Mutual Life Insurance Research Articles

631-P: Development of Noninvasive Diabetes Management Method Using Glycated Albumin in Tears

Aims/Background: Several clinical trials have demonstrated that strict glycemic control is important to minimize the risk of diabetic complications. Although frequent measurement of blood glucose levels by the invasive finger prick method is useful to achieve strict glycemic control, this method is invasive and burdensome to the patients. Glycated albumin (GA) is a biomarker which reflects the glycemic control status over the previous 2 weeks. We demonstrated GA levels in tears correlated those in blood. We hypothesized that regular GA tests in tears caused behavior change and improved glycemic control. Methods: Participants with type 2 diabetes were recruited and randomly divided to two groups. One group (intervention group) was performed tear GA tests every 2 weeks and reported the results, while the other group (control group) was not. After 8 weeks of intervention, the two groups were compared. GA levels in tears were measured by Liquid Chromatography / Mass Spectrometry. Results: We enrolled 56 participants to the study. Compared with the control group, the intervention group showed improvement in fasting blood glucose, HbA1c, GA, non-HDL cholesterol. Conclusions: Levels of GA, as a diabetes-related biomarker, in tears can be measured noninvasively. Regular measurement of the GA levels in tears could allow smoother management of diabetes mellitus and reduce the risk of complications noninvasively. Disclosure M.Aihara: None. N.Kubota: None. T.Yamauchi: Other Relationship; Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited, Novo Nordisk, Astellas Pharma Inc., AstraZeneca, Ono Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim, Kyowa Kirin Co., Ltd., Kowa Company, Ltd., Merck & Co., Inc., Sanofi, Sanwa Kagaku Kenkyusho, Shionogi & Co., Ltd., Daiichi Sankyo, Taiho Pharmaceutical Co. Ltd., Tosoh Corporation, Eli Lilly Japan K.K., Kissei Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., NTT Docomo Inc., Aero Switch, Asahi Mutual Life Insurance Company, NIPRO Medical Corporation, Abbott Japan Co., Ltd., Bayer Inc., Kyorin Pharmaceutical Company, Limited.

SECTION 60 OF THE EMPLOYMENT EQUITY ACT 1998: WILL A COMPARATIVE APPROACH SHAKE THIS JOKER OUT OF THE PACK?

Section 60 of the Employment Equity Act 1998 provides for the liability of an employer to an employee suffering from discriminatory conduct by another employee. Section 60 also provides two defences that can be raised by the employer in such circumstances. In this article the circumstances under which an employer can be held liable in terms of section 60 are explored. More particularly, the meaning of the requirement that the discriminatory conduct must relate to an employment policy or practice is considered. The possible meaning of harassment in the workplace is also reflected upon with reference to developments and jurisprudence in the context of sexual harassment. The nature and content of the defences available in terms of section 60 are analysed with reference to comparative jurisprudence in Britain, Australia, Canada and the United States of America. In view of this, reservations are expressed about the correctness of the judgment of the Labour Court in SATAWU obo Finca v Old Mutual Life Insurance Company (SA) Limited and Burger.

The Mutual Life Insurance Scandal: Making Public Opinion

ABSTRACT This study explores a 1905 New York Legislature investigation of life insurance company practices, including the widespread use of press agents to shape newspaper content. The principal targets of the so-called Armstrong Committee hearings were Mutual Life Insurance Co., Equitable Life Assurance Society, and New York Life Insurance Co. Committee hearings found that company executives made low interest loans to each other, funded political campaigns, used corporate money to buy controlling interests in other companies, and received inflated salaries while policyholder dividends dwindled. They also purchased favorable publicity from newspapers and magazines while the committee hearing was in session. Allan Forman, editor and publisher of the Journalist, was among prominent newsmen tainted by their involvement in the public relations effort. This and other discoveries ignited a debate about what constituted legitimate public relations practices and their relationship to news organizations.

Thrift in a time of war and influenza: American mutual life insurance companies, 1917–1920

Thrift in a time of war and influenza<b>: American mutual life insurance companies, 1917–1920</b>

Auditor quality, audit fees, organizational structure, and risk taking in the US life insurance industry

AbstractUsing a system of simultaneous equations, this study examines the relation among external audit monitoring, in the US life insurance industry. We find insurers with higher leverage risk and surplus risk are more likely to use Big‐4 auditors and to pay higher fees. In return, insurers hiring Big‐4 auditors and paying higher audit fees have lower leverage risk and surplus risk. Second, the results suggest that mutual life insurers have a higher leverage risk and surplus risk than stock life insurers. This evidence is in contrast to that for property–liability insurance companies. Third, we find insurers are less likely to hire Big‐4 auditors and to pay higher audit fees after implementation of the Sarbanes–Oxley Act (SOX). Finally, life insurers with Big‐4 auditors or paying higher audit fees are more likely to take lower risks after the implementation of SOX.

1741-P: Immune Regulation of Postprandial Glycemia and Whole-Body Insulin Sensitivity through Myeloid Production of IL-10

As feeding increases signals that potently induce gene expression in immune cells, we aimed to elucidate the role of myeloid cells in normal postprandial metabolism. Feeding increased serum levels of LPS, which is known to induce multiple genes in immune cells. Notably, LPS together with insulin potently induced IL-10 in macrophages, which could also be detected in the postprandial portal vein in vivo. In cultured hepatocytes, physiological levels of insulin alone did not suppress gluconeogenic gene expression, although when added together with medium from macrophages stimulated with LPS and insulin, they were markedly suppressed. This suppression was not seen in medium from macrophages of IL-10 knockout mice, showing this to be an IL-10 dependent process. Plasma glucose concentration ad libitum was elevated in mice injected with adenovirus encoding shRNA targeting the IL-10 receptor, and the normal postprandial suppression of gluconeogenic genes in liver was compromised, showing the importance of the IL-10 signal in postprandial glucose metabolism. Furthermore, myeloid-specific knockout of Akt1 and Akt2 resulted in similar phenotypes that were rescued by incrementing mTOR signaling, pointing to an Akt-mTOR dependent mechanism. As whole-body deficiency of IL-10 has been reported to decrease body weight and increase insulin sensitivity, we assessed the effect of myeloid deficiency of IL-10 by conducting bone marrow transfer from IL-10 knockout mice to wild type mice. While these phenotypes were recapitulated, postprandial glucose production was not improved despite markedly increased whole-body insulin sensitivity. These results pointed to the differential actions of myeloid IL-10 where baseline production maintains normal body weight, while postprandial increases in the hepatic-portal system suppresses hepatic gluconeogenic gene expression, collectively showing the need for context-dependent administration of IL-10 based therapies. Disclosure G. Toda: None. K. Soeda: None. N. Arakawa: None. Y. Masuda: None. N. Kobayashi: None. H. Suwanai: None. Y. Izumida: None. T. Yamauchi: Research Support; Self; AeroSwitch, Asahi Mutual Life Insurance Company, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim International GmbH, Daiichi Sankyo Company, Limited, Kowa Pharmaceutical company,limited., Kyowa Hakko Kirin Co., Ltd., Merck Sharp &amp; Dohme Corp., Mitsubishi Corporation Life Sciences Limited, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Novo Nordisk Inc., NTT Docomo Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Shionogi &amp; Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, TOSOH CORPORATION. Other Relationship; Self; Covidien Japan Inc. (Medtronic Japan Co., Ltd.), Eli Lilly Japan K.K., Johnson &amp; Johnson, Kissei Pharmaceutical Co., Ltd. T. Kadowaki: Research Support; Self; Astellas Pharma Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Pharmaceuticals, Inc., Cosmic Corporation, Daiichi Sankyo, Eli Lilly Japan K.K., FUJIFILM, Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Medscape Education, Medtronic, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, NIPRO Medical Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Asahi Mutual Life Insurance. K. Ueki: None. Funding Japan Society for the Promotion of Science (16K15488, 17K16141, 19K17954)

1697-P: NFIA Differentially Regulates Adipogenesis and Myogenesis through Distinct Molecular Pathways to Ensure Adipocyte Differentiation

Brown and beige fat dissipate chemical energy in the form of heat through uncoupling protein-1 (Ucp1) on the mitochondrial inner membrane as well as through the other pathways, while white fat generally stores energy in the form of lipid. Stimulating development and/or function of brown fat is highly anticipated as a novel strategy for the treatment of obesity and its complications including type 2 diabetes. Previously, we identified a transcription factor nuclear factor I-A (NFIA) as a crucial regulator of brown fat. NFIA binds to and activates the brown-fat-specific enhancers even before differentiation and later facilitates the binding of PPARgamma (peroxisome proliferator-activated receptor gamma—a master transcription factor of adipogenesis), to control the brown fat gene program. Here we show that the C-terminal 17 amino acid residues of NFIA (which we call pro#3 domain) are required for the transcriptional activity of NFIA. Full-length NFIA—but not deletion mutant lacking pro#3 domain—rescued impaired Pparg expression and adipogenesis in NFIA-knockout cells. However, the deletion mutant still binds to Myod1 enhancer to represses Myod1 expression via competition with KLF5 in terms of enhancer binding, leading to suppression of myogenic gene program. Therefore, the negative effect of NFIA on the myogenic gene program is, at least partly, independent of the positive effect on Pparg expression and its downstream adipogenic gene program. Overall, our results uncover multiple ways of action of NFIA to ensure optimal regulation of brown adipocyte differentiation. Disclosure Y. Hiraike: Research Support; Self; Daiichi Sankyo, Daiichi Sankyo, Novo Nordisk Inc., Novo Nordisk Inc. H. Waki: Research Support; Self; Astellas Pharma Inc., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Takeda Science Foundation, The Cell Science Research Foundation. Speaker’s Bureau; Self; AstraZeneca K.K., AstraZeneca K.K., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo, Kyowa Hakko Kirin Co., Ltd., Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K. K. Miyake: Research Support; Self; NTT DOCOMO, INC. M. Oguchi: None. T. Yamauchi: Research Support; Self; AeroSwitch, Asahi Mutual Life Insurance Company, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim International GmbH, Daiichi Sankyo Company, Limited, Kowa Pharmaceutical company,limited., Kyowa Hakko Kirin Co., Ltd., Merck Sharp &amp; Dohme Corp., Mitsubishi Corporation Life Sciences Limited, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma K.K., Novo Nordisk Inc., NTT Docomo Inc., Ono Pharmaceutical Co., Ltd., Sanofi K.K., Sanwa Kagaku Kenkyusho, Shionogi &amp; Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, TOSOH CORPORATION. Other Relationship; Self; Covidien Japan Inc. (Medtronic Japan Co., Ltd.), Eli Lilly Japan K.K., Johnson &amp; Johnson, Kissei Pharmaceutical Co., Ltd. T. Kadowaki: Research Support; Self; Astellas Pharma Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Pharmaceuticals, Inc., Cosmic Corporation, Daiichi Sankyo, Eli Lilly Japan K.K., FUJIFILM, Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Medscape Education, Medtronic, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, NIPRO Medical Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Asahi Mutual Life Insurance.

The Importance of the Efficiency of Mutual Life Insurers: A Comparison to Stock Life Insurers

Abstract Research background: Mutual companies are a major component of the life insurance industry worldwide and moreover are growing in importance. Efficiency, potentially affected by whether a life insurer company is mutual or stock, can determine how well said companies perform. Purpose: The aim of this paper is to demonstrate the importance of examining the efficiency of mutual and takaful (similar to mutuals) life insurance companies. Research methodology: This research coordinates 1) ideas regarding the size and importance of the mutual and takaful life industries worldwide, 2) theoretical aspects concerning how the efficiency of mutual/takafuls is expected to compare to that of stock insurers and 3) the outcomes of germane life insurance efficiency studies. Results: The outcomes of life insurance efficiency studies tend to show that, in total, stock insurers are more efficient than mutuals apart from one conspicuous element. As mutuals are substantial within several of the world’s largest life markets and the global life industry their being inefficient can be exceedingly negative. The overall conclusion is that such inefficiency can lead to dire economic problems so it is imperative to investigate the efficiency of mutuals/takafuls and perhaps the one element of stocks. Novelty: This article is the first to investigate the results of mutual/takaful life insurer efficiency studies in concert with the abovementioned theory and draws a vital conclusion regarding mutual/takaful life insurer inefficiency.

1876-P: Gut Microbial Fermentation of Polysaccharides Impacts Insulin Resistance in Humans

Recent studies have highlighted the role of gut microbiota in the pathogenesis of cardiometabolic diseases. In particular, microbially produced metabolites have been shown to affect the host metabolism, however, their impacts on metabolic diseases have not been fully elucidated. For instance, the findings from an obese mouse model have suggested that polysaccharide fermentation could serve as the additional energy sources, yet the effects on human pathology has not been reported. To address this question, we applied a multi-omics strategy, which integrated gut microbiome analyses with multi-platform metabolomic techniques. We sampled from 306 Japanese males and females with obesity (49.7%) and prediabetes (32.7%). Fecal microbiome was analyzed by 16S rRNA amplicon and metagenomic shot-gun sequencings, while fecal hydrophilic and lipid metabolites were measured using GC-MS and LC-MS-based platforms respectively, and were clustered by their co-expression profiles. We found that three out of 19 fecal hydrophilic clusters and three out of 86 lipid clusters were significantly associated with insulin resistance (IR) defined by HOMA-IR. Notably, the identified fecal hydrophilic clusters were classified as sugar derivatives such as monosaccharides and disaccharides. These metabolites were indeed increased in not only the fecal contents but also the plasma samples of IR group. In addition, microbes belonging to genera Dorea and Coprococcus, which are known to degrade polysaccharides, were abundant in the IR group, and were highly correlated with fecal sugar derivatives, while other microbes such as Alistipes showed negative correlation. Finally, we confirmed that the oral administration of a Dorea strain to HFD-fed mice exacerbated obesity and IR compared with Alistipes administration. Collectively, we report a novel mechanistic insight into the effects of gut microbes on metabolic diseases, where microbial fermentation of polysaccharides and its derivatives impact the host metabolism. Disclosure T. Takeuchi: None. Y. Nakanishi: None. K. Ikeda: None. H. Tsugawa: None. W. Suda: None. Y. Mizuno: None. N. Yamamichi: None. M. Arita: None. M. Hattori: None. N. Kubota: None. T. Kubota: None. T. Kadowaki: Research Support; Self; Astellas Pharma Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Pharmaceuticals, Inc., Cosmic Corporation, Daiichi Sankyo, Eli Lilly Japan K.K., FUJIFILM, Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Medscape Education, Medtronic, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, NIPRO Medical Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Asahi Mutual Life Insurance. S. Koyasu: None. H. Ohno: None.

926-P: Cardiovascular (CV) and Hypoglycemia Outcomes across Age Groups in People with Type 2 Diabetes (T2D) in the CAROLINA Trial

Older people with T2D have a high prevalence of comorbidities, frailty and polypharmacy. We investigated the effects of linagliptin (LINA) 5 mg versus glimepiride (GLIM) 1-4 mg once daily across age groups in the CARdiovascular Outcome Study of LINAgliptin Versus Glimepiride in T2D (CAROLINA®). CAROLINA® recruited adults with relatively early T2D, HbA1c 6.5-8.5%, and elevated CV risk and its primary outcome was CV death, non-fatal myocardial infarction, or non-fatal stroke (3P-MACE), with secondary outcomes including mortality as well as change from baseline in HbA1c, weight and hypoglycemia. Of 6033 patients (median age 64 [range 36-85]), 846 (14.0%) were ≥75 years. During median follow-up of 6.3 years, CV and mortality outcomes rates did not differ between treatment groups overall and across age categories (interaction p-values &amp;gt;0.05). Over time, following some initial dynamics, changes in HbA1c levels were comparable between treatment-groups and across age, but hypoglycemia risk (Fig) and weight were significantly lower with LINA vs. GLIM overall and consistently across age groups. These data demonstrate that results for CV and mortality outcomes were consistent across age subgroups, but LINA has a modest benefit in weight and a significantly lower hypoglycemia burden than GLIM, which are important safety considerations when selecting therapy for the elderly. Disclosure M. Espeland: Other Relationship; Self; Boehringer Ingelheim International GmbH, Ironwood Pharmaceuticals. R.E. Pratley: Other Relationship; Self; AstraZeneca, Eli Lilly and Company, GlaxoSmithKline plc., Glytec, Janssen Scientific Affairs, LLC., Lexicon Pharmaceuticals, Inc., Ligand Pharmaceuticals Incorporated, Merck &amp; Co., Inc., Novo Nordisk Inc., Sanofi. J. Rosenstock: Research Support; Self; AstraZeneca, Bristol-Myers Squibb, Genentech, Inc., GlaxoSmithKline plc., Lexicon Pharmaceuticals, Inc., Oramed Pharmaceuticals, PegBio Co., Ltd., Pfizer Inc., REMD Biotherapeutics. Other Relationship; Self; Applied Therapeutics, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. T. Kadowaki: Research Support; Self; Astellas Pharma Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Pharmaceuticals, Inc., Cosmic Corporation, Daiichi Sankyo, Eli Lilly Japan K.K., FUJIFILM, Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Medscape Education, Medtronic, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, NIPRO Medical Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Asahi Mutual Life Insurance. Y. Seino: Research Support; Self; ARKRAY, Bayer Yakuhin, Ltd., Boehringer Ingelheim International GmbH, Eli Lilly Japan K.K., Merck Sharp &amp; Dohme Corp., Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Speaker’s Bureau; Self; Becton, Dickinson and Company, Eli Lilly Japan K.K., Kao Corporation, Merck Sharp &amp; Dohme Corp., Nippon Boehringer Ingelheim Co. Ltd., Novo Nordisk Inc., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. B. Zinman: Advisory Panel; Self; Abbott, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck Sharp &amp; Dohme Corp., Novo Nordisk Inc., Sanofi-Aventis. N. Marx: Other Relationship; Self; Amgen, AstraZeneca, Bayer Vital, Boehringer Ingelheim International GmbH, Daiichi Sankyo, Kowa Research Institute, Inc., Medtronic, Merck Sharp &amp; Dohme Corp., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. D.K. McGuire: Consultant; Self; Afimmune, Applied Therapeutics, Merck Sharp &amp; Dohme Corp., Metavant. Other Relationship; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Co., Ltd., Eli Lilly and Company, Esperion Therapeutics, Inc., GlaxoSmithKline plc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck &amp; Co., Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis. K.R. Andersen: None. M. Mattheus: None. A. Keller: Employee; Self; Boehringer Ingelheim International GmbH. O. Johansen: Employee; Self; Boehringer Ingelheim International GmbH. Funding Boehringer Ingelheim and Eli Lilly and Company Diabetes Alliance

887-P: Development of the Noninvasive Diabetes Monitoring Method

Aims/Background: To prevent diabetic complications, strict glucose control and frequent monitoring of blood glucose levels with invasive methods are necessary. We considered monitoring of diabetes-related biomarkers in tears may be the possible methods for diabetes monitoring methods. Many studies about tear glucose levels have been reported and tear glucose levels correlate with blood glucose levels. This time, we focused on glycoalbumin (GA) levels, which reflect an average of blood glucose levels over the preceding 2 weeks, and studied the correlation between GA levels in blood and tears. Methods: We recruited 100 diabetic subjects and collected blood and tear samples. GA levels in blood were measured by an enzymatic method, and GA levels in tears were measured by Liquid Chromatography/Mass Spectrometry (LC-MS/MS). Results: The GA levels in tears of 99 out of 100 samples were appropriately measured by LC-MS/MS. GA levels in blood and tears were significantly correlated (P &amp;lt; 0.001). Multiple regression analysis revealed that this correlation was maintained even after adjustment for age, gender, nephropathy stage, and obesity (P &amp;lt; 0.001). Conclusions: GA in tears was the first measured diabetes-related biomarker. GA levels in tears were strongly correlated with those in blood, considering various factors. As GA value is a ratio, GA levels in tears were not thought to be influenced by dilution or concentration of tears and showed strong correlation with those in blood. From the above, GA in tears could be a diabetes-related biomarker that can be measured noninvasively. In the future, we plan to optimize measurement conditions, develop measurement equipment and verify the effectiveness and usefulness of this diabetes monitoring method. Disclosure M. Aihara: None. N. Kubota: None. T. Kadowaki: Research Support; Self; Astellas Pharma Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca K.K., Boehringer Ingelheim Pharmaceuticals, Inc., Cosmic Corporation, Daiichi Sankyo, Eli Lilly Japan K.K., FUJIFILM, Kowa Company, Ltd., Kyowa Hakko Kirin Co., Ltd., Medscape Education, Medtronic, Mitsubishi Tanabe Pharma Corporation, MSD Corporation, NIPRO Medical Corporation, Novartis Pharma K.K., Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Terumo Medical Corporation. Other Relationship; Self; Asahi Mutual Life Insurance.

Transforming Underwriting in the Life Insurance Industry

Life insurance provides trillions of dollars of financial security for hundreds of millions of individuals and families worldwide. Life insurance companies must accurately assess individual-level mortality risk to simultaneously maintain financial strength and price their products competitively. The traditional underwriting process used to assess this risk is based on manually examining an applicant’s health, behavioral, and financial profile. The existence of large historical data sets provides an unprecedented opportunity for artificial intelligence and machine learning to transform underwriting in the life insurance industry. We present an overview of how a rich application data set and survival modeling were combined to develop a life score that has been deployed in an algorithmic underwriting system at MassMutual, an American mutual life insurance company serving millions of clients. Through a novel evaluation framework, we show that the life score outperforms traditional underwriting by 6% on the basis of claims. We describe how engagement with actuaries, medical doctors, underwriters, and reinsurers was paramount to building an algorithmic underwriting system with a predictive model at its core. Finally, we provide details of the deployed system and highlight its value, which includes saving millions of dollars in operational efficiency while driving the decisions behind tens of billions of dollars of benefits.

The Northwestern Mutual Life Insurance Co.

Corporate Philanthropy ReportVolume 34, Issue 2 p. 9-10 Corporate Profiles The Northwestern Mutual Life Insurance Co. First published: 15 January 2019 https://doi.org/10.1002/cprt.30254Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume34, Issue2February 2019Pages 9-10 RelatedInformation

Henry Schuhl: The Wayward Rabbi of Dallas’s Temple Emanu-El

Henry Schuhl: The Wayward Rabbi of Dallas’s Temple Emanu-El Richard F. Selcer (bio) Click for larger view View full resolution The only known picture of Henry Schuhl is a pen-and-ink engraving that appeared in the New York Herald at the time of his disappearance in 1898. It shows a handsome, distinguished-looking gentleman with strong features highlighted by a big walrus mustache. It is impossible to say what he looked like earlier, but by this date he did not wear the traditional full beard of most rabbis. Source: Boston Post, Nov. 26, 1898. [End Page 396] The name Henry Schuhl was in newspapers all over the country between 1881 and 1898, but today he is scarcely remembered. A history of Dallas’s Temple Emanu-El devotes less than four pages to his troubled tenure, making vague reference to a “rupture” in the congregation that was “shortly healed.”1 He was the golden boy of Cincinnati’s Jewish community, then he came to Dallas and turned the staid Temple Emanu-El on its ear. During his lifetime he was a religious seeker, a politician, a labor leader, a con man, and a fugitive from justice in addition to being a distinguished rabbi. He caused one of the great religious scandals of the nineteenth century, earning him comparisons to a notable contemporary, the Reverend Henry Ward Beecher, the famed Brooklyn clergyman. In August 1881, Henry Schuhl stepped off a train in Dallas to start his tenure as rabbi of Temple Emanu-El, considered by some at the time to be “the largest, wealthiest, and most important Hebrew society in Texas.” Five years later he was on a train out of town, leaving in disgrace amid accusations of adultery, “licentiousness,” embezzlement, and swindling. But he proved F. Scott Fitzgerald wrong by going on to a second act—and more—before his life was through. Constantly on the move and on the make, Henry’s story is an extreme version of the quintessential nineteenth-century [End Page 397] immigrant experience in America, full of self-invention and new beginnings.2 Henri Schuhl was born December 6, 1846, in France, probably in the border region of Alsace-Lorraine, an area claimed by both France and Germany, which would explain why he spoke fluent German and French. After immigrating to the United States, he Anglicized his given name to “Henry.” His wife, Brunette Nathan, was born in France on September 11, 1847. They were married on November 20, 1868, and moved to America together. They settled in New York City first, then moved to Montreal, where they lived for a short time. In 1870, they were living in California where their first child was born, a daughter they named Florette. They had three more children between 1872 and 1877, Aaron, Palmyra, and Caroline. In 1878, they moved to Cincinnati, Ohio, where the Mound Street Temple hired Henry to lead singing and congregational prayers as chazzan (cantor). It was a prestigious position, equivalent to being deputy rabbi, and as a graduate of “the leading university” of Paris Henry was well-equipped for his duties. He was a dynamic public speaker who reportedly “possessed the sublime gift of oratory” to go along with his scholarly credentials. Still, he was not an ordained rabbi. The position of chazzan did not pay very well, especially for a person described by the American Israelite, the national Jewish publication out of Cincinnati, as a “gentleman of culture and refinement” who was supporting a family of six. Apparently, the job did not occupy “sufficient of his time,” either, because in 1880 he became “city agent” for the Penn Mutual Life Insurance Company of Philadelphia. If Henry was good at anything, it was selling—especially himself.3 His detour into the insurance business did not last long, however, and in 1881 he arrived in Dallas to begin a new life at Temple Emanu-El. One scholar characterizes nineteenth-century Texas as one of the last “corners” of the historic Jewish diaspora. Dallas was one of seven Jewish congregations in the state in 1881. Although the town was struggling at this date, it still represented a golden opportunity...

A Tale of Two Cities: Evolution of Academic Physiatry in Boston and Baltimore: Part 1: The Boston Marathon

A Tale of Two Cities: Evolution of Academic Physiatry in Boston and Baltimore: Part 1: The Boston Marathon

Current State of Mind, Fed.R.Evid. 803(3): Intent of Another as Multiple Level Hearsay; Relevance and Admissibility in Domestic Violence Cases

Current State of Mind, Fed.R.Evid. 803(3): Intent of Another as Multiple Level Hearsay; Relevance and Admissibility in Domestic Violence Cases

相互会社の業務多角化と非社員契約募集

周知のように相互会社には，主として相互会社の相互性，非営利性の視点から，非社員契約に関して量的制限および質的制限がかけられている。一方で，相互会社は，内外の生保会社を買収し，子会社化することによって，保険グループとしての業務多角化を図ろうとしている。本稿は，このような相互会社の新しい業務展開に対し，保険募集面の規制がどのような形で対応しているか，特に，相互会社本体での引受けであれば非社員契約に該当する保険契約について，グループとしての募集を考えた場合，どのような点が法的に論点となりうるかについて考察するものである。さらに，内外子会社を通じて募集される保険契約と非社員契約の類似性に鑑み，より簡便な株式会社化，さらには持株会社設立によるグループ形成の道を拓くべく，「包括移転による株式会社化＋持株会社設立方式」を提案し，若干の私見を述べる。

Lessons learned in crisis management

This paper will explore lessons learned following a series of natural and man-made disasters affecting the Massachusetts Mutual Life Insurance Company and/or its subsidiaries. The company employs a team of certified continuity professionals who are charged with overseeing resilience on behalf of the enterprise and leading recovery activities wherever and whenever necessary.

Financial Aspects of the Links between Loan Insurance and Loan Recovery

In the era where banks are finding it difficult to recover their loan money from people, the banks have come up with the concept of Loan Insurance. It is mainly for insuring the term loans, like home loans etc. Home Loan Insurance is an Insurance plan that covers only your outstanding loan liability. In case of death of the borrower, the proceeds of home loan insurance cover help the family repay outstanding loan. Indian Bank has been chosen for a case study. For Loan Insurances the Indian bank has entered into tie-ups with various other Companies, like for example, for Health, the Bank has a tie up with M/s. United India Insurance Co Ltd. and for Home Loan Insurance with Kotak Mahindra Old Mutual Life Insurance Ltd. Thus, in this way the Bank recovers its money from the insurer and the Insurance company get more customers through Bank contact.

Mutual life insurers: Origins and performance in pre-1900 Britain

This article considers the evolution of mutual life insurance companies in Britain. It investigates how they obtained their financing in the absence of share capital: the need to provide security for policyholders was typically met by guarantees that directors gave or by borrowing. Mutuals were, to some degree, kept in check by policyholders, who would, in the absence of effective regulation, raise vigorous challenge to directors if a firm under-performed, which would be apparent if it declared low bonuses on its policies. Mutuals tended to have lower costs than proprietary life insurers, which may also reflect the role of policyholders in corporate governance.