Patrilocality and Child Sex Ratios in India

In multi-level and multi-layered foundations of gendered approaches for understanding the kinship system, son preferences, and male-skewed child sex ratios in India; patriarchy, and patrilineality have received greater attention than patrilocality. To fill this gap, in this study, we construct a measure of patrilocality and examine its association with skewed child sex ratios. We hypothesize that households practice sex selection and daughter discrimination because of patrilocal norms that dictate the later life co-residence between parents and sons. Our findings reveal that the child sex ratio, the sex ratio at birth, and the sex ratio at last birth are positively correlated with the patrilocality rates across states and districts of India. The relationship holds across the multiple robustness checks. Findings, although not surprising, emerge from the robust empirical analyses at a time when child sex ratios continue to worsen in India, notwithstanding the country’s socio-economic progress. We conclude that in the absence of strong social security measures and lack of preference for old-age homes amidst the accepted practice of patrilocality coupled with increasing lower fertility norms, the dependency on sons will continue and further lead to the continuation of sex selection in India.

Shoreline Detection Accuracy from Video Monitoring Systems

Video monitoring has become an indispensable tool to understand beach processes. However, the measurement accuracy derived from the images has been taken for granted despite its dependence on the calibration process and camera movements. An easy to implement self-fed image stabilization algorithm is proposed to solve the camera movements. Georeferenced images were generated from the stabilized images using only one calibration. To assess the performance of the stabilization algorithm, a second set of georeferenced images was created from unstabilized images following the accepted practice of using several calibrations. Shorelines were extracted from the images and corrected with the measured water level and the computed run-up to the 0 m contour. Image-derived corrected shorelines were validated with one hundred beach profile surveys measured during a period of four years along a 1.1 km beach stretch. The simultaneous high-frequency field data available of images and beach surveys are uncommon and allow assessing seasonal changes and long-term trends accuracy. Errors in shoreline position do not increase in time suggesting that the proposed stabilization algorithm does not propagate errors, despite the ever-evolving vegetation in the images. The image stabilization reduces the error in shoreline position by 40 percent, having a larger impact with increasing distance from the camera. Furthermore, the algorithm improves the accuracy on long-term trends by one degree of magnitude (0.01 m/year vs. 0.25 m/year).

The diagnosis of growth hormone deficiency remains a judgment call – and that is good

The diagnosis of GHD still does not reflect evidence-based and generally accepted practice, and reliance on growth hormone stimulation testing (GST) leads to a high rate of false positive diagnosis of idiopathic isolated GHD (IIGHD). While searching for more definitive indicators of GHD is attractive, it should not distract from currently available steps to reduce erroneous IIGHD diagnoses. This paper describes opportunities to improve the accuracy of the GST which include: 1) meticulous selection of candidates for GST, since a low prevalence of GHD among short children in general is a major factor undermining the test’s diagnostic accuracy; 2) departure from traditional pass/fail diagnostic GH cutoffs towards, instead, formulation of diagnoses along a continuum that spans actual GHD -> provisional GHD -> not GHD; 3) response to the provisional diagnosis of IIGHD based on GST with additional post-test observation or alternative growth-promoting interventions rather than immediate hGH treatment; 4) re-examination and often correction of a prior IIGHD diagnosis with the onset of puberty. Modern medicine is increasingly offering diagnostic tests that aim to eliminate the need for provisional diagnoses. But a pitfall of such a “definitive” test for GHD would be the temptation to respond to its results definitively. Given the nuances, variations, and fluctuations in GH axis function over time, children evaluated for growth concerns are still best served by clinical judgment that combines thoroughness, patience, flexibility, and healthy skepticism into the diagnosis of GHD.

Using Named Entity Recognition to Identify Substances Used in Self-Medication of Opioid Withdrawal: Natural Language Processing Study of Reddit Data (Preprint)

BACKGROUND Abrupt cessation of opioid use can cause withdrawal symptoms, ranging from moderate to severe. People often continue opioid misuse to avoid these symptoms. Many people who use opioids self-treat withdrawal symptoms with a wide range of substances, some of which could help and some potentially harm. Little is known about the substances people use or their effects. OBJECTIVE To validate a methodology for identifying substances used to treat symptoms of opioid withdrawal by a community of people who use opioids on the social media site Reddit. METHODS We developed a named entity recognition model and used it to extract substances and effects from nearly 4 million comments from the r/opiates and r/OpiatesRecovery subreddits. We categorized effects as (1) DSM-5 symptoms of opioid withdrawal, e.g., body aches, (2) effects of opioid use, e.g., euphoria, (3) neither, or (4) other. In this analysis, we focused on those effects which are symptoms of opioid withdrawal and substances which are potential remedies for those withdrawal symptoms. To identify these subsets, we began by deduplicating substances and effects using a combination of clustering on word embeddings and manual review. We then built a bipartite network of substance and effect co-occurrence. For each of 16 effects identified as DSM-5 symptoms of opioid withdrawal, we identified the top 10 substances most strongly associated with the effect, based on a weighted average of edge count and positive pointwise mutual information. We classified these symptom and potential remedy pairs as (1) common treatments, (2) not accepted practice but potentially useful, (3) natural/home remedies, (4) causes, or (5) other. We developed the Withdrawal Remedy Explorer app to facilitate further exploration of the data. RESULTS Our named entity recognition model achieved F1 scores of 92.1 (substances) and 81.7 (effects) on holdout data. After deduplication, we identified 458 unique substances and 253 unique effects. Of 130 potential remedies strongly associated with withdrawal symptoms, 41.54% were common, accepted treatments for the symptom; 13.08% were not accepted practice, but could be useful given their pharmacology; 10.00% were natural/home remedies; 5.38% were causes of the symptom; and 30.00% were other. We identified both potentially promising new remedies (e.g., gabapentin for body aches) and potentially common but harmful remedies (e.g., antihistamines for restless leg syndrome). CONCLUSIONS Social media is a promising source of data on self-medication of opioid withdrawal. Many of the withdrawal remedies discussed by Reddit users are either clinically proven or potentially useful. These results suggest that this methodology is a valid way to study the self-treatment behavior of an online community of people who use opioids. Our Withdrawal Remedy Explorer app provides a platform to use this data for pharmacovigilance, identification of new treatments, and better understanding the needs of people undergoing opioid withdrawal. Furthermore, this approach could be applied to many other disease states where people self-manage their symptoms (to any degree) and discuss their experiences online.

An American Notwithstanding Clause? Between Potestas and Potentia

Debates about judicial review and departmentalism have continued to rage, and in the wake of the last three Supreme Court appointments and current Presidential Commission on the Court, only look to intensify. Should the US adopt a notwithstanding or override provision, of the kind that exits in Canada and Israel? These countries take a departmentalist approach to allow the legislature to override the Court, “notwithstanding” its ruling. Although America is a presidential framework, a paradox emerges: evidence exists that its system already makes possible the equivalent of a notwithstanding clause. This consists of Congress and the President together “overruling” the Supreme Court. In another sense, however, this is not an accepted practice—large parts of the legal community hold that the US Constitution establishes judicial supremacy. To better understand this dynamic, we consider two kinds of power: formal and authorized (potestas) as well as direct and concrete (potentia). The contrast between the positions on both power and sovereignty of Thomas Hobbes (associated with potestas) and Baruch Spinoza (linked to potentia) helps clarify these issues in a contemporary context. It turns out that a robust departmentalist equivalent of the notwithstanding clause already exists in the US, as a matter of Hobbesian potestas but not of Spinozist potentia. Another term for the latter is pouvoir constituant. Spinoza’s perspective on political activity further clarifies the in-between nature of the American override capacity: the active or passive character of a multitude is not binary, but is a matter of degree. Without making an institutional recommendation, we note that Spinoza’s understanding of power also allows for dynamic interaction between potentia and potestas: formal authorization can contribute to the expression of direct power. It is, therefore, conceivable that additional codification of the existing American override capacity, either through a joint declaration of Congress and the Presidency or a Constitutional Amendment, can strengthen the effective sovereignty of the American people in relation to the courts.

1418 Non-Operative Versus Operative Management for Blunt Pancreatic Trauma in Adults: A Systematic Review of The Literature

Aim Pancreatic injury, a rare consequence of blunt abdominal trauma, is associated with significant morbidity and mortality when the appropriate management is delayed. Due to the rarity of the injury, there is currently a lack of evidence to establish a treatment pathway for adults. The aim of this review was to compare outcomes following non-operative and operative management of adults who suffered blunt pancreatic trauma injuries. Method An electronic literature search was performed from 2008 to 2020. Studies pertaining to adults sustaining blunt pancreatic injuries, of all grades (I-V) of severity, according to the American Association for the Surgery of Trauma, were included. The primary outcome was mortality, whilst secondary outcomes were components of pancreas specific morbidity. 1501 studies were initially identified and screened, and 11 studies were included in the review. Results Qualitative analysis showed an increase risk of mortality with increased severity of injury, and in the operative group compared to non-operative group. All patients who were haemodynamically unstable underwent immediate operative management, whereas the management strategy for patients with haemodynamic stability differed between the studies and depended on either the grade of injury, presence of other organ injury, or failure of initial management strategy. Conclusions This systematic review largely reaffirmed accepted practice in determining operative versus non-operative treatment for blunt pancreatic injury. Larger institutional analyses are required to add strength to the evidence supporting non-operative management for grade III or IV injuries with appropriate monitoring and subsequent intervention if required.

Effective management of serious police misconduct: a machine learning analysis

There are a range of management strategies available to police agencies to prevent serious misconduct. While many of these strategies are well accepted practice, there is limited empirical evidence demonstrating their effectiveness. This study uses partial dependence plots to explore management strategies which have been identified as either increasing or decreasing risk of serious police misconduct. These include the provision of awards or complimentary remarks to officers, remedial action resulting from sustained complaints, and transfers between workplaces. Expedient and opportune complaint resolution processes at a local level, positive behavioural reinforcement, and having a diverse range of career opportunities help prevent serious misconduct by police officers.

Adaptation Strategies: Aesthetics of the Linguistic Codes Used by Drug Addicts in Portugal

Daily continuous drug use becomes a chronic disease, and this causes the person to lose control over his actions and over his own life. The most used nomenclatures/terminologies when referring to drug users is “addict”. The desire to use drugs overrides all the activities and responsibilities that the drug addict must carry out in his daily life. The physical and psychosocial destruction of the drug user is quick and visible to all those around him and who lives with him daily. In Portugal, drug addicts, despite knowing that they are not criminalized for drug use, know and feel that this is not a socially accepted practice. In this sense, one of the ways that these people defend themselves from social criticism or judgment is through the elaboration of the perceptible linguistic signs and codes, which is understandable only by the drug addicts. In this research, the analysis dimension consisted of understanding and decoding these linguistic codes and to perceive the main reasons that are inherent to their use by drug addicts. According to the reports of drug addicts, it was possible to decode these linguistic codes of drug addicts and translate them into a language that can be accessible to the Portuguese society in general, and for all those who develop their professional practices with drug addicts. To carry out this research, the qualitative methodology was used, which is centered on a case study. Semi-structured interviews were used as a data collection technique. For data analysis, the content analysis was utilized.

Taking the principle of the primacy of the human being seriously

This paper targets an orphan topic in research ethics, namely the so called principle of the primacy of the human being, which states that the interests of the human subject should always take precedence over the interests of science and society. Although the principle occupies the central position in the majority of international ethical and legal standards for biomedical research, it has been commented in the literature mainly in passing. With a few notable exceptions, there is little in-depth discussion about the meaning and role of the principle. Several authors note that the principle is vogue, ambiguous and apparently conflicting with the accepted practice of conducting non-beneficial research on individuals unable to give consent. There are opinions that it is just “a vacuous figure of speech” and should be abandoned. This paper argues that the primacy principle is far from being “a vacuous figure of speech”, rather it should be seen as a threefold concept: a fundamental interpretative rule, a procedural rule, and a substantive rule aimed at protecting research subjects from instrumental treatment and unacceptable risks. This interpretation tracks back to the principle regulatory and normative origins in the Declaration of Helsinki of 1975, but also acknowledges changes in research ethics and practice, which took place at the turn on the twentieth and twenty-first centuries. Thus, the proposed reading of the principle is not only original, but also historically grounded and normatively fruitful. It provides a fresh and ethically rich perspective on extensively debated, but still controversial problem of an upper limit of permissible risks in non-beneficial studies.