*Investors' Greed and Fear: An Event Study of Analyst Recommendations DOI: http://dx.doi.org/10.5772/intechopen.107187*

*Financial Crises – Challenges and Solutions*

> **Table1.**

 *Yearly sample descriptive statistics for stocks listed on the NYSE (Panel A) and the NASDAQ (Panel B).*

#### *Investors' Greed and Fear: An Event Study of Analyst Recommendations DOI: http://dx.doi.org/10.5772/intechopen.107187*

For the NASDAQ, the MarketCap varies from \$3 to \$1,105,306 million with a standard deviation of \$33,942 million. The maximum MarketCap appears in 2019, which shows a large value increase in high-tech stocks in recent years. Interestingly, we observe a higher average market model beta with a value of 1.20 in 2012 rather than in the 2009 financial crisis period. The daily historical return ranges from �0.649% to 0.644%, with a standard deviation of 0.083%. It shows that the stock return is more volatile for the stocks listed on the NASDAQ. Similar to the NYSE, a very low mean and high standard deviation of stock returns are observed in 2002 and around 2008 and 2009. Pástor and Veronesi [34] show the NASDAQ "bubble" in the late 1990s, with the NASDAQ index price varying significantly from 5048 in March 2000 to 1114 in October 2002. This was accompanied by high return volatility, which is around 10%.


**3. Results**

The results include aspects (mainly LOS, TTP and laboratory analysis) of patients visiting the UCC versus visiting the ED, a Wilcoxon signed-rank test of LOS, TTP and laboratory analysis and the cost in Euros/average attendee at the UCC versus the ED.

Several di fferences appeared when comparing the first and second half of the sample (treated by the ED versus treated by the UCC). From arrival to discharge, the UCC patients spent an average of 2.11 h less at the hospital than the ED patients. TTP was thus 1.57 h less at the UCC than at the ED. There was also a reduction in terms of laboratory analysis at the UCC compared to the ED. Even though the numbers of radiology, findings, referrals, revisits and hospitalisations were minor (26 and below), the sample visiting the UCC appeared to be almost similar to the one visiting the ED (Table 2).

**Table 2.** Aspects studied of patients visiting the UCC versus patients visiting the ED (N = 200).

LOS, TTP and laboratory analyses were selected for the Wilcoxon rank test, confirming both LOS and TTP to be significantly more time consuming at the ED than at the UCC. A similar result emerged with regard to laboratory analysis.

Total cost of attendees at the UCC and the ED di ffered. The cost of UCC attendees was less than the cost of ED attendees (Table 4). (Table 3).

On average, an UCC attendee was 67–210 Euros cheaper. One reason for the di fference was fewer medical services, i.e., radiology and laboratory than at the ED. The total cost of medical services at the UCC for the population studied was an average of 37.28 Euros less than at the ED (radiology = 16.62, laboratory = 20.66) (Table 4).

**Table 4.** Cost in Euros/average attendee at the UCC and the ED distributed in total cost, radiology cost and laboratory cost.


**8. Scientific evidence of the effectiveness of neuromuscular treatment**

The effectiveness of neuromuscular training is supported by more than a dozen scientific studies conducted at university hospitals in Sweden. This section will present abstracts from three studies that are of particular relevance to HH and reflux.

In all three studies [16–18] quoted here the patients were long-term users of PPI medication before the studies began. In a Medtech Innovation Briefing [21] produced by the UK's National Institute for Health and Care Excellence in 2019 they quoted, "all patients continued with their PPI medication as advised. As symptoms reduced, patients ceased to medicate. Use or cessation of PPIs was under the control of the patients' doctors. At end-of-training in the 3 studies quoted 93%, 58% and 61% that they ceased all PPI medication, the remainder mostly reduced dose and intake frequency". For this reason, medication can be excluded as the cause for improvement.

Overall, the studies showed success rates in the region of 98%, this is the same result reported by IQoro customers [19] in a survey conducted in 2020.

In these scientific studies of neuromuscular training there was particular focus on measurement methods. Patients were recruited as suffering from intermittent oesophageal dysphagia (IED) and reflux despite PPI medication from 1 year to many years and this was confirmed by a comprehensive test battery.

The test methodologies used were:

In all cases tests were made in the recruiting process, at baseline, and at end-oftreatment; however, all patients were contacted by telephone or in the clinic two or three times to verify compliance before follow-up at end-of-treatment.

#### **8.1 Oesophageal dysphagia and reflux symptoms before and after oral**

**IQoro® training. Hägg M, Tibbling L, Franzén T. World J Gastroenterol 2015; 21(24): 7558–7562. DOI: 10.3748 / wjg.v21.i24.7558** [16]**.**

*Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason… DOI: http://dx.doi.org/10.5772/intechopen.96773*


**2. Concept of evaporation, transpiration, and evapotranspiration and its relation to crop productivity**

Evaporation is the physical process through which liquid water is converted to water vapor. The rate of E depends on the saturated vapor pressure of the liquid and increases with increase in temperature until the atmospheric pressure at the boiling point [12].

**97**

**Figure 1.**

*conditions (adapted from [15, 16]).*

*Concept and Consequence of Evapotranspiration for Sustainable Crop Production in the Era…*

Transpiration is the process by which moisture is carried through plants from roots to small pores on the underside of leaves, where it changes to vapor and is released to the atmosphere. Transpiration is principally E of water to the atmosphere from plants roots to small pores on the underside of leaves. Another type of water loss from the uninjured leaf or stem of the plant, mainly by stomata is called guttation [13]. Nearly 10% of the moisture available in the atmosphere is from the T process [14]. The remaining 90% is mainly from the E process from different water bodies [15, 16]. reported that the T is attained by the movement of water, at the vapor phase through the conductor system from the roots to the leaves of the plant, as a function of a water potential gradient from the soil (ψsoil) to the air (ψair) as

In general, ET is the sum of E and T. It is the simultaneous process of water transfer to the atmosphere both by soil water E and plants T. The study found that during a growing season, a leaf will transpire many times more water than its own weight. An acre of corn gives off about 11,400–15,100 l of water each day, and a

Depending on the vegetation conditions, size of the vegetated area, and soil water supply, different conceptions are to be defined, such as potential, actual,

Potential ET represents the combined loss of water through the plant's process of T and E of water from the Earth's surface. Both the processes are influenced by temperature, humidity, sunlight, and wind as well as Earth vegetation. ETp values indicate the amount of water that has been lost, and thus needs to be replaced,

Actual ET is the amount of water actually utilized by an extensive surface vegetated with grass, at an active growth stage, covering completely the soil surface. ETa is the quantity of water that is actually removed from a surface due to the processes

*Schematic representation of the water motion in the soil-plant-atmosphere system under optimal development*

large oak tree can transpire about 1,51,000 l per year [13] (USGS, 2016).

oasis, and crop ET [16]. Such particular terms are described as follows.

*DOI: http://dx.doi.org/10.5772/intechopen.83707*

**2.1 Potential evapotranspiration (ETp)**

through irrigation and/or rainfall [16, 17].

**2.2 Actual or real evapotranspiration (ETa)**

shown in **Figure 1**.

*Concept and Consequence of Evapotranspiration for Sustainable Crop Production in the Era… DOI: http://dx.doi.org/10.5772/intechopen.83707*

Transpiration is the process by which moisture is carried through plants from roots to small pores on the underside of leaves, where it changes to vapor and is released to the atmosphere. Transpiration is principally E of water to the atmosphere from plants roots to small pores on the underside of leaves. Another type of water loss from the uninjured leaf or stem of the plant, mainly by stomata is called guttation [13]. Nearly 10% of the moisture available in the atmosphere is from the T process [14]. The remaining 90% is mainly from the E process from different water bodies [15, 16]. reported that the T is attained by the movement of water, at the vapor phase through the conductor system from the roots to the leaves of the plant, as a function of a water potential gradient from the soil (ψsoil) to the air (ψair) as shown in **Figure 1**.

In general, ET is the sum of E and T. It is the simultaneous process of water transfer to the atmosphere both by soil water E and plants T. The study found that during a growing season, a leaf will transpire many times more water than its own weight. An acre of corn gives off about 11,400–15,100 l of water each day, and a large oak tree can transpire about 1,51,000 l per year [13] (USGS, 2016).

Depending on the vegetation conditions, size of the vegetated area, and soil water supply, different conceptions are to be defined, such as potential, actual, oasis, and crop ET [16]. Such particular terms are described as follows.


**9.2 Mechanisms for tolerance**

Tolerance is generally accepted to be an active process and, in essence, a learning experience for T cells[30]. Tolerance is said to occur mechanistically at 2 levels: centrally and peripherally.


**2. Genetics of congenital generalized lipodystrophy**

There are four different genetic subtypes of CGL that result from different mutations.

## **2.1 Type 1 CGL (CGL1) and AGPAT2**

Mutations that are responsible for CGL1 (Online Mendelian Inheritance in Man [OMIM] #608594) occur in the region of 1-acylglycerol-3-phosphate O-acyltransferase 2 (*AGPAT2*) on chromosome 9q34. Only 4% of compound heterozygotes with a null and a missense mutation still maintain some residual enzymatic activity [7]. Also, homozygous missense mutations have been reported to be 2% of CGL1 patients. Interestingly, there is no strong correlation between the type of mutation and lipodystrophy phenotype (the level of adipocyte malfunction) [7, 11]. On the contrary, a founder mutation variant might exist in a particular population [11]. In fact, almost all patients that have African origin have the founder mutation in intron 4, c589-2A>G of one or both alleles [7, 12]. In the past 5 years, several novel variants of *AGPAT2* have been identified in CGL patients: c.144C>A, c.667\_705delinsCTGCG, c.268delC, and c.316+1G>T; c.134C>A and c.216C>G [13]; c.514G>A [14]; c.685G>T, and c.514G>A [15]. In addition, a very rare case of dual mutations (c.493-1G>C and c.299G>A) in *AGPAT2* was identified in two Chilean sisters [16].

AGPAT2 is a member of lysophosphatidic acid acyltransferases (LPAATs) including AGPAT family (AGPAT1–AGPAT11) and others such as CGI-58 and endophilin [17]. In fact, AGPAT2 was identified with AGPAT1 by searching an EST database for human homologs of yeast LPAAT in 1997 [18]. There are 11 isoforms of AGPATs that are involved in the de novo synthesis of phospholipids (PLs) and triacylglycerol from glycerol-3-phosphate (G3P). *AGPAT2* is predominantly expressed in adipose tissue, and its mRNA level increases by 30-fold during the differentiation of adipocytes [19]. Patients with CGL1 normally suffer extreme loss of all metabolically active adipose tissue in most subcutaneous areas, intra-abdominal areas, intrathoracic regions, and bone marrow; however, it is postulated that the redundancy of other AGPAT isoforms or the enhanced expression of other *AGPAT* genes helps preserve mechanical fat depots located in the palms, soles, under the scalp, retro-orbital, periarticular regions, perineum, vulva, and pericalyceal regions of the kidneys [7, 20].

#### *Lipodystrophy - A Rare Condition with Serious Metabolic Abnormalities DOI: http://dx.doi.org/10.5772/intechopen.88667*

In adipose tissue, the synthesis of PLs and TAG begins with the acylation of G3P with FA-CoA by glycerol phosphate acyltransferase (GPAT) at the SN1 position to form 1-acylglycerol-3-phosphate or lysophosphatidic acid (LPA). Then AGPAT2 catalyzes the conversion of LPA into phosphatidic acid (PA) via an acylation reaction at the SN2 position. PA is a pivotal intracellular signaling lipid for it sits at the branching point of de novo PL and TAG synthesis pathway and acts as a precursor for the lipin-mediated production of diacylglycerol (DAG), followed by phosphatidylcholine (PC), phosphatidylethanolamine (PE), and TAG, and as the substrate for the cytidine diphosphate synthase (CDS)-mediated generation of cytidine diphosphate diacylglycerol (CDP-DAG), followed by phosphatidylinositol (PI), phosphatidylglycerol (PG), and cardiolipin [21]. PA is a cone-shaped lipid that has the capacity to alter the curvature of the membranes, and it has been shown to mediate membrane fusion in both soluble N-ethylmaleimidesensitive factor attachment protein (NSF)-receptor (SNARE)-dependent and SNARE-independent fashions [22, 23]. It has been implicated in the fusion of multiple LDs to form a gigantic LD [24]. In addition, PA is believed to be an endogenous antagonist of peroxisome proliferator-activated receptor gamma (PPARγ) that is the master transcription factor in adipocyte differentiation [25]. The malfunctioned *AGPAT2* in CGL1 is assumed to cause dysregulated PL and TAG synthesis, leading to defective adipose tissue development [11, 19]. However, the exact mechanism of how AGPAT2 deficiency causes lipodystrophy remains unraveled. Intriguingly, the same effect cannot be achieved by knocking out other key enzymes in the TAG synthesis including glycerol-3-phosphate acyltransferase 1 (GPAT1), GPAT4, lipin, and diacylglycerol acyltransferase 1 (DGAT1) and DGAT2 [26–30].

Ablation of *Agpat2* induces severe lipodystrophy in mice with the loss of both WAT and BAT during the first week of postnatal period, due to inflammatory infiltration to adipose tissue and massive adipocyte cell death [31]. In addition, both male and female mice have extreme insulin resistance, type 2 diabetes, hepatic steatosis, as well as organomegaly including hepatosplenomegaly, nephromegaly, and elongated small intestines as seen in human CGL [32]. Since almost all adipose tissues have disappeared, *Agpat2*−/− mice are not an ideal model to study the development of lipodystrophy; however, this type of animals can be particularly useful for the investigation of lipodystrophy-induced metabolic disorders in non-adipose tissues such as severe hepatic insulin resistance and steatosis in CGL [20]. Up to 90% of the total AGPAT activity is compromised in the liver tissue of *Agpat2*−/− mice and that can be restored by adenoviral delivery of *Agpat1* or *Agpat2*. However, overexpression of *Agpat1* or Agpat2 in *Agpat2*−/− liver failed to alleviate hepatic steatosis, indicating that the ectopic hepatic lipid accumulation was derived from insulin resistance and loss of body fat [33]. While reduced AGPAT activity is supposed to result in a reduction in PA synthesis, the PA level was seen to increase in the liver of male *Agpat2*−/− mice, which suggests an alternative pathway for PA synthesis with a compensatory activation of DAG kinase or phospholipase D [32, 34]. A high level of PA predisposes *Agpat2*−/− liver to elevated hepatic glucose production, which is attributed to insulin resistance [34]. PA accumulation was also found in differentiated *Agpat2*−/− murine embryonic fibroblast (MEF) adipocytes [31]. At day 6 of the differentiation, ultrastructural alterations in mitochondria, plasma membrane, and autophagosomes were found in *Apgat2*−/− MEF adipocytes, suggesting that in the absence of AGPAT2, cells can initiate adipogenesis, but a variety of cellular abnormalities eventually block the terminal phase of adipogenesis [31]. Enforcing adipocyte differentiation by overexpression of PPARγ, the master regulator of adipogenesis can also promote adipogenesis of *Agpat2*−/− MEFs; nevertheless, massive cell death occurred before they reached full differentiation [31]. In agreement with

this finding, preadipocytes from *Agpat2*−/− interscapular BAT underwent progressive cell death during the adipogenic induction with no activation of caspase 3 [35].

In addition, these BAT-derived preadipocytes exhibit an increased expression of autophagy-related proteins but a decreased autophagic flux [35]. In isolated musclederived multipotent cells (MDMCs) from CGL1 patients and 3T3-L1 preadipocyte cells with the knockdown of AGPAT2, cell death also proceeds during adipogenesis, which might be associated with defective Akt activation as a result of altered PI composition [36, 37]. The constitutively active Akt and PPARγ agonist pioglitazone partially rescued the adipogenic defect in the *Agpat2*−/− cells [37]. In addition, regarded as a therapy for CGL patients, leptin treatment normalizes the levels of plasma TAG, insulin, and glucose as well as improves hepatic steatosis in *Agpat2*−/− mice, which is independent of hepatic leptin receptor [38]. The role of AGPAT2 in LD biology has been rarely reported. In contrast to WT adipose tissue that manifests large unilocular LDs, *Apgat2*−/− adipocytes are featured by smaller multilocular LDs. Although LDs in *Apgat2*−/− MEFs are smaller than *Apgat2*+/+ cells, they are still normally coated with perilipin 1 (Plin1) [31].


**2.7 Carbon nanoparticles (C NPs)**

Carbon nanoparticles have distinctive properties, including morphologically small surface area and better chemical reactivity [47]. They help in increasing seed germination and crop production under salt stress [48]. Application of C NPs on *Brassica*

*napus* increased the NaCl stress tolerance in the plant by reestablishing ion homeostasis and redox balance [49]. When *Ocimum basilicum* was treated with C NPs increased enzymatic and nonenzymatic defense systems, and increased carotenoid and chlorophyll content [50]. Proline content in roots and leaves, photosystem II activity, soluble sugar in leaves were increased, and membrane integrity was maintained due to an increase in unsaturated fatty acid in *Sophora alopecuroides* C NPs treated plants under salt stress [51]. Application of C NPs on *Triticum aetivum* plants under saline conditions enhanced phosphorus and potassium content in roots and phosphorus content in shoot and increased the activity of antioxidant enzymes and improved the chlorophyll content, free ascorbic acid, amino acid, and soluble sugars [52]. **Table 1** consists of the reports of different scientists who studied the effects of the treatment of different nanoparticles on different plant species and their responses to physiological levels under salt stress.