Contexts and Corporate Voluntary Environmental Behaviors: Examining the EPA\u27s Green Lights Voluntary Program

Why do an increasingly large number of firms choose to spend their own money and resources to protect the environment beyond the extant regulatory requirements? This article addresses this question by examining the EPA’s Green Lights (GL) voluntary program in which a firm’s policy makers made an early commitment to limiting greenhouse gases through the installation of energy-efficient lighting technology in its facilities. Two theoretical perspectives—resource-based theory and neo-institutional theory—are adopted to investigate the contexts by which a firm is encouraged to undertake voluntary environmental actions and evaluate environmental strategies associated with them. Accordingly, the authors focus on two major contexts: market contexts in which a firm adopts voluntary actions as a strategic response to market pressures and to advance competitiveness; and institutional contexts in which a firm takes voluntary postures as a strategic response to institutional pressures, to obtain institutional legitimacy and weaken regulatory scrutiny. The research results partially support both contexts and their associated strategic behaviors

Principle and Imagination in Judging: A Conversation with Mr. Justice James MacPherson

In the fall of 2005, Mr. Justice James MacPherson of the Ontario Court of Appeal began his visiting term at the Dalhousie University Faculty of Law. During his visit, Justice MacPherson spoke with two students about several issues that have engaged him during his career as a lawyer, academic and judge. The conversation raised a number of questions about Canada’s changing legal landscape, and how the judiciary has attempted to balance the role of legal principle and judicial imagination in law-making. How, for example, has the public’s sceptical perception of our evolving justice system subjected judges to a higher degree of scrutiny? The result has often been an apparent trade-off between principle and perception. What are the new dilemmas in our administration of justice? More than ever before, an applicant’s right to a principled and fair hearing has been compromised by systemic problems preventing access to the courts. Consequently, courts are being pressed to be more imaginative. To what extent, then, should judges articulate the intuitive (and sometimes personal) premise that often lies at the heart of their judgement? The weight of all these issues has placed judges in a position to re-consider their role in the justice system, and how they can balance principle and imagination to better adapt to the needs of society. Justice MacPherson brings his unique perspective to these issues from his vast experience in the legal system. He was counsel for the Government of Saskatchewan in many early landmark constitutional decisions, he served as an officer in the Dickson Court, and was later involved as a judge in several high profile decisions, such as the recent Ontario same-sex marriage appeal, Halpern. v. Canada. A graduate of Dalhousie Law School in 1976, Justice MacPherson has had a remarkable legal career. He began as a law professor at the University of Victoria, spent time as Director of the Constitutional Branch of Saskatchewan, and later was Executive Legal Officer of the Supreme Court of Canada. He was the Dean of Osgoode Hall Law School until his appointment as a judge of the Ontario Superior Court, and later the Ontario Court of Appeal

Principle and Imagination in Judging: A Conversation with Mr. Justice James MacPherson

In the fall of 2005, Mr. Justice James MacPherson of the Ontario Court of Appeal began his visiting term at the Dalhousie University Faculty of Law. During his visit, Justice MacPherson spoke with two students about several issues that have engaged him during his career as a lawyer, academic and judge. The conversation raised a number of questions about Canada’s changing legal landscape, and how the judiciary has attempted to balance the role of legal principle and judicial imagination in law-making. How, for example, has the public’s sceptical perception of our evolving justice system subjected judges to a higher degree of scrutiny? The result has often been an apparent trade-off between principle and perception. What are the new dilemmas in our administration of justice? More than ever before, an applicant’s right to a principled and fair hearing has been compromised by systemic problems preventing access to the courts. Consequently, courts are being pressed to be more imaginative. To what extent, then, should judges articulate the intuitive (and sometimes personal) premise that often lies at the heart of their judgement? The weight of all these issues has placed judges in a position to re-consider their role in the justice system, and how they can balance principle and imagination to better adapt to the needs of society. Justice MacPherson brings his unique perspective to these issues from his vast experience in the legal system. He was counsel for the Government of Saskatchewan in many early landmark constitutional decisions, he served as an officer in the Dickson Court, and was later involved as a judge in several high profile decisions, such as the recent Ontario same-sex marriage appeal, Halpern. v. Canada. A graduate of Dalhousie Law School in 1976, Justice MacPherson has had a remarkable legal career. He began as a law professor at the University of Victoria, spent time as Director of the Constitutional Branch of Saskatchewan, and later was Executive Legal Officer of the Supreme Court of Canada. He was the Dean of Osgoode Hall Law School until his appointment as a judge of the Ontario Superior Court, and later the Ontario Court of Appeal

Viscometric Studies on the Biodegradation of Some Vegetable Oils using Aspergillus Niger

The continual utilization of vegetable oils in homes, restaurants, hotels and cosmetic industries require their preservation against microorganisms. Aerobic biodegradation of four different seed oils were carried out using Aspergillus niger in order to determined their susceptibility to these common microbes in a temperate climate. The intrinsic viscosities of the inoculated oils, incubated at temperature of 35oC, were determined from the relative viscosities measured at intervals of seven days for six weeks. The viscosities of the un-inoculated oils were determined and used as control. A gradual increase in the viscosities with increase in the time of incubation was observed. This was ascribed to the possible growth of the microbes as they consume the smaller molecules formed during the break down of the oil. A remarkable change in the colour of the oils sample was noticed. This was then attributed to break down of compounds responsible for colours in these oils. The maximum viscosity values were obtained on the twenty eight day of incubation beyond which a decline was observed.  This was credited to the formation of secondary metabolites. The Fourier Transform- Infra Red spectrogram and the pH supported the secretion of enzymes and subsequent conversion of oil to secondary metabolites by the Aspergillus niger.  Absorption peaks at 2923.04-2930.09cm-1 and 3359.14-3429.69 cm-1 were due to hydroxyl and carboxyl groups in the biodegraded compounds. Edible oils with high free fatty acid value would therefore, biodegrade easily if contaminated by common fungi such as Aspergillusniger at temperature of 35oC.  The consumption of edible oil without frying commonly practiced in Nigeria may have been the source of diseases such as diarrhea, flu, vomiting, etc. It is recommended that edible Oils such as Palm, Ground nut, Cotton seed oil should be stored at temperature below 30oC and properly covered to prevent any contact with fungi. Keywords: Oil, Biodegradation, Aspergillus niger, Viscosit

Effect of Adjunct Metformin Treatment in Patients with Type-1 Diabetes and Persistent Inadequate Glycaemic Control. A Randomized Study

Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment with metformin versus placebo in patients with T1DM and persistent poor glycaemic control.One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c) (HbA(1c)) > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment. At enrolment, mean (standard deviation) HbA(1c) was 9.48% (0.99) for the metformin group (n = 49) and 9.60% (0.86) for the placebo group (n = 51). Mean (95% confidence interval) baseline-adjusted differences after 12 months with metformin (n = 48) versus placebo (n = 50) were: HbA(1c), 0.13% (-0.19; 0.44), p = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9), p<0.001; body weight, -1.74 kg (-3.32; -0.17), p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated.In patients with poorly controlled T1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects of metformin therapy in patients with T1DM are warranted.ClinicalTrials.gov NCT00118937

Using the relationship between brain tissue regional saturation of oxygen and mean arterial pressure to determine the optimal mean arterial pressure in patients following cardiac arrest: A pilot proof-of-concept study.

INTRODUCTION: Prospectively assess cerebral autoregulation and optimal mean arterial pressure (MAPOPT) using the dynamic relationship between MAP and regional saturation of oxygen (rSO2) using near-infrared spectroscopy. METHODS: Feasibility study of twenty patients admitted to the intensive care unit following a cardiac arrest. All patients underwent continuous rSO2 monitoring using the INVOS(®) cerebral oximeter. ICM+(®) brain monitoring software calculates the cerebral oximetry index (COx) in real-time which is a moving Pearson correlation coefficient between 30 consecutive, 10-s averaged values of MAP and correspond rSO2 signals. When rSO2 increases with increasing MAP (COx ≥0.3), cerebral autoregulation is dysfunctional. Conversely, when rSO2 remains constant or decreases with increasing MAP (COx <0.3), autoregulation is preserved. ICM+(®) fits a U-shaped curve through the COx values plotted vs. MAP. The MAPOPT is nadir of this curve. RESULTS: The median age was 59 years (IQR 54-67) and 7 of 20 were female. The cardiac arrest was caused by myocardial infarction in 12 (60%) patients. Nineteen arrests were witnessed and return of spontaneous circulation occurred in a median of 15.5min (IQR 8-33). Patients underwent a median of 30h (IQR 23-46) of monitoring. COx curves and MAPOPT were generated in all patients. The mean overall MAP and MAPOPT were 76mmHg (SD 10) and 76mmHg (SD 7), respectively. MAP was outside of 5mmHg from MAPOPT in 50% (SD 15) of the time. Out of the 7672 5-min averaged COx measurements, 1182 (15%) were at 0.3 or above, indicating absence of autoregulation. Multivariable polynomial fractional regression demonstrated an increase in COx with increasing temperature (P=0.008). CONCLUSIONS: We demonstrated the feasibility to determine a MAPOPT using cerebral oximetry in patients after cardiac arrest

TCT-819 Prediabetes and its Impact on 1-Year Clinical Outcome After Treatment with Newer-Generation Drug-eluting Stents in 2,986 All-Comer Patients

BACKGROUND Prediabetes (Pre-DM) is a risk factor state for developing diabetes mellitus (DM). Yet it is unclear whether detection of Pre-DM by routine assessment of glycated haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) among patients undergoing percutaneous coronary intervention (PCI) may help identify subjects with increased event risk. We assessed in all-comers who underwent PCI with contemporary drug-eluting stents (DES) the relation between glycaemia status and 1-year clinical outcome. METHODS HbA1c and FPG was determined in 2,362 non-DM participants in the multicenter, randomized, investigator-initiated TWENTE III trial, in order to identify Pre-DM (HbA1c 42-47mmol/mol; FPG 6.1- 6.9 mmol/L) and DM (HbA1c>=48mmol/mol; FPG >7 mmol/L). Another 624 patients had medically treated DM. The main clinical outcome parameter was a composite endpoint consisting of death, myocardial infarction, or revascularisation. RESULTS Glycaemic state was known in 2,986 trial participants: Pre- DM was present in 324 (11%), DM in 793 (27%), and normoglycaemia in 1,869 (63%) patients. Patients with Pre-DM and DM differed from normoglycemic patients in cardiovascular risk factors. The composite clinical endpoint in Pre-DM occurred in 11.1%, in DM in 10.5%, and in normoglycemic patients in 5.7% (

Bifurcation treatment with novel, highly flexible drug-eluting coronary stents in all-comers: 2-year outcome in patients of the DUTCH PEERS trial

Background: Percutaneous coronary intervention (PCI) in bifurcated lesions with second-generation drug-eluting stents (DES) was associated with increased myocardial infarction (MI) rates. Flexible stent designs that accommodate well to vessel tapering may be of benefit in challenging anatomies such as bifurcated target lesions, but so far data are scarce.Methods: We analyzed the 2-year follow-up data of the DUTCH PEERS (TWENTE II) trial, which randomized 1811 all-comer patients to PCI with newer generation resolute integrity zotarolimus-eluting (Medtronic) or promus element everolimus-eluting stents (Boston Scientific). In bifurcated lesions, provisional stenting was generally performed. Target vessel failure is a composite endpoint, consisting of cardiac death, target vessel MI, or target vessel revascularization.Results: Patients with at least one bifurcated lesion (n = 465, 25.7 %) versus patients with non-bifurcated target lesions only (n = 1346, 74.3 %) showed similar rates of clinical endpoints including target vessel failure (9.2 versus 7.9 %, p = 0.36) and definite stent thrombosis (0.4 versus 1.0 %, p = 0.38). Target vessel MI was more common in patients with bifurcated lesions (3.4 versus 1.6 %, p = 0.02); but after multivariate analysis with propensity score adjustment, bifurcation treatment was found not to be an independent predictor of target vessel MI (HR 1.40, 95 % CI 0.71–2.76; p = 0.34). Among patients with bifurcated lesions, DES type and side-branch size did not affect outcome, but periprocedural MI occurred more often after two-stent approaches (9.0 versus 2.1 %; p = 0.002).Conclusion: All-comer patients treated for bifurcated and non-bifurcated target lesions showed similar and low rates of clinical endpoints, suggesting that the DES used are efficacious and safe for treating bifurcated target lesions

TCT-588 2-Year Clinical Outcome of the Randomized, Multicenter DUTCH PEERS (TWENTE II) Trial, Comparing Cobalt-Chromium Zotarolimus-Eluting Resolute Integrity Stents and Platinum-Chromium Everolimus-Eluting Promus Element Stents in “All-Comer” Patients

Background: The multicenter, prospective, randomized, single-blinded, investigator-initiated DUTCH PEERS (TWENTE II) “All Comers” Trial demonstrated at 1-year follow-up the non-inferiority of third-generation Resolute Integrity zotarolimus-eluting stents (Medtronic Vascular, Santa Rosa, CA) versus Promus Element everolimus-eluting stents (Boston Scientific, Natick, MA), based on a similar incidence of the primary endpoint target vessel failure (TVF), a composite of cardiac death, target vessel revascularization (TVR), or myocardial infarction (MI). No other follow-up data beyond 12 months have been published from a randomized head-to-head comparison of both stents. Methods: In 4 study centers in the Netherlands, 1,811 patients were 1:1 randomly assigned to treatment with one of both stents. Patients with any clinical syndrome, any lesion type, and any number of lesions or vessels to be treated were included. Study monitoring and clinical event adjudication were performed by two independent Dutch contract research organizations (Diagram, Zwolle, and Cardialysis, Rotterdam, respectively). Results: DUTCH PEERS examines an all-comer patient population that included 59% of patients with acute coronary syndromes (20% of all patients presented with an acute STEMI) and 66% of patients with complex target lesions. We will compare for both stent groups the 2-year incidence of TVF (primary endpoint) and various secondary endpoints, including individual components of the primary endpoint, the incidence of stent thrombosis, and other composite endpoints, such as target lesion failure, major adverse cardiac events, and the patient-oriented composite endpoint. In addition, we will report the outcome of patients with longitudinal stent deformation after discontinuation of dual anti-platelet therapy. Conclusions: Clinical outcome of the DUTCH PEERS trial at 2-year follow-up will be presented

Final 5-Year Report of the Randomized BIO-RESORT Trial Comparing 3 Contemporary Drug-Eluting Stents in All-Comers

BACKGROUND: In a previous trial, higher 5‐year mortality was observed following treatment with biodegradable polymer Orsiro sirolimus‐eluting stents (SES). We assessed 5‐year safety and efficacy of all‐comers as well as patients with diabetes treated with SES or Synergy everolimus‐eluting stents (EES) versus durable polymer Resolute Integrity zotarolimus‐eluting stents (ZES). METHODS AND RESULTS: The randomized BIO‐RESORT (Comparison of Biodegradable Polymer and Durable Polymer Drug‐Eluting Stents in an All Comers Population) trial enrolled 3514 all‐comer patients at 4 Dutch cardiac centers. Patients aged ≥18 years who required percutaneous coronary intervention were eligible. Participants were stratified for diabetes and randomized to treatment with SES, EES, or ZES (1:1:1). The main end point was target vessel failure (cardiac mortality, target vessel myocardial infarction, or target vessel revascularization). Five‐year follow‐up was available in 3183 of 3514 (90.6%) patients. The main end point target vessel failure occurred in 142 of 1169 (12.7%) patients treated with SES, 130 of 1172 (11.6%) treated with EES, versus 157 of 1173 (14.1%) treated with ZES (hazard ratio [HR], 0.89 [95% CI, 0.71–1.12], P (log‐rank)=0.31; and HR, 0.82 [95% CI, 0.65–1.04], P (log‐rank)=0.10, respectively). Individual components of target vessel failure showed no significant between‐stent difference. Very late definite stent thrombosis rates were low and similar (SES, 1.1%; EES, 0.6%; ZES, 0.9%). In patients with diabetes, target vessel failure did not differ significantly between stent‐groups (SES, 19.8%; EES, 19.2%; versus ZES, 21.1% [P (log‐rank)=0.69 and P (log‐rank)=0.63]). CONCLUSIONS: Orsiro SES, Synergy EES, and Resolute Integrity ZES showed similar 5‐year outcomes of safety and efficacy, including mortality. A prespecified stent comparison in patients with diabetes also revealed no significant differences in 5‐year clinical outcomes. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01674803