Determining appropriate government guarantees for concession contract: lessons learned from 10 PPP projects in China

Governments worldwide are keen to encourage PPP schemes, however PPP is not a foolproof business. Many local governments and private investors have suffered severe or trying experiences. In this research, 10 case studies were conducted to identify the obstacles and difficulties for successful implementation of PPP projects from the perspective of government guarantees. These PPP projects include two water supply plants, two sewage treatment plants, two power supply plants, two highway projects, and two bridge projects. The findings obtained indicate that the local governments are familiar with “the type of guarantees” to provide to the private investor but they are unsure of the “amount” that should be given. Many PPP projects have therefore been heavily criticized for over benefiting the private investors as the government provides them with too many guarantees. The inappropriate guarantees offered by the government are regarded as one of the root causes of PPP projects’ failure. The lessons learned are valuable for determining appropriate government guarantees for future PPP projects and broadening the opportunities for infrastructure development with PPP procurement model

Developing a Holistic Fire Risk Assessment Framework for Building Construction Sites in Hong Kong

Amongst all types of construction accidents, industrial practitioners tend to pay less attention to the prevention of fires at construction sites.  Although fires may not occur frequently on construction sites, statistics show that when they do, the consequences are very serious; involving fatalities, injuries, serious project delays and financial loss.  There are many reasons why fires occur on sites, but a simple lack of awareness of the risks of fire is a major contributor.  Fire risk assessment is not commonly performed on sites.  Hence, it is believed that an appropriate assessment method for evaluating potential fire risk is required in order to improve the awareness of fire risk on construction sites.  This paper reports on the key findings of a research project which aims to develop a comprehensive, objective, reliable, and practical fire risk assessment framework for building construction sites based in Hong Kong.  A comprehensive list of those factors (or conditions) which may constitute a fire risk was compiled using desktop research and structured face-to-face interviews with experienced site personnel.  This list of factors was then used to develop a questionnaire survey form and the Reliability Interval Method (RIM) was used to analyse the survey results and determine the relative importance and rankings of the various fire risk factors at a broad level and risk sub-factors at a detailed level.  It was found that the fire risk factor of “Fire Services Equipment and Installations” has the greatest impact on construction site fire safety, with “Means of Escape in Case of Fire” being the second, and “Attitude of Main Contractor towards Fire Safety” being the third.  In fact, it is the main contractor who plays the pivotal role in maintaining construction site fire safety, which is in line with the high ranking given to the fire risk factor of “Attitude of Main Contractor towards Fire Safety”.  The proposed fire risk assessment framework can be used to develop a useful checklist for assessing the overall level of fire risk for a construction site, and to identify any areas needing improvement.  Although the fire risk assessment framework was developed locally in Hong Kong, the research methodology could be replicated in other countries to produce similar frameworks for international comparison.  Such an extension would aid the understanding of the management of fire risk on construction sites and help discover differences between countries

A computerized risk evaluation model for public-private partnership (PPP) projects and its application

PPP projects usually involve more risks than other traditional procurement models because of their complexity. This paper presents the third stage of a funded study, which aims to develop a practical and computerized risk evaluation model for PPP projects. In the first and second stages, a risk hierarchal structure composed of 17 weighted risk factors is developed to describe risk profiles of PPP projects. The weightings and membership functions for risk factors are established using the Delphi survey technique and Fuzzy Set Theory. The risk evaluation model is then developed using a fuzzy synthetic evaluation approach. In the third stage, an automated decision support tool based on the risk evaluation model is designed for PPP practitioners by using Visual Basic for Application (VBA). The computerized tool can not only assist PPP participants to assess a PPP project's overall risk level for auxiliary investment decision, but can also help practitioners to identify the most risky areas of a PPP project for effective risk response. To demonstrate the applicability of the computerized model, an illustrative case is finally provided

Developing a concession pricing model for PPP highway projects

The concession pricing is one of the most important issues during the negotiation period of PPP contracts. Pricing should vary in accordance with risks assumed by the private sector and embody equitable risk sharing between the government and the private sector to lower the minimum feasible concession price and ensure effective risk management. In this study, a general concession pricing model is developed through cost-benefit analysis from the perspective of the private sector. The model integrates project risk variables, price parameters, and other financial elements into a concession pricing formula based on cash flow table. Meanwhile, to cope with the occurrence of unforeseeable losses triggered by risk factors, such as interest rate fluctuation, inflation, traffic volume change, etc., a price adjustment mechanism is established to adjust the initial price and ensure the project's financial viability. The concession pricing model and adjustment mechanism allow the government and the private sector to reach a consensus on the tariff scheme of a PPP project. It is believed that the model is beneficial to create a “win-win” situation for both the government and the private sector

Alcohol consumption and lifetime change in cognitive ability:a gene × environment interaction study

Studies of the effect of alcohol consumption on cognitive ability are often confounded. One approach to avoid confounding is the Mendelian randomization design. Here, we used such a design to test the hypothesis that a genetic score for alcohol processing capacity moderates the association between alcohol consumption and lifetime change in cognitive ability. Members of the Lothian Birth Cohort 1936 completed the same test of intelligence at age 11 and 70 years. They were assessed for recent alcohol consumption in later life and genotyped for a set of four single-nucleotide polymorphisms in three alcohol dehydrogenase genes. These variants were unrelated to late-life cognition or to socioeconomic status. We found a significant gene × alcohol consumption interaction on lifetime cognitive change (p = 0.007). Individuals with higher genetic ability to process alcohol showed relative improvements in cognitive ability with more consumption, whereas those with low processing capacity showed a negative relationship between cognitive change and alcohol consumption with more consumption. The effect of alcohol consumption on cognitive change may thus depend on genetic differences in the ability to metabolize alcohol

Early rheumatoid arthritis is characterized by a distinct and transient synovial fluid cytokine profile of T cell and stromal cell origin

Pathological processes involved in the initiation of rheumatoid synovitis remain unclear. We undertook the present study to identify immune and stromal processes that are present soon after the clinical onset of rheumatoid arthritis ( RA) by assessing a panel of T cell, macrophage, and stromal cell related cytokines and chemokines in the synovial fluid of patients with early synovitis. Synovial fluid was aspirated from inflamed joints of patients with inflammatory arthritis of duration 3 months or less, whose outcomes were subsequently determined by follow up. For comparison, synovial fluid was aspirated from patients with acute crystal arthritis, established RA and osteoarthritis. Rheumatoid factor activity was blocked in the synovial fluid samples, and a panel of 23 cytokines and chemokines measured using a multiplex based system. Patients with early inflammatory arthritis who subsequently developed RA had a distinct but transient synovial fluid cytokine profile. The levels of a range of T cell, macrophage and stromal cell related cytokines ( e. g. IL-2, IL-4, IL-13, IL-17, IL-15, basic fibroblast growth factor and epidermal growth factor) were significantly elevated in these patients within 3 months after symptom onset, as compared with early arthritis patients who did not develop RA. In addition, this profile was no longer present in established RA. In contrast, patients with non-rheumatoid persistent synovitis exhibited elevated levels of interferon-gamma at initiation. Early synovitis destined to develop into RA is thus characterized by a distinct and transient synovial fluid cytokine profile. The cytokines present in the early rheumatoid lesion suggest that this response is likely to influence the microenvironment required for persistent RA

Ischaemic strokes in patients with pulmonary arteriovenous malformations and hereditary hemorrhagic telangiectasia: associations with iron deficiency and platelets.

<div><p>Background</p><p>Pulmonary first pass filtration of particles marginally exceeding ∼7 µm (the size of a red blood cell) is used routinely in diagnostics, and allows cellular aggregates forming or entering the circulation in the preceding cardiac cycle to lodge safely in pulmonary capillaries/arterioles. Pulmonary arteriovenous malformations compromise capillary bed filtration, and are commonly associated with ischaemic stroke. Cohorts with CT-scan evident malformations associated with the highest contrast echocardiographic shunt grades are known to be at higher stroke risk. Our goal was to identify within this broad grouping, which patients were at higher risk of stroke.</p><p>Methodology</p><p>497 consecutive patients with CT-proven pulmonary arteriovenous malformations due to hereditary haemorrhagic telangiectasia were studied. Relationships with radiologically-confirmed clinical ischaemic stroke were examined using logistic regression, receiver operating characteristic analyses, and platelet studies.</p><p>Principal Findings</p><p>Sixty-one individuals (12.3%) had acute, non-iatrogenic ischaemic clinical strokes at a median age of 52 (IQR 41–63) years. In crude and age-adjusted logistic regression, stroke risk was associated not with venous thromboemboli or conventional neurovascular risk factors, but with low serum iron (adjusted odds ratio 0.96 [95% confidence intervals 0.92, 1.00]), and more weakly with low oxygen saturations reflecting a larger right-to-left shunt (adjusted OR 0.96 [0.92, 1.01]). For the same pulmonary arteriovenous malformations, the stroke risk would approximately double with serum iron 6 µmol/L compared to mid-normal range (7–27 µmol/L). Platelet studies confirmed overlooked data that iron deficiency is associated with exuberant platelet aggregation to serotonin (5HT), correcting following iron treatment. By MANOVA, adjusting for participant and 5HT, iron or ferritin explained 14% of the variance in log-transformed aggregation-rate (p = 0.039/p = 0.021).</p><p>Significance</p><p>These data suggest that patients with compromised pulmonary capillary filtration due to pulmonary arteriovenous malformations are at increased risk of ischaemic stroke if they are iron deficient, and that mechanisms are likely to include enhanced aggregation of circulating platelets.</p></div

Non-invasive prenatal assessment of trisomy 21 by multiplexed maternal plasma DNA sequencing: large scale validity study

Objectives To validate the clinical efficacy and practical feasibility of massively parallel maternal plasma DNA sequencing to screen for fetal trisomy 21 among high risk pregnancies clinically indicated for amniocentesis or chorionic villus sampling

Regulation of RKIP Function by Helicobacter pylori in Gastric Cancer

Helicobacter pylori (H. pylori) is a gram-negative, spiral-shaped bacterium that infects more than half of the world’s population and is a major cause of gastric adenocarcinoma. The mechanisms that link H. pylori infection to gastric carcinogenesis are not well understood. In the present study, we report that the Raf-kinase inhibitor protein (RKIP) has a role in the induction of apoptosis by H. pylori in gastric epithelial cells. Western blot and luciferase transcription reporter assays demonstrate that the pathogenicity island of H. pylori rapidly phosphorylates RKIP, which then localizes to the nucleus where it activates its own transcription and induces apoptosis. Forced overexpression of RKIP enhances apoptosis in H. pylori-infected cells, whereas RKIP RNA inhibition suppresses the induction of apoptosis by H. pylori infection. While inducing the phosphorylation of RKIP, H. pylori simultaneously targets non-phosphorylated RKIP for proteasome-mediated degradation. The increase in RKIP transcription and phosphorylation is abrogated by mutating RKIP serine 153 to valine, demonstrating that regulation of RKIP activity by H. pylori is dependent upon RKIP’s S153 residue. In addition, H. pylori infection increases the expression of Snail, a transcriptional repressor of RKIP. Our results suggest that H. pylori utilizes a tumor suppressor protein, RKIP, to promote apoptosis in gastric cancer cells