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When autocratic ruling parties accede to democratization, they do not always fade away into history. Following forty-one transitions since 1940, including those in Mexico, Taiwan, Bulgaria and Ghana, the ruling party survived and won power after democratization. Why do some former autocratic parties prosper under democracy while others quickly dissolve? What effect does this have on democratic survival? This article uses original data to predict the post-transition fates of eighty-four autocratic ruling parties through 2015. Whereas extant theories emphasize radical reinvention and outsider struggle, the author argues that success is instead about maintaining ruling-party advantages into the democratic period. Parties succeed when they have authoritarian legacies that easily translate to democratic competition, such as broad programmatic experience, strong organization and policy success. In addition, democratic institutions that disadvantage new parties and actors benefit autocratic parties. Lastly, an instrumental variables design shows that autocratic party success negatively impacts democratic survival and quality.
Species distribution models (SDMs) are statistical tools used to develop continuous predictions of species occurrence. ‘Integrated SDMs’ (ISDMs) are an elaboration of this approach with potential advantages that allow for the dual use of opportunistically collected presence-only data and site-occupancy data from planned surveys. These models also account for survey bias and imperfect detection through the use of a hierarchical modelling framework that separately estimates the species–environment response and detection process. This is particularly helpful for conservation applications and predictions for rare species, where data are often limited and prediction errors may have significant management consequences. Despite this potential importance, ISDMs remain largely untested under a variety of scenarios. We performed an exploration of key modelling decisions and assumptions on an ISDM using the endangered Baird’s tapir (Tapirus bairdii) as a test species. We found that site area had the strongest effect on the magnitude of population estimates and underlying intensity surface and was driven by estimates of model intercepts. Selecting a site area that accounted for the individual movements of the species within an average home range led to population estimates that coincided with expert estimates. ISDMs that do not account for the individual movements of species will likely lead to less accurate estimates of species intensity (number of individuals per unit area) and thus overall population estimates. This bias could be severe and highly detrimental to conservation actions if uninformed ISDMs are used to estimate global populations of threatened and data-deficient species, particularly those that lack natural history and movement information. However, the ISDM was consistently the most accurate model compared to other approaches, which demonstrates the importance of this new modelling framework and the ability to combine opportunistic data with systematic survey data. Thus, we recommend researchers use ISDMs with conservative movement information when estimating population sizes of rare and data-deficient species. ISDMs could be improved by using a similar parameterization to spatial capture–recapture models that explicitly incorporate animal movement as a model parameter, which would further remove the need for spatial subsampling prior to implementation.
A novel high-power impulse plasma source (HiPIPS) technology that combines atmospheric pressure plasma jets with high-power pulsed direct current generators is described. Pulsed power is applied in microsecond pulses (20 µs) at low duty cycle (10%) and low frequency (0.5 kHz) leading to high peak power densities (10–75 kW) and high peak currents (100–250 A) while maintaining low average power (<40 W) and low processing temperatures (<50 °C). These conditions result in the generation of a highly dense plasma discharge (ne = 6.23 × 1016 cm−3) for surface modification and deposition of coatings. Using HiPIPS, Ar-initiated metallic Ti, CoCr, or Ti–6Al–4V plasma was generated, and the plasma properties were characterized by measuring current–voltage characteristics, electron densities (Langmuir probe), and optical emission spectra. HiPIPS CoCr and Ti–6Al–4V coatings were deposited for proof of concept of the technique. The resulting coatings were examined with scanning electron microscopy, energy-dispersive X-ray spectroscopy, and nanoindentation.
Cardiac catheterisation is commonly used for diagnosis and therapeutic interventions in paediatric cardiology. The inherent risk of the procedure can result in unanticipated admissions to critical care. Our goals were to provide a qualitative description of characteristics and evaluation of children admitted unexpectedly to the cardiac critical care unit (CCCU).
A retrospective single centre review of cardiac catheterisation procedures was done between 1 January, 2003 and 30 April, 2013.
Of 9336 cardiac catheterisations performed, 146 (1.6%) were admitted from the catheterisation laboratory to the CCCU and met inclusion criteria. Of these 146 patients, 117 (1.3%) met criteria for unexpected admission and 29 (0.3%) were planned admissions. The majority admitted unexpectedly were below 1 year of age without co-morbidity aside from heart disease. Patients with planned admissions were significantly more likely to have single ventricle physiology, undergoing angiography or transferred for observation. Most unplanned admissions were triggered by interventional catheterisations or procedure-related complications. Patients received mechanical ventilation as the main CCCU management. Eighteen patients needed either cardiopulmonary resuscitation and/or extracorporeal membrane oxygenation during their catheterisation. About 106/117 (90.6%) patients survived to hospital discharge with no deaths in the planned admission group.
Admission to CCCU following cardiac catheterisation was uncommon and tended to occur in younger children undergoing interventional procedures. Outcomes did not differ between patients experiencing planned and unplanned CCCU admission. Ongoing development of risk stratification tools may help to decrease unplanned CCCU admissions. Further studies are needed to determine whether unplanned admission following paediatric cardiac catheterisation should be utilised as a quality indicator.
The Jewish Tandelmarkt in Prague's Old Town was a nonresidential Jewish exclave, situated outside of Prague's Jewish Town. This thriving marketplace afforded Jewish merchants and peddlers an opportunity to ply their wares in the Old Town, but it also left them unprotected in the face of physical and verbal attacks. This article examines memoirs, travelogues, guidebooks, newspapers, novels, and visual images to understand how the Tandelmarkt (junk market) functioned in various discourses about Prague Jewry, especially in the eighteenth and nineteenth centuries. Jews were vulnerable and exposed in the Tandelmarkt, but the centrality and visibility of this marketplace also allowed non-Jews to observe their “exotic” Jewish neighbors. A nineteenth-century novelist described the Tandelmarkt as a “theater” where passersby could “lose themselves” for half an hour in its disarray and commotion. At times it was a theater of violence, where Jews fell victim to attack. It was also a theater of emancipation, where Jews could show their Christian neighbors that they were capable of self-improvement and change.
The global burden of neurological infectious diseases is huge. Sometimes the diagnosis is straightforward. On other occasions it may be difficult, especially because of the overlap with inflammatory neurological conditions. Delays or missed diagnoses can have devastating consequences for patients. This book brings together adult and pediatric clinical cases in neurological infection and inflammation, including important conditions for both developed countries and resource-poor settings. Clinical case studies are recognized as a useful learning tool for clinicians at all stages in their careers. Each real case works through the history, examination, and investigation findings to the diagnosis and treatment pathway. This is followed by discussion of the key issues, with the inclusion of historical or quirky facts. Many cases are supported online by a certified post-case quiz, testing the reader's clinical reasoning, integrative thinking, and problem-solving.
The impact of dementia-related stressors and strains have been examined for their potential to threaten the well-being of either the person with dementia or the family care partner, but rarely have studies considered the dyadic nature of well-being in dementia. The purpose of this study was to examine the dyadic effects of multiple dimensions of strain on the well-being of dementia care dyads.
Using multilevel modeling to account for the inter-relatedness of individual well-being within dementia care dyads, we examined cross-sectional responses collected from 42 dyads comprised of a hospitalized patient diagnosed with a primary progressive dementia (PWD) and their family care partner (CP). Both PWDs and CPs self-reported on their own well-being using measures of quality of life (QOL-Alzheimer’s Disease scale) and depressive symptoms (Center for Epidemiological Studies Depression Scale).
In adjusted models, the PWD’s well-being (higher QOL and lower depressive symptoms) was associated with significantly less strain in the dyad’s relationship. The CP’s well-being was associated with significantly less care-related strain and (for QOL scale) less relationship strain.
Understanding the impact of dementia on the well-being of PWDs or CPs may require an assessment of both members of the dementia care dyad in order to gain a complete picture of how dementia-related stressors and strains impact individual well-being. These results underscore the need to assess and manage dementia-related strain as a multi-dimensional construct that may include strain related to the progression of the disease, strain from providing care, and strain on the dyad’s relationship quality.
This study examined differences in learning outcomes among newborn intensive care unit (NICU) workers who underwent virtual reality simulation (VRS) emergency evacuation training versus those who received web-based clinical updates (CU). Learning outcomes included a) knowledge gained, b) confidence with evacuation, and c) performance in a live evacuation exercise.
A longitudinal, mixed-method, quasi-experimental design was implemented utilizing a sample of NICU workers randomly assigned to VRS training or CUs. Four VRS scenarios were created that augmented neonate evacuation training materials. Learning was measured using cognitive assessments, self-efficacy questionnaire (baseline, 0, 4, 8, 12 months), and performance in a live drill (baseline, 12 months). Data were collected following training and analyzed using mixed model analysis. Focus groups captured VRS participant experiences.
The VRS and CU groups did not statistically differ based upon the scores on the Cognitive Assessment or perceived self-efficacy. The virtual reality group performance in the live exercise was statistically (P<.0001) and clinically (effect size of 1.71) better than that of the CU group.
Training using VRS is effective in promoting positive performance outcomes and should be included as a method for disaster training. VRS can allow an organization to train, test, and identify gaps in current emergency operation plans. In the unique case of disasters, which are low-volume and high-risk events, the participant can have access to an environment without endangering themselves or clients. (Disaster Med Public Health Preparedness. 2019;13:301–308)
Infants with prenatally diagnosed CHD are at high risk for adverse outcomes owing to multiple physiologic and psychosocial factors. Lack of immediate physical postnatal contact because of rapid initiation of medical therapy impairs maternal–infant bonding. On the basis of expected physiology, maternal–infant bonding may be safe for select cardiac diagnoses.
This is a single-centre study to assess safety of maternal–infant bonding in prenatal CHD.
In total, 157 fetuses with prenatally diagnosed CHD were reviewed. On the basis of cardiac diagnosis, 91 fetuses (58%) were prenatally approved for bonding and successfully bonded, 38 fetuses (24%) were prenatally approved but deemed not suitable for bonding at delivery, and 28 (18%) were not prenatally approved to bond. There were no complications attributable to bonding. Those who successfully bonded were larger in weight (3.26 versus 2.6 kg, p<0.001) and at later gestation (39 versus 38 weeks, p<0.001). Those unsuccessful at bonding were more likely to have been delivered via Caesarean section (74 versus 49%, p=0.011) and have additional non-cardiac diagnoses (53 versus 29%, p=0.014). There was no significant difference regarding the need for cardiac intervention before hospital discharge. Infants who bonded had shorter hospital (7 versus 26 days, p=0.02) and ICU lengths of stay (5 versus 23 days, p=0.002) and higher survival (98 versus 76%, p<0.001).
Fetal echocardiography combined with a structured bonding programme can permit mothers and infants with select types of CHD to successfully bond before ICU admission and intervention.