Percentage Fall Research Articles

Revenue effects of Denuvo digital rights management on PC video games

In the personal computer video game market, a digital rights management (DRM) technology called Denuvo has been used since 2014 to restrict software usage to legitimate buyers, thereby preventing piracy. Sometimes Denuvo DRM is bypassed or “cracked”, after which the video game can be pirated. I exploit the randomness with which Denuvo is cracked to estimate the effect Denuvo has on protecting revenue from piracy displacement. When Denuvo is cracked very early on, piracy leads to an estimated 20 percent fall in total revenue on average relative to an uncracked counterfactual, but that effect is weaker the longer it takes for Denuvo to be cracked. When Denuvo survives for at least 12 weeks, piracy leads to nearly zero total revenue loss on average. The results suggest that Denuvo does protect legitimate sales to an estimated mean of 15 percent of total revenue and median of 20 percent, but there is little justification to employ Denuvo long-term (i.e. for more than three months), especially given that Denuvo can have negative technical side effects and is generally disliked by users.

Exploring the Impact of Remittance and Economic Growth on Inflation

This study investigates the influence of remittance income and economic growth on the inflation rate in South Asian Association for Regional Corporation (SAARC) countries. Remittance inflows have a double effect on the economy’s inflation rate: firstly, it increases consumer spending capacity, driving up demand for goods and services, which can lead to higher prices; secondly the influx of foreign currency can cause local currency appreciation, raising import costs and contributing to inflation. While previous studies have focused primarily on how inflation hinders economic growth, this study seeks to understand how economic growth causes inflation from the other side. Economic growth boosts consumer and business spending, increasing demand for goods and services, which can increase prices. Furthermore, higher demand for resources and labor can raise production costs, further contributing to inflation. The correlation between remittance income and inflation has been extensively documented, but the impact of economic growth on inflation remains to be determined. The study is based on descriptive and exploratory research design and driven by a positivist research philosophy. The present study is based on secondary data collected from World Bank reports and the countries’ economic surveys. This study uses an unbalanced panel dataset of 272 data points from eight member countries of SAARC. Basic econometric techniques such as covariance analysis, panel unit root testing, panel autoregressive distributed lag model, and scaled coefficient analysis are employed. The remittance income is only statistically significant at the 10 percent significance level. A one percent increase in remittance income leads to a 0.284 percent increase in inflation over the long run. The growth rate of gross domestic product plays a crucial role in setting inflation. One percent rise in gross domestic product growth leads to a 0.3405 percent increase in inflation in the long term. The error correction term exhibits a negative and statistically significant relationship. The coefficient size suggested that around 65.14 percent of the disequilibrium was rectified in each cycle. The current year’s lagged gross domestic product growth negatively and statistically significantly impacts economic growth. One percent rise in gross domestic product growth led to 0.3308 percent fall in inflation in the short term across SAARC countries. The results indicate that remittance income has a minimal long-term effect on inflation in SAARC nations, whereas gross domestic product growth substantially impacts inflation. Policymakers should prioritize promoting sustainable economic growth to mitigate inflationary pressures effectively.

Relationship between parathyroid adenoma size, weight and histological subtypes with perioperative serum levels

AimsThis study aims to identify associations between parathyroid adenoma (PTA) characteristics (histology, weight and size) with the change in parathyroid hormone (PTH) and calcium levels.MethodsA historical cohort study was conducted...

Comparison of hemodynamic changes in normotensive and preeclamptic parturients undergoing cesarean section under spinal anesthesia: A prospective observational study

Abstract Background and Aims: The safety of subarachnoid block (SAB) was established in preeclamptic parturients, but most of studies are of low quality. The study aimed to compare the hemodynamic parameters, phenylephrine requirement, and the neonatal outcome between normotensive and preeclamptic parturients undergoing cesarean section. Methods: This prospective observational study was conducted in 100 parturients, aged between 18 and 35 years, American Society of Anesthesiologists II/III scheduled for elective cesarean section under SAB. The heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) were recorded at the baseline, before SAB, and every 2 min till 30 min and then every 5 min till the end of the surgery. Phenylephrine was administered in a bolus of 50 μg when the MBP falls by 20% from the baseline. Neonatal outcomes were measured with the umbilical artery pH and APGAR scores at 1 and 5 min. The Statistical Package for the Social Science (SPSS) 26 was used for analysis. Results: The percentage fall in DBP and mean arterial BP from baseline was statistically significant between groups (26.83% ± 9.58% vs. 20.06% ± 14.17% and 24.90% ± 6.49% vs. 20.11% ± 9.75%). The mean requirement of phenylephrine was higher in the normotensive group than the preeclamptic (95.16 ± 41.54, 68.42 ± 31.14) (P < 0.001). The umbilical artery pH and APGAR scores at 1 and 5 min were comparable in both the groups. Conclusion: The incidence of hypotension was less in preeclamptic and required less phenylephrine compared to normotensives, with comparable neonatal parameters in parturients undergoing cesarean section under spinal anesthesia.

The Financial Impact of State Tax Regimes on Local Economies in the U.S.

We examine the complex relationship between taxes and local economies at the county level. Specifically, we explore the impacts of different types of state-level taxes, including income and payroll taxes, property and other taxes, as well as sales tax, on key economic performance indicators. Our study aims to comprehensively analyze how state-level taxation influences entrepreneurship, innovation, labor markets, and overall economic growth in local communities. The findings consistently demonstrate that taxes harm local economies, although the magnitude of the impact varies depending on the specific type of tax. Notably, a 10 percent increase in income and payroll taxes leads to a 3 percent drop in the nonfarm proprietors employment rate, 0.3 fewer patents per 1000 people, and a USD 3000 decrease in GDP per capita. A similar tax hike in sales taxes results in a 4.5 percent decline in the nonfarm employment rate and a 0.2 patent reduction per 1000 people. Property and other taxes also harm the economy: a 10 percent increase is linked to a 5.3 percent fall in the nonfarm proprietors employment rate, a 7.5 percent rise in local unemployment, and a USD 55,000 drop in regional GDP per capita.

ICT Adoption and Factor Productivity of Manufacturing Firms in India

This paper examines the effect of information and communication technology (ICT) adoption on the factor productivity of the Indian manufacturing firms during 2010-19. The study focuses on the selfselection and endogenous effects of ICT adoption on capital-labour productivity and discusses strategies to capture untapped growth opportunities. We find that ICT adopters have greater stakes for survival and growth, have a larger proportion of tangible assets, and are intensively engaged in exporting and outreach. In addition, ICT adoption leads to a 155 percent growth in capital productivity and a 62 percent fall in labour productivity – leading to a net growth of 80 percent in the capital-labour productivity ratio.

Effect of Multimedia Teaching Tools in Parental Anxiety and Comprehension of Informed Consent Procedure in Pediatric Surgical Procedures: A Single Centre Randomized Control Trial

IntroductionInformed consent is an essential component of medical ethics. In children, the parent or legally authorized guardian must consent to any medical or surgical intervention. A number of adjuncts have been developed to supplement the consent process including multimedia tools. Unfortunately, there is little information regarding the use of Multimedia teaching tools (MMT) in pediatric settings in developing countries with diversities in language, socioeconomic and educational status. ObjectivesThe objectives of the study were to compare the parental comprehension of the surgery through the informed consent obtained either by conventional method or by multimedia tool and the effect of MMT in alleviating parental anxiety against the conventional method and to assess their overall satisfaction. MethodsA randomized control trial was conducted between 2018 and 2020, including MMT and conventional groups. A novel Multimedia tool with a Microsoft PowerPoint presentation was created. A 5-Question knowledge-based test, State-Trait Anxiety Inventory (STAI) tool, and a Likert-based questionnaire were used to assess the comprehension, anxiety, and satisfaction of parents. ResultsAmong 122 randomized cohorts, the mean value of percentage fall in anxiety STAI score in the MMT group was 44.64 ± 10.14 whereas in the Conventional group it was 26.6 ± 11.91 (p < 0.05). MMT cohort scored higher in the knowledge-based test (p < 0.05) and recorded higher parental satisfaction. ConclusionThe Multimedia tool aided consent procedure is effective in reducing parental anxiety and improving their comprehension and overall satisfaction. Thus, they can be used as an effective supplement in preoperative surgical education and consent procedure. Level of evidenceLevel I.

Intravenous Tranexamic Acid Given at Femoral Fragility Fracture Surgery Reduces Blood Transfusion Requirements Fourfold

AimsThis study aims to determine whether intraoperative intravenous (IV) tranexamic acid (TXA) affects blood loss following the surgical management of femoral fragility fractures (FFF).MethodsThis was a single centre (university teaching hospital) non-randomised case–control study. There were 361 consecutive patients with FFF admitted over a 4-month period were included (mean age 81.4yrs; mean BMI 23.5; 73.7% female). Patient demographics, comorbidities, preoperative anticoagulation use, surgical management, intravenous TXA use, perioperative haemoglobin (Hb) and haematocrit, and requirement for blood transfusion were recorded. The primary outcome was postoperative blood transfusion requirement. Secondary outcomes included postoperative day one calculated blood loss (CBL) (using the Nadler and Gross formulae) and fall in Hb (percentage) from preoperative levels; and the incidence of thrombotic events and mortality up to 30 days.ResultsGroups were well matched in terms of patient demographics, comorbidities, preoperative anticoagulation use, injury types and surgical management. Intravenous TXA 1 g given at the beginning of surgery at the discretion of the operating team: 178 (49%) received TXA and 183 (51%) did not. The requirement for postoperative blood transfusion was significantly less in the TXA group: 15/178 (8.4%) compared to 58/183 (31.7%) (p < 0.001; Chi square). TXA significantly reduced both the percentage fall in Hb (mean difference 4.3%, p < 0.001) and the CBL (mean difference −222 ml, p < 0.001). There was no difference in VTE (2 vs 1, p = 0.620) or other thrombotic events (2 vs 0, p = 0.244) between groups.Conclusion1 g of intraoperative intravenous TXA during the surgical management of FFF was associated with reduced rate of transfusion, CBL and the percentage drop in HB. The use of TXA in this study was not randomised, so there could be un-quantifiable bias in the patient selection.

Allergen bronchoprovocation: correlation between FEV1 maximal percent fall and area under the FEV1 curve and impact of allergen on recovery

BackgroundHouse dust mite (HDM) induces greater responses than other allergens during allergen bronchoprovocation (ABP) testing. The two standardized methods for reporting results of ABP tests are the maximal percent fall in forced expiratory volume in one second (FEV1, max; %) and the area under the FEV1 vs time curve (AUC; %FEV1 x min). The relationship between these methods has not been previously investigated.AimsWe aimed to measure the correlation between FEV1, max and AUC during the early asthmatic response (EAR) and the late asthmatic response (LAR), and to determine if the EAR recovery period for HDM would be longer than other allergens (cat, grass, horse, and ragweed).MethodsWe retrospectively calculated the AUC and correlation between FEV1, max and AUC during the EAR(0-2 h) and LAR(3-7 h) for each allergen. We compared EAR(0-3 h) and LAR(3-7 h) FEV1, max, AUC and absolute difference in FEV1, max to the most recovered FEV1 (FEV1, min). We performed pairwise comparisons of correlation and slope values using Fischer’s r to z transformation and t-tests, respectively. AUC and absolute differences in FEV1, max and FEV1, min were compared using a one-way ANOVA test, followed by a post-hoc Scheffe test.ResultsCorrelation between the FEV1, max and AUC during the EAR(0-2 h) (n = 221) was 0.807, and was 0.798 during the LAR(3-7 h) (n = 157 of 221), (difference p = 0.408). The EAR(0-3 h) AUC and FEV1, max did differ between allergens (both p < 0.0001) but the LAR(3-7 h) AUC and FEV1, max did not (p = 0.548 and 0.824, respectively). HDM did not have a larger AUC or FEV1, max, than all other allergens during the EAR(0-3 h) or the LAR(3-7 h). The absolute difference between the FEV1, max and FEV1, min during the EAR(0-3 h) did not differ between allergens (p = 0.180).ConclusionThe FEV1, max and AUC for both the EAR(0-2 h) and LAR(3-7 h) had excellent correlation, with no significant difference. Thus, significant bronchoconstriction will likely result in a longer recovery period. There was no evidence of delayed EAR(0-3 h) recovery following HDM challenges, so HDM did not induce a larger response compared to all the other allergens examined.Registration: Not registered. This is not a clinical trial. (This study is a retrospective analysis of data collected during several registered trials.)

Early Six-Minute Walk Test May Predict Midterm Outcomes Following Coronary Artery Bypass Grafting.

This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

Oil-supply news and dynamics of exchange rates in oil-exporting countries

Most sub-Saharan African (SSA) countries have benefited and also suffered from the consequences of oil price fluctuations. The suffering of these nations has reverberated especially from the influencing power of exchange rate volatility, high inflation as well as an adverse impact on other macroeconomic variables. Therefore, this study estimated the magnitude of the effects of oil supply news shocks on the dynamics of exchange rates and also, the impact of exchange rate dynamics on oil supply news shocks in oil-exporting countries of West Africa (WA) countries. We implemented a panel non-linear autoregressive distributed lag (P-NARDL) model. The finding of the study indicates that rising fluctuations in oil prices caused by Organization of the Petroleum Exporting Countries (OPEC) news of oil supply disruption significantly induce exchange rate devaluation. Unambiguously, a 1 percent increase in oil supply news shocks stimulated 1.59432 percent appreciation while the same-size decrease in oil prices led to 0.86397 percent devaluation. These validate asymmetrical presence in exchange rate behaviour concerning the oil market. Also, we found 1.09452 percent devaluation and 0.25371 percent appreciation in the exchange rates of oil-producing African nations following a 1 percent rise and fall in inflation rates indicating a symmetric relationship between inflation rate and exchange rates. Oil-producing countries of WA should utilize foreign exchange (FX) from oil export to acquire capital-intensive projects.

Clinical outcomes with of the Contix Faecal Incontinence Management System: preliminary results.

Fecal incontinence (FI) has a significant long-term impact on patient quality of life for which there is a range of medical and surgical management alternatives. We report the preliminary outcome using the ForConti Contix Faecal Incontinence Management System (FIMS) in FI patients who had failed conservative therapy and who were recruited at 2 tertiary institutions between September 2018 and September 2020. Comparative assessments were made before and after 2 week periods of treatment using bowel diaries and subjective Wexner and Faecal Incontinence Quality of Life scores. Of 17 patients enrolled, 11 completed an 8-week assessment with a significant fall in the average percentage of FI days reported from 84% before treatment to 16.8% at the first posttreatment assessment and down to 13.2% by the second assessment period. This finding correlated with a similar reduction in the total weekly number of episodes of frank FI, minor soiling, and fecal urgency reported by patients along with concomitant improvements in the Wexner scores. For those using the device, there was less concern about accidental bowel leakage, high rates of satisfaction, and minimal problems with the device. Initial results are encouraging warranting further study.

Economic events and the volatility of government bill rates.

Many studies show that in many countries (especially the G7), volatility in government bill rates far exceeds that in consumption growth rates. This volatility puzzle cannot be predicted by traditional disaster models, in which rare economic disasters are defined as a peak-to-trough percent fall in consumption (or real per capita GDP) by a high threshold (≥10%). For this purpose, we extend the traditional definition of rare economic disasters and propose a novel asset pricing model that models both good and bad events. We define a bad (or good) event as a peak-to-trough absolute decline (or a trough-to-peak absolute rise) in consumption growth rates by a low threshold (<10%). Compared to traditional disaster models, our model contains three improvements. First, model good and bad events, not just bad ones (e.g., rare economic disasters). Second, the event's impact lasts for multiple periods rather than one period. Third, model non-rare economic events. We calibrate the parameters in our model to match the moments from U.S. asset return data. Simulation results indicate that the model can successfully predict the volatility of U.S. government bill rates higher than that of U.S. consumption growth rates.

Cut-off value for exercise-induced bronchoconstriction based on the features of the airway obstruction.

The current cut-off value for diagnosing exercise-induced bronchoconstriction (EIB) in adults—percent fall in FEV1 (ΔFEV1) ≥ 10% after exercise challenge test (ECT)—has low specificity and weak evidences. Therefore, this study aimed to identify the cut-off value for EIB that provides the highest diagnostic sensitivity and specificity. Participants who underwent the ECT between 2007 and 2018 were categorized according to ΔFEV1: definite EIB (ΔFEV1 ≥ 15%), borderline (10% ≤ ΔFEV1 < 15%), and normal (ΔFEV1 < 10%). Distinct characteristics of the definite EIB group were identified and explored in the borderline EIB group. A receiver operating characteristic curve was plotted to determine the optimal cut-off value. Of 128 patients, 60 were grouped as the definite EIB group, 23 as the borderline group, and 45 as the normal group. All participants were men, with a median age of 20 years (interquartile range [IQR:] 19–23 years). The definite EIB group exhibited wheezing on auscultation (P < 0.001), ΔFEV1/FVC ≥ 10% (P < 0.001), and ΔFEF25–75% ≥ 25% (P < 0.001) compared to other groups. Eight (8/23, 34.8%) patients in the borderline group had at least one of these features, but the trend was more similar to that of the normal group than the definite EIB group. A cut-off value of ΔFEV1 ≥ 13.5% had a sensitivity of 98.5% and specificity of 93.5% for EIB. Wheezing on auscultation, ΔFEV1/FVC ≥ 10%, and ΔFEF25–75% ≥ 25% after ECT may be useful for the diagnosis of EIB, particularly in individuals with a ΔFEV1 of 10–15%. For EIB, a higher cut-off value, possibly ΔFEV1 ≥ 13.5%, should be considered as the diagnostic criterion.

Comparison of hemodynamic changes and fetal outcome between normotensive and preeclamptic parturient undergoing elective cesarean section under spinal anesthesia: A prospective observational cohort study

BackgroundMaternal hypotension is a common problem during spinal anesthesia resulting in adverse maternal and fetal outcomes. According to theoretical knowledge, it is more common in severe preeclamptic parturients undergoing cesarean section with spinal anesthesia. ObjectiveTo compare fetomother outcome in normotensive and severe preeclamptic parturients undergoing elective cesarean section under spinal anesthesia. MethodologyA prospective cohort study was conducted from Novembers to May 30, 2019 on 84 ASA II and III pregnant mothers. After preloading with 500 ml–1000ml crystalloids, a 0.5%isobaric bupivacaine of 10 mg–12.5 mg was administered for spinal anesthesia.Vital signs (SBP, DBP, MAP and HR) were recorded every 3 min till 30 min, every 5 min then after. Neonatal Apgar scores at one and 5 min after birth and intraoperative fluids consumption were recorded. Data distribution was checked by Shapiro walk's test. Chi-square test was used to calculate the incidence of hypotension between groups; both paired and unpaired t-tests were also used to calculate the percent fall in blood pressure and heart rate from baselines of each group and intergroup respectively, and P-value less than 0.05 were considered statistical significance. ResultsThe incidence of hypotension (over a period of 30 min after spinal anesthesia) in the preeclamptic patients (31%) was less than that of the healthy parturients (59.5%). There was no statistically significant difference in heart rate of both groups before and after induction of spinal anesthesia. The 5th minute Apgar score recordings were also comparable between the groups. ConclusionThis study showed that the incidence and magnitude of spinal anesthesia-induced hypotension was less in severely preeclamptic parturient than healthy parturient who underwent elective cesarean delivery under spinal anesthesia and fetal outcome was comparable.

Evaluation of periprocedural anxiety during Gamma Knife radiosurgery (GKRS) frame fixation for brain lesions

IntroductionApplication of stereotaxy frame for gamma knife under local anesthesia creates anxiety and phobia in many patients. Vasovagal syncopal attacks and events of bradycardia are not infrequently seen. We tried to analyse the various factors affecting these events and set standards and safety recommendations for the procedure. Materials and methodsThis prospective study was carried out in Gamma Knife Centre, AIIMS, New Delhi over a 6 month period between June, 2021- November, 2021. All patients coming to Gamma knife for various etiologies were asked to fill Hamilton Anxiety Rating Scale (HAM-A) before frame application. Baseline pulse rate was evaluated and with every pin application pulse rate was recorded. A VAS (visual analogue scale) for pain was also administered after the procedure. Twenty percent fall in pulse rate were considered as significant bradycardia. Intraprocedural syncopal events were also recorded. ResultsA total of 141 patients were studied of which 6% patients had intraprocedural syncopal attacks requiring medical treatment while 32% patients had bradycardia. Having previous surgery, having breakfast before the procedure, duration of pin application, quantity of local anaesthetia, primary diagnosis, sex of patients were not found to alter the syncope or bradycardia events. Patients who were found anxious (score > 18 on HAM-A) had a significantly higher risk of having a procedural event. Previous history of syncope was also associated with 1.7 times more chances of developing Intraprocedural bradycardia. ConclusionsFrame application for gamma-knife is a relatively safe procedure however procedure rooms should be equipped with emergency drugs and fluids for management of syncope. A Simple anxiety questionnaire can predict ‘at risk’ patients’ for procedural events

Treatment and Outcome of Autoimmune Hepatitis (AIH): Audit of 28 UK centres.

With few data regarding treatment and outcome of patients with AIH outside of large centres we present such a study of patients with AIH in 28 UK hospitals of varying size and facilities. Patients with AIH were identified in 14 University and 14 District General hospitals; incident cases during 2007-2015 and prevalent cases, presenting 2000-2015. Treatment and outcomes were analysed. In 1267 patients with AIH, followed-up for 3.8(0-15) years, 5- and 10-year death/transplant rates were 7.1+0.8% and 10.1+1.3% (all-cause) and 4.0+0.6% and 5.9+1% (liver-related) respectively. Baseline parameters independently associated with death/transplantation for all-causes were: older age, vascular/respiratory co-morbidity, cirrhosis, decompensation, platelet count, attending transplant centre and for liver-related: the last four of these and peak bilirubin All-cause and liver-related death/transplantation was independently associated with: non-treatment with corticosteroids, non-treatment with a steroid-sparing agent (SSA), non-treatment of asymptomatic or non-cirrhotic patients and initial dose of Prednisolone >35mg/0.5mg/kg/day (all-cause only), but not with type of steroid (Prednisolone versus Budesonide) or steroid duration beyond 12-months. Subsequent all-cause and liver-death/transplant rates showed independent associations with smaller percentage fall in serum ALT after 1 and 3-months, but not with failure to normalise levels over 12-months. We observed higher death/transplant rates in patients with AIH who were untreated with steroids (including asymptomatic or non-cirrhotic sub-groups), those receiving higher Prednisolone doses and those who did not receive an SSA. Similar death/transplant rates were seen in those receiving Prednisolone or Budesonide, those continuing steroids after 12-months and patients attaining normal ALT within 12-months versus not.

The Rise and Fall of India’s Relative Investment Price: A Tale of Policy Error and Reform

India’s relative price of investment rose 44 percent from 1981 to 1991 and fell 26 percent from 1991 to 2006. We build a simple DGE model, calibrated to Indian data, in order to explore the impact of capital import substitution policies and their reform post-1991 in accounting for this rise and fall. Our model delivers a 23 percent rise before reform and a 31 percent fall thereafter. GDP per effective labor was 3 percent lower in 1991 compared to 1981 due to import restrictions on capital goods. Their removal, and a 71 percentage point reduction in tariff rates, raised GDP per effective labor permanently by 20 percent. (JEL E22, E23, F13, O11, O16, O19)

Entry, Variable Markups, and Business Cycles

&lt;ns3:p&gt;The creation of new businesses declines in recessions. In this paper, I study the effects of pro-cyclical business formation on aggregate employment in a general equilibrium model of firm dynamics. The key features of the model are that the elasticity of demand faced by firms falls with their market share and that adjustment costs slow the reallocation of employment between firms. In response to a decline in entry, incumbent firms' market shares increase, their elasticity of demand falls, and they increase their markups and reduce employment. To quantify the model, I study the relationship between variable input use and revenue in panel data on large firms. Viewed through the lens of my model, my estimates imply that for large firms, the within-firm elasticity of the markup to relative sales is 25 percent. I use the calibrated model to study shocks to entry, finding that a fall in entry can lead to a significant contraction in employment. A shock to entry that replicates the decline in the number of businesses during the Great Recession generates a prolonged 2.5 percent fall in employment in the model. Finally, I show that the declining correlation between revenue and variable input use over the past 30 years implies that the effect of entry on the business cycle has become stronger over time.&lt;/ns3:p&gt;

Albuterol/budesonide for the treatment of exercise-induced bronchoconstriction in patients with asthma: The TYREE study

BackgroundPT027 is a fixed-dose combination of albuterol (salbutamol) and budesonide in a single pressurized metered-dose inhaler. ObjectiveTo evaluate the efficacy and safety of albuterol/budesonide compared with placebo in patients with asthma and exercise-induced bronchoconstriction (EIB). MethodsIn this randomized, double-blind, 2-period, single-dose crossover study, adolescents and adults with asthma and EIB (defined by ≥20% decrease from pre-exercise challenge forced expiratory volume in 1 second [FEV1]) were randomized to albuterol/budesonide (180/160 µg) followed by placebo (n = 29) or the reverse sequence (n = 31). Subjects were stratified by background therapy (as-needed short-acting β2-agonist alone or low-to-medium dose inhaled corticosteroid plus as-needed short-acting β2-agonist). FEV1 was measured 5 minutes pre-dose, 30 minutes postdose (5 minutes pre-exercise challenge [baseline]), and 5, 10, 15, 30, and 60 minutes postexercise. The primary end point was maximum percentage fall from baseline in FEV1 up to 60 minutes postexercise challenge. ResultsLeast squares mean maximum percentage fall in FEV1 up to 60 minutes postexercise challenge was 5.45% with albuterol/budesonide vs 18.97% with placebo (difference, −13.51% [95% confidence interval, −16.94% to −10.09%]; P < .001). More subjects were fully protected (maximum percentage fall in FEV1 post-exercise challenge < 10%) with albuterol/budesonide than with placebo (78.3% vs 28.3%; P < .001). The treatment effect was consistent irrespective of background inhaled corticosteroid therapy, and albuterol/budesonide was well tolerated. ConclusionIn adolescents and adults with asthma and EIB, a single dose of albuterol/budesonide 180/160 µg taken approximately 30 minutes before exercise was significantly more effective than placebo in preventing EIB. Trial RegistrationClinicalTrials.gov Identifier: NCT04234464