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Tax Incentives Around The World
No full textGovernments often use direct subsidies or tax credits to encourage investment and promote economic growth and other development objectives. Properly designed and implemented, these incentives can advance a wide range of policy objectives (increasing employment, promoting sustainability, and reducing inequality). Yet since design and implementation are complicated, incentives have been associated with rent-seeking and wasteful public spending.
This collection illustrates the different types and uses of these initiatives worldwide and examines the institutional steps that extend their value. By combining economic analysis with development impacts, regulatory issues, and policy options, these essays show not only how to increase the mobility of capital so that cities, states, nations, and regions can better attract, direct, and retain investments but also how to craft policy and compromise to ensure incentives endure
Machine Learning to Estimate Exposure and Effects of Emerging Chemicals and Other Consumer Product Ingredients
No full textChemicals in consumer products can influence our risk for developing adverse health conditions. This research addresses knowledge gaps in our ability to evaluate chemical safety, particularly for emerging substances on the market. Acknowledging the need for more high-throughput exposure and hazard models to support risk assessment, computational frameworks leveraging machine learning strategies and "big data" from public databases and mass social data sources were tested.First, to understand consumer exposure, we require a better understanding of ingredient concentrations in products. A computational framework was developed to estimate chemical weight fractions for consumer products containing emerging substances. Nanomaterial-enabled products were used as a case study to represent such substances with limited physicochemical property data. Feature variables included chemical properties, functional use categories (e.g., antimicrobial), the type of product and its matrix. Weight fractions were classified as low, medium or high using a random forest or nonlinear support vector classifier. Performance of machine learning models was qualitatively compared with that of models from a second framework trained on data-rich, bulk-scale organic chemical product data. Models could roughly stratify material-product observations into weight fraction bins with moderate success. The best model achieved an average balanced accuracy of 73% on nanomaterials product data. Chemical functional use features served as particularly insightful predictors, suggesting that functional use data may be useful in evaluating the safety and sustainability of emerging chemicals. Investment in chemical and product data collection could see continued improvement of such machine learning models. Shifting focus to the impact of chemicals on consumers, data on personal care products, ingredients, and customer reviews from online retailers and databases was collected to see if certain chemicals might increase risk of adverse reactions to products. The study scope was narrowed to shampoo products for hypothesis testing. Processing steps in the data pipeline included informatics and machine learning methods, namely, natural language processing for interpreting product reviews, text extraction from images of product labels, and feature reduction using chemical structure and ingredient source data. Fifty-one ingredient clusters were identified as having a significant correlation with higher adverse reaction rates in consumers when present in shampoos. Among these, there were a few common plant-based ingredients and synthetic preservatives known for causing skin sensitivity or irritation. In comparison with other constituents, however, the positively correlated ingredient groups had a general lack of published structural, physicochemical property and toxicity data. Results suggest an urgent need for targeted, higher-throughput chemical evaluations to safeguard consumers.Together, these proof-of-concept studies progress our ability to quantify exposure and hazard of emerging and data-poor substances in consumer products. The outcomes of the computational frameworks can help prioritize potentially problematic substances for additional study to characterize risk.</p
Association of Pneumonia, Wound Infection, and Sepsis with Clinical Outcomes after Acute Traumatic Spinal Cord Injury.
No full textPneumonia, wound infections, and sepsis (PWS) are the leading causes of acute mortality after traumatic spinal cord injury (SCI). However, the impact of PWS on neurological and functional outcomes is largely unknown. The present study analyzed participants from the prospective North American Clinical Trials Network (NACTN) registry and the Surgical Timing in Acute SCI Study (STASCIS) for the association between PWS and functional outcome (assessed as Spinal Cord Independence Measure subscores for respiration and indoor ambulation) at 6 months post-injury. Neurological outcome was analyzed as a secondary end-point. Among 1299 participants studied, 180 (14%) developed PWS during the acute admission. Compared with those without PWS, participants with PWS were mostly male (76% vs. 86%; p = 0.007), or presented with mostly American Spinal Injury Association Impairment Scale (AIS) grade A injury (36% vs. 61%; p < 0.001). There were no statistical differences between participants with or without PWS with respect to time from injury to surgery, and administration of steroids. Dominance analysis showed injury level, baseline AIS grade, and subject pre-morbid medical status collectively accounted for 77.7% of the predicted variance of PWS. Regression analysis indicated subjects with PWS demonstrated higher odds for respiratory (odds ratio [OR] 3.91, 95% confidence interval [CI]: 1.42-10.79) and ambulatory (OR 3.94, 95% CI: 1.50-10.38) support at 6 month follow-up in adjusted analysis. This study has shown an association between PWS occurring during acute admission and poorer functional outcomes following SCI
ZFX Mediates Non-canonical Oncogenic Functions of the Androgen Receptor Splice Variant 7 in Castrate-Resistant Prostate Cancer
No full textFrequency, risk factors, and treatment of distal adjacent segment pathology after long thoracolumbar fusion: a systematic review.
No full textStudy designSystematic review.ObjectiveTo systematically review the literature related to distal adjacent segment pathology (ASP) after long thoracolumbar fusions for deformity including frequency, risk factors, frequency differences between adolescents and adults, surgical approach for revision, and revision complications.Summary of background dataSpinal deformity surgery complications include ASP. Although ASP at the rostral end of instrumented fusions has been well described, substantially less has been documented about distal ASP.MethodsA systematic search was conducted in Medline and the Cochrane Collaboration Library for articles published between January 1, 1983, and March 15, 2012. We included all articles that described distal ASP after long thoracolumbar fusion for deformity. Radiographical ASP (RASP) was defined as evidence of ASP based on imaging, and clinical ASP (CASP) was defined as symptomatic ASP.ResultsSeven retrospective cohort studies met inclusion criteria. Distal CASP developed in 17.7% at 2- 6-year follow-up and 19.8% at 9-year follow-up, whereas reoperation due to CASP was reported in 15.6% at 2 to 6 years and 14.4% at 9 years. Distal RASP was more frequent (44.7%-65.5%). Preoperative sagittal imbalance was associated with increased risk of distal ASP. There was increased risk of CASP in patients with higher postoperative fractional curve and increased risk of RASP in younger patients and those with preoperative disc degeneration, longer fusions, circumferential procedures, and postoperative L5-S1 disc space narrowing. No studies meeting inclusion criteria compared distal ASP in adults and adolescents or defined the best approach or complications for distal ASP revision.ConclusionLow-quality evidence suggests a cumulative rate of 18% to 20% for CASP and 45% to 65% for RASP after long thoracolumbar fusion for spinal deformity during 9-year follow-up. Low-quality evidence suggests an association between preoperative sagittal imbalance and distal ASP, with greater risk of distal ASP in patients with sagittal imbalance. Low-quality evidence suggests increased risk of CASP in patients with higher postoperative fractional curve and increased risk of RASP in younger patients and those with preoperative disc degeneration, longer fusions, circumferential procedures, and postoperative L5-S1 disc space narrowing.Consensus statement1. The risk of developing new symptoms secondary to distal adjacent segment pathology following long thoracolumbar fusion for deformity is approximately 18–20% during a period of 9 years follow up, and most of these patients will require revision surgery. Strength of Statement: Weak. 2. The risk of developing distal adjacent segment pathology may be higher in those with preoperative sagittal imbalance, preoperative disc degeneration, longer fusions, circumferential procedures, and postoperative L5–S1 disc space narrowing. Strength of Statement: Weak
Reproductive Rights as Social Rights: Building a Post-Pandemic Reproductive Healthcare Service Recovery Agenda of Kenya
No full textReproductive health is crucial in female empowerment, as it enhances one’s physical and mental well-being. In Sub-Saharan Africa, national health infrastructure and institutional financing lag behind individuals’ need for access to reproductive healthcare services. The COVID-19 pandemic halted essential reproductive care delivery by limiting in-person visits and reducing workforce and funding. To meet population needs in post-pandemic life, the government needs to adjust a national rights-based framework for reproductive health to lessons from this global health crisis. This thesis aims to construct a post-pandemic reproductive healthcare service recovery framework grounded on theoretical knowledge of reproductive rights as ‘social rights’. This framework highlights the need for practical actions mentioned in the Kenyan government’s Reproductive Health Policy Strategy (2022-2032) and incorporates key informants’ lessons on reproductive justice during the COVID-19 pandemic. Interviews with 25 Kenyan reproductive health key informant organisations were conducted to collect data. Responses were initially coded using factors of the health policy framework, and any noteworthy codes were later defined during the analysis. Then, these codes were later redistributed by each factor of Political, Economic, Sociological, Technological, Legal and Environmental (PESTEL) analysis utilised in the national Reproductive Health Policy Strategy (2022-2032). Key findings are the critical impact of the government’s decisions to halt transmission being a major disruptor of RH service delivery and two distinct perspectives of returning to “normalcy” among service providers. Acknowledging the government’s role in achieving reproductive justice, this framework will be crucial in ascertaining necessary critical changes to move a step further for reproductive health equity in post-pandemic lives
Mapping Manioc: Grounded Relations in the Caribbean
No full text“Mapping Manioc” looks in the ground, taking the dense, starchy, and lively materiality of a root tuber as a lens through which to read human relations of domination and reciprocity in the French colonial Caribbean. Borrowing fertile and intersecting methodologies from French and Francophone studies, Africana studies, ecopoetics, decolonial ecologies, food studies, geography, historical anthropology, and history of science, the project divests the vegetal of its connotations of lethargy to frame the manioc root as an active “plant witness” to historical tensions between colonial exploitation and practices of earth-based sustenance. In dialogue with anglophone theorists of the “Plantationocene,” recent criticism from France’s Outre-mer regions contends that present-day extractivist paradigms producing differential vulnerability to environmental harms stem from the racial taxonomies of plantation societies. This dissertation returns to the epochal shifts at the heart of French colonization in the Caribbean to uncover how one plant was harnessed to feed both the plantation’s devaluation of life and thriving configurations of human and nonhuman being beyond its reach.“Mapping Manioc” relies on a reading practice that breaches the surface of colonial archives to excavate the frictions between Indigenous and Afro/descended peoples’ nonextractive relations with a nurturing earth, on the one hand, and the exploitation of manioc’s carbohydrate calories to fuel settler colonialism and chattel slavery, on the other. This corpus attuned to plant liveliness spans a long eighteenth century, and consists of missionary accounts by Raymond Breton, Jean-Baptiste Labat, and others; lay travel narratives such as that of the anonymous mariner of Carpentras; botanical treatises and natural histories by figures like Guillaume Silvestre Delahaye; planters’ manuals, ships’ logbooks, habitation daybooks, and legal ordinances; and visual materials including engravings, watercolors, "plans d’habitation," and cartography. To evoke counterhistorical visions of human freedoms grounded in ecological flourishing, the project interweaves the colonial archive with Caribbean and Black feminist theorizations of geography and subjectivation; with perspectives from anthropology “beyond the human” and sensory ethnobotany; and with Caribbean literary and visual engagements, including novels by Édouard Glissant. Engaging these sources and artifacts, “Mapping Manioc” tracks embodied meetings of skin and starch across colonial Martinique, Guadeloupe, Saint-Domingue, and French Guiana. This approach routes ancestral life through plant life, attending to the patterns of existence of subjects who forged solidarities with nonhuman beings against plantation epistemologies and their devastating afterlives. By illuminating a genealogy of earthy resistance to colonial extractivism and dispossession, the project points to the role of ancestral food plants in resurgence, solidarity, and self-determination in the Outre-mers, foregrounding the contributions of French and Francophone studies to planetary climate justice, Caribbean climate resilience, and climate cuisine movements.</p
The use of allograft and recombinant human bone morphogenetic protein for instrumented atlantoaxial fusions.
No full textBackgroundIliac crest autograft is the historic gold standard for bone grafting, but is associated with a significant patient morbidity. Fusion rates of C1-C2 up to 88.9% using allograft and 96.7% using autologous iliac crest bone graft can be achieved when combined with rigid screw fixation. We sought to determine our fusion rate when combining allograft with recombinant human bone morphogenetic protein-2 (rh-BMP2) and rigid screw fixation.MethodsWe reviewed our experience using allograft, bone morphogenetic protein (rh-BMP2) and screw fixation of C1-C2 in 52 patients and examined indications, surgical technique, fusion rates, and complications. In 28 patients, corticocancellous allograft pieces were laid along decorticated bone after a C2 neurectomy was performed. In 24 patients, unicortical iliac crest allograft was precision-cut to fit between the C1 lamina and C2 spinous processes.ResultsFifty-two C1-C2 fusions were performed with allograft, rh-BMP2, and rigid screw fixation. There were 25 female and 27 male patients ranging in age from 6 to 92 years (mean, 65.8 years). Operative indications included trauma (56%), degenerative disease (21%), rheumatoid arthritis (15%), congenital anomalies (6%), and synovial cyst (2%). The mean follow-up was 23.9 ± 2.1 months (range, 2-55 months). The mean dose of rh-BMP2 used for all patients was 4.5 mg (range, 2.2-12 mg). In patients who achieved sufficient follow-up, 100% achieved solid fusion: 45/50 Lenke A, 5/50 Lenke B. There were no known complications attributable to the use of rh-BMP2.ConclusionsThe use of small doses of rh-BMP2 added to allograft in addition to rigid screw fixation is a safe and highly effective means of promoting a solid fusion of the atlantoaxial complex and spares the patient the morbidity of iliac crest harvest
An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography.
No full textBackgroundThe treatment of ankle osteoarthritis (OA) varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported subpar reproducibility and reliability. The purpose of this study was to develop and describe computational methods to objectively quantify radiographic changes associated with ankle OA apparent on low-dose weightbearing CT (WBCT).MethodsTwo patients with ankle OA and 1 healthy control who had all undergone WBCT of the foot and ankle were analyzed. The severity of OA in the ankle of each patient was scored using the Kellgren-Lawrence (KL) classification using plain radiographs. For each ankle, a volume of interest (VOI) was centered on the tibiotalar joint. Initial computation analysis used WBCT image intensity (Hounsfield units [HU]) profiles along lines perpendicular to the subchondral bone/cartilage interface of the distal tibia extending across the entire VOI. Graphical plots of the HU distributions were generated and recorded for each line. These plots were then used to calculate the joint space width (JSW) and HU contrast.ResultsThe average JSW was 3.89 mm for the control ankle, 3.06 mm for mild arthritis (KL 2), and 1.57 mm for severe arthritis (KL 4). The average HU contrast was 72.31 for control, 62.69 for mild arthritis, and 33.98 for severe arthritis. The use of 4 projections at different locations throughout the joint allowed us to visualize specifically which quadrants have reduced joint space width and contrast.ConclusionIn this technique report, we describe a novel methodology for objective quantitative assessment of OA using JSW and HU contrast.Clinical relevanceObjective, software-based measurements are generally more reliable than subjective qualitative evaluations. This method may offer a starting point for the development of a more robust OA classification system or deeper understanding of the pathogenesis and response to ankle OA treatment
Therapeutic plasma exchange and intravenous immune globulin in the treatment of heparin-induced thrombocytopenia: A systematic review.
No full textBackgroundImmunomodulatory strategies in heparin-induced thrombocytopenia (HIT) include the use of intravenous immune globulin (IVIG) and therapeutic plasma exchange (TPE). The optimal application of these therapies is unknown and outcomes data are limited. We investigated treatment categories and laboratory and clinical outcomes of IVIG and/or TPE in HIT with a systematic literature review.Study design and methodsWe searched MEDLINE, Embase, and Web of Science through December 2019 for studies combining controlled vocabulary and keywords related to thrombocytopenia, heparin, TPE, and IVIG. The primary outcome was treatment indication. Secondary outcomes were platelet recovery, HIT laboratory parameters, heparin re-exposure, and post-treatment course. Case-level data were analyzed by qualitative synthesis.ResultsAfter 4241 references were screened, we identified 60 studies with four main categories of IVIG and/or TPE use as follows: (a) treatment of refractory HIT (n = 35; 31%); (b) initial therapy (n = 45; 40%); (c) cardiopulmonary bypass surgery (CPB; n = 30; 27%); and (d) other (n = 2; 2%). IVIG was most commonly used for the treatment of refractory HIT while TPE was primarily used to facilitate heparin exposure during CPB. Both IVIG and TPE were equally used as initial therapy. Heparin re-exposure occurred without thrombotic event in 29 TPE-treated patients and three IVIG-treated patients.ConclusionIn patients with HIT, both TPE and IVIG are used for initial therapy or treatment of refractory HIT. However, TPE is more commonly used in patients undergoing CPB. Prospective studies may help clarify which treatment is indicated in HIT population subsets