Risk Allocation in Toll Highway Concessions in Spain: Lessons from Economic Recession

Spain has a long tradition of encouraging toll highways by granting concessions to private companies. Concessions in Spain have been characterized by a willingness to transfer considerable risk to the private sector. Traffic demand, acquisition of the right-of-way, and financial risk have often been allocated to the private sector. From 1996 to 2011, 16 toll highway concessions, covering a total distance of 835 km, were awarded by the central government of Spain with this approach. Some of those highways started their operations just before the economic recession began. The recession had negative consequences for Spain's economy. The gross domestic product per capita plummeted, and the unemployment rate increased from 9% to 20% of the working population in just 2 years. The recession also had severe consequences for the economic performance of toll highway concessions. Traffic levels declined at a much greater rate than did the gross domestic product. In addition, the conditions imposed by the financial markets on borrowers became much stricter because of the liquidity crisis. This study analyzes the impact that the economic recession ultimately had on the performance of toll highway concessions in Spain and the actions that the government adopted to avoid the bankruptcy of the concessionaires. It was found that the economic recession helped identify some deficiencies in how risk had been allocated in Spain. The measures that both Spain and the European Union are adopting so as to improve risk allocation are discussed

LDV measurement and Navier-Stokes computation of parallel jet mixing in a rectangular confinement

Laser Doppler Velocimetry (LDV) measurements were taken in a rectangular confinement into which issues a row of parallel jets. Two-component measurements were taken with two optics orientations yielding three mean velocity components and four Reynolds stress components. As observed in isolated three dimensional wall bounded jets, the transverse diffusion of the jets is quite large. The data indicates that this rapid mixing process is due to strong secondary flows, transport of large inlet intensities and Reynolds stress anisotropy effects. Navier-Stokes analyses of this configuration underpredict the rate of transverse jet diffusion. Detailed numerical accuracy studies show that this is attributed to shortcomings in low-Reynolds number two-equation turbulence modelling. A low-Reynolds number full-Reynolds stress model is shown to provide improvement

We need to talk about manels: the problem of implicit gender bias in sport and exercise medicine.

In 2015, a website (www.allmalepanels.tumblr. com/) began documenting instances of all-male panels (colloquially known as a ‘manel’). This, along with the Twitter hashtag #manel, has helped drive recognition of the persistent and pervasive gender bias in the composition of experts assembled to present at conferences and other events. Recent social media discussions have similarly highlighted the prevalence of all-male panels in Sport and Exercise Medicine (SEM). While, to our knowledge, all-male panel trends in SEM have not yet formally been documented or published, one need look no further than SEM conference committees, keynote speaker lists, panels and other events to see that it exists in practice. Why, in 2018, is SEM and its related disciplines still failing to identify and acknowledge the role that implicit bias plays in the very structure of our own research, practice and education? SEM is, after all, a profession that contains experts, and serves populations, of all genders. This editorial will introduce the definition, implications and manifestations of implicit gender bias and then explore how the SEM community can begin to address this issue, advance the discussion and develop a more equitable global community

eHealth in geriatric rehabilitation: an International survey of the experiences and needs of healthcare professionals

While eHealth can help improve outcomes for older patients receiving geriatric rehabilitation, the implementation and integration of eHealth is often complex and time-consuming. To use eHealth effectively in geriatric rehabilitation, it is essential to understand the experiences and needs of healthcare professionals. In this international multicentre cross-sectional study, we used a web-based survey to explore the use, benefits, feasibility and usability of eHealth in geriatric rehabilitation settings, together with the needs of working healthcare professionals. Descriptive statistics were used to summarize quantitative findings. The survey was completed by 513 healthcare professionals from 16 countries. Over half had experience with eHealth, although very few (52 of 263 = 20%) integrated eHealth into daily practice. Important barriers to the use or implementation of eHealth included insufficient resources, lack of an organization-wide implementation strategy and lack of knowledge. Professionals felt that eHealth is more complex for patients than for themselves, and also expressed a need for reliable information concerning available eHealth interventions and their applications. While eHealth has clear benefits, important barriers hinder successful implementation and integration into healthcare. Tailored implementation strategies and reliable information on effective eHealth applications are needed to overcome these barriers.Geriatrics in primary carePublic Health and primary carePrevention, Population and Disease management (PrePoD

Using microphone arrays to investigate microhabitat selection by declining breeding birds

Understanding the microhabitat preferences of animals can help managers to develop better conservation and recovery strategies but this is challenging. Traditional methods are limited by cost, accuracy and human resources. In this study, we investigated avian microhabitat preferences using microphone arrays that are capable of accurately locating vocalizing birds. Our objective was to identify the microhabitat associations of two common species in steep population decline, the Boreal Chickadee Poecile hudsonicus and the Cape May Warbler Setophaga tigrina. We deployed 68 eight‐channel arrays at random locations in Labrador, Canada, during the 2016 avian breeding season. We returned in 2017 to the 18 array locations where the target species had been detected the previous year and characterized the microhabitat at the exact locations where they had been detected. We also characterized the microhabitat at randomly determined control locations. Results show that Boreal Chickadees select trees with greater diameter‐at‐breast‐height that are surrounded by greater stem density. We did not find evidence that Cape May Warblers exhibit microhabitat selection during song production. The study shows that microphone arrays are an effective tool for identifying preferred microhabitat that could be incorporated into future conservation or recovery strategies

Differentiated Thyroid Carcinomas And Their B7h1 Shield

[No abstract available]91014171419Muzza, M., Degl'innocenti, D., Colombo, C., Tight relationship between papillary thyroid cancer, autoimmunity and inflammation: Clinical and molecular studies (2010) Clin. Endocrinol, 72 (5), pp. 702-708De Vries, A.C., Van Grieken, N.C.T., Looman, C.W.N., Casparie, M.K., De Vries, E., Meijer, G.A., Kuipers, E.J., Gastric Cancer Risk in Patients With Premalignant Gastric Lesions: A Nationwide Cohort Study in the Netherlands (2008) Gastroenterology, 134 (4), pp. 945-952. , DOI 10.1053/j.gastro.2008.01.071, PII S0016508508001777Cunha, L.L., Tincani, A.J., Assumpcao, L.V., Soares, F.A., Vassallo, J., Ward, L.S., Interleukin-10 but not interleukin-18 may be associated with the immune response against well-differentiated thyroid cancer (2011) Clinics, 66 (7), pp. 1203-1208Siegel, R., Naishadham, D., Jemal, A., Cancer statistics, 2013 (2013) CA Cancer J. Clin, 63 (1), pp. 11-30Kantoff, P.W., Higano, C.S., Shore, N.D., Sipuleucel-t immunotherapy for castration-resistant prostate cancer (2010) N. Engl. J. Med, 363 (5), pp. 411-422Hodi, F.S., O'Day, S.J., McDermott, D.F., Improved survival with ipilimumab in patients with metastatic melanoma (2010) N. Engl. J. Med, 363 (8), pp. 711-723Brahmer, J.R., Tykodi, S.S., Chow, L.Q., Safety and activity of anti-pd-l1antibody in patients with advanced cancer (2012) N. Engl. J. Med, 366 (26), pp. 2455-2465Cunha, L.L., Ward, L.S., Concurrent lymphocytic thyroiditis is associated to less aggressive papillary thyroid carcinomas (2012) Eur. Arch. Otorhinolaryngol, 269 (2), pp. 699-700Gogali, F., Paterakis, G., Rassidakis, G.Z., Phenotypical analysis of lymphocytes with suppressive and regulatory properties (tregs) and nk cells in the papillary carcinoma of thyroid (2012) J. Clin. Endocrinol. Metab, 97 (5), pp. 1474-1482French, J.D., Weber, Z.J., Fretwell, D.L., Said, S., Klopper, J.P., Haugen, B.R., Tumor-associated lymphocytes and increased foxp3+ regulatory t cell frequency correlate with more aggressive papillary thyroid cancer (2010) J. Clin. Endocrinol. Metab, 95 (5), pp. 2325-2333Zhou, G., Drake, C.G., Levitsky, H.I., Amplification of tumor-specific regulatory T cells following therapeutic cancer vaccines (2006) Blood, 107 (2), pp. 628-636. , http://www.bloodjournal.org/cgi/reprint/107/2/628, DOI 10.1182/blood-2005-07-2737Hamanishi, J., Mandai, M., Iwasaki, M., Okazaki, T., Tanaka, Y., Yamaguchi, K., Higuchi, T., Fujii, S., Programmed cell death 1 ligand 1 and tumor-infiltrating CD8+ T lymphocytes are prognostic factors of human ovarian cancer (2007) Proceedings of the National Academy of Sciences of the United States of America, 104 (9), pp. 3360-3365. , DOI 10.1073/pnas.0611533104Dong, H., Strome, S.E., Salomao, D.R., Tumor-associated b7-h1 promotes t-cell apoptosis: A potential mechanism of immune evasion (2002) Nat. Med, 8 (8), pp. 793-800Thompson, R.H., Kuntz, S.M., Leibovich, B.C., Tumor b7-h1 is associated with poor prognosis in renal cell carcinoma patients with long-term follow-up (2006) Cancer Res, 66 (7), pp. 3381-3385Cunha, L.L., Marcello, M.A., Morari, E.C., Differentiated thyroid carcinomas may elude the immune system by b7h1 upregulation (2013) Endocr. Relat. Cancer, 20 (1), pp. 103-110Routh, J.C., Ashley, R.A., Sebo, T.J., B7-h1 expression in wilms tumor: Correlation with tumor biology and disease recurrence (2008) J. Urol, 179 (5), pp. 1954-1960Yao, Y., Tao, R., Wang, X., Wang, Y., Mao, Y., Zhou, L.F., B7-h1 is correlated with malignancy-grade gliomas but is not expressed exclusively on tumor stem-like cells (2009) Neuro. Oncol, 11 (6), pp. 757-766French, J.D., Kotnis, G.R., Said, S., Programmed death-1+ t cells and regulatory t cells are enriched in tumor-involved lymph nodes and associated with aggressive features in papillary thyroid cancer (2012) J. Clin. Endocrinol. Metab, 97 (6), pp. e934-e943Fife, B.T., Pauken, K.E., Eagar, T.N., Interactions between pd-1 and pd-l1 promote tolerance by blocking the tcr-induced stop signal (2009) Nat. Immunol, 10 (11), pp. 1185-1192Iwai, Y., Ishida, M., Tanaka, Y., Okazaki, T., Honjo, T., Minato, N., Involvement of pd-l1 on tumor cells in the escape from host immune system and tumor immunotherapy by pd-l1 blockade (2002) Proc. Natl Acad. Sci. USA, 99 (19), pp. 12293-1229

Selective loss of carbohydrates from plant remains during coalification

Fossil leaves ofOleinites willsii, Banksieaephyllum angustum, associated organic matter and rhizomes ofGleichenia sp. isolated from Yallourn brown coal deposits, Latrobe Valley, Victoria, Australia and their living relatives have been analysed by high-resolution solid-state13C nuclear magnetic resonance spectroscopy, infrared spectroscopy and pyrolysis—gas chromatography—mass spectrometry. The fossil leaves and rhizomes retain carbohydrates and, on a carbon basis, the amounts of carbohydrates in the fossil rhizomes and their living relatives appear to be similar. On the other hand, the amount of carbohydrates in the fossil leaves is substantially less than in the living relatives. The organic matter found intimately associated with the fossil leaves is quite different in structure from the fossil leaves themselves and bears a closer resemblance to humic acids and the smallest (<75μm) fractions of Yallourn brown coal. Since the fossil leaves are found in stratified beds, interfolded with associated organic matter, it is suggested that during coalification the leaves and associated organic matter undergo independent transformations and are brought together by water transport.Michael A. Wilson, T. Vincent Verheyen, Anthony M. Vassallo, Robert S. Hill, Geoff J. Perr

Reversal Of Bone Marrow Fibrosis In Idiopathic Myelofibrosis After Treatment With α-interferon

A 14-year-old boy presenting with primary myelofibrosis (MMM) was treated with α-interferon (IFN). After 6 months his spleen-was no longer palpable and blood counts had returned to normal. A reversal of bone marrow fibrosis was histologically documented. Although improvement in symptoms and blood counts has been reported, this is only the second description of reversal of bone marrow fibrosis in MMM after treatment.83121124112