The Fundamentals of Accounting: A Series of Case Reports

The Patterson School of Accountancy encourages students to participate in an internship before graduating. These internships occur in the spring of senior year which conflicts with the traditional schedule for completing a thesis. The Sally McDonnell Barksdale Honors College allows accounting students to enroll in this alternative thesis track led by Dr. Vicki Dickinson. Dr. D is the most passionate professor I have encountered in the accounting school and her class was the single most enriching course in all of my major studies. She led a comprehensive study of technical accounting using this set of cases while also setting us up to network with our future employers. The following body of work required a complete knowledge of accounting and the theories and laws behind it. I can now properly account for a transaction and then follow it all the way to the final financial statements. In addition, I can research and explain our accounting regulation. These are both demonstrated on many occasions in this thesis. The following collection of cases represents my growth from a curious student into the employed accounting major that I am today

Effects of study area size on geographic characterizations of health events: Prostate cancer incidence in Southern New England, USA, 1994–1998

BACKGROUND: We consider how representations of geographic variation in prostate cancer incidence across Southern New England, USA may be affected by selection of study area and/or properties of the statistical analysis. METHOD: A spatial scan statistic was used to monitor geographic variation among 35,167 incident prostate cancer cases diagnosed in Massachusetts, Connecticut and Rhode Island from 1994 to 1998, in relation to the 1990 populations of men 20+ years of age living in that region. Results from the combined-states analysis were compared to those from single-states. Impact of scanning procedures set to examine up to 50% or no more than10% of at-risk populations also was evaluated. RESULTS: With scanning set to 50%, 5 locations in the combined-states analysis were identified with markedly distinct incidence rates. Fewer than expected cases were estimated for nearly all Connecticut, Rhode Island and West Central Massachusetts, whereas census tracts on and around Cape Cod, and areas of Southwestern Connecticut and adjacent to greater Boston were estimated to have yielded more than expected incidence. Results of single-state analyses exhibited several discrepancies from the combined-states analysis. More conservative scanning found many more locations with varying incidence, but discrepancies between the combined- and single-state analysis were fewer. CONCLUSION: It is important to acknowledge the conditional nature of spatial analyses and carefully consider whether a true cluster of events is identified or artifact stemming from selection of study area size and/or scanning properties

Transforming Preprofessional Health Education Through Relationship-Centered Care and Narrative Medicine

There is increasing evidence that practitioners’ relational skills, such as empathy and reflection, improve patients’ health outcomes. Efforts to shift education toward patient-centered care in interprofessional teams have been made at the professional level, most notably in medical schools. However, reform must begin at the preprofessional level, to start cultivation of the habits that support humane care as early as possible and protect against empathic decline and the development of counterproductive attitudes to collaboration. The conceptual basis for reform is offered by relationship-centered care (RCC), a framework that goes beyond patient-centered care and interprofessional teamwork to focus on the reciprocal human interactions at the micro, mezzo, and macro levels of care. RCC identifies practitioners’ relationships with patients, colleagues, community, and self as the critical interpersonal dimensions of healthcare and describes a foundation of values, knowledge, and skills required for teaching each dimension. The teaching of these foundations can be facilitated with techniques from narrative medicine, a compatible care model that conceptualizes health care as a context in which humans exchange stories and thus require narrative competence. We suggest beginning the educational reform at the preprofessional level with the implementation of a formal curriculum based on the 4 RCC dimensions with students expected to gain beginner levels of competency on these dimensions in addition to evidence-based principles of health sciences. This requires interprofessional collaboration among health professions, social science, and liberal arts faculty and training of health professions faculty in narrative medicine

Breath Stable Isotope Analysis Serves as a Non-invasive Analytical Tool to Demonstrate Dietary Changes in Adolescent Students Over Time

Concern about adolescent diets, obesity, and the associated health risks have been growing in the United States. This inspired former First Lady Michelle Obama to spearhead the Healthy Hunger-Free Kids Act (HHFKA), which made changes to the national school lunch program by increasing servings of whole grains, fruits, and vegetables. Our study examined the variability of student carbohydrate sources throughout the day and before and after the implementation of HHFKA using a stable isotope dietary biomarker. This method uses carbon stable isotope values of exhaled CO2 breath (δ13Cbreath) and provides a quantitative, non-invasive measure. δ13Cbreath samples were collected throughout the day from students (n = 31) that attended a public high school in Salt Lake City, UT. δ13Cbreath measurements reflected the short-term carbohydrate inputs from the previous meal. Carbohydrate sources were not consistent throughout the day; most students had their lowest inputs of corn/sugar-based carbohydrates after lunch. We compared our results with an earlier study that had been conducted pre-HHFKA. After-lunch δ13Cbreath values decreased significantly between the two time points, suggesting an increase in whole grain, fruit, and vegetable carbohydrates in the lunch program. Our results demonstrated that δ13Cbreath measurements provide a valuable tool to examine carbohydrate sources in an individual's diet throughout the day. We believe that this tool could be beneficial to studies examining the relationship between sugar sweetened beverages, added sugars, and refined carbohydrates and health outcomes like diabetes and obesity in both adolescent and adult populations.Fil: Mancuso, Christy J.. University of New Mexico. Department of Biology; Estados UnidosFil: Cornwall, Collette M.. Highland High School; Estados UnidosFil: Robinson, Swede. Highland High School; Estados UnidosFil: Valenzuela, Luciano Oscar. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad de Ciencias Sociales. Departamento de Arqueología. Laboratorio de Ecología Evolutiva Humana (Sede Quequén); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tandil; ArgentinaFil: Ehleringer, James R.. University Of Utah. Department Of Biology; Estados Unido

Correlation between serum-ascites albumin gradient (SAAG) and esophageal varices in patients with portal hypertension

Introduction: Esophageal varices (EV) and ascites are two major findings of portal hypertension (PTHN). Several studies have evaluated possible noninvasive markers of EVs in patients with portal hypertension. Aim: This study was conducted to determine the correlation between the serum-ascites albumin concentration gradient (SAAG) and the incidence of esophageal varices (EV) and its grades in patients with ascites due to (PHTN). Materials and Methods: Our study was conducted at Alassad and Tishreen University Hospitals during the period between March 2016 – March 2017. The study included 76 patients with ascites, demonstrated by ultrasonography, who had measurement of the SAAG. All had upper gastrointestinal endoscopy to assess of the presence and size of EV. High SAAG was considered to be present when SAAG was  ≥ 1.1 g/dl and Low SAAG when it was  < 1.1 g/dl. Results: We found that 60 of 76 (79%) patients had High SAAG and 16 of 76 (21%) had Low SAAG. Esophageal varices were present in 40 of 60 (66.7%) patients with High SAAG and in none of 16 (0%) patients with Low SAAG (p<0.05) that means, there is a direct relation between high SAAG and the presence of EVs. We found a direct relation between the level of SAAG and the presence of EVs (P<0.05) in patients with high SAAG ascites. The size of the EV did not demonstrate significant statistical association with the degree of SAAG in patients with High SAAG (P=0.32). Using the Receiver- Operating-Characteristic Curve a SAAG value of ≥ 1.5  g/dl was an accurate indicator of the presence of EV (cutoff point for the higher predictive value : positive 82.5% and negative 65 % ، accuracy : 76.7%). We also found no difference in the presence of EV between alcoholic and non-alcoholic cirrhosis (P = 0.4). There is a direct relation between the severity of liver disease according to Child-Pugh classification and the presence of EVs (P=0.00008) in patients with liver cirrhosis. Conclusion: The serum-ascites albumin concentration gradient (SAAG) can predict the presence of Esophageal varices (EVs) in patients with portal hypertension (PHTN), but does not allow to predict the degree of varices. Keywords: Ascites, Portal Hypertension (PHTN), Esophageal varices (EV), Serum-ascites albumin concentration gradient (SAAG). العلاقة بين مدروج ألبومين المصل- الحبن(SAAG) ودوالي المري لدى مرضى ارتفاع توتر وريد الباب مقدمة: يعتبر كل من دوالي المري والحبن موجودتان كبيرتان لارتفاع توتر وريد الباب. أُجريت دراسات عديدة لتقييم المُشعرات التنبؤية غير الغازية التي تقترح حدوث دوالي المري عند مرضى ارتفاع توتر وريد الباب. الهدف: هدف الدراسة هو تحديد العلاقة بين مدروج ألبومين المصل والحبن (SAAG) وحدوث دوالي المري   ودرجتها إن وجدت عند مرضى الحبن التالي لارتفاع توتر وريد الباب. المواد و الطرق: تمت الدراسة في مستشفيي الأسد و تشرين الجامعيين في الفترة الممتدة بين آذار 2016 و آذار 2017 .شملت الدراسة 76 مريضاً لديهم حبن  مشخص بالتصوير بالإيكو ، تم قياس المدروج (SAAG) لهؤلاء المرضى ، خضع جميع المرضى لتنظير هضمي علوي لتقييم وجود ودرجة دوالي المري. تم اعتبار قيم المدروج مرتفعة عندما يكون  SAAG ≥ 1.1 غ/دل. ومنخفضةً عندما يكون  SAAG > 1.1 غ/دل. النتائج: وجدنا أن 60 مريضاً من أصل 76 (79%) لديهم حبن مرتفع المدروج , و 16 مريضاً من أصل 76 (21%) لديه حبن منخفض المدروج. وجدت دوالي المري عند 40 مريضاً (66.7%) من أصل 60 مريضاً لديهم حبن مرتفع المدروج ، و لم تشاهد دوالي المري عند أي من مرضى الحبن منخفض المدروج (0%) ( P<0.05) ، أي هناك علاقة مباشرة بين الحبن مرتفع المدروج وحدوث دوالي المري. كذلك وجدنا أن هناك علاقة مباشرة بين قيمة المدروج SAAG وحدوث دوالي المري (P<0.05) عند مرضى الحبن مرتفع المدروج. لم نلاحظ وجود ترافق إحصائي هام بين قيمة SAAG و درجة دوالي المري عند مرضى الحبن مرتفع المدروج  (P=0.32). باستخدام منحنى ROC: فإن قيمة SAAG ≥ 1.5 غ/دل تترافق مع حدوث دوالي مري بقيمة تنبؤية إيجابية: 82.5%  وقيمة تنبؤية سلبية : 65%  ودقة تشخيص : 76.7% لم يكن هناك فرق في حدوث دوالي المري لدى المرضى الذين لديهم حبن مرتفع المدروج بسبب التشمع الكحولي أو التشمع غير الكحولي (P=0.4) ، كما وجدنا أن هناك علاقة مباشرة بين شدة المرض الكبدي مقدرةً وفق تصنيف Child-Pugh وبين حدوث دوالي المري (P=0.0008 ) عند مرضى ارتفاع توتر وريد الباب بسبب تشمع كبد. الخلاصة: إن مدروج ألبومين المصل -الحبن (SAAG) يسمح بالتنبؤ بحدوث دوالي المري عند مرضى ارتفاع توتر وريد الباب ، ولكن لا يتيح التنبؤ بدرجة الدوالي

Up-Regulated Dicer Expression in Patients with Cutaneous Melanoma

BACKGROUND: MicroRNAs (miRNAs) are small non-coding RNAs (18-24 nucleotides) that have recently been shown to regulate gene expression during cancer progression. Dicer, a central enzyme in the multi-component miRNA biogenesis pathway, is involved in cutting precursor miRNAs to functionally mature forms. Emerging evidence shows that Dicer expression is deregulated in some human malignancies and it correlates with tumor progression, yet this role has not yet been investigated in skin cancers. METHODS AND FINDINGS: Using an anti-human monoclonal antibody against Dicer and immunohistochemistry, we compared the expression of Dicer protein among 404 clinically annotated controls and skin tumors consisting of melanocytic nevi (n = 71), a variety of melanomas (n = 223), carcinomas (n = 73) and sarcomas (n = 12). Results showed a cell-specific up-regulated Dicer in 81% of cutaneous, 80% of acrolentiginous and 96% of metastatic melanoma specimens compared to carcinoma or sarcoma specimens (P<0.0001). The expression of Dicer was significantly higher in melanomas compared to benign melanocytic nevi (P<0.0001). In patients with cutaneous melanomas, Dicer up-regulation was found to be significantly associated with an increased tumor mitotic index (P = 0.04), Breslow's depth of invasion (P = 0.03), nodal metastasis (P = 0.04) and a higher American Joint Committee on Caner (AJCC) clinical stage (P = 0.009). Using western blot analysis, we confirmed the cell-specific up-regulation of Dicer protein in vitro. A pooled-analysis on mRNA profiling in cutaneous tumors showed up-regulation of Dicer at the RNA level in cutaneous melanoma, also showing deregulation of other enzymes that participate in the biogenesis and maturation of canonical miRNAs. CONCLUSIONS: Increased Dicer expression may be a clinically useful biomarker for patients with cutaneous melanoma. Understanding deregulation of Dicer and its influence on miRNA maturation is needed to predict the susceptibility of melanoma patients to miRNA-based therapy in the future

Nuclear Capacity Auctions

We propose nuclear capacity auctions as a means to improve the incentives for investing in nuclear power. A properly designed auction would (i) allocate the license to the most efficient bidder; (ii) sell the license if and only if new nuclear power was socially optimal. In particular, capacity auctions open the market for large-scale entry by outside firms. Requiring licensees to sell a share of capacity as virtual power plant contracts increases auction efficiency by softening incumbent producers incentive to bid for market power. Our motivating example is Swedens recent decision to allow new nuclear power to replace old reactors