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Why did Chile’s think tank sector become more concentrated even as supply and demand for expert opinion expanded? This article examines nine organizations between 2011 and 2022, tracking 18,948 public interventions and conducting sixty-six interviews with think tank members and stakeholders to understand this apparent paradox. While political crises, from student movements to the 2019 social “outbreak” offered opportunities for new voices to emerge, established think tanks systematically consolidated their advantages. This article develops the concept of intellectual infrastructure—the material, institutional, technological, and network conditions enabling expert interventions—to explain how advantages in funding and media access become self-reinforcing. In a middle-income country where international funding dried up without the emergence of domestic philanthropy, organizations with larger, more flexibly allocated resources could effectively crowd out competitors. This challenges assumptions about expertise democratization, revealing how intellectual authority becomes concentrated even during periods of apparent openness.
Scholarly work on the politics of immigration in the U.S. has focused primarily on the influence of local demographics. Less understood are the ways in which local governments respond to demographic changes beyond the city limits. We hypothesize that local governments anticipate future influxes of immigrants from neighboring localities and adjust policies ex ante in order to constrain their movement before it can occur. We predict variation in anti-immigrant legislation as a function of proximity to nearby immigrant populations and find that a 10 percentage point increase in the share of the foreign-born population in a city’s surrounding areas doubles the likelihood that a city considers a restrictive policy. The effect is more pronounced when neighboring immigrants originate from Latin America than from other regions. We also find suggestive evidence that knowledge of adjacent foreign-born populations is transmitted via commuting patterns as neighboring populations commute into cities for work. Our research highlights the importance of spatial networks in local politics and how local political units influence one another and engage in an anticipatory strategic response.
Involvement of non-ocular motor cranial nerves, such as the trigeminal, facial or hypoglossal nerves, has rarely been reported in recurrent painful ophthalmoplegic neuropathy (RPON). This study aimed to determine the incidence and clinical significance of multi-cranial nerve involvement in RPON.
Methods:
Eight patients (females = 5; mean age = 53.3 ± 15.6 years) who met International Classification of Headache Disorders-3 diagnostic criteria for RPON were enrolled at a single tertiary hospital. Repeated evaluations were performed for differential diagnosis, including cranial nerve examination, brain MRI, CSF analysis and serologic testing for autoimmune and tumor markers. Clinical features, neuroimaging findings and laboratory results were reviewed.
Results:
Five patients (62.5%) had a present or past history of migraine. Among 25 ophthalmoplegic attacks, the abducens nerve was most frequently affected (60%), followed by the oculomotor nerve (32%). Most attacks were preceded by ipsilateral headache (4.0 ± 2.9 days; 88%). Facial nerve involvement was common (7/8, 87.5%); two patients had three recurrent facial neuropathies on the same side, and one showed simultaneous ipsilateral oculomotor and facial neuropathies. All facial neuropathies were peripheral. Of the three patients who underwent MRI for facial neuropathy, two demonstrated focal facial nerve enhancement. Postauricular pain usually preceded facial neuropathy and lacked migrainous features. Both facial neuropathy and ophthalmoplegia resolved within days to weeks.
Conclusion:
Facial neuropathy may be more common in RPON than previously recognized. Despite similarities to Bell’s palsy, our findings support considering facial neuropathy within the RPON spectrum and suggest that recurrent, multifocal and alternating cranial neuropathy may underlie its pathophysiology.
It remains unclear which patient and treatment characteristics are associated with greater cognitive and functional gains from individualised occupational therapy (IOT) in schizophrenia.
Aims
To explore predictors of changes in cognition and functioning and their maintenance among patients with schizophrenia who received IOT.
Method
This secondary analysis used data from a randomised controlled trial and its follow-up. Participants allocated to the group occupational therapy plus IOT arm who received IOT during their hospital stay and had available outcome data were included (n = 34; with follow-up data available for 32 participants). Changes in cognition (Brief Assessment of Cognition in Schizophrenia) and functioning (modified Global Assessment of Functioning – social functioning subscale) were examined. Linear mixed-effects models were used to evaluate patient- and treatment-related predictors of change and maintenance.
Results
Greater improvement in cognition was associated with lower baseline cognition (β = −0.40, p = 0.003). Maintenance of cognitive improvement was associated with fewer prior hospital stays (β = −0.21, p = 0.031) and better post-treatment quality of life (β = 5.61, p < 0.001). Greater improvement in functioning was associated with lower baseline functioning (β = −0.50, p < 0.001) and fewer physical comorbidities (β = −8.43, p = 0.004), whereas maintenance of functional improvement was associated with better post-treatment cognition (β = 2.27, p = 0.014) and greater engagement in self-monitoring (β = 0.27, p = 0.026).
Conclusions
Both patient characteristics and engagement in specific IOT components were associated with variability in changes in outcomes and their maintenance. These findings may inform more personalised occupational therapy strategies for schizophrenia.
This paper examines reflective judgement as a crucial aspect of the power of judgement in Kant’s third Critique. Following Ginsborg’s normative-regulative interpretation, it demonstrates how aesthetics and teleology emerge from a single principle of reflection, which takes the form of contingent contingency, or possible lawfulness, in both. This reading establishes a parallel between common sense and the intuitive intellect, and allows one to preserve the normative dimension of Kant’s work while making Kant’s more speculative legacy continuous with it.
This article examines the multifaceted nature of the rule of law. It primarily shows a way to measure how the meaning of the rule of law differs across countries, or across different contexts more generally, by analyzing parliamentary discourse on the rule of law. The findings point to a convergence in the conceptualization of the rule of law across diverse legal traditions despite ex ante differences between common law, French, German, and post-socialist legal traditions. The article also proposes a principled approach for deriving weights for rule-of-law indicators in order to assess the sensitivity of country rankings with respect to the adherence to rule-of-law principles.
Many guidelines recommend deprescribing benzodiazepines and z-drugs in most long-term users. Due to physical dependence in those using medication as prescribed (distinct from addiction), discontinuation can be difficult and is often unsuccessful, as withdrawal symptoms can be severe and long-lasting, especially after long-term use. There is a lack of clarity on how to taper patients in a tolerable manner that minimizes discomfort. Current guidelines vary with some suggesting linear reductions (e.g. 1 mg every 1–4 weeks) and some proportionate reductions (e.g. 5%–10% of the most recent dose per month, with smaller reductions as the dose decreases). The shape of the relationship between dose of benzodiazepine and activity at gamma-aminobutyric acid-A (GABA-A) receptors is hyperbolic: steeply inclining at low doses, flattening at higher doses. Consequently, linear dose reductions produce increasingly large changes in receptor occupancy, predicting escalating withdrawal effects, while hyperbolic or proportionate dose reductions produce linear reductions in pharmacological effect. Slower tapering (over months and years) may be more successful than tapering over days or weeks. In practice, rate of tapering should be adjusted according to severity of withdrawal effects. Final doses for some people will need to be very small (equivalent to as little as 0.2 mg of diazepam, or less) so that the last ‘step down’ to zero is not larger than prior tolerated reductions in terms of pharmacological effects. Liquids or compounded formulations of medication can be helpful at low doses to make small reductions. Guidelines should recommend hyperbolic tapering while awaiting randomized trials comparing linear with hyperbolic tapering.
This work demonstrates the occurrence of travelling wave flutter instabilities on viscoelastic coatings in supersonic flows, which forms an important milestone towards developing viscoelastic materials for high-speed flow applications. The flow-induced travelling surface waves were generated by elevating the air speed such that the flow dynamic pressure and the material Young’s modulus are of the similar order, their ratio defined as the compliance parameter. Experimental investigations probed the critical compliance parameter corresponding to surface instability onset across different fluid-structural non-dimensional parameters. The results revealed a strong dependence of the critical compliance parameter on the flow Mach number in addition to other flow and structural parameters that were found to influence the instability onset in earlier studies with aqueous flows. A broader parametric sweep of these parameters was performed using linear stability analysis. Consistent qualitative comparisons were obtained between the experiments and stability calculations on the most amplified wave characteristics. Further investigations revealed that the interaction mechanisms are similar to incompressible flows.
A mutual influence between mood disorders and obesity has been reported. Maladapting eating behaviors associated with mood spectrum swings may play a pivotal role in the development and maintenance of obesity. Considering that, the aim of the present study is to investigate the relationship between problematic eating behaviors, namely emotional eating, grazing and night eating, with impulsivity and lifetime mood spectrum (mood, energy, cognition, rhythmicity and vegetative functions) in severe obese patients seeking bariatric surgery.
Methods
304 obese outpatients were recruited at the Psychiatric Unit of the University Hospital of Pisa. Participants completed psychometric tools including the Emotional Eating Scale (EES), the Italian-Night Eating Questionnaire (I-NEQ), the Grazing Questionnaire (GRAZ), the Barratt Impulsiveness Scale (BIS-11), and the Mood Spectrum Self-Report – lifetime version (MOODS-SR). Descriptive analyses and linear correlation were performed.
Results
The sample was predominantly female (71.4%), with a mean age of 47.5 ± 10.9 years and a mean BMI of 43.3 ± 6.3 kg/m2. Impulsivity was positively correlated with depressive and manic mood, energy, and cognitive MOODS-SR domains. Emotional eating, night eating, and grazing were significantly associated with the MOODS-SR total score (r=0.422, p=0.000; r=0.321, p=0.001; r=0.321, p=0.000, respectively) and with specific depressive and manic subdomains of the MOODS-SR.
Conclusion
Loss-of-control eating behaviors were positively associated with lifetime depressive and manic mood spectrum features in bariatric patients, highlighting the importance of assessing these dimensions to promote a tailored and integrated treatment.
The ‘left behind’, commonly defined by socio-economic factors such as rural residence, working-class status, and subjective perceptions of marginalization, have been repeatedly linked to support for populism and authoritarianism. However, it remains unclear whether the left behind are truly turning away from democracy and whether and how perceived marginalization (understood as a lack of recognition in different areas) is linked to fundamental democratic orientations (democratic attitudes, understandings, and governance preferences) that go beyond support for populist parties or specific policies. Using data from about 2,500 respondents in both the United States and Germany, I investigate how perceived societal marginalization is related to democratic orientations while accounting for traditional socio-economic factors. The results show that a lack of cultural recognition (feeling that one’s values are becoming less important or that one’s group cannot freely express its opinion in public) is associated with lower democratic support, an authoritarian and majoritarian understanding of politics, and higher support for authoritarian governance. Conversely, feeling unseen and unheard by politicians is associated with dissatisfaction with democracy and lower support for representative governance but also with high democratic support, a liberal understanding of politics, and support for citizen-centered decision-making in the form of referendums. These findings challenge simplistic portrayals of the left behind as inherently undemocratic. They also highlight the need for nuanced approaches to engage the left behind based on the dimensions in which they experience a lack of recognition to ensure democratic stability.