Biomarkers in congenital adrenal hyperplasia

Monitoring of hormone replacement therapy represents a major challenge in the management of congenital adrenal hyperplasia (CAH). In the absence of clear guidance and standardised monitoring strategies, there is no consensus among clinicians regarding the relevance of various biochemical markers used in practice, leading to wide variability in their application and interpretation. In this review, we summarise the published evidence on biochemical monitoring of CAH. We discuss temporal variations of the most commonly measured biomarkers throughout the day, the interrelationship between different biomarkers, as well as their relationship with different glucocorticoid and mineralocorticoid treatment regimens and clinical outcomes. Our review highlights significant heterogeneity across studies in both aims and methodology. However, we identified key messages for the management of patients with CAH. The approach to hormone replacement therapy should be individualised, based on the individual hormonal profile throughout the day in relation to medication. There are limitations to using 17-hydroxyprogesterone, androstenedione and testosterone, and the role of additional biomarkers such 11-oxygenated androgens which are more disease specific should be further established. Noninvasive monitoring via salivary and urinary steroid measurements is becoming increasingly available and should be considered, especially in the management of children with CAH. Additionally, this review indicates the need for large scale longitudinal studies analysing the interrelation between different monitoring strategies used in clinical practice and health outcomes in children and adults with CAH

Mutual fund performance: A synthesis of taxonomic and methodological issues

AbstractThis paper provides a comprehensive taxonomy of mutual funds and discusses the relative importance of these fund types. While most academic research focuses on US equity funds, we provide results for many more asset classes with this taxonomy—fixed income, balanced, global, International, sector, market-neutral and long-short funds. For each, we start by reporting statistics on the number of funds and their total net asset values at different intervals over the last four decades. We then identify short and long-term patterns in annual returns to mutual funds. We study the cross-sectional and time-series properties of the distribution of investor flows into different types of mutual funds, describe the relationship between flows and performance and discuss its implications for the strategic behaviour of managers and investors. We estimate and interpret fund performance alphas using both the single-factor and four-factor Fama-French models for each taxonomy type. Finally we describe the state of academic research on portfolio performance evaluation tilted towards an applied audience

On the characteristics and performance of long-short, market-neutral and bear mutual funds

We evaluate the return performance of long-short, market-neutral and bear mutual funds using multi-factor models and a conditional CAPM that allows for time-varying risk. Differences in the bearish posture of these mutual funds result in different performance characteristics. Returns to long-short mutual funds vary with the market, returns to market-neutral mutual funds are uncorrelated with the market and returns to bear mutual funds are negatively correlated. Using the conditional CAPM we document significant changes in the market-risk exposure of the most bearish of these funds during different economic climates. We then assess the flow-performance relationship for up to 60 months following up and down markets and find that investors direct flows towards market-neutral and bearish funds for several months after down markets. Market-neutral funds provide a down market hedge, but bear funds do not generate the returns that investors hope for.Mutual funds Conditional performance evaluation Long-short funds Market-neutral funds Bear funds

General affine transform families: why is the Pareto an exponential transform?

location-scale transform, Efron transform, heavy-tailed distributions, simulation, confidence interval,

Can consumers enforce environmental regulations? The role of the market in hazardous waste compliance

We examine the U.S. hazardous waste management industry to assess the role that consumers play in encouraging environmental compliance. We first examine whether environmental performance affects consumer demand and find that noncompliance does decrease demand, at least in the short term. Next we consider whether market characteristics affect compliance behavior. While we do not find evidence that market size affects behavior, local competition does appear to increase compliance. However, as competition becomes less localized, it has a smaller effect. Finally, regardless of the pressures exerted by consumers to comply, commercial managers are less likely to be in compliance than on-site managers. Copyright Springer Science+Business Media, LLC 2007Commercial environmentalism, Compliance, Enforcement, Hazardous waste, Market size, Competition, Q28, K42, D21,