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We study risk management in financial institutions using data on hedging of interest rate and foreign exchange risk. We find strong evidence that institutions with higher net worth hedge more, controlling for risk exposures, across institutions and within institutions over time. For identification, we exploit net worth shocks resulting from loan losses due to declines in house prices. Institutions that sustain such shocks reduce hedging significantly relative to otherwise‐similar institutions. The reduction in hedging is differentially larger among institutions with high real estate exposure. The evidence is consistent with the theory that financial constraints impede both financing and hedging.

Background and purpose The aim of this study was to define the prevalence and characteristics of peri-electrode edema in a prospective cohort of patients undergoing deep brain stimulation (DBS) surgery and to correlate it with clinical findings. Methods We performed brain magnetic resonance imaging (MRI) between 7 and 20 days after surgery in 19 consecutive patients undergoing DBS surgery for Parkinson's disease. The T2-weighted hyperintensity surrounding DBS leads was characterized and quantified. Any evidence of bleeding around the leads was also evaluated. Clinical and follow-up data were recorded. In a subgroup of patients, a follow-up MRI was performed 3-6 weeks after surgery. We also retrospectively reviewed the post-operative computed tomography scans of patients who underwent DBS at our center since 2013. Results Magnetic resonance imaging showed a peri-lead edematous reaction in all (100%) patients, which was unilateral in three patients (15.8%). In six patients (31.6%), we detected minor peri-lead hemorrhage. Edema completely resolved in eight out of 11 patients with a follow-up MRI and was markedly reduced in the others. Most patients were asymptomatic but six (31.6%) manifested various degrees of confusional state without motor symptoms. We found no significant correlation between edema volume, distribution and any clinical feature, including new post-operative neurological symptoms. The retrospective computed tomography analysis showed that peri-electrode hypodensity consistent with edema is absent at early post-operative imaging but is common at scans performed >3 days after surgery. Conclusions Peri-electrode edema is a common, transient reaction to DBS lead placement and a convincing relation between edema and post-operative clinical status is lacking.

Adaptive deep brain stimulation (DBS) devices aim to personalize stimulation delivery by following the current state of symptom-specific neural signals during different activities of daily living (walking, sleeping, etc.). This approach is not yet suitable for clinical practice, and groundwork is needed. The first essential steps for establishing adaptive DBS comprise the capacity for measurements in chronically implanted patients (to avoid the “stunning effect”) and for prolonged recordings not corrupted by artifacts.

Background We investigated whether the pattern of intensity-modulated radiotherapy (IMRT) dose distribution to the skin can be correlated with the development of G3/G4 radiation dermatitis (RD). Methods A frequency-matched cohort analysis was perfomed on patients treated with IMRT and concurrent cisplatin or cetuximab. Risk ratios were obtained by fitting Poisson regression models. Results The incidence of G3/G4 RD was 41.1% in 90 patients included (50% vs 36.6% in the cetuximab and cisplatin cohorts, respectively). In multivariate analysis, PS ≥ 1 and weight loss at RT completion >10 kg were the only factors that retained significance. The best dosimetric predictive accuracy was provided by 19.9 cc and 5.8 cc of skin ring 2 mm V50 and V60, respectively (AUC: 0.61 for both). Conclusion Along with clinical factors, the pattern of dose distribution to a ring structure localized 2 mm below the patient's surface may help predict the development of severe RD.

Background Research investigating treatments and interventions for cognitive decline fail due to difficulties in accurately recognizing behavioral signatures in the presymptomatic stages of the disease. For this validation study, we took our previously constructed digital biomarker‐based prognostic models and focused on generalizability and robustness of the models. Method We validated prognostic models characterizing subjects using digital biomarkers in a longitudinal, multi‐site, 40‐month prospective study collecting data in memory clinics, general practitioner offices, and home environments. Results Our models were able to accurately discriminate between healthy subjects and individuals at risk to progress to dementia within 3 years. The model was also able to differentiate between people with or without amyloid neuropathology and classify fast and slow cognitive decliners with a very good diagnostic performance. Conclusion Digital biomarker prognostic models can be a useful tool to assist large‐scale population screening for the early detection of cognitive impairment and patient monitoring over time.

Transsphenoidal route is now considered the gold standard for the removal of pituitary adenoma. Up to date, no clear superiority in terms of efficacy has been demonstrated between transsphenoidal microscopic and endoscopic approaches. Surgical safety may be a relevant argument in favor or against the choice of one of the two surgical approaches. In our experience, the microscope and the endoscope are both safe instruments for the resection of pituitary adenomas. Because of the lack of prospective randomized controlled trials, the choice of one of the two instruments should depend on surgeon-specific preferences and hospital assets. This article is protected by copyright. All rights reserved.

The future of deep brain stimulation (DBS) for Parkinson's disease (PD) lies in new closed‐loop systems that continuously supply the implanted stimulator with new settings obtained by analyzing a feedback signal related to the patient's current clinical condition.1 The most suitable feedback for PD is subthalamic local field potential (LFP) activity recorded from the stimulating electrode itself.2, 3, 4 This closed‐loop technology known as adaptive DBS (aDBS) recently proved superior to conventional open‐loop DBS (cDBS) in patients with PD.2 No studies have yet tested aDBS in freely moving humans for a prolonged time. This information is an essential prerequisite for developing new implantable aDBS devices for chronic PD treatment. In this single‐case study, we tested whether a portable DBS device we developed is suitable to compare the clinical benefit in a freely moving PD patient induced by either aDBS or cDBS. To do so, after a first experimental session for extracting patient settings to personalize the aDBS algorithm, we treated a blinded patient (51 y old, male, 8 y PD history) with cDBS and aDBS in two separate experimental sessions each lasting 120 min, 5 and 6 d, respectively, after DBS electrode implant. To ensure reliable results, the patient underwent repeated clinical assessments every 20 min (T1‐T5) by two independent blinded neurologists through Unified Parkinson's Disease Rating Scale (UPDRS) III subsections and Rush Dyskinesia Rating Scale (see Supplemental Data for details).

Interferon alpha 2b for the treatment of complex haemangiomas of infancy (HI) and childhood. Background Recombinant interferon α has been used with success in the treatment of complex haemangiomas of infancy. Materials and methods Eleven infants and children (10 females and 1 male) with complex haemangiomas (age 3–14 months) were treated with interferon α 2b by subcutaneous infection of up to 1 million UI/m 2 /day three times a week for 2 weeks; then the dosage was increased to 3 million UI/m 2 /day three times a week. The duration of treatment ranged from 6 to 14 months. A decrease of 50% or more in the dimension of haemangiomas that was maintained for at least 6 months during the treatment or after the withdrawal of the medication was considered a consequence of therapy. Results In 1 case regression of HI was of 20%; in the other 10 cases, regression ranged from 60% to 90%. The side effects of interferon therapy were mild and transient. Our treatment schedule shows that the administration of interferon α 2b three times a week is as effective as the daily administration of the drug. In our opinion interferon α 2b is a safe agent in the treatment of complex haemangiomas of infancy and therefore should be considered a first line therapeutic option.

Snowmelt is an important component of the river discharge in mountain environments. In the past 40 years, the snowmelt dynamics has been mostly evaluated using degree-day-based models like the snowmelt runoff model (SRM). This model has no control on the volume of the melting snow, even if SRM includes as data input the snow-covered area. This lack explains why the application of SRM may lead to inaccurate snowmelt volume estimations, even if the discharge volumes are accurately reproduced. Here we introduce in SRM the control on the melted snow volume and consider it in the determination of SRM parameters. The total snow volume, accumulated at the end of winter season, is evaluated by a snow water equivalent statistically based model, SWE-SEM, and used as an estimate of the melting snow during the summer season. The benefit derived from the introduction of the control on the melting snow volume was investigated in the Mallero basin (northern Italy) for the 2003 and 2004 snow melting seasons. The analysis compares the model's results adopting different parameter sets, both considering and ignoring the control on the melting snow volume. Copyright © 2011 John Wiley & Sons, Ltd.

Collateral constraints imply that financing and risk management are fundamentally linked. The opportunity cost of engaging in risk management and conserving debt capacity to hedge future financing needs is forgone current investment, and is higher for more productive and less well-capitalized firms. More constrained firms engage in less risk management and may exhaust their debt capacity and abstain from risk management, consistent with empirical evidence and in contrast to received theory. When cash flows are low, such firms may be unable to seize investment opportunities and be forced to downsize. Consequently, capital may be less productively deployed in downturns. Copyright (c) 2010 the American Finance Association.

Aim To investigate the molecular phylogenetic divergence and historical biogeography of cave crickets belonging to the genus Dolichopoda (Orthoptera, Rhaphidophoridae). Location Caves in continental and insular Greece. Methods We sequenced 1967 bp of mitochondrial DNA, corresponding to three fragments of the small and large subunit of the ribosomal RNA (16S and 12S rRNA, respectively) and to the subunit I of cytochrome oxidase (COI), to reconstruct phylogenetic relationships among all 30 known Greek species of Dolichopoda. Alternative hypotheses about the colonization of the Hellenic Peninsula by Dolichopoda species were tested by comparing the degree of discordance between species trees and gene trees under four plausible biogeographical scenarios. Results The present study revealed a rather well resolved phylogeny at species level, identifying a number of clades that represent long-separated lineages and diverse evolutionary histories within the genus Dolichopoda. Two main clades were revealed within Hellenic–Aegean species, identifying a north-western and a south-eastern species group. Based on Bayesian analysis, we applied a relaxed molecular clock to estimate the divergence times between the lineages. The results revealed that the origins of eastern Mediterranean lineages are much older than those of previously studied western Mediterranean Dolichopoda. Tests of alternative biogeographical hypotheses showed that a double colonization of the Hellenic Peninsula, following separate continental and trans-Aegean routes during the Messinian stage, best accounts for the present distribution of Greek Dolichopoda species. Main conclusions Reconstruction and biogeographical hypothesis testing indicated that the colonization of Greece by Dolichopoda species comprised two episodes and two different routes. The southern lineage probably arose from a trans- Aegean colonization during the Messinian salinity crisis (5.96–5.33 Ma). The northern lineage could be the result of dispersal from the north through the Balkan Peninsula. The opening of the Mid-Aegean Trench could have promoted an initial diversification within the uprising Anatolian Plateau, while the Messinian marine regression offered the conditions for a rapid dispersal through the whole Aegean– Hellenic region. In addition, climatic events during the Plio-Pleistocene may have been responsible for the speciation within each of the two different phylogeographical units, principally attributable to vicariance events.

Lipoproteins are a subgroup of secreted bacterial proteins characterized by a lipidated N-terminus, processing of which is mediated by the consecutive activity of prolipoprotein diacylglyceryl transferase (Lgt) and lipoprotein signal peptidase (LspA). The study of LspA function has been limited mainly to non-pathogenic microorganisms. To study a potential role for LspA in the pathogenesis of bacterial infections, we have disrupted lspA by allelic replacement in Mycobacterium tuberculosis, one of the world's most devastating pathogens. Despite the presence of an impermeable lipid outer layer, it was found that LspA was dispensable for growth under in vitro culture conditions. In contrast, the mutant was markedly attenuated in virulence models of tuberculosis. Our findings establish lipoprotein metabolism as a major virulence determinant of tuberculosis and define a role for lipoprotein processing in bacterial pathogenesis. In addition, these results hint at a promising new target for therapeutic intervention, as a highly specific inhibitor of bacterial lipoprotein signal peptidases is available.

Deep brain stimulation (DBS) of subthalamic nucleus (STN) is an effective treatment for advanced Parkinson's disease. It also provides an opportunity to record neural activity from the human basal ganglia. In this study, to investigate the involvement of the human STN in sensory functions, we recorded somatosensory evoked potentials (SEPs) elicited by contralateral median-nerve stimulation, from STN electrodes implanted for DBS in patients with Parkinson's disease. We suggest that the STN N18 component of SEPs in Parkinson's disease is a mainly local field potential elicited by muscle afferent input to the nucleus.

Solid materials contain impurities from manufacturing/cleaning processes which diffuse (out-gas) to the exterior during exposure to vacuum, especially at elevated temperature levels. Materials like plastics and resins tend to disintegrate under space conditions. In addition to the above mentioned diffusion process, contaminants adsorbed and absorbed from the environment encountered previously, e.g. during manufacturing, cleaning, integration, test and launch phases, might be desorbed from the surfaces. The released products represent a permanent source of potential contamination. This paper provides an overview of a research program carried out at the Austrian Research Centers Seibersdorf (ARCS), Aerospace Materials Technology Testhouse (AMTT), by means of the AMTT Sublimation Test Facility to acquire in-depth knowledge of the outgassing kinetics characteristics of a set of non-metallic materials, selected by Alenia on the basis of their usage on the International Space Station (ISS) and Scientific Satellites.

Purpose To describe a case of bilateral Idiopathic Retinitis,Vasculitis,Aneurysms and Neuroretinitis(IRVAN)successfully treated with systemic immunomodulatory treatment including steroid, cyclosporine and methotrexate. Methods A 47-year-old Italian woman was diagnosed with IRVAN at our Service.She underwent extensive general and laboratory evaluation.Periodical ophthalmologic evaluations included best correct visual acuity(BCVA)assessment,slit lamp and fundus examination.Ocular alterations were documented by fluorescein and green indocyanine angiogram,and optical coherence tomography. Results At her first examination BCVA was 20/32 in the right eye(RE)and 20/40 in the left eye(LE).In both eyes angiography showed retinal vasculitis with arterial aneurysms and moderate ischemia,mild papillitis and macular oedema.The patient started a systemic steroid spearing immunomodulatory treatment.After 12 months of follow-up BCVA was 20/25 in the RE and 20/20 in the LE.Imaging showed a complete resolution of the retinal and optic nerve head active inflammation in both eyes,with significant reduction of macular oedema. Conclusion IRVAN is an isolated retinal vascular disease that can progress to severe visual loss due to ischemic sequelae.Ocular inflammation is likely related to immunitary disregulation,even if the aetiology is still not clear.In the presented case the bilateral involvement with papillitis and the progression of the visual loss in spite of previous local and systemic steroid regimen, were the reasons that convinced us to propose a systemic immunomodulatory treatment.This treatment was well tolerated, with a complete resolution after one year of follow-up.