The ECB's Independence under Siege - Political Audience Cost Theory and Unconventional Monetary Policy

Since the beginning of the global financial crisis in the fall of 2008, the European Central Bank (ECB) and other central banks around the world have reached far beyond classical monetary policy in order to prevent the collapse of the financial system. Today, several years after any immediate risk of financial collapse has passed and despite the questionable track record of unconventional monetary policy, monetary policy has still not normalized, leaving us wondering why the ECB continues to engage in unconventional monetary policy. Applying the Audience Cost Theory, this dissertation shows that the ECB is indeed susceptible to external audience groups’ monetary policy preferences. The analysis shows that these preferences are a good indicator of actual ECB policy-making between 2007 and 2014, as for the majority of the time period covered, the ECB’s refinancing rate moved in line with the average Eurozone monetary policy preference

Hypothermic Oxygenated Machine Perfusion (HOPE) Prior to Liver Transplantation Mitigates Post-Reperfusion Syndrome and Perioperative Electrolyte Shifts

(1) Background: Post-reperfusion syndrome (PRS) and electrolyte shifts (ES) represent considerable challenges during liver transplantation (LT) being associated with significant morbidity. We aimed to investigate the impact of hypothermic oxygenated machine perfusion (HOPE) on PRS and ES in LT. (2) Methods: In this retrospective study, we compared intraoperative parameters of 100 LTs, with 50 HOPE preconditioned liver grafts and 50 grafts stored in static cold storage (SCS). During reperfusion phase, prospectively registered serum parameters and vasopressor administration were analyzed. (3) Results: Twelve percent of patients developed PRS in the HOPE cohort vs. 42% in the SCS group (p = 0.0013). Total vasopressor demand in the first hour after reperfusion was lower after HOPE pretreatment, with reduced usage of norepinephrine (-26%;p = 0.122) and significant reduction of epinephrine consumption (-52%;p = 0.018). Serum potassium concentration dropped by a mean of 14.1% in transplantations after HOPE, compared to a slight decrease of 1% (p < 0.001) after SCS. The overall incidence of early allograft dysfunction (EAD) was reduced by 44% in the HOPE group (p = 0.04). (4) Conclusions: Pre-transplant graft preconditioning with HOPE results in higher hemodynamic stability during reperfusion and lower incidence of PRS and EAD. HOPE has the potential to mitigate ES by preventing hyperpotassemic complications that need to be addressed in LT with HOPE-pre-treated grafts

A Novel Deep Learning Model as a Donor-Recipient Matching Tool to Predict Survival after Liver Transplantation

Background: The digital era in the field of medicine is the new here and now. Artificial intelligence has entered many fields of medicine and is recently emerging in the field of organ transplantation. Solid organs remain a scarce resource. Being able to predict the outcome after liver transplantation promises to solve one of the long-standing problems within organ transplantation. What is the perfect donor recipient match? Within this work we developed and validated a novel deep-learning-based donor-recipient allocation system for liver transplantation. Method: In this study we used data collected from all liver transplant patients between 2004 and 2019 at the university transplantation centre in Munich. We aimed to design a transparent and interpretable deep learning framework to predict the outcome after liver transplantation. An individually designed neural network was developed to meet the unique requirements of transplantation data. The metrics used to determine the model quality and its level of performance are accuracy, cross-entropy loss, and F1 score as well as AUC score. Results: A total of 529 transplantations with a total of 1058 matching donor and recipient observations were added into the database. The combined prediction of all outcome parameters was 95.8% accurate (cross-entropy loss of 0.042). The prediction of death within the hospital was 94.3% accurate (cross-entropy loss of 0.057). The overall F1 score was 0.899 on average, whereas the overall AUC score was 0.940. Conclusion: With the achieved results, the network serves as a reliable tool to predict survival. It adds new insight into the potential of deep learning to assist medical decisions. Especially in the field of transplantation, an AUC Score of 94% is very valuable. This neuronal network is unique as it utilizes transparent and easily interpretable data to predict the outcome after liver transplantation. Further validation must be performed prior to utilization in a clinical context

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

D. Nicolai Börners, Der Röm. Kayserl. Reichs-Academie Nat. Cur. Mitgliedes und Medici Senioris zur Neustadt an der Orla, Physica Oder Vernünftige Abhandlung Natürlicher Wissenschaften : Worinnen nicht nur Sämmtliche Welt-Cörper nach mathematischen Gründen betrachtet, sondern auch andere zur Natur-Lehre gehörige Sachen untersuchet, und die vorkommenen Phänomena hinlänglich erkläret werden ... : Nebst einer Vorrede Herrn D. Johann Ernst Hebenstreits, Prof. Publ. Ordinar. zu Leipzig, [et]c. ans Licht gestellet, Auch ... Mit einem gehörigen Register versehen

Titelbl. in Rot- und Schwarzdr.Autopsie nach Ex. der ULB Sachsen-AnhaltVorlageform des Erscheinungsvermerks: Franckfurth und Leipzig, bey Michael Blochbergern, 1742

D. Nicolai Börners, Der Röm. Kayserl. Leopold-Franciscischen Reichs-Academie Nat. Curios. Mitgliedes, und Poliatr. Sen. zu Neustadt an der Orla, Medicvs Svi Ipsivs oder Sein selbst Artzt : Jn welchem nach vernünftigen Hygieinischen Grund-Sätzen Anweisung gegeben wird, Wie ein ieder Seine Gesundheit erhalten, Und mit Gott eines langen Lebens teilhaftig werden könne

Vorlageform der Veröffentlichungsangabe: Franckfurt und Leipzig, ... Verlegts Michael Blochberge

Die Erwartungshaltung des Patienten beeinflusst die Rekonvaleszenz nach Major Leberresektion

Hintergrund Placeboeffekte existieren auf allen Gebieten der Medizin und werden vom Arzt-Patienten-Verhältnis beeinflusst. Eine Reihe an Studien suggeriert einen bedeutenden Einfluss der Patientenerwartung als Teil des Placeboeffekts. Wir stellten daher die Hypothese auf, dass die präoperative Patientenerwartung an die postoperative Verweildauer Marker physischer Erholung nach Leberresektion beeinflusst. Methoden 33 Patienten mit Leberresektion (≥4 Segmente) wurden nach Randomisierung über ein standardisiertes Video präoperativ entweder eine erwartete postoperative Verweildauer von 7-10 (kurzer Arm) oder 12- 16 Tagen (langer Arm) genannt und bezüglich psychologischer Merkmale befragt. Darüber hinaus blieb die perioperative Behandlung unverändert. Primärer Endpunkt war das Erreichen vordefinierter objektiver Entlasskriterien (orale Analgetika, intakte Stuhlpassage, Kostaufbau, Mobilisierung, keine Komplikationen). Ergebnisse Patienten im kurzen Arm erreichten die objektiven Entlasskriterien nach 7,94 (SD 3,21) und im Patienten im langen Arm nach 14,00 (SD 5,92) Tagen (p=0,002). Die tatsächliche Verweildauer betrug im kurzen Arm 12,0 (IQR 8-16) und im langen Arm 19,3 (IQR 14-26) Tage (p=0.008). Eine stärkere Selbstwirksamkeitsüberzeugung der Patienten korrelierte dabei mit schnellerem Erreichen der objektiven Entlasskriterien (p=0,04). Schlussfolgerung Die Erwartung einer kürzeren Aufenthaltsdauer resultiert in einer schnelleren physischen Erholung der Patienten nach Leberresektion. Weiterhin kann diese Erwartung moduliert und im Sinne des Patienten für verbesserte Ergebnisse genutzt werde

Medicvs Svi Ipsivs oder Sein selbst Artzt

Vorlageform des Erscheinungsvermerks: Franckfurt und Leipzig, 1748. Verlegts Michael Blochberger

The ECB's Independence under Siege - Political Audience Cost Theory and Unconventional Monetary Policy

Since the beginning of the global financial crisis in the fall of 2008, the European Central Bank (ECB) and other central banks around the world have reached far beyond classical monetary policy in order to prevent the collapse of the financial system. Today, several years after any immediate risk of financial collapse has passed and despite the questionable track record of unconventional monetary policy, monetary policy has still not normalized, leaving us wondering why the ECB continues to engage in unconventional monetary policy. Applying the Audience Cost Theory, this dissertation shows that the ECB is indeed susceptible to external audience groups’ monetary policy preferences. The analysis shows that these preferences are a good indicator of actual ECB policy-making between 2007 and 2014, as for the majority of the time period covered, the ECB’s refinancing rate moved in line with the average Eurozone monetary policy preference