Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. Magnetic resonance imaging is the ideal modality for the evaluation of colorectal cancer, since it allows staging by determining invasion beyond the muscularis propria, extension towards adjacent organs, identification of patients who are candidates for chemotherapy or pre-surgical radiotherapy and planning of the surgical procedure. The key point is based on the differentiation between T2 and T3 stages through the use of sequences with high-resolution T2 information. In addition to this, it allows the assessment of the size and morphology of the lymph nodes, and considerably increases the specificity for the detection of lymph node involvement. MRI is a technique with high specificity and high reproducibility.
Objective: To evaluate the imaging features of spondyloarthritis on magnetic resonance imaging (MRI) of the sacroiliac (SI) joints in terms of topography (in thirds) and affected margin, since this aspect is rarely addressed in the literature. Methods: Cross-sectional study with MRI (1.5 T) evaluation of the SI in 16 patients with diagnosis of axial spondyloarthritis regarding the presence of acute (subchondral bone edema, enthesitis, synovitis and capsulitis) and chronic changes (erosions, subchondral bone sclerosis, bone bridging and fatty replacement), performed by two radiologists, blinded to clinical data. MRI findings were correlated with clinical data including age, disease duration, medications, HLA-B27, BASDAI, ASDAS-VHS and ASDAS-PCR, BASMI, BASFI, and mSASSS. Results: Bone edema pattern and erosions showed predominance in the upper third of SI (p = 0.050, p = 0.0014, respectively). There was a correlation between the time of disease and structural changes by affected third (p = 0.028-0.037), as well as the presence of bone bridges with BASMI (p = 0.028) and mSASSS (p = 0.014). Patients with osteitis of the lower third had higher ASDAS values (ESRV: p = 0.011 and CRP: p = 0.017). Conclusion: Chronic inflammatory changes and the pattern of bone edema predominated in the upper third of the SI, but there was also concomitant involvement of the middle or lower thirds of the joint. The localization of involvement in the upper third of the SI was insufficient to differentiate between degeneration and inflammation.
The whole world is in a fuel crisis nearly approaching exhaustion, with climate change knocking at our doorsteps. In the fight against global warming, one of the principle components that demands technocratic attention is Transportation, not just as a significant contributor to atmospheric emissions but from a much broader perspective of environmental sustainability.
From the traditional technocratic aspect of transport planning, our epiphany comes in the form of Land Use integrated sustainable transport policy in which Singapore has been a pioneer, and has led the way for both developed and developing nations in terms of mobility management. We intend to investigate Singapore’s Transport policy timeline delving into the past, present and future, with a case by case analysis for varying dimensions in the present scenario through selective benchmarking against contemporary cities like Hong Kong, London and New York. The discussions will include themes of modal split, land use policy, vehicular ownership, emission policy, parking policy, safety and road traffic management to name a few. A visualization of Singapore’s future in transportation particularly from the perspective of automated vehicles in conjunction with last mile solutions is also detailed.
Although infrastructure is widely recognized as a key ingredient in a country’s economic success, many issues surrounding infrastructurespending are not well understood. This paper explores six themes: the returns to infrastructure; the role of the private sector; the evaluation and delivery of infrastructure in practice; the nature of network industries, pricing and regulation; political economy considerations of infrastructure provision; and infrastructure in developing countries. This paper aims to provide insights into many of these questions, drawing on the existing literature.
Infrastructure development is critical to delivering growth, reducing poverty and addressing broader development goals, as argued in the World Bank Report Transformation through Infrastructure (2012). This paper surveys the literature of the linkages between infrastructure investment and economic growth, discusses the role of infrastructure in the participation of global value chains and in supporting economic upgrades, highlights the challenges faced the least developed countries and provides policy recommendations. It suggests that addressing the bottlenecks in infrastructure is a necessary condition to provide a window of opportunity for an economy to develop following its comparative advantage. With the right conditions, good infrastructure can support an economy, particularly a less developed economy, to reap the benefit through the participation in the global value chains to upgrade the economic structure.
This study examines conditions that impact PPP delivery success or failure in the roadways sector in India using Qualitative Comparative Analysis. QCA is well-suited for problems where multiple factors combine to create pathways leading to an outcome. Past investigations have compared PPP and non-PPP project delivery performance, but this study examines performance within PPPs by uncovering a set of conditions that combine to influence the success or failure road PPP project delivery in India. Based on data from 21 cases, pathways explaining project delivery success or failure were identified. Specifically, PPPs with high concessionaire equity investment and low regional industrial activity led to project delivery success. Projects with lower concessionaire equity investment and low reliance on toll revenue and with either: (a) high project technical complexity or (b) high regional industrial activity, led to project delivery failure. The pathways identified did not have coverage values that they were extremely strong. Coverage strength was hindered by lack of access to information on additional conditions that could be configurationally important. Further, certain characteristics of the Indian market limit generalization. Identification of combinations of conditions leading to PPP project delivery success or failure improves knowledge of the impacts of structure and characteristics of these complex arrangements. This study is one of the first to use fuzzy QCA to understand project delivery success/failure in road PPP projects. Moreover, this study takes into account factors specific to a sector and delivery mode to explain project delivery performance.
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