Expert opinion. There is established evidence that high levels of HDL-C in nature are associated with a lower risk of CAD. Unlike LDL-C, the mechanisms controlling HDL-C are more complex. Lifestyle interventions are safe but only modestly increase HDL-C. The best treatments available currently seem the niacin derivatives, although the newer CETP inhibitors, reconstituted HDL infusion and apolipoprotein A-1 Milano infusion hold much promise. The next 5 years should provide information on whether improving vascular protective function of HDL is more important than HDL-C levels and also whether we should target raising specific HDL subclasses rather than HDL-C itself. • Treatment of dyslipidemia in diabetic patients remains a very challenging issue in CAD prevention, there is an increased interest in treatments that has a dual favorable effect on both glycemic control and lipid control, most important in this issue is the up-growing role of glitazars, especially aleglitazar, which is foreseen to be the upcoming treatment for lipid regulation in diabetic patients. • Nowadays, with a better understanding of the immunological and inflammatory mecha- nisms underlying atherosclerosis, treatments that stabilize vulnerable plaques and halts atherosclerosis progression are gaining wide interest and will show promising results within the next few years. Lp-PLA2 is an emerging biomarker of CV risk that is phar- macologically modifiable through specific Lp-PLA2 inhibitors, as darapladib. Moreover, Aliskiren, a direct renin inhibitor is gaining wide interest in terms of plaque stabilization and regression in established atherosclerosis. • Combination therapy can provide marked lipoprotein changes in patients at risk for atherosclerotic events. Three large clinical trials, involving more than 45,000 patients in aggregate, are currently testing the effect on major clinical endpoints of adding niacin or ezetimibe to statin treatment in patients at high risk156, 157, 296. Results of these trials are expected in 2012–2013. Nevertheless, a recent systematic review of 102 studies found no benefit of combination therapy over high-dose statin monotherapy in terms of mortality, MI, stroke, and revascularization procedures in patients requiring intensive lipid-lowering therapy297. An effective strategy in patients requiring intensive lipid-lowering therapy is critically needed and still controversial, and is a field for further research. • Novel anti-anginal treatments, as ivabradine, fasudil and ...
Expert opinion. DAS may require the Policyholder or Insured Person to get, at their own expense, an opinion from an expert that DAS consider appropriate, on the merits of the claim or proceedings, or on a legal principle. The expert must be approved in advance by DAS and the cost agreed in writing between the Policyholder or Insured Person and DAS. Subject to this, DAS will pay the cost of getting the opinion if the expert’s opinion indicates that it is more likely than not that the Policyholder or Insured Person will recover damages (or obtain any other legal remedy that DAS have agreed to) or make a successful defence.
Expert opinion. In accordance with the Expert Opinion Report prepared by KPMG Yönetim Danışmanlığı A.Ş. dated 19.03.2021, ➢ The reasonable share value of Volkswagen Doğuş Finansman A.Şis calculated as TL 280,694,402.23, and the reasonable share value of VDF Servis is calculated as TL 1,048,484,725.85. ➢ The de-merger rate is 88.40%, and the exhangerate is 0.000759. ➢ As a result of the de-merger process in this direction, the capital increase of VDF Servis will be TL 669,018.06, thus the capital of VDF Servis will be TL 5,769,018.06, with the said capital increase, Doğuş Otomotiv's capital in VDF Servis is TL 655,364.62 TL and Doğuş Holding will become the owner of a new share of TL 13,653.44, ➢ It has been determined that the de-merger and exchange rates calculated by considering the fair share values for the Spin-off Companies and the Transferee Company are fair, reasonable and reliable.
Expert opinion. Agreement It is important that everyone knows what to expect. This will allow participants to adequately prepare, to know their rights and maximise the chances of everyone feeling satisfied with the process. The agreement sets out the legal rights in plain English - these are important to understand. The Resolution Facilitator is also available to explain the process and the terms of the agreement EXPERT VIEW (NON-BINDING): Agreement Between: Name: Address: Name: Address: (collectively the “Participants”) And Name: Address: (the “Expert”) And Name: Address: (the “Resolution Facilitator”)
Expert opinion. If it is about a technical disagreement, it shall be submitted to the expert’s opinion, appointed as follows: one by each Party and the third one by the two main experts, and if there is not consensus between them, and at the request of any of the Parties, said third one shall be appointed by the professional association related to the issue in controversy, that be a technical advisory institution of the Government and located in Bogotá. Once experts have been appointed:
Expert opinion. Any matter which may arise out of or in connection with this agreement and which is to be determined by an expert will be referred to a person suitably qualified to determine that matter who will be nominated by the Party seeking the Expert Opinion or resolution by an expert and approved by the other Party, such approval not to be unreasonably withheld, conditioned or delayed. The Expert will act as an expert and not as an arbitrator and his terms of appointment will include:
Expert opinion. (a) The Dispute Resolution Board consists of three members unless the Parties agree that the Dispute Resolution Board shall consist of one member.
Expert opinion. If you do not agree with the company doctor's recommendation, you can ask UWV for an expert opinion. The following rules apply: • You must request the expert opinion no later than one week after the return- to-work recommendation is issued. • You must notify your line manager and the company doctor immediately. • You must be available for examination by a doctor from UWV. • If UWV agrees with you, you must make an appointment with the company doctor immediately. • If UWV disagrees with you, you must return to work immediately that same day. Any working hours that you miss between being found fit to return to work and actually returning to work are treated as holiday. If the balance of your holiday entitlement is insufficient to cover the working hours, the cash value of the holiday entitlement value will be deducted from your salary. Appendix II Banker's Oath and disciplinary law Under the Financial Supervision Act (Wft), you are required to swear the Bankers' Oath. In this context, disciplinary law applies. When you take this oath, you swear or promise that you will perform your work ethically and with due care. The bank will ensure that the Banker's Oath remains relevant and promotes awareness of desired behaviour, which puts clients' interests first, and will continue to do so after you have taken the Banker's Oath.
Expert opinion. With the introduction of sugammadex, a new way of neuromuscular reversal became available that differs radically from reversal with acetylcholinesterase inhibitors. By encapsulating aminosteroidal neuromuscular blocking drugs (NMBD), sugammadex is able to reverse any depth of neuromuscular block in a short period of time. In vitro indications that sugammadex is able to bind to other (i.e. non-NMBD) steroidal agents are probably not relevant in vivo. Additionally, the effects of sugammadex on the QT-interval or clotting time do not appear to be of clinical significance. However, there are tenacious concerns with the use of sugammadex, of which the most important are the recently reported high incidence of hypersensitivity reactions50,70,71, and adverse cardio-vascular events such as bradycardia and haemodynamic collapse95,96. Although the presentation of these conditions sometimes overlap, the involved mechanisms remain unknown. Post-marketing data of sugammadex associated adverse events are however reassuring. In the Netherlands, 13 cases of a severe adverse event have been reported to the Netherlands Pharmacovigilance Centre Lareb between 2011 and November 2017. This included one case with bradycardia and 5 cases with anaphylaxis97. Data on mortality are not available. The 2015 FDA briefing document of sugammadex reports 273 cases of anaphylaxis among 11.5 million sugammadex exposures of which 4 were fatal98. In addition, fatal outcome related to cardiac arrhythmias was reported in 3 cases and related to other causes in chapter administered high-risk agents99. Finally, a recent Cochrane meta-analysis reported an equal risk for serious adverse events for both sugammadex and neostigmine (<1%), but a superior overall risk-benefit profile for sugammadex90. We contend that sugammadex is safe to use, and that only on rare occasions it may induce life- threatening reactions. It is our opinion that sugammadex offers advantages in the perioperative setting that outweigh the previous stated concerns, especially when compared to its alternative neostigmine. Sugammadex significantly reduces the incidence of residual neuromuscular block100, provided that objective neuromuscular monitoring is applied and sugammadex is properly dosed38-40. This is pivotal, as incidences of RNMB and the associated pulmonary complications are traditionally substantial and have not shown any improvement over the past decades101. Neostigmine has clearly failed to make a significant differen...
Expert opinion. If, due to disagreement between the Parties or in order to preserve the evidence, an expert opinion is required, the procedure thereof shall comply with the rules of procedure for appointing experts laid down by the Building and Construction Arbitration Board.
