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The rich literature on election trust predominantly uses domestic determinants as explanatory factors. But given the international nature of the autocratization wave, can an autocratization event across borders erode election trust? This article argues that an authoritarian's electoral success in a neighboring country can shatter democratic norms and demonstrate the viability of authoritarians. This autocratization event abroad can thus reduce citizens' principled support for democracy and its political system. Consequently, citizens across borders are less likely to see democratic elections as the "only game in town" and they have less trust in elections. To test this idea, I study the spillover effects of the 2018 Brazilian presidential election, in which an authoritarian candidate won decisively. Using the AmericasBarometer in Colombia that was launched throughout this election, I find that the election trust of Colombian citizens erodes after Jair Bolsonaro's electoral success. To probe into the mechanism, I uncover that his electoral victory leads Colombian citizens to be less supportive of the domestic political system and reduces their principled support for democracy. The causal mediation analysis demonstrates that these two variables mediate the effect of the authoritarian's electoral success on election trust. These findings on autocratization spillover effects illustrate the importance of external autocratization events in the study of election trust.
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BACKGROUND: Deep brain stimulation (DBS) is an emerging and effective therapy for Parkinson's disease (PD). However, little is known about its utilization, surgical populations, centers, coverages, regional balance, and influential factors. MATERIALS AND METHODS: This large-scale multicenter cross-sectional study was conducted using a national census involving 74 Chinese centers. National DBS populations and centers for PD were investigated in 1997-2021, and regional sociodemographic features, surgical populations, related resources, and insurance policies in 2020 were explored. RESULTS: Since the first DBS surgery in 1997, a total of 38 122 PD patients from 349 centers underwent DBS by 2021, which covered 1.118% (1.108-1.129) of patients and 0.954% (0.933-0.976) of centers. Significant upward trends in the annual surgical population and coverages were observed with rapid climbing rates, while the annual surgical centers and their coverage showed two growth peaks in 2002-2006 and 2010-2018, correlating with clinical approvals and new technologies. A total of 103 070 (51 165-154 975) PD patients [2.088% (1.351-2.825) coverage] and 603 (72-1134) centers [1.356% (1.126-1.586) coverage] are predicted to conduct DBS by 2030. The new remotely programmed DBS technology was recoded as the first application in 2015 and rapidly increased to 2771 (47.39%, 46.11-48.67) patients with 10 507 remote programming sessions annually in 2021. Provinces in the eastern and central regions had better economic status, more surgical patients, higher insurance affordability, and more related resources than those in the western and northeastern regions. Higher gross domestic product per capita ( ß =5.041, 3.324-6.758 and ß =0.008, 0.004-0.012; all P <0.001) and more functional neurosurgery doctors ( ß =3.596, 0.353-6.839; P =0.031 and ß =0.010, 0.002-0.017; P =0.013) positively influenced surgical populations and coverages, while higher insurance levels ( ß =128.888, 64.702-193.075; P <0.001) positively influenced surgical coverages. CONCLUSION: Although surgical populations, centers, and coverages of DBS for PD have rapidly improved and are predicted to show future increases, this is still insufficient to cover potential eligible patients. Regionally imbalanced health coverage should be given attention to promote coordinated development.
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Estimulación Encefálica Profunda , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/terapia , Estudios Transversales , Resultado del TratamientoRESUMEN
This study investigated butyltin contamination in Hong Kong waters using the rock shell Thais clavigera as a biomonitor. We collected rock shells from nine coastal sites in both winter 2005 and summer 2006 to examine the spatial and seasonal patterns. The relative penis size index (RPSI) and vas deferens sequence index (VDSI) were determined following a standard protocol, while the tissue concentrations of butyltins (i.e., mono-, di- and tri-butyltin) were measured using gas chromatography. The results showed that imposex was particularly severe in T. clavigera collected from Victoria Harbour, Pak Sha Wan and Sai Kung Pier where shipping activities were frequent. Both imposex indices had a positive correlation with tissue concentration of tributyltin in T. clavigera. While VDSI exhibited little seasonal variation, RPSI of winter specimens was significantly higher than that of summer specimens. Thus, sampling season should be standardised when using RPSI as a biomarker.
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Gastrópodos/metabolismo , Compuestos Orgánicos de Estaño/metabolismo , Contaminantes Químicos del Agua/metabolismo , Animales , Trastornos del Desarrollo Sexual/inducido químicamente , Trastornos del Desarrollo Sexual/epidemiología , Trastornos del Desarrollo Sexual/veterinaria , Monitoreo del Ambiente , Monitoreo Epidemiológico , Femenino , Gastrópodos/efectos de los fármacos , Gastrópodos/fisiología , Hong Kong , Masculino , Compuestos Orgánicos de Estaño/análisis , Compuestos Orgánicos de Estaño/toxicidad , Pene/efectos de los fármacos , Pene/fisiología , Estaciones del Año , Razón de Masculinidad , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidadRESUMEN
We conducted a 3-month reciprocal transplant of the neogastropod Thais clavigera in cages between a site heavily contaminated with tributyltin and a relatively clean site to compare the sensitivity of its reproductive and physiological responses to accumulation and depuration of butyltins. Transplanting T. clavigera from the relatively clean site to the contaminated site resulted in a higher butyltin tissue concentration, higher relative penis size index (RPSI), as well as lower scope for growth (SFG) and lower Oxygen : Nitrogen (O:N) ratio. Nevertheless, growth and vas deferens sequence index (VDSI) were unaffected. Transplanting T. clavigera from the contaminated site to the relatively clean site resulted in a significant decline in tissue burden of butyltins and an elevation of scope for growth (SFG) and O:N ratio; however, there were no marked changes in growth, RPSI or VDSI. Our results thus indicated that growth is not sensitive enough for use in short-term transplant study, SFG and O:N ratio can be used as sensitive biomarkers of both accumulation and depuration of butyltins, whereas RPSI can be used only as a biomarker of accumulation of butyltins.
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Moluscos/efectos de los fármacos , Moluscos/metabolismo , Compuestos Orgánicos de Estaño/metabolismo , Compuestos Orgánicos de Estaño/toxicidad , Animales , Monitoreo del Ambiente , Femenino , Hong Kong , Masculino , Océanos y MaresRESUMEN
We assessed the current status of tributyltin (TBT) contamination of Thais clavigera (Gastropoda) along the coastal area of Mirs Bay, China for the first time. The snail samples were collected from 10 different sites in the summer (June) and winter (December) of 2006, respectively. They were analyzed for imposex status, i.e. relative penis size index (RPSI) and vas deferens sequence index (VDSI), followed by quantification of butyltins in their tissues. Most of the collected females suffered from imposex, but the level of butyltin contamination varied with the distance from Yantian Port, which is currently the fourth busiest container port in the world. The tissue concentration of TBT varied with season. For a particular site, the winter samples in general contained much higher concentration of TBT than the summer samples. RPSI, VDSI and organotin concentrations were higher in T. clavigera collected from sites closer to the Port, such as the Seafood Street and Kat O. Both RPSI and VDSI were positively correlated with the tissue burden of tributyltin. VDSI exhibited little seasonal variability, whereas RPSI showed marked seasonal variability, with lower values in the summer samples. The current results will serve as an important reference for long-term monitoring of butyltin contamination in this area.