Deep and Proximate Determinants of the World Income Distribution

This paper studies the deep and proximate determinants of the evolution of the cross-country distribution of GDP per worker in the period 1960–2008 by a novel method based on an information criterion. We find that countries of our sample follow three distinctive growth regimes identified by two deep determinants, namely life expectancy at birth in 1960 and the share of Catholics in 1965, and that each regime is characterized by non-linearities. Growth regimes appear to be the main cause of the increased inequality and polarization, while technological catch-up, proxied by the initial level of GDP per worker, acts in the opposite direction. Finally, human capital marginally reduces polarization, while investment rates and employment growth have no distributional effect

Prevalence and Trends in Transmitted and Acquired Antiretroviral Drug Resistance, Washington, DC, 1999-2014.

Background Drug resistance limits options for antiretroviral therapy (ART) and results in poorer health outcomes among HIV-infected persons. We sought to characterize resistance patterns and to identify predictors of resistance in Washington, DC. Methods We analyzed resistance in the DC Cohort, a longitudinal study of HIV-infected persons in care in Washington, DC. We measured cumulative drug resistance (CDR) among participants with any genotype between 1999 and 2014 (n = 3411), transmitted drug resistance (TDR) in ART-naïve persons (n = 1503), and acquired drug resistance (ADR) in persons with genotypes before and after ART initiation (n = 309). Using logistic regression, we assessed associations between patient characteristics and transmitted resistance to any antiretroviral. Results Prevalence of TDR was 20.5%, of ADR 40.5%, and of CDR 45.1% in the respective analysis groups. From 2004 to 2013, TDR prevalence decreased for nucleoside and nucleotide analogue reverse transcriptase inhibitors (15.0 to 5.5%; p = 0.0003) and increased for integrase strand transfer inhibitors (INSTIs) (0.0–1.4%; p = 0.04). In multivariable analysis, TDR was not associated with age, race/ethnicity, HIV risk group, or years from HIV diagnosis. Conclusions In this urban cohort of HIV-infected persons, almost half of participants tested had evidence of CDR; and resistance to INSTIs was increasing. If this trend continues, inclusion of the integrase-encoding region in baseline genotype testing should be strongly considered

A techno-economic approach for decision-making in metal additive manufacturing: metal extrusion versus single and multiple laser powder bed fusion

This work presents a decision-making methodology that allows the merging of quantitative and qualitative decision variables for selecting the optimal metal Additive Manufacturing (AM) technology. The approach is applied on two competing technologies in the field of metal AM industry, i.e., the metal extrusion AM process (metal FFF) and the Laser Powder Bed Fusion process (LPBF) with single and multiple lasers, which represent the benchmark solution currently on the market. A comprehensive techno-economical comparison is presented where the two processes are analysed in terms of process capabilities (quality, easiness of use, setup time, range of possible materials, etc.) and costs, considering two different production scenarios and different parts’ geometries. In the first scenario, the AM system is assumed to be dedicated to one single part production while in this second scenario, the AM system is assumed to be saturated, as devoted to producing a wide mix of part types. For each scenario, two different part types made of 17–4 PH stainless steel are considered as a reference to investigate the effect of shape complexity, part size and production times to select the best technology when metal FFF and LPBF must be considered. The first part type refers to an extrusion die, to represent typical shapes of interest in the tooling industry, while the second part type is an impeller which can be used in many different industrial sectors, ranging from oil and gas to aerospace. In order to include quantitative and qualitative criteria, a decision-making model based on Analytic Hierarchy Process (AHP) is proposed as the enabler tool for decision making. The proposed approach allows to determine the most effective solution depending on the different production configurations and part types and can be used as a guideline and extended to include other technologies in the field of metal AM. On the other side, the critical discussion of the criteria selected, and the results achieved allow to highlight the pros and cons of the competing technologies, thus defining the existing limits to define directions for future research

The IkB kinase inhibitor nuclear factor-kB essential modulator–binding domain peptide for inhibition of balloon injury-induced neointimal formation

Objective—The activation of nuclear factor-kB (NF-kB) is a crucial step in the arterial wall’s response to injury. The identification and characterization of the NF-kB essential modulator– binding domain (NBD) peptide, which can block the activation of the IkB kinase complex, have provided an opportunity to selectively abrogate the inflammation-induced activation of NF-kB. The aim of the present study was to evaluate the effect of the NBD peptide on neointimal formation.<br></br> Methods and Results—In the rat carotid artery balloon angioplasty model, local treatment with the NBD peptide (300 microg/site) significantly reduced the number of proliferating cells at day 7 (by 40%; P<0.01) and reduced injury-induced neointimal formation (by 50%; P<0.001) at day 14. These effects were associated with a significant reduction of NF-kB activation and monocyte chemotactic protein-1 expression in the carotid arteries of rats treated with the peptide. In addition, the NBD peptide (0.01 to 1 micromol/L) reduced rat smooth muscle cell proliferation, migration, and invasion in vitro. Similar results were observed in apolipoprotein E-/-, mice in which the NBD peptide (150 microg/site) reduced wire-induced neointimal formation at day 28 (by 47%; P<0.01).<br></br> Conclusion—The NBD peptide reduces neointimal formation and smooth muscle cell proliferation/migration, both effects associated with the inhibition of NF-kB activation

'White knuckle care work' : violence, gender and new public management in the voluntary sector

Drawing on comparative data from Canada and Scotland, this article explores reasons why violence is tolerated in non-profit care settings. This article will provide insights into how workers' orientations to work, the desire to care and the intrinsic rewards from working in a non-profit context interact with the organization of work and managerially constructed workplace norms and cultures (Burawoy, 1979) to offset the tensions in an environment characterized by scarce resources and poor working conditions. This article will also outline how the same environment of scarce resources causes strains in management's efforts to establish such cultures. Working with highly excluded service users with problems that do not respond to easy interventions, workers find themselves working at the edge of their endurance, hanging on by their fingernails, and beginning to participate in various forms of resistance; suggesting that even among the most highly committed, 'white knuckle care' may be unsustainable

Integrated strategies to prevent intradialytic hypotension: research protocol of the DialHypot study, a prospective randomised clinical trial in hypotension-prone haemodialysis patients

INTRODUCTION: In patients on maintenance haemodialysis (HD), intradialytic hypotension (IDH) is a clinical problem that nephrologists and dialysis nurses face daily in their clinical routine. Despite the technological advances in the field of HD, the incidence of hypotensive events occurring during a standard dialytic treatment is still very high. Frequently recurring hypotensive episodes during HD sessions expose patients not only to severe immediate complications but also to a higher mortality risk in the medium term. Various strategies aimed at preventing IDH are currently available, but there is lack of conclusive data on more integrated approaches combining different interventions. METHODS AND ANALYSIS: This is a prospective, randomised, open-label, crossover trial (each subject will be used as his/her own control) that will be performed in two distinct phases, each of which is divided into several subphases. In the first phase, 27 HD sessions for each patient will be used, and will be aimed at the validation of a new ultrafiltration (UF) profile, designed with an ascending/descending shape, and a standard dialysate sodium concentration. In the second phase, 33 HD sessions for each patient will be used and will be aimed at evaluating the combination of different UF and sodium profiling strategies through individualised dialysate sodium concentration. ETHICS AND DISSEMINATION: The trial protocol has been reviewed and approved by the local Institutional Ethics Committee (Comitato Etico AVEN, prot. 43391 22.10.19). The results of the trial will be presented at local and international conferences and submitted for publication to a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03949088)

Risk perception and media in shaping protective behaviors: insights from the early phase of COVID-19 Italian outbreak

In the absence of target treatments or vaccination, the SARS-CoV-2 pandemic can be impeded by effectively implementing containment measures and behaviors. This relies on individuals’ adoption of protective behaviors, their perceived risk, and the use and trust of information sources. During a health emergency, receiving timely and accurate information enables individuals to take appropriate actions to protect themselves, shaping their risk perception. Italy was the first western country plagued by COVID-19 and one of the most affected in the early phase. During this period, we surveyed 2,223 Italians before the national lockdown. A quarter of the sample perceived COVID-19 less threatening than flu and would not vaccinate, if a vaccine was available. Besides, most people perceived containment measures, based on social distancing or wearing masks, not useful. This perceived utility was related to COVID-19 threat perception and efficacy beliefs. All these measures were associated with the use of media and their truthfulness: participants declared to mainly use the Internet, while health organizations’ websites were the most trusted. Although social networks were frequently used, they were rated lower for trustfulness. Our data differ from those obtained in other community samples, suggesting the relevance to explore changes across different countries and during the different phases of the pandemic. Understanding these phenomena, and how people access the media, may contribute to improve the efficacy of containment measures, tailoring specific policies and health communications

Crohn's-like ileo-colitis in patients affected by glycogen storage disease Ib: Two years' follow-up of patients with a wide spectrum of gastrointestinal signs

Aim: To investigate the presence of inflammatory bowel disease (IBD) and to evaluate the progression of bowel involvement after two years' follow-up in seven patients affected by glycogen storage disease type Ib (GSDIb). Methods: Seven patients (5F, 2M, aged 4.5-20.6 y) entered the study. Bowel involvement was evaluated by ileocolonoscopy and specific IBD serologic markers. To evaluate disease activity, Paediatric Crohn's Disease Activity Index (PCDAI), terminal ileum wall thickness detected at ultrasonography (US), 99mTechnetium labelled autologous White Cell Scan (Tc-WCS) and barium meal with follow-through were investigated. Results: Ileocolonoscopy and histology examination revealed variable degrees of bowel involvement in all patients. The results of serologic markers were indicative of a Crohn's-like ileocolitis. US and Tc-WCS, could clearly define patients with severe inflammatory involvement, but failed to identify all patients with mild to moderate disease. For the most severely affected patients, anti-inflammatory agents and steroids were prescribed, whereas nutritional therapy with polymeric formula and antibiotics were assumed by two other patients and antibiotics only by one patient. Granulocyte colony-stimulating factor (G-CSF) was prescribed to all patients. Ileocolonoscopy and histology data improved in all patients. The assumption of G-CSF and/or gastric drip feeding (g.d.f.) was inversely associated with the PCDAI results (p < 0.05). Conclusion: IBD is common in patients affected by GSDIb independently of the severity of gastrointestinal signs and symptoms. Different therapeutic approaches can be used according to the severity of IBD. G-CSF treatment and g.d.f. can be protective factors for IBD

Quark deconfinement and implications for the radius and the limiting mass of compact stars

We study the consequences of the hadron-quark deconfinement phase transition in stellar compact objects when finite size effects between the deconfined quark phase and the hadronic phase are taken into account. We show that above a threshold value of the central pressure (gravitational mass) a neutron star is metastable to the decay (conversion) to a hybrid neutron star or to a strange star. The "mean-life time" of the metastable configuration dramatically depends on the value of the stellar central pressure. We explore the consequences of the metastability of ``massive'' neutron stars and of the existence of stable compact quark stars (hybrid neutron stars or strange stars) on the concept of limiting mass of compact stars. We discuss the implications of our scenario on the interpretation of the stellar mass and radius extracted from the spectra of several X-ray compact sources. Finally, we show that our scenario implies, as a natural consequence a two step-process which is able to explain the inferred ``delayed'' connection between supernova explosions and GRBs, giving also the correct energy to power GRBs.Comment: 34 pages, 10 figure