4.   John is a 16-year-old who loves to play soccer. His 18-year-old brother, Andre, passed out while playing basketball and has now been diagnosed with long QT syndrome (LQT1). The cardiologist involved suggests that all Andre’s siblings should have a cardiac examination, including an electrocardiogram (ECG), before they play sports. John’s ECG shows a borderline QT prolongation during activity, so the cardiologist recommends genetic testing. John tests positive for the same mutation in the gene KCNQ1 (LQT1) that Andre has, and he is told that he must stop playing soccer. He is counseled to take up a less intense sport, like golf. John is clearly upset and wants to know why this is happening to him. He feels just fine and does not understand why he cannot play his favorite sport.
A.   What is the connection between sports restrictions and Long QT syndrome
B.   How can understanding the genetics help to predict who might be affected by Long QT syndrome if someone in the family is already affected.
C.   How and in what terms will you explain to John why these modifications in exercise are necessary

Please ans them both.14

What is the firm's total change in cash from the prior year to the current year?

What is the firm's cash flow from financing?

A 59-year-old man with headaches, double vision, dizziness, and ataxia

Chief Complaint

A 59-year-old, right-handed male was admitted to the hospital with a chief complaint of occipital headaches of 4 days duration.

History of Chief Complaint

Three days prior to admission, the patient noted a sudden onset of diplopia on forward gaze and a sensation of dizziness. These complaints resolved within twenty-four hours. He experienced several episodes of dizziness and diplopia over the next 24 hours. One day prior to admission he noted a relatively sudden onset of dizziness, diploia and clumsiness in the right hand. These complaints have persisted since that time.

Medical History

The patient had been under treatment for hypertension for 6 years duration with blood pressures in the range of 180/110.

General Physical Examination

The patient was alert, oriented, and cooperative; he was a well-nourished man of medium height who appeared his stated age. Funduscopic examination revealed clear optic disc with sharp borders. The external auditory canal was patent and uninflamed. Pharynx and larynx were non-reddened. A grade II/W bruit was present over the right carotid artery. His blood pressure was elevated (192/96). Peripheral pulses were intact at the ankle and wrist. Respirations were normal. His chest was clear to auscultation: skin was warm and of normal texture; abdomen was soft with no tenderness, lumps, or masses. No edema was present in the extremities; no lymphadenopathy was present in the cervical or inguinal areas.

Neurologic Examination

Mental Status. The patient was awake and oriented with respect to person, place, and time. Memory was appropriate for his age. Speech was articulate and meaningful and he could follow three and four-step commands.

Cranial Nerves. Extraocular movements were full, but tine patient complained of diplopia made worse by lateral gaze to the left. Nystagmus was present on left lateral gaze. The right pupil measured 3 mm, the left was 5 mm, but both responded to light and accommodation. Ptosis of the right eyelid and decreased sweating on the right side of the face (anhidrosis) were also present. Hearing was diminished in both ears to high frequencies. He admits to a feel of dizziness that he describes as the world moving around him. Pain, but not touch sensation, was decreased on the right side of the face with the exception of some sparing around the lips and nasal region. The right corneal reflex was diminished. Facial expressions were full and symmetric. The uvula deviated to tile left, and there was deficient elevation of the right side of the palate. There was also a suggestion of hoarseness.

Motor System. Strength was intact throughout the body; deep tendon reflexes were intact and symmetric. An ataxia was evident in the right upper extremity on finger-tapping, hand-patting, and finger-to-nose tests. A side-to-side intention tremor was present. Ataxia was also present in the right lower extremity, on heel-to-shin and tibia-tapping tests.

Sensory Examination: He had a mild analgesia to pinprick on the left side of the body, the left "'arm, and the left leg. Position, vibration, and touch modalities were intact throughout the entire body.

1. Does the patient exhibit a language or memory deficit or an alteration in consciousness or cognition? 2. Are signs of cranial nerve dysfunction present? If so, which cranial nerves? 3. Are there any changes in motor functions, such as reflexes, muscle tone, movement, or coordination? 4. Are any changes in sensory functions detectable? 5. Based on the answers to the above questions, at what level in the neuraxis is this lesion most likely located? 6. Is the pathology focal, multifocal, or diffuse in its distribution within the nervous system? 7. What is the clinical-temporal profile of the neurologic pathology in this patient: acute or chronic; progressive or stable? 8. Based upon your answers to the above two questions describe the pathology occurring in this patient. 9. If you feel this patient’s pathology is the result of a vascular accident, what vessels are most likely involved?

YAn 18-year-old man and his 17-year-old wife had $800 of wages from part-time jobs and no other income. Neither is required to file a tax return. Taxes were taken out of their pay, so they filed a joint return only to get a refund of the withheld taxes. What questions would you ask these clients, and what documents may you want to review?

Assume that 25-year-old Denise wastes $10 per week buying lottery tickets, averaging $520 per year. Now let's assume that Denise "sees the light" and decides to take that $520 she would have spent on lottery tickets and deposit it at the end of each year in an annuity paying 6% compounded annually.

By now, Denise is 45 years old. She's got a pretty good job, but she's starting to think about retirement and realizing that Social Security just isn't enough to live on after age 65. Since her IRA pays a little better interest than that 6% annuity paid, she decides to move all the 6% money into the IRA account with the other money. IRA account pays 7% compounded monthly.

a. How much total money does she begin with in the IRA account at this point?

Up to this point, Denise has been saving $1000 a year ($520+$480). Because she's making better money now, she wants to increase her investment in herself by putting $150 a month ($1800 a year) into the IRA account on top of the money that's already in there.

Consider the following two bond issues.

Bond M: 4% 30-year bond

Bond N: 6% 30-year bond

Neither bond has an embedded option. Both bonds are trading in the market at the same yield.

Which bond will fluctuate more in price when interest rates change? Why?

18.Rank the following bonds, from highest to lowest interest rate risk: 2-year zero coupon, 2-year 5% coupon bond, 30-year 5% coupon bond, 30-year, zero coupon bond.

A.30-year zero coupon bond, 30-year 5% coupon bond, 2-year 5% coupon bond, 2-year zero coupon bond

B.30-year zero coupon bond, 30-year 5% coupon bond, 2-year zero coupon bond, 2-year 5% coupon bond

C.30-year 5% coupon bond, 30-year zero coupon bond, 2-year 5% coupon bond, 2-year zero coupon bond

D.2-year 5% coupon bond, 2-year zero coupon bond, 30-year 5% coupon bond, 30-year zero coupon bond

E.2-year zero coupon bond, 2-year 5% coupon bond, 30-year 5% coupon bond, 30-year zero coupon bond

19.A corporate bond with a 5.75 percent coupon has 15 years left to maturity. It has had a credit rating of BB and a yield to maturity of 6.25 percent. The firm has recently gotten more financially stable and the rating agency is upgrading the bonds to BBB. Thenew appropriate discount rate will be 6.00 percent. What will be the change in the bond's price in dollars? (Assume interest payments are paid semi-annually and a par value of $1,000.)

A.increase $28.75

B.decrease $22.25

C.increase $22.25

D.decrease $23.72

E.increase $23.72

20.A 6.00percent coupon bond with 12 years left to maturity is priced to offer a 6.50percent yield to maturity. You believe that in one year, the yield to maturity will be 6.25 percent. What is the change in price the bondwill experience in dollars? (Assume semi-annual interest payments and $1,000 par value.)A.$12.50B.$19.67C.$20.22D.$21.55E.$25.00

Edmonds, Christopher T., Ryan D. Leece, Beth Y. Vermeer, and Thomas E. Vermeer (2020). The Information Value of Qualified and Adverse Audit Reports: Evidence from the Municipal Sector. Auditing: a Journal of Practice & Theory 39(1), February, 21-41.

1. Based on a review of the abstract, summarize the findings in one or two sentences.

2. Read Section II, Institutional Background. Summarize it in around 100 words using your own language. Be sure to mention the Single Audit Act of 1984.

Over the past 40 years, the SEC and others have consistently asserted that the information contained in an independent audit report is important to investors and, further, that expanded audit reporting enhances the transparency and stability of municipal markets (GFOA 2015; SEC 2012). Although the SEC cites anecdotal evidence to support the importance of the information provided by municipal independent audit reports, to our knowledge, there is no recent U.S. empirical evidence on the information value of qualified/adverse audit reports in the municipal sector. Using hand-collected data from 2000 to 2012, we find that municipal bond markets penalize governments with qualified/ adverse audit opinions for both primary market issuances and secondary trading. Specifically, in our propensity score matched sample, we find that municipalities receiving a qualified/adverse opinion suffer borrowing costs that are 34 basis points, on average, higher than municipalities receiving an unqualified opinion, holding all else constant. Overall, the weight of evidence is consistent with rejecting the null hypothesis that audit opinions on the fairness of GAAP financial statements are independent of borrowing costs in municipal markets. However, our archival research design cannot completely eliminate the threat of a correlated omitted variable. To our knowledge, recent research has not examined whether investors value the information content of qualified/adverse opinions on the fairness of the financial statements. Our results suggest that these auditor assurances are value relevant and that municipal investors differentiate between governments receiving unqualified and qualified/adverse opinions. However, similar to the for-profit sector, most governments receive an unqualified opinion (97 percent of our sample), which does not allow for differentiation among the majority of municipal audit reports. Our finding that the audit report is value relevant to municipal investors should be of interest to the SEC as they consider expanding municipal audit reporting, such as including communication of critical audit matters and auditor tenure (similar to the PCAOB auditor reporting standard adopted on June 1, 2017 ). Future research should examine whether the impact on municipal debt costs depends on the type of opinion received (i.e., qualified versus adverse) and/or the specific reasons provided (i.e., scope restriction versus departure from GAAP) for the nonstandard opinion. In an untabulated analysis, we found that the average yield for adverse audit opinions is higher than the average yield for qualified audit opinions (4.4 compared to 3.99, t-test statistic 1⁄4 1.95; p , 0.0653). However, we were unable to find significant differences in a multivariate model. Small samples also prevented us from determining whether investors differentiate based on the specific reasons provided (i.e., scope restriction versus departure from GAAP) for the nonstandard opinion. We also found no association between the choice of an independent CPA firm/state auditor and municipal debt costs (p-value 1⁄4 0.127). Future research should further explore this question as more data become available.

SECTION 2:

The overall purpose of an audit is to express an opinion on whether the historical financial statements are fairly stated in accordance with applicable accounting standards (Arens, Elder, and Beasley 2013). In both governmental and non-publicly traded companies, audits of historical financial statements must comply with generally accepted auditing standards (GAAS) and 8 statements on auditing standards (SASs) established by the American Institute of Certified Public Accountants. Although independent CPA firms audit most local governments, some municipalities are either audited by state audit agencies or the state agency reviews reports prepared by independent public auditors to ensure compliance with standards. While audits of governments, non-publicly traded companies, and U.S. publicly traded companies share a similar purpose, the municipal securities market has not been subject to the same level of audit regulation as other sectors of the U.S. capital market (SEC 2012). U.S. publicly traded companies are required to have audits under the Securities Act of 1933 and the Securities and Exchange Act of 1934 (1933 and 1934 Acts). Furthermore, an audit opinion that is qualified due to a scope limitation or departure from GAAP will not meet the stringent requirements under Rule 2-02(b) of Regulation S-X. While the SEC has broad regulatory control over the for-profit sector, the 1933 and 1934 Acts were passed with expansive exemptions for the municipal securities market (Gellis 1996). In fact, except for the antifraud provisions contained in these Acts, current federal securities laws do not provide the authority to the SEC or the Municipal Securities Rulemaking Board (MSRB) to require audited financial statements for municipal securities issuers. Although the SEC and MSRB have no direct authority to require municipal audited financial statements, larger municipal issuers typically have their financial statements audited due to rating agency requirements, other regulatory requirements, and voluntary disclosure guidelines from industry groups. Rating agencies generally demand audited financial statements to assign or maintain ratings. For example, Moody’s Investors Service requires audited financial statements within 12 months after the end of the fiscal year to assign or maintain a general obligation (GO) bond rating (Moody’s 2016). Further, Moors & Cabot, Inc., a leading financial advisor of municipal securities in the United States, notes that most analysts require audited financial statements as a condition of buying GO obligations. The two primary regulatory statutes requiring audited financial statements from local governments are the Single Audit Act of 1984 (federal government level regulation) and local government statutes (state level regulation). The Single Audit Act of 1984 requires that local governments with federal expenditures of $500,000 or more of federal financial assistance within a fiscal year have a Single Audit that includes an audit opinion on the historical financial statements. The Single Audit Act covers all 50 states and many of the more than 80,000 local governmental units (Freeman, Shoulders, Allison, and Smith 2013). In a similar manner, at the state level, the Utah State Auditor requires an annual financial statement audit for local government entities with greater than $750,000 in total annual revenues or expenses (Office of the Utah State Auditor 2016). In addition to the regulatory requirements of the Single Audit Act of 1984 and individual states, the Government Finance Officers Association (GFOA) Certificate of Achievement for Excellence in Financial Reporting is the primary voluntary industry group program requiring audited financial statements. Established in 1945 to encourage state and local governments to go beyond the minimum requirements of generally accepted accounting principles, the GFOA awarded the Certificate of Achievement to 4,231 organizations in 2015 (GFOA 2018). Although the SEC and MSRB cannot require audited financial statements from municipal issuers, rating agencies, other regulatory requirements, and voluntary industry programs ensure that local governments that issue GO bonds have their financial statements audited. Overall, the absence of audited municipal financial statements is more prevalent with less sophisticated issuers and non-governmental conduit borrowers (SEC 2012).