The pivotal role of cholesterol absorption inhibitors in the management of dyslipidemia

Elevated low-density lipoprotein (LDL)-cholesterol is associated with a significantly increased risk of coronary heart disease. Ezetimibe is the first member of a new class of selective cholesterol absorption inhibitors. It impairs the intestinal reabsorption of both dietary and hepatically excreted biliary cholesterol. Ezetimibe is an effective and safe agent for lowering LDL-C and non HDL-C. Short term clinical trials have established the role of ezetimibe monotherapy and its use in combination with statins. Furthermore, ezetimibe and statin combination therapy increased the percentage of patients who achieved their LDL-C treatment goal. Studies using surrogate markers of atherosclerosis have suggested a possible role of ezetimibe in combating atherosclerosis. Ezetimibe provides an effective therapeutic strategy for the management of homozygous familial hypercholesterolemia (HoFH) and sitosterolemia. The lack of outcomes and long term safety data is attributed to the relatively recent introduction of this medication

Macro Uncertainty Impacts on ESG Performance and Carbon Emission Reduction Targets

This study examines the impact of three macro uncertainty factors: economic policy uncertainty (EPU), political instability (PIS), and cultural uncertainty avoidance (UA), on corporate environmental, social and governance (ESG) performance and carbon emission reduction targets. Additionally, we examine whether these macro factors are affected by the profitability of the company. Using an unbalanced sample of companies located in the USA, China, and the UK during the period 2013-2020, results show that during times of economic uncertainty, companies are more likely to engage in ESG activities, including establishing emission reduction targets. Companies in countries with lower levels of political stability (PS) exhibit greater levels of social and environmental engagement, and companies operating in societies that tolerate risks, including the risk associated with climate change, are more likely to have better ESG performance and be committed to emission reduction targets. The results also suggest that profitable companies are more likely to deal with uncertain environments successfully, as they have the required resources to invest in ESG. The study suggests several practical implications for managers and policymakers. [1

Sustainable Products and Audit Fees: Empirical Evidence from Western European Countries

Purpose –The present study examines whether firms that appear to exhibit high sustainable outputs are more likely to pay higher audit fees than firms without such outputs. Design/methodology/approach–The sustainability outputs are measured using a sustainable product portfolio consisting of four products: clean energy products (CEP), eco-design products (EDP), environmental products (EP) and sustainable building projects (SBP). The audit fee variable is measured by the natural logarithm of the total amount of audit fees. The study tests two models of the association between these outputs and audit fees; Model 1 tests this association in the absence of the moderating variable (sustainability committee) and Model 2 tests the association in the presence of the moderating variable. Findings– An analysis of data on 261 European firms from the Refinitiv Eikon database from 2010 to 2019, shows that high sustainability outputs are significantly and positively associated with audit fees. More importantly, this association is moderated by the presence of a board-level sustainability committee, suggesting that this type of committee reflects a factor considered by auditors in their audit risk assessment practices. The findings indicate that in Model 1, one (EP) out of four variables has a significant and positive association with audit fees, while in Model 2 and in the presence of sustainability committee, two variables (EP and EDP) have a significant and negative association with audit fees. However, the robust analysis shows that three variables (EP, EDP and SBP) have significant and negative associations with audit fees. Practical implications –The study findings have important implications for policy makers, auditors and firms’ managers. For policy makers, the findings provide support for the argument that sustainable attitudes incentive firms to manage sustainable product profiles more effectively. As such, policy makers should incentivise firms to establish a sustainability committee and regulate its role and responsibilities. Auditors should coordinate with the sustainability committee to facilitate audit efforts and reduce audit fees. Social implications Understanding the relationship between sustainable products and audit fees will allow firms to improve their portfolio of sustainable products. In addition, other social implications of this study relate to improving relationships with society by establishing a sustainability committee that is responsible to communicate with that society. Originality/value–The results support the argument that firms should manage sustainable product portfolios more effectively. In addition, the results of the study highlight the importance of a new variable as a moderator, the sustainability committee, which has not been examined before

Are the effects of nicotinic acid on insulin resistance precipitated by abnormal phosphorous metabolism?

Nicotinic acid is a unique cholesterol modifying agent that exerts favorable effects on all cholesterol parameters. It holds promise as one of the main pharmacological agents to treat mixed dyslipidemia in metabolic syndrome and diabetic patients. The use of nicotinic acid has always been haunted with concerns that it might worsen insulin resistance and complicate diabetes management. We will discuss the interaction between phosphorous metabolism and carbohydrate metabolism and the possibility that worsening of insulin resistance could be related to adrug induced alteration in phosphorous metabolism, and the implications of that in medical management of diabetes and metabolic syndrome patients with mixed dyslipidemia

The Impact of Internal Governance Mechanisms on Environmental Performance of Saudi Firms

Purpose- We argue that firms that have a sustainability committee operating on the board, publish separate sustainability reports that are externally assured by an independent external audit, and have large and active boards are more likely to be engaged in environmental practices and have better environmental performance. Design/methodology/approach- Based on a sample of firms listed on the Saudi Stock Exchange, covering the period 2014–2021, we apply panel data models to examine the research hypotheses. Findings- Our findings show significant positive associations between the existence of sustainability committee, the publication of a separate sustainability reports, and the independent external assurance of these reports and environmental performance. We also find that the composite internal governance index is significant and positively associated with environmental performance. Practical implications- Policy makers should support the creation of sustainability committee on the boards of Saudi firms and review its role and responsibilities. Our findings inform regulators of the importance of the existence of independent external assurance of sustainability reports of Saudi firms to enhance the credibility and reliability of these reports. Managers need to establish devoted committees committed to sustainability related tasks that help coordinate communications between the firm and stakeholders. Originality/value- The Saudi Arabia government has implemented a range of policies and initiatives aim to improve environmental performance which is a main focus of Saudi Vision 2030 to achieve environmental sustainability. Therefore, we provide a unique evidence and new insights on impact of internal governance on corporate environmental performance in the Saudi context

Using Argumentation Logic for Firewall Policy Specification and Analysis

Firewalls are important perimeter security mechanisms that imple-ment an organisation's network security requirements and can be notoriously difficult to configure correctly. Given their widespread use, it is crucial that network administrators have tools to translate their security requirements into firewall configuration rules and ensure that these rules are consistent with each other. In this paper we propose an approach to firewall policy specification and analysis that uses a formal framework for argumentation based preference reasoning. By allowing administrators to define network abstractions (e.g. subnets, protocols etc) security requirements can be specified in a declarative manner using high-level terms. Also it is possible to specify preferences to express the importance of one requirement over another. The use of a formal framework means that the security requirements defined can be automatically analysed for inconsistencies and firewall configurations can be automatically generated. We demonstrate that the technique allows any inconsistency property, including those identified in previous research, to be specified and automatically checked and the use of an argumentation reasoning framework provides administrators with information regarding the causes of the inconsistency

The accountancy profession and emerging economies : reflections on the case of Syria at the margins of the global order

Syria, prior to the outbreak of extreme violence in 2011, was seeking increased economic liberalisation and aspiring to gain a larger stake in the global economy after a long period of isolation and animosity with the West. The authors elaborate, with critical insight, on how, before the violent events of more recent times, Syrian accountants were mobilising debates and shaping their professional identity vis-à-vis the new role they envisaged for the accountancy profession in this era of globalisation. Future research possibilities are considered, including reflecting in this context on the terrible and tragic events impacting Syria in recent times

Reflecting on Hybrid Events: Learning from a Year of Hybrid Experiences

The COVID-19 pandemic led to a sudden shift to virtual work and events, with the last two years enabling an appropriated and rather simulated togetherness - the hybrid mode. As we return to in-person events, it is important to reflect on not only what we learned about technologies and social justice, but about the types of events we desire, and how to re-design them accordingly. This SIG aims to reflect on hybrid events and their execution: scaling them across sectors, communities, and industries; considering trade-offs when choosing technologies; studying best practices and defining measures of "success"for hybrid events; and finally, identifying and charting the wider social, ethical, and legal implications of hybrid formats. This SIG will consolidate these topics by inviting participants to collaboratively reflect on previous hybrid experiences and what can be learned from them

Ethionamide Population Pharmacokinetic Model and Target Attainment in Multidrug-Resistant Tuberculosis

Ethionamide (ETA), an isonicotinic acid derivative, is part of the multidrug-resistant tuberculosis (MDR-TB) regimen. The current guidelines have deprioritized ETA because it is potentially less effective than other agents. Our aim was to develop a population pharmacokinetic (PK) model and simulate ETA dosing regimens in order to assess target attainment. This study included subjects from four different sites, including healthy volunteers and patients with MDR-TB. The TB centers included were two in the United States and one in Bangladesh. Patients who received ETA and had at least one drug concentration reported were included. The population PK model was developed, regimens with a total of 1,000 to 2,250 mg daily were simulated, and target attainment using published MICs and targets of 1.0-log kill and resistance suppression was assessed with the Pmetrics R package. We included 1,167 ethionamide concentrations from 94 subjects. The final population model was a one-compartment model with first-order elimination and absorption with a lag time. The mean (standard deviation [SD]) final population parameter estimates were as follows: absorption rate constant, 1.02 (1.11) h(-1); elimination rate constant, 0.69 (0.46) h(-1); volume of distribution, 104.16 (59.87) liters; lag time, 0.43 (0.32) h. A total daily dose of 1,500 mg or more was needed for >= 90% attainment of the 1.0-log kill target at a MIC of 1 mg/liter, and 2,250 mg/day led to 80% attainment of the resistance suppression target at a MIC of 0.5 mg/liter. In conclusion, we developed a population PK model and assessed target attainment for different ETA regimens. Patients may not be able to tolerate the doses needed to achieve the pre-defined targets supporting the current recommendations for ETA deprioritization