Risk management and stable financial structures

Conventional development economics has focused mainly on generating economic growth by mobilizing savings and allocating them wisely among investment opportunities. Savings (external and domestic) were to be mobilized through tax incentives, income, and interest rate policies. Their allocation often involved direct government intervention in the investment process. After the disastrous results of the 1980s, the new wisdom is to let the private sector generate growth, while the government provides the regulatory and supervisory framework for competitive markets, ensures the existence of level playing fields, and removes obvious cases of moral hazard. But the private sector working under an inappropriate financial structure may do no better than the government in making right investment choices for long-term growth. So governments (which in a financial crisis are responsible for all national debts) should have an effective national risk management strategy, with an understanding of the national balance sheet, and the necessity of a stable financial structure for steady long-term economic growth. The authors argue that it is not only how much investment is mobilized and allocated but also how investments are financed that matters for an economy's long-term growth. Finance and development are inextricably linked with risk management (both at the sectoral and national levels). Development is a function not just of promoting the right industries and allocating capital for the high-return investments (asset management) but also of choosing the right financial structure (liability management) - and of the related risks arising from the liability mix chosen. The authors argue that one of the ingredients of the East Asian success is prudent risk management by these governments. They present five rules for national risk management, concluding, among other things, to: (a) establish fiscal discipline and price stability as the anchor of overall financial stability; (b) encourage asset diversification through industrialization and export orientation, financed by foreign direct investment; (c) avoid sectoral imbalances, such as excessive domestic or external borrowing, including the development of instruments and institutions to absorb shocks; (d) establish strong institutional capacity to assess and contain systemic risks; and (e) when the above conditions are not adequately met, retain some policy measures to handle the risk.Environmental Economics&Policies,Financial Intermediation,Public Sector Economics&Finance,Banks&Banking Reform,Economic Theory&Research

Antiquated paperwork processes in hospitals: the problems and solutions with health information technology systems

BACKGROUND. The United States healthcare system is one of the most expensive in the world, equaling approximately one trillion dollars. However, the quality of healthcare is low, as indicated by mortality rates, prevalence of diseases, rates of readmission to hospitals, dissatisfaction rates, and much more. One of the inefficiencies in the healthcare system that is causing errors and a decline in patient care to occur is the current paperwork system. Physicians and nurses spend much more time taking care of patient paperwork rather than giving direct treatment to patients themselves, and it's been shown that patient dissatisfaction levels rise and errors occur more frequently as a result of current physician/nurse workload. In order to change from paperwork to electronic files, hospitals must invest the time and money to look for alternative mechanisms that would decrease turn-around time of paperwork completion by leveraging digital solutions. A study was carried out to observe log back of paperwork by counting the amount of papers for each physician before and after an electronic email message intervention. RESULTS. The results were as expected: a simple email message did not drastically affect the amount of paperwork back log by residents, and numbers stayed consistent throughout. More than 50% of patient paperwork for residents in year 1 and 3 was more than 28 days old, which signifies the lack of paperwork availability and accessibility to the residents while off-site. CONCLUSION. Addressing the problem of paperwork burden to residents requires alternative solutions that include changing the entire paperwork system to a paperless, electronic system. Other solutions that require less effort, time and cost are possible, such as an email reminder as was done in this study, but will most likely not be as effective as switching to a paperless system that allows for physician-patient communication on a more consistent basis even though they may be off site. These changes would significantly improve quality of patient care as well as decrease administrative costs and waste

Mitigating absenteeism in hospital workers during a pandemic

Objectives: An influenza pandemic, as with any disaster involving contagion or contamination, has the potential to influence the number of health care employees who will report for duty. Our project assessed the uptake of proposed interventions to mitigate absenteeism in hospital workers during a pandemic. Methods: Focus groups were followed by an Internet-based survey of a convenience sample frame of 17,000 hospital workers across 5 large urban facilities. Employees were asked to select their top barrier to reporting for duty and to score their willingness to work before and after a series of interventions were offered to mitigate it. Results: Overall, 2864 responses were analyzed. Safety concerns were the most frequently cited top barrier to reporting for work, followed by issues of dependent care and transportation. Significant increases in employee willingness to work scores were observed from mitigation strategies that included preferential access to antiviral medication or personal protective equipment for the employee as well as their immediate family. Conclusions: The knowledge base on workforce absenteeism during disasters is growing, although in general this issue is underrepresented in emergency planning efforts. Our data suggest that a mitigation strategy that includes options for preferential access to either antiviral therapy, protective equipment, or both for the employee as well as his or her immediate family will have the greatest impact. These findings likely have import for other disasters involving contamination or contagion, and in critical infrastructure sectors beyond health care

Nearest Neighbor Guidance for Out-of-Distribution Detection

Detecting out-of-distribution (OOD) samples are crucial for machine learning models deployed in open-world environments. Classifier-based scores are a standard approach for OOD detection due to their fine-grained detection capability. However, these scores often suffer from overconfidence issues, misclassifying OOD samples distant from the in-distribution region. To address this challenge, we propose a method called Nearest Neighbor Guidance (NNGuide) that guides the classifier-based score to respect the boundary geometry of the data manifold. NNGuide reduces the overconfidence of OOD samples while preserving the fine-grained capability of the classifier-based score. We conduct extensive experiments on ImageNet OOD detection benchmarks under diverse settings, including a scenario where the ID data undergoes natural distribution shift. Our results demonstrate that NNGuide provides a significant performance improvement on the base detection scores, achieving state-of-the-art results on both AUROC, FPR95, and AUPR metrics. The code is given at \url{https://github.com/roomo7time/nnguide}.Comment: Accepted to ICCV202

Proactive and reactive cognitive control and dorsolateral prefrontal cortex dysfunction in first episode schizophrenia.

Cognitive control deficits have been consistently documented in patients with schizophrenia. Recent work in cognitive neuroscience has hypothesized a distinction between two theoretically separable modes of cognitive control-reactive and proactive. However, it remains unclear the extent to which these processes are uniquely associated with dysfunctional neural recruitment in individuals with schizophrenia. This functional magnetic resonance imaging (fMRI) study utilized the color word Stroop task and AX Continuous Performance Task (AX-CPT) to tap reactive and proactive control processes, respectively, in a sample of 54 healthy controls and 43 patients with first episode schizophrenia. Healthy controls demonstrated robust dorsolateral prefrontal, anterior cingulate, and parietal cortex activity on both tasks. In contrast, patients with schizophrenia did not show any significant activation during proactive control, while showing activation similar to control subjects during reactive control. Critically, an interaction analysis showed that the degree to which prefrontal activity was reduced in patients versus controls depended on the type of control process engaged. Controls showed increased dorsolateral prefrontal cortex (DLPFC) and parietal activity in the proactive compared to the reactive control task, whereas patients with schizophrenia did not demonstrate this increase. Additionally, patients' DLPFC activity and performance during proactive control was associated with disorganization symptoms, while no reactive control measures showed this association. Proactive control processes and concomitant dysfunctional recruitment of DLPFC represent robust features of schizophrenia that are also directly associated with symptoms of disorganization

Assessment of Oyster Shell Structural Properties for the Development of \u27Green\u27 Composite Materials

Abstract of Technical Paper Presented at the 101st Annual Meeting National Shellfisheries Association Savannah, Georgia March 22–26, 200

Biomarker analyses of clinical outcomes in patients with advanced hepatocellular carcinoma treated with Sorafenib with or without Erlotinib in the SEARCH Trial

Purpose: Sorafenib is the current standard therapy for advanced HCC, but validated biomarkers predicting clinical outcomes are lacking. This study aimed to identify biomarkers predicting prognosis and/or response to sorafenib, with or without erlotinib, in HCC patients from the phase 3 SEARCH trial. Experimental Design: 720 patients were randomized to receive oral sorafenib 400 mg BID plus erlotinib 150 mg QD or placebo. Fifteen growth factors relevant to the treatment regimen and/or to HCC were measured in baseline plasma samples. Results: Baseline plasma biomarkers were measured in 494 (69%) patients (sorafenib plus erlotinib, n=243; sorafenib plus placebo, n=251). Treatment arm–independent analyses showed that elevated HGF (HR, 1.687 [high vs low expression]; endpoint multiplicity adjusted [e-adj] P=0.0001) and elevated plasma VEGF-A (HR, 1.386; e-adj P=0..0377) were significantly associated with poor OS in multivariate analyses, and low plasma KIT (HR, 0.75 [high vs low]; P=0.0233; e-adj P=0.2793) tended to correlate with poorer OS. High plasma VEGF-C independently correlated with longer TTP (HR, 0.633; e-adj P=0.0010) and trended toward associating with improved disease control rate (univariate:OR, 2.047; P=0.030; e-adj P=0.420). In 67% of evaluable patients (339/494), a multimarker signature of HGF, VEGF-A, KIT, epigen, and VEGF-C correlated with improved median OS in multivariate analysis (HR, 0.150; P<0.00001). No biomarker predicted efficacy from erlotinib. Conclusions: Baseline plasma HGF, VEGF-A, KIT, and VEGF-C correlated with clinical outcomes in HCC patients treated with sorafenib with or without erlotinib. These biomarkers plus epigen constituted a multimarker signature for improved OS