Joint diagnostic test of regression discontinuity designs: multiple testing problem

Current diagnostic tests for regression discontinuity (RD) design face a multiple testing problem. We find a massive over-rejection of the identifying restriction among empirical RD studies published in top-five economics journals. Each test achieves a nominal size of 5%; however, the median number of tests per study is 12. Consequently, more than one-third of studies reject at least one of these tests and their diagnostic procedures are invalid for justifying the identifying assumption. We offer a joint testing procedure to resolve the multiple testing problem. Our procedure is based on a new joint asymptotic normality of local linear estimates and local polynomial density estimates. In simulation studies, our joint testing procedures outperform the Bonferroni correction

Transabdominal Approach for Spontaneous Oesophageal Perforation: A Review of Four Cases

Spontaneous oesophageal perforation is an uncommon and life-threatening disease. Although several methods of treatment have been proposed, surgical treatment is considered the standard procedure. Primary repair using the transthoracic approach is the most common. However, few studies have evaluated the characteristics of the transabdominal approach. This study aimed to investigate the clinical outcomes of spontaneous oesophageal perforation that was surgically treated using the transabdominal approach. We retrospectively reviewed all patients with spontaneous oesophageal perforation who were admitted to the surgical department of our institution between November 2010 and April 2017, and identified a total of four patients. Data including demographic factors (age and sex), location of perforation, time to operation, operative method, complications, length of hospital stay, and postoperative recovery were reviewed. In all four cases, we treated the defect using the transabdominal approach, which provides a good surgical field of view. The aims of operative intervention, namely primary repair and access for enteral feeding, can be achieved using this approach. The most commonly observed complication was pyothorax, and we suggest the addition of intrapleural drainage for its prevention. Dysgraphia was observed in two patients, which improved with conservative treatment. The overall mortality rate was 0%. Our results demonstrate that primary repair using the transabdominal approach is safe and effective for the management of spontaneous oesophageal perforation. Addition of intrapleural drainage can improve the outcome associated with this approach

Impact of insulin resistance on subclinical left ventricular dysfunction in normal weight and overweight/obese japanese subjects in a general community

Background Insulin resistance carries increased risk of heart failure, although the pathophysiological mechanisms remain unclear. LV global longitudinal strain (LVGLS) assessed by speckle-tracking echocardiography has emerged as an important tool to detect early LV systolic abnormalities. This study aimed to investigate the association between insulin resistance and subclinical left ventricular (LV) dysfunction in a sample of the general population without overt cardiac disease. Methods We investigated 539 participants who voluntarily underwent extensive cardiovascular health check including laboratory test and speckle-tracking echocardiography. Glycemic profiles were categorized into 3 groups according to homeostatic model assessment of insulin resistance (HOMA-IR): absence of insulin resistance (HOMA-IR  − 16.65%). Results Forty-five (8.3%) participants had DM and 66 (12.2%) had abnormal HOMA-IR. LV mass index and E/e′ ratio did not differ between participants with and without abnormal HOMA-IR, whereas abnormal HOMA-IR group had significantly decreased LVGLS (− 17.6 ± 2.6% vs. − 19.7 ± 3.1%, p < 0.05). The prevalence of impaired LVGLS was higher in abnormal HOMA-IR group compared with normal HOMA-IR group (42.4% vs. 14.0%) and similar to that of DM (48.9%). In multivariable analyses, glycemic abnormalities were significantly associated with impaired LVGLS, independent of traditional cardiovascular risk factors and pertinent laboratory and echocardiographic parameters [adjusted odds ratio (OR) 2.38, p = 0.007 for abnormal HOMA-IR; adjusted OR 3.02, p = 0.003 for DM]. The independent association persisted even after adjustment for waist circumference as a marker of abdominal adiposity. Sub-group analyses stratified by body mass index showed significant association between abnormal HOMA-IR and impaired LVGLS in normal weight individuals (adjusted OR 4.59, p = 0.001), but not in overweight/obese individuals (adjusted OR 1.62, p = 0.300). Conclusions In the general population without overt cardiac disease, insulin resistance carries independent risk for subclinical LV dysfunction, especially in normal weight individuals

Estimation of target strength of Sardina pilchardus and Sardinella aurita by theoretical approach

The target strength (TS) patterns of Sardina pilchardus and Sardinella aurita at 38 and 120 kHz were estimated by a prolate-spheroid model, using measurements of swimbladder length and width. The ratio of swimbladder length to total length (TL) was similar in both species, however the ratio of swimbladder width to TL was smaller and more variable for S. aurita. Assuming a normal distribution of fish swimming orientation angle (θfish) with mean ± standard deviation (SD) of 0 ± 10°, the normalized (by TL) average TS (b20) was estimated to be -64.0 dB (38 kHz) and -65.2 dB (120 kHz) for S. pilchardus, and -66.2 dB (38 kHz) and -67.2 dB (120 kHz) for S. aurita. Compared with currently applied b20 values at 38 kHz, our results under four different θfish assumptions (0 ± 10°, 0 ± 15°, -5 ± 10°, and -5 ± 15°) were 6-9 dB higher for S. pilchardus and 5-7 dB higher for S. aurita. This suggests four- to eightfold overestimation risk for S. pilchardus and three- to fivefold overestimation risk for S. aurita when using the currently applied b20 values