The relationship between public listing, context, multi-nationality and internal CSR

Are MNEs more socially responsible, and where is this more likely to occur? Are firms less responsible in emerging or transitional economies, and what impact does the dominant national corporate governance regime have? We explore the association between public listing and the existence of a CSR code within specific institutional settings and assess whether MNEs are any different to their local counterparts, based on an internationally comparative survey. We find that listed firms as well as firms from civil law countries are more likely to have CSR statements. MNEs are also more likely to have CSR statement, independent of their country of origin. While we find consistent evidence of a correlation between the existence of a CSR statement and investment in staff training, the correlation between the former and employee-friendly HRM is weaker

Impact of Valvular Prosthesis Type on Cardiovascular Outcomes in Patients on Chronic Dialysis

There is conflicting evidence guiding valve prosthesis selection in patients with end-stage renal disease on dialysis. We sought to determine, after reviewing the relevant literature, the best valve substitute in patients on chronic dialysis. A total of 9 retrospective studies compared the outcomes of two valves, showing similar results and highlighting the safety of implanting bioprostheses in patients on chronic dialysis. Standards of valve selection have changed over time; it has long been believed that tissue valves undergo premature degeneration due to calcium metabolism derangements in patients with end-stage renal disease. Bleeding was the most common valve-related complication and represented a major drawback of mechanical valves. Two studies demonstrated a survival advantage in favour of mechanical prostheses. It can be concluded that surgeons should not hesitate to implant bioprostheses because singular valve decomposition would be uncommon in this patient population. Prosthesis selection should be based on the same criteria as those used for non-dialysis patients

EFFICACY AND SAFETY OF EVEROLIMUS-EXEMESTANE COMBINATION IN BREAST CANCER PATIENTS

Breast cancer is the second leading cause of cancer death in women worldwide. In Lebanon, hormone positive patients resistant to endocrine treatments account for most of the cases. These two facts directed the attention to evaluate everolimus-exemestane use in hormonal receptor positive metastatic breast cancer patients, in Lebanon. A multi-center, observational, retrospective cohort study was carried out by screening 69 metastatic breast cancer patient’s files in order to determine the progression free survival (PFS), overall survival (OS) and side effects of everolimus. This study revealed that across different therapy lines, the median PFS for patients on everolimus-exemestane combination was 5.87 ± 10.84 months at a median follow up of 5.135 ± 6.375, and the median survival was 23.83 months with minimum and maximum survival, at 0.26 months and 30.5 months, respectively. Everolimus-exemestane has been shown to be effective in overcoming hormonal resistance in Lebanese breast cancer patients. Stomatitis, as a side effect of everolimus, accounted for 30.84% of the cases. Medical intervention, dose modification, dose postponing, drug discontinuation, and spontaneous resolution were used to manage all side effects. In comparison to previous studies, the current work demonstrated lower stomatitis percentages reflecting the preventives measures taken by oncologists. As a conclusion, everolimus-exemestane co-administration has proven to be an effective combination in overcoming hormonal resistance in Lebanon and a better tolerance is attributed to preventive measures in order to control drugs side effects

The influence of tropospheric biennial oscillation on mid-tropospheric CO_2

Mid-tropospheric CO_2 retrieved from the Atmospheric Infrared Sounder (AIRS) was used to investigate CO_2 interannual variability over the Indo-Pacific region. A signal with periodicity around two years was found for the AIRS mid-tropospheric CO_2 for the first time, which is related to the Tropospheric Biennial Oscillation (TBO) associated with the strength of the monsoon. During a strong (weak) monsoon year, the Western Walker Circulation is strong (weak), resulting in enhanced (diminished) CO_2 transport from the surface to the mid-troposphere. As a result, there are positive (negative) CO2 anomalies at mid-troposphere over the Indo-Pacific region. We simulated the influence of the TBO on the mid-tropospheric CO_2 over the Indo-Pacific region using the MOZART-2 model, and results were consistent with observations, although we found the TBO signal in the model CO_2 is to be smaller than that in the AIRS observations

Capture and inception of bubbles near line vortices

Motivated by the need to predict vortex cavitation inception, a study has been conducted to investigate bubble capture by a concentrated line vortex of core size rcrc and circulation Γ0Γ0 under noncavitating and cavitating conditions. Direct numerical simulations that solve simultaneously for the two phase flow field, as well as a simpler one-way coupled point-particle-tracking model (PTM) were used to investigate the capture process. The capture times were compared to experimental observations. It was found that the point-particle-tracking model can successfully predict the capture of noncavitating small nuclei by a line vortex released far from the vortex axis. The nucleus grows very slowly during capture until the late stages of the process, where bubble/vortex interaction and bubble deformation become important. Consequently, PTM can be used to study the capture of cavitating nuclei by dividing the process into the noncavitating capture of the nucleus, and then the growth of the nucleus in the low-pressure core region. Bubble growth and deformation act to speed up the capture process.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87832/2/022105_1.pd

Evaluation of renal drug dosing adjustment in chronic kidney disease patients at two university hospitals in Lebanon

Background: Inappropriate medication dosing in patients with chronic kidney disease can cause toxicity or ineffective therapy. Patients are at a high risk of developing related adverse events caused by the altered effect of drugs in conjunction with the use of polypharmacy to treat comorbid conditions. This necessitates adequate renal dosing adjustments. Objective: The current study aims at assessing whether appropriate dosing adjustments were made in hospitalized patients with chronic kidney disease. Methods: A retrospective descriptive study was conducted at two university hospitals in Beirut between January and December 2016. All adult CKD patients with creatinine clearance less than 60 ml/min and receiving at least one medication that require renal dosing adjustment were included. Kidney function was estimated from serum creatinine using Cockcroft-Gault equation, and dose appropriateness was determined by comparing practice with specific guidelines. The rates of renal drug dosing adjustment were investigated, in addition to the influence of possible determinants, such as the severity of renal impairment, reason of hospital admission, and other patient characteristics. Results: 2138 patients admitted in 2016 were screened. 223 adults receiving 578 drug orders that require adjustment were included. Among the 578 orders, 215 (37%) were adjusted adequately, 284 (49%) were adjusted inadequately, and 79 (14%) were not adjusted at all. Beta-blockers were the most inadequately dosed (83.6%) class of medication, whereas lipid-lowering agents had the highest percentage of adequate dosing (65.1%). As per patient, 84.3% of patients appeared to be receiving at least one inappropriate drug dose. Conclusions: Our study confirms that physicians are not prescribing appropriate dosing adjustments in chronic kidney disease inpatients, which may have deleterious effects. This highlights the need for more nephrology consultation and the implementation of physician education programs

Predicting Progression in Parkinson's Disease Using Baseline and 1-Year Change Measures.

BackgroundImproved prediction of Parkinson's disease (PD) progression is needed to support clinical decision-making and to accelerate research trials.ObjectivesTo examine whether baseline measures and their 1-year change predict longer-term progression in early PD.MethodsParkinson's Progression Markers Initiative study data were used. Participants had disease duration ≤2 years, abnormal dopamine transporter (DAT) imaging, and were untreated with PD medications. Baseline and 1-year change in clinical, cerebrospinal fluid (CSF), and imaging measures were evaluated as candidate predictors of longer-term (up to 5 years) change in Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score and DAT specific binding ratios (SBR) using linear mixed-effects models.ResultsAmong 413 PD participants, median follow-up was 5 years. Change in MDS-UPDRS from year-2 to last follow-up was associated with disease duration (β= 0.351; 95% CI = 0.146, 0.555), male gender (β= 3.090; 95% CI = 0.310, 5.869), and baseline (β= -0.199; 95% CI = -0.315, -0.082) and 1-year change (β= 0.540; 95% CI = 0.423, 0.658) in MDS-UPDRS; predictors in the model accounted for 17.6% of the variance in outcome. Predictors of percent change in mean SBR from year-2 to last follow-up included baseline rapid eye movement sleep behavior disorder score (β= -0.6229; 95% CI = -1.2910, 0.0452), baseline (β= 7.232; 95% CI = 2.268, 12.195) and 1-year change (β= 45.918; 95% CI = 35.994,55.843) in mean striatum SBR, and 1-year change in autonomic symptom score (β= -0.325;95% CI = -0.695, 0.045); predictors in the model accounted for 44.1% of the variance.ConclusionsBaseline clinical, CSF, and imaging measures in early PD predicted change in MDS-UPDRS and dopamine-transporter binding, but the predictive value of the models was low. Adding the short-term change of possible predictors improved the predictive value, especially for modeling change in dopamine-transporter binding

Exact relations between damage spreading and thermodynamic functions for the N-color Ashkin-Teller model

Exact results are derived relating quantities computable by the so-called damage spreading method and thermodynamic functions for the N-color Ashkin-Teller model. The results are valid for any ergodic dynamics. Since we restrict our analysis to the ferromagnetic case the results are also valid for any translational invariant lattice. The derived relations should be used in order to determine numerically the N-color Ashkin-Teller critical exponents with better accuracy and less computational efforts than standard Monte Carlo simulations.Comment: 6 pages, to be published in JSTAT (Journal of Statistical Mechanics: Theory and Experiment). The results of a computer simulation were included for N=3 as an example on how to use the analytical relations derived in the paper as a guide to obtain the critical temperature and critical exponent

The effect of pramipexole extended release on the levodopa equivalent daily dose in Lebanese Parkinson diseased patients

Objective: The objective of this study is to compute the potential benefit of Pramipexole ER on total levodopa equivalent dose (LED) and Unified Parkinson Disease Rating Score (UPDRS-III) compared to mono- or combined therapy of pramipexole IR and/or carbidopa/levodopa. Methods: This is a retrospective observational study conducted in a specialized PD (Parkinson Disease) and movement disease center in Lebanon between January and December 2017. Results: A total of 176 patient’s record was reviewed. Pramipexole ER showed a significant difference on the mean changes in LED and UPDRS-III score. After 13 weeks of initiating Pramipexole ER, the mean decrease in LED was -49.42 mg for all patients (p < 0.001, CI 95% [35.28-63.55]) and the mean decrease in UPDRS-III score for all patients was -6 points (P< 0.001). According to the subgroup analysis, patients aged 65 years and below, the change in mean total LED from baseline ( 350.80 mg) was a decrease of 63.19 mg with a p<0.001, CI 95% [42.07-84.31]. In patients aged more than 65 years and shifted to mono or combined pramipexole ER therapy, the change in mean total LED from baseline (559.25 mg) was a decrease of 34.67 mg with a p<0.001 CI 95% [16.16-53.18]. In addition the results showed that in patients having an UPDRS-III score of less than or equal to 33, the change in mean total LED from baseline (436.73 mg) was a decrease of 56.76 mg (p<0.001; CI 95% [41.32-72.20]). However, in patients having an UPDRS-III score of more than 33 the change in mean total LED from baseline (545.06 mg) was a decrease of 2.96 mg with a p value < 0.844 CI 95% [27.32-33.15]. Conclusions: This study demonstrated the efficacy of Pramipexole ER on decreasing the total levodopa equivalent dose (LED).The role of health care professionals is to maintain the patient on the lowest effective levodopa equivalent daily dose and optimize the treatment therapy, thus decreasing the side effects that might arise from overdosing of antiparkinsonian drugs