Measuring Up: A Study on Corporate Sustainability Reporting in Canada

In response to the growth in corporate sustainability reporting in Canada, CGA-Canada commissioned a sustainability reporting survey in the fall of 2004. The survey sought to advance understanding of sustainability reporting, advocate for business value and transparency in reporting, and look to enjoin participation by all stakeholders. The results of the survey show the growing trend towards sustainability reporting in Canada. Some 18% of all companies produce a dedicated sustainability report, while approximately 5% spend more than $100,000 annually to report on sustainability issues. Regulatory requirements, stakeholder pressure, and corporate image objectives influence the most the decision to adopt a corporate sustainability reporting practice. In turn, added cost and potential information overload were two of the main reasons why organizations have not adopted a comprehensive sustainability reporting function. Concerns regarding the credibility and the vagueness of reporting practices and guidelines were also expressed.sustainability reporting, corporate social responsibility, reporting practices, sustainable development, socially responsible investment

Postoperative mortality after inpatient surgery: Incidence and risk factors

Karamarie Fecho1, Anne T Lunney1, Philip G Boysen1, Peter Rock2, Edward A Norfleet11Department of Anesthesiology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; 2Department of Anesthesiology, University of Maryland, Baltimore, MD, USAPurpose: This study determined the incidence of and identified risk factors for 48 hour (h) and 30 day (d) postoperative mortality after inpatient operations.Methods: A retrospective cohort study was conducted using Anesthesiology’s Quality Indicator database as the main data source. The database was queried for data related to the surgical procedure, anesthetic care, perioperative adverse events, and birth/death/operation dates. The 48 h and 30 d cumulative incidence of postoperative mortality was calculated and data were analyzed using Chi-square or Fisher’s exact test and generalized estimating equations.Results: The 48 h and 30 d incidence of postoperative mortality was 0.57% and 2.1%, respectively. Higher American Society of Anesthesiologists physical status scores, extremes of age, emergencies, perioperative adverse events and postoperative Intensive Care Unit admission were identified as risk factors. The use of monitored anesthesia care or general anesthesia versus regional or combined anesthesia was a risk factor for 30 d postoperative mortality only. Time under anesthesia care, perioperative hypothermia, trauma, deliberate hypotension and invasive monitoring via arterial, pulmonary artery or cardiovascular catheters were not identified as risk factors.Conclusions: Our findings can be used to track postoperative mortality rates and to test preventative interventions at our institution and elsewhere.Keywords: postoperative mortality, risk factors, operations, anesthesia, inpatient surger

On-Orbit Performance of the Helioseismic and Magnetic Imager Instrument onboard the Solar Dynamics Observatory

The Helioseismic and Magnetic Imager (HMI) instrument is a major component of NASA's Solar Dynamics Observatory (SDO) spacecraft. Since beginning normal science operations on 1 May 2010, HMI has operated with remarkable continuity, e.g. during the more than five years of the SDO prime mission that ended 30 September 2015, HMI collected 98.4% of all possible 45-second velocity maps; minimizing gaps in these full-disk Dopplergrams is crucial for helioseismology. HMI velocity, intensity, and magnetic-field measurements are used in numerous investigations, so understanding the quality of the data is important. We describe the calibration measurements used to track HMI performance and detail trends in important instrument parameters during the mission. Regular calibration sequences provide information used to improve and update the HMI data calibration. The set-point temperature of the instrument front window and optical bench is adjusted regularly to maintain instrument focus, and changes in the temperature-control scheme have been made to improve stability in the observable quantities. The exposure time has been changed to compensate for a 15% decrease in instrument throughput. Measurements of the performance of the shutter and tuning mechanisms show that they are aging as expected and continue to perform according to specification. Parameters of the tunable-optical-filter elements are regularly adjusted to account for drifts in the central wavelength. Frequent measurements of changing CCD-camera characteristics, such as gain and flat field, are used to calibrate the observations. Infrequent expected events, such as eclipses, transits, and spacecraft off-points, interrupt regular instrument operations and provide the opportunity to perform additional calibration. Onboard instrument anomalies are rare and seem to occur quite uniformly in time. The instrument continues to perform very well.Comment: 50 pages, 18 figures, 20 table

Shuttle Gaseous Hydrogen Venting Risk from Flow Control Valve Failure

This paper describes a series of studies to assess the potential risk associated with the failure of one of three gaseous hydrogen flow control valves in the orbiter's main propulsion system during the launch of Shuttle Endeavour (STS-126) in November 2008. The studies focused on critical issues associated with the possibility of combustion resulting from release of gaseous hydrogen from the external tank into the atmosphere during assent. The Shuttle Program currently assumes hydrogen venting from the external tank will result in a critical failure. The current effort was conducted to increase understanding of the risk associated with venting hydrogen given the flow control valve failure scenarios being considered in the Integrated In-Flight Anomaly Investigation being conducted by NASA

1003. Targeted Site-Specific Integration in Human Cells Using Designed Zinc Finger Nucleases

We have shown previously that human genome editing can be performed at high efficiency using designed zinc finger nucleases (ZFNs). ZFNs can be engineered to generate a double-strand break at a specific chromosomal location both in transformed and primary human cells. These breaks are repaired by the cell's own DNA repair machinery, and when a homologous extrachromosomal donor molecule is provided, a homology-directed repair process leads to highly efficient transfer of single-base-pair changes into the chromosome (Urnov et al. Nature 435: 646). ZFNs can be engineered to target virtually any chromosomal location (Pabo et al., Ann. Rev. Biochem. 70: 313), and function robustly in human hematopoietic stem cells, hence such localized gene modification may potentially be useful in the correction and treatment of certain monogenic diseases. Here we show that ZFNs can also be used for the preciseinsertion of a novel sequence into a pre-determined location in the human genome. Remarkably, this novel sequence can constitute a short patch sequence or several kilobases of one or more transgenes. We have observed ZFN-driven targeted integration into endogenous chromosomal loci in human cells of entire open reading frames and promoter-transcription units at a frequency of 5% in the absence of any selection. We also show the use of this process to disrupt with high efficiency an endogenous chromosomal locus with a selectable marker ORF. Finally, we describe our work on using ZFN-driven integration to insert a therapeutically-relevant transgene into a |[ldquo]|safe-harbor|[rdquo]| locus in the human genome, potentially avoiding the problem of insertional mutagenesis. Hence, the homology-directed repair process invoked by the ZFNs can be used to carry out high-efficiency targeted integration to potentially improve the safety and efficacy of gene therapy

Diagnosis of Cystic Fibrosis: Consensus Guidelines from the Cystic Fibrosis Foundation

Objective Cystic fibrosis (CF), caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, continues to present diagnostic challenges. Newborn screening and an evolving understanding of CF genetics have prompted a reconsideration of the diagnosis criteria. Study design To improve diagnosis and achieve standardized definitions worldwide, the CF Foundation convened a committee of 32 experts in CF diagnosis from 9 countries to develop clear and actionable consensus guidelines on the diagnosis of CF and to clarify diagnostic criteria and terminology for other disorders associated with CFTR mutations. An a priori threshold of ≥80% affirmative votes was required for acceptance of each recommendation statement. Results After reviewing relevant literature, the committee convened to review evidence and cases. Following the conference, consensus statements were developed by an executive subcommittee. The entire consensus committee voted and approved 27 of 28 statements, 7 of which needed revisions and a second round of voting. Conclusions It is recommended that diagnoses associated with CFTR mutations in all individuals, from newborn to adult, be established by evaluation of CFTR function with a sweat chloride test. The latest mutation classifications annotated in the Clinical and Functional Translation of CFTR project (http://www.cftr2.org/index.php) should be used to aid in diagnosis. Newborns with a high immunoreactive trypsinogen level and inconclusive CFTR functional and genetic testing may be designated CFTR-related metabolic syndrome or CF screen positive, inconclusive diagnosis; these terms are now merged and equivalent, and CFTR-related metabolic syndrome/CF screen positive, inconclusive diagnosis may be used. International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes for use in diagnoses associated with CFTR mutations are included

Diagnosis of Cystic Fibrosis in Screened Populations

Objective Cystic fibrosis (CF) can be difficult to diagnose, even when newborn screening (NBS) tests yield positive results. This challenge is exacerbated by the multitude of NBS protocols, misunderstandings about screening vs diagnostic tests, and the lack of guidelines for presumptive diagnoses. There is also confusion regarding the designation of age at diagnosis. Study design To improve diagnosis and achieve standardization in definitions worldwide, the CF Foundation convened a committee of 32 experts with a mission to develop clear and actionable consensus guidelines on diagnosis of CF with an emphasis on screened populations, especially the newborn population. A comprehensive literature review was performed with emphasis on relevant articles published during the past decade. Results After reviewing the common screening protocols and outcome scenarios, 14 of 27 consensus statements were drafted that apply to screened populations. These were approved by 80% or more of the participants. Conclusions It is recommended that all diagnoses be established by demonstrating dysfunction of the CF transmembrane conductance regulator (CFTR) channel, initially with a sweat chloride test and, when needed, potentially with newer methods assessing membrane transport directly, such as intestinal current measurements. Even in babies with 2 CF-causing mutations detected via NBS, diagnosis must be confirmed by demonstrating CFTR dysfunction. The committee also recommends that the latest classifications identified in the Clinical and Functional Translation of CFTR project [http://www.cftr2.org/index.php] should be used to aid with CF diagnosis. Finally, to avoid delays in treatment, we provide guidelines for presumptive diagnoses and recommend how to determine the age of diagnosis

Regional differences in the evolution of lung disease in children with cystic fibrosis

Progression of lung disease is a major event in children with cystic fibrosis (CF), but regional differences in its evolution are unclear. We hypothesized that regional differences occur beginning in early childhood. We examined this issue by evaluating 132 patients followed in the Wisconsin Neonatal Screening Project between 1985 and 2010. We scored chest x-rays obtained every 1–2 years with the Wisconsin chest x-ray system, in which we divided the lungs into quadrants, and gave special attention to ratings for bronchiectasis (BX) and nodular/branching opacities. We compared the upper and lower quadrant scores, and upper right and left quadrant scores, as patients aged using a multivariable generalized estimation equation (GEE) model. We did a confirmatory analysis for a subset of 81 patients with chest computerized tomography (CT) images obtained in 2000 and scored using the Brody scoring system. The chest x-ray analysis shows that the upper quadrants have higher BX (p<0.001) and nodular/branching opacities (p<0.001) scores than the lower quadrants. CT analysis likewise reveals that the upper quadrants have more BX (p=0.02). Patients positive for mucoid PA showed significantly higher BX scores than patients with nonmucoid PA (p= 0.001). Chest x-ray scoring also revealed that the upper right quadrant has more BX (p< 0.001) than the upper left quadrant, and CT analysis was again confirmatory (p< 0.001). We conclude that pediatric patients with CF develop more severe lung disease in the upper lobes than the lower lobes in association with mucoid PA infections and also have more severe lung disease on the right side than on the left side in the upper quadrants. A variety of potential explanations such as aspiration episodes may be clinically relevant and provide insights regarding therapies

A systematic review assessing non-pharmacological conservative treatment studies for people with non-inflammatory multi-joint pain: clinical outcomes and research design considerations

To systematically review the evidence to determine the clinical outcomes and the important methodological quality features of interventional studies on adults with non-inflammatory multi-joint pain (MJP). Systematic search of published and unpublished literature using the databases: AMED, CINAHL, MEDLINE, EMBASE, psycINFO, SPORTDiscus, PEDro, OpenGrey, the EU Clinical Trials Register, World Health Organization International Clinical Trial Registry Platform, ClinicalTrials.gov and the ISRCTN registry (search: inception to 19th October 2017). All papers reporting the clinical outcomes of non-pharmacological interventions for people with non-inflammatory MJP were included. Studies were critically appraised using the Downs and Black Critical Appraisal and the TIDieR reporting checklists. Data were analysed using a Best Evidence Synthesis approach. From 3824 citations, four papers satisfied the eligibility criteria. Three studies reported outcomes from multidisciplinary rehabilitation programmes and one study reported the findings of a spa therapy intervention. All interventions significantly improved pain, function and quality of life in the short-term. There was limited reporting of measures for absenteeism, presenteeism and psychosocial outcomes. The evidence was ‘weak’, and due to a lack of controlled trials, there is limited evidence to ascertain treatment effectiveness. Design consideration for future trials surround improved reporting of participant characteristics, interventions and the standardisation of core outcome measures. There is insufficient high-quality trial data to determine the effectiveness of treatments for non-inflammatory MJP. Given the significant health burden which this condition presents on both individuals and wider society, developing and testing interventions and accurately reporting these, should be a research priority