2017 Trade Finance Gaps, Growth and Jobs Survey

Key Points • The global trade finance gap is estimated at $1.5 trillion. • 40% of the gap originates in Asia and the Pacific. • 74% of rejected trade finance transactions come from SMEs and midcap firms. • Female-owned firms report higher rejection rates, and are less likely to find alternatives in the formal financial sector. • At least 36% of rejected trade finance may be fundable by other financial institutions. • A 10% increase in trade finance could boost employment by 1%. • 80% of banks report digitization will cut costs, yet no evidence that savings translate to tional trade finance apacity

Understanding A Physician’s Role in Combating the Anti-Vaccination Movement: A Retrospective Analysis Using 2014-2019 Data

Childhood vaccination has been one of public health’s greatest achievements in its history. Just over the past 20 years, immunizations averted more than 21 million hospitalizations and 732,000 deaths in the US (Skinner, 2017). However, healthcare professionals, public health advocates, and researchers are still witnessing an unceasing tension between the anti-vaccination movement and pro-vaccination organizations. Since the invention of the first vaccines, individuals from various religious sects, cultural backgrounds, and ethnic groups have been questioning the efficacy of vaccines, the possible health risks and side effects that may be introduced, and the morality behind the act of vaccinating. With questionable rates of immunizations, some wellcontrolled and/or even eradicated diseases—measles in particular—have begun to resurface and affect millions across the nation. Ultimately, it is important for medical personnel, especially physicians, to raise awareness and properly educate their patients on vaccinations. Through a systematic analysis of the literature and scientific studies published from 2014 until the present day, this retrospective, qualitative study aims to determine why there is such an anti-vaccination rush and the factors causing it, investigate what physicians have been doing to combat the antivaccination sentiment, and offer a proposal that could be implemented to help providers improve health outcomes and better serve their patients by advocating for vaccination. In the final analysis, three key techniques that physicians should incorporate into their practice were examined: (1) study the ins and outs of childhood vaccinations and anti-vaccination responses, (2) execute practices of better communication about vaccines in order to build relationships based on trust, and (3) utilize personal social media platforms and reference parents to informational websites that accurately cover the pros and cons of vaccines

Seaman\u27s Direct Buying Service, Inc. v. Standard Oil Co.: Scaling the Stonewall Tort

In Seaman\u27s Direct Buying Service, Inc. v. Standard Oil CO., the California Supreme Court affirmed its position that an insurance carrier may risk tort liability for breach of the implied covenant of good faith and fair dealing in addition to contract damages. Moreover, Seaman\u27s enabled the court to explore such liability in the context of an ordinary commercial contract in which parties of roughly equal bargaining power are free to shape the contours of their agreement. The Seaman\u27s majority deemed it unnecessary to find tort liability on the breach of the implied covenant issue. Instead the court created a more limited area of tort liability - the so-called tort of stonewalling - in which the breaching party denies, in bad faith and without probable cause, the existence of a contract to shield itself from liability. This narrowly defined tort may well have ramifications on freedom of contract and affect the future of commercial contract negotiation. The essence of freedom of contract lies in the parties assuming responsibility for making enforceable contracts. This freedom also permits the parties to breach their contracts, resulting in liability to the other party for compensatory damages. Parties in an ordinary commercial contract who have mutually agreed on their obligations and expectations subject to specified covenants, conditions and remedies may not look favorably upon the imposition of tort liability for breach of contract in addition to traditional contract damages

Imaging for the Diagnosis and Management of Traumatic Brain Injury

To understand the role of imaging in traumatic brain injury (TBI), it is important to appreciate that TBI encompasses a heterogeneous group of intracranial injuries and includes both insults at the time of impact and a deleterious secondary cascade of insults that require optimal medical and surgical management. Initial imaging identifies the acute primary insult that is essential to diagnosing TBI, but serial imaging surveillance is also critical to identifying secondary injuries such as cerebral herniation and swelling that guide neurocritical management. Computed tomography (CT) is the mainstay of TBI imaging in the acute setting, but magnetic resonance tomography (MRI) has better diagnostic sensitivity for nonhemorrhagic contusions and shear-strain injuries. Both CT and MRI can be used to prognosticate clinical outcome, and there is particular interest in advanced applications of both techniques that may greatly improve the sensitivity of conventional CT and MRI for both the diagnosis and prognosis of TBI

The Role of Autophagy During Myocardial Ischemia/Reperfusion Injury

Autophagy is a housekeeping process to remove damaged cytoplasmic constituents. However, a debate persists on whether autophagy is beneficial or detrimental when an ischemic/reperfusion (I/R) insult occurs in the heart. This study tested the effects of autophagy enhancers (e.g. rapamycin and trehalose) and autophagy inhibitor (e.g. 3-methyladenine) on heart function and infarct size after global I (30 minutes) and R (45 minutes) when given prior to ischemia (pre-treatment) or at the beginning of reperfusion (post-treatment). We found that Rapamycin (25nM) pre-treatment and post-treatment significantly restored final left ventricular developed pressure (LVDP) to 75.4±9.1% and 60±5% of initial baseline respectively (both n=5, p\u3c0.05), compared to I/R group (n=9) that recovered to 35±5.5% of initial baseline. Likewise, trehalose (5mM) pre-treatment and post-treatment also significantly restored final LVDP to 61.4±3.7% (n=6) and 69.1±2.7% (n=5) of initial baseline respectively, compared to I/R group. However, 3-methyladenine (1mM) pre-treatment (n=6) and post-treatment (n=5) showed similar reduction in final LVDP to 24.7±9.1% and 33.4±12.8 % of initial baseline respectively, as I/R group. Moreover, infarction percentage was significantly reduced by rapamycin pre-treatment and post-treatment (14 ± 2.8% and 21.4 ± 5.3%, respectively; both p\u3c0.05); and trehalose pre-treatment and post-treatment (19.2 ± 3% and 15.2% ± 3, respectively; both p\u3c0.05), but not by 3-methyladenine pre-treatment and post-treatment (26±2% and 28±4.1%, respectively) when compared to I/R group (38.6±4.3%). The data suggests that autophagy enhancement before ischemia or at reperfusion is beneficial for reducing I/R injury

Experiential Learning: Critical Analysis of Standardized Patient and Disability Simulation

Current revisions to the accreditation standards for occupational therapy (OT) education include proposed changes to experiential learning. The AOTA Fieldwork/Experiential Learning Ad Hoc Committee recommends that fieldwork Level I experiences be replaced with a new model of experiential education that includes the use of standardized patients and simulation (AOTA, 2017). The purpose of this article is to present critical perspectives about standardized patient simulation and disability simulation to support informed decision-making about the integration of experiential learning in OT professional education. In standardized patient simulation, actors play the roles of clients and important others in therapeutic scenarios; in disability simulation, students act out impairments in a variety of settings. While these forms of simulation are commonly used within OT education, they are critiqued for failing to present participants with authentic lived experiences of disability. This paper presents alternative approaches that would more fully align the OT curriculum with perspectives and priorities of intersectional disability communities. Recommendations to be considered by educators and educational programs include becoming familiar with relevant literature across fields and communities; developing long-term partnerships with disability organizations and community members; involving people with disabilities in the development, implementation, and evaluation of experiential learning opportunities; and providing experiential learning opportunities that take place outside educational and clinical settings and that attend to multiple intersecting dimensions of people with disabilities’ lived experiences. Together, these recommendations can help ensure that students have access to evidence-based educational approaches and best practices that accurately reflect the self-identified needs, concerns, and priorities of intersectional disability communities

The Effect of Caffeic Acid Phenethyl Ester (CAPE) on H2O2-Induced Oxidative Stress in Cultured H9c2 Cells Compared to Common Antioxidants

Caffeic Acid Phenethyl Ester (CAPE) is a natural compound that has previously exhibited anti-proliferative, anti-inflammation and antioxidant activities. However, CAPE’s effects have not been fully elucidated in myoblasts under oxidative stress. We compared the effects of 24 hour pretreatment of CAPE to several known antioxidants (caffeic acid, vitamin C, and trolox) in H9c2 cells following oxidative injury by hydrogen peroxide (H2O2). H9c2 cells incubated with H2O2 treatment (100-700 μM, n=4) for 24 hours dose-dependently reduced cell viability (assessed by a cell counting assay). Compared to the reduction in viability from H2O2 500 μM treatment (22 ± 4%), H9c2 cell viability was significantly restored by pretreatment of CAPE (at 10 μM (100 ± 25%); 20 μM (112 ± 15%); 40 μM (109 ± 15%) n=5, p\u3c0.001) and Trolox (at 50 μM (83 ± 10%); 100 μM (89 ± 8%) n=4, p\u3c0.001). In contrast, pretreatment of H9c2 cells with caffeic acid (1-80 μM, n=3) and vitamin C (1000-10,000 μM, n=3) did not restore cell viability following H2O2-induced injury. CAPE’s mechanism was further investigated by measuring reactive oxygen species via a dichlorofluorescin diacetate assay and by evaluating heme oxygenase-1 (HO-1) expression via western blot. Increases in ROS caused by H2O2 500 μM (239 ± 30% of control, n=3) were significantly restored to control by pretreatment of CAPE dose-dependently (n=3, p\u3c0.001). Moreover, CAPE dose-dependently increased HO-1 expression (n=3). These results suggest CAPE can mitigate oxidative stress in H9c2 cells which may involve the induction of HO-1