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The fiscal and macroeconomic effects of fiscal rules
Get PDFA majority of advanced and developing countries have adopted fiscal rules, which aim on managing fiscal aspects, such as government debt, government budget balances and other factors. Alongside national fiscal rules, many economic and monetary unions have implemented common fiscal rules, which affect all member countries and aim on controlling their fiscal aspects in a common way to address potential spillover effects from negative fiscal shocks and provide a more stable macro-fiscal environment. This study uses a fixed effect panel approach on a sample of 106 countries from 1985 to 2021 to study how national and supranational fiscal rules have affected the development of government debt, government budget balances, public investment and economic growth. The results imply that the effectiveness of different fiscal rules is highly heterogeneous and that supranational fiscal rules substantially outperform national fiscal rules. However, a majority of the effects from national fiscal rules remains unchanged when studied alongside supranational rules, suggesting that these rules act as complements rather than substitutes. The effects of fiscal rules are most significant for the studied fiscal variables, with some additional impacts observed for public investment and economic growth.</p
Euthyroidectomy under local versus general anesthesia in health camp settings in Uganda: a protocol for randomized prospective equivalence single-blind controlled trial
Get PDFBackground: Endemic goiter is highly prevalent in Uganda at 60.2%, contributing to the high surgical burden. While compelling evidence suggest that in selected cases, thyroidectomy under local anesthesia (LA) is associated with fewer post-operative complications, low costs, and short hospital stays, local anesthesia is not considered a priority technique for thyroidectomy in resource-constrained settings such as Uganda, despite having fewer general anesthesia (GA) and critical care providers. The objective of this trial is to compare euthyroidectomy under local versus general anesthesia among patients with grade 1-2 uncomplicated euthyroid goiter in Uganda.Methods: This prospective equivalence randomized, single-blind controlled trial protocol will be conducted among eligible participants with grade 1-2 uncomplicated euthyroid goiters. The recruitment processes will start in October 2022 and end in April 2023. Consenting participants with an indication for thyroidectomy will be randomized into two arms of 29 participants in each arm during the Bulamu Health Care Organization surgical camps in Uganda.Discussion: The primary outcome of this trial protocol is to compare the early post-operative complications of euthyroidectomy done under LA versus GA. The outcome variables include post-operative pain based on visual analogue scale, nausea, vomiting, hematoma formation, and transient voice changes determined at an interval of 6, 12, and 24 h and at 30 days. In addition, we shall compare the surgical site infection rates, procedure costs, hospital stay, and patients' level of satisfaction based on a 5-point Likert scale and their willingness to undergo a similar surgery using the same anesthetic technique between the two groups. We hypothesize that euthyroidectomy under LA could potentially offer similar benefits as GA, reduce costs related to procedure, complications, and hospital stay while at the same time mitigating the unmet need for surgery attributable to shortage of general anesthesia providers and critical care facilities in low-income settings.Trial registration: Pan African Clinical Trial Registry PACTR202208635457430. Registered on 11th August 2022. All items from the WHO trial registration data set are within the protocol. Version number and date: version 3, 15/03/2023.</p
Occupancy-frequency distribution of birds in land-sharing and -sparing urban landscapes in Europe
Get PDFSpecies richness is a widely used proxy for patterns of biodiversity variation in metacommunities. However, deeper analyses require additional metrics, such as the occupancy-frequency distributions (SOFD) of different local communities. The SOFD patterns indicate the number of shared species between study sites; therefore, they can provide new insights into the current debate on how to create more biodiversity-friendly cities. Breeding birds were counted from 593 point-count stations located in five 500 m x 500 m squares in land-sharing (LSH; low-density built areas interspersed with green spaces) and five similar nearby squares in land-sparing (LSP; densely built-up with set-aside, large-sized, continuous green spaces) landscapes in nine cities across Europe. High beta-diversity (with over 42% of the 103 species detected being restricted to a single city and only 7% found in all studied cities) showed the uniqueness of cities at the continental scale. Urban bird metacommunities followed the unimodal-satellite SOFD pattern at the European continental scale but a bimodal symmetric or asymmetric distribution at the city-level scale, suggesting that many common species occur in cities on a smaller scale. The LSP urban areas followed a unimodal satellite SOFD pattern with numerous rare species. In contrast, the LSH areas fit several types of bimodal SOFD patterns equally well, where communities share several common species. The findings also highlight the need to use multi-scale approaches to analyze the effects of LSH-LSP urban designs on urban bird diversity
Gauging Misclassification in Rapid Guessing Identification in a Fast-Paced Vocabulary Test
Get PDFIn low-stakes testing, rapid-guessing behavior (RG) presents a significant challenge to the validity of test scores. This study investigates the misclassification produced by nine different response time (RT) threshold methods in identifying RG, using large-scale assessment data from a fast-paced vocabulary test and introducing choice reaction time (CRT) as a ground truth variable. Although the methods varied mostly in their ability to estimate thresholds at all and not in the misclassification rates nor in their nature, the results show significant misclassification rates across methods, ranging from .080 to .096 (Finnish speakers) and from .087 to .164 (non-Finnish speakers). All methods were more conservative than liberal, with false negatives outnumbering false positives. The findings emphasize the problem of the binary mind-set in RG identification, and suggest that there is a need for approaches that identify RG at the participant-by-item level in order to improve the accuracy of RG identification.</p
Likelihood contrasts: a machine learning algorithm for binary classification of longitudinal data
Get PDFMachine learning methods have gained increased popularity in biomedical research during the recent years. However, very few of them support the analysis of longitudinal data, where several samples are collected from an individual over time. Additionally, most of the available longitudinal machine learning methods assume that the measurements are aligned in time, which is often not the case in real data. Here, we introduce a robust longitudinal machine learning method, named likelihood contrasts (LC), which supports study designs with unaligned time points. Our LC method is a binary classifier, which uses linear mixed models for modelling and log-likelihood for decision making. To demonstrate the benefits of our approach, we compared it with existing methods in four simulated and three real data sets. In each simulated data set, LC was the most accurate method, while the real data sets further supported the robust performance of the method. LC is also computationally efficient and easy to use.</p
Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study
Get PDFFoot disorders in older individuals compromise balance and contribute to postural and gait instabilities, causing a decrease in the activities of daily living and quality of life. In this cross-sectional study, we analyzed the foot-related data of 160 frail older participants who attended day service centers in A prefecture in Japan to determine the prevalence of foot problems and their associations with toe grip strength and walking speed in frail older people. Multiple regression analysis was used to identify foot-related variables that correlated with toe grip strength and walking speed. The prevalence rates of skin dryness (Support level 88.2%, Care level 85.2% for men; Support level 84.9%, Care level 93% for women) and suspected and existing fungal infections in nails (Support level 94.1%, Care level 92.6% for men; Support level 98.1%, Care level 95.2% for women) were high in both sexes regardless of the level of care required. Furthermore, in both sexes, the prevalence rates of toe and arch deformities were significantly increased in the people who required care. Regression analysis revealed that some right-sided foot-related problems were significantly associated with right toe grip strength and walking speed. The decrease in toe grip strength was significantly associated with walking speed. Our study provides evidence that some specific conditions were associated with toe grip force and walking speed. This finding can contribute to future strategies to protect foot health in community-dwelling older individuals
Computing in Cardiology 2022
Get PDFDetection of heart murmurs from stethoscope sounds is a key clinical technique used to identify cardiac abnormalities. We describe the creation of an ensemble classifier using both deep and hand-crafted features to screen for heart murmurs and clinical abnormality from phonocardiogram recordings over multiple auscultation locations. The model was created by the team Murmur Mia! for the George B. Moody PhysioNet Challenge 2022. Methods: Recordings were first filtered through a gradient boosting algorithm to detect Unknown. We assume that these are related to poor quality recordings, and hence we use input features commonly used to assess audio quality. Two further models, a gradient boosting model and ensemble of convolutional neural networks, were trained using time-frequency features and the mel-frequency cepstral coefficients (MFCC) as inputs, respectively. The models were combined using logistic regression, with bespoke rules to convert individual recording outputs to patient predictions. Results: On the hidden challenge test set, our classifier scored 0.755 for the weighted accuracy and 14228 for clinical outcome challenge metric. This placed 9/40 and 28/39 on the challenge leaderboard, for each scoring metric, respectively.</p
Single therapeutic dose of an antiviral UL29 siRNA swarm diminishes symptoms and viral load of mice infected intranasally with HSV-1
Get PDFHerpes simplex virus type 1 (HSV-1) is a human pathogen that causes recurrent infections. Acyclovir-resistant strains exist and can cause severe complications, which are potentially untreatable with current therapies. We have developed siRNA swarms that target a 653 base pair long region of the essential HSV gene UL29. As per our previous results, the anti-UL29 siRNA swarm effectively inhibits the replication of circulating HSV strains and acyclovir-resistant HSV strains in vitro, while displaying a good safety profile. We investigated a single intranasal therapeutic dose of a siRNA swarm in mice, which were first inoculated intranasally with HSV-1 and given treatment 4 h later. We utilized a luciferase-expressing HSV-1 strain, which enabled daily follow-up of infection with in vivo imaging. Our results show that a single dose of a UL29-targeted siRNA swarm can inhibit the replication of HSV-1 in orofacial tissue, which was reflected in ex vivo HSV titers and HSV DNA copy numbers as well as by a decrease in a luciferase-derived signal. Furthermore, the treatment had a tendency to protect mice from severe clinical symptoms and delay the onset of the symptoms. These results support the development of antiviral siRNA swarms as a novel treatment for HSV-1 infections.</p