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With short-term interest rates at the zero lower bound, forward guidance has become a key tool for central bankers, and yet we know little about its effectiveness. This paper first empirically documents the impact of forward guidance announcements on a broad cross section of financial markets data and professional forecasts. We find that Federal Open Market Committee (FOMC) announcements containing forward guidance had heterogeneous effects depending on the other content of the statement. We show that once we control for these other elements, forward guidance had, on average, positive and meaningful effects on output and inflation expectations. Using this benchmark, we then show that standard medium-scale DSGE models tend to grossly overestimate the impact of forward guidance on the macroeconomy, a phenomenon we call the “forward guidance puzzle.” We explain why this is the case and show that incorporating a perpetual youth structure into the benchmark provides a possible resolution to the puzzle.

INTRODUCTION: Continuous neurological assessment in the pediatric intensive care unit (PICU) is challenging. Current electroencephalography (EEG) guidelines support monitoring status epilepticus, vasospasm detection, and cardiac arrest prognostication, but the scope of brain dysfunction in critically-ill patients is larger. We explore quantitative electroencephalography (QEEG) in PICU patients with neurological emergencies to identify QEEG changes preceding clinical detection. METHODS: From 2017 to 2020, we identified PICU patients at a single quaternary children’s hospital with EEG recording near or during acute neurological deterioration. QEEG analysis was performed using Persyst P14 (Persyst Development Corporation). Included features were FFT, asymmetry, and rhythmicity spectrograms, “from-baseline” patient-specific versions of above features, and quantitative suppression ratio. Timing of QEEG changes was determined by expert review and prespecified QEEG alert thresholds. Clinical detection of neurologic deterioration was defined pre-hoc and determined by Electronic Medical Record documentation of exam change or intervention. RESULTS: 10 patients were identified, age 23 months to 27 years, 50% female. Of 10 patients, 6 died, 1 had new morbidity, and 3 had good recovery; the most common cause of death was cerebral edema and herniation. The fastest changes were on “from-baseline” FFT spectrograms, while persistent changes on asymmetry spectrograms and suppression ratio were most associated with morbidity and mortality. Median time from first QEEG change to clinical detection was 332 min (Interquartile range: 201 -- 456 min). CONCLUSION: Quantitative EEG is potentially useful in earlier detection of neurological deterioration in critically-ill PICU patients. Further work is required to quantify the predictive value, measure improvement in outcome, and automate the process.

Supplemental Material, sj-pdf-1-jcn-10.1177_08830738211041824 for Pediatric Neurologists’ Perspectives on Sexual and Reproductive Health Care for Adolescent and Young Adult Women With Epilepsy and Intellectual Disability by Laura Kirkpatrick, Amy Collins, Elizabeth Harrison, Elizabeth Miller, Christina Patterson, Yoshimi Sogawa, Anne C. Van Cott and Traci M. Kazmerski in Journal of Child Neurology