Appropriate Financial Instruments for Public-Private Partnership to Boost Cross-Border Infrastructural Development-EU Experience

The member states of the European Union (EU) and the EU institutions have increasingly been using public-private partnerships (PPPs) to accelerate the development of (ambitious) trans-national infrastructure. This paper argues that in the EU (i) private sector partners remain risk-averse; and (ii) risk-pooling across a larger number of tax-payers tends to reduce the cost of risk to zero, making EU funds highly desirable and sought after for public infrastructure development. This paper argues that private equity has not been forthcoming to the extent that had been expected by those propagating this method of finance. In those instances where private non-publicly guaranteed resources have been used, the distribution of risks between public and private partners remained asymmetric, with public governmental bodies carrying the financial risks, which ultimately may become a contingent liability for the country’s public finances. However, EU and European Investment Bank (EIB) public funding is used not simply because the risks are spread more widely, but rather because EU rules and regulations for using such funds lead to better preparation of projects and greater efficiency gains in project implementation and delivery.public-private partnerships; trans-national infrastructure; european union institutions; european union; public infrastructure development

The time for rapid redevelopment of coal regions is now. CEPS Policy Insights 20 May 2020.

The economic slow-down caused by the pandemic will aggravate the existing stress in some regions, especially those relying on lignite, coal and peat as their main economic activity. But efficient and effective use of Covid-19 recovery funds can give real meaning to the ‘just transition’ concept if they focus on tangible progress to the benefit of the regional, national and EU economy while improving the environment and implementing the European Green Deal. For coal regions, the European Commission needs a regional place-based approach that builds on the ‘targeted approach’ of the European Green Deal while identifying urgent actions. Member states must reinforce regional strategies for coal regions in light of the recovery measures and the European Green Deal for the next multiannual financial framework 2021-27, taking account of the transition towards a more sustainable and lower carbon economic structure. Appropriate EU instruments should be combined in a complementary way to restructure the economies of the regions by developing low-carbon power and other carbon-saving solutions, using the know-how and infrastructures in place. Solid strategies to address the transition costs that creating an investment-friendly economic environment should be devised to build up self-sustainable activities and avoid subsidy dependency. The opportunities offered by InvestEU should be used as funding leverage to attract large-scale new industry investment. The short-term economic and social costs should soon be recovered. By contrast, supporting declining activities will most likely lead to significant long-term losses. Many good examples of conversions exist to inform those addressing inter- and intra-generational redistribution issues

Three-dimensional cardiac fibre disorganization as a novel parameter for ventricular arrhythmia stratification after myocardial infarction

Aims: Myocardial infarction (MI) alters cardiac fibre organization with unknown consequences on ventricular arrhythmia. We used diffusion tensor imaging (DTI) of three-dimensional (3D) cardiac fibres and scar reconstructions to identify the main parameters associated with ventricular arrhythmia inducibility and ventricular tachycardia (VT) features after MI. Methods and results: Twelve pigs with established MI and three controls underwent invasive electrophysiological characterization of ventricular arrhythmia inducibility and VT features. Animal-specific 3D scar and myocardial fibre distribution were obtained from ex vivo high-resolution contrast-enhanced T1 mapping and DTI sequences. Diffusion tensor imaging-derived parameters significantly different between healthy and scarring myocardium, scar volumes, and left ventricular ejection fraction (LVEF) were included for arrhythmia risk stratification and correlation analyses with VT features. Ventricular fibrillation (VF) was the only inducible arrhythmia in 4 out of 12 infarcted pigs and all controls. Ventricular tachycardia was also inducible in the remaining eight pigs during programmed ventricular stimulation. A DTI-based 3D fibre disorganization index (FDI) showed higher disorganization within dense scar regions of VF-only inducible pigs compared with VT inducible animals (FDI: 0.36; 0.36-0.37 vs. 0.32; 0.26-0.33, respectively, P = 0.0485). Ventricular fibrillation induction required lower programmed stimulation aggressiveness in VF-only inducible pigs than VT inducible and control animals. Neither LVEF nor scar volumes differentiated between VF and VT inducible animals. Re-entrant VT circuits were localized within areas of highly disorganized fibres. Moreover, the FDI within heterogeneous scar regions was associated with the median VT cycle length per animal (R2 = 0.5320). Conclusion: The amount of scar-related cardiac fibre disorganization in DTI sequences is a promising approach for ventricular arrhythmia stratification after MI.The CNIC (Madrid, Spain) is supported by the Ministry of Science, Innovation and Universities and the Pro CNIC Foundation. The CNIC and the BSC (Barcelona, Spain) are Severo Ochoa Centers of Excellence (SEV-2015-0505 and SEV-2011-0067, respectively). This study was supported by grants from Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional (RD12/0042/0036, CB16/11/00458), Spanish Ministry of Science, Innovation and Universities (SAF2016-80324-R, PI16/02110, and DTS17/00136), and by the European Commission [ERA-CVD Joint Call (JTC2016/APCIN-ISCIII-2016), grant#AC16/00021]. The study was also partially supported by the Fundacion Interhospitalaria para la Investigacion Cardiovascular (FIC, Madrid, Spain), the Spanish Society of Cardiology (Dr. Pedro Zarco award) and the Heart Rhythm section of the Spanish Society of Cardiology (DFR). J.J. is supported by R01 Grant HL122352 from the National Heart Lung and Blood Institute, USA National Institutes of Health. J.A.S. is funded by the CompBioMed project, H2020-EU.1.4.1.3 European Union's Horizon 2020 research and innovation programme, grant#675451. D.G.L. has received financial support through the 'la Caixa' Fellowship Grant for Doctoral Studies, 'la Caixa' Banking Foundation, Barcelona, Spain.S

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

The circle that cannot be squared. CEPS Commentary, 21 October 2010

This Commentary takes a close look at the recently leaked Commission’s Communication on the future of the CAP. The author finds it a carefully drafted document containing the usual CAP rhetoric punctuated by some apparently strong deviations from past doctrine. But once the objectives and policy proposals are reduced to their basic components, he discovers that much of the fizz disappears

Some reflections on the EU budget review. CEPS Commentary, 21 October 2010

In this review of the Commission’s Communication on the budget review, published on 19 October 2010, Jorge Núñez Ferrer finds that the proposals in general are healthy and commendable, but that the document has weaknesses, notably in its failure to address actual policies in any depth, especially agriculture, or to demonstrate any commitment to budgetary austerity. The latter oversight may prove particularly problematic in today’s atmosphere

Enlargement and Industrial Competitiveness: Policy Implications for New and Old Member States of the EU. CEPS Working Document No. 235, January 2006

This paper draws policy conclusions for the EU based on the studies performed for the Fifth Framework Programme on industrial competitiveness and other relevant literature. The issue of competitiveness of the new member states and the implications of enlargement for the EU as a whole and for individual member states is complex. This paper discusses the policy implications that result from the research undertaken in the context of this project and presents some additional considerations. Policy actions on industrial competitiveness may be taken at national or EU level. Understanding the positive and negative implications of specific policy interventions is very important, as national or sectoral interests can clash with an optimum EU policy. The paper generally recommends avoiding specific industrial policies, in particular at member state level, that would harm other member states. Industrial competitiveness depends heavily on the investment and economic climate in the member states. This paper recommends improving this climate and in particular completing the single market also for services

Goodbye, Agenda 2000 - Hello, Agenda 2003: Effects of the Berlin Summit on Own Resources, Expenditures and EU Net Balances. CEPS Working Document No. 140, February 2000

This paper describes the development of the negotiations from the birth of the Agenda 2000 proposals to the end of the Berlin European Council Summit and discusses the consequences of the outcome. The study shows to what extent net contributions to the EU budget and narrow national interests dominated the negotiations, at the expense of the original aims of the reforms (to prepare the Union for enlargement and for the next round of WTO negotiations), which were practically forgotten. This type of behaviour is by no means unique. On the contrary, it has been recurrent in the history of the EU. Estimates of future expenditures and own resources show that the Berlin European Council conclusions will prove to be far from satisfactory