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Park, S.; Yuki, H.; Niida, T.; Suzuki, K.; Kinoshita, D.; McNulty, I.; ... ; Jang, I.K. 2023

A novel deep learning model for a computed tomography diagnosis of coronary plaque erosion

Article / Letter to editor

open access

Patients with acute coronary syndromes caused by plaque erosion might be managed conservatively without stenting. Currently, the diagnosis of plaque erosion requires an invasive imaging procedure.... Show morePatients with acute coronary syndromes caused by plaque erosion might be managed conservatively without stenting. Currently, the diagnosis of plaque erosion requires an invasive imaging procedure. We sought to develop a deep learning (DL) model that enables an accurate diagnosis of plaque erosion using coronary computed tomography angiography (CTA). A total of 532 CTA scans from 395 patients were used to develop a DL model: 426 CTA scans from 316 patients for training and internal validation, and 106 separate scans from 79 patients for validation. Momentum Distillation-enhanced Composite Transformer Attention (MD-CTA), a novel DL model that can effectively process the entire set of CTA scans to diagnose plaque erosion, was developed. The novel DL model, compared to the convolution neural network, showed significantly improved AUC (0.899 [0.841-0.957] vs. 0.724 [0.622-0.826]), sensitivity (87.1 [70.2-96.4] vs. 71.0 [52.0-85.8]), and specificity (85.3 [75.3-92.4] vs. 68.0 [56.2-78.3]), respectively, for the patient-level prediction. Similar results were obtained at the slice-level prediction AUC (0.897 [0.890-0.904] vs. 0.757 [0.744-0.770]), sensitivity (82.2 [79.8-84.3] vs. 68.9 [66.2-71.6]), and specificity (80.1 [79.1-81.0] vs. 67.3 [66.3-68.4]), respectively. This newly developed DL model enables an accurate CT diagnosis of plaque erosion, which might enable cardiologists to provide tailored therapy without invasive procedures.Clinical Trial Registration:http://www.clinicaltrials.gov, NCT04523194. Show less

Suzuki, K.; Hyunkang, H. 2023

Politicization, bureaucratic closedness in personnel policy, and turnover intention

Article / Letter to editor

open access

Previous studies have identified individual and organizational factors that influence the turnover intentions of bureaucrats. However, they have overlooked how the type of national bureaucracy... Show morePrevious studies have identified individual and organizational factors that influence the turnover intentions of bureaucrats. However, they have overlooked how the type of national bureaucracy influences turnover intention. Combining data sets on macro-level bureaucratic structures and individual civil servants, we examine how bureaucratic politicization and closedness are associated with the turnover intentions of bureaucrats in 36 countries. Our analysis indicates that there is large cross-national variation in turnover intention, and that bureaucratic structures matter as one of the predictors of turnover intention. Public servants working in more closed and regulated bureaucracies exhibit lower turnover intention. We also find that public servants working in more politicized bureaucracies (in which personnel decisions are made via political connections) have lower turnover intention than those working in more merit-based systems. Such low turnover intention in politicized bureaucracies may be explained by the characteristics of patronage appointments in which public jobs are distributed based on personal or political loyalty. Show less

Oliveira, E.; Abner, G.; Lee, S.; Suzuki, K.; Hur, H.; Perry, J.L. 2023

What does the evidence tell us about merit principles and government performance?

Article / Letter to editor

open access

In October 2020, President Donald Trump sought to convert many US federal civil servants to at-will employees by executive order. Trump's initiative, referred to as Schedule F, has stimulated a... Show moreIn October 2020, President Donald Trump sought to convert many US federal civil servants to at-will employees by executive order. Trump's initiative, referred to as Schedule F, has stimulated a partisan debate about dismantling the merit system in the US federal government. A substantial international body of evidence has developed during the last three decades about the effects of administrative practices associated with meritocracy and the likely consequences of changes to civil service systems, such as those embedded in Schedule F. This article employs guidelines established under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to conduct a systematic review of the evidence to address the question: What does the evidence tell us about merit principles and government performance? This systematic review summarizes what empirical research tells us about effects of civil service practices, such as meritocratic appointments, meritocratic advancement, and tenure protection, for government performance and the quality of government. The findings indicate that factors such as meritocratic appointments/recruitment, tenure protection, impartiality, and professionalism are strongly associated with higher government performance and lower corruption. We conclude by discussing implications of our findings for public policy and management and for future research. Show less

Fujii, R.; Pattaro, C.; Tsuboi, Y.; Ishihara, Y.; Melotti, R.; Yamada, H.; ... ; Suzuki, K. 2022

Comparison of glomerular filtration rate estimating formulas among Japanese adults without kidney disease

Article / Letter to editor

open access

BackgroundPrevious studies have proposed different formulas of estimating glomerular filtration rate (eGFR) among clinical patients. The comprehensive comparison of eGFR formulas is not well... Show moreBackgroundPrevious studies have proposed different formulas of estimating glomerular filtration rate (eGFR) among clinical patients. The comprehensive comparison of eGFR formulas is not well established in a Japanese population. We compared eGFR values and chronic kidney disease (CKD) classification of nine different eGFR in a Japanese general population sample.MethodsWe analyzed 469 Japanese community-dwelling adults (184 men) without any self-reported kidney disease. GFR estimated using the 4- and 6-parameter Modification of Diet in Renal Disease (MDRD) formulas (MDRD4 and MDRD6); the CKD-EPI formulas based on creatinine with (CKD-EPI-2009) and without race coefficient (CKD-EPI-2021), on cystatin C (CKD-EPI-Cys), on both (CKD-EPI-CreCys); the Japanese creatinine-based formula (JPN-Cre), cystatin C-based formula (JPN-Cys), and modified CKD-EPI formula (JPN-CKD-EPI). CKD stages were defined by KDIGO guidelines (eGFR < 60 ml/min/1.73 m2).ResultseGFRJPN-Cre (mean = 71.2; SD = 14.3) were much lower than eGFRCKD-EPI-2021 (mean = 94.2; SD = 12.7), while eGFRJPN-Cys (mean = 102.8; SD = 24.2) was comparable to the MDRD and CKD-EPI formulas. The difference between eGFRCKD-EPI-2021 and eGFRJPN-Cre showed a V-shaped distribution across eGFR levels, indicating complex errors between these formulas. We observed very low agreement in CKD classification between eGFRJPN-Cre and the eGFRCKD-EPI-2021 (kappa = 0.13; 95% confidence interval: 0.06, 0.23).ConclusionsJPN-Cre was substantially different from the CKD-EPI formula without race term (CKD-EPI-2021), which means that it is impossible to recalibrate those with a simple coefficient. Although a comparison with measured GFR should be necessary, choice of the estimation method needs caution in clinical decision-making and academic research. Show less

Mahajan, A.; Spracklen, C.N.; Zhang, W.H.; Ng, M.C.Y.; Petty, L.E.; Kitajima, H.; ... ; Bharadwaj, D. 2022

Multi-ancestry genetic study of type 2 diabetes highlights the power of diverse populations for discovery and translation

Article / Letter to editor

open access

We assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent)... Show moreWe assembled an ancestrally diverse collection of genome-wide association studies (GWAS) of type 2 diabetes (T2D) in 180,834 affected individuals and 1,159,055 controls (48.9% non-European descent) through the Diabetes Meta-Analysis of Trans-Ethnic association studies (DIAMANTE) Consortium. Multi-ancestry GWAS meta-analysis identified 237 loci attaining stringent genome-wide significance (P < 5 x 10(-9)), which were delineated to 338 distinct association signals. Fine-mapping of these signals was enhanced by the increased sample size and expanded population diversity of the multi-ancestry meta-analysis, which localized 54.4% of T2D associations to a single variant with >50% posterior probability. This improved fine-mapping enabled systematic assessment of candidate causal genes and molecular mechanisms through which T2D associations are mediated, laying the foundations for functional investigations. Multi-ancestry genetic risk scores enhanced transferability of T2D prediction across diverse populations. Our study provides a step toward more effective clinical translation of T2D GWAS to improve global health for all, irrespective of genetic background.Genome-wide association and fine-mapping analyses in ancestrally diverse populations implicate candidate causal genes and mechanisms underlying type 2 diabetes. Trans-ancestry genetic risk scores enhance transferability across populations. Show less

Lapuente, V.; Suzuki, K. 2022

Quality of government in the Asia Pacific region

Article / Letter to editor

open access

Kweon, Y.; Suzuki, K. 2022

How partisan politics influence government policies in response to ageing populations

Article / Letter to editor

open access

Since old-age programmes mitigate life-course risks that are relevant to individuals across socio-economic groups in ageing societies, all parties have a political incentive to support these... Show moreSince old-age programmes mitigate life-course risks that are relevant to individuals across socio-economic groups in ageing societies, all parties have a political incentive to support these initiatives. Nevertheless, pre-existing partisan commitments bind the policy instruments that parties use. Cabinet-level analyses of OECD economies demonstrate that left incumbency relies more on public expenditure than right-wing governments. What is more important is that, in the context of large elderly populations, pension coverage is greater under right-leaning governments, while pension replacement rates are higher in left-leaning governments. This shows that party behaviour related to life course-related policies cannot be explained by the conventional pro-expansion versus the pro-retrenchment partisan politics. Rather, a focus on partisan variation in the use of policy instruments is required. Show less

Suzuki, K.; Hur, H 2021

Revisiting the old debate: citizens’ perceptions of meritocracy in public and private organizations

Article / Letter to editor

open access

Public management scholars have long debated public and private sector differences. However, the generalizability of empirical results has been limited due to the shortage of cross-national studies... Show morePublic management scholars have long debated public and private sector differences. However, the generalizability of empirical results has been limited due to the shortage of cross-national studies. Using a data set including citizens in twenty-one European countries, we compare citizens’ perceptions of meritocracy (i.e. hard work determines success rather than luck or connections) in public and private organizations and test how such sector differences are linked to country-level macro factors. We find that sector differences in meritocracy exist in almost all European regions. However, sector differences are smaller in countries where NPM practices and meritocratic principles are established. Show less

Suzuki, K.; Dollery, B.E.; Kortt, M.A. 2020

Addressing loneliness and social isolation amongst elderly people through local co‐production in Japan

Article / Letter to editor

metadata only

In common with many other societies with ageing populations, loneliness and social isolation have become a significant problem in contemporary Japan. The financial burden associated with an ageing... Show moreIn common with many other societies with ageing populations, loneliness and social isolation have become a significant problem in contemporary Japan. The financial burden associated with an ageing population, together with ongoing fiscal austerity, has severely constrained the ability of local authorities to address the problem. As a result, policymakers have sought cost‐effective methods of tackling the problem, including local co‐production with community groups. In this article, we consider the impact of loneliness and social isolation on wellbeing and then examine two illustrative case studies of local co‐production programs aimed at tackling social isolation amongst older adults in Japan. Show less

Lapuente, V.; Suzuki, K. 2020

The prudent entrepreneurs: women and public sector innovation

Article / Letter to editor

metadata only

Despite the large literature on gender differences in politics, there have been relatively few empirical studies testing the effects of gender in public administration. This paper examines how male... Show moreDespite the large literature on gender differences in politics, there have been relatively few empirical studies testing the effects of gender in public administration. This paper examines how male and female public managers show attitudinal differences toward innovation in the public sector. We hypothesize that male and female managers differ in three aspects. Firstly, female managers are more result-oriented than rule-following, and more oriented toward societal interests. Secondly, female public managers are more open to new ideas and creativity, and more willing to challenge the status quo. Yet, thirdly, female leaders are less eager to take risks when would-be innovations may put their organizations in peril. Thus, we argue that female managers are more prudent and entrepreneurial than their male counterparts. We test these hypotheses using a data set of 5,909 senior public managers from 20 European countries. The results of multilevel model analysis find statistically significant gender differences in attitudes toward innovation. Despite the small size of gender impacts, our findings challenge prevailing stereotypes on women’s entrepreneurial attitudes. Show less

Lapuente, V.; Suzuki, K.; Walle, S. van de 2020

Goats or wolves? Private sector managers in the public sector

Article / Letter to editor

open access

Public administration reforms have propagated the use of private sector management skills in the public sector, and an increased openness to managers with a private sector background. This has... Show morePublic administration reforms have propagated the use of private sector management skills in the public sector, and an increased openness to managers with a private sector background. This has created a debate between those who think private sector experience improves public institutions by bringing core managerial values such as results orientation, efficiency, or openness to innovation, and those who argue that private sector experience can damage core public sector values, such as impartiality and equity. Despite the abundant anecdotal evidence, broad empirical evidence on the effects of private sector experience on public managers' values remains limited. Using data from a survey among central government top managers in 18 European countries, we show that public managers with private sector experience have, as expected, more core managerial values. Yet, unlike the conventional view, core public values do not suffer. Show less

Suzuki, K.; Ha, H.; Avellaneda, C. 2020

Direct and non‐linear innovation effects of demographic shifts

Article / Letter to editor

metadata only

A varied set of pressures drive organizational innovation. Among these pressures, demographic shifts seem to boost innovation, as the public sector responds to the arrival of migrants and to... Show moreA varied set of pressures drive organizational innovation. Among these pressures, demographic shifts seem to boost innovation, as the public sector responds to the arrival of migrants and to community changes in race and ethnic composition. However, we know little about innovation by governments in response to expected population decline. In particular, studies have under‐examined how anticipated demographic pressures prompt public organizations to innovate. This study undertakes this task by arguing that innovation is more visible in municipalities facing greater anticipated demographic decline. However, we also argue for a non‐linear relationship in which too strong and/or too weak expected demographic declines lead to less visible innovation (inverted U‐shape effect). These propositions were tested with a data set of Japanese municipalities and employing a dose–response model. Findings show that anticipated demographic declines directly boost innovation visibility. However, too strong and/or too weak unexpected demographic declines make innovation less visible. Show less

Lapuente, V.; Suzuki, K. 2020

Politicization, Bureaucratic Legalism, and Innovative Attitudes in the Public Sector

Article / Letter to editor

open access

Previous studies have identified institutional, organizational, and individual factors that promote innovation in public organizations. Yet they have overlooked how the type of public... Show more

Previous studies have identified institutional, organizational, and individual factors that promote innovation in public organizations. Yet they have overlooked how the type of public administration—and the type of administrators—is associated with innovative attitudes. Using two large, unique comparative data sets on public bureaucracies and public managers, this article examines how bureaucratic politicization and legalistic features are associated with senior public managers’ attitudes toward innovation in 19 European countries. Results of multilevel analysis indicate that the bureaucratic politicization of an administration and the law background of public managers matter. Public managers working in politicized administrations and those whose education includes a law degree exhibit lower pro‐innovation attitudes (i.e., receptiveness to new ideas and creative solutions and change orientation).

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Akagi, J.; Hashimoto, K.; Suzuki, K.; Yokoi, M.; Wind, N. de; Iwai, S.; ... ; Hanaoka, F. 2020

Effect of sequence context on Pol zeta-dependent error-prone extension past (6-4) photoproducts

Article / Letter to editor

metadata only

The (6-4) pyrimidine-pyrimidone photoproduct [(6-4)PP] is a major DNA lesion induced by ultraviolet radiation. (6-4)PP induces complex mutations opposite its downstream bases, in addition to... Show moreThe (6-4) pyrimidine-pyrimidone photoproduct [(6-4)PP] is a major DNA lesion induced by ultraviolet radiation. (6-4)PP induces complex mutations opposite its downstream bases, in addition to opposite 3' or 5' base, as has been observed through a site-specific translesion DNA synthesis (TLS) assay. The mechanism by which these mutations occur is not well understood. To elucidate the mechanisms underlying mutagenesis induced by (6-4) PP, we performed an intracellular TLS assay using a replicative vector with site-specific T(thymidine)-T (6-4)PP. Rev3(-/-) p53(-/-) mouse embryonic fibroblast (MEF) cells (defective in Poll;) were almost completely defective in bypassing T-T (6-4)PP, whereas both Revl(-/-) and Poih(-/-) Poli(-/-) Polk(-/-) MEF cells (defective in Pol eta, Pol iota, and Pol kappa) presented bypassing activity comparable to that of wild-type cells, indicating that Y-family TLS polymerases are dispensable for bypassing activity, whereas Pol zeta plays an essential role, probably at the extension step. Among all cells tested, misincorporation occurred most frequently just beyond the lesion (position +1), indicating that the Pol zeta-dependent extension step is crucial for (6-4)PP-induced mutagenesis. We then examined the effects of sequence context on T-T (6-4)PP bypass using a series of T-T (6-4)PP templates with different sequences at position +1 or -1 to the lesion, and found that the dependency of T-T (6-4)PP bypass on Pol zeta is not sequence specific. However, the misincorporation frequency at position +1 differed significantly among these templates. The misincorporation of A at position +1 occurred frequently when a purine base was located at position -1. These results indicate that Pol zeta-dependent extension plays a major role in inducing base substitutions in (6-4)PP-induced mutagenesis, and its fidelity is affected by sequence context surrounding a lesion. Show less

Takekoshi, T.; Karatsu, K.; Suzuki, J.; Tamura, Y.; Oshima, T.; Taniguchi, A.; ... ; Endo, A. 2020

DESHIMA on ASTE: On-Sky Responsivity Calibration of the Integrated Superconducting Spectrometer

Article / Letter to editor

open access

Endo, A.; Karatsu, K.; Tamura, Y.; Oshima, T.; Taniguchi, A.; Takekoshi, T.; ... ; Baselmans, J.A. 2019

First light demonstration of the integrated superconducting spectrometer

Article / Letter to editor

open access

Suzuki, K.; Hur, H. 2019

Bureaucratic structures and organizational commitment: findings from a comparative study of 20 European countries

Article / Letter to editor

open access

Do civil servants in some countries have higher organizational commitment? Is there any substantial cross-national variation in the form and degree of commitment? Good governance studies show a... Show moreDo civil servants in some countries have higher organizational commitment? Is there any substantial cross-national variation in the form and degree of commitment? Good governance studies show a positive link between Weberian bureaucracy and favourable macro-level outcomes. However, previous comparative research is silent regarding cross-national differences of individual bureaucrats’ attitudes and their relationship with national bureaucratic structures. Employing social exchange theory, we argue that closed civil service systems produce higher commitment in senior public officials than open systems do. Using two large data sets in 20 European countries, we find closed systems are associated with continuance and normative commitment. Show less

Suzuki, K. 2019

Social Equity in Japan

Part of book or chapter of book

open access

Suzuki examines the status of social equity in the context of Japanese culture and society. The concept of social equity has not been widely discussed or well understood in the field of Japanese... Show moreSuzuki examines the status of social equity in the context of Japanese culture and society. The concept of social equity has not been widely discussed or well understood in the field of Japanese public administration and politics. Although the term social equity has not been explicitly used, Suzuki identifies several policies and administrative practices in Japan that serve to address various dimensions of disparities among citizens. Regional disparity is one of these dimensions of social equity that Japanese public policy and politics have addressed and been most successful in solving in the last few decades. Show less

Suzuki, K.; Han, Y. 2018

Does citizen participation affect municipal performance? Electoral competition and fiscal performance in Japan

Article / Letter to editor

open access

Subnational fiscal performance has been receiving a lot of attention from researchers in various disciplines. However, there is very little published on the impact of citizen involvement on fiscal... Show moreSubnational fiscal performance has been receiving a lot of attention from researchers in various disciplines. However, there is very little published on the impact of citizen involvement on fiscal performance. This paper shows that a lack of citizen involvement in the electoral process was associated with fiscal performance in all 807 city-level Japanese municipalities from 2006 to 2012. Show less

Suzuki, K.; Avellaneda, C.N. 2018

New Public Management and Municipal Performance: Do NPM Reforms Boost Performance?

Research paper

open access

New Public Management (NPM) reforms have been adopted worldwide since the mid-1970s to improve government effectiveness and efficiency. The basic premise of NPM reforms is that market orientation... Show moreNew Public Management (NPM) reforms have been adopted worldwide since the mid-1970s to improve government effectiveness and efficiency. The basic premise of NPM reforms is that market orientation and management focus in the public sector will enhance effectiveness and efficiency of service delivery (Christensen and Lægreid 2010). Although NPM reforms have existed for a quarter century, we still have limited understanding of whether NPM reforms fulfill their expectations. Most importantly, very few empirical studies have been conducted that actually assess the impact of NPM reforms on performance (Alonso, Clifton, and Díaz-Fuentes 2015, Dahlström, Nistotskaya, and Tyrberg 2016, Hammerschmid and Van de Walle 2011). This study helps fill this gap by examining the effect of different NPM-type reforms on municipal performance. In particular, we assess the impact of NPM reforms on three dimensions of municipal performance – gender equity, efficiency and effectiveness – by using a data set of 810 city-level Japanese municipalities. Findings show that municipalities’ overall effort to create NPM reforms is not associated with gender equity and effectiveness in revenue expansion. However, findings suggest that municipalities with a higher commitment to various NPM- type reforms are likely to operate with lower administrative overhead costs. Results also suggest that municipalities’ efforts supporting individual reform, including outsourcing and municipal assets and debt management reform, are associated with higher efficiency in overhead costs and increased revenues from selling municipal assets. This study tests the impacts of NPM-type reforms on municipal performance in an understudied Asian developed setting. Show less

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