bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic stimulus measures in the pandemic: the role of fiscal decentralisation
Authors: Elgin Ceyhun , Yalaman Abdullah , Yasar Sezer 
Published: January 2023

AbstractIs fiscal federalism associated with economic policy responses and stimulus measures adopted by national and sub-national governments to mitigate the adverse economic effects of the COVID-19 pandemic? In this paper, we provide empirical evidence that it indeed is. Our results indicate that even after controlling for various relevant factors, countries with fiscally federal (decentralised) governments have adopted larger fiscal and macro-financial policy packages (as a percent of GDP). However, there are no significant differences in monetary-policy responses between centralised and decentralised governments. We also show that these results are robust to using different federalism measures, including different sets of control variables and different econometric specifications that include an instrumental variable estimation.
Specialist Herbivore Performance on Introduced Plants During Native Host Decline
Authors: Horne Grace M , Manderino Rea , Jaffe Samuel P 
Published: January 2023

AbstractAsh (Fraxinus spp.) is in rapid decline across the northeastern USA due to the invasive emerald ash borer (Agrilus planipennis Fairmaire). Three recently co-occurring confamilial species may serve as alternative larval host plants for ash-reliant Lepidoptera. These prospective hosts are nonnative shrubs often planted in managed suburban landscapes and are sometimes invasive or naturalized in North America. Given the imminent decline of ash trees, we considered potential downstream effects on insect herbivores historically specialized on ash foliage. We measured the performance of three ash-specialist hawkmoths (Lepidoptera: Sphingidae) on native white ash (Fraxinus americana L.) and alternative host plants: common lilac (Syringa vulgaris L.), weeping forsythia [Forsythia suspensa (Thunb.) Vahl], and European privet (Ligustrum vulgare L.). We found the nonnative host plants provided varied support for larval survival to pupation, with biomass and growth rate affected differently by both plant and insect identity. Nearly all caterpillars reared on one alternative host, European privet, exhibited distinct malformations of the wing buds at pupation. Given caterpillar presence on privet in the field, privet may constitute an ecological trap (i.e., when female moths select a sub-optimal host, offspring survival and fitness are reduced). This work demonstrates how performance testing can reveal species-specific effects of host plant loss on mono- or oligophagous insects. For some ash specialists, alternative nonnative host plants may be suboptimal, but some cultivated host plants may be able to support certain specialist insects during native host decline. We suggest that landscaping decisions can be tailored to support threatened insect species.
The Originality of Outsiders: Innovation in the Investment Treaty System
Authors: Roberts Anthea , St John Taylor 
Published: January 2023

Abstract
In recent years, several proposals by states to reform or displace investor-state dispute settlement (ISDS) have gained prominence. While many factors shape which reform proposals states support, here we focus on one important, but often overlooked, factor: the ‘insider’ or ‘outsider’ status of the government officials who formulate states’ proposals. Based on five years of para-ethnographic observation and interviews with officials involved in ISDS reform, and informed by the interdisciplinary innovation literature, we explore how individuals who have not spent their careers within the field of investment arbitration (and are perceived as ‘outsiders’ by those within that field) have developed more disruptive reform proposals while arbitral insiders have typically proposed sustaining reforms. We illuminate these dynamics in the ISDS reform debates with case studies of four actors: the USA, the European Union, Bahrain and Brazil.
Exploring the incremental utility of circulating biomarkers for robust risk prediction of incident atrial fibrillation in European cohorts using regressions and modern machine learning methods
Authors: Toprak Betül , Brandt Stephanie , Brederecke Jan , Gianfagna Francesco , Vishram-Nielsen Julie K K , Ojeda Francisco M , Costanzo Simona , Börschel Christin S , Söderberg Stefan , Katsoularis Ioannis , Camen Stephan , Vartiainen Erkki , Donati Maria Benedetta , Kontto Jukka , Bobak Martin , Mathiesen Ellisiv B , Linneberg Allan , Koenig Wolfgang , Løchen Maja-Lisa , Di Castelnuovo Augusto , Blankenberg Stefan , de Gaetano Giovanni , Kuulasmaa Kari , Salomaa Veikko , Iacoviello Licia , Niiranen Teemu , Zeller Tanja , Schnabel Renate B 
Published: January 2023

AbstractAimsTo identify robust circulating predictors for incident atrial fibrillation (AF) using classical regressions and machine learning (ML) techniques within a broad spectrum of candidate variables.Methods and resultsIn pooled European community cohorts (n = 42 280 individuals), 14 routinely available biomarkers mirroring distinct pathophysiological pathways including lipids, inflammation, renal, and myocardium-specific markers (N-terminal pro B-type natriuretic peptide [NT-proBNP], high-sensitivity troponin I [hsTnI]) were examined in relation to incident AF using Cox regressions and distinct ML methods. Of 42 280 individuals (21 843 women [51.7%]; median [interquartile range, IQR] age, 52.2 [42.7, 62.0] years), 1496 (3.5%) developed AF during a median follow-up time of 5.7 years. In multivariable-adjusted Cox-regression analysis, NT-proBNP was the strongest circulating predictor of incident AF [hazard ratio (HR) per standard deviation (SD), 1.93 (95% CI, 1.82–2.04); P &lt; 0.001]. Further, hsTnI [HR per SD, 1.18 (95% CI, 1.13–1.22); P &lt; 0.001], cystatin C [HR per SD, 1.16 (95% CI, 1.10–1.23); P &lt; 0.001], and C-reactive protein [HR per SD, 1.08 (95% CI, 1.02–1.14); P = 0.012] correlated positively with incident AF. Applying various ML techniques, a high inter-method consistency of selected candidate variables was observed. NT-proBNP was identified as the blood-based marker with the highest predictive value for incident AF. Relevant clinical predictors were age, the use of antihypertensive medication, and body mass index.ConclusionUsing different variable selection procedures including ML methods, NT-proBNP consistently remained the strongest blood-based predictor of incident AF and ranked before classical cardiovascular risk factors. The clinical benefit of these findings for identifying at-risk individuals for targeted AF screening needs to be elucidated and tested prospectively.
Electrophysiological characteristics and long-term outcome of substrate-based catheter ablation for left posterior fascicular ventricular tachycardia targeting fragmented antegrade Purkinje potentials during sinus rhythm
Authors: Wei Hui-Qiang , Liao Zili , Liang Yuanhong , Fang Xianhong , Liao Hongtao , Deng Hai , Wei Wei , Huang Yingjie , Liu Yang , Liu Fangzhou , Lin Weidong , Liang Jackson J , Xue Yumei , Wu Shulin , Zhan Xianzhang 
Published: January 2023

AbstractAimsThe aim of this study was to investigate the electrophysiological characteristics and long-term outcome of patients undergoing substrate-based ablation of left posterior fascicular ventricular tachycardia (LPF-VT) guided by targeting of fragmented antegrade Purkinje potentials (FAPs) during sinus rhythm.Methods and resultsThis study retrospectively analysed 50 consecutive patients referred for ablation. Substrate mapping during sinus rhythm was performed to identify the FAP that was targeted by ablation. FAPs were recorded in 48 of 50 (96%) patients during sinus rhythm. The distribution of FAPs was located at the proximal segment of posterior septal left ventricle (LV) in two (4.2%) patients, middle segment in 33 (68.8%) patients, and distal segment in 13 (27.1%) patients. In 32 of 48 (66.7%) patients, the FAP displayed a continuous multicomponent fragmented electrogram, while a fragmented, split, and uncoupled electrogram was recorded in 16 (33.3%) patients. Entrainment attempts at FAP region were performed successfully in seven patients, demonstrating concealed fusion and the critical isthmus of LPF-VT. Catheter ablation targeting at the FAPs successfully terminated the LPF-VT in all 48 patients in whom they were seen. Left posterior fascicular (LPF) block occurred in four (8%) patients after ablation. During a median follow-up period of 61.2 ± 16.8 months, 47 of 50 (94%) patients remained free from recurrent LPF-VT.ConclusionAblation of LPF-VT targeting FAP during sinus rhythm results in excellent long-term clinical outcome. FAPs were commonly located at the middle segment of posterior septal LV. Region with FAPs during sinus rhythm was predictive of critical site for re-entry.
A new radiomics approach combining the tumor and peri-tumor regions to predict lymph node metastasis and prognosis in gastric cancer
Authors: Yang Yutao , Chen Hao , Ji Min , Wu Jianzhang , Chen Xiaoshan , Liu Fenglin , Rao Shengxiang 
Published: January 2023

AbstractObjectiveThe development of non-invasive methods for evaluating lymph node metastasis (LNM) preoperatively in gastric cancer (GC) is necessary. In this study, we developed a new radiomics model combining features from the tumor and peri-tumor regions for predicting LNM and prognoses.MethodsThis was a retrospective observational study. In this study, two cohorts of patients with GC treated in Zhongshan Hospital Fudan University (Shanghai, China) were included. In total, 193 patients were assigned to the internal training/validation cohort; another 98 patients were assigned to the independent testing cohort. The radiomics features were extracted from venous phase computerized tomography (CT) images. The radiomics model was constructed and the output was defined as the radiomics score (RS). The performance of the RS and CT-defined N status (ctN) for predicting LNM was compared using the area under the curve (AUC). The 5-year overall survival and progression-free survival were compared between different subgroups using Kaplan–Meier curves.ResultsIn both cohorts, the RS was significantly higher in the LNM-positive group than that in the LNM-negative group (all P &lt; 0.001). The radiomics model combining features from the tumor and peri-tumor regions achieved the highest AUC in predicting LNM (AUC, 0.779 and 0.724, respectively), which performed better than the radiomics model based only on the tumor region and ctN (AUC, 0.717, 0.622 and 0.710, 0.603, respectively). The differences in 5-year overall survival and progression-free survival between high-risk and low-risk groups were significant (both P &lt; 0.001).ConclusionsThe radiomics model combining features from the tumor and peri-tumor regions could effectively predict the LNM in GC. Risk stratification based on the RS was capable of distinguishing patients with poor prognoses.
X Chromosome Factor Kdm6a Enhances Cognition Independent of Its Demethylase Function in the Aging XY Male Brain
Authors: Shaw Cayce K , Abdulai-Saiku Samira , Marino Francesca , Wang Dan , Davis Emily J , Panning Barbara , Dubal Dena B 
Published: January 2023

Abstract
Males exhibit shorter life span and more cognitive deficits, in the absence of dementia, in aging human populations. In mammals, the X chromosome is enriched for neural genes and is a major source of biologic sex difference, in part, because males show decreased expression of select X factors (XY). While each sex (XX and XY) harbors one active X due to X chromosome inactivation in females, some genes, such as Kdm6a, transcriptionally escape silencing in females—resulting in lower transcript levels in males. Kdm6a is a known histone demethylase (H3K27me2/3) with multiple functional domains that is linked with synaptic plasticity and cognition. Whether elevating Kdm6a could benefit the aged male brain and whether this requires its demethylase function remains unknown. We used lentiviral-mediated overexpression of the X factor in the hippocampus of aging male mice and tested their cognition and behavior in the Morris water-maze. We found that acutely increasing Kdm6a—in a form without demethylase function—selectively improved learning and memory, in the aging XY brain, without altering total activity or anxiety-like measures. Further understanding the demethylase-independent downstream mechanisms of Kdm6a may lead to novel therapies for treating age-induced cognitive deficits in both sexes.
Slc9a6 mutation causes Purkinje cell loss and ataxia in theshakerrat
Authors: Figueroa Karla P , Anderson Collin J , Paul Sharan , Dansithong Warunee , Gandelman Mandi , Scoles Daniel R , Pulst Stefan M 
Published: January 2023

AbstractThe shaker rat carries a naturally occurring mutation leading to progressive ataxia characterized by Purkinje cell (PC) loss. We previously reported on fine-mapping the shaker locus to the long arm of the rat X chromosome. In this work, we sought to identify the mutated gene underlying the shaker phenotype and confirm its identity by functional complementation. We fine-mapped the candidate region and analyzed cerebellar transcriptomes, identifying a XM_217630.9 (Slc9a6):c.[191_195delinsA] variant in the Slc9a6 gene that segregated with disease. We generated an adeno-associated virus (AAV) targeting Slc9a6 expression to PCs using the mouse L7–6 (L7) promoter. We administered the AAV prior to the onset of PC degeneration through intracerebroventricular injection and found that it reduced the shaker motor, molecular and cellular phenotypes. Therefore, Slc9a6 is mutated in shaker and AAV-based gene therapy may be a viable therapeutic strategy for Christianson syndrome, also caused by Slc9a6 mutation.
The UK Supreme Court’s Miller II: Keeping the Court out of politics’ way?
Authors: Helmich Maurits 
Published: January 2023

Abstract
In recent years, the legitimacy of the United Kingdom’s Supreme Court has come under increasing pressure, with critics accusing the Court of unduly entering the domain of “politics.” Using the September 2019 Miller/Cherry “prorogation” judgment as a case study, this article analyzes the tension underpinning the criticisms. In particular, it makes two theoretical claims. First, three normative worries guide attempts to distance adjudicative judgment from the political sphere. Courts should not disrespect settled law (the “lawmaking worry”), interfere with the autonomy of politics (“the interventionism worry”), or answer political questions (“non-justiciability worry”). Second, though all three worries represent coherent norms in the abstract, in deeply controversial cases like Miller/Cherry, those norms fail to be of independent help. Attempts to distinguish the judicial domain from the domain of politics, the article argues, are themselves rooted in ideologically deeply colored definitions and acts of political stance-taking.
Standing in the shadows of balancing: Proportionality and the necessity test
Authors: da Silva Virgílio Afonso 
Published: January 2023

Abstract
The necessity test is one of the steps of the proportionality test. However, in the literature on the subject, written both by supporters as well as by critics of proportionality, the role of the necessity test has been frequently downplayed, sometimes plainly ignored. The spotlight has always been on balancing. This article shows that proportionality is not just about balancing, and that the necessity test has a much more important role to play than has been acknowledged so far. Its strengths are emphasized, especially its connection to politics, knowledge from other areas, time, and technological development. The article argues that shedding the appropriate light on these strengths has important implications for several ongoing debates around the proportionality test.
A critical reflection on the ‘Public Interest Exemption’ in China’s merger control regime
Authors: Ai Huizi , Philipsen Niels J 
Published: January 2023

Abstract
The Anti-Monopoly Law (AML) in China allows the responsible authority for merger control to consider not only the competition interest but also other public interest reasons when it reviews a takeover or merger. Where the responsible authority considers that the benefits of a takeover or merger to the public interest outweigh the harms to competition, it may ‘exempt’ the transaction. This ‘public interest exemption’ has never been formally applied since the introduction of the law in 2008. One explanation for this can be found in the ambiguity of the law: there are no legal provisions that clarify the public interest considerations. A second explanation is that China did not establish a separate review procedure for this public interest exemption. In practice, some approval decisions made by the enforcement authority led to confusion, as it was unclear whether the transactions were ‘exempted’ for public interest reasons or for industrial policies. This article reflects on the role of the public interest exemption in China. By drawing lessons from the past and examining the public interest exemption regime in Germany, it aims to provide suggestions for future reforms, against the background of the promulgation of the Amendment to the AML in 2022.
Optimizing Equity: Working towards Fair Machine Learning Algorithms in Laboratory Medicine
Authors: Azimi Vahid , Zaydman Mark A 
Published: January 2023

AbstractBackgroundMethods of machine learning provide opportunities to use real-world data to solve complex problems. Applications of these methods in laboratory medicine promise to increase diagnostic accuracy and streamline laboratory operations leading to improvement in the quality and efficiency of healthcare delivery. However, machine learning models are vulnerable to learning from undesirable patterns in the data that reflect societal biases. As a result, irresponsible application of machine learning may lead to the perpetuation, or even amplification, of existing disparities in healthcare outcomes.ContentIn this work, we review what it means for a model to be unfair, discuss the various ways that machine learning models become unfair, and present engineering principles emerging from the field of algorithmic fairness. These materials are presented with a focus on the development of machine learning models in laboratory medicine.SummaryWe hope that this work will serve to increase awareness, and stimulate further discussion, of this important issue among laboratorians as the field moves forward with the incorporation of machine learning models into laboratory practice.
A Statistical Simulation to Evaluate the Robustness of Hb A1c Measurement in the Presence of Quantitative Error
Authors: Lyon Oliver A S , Inman Mark 
Published: January 2023

Abstract

Background
The performance requirements for hemoglobin (Hb) A1c analysis have been questioned as analytic methods have improved. We developed a statistical simulation that relates error to the clinical utility of an oft-used laboratory test, as a means of assessing test performance expectations.

Methods
Finite mixture modeling of the Centers for Disease Control and Prevention—National Health and Nutrition Examination Survey (NHANES) 2017–2020 Hb A1c data in conjunction with Monte Carlo sampling were used to model and simulate a population prior to the introduction of error into the results. The impact of error on clinical utility was assessed by categorizing the results using the American Diabetes Association (ADA) diagnostic criteria and assessing the sensitivity and specificity of Hb A1c under various degrees of error (bias and imprecision).

Results
With the current allowable total error threshold of 6% for Hb A1c measurement, the simulation estimated a worst case between 50% and 60% for both test sensitivity and specificity for the non-diabetic category. Similarly, sensitivity and specificity estimates for the pre-diabetic category were 30% to 40% and 60% to 70%, respectively. Finally, estimates for the diabetic category yielded values of 80% to 90% for sensitivity and &gt;90% for specificity.

Conclusions
Bias and imprecision greatly affect the clinical utility of Hb A1c for all patient groups. The simulated error demonstrated in this modeling impacts 3 critical applications of the Hb A1c in diabetes management: the capacity to reliably screen, diagnostic accuracy, and utility in diabetes monitoring.
Choice Architecture to Assist Clinicians with Appropriate COVID-19 Test Ordering
Authors: Sangal Rohit B , Venkatesh Arjun K , Cahill Justin , Pettker Christian M , Peaper David R 
Published: January 2023

AbstractBackgroundDespite improving supplies, SARS-CoV-2 nucleic acid amplification tests remain limited during surges and more so given concerns around COVID-19/influenza co-occurrence. Matching clinical guidelines to available supplies ensures resources remain available to meet clinical needs. We report a change in clinician practice after an electronic health record (EHR) order redesign to impact emergency department (ED) testing patterns.MethodsWe included all ED visits between December 1, 2021 and January 18, 2022 across a hospital system to assess the impact of EHR order changes on provider behavior 3 weeks before and after the change. The EHR order redesign included embedded symptom-based order guidance. Primary outcomes were the proportion of COVID-19 + flu/respiratory syncytial virus (RSV) testing performed on symptomatic, admitted, and discharged patients, and the proportion of COVID-19 + flu testing on symptomatic, discharged patients.ResultsA total of 52 215 ED visits were included. For symptomatic, discharged patients, COVID-19 + flu/RSV testing decreased from 11.4 to 5.8 tests per 100 symptomatic visits, and the rate of COVID-19 + flu testing increased from 7.4 to 19.1 before and after the intervention, respectively. The rate of COVID-19 + flu/RSV testing increased from 5.7 to 13.1 tests per 100 symptomatic visits for symptomatic patients admitted to the hospital. All changes were significant (P &lt; 0.0001).ConclusionsA simple EHR order redesign was associated with increased adherence to institutional guidelines for SARS-CoV-2 and influenza testing amidst supply chain limitations necessitating optimal allocation of scarce testing resources. With continually shifting resource availability, clinician education is not sufficient. Rather, system-based interventions embedded within exiting workflows can better align resources and serve testing needs of the community.
Data-Driven Anomaly Detection in Laboratory Medicine: Past, Present, and Future
Authors: Spies Nicholas C , Farnsworth Christopher W , Jackups Ronald 
Published: January 2023

Abstract

Background
Anomaly detection is an integral component of operating a clinical laboratory. It covers both the recognition of laboratory errors and the rapid reporting of clinically impactful results. Procedures for identifying laboratory errors and highlighting critical results can be improved by applying modern data-driven approaches.

Content
This review will prepare the reader to appraise anomaly detection literature, identify common sources of anomalous results in the clinical laboratory, and offer potential solutions for common shortcomings in current laboratory practices.

Summary
Laboratories should implement data-driven approaches to detect technical anomalies and keep them from entering the medical record, while also using the full array of clinical metadata available in the laboratory information system for context-dependent, patient-centered result interpretations.