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You can only respond using information in the context block.
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What is the difference between supply-side economics and trickle-down economics?
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In this paper I discuss what can be learned about “trickle-down” ideas from recent empirical evidence on tax incidence. Tax incidence, defined as the effect of tax policies on the distribution of welfare, provides an ideal framework because of the explicit focus on tracing the impacts of a policy beyond the directly affected group (ex. the rich). I arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude with a discussion of fruitful avenues of further research, particularly on how tax incidence depends on various institutional features of labor markets, product markets and tax systems. There are two ideas of government. There are those who believe that if you just legislate to make the well-to-do prosperous, that their prosperity will leak through on those below. The Democratic idea has been that if you legislate to make the masses prosperous their prosperity will find its way up and through every class that rests upon it. - William Jennings Bryan (1896) 1 to the needy. Mr. Hoover was an engineer. He knew that water trickles down. Put it uphill and let it go and it will reach the driest little spot. But he didn’t know that money trickled up. Give it to the people at the bottom and the people at the top will have it before night, anyhow. But it will at least have passed through the poor fellow’s hands. They saved the big banks, but the little ones went up the flue. - Will Rogers (1932), first use of “trickle down” The idea of “trickle-down” originated from political debates to describe the economic policies of a party or politician. There was never a formal concept of “trickle-down economics” in the sense of economic theory. The term-of-art was used to describe policies that directly benefited to rich but were justified by arguments they would ultimately also benefit the middle class and poor. In fact, the term was not originally used by those advocating for such policies, but as a critique of the political discourse promoting such policies. While the term “trickle-down” was not used by William Jennings Bryan in his 1896 speech as he was running for president, the rhetoric was present in the introductory quote above. The term was first introduced by humorist and vaudville performer Will Rogers in a column critiquing then-President Herbert Hoover’s economic policies, also quoted above. The term, and the critique it embodied, stuck with politicians and parties that promoted economic policies where the direct benefits were for the rich, particularly those with respect to tax policies.1 The relationship between trickle-down ideas, tax policy and economics was secured during the Ronald Reagan administration, when the proposed tax cuts where linked to the recently articulated “supply-side” economic theory. Supply-side economics, broadly developed around the ideas of economists Robert Mundell and Arthur Laffer, focused on growth through reducing marginal income tax rates and promoting investment 1William J. Bennett, a conservative politician who served in the administrations of Ronald Reagan and George H. W. Bush, lamented in his 2007 book, “Humorist Will Rogers referred to the theory that cutting taxes for higher earners and businesses was a ”trickle-down” policy, a term that has stuck over the years.” 2 through lower capital income tax rates and deregulation. These ideas had a natural relationship with trickle-down ideas in that the direct beneficiaries of lower marginal and capital tax rates were disproportionately the rich - those that faced the highest marginal tax rates and disproportionately owned the capital - but the theory stated that this would ultimately benefit lower income consumers/workers through growth (led by capital investment), employment and lower prices. The Reagan administration turned to “supply-side” rhetoric to promote large marginal rate and business income tax cuts, and the concepts of supply-side and trickle-down tax policies have been linked since.2 Figure 1 shows the Google Trends of the term “trickle down” since 2005, and reveals that spikes in its use are concentrated around changes in tax policy or U.S. presidential elections where tax policy was on the agenda. 1.2. Economic Analysis of Trickle-Down In this article I will discuss the idea of trickle-down as it relates to taxes. I will focus on tax policies that have direct effects on the rich and capital owners - tax rates faced by high income households and capital tax policies specifically related to growth (supply-side) - with a focus on how the effects of these policies “trickle down” to lower income households or workers. Given that trickle-down originated as a political debate, I will discuss both positive analyses of these policies and normative frameworks that apply to the policies. Given this, the best economic framework to study these questions is the theory of tax incidence. Tax incidence is the study of the impact of taxes on the distribution of welfare, 3 and it derives from the insight that the person or entity with the the legal or statutory obligation to make the tax payment may not be the only one whose welfare is affected by the tax. In this way, the study of tax incidence maps directly onto trickle-down ideas by taking the direct or statutory beneficiary of the tax policy and following how it affects the distribution of welfare across the economy (whom does it trickle to?). Therefore, this paper will frame trickle-down ideas through positive and normative applications of tax incidence. I focus primarily on new empirical research about how taxing capital or the rich affect “the distribution of welfare.” Various economic models offer competing predictions about whether to expect that taxing capital owners at the top of the income distribution affects lower earning workers, if so, in what direction and by what channel. In the wake of this, some supply-side advocates have lamented how it has been used to promote trickledown ideas. In a 2007 article titled, How Supply-Side Economics Trickled Down, Bruce Bartlett, a former Reagan advisor wrote, “most accept the basic ideas of supply-side economics – that incentives matter, that high tax rates are bad for growth, and that inflation is fundamentally a monetary phenomenon. . . . Today, supply-side economics has become associated with an obsession for cutting taxes under any and all circumstances. No longer do its advocates in Congress and elsewhere confine themselves to cutting marginal tax rates – the tax on each additional dollar earned – as the original supply-siders did. Rather, they support even the most gimmicky, economically dubious tax cuts with the same intensity. ... today it is common to hear tax cutters claim, implausibly, that all tax cuts raise revenue.” Yet, another former Reagan advisor David Stockman has issued a competing complaint arguing that supply-side economics was always a cover for trickle-down ideas stating, “It’s kind of hard to sell ’trickle down,’ so the supply-side formula was the only way to get a tax policy that was really ’trickle down.’ Supply-side is ’trickle-down’ theory.” Therefore, it is ultimately an empirical question as to whether, and how, changes in these tax rates affect workers. Advances in data quality, particularly administrative linked firm-worker data, econometric methods for identifying causal effects of tax policies, and micro-economic theory on product and labor markets have led to new insights about whether and how taxes that directly affect the rich / capital owners ultimately affect lower earning workers. I review this new literature according to themes related to trickle-down and supply-side tax ideas and arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude by arguing that from a policy standpoint, considering who bears the burden of a tax in isolation is insufficient for addressing trickle-down ideas or critiques and advocate for a more unified discussion of the efficiency and equity consequences of both tax and spending policies.
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You can only respond using information in the context block.] What is the difference between supply-side economics and trickle-down economics? In this paper I discuss what can be learned about “trickle-down” ideas from recent empirical evidence on tax incidence. Tax incidence, defined as the effect of tax policies on the distribution of welfare, provides an ideal framework because of the explicit focus on tracing the impacts of a policy beyond the directly affected group (ex. the rich). I arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude with a discussion of fruitful avenues of further research, particularly on how tax incidence depends on various institutional features of labor markets, product markets and tax systems. There are two ideas of government. There are those who believe that if you just legislate to make the well-to-do prosperous, that their prosperity will leak through on those below. The Democratic idea has been that if you legislate to make the masses prosperous their prosperity will find its way up and through every class that rests upon it. - William Jennings Bryan (1896) 1 to the needy. Mr. Hoover was an engineer. He knew that water trickles down. Put it uphill and let it go and it will reach the driest little spot. But he didn’t know that money trickled up. Give it to the people at the bottom and the people at the top will have it before night, anyhow. But it will at least have passed through the poor fellow’s hands. They saved the big banks, but the little ones went up the flue. - Will Rogers (1932), first use of “trickle down” The idea of “trickle-down” originated from political debates to describe the economic policies of a party or politician. There was never a formal concept of “trickle-down economics” in the sense of economic theory. The term-of-art was used to describe policies that directly benefited to rich but were justified by arguments they would ultimately also benefit the middle class and poor. In fact, the term was not originally used by those advocating for such policies, but as a critique of the political discourse promoting such policies. While the term “trickle-down” was not used by William Jennings Bryan in his 1896 speech as he was running for president, the rhetoric was present in the introductory quote above. The term was first introduced by humorist and vaudville performer Will Rogers in a column critiquing then-President Herbert Hoover’s economic policies, also quoted above. The term, and the critique it embodied, stuck with politicians and parties that promoted economic policies where the direct benefits were for the rich, particularly those with respect to tax policies.1 The relationship between trickle-down ideas, tax policy and economics was secured during the Ronald Reagan administration, when the proposed tax cuts where linked to the recently articulated “supply-side” economic theory. Supply-side economics, broadly developed around the ideas of economists Robert Mundell and Arthur Laffer, focused on growth through reducing marginal income tax rates and promoting investment 1William J. Bennett, a conservative politician who served in the administrations of Ronald Reagan and George H. W. Bush, lamented in his 2007 book, “Humorist Will Rogers referred to the theory that cutting taxes for higher earners and businesses was a ”trickle-down” policy, a term that has stuck over the years.” 2 through lower capital income tax rates and deregulation. These ideas had a natural relationship with trickle-down ideas in that the direct beneficiaries of lower marginal and capital tax rates were disproportionately the rich - those that faced the highest marginal tax rates and disproportionately owned the capital - but the theory stated that this would ultimately benefit lower income consumers/workers through growth (led by capital investment), employment and lower prices. The Reagan administration turned to “supply-side” rhetoric to promote large marginal rate and business income tax cuts, and the concepts of supply-side and trickle-down tax policies have been linked since.2 Figure 1 shows the Google Trends of the term “trickle down” since 2005, and reveals that spikes in its use are concentrated around changes in tax policy or U.S. presidential elections where tax policy was on the agenda. 1.2. Economic Analysis of Trickle-Down In this article I will discuss the idea of trickle-down as it relates to taxes. I will focus on tax policies that have direct effects on the rich and capital owners - tax rates faced by high income households and capital tax policies specifically related to growth (supply-side) - with a focus on how the effects of these policies “trickle down” to lower income households or workers. Given that trickle-down originated as a political debate, I will discuss both positive analyses of these policies and normative frameworks that apply to the policies. Given this, the best economic framework to study these questions is the theory of tax incidence. Tax incidence is the study of the impact of taxes on the distribution of welfare, 3 and it derives from the insight that the person or entity with the the legal or statutory obligation to make the tax payment may not be the only one whose welfare is affected by the tax. In this way, the study of tax incidence maps directly onto trickle-down ideas by taking the direct or statutory beneficiary of the tax policy and following how it affects the distribution of welfare across the economy (whom does it trickle to?). Therefore, this paper will frame trickle-down ideas through positive and normative applications of tax incidence. I focus primarily on new empirical research about how taxing capital or the rich affect “the distribution of welfare.” Various economic models offer competing predictions about whether to expect that taxing capital owners at the top of the income distribution affects lower earning workers, if so, in what direction and by what channel. In the wake of this, some supply-side advocates have lamented how it has been used to promote trickledown ideas. In a 2007 article titled, How Supply-Side Economics Trickled Down, Bruce Bartlett, a former Reagan advisor wrote, “most accept the basic ideas of supply-side economics – that incentives matter, that high tax rates are bad for growth, and that inflation is fundamentally a monetary phenomenon. . . . Today, supply-side economics has become associated with an obsession for cutting taxes under any and all circumstances. No longer do its advocates in Congress and elsewhere confine themselves to cutting marginal tax rates – the tax on each additional dollar earned – as the original supply-siders did. Rather, they support even the most gimmicky, economically dubious tax cuts with the same intensity. ... today it is common to hear tax cutters claim, implausibly, that all tax cuts raise revenue.” Yet, another former Reagan advisor David Stockman has issued a competing complaint arguing that supply-side economics was always a cover for trickle-down ideas stating, “It’s kind of hard to sell ’trickle down,’ so the supply-side formula was the only way to get a tax policy that was really ’trickle down.’ Supply-side is ’trickle-down’ theory.” Therefore, it is ultimately an empirical question as to whether, and how, changes in these tax rates affect workers. Advances in data quality, particularly administrative linked firm-worker data, econometric methods for identifying causal effects of tax policies, and micro-economic theory on product and labor markets have led to new insights about whether and how taxes that directly affect the rich / capital owners ultimately affect lower earning workers. I review this new literature according to themes related to trickle-down and supply-side tax ideas and arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude by arguing that from a policy standpoint, considering who bears the burden of a tax in isolation is insufficient for addressing trickle-down ideas or critiques and advocate for a more unified discussion of the efficiency and equity consequences of both tax and spending policies.
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You can only respond using information in the context block.
EVIDENCE:
In this paper I discuss what can be learned about “trickle-down” ideas from recent empirical evidence on tax incidence. Tax incidence, defined as the effect of tax policies on the distribution of welfare, provides an ideal framework because of the explicit focus on tracing the impacts of a policy beyond the directly affected group (ex. the rich). I arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude with a discussion of fruitful avenues of further research, particularly on how tax incidence depends on various institutional features of labor markets, product markets and tax systems. There are two ideas of government. There are those who believe that if you just legislate to make the well-to-do prosperous, that their prosperity will leak through on those below. The Democratic idea has been that if you legislate to make the masses prosperous their prosperity will find its way up and through every class that rests upon it. - William Jennings Bryan (1896) 1 to the needy. Mr. Hoover was an engineer. He knew that water trickles down. Put it uphill and let it go and it will reach the driest little spot. But he didn’t know that money trickled up. Give it to the people at the bottom and the people at the top will have it before night, anyhow. But it will at least have passed through the poor fellow’s hands. They saved the big banks, but the little ones went up the flue. - Will Rogers (1932), first use of “trickle down” The idea of “trickle-down” originated from political debates to describe the economic policies of a party or politician. There was never a formal concept of “trickle-down economics” in the sense of economic theory. The term-of-art was used to describe policies that directly benefited to rich but were justified by arguments they would ultimately also benefit the middle class and poor. In fact, the term was not originally used by those advocating for such policies, but as a critique of the political discourse promoting such policies. While the term “trickle-down” was not used by William Jennings Bryan in his 1896 speech as he was running for president, the rhetoric was present in the introductory quote above. The term was first introduced by humorist and vaudville performer Will Rogers in a column critiquing then-President Herbert Hoover’s economic policies, also quoted above. The term, and the critique it embodied, stuck with politicians and parties that promoted economic policies where the direct benefits were for the rich, particularly those with respect to tax policies.1 The relationship between trickle-down ideas, tax policy and economics was secured during the Ronald Reagan administration, when the proposed tax cuts where linked to the recently articulated “supply-side” economic theory. Supply-side economics, broadly developed around the ideas of economists Robert Mundell and Arthur Laffer, focused on growth through reducing marginal income tax rates and promoting investment 1William J. Bennett, a conservative politician who served in the administrations of Ronald Reagan and George H. W. Bush, lamented in his 2007 book, “Humorist Will Rogers referred to the theory that cutting taxes for higher earners and businesses was a ”trickle-down” policy, a term that has stuck over the years.” 2 through lower capital income tax rates and deregulation. These ideas had a natural relationship with trickle-down ideas in that the direct beneficiaries of lower marginal and capital tax rates were disproportionately the rich - those that faced the highest marginal tax rates and disproportionately owned the capital - but the theory stated that this would ultimately benefit lower income consumers/workers through growth (led by capital investment), employment and lower prices. The Reagan administration turned to “supply-side” rhetoric to promote large marginal rate and business income tax cuts, and the concepts of supply-side and trickle-down tax policies have been linked since.2 Figure 1 shows the Google Trends of the term “trickle down” since 2005, and reveals that spikes in its use are concentrated around changes in tax policy or U.S. presidential elections where tax policy was on the agenda. 1.2. Economic Analysis of Trickle-Down In this article I will discuss the idea of trickle-down as it relates to taxes. I will focus on tax policies that have direct effects on the rich and capital owners - tax rates faced by high income households and capital tax policies specifically related to growth (supply-side) - with a focus on how the effects of these policies “trickle down” to lower income households or workers. Given that trickle-down originated as a political debate, I will discuss both positive analyses of these policies and normative frameworks that apply to the policies. Given this, the best economic framework to study these questions is the theory of tax incidence. Tax incidence is the study of the impact of taxes on the distribution of welfare, 3 and it derives from the insight that the person or entity with the the legal or statutory obligation to make the tax payment may not be the only one whose welfare is affected by the tax. In this way, the study of tax incidence maps directly onto trickle-down ideas by taking the direct or statutory beneficiary of the tax policy and following how it affects the distribution of welfare across the economy (whom does it trickle to?). Therefore, this paper will frame trickle-down ideas through positive and normative applications of tax incidence. I focus primarily on new empirical research about how taxing capital or the rich affect “the distribution of welfare.” Various economic models offer competing predictions about whether to expect that taxing capital owners at the top of the income distribution affects lower earning workers, if so, in what direction and by what channel. In the wake of this, some supply-side advocates have lamented how it has been used to promote trickledown ideas. In a 2007 article titled, How Supply-Side Economics Trickled Down, Bruce Bartlett, a former Reagan advisor wrote, “most accept the basic ideas of supply-side economics – that incentives matter, that high tax rates are bad for growth, and that inflation is fundamentally a monetary phenomenon. . . . Today, supply-side economics has become associated with an obsession for cutting taxes under any and all circumstances. No longer do its advocates in Congress and elsewhere confine themselves to cutting marginal tax rates – the tax on each additional dollar earned – as the original supply-siders did. Rather, they support even the most gimmicky, economically dubious tax cuts with the same intensity. ... today it is common to hear tax cutters claim, implausibly, that all tax cuts raise revenue.” Yet, another former Reagan advisor David Stockman has issued a competing complaint arguing that supply-side economics was always a cover for trickle-down ideas stating, “It’s kind of hard to sell ’trickle down,’ so the supply-side formula was the only way to get a tax policy that was really ’trickle down.’ Supply-side is ’trickle-down’ theory.” Therefore, it is ultimately an empirical question as to whether, and how, changes in these tax rates affect workers. Advances in data quality, particularly administrative linked firm-worker data, econometric methods for identifying causal effects of tax policies, and micro-economic theory on product and labor markets have led to new insights about whether and how taxes that directly affect the rich / capital owners ultimately affect lower earning workers. I review this new literature according to themes related to trickle-down and supply-side tax ideas and arrive at three main lessons. First, recent evidence finds that business income taxes do affect the earnings of workers, but these effects are mostly a result of rent-sharing and taxation of rents, not from traditional supply-side channels. Second, there are systematic differences in the types of workers that are affected by the tax policies, so to understand how taxing businesses or business owners affects the distribution of welfare, it is not sufficient to treat workers/labor as a class. Third, across different income tax policies that statutorily affect the rich, the burden is generally ultimately born by the rich. I conclude by arguing that from a policy standpoint, considering who bears the burden of a tax in isolation is insufficient for addressing trickle-down ideas or critiques and advocate for a more unified discussion of the efficiency and equity consequences of both tax and spending policies.
USER:
What is the difference between supply-side economics and trickle-down economics?
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
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Respond to the following question with only the information I provide within this prompt, your answer should be two paragraphs long.
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Why is Mr Lloyd's strategy unusual?
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A. INTRODUCTION 1. Mr Richard Lloyd - with financial backing from Therium Litigation Funding IC, a commercial litigation funder - has issued a claim against Google LLC, alleging breach of its duties as a data controller under section 4(4) of the Data Protection Act 1998 (“the DPA 1998”). The claim alleges that, for several months in late 2011 and early 2012, Google secretly tracked the internet activity of millions of Apple iPhone users and used the data collected in this way for commercial purposes without the users’ knowledge or consent. 2. The factual allegation is not new. In August 2012, Google agreed to pay a civil penalty of US$22.5m to settle charges brought by the United States Federal Trade Commission based upon the allegation. In November 2013, Google agreed to pay US$17m to settle consumer-based actions brought against it in the United States. In England and Wales, three individuals sued Google in June 2013 making the same allegation and claiming compensation under the DPA 1998 and at common law for misuse of private information: see Vidal-Hall v Google Inc (Information Comr intervening) [2015] EWCA Civ 311; [2016] QB 1003. Following a dispute over jurisdiction, their claims were settled before Google had served a defence. What is new about the present action is that Mr Lloyd is not just claiming damages in his own right, as the three claimants did in Vidal-Hall. He claims to represent everyone resident in England and Wales who owned an Apple iPhone at the relevant time and whose data were obtained by Google without their consent, and to be entitled to recover damages on behalf of all these people. It is estimated that they number more than 4m. 3. Class actions, in which a single person is permitted to bring a claim and obtain redress on behalf of a class of people who have been affected in a similar way by alleged wrongdoing, have long been possible in the United States and, more recently, in Canada and Australia. Whether legislation to establish a class action regime should be enacted in the UK has been much discussed. In 2009, the Government rejected a recommendation from the Civil Justice Council to introduce a generic class action regime applicable to all types of claim, preferring a “sector based approach”. This was for two reasons: “Firstly, there are potential structural differences between the sectors which will require different consideration. … Secondly, it will be necessary to undertake a full assessment Page 3 of the likely economic and other impacts before implementing any reform.” See the Government’s Response to the Civil Justice Council’s Report: “Improving Access to Justice through Collective Actions” (2008), paras 12-13. 4. Since then, the only sector for which such a regime has so far been enacted is that of competition law. Parliament has not legislated to establish a class action regime in the field of data protection. 5. Mr Lloyd has sought to overcome this difficulty by what the Court of Appeal in this case described as “an unusual and innovative use of the representative procedure” in rule 19.6 of the Civil Procedure Rules: see [2019] EWCA Civ 1599; [2020] QB 747, para 7. This is a procedure of very long standing in England and Wales whereby a claim can be brought by (or against) one or more persons as representatives of others who have “the same interest” in the claim. Mr Lloyd accepts that he could not use this procedure to claim compensation on behalf of other iPhone users if the compensation recoverable by each user would have to be individually assessed. But he contends that such individual assessment is unnecessary. He argues that, as a matter of law, compensation can be awarded under the DPA 1998 for “loss of control” of personal data without the need to prove that the claimant suffered any financial loss or mental distress as a result of the breach. Mr Lloyd further argues that a “uniform sum” of damages can properly be awarded in relation to each person whose data protection rights have been infringed without the need to investigate any circumstances particular to their individual case. The amount of damages recoverable per person would be a matter for argument, but a figure of £750 was advanced in a letter of claim. Multiplied by the number of people whom Mr Lloyd claims to represent, this would produce an award of damages of the order of £3 billion. 6. Because Google is a Delaware corporation, the claimant needs the court’s permission to serve the claim form on Google outside the jurisdiction. The application for permission has been contested by Google on the grounds that the claim has no real prospect of success as: (1) damages cannot be awarded under the DPA 1998 for “loss of control” of data without proof that it caused financial damage or distress; and (2) the claim in any event is not suitable to proceed as a representative action. In the High Court Warby J decided both issues in Google’s favour and therefore refused permission to serve the proceedings on Google: see [2018] EWHC 2599 (QB); [2019] 1 WLR 1265. The Court of Appeal reversed that decision, for reasons given in a judgment of the Chancellor, Sir Geoffrey Vos, with which Davis LJ and Dame Victoria Sharp agreed: [2019] EWCA Civ 1599; [2020] QB 747. Page 4 7. On this further appeal, because of the potential ramifications of the issues raised, as well as hearing the claimant and Google, the court has received written and oral submissions from the Information Commissioner and written submissions from five further interested parties. 8. In this judgment I will first summarise the facts alleged and the relevant legal framework for data protection before considering the different methods currently available in English procedural law for claiming collective redress and, in particular, the representative procedure which the claimant is seeking to use. Whether that procedure is capable of being used in this case critically depends, as the claimant accepts, on whether compensation for the alleged breaches of data protection law would need to be individually assessed. I will then consider the claimant’s arguments that individual assessment is unnecessary. For the reasons given in detail below, those arguments cannot in my view withstand scrutiny. In order to recover compensation under the DPA 1998 for any given individual, it would be necessary to show both that Google made some unlawful use of personal data relating to that individual and that the individual suffered some damage as a result. The claimant’s attempt to recover compensation under the Act without proving either matter in any individual case is therefore doomed to fail. B. FACTUAL BACKGROUND 9. The relevant events took place between 9 August 2011 and 15 February 2012 and involved the alleged use by Google of what has been called the “Safari workaround” to bypass privacy settings on Apple iPhones. 10. Safari is an internet browser developed by Apple and installed on its iPhones. At the relevant time, unlike most other internet browsers, all relevant versions of Safari were set by default to block third party cookies. A “cookie” is a small block of data that is placed on a device when the user visits a website. A “third party cookie” is a cookie placed on the device not by the website visited by the user but by a third party whose content is included on that website. Third party cookies are often used to gather information about internet use, and in particular web pages visited over time, to enable the delivery to the user of advertisements tailored to interests inferred from the user’s browsing history. 11. Google had a cookie known as the “DoubleClick Ad cookie” which could operate as a third party cookie. It would be placed on a device if the user visited a website that included DoubleClick Ad content. The DoubleClick Ad cookie enabled Google to identify visits by the device to any website displaying an advertisement from its vast Page 5 advertising network and to collect considerable amounts of information. It could tell the date and time of any visit to a given website, how long the user spent there, which pages were visited for how long, and what advertisements were viewed for how long. In some cases, by means of the IP address of the browser, the user’s approximate geographical location could be identified. 12. Although the default settings for Safari blocked all third party cookies, a blanket application of these settings would have prevented the use of certain popular web functions; so Apple devised some exceptions to them. These exceptions were in place until March 2012, when the system was changed. But in the meantime the exceptions made it possible for Google to devise and implement the Safari workaround. Its effect was to place the DoubleClick Ad cookie on an Apple device, without the user’s knowledge or consent, immediately, whenever the user visited a website that contained DoubleClick Ad content. 13. It is alleged that, in this way, Google was able to collect or infer information relating not only to users’ internet surfing habits and location, but also about such diverse factors as their interests and pastimes, race or ethnicity, social class, political or religious beliefs or affiliations, health, sexual interests, age, gender and financial situation. 14. Further, it is said that Google aggregated browser generated information from users displaying similar patterns, creating groups with labels such as “football lovers”, or “current affairs enthusiasts”. Google’s DoubleClick service then offered these group labels to subscribing advertisers to choose from when selecting the type of people at whom they wanted to target their advertisements
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Respond to the following question with only the information I provide within this prompt, your answer should be two paragraphs long. Why is Mr Lloyd's strategy unusual? A. INTRODUCTION 1. Mr Richard Lloyd - with financial backing from Therium Litigation Funding IC, a commercial litigation funder - has issued a claim against Google LLC, alleging breach of its duties as a data controller under section 4(4) of the Data Protection Act 1998 (“the DPA 1998”). The claim alleges that, for several months in late 2011 and early 2012, Google secretly tracked the internet activity of millions of Apple iPhone users and used the data collected in this way for commercial purposes without the users’ knowledge or consent. 2. The factual allegation is not new. In August 2012, Google agreed to pay a civil penalty of US$22.5m to settle charges brought by the United States Federal Trade Commission based upon the allegation. In November 2013, Google agreed to pay US$17m to settle consumer-based actions brought against it in the United States. In England and Wales, three individuals sued Google in June 2013 making the same allegation and claiming compensation under the DPA 1998 and at common law for misuse of private information: see Vidal-Hall v Google Inc (Information Comr intervening) [2015] EWCA Civ 311; [2016] QB 1003. Following a dispute over jurisdiction, their claims were settled before Google had served a defence. What is new about the present action is that Mr Lloyd is not just claiming damages in his own right, as the three claimants did in Vidal-Hall. He claims to represent everyone resident in England and Wales who owned an Apple iPhone at the relevant time and whose data were obtained by Google without their consent, and to be entitled to recover damages on behalf of all these people. It is estimated that they number more than 4m. 3. Class actions, in which a single person is permitted to bring a claim and obtain redress on behalf of a class of people who have been affected in a similar way by alleged wrongdoing, have long been possible in the United States and, more recently, in Canada and Australia. Whether legislation to establish a class action regime should be enacted in the UK has been much discussed. In 2009, the Government rejected a recommendation from the Civil Justice Council to introduce a generic class action regime applicable to all types of claim, preferring a “sector based approach”. This was for two reasons: “Firstly, there are potential structural differences between the sectors which will require different consideration. … Secondly, it will be necessary to undertake a full assessment Page 3 of the likely economic and other impacts before implementing any reform.” See the Government’s Response to the Civil Justice Council’s Report: “Improving Access to Justice through Collective Actions” (2008), paras 12-13. 4. Since then, the only sector for which such a regime has so far been enacted is that of competition law. Parliament has not legislated to establish a class action regime in the field of data protection. 5. Mr Lloyd has sought to overcome this difficulty by what the Court of Appeal in this case described as “an unusual and innovative use of the representative procedure” in rule 19.6 of the Civil Procedure Rules: see [2019] EWCA Civ 1599; [2020] QB 747, para 7. This is a procedure of very long standing in England and Wales whereby a claim can be brought by (or against) one or more persons as representatives of others who have “the same interest” in the claim. Mr Lloyd accepts that he could not use this procedure to claim compensation on behalf of other iPhone users if the compensation recoverable by each user would have to be individually assessed. But he contends that such individual assessment is unnecessary. He argues that, as a matter of law, compensation can be awarded under the DPA 1998 for “loss of control” of personal data without the need to prove that the claimant suffered any financial loss or mental distress as a result of the breach. Mr Lloyd further argues that a “uniform sum” of damages can properly be awarded in relation to each person whose data protection rights have been infringed without the need to investigate any circumstances particular to their individual case. The amount of damages recoverable per person would be a matter for argument, but a figure of £750 was advanced in a letter of claim. Multiplied by the number of people whom Mr Lloyd claims to represent, this would produce an award of damages of the order of £3 billion. 6. Because Google is a Delaware corporation, the claimant needs the court’s permission to serve the claim form on Google outside the jurisdiction. The application for permission has been contested by Google on the grounds that the claim has no real prospect of success as: (1) damages cannot be awarded under the DPA 1998 for “loss of control” of data without proof that it caused financial damage or distress; and (2) the claim in any event is not suitable to proceed as a representative action. In the High Court Warby J decided both issues in Google’s favour and therefore refused permission to serve the proceedings on Google: see [2018] EWHC 2599 (QB); [2019] 1 WLR 1265. The Court of Appeal reversed that decision, for reasons given in a judgment of the Chancellor, Sir Geoffrey Vos, with which Davis LJ and Dame Victoria Sharp agreed: [2019] EWCA Civ 1599; [2020] QB 747. Page 4 7. On this further appeal, because of the potential ramifications of the issues raised, as well as hearing the claimant and Google, the court has received written and oral submissions from the Information Commissioner and written submissions from five further interested parties. 8. In this judgment I will first summarise the facts alleged and the relevant legal framework for data protection before considering the different methods currently available in English procedural law for claiming collective redress and, in particular, the representative procedure which the claimant is seeking to use. Whether that procedure is capable of being used in this case critically depends, as the claimant accepts, on whether compensation for the alleged breaches of data protection law would need to be individually assessed. I will then consider the claimant’s arguments that individual assessment is unnecessary. For the reasons given in detail below, those arguments cannot in my view withstand scrutiny. In order to recover compensation under the DPA 1998 for any given individual, it would be necessary to show both that Google made some unlawful use of personal data relating to that individual and that the individual suffered some damage as a result. The claimant’s attempt to recover compensation under the Act without proving either matter in any individual case is therefore doomed to fail. B. FACTUAL BACKGROUND 9. The relevant events took place between 9 August 2011 and 15 February 2012 and involved the alleged use by Google of what has been called the “Safari workaround” to bypass privacy settings on Apple iPhones. 10. Safari is an internet browser developed by Apple and installed on its iPhones. At the relevant time, unlike most other internet browsers, all relevant versions of Safari were set by default to block third party cookies. A “cookie” is a small block of data that is placed on a device when the user visits a website. A “third party cookie” is a cookie placed on the device not by the website visited by the user but by a third party whose content is included on that website. Third party cookies are often used to gather information about internet use, and in particular web pages visited over time, to enable the delivery to the user of advertisements tailored to interests inferred from the user’s browsing history. 11. Google had a cookie known as the “DoubleClick Ad cookie” which could operate as a third party cookie. It would be placed on a device if the user visited a website that included DoubleClick Ad content. The DoubleClick Ad cookie enabled Google to identify visits by the device to any website displaying an advertisement from its vast Page 5 advertising network and to collect considerable amounts of information. It could tell the date and time of any visit to a given website, how long the user spent there, which pages were visited for how long, and what advertisements were viewed for how long. In some cases, by means of the IP address of the browser, the user’s approximate geographical location could be identified. 12. Although the default settings for Safari blocked all third party cookies, a blanket application of these settings would have prevented the use of certain popular web functions; so Apple devised some exceptions to them. These exceptions were in place until March 2012, when the system was changed. But in the meantime the exceptions made it possible for Google to devise and implement the Safari workaround. Its effect was to place the DoubleClick Ad cookie on an Apple device, without the user’s knowledge or consent, immediately, whenever the user visited a website that contained DoubleClick Ad content. 13. It is alleged that, in this way, Google was able to collect or infer information relating not only to users’ internet surfing habits and location, but also about such diverse factors as their interests and pastimes, race or ethnicity, social class, political or religious beliefs or affiliations, health, sexual interests, age, gender and financial situation. 14. Further, it is said that Google aggregated browser generated information from users displaying similar patterns, creating groups with labels such as “football lovers”, or “current affairs enthusiasts”. Google’s DoubleClick service then offered these group labels to subscribing advertisers to choose from when selecting the type of people at whom they wanted to target their advertisements
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Respond to the following question with only the information I provide within this prompt, your answer should be two paragraphs long.
EVIDENCE:
A. INTRODUCTION 1. Mr Richard Lloyd - with financial backing from Therium Litigation Funding IC, a commercial litigation funder - has issued a claim against Google LLC, alleging breach of its duties as a data controller under section 4(4) of the Data Protection Act 1998 (“the DPA 1998”). The claim alleges that, for several months in late 2011 and early 2012, Google secretly tracked the internet activity of millions of Apple iPhone users and used the data collected in this way for commercial purposes without the users’ knowledge or consent. 2. The factual allegation is not new. In August 2012, Google agreed to pay a civil penalty of US$22.5m to settle charges brought by the United States Federal Trade Commission based upon the allegation. In November 2013, Google agreed to pay US$17m to settle consumer-based actions brought against it in the United States. In England and Wales, three individuals sued Google in June 2013 making the same allegation and claiming compensation under the DPA 1998 and at common law for misuse of private information: see Vidal-Hall v Google Inc (Information Comr intervening) [2015] EWCA Civ 311; [2016] QB 1003. Following a dispute over jurisdiction, their claims were settled before Google had served a defence. What is new about the present action is that Mr Lloyd is not just claiming damages in his own right, as the three claimants did in Vidal-Hall. He claims to represent everyone resident in England and Wales who owned an Apple iPhone at the relevant time and whose data were obtained by Google without their consent, and to be entitled to recover damages on behalf of all these people. It is estimated that they number more than 4m. 3. Class actions, in which a single person is permitted to bring a claim and obtain redress on behalf of a class of people who have been affected in a similar way by alleged wrongdoing, have long been possible in the United States and, more recently, in Canada and Australia. Whether legislation to establish a class action regime should be enacted in the UK has been much discussed. In 2009, the Government rejected a recommendation from the Civil Justice Council to introduce a generic class action regime applicable to all types of claim, preferring a “sector based approach”. This was for two reasons: “Firstly, there are potential structural differences between the sectors which will require different consideration. … Secondly, it will be necessary to undertake a full assessment Page 3 of the likely economic and other impacts before implementing any reform.” See the Government’s Response to the Civil Justice Council’s Report: “Improving Access to Justice through Collective Actions” (2008), paras 12-13. 4. Since then, the only sector for which such a regime has so far been enacted is that of competition law. Parliament has not legislated to establish a class action regime in the field of data protection. 5. Mr Lloyd has sought to overcome this difficulty by what the Court of Appeal in this case described as “an unusual and innovative use of the representative procedure” in rule 19.6 of the Civil Procedure Rules: see [2019] EWCA Civ 1599; [2020] QB 747, para 7. This is a procedure of very long standing in England and Wales whereby a claim can be brought by (or against) one or more persons as representatives of others who have “the same interest” in the claim. Mr Lloyd accepts that he could not use this procedure to claim compensation on behalf of other iPhone users if the compensation recoverable by each user would have to be individually assessed. But he contends that such individual assessment is unnecessary. He argues that, as a matter of law, compensation can be awarded under the DPA 1998 for “loss of control” of personal data without the need to prove that the claimant suffered any financial loss or mental distress as a result of the breach. Mr Lloyd further argues that a “uniform sum” of damages can properly be awarded in relation to each person whose data protection rights have been infringed without the need to investigate any circumstances particular to their individual case. The amount of damages recoverable per person would be a matter for argument, but a figure of £750 was advanced in a letter of claim. Multiplied by the number of people whom Mr Lloyd claims to represent, this would produce an award of damages of the order of £3 billion. 6. Because Google is a Delaware corporation, the claimant needs the court’s permission to serve the claim form on Google outside the jurisdiction. The application for permission has been contested by Google on the grounds that the claim has no real prospect of success as: (1) damages cannot be awarded under the DPA 1998 for “loss of control” of data without proof that it caused financial damage or distress; and (2) the claim in any event is not suitable to proceed as a representative action. In the High Court Warby J decided both issues in Google’s favour and therefore refused permission to serve the proceedings on Google: see [2018] EWHC 2599 (QB); [2019] 1 WLR 1265. The Court of Appeal reversed that decision, for reasons given in a judgment of the Chancellor, Sir Geoffrey Vos, with which Davis LJ and Dame Victoria Sharp agreed: [2019] EWCA Civ 1599; [2020] QB 747. Page 4 7. On this further appeal, because of the potential ramifications of the issues raised, as well as hearing the claimant and Google, the court has received written and oral submissions from the Information Commissioner and written submissions from five further interested parties. 8. In this judgment I will first summarise the facts alleged and the relevant legal framework for data protection before considering the different methods currently available in English procedural law for claiming collective redress and, in particular, the representative procedure which the claimant is seeking to use. Whether that procedure is capable of being used in this case critically depends, as the claimant accepts, on whether compensation for the alleged breaches of data protection law would need to be individually assessed. I will then consider the claimant’s arguments that individual assessment is unnecessary. For the reasons given in detail below, those arguments cannot in my view withstand scrutiny. In order to recover compensation under the DPA 1998 for any given individual, it would be necessary to show both that Google made some unlawful use of personal data relating to that individual and that the individual suffered some damage as a result. The claimant’s attempt to recover compensation under the Act without proving either matter in any individual case is therefore doomed to fail. B. FACTUAL BACKGROUND 9. The relevant events took place between 9 August 2011 and 15 February 2012 and involved the alleged use by Google of what has been called the “Safari workaround” to bypass privacy settings on Apple iPhones. 10. Safari is an internet browser developed by Apple and installed on its iPhones. At the relevant time, unlike most other internet browsers, all relevant versions of Safari were set by default to block third party cookies. A “cookie” is a small block of data that is placed on a device when the user visits a website. A “third party cookie” is a cookie placed on the device not by the website visited by the user but by a third party whose content is included on that website. Third party cookies are often used to gather information about internet use, and in particular web pages visited over time, to enable the delivery to the user of advertisements tailored to interests inferred from the user’s browsing history. 11. Google had a cookie known as the “DoubleClick Ad cookie” which could operate as a third party cookie. It would be placed on a device if the user visited a website that included DoubleClick Ad content. The DoubleClick Ad cookie enabled Google to identify visits by the device to any website displaying an advertisement from its vast Page 5 advertising network and to collect considerable amounts of information. It could tell the date and time of any visit to a given website, how long the user spent there, which pages were visited for how long, and what advertisements were viewed for how long. In some cases, by means of the IP address of the browser, the user’s approximate geographical location could be identified. 12. Although the default settings for Safari blocked all third party cookies, a blanket application of these settings would have prevented the use of certain popular web functions; so Apple devised some exceptions to them. These exceptions were in place until March 2012, when the system was changed. But in the meantime the exceptions made it possible for Google to devise and implement the Safari workaround. Its effect was to place the DoubleClick Ad cookie on an Apple device, without the user’s knowledge or consent, immediately, whenever the user visited a website that contained DoubleClick Ad content. 13. It is alleged that, in this way, Google was able to collect or infer information relating not only to users’ internet surfing habits and location, but also about such diverse factors as their interests and pastimes, race or ethnicity, social class, political or religious beliefs or affiliations, health, sexual interests, age, gender and financial situation. 14. Further, it is said that Google aggregated browser generated information from users displaying similar patterns, creating groups with labels such as “football lovers”, or “current affairs enthusiasts”. Google’s DoubleClick service then offered these group labels to subscribing advertisers to choose from when selecting the type of people at whom they wanted to target their advertisements
USER:
Why is Mr Lloyd's strategy unusual?
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
| false | 21 | 6 | 1,603 | null | 754 |
Exclusively use the information found in the prompt to provide responses limited to 300 words. Use bullet formatting if listing more than 2 items. Use numerical formatting is the response includes instructions. If there's is not enough information to answer some or all of an user's prompt then state so but answer the parts that you can, if any. Cite examples supporting main statements in your response when available.
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How does Executive Order (E.O.) 14110 address concerns that were previously outlined in the E.O. on _Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety_?
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A number of concerns have been raised about law enforcement use of AI, including whether its use perpetuates biases; one criticism is that the data on which the software are trained contain bias, thus training bias into the AI systems. Another concern is whether reliance on AI technology may lead police to ignore contradictory evidence. Policymakers may consider increased oversight over police use of AI systems to help evaluate and alleviate some of the shortcomings. On October 30, 2023, President Biden issued Executive Order (E.O.) 14110 on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. This E.O. advances a government-wide approach to “governing the development and use of AI safely and responsibly” and directs efforts in AI policy areas involving safety and security, innovation and competition, worker support, equity and civil rights, individual protections, privacy protections, federal AI use, and international leadership. E.O. 14110 acknowledges the risk of AI exacerbating discrimination and directs federal law enforcement in various ways. (In doing so, it references accountability focused directives for federal law enforcement previously outlined in the May 25, 2022, E.O. 14074 on Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety.) Directives in E.O. 14110 include the following: • The Attorney General (AG) shall coordinate and support enforcement of federal laws addressing discrimination and violations of civil rights and civil liberties related to AI. The Department of Justice’s Civil Rights Division shall also coordinate with other federal civil rights offices to assess how their offices can prevent and address discrimination in automated systems—including algorithmic discrimination. • The AG, with the Homeland Security Secretary and Office of Science and Technology Policy Director, shall submit a report to the President on the use of AI in the criminal justice system, including how AI can enhance law enforcement efficiency and accuracy, consistent with privacy, civil rights, and civil liberties protections. The report should also recommend best practices for law enforcement, including guidance on AI use, to address concerns outlined in E.O. 14074 with respect to law enforcement use of “facial recognition technology, other technologies using biometric information, and predictive algorithms, as well as data storage and access regarding such technologies.” • The interagency working group established by E.O. 14074 shall share best practices for recruiting law enforcement professionals with AI expertise and training them on responsible AI use. The AG, along with the Homeland Security Secretary, may review these and recommend best practices for state, local, tribal, and territorial law enforcement. • The AG shall review the Justice Department’s capacity to “investigate law enforcement deprivation of rights under color of law resulting from the use of AI,” including through increasing or improving training for federal law enforcement officers and prosecutors. Congressional Research Service 3 Policymakers conducting oversight of executive branch activities to ensure that AI is used in a fair and equitable manner may examine not only these elements of E.O. 14110 that specifically relate to federal law enforcement but also other elements—such as the development of industry standards on AI—that may in turn affect law enforcement use of AI. They may also explore whether there should be specific standards for AI use in the criminal justice sector or AI-specific requirements for criminal justice entities receiving federal grants. Additionally, policymakers may continue to debate law enforcement use of specific AI technologies in its toolbox such as facial recognition technology.
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System instruction: Exclusively use the information found in the prompt to provide responses limited to 300 words. Use bullet formatting if listing more than 2 items. Use numerical formatting is the response includes instructions. If there's is not enough information to answer some or all of an user's prompt then state so but answer the parts that you can, if any. Cite examples supporting main statements in your response when available. context: A number of concerns have been raised about law enforcement use of AI, including whether its use perpetuates biases; one criticism is that the data on which the software are trained contain bias, thus training bias into the AI systems. Another concern is whether reliance on AI technology may lead police to ignore contradictory evidence. Policymakers may consider increased oversight over police use of AI systems to help evaluate and alleviate some of the shortcomings. On October 30, 2023, President Biden issued Executive Order (E.O.) 14110 on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. This E.O. advances a government-wide approach to “governing the development and use of AI safely and responsibly” and directs efforts in AI policy areas involving safety and security, innovation and competition, worker support, equity and civil rights, individual protections, privacy protections, federal AI use, and international leadership. E.O. 14110 acknowledges the risk of AI exacerbating discrimination and directs federal law enforcement in various ways. (In doing so, it references accountability focused directives for federal law enforcement previously outlined in the May 25, 2022, E.O. 14074 on Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety.) Directives in E.O. 14110 include the following: • The Attorney General (AG) shall coordinate and support enforcement of federal laws addressing discrimination and violations of civil rights and civil liberties related to AI. The Department of Justice’s Civil Rights Division shall also coordinate with other federal civil rights offices to assess how their offices can prevent and address discrimination in automated systems—including algorithmic discrimination. • The AG, with the Homeland Security Secretary and Office of Science and Technology Policy Director, shall submit a report to the President on the use of AI in the criminal justice system, including how AI can enhance law enforcement efficiency and accuracy, consistent with privacy, civil rights, and civil liberties protections. The report should also recommend best practices for law enforcement, including guidance on AI use, to address concerns outlined in E.O. 14074 with respect to law enforcement use of “facial recognition technology, other technologies using biometric information, and predictive algorithms, as well as data storage and access regarding such technologies.” • The interagency working group established by E.O. 14074 shall share best practices for recruiting law enforcement professionals with AI expertise and training them on responsible AI use. The AG, along with the Homeland Security Secretary, may review these and recommend best practices for state, local, tribal, and territorial law enforcement. • The AG shall review the Justice Department’s capacity to “investigate law enforcement deprivation of rights under color of law resulting from the use of AI,” including through increasing or improving training for federal law enforcement officers and prosecutors. Congressional Research Service 3 Policymakers conducting oversight of executive branch activities to ensure that AI is used in a fair and equitable manner may examine not only these elements of E.O. 14110 that specifically relate to federal law enforcement but also other elements—such as the development of industry standards on AI—that may in turn affect law enforcement use of AI. They may also explore whether there should be specific standards for AI use in the criminal justice sector or AI-specific requirements for criminal justice entities receiving federal grants. Additionally, policymakers may continue to debate law enforcement use of specific AI technologies in its toolbox such as facial recognition technology. question: How does Executive Order (E.O.) 14110 address concerns that were previously outlined in the E.O. on _Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety_?
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Exclusively use the information found in the prompt to provide responses limited to 300 words. Use bullet formatting if listing more than 2 items. Use numerical formatting is the response includes instructions. If there's is not enough information to answer some or all of an user's prompt then state so but answer the parts that you can, if any. Cite examples supporting main statements in your response when available.
EVIDENCE:
A number of concerns have been raised about law enforcement use of AI, including whether its use perpetuates biases; one criticism is that the data on which the software are trained contain bias, thus training bias into the AI systems. Another concern is whether reliance on AI technology may lead police to ignore contradictory evidence. Policymakers may consider increased oversight over police use of AI systems to help evaluate and alleviate some of the shortcomings. On October 30, 2023, President Biden issued Executive Order (E.O.) 14110 on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. This E.O. advances a government-wide approach to “governing the development and use of AI safely and responsibly” and directs efforts in AI policy areas involving safety and security, innovation and competition, worker support, equity and civil rights, individual protections, privacy protections, federal AI use, and international leadership. E.O. 14110 acknowledges the risk of AI exacerbating discrimination and directs federal law enforcement in various ways. (In doing so, it references accountability focused directives for federal law enforcement previously outlined in the May 25, 2022, E.O. 14074 on Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety.) Directives in E.O. 14110 include the following: • The Attorney General (AG) shall coordinate and support enforcement of federal laws addressing discrimination and violations of civil rights and civil liberties related to AI. The Department of Justice’s Civil Rights Division shall also coordinate with other federal civil rights offices to assess how their offices can prevent and address discrimination in automated systems—including algorithmic discrimination. • The AG, with the Homeland Security Secretary and Office of Science and Technology Policy Director, shall submit a report to the President on the use of AI in the criminal justice system, including how AI can enhance law enforcement efficiency and accuracy, consistent with privacy, civil rights, and civil liberties protections. The report should also recommend best practices for law enforcement, including guidance on AI use, to address concerns outlined in E.O. 14074 with respect to law enforcement use of “facial recognition technology, other technologies using biometric information, and predictive algorithms, as well as data storage and access regarding such technologies.” • The interagency working group established by E.O. 14074 shall share best practices for recruiting law enforcement professionals with AI expertise and training them on responsible AI use. The AG, along with the Homeland Security Secretary, may review these and recommend best practices for state, local, tribal, and territorial law enforcement. • The AG shall review the Justice Department’s capacity to “investigate law enforcement deprivation of rights under color of law resulting from the use of AI,” including through increasing or improving training for federal law enforcement officers and prosecutors. Congressional Research Service 3 Policymakers conducting oversight of executive branch activities to ensure that AI is used in a fair and equitable manner may examine not only these elements of E.O. 14110 that specifically relate to federal law enforcement but also other elements—such as the development of industry standards on AI—that may in turn affect law enforcement use of AI. They may also explore whether there should be specific standards for AI use in the criminal justice sector or AI-specific requirements for criminal justice entities receiving federal grants. Additionally, policymakers may continue to debate law enforcement use of specific AI technologies in its toolbox such as facial recognition technology.
USER:
How does Executive Order (E.O.) 14110 address concerns that were previously outlined in the E.O. on _Advancing Effective, Accountable Policing and Criminal Justice Practices to Enhance Public Trust and Public Safety_?
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
| false | 69 | 31 | 564 | null | 136 |
{instruction} ========== In your answer, refer only to the context document. Do not employ any outside knowledge {question} ========== [user request] {passage 0} ========== [context document]
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I'm middle-aged, never smoked, had my ears blown out in the war, get a case of the sads pretty regular, and eat mostly garbage. What are my risk factors for dementia? What does cognitive engagement have to do with it?
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high blood pressure People who have consistent high blood pressure (hypertension) in mid-life (ages 45 to 65) are more likely to develop dementia compared to those with normal blood pressure. High blood pressure can increase the risk of developing dementia, particularly vascular dementia, because of its effect on the heart, the arteries, and blood circulation. Smoking The evidence is strong and consistent that smokers are at a higher risk of developing dementia vs. non-smokers or ex-smokers. It’s never too late to quit! Smokers who quit can reduce their risk of developing dementia. diabetes People with type 2 diabetes in mid-life (ages 45 to 65) are at an increased risk of developing dementia, particularly Alzheimer’s disease and vascular dementia. Obesity Obesity in mid-life (ages 45 to 65) increases the risk of developing dementia. Obesity also increases the risk of developing other risk factors such as type 2 diabetes. lack of physical activity Physical inactivity in later life (ages 65 and up) increases the risk of developing dementia. poor diet An unhealthy diet, high in saturated fat, sugar, and salt, can increase the risk of developing many illnesses, including dementia and cardiovascular disease. high alcohol consumption Drinking excessively (more than 12 drinks per week), can increase your risk of developing dementia low cognitive engagement Cognitive engagement is thought to support the development of a “cognitive reserve”. This is the idea that people who actively use their brains throughout their lives may be more protected against brain cell damage caused by dementia. depression People who experience depression in mid- or later life have a higher risk of developing dementia. However, the relationship between depression and dementia is still unclear. Many researchers believe that depression is a risk factor for dementia, whereas others believe it may be an early symptom of the disease, or both. traumatic brain injury People who experience severe or repeated head injuries are at increased risk of developing dementia. Brain injuries may trigger a process that might eventually lead to dementia. This particularly affects athletes in boxing, soccer, hockey, and football, which often have repeated head injuries. Falls are the leading cause of traumatic brain injury. Falling is especially dangerous for older adults. hearing loss Mild levels of hearing loss increase the risk of cognitive decline and dementia. Though it is still unclear how exactly it affects cognitive decline, hearing loss can lead to social isolation, loss of independence, and problems with everyday activities. social isolation Social isolation can increase the risk of hypertension, coronary heart disease, depression, and dementia. Staying socially active may reduce the risk of dementia. Social interaction may also help slow down the progression of the disease. air pollution The relationship between air pollution and dementia is still unclear. However, it’s estimated that those living close to busy roads have a higher risk of dementia because they may be exposed to higher levels of air pollution from vehicle emissions. It’s never too soon, or too late, to make changes that will maintain or improve your brain health. Learn more about managing some of these risk factors.
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{instruction} ========== In your answer, refer only to the context document. Do not employ any outside knowledge {question} ========== I'm middle-aged, never smoked, had my ears blown out in the war, get a case of the sads pretty regular, and eat mostly garbage. What are my risk factors for dementia? What does cognitive engagement have to do with it? {passage 0} ========== high blood pressure People who have consistent high blood pressure (hypertension) in mid-life (ages 45 to 65) are more likely to develop dementia compared to those with normal blood pressure. High blood pressure can increase the risk of developing dementia, particularly vascular dementia, because of its effect on the heart, the arteries, and blood circulation. Smoking The evidence is strong and consistent that smokers are at a higher risk of developing dementia vs. non-smokers or ex-smokers. It’s never too late to quit! Smokers who quit can reduce their risk of developing dementia. diabetes People with type 2 diabetes in mid-life (ages 45 to 65) are at an increased risk of developing dementia, particularly Alzheimer’s disease and vascular dementia. Obesity Obesity in mid-life (ages 45 to 65) increases the risk of developing dementia. Obesity also increases the risk of developing other risk factors such as type 2 diabetes. lack of physical activity Physical inactivity in later life (ages 65 and up) increases the risk of developing dementia. poor diet An unhealthy diet, high in saturated fat, sugar, and salt, can increase the risk of developing many illnesses, including dementia and cardiovascular disease. high alcohol consumption Drinking excessively (more than 12 drinks per week), can increase your risk of developing dementia low cognitive engagement Cognitive engagement is thought to support the development of a “cognitive reserve”. This is the idea that people who actively use their brains throughout their lives may be more protected against brain cell damage caused by dementia. depression People who experience depression in mid- or later life have a higher risk of developing dementia. However, the relationship between depression and dementia is still unclear. Many researchers believe that depression is a risk factor for dementia, whereas others believe it may be an early symptom of the disease, or both. traumatic brain injury People who experience severe or repeated head injuries are at increased risk of developing dementia. Brain injuries may trigger a process that might eventually lead to dementia. This particularly affects athletes in boxing, soccer, hockey, and football, which often have repeated head injuries. Falls are the leading cause of traumatic brain injury. Falling is especially dangerous for older adults. hearing loss Mild levels of hearing loss increase the risk of cognitive decline and dementia. Though it is still unclear how exactly it affects cognitive decline, hearing loss can lead to social isolation, loss of independence, and problems with everyday activities. social isolation Social isolation can increase the risk of hypertension, coronary heart disease, depression, and dementia. Staying socially active may reduce the risk of dementia. Social interaction may also help slow down the progression of the disease. air pollution The relationship between air pollution and dementia is still unclear. However, it’s estimated that those living close to busy roads have a higher risk of dementia because they may be exposed to higher levels of air pollution from vehicle emissions. It’s never too soon, or too late, to make changes that will maintain or improve your brain health. Learn more about managing some of these risk factors. https://alzheimer.ca/en/about-dementia/how-can-i-reduce-risk-dementia/risk-factors-dementia?gad_source=1&gclid=CjwKCAjw3P-2BhAEEiwA3yPhwN2aQl6V8InKOUxaehsfGBSWmuIpGEoeJdWNsl5fH_T9LOUlOk7-gxoCHcYQAvD_BwE
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{instruction} ========== In your answer, refer only to the context document. Do not employ any outside knowledge {question} ========== [user request] {passage 0} ========== [context document]
EVIDENCE:
high blood pressure People who have consistent high blood pressure (hypertension) in mid-life (ages 45 to 65) are more likely to develop dementia compared to those with normal blood pressure. High blood pressure can increase the risk of developing dementia, particularly vascular dementia, because of its effect on the heart, the arteries, and blood circulation. Smoking The evidence is strong and consistent that smokers are at a higher risk of developing dementia vs. non-smokers or ex-smokers. It’s never too late to quit! Smokers who quit can reduce their risk of developing dementia. diabetes People with type 2 diabetes in mid-life (ages 45 to 65) are at an increased risk of developing dementia, particularly Alzheimer’s disease and vascular dementia. Obesity Obesity in mid-life (ages 45 to 65) increases the risk of developing dementia. Obesity also increases the risk of developing other risk factors such as type 2 diabetes. lack of physical activity Physical inactivity in later life (ages 65 and up) increases the risk of developing dementia. poor diet An unhealthy diet, high in saturated fat, sugar, and salt, can increase the risk of developing many illnesses, including dementia and cardiovascular disease. high alcohol consumption Drinking excessively (more than 12 drinks per week), can increase your risk of developing dementia low cognitive engagement Cognitive engagement is thought to support the development of a “cognitive reserve”. This is the idea that people who actively use their brains throughout their lives may be more protected against brain cell damage caused by dementia. depression People who experience depression in mid- or later life have a higher risk of developing dementia. However, the relationship between depression and dementia is still unclear. Many researchers believe that depression is a risk factor for dementia, whereas others believe it may be an early symptom of the disease, or both. traumatic brain injury People who experience severe or repeated head injuries are at increased risk of developing dementia. Brain injuries may trigger a process that might eventually lead to dementia. This particularly affects athletes in boxing, soccer, hockey, and football, which often have repeated head injuries. Falls are the leading cause of traumatic brain injury. Falling is especially dangerous for older adults. hearing loss Mild levels of hearing loss increase the risk of cognitive decline and dementia. Though it is still unclear how exactly it affects cognitive decline, hearing loss can lead to social isolation, loss of independence, and problems with everyday activities. social isolation Social isolation can increase the risk of hypertension, coronary heart disease, depression, and dementia. Staying socially active may reduce the risk of dementia. Social interaction may also help slow down the progression of the disease. air pollution The relationship between air pollution and dementia is still unclear. However, it’s estimated that those living close to busy roads have a higher risk of dementia because they may be exposed to higher levels of air pollution from vehicle emissions. It’s never too soon, or too late, to make changes that will maintain or improve your brain health. Learn more about managing some of these risk factors.
USER:
I'm middle-aged, never smoked, had my ears blown out in the war, get a case of the sads pretty regular, and eat mostly garbage. What are my risk factors for dementia? What does cognitive engagement have to do with it?
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
| false | 26 | 40 | 510 | null | 0 |
Answer the question based solely on the information provided in the passage. Do not use any external knowledge or resources. [user request] [context document]
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What does each option's Greek measure and how is it used to determine options pricing?Also, even though it's not a Greek, also include an explanation of implied volatility.
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Delta Delta measures how much an option's price can be expected to move for every $1 change in the price of the underlying security or index. For example, a Delta of 0.40 means the option's price will theoretically move $0.40 for every $1 change in the price of the underlying stock or index. As you might guess, this means the higher the Delta, the bigger the price change. Traders often use Delta to predict whether a given option will expire ITM. So, a Delta of 0.40 is taken to mean that at that moment in time, the option has about a 40% chance of being ITM at expiration. This doesn't mean higher-Delta options are always profitable. After all, if you paid a large premium for an option that expires ITM, you might not make any money. You can also think of Delta as the number of shares of the underlying stock the option behaves like. So, a Delta of 0.40 suggests that given a $1 move in the underlying stock, the option will likely gain or lose about the same amount of money as 40 shares of the stock. Call options Call options have a positive Delta that can range from 0.00 to 1.00. At-the-money options usually have a Delta near 0.50. The Delta will increase (and approach 1.00) as the option gets deeper ITM. The Delta of ITM call options will get closer to 1.00 as expiration approaches. The Delta of out-of-the-money call options will get closer to 0.00 as expiration approaches. Put options Put options have a negative Delta that can range from 0.00 to –1.00. At-the-money options usually have a Delta near –0.50. The Delta will decrease (and approach –1.00) as the option gets deeper ITM. The Delta of ITM put options will get closer to –1.00 as expiration approaches. The Delta of out-of-the-money put options will get closer to 0.00 as expiration approaches. Gamma Where Delta is a snapshot in time, Gamma measures the rate of change in an option's Delta over time. If you remember high school physics class, you can think of Delta as speed and Gamma as acceleration. In practice, Gamma is the rate of change in an option's Delta per $1 change in the price of the underlying stock. In the example above, we imagined an option with a Delta of .40. If the underlying stock moves $1 and the option moves $.40 along with it, the option's Delta is no longer 0.40. Why? This $1 move would mean the call option is now even deeper ITM, and so its Delta should move even closer to 1.00. So, let's assume that as a result the Delta is now 0.55. The change in Delta from 0.40 to 0.55 is 0.15—this is the option's Gamma. Because Delta can't exceed 1.00, Gamma decreases as an option gets further ITM and Delta approaches 1.00. After all, there's less room for acceleration as you approach top speed. Theta Theta tells you how much the price of an option should decrease each day as the option nears expiration, if all other factors remain the same. This kind of price erosion over time is known as time decay. Time-value erosion is not linear, meaning the price erosion of at-the-money (ATM), just slightly out-of-the-money, and ITM options generally increases as expiration approaches, while that of far out-of-the-money (OOTM) options generally decreases as expiration approaches. Time-value erosion Source: Schwab Center for Financial Research Vega Vega measures the rate of change in an option's price per one-percentage-point change in the implied volatility of the underlying stock. (There's more on implied volatility below.) While Vega is not a real Greek letter, it is intended to tell you how much an option's price should move when the volatility of the underlying security or index increases or decreases. More about Vega: Volatility is one of the most important factors affecting the value of options. A drop in Vega will typically cause both calls and puts to lose value. An increase in Vega will typically cause both calls and puts to gain value. Neglecting Vega can cause you to potentially overpay when buying options. All other factors being equal, when determining strategy, consider buying options when Vega is below "normal" levels and selling options when Vega is above "normal" levels. One way to determine this is to compare the historical volatility to the implied volatility. Chart studies for both values are available on StreetSmart Edge®. Rho Rho measures the expected change in an option's price per one-percentage-point change in interest rates. It tells you how much the price of an option should rise or fall if the risk-free interest rate (U.S. Treasury-bills)* increases or decreases. More about Rho: As interest rates increase, the value of call options will generally increase. As interest rates increase, the value of put options will usually decrease. For these reasons, call options have positive Rho and put options have negative Rho. Consider a hypothetical stock that's trading exactly at its strike price. If the stock is trading at $25, the 25 calls and the 25 puts would both be exactly at the money. You might see the calls trading at, say, $0.60, while the puts could be trading at $0.50. When interest rates are low, the price difference between puts and calls will be relatively small. If interest rates increase, the gap will get wider—calls will become more expensive and puts will become less so. Rho is generally not a huge factor in the price of an option, but should be considered if prevailing interest rates are expected to change, such as just before a Federal Open Market Committee (FOMC) meeting. Long-Term Equity AnticiPation Securities® (LEAPS®) options are far more sensitive to changes in interest rates than are shorter-term options. Implied volatility: like a Greek Though not actually a Greek, implied volatility is closely related. Implied volatility is a forecast of how volatile an underlying stock is expected to be in the future—but it's strictly theoretical. While it's possible to forecast a stock's future moves by looking at its historical volatility, among other factors, the implied volatility reflected in the price of an option is an inference based on other factors, too, such as upcoming earnings reports, merger and acquisition rumors, pending product launches, etc. Key points to remember: Figuring out exactly how volatile a stock will be at any given time is difficult, but looking at implied volatility can give you a sense of what assumptions market makers are using to determine their quoted bid and ask prices. As such, implied volatility can be a helpful proxy in gauging the market. Higher-than-normal implied volatilities are usually more favorable for options sellers, while lower-than-normal implied volatilities are more favorable for option buyers, because volatility often reverts back to its mean over time. Implied volatility is often provided on options trading platforms because it is typically more useful for traders to know how volatile a market maker thinks a stock will be than to try to estimate it themselves. Implied volatility is usually not consistent for all options of a particular security or index and will generally be lowest for at-the-money and near-the-money options.
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Answer the question based solely on the information provided in the passage. Do not use any external knowledge or resources. What does each option's Greek measure and how is it used to determine options pricing?Also, even though it's not a Greek, also include an explanation of implied volatility. Delta Delta measures how much an option's price can be expected to move for every $1 change in the price of the underlying security or index. For example, a Delta of 0.40 means the option's price will theoretically move $0.40 for every $1 change in the price of the underlying stock or index. As you might guess, this means the higher the Delta, the bigger the price change. Traders often use Delta to predict whether a given option will expire ITM. So, a Delta of 0.40 is taken to mean that at that moment in time, the option has about a 40% chance of being ITM at expiration. This doesn't mean higher-Delta options are always profitable. After all, if you paid a large premium for an option that expires ITM, you might not make any money. You can also think of Delta as the number of shares of the underlying stock the option behaves like. So, a Delta of 0.40 suggests that given a $1 move in the underlying stock, the option will likely gain or lose about the same amount of money as 40 shares of the stock. Call options Call options have a positive Delta that can range from 0.00 to 1.00. At-the-money options usually have a Delta near 0.50. The Delta will increase (and approach 1.00) as the option gets deeper ITM. The Delta of ITM call options will get closer to 1.00 as expiration approaches. The Delta of out-of-the-money call options will get closer to 0.00 as expiration approaches. Put options Put options have a negative Delta that can range from 0.00 to –1.00. At-the-money options usually have a Delta near –0.50. The Delta will decrease (and approach –1.00) as the option gets deeper ITM. The Delta of ITM put options will get closer to –1.00 as expiration approaches. The Delta of out-of-the-money put options will get closer to 0.00 as expiration approaches. Gamma Where Delta is a snapshot in time, Gamma measures the rate of change in an option's Delta over time. If you remember high school physics class, you can think of Delta as speed and Gamma as acceleration. In practice, Gamma is the rate of change in an option's Delta per $1 change in the price of the underlying stock. In the example above, we imagined an option with a Delta of .40. If the underlying stock moves $1 and the option moves $.40 along with it, the option's Delta is no longer 0.40. Why? This $1 move would mean the call option is now even deeper ITM, and so its Delta should move even closer to 1.00. So, let's assume that as a result the Delta is now 0.55. The change in Delta from 0.40 to 0.55 is 0.15—this is the option's Gamma. Because Delta can't exceed 1.00, Gamma decreases as an option gets further ITM and Delta approaches 1.00. After all, there's less room for acceleration as you approach top speed. Theta Theta tells you how much the price of an option should decrease each day as the option nears expiration, if all other factors remain the same. This kind of price erosion over time is known as time decay. Time-value erosion is not linear, meaning the price erosion of at-the-money (ATM), just slightly out-of-the-money, and ITM options generally increases as expiration approaches, while that of far out-of-the-money (OOTM) options generally decreases as expiration approaches. Time-value erosion Source: Schwab Center for Financial Research Vega Vega measures the rate of change in an option's price per one-percentage-point change in the implied volatility of the underlying stock. (There's more on implied volatility below.) While Vega is not a real Greek letter, it is intended to tell you how much an option's price should move when the volatility of the underlying security or index increases or decreases. More about Vega: Volatility is one of the most important factors affecting the value of options. A drop in Vega will typically cause both calls and puts to lose value. An increase in Vega will typically cause both calls and puts to gain value. Neglecting Vega can cause you to potentially overpay when buying options. All other factors being equal, when determining strategy, consider buying options when Vega is below "normal" levels and selling options when Vega is above "normal" levels. One way to determine this is to compare the historical volatility to the implied volatility. Chart studies for both values are available on StreetSmart Edge®. Rho Rho measures the expected change in an option's price per one-percentage-point change in interest rates. It tells you how much the price of an option should rise or fall if the risk-free interest rate (U.S. Treasury-bills)* increases or decreases. More about Rho: As interest rates increase, the value of call options will generally increase. As interest rates increase, the value of put options will usually decrease. For these reasons, call options have positive Rho and put options have negative Rho. Consider a hypothetical stock that's trading exactly at its strike price. If the stock is trading at $25, the 25 calls and the 25 puts would both be exactly at the money. You might see the calls trading at, say, $0.60, while the puts could be trading at $0.50. When interest rates are low, the price difference between puts and calls will be relatively small. If interest rates increase, the gap will get wider—calls will become more expensive and puts will become less so. Rho is generally not a huge factor in the price of an option, but should be considered if prevailing interest rates are expected to change, such as just before a Federal Open Market Committee (FOMC) meeting. Long-Term Equity AnticiPation Securities® (LEAPS®) options are far more sensitive to changes in interest rates than are shorter-term options. Implied volatility: like a Greek Though not actually a Greek, implied volatility is closely related. Implied volatility is a forecast of how volatile an underlying stock is expected to be in the future—but it's strictly theoretical. While it's possible to forecast a stock's future moves by looking at its historical volatility, among other factors, the implied volatility reflected in the price of an option is an inference based on other factors, too, such as upcoming earnings reports, merger and acquisition rumors, pending product launches, etc. Key points to remember: Figuring out exactly how volatile a stock will be at any given time is difficult, but looking at implied volatility can give you a sense of what assumptions market makers are using to determine their quoted bid and ask prices. As such, implied volatility can be a helpful proxy in gauging the market. Higher-than-normal implied volatilities are usually more favorable for options sellers, while lower-than-normal implied volatilities are more favorable for option buyers, because volatility often reverts back to its mean over time. Implied volatility is often provided on options trading platforms because it is typically more useful for traders to know how volatile a market maker thinks a stock will be than to try to estimate it themselves. Implied volatility is usually not consistent for all options of a particular security or index and will generally be lowest for at-the-money and near-the-money options. https://www.schwab.com/learn/story/get-to-know-option-greeks
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Answer the question based solely on the information provided in the passage. Do not use any external knowledge or resources. [user request] [context document]
EVIDENCE:
Delta Delta measures how much an option's price can be expected to move for every $1 change in the price of the underlying security or index. For example, a Delta of 0.40 means the option's price will theoretically move $0.40 for every $1 change in the price of the underlying stock or index. As you might guess, this means the higher the Delta, the bigger the price change. Traders often use Delta to predict whether a given option will expire ITM. So, a Delta of 0.40 is taken to mean that at that moment in time, the option has about a 40% chance of being ITM at expiration. This doesn't mean higher-Delta options are always profitable. After all, if you paid a large premium for an option that expires ITM, you might not make any money. You can also think of Delta as the number of shares of the underlying stock the option behaves like. So, a Delta of 0.40 suggests that given a $1 move in the underlying stock, the option will likely gain or lose about the same amount of money as 40 shares of the stock. Call options Call options have a positive Delta that can range from 0.00 to 1.00. At-the-money options usually have a Delta near 0.50. The Delta will increase (and approach 1.00) as the option gets deeper ITM. The Delta of ITM call options will get closer to 1.00 as expiration approaches. The Delta of out-of-the-money call options will get closer to 0.00 as expiration approaches. Put options Put options have a negative Delta that can range from 0.00 to –1.00. At-the-money options usually have a Delta near –0.50. The Delta will decrease (and approach –1.00) as the option gets deeper ITM. The Delta of ITM put options will get closer to –1.00 as expiration approaches. The Delta of out-of-the-money put options will get closer to 0.00 as expiration approaches. Gamma Where Delta is a snapshot in time, Gamma measures the rate of change in an option's Delta over time. If you remember high school physics class, you can think of Delta as speed and Gamma as acceleration. In practice, Gamma is the rate of change in an option's Delta per $1 change in the price of the underlying stock. In the example above, we imagined an option with a Delta of .40. If the underlying stock moves $1 and the option moves $.40 along with it, the option's Delta is no longer 0.40. Why? This $1 move would mean the call option is now even deeper ITM, and so its Delta should move even closer to 1.00. So, let's assume that as a result the Delta is now 0.55. The change in Delta from 0.40 to 0.55 is 0.15—this is the option's Gamma. Because Delta can't exceed 1.00, Gamma decreases as an option gets further ITM and Delta approaches 1.00. After all, there's less room for acceleration as you approach top speed. Theta Theta tells you how much the price of an option should decrease each day as the option nears expiration, if all other factors remain the same. This kind of price erosion over time is known as time decay. Time-value erosion is not linear, meaning the price erosion of at-the-money (ATM), just slightly out-of-the-money, and ITM options generally increases as expiration approaches, while that of far out-of-the-money (OOTM) options generally decreases as expiration approaches. Time-value erosion Source: Schwab Center for Financial Research Vega Vega measures the rate of change in an option's price per one-percentage-point change in the implied volatility of the underlying stock. (There's more on implied volatility below.) While Vega is not a real Greek letter, it is intended to tell you how much an option's price should move when the volatility of the underlying security or index increases or decreases. More about Vega: Volatility is one of the most important factors affecting the value of options. A drop in Vega will typically cause both calls and puts to lose value. An increase in Vega will typically cause both calls and puts to gain value. Neglecting Vega can cause you to potentially overpay when buying options. All other factors being equal, when determining strategy, consider buying options when Vega is below "normal" levels and selling options when Vega is above "normal" levels. One way to determine this is to compare the historical volatility to the implied volatility. Chart studies for both values are available on StreetSmart Edge®. Rho Rho measures the expected change in an option's price per one-percentage-point change in interest rates. It tells you how much the price of an option should rise or fall if the risk-free interest rate (U.S. Treasury-bills)* increases or decreases. More about Rho: As interest rates increase, the value of call options will generally increase. As interest rates increase, the value of put options will usually decrease. For these reasons, call options have positive Rho and put options have negative Rho. Consider a hypothetical stock that's trading exactly at its strike price. If the stock is trading at $25, the 25 calls and the 25 puts would both be exactly at the money. You might see the calls trading at, say, $0.60, while the puts could be trading at $0.50. When interest rates are low, the price difference between puts and calls will be relatively small. If interest rates increase, the gap will get wider—calls will become more expensive and puts will become less so. Rho is generally not a huge factor in the price of an option, but should be considered if prevailing interest rates are expected to change, such as just before a Federal Open Market Committee (FOMC) meeting. Long-Term Equity AnticiPation Securities® (LEAPS®) options are far more sensitive to changes in interest rates than are shorter-term options. Implied volatility: like a Greek Though not actually a Greek, implied volatility is closely related. Implied volatility is a forecast of how volatile an underlying stock is expected to be in the future—but it's strictly theoretical. While it's possible to forecast a stock's future moves by looking at its historical volatility, among other factors, the implied volatility reflected in the price of an option is an inference based on other factors, too, such as upcoming earnings reports, merger and acquisition rumors, pending product launches, etc. Key points to remember: Figuring out exactly how volatile a stock will be at any given time is difficult, but looking at implied volatility can give you a sense of what assumptions market makers are using to determine their quoted bid and ask prices. As such, implied volatility can be a helpful proxy in gauging the market. Higher-than-normal implied volatilities are usually more favorable for options sellers, while lower-than-normal implied volatilities are more favorable for option buyers, because volatility often reverts back to its mean over time. Implied volatility is often provided on options trading platforms because it is typically more useful for traders to know how volatile a market maker thinks a stock will be than to try to estimate it themselves. Implied volatility is usually not consistent for all options of a particular security or index and will generally be lowest for at-the-money and near-the-money options.
USER:
What does each option's Greek measure and how is it used to determine options pricing?Also, even though it's not a Greek, also include an explanation of implied volatility.
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
| false | 24 | 28 | 1,192 | null | 588 |
You will answer all questions using only information from the resource provided in the prompt.
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Use the text provided to explain the difference between Adam Smith's economic philosophy and that of Friedrich List.
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Class 1: The Purpose of the Corporation (Dodge v. Ford Motor Company) Dodge v. Ford Motor Company is a great case. It is important because its ruling touches on a question at the very core of corporate law: what is the purpose of the corporation? Is it exclusively to make the most money for shareholders? (And if so – making the most money long-term or short- term?) Or perhaps it is also permissible – or even required – that the corporation would act in the interests of other stakeholders – employees, creditors, customers, the local community, or the nation in which it is incorporated? But there is another reason why Dodge v. Ford Motor Company is a great case: the parties are pretending to act for reasons different than those that really motivate them. As we will see in class, the plaintiff and defendant present their interests in ways that don’t make sense once you think things through. And read narrowly, the court’s decision seems almost arbitrary and in contrast to established law. But once you understand the entire context, the court ruling can be seen as a clever way to maintain both the letter and the spirit of established law. But no case is perfect. The main weakness of Dodge is that it is not well-written; indeed, it is quite boring to read. Another weakness is that the actual legal question it discusses is a narrow one that requires knowing some corporate law to understand. Therefore, though I am including the text of the case for you to read ahead of class, it is not the main assignment and you should not feel frustrated if it’s not clear to you. I will explain the case in class. Rather, the main reading assignment ahead of class is an excerpt from an old magazine article, about an economist you may never have heard about – Friedrich List. I think this is a more enjoyable reading, and it will give you background for a discussion on the big policy question Dodge tackles: whose interests should the corporation serve? No doubt you have heard of Adam Smith and later classical economists who espoused free-market economics, based on the idea that self-interested behavior by market participants enriches society as a whole. The line of corporate law doctrine that fits with this worldview is the norm that a corporation should operate solely for the purpose of its shareholders, and that this would ultimately benefit all other stakeholders (employees, customers, society as a whole, etc.). Friedrich List is a leading intellectual force behind an opposing view, which is why I ask that you read the article to understand the main differences between his world view and that of his free- market opponents (which he called the “cosmopolitans”). While List is not widely known today, his work is credited with influencing the thinking of several policy makers and leaders, including China’s Deng Xiaoping. In some ways, List appears more relevant to political debate today – with the rise of populist politicians in several countries including the U.S. – than it was when the article was written. But in other ways, this article is very much a product of its time. To a contemporary reader it may appear odd how much Japan and Germany are mentioned in the article compared to other countries (for example, China). But this was very typical of American policy analysis (and popular culture) in the 1980s. At that time, the American economy was relatively stagnant, while the economies of Japan and Germany were booming. The US had a large trade deficit with these countries, with cheaper German and Japanese imports crowding out a shrinking American industry, and German and Japanese firms used the dollars they acquired from the deficit to acquire iconic American assets. The result was fear of those two countries on one hand, and a desire to mimic them on the other hand. The article is in the tail end of that trend; by the 1990s Japan entered a prolonged recession, the German economy slowed under the costs of the reunification of West and East Germany, and the American economy prospered again. You may be more familiar with a reincarnation of this trend, in the 2000s and early 2010s, this time focused on China.
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System Instruction: You will answer all questions using only information from the resource provided in the prompt. Question: Use the text provided to explain the difference between Adam Smith's economic philosophy and that of Friedrich List. Context Block: Class 1: The Purpose of the Corporation (Dodge v. Ford Motor Company) Dodge v. Ford Motor Company is a great case. It is important because its ruling touches on a question at the very core of corporate law: what is the purpose of the corporation? Is it exclusively to make the most money for shareholders? (And if so – making the most money long-term or short- term?) Or perhaps it is also permissible – or even required – that the corporation would act in the interests of other stakeholders – employees, creditors, customers, the local community, or the nation in which it is incorporated? But there is another reason why Dodge v. Ford Motor Company is a great case: the parties are pretending to act for reasons different than those that really motivate them. As we will see in class, the plaintiff and defendant present their interests in ways that don’t make sense once you think things through. And read narrowly, the court’s decision seems almost arbitrary and in contrast to established law. But once you understand the entire context, the court ruling can be seen as a clever way to maintain both the letter and the spirit of established law. But no case is perfect. The main weakness of Dodge is that it is not well-written; indeed, it is quite boring to read. Another weakness is that the actual legal question it discusses is a narrow one that requires knowing some corporate law to understand. Therefore, though I am including the text of the case for you to read ahead of class, it is not the main assignment and you should not feel frustrated if it’s not clear to you. I will explain the case in class. Rather, the main reading assignment ahead of class is an excerpt from an old magazine article, about an economist you may never have heard about – Friedrich List. I think this is a more enjoyable reading, and it will give you background for a discussion on the big policy question Dodge tackles: whose interests should the corporation serve? No doubt you have heard of Adam Smith and later classical economists who espoused free-market economics, based on the idea that self-interested behavior by market participants enriches society as a whole. The line of corporate law doctrine that fits with this worldview is the norm that a corporation should operate solely for the purpose of its shareholders, and that this would ultimately benefit all other stakeholders (employees, customers, society as a whole, etc.). Friedrich List is a leading intellectual force behind an opposing view, which is why I ask that you read the article to understand the main differences between his world view and that of his free- market opponents (which he called the “cosmopolitans”). While List is not widely known today, his work is credited with influencing the thinking of several policy makers and leaders, including China’s Deng Xiaoping. In some ways, List appears more relevant to political debate today – with the rise of populist politicians in several countries including the U.S. – than it was when the article was written. But in other ways, this article is very much a product of its time. To a contemporary reader it may appear odd how much Japan and Germany are mentioned in the article compared to other countries (for example, China). But this was very typical of American policy analysis (and popular culture) in the 1980s. At that time, the American economy was relatively stagnant, while the economies of Japan and Germany were booming. The US had a large trade deficit with these countries, with cheaper German and Japanese imports crowding out a shrinking American industry, and German and Japanese firms used the dollars they acquired from the deficit to acquire iconic American assets. The result was fear of those two countries on one hand, and a desire to mimic them on the other hand. The article is in the tail end of that trend; by the 1990s Japan entered a prolonged recession, the German economy slowed under the costs of the reunification of West and East Germany, and the American economy prospered again. You may be more familiar with a reincarnation of this trend, in the 2000s and early 2010s, this time focused on China.
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You will answer all questions using only information from the resource provided in the prompt.
EVIDENCE:
Class 1: The Purpose of the Corporation (Dodge v. Ford Motor Company) Dodge v. Ford Motor Company is a great case. It is important because its ruling touches on a question at the very core of corporate law: what is the purpose of the corporation? Is it exclusively to make the most money for shareholders? (And if so – making the most money long-term or short- term?) Or perhaps it is also permissible – or even required – that the corporation would act in the interests of other stakeholders – employees, creditors, customers, the local community, or the nation in which it is incorporated? But there is another reason why Dodge v. Ford Motor Company is a great case: the parties are pretending to act for reasons different than those that really motivate them. As we will see in class, the plaintiff and defendant present their interests in ways that don’t make sense once you think things through. And read narrowly, the court’s decision seems almost arbitrary and in contrast to established law. But once you understand the entire context, the court ruling can be seen as a clever way to maintain both the letter and the spirit of established law. But no case is perfect. The main weakness of Dodge is that it is not well-written; indeed, it is quite boring to read. Another weakness is that the actual legal question it discusses is a narrow one that requires knowing some corporate law to understand. Therefore, though I am including the text of the case for you to read ahead of class, it is not the main assignment and you should not feel frustrated if it’s not clear to you. I will explain the case in class. Rather, the main reading assignment ahead of class is an excerpt from an old magazine article, about an economist you may never have heard about – Friedrich List. I think this is a more enjoyable reading, and it will give you background for a discussion on the big policy question Dodge tackles: whose interests should the corporation serve? No doubt you have heard of Adam Smith and later classical economists who espoused free-market economics, based on the idea that self-interested behavior by market participants enriches society as a whole. The line of corporate law doctrine that fits with this worldview is the norm that a corporation should operate solely for the purpose of its shareholders, and that this would ultimately benefit all other stakeholders (employees, customers, society as a whole, etc.). Friedrich List is a leading intellectual force behind an opposing view, which is why I ask that you read the article to understand the main differences between his world view and that of his free- market opponents (which he called the “cosmopolitans”). While List is not widely known today, his work is credited with influencing the thinking of several policy makers and leaders, including China’s Deng Xiaoping. In some ways, List appears more relevant to political debate today – with the rise of populist politicians in several countries including the U.S. – than it was when the article was written. But in other ways, this article is very much a product of its time. To a contemporary reader it may appear odd how much Japan and Germany are mentioned in the article compared to other countries (for example, China). But this was very typical of American policy analysis (and popular culture) in the 1980s. At that time, the American economy was relatively stagnant, while the economies of Japan and Germany were booming. The US had a large trade deficit with these countries, with cheaper German and Japanese imports crowding out a shrinking American industry, and German and Japanese firms used the dollars they acquired from the deficit to acquire iconic American assets. The result was fear of those two countries on one hand, and a desire to mimic them on the other hand. The article is in the tail end of that trend; by the 1990s Japan entered a prolonged recession, the German economy slowed under the costs of the reunification of West and East Germany, and the American economy prospered again. You may be more familiar with a reincarnation of this trend, in the 2000s and early 2010s, this time focused on China.
USER:
Use the text provided to explain the difference between Adam Smith's economic philosophy and that of Friedrich List.
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
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Use only the information contained in the prompt to answer any questions the user may ask. Do not use any other sources or any information from your stored data from before this conversation. If you cannot answer the user's question using only the provided context, say "I can't determine the answer as the information you are seeking is not provided in the reference document." Format your answer in a bullet point list.
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What mechanisms have been proposed for post-Covid neurological complications?
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Introduction The predominant acute presentations of COVID-19 are respiratory, but neurological manifestations have been recognized as an important component of the disease, even in cases without respiratory symptoms (2-5). The neurological manifestations associated with COVID-19 range from mild to critical, affect adults and children and can present both during and after acute COVID-19 infection. Reported neurological signs, symptoms or syndromes in the acute phase include headache, dizziness, impaired taste or smell, delirium, agitation, stroke, seizures, coma, meningoencephalitis and Guillain-Barré syndrome (6, 7). Consequences in the post-acute phase are also emerging, as either persisting or newly developing signs and symptoms (post-COVID-19 condition); these include headache, problems with smell or taste, cognitive impairment, confusion, fatigue, difficulty concentrating, sleep disturbances and neuropsychiatric symptoms (8, 9). COVID-19 disproportionately affects people with pre-existing neurological disorders. Chronic neurological disorders were found to be independently associated with increased mortality in hospitalized COVID-19 patients (hazard ratio [HR]: 2.13; 95% confidence interval [CI]: 1.38–3.28) (10). Individuals with pre-existing neurological conditions have been affected by disruptions to routine care, delayed care because of concerns about infectious risks and disruptions to supply chains for medicines and resultant stock-outs (11). This scientific brief provides a comprehensive overview of the relationship between neurology and COVID-19 and covers what is currently known about: • the acute neurological manifestations of COVID-19 • the neurological sequelae associated with post-COVID-19 condition • the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions • the extent of disruptions to neurological services caused by the pandemic and mitigation strategies to address these disruptions • emerging evidence for neurological complications following COVID-19 vaccination. The target audience for this document includes health care providers, researchers, policy-makers and other stakeholders interested in the evidence relating to neurology and COVID-19. The aim is to increase awareness and recognition of the associated neurological aspects of COVID-19 to improve care and mitigation responses, particularly in low-resource settings. Methods This scientific brief is based on the evidence that emerged from systematic or rapid reviews and meta-analyses commissioned by WHO (14);1 WHO pulse surveys (15); WHO’s rapid assessment on services for mental, neurological and substance use (MNS) disorders (16) and other relevant publications. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265); and Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T. et al. Frequency of neurological manifestations in COVID-19: a systematic review and meta-analysis of 350 studies (https://www.medrxiv.org/content/10.1101/2021.04.20.21255780v1) 1 Neurology and COVID-19: Scientific brief -2- Review of the evidence Acute neurological manifestations of COVID-19 To assess the types and frequencies of reported neurological manifestations associated with COVID-19, WHO assisted with a systematic review and meta-analysis involving data from 145 721 patients with acute COVID-19 infections derived from 350 case series (17). COVID-19 infection was confirmed by real-time reverse-transcription polymerase chain reaction (RT-PCR) detection, high-throughput sequencing, SARS-CoV-2 viral culture in throat swab specimens, SARS-CoV-2 antibody detection in blood samples or SARS-CoV-2 viral culture in throat swab specimens. Most patients (n=129 786, 89%) included in the review were hospitalized. A total of 23 acute neurological symptoms (Table 1) and 14 neurological diagnoses (Table 2) were reported in the literature. Up to one third (n=48 059) of COVID-19 patients experienced some type of neurological manifestation, and 1 in 50 developed a stroke. In COVID-19 patients aged over 60 years, the most frequent neurological manifestation was acute confusion/delirium (pooled prevalence: 34%; 95% CI: 23–46%). For all ages, the likelihood of experiencing acute confusion/delirium, stroke, seizure and movement disorders increased with increasing severity of COVID-19, but these associations were not statistically significant. Smell and taste impairments were significantly associated with non-severe COVID-19 (odds ratio [OR]: 0.44; 95% CI: 0.28–0.68 and OR: 0.62; 95% CI: 0.42–0.91, respectively). In COVID-19 patients aged over 60 years, the presence of any neurological manifestations was associated with significantly increased mortality (OR: 1.80; 95% CI: 1.11–2.91). Limitations The overall risk of bias was assessed as being low for most studies (n=296, 85%) but studies with higher risk of bias yielded higher prevalence estimates. Also, for most outcomes the meta-analyses yielded a high degree of heterogeneity, indicating substantial clinical or methodological diversity, which in some instances rendered the pooling of data inappropriate. There are gaps in the evidence for non-hospitalized patient cohorts because their data are rarely reported in the literature. The evidence gaps have implications for incidence, prevalence, duration and severity. Similarly, the timing of the onset of signs or symptoms is often not reported. Limitations in study design of included case series precluded the comparison between acute neurological manifestations caused by COVID-19 and the incidence of such manifestations in the general population. Finally, in the absence of well-designed cohort studies, there are insufficient data to definitively assert causality between these symptoms and COVID-19. Neurological sequelae associated with post-COVID-19 condition Complications following acute viral illnesses are well described (18, 19). Soon after the advent of the COVID-19 pandemic, longitudinal cohort studies started to assess long-term sequelae of COVID-19, including neurological manifestations. At the same time, patients began to connect with each other and report on prolonged symptoms of COVID-19. In response, WHO commissioned a rapid review of 28 published population-based, cohort or case-control studies2. The review established specific new-onset neurological symptoms, signs or diagnoses occurring after the acute phase of COVID-19 that can be interpreted as complications of COVID-19; assessed specific neurological symptoms, signs or diagnoses that persist after the acute phase of COVID-19; and determined factors associated with these post acute neurological manifestations. Of the 28 studies, only two followed patients for up to 6 months. Pooling of information was not possible for methodological reasons. In a retrospective cohort of 1733 COVID-19 patients discharged from hospital, 19.6% (n=340) reported neurological manifestations after a median follow-up of 186 days (9). The complaints most commonly reported were fatigue or muscle weakness (63%; 1038/1655) and sleep difficulties (26%; 437/1655). Anxiety and depression were reported by 23% (367/1617) of patients and difficulty walking by 24% (103/423). The second prospective study followed 61 hospitalized COVID-19 patients with and without history of admission to an intensive care unit (ICU) (20). 2 Beghi E, Giussani G, Westenberg E, Allegri R, Garcia-Azorin D, Guekht A, Acute and Post-Acute Neurological Manifestations of COVID-19: Present findings, critical appraisal, and future directions. Manuscript in preparation, 2021. Neurology and COVID-19: Scientific brief Common complaints at discharge included amnestic dysfunction (30%; 18/61), dysexecutive syndrome (33%; 20/61), ataxia (11%, 7/61), and tetraparesis (18%; 11/61) (20). Limitations The evidence for long-term or newly emerging neurological complications after COVID-19 is limited, particularly in asymptomatic or non-hospitalized patients. Similarly, little is known about neurological sequelae in paediatric patients with conditions related to COVID-19, including multisystem inflammatory syndrome (MIS-C). Data from low- and middle-income countries are scarce, particularly in the post-acute phase. This has led to underreporting of neurological findings in the context of COVID-19 with reference to geography, ethnicity and sociocultural environment. Methodological issues and study design flaws further reduce the strength of the current evidence because some studies have included in the control group asymptomatic patients who were not screened with molecular or serological tests to confirm or exclude SARS-CoV-2 infection. Screening methods and diagnostic protocols vary across studies, depending on the background of the local investigators, the diagnostic approach, the number and type of contacts during follow-up and, not least, attrition and patient compliance. In addition, studies were done under surge conditions, which led to incomplete diagnostic assessment. The current understanding of neurological sequelae associated with post-COVID-19 condition is based mainly on patient reports; clinically relevant manifestations; and greater attention towards symptoms, signs and diseases that have been illustrated in previous reports By contrast, information is limited on signs that can be documented only through testing, imaging or biochemical or pathological investigations. Pre-existing neurological conditions and COVID-19 A range of pre-existing noncommunicable diseases (NCDs) are associated with an increased risk of severe outcomes in COVID-19 (21). These include several neurological conditions such as stroke and dementia. People with certain pre existing neurological conditions are more vulnerable to SARS-CoV-2 infection, experience exacerbations of their pre existing disease (22) and have higher risks of severe outcomes and death (10, 23). To synthesize the growing evidence on this topic, WHO commissioned a rapid review of 26 articles from 12 countries across three continents, with a total of 379 947 COVID-19 patients, to establish the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions.3 The rapid review found that certain pre-existing neurological diseases are associated with severity of COVID-19.4 The most prevalent were cerebrovascular disease and dementia/neurodegenerative diseases (pooled OR: 1.99; 95% CI: 1.81 2.18). Mortality was high among people with pre-existing neurological conditions (pooled OR: 1.74; 95% CI: 1.56 1.94). Limitations Risk of bias was deemed high for most articles, and the overall quality of studies using GRADE (Grading of Recommendations Assessment, Development and Evaluations) methodology was low; hence, the value of the current evidence is limited. Most studies on the relationship between SARS-CoV-2 and pre-existing neurological conditions are based on retrospective cohorts or case series, with few data from prospective studies. Future research will benefit greatly from the use of standardized definitions and reporting for comorbidities, neurological symptoms or diagnoses. Use of standardized case report forms – such as those published by WHO (25, 26) – can also contribute to the accuracy and reliability of data. Disruptions to essential neurological services caused by the COVID-19 pandemic and mitigation strategies Interruption of routine treatment and care, as well as supply chains for medications during the COVID-19 pandemic, present significant challenges for people with neurological conditions (11). According to the latest WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic (27), 45% of 121 countries for which information was available still reported disruptions to services for MNS disorders in the first quarter of 2021. Likewise, 3Chomba M, Schiess N, Seeher K, Akpalu A, Baila J, Boruah AP et al. Pre-existing neurological conditions and COVID-19 risk. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265) 4Ibid. -4- Neurology and COVID-19: Scientific brief disruptions to rehabilitation services, a crucial aspect of neurological care, continue to be reported by 53% (of 89 countries). With respect to neurology-specific services, WHO’s rapid assessment of services for MNS disorders during the COVID-19 pandemic in mid-2020 (16) revealed that one in three of 98 countries closed down neurology inpatient units at least partly during the pandemic. Regarding service provision, surgeries for neurological disorders were disrupted in two-thirds of 130 countries for which information was available, and the management of emergency conditions such as status epilepticus was at least partially disrupted in 35% of the same 130 countries. To better understand the extent of service disruption, its causes and mitigation strategies for neurological disorders in the context of COVID-19, WHO commissioned a rapid review of 369 articles, providing data on 210 419 patients from 105 countries (14). Studies that investigated the extent of service disruption (n=188) described it as mild (n=40, 21%), moderate (n=131, 70%) or severe (n=10, 5%). The most frequently described reasons for service disruption across 240 studies were travel restrictions related to lockdown (n=196, 82%), closure of services or consultations as per health authority directive (n=157, 65%) and reduced outpatient volume due to patients not presenting (n=135, 56%). A total of 224 studies reported on mitigation strategies, with the most frequently reported strategies being telemedicine and other teleconsultation formats (n=184, 82%), novel dispensing approaches for medicines (n=116, 52%) and redirection of patients (n=95, 42%). Limitations To date, most of the data on service disruption have been derived from high- and middle-income countries, with information from low-income countries lacking. Similarly, evidence of the effectiveness and acceptability of mitigation strategies to patients remains limited. In addition, the current published literature seems biased towards certain settings or types of services (e.g. outpatient, emergency or inpatient care). There are few reports on other areas that are crucial for treating people with chronic neurological conditions (e.g. neurorehabilitation). Going forward, more systematic evaluations and reporting of disruption of the whole spectrum of neurological services can provide a more comprehensive picture. Neurological complications following COVID-19 vaccination There is a low risk following COVID-19 vaccination of neurological complications including Bell’s palsy (28), cerebral venous sinus thrombosis (CVST) and possibly Guillain-Barré syndrome (29). However, the risk of such complications is substantially lower than the risks associated with infection with SARS-CoV-2 (30, 31). Since March 2021, cases of thromboses associated with thrombocytopenia have been reported in patients vaccinated with the Oxford-AstraZeneca ChAdOx1-S and Johnson & Johnson (J&J) Janssen Ad26.COV2.S COVID-19 vaccines. Evaluation of the cases by national and international bodies concluded that there was a plausible causal link between these two adenovirus-vectored vaccines and CVST (32-34), based on the temporal association with vaccination and an increased incidence when compared with expected baseline rates of CVST (35-42). WHO has provided guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination against COVID-19 (43). Overall knowledge gaps Current evidence suggests that SARS-CoV-2 can affect the nervous system. Multiple and probably overlapping mechanisms have been proposed for the neurological manifestations; they include hypoxia, cytokine storm, post infectious autoimmune responses, hypercoagulability, neurologic complications of severe systemic illness and potential direct neurotropism. Questions remain regarding the characteristics, timing and severity of neurological manifestations of COVID-19, including the pathophysiological mechanisms through which SARS-CoV-2 affects the nervous system. As more data emerge, associations of specific neurological disorders with COVID-19 will be further clarified – as has been seen, for example, with Guillain-Barré syndrome (29). Prospective data, as well as biomarker and neuropathological studies, are needed on the short- and long-term neurological sequelae. Existing reports on the association between COVID-19 and most neurological manifestations are flawed by selection and information bias, and available data reflect the spectrum of neurological manifestations in patients with the more severe COVID-19 cases. Neurological signs or symptoms occurring during the acute phase of COVID-19 infection cannot easily be disentangled from those with onset in the post-acute phase, and follow-up data are scarce, particularly for subclinical findings such as cognitive impairment. -5- Neurology and COVID-19: Scientific brief Other gaps in the literature include a lack of clarity on the interplay between pre-existing neurological disease and other underlying comorbidities such as hypertension and diabetes. Studies in this area were hospital-based and biased to people with more severe symptoms, making the findings difficult to generalize to people based in the community or having only mild symptoms. Understanding the impact of neurological conditions requires the inclusion of diverse populations from a variety of social backgrounds. Guidance is also needed for studies evaluating the disruption or the efficacy of mitigation strategies for care. Efforts should be made to harmonize the methods in this area of research and to enhance the comparability between studies and over time. In addition, funding for and progress in neurological research and training have been affected by the pandemic, owing to the temporary suspension of research projects or postponement or cancellation of fellowships, which need to be re-established as soon as possible (44). Implications for further research Well-designed case–control and cohort studies are needed to understand which patients are most vulnerable to neurological manifestations in the acute and post COVID-19 condition and to understand causality related to COVID 19. Series of patients with neurological conditions need to be compared to patients without neurological conditions. Use of case report forms (CRFs) such as WHO’s post-COVID-19 condition CRF (45) is encouraged to standardize data collection. Future research directions should include more “bottom-up” evidence-gathering efforts; for example, international surveys of neurological associations such as one recently undertaken by the European Federation of Neurological Associations (EFNA) with support from members of the WHO Neurology and COVID-19 Global Forum (46). Conclusion A wide spectrum of acute and post-acute neurological manifestations associated with COVID-19 have been reported across the globe. Clinicians and health care workers should be aware of such presentations and complications even in the absence of respiratory symptoms. Disruptions in access to essential neurological services and availability of essential medications for people with pre-existing neurological conditions can be detrimental; hence, mitigation strategies such as remote technology and telemedicine alternatives should be judiciously employed. The COVID-19 pandemic continues to have an impact on neurological health, service delivery, research and training while widening existing disparities worldwide. Recognizing and addressing these factors will provide opportunities to improve neurological care worldwide. Plans for updating WHO continues to monitor the situation closely for any changes that may affect this scientific brief.
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System instruction: Use only the information contained in the prompt to answer any questions the user may ask. Do not use any other sources or any information from your stored data from before this conversation. If you cannot answer the user's question using only the provided context, say "I can't determine the answer as the information you are seeking is not provided in the reference document." Format your answer in a bullet point list. Question: What mechanisms have been proposed for post-Covid neurological complications? Context: Introduction The predominant acute presentations of COVID-19 are respiratory, but neurological manifestations have been recognized as an important component of the disease, even in cases without respiratory symptoms (2-5). The neurological manifestations associated with COVID-19 range from mild to critical, affect adults and children and can present both during and after acute COVID-19 infection. Reported neurological signs, symptoms or syndromes in the acute phase include headache, dizziness, impaired taste or smell, delirium, agitation, stroke, seizures, coma, meningoencephalitis and Guillain-Barré syndrome (6, 7). Consequences in the post-acute phase are also emerging, as either persisting or newly developing signs and symptoms (post-COVID-19 condition); these include headache, problems with smell or taste, cognitive impairment, confusion, fatigue, difficulty concentrating, sleep disturbances and neuropsychiatric symptoms (8, 9). COVID-19 disproportionately affects people with pre-existing neurological disorders. Chronic neurological disorders were found to be independently associated with increased mortality in hospitalized COVID-19 patients (hazard ratio [HR]: 2.13; 95% confidence interval [CI]: 1.38–3.28) (10). Individuals with pre-existing neurological conditions have been affected by disruptions to routine care, delayed care because of concerns about infectious risks and disruptions to supply chains for medicines and resultant stock-outs (11). This scientific brief provides a comprehensive overview of the relationship between neurology and COVID-19 and covers what is currently known about: • the acute neurological manifestations of COVID-19 • the neurological sequelae associated with post-COVID-19 condition • the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions • the extent of disruptions to neurological services caused by the pandemic and mitigation strategies to address these disruptions • emerging evidence for neurological complications following COVID-19 vaccination. The target audience for this document includes health care providers, researchers, policy-makers and other stakeholders interested in the evidence relating to neurology and COVID-19. The aim is to increase awareness and recognition of the associated neurological aspects of COVID-19 to improve care and mitigation responses, particularly in low-resource settings. Methods This scientific brief is based on the evidence that emerged from systematic or rapid reviews and meta-analyses commissioned by WHO (14);1 WHO pulse surveys (15); WHO’s rapid assessment on services for mental, neurological and substance use (MNS) disorders (16) and other relevant publications. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265); and Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T. et al. Frequency of neurological manifestations in COVID-19: a systematic review and meta-analysis of 350 studies (https://www.medrxiv.org/content/10.1101/2021.04.20.21255780v1) 1 Neurology and COVID-19: Scientific brief -2- Review of the evidence Acute neurological manifestations of COVID-19 To assess the types and frequencies of reported neurological manifestations associated with COVID-19, WHO assisted with a systematic review and meta-analysis involving data from 145 721 patients with acute COVID-19 infections derived from 350 case series (17). COVID-19 infection was confirmed by real-time reverse-transcription polymerase chain reaction (RT-PCR) detection, high-throughput sequencing, SARS-CoV-2 viral culture in throat swab specimens, SARS-CoV-2 antibody detection in blood samples or SARS-CoV-2 viral culture in throat swab specimens. Most patients (n=129 786, 89%) included in the review were hospitalized. A total of 23 acute neurological symptoms (Table 1) and 14 neurological diagnoses (Table 2) were reported in the literature. Up to one third (n=48 059) of COVID-19 patients experienced some type of neurological manifestation, and 1 in 50 developed a stroke. In COVID-19 patients aged over 60 years, the most frequent neurological manifestation was acute confusion/delirium (pooled prevalence: 34%; 95% CI: 23–46%). For all ages, the likelihood of experiencing acute confusion/delirium, stroke, seizure and movement disorders increased with increasing severity of COVID-19, but these associations were not statistically significant. Smell and taste impairments were significantly associated with non-severe COVID-19 (odds ratio [OR]: 0.44; 95% CI: 0.28–0.68 and OR: 0.62; 95% CI: 0.42–0.91, respectively). In COVID-19 patients aged over 60 years, the presence of any neurological manifestations was associated with significantly increased mortality (OR: 1.80; 95% CI: 1.11–2.91). Limitations The overall risk of bias was assessed as being low for most studies (n=296, 85%) but studies with higher risk of bias yielded higher prevalence estimates. Also, for most outcomes the meta-analyses yielded a high degree of heterogeneity, indicating substantial clinical or methodological diversity, which in some instances rendered the pooling of data inappropriate. There are gaps in the evidence for non-hospitalized patient cohorts because their data are rarely reported in the literature. The evidence gaps have implications for incidence, prevalence, duration and severity. Similarly, the timing of the onset of signs or symptoms is often not reported. Limitations in study design of included case series precluded the comparison between acute neurological manifestations caused by COVID-19 and the incidence of such manifestations in the general population. Finally, in the absence of well-designed cohort studies, there are insufficient data to definitively assert causality between these symptoms and COVID-19. Neurological sequelae associated with post-COVID-19 condition Complications following acute viral illnesses are well described (18, 19). Soon after the advent of the COVID-19 pandemic, longitudinal cohort studies started to assess long-term sequelae of COVID-19, including neurological manifestations. At the same time, patients began to connect with each other and report on prolonged symptoms of COVID-19. In response, WHO commissioned a rapid review of 28 published population-based, cohort or case-control studies2. The review established specific new-onset neurological symptoms, signs or diagnoses occurring after the acute phase of COVID-19 that can be interpreted as complications of COVID-19; assessed specific neurological symptoms, signs or diagnoses that persist after the acute phase of COVID-19; and determined factors associated with these post acute neurological manifestations. Of the 28 studies, only two followed patients for up to 6 months. Pooling of information was not possible for methodological reasons. In a retrospective cohort of 1733 COVID-19 patients discharged from hospital, 19.6% (n=340) reported neurological manifestations after a median follow-up of 186 days (9). The complaints most commonly reported were fatigue or muscle weakness (63%; 1038/1655) and sleep difficulties (26%; 437/1655). Anxiety and depression were reported by 23% (367/1617) of patients and difficulty walking by 24% (103/423). The second prospective study followed 61 hospitalized COVID-19 patients with and without history of admission to an intensive care unit (ICU) (20). 2 Beghi E, Giussani G, Westenberg E, Allegri R, Garcia-Azorin D, Guekht A, Acute and Post-Acute Neurological Manifestations of COVID-19: Present findings, critical appraisal, and future directions. Manuscript in preparation, 2021. Neurology and COVID-19: Scientific brief Common complaints at discharge included amnestic dysfunction (30%; 18/61), dysexecutive syndrome (33%; 20/61), ataxia (11%, 7/61), and tetraparesis (18%; 11/61) (20). Limitations The evidence for long-term or newly emerging neurological complications after COVID-19 is limited, particularly in asymptomatic or non-hospitalized patients. Similarly, little is known about neurological sequelae in paediatric patients with conditions related to COVID-19, including multisystem inflammatory syndrome (MIS-C). Data from low- and middle-income countries are scarce, particularly in the post-acute phase. This has led to underreporting of neurological findings in the context of COVID-19 with reference to geography, ethnicity and sociocultural environment. Methodological issues and study design flaws further reduce the strength of the current evidence because some studies have included in the control group asymptomatic patients who were not screened with molecular or serological tests to confirm or exclude SARS-CoV-2 infection. Screening methods and diagnostic protocols vary across studies, depending on the background of the local investigators, the diagnostic approach, the number and type of contacts during follow-up and, not least, attrition and patient compliance. In addition, studies were done under surge conditions, which led to incomplete diagnostic assessment. The current understanding of neurological sequelae associated with post-COVID-19 condition is based mainly on patient reports; clinically relevant manifestations; and greater attention towards symptoms, signs and diseases that have been illustrated in previous reports By contrast, information is limited on signs that can be documented only through testing, imaging or biochemical or pathological investigations. Pre-existing neurological conditions and COVID-19 A range of pre-existing noncommunicable diseases (NCDs) are associated with an increased risk of severe outcomes in COVID-19 (21). These include several neurological conditions such as stroke and dementia. People with certain pre existing neurological conditions are more vulnerable to SARS-CoV-2 infection, experience exacerbations of their pre existing disease (22) and have higher risks of severe outcomes and death (10, 23). To synthesize the growing evidence on this topic, WHO commissioned a rapid review of 26 articles from 12 countries across three continents, with a total of 379 947 COVID-19 patients, to establish the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions.3 The rapid review found that certain pre-existing neurological diseases are associated with severity of COVID-19.4 The most prevalent were cerebrovascular disease and dementia/neurodegenerative diseases (pooled OR: 1.99; 95% CI: 1.81 2.18). Mortality was high among people with pre-existing neurological conditions (pooled OR: 1.74; 95% CI: 1.56 1.94). Limitations Risk of bias was deemed high for most articles, and the overall quality of studies using GRADE (Grading of Recommendations Assessment, Development and Evaluations) methodology was low; hence, the value of the current evidence is limited. Most studies on the relationship between SARS-CoV-2 and pre-existing neurological conditions are based on retrospective cohorts or case series, with few data from prospective studies. Future research will benefit greatly from the use of standardized definitions and reporting for comorbidities, neurological symptoms or diagnoses. Use of standardized case report forms – such as those published by WHO (25, 26) – can also contribute to the accuracy and reliability of data. Disruptions to essential neurological services caused by the COVID-19 pandemic and mitigation strategies Interruption of routine treatment and care, as well as supply chains for medications during the COVID-19 pandemic, present significant challenges for people with neurological conditions (11). According to the latest WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic (27), 45% of 121 countries for which information was available still reported disruptions to services for MNS disorders in the first quarter of 2021. Likewise, 3Chomba M, Schiess N, Seeher K, Akpalu A, Baila J, Boruah AP et al. Pre-existing neurological conditions and COVID-19 risk. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265) 4Ibid. -4- Neurology and COVID-19: Scientific brief disruptions to rehabilitation services, a crucial aspect of neurological care, continue to be reported by 53% (of 89 countries). With respect to neurology-specific services, WHO’s rapid assessment of services for MNS disorders during the COVID-19 pandemic in mid-2020 (16) revealed that one in three of 98 countries closed down neurology inpatient units at least partly during the pandemic. Regarding service provision, surgeries for neurological disorders were disrupted in two-thirds of 130 countries for which information was available, and the management of emergency conditions such as status epilepticus was at least partially disrupted in 35% of the same 130 countries. To better understand the extent of service disruption, its causes and mitigation strategies for neurological disorders in the context of COVID-19, WHO commissioned a rapid review of 369 articles, providing data on 210 419 patients from 105 countries (14). Studies that investigated the extent of service disruption (n=188) described it as mild (n=40, 21%), moderate (n=131, 70%) or severe (n=10, 5%). The most frequently described reasons for service disruption across 240 studies were travel restrictions related to lockdown (n=196, 82%), closure of services or consultations as per health authority directive (n=157, 65%) and reduced outpatient volume due to patients not presenting (n=135, 56%). A total of 224 studies reported on mitigation strategies, with the most frequently reported strategies being telemedicine and other teleconsultation formats (n=184, 82%), novel dispensing approaches for medicines (n=116, 52%) and redirection of patients (n=95, 42%). Limitations To date, most of the data on service disruption have been derived from high- and middle-income countries, with information from low-income countries lacking. Similarly, evidence of the effectiveness and acceptability of mitigation strategies to patients remains limited. In addition, the current published literature seems biased towards certain settings or types of services (e.g. outpatient, emergency or inpatient care). There are few reports on other areas that are crucial for treating people with chronic neurological conditions (e.g. neurorehabilitation). Going forward, more systematic evaluations and reporting of disruption of the whole spectrum of neurological services can provide a more comprehensive picture. Neurological complications following COVID-19 vaccination There is a low risk following COVID-19 vaccination of neurological complications including Bell’s palsy (28), cerebral venous sinus thrombosis (CVST) and possibly Guillain-Barré syndrome (29). However, the risk of such complications is substantially lower than the risks associated with infection with SARS-CoV-2 (30, 31). Since March 2021, cases of thromboses associated with thrombocytopenia have been reported in patients vaccinated with the Oxford-AstraZeneca ChAdOx1-S and Johnson & Johnson (J&J) Janssen Ad26.COV2.S COVID-19 vaccines. Evaluation of the cases by national and international bodies concluded that there was a plausible causal link between these two adenovirus-vectored vaccines and CVST (32-34), based on the temporal association with vaccination and an increased incidence when compared with expected baseline rates of CVST (35-42). WHO has provided guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination against COVID-19 (43). Overall knowledge gaps Current evidence suggests that SARS-CoV-2 can affect the nervous system. Multiple and probably overlapping mechanisms have been proposed for the neurological manifestations; they include hypoxia, cytokine storm, post infectious autoimmune responses, hypercoagulability, neurologic complications of severe systemic illness and potential direct neurotropism. Questions remain regarding the characteristics, timing and severity of neurological manifestations of COVID-19, including the pathophysiological mechanisms through which SARS-CoV-2 affects the nervous system. As more data emerge, associations of specific neurological disorders with COVID-19 will be further clarified – as has been seen, for example, with Guillain-Barré syndrome (29). Prospective data, as well as biomarker and neuropathological studies, are needed on the short- and long-term neurological sequelae. Existing reports on the association between COVID-19 and most neurological manifestations are flawed by selection and information bias, and available data reflect the spectrum of neurological manifestations in patients with the more severe COVID-19 cases. Neurological signs or symptoms occurring during the acute phase of COVID-19 infection cannot easily be disentangled from those with onset in the post-acute phase, and follow-up data are scarce, particularly for subclinical findings such as cognitive impairment. -5- Neurology and COVID-19: Scientific brief Other gaps in the literature include a lack of clarity on the interplay between pre-existing neurological disease and other underlying comorbidities such as hypertension and diabetes. Studies in this area were hospital-based and biased to people with more severe symptoms, making the findings difficult to generalize to people based in the community or having only mild symptoms. Understanding the impact of neurological conditions requires the inclusion of diverse populations from a variety of social backgrounds. Guidance is also needed for studies evaluating the disruption or the efficacy of mitigation strategies for care. Efforts should be made to harmonize the methods in this area of research and to enhance the comparability between studies and over time. In addition, funding for and progress in neurological research and training have been affected by the pandemic, owing to the temporary suspension of research projects or postponement or cancellation of fellowships, which need to be re-established as soon as possible (44). Implications for further research Well-designed case–control and cohort studies are needed to understand which patients are most vulnerable to neurological manifestations in the acute and post COVID-19 condition and to understand causality related to COVID 19. Series of patients with neurological conditions need to be compared to patients without neurological conditions. Use of case report forms (CRFs) such as WHO’s post-COVID-19 condition CRF (45) is encouraged to standardize data collection. Future research directions should include more “bottom-up” evidence-gathering efforts; for example, international surveys of neurological associations such as one recently undertaken by the European Federation of Neurological Associations (EFNA) with support from members of the WHO Neurology and COVID-19 Global Forum (46). Conclusion A wide spectrum of acute and post-acute neurological manifestations associated with COVID-19 have been reported across the globe. Clinicians and health care workers should be aware of such presentations and complications even in the absence of respiratory symptoms. Disruptions in access to essential neurological services and availability of essential medications for people with pre-existing neurological conditions can be detrimental; hence, mitigation strategies such as remote technology and telemedicine alternatives should be judiciously employed. The COVID-19 pandemic continues to have an impact on neurological health, service delivery, research and training while widening existing disparities worldwide. Recognizing and addressing these factors will provide opportunities to improve neurological care worldwide. Plans for updating WHO continues to monitor the situation closely for any changes that may affect this scientific brief.
|
Use only the information contained in the prompt to answer any questions the user may ask. Do not use any other sources or any information from your stored data from before this conversation. If you cannot answer the user's question using only the provided context, say "I can't determine the answer as the information you are seeking is not provided in the reference document." Format your answer in a bullet point list.
EVIDENCE:
Introduction The predominant acute presentations of COVID-19 are respiratory, but neurological manifestations have been recognized as an important component of the disease, even in cases without respiratory symptoms (2-5). The neurological manifestations associated with COVID-19 range from mild to critical, affect adults and children and can present both during and after acute COVID-19 infection. Reported neurological signs, symptoms or syndromes in the acute phase include headache, dizziness, impaired taste or smell, delirium, agitation, stroke, seizures, coma, meningoencephalitis and Guillain-Barré syndrome (6, 7). Consequences in the post-acute phase are also emerging, as either persisting or newly developing signs and symptoms (post-COVID-19 condition); these include headache, problems with smell or taste, cognitive impairment, confusion, fatigue, difficulty concentrating, sleep disturbances and neuropsychiatric symptoms (8, 9). COVID-19 disproportionately affects people with pre-existing neurological disorders. Chronic neurological disorders were found to be independently associated with increased mortality in hospitalized COVID-19 patients (hazard ratio [HR]: 2.13; 95% confidence interval [CI]: 1.38–3.28) (10). Individuals with pre-existing neurological conditions have been affected by disruptions to routine care, delayed care because of concerns about infectious risks and disruptions to supply chains for medicines and resultant stock-outs (11). This scientific brief provides a comprehensive overview of the relationship between neurology and COVID-19 and covers what is currently known about: • the acute neurological manifestations of COVID-19 • the neurological sequelae associated with post-COVID-19 condition • the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions • the extent of disruptions to neurological services caused by the pandemic and mitigation strategies to address these disruptions • emerging evidence for neurological complications following COVID-19 vaccination. The target audience for this document includes health care providers, researchers, policy-makers and other stakeholders interested in the evidence relating to neurology and COVID-19. The aim is to increase awareness and recognition of the associated neurological aspects of COVID-19 to improve care and mitigation responses, particularly in low-resource settings. Methods This scientific brief is based on the evidence that emerged from systematic or rapid reviews and meta-analyses commissioned by WHO (14);1 WHO pulse surveys (15); WHO’s rapid assessment on services for mental, neurological and substance use (MNS) disorders (16) and other relevant publications. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265); and Misra S, Kolappa K, Prasad M, Radhakrishnan D, Thakur KT, Solomon T. et al. Frequency of neurological manifestations in COVID-19: a systematic review and meta-analysis of 350 studies (https://www.medrxiv.org/content/10.1101/2021.04.20.21255780v1) 1 Neurology and COVID-19: Scientific brief -2- Review of the evidence Acute neurological manifestations of COVID-19 To assess the types and frequencies of reported neurological manifestations associated with COVID-19, WHO assisted with a systematic review and meta-analysis involving data from 145 721 patients with acute COVID-19 infections derived from 350 case series (17). COVID-19 infection was confirmed by real-time reverse-transcription polymerase chain reaction (RT-PCR) detection, high-throughput sequencing, SARS-CoV-2 viral culture in throat swab specimens, SARS-CoV-2 antibody detection in blood samples or SARS-CoV-2 viral culture in throat swab specimens. Most patients (n=129 786, 89%) included in the review were hospitalized. A total of 23 acute neurological symptoms (Table 1) and 14 neurological diagnoses (Table 2) were reported in the literature. Up to one third (n=48 059) of COVID-19 patients experienced some type of neurological manifestation, and 1 in 50 developed a stroke. In COVID-19 patients aged over 60 years, the most frequent neurological manifestation was acute confusion/delirium (pooled prevalence: 34%; 95% CI: 23–46%). For all ages, the likelihood of experiencing acute confusion/delirium, stroke, seizure and movement disorders increased with increasing severity of COVID-19, but these associations were not statistically significant. Smell and taste impairments were significantly associated with non-severe COVID-19 (odds ratio [OR]: 0.44; 95% CI: 0.28–0.68 and OR: 0.62; 95% CI: 0.42–0.91, respectively). In COVID-19 patients aged over 60 years, the presence of any neurological manifestations was associated with significantly increased mortality (OR: 1.80; 95% CI: 1.11–2.91). Limitations The overall risk of bias was assessed as being low for most studies (n=296, 85%) but studies with higher risk of bias yielded higher prevalence estimates. Also, for most outcomes the meta-analyses yielded a high degree of heterogeneity, indicating substantial clinical or methodological diversity, which in some instances rendered the pooling of data inappropriate. There are gaps in the evidence for non-hospitalized patient cohorts because their data are rarely reported in the literature. The evidence gaps have implications for incidence, prevalence, duration and severity. Similarly, the timing of the onset of signs or symptoms is often not reported. Limitations in study design of included case series precluded the comparison between acute neurological manifestations caused by COVID-19 and the incidence of such manifestations in the general population. Finally, in the absence of well-designed cohort studies, there are insufficient data to definitively assert causality between these symptoms and COVID-19. Neurological sequelae associated with post-COVID-19 condition Complications following acute viral illnesses are well described (18, 19). Soon after the advent of the COVID-19 pandemic, longitudinal cohort studies started to assess long-term sequelae of COVID-19, including neurological manifestations. At the same time, patients began to connect with each other and report on prolonged symptoms of COVID-19. In response, WHO commissioned a rapid review of 28 published population-based, cohort or case-control studies2. The review established specific new-onset neurological symptoms, signs or diagnoses occurring after the acute phase of COVID-19 that can be interpreted as complications of COVID-19; assessed specific neurological symptoms, signs or diagnoses that persist after the acute phase of COVID-19; and determined factors associated with these post acute neurological manifestations. Of the 28 studies, only two followed patients for up to 6 months. Pooling of information was not possible for methodological reasons. In a retrospective cohort of 1733 COVID-19 patients discharged from hospital, 19.6% (n=340) reported neurological manifestations after a median follow-up of 186 days (9). The complaints most commonly reported were fatigue or muscle weakness (63%; 1038/1655) and sleep difficulties (26%; 437/1655). Anxiety and depression were reported by 23% (367/1617) of patients and difficulty walking by 24% (103/423). The second prospective study followed 61 hospitalized COVID-19 patients with and without history of admission to an intensive care unit (ICU) (20). 2 Beghi E, Giussani G, Westenberg E, Allegri R, Garcia-Azorin D, Guekht A, Acute and Post-Acute Neurological Manifestations of COVID-19: Present findings, critical appraisal, and future directions. Manuscript in preparation, 2021. Neurology and COVID-19: Scientific brief Common complaints at discharge included amnestic dysfunction (30%; 18/61), dysexecutive syndrome (33%; 20/61), ataxia (11%, 7/61), and tetraparesis (18%; 11/61) (20). Limitations The evidence for long-term or newly emerging neurological complications after COVID-19 is limited, particularly in asymptomatic or non-hospitalized patients. Similarly, little is known about neurological sequelae in paediatric patients with conditions related to COVID-19, including multisystem inflammatory syndrome (MIS-C). Data from low- and middle-income countries are scarce, particularly in the post-acute phase. This has led to underreporting of neurological findings in the context of COVID-19 with reference to geography, ethnicity and sociocultural environment. Methodological issues and study design flaws further reduce the strength of the current evidence because some studies have included in the control group asymptomatic patients who were not screened with molecular or serological tests to confirm or exclude SARS-CoV-2 infection. Screening methods and diagnostic protocols vary across studies, depending on the background of the local investigators, the diagnostic approach, the number and type of contacts during follow-up and, not least, attrition and patient compliance. In addition, studies were done under surge conditions, which led to incomplete diagnostic assessment. The current understanding of neurological sequelae associated with post-COVID-19 condition is based mainly on patient reports; clinically relevant manifestations; and greater attention towards symptoms, signs and diseases that have been illustrated in previous reports By contrast, information is limited on signs that can be documented only through testing, imaging or biochemical or pathological investigations. Pre-existing neurological conditions and COVID-19 A range of pre-existing noncommunicable diseases (NCDs) are associated with an increased risk of severe outcomes in COVID-19 (21). These include several neurological conditions such as stroke and dementia. People with certain pre existing neurological conditions are more vulnerable to SARS-CoV-2 infection, experience exacerbations of their pre existing disease (22) and have higher risks of severe outcomes and death (10, 23). To synthesize the growing evidence on this topic, WHO commissioned a rapid review of 26 articles from 12 countries across three continents, with a total of 379 947 COVID-19 patients, to establish the risk of infection, severe illness and mortality from COVID-19 for people with pre-existing neurological conditions.3 The rapid review found that certain pre-existing neurological diseases are associated with severity of COVID-19.4 The most prevalent were cerebrovascular disease and dementia/neurodegenerative diseases (pooled OR: 1.99; 95% CI: 1.81 2.18). Mortality was high among people with pre-existing neurological conditions (pooled OR: 1.74; 95% CI: 1.56 1.94). Limitations Risk of bias was deemed high for most articles, and the overall quality of studies using GRADE (Grading of Recommendations Assessment, Development and Evaluations) methodology was low; hence, the value of the current evidence is limited. Most studies on the relationship between SARS-CoV-2 and pre-existing neurological conditions are based on retrospective cohorts or case series, with few data from prospective studies. Future research will benefit greatly from the use of standardized definitions and reporting for comorbidities, neurological symptoms or diagnoses. Use of standardized case report forms – such as those published by WHO (25, 26) – can also contribute to the accuracy and reliability of data. Disruptions to essential neurological services caused by the COVID-19 pandemic and mitigation strategies Interruption of routine treatment and care, as well as supply chains for medications during the COVID-19 pandemic, present significant challenges for people with neurological conditions (11). According to the latest WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic (27), 45% of 121 countries for which information was available still reported disruptions to services for MNS disorders in the first quarter of 2021. Likewise, 3Chomba M, Schiess N, Seeher K, Akpalu A, Baila J, Boruah AP et al. Pre-existing neurological conditions and COVID-19 risk. A commissioned rapid review. (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3907265) 4Ibid. -4- Neurology and COVID-19: Scientific brief disruptions to rehabilitation services, a crucial aspect of neurological care, continue to be reported by 53% (of 89 countries). With respect to neurology-specific services, WHO’s rapid assessment of services for MNS disorders during the COVID-19 pandemic in mid-2020 (16) revealed that one in three of 98 countries closed down neurology inpatient units at least partly during the pandemic. Regarding service provision, surgeries for neurological disorders were disrupted in two-thirds of 130 countries for which information was available, and the management of emergency conditions such as status epilepticus was at least partially disrupted in 35% of the same 130 countries. To better understand the extent of service disruption, its causes and mitigation strategies for neurological disorders in the context of COVID-19, WHO commissioned a rapid review of 369 articles, providing data on 210 419 patients from 105 countries (14). Studies that investigated the extent of service disruption (n=188) described it as mild (n=40, 21%), moderate (n=131, 70%) or severe (n=10, 5%). The most frequently described reasons for service disruption across 240 studies were travel restrictions related to lockdown (n=196, 82%), closure of services or consultations as per health authority directive (n=157, 65%) and reduced outpatient volume due to patients not presenting (n=135, 56%). A total of 224 studies reported on mitigation strategies, with the most frequently reported strategies being telemedicine and other teleconsultation formats (n=184, 82%), novel dispensing approaches for medicines (n=116, 52%) and redirection of patients (n=95, 42%). Limitations To date, most of the data on service disruption have been derived from high- and middle-income countries, with information from low-income countries lacking. Similarly, evidence of the effectiveness and acceptability of mitigation strategies to patients remains limited. In addition, the current published literature seems biased towards certain settings or types of services (e.g. outpatient, emergency or inpatient care). There are few reports on other areas that are crucial for treating people with chronic neurological conditions (e.g. neurorehabilitation). Going forward, more systematic evaluations and reporting of disruption of the whole spectrum of neurological services can provide a more comprehensive picture. Neurological complications following COVID-19 vaccination There is a low risk following COVID-19 vaccination of neurological complications including Bell’s palsy (28), cerebral venous sinus thrombosis (CVST) and possibly Guillain-Barré syndrome (29). However, the risk of such complications is substantially lower than the risks associated with infection with SARS-CoV-2 (30, 31). Since March 2021, cases of thromboses associated with thrombocytopenia have been reported in patients vaccinated with the Oxford-AstraZeneca ChAdOx1-S and Johnson & Johnson (J&J) Janssen Ad26.COV2.S COVID-19 vaccines. Evaluation of the cases by national and international bodies concluded that there was a plausible causal link between these two adenovirus-vectored vaccines and CVST (32-34), based on the temporal association with vaccination and an increased incidence when compared with expected baseline rates of CVST (35-42). WHO has provided guidance for clinical case management of thrombosis with thrombocytopenia syndrome (TTS) following vaccination against COVID-19 (43). Overall knowledge gaps Current evidence suggests that SARS-CoV-2 can affect the nervous system. Multiple and probably overlapping mechanisms have been proposed for the neurological manifestations; they include hypoxia, cytokine storm, post infectious autoimmune responses, hypercoagulability, neurologic complications of severe systemic illness and potential direct neurotropism. Questions remain regarding the characteristics, timing and severity of neurological manifestations of COVID-19, including the pathophysiological mechanisms through which SARS-CoV-2 affects the nervous system. As more data emerge, associations of specific neurological disorders with COVID-19 will be further clarified – as has been seen, for example, with Guillain-Barré syndrome (29). Prospective data, as well as biomarker and neuropathological studies, are needed on the short- and long-term neurological sequelae. Existing reports on the association between COVID-19 and most neurological manifestations are flawed by selection and information bias, and available data reflect the spectrum of neurological manifestations in patients with the more severe COVID-19 cases. Neurological signs or symptoms occurring during the acute phase of COVID-19 infection cannot easily be disentangled from those with onset in the post-acute phase, and follow-up data are scarce, particularly for subclinical findings such as cognitive impairment. -5- Neurology and COVID-19: Scientific brief Other gaps in the literature include a lack of clarity on the interplay between pre-existing neurological disease and other underlying comorbidities such as hypertension and diabetes. Studies in this area were hospital-based and biased to people with more severe symptoms, making the findings difficult to generalize to people based in the community or having only mild symptoms. Understanding the impact of neurological conditions requires the inclusion of diverse populations from a variety of social backgrounds. Guidance is also needed for studies evaluating the disruption or the efficacy of mitigation strategies for care. Efforts should be made to harmonize the methods in this area of research and to enhance the comparability between studies and over time. In addition, funding for and progress in neurological research and training have been affected by the pandemic, owing to the temporary suspension of research projects or postponement or cancellation of fellowships, which need to be re-established as soon as possible (44). Implications for further research Well-designed case–control and cohort studies are needed to understand which patients are most vulnerable to neurological manifestations in the acute and post COVID-19 condition and to understand causality related to COVID 19. Series of patients with neurological conditions need to be compared to patients without neurological conditions. Use of case report forms (CRFs) such as WHO’s post-COVID-19 condition CRF (45) is encouraged to standardize data collection. Future research directions should include more “bottom-up” evidence-gathering efforts; for example, international surveys of neurological associations such as one recently undertaken by the European Federation of Neurological Associations (EFNA) with support from members of the WHO Neurology and COVID-19 Global Forum (46). Conclusion A wide spectrum of acute and post-acute neurological manifestations associated with COVID-19 have been reported across the globe. Clinicians and health care workers should be aware of such presentations and complications even in the absence of respiratory symptoms. Disruptions in access to essential neurological services and availability of essential medications for people with pre-existing neurological conditions can be detrimental; hence, mitigation strategies such as remote technology and telemedicine alternatives should be judiciously employed. The COVID-19 pandemic continues to have an impact on neurological health, service delivery, research and training while widening existing disparities worldwide. Recognizing and addressing these factors will provide opportunities to improve neurological care worldwide. Plans for updating WHO continues to monitor the situation closely for any changes that may affect this scientific brief.
USER:
What mechanisms have been proposed for post-Covid neurological complications?
Assistant: Answer *only* using the evidence. If unknown, say you cannot answer. Cite sources.
| true | 72 | 9 | 2,722 | null | 382 |
"Only respond using the information in the context block. Do not in any way rely on your own knowled(...TRUNCATED) | "Why do people believe independent bookstores might make a comeback, despite chains like Amazon and (...TRUNCATED) | "Book Brawl Independent bookstores, the Internet, chain stores and discount houses duke it out. (Who(...TRUNCATED) | "Only respond using the information in the context block. Do not in any way rely on your own knowled(...TRUNCATED) | "Only respond using the information in the context block. Do not in any way rely on your own knowled(...TRUNCATED) | false | 37 | 18 | 1,635 | null | 356 |
"<TASK DESCRIPTION> Only use the provided text to answer the question, no outside sources. <QUESTION(...TRUNCATED) | "What does cholelithiasis mean and how serious is it? Provide a list of symptoms in bullet points. Y(...TRUNCATED) | "Gallstones Gallstones (cholelithiasis) are hardened pieces of bile that form in your gallbladder or(...TRUNCATED) | "<TASK DESCRIPTION> Only use the provided text to answer the question, no outside sources. <QUESTION(...TRUNCATED) | "<TASK DESCRIPTION> Only use the provided text to answer the question, no outside sources. <QUESTION(...TRUNCATED) | false | 20 | 27 | 892 | null | 474 |
In your answer, refer only to the context document. Do not employ any outside knowledge
|
Based on the provided context, what are some ways the City of Stronghold helps small businesses?
| "**Small Business Startup/Management Guide** The Strongsville Business Startup & Management Guide Se(...TRUNCATED) | "{question} ========== Based on the provided context, what are some ways the City of Stronghold help(...TRUNCATED) | "In your answer, refer only to the context document. Do not employ any outside knowledge\n\nEVIDENCE(...TRUNCATED) | true | 15 | 16 | 1,422 | null | 435 |
End of preview. Expand
in Data Studio
Facts Grounding Processed
This dataset is a processed and reformatted version of google/FACTS-grounding-public, designed for LLM factuality and grounding evaluation.
It has been cleaned, enriched with additional metadata, and split into train and validation sets.
Dataset Summary
The dataset contains prompts, context documents, and target answers that challenge models to stay grounded in provided context rather than hallucinating.
Processing steps added extra features like:
prompt– consolidated instruction + user request + contexthas_url_in_context– boolean flag for URLs in contextlen_system,len_user,len_context– token/word length statisticsrow_id– unique identifier for tracking
Dataset Structure
Splits:
- train – 688 rows
- validation – 172 rows
Features:
| Feature | Type | Description |
|---|---|---|
system_instruction |
string | System-level instruction template |
user_request |
string | User query or prompt |
context_document |
string | Provided factual context |
full_prompt |
string | Original concatenated instruction + context |
prompt |
string | Processed consolidated prompt |
has_url_in_context |
bool | Whether the context contains a URL |
len_system |
int64 | Length of system instruction |
len_user |
int64 | Length of user request |
len_context |
int64 | Length of context document |
target |
string | Grounded factual answer |
row_id |
int64 | Unique row identifier |
Processing
The preprocessing was done in Python with the Hugging Face datasets library:
- Loaded the original dataset (
google/FACTS-grounding-public) - Added custom features (URL detection, length counts)
- Generated combined prompt field
- Split into train (80%) and validation (20%)
- Exported as Arrow and JSONL formats
The preprocessing script is included in the repository for reproducibility.
Intended Uses
- LLM grounding & hallucination evaluation
- Prompt engineering experiments
- Fine-tuning or zero/few-shot evaluation pipelines
- Data formatting utilities
How to Use
from datasets import load_dataset
dataset = load_dataset("GenAIDevTOProd/facts-grounding-processed")
print(dataset["train"][0])
License:
This processed dataset is licensed under Apache 2.0.
The original data source is google/FACTS-grounding-public.
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