We present a game-theoretic model of a firm’s production decision to analyze the conditions under which the firm would engage in sustainable practices when there exists a certification agency that ...can audit the firm. Our results show that when the certification agency is firm-owned or when it is an independent, profit-maximizing entity, then there is no equilibrium in which the firm chooses to produce in a sustainable manner. We also present real-world examples from the apparel and footwear industry, as well as the mining industry, that are consistent with our theoretical results. We consider what would happen if the certification agency is government-operated or a non-profit organization with a mandate to monitor the firm’s production process. We show that – combined with tax incentives or subsidies for the firm if necessary, and greater specificity regarding what is sustainable – there exists an equilibrium in which the firm would choose to engage in sustainable production in this case. We analyze extensions of the model to examine conditions under which the phenomenon of greenwashing can arise as an equilibrium outcome. We also propose a “bounty system” that the government can implement to incentivize monitoring of firms’ production processes, and we show how such a policy can induce more sustainable production practices by the firm.
Prior studies have examined the effect of blood type on heart transplantation (HTx) waitlist outcomes in cohorts through 2015. We aim to analyze the effect of blood type on contemporary waitlist ...outcomes with a new allocation system focus.
Adults listed for HTx between April 2015 and December 2020 were included. Survival to HTx and waitlist death/deterioration was compared between type O and non-type O candidates using competing risks regression. Donor/recipient ABO compatibility trends were further investigated.
Candidates with blood type O (n = 7509) underwent HTx less frequently than candidates with blood type other than type O (n = 9699) (subhazard ratio sHR, 0.56; 95% CI, 0.53-0.58) with higher rates of waitlist death/deterioration (sHR, 1.18; 95% CI, 1.04-1.34). Subgroup analyses demonstrated persistence of this trend under the new donor heart allocation system (HTx: sHR, 0.58; 95% CI, 0.54-0.62; death/clinical deterioration: sHR, 1.27; 95% CI, 1.02-1.60), especially among those listed at high status (1, 2, or 3) (HTx: sHR, 0.69; 95% CI, 0.63-0.75; death/deterioration: sHR, 1.61; 95% CI, 1.16-2.22). Among those listed at status 3, waitlist death/deterioration was modified by presence of a durable left ventricular assist device (left ventricular assist device: sHR, 1.57; 95% CI, 0.58-4.29; no left ventricular assist device: sHR, 3.79; 95% CI, 1.28-11.2). Type O donor heart allocation to secondary ABO candidates increased in the new system (14.5% vs 12.0%; P < .01); post-HTx survival remained comparable between recipients with blood type O and non-type O (log-rank P = .07).
Further logistical considerations are warranted to minimize allocation inequity regarding blood type under the new allocation system.
Although the use of extended criteria donors (ECDs) is traditionally avoided because of poorer outcomes, management of heart transplant (HTx) recipients has evolved over the past decades. We sought ...to examine the temporal trends in outcomes of ECDs in HTx.
We queried the United Network for Organ Sharing database for adult HTx recipients who fit the EXPAND Trial criteria for ECDs: ischemic time ≥ 4 hours, ejection fraction < 50%, age > 55 years, and history of coronary artery disease. Transplant years were stratified into the following 4 periods: (1) 2000 to 2004, (2) 2005 to 2009, (3) 2010 to 2014, and (4) 2014 to 2018. The 2-sample t test, Kaplan-Meier survival analysis, log-rank test, analysis of variance, multivariable Cox proportional hazards, and multinomial logistic regression were used to compare data between periods.
Through periods 1 to 4, 39,028 patients were stratified as follows: 9217 (2942 ECDs, 31.9%), 9224 (2730 ECDs, 29.6%), 10,309 (2762 ECDs, 26.8%), and 10,278 (2190 ECDs, 21.3%). Transplants using ECDs in periods 1 and 2 had increased 1-year mortality compared with periods 3 and 4 (16.9% and 15.6% vs 11.9% and 10.9% respectively, P < .001). Later periods also demonstrated improved Karnofsky scores (P < .001).
Although use of ECDs decreased across the periods, we noted significant improvement in 1-year survival rates and postoperative functional status.
Disentangling bias Chen, Frederick R.
Conflict management and peace science,
03/2019, Volume:
36, Issue:
2
Journal Article
Peer reviewed
Existing literature on bias and third-party conflict management mainly focuses on the dichotomy of whether the mediator's bias as a whole can contribute to mediation onset and outcomes. I argue that ...we need more specific and disaggregated research on the mediator's bias because the side on which a prospective mediator's bias lies may significantly affect the likelihood of mediation onset. Why are some biased mediations initiated by third parties while others are not? By disentangling the mediator's bias and by distinguishing between different levels of bias, I find that the likelihood of mediation onset tends to increase if the potential mediator shares a closer political relationship with a conflicting state that has greater national capabilities or that is more authoritarian than the counterparty. However, the effect is largely conditional on the levels of the mediator's bias, where a more obvious level of bias is more likely to facilitate mediation initiation. This article advances our understanding of bias and international conflict mediation.
Background
Carotid access has shown promise as an excellent delivery route for transcatheter aortic valve replacement (TAVR). We aimed to compare outcomes of transcarotid (TC) and transfemoral (TF) ...TAVR by conducting a search and analysis of the best evidence in the literature to shed light on its safety and effectiveness.
Methods
The PubMed/MEDLINE, Embase, and Cochrane library from inception to July 2020 were searched to identify articles reporting comparative data on TC versus TF approaches for TAVR. Patients' baseline characteristics and clinical outcomes were extracted from the articles and pooled for analysis.
Results
Five studies, including a total of 2470 patients, were included in the study with 1859 patients in the TF group and 611 patients in the TC group. The TC group had higher prevalence of peripheral vascular disease, while the patients in the TF group was older. Meta‐analysis revealed that there was no significant differences between the two groups with regard to 30‐day mortality (p = 0.09), stroke (p = 0.28), new dialysis (p = 0.58), major bleeding (p = 0.69), or pacemaker implantation (p = 0.44). The TF group had a higher incidence of vascular complications (3.9% vs. 2.3%; OR 2.22; 95% CI 1.13, 4.38; p = 0.02).
Conclusions
Compared with the TF approach, TC‐TAVR is associated with comparable procedural and clinical outcomes. Our analysis found a lower rate of vascular complication in TC access compared with TF access. This supports consideration of such an alternative access when there are concerns over the feasibility of TF access.
Abstract Family physicians' scope of practice is declining despite being well prepared to provide a range of clinical services. To evaluate whether this is a new phenomenon, we compared the ...proportions of regional family medicine residency graduates who report practicing and those who report feeling more than adequately prepared to practice various procedures and clinical services from 2 points in time–a survey in 2000 of graduates from 1996-1999 (n = 293) and a survey in 2012 or 2014 of graduates from 2010-2013 (n = 408). The recent graduates felt better prepared, but reported a narrower scope of practice than those who graduated more than a decade earlier. These findings suggest that family medicine residency training has improved over time but the declining scope of practice is a concerning trend.
Excellent resistive switching memory characteristics were demonstrated for an Al/Cu/Ti/TaO
x
/W structure with a Ti nanolayer at the Cu/TaO
x
interface under low voltage operation of ± 1.5 V and a ...range of current compliances (CCs) from 0.1 to 500 μA. Oxygen accumulation at the Ti nanolayer and formation of a defective high-κ TaO
x
film were confirmed by high-resolution transmission electron microscopy, energy dispersive X-ray spectroscopy, and X-ray photo-electron spectroscopy. The resistive switching memory characteristics of the Al/Cu/Ti/TaO
x
/W structure, such as HRS/LRS (approximately 10
4
), stable switching cycle stability (>10
6
) and multi-level operation, were improved compared with those of Al/Cu/TaO
x
/W devices. These results were attributed to the control of Cu migration/dissolution by the insertion of a Ti nanolayer at the Cu/TaO
x
interface. In contrast, CuO
x
formation at the Cu/TaO
x
interface was observed in an Al/Cu/TaO
x
/W structure, which hindered dissolution of the Cu filament and resulted in a small resistance ratio of approximately 10 at a CC of 500 μA. A high charge-trapping density of 6.9 × 10
16
/cm
2
was observed in the Al/Cu/Ti/TaO
x
/W structure from capacitance-voltage hysteresis characteristics, indicating the migration of Cu ions through defect sites. The switching mechanism was successfully explained for structures with and without the Ti nanolayer. By using a new approach, the nanoscale diameter of Cu filament decreased from 10.4 to 0.17 nm as the CC decreased from 500 to 0.1 μA, resulting in a large memory size of 7.6 T to 28 Pbit/sq in. Extrapolated 10-year data retention of the Ti nanolayer device was also obtained. The findings of this study will not only improve resistive switching memory performance but also aid future design of nanoscale nonvolatile memory.
ReRAM is a promising next-generation nonvolatile memory (NVM) with fast write speed and low-power operation. However, ReRAM faces two major challenges in read operations: 1) low read yield due to ...wide resistance distribution and 2) the requirement of accurate bit line (BL) bias voltage control to prevent read disturbance. This study proposes two process-variation-tolerant schemes for current-mode read operation of ReRAM: parallel-series reference-cell (PSRC) and process-temperature-aware dynamic BL-bias (PTADB) schemes. These schemes are meant to improve the read speed and yield of ReRAM, while taking read disturbance into consideration. PSRC narrows the reference current distribution to achieve high read yield against resistance variation. PTADB achieves small fluctuations in BL bias voltage to prevent read disturbance, while providing rapid BL precharge speeds. This study fabricated a 4-Mb ReRAM macro to confirm the effectiveness of the proposed schemes for both SLC and MLC operations. The fastest sub-8-ns (7.2 ns) read-write random access time among megabit scaled embedded NVM macros has been demonstrated.
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