Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Negativity effects in impression formation: A test in the political arena.

Previous research had shown that negative information has a stronger influence on impressions of others than does positive information; a tendency known as the negativity effect. The hypothesis that this effect would characterize impressions of presidential candidates was tested using National Election Study surveys from 1984 and 1988. Analyses were conducted at both aggregate and idiographic levels. The aggregate level analysis revealed that personality characteristics that the nation, on average, judged to represent character weaknesses were more predictive of overall evaluations and voting than were characteristics judged as representing strengths. At the idiographic level, it was found that a trait was significantly more predictive when it fell below an individual's average trait rating for a candidate than when it was located above this mean. Thus, these results show that a negativity effect did characterize impressions of candidates; character weaknesses were more important than strengths in determining the public's evaluations of the candidate and the ultimate vote. Additional analyses were conducted to further investigate negativity in political impressions. It was found that a trait on which the candidates were judged to differ had a larger influence on evaluations than a trait on which the candidates were judged to be similar, but only for the candidate that received the lower rating for the distinctive trait. The expectancy-contrast and cost-orientation explanations for negativity were also examined. No support was found for expectancy-contrast theory, while mixed support was found for cost-orientation. In addition, negativity was found to be more descriptive of impressions of disliked candidates than liked candidates; favorable predispositions toward a candidate reduced negativity.Ph.D.PsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/103761/1/9034456.pdfDescription of 9034456.pdf : Restricted to UM users only

Us Versus Them, or Us Versus Everyone? Delineating Consumer Aversion to Foreign Goods

This paper presents evidence that international animosity and consumer ethnocentrism are distinct constructs that play different roles depending on the set of products available to consumers. Results show that animosity toward a foreign nation is related to choices between foreign goods, while consumer ethnocentrism is related to choices between domestic and foreign goods. Further, the study finds animosity effects even though anger levels are generally low, thus extending the boundaries of the animosity model of foreign purchase. The study focuses on U.S. consumer views of Japan and Japanese products. Implications for decisions concerning global versus local branding strategies are discussed.© 2002 JIBS. Journal of International Business Studies (2002) 33, 345–363

Extending the construct of consumer ethnocentrism: When foreign products are preferred

Purpose - This research has the purpose of exploring whether the construct of consumer ethnocentrism extends to contexts in which foreign products are preferred to domestic products. Design/methodology/approach - The study evaluates the psychometric properties of the consumer ethnocentrism scale (CETSCALE) in the transition economies of China and Russia using both student and non-student samples. A valid and reliable six-item version of the CETSCALE is developed based on these samples. The refined six-item scale is then validated through a re-analysis of Netemeyer et al.\u27s data collected in four developed countries. Findings - Findings show that the scale can be used effectively in these transitional economies. A consistent pattern of support is found for the six-item CETSCALE across eight samples from six countries. Originality/value - The research provides practicing marketers as well as international researchers with a parsimonious six-item CETSCALE that can be used in both developed and transition economies. © Emerald Group Publishing Limited