10 research outputs found

    Political Competition and Judicial Independence: How Courts Fill the Void When Legislatures Are Ineffective

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    What effect does political competition have in generating de facto judicial independence? We argue that competition in a legislature can drive increases in de facto judicial independence. Our game-theoretic model reveals that increased competition for seats impedes legislators’ ability to enact their platforms, regardless of government turnover probability, and increased legislative fractionalization also makes court intervention more likely. Utilizing a sample of democratic states, empirical evidence suggests when a country’s legislature is increasingly fractionalized among parties or has increasing seat turnover, we observe increases in de facto independence. This research provides new perspectives on the link between independence and competition

    Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

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    BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

    Bureaucrats under populism

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    We explore the consequences of populism for bureaucrats’ incentives by analyzing a model of delegated policymaking between politicians and bureaucrats. Populist politicians prefer a bureaucrat who implements their policy commitment, while non-populist politicians prefer a good bureaucrat with discretion.The presence of populist politicians thus determines replacement of good with bad bureaucrats and creates incentives for good bureaucrats to ‘‘feign loyalty”. We show that feigning loyalty is more prevalent when the probability of populist leadership in the future is higher and the bureaucrats’ pool of potential replacements is worse. We also show that bureaucratic turnover is higher under populists when the bureaucracy is strong and higher under non-populists when the bureaucracy is weak

    Minimally Invasive Spine Surgery: A Historical Perspective

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    The Political Economy of Populism

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    The 1980s

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    Bibliography

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    The 1970s

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