3,077 research outputs found

    The Qualified Legal Compliance Committee: Using the Attorney Conduct Rules to Restructure the Board of Directors

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    The Securities and Exchange Commission introduced a new corporate governance structure, the qualified legal compliance committee, as part of the professional standards of conduct for attorneys mandated by the Sarbanes-Oxley Act of 2002. QLCCs are consistent with the Commission\u27s general approach to improving corporate governance through specialized committees of independent directors. This Article suggests, however, that assessing the benefits and costs of creating QLCCs may be more complex than is initially apparent. Importantly, QLCCs are unlikely to be effective in the absence of incentives for active director monitoring. This Article concludes by considering three ways of increasing these incentives

    Historical antecedents of /h/, /s/, /j/ and /ř/ in Utkuhiksalik (Inuktitut)

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    Utkuhiksalik is a sub-dialect of Natsilik within the Western Canadian Inuit dialect continuum. Unlike many Western dialects, Utkuhiksalik contrasts /h/ and /s/, /j/ and /ř/. The goal of this paper is to show how such contrasts arose: we describe the sound changes from Proto-Eskimoan *j, *ð, and *c to Utkuhiksalik /h/, /s/, /j/ and /ř/.L’utkuhiksalik est un sous-dialecte natsilik qui se situe dans le continuum dialectal de l’inuit de l’ouest du Canada. Contrairement à bien d’autres dialectes de l’ouest, l’utkuhiksalik démontre une opposition phonologique entre /h/ et /s/, /j/ et /ř/. Le but de cet article est d’esquisser comment ces contrastes se sont développés: nous décrivons les changements historiques à partir des sons proto-esquimaux *j, *ð, et *c jusqu’aux sons utkuhiksalik /h/, /s/, /j/, et /ř/

    The ballot initiative process does not make people moregenerally knowledgeable about politics

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    Do ballot initiatives help to improve people’s knowledge about politics? In new research which uses election survey data from more than 120,000 voters across 48 states Nicholas R. Seabrook, Joshua J. Dyck and Edward L. Lascher, Jr. find that ballot initiatives have no positive effect on general political knowledge. They write that these results hold no matter how often ballot initiatives are used, how many initiatives are on the ballot during an election, and how much money was spent by the initiative’s supporters and opponents

    development of measures of polyneuropathy impairment in hattr amyloidosis from nis to mnis 7

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    Abstract Hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) is a rare, life-threatening disease, caused by point mutations in the transthyretin gene. It is a heterogeneous, multisystem disease with rapidly progressing polyneuropathy (including sensory, motor, and autonomic impairments) and cardiac dysfunction. Measures used to assess polyneuropathy in other diseases have been tested as endpoints in hATTR amyloidosis clinical trials (i.e. Neuropathy Impairment Score [NIS], NIS-lower limb, and NIS + 7), yet the unique nature of the polyneuropathy in this disease has necessitated modifications to these scales. In particular, the heterogeneous impairment and the aggressive disease course have been key drivers in developing scales that better capture the disease burden and progression of polyneuropathy in hATTR amyloidosis. The modified NIS + 7 (mNIS + 7) scale was specifically designed to assess polyneuropathy impairment in patients with hATTR amyloidosis, and has been the primary endpoint in two recent, phase III studies in this disease. The mNIS + 7 uses highly standardized, quantitative, and referenced assessments to quantify decreased muscle weakness, muscle stretch reflexes, sensory loss, and autonomic impairment. Physicians using this scale in clinical trials should be specifically trained and monitored to minimize variability. This article discusses the different scales that have been/are being used to assess polyneuropathy in patients with hATTR amyloidosis, their correlation with other disease assessments, and reflects on how and why scales have evolved to the latest iteration of mNIS + 7

    Inequality in physical activity, global trends by income inequality and gender in adults

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    Background: Physical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity. Methods: Two thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent. Results: Significantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries. Conclusions: Economic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction

    Polyneuropathy improvement following autologous stem cell transplantation for POEMS syndrome

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    OBJECTIVE: To study the evolution of the neuropathy and long-term disability in a large cohort of patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome following autologous stem cell transplantation (ASCT). METHODS: Retrospective chart review documenting the clinical, electrophysiologic, and laboratory characteristics of patients with POEMS syndrome undergoing ASCT at Mayo Clinic, Rochester. RESULTS: Sixty patients with a median follow-up time of 61 months were studied. All patients had peripheral polyneuropathy and demonstrated neurologic improvement after ASCT (apart from one patient who died early). Before ASCT, 27 patients (45%) required a wheelchair and 17 (29%) required a walker or foot brace. At the end of the follow-up period, no patient was using a wheelchair and 23 patients (38%) were using a foot brace. The median Neuropathy Impairment Score improved from 66 to 48 points at 12 months and to 30 points at most recent follow-up (p < 0.0001). Median Rankin Scale score improved from 3 to 1.5 (p < 0.0001). Vascular endothelial growth factor levels decreased from a median of 452 to 63.5 pg/mL (p < 0.0001). The ulnar compound motor action potential amplitude (median) improved from 4.3 to 7.6 mV (p < 0.0001) and ulnar compound motor action potential conduction velocity (median) improved from 34 to 51 m/s (p < 0.0001). Predicted forced vital capacity improved from 81% to 88% (p < 0.0001). Periengraftment syndrome occurred in 24 patients. Fourteen patients required additional chemotherapy and/or radiation following ASCT, but there was no clinical deterioration in the neuropathy in any of these patients. Six patients died: 1 due to POEMS, 1 due to failed engraftment, and 4 due to other malignancies (2 myelodysplastic syndrome, 1 lymphoma, 1 metastatic lung cancer). CONCLUSION: Patients with POEMS syndrome who undergo ASCT have a significant and meaningful improvement of their neuropathy by multiple measurements during both short and long-term follow-up, which corresponds to reduction in morbidity and disability (none are in wheelchair long-term). Periengraftment syndrome was common but manageable. Fatal complications, although rare, did occur, usually in association with other malignancies. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that for patients with POEMS syndrome, ASCT improves neuropathy-related function

    Quantum Logic with a Single Trapped Electron

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    We propose the use of a trapped electron to implement quantum logic operations. The fundamental controlled-NOT gate is shown to be feasible. The two quantum bits are stored in the internal and external (motional) degrees of freedom.Comment: 7 Pages, REVTeX, No Figures, To appear in Phys. Rev.

    Implementing a Pain Toolkit to Improve Pain Management

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    Abstract OBJECTIVES: The purpose of this study was to evaluate the effect of a pain toolkit to improve pain management. BACKGROUND: The World Health Organization and Joint Commission state effective pain management is a basic human right. METHODS: Patients’ ratings of pain management on a 25-bed orthopedic/neurology unit three months before and after implementation of a toolkit were compared. The toolkit included bedside report, care board, purposeful hourly rounding, pain algorithm, pain status indicator, and complex pain interventions. The data are comprised of patient responses to the following Hospital Consumer Assessment of Healthcare Providers and Systems survey questions: pain control and staff’s help with pain. RESULTS: There was statistically significant improvement in patients’ perceptions that staff “always” did everything to help with pain. There was no statistically significant improvement in patients’ perceptions that pain as “always” well controlled. CONCULSIONS: The toolkit is a valuable resource in improving pain management

    Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments

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    Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13–18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs

    A Large, First-Year, Introductory, Multi-Sectional Biological Concepts of Health Course Designed to Develop Skills and Enhance Deeper Learning

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    Large first-year biology classes, with their heavy emphasis on factual content, contribute to low student engagement and misrepresent the dynamic, interdisciplinary nature of biological science. We sought to redesign a course to deliver fundamental biology curriculum through the study of health, promote skills development, and encourage a deeper level of learning for a large, multi-section first-year class. We describe the Biological Concepts of Health course designed to encourage higher-order learning and teach oral communication and independent learning skills to large numbers of first-year students. We used the Blooming Biology Tool to determine the cognitive skills level assessed in the newly developed course and the courses it replaced. This evidence-based approach demonstrated that our new course design achieved the goal of encouraging a deeper level of cognition, and further, successfully introduced both oral communication and independent learning skills in large first-year classes. &nbsp;En mettant l’emphase sur un contenu factuel, les grandes classes de biologie de première année contribuent au faible engagement des élèves et donnent une représentation imprécise de la nature dynamique et interdisciplinaire des sciences de la biologie. Afin d’offrir un programme fondamental en biologie par l’étude de la santé, de promouvoir le perfectionnement des compétences et d’encourager un niveau d’apprentissage marqué, nous avons repensé un cours pour une grande classe de première année contenant plusieurs sous-groupes. Nous décrivons le cours «&nbsp;Biological Concepts of Health&nbsp;» conçu pour encourager l’apprentissage supérieur, ainsi que pour enseigner la communication orale et les habiletés d’apprentissage individualisé à un grand nombre d’étudiants de première année. Pour déterminer le niveau d’habiletés cognitives évalué dans ce cours nouvellement conçu et les cours qu’il remplace, nous avons utilisé le «&nbsp;Blooming Biology Tool&nbsp;». Cette approche éprouvée démontre que ce nouveau cours a atteint son but d’encourager l’approfondissement des connaissances et, par ailleurs, a réussi à introduire la communication orale, de même que les habiletés d’apprentissage individualisé aux grandes classes de première année
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