bluuebunny/crossref_metadata_2025 huggingface dataset:
Lesser Tuberosity Osteotomy Outcomes After Anatomic Shoulder Arthroplasty in Patients With Atraumatic Avascular Necrosis
Authors: Maier Stephen P , Lopez Cesar D , Bloom Zachary J , Shiu Brian B , Petkovic Djuro , Levine William N , Jobin Charles M
Published: May 2018

Introduction

Lesser tuberosity osteotomy (LTO) is an attractive option for subscapularis management during anatomic shoulder arthroplasty due to the biomechanical strength and reliable bone-to-bone healing. Patients with humeral head avascular necrosis (AVN) may have compromised bone healing, and the outcomes of LTO during AVN are unknown.

Methods

A retrospective consecutive case series of 6 patients with Cruess grade 4 or 5 humeral head AVN who underwent anatomic shoulder arthroplasty with LTO from 2010 to 2016 was performed. Postoperative radiographic evaluation for LTO healing at 6 months was analyzed, and clinical outcomes at latest follow-up, including range of motion (ROM), strength, and pain were studied.>

Results

Average age was 50.3 years. AVN was secondary to sickle cell in 1 patient, steroid use for systemic lupus erythematosus in 4, and chronic alcoholism in 1. By 6 months after arthroplasty, 100% had radiographically united and healed LTO. Patients averaged 140 ± 21° of active forward elevation and 42 ± 7° of active external rotation. Patients reported an improvement in visual analogue scale pain from 8.3 preoperatively to 3.8 postoperatively. All patients had a normal abdominal compression test. No patients required revision surgery.

Conclusion

The use of LTO during anatomic shoulder arthroplasty for AVN has an excellent bony healing rate with improvements in pain, ROM, and strength. The diseases that cause humeral head AVN do not negatively influence LTO healing outcomes during anatomic shoulder replacement.

Level of Evidence

IV Case Series
ENT Outreach in Africa: Rules of Engagement
Authors: Mulwafu Wakisa , Fagan Johannes J. , Mukara Kaitesi Batamuliza , Ibekwe Titus S.
Published: May 2018

To address inequality of access to ear, nose, and throat (ENT) care, there must be significant and sustained investment in education and training of surgeons, audiologists, speech therapists, clinical officers, anesthetists, and specialized nurses engaged in ENT in sub‐Saharan Africa and other developing nations. Outreach by ENT surgeons from developed countries is essential if we are to address the critical lack of access to ENT care in SSA. However, it should be based on mutual respect, shared values, aspirations, a desire to create a durable and sustainable impact, and internationally accepted best practice. In this article, we propose rules of engagement for outreach projects in SSA and other developing countries to optimize their contributions by making them useful, sustainable, productive, and developmental. These proposed rules of engagement are based on our personal experiences and observations—good and bad—of outreach activities in our countries.
Reactivation of γ-globin in adult β-YAC mice after ex vivo and in vivo hematopoietic stem cell genome editing
Authors: Li Chang , Psatha Nikoletta , Sova Pavel , Gil Sucheol , Wang Hongjie , Kim Jiho , Kulkarni Chandana , Valensisi Cristina , Hawkins R. David , Stamatoyannopoulos George , Lieber André
Published: May 2018

Key Points

CRISPR/Cas9-mediated disruption of a BCL11A binding site in HSCs of β-YAC mice results in the reactivation of γ-globin in erythrocytes. Our approach for in vivo HSC genome editing that does not require HSC transplantation and myeloablation should simplify HSC gene therapy.
Socioeconomic inequalities in suicide in Europe: the widening gap
Authors: Lorant Vincent , de Gelder Rianne , Kapadia Dharmi , Borrell Carme , Kalediene Ramune , Kovács Katalin , Leinsalu Mall , Martikainen Pekka , Menvielle Gwenn , Regidor Enrique , Rodríguez-Sanz Maica , Wojtyniak Bogdan , Strand Bjørn Heine , Bopp Matthias , Mackenbach Johan P.
Published: May 2018

Background

Suicide has been decreasing over the past decade. However, we do not know whether socioeconomic inequality in suicide has been decreasing as well.

Aims

We assessed recent trends in socioeconomic inequalities in suicide in 15 European populations.

Method

The DEMETRIQ study collected and harmonised register-based data on suicide mortality follow-up of population censuses, from 1991 and 2001, in European populations aged 35–79. Absolute and relative inequalities of suicide according to education were computed on more than 300 million person-years.

Results

In the 1990s, people in the lowest educational group had 1.82 times more suicides than those in the highest group. In the 2000s, this ratio increased to 2.12. Among men, absolute and relative inequalities were substantial in both periods and generally did not decrease over time, whereas among women inequalities were absent in the first period and emerged in the second.

Conclusions

The World Health Organization (WHO) plan for ‘Fair opportunity of mental wellbeing’ is not likely to be met.

Declaration of interest

None.
Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update
Authors: Denduluri Neelima , Chavez-MacGregor Mariana , Telli Melinda L. , Eisen Andrea , Graff Stephanie L. , Hassett Michael J. , Holloway Jamie N. , Hurria Arti , King Tari A. , Lyman Gary H. , Partridge Ann H. , Somerfield Mark R. , Trudeau Maureen E. , Wolff Antonio C. , Giordano Sharon H.
Published: May 2018

Purpose

To update key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer.

Methods

An Expert Panel conducted targeted systematic literature reviews guided by a signals approach to identify new, potentially practice-changing data that might translate to revised practice recommendations.

Results

The Expert Panel reviewed phase III trials that evaluated adjuvant capecitabine after completion of standard preoperative anthracycline- and taxane-based combination chemotherapy by patients with early-stage breast cancer HER2-negative breast cancer with residual invasive disease at surgery; the addition of 1 year of adjuvant pertuzumab to combination chemotherapy and trastuzumab for patients with early-stage, HER2-positive breast cancer; and the use of neratinib as extended adjuvant therapy for patients after combination chemotherapy and trastuzumab-based adjuvant therapy with early-stage, HER2-positive breast cancer.

Recommendations

Patients with early-stage HER2-negative breast cancer with pathologic, invasive residual disease at surgery following standard anthracycline- and taxane-based preoperative therapy may be offered up to six to eight cycles of adjuvant capecitabine. Clinicians may add 1 year of adjuvant pertuzumab to trastuzumab-based combination chemotherapy in patients with high-risk, early-stage, HER2-positive breast cancer. Clinicians may use extended adjuvant therapy with neratinib to follow trastuzumab in patients with early-stage, HER2-positive breast cancer. Neratinib causes substantial diarrhea, and diarrhea prophylaxis must be used. Additional information can be found at www.asco.org/breast-cancer-guidelines .
Perioperative Peripheral Nerve Injury After General Anesthesia: A Qualitative Systematic Review
Authors: Chui Jason , Murkin John M. , Posner Karen L. , Domino Karen B.
Published: May 2018

Perioperative peripheral nerve injury (PNI) is a well-recognized complication of general anesthesia that continues to result in patient disability and malpractice claims. However, the multifactorial etiology of PNI is often not appreciated in malpractice claims given that most PNI is alleged to be due to errors in patient positioning. New advances in monitoring may aid anesthesiologists in the early detection of PNI. This article reviews recent studies of perioperative PNI after general anesthesia and discusses the epidemiology and potential mechanisms of injury and preventive measures. We performed a systematic literature search, reviewed the available evidence, and identified areas for further investigation. We also reviewed perioperative PNI in the Anesthesia Closed Claims Project database for adverse events from 1990 to 2013. The incidence of perioperative PNI after general anesthesia varies considerably depending on the type of surgical procedure, the age and risk factors of the patient population, and whether the detection was made retrospectively or prospectively. Taken together, studies suggest that the incidence in a general population of surgical patients undergoing all types of procedures is <1%, with higher incidence in cardiac, neurosurgery, and some orthopedic procedures. PNI represent 12% of general anesthesia malpractice claims since 1990, with injuries to the brachial plexus and ulnar nerves representing two-thirds of PNI claims. The causes of perioperative PNI after general anesthesia are likely multifactorial, resulting in a “difficult to predict and prevent” phenomenon. Nearly half of the PNI closed claims did not have an obvious etiology, and most (91%) were associated with appropriate anesthetic care. Future studies should focus on the interaction between different mechanisms of insult, severity and duration of injury, and underlying neuronal reserves. Recent automated detection technology in neuromonitoring with somatosensory evoked potentials may increase the ability to identify at-risk patients and individualize patient management.
“Modified Dynamic Needle Tip Positioning” Short-Axis, Out-of-Plane, Ultrasound-Guided Radial Artery Cannulation in Neonates: A Randomized Controlled Trial
Authors: Liu Lifei , Tan Yanzhe , Li Shangyingying , Tian Jie
Published: May 2018

BACKGROUND:

Radial artery cannulation is extremely challenging in neonatal patients. Herein, we compared the success rate of the modified dynamic needle tip positioning short-axis, out-of-plane, ultrasound-guided technique with that of the traditional palpation technique in neonatal radial artery cannulation.

METHODS:

Sixty term neonates undergoing major abdominal surgery were randomized into the ultrasound or palpation group via the sealed-envelope method. The ultrasound group underwent radial artery cannulation using an ultrasonic apparatus, while traditional palpation of arterial pulsation was used in the palpation group. The arterial diameter and depth were measured on ultrasound before the puncture. We recorded age, weight, sex, and other background characteristics. The primary outcomes included the first-attempt, total success rates, and the total puncture procedure duration. Secondary outcomes included the incidence of complications (hematoma and thrombosis). Data were compared between the 2 groups.

RESULTS:

Sixty term neonates were enrolled in the study. The success rates of the first attempt in the ultrasound and palpation groups were 40% (n = 30) and 10% (n = 30), respectively (P = .007; relative risk, 4.0; 95% confidence interval, 1.3–12.8). The total success rate was 96.7% in the ultrasound group and 60.0% in the palpation group (P = .001; relative risk, 1.61; 95% confidence interval, 1.19–2.17). The average time to accomplish radial artery cannulation in the ultrasound and palpation groups was 91.4 ± 55.4 and 284.7 ± 153.6 seconds, respectively (P < .001; estimated difference, −193; 95% confidence interval, −256 to −130). In addition, 3.3% of the patients in the ultrasound group and 26.7% in the palpation group suffered puncture hematoma (P = .026; relative risk, 0.13; 95% confidence interval, 0.02–0.94).

CONCLUSIONS:

Modified dynamic needle tip positioning short-axis, out-of-plane, ultrasound-guided radial artery cannulation in neonates improves the first-attempt and total success rates and decreases the total procedural time and incidence of cannulation-related complications.
Does Respiratory Variation in Inferior Vena Cava Diameter Predict Fluid Responsiveness in Mechanically Ventilated Patients? A Systematic Review and Meta-analysis
Authors: Si Xiang , Xu Hailin , Liu Zimeng , Wu Jianfeng , Cao Daiyin , Chen Juan , Chen Minying , Liu Yongjun , Guan Xiangdong
Published: May 2018

BACKGROUND:

We performed a systematic review and meta-analysis of studies investigating the diagnostic accuracy of respiratory variation in inferior vena cava diameter (ΔIVC) for predicting fluid responsiveness in patients receiving mechanical ventilation.

METHODS:

MEDLINE, EMBASE, the Cochrane Library, and Web of Science were screened from inception to February 2017. The meta-analysis assessed the pooled sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve. In addition, heterogeneity and subgroup analyses were performed.

RESULTS:

A total of 12 studies involving 753 patients were included. Significant heterogeneity existed among the studies, and meta-regression indicated that ventilator settings were the main sources of heterogeneity. Subgroup analysis indicated that ΔIVC exhibited better diagnostic performance in the group of patients ventilated with tidal volume (TV) ≥8 mL/kg and positive end-expiratory pressure (PEEP) ≤5 cm H2O than in the group ventilated with TV <8 mL/kg or PEEP >5 cm H2O, as demonstrated by higher sensitivity (0.80 vs 0.66; P = .02), specificity (0.94 vs 0.68; P < .001), diagnostic odds ratio (68 vs 4; P < .001), and area under the receiver operating characteristic curve (0.88 vs 0.70; P < .001). The best ΔIVC threshold for predicting fluid responsiveness was 16% ± 2% in the group of TV ≥8 mL/kg and PEEP ≤5 cm H2O, whereas in the group of TV <8 mL/kg or PEEP >5 cm H2O, this threshold was 14% ± 5%.

CONCLUSIONS:

ΔIVC shows limited ability for predicting fluid responsiveness in distinct ventilator settings. In patients with TV ≥8 mL/kg and PEEP ≤5 cm H2O, ΔIVC was an accurate predictor of fluid responsiveness, while in patients with TV <8 mL/kg or PEEP >5 cm H2O, ΔIVC was a poor predictor. Thus, intensivists must be cautious when using ΔIVC.
Perianesthetic and Anesthesia-Related Mortality in a Southeastern United States Population: A Longitudinal Review of a Prospectively Collected Quality Assurance Data Base
Authors: Pollard Richard J. , Hopkins Thomas , Smith C. Tyler , May Bryan V. , Doyle James , Chambers C. Labron , Clark Reese , Buhrman William
Published: May 2018

BACKGROUND:

Perianesthetic mortality (death occurring within 48 hours of an anesthetic) continues to vary widely depending on the study population examined. The authors study in a private practice physician group that covers multiple anesthetizing locations in the Southeastern United States. This group has in place a robust quality assurance (QA) database to follow all patients undergoing anesthesia. With this study, we estimate the incidence of anesthesia-related and perianesthetic mortality in this QA database.

METHODS:

Following institutional review board approval, data from 2011 to 2016 were obtained from the QA database of a large, community-based anesthesiology group practice. The physician practice covers 233 anesthetizing locations across 20 facilities in 2 US states. All detected cases of perianesthetic death were extracted from the database and compared to the patients’ electronic medical record. These cases were further examined by a committee of 3 anesthesiologists to determine whether the death was anesthesia related (a perioperative death solely attributable to either the anesthesia provider or anesthetic technique), anesthetic contributory (a perioperative death in which anesthesia role could not be entirely excluded), or not due to anesthesia.

RESULTS:

A total of 785,467 anesthesia procedures were examined from the study period. A total of 592 cases of perianesthetic deaths were detected, giving an overall death rate of 75.37 in 100,000 cases (95% CI, 69.5–81.7). Mortality judged to be anesthesia related was found in 4 cases, giving a mortality rate of 0.509 in 100,000 (95% CI, 0.198–1.31). Mortality judged to be anesthesia contributory were found in 18 cases, giving a mortality of 2.29 in 100,000 patients (95% CI, 1.45–3.7). A total of 570 cases were judged to be nonanesthesia related, giving an incidence of 72.6 per 100,000 anesthetics (95% CI, 69.3–75.7).

CONCLUSIONS:

In a large, comprehensive database representing the full range of anesthesia practices and locations in the Southeastern United States, the rate of perianesthestic death was 0.509 in 100,000 (95% CI, 0.198–1.31). Future in-depth analysis of the epidemiology of perianesthetic deaths will be reported in later studies.
Gestational low-protein intake enhances whole-kidney miR-192 and miR-200 family expression and epithelial-to-mesenchymal transition in rat adult male offspring
Authors: Sene Letícia B. , Rizzi Victor Hugo Gonçalves , Gontijo José A. R. , Boer Patricia A.
Published: May 2018

Studies have shown that adult offspring of mothers fed a protein-restricted diet during pregnancy present a pronounced reduction of nephron number associated with decreased fractional urinary sodium excretion and arterial hypertension. Additionally, recent advances in our understanding of the molecular pathways that govern the association of gestational nutritional restriction, intrauterine growth retardation and inflammation with impaired nephrogenesis, nephron underdosing and kidney fibrosis point to the epithelial to mesenchymal transition (EMT) as a common factor. In the current study, protein and sodium urinary excretion rates were evaluated in rats, and immunohistochemistry and western blot techniques were used to characterize kidney structure changes in 16 week old male offspring of mothers fed a low-protein diet during pregnancy (LP group) compared with age-matched (NP) controls. We also verified the expression of miRNA, mRNA and protein markers of fibrosis and the EMT in whole kidney prepared from LP offspring. We found, surprisingly, that arterial hypertension and long-term hyperfiltration, manifest by proteinuria, were associated with increased renal miR-192 and miR-200 family expression in 16 week old LP relative to age-matched NP rats. Measurement of kidney fibrosis and EMT-related protein markers, by histochemistry and immunoblot techniques, showed a significant rise of TGF-β1 and type-I collagen content in glomeruli and tubulointerstitial areas, accompanied by enhanced fibronectin and ZEB1 and decreased E-cadherin immunoreactivity in 16 week old LP offspring. The results were partially confirmed by increased gene (mRNA) expression of collagen 1α1, collagen 1α2 and ZEB1 in LP whole kidneys compared with those of age-matched NP offspring. In view of the presumed functional overload in the remaining nephrons, we suggest that hypertension and proteinuria development following maternal protein restriction may be a preponderant factor for EMT and structural kidney changes in LP offspring. However, our study was not wholly able to establish the precise role of miRNAs in LP kidney disorders. Thus, further studies will be required to assess the contribution of the miR family to renal injury in a gestational protein-restricted model of fetal programming.
New approaches for assessing squid fin motions: Coupling proper orthogonal decomposition with volumetric particle tracking velocimetry
Authors: Bartol Ian K. , Krueger Paul S. , York Carly A. , Thompson Joseph T.
Published: May 2018

Squids, which swim using a coupled fin/jet system powered by muscular hydrostats, pose unique challenges for the study of locomotion. The high flexibility of the fins and complex flow fields generated by distinct propulsion systems require innovative techniques for locomotive assessment. For this study, we used proper orthogonal decomposition (POD) to decouple components of the fin motions and defocusing digital particle tracking velocimetry (DDPTV) to quantify the resultant 3D flow fields. Kinematic footage and DDPTV data were collected from brief squid Lolliguncula brevis [3.1 to 6.5 cm dorsal mantle length (DML)] swimming freely in a water tunnel at speeds of 0.39 – 7.20 DML s−1. Both flap and wave components were present in all fin motions, but the relative importance of the wave components was higher for arms-first swimming than tail-first swimming and for slower versus higher speed swimming. When prominent wave components were present, more complex interconnected vortex ring wakes were observed, while fin movements dominated by flapping resulted in more spatially separated vortex ring patterns. Although the jet often produced the majority of the thrust for steady rectilinear swimming, our results demonstrated that the fins can contribute more thrust than the jet at times, consistently produce comparable levels of lift to the jet during arms-first swimming, and can boost overall propulsive efficiency. By producing significant drag signatures, the fins can also aid in stabilization and maneuvering. Clearly fins play multiple roles in squid locomotion, and when coupled with the jet, allow squid to perform a range of swimming behaviors integral to their ecological success.
Quadratic Voting: How Mechanism Design Can Radicalize Democracy
Authors: Lalley Steven P. , Weyl E. Glen
Published: May 2018

Can mechanism design save democracy? We propose a simple design that offers a chance: individuals pay for as many votes as they wish using a number of “voice credits” quadratic in the votes they buy. Only quadratic cost induces marginal costs linear in votes purchased and thus welfare optimality if individuals' valuation of votes is proportional to their value of changing the outcome. A variety of analysis and evidence suggests that this still-nascent mechanism has significant promise to robustly correct the failure of existing democracies to incorporate intensity of preference and knowledge.
Algorithmic Fairness
Authors: Kleinberg Jon , Ludwig Jens , Mullainathan Sendhil , Rambachan Ashesh
Published: May 2018

Concerns that algorithms may discriminate against certain groups have led to numerous efforts to ‘blind’ the algorithm to race. We argue that this intuitive perspective is misleading and may do harm. Our primary result is exceedingly simple, yet often overlooked. A preference for fairness should not change the choice of estimator. Equity preferences can change how the estimated prediction function is used (e.g., different threshold for different groups) but the function itself should not change. We show in an empirical example for college admissions that the inclusion of variables such as race can increase both equity and efficiency.
Human Judgment and AI Pricing
Authors: Agrawal Ajay , Gans Joshua S. , Goldfarb Avi
Published: May 2018

This paper examines the pricing choices of a provider of artificial intelligence (AI) services. It does so in the context of AI providing predictions to a decision-maker who also exercises what we term judgment; specifically, the discovery of payoffs from action/state pairs. An AI facilitates the decision-maker obtaining judgment through experience, which is one source of demand for AI services. The other source is prediction when (and if) the decision-maker has a need for state-contingent decision-making. We show that the need to encourage learning means that the AI provider is constrained in its ability to extract rents from decision-makers.
Institutions and Emissions Trading in China
Authors: Karplus Valerie Jean
Published: May 2018

Variation in the extent of state control in industry may affect China's efforts to establish a national emissions trading system (ETS) capable of supporting the implementation of the country's CO2 intensity reduction goals through 2030. This paper examines interactions between state control and an ETS, and identifies a tension in its design in China: state-controlled firms most likely to comply with the system may operate in the least market-oriented settings. Establishing a comprehensive and cost-effective ETS may require addressing potential barriers to participation and compliance in the domestic private sector, while increasingly exposing state-controlled firms to market forces.
Nowcasting Gentrification: Using Yelp Data to Quantify Neighborhood Change
Authors: Glaeser Edward L. , Kim Hyunjin , Luca Michael
Published: May 2018

Data from digital platforms have the potential to improve our understanding of gentrification, both by predicting gentrification and by characterizing the local economy of gentrifying neighborhoods. To explore, we identify gentrifying neighborhoods using government data, and then use Yelp data to analyze local business activity. We find that gentrifying neighborhoods tend to have growing numbers of local groceries, cafes, restaurants, and bars, with little evidence of crowd-out of other types of businesses. Moreover, local economic activity, as measured by Yelp data, is a leading indicator for housing price changes and can help to predict which neighborhoods are gentrifying.
Internet Rising, Prices Falling: Measuring Inflation in a World of E-Commerce
Authors: Goolsbee Austan D. , Klenow Peter J.
Published: May 2018

The rise of ecommerce and the contrasts between online and traditional retail pricing behavior have raised questions about potential bias in CPI inflation. Using new data on online transactions, this paper shows that aggregate matched-model inflation online from 2014-2017 was more than a full percentage point lower than in the corresponding CPI. In addition, new products were tremendously important. Quantifying the net increase in number of new goods minus the exit of old goods suggests that actual inflation online may have been an additional 1.5 to 2.5 percentage points lower than indicated in matched model price indices like the CPI.
Can Information Change Personal Retirement Savings? Evidence from Social Security Benefits Statement Mailings
Authors: Carter Susan Payne , Skimmyhorn William
Published: May 2018

Despite concern about the viability of public retirement programs and potential undersaving for retirement, we still know little about the impact of government provided information on individual behavior. We exploit plausibly exogenous variation in exposure to the world's largest personalized retirement benefits statement from the US Social Security Administration to evaluate the effects of information and encouragement on individual retirement savings decisions. Using three natural experiments between 2011 and 2014 and administrative data, we find no impact of the statements on individual retirement savings in their employer provided retirement accounts.
Return-to-Work Policies and Labor Supply in Disability Insurance Programs
Authors: Zaresani Arezou
Published: May 2018

Return-to-work policies in disability insurance (DI) programs allow beneficiaries to collect a portion of their benefits while working. I investigate whether a large increase in incentives to work in a return-to-work policy could induce benefit recipients to increase their labor supply. I quantify the effects on earnings and labor force participation using a sharp discontinuity in the induced incentives to work at the month of the policy change in a DI program in Canada. Using administrative data, I document that large incentives to work could induce beneficiaries to increase their labor supply both in intensive and extensive margins.
A New Look at Lake Wobegon: Who’s in Your Canoe?
Authors: Bollinger Chris , Emerson Tisha L. N. , English Linda , Hoyt Gail M.
Published: May 2018

We re-examine the Lake Wobegon effect for reported GPA using data from students enrolled in principles of economics courses. Students are well known to over-report their GPA on surveys. In addition to standard measures of the mean difference, we extend the analysis to understand the distribution of response error using quantile regression analysis. We also examine how survey conditions impact response error. Our findings suggest that response error is more complicated than simple over-confidence. Students respond differently throughout the distribution of GPA and respond differently when seated near friends. Modeling response error should take these findings into account.
Reach for Yield and Fickle Capital Flows
Authors: Caballero Ricardo J. , Simsek Alp
Published: May 2018

In Caballero and Simsek (2017), we develop a model of fickle capital flows and show that, when countries are similar, international flows create global liquidity and mitigate crises despite their fickleness. In this paper, we focus on the asymmetric situation of Emerging Markets (EM) exchanging flows with Developed Markets (DM) that feature lower returns but less frequent crises. Relatively high DM returns help to mitigate EM crises by reducing fickle inflows and by providing greater liquidity. The situation dramatically changes as the DM returns fall, as this increases the fickle inflows driven by reach for yield and exacerbates EM crises.
Optimal Payment Areas or Optimal Currency Areas?
Authors: Bolton Patrick , Huang Haizhou
Published: May 2018

We use the Optimal Capital Structure of Nations framework in Bolton and Huang (2018) to develop a new theory of Optimum Currency Areas. Whether two economically integrated nations should form an optimal currency area depends on a trade-off between financial flexibility (the value of monetary sovereignty) and monetary discipline (the commitment not to engage in competitive monetizations). We show that a monetary union works best when combined with a fiscal union and fiscal transfers. We also show that debt monetization is still desirable in a monetary union when both member-countries simultaneously face a negative output shock.
The Disappearing Large-Firm Wage Premium
Authors: Bloom Nicholas , Guvenen Fatih , Smith Benjamin S. , Song Jae , von Wachter Till
Published: May 2018

Large firms have paid significantly higher wages for over a century. Based on administrative data we document that the large-firm wage premium (LFWP) has declined steadily over the last 30 years. Decomposing pay into worker and firm fixed effects, we then document that the LFWP can be largely explained by a rise in firm effects with firm size. The dramatic decline is due a reduction in these firm effects at large firms. These changes have been concentrated at very large employers. In contrast, worker composition has changed little. We also find the majority of the change occurs within industries.
The Welfare Consequences of Income-Induced Expenditure Switching
Authors: Bems Rudolfs , Di Giovanni Julian
Published: May 2018

Bems and di Giovanni (2016) establish that income-induced expenditure switching (IIES) from foreign goods to cheaper domestic substitutes played a significant role in external rebalancing during the 2008-2009 financial crisis in Latvia. In this paper, we examine the welfare consequences of IIES under different external sector rebalancing scenarios. We find that IIES reduced the negative welfare consequences that accompany external rebalancing by between 12-17 percent. We also show, using a historical decomposition, that IIES accounted for 18 percent of the 2008-2009 collapse in imports, which is greater than the 14 percent contribution due to the conventional price-induced expenditure switching channel.
Wealth Redistribution after Exchange Rate Devaluations
Authors: Drenik Andres , Pereira Gustavo , Perez Diego J.
Published: May 2018

We document that the likelihood of having assets in foreign currency is increasing in households' income within many emerging economies. This pattern leads to heterogeneous exposures of wealth to exchange rate movements. We analyze the redistribution of liquid wealth across households after nominal exchange rate devaluations due to the revaluation of nominal net wealth denominated in different currencies. We find that there is an important degree of redistribution from households with low income to those with high income.
Dynamic Incentives in Wait List Mechanisms
Authors: Agarwal Nikhil , Ashlagi Itai , Somaini Paulo , Waldinger Daniel
Published: May 2018

Many scarce public resources are allocated through wait lists that use priorities for individual agents. A new priority system for allocating deceased donor kidneys was adopted in 2014. This redesign was guided by simulations that held decision-rules fixed. We synthesize recent theoretical results to show that the welfare effects of a mechanism depend on the interaction between dynamic incentives and heterogeneity in preferences. We show evidence suggesting that patient decisions on the deceased donor kidney wait list respond to dynamic incentives. Therefore, an empirical approach to dynamic mechanism design is an essential complement to mechanism design theory in dynamic environments.
Central Bank Forward Guidance and the Signal Value of Market Prices
Authors: Morris Stephen , Shin Hyun Song
Published: May 2018

Central banks use forward guidance to steer market expectations of future monetary policy moves. At the same time, they rely on market prices to gauge the likely path of the economy and the appropriate stance of monetary policy. This twoway flow between market prices and forward guidance can create a circularity. Market signals may be rendered less informative when the central bank heeds market signals in formulating forward guidance, as those market signals reflect the diminished weight placed by market participants on their private signals.
Cousin Marriage Is Not Choice: Muslim Marriage and Underdevelopment
Authors: Edlund Lena
Published: May 2018

According to classical Muslim marriage law, a woman needs her guardian's (viz. father's) consent to marry. However, the resulting marriage payment, the mahr, is hers. This split bill may lie behind the high rates of consanguineous marriage in the Muslim world, where country estimates range from 20 to 60 percent. Cousin marriage can stem from a form of barter in which fathers contribute daughters to an extended family bridal pool against sons' right to draw from the same pool. In the resulting system, women are robbed of their mahr and sons marry by guarding their sisters' “honor” and heeding clan elders.
Women's Empowerment, the Gender Gap in Desired Fertility, and Fertility Outcomes in Developing Countries
Authors: Doepke Matthias , Tertilt Michèle
Published: May 2018

We document evidence on preferences for childbearing in developing countries. Across countries, men usually desire larger families than women do. Within countries, we find wide dispersion in spouses' desired fertility: there are many couples whose ideal family size differs by five children or more. This disagreement between spouses suggests that the extent to which women are empowered should matter for fertility choices. We point to evidence at both the macro and micro levels that this is indeed the case. We conclude that taking account of household bargaining and women's empowerment in analyses of fertility is an important challenge for research.
Male Social Status and Women's Work
Authors: Bernhardt Arielle , Field Erica , Pande Rohini , Rigol Natalia , Schaner Simone , Troyer-Moore Charity
Published: May 2018

Female labor force participation varies significantly even among countries with similar levels of economic development. Recent studies have shown that gender norms can help explain these differences in women's work, but the channels through which norms impact women's employment decisions are not well understood. We present novel data on spouses' preferences and perceptions of community attitudes about female labor in rural India and document associations with female work. We find that the perceived social cost of women's work falls on men and that husbands' opposition to female labor is associated with their wives' lower take-up of employment.
How Trade Sensitive Are Energy-Intensive Sectors?
Authors: Fischer Carolyn , Fox Alan K.
Published: May 2018

For most governments looking to implement climate policy—and for interest groups looking to influence it—the effect of unilateral greenhouse gas regulation on employment, production, and emissions represents an overarching concern. Critical to improving analysis of climate policy, implications for energy-intensive, trade-exposed sectors are better empirical estimates of trade sensitivities. Ex ante analysis of climate policy and carbon leakage relies heavily on economic simulations of global trade. We estimate parameters related to trade sensitivity to help identify sectors at risk for carbon leakage and to calibrate the models used to evaluate policy alternatives for addressing these problems.
Regulating Mismeasured Pollution: Implications of Firm Heterogeneity for Environmental Policy
Authors: Lyubich Eva , Shapiro Joseph S. , Walker Reed
Published: May 2018

This paper provides the first estimates of within-industry heterogeneity in energy and CO2 productivity for the entire US manufacturing sector. We measure energy and CO2 productivity as output per dollar energy input or per ton CO2 emitted. Three findings emerge. First, within narrowly defined industries, heterogeneity in energy and CO2 productivity across plants is enormous. Second, heterogeneity in energy and CO2 productivity exceeds heterogeneity in most other productivity measures, like labor or total factor productivity. Third, heterogeneity in energy and CO2 productivity has important implications for environmental policies targeting industries rather than plants, including technology standards and carbon border adjustments.
Economic Expectations, Voting, and Economic Decisions around Elections
Authors: Huberman Gur , Konitzer Tobias , Krupenkin Masha , Rothschild David , Hill Shawndra
Published: May 2018

Survey respondents who associate themselves with the “winning team” in an election, substantially increase their expectations for their stock market, but only modestly increase their expected household economic well-being. The impact of the election outcome on the “losing team” is comparatively muted. Yet, the dramatic shifts in survey responses from “winning team” respondents do not manifest themselves in their actual behavior as revealed by their online search behavior, in contrast to members of the “losing team,” whose decline in durable goods purchases correlate with their stated economic expectations. Combining novel survey data and search, this study provides a uniquely meaningful comparison of stated attitudes with actual behaviors.
Is Altruism Sensitive to Scope? The Role of Tangibility
Authors: Imas Alex , Loewenstein George
Published: May 2018

Prior work has shown that people appear insensitive to the scope of their altruistic acts and prosocial behavior. While they respond positively when their choices lead to increasing rewards for themselves, people do not change their behavior when the outcomes for others increase. We demonstrate that the scope sensitivity of altruism depends critically on its tangibility, and suggest that this relationship operates through mental accounting. We show that by increasing the level of tangibility, people can become just as sensitive to changes in the size of rewards for others as if they were earning the rewards themselves.
Mental Budgeting versus Relative Thinking
Authors: Hirshman Samuel , Pope Devin , Song Jihong
Published: May 2018

In many situations, mental budgeting and relative thinking predict results that are in opposing directions. We study a situation of this type and provide evidence for when the predictions of one model will dominate the other.
Cross-Country Differences in Household Stock Market Participation: The Role of Gender Norms
Authors: Ke Da
Published: May 2018

What explains substantial variation across countries in household stock market participation? Building on Ke (2018), I hypothesize that the prevailing gender norm in a country is an important cultural factor. In a cross-country analysis, I find that households in countries with strong gender norms are less likely to participate in the stock market. In addition, I present suggestive evidence that gender role attitudes help explain cross-country differences in participation among the wealthy. My findings underscore the role of social norms in shaping household balance sheets across countries.
The Language of Discrimination: Using Experimental versus Observational Data
Authors: Bohren Aislinn , Imas Alex , Rosenberg Michael
Published: May 2018

We use experimental and observational data to examine whether people respond differently to questions posed by females versus males. We document significant differences in the language of responses, both in terms of the distribution of language utilized, and the sentiment of this language (positive or negative). In the observational data, we also document differences in the language and sentiment of questions posed by gender. This highlights the importance of using experimental data to identify the causal role that gender plays in influencing the language choice of individuals responding to questions from males versus females.
Gendered Language on the Economics Job Market Rumors Forum
Authors: Wu Alice H.
Published: May 2018

This paper examines the existence of an unwelcoming or stereotypical culture using evidence on how women and men are portrayed in anonymous discussions on the Economics Job Market Rumors forum (EJMR). I use a Lasso-Logistic model to measure gendered language in EJMR postings, identifying the words that are most strongly associated with discussions about one gender or the other. I find that the words most predictive of a post about a woman are typically about physical appearance or personal information, whereas those most predictive of a post about a man tend to focus on academic or professional characteristics.
Representations of Men and Women in Introductory Economics Textbooks
Authors: Stevenson Betsey , Zlotnick Hanna
Published: May 2018

This paper examines the frequency and ways in which men and women appear in principles of economics textbooks. Men account for more than 90 percent of business leaders, policymakers, and economists mentioned in textbooks. In addition, women are a minority of the fictionalized people appearing in textbooks and a minority of celebrities. Fictionalized women are shown taking fewer actions and are more likely to be involved in food, fashion, or household tasks, while men are more likely both to be in leadership positions and in business or policy.
What Can UWE Do for Economics?
Authors: Avilova Tatyana , Goldin Claudia
Published: May 2018

Men outnumber women as undergraduate economics majors by three to one nationwide. Even at the best research universities and liberal arts colleges men outnumber women by two to one or more. The Undergraduate Women in Economics Challenge began in 2015 as an RCT with 20 treatment schools and at least 30 control schools to evaluate whether better course information, mentoring, encouragement, career counseling, and more relevant instructional content could move the needle. Although the RCT is still in the field, results from several within treatment-school randomized trials demonstrate that uncomplicated and inexpensive interventions can substantially increase women in economics.
Elasticity of Medicaid Access with Respect to State Financial Distress
Authors: Perez Victoria , Benitez Joseph , Seiber Eric
Published: May 2018

In 2016, total Medicaid spending, $574.2 billion, represented one-third of state budgets. Descriptive studies indicate that state policymakers adjust social welfare programs during times of financial distress, particularly Medicaid. The challenge of formally estimating this effect is that macroeconomic shocks increase Medicaid enrollment and state-level financial stress. We use an exogenous measure of Medicaid generosity to estimate the elasticity of Medicaid generosity with respect to financial conditions. We find Medicaid generosity is not adjusted during periods of fiscal distress, whether anticipated or not. Instead, we find a counter-cyclical Medicaid effect with generosity increasing with increases in the unemployment rate.
Local Violence, Academic Performance, and School Accountability
Authors: Casey Marcus , Schiman Jeffrey C. , Wachala Maciej
Published: May 2018

Standardized test scores and value-added measures largely determine “grades” assigned to teachers and schools. Poor evaluations have severe implications: in some cases, entire schools may be closed or replaced by a charter. Although evaluation depends on within-school factors, random shocks external to the school environment may affect measured test performance and evaluations. In this article, we study a salient shock: violent crime. Our results suggest exposure to an additional violent event is associated with decreased test performance. These performance declines are consequential as the schools impacted by within-testing period violent crime are also less likely to meet accountability standards.
In Debt and Approaching Retirement: Claim Social Security or Work Longer?
Authors: Butrica Barbara A. , Karamcheva Nadia S.
Published: May 2018

Over the past couple of decades, older Americans have become considerably more leveraged. This paper considers whether household debt affects the timing of retirement and Social Security benefit claiming. Using data from the Health and Retirement Study, we find that older adults with debt are more likely to work and less likely to receive Social Security benefits than those who are debt-free. Indebted adults are also more likely to delay fully retiring from the labor force and claiming their benefits. Among the sources of debt, mortgages have a stronger impact on older adults' behavior than do other sources of debt.
Indoor Air Pollution and Infant Mortality: A New Approach
Authors: Imelda
Published: May 2018

I propose a new approach to estimate the impact of changes in indoor air quality on infant mortality. I use a quasi-experimental design, leveraging the largest kerosene to liquid petroleum gas (LPG) conversion program implemented in a developing country. The Indonesian government redirected kerosene subsidy budgets to LPG, a more efficient and cleaner fuel compared to kerosene. LPG produces significantly less indoor air pollution compared to kerosene. I find 4 fewer infants died per 10,000 live births due to the program. In the developing world, one billion kerosene users switching to LPG can save about 7,000 infants per year.
Is Populism Necessarily Bad Economics?
Authors: Rodrik Dani
Published: May 2018

I distinguish between political and economic populism. Both are averse to agencies of restraint, or, equivalently, delegation to technocrats or external rules. In the economic domain, delegation to independent agencies (domestic or foreign) occurs in two different contexts: (i) in order to prevent the majority from harming itself in the future and (ii) in order to cement a redistribution arising from a temporary political advantage for the longer-term. Economic policy restraints that arise in the first case are desirable; those that arise in the second case are much less so.
Economic Drivers of Populism
Authors: Guriev Sergei
Published: May 2018

The recent wave of populism is different from the previous ones, thus generating the demand for noneconomic explanations, such as identity politics and cultural factors. In this paper, I discuss several pieces of evidence that show that economic factors, such as an increase in unemployment during the Great Recession, skill-biased trade and inequality (especially inequality of opportunity), have also played an important role in the recent rise of antiestablishment sentiment.
Private Paternalism, the Commitment Puzzle, and Model-Free Equilibrium
Authors: Laibson David
Published: May 2018

Paternalism is a policy that advances an individual's interests by restricting his or her freedom. In a setting with present-biased agents, I characterize the scope of private paternalism—paternalism implemented by private institutions. Private paternalism arises from two channels: (i) agents who seek commitment because they hold sophisticated beliefs about their present bias, and (ii) agents (naive or sophisticated) who use model-free forecasts to choose organizations that have a history of generating high experienced utility flows for their members (O'Donoghue and Rabin 1999b). When naive consumers are common, private paternalism will be shrouded, explaining why commitment mechanisms are typically shrouded in the labor market (the commitment puzzle). Private paternalism has greater traction when production occurs in the formal sector instead of the informal (household) sector, where monitors are not always present, able, or willing to implement socially efficient forcing mechanisms.