scholarly journals Slow Debt, Deep Recessions

2022 ◽  
Vol 14 (1) ◽  
pp. 224-259
Author(s):  
Joachim Jungherr ◽  
Immo Schott

Business credit lags GDP growth by about one year. This contributes to high leverage during recessions and slow deleveraging. We show that a model in which firms use risky long-term debt replicates this slow adjustment of firm debt. In the model, slow-moving debt has important effects for real activity. High levels of firm debt issued during expansions are only gradually reduced during recessions. This generates an adverse feedback loop between high default rates and low investment and thereby amplifies the downturn. Sluggish deleveraging slows down the recovery. (JEL E23, E32, E44, G31, G32)

Subject Finland's economy. Significance The Finnish economy contracted from 2012 to 2014 and grew by only 0.5% last year. It has been facing both structural and cyclical headwinds and since 2010 three different governments have been unable to jump-start it. However, the current one-year-old Finnish government has staked much of its political capital on various reforms which are expected to lead to a resumption of growth and a slower increase in public debt. Impacts Due to demographic trends, Finland's long-term growth potential is estimated to be below 2%. Prolonged economic stagnation in the EU and Russia is likely to depress export and GDP growth. The pension age in Finland will increase automatically as life expectancy rises, which may be a model for other European countries.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 234-236
Author(s):  
P Willems ◽  
J Hercun ◽  
C Vincent ◽  
F Alvarez

Abstract Background The natural history of primary sclerosing cholangitis (PSC) in children seems to differ from PSC in adults. However, studies on this matter have been limited by short follow-up periods and inconsistent classification of patients with autoimmune cholangitis (AIC) (or overlap syndrome). Consequently, it remains unclear if long-term outcomes are affected by the clinical phenotype. Aims The aims of this is study are to describe the long-term evolution of PSC and AIC in a pediatric cohort with extension of follow-up into adulthood and to evaluate the influence of phenotype on clinical outcomes. Methods This is a retrospective study of patients with AIC or PSC followed at CHU-Sainte-Justine, a pediatric referral center in Montreal. All charts between January 1998 and December 2019 were reviewed. Patients were classified as either AIC (duct disease on cholangiography with histological features of autoimmune hepatitis) or PSC (large or small duct disease on cholangiography and/or histology). Extension of follow-up after the age of 18 was done for patients followed at the Centre hospitalier de l’Université de Montréal. Clinical features at diagnosis, response to treatment at one year and liver-related outcomes were compared. Results 40 patients (27 PSC and 13 AIC) were followed for a median time of 71 months (range 2 to 347), with 52.5% followed into adulthood. 70% (28/40) had associated inflammatory bowel disease (IBD) (78% PSC vs 54% AIC; p=0.15). A similar proportion of patients had biopsy-proven significant fibrosis at diagnosis (45% PSC vs 67% AIC; p=0.23). Baseline liver tests were similar in both groups. At diagnosis, all patients were treated with ursodeoxycholic acid. Significantly more patients with AIC (77% AIC vs 30 % PSC; p=0.005) were initially treated with immunosuppressive drugs, without a significant difference in the use of Anti-TNF agents (0% AIC vs 15% PSC; p= 0.12). At one year, 55% (15/27) of patients in the PSC group had normal liver tests versus only 15% (2/13) in the AIC group (p=0.02). During follow-up, more liver-related events (cholangitis, liver transplant and cirrhosis) were reported in the AIC group (HR=3.7 (95% CI: 1.4–10), p=0.01). Abnormal liver tests at one year were a strong predictor of liver-related events during follow-up (HR=8.9(95% CI: 1.2–67.4), p=0.03), while having IBD was not (HR=0.48 (95% CI: 0.15–1.5), p=0.22). 5 patients required liver transplantation with no difference between both groups (8% CAI vs 15% CSP; p=0.53). Conclusions Pediatric patients with AIC and PSC show, at onset, similar stage of liver disease with comparable clinical and biochemical characteristics. However, patients with AIC receive more often immunosuppressive therapy and treatment response is less frequent. AIC is associated with more liver-related events and abnormal liver tests at one year are predictor of bad outcomes. Funding Agencies None


2021 ◽  
Vol 7 ◽  
pp. 237802312110247
Author(s):  
Alexandrea J. Ravenelle ◽  
Abigail Newell ◽  
Ken Cai Kowalski

The authors explore media distrust among a sample of precarious and gig workers interviewed during the COVID-19 pandemic. Although these left-leaning respondents initially increased their media consumption at the outset of the pandemic, they soon complained of media sensationalism and repurposed a readily available cultural tool: claims of “fake news.” As a result, these unsettled times have resulted in a “diffusion of distrust,” in which an elite conservative discourse of skepticism toward the media has also become a popular form of compensatory control among self-identified liberals. Perceiving “fake news” and media sensationalism as “not good” for their mental health, respondents also reported experiencing media burnout and withdrawing from media consumption. As the pandemic passes its one-year anniversary, this research has implications for long-term media coverage on COVID-19 and ongoing media trust and consumption.


Fire Ecology ◽  
2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Jessie M. Dodge ◽  
Eva K. Strand ◽  
Andrew T. Hudak ◽  
Benjamin C. Bright ◽  
Darcy H. Hammond ◽  
...  

Abstract Background Fuel treatments are widely used to alter fuels in forested ecosystems to mitigate wildfire behavior and effects. However, few studies have examined long-term ecological effects of interacting fuel treatments (commercial harvests, pre-commercial thinnings, pile and burning, and prescribed fire) and wildfire. Using annually fitted Landsat satellite-derived Normalized Burn Ratio (NBR) curves and paired pre-fire treated and untreated field sites, we tested changes in the differenced NBR (dNBR) and years since treatment as predictors of biophysical attributes one and nine years after the 2007 Egley Fire Complex in Oregon, USA. We also assessed short- and long-term fuel treatment impacts on field-measured attributes one and nine years post fire. Results One-year post-fire burn severity (dNBR) was lower in treated than in untreated sites across the Egley Fire Complex. Annual NBR trends showed that treated sites nearly recovered to pre-fire values four years post fire, while untreated sites had a slower recovery rate. Time since treatment and dNBR significantly predicted tree canopy and understory green vegetation cover in 2008, suggesting that tree canopy and understory vegetation cover increased in areas that were treated recently pre fire. Live tree density was more affected by severity than by pre-fire treatment in either year, as was dead tree density one year post fire. In 2008, neither treatment nor severity affected percent cover of functional groups (shrub, graminoid, forb, invasive, and moss–lichen–fungi); however, by 2016, shrub, graminoid, forb, and invasive cover were higher in high-severity burn sites than in low-severity burn sites. Total fuel loads nine years post fire were higher in untreated, high-severity burn sites than any other sites. Tree canopy cover and density of trees, saplings, and seedlings were lower nine years post fire than one year post fire across treatments and severity, whereas live and dead tree basal area, understory surface cover, and fuel loads increased. Conclusions Pre-fire fuel treatments effectively lowered the occurrence of high-severity wildfire, likely due to successful pre-fire tree and sapling density and surface fuels reduction. This study also quantified the changes in vegetation and fuels from one to nine years post fire. We suggest that low-severity wildfire can meet prescribed fire management objectives of lowering surface fuel accumulations while not increasing overstory tree mortality.


Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.


Vascular ◽  
2020 ◽  
pp. 170853812098112
Author(s):  
Cassra N Arbabi ◽  
Navyash Gupta ◽  
Ali Azizzadeh

Objectives Thoracic endovascular aortic repair (TEVAR) is the standard of care for descending thoracic aortic aneurysms (DTAA), and newer generation stent grafts have significant design improvements compared to earlier generation devices. Methods We report the first commercial use of the Medtronic Valiant Navion stent graft for treatment of an 85-year-old woman with a 5.8 cm DTAA and a highly tortuous thoracic aorta. Results A percutaneous TEVAR was performed using a two-piece combination of the Valiant Navion FreeFlo and CoveredSeal stent graft configurations for zones 2–5 coverage. The devices were successfully delievered through highly tortuous anatomy and deployed, excluding the entire length of the aneurysm with precise landing, excellent apposition and no evidence of endoleak. The patient tolerated the procedure well and has had no stent graft-related complications through one-year follow-up. Conclusions Design enhancements such as a lower profile delivery system, better conformability, and a shorter tapered tip are some of the improvements to this third-generation TEVAR device. Coupled with the multiple configuration options available, this gives physicians a better tool to treat thoracic aortic pathologies in patients with challenging anatomy. The early results are encouraging, and evaluation of long-term outcomes will continue.


Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract


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