Added value of coronary artery calcium score as an adjunct to gated SPECT for the evaluation of coronary artery disease in an intermediate-risk population

The coronary artery calcium (CAC) score is a readily and widely available tool for the noninvasive diagnosis of atherosclerotic coronary artery disease (CAD). The aim of this study was to investigate the added value of the CAC score as an adjunct to gated SPECT for the assessment of CAD in an intermediate-risk population. METHODS: Seventy-seven prospectively recruited patients with intermediate risk (as determined by the Framingham Heart Study 10-y CAD risk score) and referred for coronary angiography because of suspected CAD underwent stress (99m)Tc-tetrofosmin SPECT myocardial perfusion imaging (MPI) and CT CAC scoring within 2 wk before coronary angiography. The sensitivity and specificity of SPECT alone and of the combination of the 2 methods (SPECT plus CAC score) in demonstrating significant CAD (>/=50% stenosis on coronary angiography) were compared. RESULTS: Forty-two (55%) of the 77 patients had CAD on coronary angiography, and 35 (45%) had abnormal SPECT results. The CAC score was significantly higher in subjects with perfusion abnormalities than in those who had normal SPECT results (889 +/- 836 [mean +/- SD] vs. 286 +/- 335; P < 0.0001). Similarly, with rising CAC scores, a larger percentage of patients had CAD. Receiver-operating-characteristic analysis showed that a CAC score of greater than or equal to 709 was the optimal cutoff for detecting CAD missed by SPECT. SPECT alone had a sensitivity and a specificity for the detection of significant CAD of 76% and 91%, respectively. Combining SPECT with the CAC score (at a cutoff of 709) improved the sensitivity of SPECT (from 76% to 86%) for the detection of CAD, in association with a nonsignificant decrease in specificity (from 91% to 86%). CONCLUSION: The CAC score may offer incremental diagnostic information over SPECT data for identifying patients with significant CAD and negative MPI results.

Added value of dual-energy computed tomography versus single-energy computed tomography in assessing ferromagnetic properties of ballistic projectiles: implications for magnetic resonance imaging of gunshot victims.

OBJECTIVE The objective of this study was to assess the discriminative power of dual-energy computed tomography (DECT) versus single-energy CT (SECT) to distinguish between ferromagnetic and non-ferromagnetic ballistic projectiles to improve safety regarding magnetic resonance (MR) imaging studies in patients with retained projectiles. MATERIALS AND METHODS Twenty-seven ballistic projectiles including 25 bullets (diameter, 3-15 mm) and 2 shotgun pellets (2 mm each) were examined in an anthropomorphic chest phantom using 128-section dual-source CT. Data acquisition was performed with tube voltages set at 80, 100, 120, and 140 kV(p). Two readers independently assessed CT numbers of the projectile's core on images reconstructed with an extended CT scale. Dual-energy indices (DEIs) were calculated from both 80-/140-kV(p) and 100-/140-kV(p) pairs; receiver operating characteristics curves were fitted to assess ferromagnetic properties by means of CT numbers and DEI. RESULTS Nine (33%) of the projectiles were ferromagnetic; 18 were nonferromagnetic (67%). Interreader and intrareader correlations of CT number measurements were excellent (intraclass correlation coefficients, >0.906; P<0.001). The DEI calculated from both 80/140 and 100/140 kV(p) were significantly (P<0.05) different between the ferromagnetic and non-ferromagnetic projectiles. The area under the curve (AUC) was 0.75 and 0.8 for the tube voltage pairs of 80/140 and 100/140 kV(p) (P<0.05; 95% confidence interval, 0.57-0.94 and 0.62-0.97, respectively) to differentiate between the ferromagnetic and non-ferromagnetic ballistic projectiles; which increased to 0.83 and 0.85 when shotgun pellets were excluded from the analysis. The AUC for SECT was 0.69 and 0.73 (80 and 100 kV[p], respectively). CONCLUSIONS Measurements of DECT combined with an extended CT scale allow for the discrimination of projectiles with non-ferromagnetic from those with ferromagnetic properties in an anthropomorphic chest phantom with a higher AUC compared with SECT. This study indicates that DECT may have the potential to contribute to MR safety and allow for MR imaging of patients with retained projectiles. However, further studies are necessary before this concept may be used to triage clinical patients before MR.

Don't forget asking the others! - The added value of significant other's reports on patient interpersonal style for the prediction of therapy process and outcome

Theory: Interpersonal factors play a major role in causing and maintaining depression. It is unclear, however, to what degree significant others of the patient need to be involved for characterizing the patient's interpersonal style. Therefore, our study sought to investigate how impact messages as perceived by the patients' significant others add to the prediction of psychotherapy process and outcome above and beyond routine assessments, and therapist factors. Method: 143 outpatients with major depressive disorder were treated by 24 therapists with CBT or Exposure-Based Cognitive Therapy. Interpersonal style was measured pre and post therapy with the informant‐based Impact Message Inventory (IMI), in addition to the self‐report Inventory of Interpersonal Problems (IIP‐32). Indicators for the patients' dominance and affiliation as well as interpersonal distress were calculated from these measures. Depressive and general symptomatology was assessed at pre, post, and at three months follow‐up, and by process measures after every session. Results: Whereas significant other's reports did not add significantly to the prediction of the early therapeutic alliance, central mechanisms of change, or post‐therapy outcome including therapist factors, the best predictor of outcome 3 months post therapy was an increase in dominance as perceived by significant others. Conclusions: The patients' significant others seem to provide important additional information about the patients' interpersonal style and therefore should be included in the diagnostic process. Moreover, practitioners should specifically target interpersonal change as a potential mechanism of change in psychotherapy for depression.

The facility manager architect : the social responsability as an added value.

From the very first steps to execute a building, it is essential to analyze its life cycle. Similarly, we should consider the life cycle when projecting an urban intervention. Professionals of the Facility Management take part in construction projects, developing and managing DBFMO projects (Design, Build, Finance, Maintenance & Operate). Whatever the nature of the promoter is – private or public – promoters are leaders in projects of responsible management of spaces, whether these are work spaces, leisure spaces or residential spaces. They know and identify with the company and its performance, its values and its needs. These professionals give sustainable solutions in the life cycle of buildings (offices and housing), new ways to work and initiatives of innovations linked to current social changes: technology, social networks, and new habits. Concepts where innovation is essential should consider responsible values. Social, economic and sustainable aspects have to associate with the management performed by a Facilities Manager when considering the three groups of stakeholders with which it is linked: economic (shareholders), contractual (users), non-contractual (neighborhoods, organizations, etc.). Marcus Vitruvius Pollio, at the beginning of his book "The Ten Books on Architecture" describes and argues how the distribution in buildings must always adapt to their inhabitants. Let us build cities and buildings with responsible criteria, bearing in mind all its users and the needs of each one of them. Not to mention the need to adapt to future requirements with minimum cost and maximum profitability. These needs, under responsible management, are competencies developed by a Facilities Manager in his day to day. He cares and takes over the entire life cycle of buildings and their surroundings. This work is part of the PhD project whose main aim is to study the added value to the architectural profession when social responsibility criteria are applied in his/her role as Facility Manager.

Exploring the economic value of personal information from firms' financial statements

Currently personal data gathering in online markets is done on a far larger scale and much cheaper and faster than ever before. Within this scenario, a number of highly relevant companies for whom personal data is the key factor of production have emerged. However, up to now, the corresponding economic analysis has been restricted primarily to a qualitative perspective linked to privacy issues. Precisely, this paper seeks to shed light on the quantitative perspective, approximating the value of personal information for those companies that base their business model on this new type of asset. In the absence of any systematic research or methodology on the subject, an ad hoc procedure is developed in this paper. It starts with the examination of the accounts of a number of key players in online markets. This inspection first aims to determine whether the value of personal information databases is somehow reflected in the firms’ books, and second to define performance measures able to capture this value. After discussing the strengths and weaknesses of possible approaches, the method that performs best under several criteria (revenue per data record) is selected. From here, an estimation of the net present value of personal data is derived, as well as a slight digression into regional differences in the economic value of personal information.

Conflicting Role Conceptions: In Search of the European Union's Added Value for its Southern Neighbors. Bruges Regional Integration & Global Governance Paper 04/2014

Many scholars have analyzed the role of the European Union (EU) in its southern neighborhood by looking at the EU’s policy documents and strategies. As such, it is often argued that the EU is at best a useful partner in democratic reform and at worst an unsuccessful ‘normative power’. However, very few studies have analyzed the EU’s role from the recipients’ point of view: the southern neighboring countries themselves. This paper adopts an ‘outside-in approach’ and explores what the southern neighborhood countries believe the EU should be or do. On the basis of a set of 15 interviews with diplomats from the region and an analysis of 50 newspaper articles from the region on the EU’s relations with its southern neighborhood, this paper seeks to reveal the EU’s real ’added value’ for its southern Mediterranean partners. To what extent does the EU’s own perceived role in its southern neighborhood match the role conception of those countries? Based on the three case studies of Algeria, Jordan and Egypt, the paper finds that there is a clear divergence in role conceptions between the EU and its southern partners. While the EU sees itself as a ‘force for good’ and promoter of norms and democracy in the southern Mediterranean region, the three countries primarily believe that the EU perceives itself foremost as a provider of security and stability in the region, while they primarily expect it to act as a reliable partner for economic cooperation.

The propriety of allowing a qualified exportation of wool discussed historically. To which is added an appendix: containing a table, which shews the value of the woolen goods of every kind, that were entered for exportation at the custom-house, from 1697 to 1780 inclusive, as well as the prices of wool in England, during all that period.

Mode of access: Internet.

The American builder's general price book and estimator, now first published to elucidate the principles of ascertaining the correct value of every description of artificers' work required in building, from the prime cost of materials and labour in any part of the United States ... to which are added, a variety of useful tables, memorandums, etc.

Microfilm. Ann Arbor, Mich., University Microfilms [n.d.] (American culture series, Reel 35.10)

An interpretive approach to analysing the role and value of information systems in Jordanian financial organisations

Analysing investments in ISs in order to maximise benefits has become a prime concern, especially for private corporations. No formula of equilibrium exists that could link the injected amounts and accrued returns. The relationship is simply not straightforward. This thesis is based upon empirical work which involved sketching organisational ethnographies (four organographies and a sectography) into the role and value of information systems in Jordanian financial organisations. Besides deciphering the map of impacts, it explains the attributions of the variations in the impacts of ISs which were found to be related to the internal organisational processes: culturally and politically specific considerations, economically or technically rooted factors and environmental factors. The research serves as an empirical attempt to test out the applicability of adopting the interpretive paradigm to researching organisations in a developing country. The fieldwork comprised an exploratory stage, a detailed investigation of four case studies and a survey stage encompassing 16 organisations. Primary and secondary data were collected from multiple sources using a range of instruments. The evidence highlights the fact that little long term strategic planning was pursued; the emphasis was more focused on short term planning. There was no noticeable adoption of any strategic fit principle linking IS strategy to the corporate strategy. In addition, the benefits obtained were mostly intangible. Although ISs were central to the work of the organisations surveyed as the core technology, they were considered as tools or work enablers rather than weapons for competitive rivalry. The cultural specificity of IS impacts was evident and the cultural and political considerations were key factors in explaining the attributions of the variations in the impacts of ISs in JFOs. The thesis confirms that measuring the benefits of ISs is the problematic. However, in order to gain more insight, the phenomenon of "the use of ISs" has to be studied within its context.

Customer value based entry decision in International markets the concept of International Added Customer Equity

Market entry decisions are some of a firm's most important long-term strategic choices. Still, the international marketing literature has not yet fully incorporated the idea of relationship marketing in general, and the customer value concept in particular, as a basis for market entry decisions. This article presents some conceptual ideas about a customer value based market selection model. The metric International Added Customer Equity (IACE), a straightforward decision criterion derived from the customer equity concept is presented as an additional decision criterion for export market selection and ultimately market entry.

The Future of EU Cohesion Policy. Endogenous Development – Added Value of Intervention – Regulatory Frameworks

The successful operation of the regional development – or cohesion – policy of the European Union has a strategic importance from the point of view of the whole integration process. Strengthening economic, social and territorial cohesion and decreasing disparities between member states and regions are not only one of the main priorities of the integration, but at the same time these are justified expectations of the people living in the member states of the union. The cohesion transfers should be spent on those factors which have the biggest contribution to the improvement of development prospects and competitiveness in the given regions. Theories on regional development have controversial conclusions about the long-term formation of development disparities. However, it has become evident that successful development policies are based on endogenous factors, innovation and well-functioning institutions. After examining theoretical considerations and regional disparities the study analyses the impacts of EU regional policy and evaluates the main elements of the proposed regulatory frameworks for the period 2014-2020.

The quality of financial information in the extractive industries: a value relevance analysis

The extractive industry is characterized by high levels of risk and uncertainty. These attributes create challenges when applying traditional accounting concepts (such as the revenue recognition and matching concepts) to the preparation of financial statements in the industry. The International Accounting Standards Board (2010) states that the objective of general purpose financial statements is to provide useful financial information to assist the capital allocation decisions of existing and potential providers of capital. The usefulness of information is defined as being relevant and faithfully represented so as to best aid in the investment decisions of capital providers. Value relevance research utilizes adaptations of the Ohlson (1995) to assess the attribute of value relevance which is one part of the attributes resulting in useful information. This study firstly examines the value relevance of the financial information disclosed in the financial reports of extractive firms. The findings reveal that the value relevance of information disclosed in the financial reports depends on the circumstances of the firm including sector, size and profitability. Traditional accounting concepts such as the matching concept can be ineffective when applied to small firms who are primarily engaged in nonproduction activities that involve significant levels of uncertainty such as exploration activities or the development of sites. Standard setting bodies such as the International Accounting Standards Board and the Financial Accounting Standards Board have addressed the financial reporting challenges in the extractive industry by allowing a significant amount of accounting flexibility in industryspecific accounting standards, particularly in relation to the accounting treatment of exploration and evaluation expenditure. Therefore, secondly this study examines whether the choice of exploration accounting policy has an effect on the value relevance of information disclosed in the financial reports. The findings show that, in general, the Successful Efforts method produces value relevant information in the financial reports of profitable extractive firms. However, specifically in the oil & gas sector, the Full Cost method produces value relevant asset disclosures if the firm is lossmaking. This indicates that investors in production and non-production orientated firms have different information needs and these needs cannot be simultaneously fulfilled by a single accounting policy. In the mining sector, a preference by large profitable mining companies towards a more conservative policy than either the Full Cost or Successful Efforts methods does not result in more value relevant information being disclosed in the financial reports. This finding supports the fact that the qualitative characteristic of prudence is a form of bias which has a downward effect on asset values. The third aspect of this study is an examination of the effect of corporate governance on the value relevance of disclosures made in the financial reports of extractive firms. The findings show that the key factor influencing the value relevance of financial information is the ability of the directors to select accounting policies which reflect the economic substance of the particular circumstances facing the firms in an effective way. Corporate governance is found to have an effect on value relevance, particularly in the oil & gas sector. However, there is no significant difference between the exploration accounting policy choices made by directors of firms with good systems of corporate governance and those with weak systems of corporate governance.

Euphoria in financial markets: how Indian companies generate value in their cross-border acquisitions

In this paper, we investigate the effect of euphoria on returns derived by Indian companies in their cross-border acquisitions. Cognitive legitimacy generated at the country level facilitated firms in deriving higher value from internationalization. In addition, overoptimism after the legitimacy-building event led to euphoria in financial markets and short-term abnormal returns. Hence we argue that the springboard effect created by legitimacy is short-lived, as euphoria fades away over time. Using cross-border and domestic acquisitions by Indian companies during 1999-2009, and controlling for fundamental factors, both financial and non-financial, we find support for our euphoria hypothesis. Because of overoptimism, Indian companies experienced short-term abnormal returns in their cross-border acquisitions in the few years following the legitimation process, but not in later years.