Complete acute uterine inversion

No Abstract

Hedge funds performance evaluation

Masteroppgave i økonomi og administrasjon - Universitetet i Agder 2009This paper uses the traditional sharpe and some modern ratios to evaluate the performance of Credit Suisse/Tremont hedge funds index in comparison to the equity, bond and commodity markets. As concluded by previous studies, hedge funds have higher sharp ratios, negative skewness and positive kurtosis than the equity, bond and commodity indices. I found that hedge funds generally exhibit low correlation with the equity (but MSCI world), bond and commodity indices, even during financial crises. This makes hedge funds suitable for portfolio diversification. However, this diversification benefit may be minimized by the fact that the correlation between the hedge fund strategies are moderate, and slightly increase during financial crises. Also, hedge fund strategies generally exhibit higher correlation with MSCI World, Dow Jones-AIG commodity and Dow Jones corporate bond indices, than they exhibit with the other indices. Given the high degree of non-normality hedge funds returns distribution and autocorrelation of returns, modern performance measure were employed in ranking hedge fund, equity, bond and commodity indices for the entire period, during financial and non-financial crises. The sharpe ratio and modern performance measures indicate that hedge funds generally outperformed the equity, commodity and bond (excluding Dow Jones corporate bond) indices more for the non-financial and entire crises periods than during financial crises. Finally, evidence of hedge fund managers’ security selection skills (significant positive alphas) was found, except for managers’ market timing abilities. Also, hedges show low exposure to the market (S&P500 index) movements

Early versus delayed antiretroviral treatment in HIV-positive people with cryptococcal meningitis.

BACKGROUND: There remains uncertainty about the optimum timing of antiretroviral therapy (ART) initiation in HIV-positive people with cryptococcal meningitis. This uncertainty is the result of conflicting data on the mortality risk and occurrence of immune reconstitution inflammatory syndrome (IRIS) when ART is initiated less than four weeks after cryptococcal meningitis treatment is commenced. OBJECTIVES: To compare the outcomes of early initiation of ART (less than four weeks after starting antifungal treatment) versus delayed initiation of ART (four weeks or more after starting antifungal treatment) in HIV-positive people with concurrent cryptococcal meningitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase for trials published between 1 January 1980 and 7 August 2017. We additionally searched international trial registries, including ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP), and conference abstracts from the International AIDS Society (IAS) and the Conference on Retroviruses and Opportunistic Infections (CROI) for ongoing or unpublished studies between 2015 and 2017. We reviewed reference lists of included studies to identify additional studies. SELECTION CRITERIA: We included randomized controlled trials (RCTs) that compared early versus delayed ART initiation in HIV-positive people with cryptococcal meningitis. Children, adults, and adolescents from any setting were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Two review authors independently applied the inclusion criteria and extracted data. We presented dichotomous outcomes as risk ratios (RR) with 95% confidence intervals (CIs). We presented time-to-death data as hazard ratios with 95% CIs. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: Four trials including 294 adult participants met the inclusion criteria of this review. Participants were predominantly from low- and middle-income countries. Two trials treated cryptococcal meningitis with amphotericin B and fluconazole; a third trial used fluconazole monotherapy; and the fourth trial did not specify the antifungal used.Early ART initiation may increase all-cause mortality compared to delayed ART initiation (RR 1.42, 95% CI 1.02 to 1.97; 294 participants, 4 trials; low-certainty evidence). Early ART initiation may reduce relapse of cryptococcal meningitis compared to delayed ART initiation (RR 0.27, 95% CI 0.07 to 1.04; 205 participants, 2 trials, low-certainty evidence). We are uncertain whether early ART initiation increases or reduces cryptococcal IRIS events compared to delayed ART initiation (RR 3.56, 95% CI 0.51 to 25.02; 205 participants, 2 trials; I2 = 54%; very low-certainty evidence). We are uncertain if early ART initiation increases or reduces virological suppression at six months compared to delayed ART initiation (RR 0.93, 95% CI 0.72 to 1.22; 205 participants, 2 trials; I2 statistic = 0%; very low-certainty evidence).We were unable to pool results related to rate of fungal clearance for the two trials that reported this outcome; individual trial results indicated that there was no difference in cerebrospinal fluid fungal clearance between trial arms. Similarly, we were unable to pool results on adverse events for the trials reporting on this outcome; individual trial results indicated no difference in the occurrence of grade 3 to 5 adverse events between trial arms.Three of the four included trials had an overall low or unclear risk of bias related to the primary outcome of all-cause mortality. However, we assessed one trial as at high risk of bias due to selective outcome reporting and other bias. This, in addition to the few clinical events and imprecision of effect estimates, led to downgrading of the evidence to low or very low certainty. AUTHORS' CONCLUSIONS: The results of this review are relevant to HIV-positive adults with cryptococcal meningitis in low- and middle-income countries. These data suggest a higher risk of mortality among people who initiate ART within four weeks of cryptococcal meningitis diagnosis. However, it is unclear if this higher mortality risk is related to cryptococcal meningitis-IRIS

Impact of misinformation and disinformation on the use of research evidence in Africa : disinfodemic and policy in an African context

The results of this research revealed various cases, actors, origin, impact, and mitigation strategies of mis/ disinformation on the use of research evidence. The COVID-19 global pandemic has revealed the danger of mis/ disinformation with numbers of reported studies from west and central Africa demonstrating significant negative impact on evidence informed policymaking and women’s empowerment. “Evidence hesitancy” can be seen in policy makers, practitioners, and citizens alike. In this study, the underlying reasons for evidence hesitancy are analyzed: mis/disinformation; crises; culture; religion; social media. The study identified strengthening policy makers and researcher’s relationships as a way of institutionalizing research evidence for Evidence-Informed Decision Making (EIDM and EIPM, evidence-based policy-making)

Professional collaboration for vision and healthcare in Cameroon

Professional collaboration is challenging when resources are minimal and communication is compromised, as is the case in many parts of Africa. In this article, a group of health professionals from the North-West Region of Cameroon report on efforts to improve within-profession, interprofessional and interorganisational collaboration in eye care services. The article describes what collaboration is in healthcare and how it benefits patients, professionals and health systems, using eye and vision care services as an example. Obstacles such as the absence of a coordinated eye care system and the lack of institutional support are described. Seven successful strategies to promote collaboration in this context are identified, and their applications in this context are described. These strategies are as follows: being committed to collaboration; being client-focused; supporting interprofessional and continuing education; embracing new technologies; building relationships between professional groups; building relationships with organisational administrators; and building relationships in healthcare systems. Three additional aspirational strategies are: developing regional healthcare programmes; developing professional and continuing education programmes; and developing collaborative patient and public education. By providing this open report, the authors aim to stimulate discussion about how collaboration and cooperation improve quality healthcare services and support professional career development

Effect of sedimentary heterogeneities in the sealing formation on predictive analysis of geological CO₂ storage

Numerical models of geologic carbon sequestration (GCS) in saline aquifers use multiphase fluid flow-characteristic curves (relative permeability and capillary pressure) to represent the interactions of the non-wetting CO2 and the wetting brine. Relative permeability data for many sedimentary formations is very scarce, resulting in the utilisation of mathematical correlations to generate the fluid flow characteristics in these formations. The flow models are essential for the prediction of CO2 storage capacity and trapping mechanisms in the geological media. The observation of pressure dissipation across the storage and sealing formations is relevant for storage capacity and geomechanical analysis during CO2 injection. This paper evaluates the relevance of representing relative permeability variations in the sealing formation when modelling geological CO2 sequestration processes. Here we concentrate on gradational changes in the lower part of the caprock, particularly how they affect pressure evolution within the entire sealing formation when duly represented by relative permeability functions. The results demonstrate the importance of accounting for pore size variations in the mathematical model adopted to generate the characteristic curves for GCS analysis. Gradational changes at the base of the caprock influence the magnitude of pressure that propagates vertically into the caprock from the aquifer, especially at the critical zone (i.e. the region overlying the CO2 plume accumulating at the reservoir-seal interface). A higher degree of overpressure and CO2 storage capacity was observed at the base of caprocks that showed gradation. These results illustrate the need to obtain reliable relative permeability functions for GCS, beyond just permeability and porosity data. The study provides a formative principle for geomechanical simulations that study the possibility of pressure-induced caprock failure during CO2 sequestration

Prevalence and Causes of Visual Impairment in Fundong District, North West Cameroon: Results of a Population-Based Survey.

PURPOSE: To estimate the prevalence and causes of visual impairment in Fundong Health District, North West Cameroon. METHODS: A total of 51 clusters of 80 people (all ages) were sampled with probability proportionate to size and compact segment sampling. Visual acuity (VA) was measured with a tumbling "E" chart. An ophthalmic nurse examined people with VA<6/18 in either eye. The presence of hearing and physical impairments were assessed using clinical examination, and self-reported visual problems using the Washington Group Short Set. RESULTS: In total, 4080 people were enumerated of whom 3567 were screened (response rate 87%). The overall prevalence of visual impairment was 2.3% (95% CI 1.8-3.0%) and blindness was 0.6% (0.3-1.0%). The prevalence of both blindness and visual impairment increased rapidly with age, so that the vast majority of cases of visual impairment (84%) and blindness (82%) were in people aged 50+. Posterior segment disease and cataract were the main causes of blindness and visual impairment, with refractive error also an important cause of visual impairment. Cataract surgical coverage (proportion of all cataracts that had received surgery) was relatively high (87% of people at VA<6/60). Post-surgery outcomes were poor, with 31% of operated eyes having VA<6/60. Among the 82 people with visual impairment, 22% had a physical impairment or epilepsy and 30% had a hearing impairment. Self-reported difficulties in vision were relatively closely related to clinical measures of visual impairment. CONCLUSIONS: Ophthalmic programmes in Cameroon need to incorporate control of posterior segment diseases while also working to improve outcomes after cataract surgery

An Optimal Centralized Carbon Dioxide Repository for Florida, USA

For over a decade, the United States Department of Energy, and engineers, geologists, and scientists from all over the world have investigated the potential for reducing atmospheric carbon emissions through carbon sequestration. Numerous reports exist analyzing the potential for sequestering carbon dioxide at various sites around the globe, but none have identified the potential for a statewide system in Florida, USA. In 2005, 83% of Florida’s electrical energy was produced by natural gas, coal, or oil (e.g., fossil fuels), from power plants spread across the state. In addition, only limited research has been completed on evaluating optimal pipeline transportation networks to centralized carbon dioxide repositories. This paper describes the feasibility and preliminary locations for an optimal centralized Florida-wide carbon sequestration repository. Linear programming optimization modeling is used to plan and route an idealized pipeline network to existing Florida power plants. Further analysis of the subsurface geology in these general locations will provide insight into the suitability of the subsurface conditions and the available capacity for carbon sequestration at selected possible repository sites. The identification of the most favorable site(s) is also presented