Monitoring a Common Agent: Implications for Financial Contracting

We study the problem of multiple principals who want to obtain income from a privately informed agent and design their contracts non-cooperatively. Our analysis reveals that the degree of coordination between principals has strong implications for the shapes of contracts and the amount of monitoring. Equity-like contracts and excessive monitoring emerge when principals are able to coordinate monitoring or verify each others’ monitoring efforts. When this is not possible, free riding in monitoring weakens the incentive to monitor, so that flat payments, debt-like contracts and very low levels of monitoring appear. Free riding may be so strong that there may even be less monitoring than if the principals cooperated with each other, which shows that non-cooperative monitoring does not necessarily lead to excessive monitoring.monitoring, common agency, costly state verification

Regenerative treatment of an immature tooth with apical periodontitis using Platelet- Rich Fibrin and MM-MTA: a case report

This case report describes the treatment of a necrotic immature permanent central incisor with symptomatic apical periodontitis, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the literature’s methods for regeneration was provided. The root canal was gently debrided of necrotic tissue with a large diameter file, irrigated with 5,25% NaOCl and then medicated with 2% chlorhexidine. After 21 days, the tooth was asymptomatic. The canal was accessed and irrigated with saline solution and a tissue scaffold was created with PRF (Platelet-Rich Fibrin) prepared using centrifugation. The final restoration was completed immediately with MM-MTA and a composite resin. The tooth was controlled every three months over a period of 2 years and has remained symptom free. Radiographic examination shows healing of the apical radiolucency suggesting that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth

Regenerative treatment of an immature tooth with apical periodontitis using Platelet- Rich Fibrin and MM-MTA: a case report

This case report describes the treatment of a necrotic immature permanent central incisor with symptomatic apical periodontitis, which was not treated with conventional apexification techniques. Instead, a regenerative approach based on the literature’s methods for regeneration was provided. The root canal was gently debrided of necrotic tissue with a large diameter file, irrigated with 5,25% NaOCl and then medicated with 2% chlorhexidine. After 21 days, the tooth was asymptomatic. The canal was accessed and irrigated with saline solution and a tissue scaffold was created with PRF (Platelet-Rich Fibrin) prepared using centrifugation. The final restoration was completed immediately with MM-MTA and a composite resin. The tooth was controlled every three months over a period of 2 years and has remained symptom free. Radiographic examination shows healing of the apical radiolucency suggesting that appropriate biologic responses can occur with this type of treatment of the necrotic immature permanent tooth

Evaluation of right ventricular function performed by 3d-echocardiography in scleroderma patients

The impairment of the right ventricle (RV) in systemic sclerosis (SSc) is usually related to pulmonary arterial hypertension (PAH). New echocardiographic techniques, such as 3-dimensional echocardiography (3DE) and 2-dimensional speckle tracking (2DSTE), allow an accurate evaluation of the RV function. The aim of this study was to evaluate the RV function using 3DE and 2DSTE in SSc patients with no history of heart disease and no PAH. Forty-five SSc patients, 42 females and 3 males, 28 with limited cutaneous SSc (lcSSc) and 17 with diffuse cutaneous SSc (dcSSc), were studied. Forty-three age- and gender-matched healthy subjects were enrolled as controls. All of them underwent a 3DE and 2DSTE ecocardiographic evaluation of the RV function. Systolic pulmonary arterial pressure (sPAP) and total pulmonary vascular resistance (tPVR) were also estimated by power doppler. RV echocardiographic parameters were compared in the different subsets of SSc patients. A statistical analysis was performed by t-test, ANOVA and multiple logistic regression. RV areas in 2DSTE and volumes in 3DE were higher and RV function parameters were reduced in SSc patients compared with controls. Also sPAP and tVPR were higher, but they did not reach pathological values. Echocardiographic alterations were more pronounced in patients with lcSSc. 3DE and 2DSTE echocardiography allowed us to detect morphological and functional alterations of the RV in a group of SSc patients with no clinical signs of heart disease and no PAH. These patients had significantly higher sPAP and tPVR than healthy controls without reporting values compatible with PAH. These data suggest that RV alterations are related to a pressure overload rather than to an intrinsic myocardial involvement in SSc

Near Zero Energy House in Palestine: Identification of the Future Challenges

Most of researches and experiences of the concept of near zero energy buildings (NZEBs) are highly concentrated on the developed countries more than the developing countries due to many reasons related to the different contexts conditions. This paper is a part of a PhD thesis, which is being supervised by the Department of Architecture at the University of Palermo. The paper aims at highlighting the challenges facing the house design in Palestine as a developing country in terms of NZEBs by making a study which is related to discussing different experiences in the field of energy saving strategies in Palestine and some surrounded countries, such as Jordan which shares certain climatic and architectural characteristics with Palestine. The data analysis process is based on the study of several attempts and experiences taking into consideration the contemporary house design situation in Palestine. This study follows a classification of challenges toward near zero energy house (NZEH) into two categories; firstly the organizational challenges; such as costs, policies, and training challenges in effect relates to how society organizes itself and establishes its priorities. Secondly, the technical challenges of the NZEBs. The discussed results should be considered in the influential governmental institutions to provide the requisite leadership decisions for planning better future built-up environment in Palestine, also in other countries which have nearly similar context

Technological and behavioral aspects of perforated building envelope in the Mediterranean region

Perforated building envelope presents a global contemporary architectural trend which is connected – in some circumstances – to the traditional perforated models, such as ‘Mashrabiyya’, ‘Takhtabush’, ‘Qmariyyah’, etc. This study focuses on perforated models that have archetypical perforated elements within buildings and have technological and behavioural functions reflecting socio-cultural values, economic situation, and environmental needs of the building’s users. An analytical comparison (technologically and behaviourally) has been conducted between the selected contemporary cases of perforated buildings and the traditional models, by considering various aspects of the building’s envelope, and taking into consideration the interaction between perforated envelopes and occupants. After discussing the global trend, an ultimate goal of this paper is to discuss the appropriateness and potentials of advanced solutions of contemporary perforated envelopes in the Mediterranean region in order for an appropriate integration of technological and behavioural aspects to be obtained in the future of this trend

Sl-ERF2, a Tomato Ethylene Response Factor Involved in Ethylene Response and Seed Germination

Ethylene response factors (ERFs) are plant transcriptional regulators mediating ethylene-dependent gene expression via binding to the GCC motif found in the promoter region of ethylene-regulated genes. We report here on the structural and functional characterization of the tomato Sl-ERF2 gene that belongs to a distinct class of the large ERF gene family. Both spliced and unspliced versions of Sl-ERF2 transcripts were amplified from RNA samples and the search in the public tomato expressed sequence tag (EST) database confirmed the existence of the two transcript species in a number of cDNA libraries. The unspliced transcript contains two open reading frames yielding two hypothetical proteins, a small highly truncated version lacking the APETALA2 domain and a bigger protein lacking the N-terminal MCGGAAII/L consensus peptide specific to ERF members from subfamily IV. Nevertheless, functional Sl-ERF2 protein may only derive from spliced transcripts since, depending on the tissue, the level of the spliced transcript is much higher than that of the unspliced transcript. Sl-ERF2 is expressed in all plant tissues tested, though its transcript accumulates preferentially in germinating seeds and ripening fruit. Overexpression of the Sl-ERF2 gene in transgenic tomato lines results in premature seed germination and enhanced hook formation of darkgrown seedlings, which is indicative of increased ethylene sensitivity. The expression of the mannanase2 gene is upregulated in Sl-ERF2-overexpressing seeds, suggesting that Sl-ERF2 stimulates seed germination through the induction of the mannanase2 gene. It is noteworthy that the exaggerated hook phenotype is abolished when ethylene perception is blocked, strongly suggesting that Sl-ERF2 requires other ethylene-dependent components to impact the hook formation process

Feasibility Study to Assess Medical Student Visits to Developmentally Disabled Adults

Introduction The Probate Court of Kalamazoo appoints guardians to minors removed from the custody of their parents and to legally incapacitated or disabled adults. The state mandates that any child under age six placed into a guardianship be visited at least once a year to ensure proper care of the child, but there is no such mandate for the approximately 300 developmentally disabled (DD) adults under the care of the Probate Court. The purpose of this ongoing study is to determine the feasibility of annual visits to DD individuals conducted by volunteer medical students. Methods In this feasibility study, the parameters which involve medical students include the number of visits conducted to DD adults, time spent reviewing cases, travel time to and from the visitation site, time spent conducting the visit and completing the required court paperwork, and safety. For the Probate Court Staff we assessed the time spent training students, and preparation time prior to and after visitation. Results We collected data over 17 months, visiting DD wards on six separate occasions, totaling 32 DD adults in 12 homes. On average, we spent 38.4 minutes per location. Over the six occasions, we spent a total of 7.7 hours traveling, 6.1 hours preparing, 6.9 hours visiting wards, and 21 minutes finalizing reports, for a total of 21 hours to complete 32 visits. The average safety rating for these visits was 9.3/10, with a minimum safety of 7/10. Despite the short study, our results indicate that this is a feasible and worthwhile program. We were able to conduct 32 DD visits, which would not have been conducted without our participation. While the court needed 73.3 hours to prepare and review the cases, we saved the Probate Court at least 21 hours of home visitation time. Safety was not a major concern for a large majority of the homes, in part because of the use of a buddy system. Conclusion We believe that continuing program would be a valuable contribution to Probate Court. We suggest that this project continues as a longitudinal, comprehensive study that will assess not only feasibility, but outcomes and benefits of using medical students in particular. In the future we anticipate that the amount of hours contributed by medical students will increase, as a significant portion of our time was spent designing the study and defining its parameters

Tapped Twice: A Case of a Rapidly Re-accumulating Hepatic Hydrothorax in a Patient with Spontaneous Bacterial Empyema

Hepatic hydrothorax (HH) is a complication of decompensated liver cirrhosis that only occurs in about 5–6% of cirrhosis patients, defined as a pleural fluid in the setting of known liver disease, with the absence of any other cardiopulmonary etiology. Infected HH is a rare complication, designated as spontaneous bacterial empyema (SBEM), found in only 13–16% of patients with HH. This case follows a patient with SBEM who developed a recurrent pleural effusion minutes after thoracentesis. Our patient is a 56-year-old female with a history of alcoholic cirrhosis with pleuritic pain found to have right-sided pleural effusion with decompensation. She had no ascites. She was initiated on antibiotics due to leukocytosis and underwent thoracentesis, revealing a sterile but exudative pleural effusion with high neutrophil count, confirming the diagnosis of SBEM. Despite initial symptom relief, her respiratory symptoms recurred within mere minutes of thoracentesis. Imaging showed reaccumulated right-sided effusion, and repeat thoracentesis showed a transudative effusion, suggesting HH. While she was in our care, we pursued expert consultation with gastroenterology and thoracic surgery; based on our shared clinical decision making, we agreed that definitive intervention with either indwelling catheter or intrapleural surgical options would cause more harm than good to our patient given her decompensated alcoholic cirrhosis. The patient was discharged with instructions for serial thoracentesis and close follow-up with gastroenterology to discuss next steps regarding her advanced and uncontrolled cirrhosis. We refer to this case to discuss HH and its rare complication of SBEM, as well as the management options for patients with these conditions

Recent facts of eating habits and obesity among adolescent; a case of Pakistan

Background: Obesity is an escalating problem that is reaching to pandemic level. Multiple factors may involve in causing obesity such as improper food pattern of physical activities, social and ecological variables, choice of menu and other biological factors. Conducting to a study to evaluate the primary cause. However, a few studies are conducting to see the impact of eating patterns on health and weight. Methods: University students (n=150, ages 18-24 years) 50% males and 50% females were selected for data collection via questionnaire. The outcomes showed that 70 individuals prefer to eat saturated fats that can lead to accumulation of bad cholesterol. 5% females and 5% males prefer using trans-fat that is even worse. On the other hand, 44 respondents prefer to choose low fat food. Results: About 25% individuals are unaware of nutritional on facts of the products but females are more conscious as compared to the men. 55% individuals eat unconsciously while watching television and consume more than the requirement. 94 individuals got attracted by advertisement tactics of food companies and but to eat them. It is also witnessed that males (32%) consume more carbonated drinks than females (13%). 64 students strongly agreed that supplements lead to obesity. In our sample population 10% obese, 14% were overweight and 47% were of normal weight. Conclusion: The major reason of obesity could be that they are eating out more often. It could be due to the fact they are dependent on high calorie food. There is a lack of vegetables and fruits in their diet. On the other hand, fruits, veggies and whole grains are linked to less gain and even weight loss. Making smart food choices can help you stay slim and healthy.