The financial crisis of 2008 underscored the critical importance of central counterparties (CCPs) in mitigating systemic risk within the derivatives market. CCPs function as intermediaries, assuming counterparty risk to enhance market stability. This paper explores the comprehensive CCP risk waterfall framework, evaluates its robustness under prolonged market stress and provides actionable recommendations for fortifying CCP resilience. Through theoretical models and empirical simulations, the paper illustrates how CCPs manage systemic shocks and proposes improvements for future robustness. This article is also included in The Business & Management Collection which can be accessed at https:// hstalks.com/business/.
INTRODUCTION:This study aimed to assess the risk factors and triggers predisposing to asthma in Indian children and adults. METHODS:The Global Asthma Network Phase I study was a multicentre, international, school, and questionnaire-based cross-sectional study conducted across the world with nine centers in India from 2017-18, the current study being analysis of the Indian data. RESULTS:There were 20084 children, 25887 adolescents, and 81296 adults from 9 sites across India. The adjusted odds ratio (AOR) and 95% confidence interval (CI) for atopic factors were as follows: parental history of asthma in adults (AOR 2.88, CI 2.21-3.75), hay fever in children (AOR 2.05, CI 1.62-2.58), and hay fever in adolescents (AOR 1.65, CI 1.40-1.94). Environmental triggers such as exposure to damp spots in the home (AOR1.28, CI 1.05-1.55), antibiotics consumption (AOR 1.80, CI 1.30-2.51), paracetamol taken during pregnancy (AOR 1.23, CI1.02-1.49), and laying on a woollen blanket in the first year of life (AOR 1.67, CI1.34-2.03) were the risk factors predisposing to current wheeze in the children. Risk factors for current wheeze in the adolescents included passage of trucks in front of the house (AOR 1.20, CI 1.04-1.39), and pet animal exposure (AOR 1.32, CI 1.14-1.53); and in the adults included damp spots in houses (AOR 1.61, CI 1.47-1.77), and the use of coal or kerosene or cow dung as a cooking fuel (AOR 1.48, CI 1.28-1.71). Personal factors such as the history of pneumonia in the children (AOR 1.71, CI 1.36-2.15); wheezing after exercise (AOR 1.45, CI 1.23-1.69), hospitalization in the past year (AOR 2.85, CI 2.61-3.59) and caesarean birth (AOR 1.28, CI 1.07-1.53) in the adolescents were associated with current wheeze. India-specific triggers included consumption of bananas (AOR 1.34, CI 1.10-1.63), curd (AOR 1.49, CI 1.23-1.82), packed crunchies (AOR 1.23, CI 1.03-1.48), ice-creams (AOR 1.31, CI1.12-1.53) in adolescents and use of mosquito repellents in adults (AOR 1.11, CI 1.01-1.22). CONCLUSION:The study identifies genetic, environmental, personal health, and dietary risk factors for asthma in India, underscoring the need for public health measures to improve air quality, promote dietary awareness, and reduce indoor hazards.
A severe and progressive interstitial lung disease (ILD) known as idiopathic pulmonary fibrosis (IPF) has an unknown etiology with poorly defined mechanisms of development. Among the currently prescribed pharmacological interventions for IPF, nintedanib demonstrates the ability to decelerate the deterioration of lung function and yield positive clinical outcomes. Multiple randomized placebo-controlled trials have confirmed the efficacy and acceptable safety profile of nintedanib. Real-world evidence studies also support the use of nintedanib in IPF, being an efficient and well-tolerated treatment option. It has the potential to stabilize the disease progression in patients with ILD. Patients with IPF frequently have comorbidities like diabetes and hypertension, which can exacerbate the course of disease, reduce quality of life, and decrease treatment adherence. For well-informed decision-making, it is important for healthcare professionals to recognize the position of nintedanib therapy in IPF with comorbidities. The gastrointestinal adverse effects, notably diarrhea, dominate the nintedanib safety profile. These can be effectively controlled by closely monitoring side effects, administering anti-diarrheal and anti-emetic drugs, reducing the nintedanib dose, and discontinuing it in case of severe symptoms with an option to reintroduce the treatment after side effects subside. Symptomatic interventions and monitoring of liver enzymes may reduce the occurrence of permanent treatment discontinuations.
Asthma and related respiratory symptoms are growing in India and urban cities are experiencing increasing traffic-related air pollution (TRAP) levels. Our study investigates the association between TRAP and respiratory symptoms, and unplanned visits made to general practitioner/ emergency department/hospital admission in children and adolescents; we also aimed to understand whether low greenspaces surrounding the schools impacted this association. Trucks passing near the child's residences were used as a surrogate marker for measuring exposure to heavy TRAP. Exposures to school neighbourhood characteristics such as distance from major roads, a major source of TRAP, and industries were studied and the Normalized Difference Vegetation Index (NDVI) was used to measure greenspaces at 100 m and 200 m. Results showed no relationship between TRAP exposures and the odds of unplanned visits to general practitioners/emergency department /hospital admissions in young children; however, adolescents experienced increased risk. TRAP-related characteristics and greenspaces (within 200 m) strongly
