Uncertain Outcome Research Articles

Fiscal Uncertainty and Currency Crises

AbstractFiscal deficits have been put forward as the main factor in the occurrence of currency crises by the first‐generation currency crisis models. While most papers within this framework consider a fiscal deficit that occurs with certainty, in reality an increase in the government's fiscal burden may be an uncertain outcome. This paper introduces a model where there is uncertainty about the occurrence of a fiscal deficit for a finite number of periods, and studies the effects of such uncertainty on the evolution of currency crises. If the fiscal deficit materializes, the government has to abandon the fixed exchange rate regime, as in the standard case. However, the paper shows that the peg becomes unsustainable even if the fiscal deficit never materializes. Therefore, a speculative attack occurs and the fixed exchange rate regime collapses with the mere possibility of a deficit, independently of whether this outcome actually occurs or not.

Rethinking Risk: Prospect Theory Application in Health Message Framing Research

ABSTRACTAlthough prospect theory conceptualizes risk as uncertainty, health message framing research based on the theory typically conceptualizes risk as severity. This study reports the results of two experiments designed to explore these alternative conceptualizations of risk and their effect on health decision making. Participants (N1 = 768, N2 = 532) were randomly assigned to one of four conditions that presented a hypothetical scenario of a sexually transmitted disease (STD) outbreak. The conditions were defined by message prompt (deadly vs. easily curable STD) and response option frame (gain vs. loss). Participants selected which of two programs (certain outcome vs. uncertain outcome) they would prefer to combat the outbreak. Across both experiments, participants expressed strong preferences for certain (low risk) outcomes in the gain-framed conditions and no preferences in the loss-framed conditions. These differences held regardless of the consequence severity of the scenario. We discuss the theoretical and practical implications of these results and offer directions for future research.

Neurociencia aplicada a la televisión: medición de la atención y la emoción de la serie “FOREVER” / Television-applied neuroscience: measuring attention and emotion in the series “FOREVER”

En este trabajo se muestran los resultados de un experimento de neurociencia sobre el primer capítulo de la serie americana Forever, en el que se midió simultáneamente la actividad electrodérmica de un grupo de 30 personas usando la tecnología Sociograph. Tras la emisión, se realizó una encuesta de tipo auto administrado entre los participantes en el experimento. Los resultados ponen de manifiesto incrementos de EDL van precedidos de un cambio de situación sonora o visual brusca, y ligados a situaciones que imprevisibilidad que generan expectación por lo incierto del desenlace. Los decrementos se producen en situaciones de tranquilidad y calma, de solución previsible, que podrían generar tedio en la audiencia. Los cambios más importantes, de tipo súbito, en la actividad fásica (EDR) se dan en relación a contenidos violentos, en conversaciones entre los protagonistas con alta carga emotiva, y en situaciones con alta expectación. Es destacable la presencia de música en todos estos momento. En la encuesta posterior realizada al final de la emisión, los protagonistas obtienen valoraciones generales altas, lo que unido a que participan en todas las secuencias con EDL y EDR incrementadas, hace sugerir que logran mantener durante la emisión del capítulo una relación atencional y emocional positiva con los espectadores, elemento clave sin duda para el éxito de la serie. Este hecho viene sin duda reforzado por una valoración general de la serie alta, así como de la intención de seguir viéndola en el futuro.

Discovering untapped relationship potential with patients in telehealth: a qualitative interview study

ObjectivesTo explore factors that influence relationship building between telehealth professionals and patients with chronic illness over a distance, from a telehealth professional's perspective.Design4 focus group interviews were conducted in June...

Attenuated psychotic and basic symptom characteristics in adolescents with ultra-high risk criteria for psychosis, other non-psychotic psychiatric disorders and early-onset psychosis.

While attenuated psychotic symptoms (APS) and basic symptoms (BS) are the main current predictors of psychosis in adults, studies in adolescents are scarce. Thus, we (1) described the prevalence and severity of positive, negative, disorganization, general, and basic symptoms in adolescent patients at ultra-high risk for psychosis (UHR), with other non-psychotic psychiatric disorders (PC) and with early-onset psychosis (EOP); and (2) investigated BS criteria in relation to UHR criteria. Sixty-nine 12-18-year-old adolescents (15.3±1.7years, female=58.0%, UHR=22, PC=27, EOP=20) were assessed with the structured interview for prodromal syndromes (SIPS) and the schizophrenia proneness instrument-child and youth version (SPI-CY). Despite similar current and past 12-month global functioning, both UHR and EOP had significantly higher SIPS total and subscale scores compared to PC, with moderate-large effect sizes. Expectedly, UHR had significantly lower SIPS positive symptom scores than EOP, but similar SIPS negative, disorganized, and general symptom scores. Compared to PC, both EOP and UHR had more severe basic thought and perception disturbances, and significantly more often met cognitive disturbances criteria (EOP=50.0%, UHR=40.9%, PC=14.8%). Compared to UHR, both EOP and PC significantly less often met cognitive-perceptive BS criteria (EOP=35.0%, UHR=68.2%, PC=25.9%). BS were significantly more prevalent in both EOP and UHR than PC, and UHR were similar to EOP in symptom domains. Given the uncertain outcome of adolescents at clinical high-risk of psychosis, future research is needed to determine whether the combined assessment of early subjective disturbances with observable APS can improve the accuracy of psychosis prediction.

Displaced intra-articular calcaneal fractures: is there a consensus on treatment in Germany?

Open reduction in displaced intra-articular calcaneal fractures entails a high rate of wound healing deficits and infections as well as an uncertain outcome, which leads to remaining ambiguity in treatment preferences. Between January and July 2011, we emailed 575 German chairpersons of trauma and/or orthopaedic departments, asking them to complete a 31-question web-based survey regarding three broad domains: fracture classification, surgical treatment algorithms and risk factors for wound healing deficits. The response rate was 47%. With an incidence of 77%, open reduction via an extended lateral approach and plate fixation was the main treatment option for displaced intra-articular fractures of the joint-depression-type (Sanders II or III). Percutaneous techniques were only preferred in individual cases, with mainly precarious wound situations (59%) as well as in patients with a reduced general health condition (ASA 3 and 4; 41%). The re-operation rate due to infections and wound healing deficits after an extended lateral approach was reported with a percentage of 0-5% by 88% of the respondents. Participants stated that especially a poor microcirculation of the foot, disregard of soft tissue conserving techniques, overall condition of the patient, smoking, long time-to-surgery and operation time are the main reasons for wound healing deficits. Given the extended lateral approach as the preferred treatment option, we found minimally invasive techniques and primary arthrodesis of the lower ankle joint play a minor role in treating intra-articular calcaneal fractures in Germany. Ninety percent of our respondents stated less than 5% of patients required re-operations due to infections and wound healing deficits. Level of Evidence Level V, expert opinion.

Histologic outcome of thyroid nodules with repeated diagnosis of atypia in thyroid fine-needle aspiration biopsy.

We hypothesized that the estimated risk of malignancy for atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is higher than anticipated in Bethesda system. Therefore, we analyzed the actual malignancy risk of repeated AUS/FLUS diagnosis of thyroid fine-needle aspiration biopsies (FNAB). We reported retrospective analyzes of 112 cases with repeated AUS/FLUS diagnosis among 10,769 thyroid FNABs. The histologic follow-up were evaluated in the study. 112 cases with a repeated diagnosis of AUS/FLUS, histologic follow-up revealed 56 (50%) benign, 46 (41%) malignant and ten (9%) well-differentiated tumors of uncertain malignant potential outcome. The malignancy risk of AUS/FLUS category in thyroid FNABs was higher than anticipated in Bethesda system. Therefore, the management strategy of AUS/FLUS should be revised.

Accounting treatment of research and development expenditures and firms performance: evidence from Greek listed firms in the Athens Stock Exchange

It is common sense that R&D investments could be a vehicle for financial development. However these investments have been related with uncertain financial outcome. As a result of this different approaches, for the reporting of the expenditure on R&D, have been stated and also have been adopted in the Accounting Standards of many countries. We have investigated in this research study the impact of R&D expenditure on firms' value and their financial performance. For this purpose we explored 60 listed firms in the Athens Stock Exchange for the period 2011-2013 and we found evidence for significant differences in the financial performance between R&D oriented and not R&D oriented in the period of Greek financial crisis. We used and analysed reported data, in the financial statements of firms, according to the International Accounting Standards.

A Spare Life by Christina E. Kramer

terse prose perfectly captures the lives of these sad and forgotten outcasts from this small island nation. Melissa Beck Woodstock Academy, Connecticut Lidija Dimkovska. A Spare Life. Trans. Christina E. Kramer. San Francisco. Two Lines Press. 2016. 532 pages. Zlata, a Siamese twin conjoined at the head to her sister, Srebra, is the unlikely protagonist of Macedonian writer Lidija Dimkovska’s remarkable novel A Spare Life. The girls’ names in Macedonian— “zlata” means gold and “srebra,” silver— ironically contradict the misfortune of their deformity. The twins grow up in the 1980s in a squalid Skopje apartment with parents who are ill-equipped emotionally and financially to meet the challenges of raising them. The girls’ mother is a caustic, miserly woman who never shows love, only resentment, toward her daughters; their father is withdrawn and emasculated by his domineering wife and the daily struggle of providing for his family while the country breaks apart. Neighbors encountering the twins cross themselves, brandish the evil eye, or spit over their left shoulders to ward off the evil and bad luck that afflicts the girls. Dimkovska’s memorable depiction of the twins’ claustrophobic existence is riveting . The girls’ conjoined heads restrict nearly all of their physical movements— bending, stepping, or turning by one requires the other, instantaneously, to do the same. Even going to the bathroom is a shared project: one sits on a trashcan next to the toilet while the other empties herself. Dimkovska’s depiction of the girls’ dismal lives is leavened with wry humor, as when Zlata concludes that replicating Sylvia Plath’s suicide would be impossible because standard-size ovens offer too little space to stuff two heads. The girls live with the awful reality that their joined bodies subjugate their separate, individual personalities, and the psychological consequences of this are enormous. Srebra enrolls in law school, forcing Zlata to become a law student as well. And when Srebra falls in love with Darko, Zlata is unable to absent herself from their every kiss and intimacy. Each girl is the other’s unwilling captor, and this fact erases nearly all sibling affection . The two cannot even argue properly because in order to make eye contact with one another they must be facing a mirror. Dimkovska explores these nightmarish burdens with sensitivity and beautifully articulated writing that shines in Christina Kramer’s translation. The twins decide to undergo a high-risk separation surgery when they are twentyfour . The procedure’s uncertain outcome parallels the existential threat facing Macedonia from ethnic hatreds roiling it. Through these intersecting public and personal tragedies, A Spare Life poignantly reveals universal truths about the inability to ever become completely severed from the circumstances of your birth. (Editorial note: Turn to page 54 to read an interview with Dimkovska.) Lori Feathers Dallas, Texas Laia Fàbregas. Landing. Trans. Samantha Schnee. Madrid. Hispabooks. 2016. 200 pages. Landing is a multifaceted book, written under two simple chapter headings, “Her” and “Him,” alternately throughout the book. These chapters develop the individual characters and allow the parallel stories to unravel little by little. The novel can be read from the beginning chapter starting on page 5 straight through to the last sentence of the final chapter or by following each character in their alternate chapters. Either way works and both ways add meaning to the title of the novel as each character searches for his/ her ultimate destination, getting on or off the train/plane at the appropriate moment in their life’s trajectory. Landing follows two sets of episodes of their characters’ lives. These are two distinct people who meet on the first page without realizing their parallel connections , searching for answers to their lives’ questions. She, a Dutch woman, travels often to Spain in her quest to find the “angel” who pulled her out of the burning family car. He, a Spaniard, traveled to Holland searching for work in the mid-twentieth century. On their first meeting, both are on their way back to Holland, she after yet another unsuccessful trip and he after many years away from the country where he met his wife, now deceased. She is the child of parents killed in a car accident, and...

Using Minimal Residual Disease to Improve Treatment Response Definitions and Hematopoietic Cell Transplantation Strategy in Acute Leukemia

Acute leukemia is a most challenging illness for the oncohematologist because of the high risk of life-threatening complications and the complexity of treatment protocols as well as the uncertain therapeutic outcome, which depends on several host-, diseaseand treatment-related factors. When cure is the goal, as is normally the case for fit patients younger than 60 to 65 years with either acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL), the general plan is to deliver an intensive multidrug induction and postinduction treatment sequence, in which the greatest intensity, whenever required, is provided by an allogeneic hematopoietic cell transplantation (HCT). For the assessment of treatment response, a set of standard criteria was developed several years ago by a panel of experts, well before the current explosion of sophisticated technologies to assess residual disease status. In accordance, the bonemarrowmorphology is checked after induction chemotherapy to confirm the achievement of complete remission (CR), which is defined by a marrow blast cell content of less than 5%, together with the recovery of normal blood cell counts. Whereas CR is the mandatory first step of the process leading to cure, more recent technology allows the identification of submicroscopic amounts of leukemic cells in the bonemarrowof patients inCR, referred to as minimal residual disease (MRD), which goes undetected by light microscopy (one leukemic cell out of 10,000 to 100,000 cells) but nevertheless exerts a strong and independent prognostic impact, greatly increasing the risk of a patient experiencing an early relapse. HCT is a powerful therapeutic modality commonly prescribed to younger patients in CR with intermediateand high-risk characteristics. HCT is favored because of its superior activity compared with non-HCToptions, both within and outside clinical trials, and it has had little change in treatment strategy over the past decades. Having become standard practice in many developed countries, the number of HCTs performed has grown steadily, as demonstrated by the more than 40,000 and 20,000 HCTs performed worldwide in patients with AML and ALL, respectively, between 2006 and 2014. This treatment burden is unavoidable and reflects established indications and our wish to cure as many patients as possible; yet, the economic costs generated by the procedure itself as well as the management of the many related acute and chronic toxicities—and above all the associated risk of transplant-related mortality (TRM), averaging slightly below 10%, but higher in many published series—are great. To emphasize this point, a minimum of 6,000 TRMs are expected from a total of 60,000 HCTs, which is clearly an issue for the transplant team and any public health system, given that the estimated average cost of the procedure exceeds $200,000US at day 100, only to rise progressively. Apart from these concerns, HCTstill is, and will long remain, necessary to cure many patients who cannot be cured with chemotherapy, until the promises of novel, targeted therapies are fulfilled, which, to date, has occurred only in acute promyelocytic leukemia. Therefore, the clarification of any issue associated with the risk of transplantation failure, that is, recurrence or TRM, can only improve transplantation strategy and use of available resources, leading eventually to an overall therapeutic benefit. The article by Araki et al that accompanies this editorial is another relevant contribution from the Fred Hutchinson Cancer Research Center (Seattle, WA) on the relationship between CR status, reassessed through MRD analysis, and the outcome of 359 patients with AML who received myeloablative HCTs. With the MRD study performed prior to HCT by using a 10-color, multiparametric flow cytometry, Araki et al demonstrate that not all CRs are the same, and that the likelihood of post-transplantation success varies significantly by function of CR status and MRD as well. In fact, among patients in CR, the relapse rate was only 22% in the MRD-negative group compared with 67% in MRD-positive patients in CR and 65% in patients not in CR, and an MRD positivity of 0.1% or greater (or lower in some patients) retained a high, independent predictive power for relapse in multivariable comparisons with all other risk factors. The direct relationship between MRD and relapse risk was clearly evident in the large, well-performed clinical study by Araki et al. For several reasons, it is becoming difficult to ignore MRD in patients in CR with a risk profile that requires an HCT to reach cure, and these include the fact that MRD is a sensitive, patientspecific risk indicator, it is also rather inexpensive and relatively easy to assess, and it provides added information beyond standard cytogenetic risk class and underlying genetic abnormalities. In addition to improving the definition and the clinico-prognostic meaning of a CR status, now labeled as either MRD negative or MRD positive, these results prompt completely new clinical studies and, perhaps, a new transplantation strategy, as clearly stated by the authors: “patients with active AML could be

Behaving Optimistically: How the (Un)Desirability of an Outcome Can Bias People's Preparations for It

AbstractPast research on the desirability bias and on bracing for bad news has focused on the potential influence of outcome desirability on people's stated expectations. The present studies examined its influence on behavior—that is, what is done in anticipation of, or preparation for, an uncertain outcome. In five studies, the desirability of possible outcomes for an event, which was uncertain and uncontrollable by the participant, was manipulated, and preparation behavior was measured. Study 1 used a hypothetical‐events paradigm. Studies 2 and 3 involved a computer activity in which behavior was tracked on a trial‐by‐trial basis. In Studies 4 and 5, the uncertain event was the ending of a videotaped basketball game. Rather than exhibiting bracing or a reluctance to tempt fate, participants tended to behave in a manner consistent with an optimistic desirability bias. In a subset of studies, predictions and likelihood judgments were also solicited; the differential effects of outcome desirability on these measures are discussed. Copyright © 2015 John Wiley & Sons, Ltd.

Genome and transcriptome delineation of two major oncogenic pathways governing invasive ductal breast cancer development.

Invasive ductal carcinoma (IDC) is a major histo-morphologic type of breast cancer. Histological grading (HG) of IDC is widely adopted by oncologists as a prognostic factor. However, HG evaluation is highly subjective with only 50%-85% inter-observer agreements. Specifically, the subjectivity in the assignment of the intermediate grade (histologic grade 2, HG2) breast cancers (comprising ~50% of IDC cases) results in uncertain disease outcome prediction and sub-optimal systemic therapy. Despite several attempts to identify the mechanisms underlying the HG classification, their molecular bases are poorly understood.We performed integrative bioinformatics analysis of TCGA and several other cohorts (total 1246 patients). We identified a 22-gene tumor aggressiveness grading classifier (22g-TAG) that reflects global bifurcation in the IDC transcriptomes and reclassified patients with HG2 tumors into two genetically and clinically distinct subclasses: histological grade 1-like (HG1-like) and histological grade 3-like (HG3-like). The expression profiles and clinical outcomes of these subclasses were similar to the HG1 and HG3 tumors, respectively. We further reclassified IDC into low genetic grade (LGG = HG1+HG1-like) and high genetic grade (HGG = HG3-like+HG3) subclasses. For the HG1-like and HG3-like IDCs we found subclass-specific DNA alterations, somatic mutations, oncogenic pathways, cell cycle/mitosis and stem cell-like expression signatures that discriminate between these tumors. We found similar molecular patterns in the LGG and HGG tumor classes respectively.Our results suggest the existence of two genetically-predefined IDC classes, LGG and HGG, driven by distinct oncogenic pathways. They provide novel prognostic and therapeutic biomarkers and could open unique opportunities for personalized systemic therapies of IDC patients.

Fiscal Uncertainty and Currency Crises

AbstractFiscal deficits have been put forward as the main factor in the occurrence of currency crises by the first‐generation currency crisis models. While most papers within this framework consider a fiscal deficit that occurs with certainty, in reality an increase in the government's fiscal burden may be an uncertain outcome. This paper introduces a model where there is uncertainty about the occurrence of a fiscal deficit for a finite number of periods, and studies the effects of such uncertainty on the evolution of currency crises. If the fiscal deficit materializes, the government has to abandon the fixed exchange rate regime, as in the standard case. However, the paper shows that the peg becomes unsustainable even if the fiscal deficit never materializes. Therefore, a speculative attack occurs and the fixed exchange rate regime collapses with the mere possibility of a deficit, independently of whether this outcome actually occurs or not.

EP09.22: Antenatally diagnosed intra‐abdominal umbilical vein varix

We discuss an ICSI pregnancy in a 31 year old gravida 2 para 0 woman, after 15 week miscarriage and difficulty conceiving. Low BMI 21.0 and teetotal. Low risk 1st trimester screening, NT 2.30 mm at 13 + 3 weeks. 20 + 5 week scan showed no abnormality and a normal abdomen. Repeat scan at 28 weeks showed a large AC >97th centile with normal fetal growth, scan review arranged for 2 weeks. Prominent umbilical vein noted at 30 week scan and referral to FMU. Umbilical vein varix measuring 14.0 x 24.0 x 51.9 mm diagnosed, minimal turbulence noted within the vein. No other structural defects seen, umbilicoplacental Dopplers and ductus venosus flow normal, however mildly elevated MCA peak velocity. The couple were counselled that this is a rare finding with uncertain outcome, therefore the plan was for close fetal monitoring, prophylactic steroids and delivery at 34 weeks. Modern colour Doppler technology including 3D Power Doppler was helpful not only in making the diagnosis but when counselling the couple (see images). Supporting information can be found in the online version of this abstract Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

The Perceived Value of Passive Animal Health Surveillance: The Case of Highly Pathogenic Avian Influenza in Vietnam.

SummaryEconomic evaluations are critical for the assessment of the efficiency and sustainability of animal health surveillance systems and the improvement of their efficiency. Methods identifying and quantifying costs and benefits incurred by public and private actors of passive surveillance systems (i.e. actors of veterinary authorities and private actors who may report clinical signs) are needed. This study presents the evaluation of perceived costs and benefits of highly pathogenic avian influenza (HPAI) passive surveillance in Vietnam. Surveys based on participatory epidemiology methods were conducted in three provinces in Vietnam to collect data on costs and benefits resulting from the reporting of HPAI suspicions to veterinary authorities. A quantitative tool based on stated preference methods and participatory techniques was developed and applied to assess the non‐monetary costs and benefits. The study showed that poultry farmers are facing several options regarding the management of HPAI suspicions, besides reporting the following: treatment, sale or destruction of animals. The option of reporting was associated with uncertain outcome and transaction costs. Besides, actors anticipated the release of health information to cause a drop of markets prices. This cost was relevant at all levels, including farmers, veterinary authorities and private actors of the upstream sector (feed, chicks and medicine supply). One benefit associated with passive surveillance was the intervention of public services to clean farms and the environment to limit the disease spread. Private actors of the poultry sector valued information on HPAI suspicions (perceived as a non‐monetary benefit) which was mainly obtained from other private actors and media.

Risk: Mathematical and Otherwise

In 1999 NASA's Mars Climate Orbiter burned and crashed because no one had thought to check whether force, expressed in pounds, had been converted to force expressed in Newtons (Grossman, 2010). Failure to carry the one, or convert pounds to Newtons, are examples of only one of the risks encountered in attempting to apply mathematics to the management of risk.Assuming they can remember to carry the one, what role might mathematicians have to play in the management of risk? The idea of turning a risk, a possibility of loss or injury, into a "calculated" risk, a quantified probability of loss or injury, is one that has obvious appeal not just to statisticians and mathematicians - but to large numbers of others who would like to know the probability of failure before pursuing some intended course of action."Risk" (almost a billion Google hits) has become a booming business. "Risk management" yields over 80 million hits, and "chief risk officer" (of interest to those looking for employment in this field) returns half a million. Governments are keen on risk management: Turnbull, Basel, Sarbanes-Oxley are names associated with guidance, accords or legislative acts intended to ensure that financial risks are managed effectively. Most big banks now have extraordinarily highly paid chief risk officers (CROs) to ensure compliance with their requirements - in 2011 the CRO at Bank of America was paid $11.4 million (Bloomberg News, 2011). Other large, non-financial, enterprises such as General Motors and Ford, Shell and BP, Delta Airlines, Toyota, also have senior executives bearing the CRO title.The financial meltdown of 2007/2008 gave a huge boost to the risk management industry. It has now declared itself a profession and it is growing at an impressive rate: GARP, the Global Association of Risk Professionals grew more than three-fold from 55,000 members pre-crash in 2006 to more than 175,000 by 2011.Types of RiskThe growing army of risk managers seeks to manage an extraordinary range of different risks. Here is a short starter list: financial risk (credit risk, market risk, liquidity risk, value at risk ...), legal risk, reputation risk, medical risk, strategic risk, policy risks, inflation risk, recession risk, terrorism risk, sanctions risk, climate risk, radiation risk, extreme weather risk, road accident risk, etc., etc.The list could go on almost without end. Any threat of nature or any human activity, physical or intellectual, leading to an uncertain outcome can serve as a descriptor of a type of risk.A further, less open-ended, set of categories can be helpful in an attempt to illuminate the challenges facing risk managers seeking to reduce risks to calculable probabilities. Figure 1 presents a risk typology that is germane to most discussions of a wide variety of risks and their management.The Venn diagram in Figure 1 suggests that the typology can be useful to distinguish three different, but not mutually exclusive, types of risk. One need sample only a tiny fraction of the 100s of millions of Google "risk" hits to discover unnecessary and often acrimonious arguments caused by people using the same word to refer to different things and shouting past each other. The typology offered in Figure 1 can help to dispose of some unnecessary arguments and, perhaps, civilize others.Risks in the perceived directly circle are managed using judgement. We do not undertake a formal, probabilistic risk assessment before crossing the road; some combination of instinct, intuition and experience usually sees us safely to the other side. The consequences of failing to carry the one, or convert pounds to Newtons are, like road accidents, usually the result of carelessness: a failure pay attention to directly perceptible hazards.The second, the risk-perceived-through-science circle, dominates the risk management literature. This is the circle within which most of the risk professionals ply their trade. …

A novel mitochondrial DNA deletion in a patient with Pearson syndrome and neonatal diabetes mellitus provides insight into disease etiology, severity and progression

Pearson syndrome (PS) is a rare, mitochondrial DNA (mtDNA) deletion disorder mainly affecting hematopoietic system and exocrine pancreas in early infancy, which is characterized by multi-organ involvement, variable manifestations and poor prognosis. Since the clinical complexity and uncertain outcome of PS, the ability to early diagnose and anticipate disease progression is of great clinical importance. We described a patient with severe anemia and hyperglycinemia at birth was diagnosed with neonatal diabetes mellitus, and later with PS. Genetic testing revealed that a novel mtDNA deletion existed in various non-invasive tissues from the patient. The disease course was monitored by mtDNA deletion heteroplasmy and mtDNA/nucleus DNA genome ratio in different tissues and at different time points, showing a potential genotype–phenotype correlation. Our findings suggest that for patient suspected for PS, it may be therapeutically important to first perform detailed mtDNA analysis on non-invasive tissues at the initial diagnosis and during disease progression.

The Multiple Pathways to Trauma Recovery, Vindication, and National Reconciliation in Cambodia

Trauma theory has long been confined to the domain of psychology with a concern for clinical situations and vignettes. The framing of trauma as an individual or psychological problem is unable to explain what causes changes in public attitudes toward trauma victims because it fails to recognize the collective dynamics and social dimension of trauma. The collective dynamics of trauma have emerged as a vital theme in recent works including constructivist sociological models of collective trauma representations and of the changing impact of international norms. This article engages with these models in the context of the Cambodian genocide by the Khmer Rouge and explores the shifts in public perceptions of formerly stigmatized survivors, considering that trauma recovery is a never‐ending process with an uncertain outcome. It is argued that the public perception of what constitutes individual trauma and who is acknowledged as victim depends largely on cultural and political contexts. Field interviews with several victims of forced marriages, a mental health expert, and a former judge illustrate what needs to be done to help traumatized survivors find closure and obtain reparations.

Developing scenarios for the Norwegian travel industry 2025

Purpose The Norwegian travel industry faces decline in important international tourism segments and needs an industry wide and future‐oriented strategy to face these challenges. Accordingly, a common understanding of future drivers and different scenarios for the industry is needed. The paper aims to discuss these issues. Design/methodology/approach Using the process of scenario analysis and drawing upon the involvement of the tourism industry, this paper describes the method, drivers, scenarios, and implications. Findings The research identified six important drivers with predictable outcomes: uneven global economic development, digitalization, climate change, consumer demand – return on time, centralization, and demography. The Norwegian economy and Norwegian politics were the two drivers that stood out as the most significant for the tourism industry, with a very uncertain outcome, and constituted the two axes of the scenarios. This resulted in four scenarios: Money Rules, The Urban Diamond, Opportunities for All, and Master Plan. Practical implications The four scenarios represent different economic value of international tourism in Norway. The Opportunities for All and Master Plan scenarios represent the greatest economic value for Norwegian tourism. They indicate great opportunities for tourism to become the “new oil” in Norway if the oil economy declines. The two scenarios differ with respect to the degree of governance control vs market liberalization. The scenarios will be used to identify implications and risks for different parts of the tourism industry, and to further explore how governance control and market liberalization may be combined. Originality/value The research identified six drivers which are significant for the Norwegian tourism industry. This resulted in four scenarios which are used to identify implications and risks for different parts of the industry.

Drivers of University–Industry Links: The Case of Knowledge-Intensive Business Service Firms in Rural Locations

Johnston A. and Huggins R. Drivers of university–industry links: the case of knowledge-intensive business service firms in rural locations, Regional Studies. Establishing collaborative links with universities is a difficult task with an uncertain outcome and influenced by many factors including location, geographic distance, compatibility of interests, shared understanding and prior experience of collaboration. Drawing on an analysis of knowledge-intensive business service firms (KIBS) located in predominantly rural districts of the UK, this paper examines the influences on partner selection when developing formal university linkage through knowledge transfer partnerships. The findings indicate that both geographic and organizational proximity are significantly associated with partner choice, indicating that the formation of university–industry links is the result not only of spatial factors but also of prior experience of collaboration.