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Cardiogenic shock is the most frequent kind of shock in cardiac intensive care, and cardiac dysfunction and hypoxia are often seen in critically ill patients. Inadequate organ and tissue perfusion and hypoxia result in anaerobic metabolism with hyperlactatemia and oxygen debt accumulation. However, the role of accumulated oxygen debt in the course of cardiogenic shock and hypoxia has not been clearly described. Here, we first described the existence of several patterns of oxygen debt repayment in cardiogenic shock patients maintained by an extracorporeal life support system. Oxygen debt was computed from the lactate concentration at five time points, covering the first 26 h of ECLS. Patterns representing basic pathophysiological processes were independent of the cause of the primary insult. Groups of patients classified into specific patterns differed in terms of survival rate from 51.5% to only 4.6%. It is very important that the initial group not predetermine the fate of the patient and may change in the course of treatment due to ‘between-cluster migration’. We believe that our finding of different patterns of oxygen debt repayment in cardiogenic shock patients may offer new insights for a more rational, goal-directed treatment of highly morbid conditions such as hypoxia and cardiogenic shock. Three patterns of oxygen debt repayment in patients with cardiogenic shock maintained by Extracorporeal life support system. [Display omitted] •Patients in cardiogenic shock, independently of its etiology, surfer common metabolic disorder.•There are three levels of metabolic disorder which could be described in the terms of oxygen debt and repayment.•Severity of oxygen debt determines success of treatment independently from the shock etiology and time of ECLS initiation.•Prevention of oxygen debt accumulation and its repayment with ECLS affects the outcome.•Understanding basic pathophysiological process offers new insights for a goal-directed treatment of cardiogenic shock.

This report brings together the results of an eight-part series of presentations by leading experts in issues directly related to microfinance institutional sustainability. It is intended for microfinance institution (MFI) board members, managers, and staff members as well as for government regulators, supervisors, and donor staff members. The first four chapters include topics in risk management: (1) risk management systems, (2) good governance, (3) interest rates, and (4) micro-insurance. The last four chapters include four topics in new product development and efficient delivery methodologies: (5) housing microfinance, (6) micro-leasing, (7) disaster preparedness products and systems, and (8) new technologies. The objectives of the series were as follows: i) to strengthen MFIs by disseminating innovative approaches in risk management, cost control, governance, and new technologies; ii) to promote a South-South exchange of experiences and lessons learned; iii) to promote greater ties among the MFIs in the region and between MFIs and government supervisors and regulators; and iv) to highlight the Bank's ability to mobilize international technical expertise in microfinance.

East Asia and the Pacific is a region of dynamic growth. Women have contributed significantly to this growth and have benefited from it through active participation in the labor market. However, women are still disproportionately represented in the informal sector and in low paid work. Efforts to identify barriers to women's business and entrepreneurial activities in the region are critical not only to facilitate inclusive growth in a national context but also to counter the increasing trend of female migratory flows in the region. This report highlights' both the challenges and the economic opportunities for businesswomen in the region offers some useful potential pointers for reform.

This book's prime audience is government policy-makers. It provides a policy framework for governments to increase micro, small and medium enterprises' access to financial services?one which is based on empirical evidence from around the world. Financial sector policies in many developing countries often work against the ability of commercial financial institutions to serve this market segment, albeit, often unintentionally. The framework guides governments on how to best focus scarce resources on three things: ? developing an inclusive financial sector policy; ? building healthy financial institutions; and ? investing in information infrastructure such as credit bureaus and accounting standards. The book provides examples and case studies of how such a strategy has helped to build more inclusive financial institutions and systems in many countries.

Middle income countries (MICs) are facing rapidly evolving development challenges as their economist mature and integrate into the global economy. As a group, the 86 MICs account for about one -- fifth of world output, and their per capita income has grown by almost 4 percent annually since 1995. Yet there are still home to one -- third of the world's poorest citizens, living on less than 2 per day. The World Bank has provided US163 billion in loans to these countries since 1995 and it allocates about half of its administrative budget to working with them. Today, as a group these countries have far more choice than they did even 10 years again obtaining both finance and knowledge for development. With the dramatic changes in the global context, many stakeholders and outside commentators have began to propose that the Bank change its relationship with this group -- with proposals ranging from strengthened engagement to withdrawal. This IEG evaluation brings a fresh perspective to the debate by assessing the development effectiveness of the Bank's recent work. It presents evidence -- including views from the client countries themselves -- about the outcomes of the Bank's support to individual countries over the pats 12 years. It also spotlights three growing dimensions of the Bank Group's role -- sharing knowledge across countries, engaging countries in global programs, and combining support to the public and private sectors.

This chapter contains sections titled: What Is an Exit Strategy? Role of Management Entrepreneur versus Executive Determination of Goals and Direction of the Company Evolution of Executive Concerns Development of the Strategic Plan Why Is Strategic Planning Important? Real Exit Process Historical Financial Statements Quality of Earnings Meeting with the Auditors Forecasts and Projections Structuring the Deal Allocating Purchase Price Financial Covenants Debt Repayment Schedule Reporting Requirements Management and Administration Transaction (Closing) Summary

This chapter provides an overview and explains the evolution of the swap market. The story of the swaps market has been one of remarkable growth, which has demonstrated that there is a real demand for the benefits swaps can bring globally, namely access to cheap funds and risk management. The growth shows little sign of abating as swap markets continue to expand both geographically as countries deregulate and downwards into the economy. The swap must mirror any structural complexities in the debt, such as principal repayment schedules, or options to repay early, and so on. Usually a swap entered into between a bank and a customer is tailored specifically for that situation. The measurement and management of risk, whether it is interest rate, foreign exchange rate, credit and so on is, and will remain, critical for all organisations and to suddenly deny the main mechanism for managing these risks is simply irrational. It is important to ensure that users of derivatives understand and can assess derivatives, or at least employ people that do.

The goal of this article is to discuss the challenges and benefits of being a librarian at a for-profit institution, to provide some idea of what you might reasonably expect from the sector, both as a manager and as a subordinate, and to present some ideas on delivering quality reference services to the populations you would likely be serving. Of course, the ideas presented are based on the author's own experiences and each institution will have its own unique elements. For starters, there are two broad categories: public and private. Not unlike publicly traded companies, public for-profits have a board of directors and shareholders who participate in determining the institution's direction, whereas private for-profit institutions are owned by individuals or small groups and do not publicly trade their stock. Most in higher education are familiar with the rapid rise of large, publicly traded for-profit institutions, some of which have recently failed, leaving students and taxpayers in the lurch.