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A significant proportion of patients with retinal vein occlusion (RVO) are antiphospholipid antibodies (aPL) carriers. Relapsing disease occurs in nearly 10 % of cases and the role of aPL has not been established. The adjusted global antiphospholipid syndrome score (aGAPSS) was developed to assess the risk of clinical events in aPL carriers and its role in the management of RVO patients is unknown.To analyze the values of aGAPSS in a large cohort of patients with RVO and population-based controls, and to assess its usefulness to predict RVO relapses.Case-control study of RVO patients and population-based controls of similar age and sex. We have assessed and compared the aPL profile and the aGAPSS score in patients with and without relapsing disease and controls.Four-hundred and seventy-two RVO patients and 346 controls were included. Fifty-seven RVO patients had antiphospholipid syndrome (RVO-APS). Of them, 75.4 % had a high-risk profile compared to 3 % in controls (p = 0.0001). The median aGAPSS values were 8 [7-13], 3 [1-4], and 3 [0-4], in RVO-APS, RVO no-APS, and controls. Nineteen patients had had a recurrence of RVO before inclusion and 8 during the follow-up. APS was more prevalent in relapsing patients. In the adjusted multivariable regression model, the best predictor for RVO recurrence during the follow-up was an aGAPSS score ≥6 (OR 5.5, CI95% 1.3-23.7; p = 0.023).In patients with RVO, once the control of vascular risk factors has been optimized, the aGAPSS might help to identify those at risk of relapsing disease.

Using board reforms in 41 countries and staggered difference-in-differences (DiD) estimates, Fauver, Hung, Li, and Taboada (2017, FHLT) find that firm value increases following the reforms. In a study that reviews the recent econometric theory on staggered DiD estimations, Baker, Larcker, and Wang (2021, BLW) contest the robustness of FHLT’s results. They conclude that FHLT’s results become mostly insignificant using alternative approaches that address the biases suggested by this recent theory. However, we find that the insignificant findings in BLW’s analysis are largely due to selective modifications that BLW made to FHLT’s data and model specifications, which resulted in low power tests. Importantly, these changes, which were not transparently disclosed in BLW, largely explain the insignificant results reported in BLW, even before implementing the new econometric approaches. Thus, in this study, we perform a battery of tests that apply alternative approaches that address the biases suggested in this recent literature. In contrast to the conclusions in BLW, we find that FHLT’s results remain significant. Our findings reinforce the conclusion of FHLT that board reforms increase firm value and highlight the importance of fair data representation when applying modified staggered DiD methods.

We examine the spillover and direct effects of cross-border bank M&As on the systemic risk of banks in the target’s country. We document that higher cross-border bank M&A activity is associated with higher systemic risk for peer banks, while target banks exhibit a decrease in systemic risk post-merger. The effect is stronger for deals involving large acquirers from developed countries and from countries with weaker regulatory quality than the target’s country. Our data suggest that the channels for these effects are reductions in peer banks’ market value of equity and income diversity and an increase in market value of equity for target banks post-merger relative to the control group. Our findings show destabilizing effects of cross-border bank M&As that stem from improvements in the quality of the target banks that exert pressure on peer banks.

Background: The prognosis of a patient with Covid-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making. Methods: A retrospective study was performed of patients admitted with Covid-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, analytical, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance. Findings: During the study period 1,152 patients presented with Covid-19 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 hours of admission were identified: Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤5%, 6-25%, and >25% exhibited disease progression, respectively. Interpretation: A simple risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis. Funding Statement: This project was funded by the Carlos III Health Institute, Spain, Grant/Award Number: COV20/00404; Ministry of Economy and Competitiveness (SPAIN) and the European Regional Development Fund (FEDER). Declaration of Interests: The authors declare no conflicts of interest associated with this publication. Ethics Approval Statement: The study was conducted in accordance with the guidelines of the Declaration of Helsinki and the principles of good clinical practice and was approved by the Institutional Review Board (IRB) of the Galician Health Service on April 3, 2020 (#2020/194). Informed consent forms were waived by the IRB.

Background: The simplicity and low cost of rapid point-of-care tests greatly facilitate large-scale population testing, which can contribute to controlling the spread of the COVID-19 virus. Methods: Between April and May 2020, the applicability of a self-testing strategy for SARS-CoV2 detection was evaluated in a population-based, cross-sectional study in Cantabria, Spain. For the self-testing strategy, participants received the necessary material for blood self-collection and performance of a rapid antibodies test using lateral flow immunoassay at home without the supervision of healthcare personnel. Findings: A total of 1,022 participants were enrolled. The vast majority of participants correctly performed the COVID-19 self-test the first time (91.3% [95% IC 89.4-92.9]). Only a minority of participants (0.7%) needed the help of healthcare personnel, and 6.9% required a second kit delivery, for a total valid test result in 96.9% of the participants. Incorrect use of the self-test did not depend on the educational level, age over 65 years, or housing area. Prevalence of IgG antibodies against SARS-CoV2 for subjects with a valid rapid test result was 3.1% (95% IC 2.2-4.4), similar to the seroprevalence result obtained using a conventional approach carried out by healthcare professionals. Interpretation: A strategy of COVID-19 self-testing could be applied as a screening tool in surveillance programs. Funding Statement: No funding. Declaration of Interests: The authors report no relevant conflict of interest or disclosures relevant to this manuscript. Ethics Approval Statement: The Ethics Committee of investigation of Cantabria approved this study (code 2020.176) and written informed consent was obtained from all participants.

Using a sample of 3,964 bank mergers during the 1999-2016 period, we examine the effects of merger and local market characteristics on local small business lending through banks’ dependence on soft information acquisition relative to technology driven lending. Mergers involving small or in-state acquirers are positively associated with small business loan (SBL) originations in counties where the target bank has a presence, particularly in counties with a larger number of small firms. In contrast, mergers involving large acquirers are associated with fewer SBL originations while those involving out-of-state acquirers have no impact on SBL originations. Analyses of acquirer bank SBL origination activity post-merger corroborate our county-level results. Post-merger, small bank acquirers increase in SBL originations, while large acquirers do not. Examining the behavior of local competitor banks shows that competitors of small acquirers decrease SBL originations, partially offsetting the positive effect associated small bank acquirers. Taken together, our findings underscore the importance of soft information acquisition in small business lending and suggest one-size-fits-all policy solutions are not likely to lead to common outcomes at the local level. Encouraging mergers by small banks and by in-state acquirers can positively affect small business lending and community investment, particularly in counties with a large fraction of small firms.

Using a sample of 469 banks from 39 countries between 2008 and 2017 and a generalized difference-in-differences methodology, we show that board gender quota laws lead to increased female board representation. We find an increase in risk taking and systemic risk and worse long-run operating performance post quota law for banks most impacted by the reforms, and those located in countries with a smaller pool of qualified women executives. Results suggest that the addition of younger and less experienced female board members to important board committees due labor market constraints drive the risk taking and performance outcomes.

In this paper, we examine the impact of adopting macroprudential policies on bank risk taking and systemic risk. Using a difference-in-differences (DiD) design and a sample of 3,342 banks from 77 countries over the period 1997-2016, we find that macroprudential policy instruments mitigate bank risk taking and lower systemic risk. The mitigation depends on the policy target. We find borrower-targeted policies are effective, while policies targeting financial institutions’ assets or liabilities are not effective. We find the impact of borrower-targeted macroprudential policies on systemic risk is stronger in countries with more closed economies and those with tighter restrictions on bank activities. We find some evidence of a reduction in the effectiveness of policies adopted after the global financial crisis (GFC). Our results are robust to a battery of tests.

Some argue too-big-to-fail (TBTF) status increases the value of the largest banks. In contrast, we find that the value of the largest banks is negatively related to asset size in normal times, but much less so during the crisis. Further, shareholders lose when large banks cross a TBTF threshold through acquisitions. The negative relation between bank value and bank size for the largest banks cannot be explained by differences in ROA, ROE, equity volatility, tail risk, distress risk, or equity discount rates, but it can be partly explained by the market’s discounting of trading activities. Received December 20, 2017; editorial decision November 14, 2018 by Editor Itay Goldstein.

We examine the valuation impact of employee-friendly (EF) culture. Using a sample of 3,457 firms from 43 countries for the period 2003 to 2014, we show that firms with a more EF culture have higher valuations (Tobin’s q). The impact on valuation stems from improved technical efficiency and higher profitability. Consistent with the good governance view, we find that the positive valuation impact of an EF culture is larger for firms in countries with better investor protection, for firms with better governance and fewer agency problems, and for those in high-tech and in labor-intensive industries.

We investigate whether the value of large banks, defined as banks with assets in excess of the Dodd-Frank threshold for enhanced supervision, increases with the size of their assets using Tobin’s q and market-to-book as our valuation measures. Many argue that large banks receive subsidies from the regulatory safety net, so they should be worth more and their valuation should increase with size. Instead, using a variety of approaches, we find (1) no evidence that large banks are valued more highly, (2) strong cross-sectional evidence that the valuation of large banks falls with size, and (3) strong evidence of a within-bank negative relation between valuation and size for large banks from 1987 to 2006 but not when the post-Dodd-Frank period is included in the sample. The negative relation between bank value and bank size for large banks cannot be systematically explained by differences in ROA or ROE, equity volatility, tail risk, distress risk, and equity discount rates. However, we find that banks with more trading assets are worth less. A 1% increase in trading assets is associated with a Tobin’s q lower by 0.2% in regressions with year and bank fixed effects. This relation between bank value and trading assets helps explain the cross-sectional negative relation between large bank valuation and size. Our results hold when we use instrumental variables for bank size.