The less economic freedom a state has, the more political connections local firms need

Daniel M. Gropper, John S. Jahera Jr. and Jung Chul Park argue this is the case for US bank

THE COST STRUCTURE OF MICROFINANCE INSTITUTIONS IN EASTERN EUROPE AND CENTRAL ASIA

Microfinance institutions are important, particularly in developing countries, because they expand the frontier of financial intermediation by providing loans to those traditionally excluded from formal financial markets. This paper presents the first systematic statistical examination of the performance of MFIs operating in Eastern Europe and Central Asia. A cost function is estimated for MFIs in the region from 1999-2004. First, the presence of subsidies is found to be associated with higher MFI costs. When output is measured as the number of loans made, we find that MFIs become more efficient over time and that MFIs involved in the provision of group loans and loans to women have lower costs. However, when output is measured as volume of loans rather than their number, this last finding is reversed. This may be due to the fact that such loans are smaller in size; thus for a given volume more loans must be made.http://deepblue.lib.umich.edu/bitstream/2027.42/40195/3/wp809.pd

Nutritional evaluation of children with phenylketonuria

CONTEXT: Dietary phenylalanine (PA) restriction is the most effective form for reducing its excess in the blood and is the only efficient method for treating phenylketonuria. The diet is complex and should be adapted to combine the patients' eating habits, growth and development. It depends basically on the use of industrialized products as substitutes free of PA for proteins that are not fully supplied. OBJECTIVE: To evaluate the nutritional status of children with phenylketonuria (PKU) by anthropometric measurements and food intake. DESIGN: Cross-sectional study. SETTING: Children with PKU attending the Association of Parents and Friends of Handicapped Children (Associação de Pais e Amigos dos Excepcionais - APAE) and normal children attending at municipal day care centers in São Paulo. PARTICIPANTS: 42 children with PKU and 31 normal children aged 1 to 12 of both sexes were assessed in two groups, under and over 7 years of age. MAIN MEASUREMENTS: Weight and height measurements. RESULTS: Children with PKU ingested calories, calcium, iron, zinc, and copper below the recommended values, whereas the protein intake was within the normal range. Food intake in the group of normal children was within normality rates. The height/weight Z-score means for children with PKU were 0.47 for those under 7 years and 1.86 for 7 year-olds and over; in normal children the means were 0.97 <7 years and 1.54 ³7 years, with no statistically significant difference. The height/age Z-score means were significantly lower in the PKU children <7 years (-1.23) than in the normal controls (0.91). CONCLUSIONS: The data presented demonstrate the importance of nutritional surveillance in patients with PKU so as to support adequacy of nutrient intake and to guarantee growth within the relevant standards.CONTEXTO: A restrição dietética da fenilalanina (FAL) é a forma mais efetiva para reduzir o seu excesso no sangue e o único método efetivo de tratar a fenilcetonúria. A dieta é complexa e deve ser adaptada para combinar hábitos alimentares, crescimento e desenvolvimento dos pacientes. Depende basicamente do uso de produtos industrializados como substitutos protéicos isentos de FAL, não totalmente suplementados. OBJETIVO: Avaliar o estado nutricional das crianças fenilcetonúricas por medidas antropométricas e o consumo alimentar. TIPO DE ESTUDO: Estudo transversal LOCAL: Associação de Pais e Amigos dos Excepcionais (APAE) de São Paulo, Creche e Centro de Juventude da Prefeitura de São Paulo. PARTICIPANTES: 42 crianças fenilcetonúricas e 31 normais, na faixa etária de 1 a 12 anos, divididas em dois grupos abaixo e acima de 7 anos, de ambos os sexos. RESULTADOS: As fenilcetonúricas apresentaram porcentagem de adequação da ingestão de calorias, cálcio, ferro, zinco e cobre abaixo do recomendado. A ingestão protéica estava dentro da normalidade. O consumo alimentar no grupo de crianças normais apresentou-se dentro da faixa da normalidade. As médias de peso para estatura em escore z das fenilcetonúricas foram 0.47 < 7 anos e 1.86 ³ 7 anos; nas normais 0.97 < 7 anos e 1.54 ³ 7 anos, sem diferença estatisticamente significante. As médias de E/I apresentaram diferença estatisticamente significante entre fenilcetonúricas < 7 anos (- 1.23) e crianças normais de mesma faixa etária (0,91). CONCLUSÃO: Concluiu-se que a vigilância nutricional em crianças fenilcetonúricas é importante para manutenção dos padrões de crescimento e o adequado consumo de nutrientes.University of São PauloFederal University of São PauloUNIFESPSciEL

Changes in Energy Expenditure with Ingestion of High Protein, High Fat versus High Protein, Low Fat Meals among Underweight, Normal Weight, and Overweight Females.

Background: Metabolic rate is known to rise above basal levels after eating, especially following protein consumption. Yet, this postprandial rise in metabolism appears to vary among individuals. This study examined changes in energy expenditure in response to ingestion of a high protein, high fat (HPHF) meal versus an isocaloric high protein, low fat (HPLF) meal in underweight, normal weight, or overweight females (n = 21) aged 19–28 years. Methods: Energy expenditure, measured using indirect calorimetry, was assessed before and every 30 minutes for 3.5 hours following consumption of the meals on two separate occasions. Height and weight were measured using standard techniques. Body composition was measured using bioelectrical impedance analysis. Results: Significant positive correlations were found between body mass index (BMI) and baseline metabolic rate (MR) (r = 0.539; p = 0.017), between body weight and baseline MR (r = 0.567; p = 0.011), between BMI and average total change in MR (r = 0.591; p = 0.008), and between body weight and average total change in MR (r = 0.464; p = 0.045). Metabolic rate (kcal/min) was significantly higher in the overweight group than the normal weight group, which was significantly higher than the underweight group across all times and treatments. However, when metabolic rate was expressed per kg fat free mass (ffm), no significant difference was found in postprandial energy expenditure between the overweight and normal groups. Changes in MR (kcal/min and kcal/min/kg ffm) from the baseline rate did not significantly differ in the underweight (n = 3) or in the overweight subjects (n = 5) following consumption of either meal at any time. Changes in MR (kcal/min and kcal/min/kg ffm) from baseline were significantly higher in normal weight subjects (n = 11) across all times following consumption of the HPHF meal versus the HPLF meal. Conclusion: There is no diet-induced thermogenic advantage between the HPHF and HPLF meals in overweight and underweight subjects. In contrast, in normal weight subjects, ingestion of a HPHF meal significantly increases MR (69.3 kcal/3.5 hr) versus consumption of a HPLF meal and provides a short-term metabolic advantage

From Number Crunching To Organizational Leadership: Can Distance Education Adequately Handle The Range Of Graduate Business Classes?

With distance education delivery technology improving almost continuously, many Universities are seeking out distance education opportunities to expand their programs.&nbsp;&nbsp; We seek to examine the effectiveness of the distance delivery approach across the range of types of courses offered in MBA programs &ndash; from the organizational leadership classes to the more quantitative &ldquo;number crunching&rdquo; classes.&nbsp;&nbsp; Student performance in several types of MBA courses was evaluated as a result of presenting the same material on-campus (synchronously) and via distance education (asynchronously) in three different kinds of graduate business courses; a course in organizational leadership, an analytical course in managerial economics, and a quantitative methods course.&nbsp;&nbsp; A number of individual variables (e.g., GMAT scores, undergraduate GPA) were included as explanatory factors regarding student performance.&nbsp;&nbsp; Using multiple hierarchical regression analysis, the asynchronous distance delivery model was determined to have no adverse impact on student performance across all of these different types of MBA courses, indicating that indeed distance education techniques can adequately handle this broad range of graduate business classes

Sustaining or declining physical activity: Reports from an ethnically diverse sample of older adults

Over 80% of adults in the US fail to meet the ≥150 min weekly physical activity guideline; 40% age ≥ 75 are entirely inactive. The study purpose was to understand the reasons why community-dwelling older adults (age ≥ 60) from diverse backgrounds increase, sustain, or decline in their physical activity levels over time. Sixty-two older adults were interviewed. Two-thirds of the African Americans, 57% of the Afro-Caribbeans, and 50% of the European Americans reported being less active than 2–3 years ago. Reasons for activity decline included health issues (e.g., pain, shortness of breath), lack of time, interest, or motivation. Reasons for sustaining or increasing activity levels included meeting personal goals, having a purpose for remaining active, or feeling better when active (e.g., it is important to keep moving, good for the joints, going on a cruise). Themes identified were pride in maintaining activity, goal-driven activity, pushing oneself to get past pain or fatigue, and some confusion between social and physical activity in participant reports. The results indicate widespread acceptance that activity is beneficial, but that knowledge alone was insufficient to maintain activity levels over time unless individuals had a goal or purpose (“means to an end”) and could overcome their physical and psychological barriers to physical activity

Computational reconstruction of tissue-specific metabolic models: application to human liver metabolism

The first computational approach for the rapid generation of genome-scale tissue-specific models from a generic species model.A genome scale model of human liver metabolism, which is comprehensively tested and validated using cross-validation and the ability to carry out complex hepatic metabolic functions.The model's flux predictions are shown to correlate with flux measurements across a variety of hormonal and dietary conditions, and are successfully used to predict biomarker changes in genetic metabolic disorders, both with higher accuracy than the generic human model

Diet coaching to improve protein intake, muscle strength, and muscle function in adults

A 10-week intervention study provided a per-meal protein prescription, nutrition education, and tele-diet coaching to a group of 20 older adults. Significant improvements were found for protein intake as well as 3m walk, timed-up-and-go, chair rise tests, and grip strength

Safety of dabigatran etexilate for the secondary prevention of venous thromboembolism in children

This open-label, single-arm, prospective cohort trial is the first phase 3 safety study to describe outcomes in children treated with dabigatran etexilate for secondary venous thromboembolism (VTE) prevention. Eligible children aged 12 to &lt;18 years (age stratum 1), 2 to &lt;12 years (stratum 2), and &gt;3 months to &lt;2 years (stratum 3) had an objectively confirmed diagnosis of VTE treated with standard of care (SOC) for ‡3 months, or had completed dabigatran or SOC treatment in the DIVERSITY trial (NCT01895777) and had an unresolved clinical thrombosis risk factor requiring further anticoagulation. Children received dabigatran for up to 12 months, or less if the identified VTE clinical risk factor resolved. Primary end points included VTE recurrence, bleeding events, and mortality at 6 and 12 months. Overall, 203 children received dabigatran, with median exposure being 36.3 weeks (range, 0-57 weeks); 171 of 203 (84.2%) and 32 of 203 (15.8%) took capsules and pellets, respectively. Overall, 2 of 203 children (1.0%) experienced on-treatment VTE recurrence, and 3 of 203 (1.5%) experienced major bleeding events, with 2 (1.0%) reporting clinically relevant nonmajor bleeding events, and 37 (18.2%) minor bleeding events. There were no on-treatment deaths. On-treatment postthrombotic syndrome was reported for 2 of 162 children (1.2%) who had deep vein thrombosis or central-line thrombosis as their most recent VTE. Pharmacokinetic/pharmacodynamic relationships of dabigatran were similar to those in adult VTE patients. In summary, dabigatran showed a favorable safety profile for secondary VTE prevention in children aged from &gt;3 months to &lt;18 years with persistent VTE risk factor(s). This trial was registered at www.clinicaltrials.gov as #NCT02197416. (Blood. 2020;135(7):491-504

Safety of dabigatran etexilate for the secondary prevention of venous thromboembolism in children

This open-label, single-arm, prospective cohort trial is the first phase 3 safety study to describe outcomes in children treated with dabigatran etexilate for secondary venous thromboembolism (VTE) prevention. Eligible children aged 12 to &lt;18 years (age stratum 1), 2 to &lt;12 years (stratum 2), and &gt;3 months to &lt;2 years (stratum 3) had an objectively confirmed diagnosis of VTE treated with standard of care (SOC) for ‡3 months, or had completed dabigatran or SOC treatment in the DIVERSITY trial (NCT01895777) and had an unresolved clinical thrombosis risk factor requiring further anticoagulation. Children received dabigatran for up to 12 months, or less if the identified VTE clinical risk factor resolved. Primary end points included VTE recurrence, bleeding events, and mortality at 6 and 12 months. Overall, 203 children received dabigatran, with median exposure being 36.3 weeks (range, 0-57 weeks); 171 of 203 (84.2%) and 32 of 203 (15.8%) took capsules and pellets, respectively. Overall, 2 of 203 children (1.0%) experienced on-treatment VTE recurrence, and 3 of 203 (1.5%) experienced major bleeding events, with 2 (1.0%) reporting clinically relevant nonmajor bleeding events, and 37 (18.2%) minor bleeding events. There were no on-treatment deaths. On-treatment postthrombotic syndrome was reported for 2 of 162 children (1.2%) who had deep vein thrombosis or central-line thrombosis as their most recent VTE. Pharmacokinetic/pharmacodynamic relationships of dabigatran were similar to those in adult VTE patients. In summary, dabigatran showed a favorable safety profile for secondary VTE prevention in children aged from &gt;3 months to &lt;18 years with persistent VTE risk factor(s). This trial was registered at www.clinicaltrials.gov as #NCT02197416. (Blood. 2020;135(7):491-504