The effects of economic policy uncertainty on European economies: Evidence from a TVP-FAVAR

Recent events such as the financial and sovereign debt crisis have triggered an increase in European Economic Policy Uncertainty (EPU). We use a TVP-FAVAR model with hierarchical priors on the hyperparameters to investigate the effect of EPU on a wide range of macroeconomic variables for eleven European Monetary Union (EMU) countries. First, we find that EPU shocks are transmitted through various channels, such as the real options-, the precautionary savings- and the financial channel. Second, we are able to distinguish between a group of fragile countries (GIIPScountries) and a group of stable countries (northern countries), where the former are more strongly affected by EPU shocks. Third, while the IRFs for most variables differ only in magnitude and not in sign between groups of countries, responses of long term interest rates to EPU shocks have a different sign across countries. Fourth, we discover that investors and traders react more sensitively than consumers to uncertainty. Fifth, we find that EPU shocks affect monetary policy decisions. Sixth, we provide evidence that the transmission of EPU shocks is quite stable over time. Finally, the increase in EPU can partly be explained by the state of the European economy and should therefore be treated as an endogenous variable.Jüngste Ereignisse wie die Finanz- und Staatsschuldenkrise in Europa gingen mit einem Anstieg der wirtschaftspolitischen Unsicherheit (EPU) einher. Um die Effekte von EPU auf neun makroökonomische Variablen für elf Länder der Europäischen Währungsunion zu quantifizieren, verwenden wir ein TVP-FAVAR Modell mit hierarchischen Prioren. Unsere Studie zeigt erstens, dass EPU über verschiedene Kanäle, wie dem realen Options-, dem vorsorglichen Spar- und dem Finanzkanal, übertragen wird. Zweitens, basierend auf den Impuls-Antwort-Folgen (IAF) können wir zwischen den GIIPS-Ländern und den nördlichen Ländern unterscheiden, wobei erstgenannte stärker von EPU-Schocks beeinflusst werden. Drittens, während sich die IAF für acht Variablen lediglich in der Stärke und nicht im Vorzeichen unterscheiden, gibt es in jenen der langfristigen Zinsen auf Staatsanleihen Unterschiede im Vorzeichen. Viertens zeigt unsere Studie, dass Investoren stärker auf EPU-Schocks reagieren als Konsumenten. Fünftens, wir zeigen, dass EPU die gemeinsame europäische Geldpolitik beeinflusst. Sechstens liefert unsere Studie empirische Belege dafür, dass der Transmissionsmechanismus von EPU-Schocks über die Zeit konstant ist. Schlussendlich geht aus unserer Studie hervor, dass der Anstieg von EPU teilweise durch die aktuelle wirtschaftliche Lage der europäischen Volkswirtschaften erklärt werden kann, weshalb EPU als endogene Variable behandelt werden sollte

On the time-varying effects of economic policy uncertainty on the US economy

We study the impact of Economic Policy Uncertainty (EPU) on the US Economy by using a VAR with time‐varying coefficients. The coefficients are allowed to evolve gradually over time which allows us to discover structural changes without imposing them a priori. We find three different regimes, which match the three major periods of the US economy, namely the Great Inflation, the Great Moderation and the Great Recession. The initial impact on real GDP ranges between −0.2% for the Great Inflation and Great Recession and −0.15% for the Great Moderation. In addition, the adverse effects of EPU are more persistent during the Great Recession providing an explanation for the slow recovery. This regime dependence is unique for EPU as the macroeconomic consequences of Financial Uncertainty turn out to be rather time invariant

Baricitinib for atopic dermatitis patients who responded inadequately to dupilumab treatment:First daily practice results

Background: Baricitinib is the first JAK inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Efficacy and safety were shown in clinical trials, but daily practice data is sparse. Objectives: To evaluate the effectiveness and safety of baricitinib treatment in daily practice in AD patients who have inadequately responded to dupilumab. Methods: In this prospective observational cohort study, AD patients who failed dupilumab treatment and started baricitinib treatment in context of standard care at the Erasmus MC (the Netherlands) were included. We analysed physician-reported scores and patient-reported outcome measure scores (PROMs). Results: Twenty-five patients were included. Baricitinib treatment resulted in significant improvement of Eczema Area and Severity Index (EASI) scores and PROMs. Seven patients showed a good and sustained response (EASI50), eight patients showed no response (&lt;EASI50), and five patients showed an initial response but worsening of EASI scores in time. Overall, baricitinib was well tolerated. Four patients discontinued baricitinib treatment due to ineffectiveness or side effects. Conclusions: Baricitinib can be an effective treatment for a subset of AD patients who failed dupilumab treatment in daily practice. We found three different treatment response groups including responders, temporarily responders, and non-responders.</p

Baricitinib for atopic dermatitis patients who responded inadequately to dupilumab treatment:First daily practice results

Background: Baricitinib is the first JAK inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Efficacy and safety were shown in clinical trials, but daily practice data is sparse. Objectives: To evaluate the effectiveness and safety of baricitinib treatment in daily practice in AD patients who have inadequately responded to dupilumab. Methods: In this prospective observational cohort study, AD patients who failed dupilumab treatment and started baricitinib treatment in context of standard care at the Erasmus MC (the Netherlands) were included. We analysed physician-reported scores and patient-reported outcome measure scores (PROMs). Results: Twenty-five patients were included. Baricitinib treatment resulted in significant improvement of Eczema Area and Severity Index (EASI) scores and PROMs. Seven patients showed a good and sustained response (EASI50), eight patients showed no response (&lt;EASI50), and five patients showed an initial response but worsening of EASI scores in time. Overall, baricitinib was well tolerated. Four patients discontinued baricitinib treatment due to ineffectiveness or side effects. Conclusions: Baricitinib can be an effective treatment for a subset of AD patients who failed dupilumab treatment in daily practice. We found three different treatment response groups including responders, temporarily responders, and non-responders.</p

Upadacitinib treatment in a real-world difficult-to-treat atopic dermatitis patient cohort

Background: Upadacitinib was the first JAK-1 selective inhibitor registered for the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and safety have been shown in clinical trials, real-world data on the use of upadacitinib in patients that have been treated with other immunosuppressants and targeted therapies is limited. Objectives: To provide real-world evidence on the use of upadacitinib treatment in moderate-to-severe atopic dermatitis. Methods: In this prospective observational single-centre study, all AD patients treated with upadacitinib treatment in the context of standard care were included between August 2021 and September 2022. Clinical outcome measures and adverse events (AEs) were analysed. Results: Forty-eight patients were included. The majority (n = 39; 81%) had failed (ineffectiveness) on other targeted therapies, including other JAK inhibitors and biologics. Thirty-four (71%) patients were still using upadacitinib treatment at last follow up (median duration 46.5 weeks). Fourteen (29%) patients discontinued treatment due to ineffectiveness or AE. Upadacitinib treatment led to a significant decrease of disease severity during a median follow up of 37.5 weeks. Median IGA at baseline decreased from 3 (IQR 2–3) to 1.5 (IQR 1–2) at last review (p &lt; 0.001). Median NRS itch decreased from 7 (IQR 5–8) at baseline to 2.25 (IQR 0.25–6.5) at last review (p &lt; 0.001). Three patients discontinued treatment due to AE. Forty-eight AEs were reported, including acne-like eruptions (25%), nausea (13%) and respiratory tract infections (10%). Conclusions: In this real-world cohort, we confirmed that upadacitinib is an effective treatment in a subset of AD patients that have failed several previous systemic immunosuppressive and biologic treatments. Overall, AE were mostly well tolerated and not a reason to discontinue treatment for most patients.</p

Higher prevalence of dupilumab-induced ocular adverse events in atopic dermatitis compared to asthma:A daily practice analysis

Background: Dupilumab has been shown to be an effective treatment in moderate-to-severe atopic dermatitis (AD) and severe asthma (SA). However, comparative real-world analyses of adverse events (AE), particularly dupilumab-associated ocular surface disease (DAOSD), are lacking. Objective: This is the first real-world study to provide insight into the prevalence of AEs associated with dupilumab in AD compared with SA. Secondary objectives were to assess the prevalence, onset and therapeutic strategies of DAOSD and evaluate dupilumab discontinuation rates. Methods: Data from two daily practice registries including AD and SA patients receiving dupilumab treatment were analyzed. Adverse events, including DAOSD, were evaluated. Results: In total, 322 AD and 148 SA patients were included. Headaches (23.6%), injection site reactions (10.1%), and influenza-like symptoms (13.5%) were more prevalent in SA patients. Interestingly, ocular AEs were significantly more prevalent in AD patients (62.1%, p &lt; 0.001), including conjunctivitis (17.1%, p = 0.004). 88% AD and 47% SA patients with ocular AEs received one or more ophthalmic treatment(s). Additionally, 20% of AD and 17.6% of SA patients discontinued dupilumab treatment due to ocular AEs, while only 65% of these AD and none of these SA patients were referred to an ophthalmologist. Conclusion: The higher incidence of DAOSD in AD patients compared with SA patients in this real-world study highlights the importance of physician awareness, especially when prescribing dupilumab to AD patients. Conversely, the findings of this study help alleviate potential concerns about ocular AEs in patients with SA who do not have comorbid AD. Furthermore, the effective management of most ocular AEs with ophthalmic treatments suggests favorable tolerability of dupilumab in daily practice, and multidisciplinary collaboration is essential to proactively manage ocular AEs before discontinuing dupilumab.</p

Monetary reward increases attentional effort in the flanker task

An important question is whether monetary reward can increase attentional effort in order to improve performance. Up to now, evidence for a positive answer is weak. Therefore, in the present study, the flanker task was used to examine this question further. Participants had to respond sooner than a certain deadline in a flanker task. One group of participants received a performance-contingent monetary reward, whereas the other group earned a fixed amount of money. As a result, monetary reward significantly improved performance in comparison with the control group. The analysis of speed accuracy trade-off functions revealed that monetary reward increased attentional effort, leading to an enhanced quality of stimulus coding. Little evidence was found that reward also improved selective spatial attention

Guideline recommendations on minimal blood vessel diameters and arteriovenous fistula outcomes

Objective: Clinical guidelines provide recommendations on the minimal blood vessel diameters required for arteriovenous fistula creation but the evidence for these recommendations is limited. We compared vascular access outcomes of fistulas created in agreement with the ESVS Clinical Practice Guidelines (i.e. arteries and veins >2 mm for forearm fistulas and >3 mm for upper arm fistulas) with fistulas created outside these recommendations. Methods: The multicenter Shunt Simulation Study cohort contains 211 hemodialysis patients who received a first radiocephalic, brachiocephalic, or brachiobasilic fistula before publication of the ESVS Clinical Practice Guidelines. All patients had preoperative duplex ultrasound measurements according to a standardized protocol. Outcomes included duplex ultrasound findings at 6 weeks after surgery, vascular access function, and intervention rates until 1 year after surgery. Results: In 55% of patients, fistulas were created in agreement with the ESVS Clinical Practice Guidelines recommendations on minimal blood vessel diameters. Concordance with the guideline recommendations was more frequent for forearm fistulas than for upper arm fistulas (65% vs 46%, p = 0.01). In the entire cohort, agreement with the guideline recommendations was not associated with an increased proportion of functional vascular accesses (70% vs 66% for fistulas created within and outside guideline recommendations, respectively; p = 0.61) or with decreased access-related intervention rates (1.45 vs 1.68 per patient-year, p = 0.20). In forearm fistulas, however, only 52% of arteriovenous fistulas created outside these recommendations developed into a timely functional vascular access. Conclusions: Whereas upper arm arteriovenous fistulas with preoperative blood vessel diameters <3 mm had similar vascular access function as fistulas created with larger blood vessels, forearm arteriovenous fistulas with preoperative blood vessel diameters <2 mm had poor clinical outcomes. These results support that clinical decision-making should be guided by an individual approach

Soziale Tatherrschaft | Ein Beitrag zur Frage der Täterschaft in organisatorischen Machtapparaten

Die Begriffe Täterschaft und Teilnahme werden nach ganz herrschender Meinung anhand des Kriteriums "Tatherrschaft" voneinander abgegrenzt. Da eine Person nicht zugleich "frei" und "beherrscht" sein kann, rückt über den Begriff der (Tat-)Herrschaft der Begriff der Freiheit ins Zentrum der Fragestellung. Der klassischen Täterlehre liegt eine individualistische Freiheitskonzeption zugrunde, wie sie sich aus der Verantwortungskonzeption des Strafgesetzbuches ableiten lässt (§§ 17, 19-21, 35 StGB). Erteilt ein an der Spitze einer hierarchischen Organisation stehendes Leitungsorgan die Anweisung, eine Straftat zu begehen, und wird diese durch ein schuldhaft handelndes Organ ausgeführt, dann ist der die Straftat anordnende Hintermann Teilnehmer an der vom Ausführungsorgan täterschaftlich begangenen Tat. Entgegen diesem Zurechnungsergebnis wird aber von der Rechtsprechung und der ganz herrschenden Lehre versucht, die Täterschaft des sogenannten Schreibtischtäters zu begründen.Zielsetzung der Arbeit ist es, das darin zum Ausdruck gebrachte Vorverständnis der ganz herrschenden Meinung in der Strafrechtsdogmatik zu hinterfragen und es begrifflich zu klären. Im Ergebnis führt dies zur Aufgabe des individualistischen Freiheitsverständnisses und zur Einführung eines neuen Subjektverständnisses in die Strafrechtsdogmatik durch Begründung einer sozialen Tatherrschaftslehre