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Purpose - This paper aims to present an analysis of the role of financial incentives, moral hazard and conflicts of interests leading up to the 2008 financial crisis. Design/methodology/approach - The study’s analysis has identified common structural flaws throughout the securitization food chain. These structural flaws include inappropriate incentives, the absence of punishment, moral hazard and conflicts of interest. This research sees the full impact of these structural flaws when considering their co-occurrence throughout the financial system. The authors address systemic defects in the securitization food chain and examine the inter-relationships among homeowners, mortgage originators, investment banks and investors. The authors also address the role of exogenous factors, including the SEC, AIG, the credit rating agencies, Congress, business academia and the business media. Findings - The study argues that the lack of criminal prosecutions of key financial executives has been a key factor in creating moral hazard. Eight years after the Great Recession ended in the USA, the financial services industry continues to suffer from a crisis of trust with society. Practical implications - An overwhelming majority of Americans, 89 per cent, believe that the federal government does a poor job of regulating the financial services industry (Puzzanghera, 2014). A study argues that the current corporate lobbying framework undermines societal expectations of political equality and consent (Alzola, 2013). The authors believe the Singapore model may be a useful starting point to restructure regulatory agencies so that they are more responsive to societal concerns and less responsive to special interests. Finally, the widespread perception is that the financial services sector, in particular, is ethically challenged (Ferguson, 2012); perhaps there would be some benefit from the implementation of ethical climate monitoring in firms that have been subject to deferred prosecution agreements for serious ethical violations (Arnaud, 2010). Originality/value - The authors believe the paper makes a truly original contribution. They provide new insights via their analysis of the role of financial incentives, moral hazard and conflicts of interests leading up to the 2008 financial crisis.

Background: Methotrexate (MTX) is has been associated with hepatotoxicity including hepatic fibrosis; however, the incidence of severe hepatic fibrosis or cirrhosis with MTX use has remained a controversial issue. The gold standard test for detecting liver fibrosis has been a liver biopsy, which is an invasive procedure with potentially serious complications. The transient elastography (TE) is a noninvasive method of assessing hepatic fibrosis. The primary objective of this study was to assess the prevalence of hepatic fibrosis associated with long-term MTX therapy in patients with RA and the secondary objective was to assess the correlation of cumulative MTX dose with hepatic fibrosis as assessed by TE using Fibroscan. Methods: In this cross-sectional study patients with RA who had been on MTX treatment for >5 years were included. Hepatic fibrosis was determined by measuring the hepatic stiffness by TE method (by FibroScan) in kilopascal (kPa) in study patients. The hepatic stiffness of the patient group was compared with that of healthy controls. Results: A total of 160 patients and 63 healthy controls were included in the study. The mean age of the patients was 51±10.9 years and there were 139 female and 21 male patients.The median duration of MTX use was 317.5 weeks (range 260, 1302 years). Median MTX cumulative dose was 4225 mg (range 2340, 18,200 mg). Mean hepatic stiffness was 4.8 kPa (SD 1.35) in the patient group and 4.7 kPa (SD 1.07) in the control group (P = 0.550). Cumulative dose or duration of MTX treatment did not correlate with hepatic fibrosis. Conclusions: Severe hepatic fibrosis or cirrhosis as detected by the TE using Fibroscan was uncommon with high cumulative dose of MTX when administered in the low-dose weekly schedule. The cumulative dose of MTX did not correlate with hepatic fibrosis as assessed by FibroScan.

Background and study aims There is sparse data on the endoscopic management of caustic-induced gastric outlet obstruction (GOO). The present retrospective study aimed to define the response to endoscopic balloon dilatation (EBD) in such patients and their long-term outcome. Patients and methods The data from symptomatic patients of caustic-induced GOO who underwent EBD at our tertiary care center between January 1999 and June 2014 were retrieved. EBD was performed using wire-guided balloons in an incremental manner. Procedural success and clinical success of EBD were evaluated, including complications and long-term outcome. Results A total of 138 patients were evaluated of whom 111 underwent EBD (mean age: 30.79 ± 11.95 years; 65 male patients; 78 patients with isolated gastric stricture; 33 patients with both esophagus plus gastric stricture). The initial balloon diameter at the start of dilatation, and the last balloon diameter were 9.6 ± 2.06 mm (6 – 15 mm) and 14.5 ± 1.6 mm (6 – 15 mm), respectively. Procedural and clinical success was achieved in 95 (85.6 %) and 108 (97.3 %) patients, respectively, requiring a mean (SD) of 5.3 (2.6) and 7.21 (3.86) sessions, respectively. Patients with isolated gastric obstruction had a better response than those with combined esophagus and gastric stricture. Minor complications such as self-limited pain or bleeding were seen in 18 (16.2 %) and 16 (14.4 %), respectively. Perforation occurred in two patients. Over a follow-up period of 98 months, there were no recurrences. Conclusion Caustic-induced GOO can be successfully managed using EBD with 97.3 % clinical success.

The transition economies of Eastern Europe present both the opportunities and challenges for companies operating in these markets. On one hand, these countries have a large number of technology savvy young consumers, and on the other, the markets must also take into consideration the macro-environment of a country and market conditions which make the use of certain market technologies more feasible and attractive compared to others. It is certainly true in terms of the timing for introduction of various technologies in a country. Drawing analogy for the “IDITAROD RACE” we develop three different “Sled Dog Team layouts” for market characteristics and technologies for three Eastern European countries, namely, Slovakia, Bulgaria, and Albania. The ten market characteristics included in our research are: digital connectivity divide, economic power, demand type, privacy laws, demographics, and competitive conditions, attitude towards technology, institutional maturity, corporate social responsibility, and corruption. The ten marketing technologies included in our research are: digital profiling, segmentation, websites, and search engines marketing, campaign management, content management, social media, mobile application, digital collaborations, and analytics. Company case studies are analyzed and reported for each of these three countries which support the three models presented in our research.

Background: Liver dysfunction leads to endocrine disturbance due to the alteration in protein metabolism or synthesis. We studied the presence of occult endocrine dysfunction in liver cirrhosis and compared the same with underlying etiology. Materials and Methods: We evaluated thirty patients with liver cirrhosis in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, and gonadal function. The patients were divided into Group 1 (cirrhosis, n = 30) and Group 2 (controls, n = 15) and the data were analyzed with appropriate statistical tests. Results: The study participants (20 males, 10 females) had a mean age of 54.5 ± 12.4 years and duration of the cirrhosis 5.1 ± 2.7 years. Four patients were in Child Class A, 11 and 15 patients were in Child Classes B and C, respectively. Eleven out of thirty patients (37%) had endocrine disorders, that include subclinical hypothyroidism (n = 3), primary hypothyroidism (n = 1), Sick Euthyroid syndrome (n = 3), central hypothyroidism (n = 2), secondary hypogonadism (n = 3) and growth hormone deficiency in three patients. Two patients had partial hypopituitarism and one patient had complete hypopituitarism. Conclusion: Occult endocrine dysfunction of thyroid and gonadal axes is common in patients with cirrhosis of the liver. The hormonal abnormalities are not different based on the etiology of the cirrhosis.