Asset management industry adapting to climate change : a case study on Nordea AM

This case study examines the strategies and adaptive measures taken by Nordea Asset Management (NAM) in response to the increasing demand for sustainable investments amid the ongoing climate change crisis. The case delves into how NAM has adjusted its resources, products, and strategies to adapt to rapid shifts and enhance its competitiveness in the asset management industry. The study aims to determine whether NAM should continue focusing on sustainable investing and positioning itself as a leader in the ESG asset management sector. This case follows a pedagogical structure and provides an analysis of the European Asset Management firm and its strategic adaptation, with a particular focus on ESG and the efforts of financial services and regulators to bring about change in the industry. Theoretical concepts and frameworks are used for analysis, and teaching notes are included as a guide for solutions. The study concludes with the recommendation that NAM should continue to differentiate its products and diversify its distribution channels. This recommendation is based on a key element: NAM's resources and dynamic capabilities provide a competitive advantage that have contributed to its status as a ESG leader in the industry, enabling the company to achieve higher rewards; the ongoing Russian invasion makes it difficult to predict how the global situation will evolve and could potentially affect the findings in the teaching notes.Este estudo de caso examina as estratégias e medidas adaptativas adotadas pela Nordea Asset Management (NAM) diante da crescente demanda por investimentos sustentáveis durante a crise climática em curso. O caso aprofunda-se em como a NAM ajustou seus recursos, produtos e estratégias para se adaptar a mudanças rápidas e aumentar sua competitividade no setor de gestão de ativos. O estudo busca determinar se a NAM deve continuar se concentrando em investimentos sustentáveis e se posicionando como líder no setor de gestão de ativos ESG. Este caso segue uma estrutura pedagógica e fornece uma análise da empresa de Gestão de Ativos Europeia e sua adaptação estratégica, com um foco particular em ESG e nos esforços dos serviços financeiros e reguladores para promover mudanças na indústria. Conceitos teóricos e quadros de referência são utilizados para análise, e notas de aula são incluídas como guia de soluções. O studio conclui com a recomendação de que a NAM continue a diferenciar seus produtos e diversificar seus canais de distribuição. Essa recomendação é baseada em um elemento-chave: os recursos e as capacidades dinâmicas da NAM proporcionam uma vantagem competitiva que contribuiu para o seu status de líder ESG na indústria, permitindo à empresa alcançar recompensas mais elevadas; a invasão russa em curso dificulta a previsão de como a situação global pode evoluir e pode potencialmente afetar os resultados nas notas de aula

Risks of combining immunosuppressive and biological treatments in inflammatory bowel disease - in reply

We thank Roblin and Phelip for their comment on a timely issue. The recent report of the rare hepatosplenic T-cell lymphoma (HSTCL) in young patients with CD treated with both infliximab and azathioprine or steroids has rightly unleashed a series of doubts regarding the optimal use of biological agents in this and other conditions. How these observations may directly relate to the design of our study\u2014as implied by Roblin and Phelip\u2014is unclear though. While azathioprine by itself has been linked to lymphoma development including HSTCL, recent studies have shown that neither infliximab nor methotrexate, which was used in our study, alone or in combination in CD or in rheumatoid arthritis, appear to be associated with an increased risk of developing lymphomas. In addition, methotrexate alone has never been associated thus far with HSTCL in CD

Functional health literacy of asylum seekers and refugees. A pilot study in italy

Literature shows how some groups of populations, among which are people seeking international protection and refugees, find it difficult to access services in national health systems. Usually, asylum seekers have limited Health Literacy (HL), which makes understanding the appropriate health information difficult. The objective of this research is to consider the relationship between how people requesting international protection and refugees approach the Italian Health System to request health services and their level of Functional Health Literacy (FHL). These relationships are examined through mixed methods. Data were obtained using several tools: a self-administered questionnaire in which the subjects revealed social and demographic data and a face-to-face interview together with the S-FHL Scale fulfilment in order to identify the functional level of HL. Twenty-one subjects were interviewed in two Centers of Protection System for Asylum Seekers and Refugees (SPRAR). Results show a picture of the actual situation. Data report a problematic or insufficient FHL level. Some factors, such as gender, age and health perceptions, play a role in the FHL levels. Some racial prejudices were reported. Language barriers had the most impact on the communication gap. Nevertheless, none of the subjects were denied health services. In conclusion, although this study is a pilot, we have experienced difficulty in obtaining asylum seekers’ trust to be open about their experience. This explains the number of the sample that should be more indicated for a qualitative study. Our results are in accordance with literature for inadequate level of FHL and lack of knowledge of the Italian Health System. This study highlighted several other issues to be taken into consideration for future research on the subject

Targeting Notch Trafficking and Processing in Cancers

The Notch family comprises a group of four ligand-dependent receptors that control evolutionarily conserved developmental and homeostatic processes and transmit signals to the microenvironment. NOTCH undergoes remodeling, maturation, and trafficking in a series of post-translational events, including glycosylation, ubiquitination, and endocytosis. The regulatory modifications occurring in the endoplasmic reticulum/Golgi precede the intramembrane γ-secretase proteolysis and the transfer of active NOTCH to the nucleus. Hence, NOTCH proteins coexist in different subcellular compartments and undergo continuous relocation. Various factors, including ion concentration, enzymatic activity, and co-regulatory elements control Notch trafficking. Interfering with these regulatory mechanisms represents an innovative therapeutic way to bar oncogenic Notch signaling. In this review, we briefly summarize the role of Notch signaling in cancer and describe the protein modifications required for NOTCH to relocate across different subcellular compartments. We focus on the functional relationship between these modifications and the corresponding therapeutic options, and our findings could support the development of trafficking modulators as a potential alternative to the well-known γ-secretase inhibitors

Generalized scaling-up approach based on Buckingham theorem for Polymer Electrolyte Membrane Fuel Cells impedance simulation

Abstract The present paper describes a generalized scaling-up methodology applied to Polymer Electrolyte Membrane Fuel Cells. The use of proper scaling-up algorithms can reduce testing costs within fuel cell manufacturing process by evaluating full stack performance (i.e., impedance behavior) from a single cell/short stack measurement. The algorithm here described relies on a former approach developed by the authors and consists in a generalized methodology combining information measured on single cell and simple physical models (e.g., charge transfer resistance expressed through Tafel equation). A robust technique for the identification of cell reference operational state, such as membrane hydration, from non-scaled data is also introduced. Connection between charge transfer resistance and limiting current is established through diffusion losses modelling. Single cell internal states are estimated by means of inverse models function of numerical intercepts of measured cell spectrum. Stack impedance estimation is then performed through stack internal states assumptions. To prove the consistency and robustness of the proposed methodology, literature data used to design and test the former algorithm version are here considered for algorithm testing and verification

GDA, a web-based tool for Genomics and Drugs integrated analysis

Several major screenings of genetic profiling and drug testing in cancer cell lines proved that the integration of genomic portraits and compound activities is effective in discovering new genetic markers of drug sensitivity and clinically relevant anticancer compounds. Despite most genetic and drug response data are publicly available, the availability of user-friendly tools for their integrative analysis remains limited, thus hampering an effective exploitation of this information. Here, we present GDA, a web-based tool for Genomics and Drugs integrated Analysis that combines drug response data for >50 800 compounds with mutations and gene expression profiles across 73 cancer cell lines. Genomic and pharmacological data are integrated through a modular architecture that allows users to identify compounds active towards cancer cell lines bearing a specific genomic background and, conversely, the mutational or transcriptional status of cells responding or not-responding to a specific compound. Results are presented through intuitive graphical representations and supplemented with information obtained from public repositories. As both personalized targeted therapies and drug-repurposing are gaining increasing attention, GDA represents a resource to formulate hypotheses on the interplay between genomic traits and drug response in cancer. GDA is freely available at http://gda.unimore.it/

A Health Technology Assessment in Maxillofacial Cancer Surgery by Using the Six Sigma Methodology

Squamous cell carcinoma represents the most common cancer affecting the oral cavity. At the University of Naples “Federico II”, two different antibiotic protocols were used in patients undergoing oral mucosa cancer surgery from 2006 to 2018. From 2011, there was a shift; the combination of Cefazolin plus Clindamycin as a postoperative prophylactic protocol was chosen. In this paper, a health technology assessment (HTA) is performed by using the Six Sigma and DMAIC (Define, Measure, Analyse, Improve, Control) cycle in order to compare the performance of the antibiotic protocols according to the length of hospital stay (LOS). The data (13 variables) of two groups were collected and analysed; overall, 136 patients were involved. The American Society of Anaesthesiologist score, use of lymphadenectomy or tracheotomy and the presence of infections influenced LOS significantly (p-value < 0.05) in both groups. Then, the groups were compared: the overall difference between LOS of the groups was not statistically significant, but some insights were provided by comparing the LOS of the groups according to each variable. In conclusion, in light of the insights provided by this study regarding the comparison of two antibiotic protocols, the utilization of DMAIC cycle and Six Sigma tools to perform HTA studies could be considered in future research

Application of DMAIC Cycle and Modeling as Tools for Health Technology Assessment in a University Hospital

Background. The Health Technology Assessment (HTA) is used to evaluate health services, manage healthcare processes more efficiently, and compare medical technologies. The aim of this paper is to carry out an HTA study that compares two pharmacological therapies and provides the clinicians with two models to predict the length of hospital stay (LOS) of patients undergoing oral cavity cancer surgery on the bone tissue. Methods. The six Sigma method was used as a tool of HTA; it is a technique of quality management and process improvement that combines the use of statistics with a five-step procedure: “Define, Measure, Analyze, Improve, Control” referred to in the acronym DMAIC. Subsequently, multiple linear regression has been used to create two models. Two groups of patients were analyzed: 45 were treated with ceftriaxone while 48 were treated with the combination of cefazolin and clindamycin. Results. A reduction of the overall mean LOS of patients undergoing oral cavity cancer surgery on bone was observed of 40.9% in the group treated with ceftriaxone. Its reduction was observed in all the variables of the ceftriaxone group. The best results are obtained in younger patients (−54.1%) and in patients with low oral hygiene (−52.4%) treated. The regression results showed that the best LOS predictors for cefazolin/clindamycin are ASA score and flap while for ceftriaxone, in addition to these two, oral hygiene and lymphadenectomy are the best predictors. In addition, the adjusted R squared showed that the variables considered explain most of the variance of LOS. Conclusion. SS methodology, used as an HTA tool, allowed us to understand the performance of the antibiotics and provided variables that mostly influence postoperative LOS. The obtained models can improve the outcome of patients, reducing the postoperative LOS and the relative costs, consequently increasing patient safety, and improving the quality of care provided

Glucocorticoid receptor signalling activates YAP in breast cancer

The Hippo pathway is an oncosuppressor signalling cascade that plays a major role in the control of cell growth, tissue homoeostasis and organ size. Dysregulation of the Hippo pathway leads to aberrant activation of the transcription co-activator YAP (Yes-associated protein) that contributes to tumorigenesis in several tissues. Here we identify glucocorticoids (GCs) as hormonal activators of YAP. Stimulation of glucocorticoid receptor (GR) leads to increase of YAP protein levels, nuclear accumulation and transcriptional activity in vitro and in vivo. Mechanistically, we find that GCs increase expression and deposition of fibronectin leading to the focal adhesion-Src pathway stimulation, cytoskeleton-dependent YAP activation and expansion of chemoresistant cancer stem cells. GR activation correlates with YAP activity in human breast cancer and predicts bad prognosis in the basal-like subtype. Our results unveil a novel mechanism of YAP activation in cancer and open the possibility to target GR to prevent cancer stem cells self-renewal and chemoresistance