Substantive Benefit Research Articles

Promotional Effects of Recorded Music and Superstars on Concert Financial Outcomes

Using a comprehensive data set of hand-collected observations of top touring performing artists, I examine the complementary relationship between recorded music and concert financial outcomes. I find that music streaming derives substantive financial benefit to the top 100 touring artists as a means to promote their live performances. Using empirical estimates from a panel model with artist fixed effects, an artist can derive an incremental $46K to $49K per show when achieving a 20% increase in music streaming. Additionally, using a 2SLS model with artist fixed effects to account for potential endogenous promotional effects, I identify top performers (or ‘superstars’) who derive significant additional concert revenue because of their back catalogue of hit songs. These top performers earn an incremental $15K per show for every week they have a song from their catalogue in the Billboard Top 20. These findings indicate that artists can use their legacy to build lifelong earnings from their music and performances. JEL Classifications: D12, D22, L82, Z10

Progressive Legal Perspective on the Ultra Petita Decision of the Constitutional Court

Until now, the discourse on ultra petita decisions has not found a point meeting between various parties. In this matter it is also necessary to examine, what are the considerations for making ultra decisions the petita , so that it can be known in what ways the constitutional judges can drop decision which contain super petita. From consideration- With these considerations, we can determine whether there really is enforcement law which progressive. This legal research uses a normative juridical approach with research specification analytical description. The type of data used is secondary data, consists of primary legal materials, secondary legal materials and tertiary legal materials. Technique data collection using library research ( library research) and from the data which collected and then analyzed in a manner qualitative-normative. From results study which conducted get it conclusion, that doctrine ban super petita for judge no apply absolute and general. With use approach normative and interpretation systemic could said that provision in Constitution MK nor Regulation MK no give possibility for judge constitution for make decision super petita. In issue decisions containing ultra petita, in general the Court based there is an inseparable connection between the article being reviewed and other articles which is not tested, so therefore the article or the entire law must be stated no strength law, in side because reason for avoid lawlessness and uphold substantive justice. MK's breakthrough in making ultra petita decisions in principle are a form of progressive law enforcement, However, any creativity carried out by law enforcers may not be progressive meaning if not to realize substantive justice, placing justice, benefit and human happiness as a goal finally.

Restricting emigration for their protection? Exit controls and the protection of (women) migrant workers

Abstract Abuse and exploitation of migrant workers in Gulf States is common and well-documented, and women domestic workers are at special risk. Sending states—often relatively poorer South Asian states—are limited in the ways that they can protect the rights of their citizens when they are labouring abroad. One strategy that sending states have deployed is the adoption of ‘emigration bans’ or ‘emigration conditions’. Emigration bans restrict citizens from taking up temporary labour market contracts, usually in specific states, but sometimes in general. ‘Emigration conditions’ require would-be migrants to meet specific requirements in order to be permitted, by the sending state, to take up a labour market contract abroad. In this article, I examine whether it is morally permissible for source countries to prohibit migration to countries where they risk being exploited or abused. I examine the reasons states give to justify emigration bans and conditions: the ‘structured vulnerability’ reason; the ‘gendered structured vulnerability’ reason; and the ‘gendered paternalism’ reason. Overall, I agree that the reasons motivating the bans and conditions are good ones—though I offer some criticism of the reasons I describe as ‘gendered paternalism’. But, since there is only limited evidence of the effectiveness of bans and conditions in achieving substantive benefit for labour migrants, and on the contrary evidence of the real harm they can sometimes generate, I argue that, absent positive evidence of success in achieving their objectives, they ought to be rejected in practice even if they are permissible in principle.

Self-help groups as platforms for development: The role of social capital.

Women-led self-help groups (SHGs) are increasingly being utilized as platforms for delivering development activities by funding agencies and governmental bodies. However, there is currently little understanding as to whether SHGs are effective or equitable platforms for delivering health or livelihoods interventions. Social capital is hypothesized as a comparative advantage when utilizing SHGs as development platforms, however the specific mechanisms have yet to be explored. This paper investigates the efficacy and equity of SHGs as platforms for development programs through analyzing 64 interviews and 6 focus group discussions collected from an agriculture and behavior change intervention delivered through SHGs in eastern India. We find that while, theoretically, SHGs are a promising platform for health messaging this is largely dependent on SHG norms of attendance, which itself is closely tied to socioeconomic conditions and social capital. Social capital is important both within SHGs as well as between SHGs and the implementing organization. Sites with more mature SHGs had greater economic security allowing more active participation in the intervention than sites with more poverty and young SHGs. The former sites also had greater norms of trust and reciprocity (social capital) with the implementing organization that led them to accept additional interventions. In the latter sites, SHG members had competing demands on their time and less trust in the implementers, making it difficult to attend both SHG meetings and health sessions. We put forth a materialist understanding of social capital formation, where SHG members must have already received substantive benefit from membership for new activities to be successfully incorporated into their agenda. Further, using SHGs as a nutrition message delivery platform should not detract from individual engagement with more vulnerable members of the community.

Interferon-γ: teammate or opponent in the tumour microenvironment?

Cancer immunotherapy offers substantive benefit to patients with various tumour types, in some cases leading to complete tumour clearance. However, many patients do not respond to immunotherapy, galvanizing the field to define the mechanisms of pre-existing and acquired resistance. Interferon-γ (IFNγ) is a cytokine that has both protumour and antitumour activities, suggesting that it may serve as a nexus for responsiveness to immunotherapy. Many cancer immunotherapies and chemotherapies induce IFNγ production by various cell types, including activated T cells and natural killer cells. Patients resistant to these therapies commonly have molecular aberrations in the IFNγ signalling pathway or express resistance molecules driven by IFNγ. Given that all nucleated cells can respond to IFNγ, the functional consequences of IFNγ production need to be carefully dissected on a cell-by-cell basis. Here, we review the cells that produce IFNγ and the different effects of IFNγ in the tumour microenvironment, highlighting the pleiotropic nature of this multifunctional and abundant cytokine.

Group Medical Visit and Microfinance Intervention for Patients With Diabetes or Hypertension in Kenya

BackgroundIncorporating social determinants of health into care delivery for chronic diseases is a priority. ObjectivesThe goal of this study was to evaluate the impact of group medical visits and/or microfinance on blood pressure reduction. MethodsThe authors conducted a cluster randomized trial with 4 arms and 24 clusters: 1) usual care (UC); 2) usual care plus microfinance (MF); 3) group medical visits (GMVs); and 4) GMV integrated into MF (GMV-MF). The primary outcome was 1-year change in systolic blood pressure (SBP). Mixed-effects intention-to-treat models were used to evaluate the outcomes. ResultsA total of 2,890 individuals (69.9% women) were enrolled (708 UC, 709 MF, 740 GMV, and 733 GMV-MF). Average baseline SBP was 157.5 mm Hg. Mean SBP declined −11.4, −14.8, −14.7, and −16.4 mm Hg in UC, MF, GMV, and GMV-MF, respectively. Adjusted estimates and multiplicity-adjusted 98.3% confidence intervals showed that, relative to UC, SBP reduction was 3.9 mm Hg (−8.5 to 0.7), 3.3 mm Hg (−7.8 to 1.2), and 2.3 mm Hg (−7.0 to 2.4) greater in GMV-MF, GMV, and MF, respectively. GMV and GMV-MF tended to benefit women, and MF and GMV-MF tended to benefit poorer individuals. Active participation in GMV-MF was associated with greater benefit. ConclusionsA strategy combining GMV and MF for individuals with diabetes or hypertension in Kenya led to clinically meaningful SBP reductions associated with cardiovascular benefit. Although the significance threshold was not met in pairwise comparison hypothesis testing, confidence intervals for GMV-MF were consistent with impacts ranging from substantive benefit to neutral effect relative to UC. Incorporating social determinants of health into care delivery for chronic diseases has potential to improve outcomes. (Bridging Income Generation With Group Integrated Care [BIGPIC]; NCT02501746)

Restricting Emigration for Their Protection? Exit Controls and the Protection of (Women) Migrant Workers

Abuse and exploitation of migrant workers in Gulf States is common and well-documented, and women domestic workers are at special risk. Sending states – often relatively poorer South Asian states – are limited in the ways that they can protect the rights of their citizens when they are labouring abroad. One strategy that sending states have deployed is the adoption of “emigration bans” or “emigration conditions.” Emigration bans restrict citizens from taking up temporary labour market contracts, usually in specific states, but sometimes in general. “Emigration conditions” require would-be migrants to meet specific requirements in order to be permitted, by the sending state, to take up a labour market contract abroad. In this article, I examine whether it is morally permissible for source countries to prohibit migration to countries where they risk being exploited or abused. I examine the reasons states give to justify emigration bans and conditions: the “structured vulnerability” reason; the “gendered structured vulnerability” reason; and the “gendered paternalism” reason. Overall, I agree that the reasons motivating the bans and conditions are good ones – though I offer some criticism of the reason I describe as “gendered paternalism”. But, since there is only limited evidence of the effectiveness of bans and conditions in achieving substantive benefit for labour migrants, and on the contrary evidence of the real harm they can sometimes generate, I argue that, absent positive evidence of their success in achieving their objectives, they ought to be rejected in practice even if they are permissible in principle.

Robust Overall Survival and Sustained Efficacy Outcomes during Long Term Exposure to Momelotinib in JAK Inhibitor Naïve and Previously JAK Inhibitor Treated Intermediate/High Risk Myelofibrosis Patients

Robust Overall Survival and Sustained Efficacy Outcomes during Long Term Exposure to Momelotinib in JAK Inhibitor Naïve and Previously JAK Inhibitor Treated Intermediate/High Risk Myelofibrosis Patients

Caseload is increased by resequencing cases before and on the day of surgery at ambulatory surgery centers where initial patient recovery is in operating rooms and cleanup times are longer than typical

Study objectiveThe coronavirus disease 2019 (COVID-19) pandemic impacts operating room (OR) management in regions with high prevalence (e.g., >1.0% of asymptomatic patients testing positive). Cases with aerosol producing procedures are isolated to a few ORs, initial phase I recovery of those patients is in the ORs, and multimodal environmental decontamination applied. We quantified the potential increase in productivity from also resequencing these cases among those 2 or 3 ORs. DesignComputer simulation provided sample sizes requiring >100 years experimentally. Resequencing was limited to changes in the start times of surgeons' lists of cases. SettingAmbulatory surgery center or hospital outpatient department. Main resultsWith case resequencing applied before and on the day of surgery, there were 5.6% and 5.5% more cases per OR per day for the 2 ORs and 3 ORs, respectively, both standard errors (SE) < 0.1%. Resequencing cases among ORs to start cases earlier permitted increases in the hours into which cases could be scheduled from 10.5 to 11.0 h, while assuring >90% probability of each OR finishing within the prespecified 12-h shift. Thus, the additional cases were all scheduled before the day of surgery. The greater allocated time also resulted in less overutilized time, a mean of 4.2 min per OR per day for 2 ORs (SE 0.5) and 6.3 min per OR per day for 3 ORs (SE 0.4). The benefit could be achieved while limiting application of resequencing to days when the OR with the fewest estimated hours of cases has ≤8 h. ConclusionsSome ambulatory surgery ORs have unusually long OR times and/or room cleanup times (e.g., infection control efforts because of the pandemic). Resequencing cases before and on the day of surgery should be considered, because moving 1 or 2 cases occasionally has little to no cost with substantive benefit.

Some Remarks on the Protection of Legitimate Expectations in International Investment Law

This article examines the nature of legitimate expectations in international investment law. The author considers international investment case law to suggest that legitimate expectations consist of four basic elements: specific representation or promise made by the host State, legitimacy, reasonability, and objectivity of expectations, reliance (trust) the investor had in the representation made by the host State and the substantive benefit received by the investor by way of representation or promise made by the host State. After briefly explaining the basics of the protection of legitimate expectations, the article addresses each element, including the criteria of effective representations or promise made by the host State that is capable of creating legitimate expectations. It also shows that the focus should be placed on the reliance element

Cost-effectiveness of adult spinal deformity surgery in a military healthcare system.

OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing spinal deformity surgery in the unique environment of a military healthcare system (MHS).METHODSPatients were enrolled between 2011 and 2017. Patients were eligible to participate if they were undergoing a thoracolumbar spinal fusion spanning more than 6 levels to treat an underlying deformity. Patients completed the 36-Item Short Form Health Survey (SF-36) prior to surgery and 6 and 12 months after surgery. The authors used paired t-tests to compare SF-36 Physical Component Summary (PCS) scores between baseline and postsurgery. To estimate the cost per QALY of complex spine surgery in this population, the authors extended the change in health-related quality of life (HRQOL) between baseline and follow-up over 5 years. Data on the cost of surgery were obtained from the MHS and include all facility and physician costs.RESULTSHRQOL and surgical data were available for 49 of 91 eligible patients. Thirty-one patients met additional criteria allowing for cost-effectiveness analysis. Over 12 months, patients demonstrated significant improvement (p < 0.01) in SF-36 PCS scores. A majority of patients met the minimum clinically important difference (MCID; 83.7%) and substantive clinical benefit threshold (SCBT; 83.7%). The average change in QALY was an increase of 0.08. Extended across 5 years, including the 3.5% discounting per year, study participants increased their QALYs by 0.39, resulting in an average cost per QALY of $181,649.20. Nineteen percent of patients met the < $100,000/QALY threshold with half of the patients meeting the < $100,000/QALY mark by 10 years. A sensitivity analysis showed that patients who scored below 60 on their preoperative SF-36 PCS had an average increase in QALYs of 0.10 per year or 0.47 over 5 years.CONCLUSIONSWith a 5-year extended analysis, patients who receive spinal deformity surgery in the MHS increased their QALYs by 0.39, with 19% of patients meeting the $100,000/QALY threshold. The majority of patients met the threshold for MCID and SCBT at 1 year postoperatively. Consideration of preoperative functional status (SF-36 PCS score < 60) may be an important factor in determining which patients benefit the most from spinal deformity surgery.

Task preparation as a mnemonic: The benefits of drawing (and not drawing).

Creating a visual representation of an item through drawing affords that item a substantive memory benefit, relative to several control tasks. Recent findings demonstrate the robustness of this drawing effect across several stimulus classes, irrespective of encoding time, setting, age group, or memory measure. The advantage for drawn information has been attributed to the integrated contributions of at least three components of visual production through drawing, which can independently facilitate memory: elaborative, motoric, and pictorial. In the current work, we investigated the importance of the elaborative process one must engage in while preparing to draw, and directly tested whether this generative period alone was sufficient to improve memory. Participants were prompted to either draw or write out presented words, and were provided with a 1- or 2-s preparatory period prior to completing the prompted task. Critically, on a subset of the trials, participants were prevented from completing the prompted task. There was strong evidence in support of better memory for drawn items, which replicates the drawing effect commonly observed in prior work. Interestingly, following prompts to draw, there was also a reliable memory benefit of the preparatory period alone. In other words, simply engaging in the elaborative process of preparing to draw (i.e., without completing the drawing) was enough to produce a reliable increase in later memory relative to actually writing.

Responses to eccentric and concentric cycling in patients with chronic heart failure: Comparison to age-matched healthy controls

Introduction: Chronic heart failure (CHF) is a common and debilitating disease with a prognosis that remains poorer than most cancers. Patients with CHF are characterised by dyspnea and poor exercise tolerance, which sometimes limits the ability to prescribe exercise at intensity high enough to induce substantive physiological benefit. At matched workloads, eccentric (ECC) cycling can be performed at a lower VO2 in healthy populations however, whether this relationship remains the same in a group of age-matched patients with CHF has not previously been investigated.

Direct Reconstruction of CT-based Attenuation Correction Images for PET with Cluster-Based Penalties.

Extremely low-dose CT acquisitions used for PET attenuation correction have high levels of noise and potential bias artifacts due to photon starvation. This work explores the use of a priori knowledge for iterative image reconstruction of the CT-based attenuation map. We investigate a maximum a posteriori framework with cluster-based multinomial penalty for direct iterative coordinate decent (dICD) reconstruction of the PET attenuation map. The objective function for direct iterative attenuation map reconstruction used a Poisson log-likelihood data fit term and evaluated two image penalty terms of spatial and mixture distributions. The spatial regularization is based on a quadratic penalty. For the mixture penalty, we assumed that the attenuation map may consist of four material clusters: air+background, lung, soft tissue, and bone. Using simulated noisy sinogram data, dICD reconstruction was performed with different strengths of the spatial and mixture penalties. The combined spatial and mixture penalties reduced the RMSE by roughly 2 times compared to a weighted least square and filtered backprojection reconstruction of CT images. The combined spatial and mixture penalties resulted in only slightly lower RMSE compared to a spatial quadratic penalty alone. For direct PET attenuation map reconstruction from ultra-low dose CT acquisitions, the combination of spatial and mixture penalties offers regularization of both variance and bias and is a potential method to reconstruct attenuation maps with negligible patient dose. The presented results, using a best-case histogram suggest that the mixture penalty does not offer a substantive benefit over conventional quadratic regularization and diminishes enthusiasm for exploring future application of the mixture penalty.

Reef-scale trends in Florida Acropora spp. abundance and the effects of population enhancement.

Since the listing of Acropora palmata and A. cervicornis under the US Endangered Species Act in 2006, increasing investments have been made in propagation of listed corals (primarily A. cervicornis, A. palmata to a much lesser extent) in offshore coral nurseries and outplanting cultured fragments to reef habitats. This investment is superimposed over a spatiotemporal patchwork of ongoing disturbances (especially storms, thermal bleaching, and disease) as well as the potential for natural population recovery. In 2014 and 2015, we repeated broad scale (>50 ha), low precision Acropora spp. censuses (i.e., direct observation by snorkelers documented via handheld GPS) originally conducted in appropriate reef habitats during 2005–2007 to evaluate the trajectory of local populations and the effect of population enhancement. Over the decade-long study, A. palmata showed a cumulative proportional decline of 0.4 –0.7x in colony density across all sites, despite very low levels of outplanting at some sites. A. cervicornis showed similar proportional declines at sites without outplanting. In contrast, sites that received A. cervicornis outplants showed a dramatic increase in density (over 13x). Indeed, change in A. cervicornis colony density was significantly positively correlated with cumulative numbers of outplants across sites. This study documents a substantive reef-scale benefit of Acropora spp. population enhancement in the Florida Keys, when performed at adequate levels, against a backdrop of ongoing population decline.

Use of Aldosterone Antagonists for Treatment of Uncontrolled Resistant Hypertension

Multiple studies indicate that primary aldosteronism (PA) is common in patients with resistant hypertension, with an estimated prevalence of approximately 20%. Additional studies suggest that beyond this 20% of patients with classical PA, there is a larger proportion of patients with lesser degrees of hyperaldosteronism which contributes even more broadly to antihypertensive treatment resistance. Given these observations, it is intuitive that use of aldosterone antagonists will provide antihypertensive benefit in patients with resistant hypertension and evidence of aldosterone excess. Intriguingly, however, are clinical findings demonstrating substantive benefit of aldosterone antagonists in patients with resistant hypertension, but without demonstrative evidence of hyperaldosteronism, that is, with seemingly normal or even low aldosterone levels. Spironolactone is clearly established as the most effective fourth agent for treatment of uncontrolled resistant hypertension. Emerging observations suggest a further role of spironolactone for counteracting the effects of diet high in sodium, particularly in obese, hypertensive patients.

Certified normal: Alzheimer's disease biomarkers and normative estimates of cognitive functioning

Normative samples drawn from older populations may unintentionally include individuals with preclinical Alzheimer's disease (AD) pathology, resulting in reduced means, increased variability, and overestimation of age effects on cognitive performance. A total of 264 cognitively normal (Clinical Dementia Rating = 0) older adults were classified as biomarker negative (“Robust Normal,” n = 177) or biomarker positive (“Preclinical Alzheimer's Disease” [PCAD], n = 87) based on amyloid imaging, cerebrospinal fluid biomarkers, and hippocampal volumes. PCAD participants performed worse than robust normals on nearly all cognitive measures. Removing PCAD participants from the normative sample yielded higher means and less variability on episodic memory, visuospatial ability, and executive functioning measures. These results were more pronounced in participants aged 75 years and older. Notably, removing PCAD participants from the sample significantly reduced age effects across all cognitive domains. Applying norms from the robust normal sample to a separate cohort did not improve Clinical Dementia Rating classification when using standard deviation cutoff scores. Overall, removing individuals with biomarker evidence of preclinical AD improves normative sample quality and substantially reduces age effects on cognitive performance but provides no substantive benefit for diagnostic classifications.

Meeting physical activity recommendations may be protective against temporal lobe atrophy in older adults at risk for Alzheimer's disease

IntroductionPhysical activity (PA) is associated with brain health in older adults. However, it is unknown whether the current physical activity recommendations (PAR) impart substantive benefit. The objective of this study was to compare temporal lobe volumes between older adults who met PAR and those who did not. MethodsNinety-one enrollees from the Wisconsin Registry for Alzheimer's Prevention wore an accelerometer for seven consecutive days to quantify their PA behaviors and underwent a T-1 anatomic magnetic resonance imaging scan. Participants were categorized as either having met PAR or not based on the US Department of Health and Human Services recommendations of 150 minutes of moderate-to-vigorous physical activity per week. ResultsParticipants who met PAR possessed significantly greater inferior (η2P = .050) and anterior (η2P = .055) temporal lobe volumes compared with those who did not (P < .05). DiscussionIndividuals at-risk for AD experience accelerated rates of brain atrophy. These results suggest that regular engagement in PA at or above PAR could attenuate this decline.

Lowering cholesterol in chronic kidney disease: is it safe and effective?

The value of cholesterol lowering in preventing cardiovascular disease has now been established in patients with chronic kidney disease (CKD), who are intrinsically at high cardiovascular risk. While data from completed studies has clearly demonstrated substantive benefit of statins in early CKD, the effects in end-stage CKD remain controversial. Recent studies have also suggested that the effects of different statins on the kidney may be heterogeneous, and the safety of high-dose statins in this population remains uncertain. Communications from regulators such as the US Food and Drug Administration concerning potential side effects of statin therapy (particularly memory loss and the risk of diabetes) have created debate in the medical literature and unrest in the public mind about the value of long-term statin therapy for vulnerable patient populations. The evaluation of risks and benefits for this class of agents is critically dependent on baseline risk. This article will review current evidence for the benefits and risks of statin therapy for kidney and cardiovascular disease progression in the CKD population.

How neurologists can choose (even more) wisely: prioritizing waste reduction targets and identifying gaps in knowledge.

How neurologists can choose (even more) wisely: prioritizing waste reduction targets and identifying gaps in knowledge.