Category: 3. Business

Pierre advises issuers, underwriters, and investors on international capital markets transactions and cross-border leveraged financings. He is widely recognized for his deep expertise in high yield bonds, acquisition financing, restructurings and liability management transactions.

Following the arrival of Paris-based leveraged finance partner Michel Houdayer last year, Pierre’s addition further deepens the firm’s bench in France and underscores A&O Shearman’s commitment to providing clients with an integrated, best-in-class high yield and leveraged finance capability across Europe.

John Kicken, head of high yield at A&O Shearman, commented: “With Pierre’s appointment, we continue to build out our top tier high yield capabilities across Europe, supported by specialist teams in London, Frankfurt and Paris. Our integrated model, unique in the market, enables us to deliver seamless and sophisticated solutions to our clients’ most complex challenges.”

Julien Roux, managing partner of A&O Shearman in France, added: “Pierre’s arrival reinforces the strength of our Paris finance and capital markets team, already one of the largest in the market. His expertise in high yield financing enhances our ability to advise clients across the full spectrum of debt instruments – under French, English, and U.S. law. This move perfectly complements our finance offering in Paris and, in line with our growth strategy in Europe and the U.S., will further bolster other key practices of the firm such as M&A, private equity and restructuring.”

Pierre Brulé said: “Joining A&O Shearman is a fantastic opportunity to contribute to an ambitious and market-leading high yield platform. I’m excited to work alongside a team renowned for its excellence, collaboration and client focus.”

Pierre will be joined by senior associate David St-Onge, with whom he has long collaborated and who brings deep experience in the French and European high yield market.

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This study underscores the efficacy of a structured interhospital transfer program in managing patients requiring various levels of cardiac surgical intervention. Key findings reveal distinct patterns in patient characteristics, urgency classifications, and clinical outcomes, similar findings were found in a study from Sanaiha et al. [7]. Emergent patients displayed significantly higher rates of myocardial infarction, preoperative shock, and mechanical ventilation, which correlated with an elevated in-hospital mortality rate of 6.9%, findings consistent with these were reported by Metkus [8]. These results were not surprising, as those criteria are, per se, predictors of in-hospital mortality in the STS Score and the EuroSCORE II [9, 10]. In contrast, urgent and elective patients had lower mortality rates and reduced preoperative risk profiles. At Düsseldorf University Hospital, we operated on an average of 1,650 patients per year. The overall in-hospital mortality rate was 5.2%. Stratified by urgency, the mortality rate was 2.0% for elective cases, 5.2% for urgent cases, and 16% for emergency cases. The markedly high mortality rate among emergency patients can be attributed, among other factors, to the high proportion of in-house resuscitations from other departments within the university hospital, as well as to the frequent admissions following out-of-hospital cardiac arrests, given our role as a major cardiac arrest center. Interestingly, the emergency patient cohort transferred from the Karl-Leisner-Klinikum demonstrated a notably lower in-hospital mortality rate. This discrepancy may be explained by significant differences in patient selection and timing. In particular, the patients referred emergently from external hospitals were usually hemodynamically stabilized prior to transport, and resuscitated patients were typically not transferred unless a return of spontaneous circulation (ROSC) had been achieved and a certain degree of neurological prognosis could be anticipated. Additionally, the Karl-Leisner-Klinikum lacks a dedicated cardiac arrest center, which may have led to a different triage and referral strategy, focusing more on potentially salvageable patients with a better short-term prognosis. Consequently, while the clinical severity of transferred patients was still high, the proportion of high-risk, non-survivable emergencies may have been lower compared to the in-house emergency population at the tertiary center.

The stepwise development of the program allowed for iterative improvements in communication, triage, and transport logistics [11]. Trends across the five-year period demonstrated a gradual shift toward a higher proportion of urgent admissions, reflecting growing confidence and reliance on the transfer protocol by referring clinicians. The stability of emergent case proportions, along with consistent transport durations, indicates that the program successfully maintained efficiency under varying clinical loads. CABG remained the predominant surgical procedure, especially among emergent patients, emphasizing the program’s responsiveness to ischemic heart disease [12, 13]. The relatively short median time to surgery for emergent cases (4 h) reflects a high level of logistical coordination between the hospitals, from transfer initiation to operative readiness, this factor was crucial to consider in the study, as the duration of the operation is a well-known predictor of outcomes [14, 15]. Telemedicine integration represents the next logical evolution for this program. Real-time virtual consultations can facilitate early triage decisions, optimize patient stabilization prior to transfer, and reduce unnecessary referrals, the efficacy of such programs was also demonstrated in Morh et al. study [16]. Standardized digital documentation and dedicated transfer coordination teams may further streamline operations, decrease time to surgery, and improve outcomes.

The findings of this study provide actionable insights into optimizing IHT programs for cardiac surgical patients. The demonstrated ability to transfer emergent patients with a median time-to-surgery of only 4 h confirms that well-structured interfacility logistics can meet the critical time demands of life-threatening cardiac conditions. This supports the broader implementation of time-targeted transfer protocols, particularly for patients at high risk for preoperative shock or myocardial infarction. Furthermore, the observed trend toward increased urgent referrals over time suggests that program transparency and reliability foster greater trust among referring clinicians—a factor that may enhance early identification and mobilization of at-risk patients. The stable proportion of emergent cases, despite rising volumes, highlights the system’s resilience and scalability. These results argue for wider adoption of standardized triage tools and escalation pathways within regional hospital networks. Integration of telemedicine and dedicated transfer coordinators, as proposed, would not only improve clinical decision-making but also reduce time-to-treatment disparities—an especially relevant factor in geographically distributed healthcare systems.

Notably, several measures could further enhance the IHT process:

• Implementing standardized triage criteria across referring centers [17].

• Establishing dedicated IHT coordinators [18].

• Enhancing pre-transfer stabilization protocols [19].

• Incorporating predictive risk stratification tools to assist with surgical prioritization [20].

The Spanish-German engineering company Siemens Gamesa has decided to shelve plans for an offshore wind turbine nacelle factory at the Port of Esbjerg in Denmark.

Siemens Gamesa told offshoreWIND.biz that the Port of Esbjerg remains a key hub for its offshore wind activities and that the company continues to assess potential investment options there.

“Siemens Gamesa has maintained a longstanding presence at the Port of Esbjerg, which is a strategically important location for our offshore wind operations, also in the future. Like in any other place, we continue to evaluate potential investment opportunities,” said the spokesperson.

“ However, given the current market conditions, any such decision will require greater clarity and stability in the industry.”

In 2022, Siemens Gamesa announced that it would be the first tenant to Port of Esbjerg’s new warehouse facility, planned to handle components used in the offshore wind market.

The 35-metre-high hall is capable of accommodating port-related and assembly activities.

Siemens Gamesa will supply SG 14-236 DD turbines to the 1.1 GW Thor offshore wind in Denmark. Wind turbine installation is scheduled to start next year and will be carried out from the Port of Esbjerg.

Last week, another wind turbine manufacturer, Vestas, announced that it would put its plans to open a factory in Poland on hold.

The facility would produce blades for its flagship offshore wind turbine, the V236-15.0 MW.

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This meta-analysis demonstrates that SGLT2 inhibitors confer significant benefit in patients with HFpEF by reducing the composite outcome of cardiovascular death or hospitalization for heart failure. These findings align with major trials such as EMPEROR-Preserved and DELIVER [5, 8]. The reduction in HF hospitalization is particularly meaningful, reflecting an important improvement in morbidity for this complex patient population.

The lack of a statistically significant effect on all-cause mortality, despite a favorable trend, merits careful interpretation. This observation likely reflects the heterogeneity of HFpEF phenotypes and the limited modulation of natriuretic peptides observed in this subgroup, as noted in recent evidence.¹⁷ Even in advanced HFrEF, where stronger mortality signals have been observed, SGLT2 inhibitors may exert their benefits predominantly through metabolic and renal pathways rather than direct hemodynamic effects. This underscores the complexity in translating mechanistic improvements into mortality reductions, particularly in HFpEF [20, 21].

The use of an LVEF > 40% threshold in our inclusion criteria, though broader than the conventional ≥ 50% definition, was deliberately chosen to reflect contemporary trial designs and clinical practice patterns. This approach facilitates methodological consistency with EMPEROR-Preserved and DELIVER [5, 8]. and ensures that our findings are applicable to both HFpEF and the adjacent HFmrEF population; a clinically relevant spectrum where therapeutic options have historically been limited.

Recent meta-analytic data further illuminate the potential role of SGLT2 inhibitors in promoting favorable cardiac remodeling. Fan and Guo demonstrated that SGLT2i therapy significantly reduced left ventricular mass index, left atrial volume index, and E/e′ ratio, while modestly improving LVEF and lowering NT-proBNP levels [22]. Additional studies by Moras et al. and Alcidi et al. reinforce these findings, suggesting improvements in global longitudinal strain, myocardial mechanics, and diastolic function [21, 23]. While these surrogate endpoints do not directly translate into mortality reductions, they provide compelling mechanistic support for the clinical utility of SGLT2 inhibitors [21].

The modest improvement in KCCQ scores observed in our analysis complements the reduction in HF hospitalization risk and highlights the multidimensional benefit profile of SGLT2 inhibitors. The pooled mean difference of approximately + 1.8 points, while small, suggests a consistent effect on patient-reported symptoms and function, reinforcing their therapeutic relevance beyond hard clinical endpoints [2,3,4].

Our findings must be interpreted in the context of several limitations. We did not perform formal subgroup or sensitivity analyses by diabetes status, type of SGLT2 inhibitor, geographic region, or baseline patient characteristics, as stratified data were inconsistently reported across trials. This limitation reflects the inherent constraints of study-level meta-analysis and highlights the need for future patient-level meta-analytic approaches to assess potential treatment effect heterogeneity. Additionally, variability in baseline patient characteristics and trial inclusion criteria may have contributed to moderate statistical heterogeneity observed for the primary composite outcome.

In terms of potential bias, most included trials were methodologically rigorous with adequate randomization and allocation concealment. The principal sources of potential bias included incomplete outcome data from loss to follow-up and lack of blinding of outcome assessors, though these risks were generally low or moderate.

The absence of a significant effect on all-cause mortality contrasts with the substantial mortality reductions observed in large HFrEF trials such as DAPA-HF and EMPEROR-Reduced [4, 5], further underscoring differences in disease biology and therapeutic responsiveness between HF phenotypes. The benefits observed in these HFrEF trials, including reductions in cardiovascular death and HF hospitalization and improvements in KCCQ scores, provide important context for interpreting the more modest-but still clinically meaningful; effects seen in HFpEF [18].

BEIJING – China’s wholesale and retail sectors posted solid growth in the first nine months of 2025, providing sound support for expanding domestic demand in the country, the Commerce Ministry said on Monday.

From January to September, the added value of China’s wholesale and retail trade grew by 5.6 percent from a year earlier to reach 10.5 trillion yuan (about $1.48 trillion), which accounted for 10.3 percent of the country’s gross domestic product, said an official with the ministry, quoting data from the National Bureau of Statistics.

During this period, profits of key commodity markets in the wholesale industry expanded by 8.2 percent year-on-year, while profits of industrial consumer goods markets increased by 17.9 percent year-on-year, the ministry said.

Looking at the retail industry, retail sales of goods reached 32.5 trillion yuan in the first three quarters of 2025, an increase of 4.6 percent year-on-year.

Online retail sales in China’s rural areas registered a 7.7 percent year-on-year increase in the January-September period, while sales of agricultural products via e-commerce platforms grew by 9.6 percent.

China has seen about 126 million new home appliances sold under its consumer goods trade-in program this year, the ministry noted.

The bank, which exited Saudi Arabia in 2014, is now securing a new investment banking license and plans to open offices in Riyadh by early 2026, CEO C.S. Venkatakrishnan said in an interview with Bloomberg TV, where he was attending the Fortune Global Forum and the kingdom’s flagship annual Future Investment Initiative summit. ​Confirming the bank’s re-entry into Saudi Arabia and that the kingdom “will be recognizing” the new regional headquarters in just a couple of days, the kingdom’s Investment Minister Khalid Al-Falih said, “People have seen that the kingdom is a long-term partner. We’re not transactional.”

Venkatakrishnan told Fortune Editor-in-Chief Alyson Shontell that working with trusted partners is important “because you’re making fairly large commitments financially and otherwise, and you need to work with partners whom you can trust and who are there for the long term and who will help you through the teething troubles.”

Barclays joins a growing list of financial giants like Citigroup, Goldman Sachs, and HSBC setting up deeper roots in the Gulf’s largest economy; by contrast JP Morgan is celebrating 90 years of doing business in the region. The move underscores Saudi Arabia’s ambition to transform itself from being a petroleum superpower into a diversified global business and financial hub, and increasingly a strategic nexus from which major businesses can access three different continents with ease.

The wider RHQ program

Saudi Arabia’s nine-year-old economic transformation plan, known as Vision 2030, is 85% complete, Minister Al-Falih said in opening remarks at the Fortune Global Forum. The strategy has already attracted over 675 regional headquarters—well past its original target of 500 by 2030—through generous incentives such as 30-year tax exemptions, tax relief, and streamlined regulatory frameworks.​

The government’s Regional Headquarters Program, launched in 2021 by the Royal Commission for Riyadh City, aims to make the capital the de facto economic center of the Middle East. Multinational players such as PwC, Deloitte, Lenovo, and Siemens Energy have already relocated leadership operations from Dubai and other hubs to Riyadh. Unlike special economic zone offices elsewhere, RHQs in Riyadh are designed to serve as genuine operational bases—not symbolic branches—managing corporate strategy and human capital across the entire Middle East and Africa. Also, Riyadh’s trillion-dollar transformation—anchored by NEOM, the Public Investment Fund (PIF), and megaprojects across tourism, AI, and green energy—represents a lucrative opportunity for capital providers.​​

At a breakout session at the Fortune Global Forum, executives hailed the program as transformative for localization, manufacturing, and innovation. Executives at Lenovo, for example, detailed construction of the region’s largest ICT manufacturing plant in the Saudi desert, while leaders at Siemens Energy spoke of expanding exports across the Middle East through its Riyadh-based regional center.​

In conversation with Diane Brady, Executive Editorial Director, Fortune Live Media, executives from Massimo, Siemens, and Lucid Motors highlighted that their RHQs have allowed them to do things like scale production, export vehicles to Europe, and build AI-driven health and transport systems from within the kingdom.​

Air Liquide announces today that it has entered into an agreement to acquire NovaAir, a leading industrial gas producer and supplier in India, from PAG, an Asia-focused private equity firm. This acquisition represents another investment for the Group in the country and a strategic milestone in its Indian growth story.

Founded in 2019, NovaAir is a full-service industrial gases platform supplying bulk industrial gases, critical specialty gases, and providing onsite services and EPC (Engineering, Procurement and Construction) support to its clients in the key industrial regions of East and South India. The company serves customers in the steel, automotive, fabrication, electronics, photovoltaic and healthcare industries, among others. 

The acquisition of NovaAir which is present in the East and South of India complements Air Liquide’s existing operations in the North and West of the country, bringing a large project portfolio managed by an experienced team. Through this operation, the expanded geographical reach will substantially strengthen Air Liquide’s footprint in the industrial merchant market, allowing it to better serve customers in the growing automotive, metals, electronics and healthcare sectors.

This acquisition follows a series of recent investments in India by Air Liquide, underscoring the Group’s commitment to investing in the long-term growth opportunities of the Indian market. Air Liquide has been present in India since 1992 and has solid ambitions in this country. The Group’s operations in India encompass the supply of industrial and medical gases, engineering and construction services, cryogenic equipment manufacturing, medical systems for healthcare and the development of speciality chemical ingredients.

Emilie Mouren-Renouard, member of Air Liquide’s Executive Committee, notably in charge of supervising activities in India, stated: 

“This acquisition represents a new step in our development in India. It demonstrates our long-term commitment to supporting the country’s industrial and healthcare development. This acquisition will significantly enhance our capacity to serve customers from small and medium enterprises to large industrial players, across a wider geographic footprint. It is another illustration of the growth potential of the Group.”