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Major Risk (major + risk)
Terms modified by Major Risk Selected AbstractsNeurotrophic rationale in glaucoma: A TrkA agonist, but not NGF or a p75 antagonist, protects retinal ganglion cells in vivoDEVELOPMENTAL NEUROBIOLOGY, Issue 7 2007ZhiHua Shi Abstract Glaucoma is a major cause of vision impairment, which arises from the sustained and progressive apoptosis of retinal ganglion cells (RGC), with ocular hypertension being a major risk or co-morbidity factor. Because RGC death often continues after normalization of ocular hypertension, growth factor-mediated protection of compromised neurons may be useful. However, the therapeutic use of nerve growth factor (NGF) has not proven effective at delaying RGC death in glaucoma. We postulated that one cause for the failure of NGF may be related to its binding to two receptors, TrkA and p75. These receptors have distinct cellular distribution in the retina and in neurons they induce complex and sometimes opposing activities. Here, we show in an in vivo therapeutic model of glaucoma that a selective agonist of the pro-survival TrkA receptor was effective at preventing RGC death. RGC loss was fully prevented by combining the selective agonist of TrkA with intraocular pressure-lowering drugs. In contrast, neither NGF nor an antagonist of the pro-apoptotic p75 receptor protected RGCs. These results further a neurotrophic rationale for glaucoma. © 2007 Wiley Periodicals, Inc. Develop Neurobiol, 2007. [source] COMMERCIAL DEVELOPMENT AND NATURAL RESOURCE MANAGEMENT ON THE INDIGENOUS ESTATE: A PROFIT-RELATED INVESTMENT PROPOSALECONOMIC PAPERS: A JOURNAL OF APPLIED ECONOMICS AND POLICY, Issue 3 2005Jon Altman This article assesses the state of commercial development and resource management on Indigenous land in remote Australia. Indigenous landowners control significant assets,over one million square kilometres of land,often with substantial resource rights and income earning potential. The inactivity and missed opportunities on the Indigenous estate are of such magnitude as to represent a major risk both for Indigenous landowning communities, in terms of their future economic and social well-being, and for national and international interests in terms of ecological vulnerability. The article explores the role of government as risk manager in such circumstances and outlines the principles that might underpin any intervention program targeted to the commercial development of Indigenous land. Using the analytical framework for profit-related loans and elements of an existing venture capital support programme, the Innovation Investment Fund Program, we outline the hypothetical skeleton of a new investment scheme to assist development and natural resource management on the Indigenous estate. Our proposal can be conceptualised as a profit-related loan scheme or as a form of capped public investment. It seeks to address key elements of the market failure that exists in relation to financing development on remote Indigenous land, provides incentives for greater private sector investment, and ensures that commercial and social risks are shared equitably between government, private sector investors and Indigenous-owned corporations to avoid problems of adverse selection and moral hazard. [source] Comparing senior executive and project manager perceptions of IT project risk: a Chinese Delphi studyINFORMATION SYSTEMS JOURNAL, Issue 4 2010Shan Liu Abstract The success rate for information technology (IT) projects continues to be low. With an increasing number of IT projects in developing countries such as China, it is important to understand the risks they are experiencing on IT projects. To date, there has been little research documenting Asian perceptions of IT project risk. In this research, we examine the risks identified by Chinese senior executives (SEs) and project managers (PMs), and compare these two groups. The importance of top management support in IT projects is well documented. Prior research has shown that from the perspective of IT PMs, lack of support from SEs is the number one risk in IT projects. Surprisingly, senior executives' perceptions towards IT project risk have never been systematically examined. One reason why lack of support from senior executives continues to represent a major risk may be that senior executives themselves do not realize the critical role that they can play in helping to deliver successful projects. In this study, we use the Delphi method to compare the risk perceptions of senior executives and project managers. By comparing risk factors selected by each group, zones of concordance and discordance are identified. In terms of perceived importance ascribed to risk factors, PMs tend to focus on lower-level risks with particular emphasis on risks associated with requirements and user involvement, whereas SEs tend to focus on higher-level risks such as those risks involving politics, organization structure, process, and culture. Finally, approaches for dealing with risk factors that are seen as important by both SEs and PMs are provided. [source] Intracardiac Ultrasound Detection of Thrombus on Transseptal Sheath: Incidence, Treatment, and PreventionJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 6 2005KATANEH MALEKI M.D. Background: Transseptal (TS) catheterization is used for left atrial (LA) ablation procedures and a major risk is thromboembolism. The purpose of this study was to assess (1) the value of intracardiac ultrasound (ICUS) monitoring during LA ablation procedures, and (2) a new technique to reduce the risk of thrombus formation. Methods and Results: One hundred and eighty consecutive patients underwent TS catheterization under ICUS guidance with two sheaths for atrial fibrillation ablation and one for other LA procedures. Group I included the initial 90 patients in whom TS sheaths were flushed with a standard 2 U/cc concentration of heparin; group II consisted of the next 90 patients in whom sheaths were flushed with 1,000 U/cc concentration. All patients received bolus and infusion of heparin to maintain ACT between 250,300 seconds. ICUS was monitored throughout. In group I, echodense material at the tip of the sheath consistent with thrombus was observed on ICUS in 8 of 90 patients (9%) within 5,15 minutes of entering the LA. In group II, only 1 of 90 patient (1%) demonstrated thrombus (P < 0.001). There were no significant clinical differences in group I patients with and without thrombus. In all nine patients, the clot was removed with vigorous aspiration. No patients suffered a neurological event. Conclusion: Thrombus formation on TS sheath, detected by ICUS, may be more common than expected despite adequate anticoagulation. Using a higher concentration of heparin for the TS system before deployment reduced the risk. The thrombus was retrieved with aspiration without the need to abort the procedure. [source] The invasive alien leaf miner Cameraria ohridella and the native tree Acer pseudoplatanus: a fatal attraction?AGRICULTURAL AND FOREST ENTOMOLOGY, Issue 2 2010Christelle Péré 1The horse-chestnut leaf miner Cameraria ohridella is an invasive moth in Europe and a serious pest of horse-chestnut Aesculus hippocastanum. The moth also occasionally attacks sycamore maple Acer pseudoplatanus, when situated beside infested horse-chestnuts. 2The main objective of the present study was to provide an overview of the relationship between C. ohridella and A. pseudoplatanus and to determine whether C. ohridella has the potential to shift to this native tree. 3In the field, females oviposit on different deciduous tree species. Although less frequently attacked than A. hippocastanum, A. pseudoplatanus was clearly preferred for oviposition over 12 other woody species investigated. 4Surveys in Europe demonstrated that the majority of A. pseudoplatanus trees found beside infested A. hippocastanum had mines of C. ohridella, even though more than 70% of the larvae died within the first two instars. Attack rates and development success greatly varied from site to site. Attack levels on A. pseudoplatanus were not always correlated with those on A. hippocastanum, and mines on A. pseudoplatanus were sometimes observed beside weakly-infested A. hippocastanum. 5Field observations, experimental exposure of A. pseudoplatanus saplings and rearing trials in a common garden study showed that individual trees may vary in their susceptibility to C. ohridella, whereas there was no evidence that C. ohridella populations vary in their performance on A. pseudoplatanus. 6To date, there is little evidence that C. ohridella represents a major risk for A. pseudoplatanus. [source] Malaria Antibodies and Mefloquine Levels among United Nations Troops in AngolaJOURNAL OF TRAVEL MEDICINE, Issue 3 2001Eli Schwartz Background: The United Nations deployed about 8,000 soldiers in a peacekeeping mission in Angola. Malaria is the most common disease there and consequently it was the major risk to the UN troops. Most of them are from malaria free areas. As a result of improper prophylactic measures there were many cases of malaria, including some deaths in 1995. In February,March 1996, an Israeli team was sent to Angola to evaluate the malaria situation among UN soldiers. This paper deals specifically with some aspects of chemoprophylaxis and diagnosis. The efforts were concentrated in one particular area where malaria incidence had been reported as the highest. Methods: Blood samples were collected from nonimmune soldiers who were using mefloquine as a prophylactic drug and were exposed to malaria. The mefloquine and the antimalarial antibody plasma levels were monitored. Results: While the local laboratory indicated that about 80% had a malaria episode, the serological results revealed that only 5 soldiers of the 56 (9%) examined had antimalarial antibodies, of which 3 were Angolans. Despite a controlled prophylactic regimen there was considerable variability in mefloquine plasma levels: 46% of the samples were below the required prophylactic level and 26% above it. All patients who were proven positive with malaria by both microscopic and serologic observation had a low level of mefloquine. Conclusions: In field conditions, a kit which identifies plasmodial antigens, is preferable, to a microscopic diagnostic method. Controlled mefloquine prophylaxis may not prevent malaria, especially when blood levels are low. The reason for the low mefloquine blood levels is not clear and needs further evaluation. [source] Hepatitis C virus infection in Egyptian children: single centre experienceJOURNAL OF VIRAL HEPATITIS, Issue 5 2004M. S. El-Raziky Summary., The outcome of hepatitis C virus (HCV) infection acquired in childhood is uncertain because of the diversity of the epidemiological and clinical features of infection and disease. The aim of this study was to determine the outcome of HCV infection in 105 Egyptian children who tested positive for HCV antibody (anti-HCV). The data of 105 anti-HCV-positive children presenting to the Pediatric Hepatology Unit, Cairo University Children's Hospital, between 1995 and 2002, were retrospectively analysed for risk factors. Seventy-four children with available polymerase chain reaction results were further analysed clinically, serologically and histologically. The age range was 1.3,22 years, with a mean of 11.2 ± 4.9 years. History of blood transfusion was found in 81 children (77%). HCV RNA was detected in 58.1% of 74 children. Persistently elevated alanine aminotransferase (ALT) levels were present in 40 patients (54.1%). Hepatitis B virus markers (HBsAg and/or anti-HBc) were detected in 18 patients (24.3%). Twenty-six of the 43 HCV RNA-positive children underwent a diagnostic liver biopsy that showed chronic hepatitis in 19 patients (73.1%), cirrhosis in one case only (3.8%), and normal biopsy findings in seven children (26.9%). Blood transfusion remains a major risk of HCV transmission among Egyptian children. HCV infection is not always benign in the childhood period. ALT levels remain elevated in half of the children and histological abnormalities are detected in three quarters of HCV RNA-positive cases. [source] SHORT COMMUNICATION: History of Incidence of Autoimmune and Oncological Diseases in Identical Female TwinsAMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 6 2009Z. Ulcova-Gallova Problem, The aim of study was to investigate identical female twins born in 1977 suffered from autoimmune diseases (twin A , Sjogren's syndrome, and twin B , systemic lupus erythematosus). Method of study, It was refer retrospective analysis of both sisters suffered beside autoimmune alterations (Sjogren's syndrome and systemic lupus erythematosus) also from gynecological diseases (twin A , praecancerosis of cervix uteri, twin B , carcinoma vaginae). Results, Relationships between disease activities and severities in the female twins were similar and the treatments were directed according to clinical symptoms and laboratory results. Dramatic change, unfortunately, occurred with twin B. The reason may be the association between SLE activity (lupus nephritis), hematological complication (leukopenia) and oncological vaginal recidivation. Conclusion, Association between autoimmune disease and gynecological cancer (or praecancerosis) is major risk than without immunology deviation. Twin A is periodically gynecologically observed. [source] Demographic variables routinely collected at colposcopic examination do not predict who will default from conservative management of cervical intraepithelial neoplasia IAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2005Julie A. QUINLIVAN Abstract Objective:, As a result of the low incidence of progression from low grade epithelial abnormalities to cervical intraepithelial neoplasia (CIN) 3 or cervical cancer, a conservative approach to management is supported, especially in young women. Loss to follow-up is a recognised problem with a conservative approach however, with women defaulting known to experience higher rates of cancer. Aim:, To determine if any routinely collected demographic variables could predict which Australian women would subsequently default from care having initially elected to have conservative management of CIN 1 lesions. Methods:, Prospectively collected data was audited on 279 women with a colposcopically directed biopsy diagnosis of CIN 1, confirmed on external review, who were enroled by their own choice into a conservative management program and monitored until a definitive lesion outcome was determined. Women who defaulted from follow-up and were lost to care providers despite follow-up appointments and reminder letters were compared to women who completed follow-up with either lesion resolution or progression requiring treatment, to establish if there were any demographic variables to predict default from care. Results:, Fifty-two (18.5%) women subsequently defaulted from follow-up. There were no significant differences in age, parity, proportion of women who were pregnant at diagnosis, smoking status, immunosuppressed or had a ,human papillomavirus (HPV) effect' reported on Pap-smear or colposcopic examination. Conclusion:, We cannot easily identify a subgroup of women who are more likely to default from follow-up of CIN 1 using routinely collected demographic data. Default from follow-up is a major risk with conservative approaches and further research to reduce default rates are required. [source] Extensive venous/lymphatic malformations causing life-threatening haematological complicationsBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007J. Mazereeuw-Hautier Summary Background, Large venous/lymphatic slow-flow malformations (SFM) can be associated with a coagulopathy resulting in thrombosis and haemorrhage. Such potentially life-threatening complications of SFM have been reported only rarely. Objectives, To better define the clinical characteristics of haematological complications associated with SFM, to highlight the importance of recognition and to discuss the management of these difficult-to-treat patients. Patients and methods, A cohort of six children who presented with massive SFM associated with serious haematological complications was seen between January 1980 and June 2005 in the Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, London, U.K. (tertiary referral centre for vascular anomalies). Clinical and haematological characteristics were recorded. Results, Patients were aged 1,20 years. All suffered with recurrent episodes of pain, localized skin necrosis and bleeding. All had intravascular coagulopathy and life-threatening complications. These included brain haemorrhage, massive bleeding from the uterus and colon, large and extensive thromboses of the deep vessels in the abdomen and pelvis and severe haemoptysis. One patient died suddenly at the age of 20 years from pulmonary thromboembolism and thrombosis within the deep vessels of the vascular malformation. The youngest patient underwent a leg amputation to remove the huge vascular malformation due to the major risk of complications and lack of limb function. Three of the patients underwent anticoagulation treatment and showed improvement in their coagulopathy. Conclusions, It is essential that patients with extensive SFM have their coagulation screened regularly to detect intravascular coagulopathy. This may progress to disseminated vascular coagulopathy and a serious risk of thrombosis and haemorrhage. Such patients require early anticoagulation in an attempt to prevent these secondary complications. [source] Prediction of the risk of Torsade de Pointes using the model of isolated canine Purkinje fibresBRITISH JOURNAL OF PHARMACOLOGY, Issue 3 2005Pascal Champeroux 1Torsade de Pointes (TdP) is a well-described major risk associated with various kinds of drugs. However, prediction of this risk is still uncertain both in preclinical and clinical trials. We tested 45 reference compounds on the model of isolated canine Purkinje fibres. Of them, 22 are clearly associated and/or labelled with a risk of TdP, and 13 others are drugs with published clinical evidence of QT prolongation, with only one or two exceptional cases of TdP. The 10 remaining drugs are without reports of TdP and QT prolongation. 2The relevance of different indicators such as APD90 increase, reverse use dependency, action potential triangulation or effect on Vmax was evaluated by comparison with available clinical data. Finally, a complex algorithm called TDPscreenÔ and based on two subalgorithms corresponding to particular electrophysiological patterns was defined. 3This latter algorithm enabled a clear separation of drugs into three groups: (A) drugs with numerous or several reports (>2 cases) of TdP, (B) drugs causing QT prolongation and/or TdP only, the latter at a very low frequency (2 cases), (C) drugs without reports of TdP or QT prolongation. 4The use of such an algorithm combined with a database accrued from reference compounds with available clinical data is suggested as a basis for testing new candidate drugs in the early stages of development for proarrhythmic risk prediction. British Journal of Pharmacology (2005) 144, 376,385. doi:10.1038/sj.bjp.0706070 [source] Dysmetabolic syndrome in childhood and adolescenceACTA PAEDIATRICA, Issue 8 2005Maria Bitsori Abstract The dysmetabolic syndrome, consisting of dyslipidaemia, hypertension, hyperinsulinaemia and central obesity, has been well recognized as a major risk for cardiovascular disease in adults. Although the clustering of cardiovascular risk factors has also been identified in childhood, the occurrence of full-blown dysmetabolic syndrome at younger ages has only recently been investigated. In this article we attempted an overview of the data for children and adolescents, focused on the mechanisms and natural history of the disease, the prevalence among paediatric populations, the assessment and the treatment approaches. Conclusion: There is substantial evidence that the dysmetabolic syndrome has its origins in childhood. In the face of the epidemic increase of obesity in children and adolescents, the development of effective screening and preventive strategies would be a major challenge for paediatricians. [source] Prevention of toxoplasmosis in transplant patientsCLINICAL MICROBIOLOGY AND INFECTION, Issue 12 2008F. Derouin Abstract Toxoplasmosis is a life-threatening opportunistic infection that affects haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. Its incidence in these patients is closely related to the prevalence of toxoplasmosis in the general population, which is high in Europe. In SOT recipients, toxoplasmosis results mainly from transmission of the parasite with the transplanted organ from a Toxoplasma -seropositive donor to a Toxoplasma -seronegative recipient. This risk is high in cases of transplantation of organs that are recognized sites of encystation of the parasite, e.g. the heart, and is markedly lower in other SOT recipients. Clinical symptoms usually occur within the first 3 months after transplantation, sometimes as early as 2 weeks post transplant, and involve febrile myocarditis, encephalitis or pneumonitis. In HSCT recipients, the major risk of toxoplasmosis results from the reactivation of a pre-transplant latent infection in seropositive recipients. The median point of disease onset is estimated at 2 months post transplant, with <10% of cases occurring before 30 days and 15,20% later than day 100. Toxoplasmosis usually manifests as encephalitis or pneumonitis, and frequently disseminates with multiple organ involvement. Diagnosis of toxoplasmosis is based on the demonstration of parasites or parasitic DNA in blood, bone marrow, cerebrospinal fluid, bronchoalveolar lavage fluid or biopsy specimens, and serological tests do not often contribute to the diagnosis. For prevention of toxoplasmosis, serological screening of donors and recipients before transplantation allows the identification of patients at higher risk of toxoplasmosis, i.e. seropositive HSCT recipients and mismatched (seropositive donor/seronegative recipients) SOT recipients. Preventing toxoplasmosis disease in those patients presently relies on prophylaxis via prescription of co-trimoxazole. [source] Enterprise Risk Management: Theory and PracticeJOURNAL OF APPLIED CORPORATE FINANCE, Issue 4 2006Brian W. Nocco The Chief Risk Officer of Nationwide Insurance teams up with a distinguished academic to discuss the benefits and challenges associated with the design and implementation of an enterprise risk management program. The authors begin by arguing that a carefully designed ERM program,one in which all material corporate risks are viewed and managed within a single framework,can be a source of long-run competitive advantage and value through its effects at both a "macro" or company-wide level and a "micro" or business-unit level. At the macro level, ERM enables senior management to identify, measure, and limit to acceptable levels the net exposures faced by the firm. By managing such exposures mainly with the idea of cushioning downside outcomes and protecting the firm's credit rating, ERM helps maintain the firm's access to capital and other resources necessary to implement its strategy and business plan. At the micro level, ERM adds value by ensuring that all material risks are "owned," and risk-return tradeoffs carefully evaluated, by operating managers and employees throughout the firm. To this end, business unit managers at Nationwide are required to provide information about major risks associated with all new capital projects,information that can then used by senior management to evaluate the marginal impact of the projects on the firm's total risk. And to encourage operating managers to focus on the risk-return tradeoffs in their own businesses, Nationwide's periodic performance evaluations of its business units attempt to refl ect their contributions to total risk by assigning risk-adjusted levels of "imputed" capital on which project managers are expected to earn adequate returns. The second, and by far the larger, part of the article provides an extensive guide to the process and major challenges that arise when implementing ERM, along with an account of Nationwide's approach to dealing with them. Among other issues, the authors discuss how a company should assess its risk "appetite," measure how much risk it is bearing, and decide which risks to retain and which to transfer to others. Consistent with the principle of comparative advantage it uses to guide such decisions, Nationwide attempts to limit "non-core" exposures, such as interest rate and equity risk, thereby enlarging the firm's capacity to bear the "information-intensive, insurance- specific" risks at the core of its business and competencies. [source] Inter-Firm Linkages and Profitability in the Automobile Industry: The Implications for Supply Chain ManagementJOURNAL OF SUPPLY CHAIN MANAGEMENT, Issue 1 2001Harri Ramcharran SUMMARY The current studies on supply chain management are limited in their analysis of the linkages between firms in related industries. This study estimates the degree of linkages between automotive parts suppliers and automobile manufacturers. Significant linkages are demonstrated by the high correlation coefficients of the P/E ratio of auto parts suppliers and auto manufacturers and by the results of regression analysis. Demand uncertainty in the automobile manufacturing industry, resulting from business cycles and unexpected labor disputes, is one of the major risks facing auto parts suppliers. Risk assessment, utilizing information on linkages, is important for demand management and developing profit-maximizing strategies. [source] ONE FIGHT, ONE TEAM: THE 9/11 COMMISSION REPORT ON INTELLIGENCE, FRAGMENTATION AND INFORMATIONPUBLIC ADMINISTRATION, Issue 2 2006HANS DE BRUIJN In its report published in 2004, the National Commission on Terrorist Attacks Upon the United States (known as the ,9/11 Commission') analyses the functioning of the Intelligence Community (ICo). It indicates that the ICo is both over-fragmented and guilty of not sharing enough information. The Commission recommends that central control of the ICo needs to be strengthened and that more incentives for information-sharing should be designed. This article takes a critical look at these two recommendations. Sharing information carries major risks and is therefore not something that can take place as a matter of course. Moreover, information has to be subject to a selection process before it can be shared. This selection cannot be measured objectively, so mistakes in the selection are unavoidable. Strengthening central control also poses risks: it engenders more battles over territory, it does not improve understanding of the capillaries of the organization , the capillaries being where the primary processes of information gathering, validation and assessment take place , and it involves the destruction of checks and balances. Fragmentation may even be functional since it leads to redundancy, itself a safeguard against the risk of misselecting relevant information. [source] Anesthesia-Related Complications in Living Liver Donors: The Experience from One Center and the Reporting of One DeathAMERICAN JOURNAL OF TRANSPLANTATION, Issue 10 2008S. Ozkardesler Living donor liver transplantation has become an alternative therapy for patients with end-stage liver disease. Donors are healthy individuals and donor safety is the primary concern. The objective of this study was to evaluate the anesthetic complications and outcomes for our donor cases; we report one death. The charts of the patients who underwent donor hepatectomy from February 1997 to June 2007 were retrospectively reviewed. Right hepatectomy (resection of segments 5,8) was done in 101 donors, left lobectomy (resection of segments 2,3) in 11 donors, and left hepatectomy (resection of segments 2,4) in one donor. Minor anesthetic complications were shoulder pain, pruritus and urinary retention related to epidural morphine, and major morbidity included central venous catheter-induced thrombosis of the brachial and subclavian vein, neuropraxia, foot drop and prolonged postdural puncture headache. One of 113 donors died from pulmonary embolism on the 11th postoperative day. This procedure has some major risks related to anesthesia and surgery. Although careful attention will lower complication rate, we have to keep in mind that the risks of donor surgery will not be completely eliminated. [source] | |||||||||||||