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As the recent COVID-19 pandemic has clearly demonstrated, appropriate state support policies are crucial for supporting industrial supply chains during crises to prevent viable businesses from defaulting. In this context, this study proposes a hybrid credit risk model to appropriately size public interventions for viable (worthy) businesses through systematic risk assessment during a period of turmoil. This study discusses the effects of the credit crunch-based economic downturn and proposes a methodology to assist policymakers in managing limited public resources to effectively support industrial supply chains. The proposed approach initially focuses on the dynamics of credit risk during economic recession periods, identifying the conditions that may justify a public intervention strategy based on public guarantees. Subsequently, a hybrid credit risk model is developed to appropriately size public interventions by quantifying systematic risk. Finally, a numerical application is presented to demonstrate the effectiveness of the proposed approach., Competing Interests: The authors declare no competing interests.The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

A clinical and electrophysiological study evaluated the usefulness of local steroid therapy for carpal tunnel syndrome (CTS). To evaluate the efficacy of local steroid therapy 32 patients (53 nerves) were randomly assigned to one of two groups: one (27 nerves) received 15 mg methylprednisolone acetate injected locally and the other (26 nerves) received the same amount of saline solution. The injections were repeated after a week. Clinical and electrophysiological findings were evaluated, double blind, at regular intervals. A clear-cut efficacy of steroid treatment was found. Only 8% of nerves were not benefitted while a marked early improvement was observed in most of the nerves. In order to appraise the long-term effect of local steroid treatment on CTS, 53 patients (91 nerves) were studied and followed up by means of clinical and electrophysiological examinations performed every 2 months for 2 years. The benefit of steroid treatment was transient. About 50% of the nerves became worse within 6 months and 90% within 18 months. Only a small percentage (8%) of the nerves remained improved at the 2-years follow-up. The clinical features were not useful in foretelling the duration of the improvement, which appeared to be related to the antidromic SAP latency.

The effects of steroids on normal end-plate in vivo were evaluated in man by using single-fiber electromyography (SFEMG). SFEMG was performed on voluntarily activated extensor digitorium communis muscle under basal conditions and 1 week later an intramuscular injection of 4 mg betamethasone per day was administered for 7 days. Ten patients with low back pain were examined. Steroid therapy did not induce any statistically significant variation either of the mean jitter value or of the percentage of recordings with abnormally high jitter. The results of this study do not give evidence of a direct effect of steroids on normal neuromuscular junction.

Ampicillin is considered a 'safe' drug in patients with neuromuscular transmission disorders although recently some doubt has been raised. The effect of ampicillin on neuromuscular transmission was studied in healthy subjects by means of single-fiber electromyography. A statistically significant increase of mean jitter value and of recordings with abnormally high jitter occurred after ampicillin treatment in comparison to basal examinations. Such results reaffirm that ampicillin might not be completely harmless in patients with neuromuscular transmission disturbances.