“Building Resilience” A comparison of eight OECD countries. Bertelsmann Stiftung Inclusive Growth for Germany|12

Increasing resilience is one of the top priorities of global economic policy. In a comparison of eight industrialized countries, a quite varied picture emerges. On four dimensions of performance (growth, unemployment, protection against poverty and distribution), Japan and Australia show considerable resilience in the context of crisis. France and Italy demonstrate a low level of resilience. The United States does little to serve as a role model for Europe with regard to resilience; while growth rates have been successfully stabilized there, crises have been accompanied by increases in inequality. The figure examines Germany’s performance in the context of crisis. Performance is measured using a preand post-crisis comparison. In comparison to the average of the here considered countries, Germany has coped with crises well with regard to consequences for distribution and unemployment. The consequences of a crisis with regard to poverty risks correspond with the country- sample average. In past decades, Germany has performed somewhat below the average level with regard to stabilizing growth. However, this improved significantly with the financial crisis

Economic Resilience A new concept for policy making? Bertelsmann Stiftung Inclusive Growth for Germany|11

The idea of “resilience” has in recent years gained a high level of popularity in the formulation of economic- policy objectives. Given the rapid sequence of serious crises, the rise of this concept is hardly surprising. If economic shocks are apparently unavoidable, then an economy’s ability to cope with them should be a subject of interest. However, the virtually inflationary use of the resilience concept has been accompanied by a lack of precision. In particular, there is often no clear understanding that alongside its static interpretation (retention of a system’s existing functions in the case of a crisis), crisis resilience also includes an adaptive dimension (adjustment to new surrounding conditions). Against this background, this article addresses the origin of the resilience concept, illustrates its various usages in different disciplines, and distinguishes it from other key words (“vulnerability,” “sustainability,” “stability”). On this basis, the resilience concept is given additional precision and defined in a manner useful for the economic- policy perspective. A central conclusion is that the concept of resilience can become a normative economic- policy principle if 1) it is not viewed narrowly as only a static concept; 2) it is linked to the societal objectives within the economy being studied; and 3) the interplay of different societal levels is taken into account

US-Steuerpläne bedrohen den globalen Handels- und Steuerfrieden

In den nächsten Monaten wird sich entscheiden, ob sich US-Präsident Donald Trump die Steuerpläne der Republikaner im Kongress zu Eigen macht. Diese Entscheidung ist für die internationale Unternehmensbesteuerung von historischer Tragweite, die Folgen für Handelsströme, Wechselkurse, Wettbewerbsfähigkeit von Industriestandorten, Investitionsentscheidungen und Steueraufkommen sind unabsehbar. Bei einer Umsetzung der republikanischen Besteuerungspläne würden die Vereinigten Staaten zu einem Fremdkörper im globalen System der Unternehmensbesteuerung, auf den die Industrieländer weltweit in ihrer Steuerpolitik sicherlich reagieren würden. Die bisherige Strategie, in der Organisation für wirtschaftliche Zusammenarbeit und Entwicklung (OECD) die Unternehmensbesteuerung gegen Gewinnverlagerung zu koordinieren, würde durch das Ausscheren der USA weitgehend hinfällig

Effective second-line treatment with cetuximab and bevacizumab in a patient with hepatic metastases of colorectal cancer and hyperbilirubinemia

Background: Irinotecan-based second-line chemotherapy of metastatic colorectal cancer (CRC) is effective, it might, however, be contraindicated in cases of severe liver dysfunction due to advanced liver metastases. Case Report: A 57-year-old woman with diffuse CRC liver metastases showed progressive disease on first-line treatment with capecitabine and oxaliplatin (XELOX). Chronic cholestasis and hyperbilirubinemia caused by advanced liver involvement prohibited second-line treatment with irinotecan-based chemotherapy. We initiated combined antibody treatment with cetuximab and bevacizumab. Results: Clinical performance status as well as laboratory parameters improved rapidly. Staging investigations after 8 weeks revealed a partial remission. Since bilirubin levels had returned to the upper limit of normal, therapy could be changed to standard irinotecan, 5-fluorouracil, folinic acid, and bevacizumab. Conclusion: Combined treatment with cetuximab and bevacizumab may be considered as an effective treatment option in patients who cannot be treated with standard chemotherapy regimens due to impaired liver metabolism of cytotoxic substances

Assessing prognosis in metastatic pancreatic cancer by the serum tumor marker CA 19-9: Pretreatment levels or kinetics during chemotherapy?

Background: The carbohydrate antigen 19-9 (CA 19-9) is currently the most widely used serum tumor marker in pancreatic cancer (PC). CA 19-9 pretreatment levels as well as CA 19-9 kinetics during systemic chemotherapy can provide prognostic information regarding survival of patients with metastatic PC. Case Reports: We report the clinical course of 2 patients with metastatic PC who underwent palliative chemotherapy with gemcitabine. Both patients showed a significant elevation of pretreatment CA 19-9 levels (7,505 and 150,000 U/ml, respectively), however, subsequently they experienced a highly significant reduction (> 90%) of CA 19-9 kinetics under gemcitabine chemotherapy. A good disease control and a clinical benefit response were achieved in both patients. Time to tumor progression was 30 weeks and 28 weeks, overall survival 14 months and 11 months, respectively. Conclusion: These data indicate that CA 19-9 kinetics under chemotherapy may possibly serve as a useful surrogate marker for time to tumor progression and survival in advanced PC

A viable insolvency procedure for sovereigns (VIPS) in the euro area

A mechanism to restructure the debt of an insolvent euro country is a missing element in the emerging institutional architecture of the euro area. The introduction of an insolvency proce-dure for sovereigns faces a dilemma: In the foreseeable future, its introduction would risk pushing Europe back into acute crisis. But the indefinite postponement of reform would im-pair the credibility of a future regime change. Against this background, this paper reviews arguments and existing blueprints for sovereign insolvency procedures in the euro area and develops a “Viable Insolvency Procedure for Sovereigns” (VIPS). VIPS avoids any sudden measures which could destabilize the present fragile situation but carefully designs an irre-versible transition towards the new regime. The VIPS proposal comprises two pillars: An in-solvency procedure for the long run and a credible bridge towards that system

How Europe can deliver: Optimising the division of competences among the EU and its member states

This study aims to give guidance for a better-performing EU through an improved allocation of competences between the European Union and its member states. The study analyses eight specific policies from a wide range of fields with respect to their preferable assignment. The analysis applies a unified quantified approach and is precise in its definition of ‘counterfactuals’. These counterfactuals are understood as conceptual alternatives to the allocation of competences under the status quo. As such, they either relate to a new European competence (if the policy is currently a national responsibility) or a new national competence (if the policy is currently assigned to the EU). The comprehensive, quantification-based assessments indicate that it would be preferable to have responsibility for higher education and providing farmers with income support at the national level. Conversely, a shift of competences to the EU level would be advantageous when it comes to asylum policies, defence, corporate taxation, development aid and a (complementary) unemployment insurance scheme in the euro area. For one policy – railway freight transport – the findings are indeterminate. Overall, the study recommends a differentiated integration strategy comprising both new European policies and a roll-back of EU competences in other fields

Comparison of insulin detemir and insulin glargine in a Basal-Bolus regimen, with insulin aspart as the mealtime insulin, in patients with type 1 diabetes: A 52-week, multinational, randomized, open-label, parallel-group, treat-to-target noninferiority trial

Objective: The primary study objective was to determine whether insulin detemir (detemir) was noninferior to insulin glargine (glargine) as the basal insulin in a basal-bolus regimen, with insulin aspart as the mealtime insulin, in terms of glycemic control at the end of 52 weeks in patients with type I diabetes mellitus (T1DM). Methods: This multinational, open-label, parallel-group, treat-to-target, noninferiority trial enrolled patients aged >= 18 years who had had T1DM for at least 12 months, had been taking a basal-bolus insulin regimen for at least 3 months, and had a glycosylated hemoglobin (HbA(1c)) value <= 11.0% at screening. Patients were randomized in a 2:1 ratio to receive either detemir or glargine for 52 weeks. The basal insulin was initially administered once daily (in the evening) in both groups; if patients in the detemir group were achieving the plasma glucose (PG) target before breakfast but not before dinner, they were switched to twice-daily administration. Glargine was administered once daily throughout the trial, according to its approved labeling. Each patient attended 13 study visits and received 16 scheduled telephone calls from the trial site. The primary efficacy end point was glycemic control (HbA(1c)) after 52 weeks of treatment. Secondary end points included the number of patients achieving an HbAlc value <= 7.0%, with or without a major hypoglycemic episode in the last month of treatment; fasting PG (FPG); within-patient variation in self-monitored plasma glucose (SMPG) before breakfast and dinner; and 10-point SMPG profiles. The noninferiority margin was 0.4%, consistent with US Food and Drug Administration guidelines. Results: Four hundred forty-three patients (mean [SD] age, 42 [12] years; body mass index, 26.5 [4.0] kg/m(2); duration of diabetes, 17.2 [11.4] years; HbA(1c), 8.1% [1.1%]) received study treatment. After 52 weeks, the estimated mean HbA(1c) did not differ significantly between the detemir and glargine groups (7.57% and 7.56%, respectively; mean difference, 0.01%; 95% CI -0.13 to 0.16), consistent with the noninferiority of detemir to glargine. The corresponding estimated changes in HbA(1c) were -0.53% and -0.54%. In the 90 patients who completed the trial on once-dally detemir and the 173 patients who completed the trial on twice-daily detemir, the estimated changes in HbA(1c) were-0.49% and -0.58%, respectively. After 52 weeks, there were no significant differences in the proportions of those receiving detemir and glargine who achieved an HbA(1c) value <= 7.0% without major hypo-glycemia (31.9% and 28.9%, respectively). In addition, there were no significant differences in estimated mean FPG (8.58 and 8.81 rnmol/L; mean difference, -0.23 mmol/L; 95% CI, -1.04 to 0.58) or in basal insulin doses. The basal insulin dose was numerically higher in patients receiving detemir twice rather than once daily (0.47 vs 0.33 U/kg, respectively). The relative risks for total and nocturnal hypoglycemia with detemir versus glargine were 0.94 and 1.12, respectively (both, P = NS). Six patients (2.0%) randomized to the detemir group and 4 (2.7%) randomized to the glargine group withdrew due to adverse events. Conclusions: During 52 weeks of basal-bolus therapy in patients with T1DM, detemir was noninferior to glargine in terms of overall glycemic control (HbA(1c)). When used according to the approved labeling, detemir and glargine did not differ in tolerability or in terms of the occurrence of hypoglycemia. (Clin Ther. 2009; 31:2086-2097) (C) 2009 Excerpta Medica Inc

Revenue autonomy preference in German state parliaments

Fiscal federalism in Germany is characterized by lacking sub-national tax autonomy and intensive fiscal equalization. Due to a sunset clause, the current equalization system has to be renegotiated by the year 2019. Against this backdrop, this contribution studies the reform preferences of members of state parliaments. The study makes use of a self-conducted survey among the members of all 16 German state parliaments. It tests to which extent the preferences of these veto players for tax autonomy and fiscal equalization are driven by states’ self-interest, party ideology and individual characteristics. The results are helpful to understand the political-economic constraints of federal reforms. They indicate that besides the individual ideological position higher state wealth and lower debt levels are linked to larger reform support. Therefore, a promising new reform would have to address budgetary legacies like high pre-existing debt

Vectors for co-expression of an unrestricted number of proteins

A vector system is presented that allows generation of E. coli co-expression clones by a standardized, robust cloning procedure. The number of co-expressed proteins is not limited. Five ‘pQLink’ vectors for expression of His-tag and GST-tag fusion proteins as well as untagged proteins and for cloning by restriction enzymes or Gateway cloning were generated. The vectors allow proteins to be expressed individually; to achieve co-expression, two pQLink plasmids are combined by ligation-independent cloning. pQLink co-expression plasmids can accept an unrestricted number of genes. As an example, the co-expression of a heterotetrameric human transport protein particle (TRAPP) complex from a single plasmid, its isolation and analysis of its stoichiometry are shown. pQLink clones can be used directly for pull-down experiments if the proteins are expressed with different tags. We demonstrate pull-down experiments of human valosin-containing protein (VCP) with fragments of the autocrine motility factor receptor (AMFR). The cloning method avoids PCR or gel isolation of restriction fragments, and a single resistance marker and origin of replication are used, allowing over-expression of rare tRNAs from a second plasmid. It is expected that applications are not restricted to bacteria, but could include co-expression in other hosts such as Bacluovirus/insect cells