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We analyze the 2007 European financial crisis' impact on the demand for new language skills. The crisis affected German-speaking regions less. Learning German became relatively more attractive for migration and trade. We construct a sub-national database for German as a foreign language exam (TestDaF) participation rates between 2001-2013 and define regional crisis indicators. Using a multiple-group, multiple-period difference-in-differences framework with propensity score matching, we find that TestDaF participation increased significantly in crisis-affected regions, driven by youth and severely-affected Hellenic and Latin linguistic regions.

Rationale: Oral treprostinil improves exercise capacity in patients with pulmonary arterial hypertension (PAH), but the effect on clinical outcomes was unknown.Objectives: To evaluate the effect of oral treprostinil compared with placebo on time to first adjudicated clinical worsening event in participants with PAH who recently began approved oral monotherapy.Methods: In this event-driven, double-blind study, we randomly allocated 690 participants (1:1 ratio) with PAH to receive placebo or oral treprostinil extended-release tablets three times daily. Eligible participants were using approved oral monotherapy for over 30 days before randomization and had a 6-minute-walk distance 150 m or greater. The primary endpoint was the time to first adjudicated clinical worsening event: death; hospitalization due to worsening PAH; initiation of inhaled or parenteral prostacyclin therapy; disease progression; or unsatisfactory long-term clinical response.Measurements and Main Results: Clinical worsening occurred in 26% of the oral treprostinil group compared with 36% of placebo participants (hazard ratio, 0.74; 95% confidence interval, 0.56-0.97; P = 0.028). Key measures of disease status, including functional class, Borg dyspnea score, and N-terminal pro-brain natriuretic peptide, all favored oral treprostinil treatment at Week 24 and beyond. A noninvasive risk stratification analysis demonstrated that oral treprostinil-assigned participants had a substantially higher mortality risk at baseline but achieved a lower risk profile from Study Weeks 12-60. The most common adverse events in the oral treprostinil group were headache, diarrhea, flushing, nausea, and vomiting.Conclusions: In participants with PAH, addition of oral treprostinil to approved oral monotherapy reduced the risk of clinical worsening.Clinical trial registered with www.clinicaltrials.gov (NCT01560624).

Background: Nonalcoholic fatty liver disease (NAFLD) and inflammatory periodontal disease (IPD) are both prevalent chronic conditions with growing recognition of potential interplay. Understanding their association is crucial for comprehensive disease management. Materials and Methods: A cross-sectional study was conducted among 300 participants, including 150 with NAFLD and 150 controls without NAFLD. Diagnosis of NAFLD was confirmed by liver ultrasound, while IPD was assessed through clinical periodontal examination. Demographic data, medical history, and lifestyle factors were recorded. Statistical analyses, including chi-square tests and logistic regression, were performed to determine the association between NAFLD and IPD. Results: Among participants with NAFLD, 65% were found to have IPD compared to 35% in the control group. Logistic regression analysis revealed a significant association between NAFLD and IPD (OR = 2.5, 95% CI: 1.7–3.8, p < 0.001). Additionally, individuals with NAFLD had higher mean periodontal pocket depth (4.2mm vs. 3.1mm) and greater gingival inflammation compared to controls. Conclusion: This study demonstrates a significant association between NAFLD and IPD, suggesting a potential bidirectional relationship. Comprehensive healthcare strategies addressing both conditions may be warranted to mitigate associated health risks. Further longitudinal studies are needed to elucidate the underlying mechanisms and explore therapeutic interventions targeting this comorbidity. [ABSTRACT FROM AUTHOR]

In recent years, the physical structure of cities has evolved, morphing, mutating and becoming more malleable, fluid, and more open to change than the technology and social institutions that generate them. Today, urban settlements globally face increasing flows of human movement, acceleration in the amount and periodicity of natural disasters, and iterative economic crises that modify streams of capital and their allocation to physical components of cities. As a consequence, urban settings are required to be more flexible in order to better organize and resist outside and inside pressures. In this context, there is a lot we can learn from “ephemeral cities,” the outcomes of massive contemporary pilgrimages, when rethinking the forms future cities should take and the strategies to intervene in them.

Trade mispricing is a significant channel for tax base erosion from developing countries; however, evidence based on aggregated annual trade data remains limited. This article combines statistical price filter methods based on legal rules for customs valuation and transfer pricing analysis with extensive commodity sector research to present new evidence of commodity trade mispricing from Laos. Our analysis of transaction-level export data finds significant undervaluation in exports of coffee beans and identifies multiple risks of trade mispricing in copper exports. We identify trade between related firms, regulatory loopholes, and lack of customs valuation capacity as the main drivers of this phenomenon. [ABSTRACT FROM AUTHOR]