Fair Rate Research Articles

Correlation and agreement between physical and ultrasound examination after a training session dedicated to the standardization of synovitis assessment in rheumatoid arthritis patients

ObjectivesAssessing disease activity in rheumatoid arthritis (RA) patients requires comprehensive quantification of tender and swollen joints. We aimed to evaluate the correlation and agreement between rheumatologists after a training session dedicated to the standardization of synovitis assessment and compare its performance with a reference imaging modality such as musculoskeletal ultrasonography (MSUS).MethodsIn this cross-sectional study, a total of 28 and 10 joints in RA patients were evaluated by physical examination and ultrasound (US), respectively. After participating in a training session, individual joint assessment for tenderness and swelling was performed by three rheumatologists. MSUS examination was performed separately by an experimented radiologist in a standardized manner, evaluating findings according to the Outcome Measures in Rheumatology Clinical Trial (OMERACT) guidelines.ResultsA total of 80 RA patients were included, with a mean Disease Activity Score based on 28 joints (DAS28)-ESR of 4.02. The interobserver overall agreement and concordance rate in a total of 2240 joints assessed was 81.7% (k = 0.449, p < 0.0001) for tender joints and 66% (k = 0.227, p < 0.0001) for swollen joints. The overall concordance rate was fair (Fleiss' kappa = 0.21, p = 0.027) with an overall agreement of 67.18% yet, more joints were found to be swollen by the US assessment, compared to the physical examination (43% vs 39%).ConclusionIn our study population, joint tenderness showed better interobserver agreement, correlation, and concordance rate than joint swelling. When comparing the US assessment to the physical examination, a fair overall concordance rate supports the need for the implementation of training sessions dedicated to standardization in rheumatology clinics.

Technical Notes of Full Endoscopic Lumbar Interbody Fusion with Anterior Expandable Cylindrical Fusion Cage: Clinical and Radiographic Outcomes at 1-Year Follow-Up

We sought to introduce technical notes of full endoscopic lumbar interbody fusion (FE-LIF) with an anterior expandable cylindrical fusion cage. This study retrospectively reviewed patients who underwent FE-LIF with an anterior expandable cylindrical fusion cage through transforaminal or interlaminar approaches from August 2018 to April 2019. Patient demographics and operation-related complications were recorded. Clinical and radiologic outcomes were evaluated at 1 year after surgery. A total of 32 patients (34 segments) were included in this study. Among them, 14 received full endoscopic transforaminal lumbar interbody fusion and 18 received full endoscopic interlaminar lumbar interbody fusion. There were significant differences in interbody fusion indications between the 2 groups (P < 0.05). All operations were successfully completed without complications. Postoperative lumbar magnetic resonance imaging showed that nerve decompression was sufficient in all patients, and the visual analog scale scores of low back pain and leg pain, the Oswestry Disability Index scores, and sensory and muscle strength were significantly improved after surgery (P < 0.01). The MacNab score included 9 excellent ratings, 4 good ratings, and 1 fair rating in the full endoscopic transforaminal lumbar interbody fusion group and included 10 excellent ratings and 8 good ratings in the full endoscopic interlaminar lumbar interbody fusion group; the scores were not significantly different between the 2 groups at 1 year after surgery (P > 0.05). Complete interbody fusion was achieved in both groups according to computed tomography at 1 year after surgery. FE-LIF is a safe and effective minimally invasive lumbar surgery with an anterior expandable cylindrical fusion cage.

Are spine metastasis survival scoring systems outdated and do they underestimate life expectancy? Caution in surgical recommendation guidance.

Survival scoring systems for spine metastasis (SPM) were designed to help surgical practice. The authors sought to validate the prognostic accuracy of the main preoperative scoring systems for SPM. It was hypothesized that true patient survival in SPM was better than that predicted using prognosis scores. To investigate this hypothesis, the authors designed a French national retrospective study of a prospectively collected multicenter database involving 739 patients treated for SPM between 2014 and 2017. In this series, the median survival time for all patients from an SPM diagnosis was 17.03 ± 1.5 months. Sensitivity and specificity were estimated using the area under the curve (AUC). The AUC of Tomita's prognosis score was the lowest and poorest (0.4 ± 0.023, range 0.35-0.44), whereas the AUC of the Tokuhashi score was the highest (0.825). The Lei score presented an AUC of 0.686 ± 0.022 (range 0.64-0.7), and the Rades score showed a weaker AUC (0.583 ± 0.020, range 0.54-0.63). Differences among AUCs were all statistically significant (p < 0.001). The modified Bauer score and the Rades score had the highest rate of agreement in predicting survival, with a weighted Cohen's kappa of 0.54 and 0.41, respectively, indicating a moderate agreement. The revised Tokuhashi and Lei scores had a fair rate of agreement (weighted Cohen's kappa = 0.24 and 0.22, respectively). The van der Linden and Tomita scores demonstrated the worst performance, with only a "slight" rate of agreement (weighted Cohen's kappa = 0.19 and 0.16, respectively) between what was predicted and the actual survival. The use of prognostic scoring systems in the estimation of survival in patients with SPM has become obsolete and therefore underestimates survival. Surgical treatment decisions should no longer be based on survival estimations alone but must also take into account patient symptoms, spinal instability, and quality of life.

In vitro and in vivo comparative study of a novel 68Ga-labeled PSMA-targeted inhibitor and 68Ga-PSMA-11

68Ga-radiolabeled small molecules that specifically target prostate-specific membrane antigen (PSMA) have been extensively investigated, and some of these tracers have been used in the diagnosis of prostate cancer via 68Ga-positron emission tomography (68Ga-PET). Nevertheless, current 68Ga-labeled radiotracers show only fair detection rates for metastatic prostate cancer lesions, especially those with lower levels of prostate specific antigen (PSA), which often occurs in the biochemical recurrence of prostate cancer. The goal of this study was to design and synthesize a new PSMA-targeted radiotracer, 68Ga-SC691, with high affinity for prostate cancer cells and excellent pharmacokinetics. To this end, structural optimization was carried out on the bifunctional group, target motif, and linker while the high affinity targeting scaffold remained. To explore its potential in the clinic, a comparative study was further performed in vitro and in vivo between 68Ga-SC691 and 68Ga-PSMA-11, a clinically approved tracer for PSMA-positive prostate cancer. SC691 was radiolabeled to provide 68Ga-SC691 in 99% radiolabeling yield under mild conditions. High uptake and a high internalization ratio into LNCaP cells were observed in in vitro studies. In vivo studies showed that 68Ga-SC691 had favorable biodistribution properties and could specifically accumulate on PSMA-positive LNCaP xenografts visualized by micro-PET/CT. This radiotracer showed excellent PET imaging quality and comparable, if not higher, uptake in LNCaP xenografts than 68Ga-PSMA-11.

Synthesis of MnSe @C yolk‐shell nanospheres via a water vapor‐assisted strategy for use as anode in sodium‐ion batteries

This study introduces a simple and eco-friendly synthetic strategy for yolk-shell nanospheres that consist of manganese selenide yolks and carbon shells (MnSe@C) by reacting manganese salt impregnated in the porous hollow carbon nanospheres (HCNS) with H2O vapor. First, manganese salt dissolved in ethanol was impregnated into the spacious pores of the HCNS by capillary force. Then, heat treatment of the powder in the presence of H2O triggered the nucleation and crystal growth of manganese hydroxide, resulting in the formation of HCNS whose central voids are filled with multiple nanoparticles. Subsequent selenization yielded yolk-shell nanospheres with MnSe@void@carbon configuration. MnSe@C was applied as the anode for sodium-ion batteries (SIBs), and the following electrochemical reaction was confirmed from various analytical techniques: MnSe +2Na+ + 2e− ↔ Mn + Na2Se. MnSe@C nanospheres exhibited stable cycle performance up to 1000 cycles at 0.5 A g−1, wherein a reversible capacity of 222 mA h g−1 was delivered in the 1000th cycle. Furthermore, MnSe@C nanospheres exhibited a fair rate performance (209 mA h g−1 at 2.0 A g−1).

Game Theory-Based Power Allocation Strategy for NOMA in 5G Cooperative Beamforming

Non-orthogonal multiple access (NOMA) is a Fifth Generation (5G) technique that allows many users to simultaneously access the same time–frequency separating channels via successive interference cancellation (SIC) receiver. Cooperative NOMA (CNOMA) is an effective tool to prevent performance degradation of far users by allocating minimal power to users with good channel conditions. In this paper, we proposed a fair power and channel allocation scheme based on the Nash bargaining solution (NBS) game solution in full-duplex, cooperative beamforming (BF) for multicarrier (MC) NOMA. The proposed NBS scheme assigns optimal power and channel allocation according to channel conditions while maintaining a fair rate amongst cooperative users. NBS provides a fair and optimum approach for maximizing the total rate of CNOMA. The signal-to-leakage (SLR) ratio precoding technique is considered as a design performance criterion for beamforming vector towards achieving power domain CNOMA players. Simulation results show that at BER = $${10}^{-5}$$ , the NBS power allocation (proposed scheme) improved by 2 dB in terms of Signal-to-Noise Ratio (SNR), compared with the non-cooperative scheme, and 3 dB compared with the multiple-input multiple-output NOMA (MIMO-NOMA). Both improvements were as a result of interference reduction and information sharing in the network. In terms of fairness, the proposed NBS scheme shown a high level of fairness at 0.8401, compared to the other similar approaches in the literature.

Janitor’s Attitudes: Their Effect on Performance at La Consolacion University Phippines SY 2020-2021

The purpose of this research project was to evaluate attitudes of the janitorial workforce in La Consolacion University Philippines of S.Y. 2020-2021 in order to ascertain whether there is a direct relation to their performance.&#x0D; An attitude is a psychological state of mind. It is the way a person thinks about situations, and it ultimately determines a person's behavior. In the workplace, employees can have either a positive or negative attitude about specific work tasks, products or services, co-workers or management, or the company as a whole. Positive attitudes among employees make workdays more enjoyable. Tasks are performed to a higher standard and without complaint. An example of a positive employee attitude occurs when an employee views a negative customer service call as an opportunity to change the narrative for the customer from a bad experience to a good one. However, bad attitudes result in apathy to daily tasks. Employees are easily agitated by minor problems. Tasks are completed at substandard levels (Leonard, 2018).&#x0D; Job attitudes such as satisfaction and involvement are criterion for establishing the health of an organization; rendering effective services largely depends on the human resource. Job satisfaction experienced by employees will induce the people to give their best to the organization. Both the attitudes required to enhance the performance of employees. Current study is based on the effect of attitude on employee performance. This study include the attitude related factors (behaviors of employees and leaders, job satisfaction, job commitment, motivation and training) to investigate their impact on employee performance.&#x0D; This study utilized descriptive method of research. An instrument was developed by the researcher with 8 statements to measure the perceived level of satisfaction, involvement, and performance and then distributed among the respondents with the five- point Likert scale&#x0D; &#x0D; In the totality, respondents rated majority of the janitors with an approval rating of VERY GOOD to the four janitors and GOOD to the Five Janitors while three of the Janitors got an average rating of FAIR. Result shows that all attitude related factors positively affect the employee performance. Motivation and job commitment has highly significant impact of performance of employees. As a result, organizations should value their experienced personnel and devise effective retention policy by giving competitive salary, experienced base pay and experienced based promotion. That will increase the overall performance of the organization.&#x0D; Janitors have to change their poor attitudes and must exhibit more dedication towards their job. Other employees have to make effort to correct these attitudes that is affecting the work. The following are recommendations to improve values and attitudes and to increase the individual performance:&#x0D; &#x0D; Let the janitors feel the sense of total belongingness and importance not to let them feel that they are categories into the lower level of the organizations, let them be involved and participate in all institutional activities to establish camaraderie.&#x0D; Identifying the negative of bad attitudes of the janitors and provide corresponding trainings and seminars to correct their attitudes resulting to poor performance at work.&#x0D; Motivating employees to achieve the high level of satisfaction and performance by giving appropriate awards and incentives.&#x0D; Ensure feedback is specific – Don't just tell the employee their poor attitude needs to improve. Point out exactly what negative traits they have and the impact each has on their performance and monitor their action periodically for expected change to positive attitude towards work performance.&#x0D; &#x0D; Generally, workers with good attitudes have stronger performance, and workers with poor attitudes exhibit less-than-superior performance. It is up to managers to monitor employee attitudes and address attitude problems such as negativity and laziness.

Visualization of Three Tourist Attractions in Three Minority Locations: Low-Carbon Transitions

The presence of millions of tourists and the absence of scientific evidence exacerbate the silence of alarming destruction of resources at China’s minority tourist attractions. These destructive forces motivate us to develop a quantitative and assessment model for the low-carbon transition across time for the tourism industry. We apply the DPSIR framework to construct the measurement indices, the Cloud Analytic Hierarchy Process (CAHP) to obtain indicator weights, and the Cloud Model for transforming linguistic information to potential indicators. We collected data from multiple sources with multiple methods and evaluated the low-carbon tourism across three periods (2010, 2012, and 2017) at three Dong culture minority attractions in three provinces of China. Among tourist attractions, Liping and Huangdu have upgraded from fair ratings in 2010 and 2012 to good ratings in 2017, yet Chengyang has not yet changed during the same periods. We lay the foundation for measuring and visualizing the low-carbon transition, or the lack thereof, at three tourist attractions in minority locations over time. Our visualization of low-carbon transition helps policy-makers integrate theory and practice for a niche market, nudge managers and tourists to promote sustainable tourism in other sites globally and offer practical implications to the field of organizations and the natural environment

Prioritising GDP or Tax Revenues: Indian Economists’ Dilemma

An efficient tax administration with fair tax rates is likely to generate substantial revenues, reducing the fiscal deficit, creating employments, and taming inflation. Indian tax administration has used the power to levitate tax as if it has been taken for granted by adopting the fixed money value target per geographical area instead of any data analytics. The effective tax rate and the average statutory tax rates were the highest in 2017–2018. Focus on generating non-tax revenues by multiple ways and structural reforms for boosting investments and household savings for accelerating GDP should be preferred over maximising tax revenues.

Evaluation of The Counseling on Breast and Cervical Cancers Screening Among Women in Their Reproductive Age

Background: Breast and cervical cancers are one of the leading causes of women's mortality. About 87% of cases of cervical cancer occur in developing countries. Breast cancer has the most increasing number amongst other cancers. Moreover, most of the cases of breast cancer are diagnosed in the late stadium. The late diagnosis of cancer cases is most probably due to a lack of screening at the beginning. Aim: The research aimed to discover the evaluation of breast cancer counseling and cervical cancer screening amongst women of their reproductive age. Methods: This research employed a survey method with a cross-sectional approach. The population and 63 samples were respondents taken using total sampling. The instruments were questionnaires. Results: The results showed that 37 respondents (58.7%) showed fair rates on breast cancer counseling, while 36 respondents (57.1%) gave a fair rating on cervical cancer counseling. Conclusion: This research has proven that women in this study gave fair ratings towards the counseling conducted. It is expected for midwives and health promotion teams to improve the promotional and preventive efforts, especially regarding breast and cervical cancer screening. Besides, women should be active in exploring more information and participating in every activity related to reproductive health, especially breast and cervical cancer screening. Keywords: Counseling Evaluation, Breast Cancer, Cervical Cance

Compensation packages and implications for social networks among development-induced displaced persons in Uganda’s Albertine Graben

ABSTRACT The study aimed at understanding the implications of compensation packages for the social networks of displaced persons in Uganda’s oil-rich Albertine Graben. Questionnaires, interviews, focus group discussions, and observations were used to obtain data from purposively selected respondents. Qualitative data was analysed using content analysis while quantitative data analysis entailed generating descriptive statistics (percentages) and inferential analysis was performed through cross-tabulation by way of chi-square tests. There was a significant association between compensation type and social network distortion for the affected groups (p = 0.000). Institutional management of different compensation packages exhibited professional shortcomings that need to be addressed to build sustainable social networks such as credit facilities. We thus recommend that government involves all stakeholders at every development phase and that compensation rates are continuously updated to allow for fair compensation rates in future and effective resettlement procedures during induced-displacement and resettlement processes.

Le score Oxford Knee et l’EQ-5d prédisent mal la satisfaction du patient après une arthroplastie totale du genou suivant un alignement mécanique : une étude transversale

BackgroundPatient satisfaction is increasingly used to measure the success of arthroplasty. Satisfaction with the outcome of a total knee replacement (TKR) is traditionally thought to be associated with improvements in functional status and quality of life measures. This study aims to answer the following questions: 1. What is the level of patient satisfaction, improvement in knee function and patient quality of life associated with mechanically aligned TKR? 2. What is the relationship between OKS, EQ-5d scores and ‘outcome satisfaction’?Hypothesis TKR is associated with a significant improvement in function, satisfaction and quality of life and that there is a strong correlation between OKS, EQ-5d and ‘outcome satisfaction’. MethodFive thousand eight hundred and ninety six patients underwent primary TKR between January 2010 and December 2017 and had complete pre-operative and 2-year follow up data for OKS, EQ-5d and satisfaction scores. Outcomes data were collected prospectively and recorded on our institutional database. Minimal Clinically Important Difference (MCID) and the Patient Acceptable Symptomatic State (PASS) were calculated for OKS and EQ-5d, the association between OKS, EQ-5d and ‘outcome satisfaction was measured using regression analysis. ResultsThe median 2-year ‘outcome satisfaction’ score was 90/100 with 79% of patients reporting excellent satisfaction (≥80/100) and 93.4% of patients satisfied (≥50/100). Post-operatively, median scores were 39 for OKS and 0.8 for EQ-5d. The mean increase in scores was 15.85 for OKS and 0.32 for EQ-5d. Satisfaction showed moderate positive correlation with post-operative OKS (r=0.69) and EQ-5D (0.58) scores but weaker correlation with the change in OKS (r=0.57) and EQ-5d(r=0.32) scores from pre-operative levels. Discussion/ConclusionMechanically aligned TKR is overall a successful operation responsible of fair rate of patient satisfaction. OKS and EQ-5d are imperfect predictors for satisfaction as they are significantly influenced by patients’ comorbidities. This should be taken into account when evaluating the success of an operation. Level of evidenceIIc; Observational study (based on prospectively collected data from an institutional registry).

Formula Poems for Enriching Writing in the English Classroom

The main objective of the study was to determine the effectiveness of formula poems for enriching writing in the English classroom at the University of Cebu- Main Campus. A quasi-experimental design was used. The experimental group was treated with the use of creative formulae, while the control group was taught to use freewriting. The experts utilized the researcher-made rubric to measure the students' writing performance in both groups. The writing performances of the free writing group had fair rating and there were students got ratings that were also poor. The writing performances of the formula writing group had a very good rating and good ratings which shows that they were better in poetry writing compared to the free writing group. There is a significant difference in the performances of the free writing and formula writing groups. The engagements of the subjects with the formula poems have proved that it is much effective compared to freewriting in assessing the outputs of the subjects. The study concluded that the writing strategy of the students of the formula writing group using formula poems is effective. Furthermore, student writing guided by poetic formulas contributes to more engaged learning and provides a strong framework for creative thinking.

Rate-Splitting for Multicarrier Multigroup Multicast: Precoder Design and Error Performance

Employing multi-antenna rate-splitting (RS) at the transmitter and successive interference cancellation (SIC) at the receivers, has emerged as a powerful transceiver strategy for multi-antenna networks. In this paper, we design RS precoders for an overloaded multicarrier multigroup multicast downlink system, and analyse the error performance. RS splits each group message into degraded and designated parts. The degraded parts are combined and encoded into a degraded stream, while the designated parts are encoded in designated streams. All streams are precoded and superimposed in a non-orthogonal fashion before being transmitted over the same time-frequency resource. We first derive the optimized RS-based precoder, where the design philosophy is to achieve a fair user group rate for the considered scenario by solving a joint max-min fairness and sum subcarrier rate optimization problem. Comparing with other precoding schemes including the state-of-the-art multicast transmission scheme, we show that the RS precoder outperforms its counterparts in terms of the fairness rate, with Gaussian signalling, i.e., idealistic assumptions. Then we integrate the optimized RS precoder into a practical transceiver design for link-level simulations (LLS), with realistic assumptions such as finite alphabet inputs and finite code block length. The performance metric becomes the coded bit error rate (BER). In the system under study, low-density parity-check (LDPC) encoding is applied at the transmitter, and iterative soft-input soft-output detection and decoding are employed at the successive interference cancellation based receiver, which completes the LLS processing chain and helps to generate the coded error performance results which validate the effectiveness of the proposed RS precoding scheme compared with benchmark schemes, in terms of the error performance. More importantly, we unveil the corresponding relations between the achievable rate in the idealistic case and coded BER in the realistic case, e.g., with finite alphabet input, for the RS precoded multicarrier multigroup multicast scenario.

The less I get, the more I punish: A moderated-mediation model of rejection sensitivity and guilt in depression

Depression is known to affect how individuals perceive social exchanges, either negative or positive ones. These difficulties are thought to partly arise from depression-related guilt and rejection sensitivity. Here, we examined whether individuals with elevated levels of depression reported more guilt after engaging in a series of controlled exchanges in the Ultimatum Game (UG) and if rejection sensitivity mediated this relationship in negative interactions. To this end, we utilized a multi-round, multi-shot UG in which participants (N = 72) were sequentially paired with (1) unfair and (2) altruistic allocators. State guilt and perceived fairness ratings were collected throughout the Ultimatum Game. Alternatively, we looked into perceived fairness of received offers and harm caused to the allocator as potential moderators of the mediation model. As expected, we found that rejection sensitivity partially mediated the relationship between depression and guilt. Interestingly, the effect of depression through rejection sensitivity on guilt was stronger when participants caused more harm to the allocator than when they perceived the allocator as extremely unfair. A path analysis was performed as well to check for goodness of fit of the moderated mediation model. Exploratory, we looked at how depression may interfere with the emotional and behavioral response in positive exchanges as well. Overall, our findings may contribute to the understanding of the dynamics in interpersonal transactions of depressed individuals with relevance for counseling and diagnosis. Theoretical implications and interpretive caveats are discussed.

Perceptions of campaign donors and their impact on judgments of judicial fairness

ABSTRACT Perceptions of judicial fairness for elected state judges were examined across a series of studies. Of particular interest was how campaign donations and types of cases affect perceptions that judges could be fair. In Study 1, participants (N = 120) rated the political orientation of 14 groups or companies known to provide campaign contributions and rated how fair judges could be if they received donations from these entities. In Study 2, participants read about a judge who received donations from a liberal or conservative political action committee (N = 190) or corporation (N = 188). Study 3 (N = 809) tested whether judicial recusal in conflicted cases could repair perceptions of judicial fairness. Individual differences in participant political orientation were also examined. Across all studies, participants rated judges as less fair when they received donations during their campaigns and later heard cases that were clearly related to donors’ interests. Significant interactions between participant and donor political orientation were found. Generally, liberal participants thought judges would be less fair when donors were conservative, and conservative participants thought judges would be less fair when donors were liberal. Finally, judicial recusal led to higher future fairness ratings.

Oxford Knee Score and EQ-5d poorly predict patient's satisfaction following mechanically aligned total knee replacement: A cross-sectional study

BackgroundPatient satisfaction is increasingly used to measure the success of arthroplasty. Satisfaction with the outcome of a total knee replacement (TKR) is traditionally thought to be associated with improvements in functional status and quality of life measures. This study aims to answer the following questions: 1. What is the level of patient satisfaction, improvement in knee function and patient quality of life associated with mechanically aligned TKR? 2. What is the relationship between OKS, EQ-5d scores and ‘outcome satisfaction’? HypothesisTKR is associated with a significant improvement in function, satisfaction and quality of life and that there is a strong correlation between OKS, EQ-5d and ‘outcome satisfaction’. MethodFive thousand eight hundred and ninety six patients underwent primary TKR between January 2010 and December 2017 and had complete preoperative and 2-year follow-up data for OKS, EQ-5d and satisfaction scores. Outcomes data were collected prospectively and recorded on our institutional database. Minimal clinically important difference (MCID) and the Patient acceptable symptomatic state (PASS) were calculated for OKS and EQ-5d, the association between OKS, EQ-5d and ‘outcome satisfaction’ was measured using regression analysis. ResultsThe median 2-year ‘outcome satisfaction’ score was 90/100 with 79% of patients reporting excellent satisfaction (≥80/100) and 93.4% of patients satisfied (≥50/100). Postoperatively, median scores were 39 for OKS and 0.8 for EQ-5d. The mean increase in scores was 15.85 for OKS and 0.32 for EQ-5d. Satisfaction showed moderate positive correlation with postoperative OKS (r=0.69) and EQ-5D (0.58) scores, but weaker correlation with the change in OKS (r=0.57) and EQ-5d (r=0.32) scores from preoperative levels. Discussion/ConclusionMechanically aligned TKR is overall a successful operation responsible of fair rate of patient satisfaction. OKS and EQ-5d are imperfect predictors for satisfaction as they are significantly influenced by patients’ comorbidities. This should be taken into account when evaluating the success of an operation. Level of evidenceIIc; observational study (based on prospectively collected data from an institutional registry).

Adaptive Queue Management and Traffic Class Priority Based Fairness Rate Control in Wireless Sensor Networks

Congestion control in Wireless Sensor Networks (WSNs) is one of the key areas of research and different algorithms have been proposed using either of the notions of fair rate allocation, traffic class priority, and queue management. Use of the any one of the above is not adequate to address the challenges. Hence, in this paper, we have proposed a novel congestion control algorithm using the combined notions of fair allocation of bandwidth, prioritizing traffic classes, and Adaptive Queue Management (ADQM). The proposed Weighted Priority based Fair Queue Gradient Rate Control (WPFQGRC) scheme achieves the fair distribution of spare bandwidth by considering the traffic class priority, average queue size, and the connected loads of a node. Average queue size at every node is adapted based on the proposed notion of the gradient of the differential of Global Priority (GP) with respect to the differential of queue size. The output rate of a given node is computed based on the GP of the node and the average queue size. The spare bandwidth of a node is fairly distributed by taking into account the connected load of the given node. The proposed algorithm is developed to suit to a general topology of WSN, however for the sake of illustration, we have considered a tree topology network that deals with both Real-Time (RT) and Non-Real Time (NRT) traffic classes. The proposed algorithm is implemented in NS3 platform in Linux environment and the performance of the algorithm is evaluated in terms of throughput, packet loss, packet delay, traffic class patterns, node mobility, and the average queue size. The performance of the proposed algorithm is found to be superior to that of Yaghmaee et al. ’s, Brahma et al. ’s, Monowar et al. ’s, Sarode et al. ’s, Difference of Differentials Rate Control (DDRC), Weighted Priority based DDRC (WPDDRC), and Priority based Fairness Rate Control (PFRC) algorithms respectively.

Fair insurance premium rate in connected SEIR model under epidemic outbreak

In this paper, we aim to determine an optimal insurance premium rate for health-care in deterministic and stochastic SEIR models. The studied models consider two standard SEIR centres characterised by migration fluxes and vaccination of population. The premium is calculated using the basic equivalence principle. Even in this simple set-up, there are non-intuitive results that illustrate how the premium depends on migration rates, the severity of a disease and the initial distribution of healthy and infected individuals through the centres. We investigate how the vaccination program affects the insurance costs by comparing the savings in benefits with the expenses for vaccination. We compare the results of deterministic and stochastic models.

Low Demand for Reverse Mortgages in Canada: Price, Knowledge or Preferences?

High borrowing costs, limited knowledge and preferences could explain why few Canadians purchase reverse mortgages, an asset decumulation product that is appealing to those who are house-rich but cash-poor. In this paper, we first use an asset pricing model to calculate the actuarial fair costs of guarantees built into reverse mortgage products in Canada and compare those estimates to prevailing interest rates in the market for these products. We also investigate whether Canadians understand reverse mortgages and whether low demand originates on the preference side by conducting a stated-preference experiment with 3000 Canadians. We manipulate characteristics of reverse mortgages, including the interest rate, to tease out how sensitive Canadians are to these characteristics. Our results suggest that observed interest rates are high relative to actuarially fair rates and that consumers are somewhat price sensitive in addition to demonstrating little knowledge of these products and low demand overall.