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Water pollution disrupts the ecological integrity of urbanized river systems, but its impacts on riverine metabolic processes and carbon fluxes are poorly studied in developing countries. Three seasonal field surveys were combined with two high-resolution measurements and an in situ incubation experiment to investigate the effects of untreated wastewater on organic matter biodegradation and the partial pressure of CO2 (pCO2) along the Mekong–Tonle Sap network around Phnom Penh. High-resolution measurements during the dry-season survey exhibited large downstream increases in pCO2 along the Mekong reaches receiving Tonle Sap inflows carrying urban sewage, contrasting with little spatial variation during a monsoon survey when the Mekong floodwater reversed the Tonle Sap flow. The monsoonal and dry-season surveys revealed flooding-induced homogenization and large spatial divergences in dissolved organic carbon (DOC) concentration and its δ13C and Δ14C between the Tonle Sap and connected Mekong reaches. During the 3-day incubation of Mekong waters, alone or mixed with sewage, a large initial nocturnal increase in pCO2 in sewage-supplemented river water exceeded the subsequent daytime CO2 uptake by phytoplankton photosynthesis varying with light exposure. This, combined with the preferential consumption of labile DOC components displaying protein-like fluorescence, implies sewage-enhanced biodegradation of riverine organic matter. These results suggest that neglecting wastewater-enhanced CO2 production in urbanized river basins during long dry periods can result in a significant underestimation of riverine CO2 emissions. [ABSTRACT FROM AUTHOR]

This research longitudinally examines the association between levels of state Medicaid prescription spending and the state strategies intended to constrain cost increases: the negotiated pricing strategy, as indicated by state rebate programs, and the price transparency strategy, as indicated by state operation of All-Payer Claims Databases. The findings demonstrate evidence that state Medicaid prescription spending is influenced by the negotiated pricing strategy, especially Managed Care Organization (MCO) rebates under the Patient Protection and Affordable Care Act, but not influenced by the price transparency strategy. State decisions for MCO rebates, such as carving prescription benefits into managed care benefits, were effective in containing levels of Medicaid prescription spending over time, while other single- and multi-state rebate programs were not. Based on these findings, state policymakers may consider utilizing the MCO rebate program to address increases in Medicaid prescription spending. [ABSTRACT FROM AUTHOR]

This research considered levels of public service spending according to the alternative service arrangements, and examined how the property tax cap as an external constraint, local histories, and local fiscal capacity are related to the spending in the context of the state of New York. This study provides empirical evidence that the property tax cap positively influenced local spending through contracting out, while the same variable negatively affected the spending through intermunicipal contracting. Second, the previous level of public spending was positively associated with the current level of public spending through contracts with other municipalities, but this is not the case for contracts with nongovernmental providers. In addition, in deciding the extent of public spending through contracting out, local government officials were influenced by the factors of fiscal capacity, indicated by budget solvency and tax revenues. [ABSTRACT FROM AUTHOR]

Wide variation in institutional structure and funding patterns in public libraries make this government function useful for exploring the effect of these differences on expenditures. Based on literature related to willingness to pay, special districts, and fiscal illusion, we hypothesize that libraries with taxing authority and more revenues from nonlocal sources will have higher levels of spending. We use data from an Annual Public Library Survey, and U.S. Census data, in ordinary least squares (OLS) regressions for 2007 and 2010. We find that taxing authority leads to increased spending, as expected. However, the results of funding sources are contrary to expectations; relative reliance on nonlocal sources is generally associated with lower levels of spending. This may be due to "crowding-out" of local sources, and there may also be some effect from reduced state aid following the Great Recession. [ABSTRACT FROM AUTHOR]

Background: Retinal migraine is an important differential diagnosis of recurrent transient monocular blindness accompanied by headache when other etiologies are excluded. Here, we report a case of orbital vasculitis which initially mimicked retinal migraine.Case Report: A 47-year-old woman had recurrent episodes of fully reversible transient monocular blindness accompanied by ipsilateral headache for 15 months. The patient's neuroimaging and cardiac and ophthalmologic evaluations were normal. With a diagnosis of retinal migraine, her symptoms remitted in response to prophylactic treatment with topiramate and propranolol for 8 months. Three months after discontinuation of medications, transient monocular blindness recurred. High-resolution vessel wall magnetic resonance imaging revealed enhancement of the ipsilateral orbital vessels. Isolated orbital vasculitis was diagnosed. Complete remission of transient monocular blindness was achieved after steroid pulse therapy.Discussion: Isolated orbital vasculitis should be considered in differential diagnosis of recurrent transient monocular blindness and ipsilateral headache. High-resolution vessel wall magnetic resonance imaging can be helpful for the diagnosis. [ABSTRACT FROM AUTHOR]

According to the meta-analysis on performance budgeting theory and practice, the relationship between citizens' role and performance-based budgeting is an important but under-researched topic. Missing in our understanding of the determinants of performance budgeting is an examination of how citizen participation fosters the usage of performance information in the local budgetary process. This research is intended to understand the role of citizens to use performance budgeting, particularly for strategic planning and performance evaluation. To examine the research question, this study hypothesizes that local governments with a commitment to citizen participation tend to use performance budgeting. The results allow confirming that the hypothesis is supported, and to clarify our knowledge of the role of citizen input in government fiscal decisions. [ABSTRACT FROM AUTHOR]