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OBJECTIVE The aim of this study was to evaluate the effects of needle flexor tendon tenotomy treatment of the diabetic hammertoe deformity. RESEARCH DESIGN AND METHODS A multicenter randomized controlled trial of individuals with diabetes and ulcers or impending ulcers associated with hammertoes was performed between 1 November 2019 and 31 March 2021. Participants were stratified by the presence of ulcers or impending ulcers. Participants were randomly assigned to tenotomy and standard nonsurgical treatment or to standard nonsurgical treatment alone. Primary outcomes were time to ulcer healing and progression from impending ulcer to active ulcer. RESULTS Of 224 screened participants with diabetes, 95 (59.0% men) were included. The mean follow-up was 291 ± 70 days, 28 (29.5%) had type 1 diabetes, mean diabetes (presented with 25–75% quartile) duration was 20 (13–26) years, and mean age was 67.7 ± 9.8 years. Of the included participants, 16 had ulcers, of whom 8 were randomly assigned to intervention. Of the remaining 79 with impending ulcers, 39 were randomly assigned to intervention. For participants with ulcers, healing rates favored tenotomy (100% vs. 37.5%, P = 0.026) as did time to ulcer healing (P = 0.04). For those with impending ulcers, incidence of progression to an active ulcer was lower (1 vs. 7, P = 0.028) and the number of ulcer-free days higher (P = 0.043) in the tenotomy group. No serious adverse events were recorded. CONCLUSIONS This randomized study showed that the simple procedure of needle flexor tendon tenotomy was effective and safe when treating and preventing ulcers associated with the diabetic hammertoe deformity.

While interest groups are consulted at different stages of policy making to provide expertise and legitimacy, their influence is often criticized as being undemocratic. Yet, we know little about how their participation in policy making affects citizen perceptions of the legitimacy of governance. Based on survey experiments conducted in the UK, the United States and Germany, our study shows that unequal participation between group types reduces the benefits of interest group consultation for citizens' perceived legitimacy of decision-making processes. Importantly, these legitimacy losses cannot be compensated for by policies that represent the opinion of the under-represented groups and are even greater when policy decisions favour the over-represented groups. Moreover, we show that citizen perceptions of how economically powerful and representative of society different types of interest groups are act as important drivers of legitimacy evaluations. Our results provide important new theoretical and empirical insights into when and why interest groups affect democratic legitimacy.

Background: Most interventions to prevent foot ulcers in people with diabetes do not seek to reverse the foot abnormalities that led to the ulcer. Foot-ankle exercise programs target these clinical and biomechanical factors, such as protective sensation and mechanical stress. Multiple RCTs exist investigating the effectiveness of such programs, but these have never been summarised in a systematic review and meta-analysis. Methods: We searched the available scientific literature in PubMed, EMBASE, CINAHL, Cochrane databases and trial registries for original research studies on foot-ankle exercise programs for people with diabetes at risk of foot ulceration. Both controlled and non-controlled studies were eligible for selection. Two independent reviewers assessed the risk of bias of controlled studies and extracted data. Meta-analysis (using Mantel-Haenszel's statistical method and random effect models) was performed when >2 RCTs were available that met our criteria. Evidence statements, including the certainty of evidence, were formulated according to GRADE. Results: We included a total of 29 studies, of which 16 were RCTs. A foot-ankle exercise programme of 8–12 weeks duration for people at risk of foot ulceration results in: (a) no increase or decrease risk of foot ulceration or pre-ulcerative lesion (Risk Ratio (RR): 0.56 (95% CI: 0.20–1.57)); (b) no increase or decrease risk of adverse events (RR: 1.04 (95% CI: 0.65–1.67)); (c) not increase or decrease barefoot peak plantar pressure during walking (Mean Difference (MD): −6.28 kPa (95% CI: −69.90–57.34)); (d) no increase or decrease health-related quality of life (no meta-analysis possible). Likely results in increases in ankle joint and first metatarsalphalangeal joint range of motion (MD: 1.49° (95% CI: −0.28–3.26)) may result in improvements in neuropathy signs and symptoms (MD: −1.42 (95% CI: −2.95-0.12)), may result in a small increase in daily steps in some people (MD: 131 steps (95% CI: -492-754)), and may not increase or decrease foot and ankle muscle strength and function (no meta-analysis was possible). Conclusions: In people at risk of foot ulceration, a foot-ankle exercise programme of 8–12 weeks duration may not prevent or cause diabetes-related foot ulceration. However, such a programme likely improves the ankle joint and first metatarsalphalangeal joint range of motion and neuropathy signs and symptoms. Further research is needed to strengthen the evidence base, and should also focus on the effects of specific components of foot-ankle exercise programs.

Concerns have been raised that transfers of bureaucrats and politicians into the private sector might create unfair advantages for their future employers and even lead to distrust in government. Not surprisingly, the study of the revolving door has therefore gained prominence in the academic literature. Importantly, however, less attention has been paid to the executive branch. We add to the study of the revolving door by presenting the first dataset on the executive revolving door in Denmark. To do so, we trace the frequency, timing and character of the career moves of Danish Ministers and Permanent Secretaries who held office from 2009 to 2019. Our data document that the Danish executive revolving door is widespread: more than a third of Danish Ministers and Permanent Secretaries end up in a private job within the same year or the year after they stop their job. If we extend the period and investigate the entire period after public service, the number is above 60 percent. Moreover, a substantial share of the jobs obtained is in companies and at a senior level. Our note concludes with reflections on how our data can be used to fill existing research gaps and should be complemented in future research. publishedVersion

Echocardiography is frequently used to evaluate cardiac function in rodent models of cardiovascular disease. Whereas methods to acquire the commonly used echocardiography parameters are well-described in published protocols or manuals, many important parameters are ill-defined and often open to subjective interpretation. Such lack of uniformity has engendered conflicting interpretations of the same parameters in published literature. In particular, parameters such as mitral regurgitation, mitral stenosis, pulmonary regurgitation, and aortic regurgitation that are required to define more esoteric etiologies in rarer mouse models often remain equivocal. The aim of this methods paper is to provide a practical guide to the acquisition and interpretation of infrequently used echocardiography parameters and set a framework for comprehensive analyses of right ventricle (RV), pulmonary artery (PA) pulmonary valve (PV), left atrium (LA), mitral valve (MV), and aortic valve (AoV) structure and function.

We estimated the occurrence of diabetic neuropathy using six different diagnostic modalities in individuals with newly diagnosed diabetic foot ulcers (DFUs) and assessed the association with DFU healing time. All individuals with DFU had distal symmetrical polyneuropathy. Presence of neuropathy did not associate with ulcer healing time (p ≥ 0.12).

Prior literature points to the importance of party power and ideology for interest group-party contacts in the legislative arena. But interest groups do not often have ideologies – they are typically active in a small number of policy domains and there may be different parties that share more similar preferences across different policy areas. Therefore, we examine whether and how party power and proximity in policy preferences predict the existence of party-interest group ‘lobby routines’ in specific policy domains, using a novel survey of representative samples of interest groups in seven long-established democracies. We find that groups often form routines with different parties in different policy areas and that preference proximity on relevant policy dimensions is positively associated with having such area-specific lobby routines. However, the results also suggest that powerful parties are more likely allies and that the effect of policy proximity on routines is positively conditioned by power. publishedVersion

Les epidemies s’inscrivent dans un imaginaire ancien du fleau et de l’evenement catastrophique qui vient bouleverser les societes appelant en reponse des mesures drastiques de la part des societes et des Etats. Comme nous le montre Anne Rasmussen, l’epidemie de Covid-19 ne fait pas exception. Cependant, son caractere global integrant intimement les dimensions sanitaires, sociales, politiques et economiques lui donne une dimension singuliere. Elle en fait un moment historique qui vient questionner des principes fondamentaux de l’organisation sociale et politique, a commencer par la valeur que l’on accorde a la vie.

This article examines the role of interest mobilization in strengthening or weakening congruence between elected representatives and citizens on EU policy issues. It argues that the relationship between public opinion, interest groups and elected politicians can be theorized as a selective transmission process. We expect interest groups to strengthen congruence between citizens and elected representatives who share their ideological views. To test our hypotheses we conducted a content analysis of statements made in eight European news outlets on a sample of 13 policy issues and combined this with Eurobarometer polls. Our results indicate that elected representatives from leftist parties are more congruent with left-wing voters when civil society mobilizes, while the prevalence of corporate lobby groups strengthens congruence between rightist politicians and their constituents. These findings contribute to our understanding of the role of interest groups in political representation and democratic governance. publishedVersion

Diabetic foot complications is a collective term used for the ailments of the foot that individuals with diabetes incur. The different entities of the term diabetic foot complications are closely linked to each other and several of the other complications of diabetes. Despite implementation of national and international preventive guidelines, diabetic foot complications are still a growing challenge to the individual and society in general. This highlights the need for new strategies in the treatment and prevention of diabetic foot complications. The aim of the study was to investigate associations between plasma metabolites and diabetic foot complications (diabetic foot ulcer (DFU), amputations and Charcot’s Arthropathy) in individuals with diabetes type 1. Non targeted plasma metabolites (n=75) were analyzed using mass spectrometry in a cohort comprising 637 individuals (55% male) with diabetes type 1. Cross sectional associations between metabolites and diabetic foot complications was analysed by linear regression at baseline and by Cox proportional hazards model at follow-up and adjusted for relevant confounders. The median follow up time was 10 years, age 55 (47, 64) years, diabetes duration 35 (25, 44) years and HbA1c 64 (56, 72) mmol/mol. In the adjusted model, four amino acids (proline, threonine, valine, and leucine) were associated with decreased incidence of Charcot’s arthropathy at baseline (padjusted< 0.5). In addition, the plasma levels of ribonic acid was associated with an increased risk of diabetic foot ulcers during follow-up (HR 1.38(1.06-1.8) p<0.05). This study identifies novel circulating metabolites, as potential biomarkers for risk of diabetic foot complications.One Sentence SummarySeveral plasma metabolites show promise as risk markers of diabetic foot complications.

Few existing datasets on parties and interest groups include data from both sides and a wide variety of interest groups and parties. We contribute to filling this gap by making several interconnected new datasets publicly available. The Party-Interest Group Relationships in Contemporary Democracies (PAIRDEM) datasets include cross-national data from three different surveys of (1) central party organizations, (2) legislative party groups, and (3) interest groups. A fourth dataset based on coding of party statutes and party finance data was established together with the Political Party Database. The datasets contain novel indicators on party-group relationships in up to 21 mature democracies. In this research note, we first present the main content of the datasets and the research design. Second, we present descriptive statistics documenting the extent of organizational ties between parties and groups in contemporary democracies. Third, we illustrate more advanced usage through a simple application.

The COVID-19 pandemic is viewed by many as the biggest global crisis since WWII and had profound effects on the daily lives of people and decision-making worldwide. Using the pandemic as a system-wide agenda shock, we employ a difference-in-differences design to estimate its causal effects on inequalities in political access, and social media prominence among business interests and NGOs. Our argument is twofold. First, the urgency and uncertainty of crises incentivized decision-makers to privilege providing access to business groups over securing inclusivity in the types of interests consulted. Second, NGOs compensated by increasing prominence in public communications. Our analysis of data from over 10,000 interest groups from over 100 countries registered in the European Union supports these hypotheses. Business interests successfully capitalized on the crisis in insider access, while NGOs increased prominence on social media. The results have wider implications for understanding how large-scale crises affect inequalities in representation.The online version contains supplementary material available at 10.1007/s11109-022-09842-x.

The aim was to study the mortality and the clinical course of diabetic Charcot foot.This was a retrospective cohort study including all persons with diabetes and a Charcot diagnosis from 2000 to 2016.In the mortality sub-study, 164 persons had the Charcot diagnosis, 52 (31.1%) died in the follow-up period. The mortality rate was 4.6/100 person-years at risk. Rate ratios for death were insignificantly different among smokers and non-smokers, among persons with type 1 and type 2 diabetes, among persons with a diabetes duration below or above ten years and among persons with a glycated haemoglobin (HbA1c) level above or below 60 mmol/mol after adjustment for age and gender. In the clinical course sub-study, 114 persons with Charcot were identified whereof 97 (85%) had an active Charcot. The duration from start of symptoms to diagnosis was ten weeks, the treatment period was 7.5 months and 46 (40%) had bony prominences (rocker bottom) in the planta at follow-up.The mortality rate among persons with Charcot was 4.6/person-years at risk, which was unaffected by smoking, diabetes type, diabetes duration and HbA1c level. The persons with Charcot had a long delay from symptom onset to diagnosis, a long treatment period and often developed complications.This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.not relevant.

Aim Diabetic foot ulcer (DFU) is a major complication of both Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D); however research into risk factors for DFU does not separate between these two types. The purpose of the present investigation was to identify risk factors for development of first time DFU (FTDFU) over a period of 15 years in patients with T1D and T2D separately. Methods This retrospective cohort study included 25,220 feet from 5588 patients with T1D and 7113 patients with T2D treated in the period 2001–2015. Data on baseline characteristics and comorbidities were collected from electronic patient records. Influences of various risk factors for the development of FTDFU were assessed by hazard ratios (HR) from Cox proportional hazard regression models on time from enrolment to FTDFU diagnosis or end-of-follow-up. Results In T1D independent risk factors were male sex, age >60 years, high HbA1c, long diabetes duration, history of cardiovascular disease, macro-albuminuria, decreased visual acuity, advanced diabetic retinopathy, decreased/absent vibration sense, presence of patient reported symptoms of neuropathy, and absence of foot pulses. In T2D the independent risk factors were the same except age >60 years, a history of cardiovascular disease, and long diabetes duration. Conclusions This study documents that much of the standard clinical information obtained as part of the routine follow-up are also independent risk factors for development of FTDFU. This may be used to create a basis for in which patient and when prevention should be started.

In order to examine the involvement of Asian interests in European Union politics, we develop a preliminary framework for studying the involvement of external interests in EU policy -making. Using data on the online consultations of the European Commission from 2001 till 2010, we aim at explaining both the level of engagement, the types of active actors and policy areas of involvement of different regions. We find that that external representation is partly but not fully accounted for by economic ties and possession of resources. Moreover, we find variation in which areas and by which actors different regions are represented suggesting that variation in national-sectoral structures between them affects differences in the character of representation between them.

Political parties and interest groups play a vital role in incorporating societal interests into democratic decision-making. Therefore, explaining the nature and variation in the relationship between them will advance our understanding of democratic governance. Existing research has primarily drawn attention to how exchange of resources shapes these relationships largely neglecting the role of contextual conditions. Our contribution is to examine whether parties’ structured interactions with different categories of interest groups vary systematically with the pattern of party competition at the level of policy dimensions. First, we argue that higher party fragmentation in a policy space makes organisational ties to interest groups more likely, due to fears of voter loss and splinter groups. Second, we expect higher polarisation between parties on a policy dimension to make ties to relevant groups less likely due to increased electoral costs. We find support for both expectations when analysing new data on 116 party units in 13 mature democracies along nine different policy dimensions. Our findings underline the value of considering the strategic context in which parties and interest groups interact to understand their relationship. The study sheds new light on parties and interest groups as intermediaries in democracy and contributes to a new research agenda connecting interest group research with studies of parties’ policy positions and responsiveness. publishedVersion

While a multitude of studies have investigated the link between opinion and policy, we have little knowledge of how and when organised interests affect this linkage. We argue that the alignment of organised interests affects opinion–policy congruence by influencing the weight decision-makers attach to citizen preferences. Moreover, we propose that alignment between majorities of groups and the public matters the most when status quo bias must be overcome for the public to obtain its preferred policy. We test our theoretical claims drawing on a comprehensive media content analysis of 160 policy issues in Germany and Denmark. Our results present a more sceptical picture of the ability of groups to suppress the opinion–policy linkage than the one frequently presented in the academic literature and public debate. We find that the capacity of groups to affect whether policy is congruent with the majority of the public is restricted to situations where the public supports a change in the status quo. In these cases, policy is less likely to end up reflecting public opinion if the majority of interest groups do not support the public position. In cases where the public is supportive of the policy status quo, the position of interest groups does not affect the likelihood that policy will eventually reflect the preferred position of the public. Our findings expand existing knowledge of organised interests in the study of policy representation and have important implications for understanding democratic governance. publishedVersion

This chapter sets out to introduce the literature tackling the interplay between interest groups, public opinion, and public policy. Even after nearly 60 years of political science research, there is still much controversy concerning the involvement of interest groups in public policymaking and how lobbying might affect policy congruence and responsiveness to public opinion. While interest group politics and public opinion have long been examined in separate scholarly communities, this changed in recent times. We first cover recent studies addressing (1) the alignment between interest groups and public opinion, next we discuss (2) the independent but simultaneous effects of interest groups and public opinion on public policy, and finally (3) we cover how the interaction between interest groups and public opinion affects public policymaking. We conclude by reflecting on the findings in current literature, discuss some of its analytical limitations, and propose possible avenues for future research.