Banking on Start-ups: The Changing Role of Lebanon’s Central Bank

Although there is a long global tradition of Central Bank support for economic development, the early years of the twenty-first century saw Central Banks increasingly focussed on a single objective – price stability, typically targeted by interest rate policy. However, the global financial crisis saw a rapid shift to policies to promote employment and economic growth, including for a number of European Central Banks, (France, Italy and Belgium; see [1; The Role of Central Banks, Briefing Paper 8/2015, German Development Institution (DIE)]), pursuing innovative policies such as prioritized lending to specific sectors via variable reserve asset requirements. At least one Central Bank has gone further – in incentivizing commercial banks to invest in high-technology start-ups, as well as to incubators and accelerators. This article focuses on the entrepreneurship-support role of Lebanon’s Central Bank (Banque du Liban or BdL) for years regarded as deeply conservative in imposing cash reserve requirements well in excess of international norms and prohibiting banks from speculating in risky packages of bundled debts. BdL has been credited with ameliorating the impacts of the global financial crisis on the Lebanese economy and has for some years facilitated loans to specific sectors at low interest rates. However, BdL took a more radical step in August 2013 by issuing Circular 331, providing significant incentives to commercial banks to invest in technology start-ups, either directly or through Venture Capital funds, by facilitating the banks to then access a seven-year interest-free loan invested in Lebanese Treasury Bonds. Investments in approved start-ups were guaranteed up to 75% by BdL and 100% for investments in accelerators or incubators. This article will seek to develop an impact framework for 331 and make some early assessment of its potential economic development consequences

Changing Patterns of Entrepreneurship in Lebanon

Despite some significant enterprise initiatives, relatively little is known about the level, pattern and distribution of entrepreneurship in Lebanon. Whilst Lebanon is typically regarded as entrepreneurial, and there is no shortage of Lebanese role models, there is a shortage of hard evidence about who are the entrepreneurs, and how the level of entrepreneurship varies by gender, across age groups, by level of educational attainment and by location. This paper will address these issues head-on, providing comprehensive survey data on the pattern of entrepreneurship across Lebanon and how that pattern is changing over time. However the paper will go beyond simply describing the level of entrepreneurship – it will also offer some evidence-based conjecture as to why that pattern is changing, and how policies may be adapted to encourage further growth. The research instrument for this evidence is the annual GEM survey of 2000+ adults in Lebanon, asking about their entrepreneurial activities, as well as their perceptions and demographics. In the past decade, Lebanon has participated in GEM in three years, (2009, 2015 & 2016), allowing patterns and trends to be established. The level of total early stage entrepreneurial activity, (TEA, or those actively starting or running a new business), increased from 15% in 2009 to 30% in 2015, before falling to 21% in 2016. However these averages are very blunt measures, which the detail of GEM allows to be unpicked. There are reasons to expect the level of TEA to have increased fastest in young people, given the emphasis on enterprise education and growth in entrepreneurial finance for hi-technology start-ups. There is some evidence for this – between 2009 and 2015, TEA for 18-24 year olds increased from 10% to 27%, before falling to 19% in 2016 – still almost twice the level of 2009. However, TEA for 45-54 year olds almost trebled between 2009 and 2015, (from 11% to 31%), before falling to 15% in 2016. In 2009, 45-54 year olds had been more entrepreneurial than 18-24 year olds. By 2016 this had reversed, with the younger age group being almost a third more likely to be starting or running a new business than the older age group. This paper will explore a number of key relationships with entrepreneurship, testing changes for their statistical significance and using results to develop evidence-based recommendations for the development of early-stage entrepreneurship in Lebanon

Women and Entrepreneurship in the Contemporary Middle East

The purpose of this paper is to assess the nature of relative female entrepreneurship in the contemporary Middle East, using data from the seven Middle Eastern countries that participated in the GEM Consortium in 2016 (GEM Global Report, 2016). This data will show that while some of these countries are approaching parity in terms of gender shares in new business start-up’s, in others the rate of female early stage entrepreneurship is a half or even less of the rate for males. Interestingly it is the richer Middle Eastern countries that are closest to parity, even though this includes some of the traditionally more conservative and patriarchal Gulf countries. There are important lessons for the development of policy here – some countries are foregoing substantial opportunities to increase the pool of new female-owned businesses and their subsequent economic development impacts. The data analysis will include statistical tests for significant differences between countries, and will introduce a new methodology for comparing the ratios of sample proportions. The literature on entrepreneurship evidences a continuing debate on the nature of female early-stage entrepreneurial activity, and whether female owned and run businesses grow more slowly and are less profitable than male owned businesses, (see for example Minniti and Naude 2010 & 2011). While GEM data says little about the actual performance of new businesses, that performance may be closely related to the plans and expectations of the entrepreneur, an area that is specifically addressed by GEM. Hence this paper will assess differences in attitudes and expectations by gender, including job creation and international orientation, as well as differences in opportunity and necessity entrepreneurship. The paper will conclude with some lessons for policy development

The efficacy of four-slice helical CT in evaluating pancreatic trauma: a single institution experience

<p>Abstract</p> <p>Study objective</p> <p>To assess the efficacy of computed tomography (CT) in evaluating patients with pancreatic trauma.</p> <p>Methods</p> <p>We undertook a retrospective review of all blunt trauma patients admitted to the Chi-Mei Medical Center from January 2004 to June 2006. Every patients underwent abdominal CT scan in emergency department and the CT scans were obtained with a four-slice helical CT. Diagnosis of a pancreatic injury in these patients was by surgical observation or by CT findings. Radiographic pancreatic injuries were classified as deep or superficial lesions. Deep lesions were defined as the hematomas or lacerations >50% thickness of the pancreas. Superficial lesions were described as the hematomas or lacerations <50% thickness of the pancreas; pancreatic edema; and focal fluid accumulation around the pancreas</p> <p>Results</p> <p>Nineteen patients with pancreatic trauma, fourteen males and five females, average age 40.6 ± 21.4 years, were included. Most patients (73.7%) with pancreatic trauma had associated organ injuries. CT was performed in all patients and laparotomy in 14 patients. CT was 78.9% sensitive in detecting pancreatic trauma. All deep pancreatic lesions revealed on CT required surgical treatment, and complication was discovered in two patients undergoing delayed surgery. Superficial lesions were managed conservatively.</p> <p>Conclusion</p> <p>Four-slice helical CT can detect most pancreatic trauma and provide practical therapeutic guidance. Delayed operation might result in complications and is associated with prolonged hospital stays.</p

Cargo-specific recruitment in clathrin- and dynamin-independent endocytosis

Spatially controlled, cargo-specific endocytosis is essential for development, tissue homeostasis and cancer invasion. Unlike cargo-specific clathrin-mediated endocytosis, the clathrin- and dynamin-independent endocytic pathway (CLIC-GEEC, CG pathway) is considered a bulk internalization route for the fluid phase, glycosylated membrane proteins and lipids. While the core molecular players of CG-endocytosis have been recently defined, evidence of cargo-specific adaptors or selective uptake of proteins for the pathway are lacking. Here we identify the actin-binding protein Swiprosin-1 (Swip1, EFHD2) as a cargo-specific adaptor for CG-endocytosis. Swip1 couples active Rab21-associated integrins with key components of the CG-endocytic machinery-Arf1, IRSp53 and actin-and is critical for integrin endocytosis. Through this function, Swip1 supports integrin-dependent cancer-cell migration and invasion, and is a negative prognostic marker in breast cancer. Our results demonstrate a previously unknown cargo selectivity for the CG pathway and a role for specific adaptors in recruitment into this endocytic route.Moreno-Layseca et al. identify Swip1 as an integrin-specific endocytic adaptor controlling the dynamics of integrin adhesion complexes as well as the migration and invasion of breast cancer cells

Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection

BACKGROUND Clostridium difficile is the most common cause of infectious diarrhea in hospitalized patients. Recurrences are common after antibiotic therapy. Actoxumab and bezlotoxumab are human monoclonal antibodies against C. difficile toxins A and B, respectively. METHODS We conducted two double-blind, randomized, placebo-controlled, phase 3 trials, MODIFY I and MODIFY II, involving 2655 adults receiving oral standard-of-care antibiotics for primary or recurrent C. difficile infection. Participants received an infusion of bezlotoxumab (10 mg per kilogram of body weight), actoxumab plus bezlotoxumab (10 mg per kilogram each), or placebo; actoxumab alone (10 mg per kilogram) was given in MODIFY I but discontinued after a planned interim analysis. The primary end point was recurrent infection (new episode after initial clinical cure) within 12 weeks after infusion in the modified intention-to-treat population. RESULTS In both trials, the rate of recurrent C. difficile infection was significantly lower with bezlotoxumab alone than with placebo (MODIFY I: 17% [67 of 386] vs. 28% [109 of 395]; adjusted difference, −10.1 percentage points; 95% confidence interval [CI], −15.9 to −4.3; P<0.001; MODIFY II: 16% [62 of 395] vs. 26% [97 of 378]; adjusted difference, −9.9 percentage points; 95% CI, −15.5 to −4.3; P<0.001) and was significantly lower with actoxumab plus bezlotoxumab than with placebo (MODIFY I: 16% [61 of 383] vs. 28% [109 of 395]; adjusted difference, −11.6 percentage points; 95% CI, −17.4 to −5.9; P<0.001; MODIFY II: 15% [58 of 390] vs. 26% [97 of 378]; adjusted difference, −10.7 percentage points; 95% CI, −16.4 to −5.1; P<0.001). In prespecified subgroup analyses (combined data set), rates of recurrent infection were lower in both groups that received bezlotoxumab than in the placebo group in subpopulations at high risk for recurrent infection or for an adverse outcome. The rates of initial clinical cure were 80% with bezlotoxumab alone, 73% with actoxumab plus bezlotoxumab, and 80% with placebo; the rates of sustained cure (initial clinical cure without recurrent infection in 12 weeks) were 64%, 58%, and 54%, respectively. The rates of adverse events were similar among these groups; the most common events were diarrhea and nausea. CONCLUSIONS Among participants receiving antibiotic treatment for primary or recurrent C. difficile infection, bezlotoxumab was associated with a substantially lower rate of recurrent infection than placebo and had a safety profile similar to that of placebo. The addition of actoxumab did not improve efficacy. (Funded by Merck; MODIFY I and MODIFY II ClinicalTrials.gov numbers, NCT01241552 and NCT01513239.

Changing Patterns of Entrepreneurship in Lebanon

Despite some significant enterprise initiatives, relatively little is known about the level, pattern and distribution of entrepreneurship in Lebanon. Whilst Lebanon is typically regarded as entrepreneurial, and there is no shortage of Lebanese role models, there is a shortage of hard evidence about who are the entrepreneurs, and how the level of entrepreneurship varies by gender, across age groups, by level of educational attainment and by location. This paper will address these issues head-on, providing comprehensive survey data on the pattern of entrepreneurship across Lebanon and how that pattern is changing over time. However the paper will go beyond simply describing the level of entrepreneurship – it will also offer some evidence-based conjecture as to why that pattern is changing, and how policies may be adapted to encourage further growth. The research instrument for this evidence is the annual GEM survey of 2000+ adults in Lebanon, asking about their entrepreneurial activities, as well as their perceptions and demographics. In the past decade, Lebanon has participated in GEM in three years, (2009, 2015 &amp; 2016), allowing patterns and trends to be established. The level of total early stage entrepreneurial activity, (TEA, or those actively starting or running a new business), increased from 15% in 2009 to 30% in 2015, before falling to 21% in 2016. However these averages are very blunt measures, which the detail of GEM allows to be unpicked. There are reasons to expect the level of TEA to have increased Fastest in young people, given the emphasis on enterprise education and growth in entrepreneurial finance for hi-technology start-ups. There is some evidence for this – between 2009 and 2015, TEA for 18-24 year olds increased from 10% to 27%, before falling to 19% in 2016 – still almost twice the level of 2009. However, TEA for 45-54 year olds almost trebled between 2009 and 2015, (from 11% to 31%), before falling to 15% in 2016. In 2009, 45-54 year olds had been more entrepreneurial than 18-24 year olds. By 2016 this had reversed, with the younger age group being almost a third more likely to be starting or running a new business than the older age group. This paper will explore a number of key relationships with entrepreneurship, testing changes for their statistical significance and using results to develop evidence-based recommendations for the development of early-stage entrepreneurship in Lebanon

Banking on Start-ups: the Changing Role of Lebanon's Central Bank

Although there is a long global tradition of Central Bank support for economic development, the early years of the twenty-first century saw Central Banks increasingly focussed on a single objective – price stability, typically targeted by interest rate policy. However, the global financial crisis saw a rapid shift to policies to promote employment and economic growth, including for a number of European Central Banks, (France, Italy and Belgium; see [1; The Role of Central Banks, Briefing Paper 8/2015, German Development Institution (DIE)]), pursuing innovative policies such as prioritized lending to specific sectors via variable reserve asset requirements. At least one Central Bank has gone further – in incentivizing commercial banks to invest in high-technology start-ups, as well as to incubators and accelerators. This article focuses on the entrepreneurship-support role of Lebanon's Central Bank (Banque du Liban or BdL) for years regarded as deeply conservative in imposing cash reserve requirements well in excess of International norms and prohibiting banks from speculating in risky packages of bundled debts. BdL has been credited with ameliorating the impacts of the global financial crisis on the Lebanese economy and has for some years facilitated loans to specific sectors at low interest rates. However, BdL took a more radical step in August 2013 by issuing Circular 331, providing significant incentives to commercial banks to invest in technology start-ups, either directly or through Venture Capital funds, by facilitating the banks to then access a seven-year interest-free loan invested in Lebanese Treasury Bonds. Investments in approved start-ups were guaranteed up to 75% by BdL and 100% for investments in accelerators or incubators. This article will seek to develop an impact framework for 331 and make some early assessment of its potential economic development consequences