Did DR-CAFTA Affect the Exports of the Dominican Republic to the United States?

This article evaluates the impact the Dominican Republic and Central America Free Trade Agreement (DR-CAFTA) had on the exports of the Dominican Republic (DR) to the United States. We estimate a gravity model for the DR exports to the 109 trade partners of the country from 1990 to 2014. This model quantifies the effect of the DR-CAFTA since 2007, when the agreement was ratified, and finds that the DR-CAFTA negatively affected DR exports to the US. We conduct further analysis of factors that could explain the decline in exports, in spite of the ratification of the agreement. We find that the 2008–09 crisis was not the driver of the slowdown of DR exports to the US. The increasing competition with Central American countries and other export oriented economies, like China, in the US market seem to have the leading role in the export contraction that we find in our study

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Acute pulmonary embolism is a frequent condition in emergency medicine and potentially fatal. Cause of death is right ventricular failure due to increased right ventricular afterload from both pulmonary vascular obstruction and vasoconstriction. Inodilators are interesting drugs of choice as they may improve right ventricular function and lower its afterload. We aimed to investigate the cardiovascular effects of three clinically relevant inodilators: levosimendan, milrinone, and dobutamine in acute pulmonary embolism. We conducted a randomized, blinded, animal study using 18 female pigs. Animals received large autologous pulmonary embolism until doubling of baseline mean pulmonary arterial pressure and were randomized to increasing doses of each inodilator. Effects were evaluated with bi-ventricular pressure–volume loop recordings, right heart catheterization, and blood gas analyses. Induction of pulmonary embolism increased right ventricular afterload and pulmonary pressure ( p  < 0.05) causing right ventricular dysfunction. Levosimendan and milrinone showed beneficial hemodynamic profiles by lowering right ventricular pressures and volume ( p  < 0.001) and improved right ventricular function and cardiac output ( p  < 0.05) without increasing right ventricular mechanical work. Dobutamine increased right ventricular pressure and function ( p  < 0.01) but at a cost of increased mechanical work at the highest doses, showing an adverse hemodynamic profile. In a porcine model of acute pulmonary embolism, levosimendan and milrinone reduced right ventricular afterload and improved right ventricular function, whereas dobutamine at higher doses increased right ventricular afterload and right ventricular mechanical work. The study motivates clinical testing of inodilators in patients with acute pulmonary embolism and right ventricular dysfunction

Inversion structures as potential petroleum exploration targets on Nuussuaq and northern Disko, onshore West Greenland

The onshore Cretaceous–Paleocene Nuussuaq Basin in West Greenland (Fig. 1) has long served as an analogue for offshore petroleum exploration. With the discovery of oil seeps on Disko, Nuussuaq, Ubekendt Ejland and Svartenhuk Halvø in the early 1990s, onshore exploration was also carried out. This eventually resulted in the GRO#3 wildcat exploration well on western Nuussuaq in 1996, which showed several intervals with hydrocarbons (Christiansen et al. 1997). Recent photogrammetric mapping of conspicuous marker horizons within the volcanic sequences of the basin shows that significant compressional structures may have developed in the latest Paleocene on central Nuussuuaq and northern Disko that could be promising potential exploration targets

The Danish National Database for Asthma: establishing clinical quality indicators

Asthma is one of the most common chronic diseases worldwide affecting more than 300 million people. Symptoms are often non-specific and include coughing, wheezing, chest tightness, and shortness of breath. Asthma may be highly variable within the same individual over time. Although asthma results in death only in extreme cases, the disease is associated with significant morbidity, reduced quality of life, increased absenteeism, and large costs for society. Asthma can be diagnosed based on report of characteristic symptoms and/or the use of several different diagnostic tests. However, there is currently no gold standard for making a diagnosis, and some degree of misclassification and inter-observer variation can be expected. This may lead to local and regional differences in the treatment, monitoring, and follow-up of the patients. The Danish National Database for Asthma (DNDA) is slated to be established with the overall aim of collecting data on all patients treated for asthma in Denmark and systematically monitoring the treatment quality and disease management in both primary and secondary care facilities across the country. The DNDA links information from population-based disease registers in Denmark, including the National Patient Register, the National Prescription Registry, and the National Health Insurance Services register, and potentially includes all asthma patients in Denmark. The following quality indicators have been selected to monitor trends: first, conduction of annual asthma control visits, appropriate pharmacological treatment, measurement of lung function, and asthma challenge testing; second, tools used for diagnosis in new cases; and third, annual assessment of smoking status, height, and weight measurements, and the proportion of patients with acute hospital treatment. The DNDA will be launched in 2016 and will initially include patients treated in secondary care facilities in Denmark. In the nearby future, the database aims to include asthma diagnosis codes and clinical data registered by general practitioners and specialised practitioners as well