Corporate equity and fi nancial stability: An approach based on net worth at risk.

This article is based on a study conducted jointly by the Deutsche Bundesbank, the Banco d’Espana, the Centrale dei Bilanci (Italy) and the Banque de France under the aegis of the European Committee of Central Balance Sheet Offi ces.1 It looks at companies’ resilience in the event of an exceptional cyclical shock. The article starts by outlining the economic role of equity capital, which lies at the heart of the relationship between risk and return. It can be examined from two main angles, either as a financing instrument or as a buffer in the event of a shock. This study focuses on this second function, looking at it from a meso-economic perspective for which the use of central balance sheet offices is particularly well suited. It sets out to describe the implications of a crisis situation in terms of minimum capital requirements. A comparison is drawn between the situation of manufacturing sector companies in the four countries under review over the period 1987-2002 by means of several traditional indicators (income, equity capital), which resulted in the computation of a Net Worth at Risk (NWaR) indicator. The NWaR figures are calibrated on the basis of an analysis of the distribution of accounting losses (in particular at the 90th and 95th percentiles) calculated using company samples. They indicate the minimum capital that would be required in order to absorb any losses in the event of very unfavourable economic conditions. The difference between NWaR and the observed level of equity capital gives us an indication of the number of companies for which the default rate is likely to increase significantly in a crisis situation. The proportion of companies that appear fragile in the event of a severe economic downturn is around 40%, as against 20% in a “normal” situation. However, this statistical analysis needs to be put into perspective. In practice, only a minority of companies default, since the majority of them benefit from protective measures implemented by their shareholders, managers and creditors to enable them to weather the downturn and revive their activity. In spite of the limitations of this indicator (which are also discussed in the study), these findings will draw the attention of bank and company managers to the need to make financial projections and credit risk assessments both in normal business conditions and crisis situations. An approach based on net worth at risk sheds light on the determinants of a sound financing structure and encourages the development of an active approach to preventing corporate financing problems.

Mda-9/Syntenin Is Expressed in Uveal Melanoma and Correlates with Metastatic Progression

Uveal melanoma is an aggressive cancer that metastasizes to the liver in about half of the patients, with a high lethality rate. Identification of patients at high risk of metastases may provide indication for a frequent follow-up for early detection of metastases and treatment. The analysis of the gene expression profiles of primary human uveal melanomas showed high expression of SDCBP gene (encoding for syndecan-binding protein-1 or mda-9/syntenin), which appeared higher in patients with recurrence, whereas expression of syndecans was lower and unrelated to progression. Moreover, we found that high expression of SDCBP gene was related to metastatic progression in two additional independent datasets of uveal melanoma patients. More importantly, immunohistochemistry showed that high expression of mda-9/syntenin protein in primary tumors was significantly related to metastatic recurrence in our cohort of patients. Mda-9/syntenin expression was confirmed by RT-PCR, immunofluorescence and immunohistochemistry in cultured uveal melanoma cells or primary tumors. Interestingly, mda-9/syntenin showed both cytoplasmic and nuclear localization in cell lines and in a fraction of patients, suggesting its possible involvement in nuclear functions. A pseudo-metastatic model of uveal melanoma to the liver was developed in NOD/SCID/IL2Rγ null mice and the study of mda-9/syntenin expression in primary and metastatic lesions revealed higher mda-9/syntenin in metastases. The inhibition of SDCBP expression by siRNA impaired the ability of uveal melanoma cells to migrate in a wound–healing assay. Moreover, silencing of SDCBP in mda-9/syntenin-high uveal melanoma cells inhibited the hepatocyte growth factor (HGF)-triggered invasion of matrigel membranes and inhibited the activation of FAK, AKT and Src. Conversely syntenin overexpression in mda-9/syntenin-low uveal melanoma cells mediated opposite effects. These results suggest that mda-9/syntenin is involved in uveal melanoma progression and that it warrants further investigation as a candidate molecular marker of metastases and a potential therapeutic target

Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks : an international rare cancers initiative (IRCI) ocular melanoma study

Background: Despite the completion of numerous phase II studies, a standard of care treatment has yet to be defined for metastatic uveal melanoma (mUM). To determine benchmarks of progression free survival (PFS) and overall survival (OS), we carried out a meta-analysis using individual patient level trial data. Methods: Individual patient variables and survival outcomes were requested from 29 trials published from 2000 to 2016. Univariable and multivariable analysis were carried out for prognostic factors. The variability between trial arms and between therapeutic agents on PFS and OS was investigated. Results: OS data were available for 912 patients. The median PFS was 3.3 months (95% CI 2.9-3.6) and 6-month PFS rate was 27% (95% CI 24-30). Univariable analysis showed male sex, elevated (i.e. > versus = 3 cm versus Conclusion: Benchmarks of 6-month PFS and 1-year OS rates were determined accounting for prognostic factors. These may be used to facilitate future trial design and stratification in mUM.Peer reviewe

Complications ophtalmologiques de la maladie de Horton (artérite à cellules géantes)

International audienc

Évaluation de l’inflammation conjonctivale chez les porteurs de prothèse oculaire

National audienc

Management of ophthalmologic emergencies in general emergency departments: A retrospective multicenter study.

International audienceINTRODUCTION:The growing shortage of working ophthalmologists makes it more difficult for the patient to access ophthalmological care, especially in an emergent context. These patients are thus taken to general emergency departments for ophthalmologic problems.OBJECTIVES:To observe the epidemiological characteristics of ophthalmic patients in general emergency centers and question the emergency physicians on their practice of ophthalmology.METHODS:A retrospective epidemiological study was conducted in the emergency departments of Rennes, Lorient and Saint-Brieuc over a period of three months. The demographic characteristics, diagnoses, examinations and procedures performed, opinions obtained from ophthalmologists and patient outcomes were studied. A qualitative study by online questionnaire was sent to the emergency physicians.RESULTS:Seven hundred and eighty-one patients were included, mainly men (68%) under 35 years (45%). The most frequent diagnosis was extra-ocular foreign body (32%). An ophthalmologist opinion was requested in 79% within 24hours. The online questionnaire was sent to 74 emergency physicians: 92% of them were willing to participate in additional training, 90% had sufficient means to practice ophthalmology in the emergency room.CONCLUSION:Emergency physicians could handle the most frequent ophthalmological emergencies, extra-ocular foreign bodies and minor trauma, with adapted material resources, autonomy for these conditions, and willingness for ophthalmologic training. Protocols could be proposed in order to optimize the care of these patients

Les cellulites orbitaires

International audienc