Economic freedom improves income mobility: evidence from Canadian provinces, 1982–2018

Economic freedom is robustly associated with income growth, but does this association extend to the poorest in a society? In this paper, we employ Canada's longitudinal cohorts of income mobility between 1982 and 2018 to answer this question. We find that economic freedom, as measured by the Fraser Institute's Economic Freedom of North America (EFNA) index, is positively associated with multiple measures of income mobility for people in the lowest income deciles, including (a) absolute income gain; (b) the percentage of people with rising income; and (c) average decile mobility. For the overall population, economic freedom has weaker effects.

Severity assessment of complex and repeated intracranial surgery in rats

Introduction Evidence-based grading of the impact of intracranial surgery on rat’s well-being is important for ethical and legal reasons. We assessed the severity of complex and repeated intracranial surgery in a 6-hydroxydopamine (6-OHDA) Parkinson’s rat model with subsequent intracranial electrode implantation, and in an intracranial tumor model with subsequent resection. Methods Stereotactic surgery was performed in adult male rats with the same general anesthesia and perioperative pain management. In the Parkinson’s model, Sprague Dawley (SD) rats received unilateral injection of 6-OHDA (n=11) or vehicle (n=7) into the medial forebrain bundle as first operation. After four weeks, neural electrodes were implanted in all rats as second operation. For tumor formation, BDIX/ UlmHanZtm (BDIX) rats (n=8) received frontocortical injection of BT4Ca cells as first operation, followed by tumor resection as second operation after one week. Multiple measures severity assessment was done two days before and four days after surgery in all rats, comprising clinical scoring, body weight and detailed behavioral screening. To include a condition with a known burden, rats with intracranial tumors were additionally assessed up to a predefined humane endpoint that has previously been classified as "moderate". Results After the first operation, only 6-OHDA injection resulted in transient elevated clinical scores, a mild long-lasting weight reduction and motor disturbances. After the second surgery, body weight was transiently reduced in all groups. All other parameters showed variable results. Principal Component Analysis showed a separation from the preoperative state driven by motor-related parameters after 6-OHDA injection, while separation after electrode implantation and more clearly after tumor resection was driven by pain-related parameters, although not reaching the level of the humane endpoint of our tumor model. Conclusion Overall, cranial surgery of different complexity only transiently and rather mildly affects rat’s well-being. Multiple measures assessment allows the differentiation of model-related motor disturbances in the Parkinson’s model from potentially pain-related conditions after tumor resection and electrode implantation.

Associations Between Brain Volumes and Cognitive Tests with Hypertensive Burden in UK Biobank

Background: Mid-life hypertension is an established risk factor for cognitive impairment and dementia and related to greater brain atrophy and poorer cognitive performance. Previous studies often have small sample sizes from older populations that lack utilizing multiple measures to define hypertension such as blood pressure, self-report information, and medication use; furthermore, the impact of the duration of hypertension is less extensively studied. Objective: To investigate the relationship between hypertension defined using multiple measures and length of hypertension with brain measure and cognition. Methods: Using participants from the UK Biobank MRI visit with blood pressure measurements (n = 31,513), we examined the cross-sectional relationships between hypertension and duration of hypertension with brain volumes and cognitive tests using generalized linear models adjusted for confounding. Results: Compared with normotensives, hypertensive participants had smaller brain volumes, larger white matter hyperintensities (WMH), and poorer performance on cognitive tests. For total brain, total grey, and hippocampal volumes, those with greatest duration of hypertension had the smallest brain volumes and the largest WMH, ventricular cerebrospinal fluid volumes. For other subcortical and white matter microstructural regions, there was no clear relationship. There were no significant associations between duration of hypertension and cognitive tests. Conclusion: Our results show hypertension is associated with poorer brain and cognitive health however, the impact of duration since diagnosis warrants further investigation. This work adds further insights by using multiple measures defining hypertension and analysis on duration of hypertension which is a substantial advance on prior analyses—particularly those in UK Biobank which present otherwise similar analyses on smaller subsets.

Does the Length of the Cooling-off Period Affect Audit Quality?

This paper examines the association between the length of the cooling-off period and audit quality: (1) when partners rotate back and (2) during the cooling-off period, ahead of an extension to the minimum cooling-off period requirement in Australia. Using multiple measures of audit quality, we find some evidence of a positive association between the cooling-off period length and audit quality when partners rotate back, yet evidence of a negative association between the two, during the cooling-off period. We also find that auditor and client characteristics-such as partner busyness, client knowledge, geographic proximity, and client importance-play important roles in determining the cooling-off period length and whether a partner rotates back onto a client. Overall, we provide timely evidence that extending the cooling-off period only marginally enhances audit quality when a partner rotates back onto a client, and evidence of an unintended consequence of this policy during the cooling-off period.

Virological measures and factors associated with outcomes, and missing outcome data in HIV clinical trials: a methodological study

BackgroundTo evaluate the definition of HIV virological outcomes in the literature and factors associated with outcomes and missing outcome data.MethodsWe conducted a methodological review of HIV RCTs using a search (2009–2019) of PubMed, Embase and the Cochrane Central Register of Controlled Trials.Only full-text, peer-reviewed, randomised controlled trials (RCTs) that measured virological outcomes in people living with HIV, and published in English were included.We extracted study details and outcomes. We used logistic regression to identify factors associated with a viral threshold ≤50 copies/mL and linear regression to identify factors associated with missing outcome data.ResultsOur search yielded 5847 articles; 180 were included. A virological outcome was the primary outcome in 73.5% of studies. 89 studies (49.4%) used virological success. The remaining used change in viral load (VL) (33 studies, 18.3%); virological failure (59 studies, 32.8%); or virological rebound (9 studies, 5.0%). 96 studies (53.3%) set the threshold at ≤50 copies/mL; and 33.1% used multiple measures.Compared with government and privately funded studies, RCTs with industry funding (adjusted OR 6.39; 95% CI 2.15 to 19.00; p<0.01) were significantly associated with higher odds of using a VL threshold of ≤50 copies/mL. Publication year, intervention type, income level and number of patients were not associated with a threshold of ≤50 copies/mL. Trials with pharmacological interventions had less missing data (β=−11.04; 95% CI −20.02 to −1.87; p=0.02).DiscussionCountry source of funding was associated with VL threshold choice and studies with pharmacological interventions had less missing data, which may in part explain heterogeneous virological outcomes across studies. Multiple measures of VL were not associated with missing data. The development of formal guidelines on virological outcome reporting in RCTs is needed.