Are Bank Loan Loss Reservers Materiallity Misstated

A bank\u27s estimated credit losses are reflected by its reserve for loan loss account, generally known as the Allowance for Loan and Lease Losses (ALLL). 1 In simple terms, the ALLL is an estimate of the value of loans that probably will not be collected. It has been noted that the estimation of credit loss is often the most difficult element in the preparation of a bank\u27s financial statements. Part of the problem lies in the subjective nature of the loss estimate, but a greater difficulty arises from the conflicting demands of regulatory agencies and the accounting profession. The subject is not simply a mundane accounting issue; the accuracy and sufficiency of the loss reserve is a major factor in gauging the health and survivability of a bank. Unfortunately the terms accuracy and sufficiency appear to be mutually exclusive when assessing the conflicting demands of bank management, the accountants, and bank regulators This project recounts the history and purpose of the ALLL account; examines the divergent objectives of the banking industry, the accounting profession, and the banking regulators; evaluates the conflicting guidance issued by the accounting profession and bank regulators; and analyzes financial data of American banks from 1992 through 2005 to assess whether the ALLL account is an accurate reflection of its intended purpose underGAA

Uniform documentation of measures in cases of MRSA – an important step towards improving the quality of treatment

The basis for the management and documentation of multiresistant organisms (MRO) in medical facilities in Germany are the Infection Protection Act (IPA) and the recommendations given by the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO)

First insights on plasma orthodontics - Application of cold atmospheric pressure plasma to enhance the bond strength of orthodontic brackets

Objective: The development of an ideal adhesive system has long been subject of research. Recent studies show that treatment with cold atmospheric pressure plasma (CAP) positively affects the bonding properties of enamel. Conditioning with CAP could therefore improve the mechanical and physical properties of bracket adhesives, e.g. Glass ionomer cement (GIC). Material and methods: Laser-structured brackets (Dentaurum, Ispringen) were bonded onto 60 bovine mandibular incisors using different orthodontic adhesives. For 20 specimens FujiOrthoLC (GC America Corp, Alsip, USA) was used according to manufacturer's instructions. Another 20 specimens received a 60 s CAP-treatment (kINPen med, Neoplas tool, Greifswald, Germany) before bracket bonding, of which 10 were re-moistened before applying FujiOrthoLC and 10 remained dry. Onto 20 specimens, brackets were bonded with the Composite Transbond XT (3M/Unitek, St. Paul, USA) following manufacturer's instructions. The shear bond strength of brackets on the teeth was determined with the universal testing machine Zwick BZ050/TH3A (Zwick, Ulm, Germany). Results: Brackets bonded with FujiOrthoLC in standard method, showed average shear bond strength of 5.58±0.46 MPa. Specimens treated with plasma showed clinically unacceptable adhesion values (re-moistened group: 2.79±0.38 MPa, dry group: 1.01±0.2 MPa). Bonding onto dried out teeth also led to spontaneous bracket losses (4 of 10 specimens). The composite group (Transbond XT) showed clinically acceptable adhesion values (7.9±1.03 MPa). Conclusions: Despite promising potential, surface conditioning with CAP could not improve the adhesive properties of GIC. By contrast, a decrease in shear bond strength was noticed after CAP treatment. Further investigations have to show whether it is possible to increase the retention values ​​of other orthodontic adhesives by CAP application and thus take advantage of positive characteristics and reduce side effects

First insights on plasma orthodontics - Application of cold atmospheric pressure plasma to enhance the bond strength of orthodontic brackets

Objective: The development of an ideal adhesive system has long been subject of research. Recent studies show that treatment with cold atmospheric pressure plasma (CAP) positively affects the bonding properties of enamel. Conditioning with CAP could therefore improve the mechanical and physical properties of bracket adhesives, e.g. Glass ionomer cement (GIC). Material and methods: Laser-structured brackets (Dentaurum, Ispringen) were bonded onto 60 bovine mandibular incisors using different orthodontic adhesives. For 20 specimens FujiOrthoLC (GC America Corp, Alsip, USA) was used according to manufacturer's instructions. Another 20 specimens received a 60 s CAP-treatment (kINPen med, Neoplas tool, Greifswald, Germany) before bracket bonding, of which 10 were re-moistened before applying FujiOrthoLC and 10 remained dry. Onto 20 specimens, brackets were bonded with the Composite Transbond XT (3M/Unitek, St. Paul, USA) following manufacturer's instructions. The shear bond strength of brackets on the teeth was determined with the universal testing machine Zwick BZ050/TH3A (Zwick, Ulm, Germany). Results: Brackets bonded with FujiOrthoLC in standard method, showed average shear bond strength of 5.58±0.46 MPa. Specimens treated with plasma showed clinically unacceptable adhesion values (re-moistened group: 2.79±0.38 MPa, dry group: 1.01±0.2 MPa). Bonding onto dried out teeth also led to spontaneous bracket losses (4 of 10 specimens). The composite group (Transbond XT) showed clinically acceptable adhesion values (7.9±1.03 MPa). Conclusions: Despite promising potential, surface conditioning with CAP could not improve the adhesive properties of GIC. By contrast, a decrease in shear bond strength was noticed after CAP treatment. Further investigations have to show whether it is possible to increase the retention values ​​of other orthodontic adhesives by CAP application and thus take advantage of positive characteristics and reduce side effects

Long-term Risk Assessment for Medical Application of Cold Atmospheric Pressure Plasma

Despite increasing knowledge gained based on multidisciplinary research, plasma medicine still raises various questions regarding specific effects as well as potential risks. With regard to significant statements about in vivo applicability that cannot be prognosticated exclusively based on in vitro data, there is still a deficit of clinical data. This study included a clinical follow-up of five probands who had participated five years previously in a study on the influence of cold atmospheric pressure plasma (CAP) on the wound healing of CO2 laser-induced skin lesions. The follow-up included a complex imaging diagnostic involving dermatoscopy, confocal laser scanning microscopy (CLSM) and hyperspectral imaging (HSI). Hyperspectral analysis showed no relevant microcirculatory differences between plasma-treated and non-plasma-treated areas. In summary of all the findings, no malignant changes, inflammatory reactions or pathological changes in cell architecture could be detected in the plasma-treated areas. These unique in vivo long-term data contribute to a further increase in knowledge about important safety aspects in regenerative plasma medicine. However, to confirm these findings and secure indication-specific dose recommendations, further clinical studies are required. © 2020 by the authors

Long-Term Risk Assessment for Medical Application of Cold Atmospheric Pressure Plasma

Despite increasing knowledge gained based on multidisciplinary research, plasma medicine still raises various questions regarding specific effects as well as potential risks. With regard to significant statements about in vivo applicability that cannot be prognosticated exclusively based on in vitro data, there is still a deficit of clinical data. This study included a clinical follow-up of five probands who had participated five years previously in a study on the influence of cold atmospheric pressure plasma (CAP) on the wound healing of CO2 laser-induced skin lesions. The follow-up included a complex imaging diagnostic involving dermatoscopy, confocal laser scanning microscopy (CLSM) and hyperspectral imaging (HSI). Hyperspectral analysis showed no relevant microcirculatory differences between plasma-treated and non-plasma-treated areas. In summary of all the findings, no malignant changes, inflammatory reactions or pathological changes in cell architecture could be detected in the plasma-treated areas. These unique in vivo long-term data contribute to a further increase in knowledge about important safety aspects in regenerative plasma medicine. However, to confirm these findings and secure indication-specific dose recommendations, further clinical studies are required. © 2020 by the authors

Cold argon plasma as adjuvant tumour therapy on progressive head and neck cancer: A preclinical study

Investigating cold argon plasma (CAP) for medical applications is a rapidly growing, innovative field of research. The controllable supply of reactive oxygen and nitrogen species through CAP has the potential for utilization in tumour treatment. Maxillofacial surgery is limited if tumours grow on vital structures such as the arteria carotis. Here CAP could be considered as an option for adjuvant intraoperative tumour therapy especially in the case of squamous cell carcinoma of the head and neck. Further preclinical research is necessary to investigate the efficacy of this technology for future clinical applications in cancer treatment. Initially, a variety of in vitro assays was performed on two cell lines that served as surrogate for the squamous cell carcinoma (SCC) and healthy tissue, respectively. Cell viability, motility and the activation of apoptosis in SCC cells (HNO97) was compared with those in normal HaCaT keratinocytes. In addition, induction of apoptosis in ex vivo CAP treated human tissue biopsies of patients with tumours of the head and neck was monitored and compared to healthy control tissue of the same patient. In response to CAP treatment, normal HaCaT keratinocytes differed significantly from their malignant counterpart HNO97 cells in cell motility only whereas cell viability remained similar. Moreover, CAP treatment of tumour tissue induced more apoptotic cells than in healthy tissue that was accompanied by elevated extracellular cytochrome c levels. This study promotes a future role of CAP as an adjuvant intraoperative tumour therapy option in the treatment of head and neck cancer. Moreover, patient-derived tissue explants complement in vitro examinations in a meaningful way to reflect an antitumoral role of CAP. © 2019 by the authors

Ex Vivo Exposure of Human Melanoma Tissue to Cold Physical Plasma Elicits Apoptosis and Modulates Inflammation

Cutaneous melanoma is the most aggressive type of skin cancer with a not-sufficient clinical outcome. High tumor mutation rates often hamper a remedial treatment, creating the need for palliative care in many patients. To reduce pain and burden, local palliation often includes cryo-ablation, immunotherapy via injection of IL2, or electrochemotherapy. Yet, a fraction of patients and lesions do not respond to those therapies. To reach even these resistances in a redox-mediated way, we treated skin biopsies from human melanoma ex vivo with cold physical plasma (kINPen MED plasma jet). This partially ionized gas generates a potent mixture of reactive oxygen species (ROS). Physical plasmas have been shown to be potent antitumor agents in preclinical melanoma and clinical head and neck cancer research. The innovation of this technology lies in its ease-of-use without anesthesia, as the “cold” plasma temperature of the kINPen MED does not exceed 37 °C. In metastatic melanoma skin biopsies from six patients, we identified a marked increase of apoptosis with plasma treatment ex vivo. This had an impact on the chemokine/cytokine profile of the cultured biopsies, e.g., three of six patient-derived biopsy supernatants showed an apparent decrease in VEGF compared to non-plasma treated specimens. Moreover, the baseline release levels of 24 chemokines/cytokines investigated may serve as a useful tool for future research on melanoma skin biopsy treatments. Our findings suggest a clinically useful role of cold physical plasma therapy in palliation of cutaneous melanoma lesions, possibly in a combinatory setting with other immune therapies

Molecular Mechanisms of the Efficacy of Cold Atmospheric Pressure Plasma (CAP) in Cancer Treatment

Recently, the potential use of cold atmospheric pressure plasma (CAP) in cancer treatment has gained increasing interest. Especially the enhanced selective killing of tumor cells compared to normal cells has prompted researchers to elucidate the molecular mechanisms for the efficacy of CAP in cancer treatment. This review summarizes the current understanding of how CAP triggers intracellular pathways that induce growth inhibition or cell death. We discuss what factors may contribute to the potential selectivity of CAP towards cancer cells compared to their non-malignant counterparts. Furthermore, the potential of CAP to trigger an immune response is briefly discussed. Finally, this overview demonstrates how these concepts bear first fruits in clinical applications applying CAP treatment in head and neck squamous cell cancer as well as actinic keratosis. Although significant progress towards understanding the underlying mechanisms regarding the efficacy of CAP in cancer treatment has been made, much still needs to be done with respect to different treatment conditions and comparison of malignant and non-malignant cells of the same cell type and same donor. Furthermore, clinical pilot studies and the assessment of systemic effects will be of tremendous importance towards bringing this innovative technology into clinical practice. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Molecular mechanisms of the efficacy of cold atmospheric pressure plasma (CAP) in cancer treatment

Recently, the potential use of cold atmospheric pressure plasma (CAP) in cancer treatment has gained increasing interest. Especially the enhanced selective killing of tumor cells compared to normal cells has prompted researchers to elucidate the molecular mechanisms for the efficacy of CAP in cancer treatment. This review summarizes the current understanding of how CAP triggers intracellular pathways that induce growth inhibition or cell death. We discuss what factors may contribute to the potential selectivity of CAP towards cancer cells compared to their non-malignant counterparts. Furthermore, the potential of CAP to trigger an immune response is briefly discussed. Finally, this overview demonstrates how these concepts bear first fruits in clinical applications applying CAP treatment in head and neck squamous cell cancer as well as actinic keratosis. Although significant progress towards understanding the underlying mechanisms regarding the efficacy of CAP in cancer treatment has been made, much still needs to be done with respect to different treatment conditions and comparison of malignant and non-malignant cells of the same cell type and same donor. Furthermore, clinical pilot studies and the assessment of systemic effects will be of tremendous importance towards bringing this innovative technology into clinical practice. © 2020 by the authors. Licensee MDPI, Basel, Switzerland