Elective Approach Research Articles

Dynamic Elite Partisanship: Party Loyalty and Agenda Setting in the US House

Legislators and legislative parties must strike a balance between collective and member-level goals. While there are legislative and reputational returns to co-ordinated behavior, partisan loyalty has a detrimental effect on members’ electoral success. This article argues that members and parties navigate these competing forces by pursuing partisan legislation when the threat of electoral repercussions is relatively low – when elections are distant. This study tests our theory by examining US House members’ likelihood of voting with their party on both partisan and non-divisive votes during the course of the election cycle in order to assess whether members strategically alter their levels of party loyalty as elections approach. It also explores whether majority parties strategically structure the agenda according to variation in members’ electoral constraints. This approach allows elite partisanship to follow a dynamic process, which is referred to here as dynamic elite partisanship. The results demonstrate that as elections approach, members are less likely to cast party votes, and parties are less inclined to schedule votes that divide the parties. At the same time, the study finds no evidence of strategic variation in members’ voting behavior on broadly consensual votes with election proximity.

Election Cycles and Stock Market Reaction: International Evidence

This study investigates movements of the stock return volatility during election periods (from one-year before an election to one-year after the election) with the use of data from 16 countries. The main findings of this study are (1) stock return volatility declines over time as elections approach, (2) the level of the stock return volatility during election periods is lower than that during non-election periods, and (3) the stock return volatility rises quickly during election months and immediately after the elections. The first and second findings confirm conjectures made on the dynamic pattern of the volatility in previous studies such as Pantzalis et al. (2000) and Wisniewski (2009).

Comparison of 5-Year Outcomes in Patients With and Without Unprotected Left Main Coronary Artery Disease After Treatment With Sirolimus-Eluting Stents: Insights From the j-Cypher Registry

This study assessed 5-year outcomes after implantation of sirolimus-eluting stents (SES) for unprotected left main coronary artery (ULMCA) disease in comparison with that for non-left main disease. More information on long-term outcomes after ULMCA stenting is needed. The j-Cypher is a multicenter prospective registry of consecutive patients undergoing SES implantation in Japan. Among 12,812 patients enrolled in the j-Cypher registry, the unadjusted mortality rate at 5 years was significantly higher in patients with ULMCA stenting than in patients without ULMCA stenting (22.8% vs. 14.1%; p < 0.0001); however, the risk for death with ULMCA stenting was no longer significant after adjusting for confounders (hazard ratio: 1.18, 95% confidence interval: 0.95 to 1.46; p = 0.14). In the lesion-level comparison, the nonbifurcation ULMCA lesions treated exclusively with SES had a significantly lower rate of target lesion revascularization (TLR) than those in non-ULMCA nonbifurcation lesions (2.4% vs. 12.7%; p = 0.04). Among bifurcation lesions, those treated with a provisional 2-stent approach had similar rates of TLR (12.1% vs. 11.4%; p = 0.79) between the ULMCA and non-ULMCA groups. Lesions treated with an elective 2-stent approach had higher TLR rates in the ULMCA group as compared with the non-ULMCA group (33.5% vs. 19.7%; p = 0.002). The safety of ULMCA stenting relative to non-LMCA stenting was maintained through 5 years follow-up. In terms of efficacy, SES implantation in nonbifurcation ULMCA lesions was associated with an extremely low cumulative incidence of TLR, whereas the elective 2-stent approach for ULMCA bifurcation lesions was associated with a markedly higher cumulative incidence of TLR as compared with that for non-ULMCA bifurcation lesions.

European Parliamentary Elections and National Party Policy Change

Political parties seek information about public preferences to determine how much they need to change their policies as elections approach. We argue that opposition parties can use European parliamentary election results to inform themselves about public preferences. When opposition parties lose votes at the European level, they can use this information to infer that public opinion has shifted away from the party and change their national policy strategies. We also argue that not all European elections are the same and that parties should be more responsive to those European elections that are more informative about public preferences. Empirical results from 14 European Union (EU) member countries show that opposition parties use European election results and change their positions (a) when the turnout levels between national and European elections are similar and (b) when the European election is close in time to the upcoming national election.

Anatomical variations of the deltoid artery

Despite the expansion of arthroscopic surgery of the shoulder, the open deltopectoral approach to the shoulder is still frequently used, for example in fracture fixation and shoulder replacement. However, it is sometimes accompanied by unexpected bleeding. The cephalic vein is the landmark for the deltopectoral interval, yet its intimate relationship with the deltoid artery, and the anatomical variations in that structure, have not previously been documented. In this study the vascular anatomy encountered during 100 consecutive elective deltopectoral approaches was recorded and the common variants described. Two common variants of the deltoid artery were encountered. In type I (71%) it crosses the interval and tunnels into the deltoid muscle without encountering the cephalic vein. However, in type II (21%) it crosses the interval, reaches the cephalic vein and then runs down, medial to and behind it, giving off several small arterial branches that return back across the interval to the pectoralis major. Several minor variations were also seen (8%). These variations in the deltoid artery have not previously been described and may lead to confusion and unexpected bleeding during this standard anterior surgical approach to the shoulder.

Educational Exhibit Abstract No. 246 - An elective hybrid suite approach to the management of placenta accreta-associated postpartum hemorrhage (PPH)

Learning Objectives 1. Define placenta accreta and the clinical relevance of early diagnosis. 2. Describe the multimodality imaging appearance of placenta accreta. 3. Outline the role of the interventional radiologists in the management of placenta-accreta associated PPH. 4. Describe a novel hyrbid suite approach for the collaborative elective management of placenta accreta-associated PPH. Background Postpartum hemorrhage (PPH) is an obstetric emergency associated with significant morbidity and mortality, representing a major indication for emergent hysterectomy. Placenta accreta is a significant cause of PPH, with an increasing frequency in the US secondary to the increased incidence of cesarean section. Interventional radiologists play an important and expanding role in the management of PPH. Post-partum uterine artery embolization (UAE) has a reported clinical success of 79-97%, with a demonstrated decrease in morbidity and mortality. Clinical Findings/Procedure Details The elective staged management of accreta-associated PPH involves the use of a hybrid IR/OR suite. Occlusion balloons are placed into bilateral IIA/anterior division through bilateral groin accesses and remain deflated. Cesarean section is performed in the hybrid suite followed by immediate balloon inflation. Coaxially through the occlusion balloon a micocatheter is used to selectively embolize bilateral uterine arteries and anterior division branches supplying the placenta using standard techniques. Hysterectomy is then performed by the gynecology team. The balloons are deflated and “second look” angiogram is performed as needed prior to fascial closure. Conclusion and/or Teaching Points 1. Placenta-accreta associated PPH is increasing in incidence with significant associated morbidity and mortality. 2. Post-partum UAE has been shown to decrease PPH-associated morbidity and mortality. 3. Collaborative elective staged cesarean section in a hybrid IR/OR suite is a technically feasible approach in the management of placenta accreta and may be associated with a decrease in blood product requirement, hospital stay, and maternal morbidity.

Percutaneous Anterior Internal Pelvic Fixator

Percutaneous anterior stabilization of pelvic ring instability may be useful if closed reduction and stability can be achieved. The first clinical results are promising showing sufficient anterior stabilization, where the soft tissue is spared. In this report we describe the indication and technique for the percutaneous anterior internal pelvic fixator and discuss advantages and disadvantages in context of the current literature. After posterior stability is restored by the standard techniques (eg iliosacral screw placement or posterior plating), the patient is prepared in supine position with the lower limbs included to facilitate reduction. An oblique incision of 3 cm beneath the anterior superior iliac spine bilaterally is made. Blunt dissection of the soft tissue, including the fascia , is followed by the use of a Jamshidi needle to establish the corridor in the ilium. A C-arm and wire-guided implantation of the cannulated pedicle screw is followed by subcutaneous placement of a contoured connecting rod above the abdominal muscle fascia. The described technique facilitates a definitive anterior fixation of vertically and rotationally unstable pelvic ring fractures. Sufficient posterior stability or fixation has to be assumed. Implant removal is required in a second operation. To our opinion, this technique has several advantages, but as an elective surgical approach is not applicable in hemodynamically unstable patients.

Independent but Not Indifferent: Partisan Bias in Monetary Policy at the Fed

Independent central banks are thought to be effective inflation hawks because they are run by technocrats with conservative monetary policy preferences. However, central bankers can only protect their independence by compromising with the elected officials who grant them their independence. Policy, therefore, is likely to be a weighted average of the preferences of the central bank and the government. Consequently, central bankers may be eager to help right‐wing governments stay in power and oppose the election of left‐wing governments. We show evidence from the United States that interest rates (a) decline as elections approach when Republicans control the White House, but rise when Democrats do; and (b) are sensitive to the inflation rate (output gap) when Democrats (Republicans) are in the White House. Thus, the Federal Reserve is a conditional inflation hawk. Since the Fed became operationally independent in 1951, the Republicans have exhibited a decided electoral advantage in presidential politics.

Resection and mechanical anastomosis of the sigmoid loop via an elective approach

Resection and mechanical anastomosis of the sigmoid loop via an elective approach

The role of ultrasound in percutaneous dilatational tracheostomy.

Background: The use of ultrasound to evaluate cervical anatomy and to guide tracheal puncture in real‐time has been advocated to improve safety and efficacy of percutaneous dilatational tracheostomy (PDT) in intensive care. Objective: To review the potential role, attributed theoretical benefits and supporting literature for ultrasound during PDT. Results: A significant number of mostly observational studies and case series support this modality. Real‐time guidance enables clear visualisation of anatomical landmarks and results in a consistently high success and low complication rate, with appropriate positioning of the tracheal puncture. Recognition of unconventional vascular anatomy enables selection of an appropriate alternative puncture site or an elective open surgical approach. Conclusion: Current literature supports that using ultrasound for percutaneous tracheostomy is quick, safe, reliable and offers a plausible advantage over the traditional landmark guided procedure, especially in select patient groups, such as those who are morbidly obese or have difficult to palpate cervical anatomy.

The 2012 Republican and Democratic Health Care Platforms

Here's what you need to know as the fall elections approach.

Along the Hindu Kush: Warren Hastings, the Raj, and the Northwest Frontier

Along the Hindu Kush:Warren Hastings, the Raj, and the Northwest Frontier Kenneth W. Harl (bio) As a new presidential election approaches, many Americans, when they are not thinking about gasoline prices and unemployment statistics, wonder how the national interests are served by U.S. soldiers and pilots battling in a remote corner of the world, Afghanistan. Americans are aware of the less than ideal alliance with President Hamid Karzai of Afghanistan, and the repeated disputes, negotiations, and scandals that have rocked this alliance. Many are aware of how the fighting in Afghanistan has spread over the Hindu Kush— the daunting mountain barrier that divides Central Asia from the Indian subcontinent—into Pakistan. Osama bin Laden sought refuge in Pakistan. Both al-Qaeda and the Taliban operatives have found safe havens in Pakistan's rugged borderlands. Political events in Pakistan since 2008 have thus excited reporters and baffled the American electorate. Pervez Musharraf, leading general and ex-president, was compelled to resign and flee from prosecution on grounds of complicity in the assassination of Prime Minister Benazir Bhutto and his suspension of constitutional rule. An exile in London, he plans a political comeback. Meanwhile, the current prime minister, Yousaf Raza Gillani, has had his hands full with his own crises and clashes with his military that have arisen ultimately from the fighting in Afghanistan. Most Americans are aware that the imbroglio in Afghanistan and Pakistan has wider repercussions for Iran, the Republic of India, and the far more remote Central Asian republics of Tajikistan, Kyrgyzstan, Turkmenistan, Uzbekistan, and Kazakhstan. Yet most Americans are also products of today's ahistorical educational system and have no historical reference for comprehending these events, peoples, and lands. Those few remaining of the generation that won the Second World War have such a sense of history. Those few also witnessed the partition of British India, along with its religious and ethnic violence and then fierce fighting between India and Pakistan over Kashmir and Jammu. Indeed, the British imperial legacy in India has dictated much of what goes on today in these newly created nation-states along both sides of the Hindu Kush. The imperial legacy of British India is fundamental for understanding what we face today in Afghanistan, Pakistan, India, and Central Asia. Two men are customarily hailed as the founders of the British Empire in India: Sir Robert Clive (1725-1774) and Warren Hastings (1732-1818). They turned the East India Company from a trade monopoly into the paramount military power in the subcontinent with a fiscal and military base in Bengal. Click for larger view View full resolution From Alfred Comyn Lyall, Warren Hastings (London, 1889). To Lord Macaulay, Whig politician, secretary at war (1839-1841), and historian, Robert Clive was a brave and daring conqueror comparable to Julius Caesar, the obvious standard for all proper Englishmen who learned their Caesar and Latin together in public school. Yet, given his dissolute recreation at Madras between campaigns and his appetite for prize money, Clive did not fit the proper Victorian model. Indian nationalists despise Clive because he so adeptly outmaneuvered Indian princes in the duplicitous diplomacy of the era. Clive was also extraordinarily lucky. No commander in the 18th century was missed by more musket balls and shrapnel. His victory at Plassey on June 23, 1757, was both audacious and decisive. It won for the East India Company, commonly dubbed the Honorable Company, control over Bengal and the right to collect taxes from the wealthiest provinces of the Mughal Empire under the Treaty of Allahabad.1 If Robert Clive proved the victor, Warren Hastings, the first governor-general at Calcutta (1773-1785), was the organizer of the empire in India, which came to be called the Raj after the reforms instituted in the wake of the Great Sepoy Mutiny in 1857-1858. Warren Hastings, however, is a far more complex a figure than Clive, and ultimately far more important; for he created India as we understand it today. Hastings started working for the Honorable Company as a clerk when he was 18 and rose quickly, sitting on the councils of both Calcutta and Madras. He was selected to govern British India, then divided into...

From Independence to Politics in Financial Regulation

Independent agencies have long dominated the institutional structure of financial regulation. But after the 2007-08 crisis, this Article argues, the independent agency paradigm is under attack. To monitor financial institutions more thoroughly and address future failures more effectively, the U.S. and other industrialized nations redesigned the framework of financial regulation. Post-2008 laws allocate new powers not to independent bureaucrats, but to elected politicians and their direct appointees. To document this global paradigm shift, the Article examines the laws of fifteen key jurisdictions for international banking: the U.S., the U.K., France, Germany, Japan, Spain, Switzerland, Belgium, Ireland, Italy, Denmark, Canada, Australia, Mexico, and South Korea. This analysis points to a marked increase in the influence of elected politicians over banking. Politicians’ new powers extend not only over emergencies, but also over financial institutions’ regular operations. Politicians are now at the helm of innovative institutional arrangements, typically in the form of regulatory councils that encompass pre-existing independent agencies. In these councils, supermajority requirements and veto rights designate politicians as the ultimate decision-makers.The Article shows how this paradigm shift resulted from the interplay of factors unique to the 2008 crisis and long run trends. The collapse of institutions in diverse areas of financial activity, including investment banks, insurance companies, and thrifts, created a sense that independent regulators as a class had failed. Concerns about regulatory capture, combined with disillusionment with the markets’ potential to self-correct, further undermined confidence in past paradigms. Developments in financial markets attracted great interest from ordinary Americans, who over the last two decades have increasingly relied on the financial system for their pension savings, housing credit, and other investments. Politicians could not remain as distant from financial regulation as in the past. From a normative standpoint, politicians’ greater involvement in financial regulation is in line with calls for enhanced presidential control over independent agencies. Scholars have argued that the President’s stamp of approval will increase accountability and boost the legitimacy of hard choices, such as bank bailouts. However, greater political involvement might endanger financial stability, this Article argues. Electoral strategizing can influence politicians’ bailout choices, as incumbents might be particularly sensitive to upheavals as elections approach. Politicians are also under pressure from groups at ideological extremes, which often express a deep distrust to the financial system. In this climate, financial institutions are likely to lobby politicians more intensely. Thus, the risk of a financial catastrophe may now hinge upon considerations that have little to do with the health of the financial system.

Giant cystic meconium peritonitis presenting in a neonate with classic radiographic eggshell calcifications and treated with an elective surgical approach: a case report

IntroductionGiant cystic meconium peritonitis is relatively rare. Patients often present with nonspecific physical findings such as distension and emesis. Plain abdominal films remain invaluable for identifying the characteristic calcifications seen with a meconium pseudocyst, and large eggshell calcifications are pathognomonic for the giant cystic subtype.Case presentationWe present classic plain X-ray findings and an intraoperative image of a premature low birth weight two-day-old Hispanic male baby treated for giant cystic meconium peritonitis with a staged procedure involving peritoneal drainage, ostomy creation and closure.ConclusionPediatric surgeons have a range of potential therapeutic approaches for giant cystic meconium peritonitis. A delay of definitive surgical management in the setting of massive abdominal soiling is a safe and acceptable strategy if adequate temporizing drainage is performed in the early perinatal period.

Bounded oligarchy: How and when factions constrain leaders in party position-taking

This work investigates the process of position-taking, focussing on the factional bargaining within the party. Exploiting two recently built datasets that estimated the policy positions of Italian parties and factions from 1946 to 2010, we investigate if and to what extent factions bind the party leader in choosing the platform. We find confirmation for the idea that party positions are linked to factional preferences. Overall, the party works as a ‘bounded oligarchy’. Furthermore, the electoral payoff of party unity increases the impact of factional constraints when general elections approach. In line with the cartel party theory, however, autonomous leaders who are directly elected by a wider selectorate can get rid of factional ties choosing more moderate and vote-maximizing platforms.

New State Voting Laws: A Barrier to the Latino Vote?

The large and rapidly growing Latino population gains heightened attention as the 2012 Elections approach. Similarly, after 17 states passed legislation to restrict virtually all stages of the voting process, voting rights and these new potential barriers have become hotly debated topics — in and outside of the courtroom. While this sudden surge indicated a collaborative effort nationwide, more aggressive measures were seen in the Southern United States region. More notably, in states where Latino populations have surged in the past decade or where Latinos have a strong presence. Because of the unique demographic and array of recent voter legislation, this commentary specifically focuses on the impact that the laws in Alabama, Florida, Texas, and South Carolina would have on eligible Latino voters in upcoming elections if these laws are allowed to be implemented. This analysis takes into account the social and demographic factors that drive Latinos to be severely underrepresented among the electorate, and looks further to the national impact that these laws could have on the existing low participation rates among Latinos. Lastly, it concludes with policy recommendations to help address these issues at both the state and federal level. Currently, less than half of the Latino population is eligible to vote. Much of that is due to the rapid influx of U.S. born Latino youth that are ineligible to vote, but that ultimately will enter by the thousands to the pool of eligible voters each year. The impact of this underrepresentation is exasperated by the fact that Latino participation rates fall far below any other voting population. Moreover, Latinos live in poverty at a higher rate than any other racial or ethnic group. This finding makes Latinos especially vulnerable to voting laws aimed at restricting practices and/or procedures more often utilized by lowincome voters. As a result, potential barriers that decrease or even maintain current participation rates — as Latino youth become eligible voters — will increase the current representation gap seen among the electorate and will compromise Latino representation in all levels of government.

Les lésions diaphragmatiques post-traumatiques droites méconnues : une revue de six cas

Right posttraumatic diaphragmatic injuries are rare; literature relates mainly isolated cases or small series and most often rupture are succeeding of blunt trauma. This series is interesting because the number of cases and the existence of two injuries following a right stab wound. Retrospective study between January 2002 and September 2010. We collected the data of initial trauma, clinical, radiological, operative and follow-up for six patients supported for right posttraumatic diaphragmatic injuries. All injuries were in late presentation. Four injuries were secondary to road traffic accident, and two after stab wound. The time to diagnosis was between 47 days and 15 years. Right posterolateral thoracotomy was the elective approach in the cases with diaphragmatic hernia (5 patients). In one case, video-assisted thoracoscopic surgery permits the diagnosis and repair of injury. Mortality was null and morbidity was present in one case from six. Follow-up ranging from 8 months and 42 months don't objectified complications. Right diaphragmatic hernia is terrible sequelae after thoracoabdominal trauma. Surgery becomes more complex at this stage and can be done by thoracotomy. With strong suspicious signs at the first assessment of trauma, exploration by thoracoscopy can always avoid the occurrence of long-term sequelae.

Quid Pro Quo: Builders, Politicians, and Election Finance in India

Where elections are costly but accountability mechanisms are weak, politicians often turn to private firms for illicit election finance. Where firms are highly regulated, politicians can exchange policy discretion or regulatory forbearance for bribes and monetary transfers from firms. Due to its regulatory intensity, we focus on the role of the construction sector. Specifically, we argue that builders will experience a short-term liquidity crunch as elections approach because of their need to re-route funds to politicians as a form of indirect election finance. We use variation in the demand for cement to investigate the presence of an electoral cycle in building activity in India consistent with this logic. Using a novel monthly-level dataset, we demonstrate that cement consumption does exhibit a political business cycle consistent with our hypothesis. Additional tests provide confidence in the robustness and interpretation of our findings.

Three-year outcome of sirolimus-eluting stent implantation in coronary bifurcation lesions: the provisional side branch stenting approach versus the elective two-stent approach

To explore optimal management strategies for bifurcation lesions with sirolimus-eluting stents (SES). Among 12,824 patients enrolled in the j-Cypher Registry, we identified 2,122 patients with 2,250 non-left main bifurcation lesions (average age: 69 years; diabetes: 39%; acute coronary syndrome: 24%; lesion length ≥30 mm: 17%; true bifurcation: 53%) treated exclusively with SES. The majority of lesions (1,978 lesions, 88%) were treated by provisional side branch stenting approach with a 4.5% crossover rate, while the elective two-stent approach (stenting both main and side branches) was adopted in 272 lesions. The 3-year incidence of target-lesion revascularisation (TLR) was significantly higher in the elective two-stent group than in the provisional group (18.5% vs. 9.8%, p<0.0001). The incidence of definite stent thrombosis was not different between the two groups (1.3% vs. 0.61%, p=0.21). Among 1,871 lesions with main branch stenting alone, final kissing balloon dilatation (FKB) was performed in 938 lesions (50%). The incidence of TLR was not different between the two groups with or without FKB (9.9% vs. 9.2%, p=0.98). The provisional approach provided a good long-term outcome in the majority of lesions with low crossover rate to the two-stent approach. Lesions treated with FKB had similar TLR outcome to those without FKB after main branch stenting alone.

The Race toward Caraqueño Citizenship

This article examines the relationships between race, class, and citizenship in Venezuela’s burgeoning grassroots democracy as the nation’s 2012 presidential election approaches. Although the Venezuelan political arena is frequently overshadowed by policies and the personality of President Hugo Chávez, recently developing techniques of governance permit increased local autonomy. This and an associated push to integrate marginalized populations into social and political life have played a significant role in the production of community, public space, and localized conceptions of citizenship. While emergent Caraqueño democratic forms commonly idealize equality and collaborative governance, disjunctures among the city’s communities are social, geographic, and political. This article highlights the varying modes of political belonging greatly engendered by race and class in Caracas. These experiences of citizenship, in turn, have resulted in increased participation and access to power for some as they deny inclusion to others. This study of modes of citizenship focuses on the citizen and the public sphere, emerging modes of governance and the developing Venezuelan state, and dissidence within the democratic process.