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1

SHEARGOLD, ELIZABETH, and ANDREW D. MITCHELL. "The TPP and Good Regulatory Practices: An Opportunity for Regulatory Coherence to Promote Regulatory Autonomy?" World Trade Review 15, no. 4 (February 24, 2016): 587–612. http://dx.doi.org/10.1017/s1474745616000045.

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Анотація:
AbstractChapters relating to regulatory coherence or cooperation are likely to be significant features of new preferential trade agreements, including the Trans-Pacific Partnership (TPP). While the potential for harmonization of standards or institutional cooperation to impact on the regulatory autonomy of treaty parties has been well considered, this article focuses on those elements of regulatory coherence that relate to domestic processes for the development of regulations. It examines whether the adoption of ‘good regulatory practices’ in accordance with the TPP will help to ensure that measures states enact to protect non-economic interests (such as the environment or public health) are consistent with other key obligations of international trade and investment law. Although many elements of good regulatory practice mirror the criteria used to distinguish legitimate regulatory measures from disguised protectionism, there is no guarantee that a tribunal will come to the same conclusions as those reached during a domestic impact assessment.
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2

Cai, Phoenix X. F. "Regulatory Coherence and Standardization Mechanisms in the Trans-Pacific Partnership." British Journal of American Legal Studies 5, no. 2 (December 1, 2016): 505–38. http://dx.doi.org/10.1515/bjals-2016-0018.

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Abstract This article posits a new taxonomy and framework for assessing regulatory coherence in the new generation of mega-regional, cross-cutting free trade agreements. Using the Trans-Pacific Partnership as the primary example, this article situates the rise of regulatory coherence within the current trade landscape, provides clear definitions of regulatory coherence, and argues that the real engine of regulatory coherence lies in the work of international standard setting organizations. This work has been little examined in the current literature. The article provides a detailed examination of the mechanics by which the Trans-Pacific Partnership promotes regulatory standardization and concludes with some normative implications and calls for future research.
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3

Chiu, Iris H.-Y. "Decrypting the Signs of Regulatory Competition in Regulating Cryptoassets." European Journal of Comparative Law and Governance 7, no. 3 (September 23, 2020): 297–334. http://dx.doi.org/10.1163/22134514-00703002.

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Abstract The icos market has challenged financial regulators in terms of determining fit with existing regimes and consideration for regulatory reform. Regulatory divergences have emerged in a number of jurisdictions and we discuss three dominant approaches in relation to hegemonic, self-regulatory and enabling regimes. These reflect different assumptions and regulators’ understandings of the cryptoasset industry, and we argue that the ‘terms for competition’ in relation to supply and demand side needs are still being discovered and are incomplete. This provides a unique opportunity for regulators to jettison familiar assumptions in relation to corporatized securities issuers or institutional investors in order to discover what governance needs are truly at stake. This may pose challenges for coherence with existing regulation but coherence should not itself be an obstacle for learning and potentially, reform. We also argue that signs of international regulatory coordination in relation to the Libra project are not necessarily reflective of a wider trend for the cryptoasset industry. This is because regulators can apply existing and familiar financial regulation paradigms more easily to the Libra Association, in particular its leading founding member Facebook. The cryptoasset market is still likely to give rise to diversity and should facilitate the discovery of new bases for regulatory thinking and policy, uncoordinated or otherwise.
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4

Waye, Vicki. "Regulatory Coherence and Pathways towards Global Wine Regulation." Journal of World Trade 50, Issue 3 (June 1, 2016): 497–531. http://dx.doi.org/10.54648/trad2016022.

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Анотація:
Regulatory coherence is a goal that has captured the imagination of international trade negotiators. Undeterred by the elusive nature of this holy grail, regulatory coherence is now embedded within a number modern preferential trade agreements. Using the global wine sector as an exemplar the article explores how far we have to go to achieve regulatory coherence and whether it will ever be fully achieved.
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5

Oh, Sun Young. "Domestic Countermeasures for the Regulatory Coherence in Technical Regulations." Yonsei Law Review 30, no. 2 (June 30, 2020): 213–35. http://dx.doi.org/10.21717/ylr.30.2.6.

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6

McPhilemy, Samuel, and Manuela Moschella. "Central banks under stress: Reputation, accountability and regulatory coherence." Public Administration 97, no. 3 (July 16, 2019): 489–98. http://dx.doi.org/10.1111/padm.12606.

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7

Voon, Tania, and Elizabeth Sheargold. "The Trans-Pacific Partnership." British Journal of American Legal Studies 5, no. 2 (December 1, 2016): 341–70. http://dx.doi.org/10.1515/bjals-2016-0012.

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Abstract This article provides an overview of the recently concluded Trans-Pacific Partnership Agreement (TPP), a treaty the parties have described as comprehensive and ambitious, yet also representing a balance of competing interests. The article focuses on the TPP’s chapters relating to investment, services, intellectual property and regulatory coherence, each of which provides insight into the motivations that drove the conclusion of the TPP and the negotiating dynamics that determined its final content. In areas such as investment, the TPP takes a more balanced approach than many earlier agreements, providing greater safeguards for the regulatory autonomy of states while still embodying core protections for foreign investors. In relation to intellectual property and services, the TPP goes beyond earlier agreements in several key respects, such as preventing the imposition of local presence requirements for service providers or requiring longer copyright terms than those demanded by other international treaties. The TPP chapter on regulatory coherence is one of the most novel features of the treaty, as regulatory coherence is not frequently included in earlier trade agreements, demonstrating the increased focus of states on addressing regulatory barriers to trade and investment. While all of these elements of the TPP are interesting in their own right, given the number and size of the parties involved in the agreement, they also provide valuable guidance about the direction of other ongoing and future preferential trade agreement negotiations, such as the proposed Transatlantic Trade and Investment Partnership (TTIP) and Trade in Services Agreement (TiSA).
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8

Foster, Caroline E. "Why Due Regard Is More Appropriate than Proportionality Testing in International Investment Law." Journal of World Investment & Trade 23, no. 3 (June 17, 2022): 388–416. http://dx.doi.org/10.1163/22119000-12340252.

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Abstract Global regulatory standards of due diligence, regulatory coherence, and due regard are emerging in public international law. Investment law has been concerned to settle upon the most appropriate regulatory coherence tests for application in the arbitration of regulatory disputes. Candidates have included proportionality, rationality, and reasonableness tests. This article argues instead for reliance on the due regard standard in conjunction with reasonableness or rationality testing. This will more appropriately reflect the nature of investment treaties as inter-State bargains. Further, responding to arguments for the adoption of proportionality on the basis of comparative public law, the article demonstrates that proportionality is not established as a general head of review in common law jurisdictions including England, Australia, Canada, New Zealand and South Africa. At the same time, the application of the due regard standard can have much in common with procedural proportionality testing as seen among these domestic legal systems and elsewhere.
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9

Boldyreva, Galina N., Ludmila A. Zhavoronkova, Elena V. Sharova, and Irina S. Dobronravova. "Electroencephalographic Intercentral Interaction as a Reflection of Normal and Pathological Human Brain Activity." Spanish Journal of Psychology 10, no. 1 (January 2007): 167–77. http://dx.doi.org/10.1017/s1138741600006430.

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The authors summarized EEG findings and defined the nature of the intercentral EEG relationships in different functional states in healthy subjects and patients with organic cerebral pathology, based on a coherence analysis. Similar EEG characteristics in healthy individuals were identified: an anterior-posterior gradient of average coherence levels, the type of cortical-subcortical relationships in anterior cerebral structures. Right- and left-handed individuals showed frequent and regional differences in EEG coherence, which mainly reflected specificity of intracortical relationships. Development and regression of pathology in right-and left-handed individuals with organic brain lesions were thought to be caused by these differences. Lesions of regulatory structures (diencephalic, brain stem and limbic structures) provoked a more diffused kind of changes of intercentral relationships, in contrast to cortical pathology. These changes tended to reciprocate. The dynamic nature of intercentral relationships and their interhemispheric differences was revealed when changing functional states of the brain (increase and decrease of functional level) in healthy individuals and patients with organic cerebral pathology in the process of conscious and psychic activity restoration. Changing activity predominance of certain regulatory structures was considered one of the most important factors determining the dynamic nature of EEG coherence.
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10

Hodson, Greg, and Sara Azevedo. "Regulatory principles to enhance coherence and to facilitate trade in wine." BIO Web of Conferences 3 (2014): 03002. http://dx.doi.org/10.1051/bioconf/20140303002.

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11

Borg, Yanika, Ekkehard Ullner, Afnan Alagha, Ahmed Alsaedi, Darren Nesbeth, and Alexey Zaikin. "Complex and unexpected dynamics in simple genetic regulatory networks." International Journal of Modern Physics B 28, no. 14 (April 25, 2014): 1430006. http://dx.doi.org/10.1142/s0217979214300060.

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One aim of synthetic biology is to construct increasingly complex genetic networks from interconnected simpler ones to address challenges in medicine and biotechnology. However, as systems increase in size and complexity, emergent properties lead to unexpected and complex dynamics due to nonlinear and nonequilibrium properties from component interactions. We focus on four different studies of biological systems which exhibit complex and unexpected dynamics. Using simple synthetic genetic networks, small and large populations of phase-coupled quorum sensing repressilators, Goodwin oscillators, and bistable switches, we review how coupled and stochastic components can result in clustering, chaos, noise-induced coherence and speed-dependent decision making. A system of repressilators exhibits oscillations, limit cycles, steady states or chaos depending on the nature and strength of the coupling mechanism. In large repressilator networks, rich dynamics can also be exhibited, such as clustering and chaos. In populations of Goodwin oscillators, noise can induce coherent oscillations. In bistable systems, the speed with which incoming external signals reach steady state can bias the network towards particular attractors. These studies showcase the range of dynamical behavior that simple synthetic genetic networks can exhibit. In addition, they demonstrate the ability of mathematical modeling to analyze nonlinearity and inhomogeneity within these systems.
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12

Cho, Jung-Hwan, and Seung-Hwan Yoon. "The Regulatory Impact on Services Trade in Korea." International Academy of Global Business and Trade 18, no. 4 (August 31, 2022): 33–55. http://dx.doi.org/10.20294/jgbt.2022.18.4.33.

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Анотація:
Purpose – This study aims to analyze the effect of Korea's Services Trade Restrictiveness Index (STRI) and STRI Heterogeneity Index (HG) on Korea’s services trade. Design/Methodology/Approach – Using the Poisson Pseudo Maximum Likelihood (PPML) model, this study analyzes the impact of STRI and STRI HG provided by the OECD for 26 countries on Korea’s services trade (imports). The reason for using PPML is that first, a consistent estimator can be obtained regardless of the error term’s distribution. Second, if there is net-zero services trade in the data, sample selection bias can occur as the zero-trade data is excluded from the analysis when using ordinary least squares (OLS). Findings – After converting the STRI and the STRI HG into a single index through principal component analysis (PCA), results show that the STRI is not statistically significant, but the STRI HG shows a statistically significant negative (-) sign in all analysis models. This means that the greater the STRI HG with Korea's trading partners, the more negative the impact on services trade, which implies that even if the level of services restrictiveness is low, services trade volume will reduce as regulatory coherence with trading partners decreases. Research Implications – Whereas previous studies primarily focused on major advanced countries such as OECD nations or specific service industries, this study analyzes the impact of the services trade restrictiveness on services trade for Korea and each services sector. In addition, existing studies perform cross-sectional analyses due to data availability, whereas this study reflects changes in services restrictiveness levels over time by constructing panel data for 2014–2019.
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13

Wang, Zhipeng, Davit A. Potoyan та Peter G. Wolynes. "Stochastic resonances in a distributed genetic broadcasting system: the NF κ B/I κ B paradigm". Journal of The Royal Society Interface 15, № 138 (січень 2018): 20170809. http://dx.doi.org/10.1098/rsif.2017.0809.

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Gene regulatory networks must relay information from extracellular signals to downstream genes in an efficient, timely and coherent manner. Many complex functional tasks such as the immune response require system-wide broadcasting of information not to one but to many genes carrying out distinct functions whose dynamical binding and unbinding characteristics are widely distributed. In such broadcasting networks, the intended target sites are also often dwarfed in number by the even more numerous non-functional binding sites. Taking the genetic regulatory network of NF κ B as an exemplary system we explore the impact of having numerous distributed sites on the stochastic dynamics of oscillatory broadcasting genetic networks pointing out how resonances in binding cycles control the network's specificity and performance. We also show that active kinetic regulation of binding and unbinding through molecular stripping of DNA bound transcription factors can lead to a higher coherence of gene-co-expression and synchronous clearance.
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14

Weatherill, Stephen. "The Consumer Rights Directive: How and why a quest for “coherence” has (largely) failed." Common Market Law Review 49, Issue 4 (August 1, 2012): 1279–317. http://dx.doi.org/10.54648/cola2012065.

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Directive 2011/83 on consumer rights is a case of misleading advertising. Despite its grand title, it is little more than an up-dating of the Directives on doorstep and distant selling which also re-casts them as measures of maximum, not minimum, harmonization. The real interest lies in why the Directive is such a mouse. And this story tells of political resistance to the Commission's original plan to convert also the far more significant Directives on unfair terms and consumer sales to the maximum model. This vertical shift in regulatory responsibility, driven by an aggressive rhetoric of improving "coherence" in harmonized EU contract law, was firmly rejected, with the result that the finally adopted text is stripped of any depth of ambition. Consequently Directive 2011/83 on consumer rights is not without interest for its choice of detailed regulatory technique, explored in this paper, which focuses on pre-contractual information disclosure, post-agreement rights of withdrawal and limited aspects of contractual performance. But much more so, it reveals the contested heart of the EU's internal market project - coherence achieved by suppression of national regulatory competence (unity) or preservation of regulatory experimentation and local autonomy (diversity). The making of Directive 2011/83 demonstrates political readiness to shield the latter from the Commission's current predilection for the former.
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15

Pilarska, Aleksandra. "Sense of Identity and Self-Control." Psihologijske teme 29, no. 2 (2020): 291–310. http://dx.doi.org/10.31820/pt.29.2.5.

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This study addressed the role of a sense of personal identity as a self-regulatory mechanism that facilitates congruence and coherence of goals that people set for themselves and thereby enhances their capacity to exert self-control. A total of 489 young adults completed a packet of questionnaires that assessed basic dimensions of sense of identity, congruence and coherence of goals, and self-control capacity. Direct and indirect paths of a sense of identity on self-control were examined using structural equation modelling. The proposed model was, for the most part, supported by data. It should be noted, however, that the mediation effects were fairly small, and the sense of identity had a direct predictive effect on self-control over and above congruence and coherence of goals.
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16

Aberkane, Salah. "Self-management in older adults with chronic illness: Do illness representations play a regulatory role?" Global Journal of Guidance and Counseling in Schools: Current Perspectives 8, no. 2 (August 3, 2018): 50–57. http://dx.doi.org/10.18844/gjgc.v8i2.3577.

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Background. A greater number of older adults now live with chronic illness. This poses a significant public health problem, because older adults are at high risk for chronic illness -related mortality and morbidity. Methods. In the project on older adult self care in chronic illness, we administered nine subscales (Illness Consequences, Illness Coherence, Illness Timeline—Cyclical, Personal Control, Treatment Control, Illness Representations, Illness Identity, and Causal Attributions) of the Illness Perception Questionnaire— Revised (IPQ-R). Multivariable linear regression analyses explored the associations between illness perception, wellness-focused coping, and illness-focused coping as measured by CPCI42. Results. Among the 76 respondents (39.47% women; mean age, 64.53±6.93 years), in multivariable regression models, either illness perception variables or coping strategies variables were associated with chronic illness. Higher scores on causal attributions were associated with coping strategies chosen scores. Higher scores on the causal attributions (β = 0.63), Illness Coherence (β = -0.50), illness representations(β = 0.66) and Personal Control scales(β = -0.53) were associated with several scores of coping strategies chosen by chronically ill older persons. Conclusion. Older adults with chronic illness report a high understanding of their disease, feel that chronic illness has significant illness representations consequences, and endorse both illness coherence and personal control over their coping strategies. Illness perceptions did not vary with increased age or worsening disease severity, suggesting that illness perceptions may develop during aging. The self-regulatory model may provide a useful guide for the development of effective interventions tailored to older adults. Keywords: Chronic Illness; Coping Strategies; Illness Perceptions; Older Adults; Self-Regulatory Model
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17

Humphery-Jenner, Mark. "The Desirability of ‘Weak’ Form Legal Harmonization: Perspectives from Statutory Interpretation and Legal Coherence." German Law Journal 13, no. 7 (July 2012): 807–28. http://dx.doi.org/10.1017/s2071832200020770.

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Harmonized regulatory frameworks have become increasingly important. This is especially so following the global financial crisis, where there have been calls for a harmonized international response to securities regulation. Examples in the EU include MIFID and the Takeover Directive. MIFID regulates securities traders and stock exchanges. It contains rules that indicate the obligations on exchanges and traders vis-à-vis matters such as achieving the “best execution” of trades. The Takeover Directive regulates mergers and acquisitions, their regulations include regulations on anti-takeover provisions, compulsory acquisitions, and the method of paying for acquisitions. These impose a ‘weak’ form of harmonization: member states can opt out of some provisions, many provisions are vague (and require definition by domestic regulators) and member states retain the right to legislate around the harmonized framework. These directives have not received universal support.
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18

Gari, Gabriel. "Recent Preferential Trade Agreements’ Disciplines for Tackling Regulatory Divergence in Services: How Far beyond GATS?" World Trade Review 19, no. 1 (November 12, 2018): 1–29. http://dx.doi.org/10.1017/s1474745618000368.

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AbstractThe paper reviews the disciplines for tackling regulatory divergence in services included in 23 PTAs entered into by China, the EU, Japan, and the USA. It identifies a remarkable expansion in the number and extent of disciplines on regulatory transparency, regulatory coherence, and regulatory cooperation compared with GATS, which, subject to adequate implementation, will allow these agreements to deliver a degree of market integration well beyond what could be achieved simply by removing market access restrictions and discriminatory measures from the rule book. However, the paper calls for some restraint when estimating the potential impact of these disciplines, mainly because of the soft language used for phrasing some of them and the anticipated high implementation costs, particularly for countries with unsophisticated domestic legal systems.
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19

Ragni, Chiara. "Global Regulatory Standards in Environmental and Health Disputes: Regulatory Coherence, Due Regard, and Due Diligence, written by Caroline E. Foster." International Community Law Review 24, no. 3 (April 29, 2022): 281–84. http://dx.doi.org/10.1163/18719732-bja10083.

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20

POLANCO LAZO, RODRIGO, and PIERRE SAUVÉ. "The Treatment of Regulatory Convergence in Preferential Trade Agreements." World Trade Review 17, no. 4 (December 28, 2017): 575–607. http://dx.doi.org/10.1017/s1474745617000519.

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AbstractThis article explores the concept of ‘regulatory convergence’ in the context of the evolving literature on legal convergence and divergence. Such a concept has emerged as an overarching horizontal discipline in the latest generation of preferential trade agreements and aims to reduce unnecessary regulatory incompatibilities between countries in order to facilitate cross-border trade and investment.Differing approaches to regulatory convergence found in recently concluded PTAs, or are currently under negotiation, are examined, with a special focus on the ‘regulatory cooperation’ approach embedded in CETA, the path of ‘regulatory improvement’ taken by members of the Pacific Alliance, and the ‘regulatory coherence’ track included in the TPP. We also refer to the TTIP negotiations conducted between the EU and the US.The article offers a broad understanding of the different ways in which regulatory convergence is implemented across PTAs, and the legal complexities resulting from the ambiguity of the concept. It further describes the scope and effects of the different mechanisms used to achieve regulatory convergence, on both substantive and procedural matters.
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21

Adams-Prassl, Jeremias. "Regulating algorithms at work: Lessons for a ‘European approach to artificial intelligence’." European Labour Law Journal 13, no. 1 (February 1, 2022): 30–50. http://dx.doi.org/10.1177/20319525211062558.

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This article scrutinises the potential of the existing regulatory apparatus in Union law to tackle the social, technical, and legal challenges inherent in deploying automated systems in high-risk settings such as the workplace, with a view to setting out key lessons for the proposed EU Artificial Intelligence Act. Surveying data protection and discrimination rules as well as the social acquis, it highlights key areas for further development, from coherence between different regulatory regimes to the role of social partnership in shaping key standards and monitoring their implementation.
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22

Пименов, Виктор, and Mihail Voronov. "FORMALIZATION OF REGULATORY TEXTS." Informatics and Automation 20, no. 3 (May 28, 2021): 562–90. http://dx.doi.org/10.15622/ia.2021.3.3.

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Modern information technologies provide text manipulation processes with high efficiency. First of all, this means storing, editing, and formatting texts and their components. Having achieved significant success in developing tools for content-free computer text processing, researchers faced problems with their content processing. Therefore, further steps in this direction are associated with the creation, among other things, of methods for automated purposeful manipulation of texts, taking into account their content. The analysis of works devoted to the study of the problems of formal presentation of texts and their subsequent use is carried out. Despite a number of successful projects, the challenges of solving the problem of the relationship between the content of the text and its meaning remain relevant. It seems that formalization of a General-purpose text while preserving its semantics is not feasible at this stage. However, there are types of texts that can be formalized while preserving their semantics. One of them is a regulatory text type, which is essentially a verbally expressed algorithm for a sequence of targeted actions. It is distinguished by logic and accuracy (lack of allegories), coherence and integrity, clarity, understandability (due to the lack of emotional coloring and figurative means), accessibility (due to the use of specific terminology). In other words, when developing regulatory texts, they usually try to display the mechanisms of the described actions as clearly as possible. Purpose: development of a method for formalizing a regulatory text while preserving its semantics. Methods: structural linguistics, representation of objects in the form of an ontology, constructive algorithms. The use of this method is demonstrated by describing the solution of a system of algebraic equations. Results: method for constructing a mathematical model of a regulatory text. Practical relevance: the application of the developed method makes it possible to develop software systems for building libraries of individual subject areas, develop tools for evaluating regulatory texts for their certainty, completeness, connectivity and other characteristics, as well as simulators and self-learning tools.
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23

Smismans, Stijn. "Policy Evaluation in the EU: The Challenges of Linking Ex Ante and Ex Post Appraisal." European Journal of Risk Regulation 6, no. 1 (March 2015): 6–26. http://dx.doi.org/10.1017/s1867299x00004244.

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The EU's new approach to policy evaluation is characterised by a focus on closing the policy cycle (linking ex ante and ex post appraisal) and by applying evaluation to all types of policy intervention, whether expenditure or regulatory policy. This article analyses the main features and challenges of this new approach. It first studies the conceptual and interdisciplinary challenge of such an encompassing approach to evaluation. It then assesses the new approach in the light of four key objectives of ex ante and ex post appraisal; ensuring evidence and learning; accountability, transparency and participation; policy coherence; and reducing the regulatory burden.
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24

Storskrubb, Eva. "Alternative Dispute Resolution in the EU: Regulatory Challenges." European Review of Private Law 24, Issue 1 (February 1, 2016): 7–31. http://dx.doi.org/10.54648/erpl2016002.

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Abstract: The perspective taken in the contribution is broader than consumer dispute resolution and alternative dispute resolution (ADR) encompassing EU law developments in civil justice and the impact that the EU has on civil procedure and dispute resolution as a whole. The aim is to thereby provide to a broader perspective on the current development of ADR in the EU. The particular aim is to highlight two issues. First, when the EU acts to create special rules for consumer dispute resolution and ADR, the whole dispute resolution system, i.e., the whole entity of EU civil justice, needs to be taken into account in order to achieve a regulatory coherent and efficient justice system. Second, certain weaknesses have been identified in using ADR as a regulatory choice in order to achieve effective enforcement of law and efficient access to justice. It is posited that these findings should be remembered and taken into account when the EU further develops ADR both generally and in particular for consumer matters. Résumé: Cette contribution adopte une approche qui va bien au-dela des procedures de resolution des litiges de consommation et du reglement extrajudiciaire des litiges (REL). Elle comprend une analyse du droit europeen en matiere de justice civile et de son influence sur la justice en matiere civile et les procedures de resolution des litiges dans leur ensemble. On vise, par ce biais, a donner une perspective plus globale aux evolutions actuelles relatives au REL au niveau de l’UE. L’objectif est de mettre en avant deux problematiques. D’une part, lorsque l’UE cree des procedures speciales de resolution des litiges de consommation, c’est l’ensemble du systeme europeen de resolution des litiges en matiere civile qui doit etre pris en consideration afin de garantir la coherence et l’efficacite du systeme judiciaire. D’autre part, ont ete identifiees certaines lacunes du REL en tant qu’instrument reglementaire visant une mise en oeuvre efficace du droit et un acces effectif a la justice. Selon l’article, ces constatations doivent etre prises en compte lorsque l’UE adopte des mesures supplementaires en matiere de REL, tant de maniere generale qu’en ce qui concerne les litiges de consommation en particulier.
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25

Horgan, Denis, and Alastair Kent. "EU Health Policy, Coherence, Stakeholder Diversity and Their Impact on the EMA." Biomedicine Hub 2, Suppl. 1 (November 21, 2017): 1–11. http://dx.doi.org/10.1159/000481301.

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Innovation is a major pillar in bringing new, targeted medicines to patients. In the health arena, this means the translation of knowledge into what we can call “value.” The latter covers the value to patients but must also take into account value to healthcare systems, society and, of course, manufacturers. The EU has recognised that innovations in healthcare can contribute to the health and well-being of citizens and patients through access to new products, services and treatments with added value. It is also aware that in order to stimulate development, there is a need to facilitate the translation of scientific advances into innovative medicinal products that meet regulatory standards, accelerate patients' access to new therapies and are affordable to Member States' health systems. Early dialogue between technology developers, regulators, health technology assessment and, where relevant, pricing bodies will promote innovation and quicker access to medicines at affordable prices, for the benefit of patients. But while uncertainties in healthcare policy still exist, a request by the European Ombudsman to the European Medicines Agency to provide more information about its early dialogue procedures questions the above “early dialogue” principal. It raises the issue of what the EU aims to do with its health regulation in bringing innovation to the patient. Is this added uncertainty about the hereto trusted role of the EMA a welcome development? Not necessarily.
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26

Keissar, Kobi, Linda R. Davrath, and Solange Akselrod. "Coherence analysis between respiration and heart rate variability using continuous wavelet transform." Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences 367, no. 1892 (February 27, 2009): 1393–406. http://dx.doi.org/10.1098/rsta.2008.0273.

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The continuous wavelet transform (CWT) is specifically efficient in the analysis of transient and non-stationary signals. As such, it has become a powerful candidate for time–frequency analysis of cardiovascular variability. CWT has already been established as a valid tool for the analysis of single cardiovascular signals, providing additional insights into the autonomous nervous system (ANS) activity and its control mechanism. Intercorrelation between cardiovascular signals elucidates the function of ANS central control and the peripheral reflex mechanisms. Wavelet transform coherence (WTC) can provide insight into the transient linear order of the regulatory mechanisms, via the computation of time–frequency maps of the time-variant coherence. This paper presents a framework for applying WTC for quantitative analysis of coherence in cardiovascular variability research. Computer simulations were performed to estimate the accuracy of the WTC estimates and a method for determining the coherence threshold for specific frequency band was developed and evaluated. Finally, we demonstrated, in two representative situations, the dynamic behaviour of respiration sinus arrhythmia through the analysis of the WTC between heart rate and respiration signals. This emphasizes that CWT and its application to WTC is a useful tool for dynamic analysis of cardiovascular variability.
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27

Häberli, Christian. "An International Regulatory Framework for National Employment Policies." Journal of World Trade 50, Issue 2 (April 1, 2016): 167–91. http://dx.doi.org/10.54648/trad2016010.

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Анотація:
Employment-related policies are sensitive by any standard, and they remain basically national despite international labour standards (ILS) being even older than the United Nations. Globalization is changing this situation where countries may have to choose between ‘more’ or ‘better’ jobs. The multilateral framework of the World Trade Organization (WTO) can only have an indirect impact. But Regional Trade Agreements (RTA) and International Investment Agreements (IIA) are emerging as a new way of gradually enhancing the impact of certain labour standards. In addition, unilateral measures both by governments and importers driven by social and environmental consumer preferences and pressure groups increasingly shape the international regulatory framework for national employment policies. Even small, locally operating enterprises risk marginalization and market exclusion by ignoring these developments. The long-term influence of this new ‘network approach’ on employment-related policies, including job location, gender issues, social coherence and migration remains to be seen. Nonetheless, the still flimsy evidence gathered here seems to indicate that this new, international framework might increase sustainable employment where and when supporting measures, including through unilateral preferences and even sanctions, form a ‘cocktail’ which export-oriented industries and their suppliers will find palatable.
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28

Blutman, László. "IN THE TRAP OF A LEGAL METAPHOR: INTERNATIONAL SOFT LAW." International and Comparative Law Quarterly 59, no. 3 (July 2010): 605–24. http://dx.doi.org/10.1017/s0020589310000242.

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Анотація:
AbstractInternational soft law as a legal metaphor has become part of legal discourse. The author argues not only that the term itself is misleading and contradictory, but that the terminological problem indicates deeper doctrinal difficulties which soft law theories should overcome. Identifying two main streams of these theories, the article provides a short review of the fundamental arguments for the existence of soft law. It distinguishes between two lines of arguments, ie functional arguments and proximity arguments, evaluates their coherence and explanatory power, and finds that these arguments fail to lay a coherent and persuasive foundation for international soft law. The author concludes by pointing out that non-legal norms may have essential regulatory functions in international relations but the law and non-law distinction should be maintained, and separating soft law as a distinct category is unwarranted.
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29

Krstic, Stanko S. "Regulatory Cooperation to Remove Non-tariff Barriers to Trade in Products: Key Challenges and Opportunities for the Canada-EU Comprehensive Trade Agreement." Legal Issues of Economic Integration 39, Issue 1 (February 1, 2012): 3–28. http://dx.doi.org/10.54648/leie2012002.

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Анотація:
Regulatory cooperation to eliminate non-tariff barriers to trade (NTBs) resulting from differences in product standards and technical regulations has become a prominent issue in Preferential Trade Agreement (PTA) negotiations. This paper looks at the most important challenges and opportunities for a successful model for regulatory cooperation under the Canada-EU Comprehensive Trade Agreement (CETA). It argues that the CETA will represent a compromise between the two dominant models in international trade: the EU and North American approach to regulatory cooperation in PTAs. In addition, because of the specificity of Canada's federal structure, it is argued that the CETA will be able to bring about greater regulatory coherence within Canada by disciplining provincial regulation that results in NTBs. This paper argues that, while a sui generis case, in order for it to be successful, regulatory cooperation under the CETA will have to incorporate certain elements established in theory and in previous state practice. Finally, as a first comprehensive transatlantic PTA, regulatory cooperation under the CETA will in itself become a model for future such endeavours between economically developed countries, especially in its implementation aspect.
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30

Darajati, Muhammad Rafi. "Pemberlakuan Ketentuan Regulatory Coherence dalam Trans Pasific Partnership Agreement bagi Negara Pihak dalam Perspektif Indonesia." University Of Bengkulu Law Journal 4, no. 2 (October 24, 2019): 137–51. http://dx.doi.org/10.33369/ubelaj.4.2.144-158.

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31

Hamner, J. W., Raymond J. Morin, James L. Rudolph, and J. Andrew Taylor. "Inconsistent link between low-frequency oscillations: R-R interval responses to augmented Mayer waves." Journal of Applied Physiology 90, no. 4 (April 1, 2001): 1559–64. http://dx.doi.org/10.1152/jappl.2001.90.4.1559.

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Анотація:
Low-frequency oscillations in arterial blood pressure (Mayer waves) and R-R interval are thought to be linked through the arterial baroreflex. To delve into this relationship, we applied low (10 mmHg) and moderate (30 mmHg) lower body negative pressure (LBNP) in 10-s cycles to 18 healthy young male subjects. They showed no change in average blood pressure with this oscillatory stimulus but did show a significant decrease in R-R interval ( P < 0.05) during both levels of LBNP. In addition, we succeeded in augmenting low-frequency blood pressure oscillations in a graded response to oscillatory LBNP level ( P < 0.05) while significantly increasing low-frequency R-R interval oscillations ( P < 0.05). However, cross-spectral coherence between these increased oscillations was highly variable across individuals and stimulus level. Although nearly all subjects showed significant coherence during basal conditions ( n = 17), only seven subjects maintained significant coherence during both levels of LBNP. These results suggest that a complex interaction of regulatory mechanisms determines the link between low-frequency oscillations and the responses to even low levels of LBNP.
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32

Romppanen, Seita. "Legitimacy and eu Biofuel Governance: In Search of Greater Coherence." Climate Law 4, no. 3-4 (February 23, 2014): 239–66. http://dx.doi.org/10.1163/18786561-00404004.

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Анотація:
The eu regulatory framework for sustainable biofuels is an example of today’s dynamic European climate and energy governance. The article demonstrates that there are, however, particular internal controversies that continue to undermine the overall credibility of the eu biofuel regime, as well as the effectiveness and legitimacy of the scheme. In connection with the debate on new governance, the article explores the concepts of input and output legitimacy as regards the verification of compliance with biofuel sustainability criteria. The article shows that if the procedural requirements to satisfy input legitimacy are not met, there is a risk that output legitimacy—the credibility of the substantive outcome—will also be diminished. By paying attention to the process and harmonizing the itemized process-related elements we can improve both the appropriate achievement of the substantive outcome as well as the legitimacy of eu biofuel governance.
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33

Van Tongeren, Daryl R., C. Nathan DeWall, Jeffrey D. Green, Athena H. Cairo, Don E. Davis, and Joshua N. Hook. "Self-Regulation Facilitates Meaning in Life." Review of General Psychology 22, no. 1 (March 2018): 95–106. http://dx.doi.org/10.1037/gpr0000121.

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Анотація:
Meaning is a central feature of human life. Our overarching proposition is that self-regulation helps facilitate meaning in life. We propose that purposeful, effortful, and directive actions that regulate selfish impulses are necessary to continually develop a sense of meaning in life. We explain how self-regulatory processes map onto this process: the drive for meaning is governed by internalized standards of meaning, people monitor their experiences to ensure a fit between their experiences and standards of meaning, and strength is required for deliberative behaviors aimed at reaffirming and regaining meaning. Moreover, we outline various self-regulatory pathways to gain meaning via coherence, significance, and purpose. Finally, we suggest various ways to test and expand our model and hypotheses.
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34

SILCHENKO, ROMAN. "ANALYSIS OF INTRABRANCH AND LEGAL REGULATION OF ARTIFICIAL INTELLIGENCE TECHNOLOGIES USING THE EXAMPLE OF INTERNATIONAL EXPERIENCE, THE EXPERIENCE OF FOREIGN COUNTRIES AND THE RUSSIAN FEDERATION." Sociopolitical Sciences 11, no. 4 (August 28, 2021): 107–21. http://dx.doi.org/10.33693/2223-0092-2021-11-4-107-121.

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Анотація:
The purpose of the study is to analyze intrabranch and legal regulating relations related to the development and application of artificial intelligence technologies. The documents of the strategic development of the industry, regulatory documents, and other documents directly and indirectly related to artificial intelligence technologies were studied. For example, the following are: the act of the Asilomar Conference, acts of the Council of Europe, acts of the European Union, the act of the Organization for Economic Cooperation and Development, the G20 Act, regulatory and technical documents of the United States, China, Canada, Denmark, France, the Russian Federation, as well as some bills. The analysis revealed: the insufficiency of regulatory regulation of the artificial intelligence branch, the shortcomings of national regulation of the artificial intelligence branch in some countries, the dependence of norms on the political regime, the duration and untimeness of the development of regulations, the lack of coherence in the development and application of artificial intelligence technologies at the interstate level.
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35

Fischer, Benedikt, Chris Bullen, and Wayne Hall. "A call for greater policy and regulatory coherence for an expanding menu of legal psychoactive substances." Drug and Alcohol Review 39, no. 6 (May 18, 2020): 737–42. http://dx.doi.org/10.1111/dar.13071.

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36

Chase, Peter, and Adam Schlosser. "Better Regulation – An Ongoing Journey." European Journal of Risk Regulation 6, no. 3 (September 2015): 378–79. http://dx.doi.org/10.1017/s1867299x00004803.

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Анотація:
The Commission's new Better Regulation package represents a step forward in the European Union’s decade–long journey to bringing coherence and rationality to its legislative and regulatory process. But as the Communication on the package itself suggests, the journey is far from over.The Communication consistently emphasizes the key aspects of good regulation: quality over quantity; taking time to get proposals right; evidence–based decision making; open and continuous consultation to gather evidence from all stakeholders; rigorous impact assessments and cost–benefit analysis; applying these tools to regulatory measures as well as legislation; and implementing a robust ex–post evaluation program. It is important as well that the Secretariat General published unified and detailed guidance for Commission officials on how each step of the regulatory process should work, with a “tool–box” to elaborate further on these steps.All of this is good. Yet in some areas, the Commission misses opportunities to go farther down the good governance road, and in others the guidance needs to be made much more explicit.
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37

Knyazeva, M. G., D. C. Kiper, V. Y. Vildavski, P. A. Despland, M. Maeder-Ingvar, and G. M. Innocenti. "Visual Stimulus–Dependent Changes in Interhemispheric EEG Coherence in Humans." Journal of Neurophysiology 82, no. 6 (December 1, 1999): 3095–107. http://dx.doi.org/10.1152/jn.1999.82.6.3095.

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Анотація:
We analyzed the coherence of electroencephalographic (EEG) signals recorded symmetrically from the two hemispheres, while subjects ( n = 9) were viewing visual stimuli. Considering the many common features of the callosal connectivity in mammals, we expected that, as in our animal studies, interhemispheric coherence (ICoh) would increase only with bilateral iso-oriented gratings located close to the vertical meridian of the visual field, or extending across it. Indeed, a single grating that extended across the vertical meridian significantly increased the EEG ICoh in normal adult subjects. These ICoh responses were obtained from occipital and parietal derivations and were restricted to the gamma frequency band. They were detectable with different EEG references and were robust across and within subjects. Other unilateral and bilateral stimuli, including identical gratings that were effective in anesthetized animals, did not affect ICoh in humans. This fact suggests the existence of regulatory influences, possibly of a top-down kind, on the pattern of callosal activation in conscious human subjects. In addition to establishing the validity of EEG coherence analysis for assaying cortico-cortical connectivity, this study extends to the human brain the finding that visual stimuli cause interhemispheric synchronization, particularly in frequencies of the gamma band. It also indicates that the synchronization is carried out by cortico-cortical connection and suggests similarities in the organization of visual callosal connections in animals and in man.
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38

Кулаковська, Тетяна Анатоліївна. "Research of coherence and consistency in the application of regulatory methods in the agrarian sector of Ukraine." ScienceRise 8, no. 1(13) (August 22, 2015): 58. http://dx.doi.org/10.15587/2313-8416.2015.48399.

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39

HENDLIN, Yogi Hale, Alessandra ARCURI, Robert LEPENIES, and Frank HÜESKER. "Like Oil and Water: The Politics of (Not) Assessing Glyphosate Concentrations in Aquatic Ecosystems." European Journal of Risk Regulation 11, no. 3 (September 2020): 539–64. http://dx.doi.org/10.1017/err.2020.65.

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Since the International Agency on Cancer Research’s monograph found glyphosate to be a likely carcinogen, the regulatory focus on the chemical has centred on this determinative criterion for regulatory action. Yet, other pertinent factors, such as the effects of glyphosate on fresh and ground water and ensuing effects on biodiversity, have received less attention as legitimate rationales for regulating the chemical. This underrepresentation prevents a wider policy discussion on the environmental and human health effects of the chemical and fails to disrupt assumptions of path-dependently continuing on agriculture’s chemical treadmill. To avoid ad hoc post hoc chemical regulation, we assess four areas of chemical regulatory oversight in Europe with regard to glyphosate affecting water: (1) the undue emphasis on in laboratorio versus in situ testing; (2) assessing single chemicals (isolated glyphosate) versus admixtures (glyphosate plus surfactants and adjuvants) that are used in practice; (3) the tendency to downplay harms to non-human life; and (4) the lack of policy coherence in the existing regulatory framework. Focusing on European Union regulation of pesticide and water policy affecting aquatic environments, we conclude that issues of measurement and priority have become highly politicised in both science and policy, requiring preventative, precautionary frameworks utilising plural forms of measurement.
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40

Tulibacka, Magdalena. "Europeanization of Civil Procedures: In Search of a Coherent Approach." Common Market Law Review 46, Issue 5 (October 1, 2009): 1527–65. http://dx.doi.org/10.54648/cola2009062.

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Анотація:
Civil procedure is an increasingly important element of the European Union’s legal system. The interest in it, both on the regulatory and on the academic side, has grown considerably. Time has come to re-evaluate the position. While the policy of “judicial cooperation in civil matters” coordinated by the DG Freedom, Security and Justice contains most EU activities in the area, civil procedure is also the subject of attention from various other actors within the EU. Directorates General Internal Market, Competition, or SANCO are involved in regulating civil procedures on sectoral levels. There is little doubt that coordination of domestic civil procedure rules of European Union Member States is necessary to some extent. This paper tackles two important questions: how far should the harmonization of these rules reach, and can its aims be achieved by the approach taken by the EU at present? It emphasizes the recent phenomenon of decentralized harmonization as a particular challenge to the coherence of the EU policy in the area. It sketches a blueprint for a more coherent approach to Europeanization of civil procedures.
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41

Hirano, Miharu. "Settling Water Disputes through International Investment Arbitration: When and by What Standards?" Chinese Journal of Environmental Law 6, no. 2 (December 7, 2022): 200–217. http://dx.doi.org/10.1163/24686042-12340085.

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Abstract The development of water law as environmental law may trigger disputes over investment projects, which could find their way to international investment arbitration. Consequently, domestic water law and administration can be subjected to international scrutiny. This article analyses relevant investment treaty provisions and cases concerning water resources management to examine (i) when water disputes can be submitted to investment arbitration and (ii) what standards tribunals have applied to settle them. It demonstrates that water disputes over investment projects can widely be covered by investment treaties, but they do not automatically turn water resources into legally protected commodities. Investment arbitration is commonly used by foreign investors to challenge the legality of water-related measures adopted by host States under an applicable investment treaty, it can also be used to enforce domestic environmental law. In most controversial cases, arbitral tribunals applied reasoned decision-making and regulatory coherence as emerging global regulatory standards.
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42

Zhukova, S. I., and T. N. Iureva. "Optical coherence tomography in the diagnosis and monitoring of congenital and juvenile glaucoma." Acta Biomedica Scientifica 7, no. 2 (May 24, 2022): 147–66. http://dx.doi.org/10.29413/abs.2022-7.2.16.

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Optical coherence tomography (OCT) in everyday routine practice is the method of choice for the instrumental diagnosis of glaucoma in adults. As a non-invasive and safe method of visualizing structural changes in the retina and the optic nerve, the method is of particular value in pediatric practice. At the same time, OCT diagnostics in children is associated with certain difficulties, both during the study and when interpreting the scan results.This review summarizes the data from the literature and our own research in the diagnosis and monitoring of congenital and juvenile glaucoma from the standpoint of our own long-term clinical experience in using optical coherence tomography. We consider the physiological changes of the retina and optic nerve, attention is focused on the need to create a pediatric regulatory database of retinal thickness, the factors that determine the normal range of the data obtained and allow distinguishing physiological processes from pathological ones are identified. Clinical cases confirming the value of OCT in combined pathology are presented as examples.
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43

JANČIĆ, Davor. "Transatlantic Regulatory Interdependence, Law and Governance: The Evolving Roles of the EU and US Legislatures." Cambridge Yearbook of European Legal Studies 17 (November 11, 2015): 334–59. http://dx.doi.org/10.1017/cel.2015.16.

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Анотація:
AbstractThis article analyses the roles of the European Parliament and the US Congress in addressing regulatory interdependencies arising in the EU–US strategic partnership. It examines their international actorness as a potential remedy for the problems of democratic participation, executive dominance, and opaqueness in the shaping of transatlantic relations. It shows that legislatures significantly contribute to regulatory discrepancies and trade disputes and that the adverse consequences thereof justify more intensiveex antecooperation between them. The analysis conducts two groups of case studies to demonstrate how the EP and Congress influence law and policy in areas of transatlantic regulatory and foreign policy divergence. The first group of case studies analyses parliamentary involvement in the making of international agreements (TTIP and ACTA). The second group of case studies inspects legislative action with extraterritorial effects (US Helms–Burton and Sarbanes–Oxley Acts). The article argues that the EP and Congress have so far frequently acted against the spirit of the strategic partnership in ways that are injurious to the interests of the other side, and discusses whether an interparliamentary early warning mechanism could reduce legislative and political frictions and increase the coherence of transatlantic lawmaking.
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44

Sahari, Noorul Huda, Norazlina Abdul Aziz, Nur Hafizah Harun, Farhaneen Afzal Mazlan, and Johari Ab. Latiff. "Conceptual Framework Of A Unified Legal Control Of Halal Meat Import For A Sustainable Halal Industry In Malaysia." Journal of Fatwa Management and Research 27, no. 2-SE (November 30, 2022): 80–94. http://dx.doi.org/10.33102/jfatwa.vol27no2-se.485.

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Анотація:
The recent discoveries of smuggling non-halal meat within the halal meat industry have impeached the reliability of the existing legal framework governing the import of halal meat to Malaysia. The existing halal legal framework that is scattered and non-unified contributed to the uncertain jurisdiction of multi-authority that controls the import of halal meat, lack of coherence, over-regulation, and inadequate regulatory activities. Thus this study aimed to examine the conceptual framework of unified legal control of halal meat import in Malaysia. This study adopts a qualitative method utilizing doctrinal research where data is gathered using documentation methods from books, journal articles, reports, and online data-based. The data gathered are analyzed using a document and content analysis approach. The finding shows that a more effective unified legal framework should replace the current scattered and non-unified legal framework. The unified legal framework may assist in identifying the role of each agency to avoid duplication of effort, consolidation of resources, and finding measures that help improve coherence among these agencies.
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45

COGLIANESE, CARY, and ANDRÉ SAPIR. "Risk and Regulatory Calibration: WTO Compliance Review of the US Dolphin–Safe Tuna Labeling Regime." World Trade Review 16, no. 2 (March 10, 2017): 327–48. http://dx.doi.org/10.1017/s1474745616000562.

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Анотація:
AbstractIn a series of recent disputes arising under the TBT Agreement, the Appellate Body has interpreted Article 2.1 to provide that discriminatory and trade-distortive regulation could be permissible if based upon a ‘legitimate regulatory distinction’. In its recent compliance decision in the US–Tuna II dispute, the AB reaffirmed its view that regulatory distinctions embedded in the US dolphin-safe tuna-labeling regime were not legitimate because they were not sufficiently calibrated to the risks to dolphins associated with different tuna fishing conditions. This paper analyzes the AB's application of the notion of risk-based regulation in the US–Tuna II dispute and finds the AB's reasoning lacking in coherence. Although risk analysis and calibration can in principle play useful roles in TBT cases, the AB needs to provide more explicit and careful guidance to WTO members and to panels to avoid the kind of ad hoc decision-making exhibited throughout the US–Tuna II dispute.
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46

Kysar, Douglas A. "Global Environmental Constitutionalism: Getting There from Here." Transnational Environmental Law 1, no. 1 (March 13, 2012): 83–94. http://dx.doi.org/10.1017/s2047102511000057.

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Анотація:
AbstractDominant analytical approaches to environmental law exhibit a similar, problematic form: they treat that which should be outcome determining as, instead, outcome determined. This form is most evident and influential in the welfare economic technique of regulatory cost–benefit analysis, which treats all resources – including the monetary value of human lives – as potential means towards seemingly higher yielding ends. In contrast, an environmental constitutionalism, in which certain needs and interests of present and future generations, the global community, and other forms of life are given foundational legal importance, would help to restore conceptual coherence and normative priority to the subjects of environmental law.
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47

Miller, Michelle C., Anna-Kristin Ludwig, Kanin Wichapong, Herbert Kaltner, Jürgen Kopitz, Hans-Joachim Gabius, and Kevin H. Mayo. "Adhesion/growth-regulatory galectins tested in combination: evidence for formation of hybrids as heterodimers." Biochemical Journal 475, no. 5 (March 15, 2018): 1003–18. http://dx.doi.org/10.1042/bcj20170658.

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The delineation of the physiological significance of protein (lectin)–glycan recognition and the structural analysis of individual lectins have directed our attention to studying them in combination. In this report, we tested the hypothesis of hybrid formation by using binary mixtures of homodimeric galectin-1 and -7 as well as a proteolytically truncated version of chimera-type galectin-3. Initial supportive evidence is provided by affinity chromatography using resin-presented galectin-7. Intriguingly, the extent of cell binding by cross-linking of surface counter-receptor increased significantly for monomeric galectin-3 form by the presence of galectin-1 or -7. Pulsed-field gradient NMR (nuclear magnetic resonance) diffusion measurements on these galectin mixtures indicated formation of heterodimers as opposed to larger oligomers. 15N-1H heteronuclear single quantum coherence NMR spectroscopy and molecular dynamics simulations allowed us to delineate how different galectins interact in the heterodimer. The possibility of domain exchange between galectins introduces a new concept for understanding the spectrum of their functionality, particularly when these effector molecules are spatially and temporally co-expressed as found in vivo.
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48

Shi, Jian-Cheng, Min Luo, Tao Dong, and Chu-Sheng Huang. "External Noise and External Signal Induced Transition of Gene Switch and Coherence Resonance in the Genetic Regulatory System." Acta Biotheoretica 65, no. 2 (March 17, 2017): 135–50. http://dx.doi.org/10.1007/s10441-017-9307-6.

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49

Werner, M. "Can medical decisions be standardized? Should they be?" Clinical Chemistry 39, no. 7 (July 1, 1993): 1361–68. http://dx.doi.org/10.1093/clinchem/39.7.1361.

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Анотація:
Abstract After a variety of regulatory and payment schemes have failed to stem the rising tide of health care cost, the Omnibus Budget Reconciliation Act of 1989 mandates the creation of a system of decision rules called practice parameters for appropriate medical action in many circumstances. A large body of practice guidelines already exists, but lacks the internal coherence required of a policy tool. Professional organizations therefore have developed attributes to achieve uniform style. However, little has been said or published about the constraints that might be imposed on the structure and content of an efficient and coherent system. The arguments presented here lead to the following conclusions: (a) process control is an inefficient tool to manage outcome--standards should reflect product control; (b) guidelines that proscribe are more likely to be supported by scientific data and consensus than those that prescribe; (c) the decision thresholds contained in such directives are policy choices rather than scientific imperatives; (d) neither decision analysis nor artificial intelligence is likely to readily influence medical decisions; and (e) as suggested by operations research, the development of practice parameters should concentrate on issues of therapeutic management in preference to issues of diagnostic activity.
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50

Westbrook, Travis D., Eleshia J. Morrison, Kami J. Maddocks, Farrukh T. Awan, Jeffrey A. Jones, Jennifer A. Woyach, Amy J. Johnson, John C. Byrd, and Barbara L. Andersen. "Illness Perceptions in Chronic Lymphocytic Leukemia: Testing Leventhal’s Self-regulatory Model." Annals of Behavioral Medicine 53, no. 9 (December 26, 2018): 839–48. http://dx.doi.org/10.1093/abm/kay093.

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Abstract Background Leventhal’s Self-regulatory Model proposes that somatic characteristics of a health threat (e.g., symptom severity), and prior experience with the threat (e.g., unsuccessful treatment), are determinants of illness perceptions. Chronic lymphocytic leukemia (CLL) is appropriate for test of these postulates, having three phases differing in symptom severity and prior treatment experiences: indolent disease requiring no treatment (active surveillance; AS), symptomatic disease requiring a first treatment (FT), and highly symptomatic disease in those who have relapsed and/or failed to respond to prior treatments (relapsed/refractory; RR). Purpose To test symptom severity and prior treatment experiences as determinants of illness perceptions, illness perceptions were characterized and contrasted between CLL groups. Methods Three hundred and thirty CLL patients (AS, n = 100; FT, n = 78; RR, n = 152) provided illness perception data on one occasion during a surveillance visit (AS) or prior to beginning treatment (FT, RR). Results Analysis of variance with planned comparisons revealed that consequences, identity, and concern were least favorable among RR patients, followed by FT, then AS (ps < .01). AS patients endorsed the lowest levels of coherence (ps < .01), and the most chronic illness timeline (ps < .01). FT patients endorsed the highest levels of personal and treatment control (ps < .01). Conclusions Data provide preliminary empirical support for Self-regulatory Model postulates that symptom severity and prior disease experiences influence illness perceptions. Unique knowledge needs for AS patients and elevated psychological/physical symptoms for later-stage CLL patients may warrant clinical attention.
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