We use data on the 48 largest multinational banking groups to compare the lending of their 199 foreign subsidiaries during the Great Recession with lending by a benchmark of 202 domestic banks. ...Contrary to earlier and more contained crises, parent banks were not a significant source of strength to their subsidiaries during 2008-09. When controlling for other bank characteristics, multinational bank subsidiaries had to slow down credit growth almost three times as fast as domestic banks. This was in particular the case for subsidiaries of banking groups that relied more on wholesale funding.
ABSTRACT
Globally, laying hen production systems are a focus of concern for animal welfare. Recently, the impacts of rearing environments have attracted attention, particularly with the trend toward ...more complex production systems including aviaries, furnished cages, barn, and free-range. Enriching the rearing environments with physical, sensory, and stimulatory additions can optimize the bird's development but commercial-scale research is limited. In this review, "enrichment" is defined as anything additional added to the bird's environment including structurally complex rearing systems. The impacts of enrichments on visual development, neurobehavioral development, auditory stimulation, skeletal development, immune function, behavioral development of fear and pecking, and specifically pullets destined for free-range systems are summarized and areas for future research identified. Visual enrichment and auditory stimulation may enhance neural development but specific mechanisms of impact and suitable commercial enrichments still need elucidating. Enrichments that target left/right brain hemispheres/behavioral traits may prepare birds for specific types of adult housing environments (caged, indoor, outdoor). Similarly, structural enrichments are needed to optimize skeletal development depending on the adult layer system, but specific physiological processes resulting from different types of exercise are poorly understood. Stimulating appropriate pecking behavior from hatch is critical but producers will need to adapt to different flock preferences to provide enrichments that are utilized by each rearing group. Enrichments have potential to enhance immune function through the application of mild stressors that promote adaptability, and this same principle applies to free-range pullets destined for variable outdoor environments. Complex rearing systems may have multiple benefits, including reducing fear, that improve the transition to the layer facility. Overall, there is a need to commercially validate positive impacts of cost-effective enrichments on bird behavior and physiology.
Canonical Wnt signaling has been implicated in the regulation of hematopoiesis. By employing a Wnt-reporter mouse, we observed that Wnt signaling is differentially activated during hematopoiesis, ...suggesting an important regulatory role for specific Wnt signaling levels. To investigate whether canonical Wnt signaling regulates hematopoiesis in a dosage-dependent fashion, we analyzed the effect of different mutations in the Adenomatous polyposis coli gene (
Apc), a negative modulator of the canonical Wnt pathway. By combining different targeted hypomorphic alleles and a conditional deletion allele of
Apc, a gradient of five different Wnt signaling levels was obtained in vivo. We here show that different, lineage-specific Wnt dosages regulate hematopoietic stem cells (HSCs), myeloid precursors, and T lymphoid precursors during hematopoiesis. Differential, lineage-specific optimal Wnt dosages provide a unifying concept that explains the differences reported among inducible gain-of-function approaches, leading to either HSC expansion or depletion of the HSC pool.
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► Canonical Wnt signaling is differentially regulated during hematopoiesis ► Mild levels of Wnt activation increase HSC whereas high Wnt dosage is detrimental ► Intermediate levels of Wnt signaling increase clonogenicity and myeloid development ► Early T cell development is enhanced by intermediate-high levels of Wnt signaling
Feather pecking (FP) in laying hens remains an important economic and welfare issue. This paper reviews the literature on causes of FP in laying hens. With the ban on conventional cages in the EU ...from 2012 and the expected future ban on beak trimming in many European countries, addressing this welfare issue has become more pressing than ever. The aim of this review paper is to provide a detailed overview of underlying principles of FP. FP is affected by many different factors and any approach to prevent or reduce FP in commercial flocks should acknowledge that fact and use a multifactorial approach to address this issue. Two forms of FP can be distinguished: gentle FP and severe FP. Severe FP causes the most welfare issues in commercial flocks. Severe FP is clearly related to feeding and foraging behaviour and its development seems to be enhanced in conditions where birds have difficulty in coping with environmental stressors. Stimulating feeding and foraging behaviour by providing high-fibre diets and suitable litter from an early age onwards, and controlling fear and stress levels through genetic selection, reducing maternal stress and improving the stockmanship skills of the farmer, together offer the best prospect for preventing or controlling FP.
Purpose
To describe the trends in short-term and long-term mortality in very elderly intensive care unit (ICU) patients between 2008 and 2014.
Methods
A retrospective cohort study was conducted using ...data from the National Intensive Care Evaluation Foundation from 31 Dutch ICUs. Generalized linear mixed-effects models were used to determine the change in adjusted short-term mortality (ICU/hospital deaths) and long-term mortality (3, 6, and 12 months after ICU admission) over the period 2008–2014 in very elderly patients and in patients less than 80 years old admitted to the ICU.
Results
A total of 216,196 patients admitted to 31 ICUs in the period from 2008 to 2014 were included in the study, including 28,284 (13.1%) very elderly patients (80 years or older). Follow-up data for determination of 3-, 6-, and 12-month mortality were available for, respectively, 210,005 (97.1%), 202,551 (93.7%), and 176,847 (81.8%) ICU admissions. The crude ICU and in-hospital mortality decreased, respectively, from 17.6% to 13.0% and from 30.7% to 21.0%. The annual risk-adjusted ICU and in-hospital mortality of very elderly patients (adjusted for APACHE III score, comorbidities, and admission type) decreased significantly during the study period adjusted odds ratio 0.97 (0.95–0.99) and 0.92 (0.91–0.93), respectively. Additionally, the annual risk-adjusted 3-, 6-, and 12-month mortality decreased significantly from 2008 to 2014 adjusted odds ratio 0.96 (0.95–0.97), 0.96 (0.94–0.97), and 0.97 (0.95–0.98), respectively. A similar significant annual decrease in risk-adjusted short-term and long-term mortality was observed in patients aged less than 80 years.
Conclusions
Both short-term and long-term risk-adjusted mortality decreased significantly during the study period in both very elderly ICU patients and patients aged less than 80 years in the Netherlands. This study clearly shows that in our setting very elderly patients benefit almost as much as their younger counterparts from improvement in quality of care over time.
Summary
Background
Folliculotropic mycosis fungoides (FMF) is an aggressive variant of mycosis fungoides (MF) and generally less responsive to standard skin‐directed therapies (SDTs). Recent studies ...distinguished indolent (early‐stage FMF) and more aggressive (advanced‐stage FMF) subgroups. The optimal treatment for both subgroups remains to be defined.
Objectives
To evaluate initial treatment results in patients with early‐ and advanced‐stage FMF.
Methods
A study was undertaken of 203 patients (84 early‐stage, 102 advanced‐stage, 17 extracutaneous FMF) included in the Dutch Cutaneous Lymphoma Registry between 1985 and 2014. Type and results of initial treatment were retrieved from the Dutch Registry. Main outcomes were complete remission (CR); sustained complete remission; partial remission (PR), > 50% improvement; and overall response (OR; CR + PR).
Results
Patients with early‐stage FMF were treated with nonaggressive SDTs in 67 of 84 cases resulting, respectively, in CR and OR of 28% and 83% for monotherapy topical steroids, 0% and 83% for ultraviolet B (UVB), and 30% and 88% for psoralen plus ultraviolet A (PUVA). In patients with advanced‐stage FMF these SDTs were less effective (combined CR and OR 10% and 52%, respectively). In patients with advanced‐stage FMF local radiotherapy (CR 63%; OR 100%), total skin electron beam irradiation (CR 59%; OR 100%) and PUVA combined with local radiotherapy (CR 5%, OR 75%) were most effective.
Conclusions
The results of the present study demonstrate that not all patients with FMF should be treated aggressively. Patients with early‐stage FMF may benefit very well from standard SDTs also used in early‐stage classic MF and have an excellent prognosis.
What's already known about this topic?
Folliculotropic mycosis fungoides (FMF) has a worse prognosis and is less responsive to skin‐directed therapies (SDTs) compared with classic mycosis fungoides (MF).
Recent studies distinguished indolent (early‐stage FMF) and more aggressive (advanced‐stage FMF) subgroups.
The optimal treatment for both subgroups needs still to be defined.
What does this study add?
Treatment recommendations for different subgroups of FMF are formulated.
Treatment response of patients with early‐stage FMF is superior to that of patients with advanced‐stage FMF.
Patients with early‐stage FMF may benefit very well from standard SDTs also used in classic MF and have an excellent prognosis.
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Linked Comment: Bagot. Br J Dermatol 2017; 177:17–18
The metabolic syndrome (MS) might increase the risk of cardiovascular disease in testicular cancer (TC) survivors. We investigated its prevalence, development, vascular implications, and the role of ...gonadal function.
TC survivors treated with chemotherapy and follow-up ≥3 years (N = 370, study I) were retrospectively evaluated for the development of cardiovascular risk factors. A subgroup followed 3–20 years (N = 173, study II) was compared with controls (N = 1085) for MS prevalence and evaluated for vascular function.
In TC survivors (study I), 24% developed overweight, 24% hypercholesterolemia, and 30% hypertension, after median follow-up of 1.7, 0.9, and 5.1 years, respectively. At the median follow-up of 5 years (study II), 25% of survivors have the MS {odds ratio (OR) 2.2, 95% confidence interval (CI) 1.5–3.3 compared with controls}. Survivors with MS have features of inflammation and prothrombotic state, increased carotid artery intima-media thickness. Survivors with testosterone levels <15 nmol/l (22%) have an increased risk of the MS (OR 4.1, 95% CI 1.8–9.3).
The current data suggest that the MS occurs at earlier age in TC survivors treated with chemotherapy compared with controls and is accompanied by early signs of atherosclerosis. As low testosterone may have a causal role, it is a target for interventions.
Summary
Background
Basal cell carcinoma (BCC) is the most common type of skin cancer and incidence rates are increasing. Photodynamic therapy (PDT) is a frequently used treatment, especially for ...superficial BCC (sBCC). Two topical photosensitizing agents are currently used to treat sBCC, namely 5‐aminolaevulinic acid (ALA) and its ester, methyl aminolaevulinate (MAL). Previous research showed a high efficacy for ALA‐PDT using a twofold fractionated illumination scheme in which two light fractions of 20 J cm−2 and 80 J cm−2 were delivered 4 h and 6 h after ALA application.
Objectives
To evaluate whether twofold ALA‐PDT is superior to conventional MAL‐PDT for sBCC.
Methods
We performed a single‐blind, randomized, multicentre trial in the Netherlands.
Results
Overall, 162 patients were randomized either to conventional MAL‐PDT or twofold ALA‐PDT. After 12 months, a total of six treatment failures occurred following ALA‐PDT and 13 treatment failures occurred following MAL‐PDT. The 12‐month cumulative probability of remaining free from treatment failure was 92·3% 95% confidence interval (CI) (83·7–96·5) for ALA‐PDT and 83·4% (95% CI 73·1–90·0) for MAL‐PDT (P = 0·091).
Conclusions
The twofold ALA‐PDT scheme resulted in fewer recurrences, although the difference between both treatment groups was not statistically significant. However, ALA‐PDT resulted in higher pain scores and more post‐treatment side‐effects compared with MAL‐PDT.
What's already known about this topic?
Photodynamic therapy (PDT) is a well‐known noninvasive therapy for superficial basal cell carcinoma (sBCC).
In Europe, methyl aminolaevulinate (MAL) is the most frequently used photosensitizer.
Previous research showed a high efficacy for a twofold fractionated illumination scheme using 5‐aminolaevulinic acid (ALA) in which two light fractions of 20 J cm−2 and 80 J cm−2 were delivered 4 h and 6 h after ALA application.
What does this study add?
This is the first randomized clinical trial to compare the twofold ALA‐PDT scheme with conventional MAL‐PDT.
Twofold ALA‐PDT resulted in fewer recurrences, although this was not statistically significant. Also, a higher cumulative probability of remaining free from treatment failure was found for ALA‐PDT compared with conventional MAL‐PDT.
Twofold ALA‐PDT should be considered as an effective treatment protocol.
Linked Comment: Ibbotson. Br J Dermatol 2018; 178:1003.
Plain language summary available online
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