Institutional Debt Holder Governance

Using data on the universe of US-based mutual funds, we find that two out of five fund families hold corporate bonds of firms in which they also own an equity stake. We show that the greater the fraction of debt a fund family holds in a given firm, the greater its propensity to vote in line with the interests of firm debt holders at shareholder meetings. Voting has direct policy consequences as firms that receive more votes in favor of creditors make corporate decisions more in line with the interests of debt holders

Institutional Debt Holdings and Governance

Using data on the universe of US-based mutual funds, we find that two out of five fund families hold corporate bonds of firms in which they also own an equity stake. We show that the greater the fraction of debt a fund family holds in a given firm, the greater its propensity to vote in line with the interests of firm debt holders at shareholder meetings, even when against ISS recommendation. Voting has direct policy consequences as firms that receive more votes in favor of creditors make corporate decisions more in line with the interests of debt holders

Acute pseudo-obstruction of the large bowel with caecal perforation following normal vaginal delivery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Acute pseudo-obstruction of the large bowel following normal vaginal delivery is an extremely rare complication of normal vaginal delivery. It can be fatal if not recognized early. Only one previous report has been found in the English literature.</p> <p>Case presentation</p> <p>A 36-year old Caucasian, normally fit woman presented with abdominal distension and vomiting five days post-normal vaginal delivery at term. Localised peritonitis in the right iliac fossa developed in the next few days, and caecal perforation was found at laparotomy, without evidence of appendicitis or colitis.</p> <p>Conclusion</p> <p>Although very rare, Ogilvie's syndrome should be considered by obstetricians, general surgeons and general practitioners as a potential cause of vomiting and abdominal pain following normal vaginal delivery. Early recognition and management are essential to minimize the possibility of developing serious complications.</p

Outcomes after ABO incompatible pediatric liver transplantation are comparable to ABO identical/compatible transplant

BackgroundABO incompatible (ABOi) liver transplantation (LT) was initially associated with a higher incidence of vascular, biliary, and rejection complications and a lower survival than ABO compatible (ABOc) LT. Various protocols have been proposed to manage anti-isohemagglutinin antibodies and hyperacute rejection. We present our experience with a simplified protocol using only plasmapheresis.MethodsA retrospective review of all patients who received an ABOi LT at our institution was performed. Comparisons were made based on era (early: 1997–2008, modern: 2009–2020) and severity of disease (status 1 vs. exception PELD at transplant). A pair-matched comparison was done to patients who received an ABOc LT. p &lt; 0.05 was considered significant.Results17 patients received 18 ABOi LT (3 retransplants). Median age at transplant was 7.4 months (1.1–28.9). 66.7% patients were listed as status 1. Hepatic artery thrombosis (HAT) occurred in one patient (5.6%), there were 2 cases of portal vein thrombosis (PVT) (11.1%), and 2 biliary strictures (11.1%). Patient and graft survival improved in the ABOi modern era, although not significantly. In the pair-matched comparison, complications (HAT p = 0.29; PVT p = 0.37; biliary complications p = 0.15) and survival rates were similar. Patient and graft survivals were 100% in the non-status 1 ABOi patients compared to 67% (p = 0.11) and 58% (p = 0.081) respectively for patients who were transplanted as status 1.ConclusionABO incompatible liver transplants in infants with a high PELD score have excellent outcomes. Indications for ABO incompatible transplants should be liberalized to prevent deaths on the waiting list or deterioration of children with high PELD scores

Complex gastroschisis: a new indication for fetal surgery?

Gastroschisis (GS) is a congenital abdominal wall defect, in which the bowel eviscerates from the abdominal cavity. It is a non-lethal isolated anomaly and its pathogenesis is hypothesized to occur as a result of two hits: primary rupture of the ‘physiological’ umbilical hernia (congenital anomaly) followed by progressive damage of the eviscerated bowel (secondary injury). The second hit is thought to be caused by a combination of mesenteric ischemia from constriction in the abdominal wall defect and prolonged amniotic fluid exposure with resultant inflammatory damage, which eventually leads to bowel dysfunction and complications. GS can be classified as either simple or complex, with the latter being complicated by a combination of intestinal atresia, stenosis, perforation, volvulus and/or necrosis. Complex GS requires multiple neonatal surgeries and is associated with significantly greater postnatal morbidity and mortality than is simple GS. The intrauterine reduction of the eviscerated bowel before irreversible damage occurs and subsequent defect closure may diminish or potentially prevent the bowel damage and other fetal and neonatal complications associated with this condition. Serial prenatal amnioexchange has been studied in cases with GS as a potential intervention but never adopted because of its unproven benefit in terms of survival and bowel and lung function. We believe that recent advances in prenatal diagnosis and fetoscopic surgery justify reconsideration of the antenatal management of complex GS under the rubric of the criteria for fetal surgery established by the International Fetal Medicine and Surgery Society (IFMSS). Herein, we discuss how conditions for fetoscopic repair of complex GS might be favorable according to the IFMSS criteria, including an established natural history, an accurate prenatal diagnosis, absence of fully effective perinatal treatment due to prolonged need for neonatal intensive care, experimental evidence for fetoscopic repair and maternal and fetal safety of fetoscopy in expert fetal centers. Finally, we propose a research agenda that will help overcome barriers to progress and provide a pathway toward clinical implementation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology

Direct Numerical Simulation Of Turbulent Multispecies Channel Flow With Wall Ablation

The design of solid rocket motors requires the prediction of changes induced by the ablation process occurring at the nozzle throat. The present study aims at understand-ing the effects of ablation on the turbulent boundary layer performing direct numerical simulations in a channel flow configuration. An ablation boundary condition for arbitrary chemical composition and pyrolysis scheme is developed and presented in this paper. Then, two DNS of a seven species reacting flow are performed: a) with inert walls; b) with ablated walls. Generated data are compared and analyzed looking at first order statistics. It is shown that the classical law of the wall for velocity and temperature are not appropriate to represent the numerical result. The chemical equilibrium assumption is shown to be valid in the inert case and a wall function consistent with this assumption is in fair agreement with the results. Nomenclature m ̇ wall mass flux, kg · m−2 · s−1 ṙc carbon surface recession rate, m/s ṡk surface production rate of k, kg · m−2 · s−

A spatially-VSL gravity model with 1-PN limit of GRT

A scalar gravity model is developed according the 'geometric conventionalist' approach introduced by Poincare (Einstein 1921, Poincare 1905, Reichenbach 1957, Gruenbaum1973). In principle this approach allows an alternative interpretation and formulation of General Relativity Theory (GRT), with distinct i) physical congruence standard, and ii) gravitation dynamics according Hamilton-Lagrange mechanics, while iii) retaining empirical indistinguishability with GRT. In this scalar model the congruence standards have been expressed as gravitationally modified Lorentz Transformations (Broekaert 2002). The first type of these transformations relate quantities observed by gravitationally 'affected' (natural geometry) and 'unaffected' (coordinate geometry) observers and explicitly reveal a spatially variable speed of light (VSL). The second type shunts the unaffected perspective and relates affected observers, recovering i) the invariance of the locally observed velocity of light, and ii) the local Minkowski metric (Broekaert 2003). In the case of a static gravitation field the model retrieves the phenomenology implied by the Schwarzschild metric. The case with proper source kinematics is now described by introduction of a 'sweep velocity' field w: The model then provides a hamiltonian description for particles and photons in full accordance with the first Post-Newtonian approximation of GRT (Weinberg 1972, Will 1993).Comment: v1: 11 pages, GR17 conf. paper, Dublin 2004, v2: WEP issue solved, section on acceleration transformation added, text improved, more references, same results, v3: typos removed, footnotes, added and references updated, v4: appendix added, improved tex

Colon cancer in Luxembourg: a national population-based data report, 1988–1998

BACKGROUND: Over the last two decades time trends in incidence rates of colorectal cancer, changes in the proportions of stage at diagnosis and changes in the anatomic sub-site distribution of colon cancers have been reported in some European countries. In order to determine a strategy for early detection of colon cancer in the Grand-Duchy of Luxembourg, all consecutive colon adenocarcinomas diagnosed during the period 1988–1998 at a nation-wide level were reviewed. METHODS: The population-based data of the national Morphologic Tumour Registry report all new high-grade adenomas (i.e. high-grade intraepithelial adenomatous neoplasias) and all consecutive new invasive adenocarcinomas of the colon diagnosed in the central department of pathology. Attention has been focused on variations in incidence, stage, anatomical site distribution and survival rates. Rectal cancers were excluded. RESULTS: Over the study period, 254 new colonic high-grade adenomas and 1379 new invasive adenocarcinomas were found; the crude incidence rates of colon adenocarcinomas grew steadily by 30%. Comparing the two 5-year periods 1988–1992 and 1994–1998, the crude incidence rates of high-grade adenomas (stage 0) rose by 190%, that of stage I cases by 14.3%, stage II cases 12.9% and stage III cases 38.5%, whereas the crude incidence rates of stage IV cases decreased by 11.8%. The high-grade adenoma/adenocarcinoma ratio increased. The right-sided colonic adenocarcinomas in elderly patients (>69 years) increased by 76%. The observed survival rates correlated with tumour stages. The overall observed 5-year survival rate (stage I-IV) was 51 ± 3% (95% confidence interval). CONCLUSION: The increasing incidence rates of colon adenocarcinomas, the persistence of advanced tumour stages (stage III), the mortality rates which remain stable, and the changing trends in the age- and sub-site distribution underline the need for preventive measures at the age of 50 in asymptomatic patients to reduce mortality from colo(rectal) cancer