Building consensus: shifting strategies in the territorial targeting of Turkey's public transport investment

© 2019, © 2019 Regional Studies Association. A growing amount of research explores how the allocation of regional development monies follows electoral reasons. Yet, the existing literature on distributive politics provides different and contrasting expectations on which geographical areas will be targeted. The paper focuses on proportional representation (PR) systems. While in such settings governments have incentives to target core districts and punish foes, it is suggested that when incumbents attempt to build a state–party image they may broaden the territorial allocation of benefits and even target opposition out-groups. The paper exploits data on Turkey's public transport investment for the period 2003–14 and in-depth interviews to provide results in support of the hypothesis.Harvard Emirates Leadership Initiative Fellowshi

TCT-481 Treatment of "resistant" in-stent restenosis in the drug-eluting era: comparison of repeat stent versus balloon only strategy

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Remaining Loyal to Our Soil: A Prospective Integrated Assessment of Soil Erosion on Global Food Security

Soil loss by water erosion represents a key threat to land degradation worldwide. This study employs an integrated quantitative modelling approach to estimate its long-term global sustainability impacts. The global biophysical model estimates a mean increase of soil erosion rates of between 30 and 66% over the period 2015–2070 under alternative climate-economic scenarios, assuming different greenhouse gas concentration trajectories. In a subsequent step, projected soil erosion rates are converted into land productivity losses and inputted into an economic global simulation model to identify those regional hotspots where the greatest market tensions are expected to occur. The headline result is that of a global economic contraction of up to 625 billion US$ by the year 2070. Moreover, soil erosion represents an acute challenge to food security in vulnerable regions (Africa and some tropical regions), where for certain crops (particularly oilseeds) the threat of shortages is potentially significant. Under the worst-case scenario, global primary agricultural production losses could amount to 352 million tonnes by 2070. Exploring different long-term socioeconomic-environmental pathways confirms the merits of sustainable management practises in coping with market and environmental stresses arising from soil erosion that limits the global increase of land used for food consumption to 115,000 km2 above the long run baseline. Finally, free (and fair) trade is essential to allow less affected regions to expand (marginally) their production, thereby cushioning the market tensions that are expected to occur in more acutely affected areas of the world.One of the co-authors was funded by the Horizon Europe project AI4SoilHealthSoil erosionProspective interdisciplinary/integrated modellingLand productivity lossComputable general equilibriumLand footprintsClimate-economic scenariosPublishe

Incidence, Patterns, and Associations Between Dual-Antiplatelet Therapy Cessation and Risk for Adverse Events Among Patients With and Without Diabetes Mellitus Receiving Drug-Eluting Stents: Results From the PARIS Registry.

OBJECTIVES: The aim of this study was to examine the frequency and clinical impact of different cessation patterns of dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention with drug-eluting stents among patients with and those without diabetes mellitus (DM). BACKGROUND: Early DAPT suspension after percutaneous coronary intervention increases the risk for major adverse cardiac events. However, temporal variability in risk and relation to DAPT cessation patterns among patients with DM remain unclear. METHODS: Using data from the PARIS (Patterns of Non-Adherence to Anti-Platelet Regimens in Stented Patients) registry, 1,430 patients with DM (34%) and 2,777 without DM (66%) treated with drug-eluting stents were identified. DAPT cessation modes were classified as temporary interruption (<14 days), disruption because of bleeding or poor compliance, and physician-recommended discontinuation. RESULTS: During 2-year follow-up, DM was associated with an increased risk for thrombotic events but a similar risk for bleeding. The cumulative incidence of DAPT cessation was significantly lower in patients with versus those without DM (50.1% vs. 55.4%; p < 0.01), driven largely by less frequent physician-guided discontinuation beyond 1 year. In contrast, 2-year rates of interruption and disruption were similar between groups. When DAPT was interrupted or discontinued under physician guidance, the risk for major adverse cardiac events was unchanged compared with patients with DM on uninterrupted DAPT. Conversely, when DAPT was disrupted, the risk for major adverse cardiac events increased compared with uninterrupted DAPT, regardless of diabetic status, with no evidence of statistical interaction. CONCLUSIONS: DAPT cessation patterns vary according to diabetic status, with less frequent physician-guided discontinuation among patients with DM. The presence of DM does not emerge as a modifier of cardiovascular risk after DAPT cessation

Causes, Timing, and Impact of Dual Antiplatelet Therapy Interruption for Surgery (From the PARIS Registry)

Temporary interruption of dual antiplatelet therapy (DAPT) is not infrequently required in patients undergoing percutaneous coronary intervention (PCI). We sought to describe the procedures and outcomes associated with DAPT interruption in patients treated with DAPT following successful PCI from the Patterns of non-adherence to anti-platelet regimens in stented patients registry (n = 5018). DAPT interruption was prespecified as physician recommended cessation forcohort, 490 patients (9.8%) experienced 594 DAPT interruptions over 2 years following PCI. Only 1 antiplatelet agent was interrupted in 57.2% cases and interruption was frequently recommended by noncardiologists (51.3%). Where type of surgery was reported, majority of DAPT interruptions occurred for minor surgery (68.4% vs 31.6%) and a similar cessation pattern of single versus dual antiplatelet cessation was observed regardless of minor or major surgery. Subsequent to DAPT interruption, 12 patients (2.4%) experienced 1 thrombotic event each, of which 5 (1.0%) occurred during the interruption period. All events occurred in patients who either stopped both agents (8 of 12) or clopidogrel-only (4 of 12), with no events occurring due to aspirin cessation alone. In conclusion, in the Patterns of Non-adherence to Anti-platelet Regiments in Stented Patients registry, 1 in 10 patients were recommended DAPT interruption for surgery within 2 years of PCI. Interruption was more common for a single agent rather than both antiplatelet agents regardless of severity of surgery, and was frequently recommended by noncardiologists. Only 1% of patients with DAPT interruption experienced a subsequent thrombotic event during the interruption period, which mainly occurred in patients stopping both antiplatelet agents

It’s been mostly about money!: a multi-method research approach to the sources of institutionalization

Although much has been written about the process of party system insti- tutionalization in different regions, the reasons why some party systems institutionalize while others do not still remain a mystery. Seeking to fill this lacuna in the literature, and using a mixed-methods research approach, this article constitutes a first attempt to answer simultaneously the following three questions: (1) What specific factors help party systems to institutio- nalize (or not)? (2) What are the links (in terms of time and degree) as well as the causal mechanisms behind such relationships? and (3) how do they affect a particular party system? In order to do so, this article focuses on the study of party system development and institutionalization in 13 postcommunist democracies between 1990 and 2010. Methodologically, the article innovates in five respects. First, it continues the debate on the importance of ‘‘mixed methods’’ when trying to answer different research questions. Second, it adds to the as yet brief literature on the combination of process tracing and qualitative comparative analysis. Third, it constitutes the first attempt to date to use a most similar different outcome/most different same outcome pro- cedure in order to reduce causal complexity before undertaking a crisp-set qualitative comparative analysis. Third, it also shows the merits of combining both congruence and process tracing in the same comparative study. Finally, it also develops a novel ‘‘bipolar comparative method’’ to explain the extent to which opposite outcomes are determined by reverse conditions and conflicting intervening causal forces

Dual-Antiplatelet Therapy Cessation and Cardiovascular Risk in Relation to Age: Analysis From the PARIS Registry.

OBJECTIVES: The aim of this study was to examine the association between dual-antiplatelet therapy (DAPT) cessation and cardiovascular risk after percutaneous coronary intervention in relation to age. BACKGROUND: Examination of outcomes by age after percutaneous coronary intervention is relevant given the aging population. METHODS: Two-year clinical outcomes, incidence, and effect of DAPT cessation on outcomes were compared by ages ≤55, 56 to 74, and ≥75 years from the PARIS (Patterns of Non-Adherence to Antiplatelet Regimens in Stented Patients) registry. DAPT cessation included physician-recommended discontinuation, interruption for surgery, and disruption (from noncompliance or bleeding). Clinical endpoints were major adverse cardiac events (MACE) (a composite of cardiac death, definite or probable stent thrombosis, spontaneous myocardial infarction, or clinically indicated target lesion revascularization), a secondary restrictive definition of MACE (MACE2) excluding target lesion revascularization, and bleeding. RESULTS: A total of 1,192 patients (24%) were ≤55 years, 2,869 (57%) were 56 to 74 years, and 957 (19%) were ≥75 years of age. Patients ≥75 years of age had higher DAPT cessation rates and increased risk for MACE2, death, cardiac death, and bleeding compared with younger patients. Discontinuation and interruption were not associated with increased cardiovascular risk across age groups, whereas disruption was associated with increased risk for MACE and MACE2 in younger patients but not in patients ≥75 years of age (p for trend <0.05). CONCLUSIONS: Nonadherence and outcomes vary by age, with patients ≥75 years having the highest DAPT cessation rates. We observed no association between outcomes and DAPT cessation in patients ≥75 years, whereas discontinuation was associated with lower MACE rates and disruption with increased MACE rates in patients <75 years

R2P from Below: Does the British Public View Humanitarian Interventions as Ethical and Effective?

One of the major barriers to the implementation of the Responsibility to Protect principle is the lack of a political will. Public attitudes towards intervention will have a crucial impact on elite willingness to prevent mass atrocities, yet we have little understanding of the factors that influence those attitudes. This article provides the first examination of UK public perceptions about the moral justifiability and effectiveness of humanitarian interventions. The article shows that decisions about justifiability and effectiveness are very different. Attitudes towards justification were more easily explained suggesting that judgements about effectiveness are more contextual and less easily accounted for by individuals’ background characteristics and attitudes. Experiences with both Iraq and Afghanistan have contaminated public perceptions of both the ethics and effectiveness of humanitarian interventions. Although the public is broadly supportive about the justifiability of humanitarian interventions they are extremely sceptical about the likelihood that those interventions will be successful