Corporate governance perspective on environmental reporting:Literature review and future research agenda

The last three decades have witnessed substantial growth in the literature exploring the motives and drivers of corporate greening. Extant research analyzing the governance determinants of corporate environmental disclosure provides competing and contrasting results; despite the growing sustainability challenges create an urgent need for effective monitoring and incentive mechanisms to promote corporate transparency and accountability. This warrants further inquiry in the field, yet very few comprehensive reviews have been presented on governance determinants of corporate environmental disclosure. To fill this gap we conduct a systematic review of 121 published papers and distinguish the governance mechanisms fostering corporate environmental disclosure. Our paper identifies factors influencing the adoption, extant, and quality of environmental disclosure, and provides useful future research directions

Diagnostic Accuracy of Splenoportal Index for Detection of Esophageal Varices in Patients of Liver Cirrhosis

Background: To determine the diagnostic accuracy of splenoportal index for the prediction of esophageal varices in patients with cirrhosis Methods: In this cross sectional study patients(n= 75) having clinical and laboratory evidence of liver cirrhosis were selected. Sonographic findings of splenic index and portal vein velocity were correlated with the findings of endoscopic examination. P-value ≤ 0.05 considered as significant. Results were analyzed by creating 2 x 2 contingency tables which displayed the number of subjects who were positive on ultrasound and were also positive on endoscopy (true positives), who were ultrasound positive but were negative on endoscopy (false positives), who were ultrasound negatives but were positive on endoscopy (false negatives) and who were ultrasound negative and were also negatives on endoscopy (true negatives). Results: Majority ( 65.0%) patients were males. Patients positive on ultrasound were 70.7 % and patients positive on endoscopy were 72.0% . Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were found to be 96.3%, 95.2%, 98.1%, 90.9% and 96% respectively. Conclusion: Ultrasonography allows non-invasive and cost effective detection of esophageal varices in liver cirrhosis patients, with excellent accuracy

Fallopian tube cyst: a rare complication of tubal sterilization

Tubal sterilization is one of the most commonly employed permanent method of contraception, although it is considered very safe, rarely a cyst may develop in the fallopian tube after sterilization which may undergo torsion resulting in patient presenting with acute abdomen. We are presenting a case of a middle aged women presenting to emergency room with severe lower abdominal pain, she had past history of tubal ligation done 12 years back. Pelvic ultrasound showed right sided ovarian cyst, emergency laparotomy was performed for suspected torsion of ovarian cyst, which revealed normal ovary, however a right sided fallopian tube cyst was present which had undergone torsion, right sided salpingectomy was performed and the patient was sent home in stable condition on the fourth postoperative day

Resident’s Perceptions towards the Economic, Socio-Cultural, and Environmental Impacts of Tourism: A Case Study of Nathiagali, District Abbottabad, Pakistan

The tourism industry poses both favorable and unfavorable consequences to the local communities of tourist destinations. This study aims to analyze the economic, social, and environmental impacts of tourism on the host community in Nathiagali. In this study, the data were collected through structured questionnaires from 200 residents of the selected tourist destinations. The study applied factor analysis approach for empirical results. It is found that the local community perceives positive and significant economic and social impacts from tourism in the form of job or business opportunities, raising the standard of living and infrastructural development in the area. On the other hand, tourism brings environmental threats including health hazards from air and noise pollution, environmental degradation, and traffic congestion issues for the local community. Based on the results, it is recommended that appropriate policies are needed at the government and local levels to get maximum benefits from tourism in Nathiagali, Pakistan

True knot of umbilical cord: Case report and review of literat

True knot of umbilical cord (TKUC) is a rare abnormality. When it becomes tight, it may lead to the obstruction of the foetal circulation and intrauterine death (IUD). We present two cases of TKUC managed at The Aga Khan University Hospital with two extreme outcomes. A 22 years old primigravida was diagnosed with unexplained intrauterine foetal demise at 28th week gestation. She delivered vaginally after induction and tight TKUC was identified as a cause of IUD. The second patient delivered an alive healthy male baby vaginally who was found to have a lose TKUC

Non-coding RNAs: a key to future personalized molecular therapy?

Continual discoveries on non-coding RNA (ncRNA) have changed the landscape of human genetics and molecular biology. Over the past ten years it has become clear that ncRNAs are involved in many physiological cellular processes and contribute to molecular alterations in pathological conditions. Several classes of ncRNAs, such as small interfering RNAs, microRNAs, PIWI-associated RNAs, small nucleolar RNAs and transcribed ultra-conserved regions, are implicated in cancer, heart diseases, immune disorders, and neurodegenerative and metabolic diseases. ncRNAs have a fundamental role in gene regulation and, given their molecular nature, they are thus both emerging therapeutic targets and innovative intervention tools. Next-generation sequencing technologies (for example SOLiD or Genome Analyzer) are having a substantial role in the high-throughput detection of ncRNAs. Tools for non-invasive diagnostics now include monitoring body fluid concentrations of ncRNAs, and new clinical opportunities include silencing and inhibition of ncRNAs or their replacement and re-activation. Here we review recent progress on our understanding of the biological functions of human ncRNAs and their clinical potential

USE OF NEXT-GENERATION SEQUENCING FOR GENOMIC ANALYSIS IN COMPLEX DISEASES

Since the early 1990s, Sanger method has been the gold standard methodology for sequencing analysis of DNA. Next-generation sequencing (NGS) approaches revolutionized the field of genomics over the last 5 years. These new sequencing technologies make feasible the direct and cost-effective sequencing of genomes at unprecedented scale and speed. Furthermore, the applications of these technologies are wide-spread and have been developed to explore the complex biological systems, among which RNA sequencing (RNA-seq) for transcriptomics and ChIP-seq for epigenomics. NGS has changed the way we think about scientific approaches in basic, applied and clinical research. However, the potentialities of NGS entail major bioinformatic challenges for managing and understanding this vast amount of data and also for demanding computational resources. During my PhD course, as bioinformatician, I was involved in the processing of NGS data and in the development of algorithms and pipelines for the analysis. I developed a bioinformatic tool, called GAMES (Genomic Analysis of Mutations Extracted by Sequencing) to annotate and prioritize all the variants detected from NGS. The aim is to highlight those genetic events, functionally involved in disease. I also developed a statistical method for copy number variants (CNV) detection that allows to identify structural abnormalities potentially related to pathogenetic mechanisms. The presented approaches and algorithms were applied in different projects and are widely used within the Molecular Genetics Laboratory at Hospital Papa Giovanni XXIII in Bergamo, Italy. In this thesis, I will present selected analyses performed by NGS in routinely diagnostics. In clinical settings in fact NGS is applied widely, frommolecular characterization of molecular markers for predicting therapy response in cancer patients, to the research of pathomechanism for cardiovascular disease, to multi-genes screening for differential diagnosis in pediatric age to optimize the therapeutic management. Predictive markers are factors that are associated with upfront response or resistance to a particular therapy. They are important in oncology since tumors of the same tissue vary widely in their response to therapies. Of all human cancers, colorectal cancer (CRC) remains one of principal cause of death in the world. Almost 25% of patients have stage IV (metastatic) disease at diagnosis, and their predicted 5-year survival is less than 10%. The most advanced treatment option for metastatic CRC (mCRC) patients are anti-epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) that bind to and inhibit the activity of EGFR. The use of anti-EGFR mABs, such as cetuximab and panitumumab, have had great impact in the treatment of mCRC. However, their efficacy is dependent to small GTPase Kras genotyping. In diagnostic practice, I have applied NGS for Kras gene analysis, in order to detect specific Kras mutations for the identification of patients with advanced colorectal cancer unlikely to benefit from either cetuximab or panitumumab. To this aim, a large screening by NGS allows to analysis with high level of sensitivity the heterogeneity in somatic mutations in solid tumors or tumor cell lines. Besides the importance of Kras in the tumor pathway, germline mutations in this gene are known to be causative in genetic syndromes, called RASopathies. These represent one of the largest groups of multiple congenital anomaly syndromes known, caused by germline variants in various genes encoding components of the RAS/mitogen-activated protein kinase (MAPK) pathway. Proteins belonging to this network play key roles in cell proliferation, differentiation, survival, and death. The RASopathies have many overlapping characteristics, including characteristic facial features, cardiac defects, cutaneous abnormalities, neurocognitive delay and a predisposition to malignancies. These syndromes include Noonan syndrome, Costello syndrome, neurofibromatosis-1 and Leopard syndrome Differential diagnosis is challenging and to prevent the onset of complications and to establish the correct therapeutic agent is fundamental. By NGS, it is possible the molecular characterization of genotype and to reach a definitive diagnosis of rare genetic conditions characterized by high genetic heterogeneity and phenotypic overlap. In conclusion, the aim of my PhD thesis has been to provide bioinformatic pipeline and analysis for next-generation sequencing for deeper understanding of molecular causes of these disease. This is potentially useful in diagnosis for elucidation of phenotype and for clinical decision-making

A Scoping Review of Challenges and the Adaptation Process in Academia: Implications for Occupational Therapy Educators

The fulfillment of role expectations and responsibilities as one builds an academic career can be challenging. Increased demand for occupational therapy faculty merits examination of academic experiences from the literature. This study describes the experiences of educators using adaptation models (Savickas & Porfeli, 2012; Schkade & Schultz, 2003) as a theoretical lens. Arksey and O’Malley’s Scoping Study Framework (2005) was used in the study. Researchers reviewed literature from 2005-2017 from four databases. Researchers analyzed 28 articles from higher education and the health professions using quantitative and qualitative methods. Twenty-two of the 28 articles were published from 2010-2017. The studies analyzed were conducted in seven different countries, the majority in the US (n = 11) and Australia (n = 7), and more than half used qualitative designs (n = 15). Three themes describe academic experiences: identity-related challenges in academia, process of adaptation among academics, and identification of factors affecting productivity. This study describes the various experiences of faculty to meet the demands of the academic environment. Adaptation of OT academics to their occupational roles and environments has not been widely explored. The implications for future study are discussed

Autism spectrum disorder

Background: Autism spectrum disorder is a complex heterogeneous condition that is characterized by impairments in social interaction, communication, and behavior which mostly co-exists with several comorbidities. The current prevalence of autism spectrum disorder in the general population is estimated to be 1 in 68 children. Despite significant advances in research and multiple treatment options, the management of the disease remains poor. Although there are governmental services and few non-governmental organizations working for individuals with autism, there is no official data available regarding the incidence and prevalence of autism in Malta Methods: This study focuses on the need of increasing awareness for autism spectrum disorder in Malta among the general public and health care professionals which would benefit a better understanding of the disorder for early diagnosis and more effective treatments. This was best provided through questionnaires. Results: Our survey revealed that only a limited percentage of the Maltese population had some knowledge about the symptoms, age of onset, potential causes of the disease and treatment options for autism. Conclusion: There is an immense need for improvement regarding the awareness of autism in Malta to estimate the exact burden of the disorder and make the latest diagnostic and treatment options available to the people living with this disease on the island

Comparison of intravenous magnesium sulphate versus placebo in the management of women with severe pre-eclampsia.

Objective: To investigate the effectiveness of prophylactic intravenous magnesium sulphate in management of pre-eclemptia in terms of prevention from convulsions and developemrnt of eclempsia. Methodology: This prospective randomised trial was conducted in the department of Obtetrical and gynaecology Bahawal Vctoria Hospital, Bahawalpur. From September 2016 to September 2017. Information was entered in SPSS computer software version 23.1 and analyzed for possible results. Mean and SD was calculated and presented for quantitative data like maternal age, Gestational age, Parity and Blood pressure. Frequency (percentages) were calculated and presented for qualitative data such as gender protienurea (Yes/No), C-section, development of eclempsia and maternal death. Post stratification statistical chi square test was used to see effect modification. P value ≤ 0.05 was considered as significant. Results: In this study, a total number of 100% (n=318) patients were included, divided into two equal groups, 159 in each i.e. magnesium sulphate group and placebo group The outcomes were observed as Convulsions 2.5% (n=4) and 8.2% (n=13), maternal death1.3% (n=2) and 6.3% (n=10), adverse reaction 0.6% (n=1) and 8.2% (n=13), anti-hypertensive therapy 73.6% (n=117) and 81.8% (n=130), caesarean Section 59.7% (n=95) and 48.4% (n=77), live births 88.1% (n=140) and 97.5% (n=155) and stillbirths 21.4% (n=34) and 12.6% (n=20) for magnesium sulphate group and placebo group respectively. In Mgso4 group 95% patients have good efficacy and placebo group have 84.3% good efficacy. Conclusion: Relative small incidence of convulsions (2.5%) was found in Mgso4 group, so administration of Magnesium sulphate should considered in management of pre-eclempsia