 Left-Sided; 8 Right-Sided). Infarcts Extended into the Anterior Limb of the Internal Capsule in 9 Patients, and Also the Anterior Putamen in 5 Patients. Thirteen Patients Had Motor Signs, Most Often a Slight Transient Hemiparesis. Dysarthria Was Common (11 Patients). Cognitive and Behavioral Abnormalities Were Frequent, and Included Abulia (10 Patients), Agitation and Hyperactivity (7 Patients), Contralateral Neglect (3 Patients, All Right Caudate), and Language Abnormalities (2 Patients, Both Left Caudate). the Majority of Patients Had Risk Factors for Penetrating Artery Disease. Branch Occlusion of Heubner\u27s Artery, or Perforators from the Proximal Anterior or Middle Cerebral Arteries Were the Posited Mechanism of Infarction. © 1990, American Medical Association. All Rights Reserved

Utility of preoperative ferumoxtran-10 MRI to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN 6671/GOG 0233

Rationale and objectives: To assess if ferumoxtran-10 (f-10) improves accuracy of MRI to detect lymph node (LN) metastasis in advanced cervical cancer. Materials and methods: F-10 MRI component of an IRB approved HIPAA compliant ACRIN/GOG trial was analyzed. Patients underwent f-10 MRI followed by extra-peritoneal or laparoscopic pelvic and abdominal lymphadenectomy. F-10-sensitive sequences were T2* GRE sequences with TE of 12 and 21. Seven independent blinded readers reviewed f-10-insensitive sequences and all sequences in different sessions. Region correlations were performed between pathology and MRI for eight abdomen and pelvis regions. Sensitivity and specificity were calculated at participant level. Reference standard is based on pathology result of surgically removed LNs. Results: Among 43 women enrolled in the trial between September 2007 and November 2009, 33 women (mean age 49 ± 11 years old) with advanced cervical cancer (12 IB2, 3 IIA, 15 IIB and 3 IIIB, 29 squamous cell carcinomas, 32 grade 2 or 3) were evaluable. Based on histopathology, LN metastasis was 39% in abdomen and 70% in pelvis. Sensitivity of all sequence review in pelvis, abdomen, and combined were 83%, 60%, and 86%, compared with 78%, 54%, and 80% for f-10 insensitive sequences (P: 0.24, 0.44 and 0.14, respectively). Mean diameter of the largest positive focus on histopathology was 13.7 mm in abdomen and 18.8 mm in pelvis (P = 0.018). Specificities of all sequence review in pelvis, abdomen, and combined were 48%, 75%, and 43%, compared with 75%, 83%, and 73% (P: 0.003, 0.14, 0.002 respectively) for f-10 insensitive sequences. Conclusion: Addition of f-10 increased MRI sensitivity to detect LN metastasis in advanced cervical cancer. Increased sensitivity did not reach statistical significance and was at the expense of lower specificity

Animal Models: Challenges and Opportunities to Determine Optimal Experimental Models of Pancreatitis and Pancreatic Cancer.

At the 2018 PancreasFest meeting, experts participating in basic research met to discuss the plethora of available animal models for studying exocrine pancreatic disease. In particular, the discussion focused on the challenges currently facing the field and potential solutions. That meeting culminated in this review, which describes the advantages and limitations of both common and infrequently used models of exocrine pancreatic disease, namely, pancreatitis and exocrine pancreatic cancer. The objective is to provide a comprehensive description of the available models but also to provide investigators with guidance in the application of these models to investigate both environmental and genetic contributions to exocrine pancreatic disease. The content covers both nongenic and genetically engineered models across multiple species (large and small). Recommendations for choosing the appropriate model as well as how to conduct and present results are provided