bluuebunny/crossref_metadata_2025 huggingface dataset:
Compliance to the Surgical Safety Checklist over time in late and early adopters
Authors: Seppey Romain , Oesch Antoine , Viehl Carsten T
Published: May 2019

Aims

To compare the compliance of the Surgical Safety Checklist in two groups of users: early (Group A) and late (Group B) adopters, and to detect change over time.

Method

Observational study. We collected all Surgical Safety Checklist protocols in one calendar month period and, eight months later, we repeated collection for another month. Analysis was then performed to compare the compliance in different groups and over time.

Results

There was no statistical difference in the overall compliance between the two groups or between elective and emergency cases. Equally, there was no significant change in compliance over time in Group A. In Group B, however, there was a trend to an improved compliance over time. Compliance to the Surgical Safety Checklist was significantly lower during operations performed by consulting surgeons in comparison to internally employed surgeons.
Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience
Authors: Mangold Theresa , Hamilton Erin Kinzel , Johnson Helen Boehm , Perez Rene
Published: May 2019

Background

Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery.

Objective

To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates.

Methods

This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year.

Results

The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing.

Conclusion

Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.
Prevalence, clinical features and treatment pattern of patients with concurrent diagnoses of rheumatoid arthritis and psoriatic disease: results of a 14-year retrospective study in a tertiary referral center
Authors: Chen Kai-Lung , Chiu Hsien-Yi , Lin Jui-Hsiang , Ye Jian-De , Cho Yi-Hsuan , Li Ko-Jen , Tsai Tsen-Fang
Published: May 2019

Background:

Multiple comorbidities, including rheumatoid arthritis (RA), have been reported to be associated with psoriasis.

Objective:

This study aimed to determine the prevalence and the clinical features of RA among patients with psoriasis in a tertiary referral center.

Methods:

Between January 2000 and December 2013, all patients coded with psoriatic disease (ICD-9 CM 696.0 OR ICD-9 CM696.1) and RA (ICD-9 CM 714.0) in a tertiary medical center were enrolled.

Results:

There were 10,844 patients and 9073 patients with psoriatic disease and RA identified by diagnostic codes, respectively. Among patients with psoriasis, 111 patients had claim-based diagnosis of RA (1.02%). By reviewing medical records and telephone interview or clinic visits, 25 of the 111 patients (0.23%) was identified unequivocally as having concurrent RA. Among them, 17 (68%) were female and 16 (64%) patients developed arthritis prior to the onset of psoriasis with a mean lag of 6.3 years (1–19 years); 8 (32%) had psoriasis skin lesions prior to the onset of arthritis with a mean lag of 6.9 years (3–20 years); 1 (4%) had skin lesions and arthritis in the same time; 17 (68%) patients also fulfilled the CASPAR classification criteria for psoriatic arthritis. The mean age of onset for arthritis was 49.6 years old.

Conclusions:

The prevalence of RA in psoriasis might be overestimated in some previous studies using claimed database. Patients with concurrent RA and psoriasis showed a comparable age of onset and male to female ratio, but had more axial involvements compared to patients without psoriasis.
Patient-focused interventions to support vulnerable people using oral anticoagulants: a narrative review
Authors: Yiu Angela , Bajorek Beata
Published: May 2019

The aim of this review was to identify patient-focused interventions that have been trialed to support vulnerable patient populations taking oral anticoagulants (warfarin and the direct-acting oral anticoagulants (DOACs)) such as older persons (65 years and over), those with limited health literacy, and those from culturally and linguistically diverse (CALD) backgrounds. This review also aimed to report on the effects of these interventions on outcomes relevant to the use of anticoagulant therapy. Original articles published between 1 January 1995 and 30 June 2017 were identified using several electronic databases such as Medline, Ovid, Embase, Scopus, Cochrane, and Google Scholar. The following terms were used for the three-tiered search: Tier 1, elderly, aged, older adult, geriatrics; Tier 2, health literacy, literacy, low health literacy, low English proficiency, patient literacy; and Tier 3, ethnicity, ethnic, ethnic groups, CALD, culturally and linguistically diverse, NESB, non-English speaking background, race, racial groups, religion, religious groups, and minority groups. The terms for each tier were combined with the following terms: anticoagulants, anticoagulation, warfarin, apixaban, dabigatran, rivaroxaban, DOACS, new oral anticoagulants, novel oral anticoagulants, patient care, patient knowledge, comprehension, patient education, patient participation, and communication. A total of 41 studies were identified. Most of the interventions identified included older persons taking warfarin who were monitored using the international normalized ratio (INR) and who received patient education. Many interventions reported a significant positive impact on patients’ knowledge, reduction in the number of adverse events caused by hemorrhage, and better INR control. More research on patient-focused interventions is needed that includes patients with limited health literacy, those from CALD backgrounds, and family members and caregivers of patients taking oral anticoagulants.
Antimalarial activity of hydromethanolic extract and its solvent fractions of Vernonia amygdalina leaves in mice infected with Plasmodium berghei
Authors: Bihonegn Temesgen , Giday Mirutse , Yimer Getnet , Animut Abebe , Sisay Mekonnen
Published: May 2019

Background:

Vernonia amygdalina Del. (Asteraceae) is reported to be traditionally used for the treatment of malaria. Based on folkloric repute of this plant in Ethiopian traditional medicine and crude extract-based ethnopharmacological studies conducted in few countries, this study was undertaken to evaluate the in vivo antimalarial activity of 80% methanol extract and its solvent fractions of the leaves of V. amygdalina in mice infected with Plasmodium berghei.

Methods:

A 4-day suppressive test was conducted on mice infected with P. berghei to find out antimalarial effect of chloroform, butanol and aqueous fractions obtained from the 80% methanol crude extract. In all the activity tests, mice were randomly assigned in five groups (three tests and two controls) of six animals in each and received respective treatments. Data were analyzed using one way analysis of variance followed by Tukey’s post hoc test for multiple comparisons.

Results:

Acute oral toxicity test showed that all solvent fractions of the leaves of V. amygdalina revealed neither mortality nor overt signs of toxicity up to 2000 mg/kg. This study indicated that the percentage parasitemia suppression of 80% methanol extract was 32.47% (±2.65), 35.40% (±3.14) and 37.67% (±2.50) at 200, 400 and 600 mg/kg, respectively. All doses of the 80% methanol extract of V. amygdalina prolonged survival time and prevented weight loss and packed cell volume reduction in infected mice. All doses of chloroform and butanol fractions significantly suppressed parasitemia (p < 0.05), increased survival time (p < 0.05) compared to negative control and exhibited a significant reduction in rectal temperature (p < 0.05). All solvent fractions significantly prevented weight loss (p < 0.05) at all tested doses. The 80% methanol extract and chloroform and butanol fractions significantly (p < 0.05) prevented further reduction in rectal temperature of P. berghei-infected mice at all doses.

Conclusion:

The results of this study indicated that 80% methanol extract and solvent fractions of the leaves of V. amygdalina demonstrated promising antimalarial activity. The study corroborated the folklore use of this plant for the treatment of malaria in ethnomedicine in Ethiopia.
The efficacy of blind versus real-time ultrasound-guided percutaneous renal biopsy in developing country
Authors: Pongsittisak Wanjak , Wutilertcharoenwong Naphat , Ngamvichchukorn Tanun , Kurathong Sathit , Chavanisakun Chutima , Teepprasan Tavichai , Prommool Surazee , Srisawat Nattachai
Published: May 2019

Introduction:

Renal biopsy is a useful diagnostic procedure. In developing countries, two techniques of renal biopsy, blind percutaneous renal biopsy and real-time ultrasound-guided percutaneous renal biopsy, have been performed. The majority of studies compared these using different types and sizes of biopsy needle. The aim of this study was to compare both techniques in resource constraint country.

Method:

We reviewed renal biopsy database, between 1 January 2014 to 30 June 2017. The primary outcome was the total number of glomeruli. The other outcomes were tissue adequacy and bleeding complications. We also analyzed multivariable logistic regression to find factors associated with tissue adequacy and bleeding complications.

Result:

Of the 204 renal biopsies, 100 were blind percutaneous renal biopsy and 104 real-time ultrasound-guided percutaneous renal biopsy. The number of native renal biopsies was 169 (82.8%). Baseline characteristics of two groups were comparable. The mean number of total glomeruli from real-time ultrasound-guided percutaneous renal biopsy was significantly more than blind percutaneous renal biopsy (20.8 ± 12.1 vs 16.0 ± 13.0, p = 0.001). The real-time ultrasound-guided percutaneous renal biopsy obtained more adequate tissues than blind percutaneous renal biopsy (45.2% vs 16%, p < 0.001) and was the only factor associated with adequate tissue. Moreover, 16 renal biopsies from blind percutaneous renal biopsy obtained inadequate tissue. The overall bleeding complications were not statistically different. We found being female, lower eGFR and lower hematocrit were associated with bleeding complications.

Conclusion:

In comparison with blind percutaneous renal biopsy, real-time ultrasound-guided percutaneous renal biopsy obtained more adequate tissue and number of glomeruli. While the complications of both were comparable. We encourage to practice and perform real-time ultrasound-guided percutaneous renal biopsy in resource constraint countries.
Pre-Exposure Prophylaxis (PrEP) Awareness Is Low Among Heterosexual People of Color Who Might Benefit From PrEP in Philadelphia
Authors: Roth Alexis M. , Tran Nguyen K. , Piecara Brogan L. , Shinefeld Jennifer , Brady Kathleen A.
Published: May 2019

Introduction: We assessed awareness of pre-exposure prophylaxis (PrEP) among HIV-negative Black and Latinx persons living in the Philadelphia Metropolitan Statistical Area. Methods: Using chi-square and Wilcoxon rank-sum tests, we analyzed data from the 2016 heterosexual cycle of the National HIV Behavioral Surveillance system to assess how sociodemographic factors, health care utilization, and risk behaviors affected PrEP awareness. Results: Participants (n = 472) were predominately Black, non-Hispanic (88.1%) with a median age of 41.5 years. Most participants reported having a usual source of medical care (92.1%) and seeing a medical provider within 12 months (87.0%). However, PrEP awareness was low in this sample (4.9%) and was lower among those who had a medical visit compared with those who had not ( P < .01). Conclusion: Current Centers for Disease Control and Prevention clinical guidelines suggest that providers counsel high-risk patients about PrEP. Our data suggest that this is not happening with people of color in Philadelphia. Interventions targeting medical providers working with HIV-risk people of color may be appropriate.
Meniscal Repair in Pediatric Populations: A Systematic Review of Outcomes
Authors: Liechti Daniel J. , Constantinescu David S. , Ridley Taylor J. , Chahla Jorge , Mitchell Justin J. , Vap Alexander R.
Published: May 2019

Background:

Loss of meniscal tissue in the pediatric population can have long-term consequences on joint health, highlighting the importance of meniscal preservation in this group.

Purpose:

To systematically review reported knee outcome measures and complication rates after repair of meniscal tears in children and adolescents.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A review of the literature regarding the existing evidence for pediatric meniscal tear outcomes was performed through use of the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (1980-present), and MEDLINE (1980-present). Included were articles in English that reported the outcomes of meniscal tears in the pediatric population (<18 years old) with a follow-up of more than 12 months. Clinical outcome scores were reviewed.

Results:

A total of 1003 total studies were initially retrieved, with 8 meeting the inclusion criteria. The review included 287 patients (165 male, 122 female), mean age 15.1 years (range, 4-18 years), with 301 meniscal tears (reported: 134 medial, 127 lateral, and 32 both medial and lateral, 8 location unspecified). Concomitant anterior cruciate ligament reconstruction was performed in 52% (158/301) of meniscal repairs. The average reported postoperative Lysholm scores ranged from 85.4 to 96.3, and the average reported postoperative Tegner activity scores ranged from 6.2 to 8.

Conclusion:

Arthroscopic repair of a meniscal tear in the pediatric and adolescent population is an effective treatment option that has a low failure rate, enhances postoperative clinical outcomes, and preserves meniscal tissues.
Changes in Oral Health Behaviors Associated With a Nursing Intervention in Primary Care
Authors: Cheng Jennifer K. , Faniyan Abiola , Chan Yuen Jenny , Myers Tracy , Fleck Michelle , Burgess Jane , Williams Kathryn , Wijeratne Rashmi , Webster Romi , Cox Joanne , Ng Man Wai
Published: May 2019

Objective. To describe changes in oral health behaviors following implementation of a nursing intervention targeting children at risk for early childhood caries at an urban 2-site primary care practice. Methods. Nurses used a proprietary Nursing Caries Assessment Tool (N-CAT) to identify behaviors associated with early childhood caries risk, then provided brief focused dental education, fluoride varnish applications, and dental referrals to children without a dental home. We used generalized estimating equation logistic regression models, adjusted for age at visit, to analyze changes in oral health behaviors over time including the following: (1) tooth brushing frequency, (2) use of fluoride toothpaste, and (3) adult help with brushing among children younger than 5 years of age who had at least 2 N-CATs documented during well care visits between April 2013 and June 2015. We also evaluated dietary habits including going to bed with a bottle or sippy cup and sugar-sweetened beverage consumption, as secondary study outcomes during the same time frame. Results. A total of 2097 children with a mean age of 15.8 (SD 7.6) months at the initial visit were included in the analysis; 51% were boys; 28% were black, 36% Hispanic/Latino, 5% white, 2% Asian, and 19% other; 75% were publicly insured. During the study period, significant ( P < .05) improvements were noted across the 3 oral health behaviors studied among children younger than 18 months. Conclusion. Nursing interventions show promise for promoting preventive dental care in primary care settings and deserve further study.
Choosing Wisely in Pediatric Internship
Authors: Rodrigues Mendonça Dilton , Aguiar Carolina Vila Nova , Lins-Kusterer Liliane , de Oliveira Renata Isis , Menezes Marta Silva
Published: May 2019

Background. The Choosing Wisely (CW) campaign informs physicians and the public about safety and quality in medical practice. Objective. To evaluate a CW campaign in a medical internship in pediatrics. Methods. An interventionist study with teachers of medicine and pediatric internship students in which the Delphi technique was applied using online questionnaires. Specialists identified 3 unnecessary situations that commonly occur in clinical practice. Following the Objective Structured Clinical Examination (OSCE) model evaluation, a group of students who participated in the educational interventions was compared with another group that was not exposed to the campaign. Results. Most students evaluated the CW campaign content as excellent (64%) or very good (31.6%). The level of successes in the OSCE evaluation was higher in the exposed group when compared with the nonexposed group ( P = .001). Conclusions. The CW campaign improved the clinical skills of pediatric internship students.
Visualizing the Reality of Educational Research Participants Using an Amalgamation of Grounded and Positioning Theories
Authors: McCrohon Mark , Tran Ly Thi
Published: May 2019

This article discussed the development of a framework that visualizes the ontological reality of educational research participants that is incumbent on existing grounded and positioning theories. The proposed framework constructs the ontological reality of participants from qualitative data collected in semi-structured interviews. This framework results in a visual representation of the educational participant’s reality. The article discussed how the use of versioning improves the auditability and replicability of the framework. The stepwise approach of this framework makes it an ideal candidate for automation, desirable to an emerging generation of qualitative researchers from the social sciences, including education and nursing.
Development and Psychometric Properties of Managerial Competence Scale for First-Line Nurse Managers in Indonesia
Authors: Gunawan Joko , Aungsuroch Yupin , Fisher Mary L. , McDaniel Anna M.
Published: May 2019

This study aimed to develop and psychometrically test the managerial competence scale for first-line nurse managers (FLNMs) in Indonesia. The scale was based on items derived from an integrative review and interviews with experts. A total of 300 FLNMs from 16 public hospitals were randomly selected for this test of psychometric properties. A principal component analysis generated seven dimensions with 43 items as a final scale, with overall Cronbach's α of .95 while the dimensions' Cronbach's α ranged from .71 to .90. The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of managerial competence of FLNMs.
A Case of Sarcomatoid Renal Cell Carcinoma With Osseous Metaplasia and Papillary Renal Cell Carcinoma Metastasis
Authors: Zhang Hui , Majeed Nasma K , Sharifi Roohollah , Guzman Grace
Published: May 2019

Sarcomatoid renal cell carcinoma is an uncommon and aggressive renal tumor with rapid disease progression. A median survival time is only 4-9 months after diagnosis. Osteogenic differentiation is a rare feature of the tumor. Here, we present a case of renal cell carcinoma with sarcomatoid feature and osteoid differentiation, and papillary renal cell carcinoma metastasis in a 58 year-old African-American male. This is the first reported renal cell carcinoma case with the combination of sarcomatoid feature, osteoid differentiation, and papillary renal cell carcinoma metastasis.
The significance of microbiome in personalized medicine
Authors: Behrouzi Ava , Nafari Amir Hossein , Siadat Seyed Davar
Published: May 2019

Considering the important role of microbiome, many of current investigations have focused on its beneficial aspects. Although, research explores new dimensions of the impact of microbiome and examines the differences in patients and healthy individuals for identifying biomarker patterns, but limited information is available, and investigation in this field seems to be of great value. On the other hand, new therapeutic approaches, called personalized medicine, have opened a new window in medical science, and the association between microbiome and personalized medicine seems to be one of the most interesting aspects of the subsequent research, and has a pivotal perspective on the treatment of diseases such as cancer. Accordingly, given the novelty of the relationship between these two axes, there are very few studies in this regard. The presence of specific strains may have the ability to modulate cancer progression and therapeutics; this increases the likelihood of precision medicine in relation to microbiota, in terms of treatment and prognosis, and therefore, microbiota is a next generation medicine and may develop a novel therapeutic action in this field.
American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naïve Patients
Authors: Wu Christopher L. , King Adam B. , Geiger Timothy M. , Grant Michael C. , Grocott Michael P. W. , Gupta Ruchir , Hah Jennifer M. , Miller Timothy E. , Shaw Andrew D. , Gan Tong J. , Thacker Julie K. M. , Mythen Michael G. , McEvoy Matthew D.
Published: May 2019

Surgical care episodes place opioid-naïve patients at risk for transitioning to new persistent postoperative opioid use. With one of the central principles being the application of multimodal pain interventions to reduce the reliance on opioid-based medications, enhanced recovery pathways provide a framework that decreases perioperative opioid use. The fourth Perioperative Quality Initiative brought together a group of international experts representing anesthesiology, surgery, and nursing with the objective of providing consensus recommendations on this important topic. Fourth Perioperative Quality Initiative was a consensus-building conference designed around a modified Delphi process in which the group alternately convened for plenary discussion sessions in between small group discussions. The process included several iterative steps including a literature review of the topics, building consensus around the important questions related to the topic, and sequential steps of content building and refinement until agreement was achieved and a consensus document was produced. During the fourth Perioperative Quality Initiative conference and thereafter as a writing group, reference applicability to the topic was discussed in any area where there was disagreement. For this manuscript, the questions answered included (1) What are the potential strategies for preventing persistent postoperative opioid use? (2) Is opioid-free anesthesia and analgesia feasible and appropriate for routine operations? and (3) Is opioid-free (intraoperative) anesthesia associated with equivalent or superior outcomes compared to an opioid minimization in the perioperative period? We will discuss the relevant literature for each questions, emphasize what we do not know, and prioritize the areas for future research.
Prospective External Validation of the Pediatric Risk Assessment Score in Predicting Perioperative Mortality in Children Undergoing Noncardiac Surgery
Authors: Valencia Eleonore , Staffa Steven J. , Faraoni David , DiNardo James A. , Nasr Viviane G.
Published: May 2019

BACKGROUND:

Early identification of children at high risk for perioperative mortality could lead to improved outcomes; however, there is a lack of well-validated risk prediction tools. The Pediatric Risk Assessment (PRAm) score is a new model to prognosticate perioperative risk of mortality in pediatric patients undergoing noncardiac surgery. It was derived from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Pediatric database. In this study, we aimed to externally validate the PRAm score at 1 large institution.

METHODS:

A PRAm score was prospectively assigned by the primary anesthesia team to children ≤18 years of age undergoing noncardiac surgery between July 2017 and July 2018 at a tertiary care pediatric hospital. The primary outcome was the PRAm score’s ability to predict 30-day mortality. The area under the receiver operating characteristic (ROC) curve was utilized to determine discriminative ability. Sensitivity and specificity at varying cutoffs were considered. Youden J index and the gray zone approach were applied to determine the optimal PRAm cutoff for predicting 30-day mortality.

RESULTS:

Among the 13,530 cases included in the external validation cohort, the incidence of 30-day mortality was 0.21% (29/13,530). The PRAm score was found to predict 30-day mortality with an area under the curve (AUC) of 0.956 (95% confidence interval [CI], 0.938–0.974; P < .001). Youden J index determined the optimal PRAm score threshold to be ≥5 with a sensitivity of 86% and a specificity of 91%. The gray zone identified an inconclusive risk of mortality in 6.93% (938/13,530) of patients who had PRAm scores of 4 or 5 (sensitivity or specificity <90%, respectively), therefore refining the optimal cutoff point to be a PRAm score of ≥6. The incidence of mortality for patients with an American Society of Anesthesiologists Physical Status (ASA PS) ≤3 (0.06%, 8/13,530) increased 8-fold for those with an ASA PS of ≤3 and a PRAm score of ≥6.

CONCLUSIONS:

The PRAm score is a simple and objective tool that has excellent ability to predict perioperative risk of mortality in pediatric patients undergoing noncardiac surgery and can be easily used by clinicians. The application of the PRAm score could have important implications on the safety and quality of care delivered to infants and children and on the resource utilization in the pediatric health care system.
Dual role for fungal-specific outer kinetochore proteins during cell cycle and development in Magnaporthe oryzae
Authors: Shah Hiral , Rawat Kanika , Ashar Harsh , Patkar Rajesh , Manjrekar Johannes
Published: May 2019

The outer kinetochore DAM/DASH complex ensures proper spindle structure and chromosome segregation. While DASH complex protein requirement diverges among different yeasts, its role in filamentous fungi has not been investigated so far. We studied the dynamics and role of middle (Mis12) and outer (Dam1 and Ask1) kinetochore proteins in the filamentous fungal pathogen, Magnaporthe oryzae, which undergoes multiple cell cycle linked developmental transitions. While Mis12 was constitutively present in the nucleus, Dam1 and Ask1 were recruited only during mitosis. Although Dam1 was not required for viability, loss of its function (dam1Δ) delayed mitotic progression, resulting in impaired conidial and hyphal development. Both Dam1 and Ask1 also localised to the hyphal tips, in the form of punctae oscillating back and forth from the growing ends, suggesting that Magnaporthe DASH complex proteins may play a non-canonical role in polarised growth during interphase, in addition to their function in nuclear segregation during mitosis. Impaired appressorial (infection structure) development and host penetration in the dam1Δ mutant suggest that fungus-specific Dam1 complex proteins could be an attractive target for a novel anti-fungal strategy.
LRRK1 phosphorylation of Rab7 at S72 links trafficking of EGFR-containing endosomes to its effector RILP
Authors: Hanafusa Hiroshi , Yagi Takuya , Ikeda Haruka , Hisamoto Naoki , Nishioka Tomoki , Kaibuchi Kozo , Shirakabe Kyoko , Matsumoto Kunihiro
Published: May 2019

Ligand-induced activation of epidermal growth factor receptor (EGFR) initiates trafficking events that re-localize the receptor from the cell surface to intracellular endocytic compartments. EGFR-containing endosomes are transported to lysosomes for degradation by the dynein–dynactin motor protein complex. However, this cargo-dependent endosomal trafficking mechanism remains largely uncharacterized. Here, we show that GTP-bound Rab7 is phosphorylated on S72 by leucine-rich repeat kinase 1 (LRRK1) at the endosomal membrane. This phosphorylation promotes the interaction of Rab7 (herein referring to Rab7a) with its effector RILP, resulting in recruitment of the dynein–dynactin complex to Rab7-positive vesicles. This, in turn, facilitates the dynein-driven transport of EGFR-containing endosomes toward the perinuclear region. These findings reveal a mechanism regulating the cargo-specific trafficking of endosomes.
Essential Features of Third-Party Certification Programs for Dietary Supplements: A Consensus Statement
Authors: Eichner Amy K. , Coyles Jon , Fedoruk Matthew , Maxey Timothy D. , Lenaghan Robert A. , Novitzky Jeff , Lindsey Andrea T. , Deuster Patricia A.
Published: May 2019

The presence of performance-enhancing drugs in dietary supplements poses serious anti-doping and health risks to athletes and military service members. A positive drug test, suboptimal health, or adverse event can ruin a career in either setting. These populations need to be certain in advance that a product is of high quality and free from performance-enhancing drugs and other banned substances. However, no regulatory authority conducts or mandates a quality review before dietary supplements are sold. Under the Food Drug and Cosmetic Act, the Food and Drug Administration does not have a role in the premarket safety review of dietary supplements. Due to the increasing demand for high-quality, properly labeled dietary supplements, multiple companies have stepped into this void by offering testing and quality review programs for dietary supplements. Each of these third-party programs has its own quality assurance program with varying testing components. It is difficult for consumers in the sport and military settings to assess whether a particular certification program reduces the risks enough so that they can use a product with confidence. This article puts forward the consensus of the authors on current best practices for third-party certification programs for dietary supplements consumed by athletes and military service members. Also discussed are important ways that third-party programs can develop in the future to improve access to safe, high-quality dietary supplements for these populations.
Empirical Bayes Estimation of Treatment Effects with Many A/B Tests: An Overview
Authors: Azevedo Eduardo M. , Deng Alex , Montiel Olea José L. , Weyl E. Glen
Published: May 2019

The use of large-scale experimentation to screen product innovations is increasingly common. This is a practical guide on how to use treatment effect estimates from a large number of experiments to improve estimates of the effects of each experiment. When thousands of new features are A/B tested by internet companies, the winners tend to be a combination of good features and features that got lucky experimental draws. Empirical Bayes methods are a commonly used tool in statistics to separate good features from lucky draws. We give a user-friendly overview of both classic and recent approaches to this problem.
Minding Your Ps and Qs: Going from Micro to Macro in Measuring Prices and Quantities
Authors: Ehrlich Gabriel , Haltiwanger John , Jarmin Ron , Johnson David , Shapiro Matthew D.
Published: May 2019

Key macro indicators such as output, productivity, and inflation are based on a complex system across multiple statistical agencies using different samples and levels of aggregation. The Census Bureau collects nominal sales, the Bureau of Labor Statistics collects prices, and the Bureau of Economic Analysis constructs nominal and real GDP using these data and other sources. The price and quantity data are integrated at a high level of aggregation. This paper explores alternative methods for reengineering key national output and price indices using item-level data. Such reengineering offers the promise of greatly improved key economic indicators along many dimensions.
How FinTech Enters China’s Credit Market
Authors: Hau Harald , Huang Yi , Shan Hongzhe , Sheng Zixia
Published: May 2019

How does FinTech credit mitigate local credit supply frictions in China's segmented credit market? In our simple theoretical models, we show that FinTech credit (i) expands the extensive margin of credit to borrowers of lower credit scores and (ii) provides relatively more credit to borrowers with lower credit scores. We confirm both predictions based on comprehensive data from one of China's largest FinTech credit providers.
Spatial Misallocation and Rent Controls
Authors: Chapelle Guillaume , Wasmer Etienne , Bono Pierre-Henri
Published: May 2019

In many global cities the rental housing market is partially regulated. We document that the Paris housing market is dual: a flexible rent sector coexists with a large controlled rent sector. The two sectors have very different rent gradients towards the center of the agglomeration. We develop a model explicitly accounting for these features which allows to investigate general equilibrium effects of rent controls at the city level. In this framework the coexistence of a controlled and flexible rent sector increases the spatial misallocation of households. This mismatch can generally be alleviated by an improvement in urban transport infrastructures.
How (Not) to Allocate Affordable Housing
Authors: Arnosti Nick , Shi Peng
Published: May 2019

We describe the wait-list procedure used in Providence and the lotteries used in New York City, and argue that despite their apparent differences, these systems should lead to similar outcomes. Neither approach effectively uses applicants' preferences to guide the allocation. As a result, tenants may frequently be assigned to apartments far from their family or workplace. We describe minor changes to each system that would give applicants a choice of apartments. Although these changes may shift which families receive housing, we argue that this can largely be offset by using observable characteristics to target those most in need.
Simplified Distributional National Accounts
Authors: Piketty Thomas , Saez Emmanuel , Zucman Gabriel
Published: May 2019

This paper develops a simplified methodology to distribute total national income across income groups that reproduces closely the sophisticated methodology of Piketty, Saez, and Zucman (2018). It starts from top income share series based on fiscal income of Piketty and Saez (2003) and makes two basic assumptions on how national income components not included in fiscal income are distributed: (1) nontaxable labor income and capital income from pension funds are distributed like taxable labor income; (2) other nontaxable capital income is distributed like taxable capital income. This methodology could be applied to countries with less data.
Improving the Measure of the Distribution of Personal Income
Authors: Fixler Dennis , Gindelsky Marina , Johnson David
Published: May 2019

Developing a national account-based measure of the distribution of income from the commonly used census-based concept of money income has been the subject of earlier research. We use publicly available survey and administrative data to construct a distribution of personal income after enhancing the top income distribution in the Current Population Survey (2007 and 2012). We show that inequality measures are fairly sensitive to the definition of income contemporaneously and across time. This work helps bridge the gap between micro data and macro statistics and informs about results from other studies, such as Piketty et al. (2018).
What Do Big Data Tell Us about Why People Take Gig Economy Jobs?
Authors: Koustas Dmitri K.
Published: May 2019

The gig economy is widely regarded to be a source of secondary or temporary income, but little is known about economic activity outside of the gig economy. Using data from a large, online personal finance application, I document the evolution of non-gig income and household balance sheets surrounding the participation decision for gig economy jobs. This simple analysis reveals striking pretrends in income and assets. In addition to providing insight into the reasons why households enter the gig economy, these findings have potentially important implications for the external validity of previous studies focusing on gig economy activity only.
Older Workers and the Gig Economy
Authors: Cook Cody , Diamond Rebecca , Oyer Paul
Published: May 2019

As the workforce ages, how will the work lives of older people evolve? One way to ease into retirement is to move to the gig economy where workers choose hours and intensity of work that fit their needs and capabilities. However, older workers are often reaping the benefits of the latter end of an implicit contract while gig economy workers are paid their marginal product. We show that age/earnings profiles in the traditional labor market are different than for Uber drivers. While the move to the gig economy generates flexibility, older workers are paid less than their younger coworkers.
Profit Shifting in a Globalized World
Authors: Dharmapala Dhammika
Published: May 2019

This paper briefly reviews the measurement of the magnitude of profit shifting by multinational firms. Highlighting differences between estimates using microeconomic and macroeconomic approaches, it sketches a conceptual framework that can help explain these divergent estimates. In particular, these approaches arguably differ in their conceptualization of the boundary between tax avoidance and behavioral responses to taxes. The paper also discusses the future of profit shifting, drawing on a data set that codes anti-avoidance measures undertaken by OECD countries over the period of 2000-2014. Governments have significantly strengthened these rules over this period, despite collective action problems that potentially inhibit their implementation.
New Evidence on the Cyclicality of Employer-to-Employer Flows from Canada
Authors: Nakamura Alice , Nakamura Emi , Phong Kyle , Steinsson Jón
Published: May 2019

This paper presents new estimates of gross worker flows for Canada for the sample period 1978 to 2016. We use administrative data from the Canadian Record of Employment in combination with the Canadian Labor Force Survey to estimate employer-to-employer flows in addition to flows between labor market states. We highlight three main results: Roughly two-thirds of all job separations are employer-to-employer flows. Employer-to-Employer flows are highly procyclical. The combination of these two results means that total job separations are procyclical. If employer-to-employer flows improve match quality, our results imply that recessions have a sullying effect on the labor market.
Is Inflation Just Around the Corner? The Phillips Curve and Global Inflationary Pressures
Authors: Coibion Olivier , Gorodnichenko Yuriy , Ulate Mauricio
Published: May 2019

Tightening labor markets in the United States and other advanced economies suggest inflation should be on the rise, yet it remains subdued. Is the Phillips curve broken? We bring together surveys of household or firm expectations for 18 countries to estimate an expectations-augmented Phillips curve. We find strong evidence of a Phillips curve relationship: the Phillips curve is alive and well. The fact that inflation remains well below inflation expectations, both in the United States and abroad, suggests that there remains significant slack in labor markets.
Some Principles for Regulating Cyber Risk
Authors: Kashyap Anil K. , Wetherilt Anne
Published: May 2019

We explain why cyber risk differs from other operational risks in the financial sector. The form of cyber shocks differs because of their intent, probability of success, possibility of a hidden phase, and evolving form of the risks. The impact differs because problems can spread quickly and because uncertainty over the possibility of a hidden phase can impact responses. We explain why private incentives to attend to these risks may differ from societies' preferences and develop six (micro- and macroprudential) regulatory principles to deal with cyber risk.
US Criminal Deportations and Human Capital in Central America
Authors: Sviatschi Maria Micaela
Published: May 2019

In this paper I ask whether peer effects generate changes in education investments in the areas where deported criminals are located in Central America using administrative data in El Salvador. I exploit the increase in criminal deportations from the United States in 1996 to analyze how individuals who grew up in municipalities affected by gangs in 1996 have fewer years of schooling when they are young adults. I find that individuals who were exposed during childhood to gang leaders have less schooling than those who were older than 16 in 1996 when the law was passed.
Fading Stars
Authors: GutiÉrrez GermÁn , Philippon Thomas
Published: May 2019

We study the evolution of superstar firms in the US economy over the past 60 years. Contrary to common wisdom, superstar firms have not become larger or more productive but have become more profitable. The contribution of star firms to aggregate US productivity growth has fallen over time, from about 72 basis points per year before 2000 down to about 43 afterwards.
Entertainment, Education, and Attitudes Toward Domestic Violence
Authors: Banerjee Abhijit , La Ferrara Eliana , Orozco Victor
Published: May 2019

We study attitudes towards domestic violence in a sample of young women and men exposed to the edutainment TV series MTV Shuga 3, which features a sub-plot on this theme, and in a sample that was not. We measure viewers' memory of the characters and identification with them. Eight months after the show, male viewers of Shuga report improved attitudes and are 21 percent less likely to justify violence than men in the control group. Attitudes improve among women and men who remember the characters associated with the violence plot, though not among those who identify with the characters.
Changing Family Attitudes to Promote Female Employment
Authors: Dean Joshua T. , Jayachandran Seema
Published: May 2019

India's female employment rate is one of the lowest in the world. One approach to expanding female employment is to make young women's family members more supportive of them working. We report on the effects of two interventions aimed at increasing family members' supportiveness in rural India. The first entails showing them video testimonials by working women and their family members. The second prompts a conversation between working women and their families about the benefits and challenges they face when a woman in the household works. We find no evidence that the interventions changed employment or attitudes.
A Well-Being Snapshot in a Changing World
Authors: Benjamin Daniel J. , Cooper Kristen B. , Heffetz Ori , Kimball Miles
Published: May 2019

Although technology-driven economic growth generates gains in consumption and employment opportunities, it may also negatively impact other dimensions of well-being, such as emotional well-being or sense of stability. We study 204 aspects of self-reported well-being among 1,576 US MTurk survey respondents, aggregated into seven themes: evaluative well-being, emotional well-being, positive perceptions of technology or economic growth, autonomy and flexibility, work environment, feelings of calmness and stability, and feelings of belonging and connection. Demographic associations with aspects of well-being vary somewhat across the themes. We highlight the value of a multidimensional approach when comparing well-being across different groups in the United States.
Economic Institutions and Social Progress
Authors: Fehder Daniel C. , Porter Michael E. , Stern Scott
Published: May 2019

Combining data from the social progress index and measures of economic institutions and performance, our analysis focuses on how changes in economic institutions and performance are related to subsequent changes in social progress (noneconomic dimensions of societal performance). We document a positive relationship between improved economic performance and subsequent social progress improvements, a separate impact of improved economic institutions on aspects of social progress that involve individual investment (such as education and health), and a noisy relationship between economic factors and those aspects of social progress related to issues of individual freedom and social inclusion.
Disenfranchisement and Economic Inequality: Downstream Effects of Shelby County v. Holder
Authors: Aneja Abhay P. , Avenancio-León Carlos F.
Published: May 2019

The 1965 Voting Rights Act (VRA) is considered by many to be the most effective civil rights law ever passed. In 2013, the Supreme Court struck down important provisions from the VRA in Shelby County v. Holder. This paper first discusses how the potential weakening of minority political power brought about by Shelby County may have made the government less responsive to minorities' policy demands. Then we proceed to show that the lack of minority power is already producing economic inequality that is reflected in public-sector wages and in private-sector occupations with a high number of public workers.
Student Debt and Labor Market Outcomes
Authors: Daniels Gerald Eric , Smythe Andria
Published: May 2019

We study the impact of student debt on various labor market outcomes, namely, income, hourly wages, and hours worked. Using the NLSY97 and a difference-indifference approach, we find statistically significant differences in labor market outcomes for individuals who received a student loan versus those who received no student loan. We find that the difference in post- versus pre-college income is 8-9 percent higher for individuals that received a student loan relative to individuals who received no student loan. Further, we find evidence that this higher income is due to higher work hours.
Examining Medicaid Expansion and the Treatment of Substance Use Disorders
Authors: Grooms Jevay , Ortega Alberto
Published: May 2019

As the drug epidemic continues to cripple communities and disrupt our country, identifying and understanding state and federal policies which have helped alleviate the burden of substance use disorders (SUDs) is imperative. In 2010, the passage of the Patient Protection and Affordable Care Act (ACA) expanded health coverage and services offered to millions of Americans. Prior to the ACA, treatment for substance use disorders was not included in all medical coverage. We examine the brief literature on ACA Medicaid Expansion and SUDs and complement this literature by including the effects on measures of supply and efficacy of SUD treatment.
Does Getting Health Insurance Affect Women’s Fertility? Evidence from the United Mine Workers’ Health Insurance
Authors: Troland Erin , Figinski Theodore F.
Published: May 2019

Does health insurance affect fertility decisions? Fertility may increase if insurance lowers the costs of having a child. Fertility may decrease if children are more likely to survive into adulthood (quality-quantity tradeoff). We study a largely permanent United Mine Workers of America (UMWA) insurance program. A large group of women of childbearing age gained pregnancy coverage for the first time. The insurance also covered children. We use a trend break specification with county-level variation in insurance. We find new evidence of the quality-quantity tradeoff. Fertility rates declined by about one percent per year in counties with average levels of insurance.