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How sudden- versus slow-onset environmental events affect self-identification as an environmental migrant: Evidence from Vietnamese and Kenyan survey data.
Get PDFIn response to changing climatic conditions, people are increasingly likely to migrate. However, individual-level survey data reveal that people mainly state economic, social, or political reasons as the main drivers for their relocation decision-not environmental motives or climate change specifically. To shed light on this discrepancy, we distinguish between sudden-onset (e.g., floods and storms) and slow-onset (e.g., droughts and salinity) climatic changes and argue that the salience of environmental conditions in individuals' migration decisions is shaped by the type of climate event experienced. Empirically, we combine individual-level surveys with geographic information on objective climatic changes in Vietnam and Kenya. The empirical evidence suggests that sudden-onset climate events make individuals more likely to link environmental conditions to their migration decision and, hence, to identify themselves as "environmental migrants." Regression analyses support these results and are consistent with the view that slow-onset events tend to be linked with migration decisions that are more economically motivated
The relationship of plant leaf δ13Cn-alkanes and salinity in coastal ecosystems applied to palaeobotany: Case study from the Cenomanian of the Bohemian Cretaceous Basin, Czechia
Get PDFPsychological Well-Being and Religiosity / Spirituality of Pastoral Caregivers in a Time of Crisis
No full textComparison of Mid-Term Prognosis in Intermediate-to-Low-Risk Contemporary Population with Guidelines-Oriented Age Cutoff.
Get PDFBACKGROUND
Current European guidelines support transcatheter aortic valve implantation (TAVI) in intermediate-to-low-risk patients ≥75 years-old, but its prognostic relevance is unknown.
METHODS
Intermediate-to-low-risk (The Society of Thoracic Surgeons score <8%) patients enrolled in the HORSE registry were included. We compared the populations aged under 75 with those over 75. The primary endpoint was all-cause mortality.
RESULTS
A total of 2685 patients were included: 280 (8.6%) < 75 and 2405 ≥ 75 years. Through a mean follow-up of 437 ± 381 days, 198 (8.2%) and 23 (8.2%) patients died in the two arms without statistically significant differences (log-rank p = 0.925). At Cox regression analysis, age did not predict the occurrence of all-cause death, neither as a continuous variable (HR 1.01, 95% CI 0.99-1.04, p = 0.294) nor dichotomizing according to the prespecified cutoff of 75 years (HR 0.97, 95% CI 0.63-1.51, p = 0.924). Time-to-event ROC curves showed low accuracy of age to predict all-cause mortality (area under the curve of 0.54 for both 1-year and 2-year outcomes).
CONCLUSIONS
TAVI has comparable benefits across age strata for intermediate-to-low-risk patients. The age cutoff suggested by the current guidelines is not predictive of the risk of adverse events during hospital stays or of all-cause mortality through a mid-term follow-up
PCYT2 deficiency in Saarlooswolfdogs with progressive retinal, central, and peripheral neurodegeneration.
Get PDFWe investigated a syndromic disease comprising blindness and neurodegeneration in 11 Saarlooswolfdogs. Clinical signs involved early adult onset retinal degeneration and adult-onset neurological deficits including gait abnormalities, hind limb weakness, tremors, ataxia, cognitive decline and behavioral changes such as aggression towards the owner. Histopathology in one affected dog demonstrated cataract, retinal degeneration, central and peripheral axonal degeneration, and severe astroglial hypertrophy and hyperplasia in the central nervous system. Pedigrees indicated autosomal recessive inheritance. We mapped the suspected genetic defect to a 15 Mb critical interval by combined linkage and autozygosity analysis. Whole genome sequencing revealed a private homozygous missense variant, PCYT2:c.4A>G, predicted to change the second amino acid of the encoded ethanolamine-phosphate cytidylyltransferase 2, XP_038402224.1:(p.Ile2Val). Genotyping of additional Saarlooswolfdogs confirmed the homozygous genotype in all eleven affected dogs and demonstrated an allele frequency of 9.9% in the population. This experiment also identified three additional homozygous mutant young dogs without overt clinical signs. Subsequent examination of one of these dogs revealed early-stage progressive retinal atrophy (PRA) and expansion of subarachnoid CSF spaces in MRI. Dogs homozygous for the pathogenic variant showed ether lipid accumulation, confirming a functional PCYT2 deficiency. The clinical and metabolic phenotype in affected dogs shows some parallels with human patients, in whom PCYT2 variants lead to a rare form of spastic paraplegia or axonal motor and sensory polyneuropathy. Our results demonstrate that PCYT2:c.4A>G in dogs cause PCYT2 deficiency. This canine model with histopathologically documented retinal, central, and peripheral neurodegeneration further deepens the knowledge of PCYT2 deficiency
Adaptation of nutritional risk screening tools may better predict response to nutritional treatment. A secondary analysis of the randomized controlled trial EFFORT.
No full textBACKGROUND
Nutritional screening tools have proven valuable for predicting clinical outcomes but have failed to determine which patients would be most likely to benefit from nourishment interventions. The Nutritional Risk Screening 2002 (NRS) and the Mini Nutritional Assessment (MNA) are two of these tools, which are based on both nutritional parameters and parameters reflecting disease severity.
OBJECTIVE
We hypothesized that adaptation of nutritional risk scores, by removing parameters reflecting disease severity, would improve their predictive value regarding response to a nutritional intervention while providing similar prognostic information regarding mortality at short- and long-term.
METHODS
We re-analyzed data of 2,028 patients included in the Swiss-wide multicenter, randomized controlled Effect of early nutritional therapy on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) trial comparing individualized nutritional support with usual care nutrition in medical inpatients. The primary endpoint was 30-day all-cause mortality.
RESULTS
While stratifying patients by high compared with low NRS score showed no difference in response to nutritional support, patients with high adapted NRS showed substantial benefit, while patients with low adapted NRS showed no survival benefit (adjusted hazard ratio (HR) 0.55 [95% CI 0.37 to 0.80], compared with 1.17 [95%CI 0.70-1.93], a finding that was significant in an interaction analysis (coefficient 0.48, [95%CI 0.25-0.94], p=0.031). A similar effect regarding treatment response was found when stratifying patients based on MNA vs. the adapted MNA. Regarding the prognostic performance, both original scores were slightly superior in predicting mortality compared to the adapted scores.
CONCLUSION
Adapting the NRS and MNA by including nutritional parameters only improved their ability to predict response to a nutrition intervention, but slightly reduces their overall prognostic performance. Scores dependent on disease severity may best be considered prognostic scores, while nutritional risk scores not including parameters reflecting disease severity may indeed improve a more personalized treatment approach for nourishment interventions.
CLINICAL TRIAL REGISTRATION
Clinicaltrials.gov as NCT02517476 (registered 7 August 2015)
Policy process theories in autocracies: Key observations, explanatory power, and research priorities
No full textThe policy process frameworks and theories that are currently considered mainstream were originally de-veloped in the United States, before traveling to other countries. Despite their roots in democratic values, these frameworks and theories are increasingly applied to autocracies. Given important differences between de-mocracies and autocracies, this raises questions about the desirability, limitations, and future directions of this development. In response, this article synthesizes findings from studies that apply existing policy process frameworks and theories to autocracies with the aim of assessing the extent to which the theories are, can, and should be used to explain key aspects of the policy process in autocracies. Based on qualitative content analysis of 146 English- language peer- reviewed journal articles that apply the Advocacy Coalition Framework, the Multiple Streams Framework, the Narrative Policy Framework, and the Punctuated Equilibrium Theory to 39 autocracies, we show that these theories help identify influential institutions, actors, networks, ideas, beliefs, and events. The analysis reveals important differences in policy processes between autocracies and democra-cies. Future research ought to bring existing literature on authoritarianism and authoritarian politics into pol-icy process research to test existing and new hypotheses
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