We reviewed the treatment for patients with spine metastases who initially received conventional external beam radiation (EBRT) and were reirradiated with 1-5 fractions of stereotactic body ...radiotherapy (SBRT) who did or did not subsequently develop radiation myelopathy (RM).
Spinal cord dose-volume histograms (DVHs) for 5 RM patients (5 spinal segments) and 14 no-RM patients (16 spine segments) were based on thecal sac contours at retreatment. Dose to a point within the thecal sac that receives the maximum dose (P(max)), and doses to 0.1-, 1.0-, and 2.0-cc volumes within the thecal sac were reviewed. The biologically effective doses (BED) using α/β = 2 Gy for late spinal cord toxicity were calculated and normalized to a 2-Gy equivalent dose (nBED = Gy(2/2)).
The initial conventional radiotherapy nBED ranged from ~30 to 50 Gy(2/2) (median ~40 Gy(2/2)). The SBRT reirradiation thecal sac mean P(max) nBED in the no-RM group was 20.0 Gy(2/2) (95% confidence interval CI, 10.8-29.2), which was significantly lower than the corresponding 67.4 Gy(2/2) (95% CI, 51.0-83.9) in the RM group. The mean total P(max) nBED in the no-RM group was 62.3 Gy(2/2) (95% CI, 50.3-74.3), which was significantly lower than the corresponding 105.8 Gy(2/2) (95% CI, 84.3-127.4) in the RM group. The fraction of the total P(max) nBED accounted for by the SBRT P(max) nBED for the RM patients ranged from 0.54 to 0.78 and that for the no-RM patients ranged from 0.04 to 0.53.
SBRT given at least 5 months after conventional palliative radiotherapy with a reirradiation thecal sac P(max) nBED of 20-25 Gy(2/2) appears to be safe provided the total P(max) nBED does not exceed approximately 70 Gy(2/2), and the SBRT thecal sac P(max) nBED comprises no more than approximately 50% of the total nBED.
I examine how the structure of corrupt exchanges between voters and politicians—an important-yet-underexplored form of informal institutions—shapes voters’ electoral behavior toward corruption. I ...argue that when voters have a clear idea of whom to bribe to secure desired services and how much they need to offer, they are less likely to engage in corruption voting and hold corrupt incumbents electorally accountable for their malfeasance. Utilizing the World Business Environment Survey on corruption predictability and the Asian Barometer survey on voters’ electoral behaviors, I report empirical evidence that institutionalized corruption promotes greater electoral tolerance of corrupt politicians in Asian democracies. The results hold against a number of robustness checks. The paper thus furthers our understanding of the effect of informal political institutions on corruption voting as well as Asia’s corruption exceptionalism.
This book investigates the effects of electoral systems on the relative legislative and, hence, regulatory influence of competing interests in society. Building on Ronald Rogowski and Mark Andreas ...Kayser's extension of the classic Stigler–Peltzman model of regulation, the authors demonstrate that majoritarian electoral arrangements should empower consumers relative to producers. Employing real price levels as a proxy for consumer power, the book rigorously establishes this proposition over time, within the OECD, and across a large sample of developing countries. Majoritarian electoral arrangements depress real prices by approximately ten percent, all else equal. The authors carefully construct and test their argument and broaden it to consider the overall welfare effects of electoral system design and the incentives of actors in the choice of electoral institutions.
Autocracy and human capital Chang, Eric C.C.; Wu, Wen-Chin
World development,
09/2022, Volume:
157
Journal Article
Peer reviewed
This paper examines the logic of human capital formation in authoritarian regimes based on theories of inequality and regime transition and the prospect of upward mobility model. Our central argument ...is that by investing in human capital, dictators can boost citizens' perceived levels of social mobility. Consequently, dictators can preemptively ameliorate the pressure for redistribution from the poor and neutralize threats from the masses. In other words, dictators invest in human capital as a way of increasing citizens' perceived social mobility and thus sustaining political stability in their authoritarian regimes. Our cross-national analysis covers more than 80 authoritarian regimes from 1970 to 2010 and shows that higher levels of education spending are associated with a lower probability of regime breakdown in autocracies. We further use a causal mediation analysis with the Asian Barometer Survey data and connect our causal link from human capital formation to perceived social mobility and then to authoritarian regime support.
China launched a pilot scheme in March 2010 to lift the ban on short-selling and margin-trading for stocks on a designated list. We find that stocks experience negative returns when added to the ...list. After the ban is lifted, price efficiency increases while stock return volatility decreases. Panel data regressions reveal that intensified short-selling activities are associated with improved price efficiency. Short-sellers trade to eliminate overpricing by selling stocks with higher contemporaneous returns following a downward trend, and their trades predict future returns. In contrast, we find intensified margin-trading activities for stocks with lower contemporaneous returns, and these trades have no return predictive power.
Rationale
How striatal dopamine synthesis capacity (DSC) contributes to the pathogenesis of negative symptoms in first-episode schizophrenia (SZ) and delusional disorder (DD) has seldom been ...explored. As negative symptoms during active psychotic episodes can be complicated by secondary influences, such as positive symptoms, longitudinal investigations may help to clarify the relationship between striatal DSC and negative symptoms and differentiate between primary and secondary negative symptoms.
Objective
A longitudinal study was conducted to examine whether baseline striatal DSC would be related to negative symptoms at 3 months in first-episode SZ and DD patients.
Methods
Twenty-three first-episode age- and gender-matched patients (11 DD and 12 SZ) were consecutively recruited through an early intervention service for psychosis in Hong Kong. Among them, 19 (82.6%) patients (9 DD and 10 SZ) were followed up at 3 months. All patients received an
18
F-DOPA PET/MR scan at baseline.
Results
Baseline striatal DSC (
K
occ;30–60
) was inversely associated with negative symptoms at 3 months in first-episode SZ patients (
r
s
= − 0.80,
p
= 0.010). This association remained in SZ patients even when controlling for baseline negative, positive, and depressive symptoms, as well as cumulative antipsychotic dosage (
β
= − 0.69,
p
= 0.012). Such associations were not observed in first-episode DD patients. Meanwhile, the severity of negative symptoms at 3 months was associated with more positive symptoms in DD patients (
r
s
= 0.74,
p
= 0.010) and not in SZ patients.
Conclusions
These findings highlight the role of striatal DSC in negative symptoms upon resolution of active psychotic episodes among first-episode SZ patients. Baseline striatal dopamine activity may inform future symptom expression with important treatment implications.
The gut microbiome and its metabolites are increasingly implicated in several cardiovascular diseases, but their role in human myocardial infarction (MI) injury responses have yet to be established. ...To address this, we examined stool samples from 77 ST-elevation MI (STEMI) patients using 16 S V3-V4 next-generation sequencing, metagenomics and machine learning. Our analysis identified an enriched population of butyrate-producing bacteria. These findings were then validated using a controlled ischemia/reperfusion model using eight nonhuman primates. To elucidate mechanisms, we inoculated gnotobiotic mice with these bacteria and found that they can produce beta-hydroxybutyrate, supporting cardiac function post-MI. This was further confirmed using HMGCS2-deficient mice which lack endogenous ketogenesis and have poor outcomes after MI. Inoculation increased plasma ketone levels and provided significant improvements in cardiac function post-MI. Together, this demonstrates a previously unknown role of gut butyrate-producers in the post-MI response.
Malaria is a global health problem that threatens 300-500 million people and kills more than one million people annually. Disease control is hampered by the occurrence of multi-drug-resistant strains ...of the malaria parasite Plasmodium falciparum. Synthetic antimalarial drugs and malarial vaccines are currently being developed, but their efficacy against malaria awaits rigorous clinical testing. Artemisinin, a sesquiterpene lactone endoperoxide extracted from Artemisia annua L (family Asteraceae; commonly known as sweet wormwood), is highly effective against multi-drug-resistant Plasmodium spp., but is in short supply and unaffordable to most malaria sufferers. Although total synthesis of artemisinin is difficult and costly, the semi-synthesis of artemisinin or any derivative from microbially sourced artemisinic acid, its immediate precursor, could be a cost-effective, environmentally friendly, high-quality and reliable source of artemisinin. Here we report the engineering of Saccharomyces cerevisiae to produce high titres (up to 100 mg l-1) of artemisinic acid using an engineered mevalonate pathway, amorphadiene synthase, and a novel cytochrome P450 monooxygenase (CYP71AV1) from A. annua that performs a three-step oxidation of amorpha-4,11-diene to artemisinic acid. The synthesized artemisinic acid is transported out and retained on the outside of the engineered yeast, meaning that a simple and inexpensive purification process can be used to obtain the desired product. Although the engineered yeast is already capable of producing artemisinic acid at a significantly higher specific productivity than A. annua, yield optimization and industrial scale-up will be required to raise artemisinic acid production to a level high enough to reduce artemisinin combination therapies to significantly below their current prices.
New neurons continue to be generated in the subgranular zone of the dentate gyrus of the adult mammalian hippocampus. This process has been linked to learning and memory, stress and exercise, and is ...thought to be altered in neurological disease. In humans, some studies have suggested that hundreds of new neurons are added to the adult dentate gyrus every day, whereas other studies find many fewer putative new neurons. Despite these discrepancies, it is generally believed that the adult human hippocampus continues to generate new neurons. Here we show that a defined population of progenitor cells does not coalesce in the subgranular zone during human fetal or postnatal development. We also find that the number of proliferating progenitors and young neurons in the dentate gyrus declines sharply during the first year of life and only a few isolated young neurons are observed by 7 and 13 years of age. In adult patients with epilepsy and healthy adults (18-77 years; n = 17 post-mortem samples from controls; n = 12 surgical resection samples from patients with epilepsy), young neurons were not detected in the dentate gyrus. In the monkey (Macaca mulatta) hippocampus, proliferation of neurons in the subgranular zone was found in early postnatal life, but this diminished during juvenile development as neurogenesis decreased. We conclude that recruitment of young neurons to the primate hippocampus decreases rapidly during the first years of life, and that neurogenesis in the dentate gyrus does not continue, or is extremely rare, in adult humans. The early decline in hippocampal neurogenesis raises questions about how the function of the dentate gyrus differs between humans and other species in which adult hippocampal neurogenesis is preserved.
Utilizing a unique data set from the Italian Ministry of Justice reporting the transmission to the Chamber of Deputies of more than the thousand requests for the removal of parliamentary immunity ...from deputies suspected of criminal wrongdoing, the authors analyze the political careers of members of the Chamber during the first eleven postwar legislatures (1948–94). They find that judicial investigation typically did not discourage deputies from standing for reelection in Italy's large multimember electoral districts. They also show that voters did not punish allegedly malfeasant legislators with loss of office until the last (Eleventh) legislature in the sample. To account for the dramatic change in voter behavior that occurred in the early 1990s, the investigation focuses on the roles of the judiciary and the press. The results are consistent with a theory that a vigilant and free press is a necessary condition for political accountability in democratic settings. An independent judiciary alone is ineffective in ensuring electoral accountability if the public is not informed of political malfeasance.
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