Profits and balance sheet developments at U.S. commercial banks in 1998

The performance of the U.S. commercial banking industry remained strong in 1998, but slipped a bit from the remarkable results of recent years. Both the return on assets and the return on equity edged down last year, although they remained high by historical standards. While supported by growth in fee income, profitability was damped by a large decline in the rates banks earned on their interest-bearing assets relative to the rates they paid on their liabilities, and also by higher noninterest costs, especially merger and restructuring expenses. Profitability was uneven last year across bank sizes: Whereas the largest and the smallest banks posted lower earnings, the profits of medium-sized banks--which account for almost two-thirds of industry assets--improved once again in 1998. Nevertheless, though these figures attest to the profitability of most banks, the share of bank assets at unprofitable institutions increased 2 percentage points, to 2.6 percent, the highest since 1994.Banks and banking ; Bank profits ; Bank assets

Psychologists and Medications in the Era of Interprofessional Care: Collaboration is Less Problematic and Costly Than Prescribing

Increasing emphasis on interprofessionalism and teamwork in healthcare renders psychologists’ collaborations critical and invites reexamination of psychologists’ roles related to medications. The Collaboration Level outlined by the APA’s Ad Hoc Task Force is more achievable and in synch with health reform than prescription privileges (RxP). RxP remains controversial due to training and safety concerns, lacking support from health professionals, psychologists, and consumers. Differences in educational preparation of psychologists relative to prescribing professionals are discussed. Enactment of only three of 170 RxP initiatives reveals RxP to be a costly, ineffectual agenda. Alternatives (e.g., integrated care, collaboration, telehealth) increase access without risks associated with lesser medical knowledge. Concerns about RxP and the movement toward team-based care warrant reconsideration of the profession’s objectives regarding psychopharmacology

The Tax Benefits of Not-for-Profit Hospitals

This paper investigates three special tax provisions for not-for-profit (NFP) hospitals. First taxes -- both income and property taxes. Second, they issue tax-exempt bonds so lenders do not pay income taxes on interest received. Third, donors deduct charitable contributions from their income tax bases. The rationale for these policies is that the NFP hospitals provide community benefits, the definition of which is often loosely-specified. The value of capital tax exemptions depends on the capital intensity of NFP hospitals, and for income taxes, the hospitals' profitability. For 1995, the aggregate value of the exemption from income taxes is $4.6 billion; the median hospital receives benefits of 1.8 percent of total assets. For the property tax exemption, we estimate an aggregate value of$1.7 billion. The value of the property tax exemption varies across hospitals depending on state and local tax policies and the hospital asset mix. Tax-exempt bonds and deductible contributions are concentrated among larger hospitals. Only 19.7 percent of NFP hospitals had outstanding tax-exempt debt in 1994. Almost half of existing bond debt could be replaced by using hospital endowments; we calculate an annual aggregate benefit of $354 million from using tax-exempt bonds. For charitable contributions, roughly four percent of hospitals receive 71 percent of the contributions. We estimate that the lost tax revenue from these contributions is$1.1 billion in 1994.

Automated System for Early Breast Cancer Detection in Mammograms

The increasing demand on mammographic screening for early breast cancer detection, and the subtlety of early breast cancer signs on mammograms, suggest an automated image processing system that can serve as a diagnostic aid in radiology clinics. We present a fully automated algorithm for detecting clusters of microcalcifications that are the most common signs of early, potentially curable breast cancer. By using the contour map of the mammogram, the algorithm circumvents some of the difficulties encountered with standard image processing methods. The clinical implementation of an automated instrument based on this algorithm is also discussed

Diets of shags Phalacrocorax aristotelis and cormorants P. carbo in Norway and possible implications for gadoid stock recruitment

The diets of shags and cormorants were studied in Norway through analyses of regurgitated pellets. Although this method has many limitations, indications were that both species rely heavily on small gadoids (Gadidae) and sand eels (Ammodytidae) for food throughout their range, but also eat other fish species when available. There was considerable dietary overlap between species, despite a tendency for cormorants to eat larger fish and more benthic items than shags. Predation by shags and cormorants could be a factor limiting the recruitment of cod and saithe into what are now severely reduced, but commercially important stocks in the Norwegian and Barents Seas

Hydrographic Study of Peirce Island Wastewater Treatment Plant Effluent in the Piscataqua River of Portsmouth, New Hampshire: Report of Findings from the December 10 – 14, 2012 Study Period

In order to assist the New Hampshire Department of Environmental Services (NHDES) evaluate the impact of treated wastewater effluent from Peirce Island Wastewater Treatment Plant (WWTP) to the Lower Piscataqua River and Portsmouth Harbor a hydrographic dye study was conducted in December 2012 in Portsmouth, NH. Eight (8) shellfish cages with American oysters (Crassostrea virginica) and blue mussels (Mytilus edulis) were deployed both upstream and downstream of the Peirce Island WWTP in the Piscataqua River, Little Harbor, and the entrance of Little Bay. Eight (8) mini CTDs that monitor conductivity/salinity, temperature, and depth, and six (6) moored fluorometers, which measure dye tagged effluent from the Peirce Island WWTP were attached to the subsurface cages. A fifty (50) gallon mixture of Rhodamine WT dye and distilled water was injected into WWTP on December 11, 2012 for a half tidal cycle (approximately 12.4 hours). Additionally, boat tracking fluorometers connected with a mobile geographic information system (GIS) were used to measure dye levels on the surface in situ and in real time. Microbiological analyses of fecal coliform (FC), male-specific coliphage (MSC), Norovirus (NoV) genogroup I (GI) and genogroup II (GII), and Adenovirus (AdV) were conducted on WWTP influent and effluent composite samples collected with automated samplers to determine the WWTP efficiency in reducing indicator bacteria and viruses. Microbiological sampling and testing of oysters and mussels from the eight (8) sentinel cages was conducted to assess the impact of WWTP effluent on shellfish growing areas and growing area classifications. Prior to conducting the study, the assumption was that the FDA’s recommended minimum dilution of 1000:1was not applicable in this situation because the recommended dilution is based on a WWTP having at least secondary treatment. The microbiological findings in shellfish samples, wastewater samples from the Peirce Island WWTP, and the results of the dye study, confirm that a minimum of 1,000:1 dilution with respect to Peirce Island WWTP is currently not applicable for this WWTP. The FDA and NHDES recommend continued MSC testing of wastewater samples from the WWTP before and after the WWTP upgrade. The FDA and NHDES recommend a future field study after the WWTP upgrade in order to delineate the 1,000:1 dilution zone

Employing pre-stress to generate finite cloaks for antiplane elastic waves

It is shown that nonlinear elastic pre-stress of neo-Hookean hyperelastic materials can be used as a mechanism to generate finite cloaks and thus render objects near-invisible to incoming antiplane elastic waves. This approach appears to negate the requirement for special cloaking metamaterials with inhomogeneous and anisotropic material properties in this case. These properties are induced naturally by virtue of the pre-stress. This appears to provide a mechanism for broadband cloaking since dispersive effects due to metamaterial microstructure will not arise.Comment: 4 pages, 2 figure

Confronting the opioid crisis: Practical pain management and strategies: AOA 2018 critical issues symposium

The United States is in the midst of an opioid crisis. Clinicians have been part of the problem because of overprescribing of narcotics for perioperative pain management. Clinicians need to understand the pathophysiology and science of addiction to improve perioperative management of pain for their patients. Multiple modalities for pain management exist that decrease the use of narcotics. Physical strategies, cognitive strategies, and multimodal medication can all provide improved pain relief and decrease the use of narcotics. National medical societies are developing clinical practice guidelines for pain management that incorporate multimodal strategies and multimodal medication. Changes to policy that improve provider education, access to naloxone, and treatment for addiction can decrease narcotic misuse and the risk of addiction