Representation of Women in Stroke Clinical Trials: A Review of 281 Trials Involving More Than 500,000 Participants

Background and ObjectivesWomen have been underrepresented in cardiovascular disease clinical trials but there is less certainty over the level of disparity specifically in stroke. We examined the participation of women in trials according to stroke prevalence in the population.MethodsPublished randomized controlled trials with ≥100 participants enrolled between 1990 and 2020 were identified from ClinicalTrials.gov. To quantify sex disparities in enrollment, we calculated the participation to prevalence ratio (PPR), defined as the percentage of women participating in a trial vs the prevalence of women in the disease population.ResultsThere were 281 stroke trials eligible for analyses with a total of 588,887 participants, of whom 37.4% were women. Overall, women were represented at a lower proportion relative to their prevalence in the underlying population (mean PPR 0.84; 95% confidence interval [CI] 0.81-0.87). The greatest differences were observed in trials of intracerebral hemorrhage (PPR 0.73; 95% CI 0.71-0.74), trials with a mean age of participants <70 years (PPR 0.81; 95% CI 0.78-0.84), nonacute interventions (PPR 0.80; 95% CI 0.76-0.84), and rehabilitation trials (PPR 0.77; 95% CI 0.71-0.83). These findings did not significantly change over the period from 1990 to 2020 (p for trend = 0.201).DiscussionWomen are disproportionately underrepresented in stroke trials relative to the burden of disease in the population. Clear guidance and effective implementation strategies are required to improve the inclusion of women and thus broader knowledge of the impact of interventions in clinical trials

Together forever? Explaining exclusivity in party-firm relations

Parties and firms are the key actors of representative democracy and capitalism respectively and the dynamic of attachment between them is a central feature of any political economy. This is the first article to systematically analyse the exclusivity of party-firm relations. We consider exclusivity at a point in time and exclusivity over time. Does a firm have a relationship with only one party at a given point in time, or is it close to more than one party? Does a firm maintain a relationship with only one party over time, or does it switch between parties? Most important, how do patterns of exclusivity impact on a firm’s ability to lobby successfully? We propose a general theory, which explains patterns of party-firm relations by reference to the division of institutions and the type of party competition in a political system. A preliminary test of our theory with Polish survey data confirms our predictions, establishing a promising hypothesis for future research

Poliethiological ulcerative mycotic keratitis in horse

Opisano przypadek klinicznego grzybicze zapalenie rogówki o złożonej etiologii u konia. Chorobę rozpoznano u klaczy, maści gniadej, w wieku 7 lat. Badanie okulistyczne wykazało w dolnym skroniowym kwadrancie rogówki: wrastanie naczyń krwionośnych, naciek zapalny, obrzęk, wieloogniskowe nacieki podnabłonkowe oraz powierzchowne owrzodzenie rogówki z oddzieleniem nabłonka. Cytologia impresyjna oraz badania mikologiczne wykazały w pobranym materiale obecność Aspergillus fumigatus, a także pojedyncze kolonie Aspergillus flavus. Koń był leczony chirurgiczne oraz przy użyciu kropli okulistycznych z 0,2% flukonazolu i 30% DMSO. Doustnie podawano kapsułki flukonazolu, w dawce 500 mg dwa razy dziennie. Po 2 tygodniach od operacji stwierdzono wygojenie się owrzodzenia rogówki, z obecnością białego koloru blizny. Leczenie farmakologiczne kontynuowano przez 12 tygodni. Badanie kontrolne wykonane po 1 roku wykazało znaczne zmniejszenie blizny w porównaniu do stanu po operacji, brak naczyń krwionośnych i w miejscu wrzodu zwiększenie przejrzystości rogówki.The authors report a clinical case of poliethiological ulcerative mycotic keratitis in horse. The disease was diagnosed with mare, bay colour, aged 7 years. The ocular examination revealed in the inferior cranial quadrant of the right cornea: the superficial and deep blood vessel ingrowth, oedema, multifocal dark brown subepithelial infiltrations as well as superficial corneal ulceration with the demarcated epithelial. The impression cytology and mycological evaluation showed the presence of Aspergillus fumigatus as well as single colonies of Aspergillus flavus in the examined research material. The horse was surgery treated and with the use ophthalmic drops containing 0,2% fluconazole and 30% DMSO mixture. Oral fluconazole 500mg was given twice a day. The ophthalmic examination revealed the complete recovery of the corneal ulceration, with a white scar 2 weeks after operation. The pharmacological treatment was continued by 12 weeks. The control check-up a year after the treatment institution showed no blood vessels growing into the cornea, marked diminishment of the postoperative scar as well as higher corneal transparency at the ulcer site