Impact of Aldosterone Antagonists on Sudden Cardiac Death Prevention in Heart Failure and Post-Myocardial Infarction Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND AND OBJECTIVES: Sudden cardiac death (SCD) is a severe burden of modern medicine. Aldosterone antagonist is publicized as effective in reducing mortality in patients with heart failure (HF) or post myocardial infarction (MI). Our study aimed to assess the efficacy of AAs on mortality including SCD, hospitalization admission and several common adverse effects. METHODS: We searched Embase, PubMed, Web of Science, Cochrane library and clinicaltrial.gov for randomized controlled trials (RCTs) assigning AAs in patients with HF or post MI through May 2015. The comparator included standard medication or placebo, or both. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Event rates were compared using a random effects model. Prospective RCTs of AAs with durations of at least 8 weeks were selected if they included at least one of the following outcomes: SCD, all-cause/cardiovascular mortality, all-cause/cardiovascular hospitalization and common side effects (hyperkalemia, renal function degradation and gynecomastia). RESULTS: Data from 19,333 patients enrolled in 25 trials were included. In patients with HF, this treatment significantly reduced the risk of SCD by 19% (RR 0.81; 95% CI, 0.67-0.98; p = 0.03); all-cause mortality by 19% (RR 0.81; 95% CI, 0.74-0.88, p<0.00001) and cardiovascular death by 21% (RR 0.79; 95% CI, 0.70-0.89, p<0.00001). In patients with post-MI, the matching reduced risks were 20% (RR 0.80; 95% CI, 0.66-0.98; p = 0.03), 15% (RR 0.85; 95% CI, 0.76-0.95, p = 0.003) and 17% (RR 0.83; 95% CI, 0.74-0.94, p = 0.003), respectively. Concerning both subgroups, the relative risks respectively decreased by 19% (RR 0.81; 95% CI, 0.71-0.92; p = 0.002) for SCD, 18% (RR 0.82; 95% CI, 0.77-0.88, p < 0.0001) for all-cause mortality and 20% (RR 0.80; 95% CI, 0.74-0.87, p < 0.0001) for cardiovascular mortality in patients treated with AAs. As well, hospitalizations were significantly reduced, while common adverse effects were significantly increased. CONCLUSION: Aldosterone antagonists appear to be effective in reducing SCD and other mortality events, compared with placebo or standard medication in patients with HF and/or after a MI.

Strategies to evaluate the impact of rectal volume on prostate motion during three-dimensional conformal radiotherapy for prostate cancer

Abstract Objective: To evaluate the rectal volume influence on prostate motion during three-dimensional conformal radiotherapy (3D-CRT) for prostate cancer. Materials and Methods: Fifty-one patients with prostate cancer underwent a series of three computed tomography scans including an initial planning scan and two subsequent scans during 3D-CRT. The organs of interest were outlined. The prostate contour was compared with the initial CT images considering the anterior, posterior, superior, inferior and lateral edges of the organ. Variations in the anterior limits and volume of the rectum were assessed and correlated with prostate motion in the anteroposterior direction. Results: The maximum range of prostate motion was observed in the superoinferior direction, followed by the anteroposterior direction. A significant correlation was observed between prostate motion and rectal volume variation ( p = 0.037). A baseline rectal volume superior to 70 cm3 had a significant influence on the prostate motion in the anteroposterior direction ( p = 0.045). Conclusion: The present study showed a significant interfraction motion of the prostate during 3D-CRT with greatest variations in the superoinferior and anteroposterior directions, and that a large rectal volume influences the prostate motion with a cutoff value of 70 cm3. Therefore, the treatment of patients with a rectal volume > 70 cm3 should be re-planned with appropriate rectal preparation.

The impact of evaporative cooling on the thermoregulation and sensible heat loss of sows during farrowing

Pigs are more sensitive to high environmental temperatures explained by the inability of sweating and panting properly when compared to other species of farmed livestock. The evaporative cooling system might favor the thermal comfort of animals during exposure to extreme environmental heat and reduce the harmful effects of heat stress. The purpose of this study was to assess the sensible heat loss and thermoregulation parameters from lactating sows during summer submitted to two different acclimatization systems: natural and evaporative cooling. The experiment was carried out in a commercial farm with 72 lactating sows. The ambient variables (temperature, relative humidity and air velocity) and sows physiological parameters (rectal temperature, surface temperature and respiratory rate) were monitored and then the sensible heat loss at 21days lactation was calculated. The results of rectal temperature did not differ between treatments. However, the evaporative cooling led to a significant reduction in surface temperature and respiratory rate and a significant increase in the sow's sensible heat loss. It was concluded that the use of evaporative cooling system was essential to increase sensible heat loss; thus, it should reduce the negative effects of heat on the sows' thermoregulation during summer.

Impact of HPV infection on the development of head and neck cancer

Human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is considered to be a distinct clinical entity with better prognosis than the classical tobacco- and alcohol-associated tumors. The increasing incidence of this neoplasia during the last decades highlights the need to better understand the role of HPV in the development of these cancers. Although the proportion of HNSCC attributed to HPV varies considerably according to anatomical site, overall approximately 25% of all HNSCC are HPV-DNA positive, and HPV-16 is by far the most prevalent type. In this review we discuss the existing evidence for a causal association between HPV infection and HNSCC at diverse anatomical head and neck subsites.

Exploring the impact of a hands-on intervention on grade 7 girls and their feelings about self, mathematics, science, technology and related careers

Forty-five 12- and 13-year-old females attending Grade 7 in North York, Ontario were randomly selected from a group of 100 females who had volunteered to participate in a oneday hands-on workshop called It's Your Choice at Seneca College. The goals of this intervention were to broaden the career horizons of these students and to help them realize the need to continue mathematics and science through high school in order to keep occupational options unlimited. The young women were given a pre- and post-attitude survey to provide background information. In the month following participation in the workshop the students were interviewed in small groups (S students per group) to discover their perceptions of the impact of the workshop. The interviews revealed that participants felt that after the workshop their feelings of self-confidence increased, specifically with respect to working with their hands. Participants felt more aware of the usefulness and importance of the study of mathematics, science and technology, They also felt that It's Your Choice increased their interest in careers in these domains and helped them to see that these careers are viable choices for females. The interviews also revealed that many of the participants felt that in this society their roles and their choices were influenced and probably limited by the fact that they are female.

The impact of integrated programming on student attitude and achievement in grade 9 academic mathematics and science

This research studioo the effect of integrated instruction in mathematics and~ science on student achievement in and attitude towards both mathematics and science. A group of grade 9 academic students received instruction in both science and mathematics in an integrated program specifically developed for the purposes of the research. This group was compared to a control group that had received science and mathematics instruction in a traditional, nonintegrated program. The findings showed that in all measures of attitude, there was no significant difference between the students who participated in the integrated science and mathematics program and those who participated in a traditional science and mathematics program. The findings also revealed that integration did improve achievement on some of the measures used. The performance on mathematics open-ended problem-solving tasks improved after participation in the integrated program, suggesting that the integrated students were better able to apply their understanding of mathematics in a real-life context. The performance on the final science exam was also improved for the integrated group. Improvement was not noted on the other measures, which included EQAO scores and laboratory practical tasks. These results raise the issue of the suitability of the instruments used to gauge both achievement and attitude. The accuracy and suitability of traditional measures of achievement are considered. It is argued that they should not necessarily be used as the measure of the value of integrated instruction in a science and mathematics classroom.

Characterizing the impact of multiple potential enemies (predators and parasites) on the behaviour of ranid tadpoles

In order to fully understand an organism's behaviours the interactions between multiple enemies or selective pressures need to be considered, as these interactions are usually far more complex than the simple addition of their effects in isolation. In this thesis, I consider the impact of multiple enemies (fish predators and parasites) on the behaviour of three larval anurans (Lithobates sylvaticus, L. clamitans and L. catesbeianus). I also determine whether species that differ in life-histories and habitat preferences possess different antipredator mechanisms and how this affects species responses to multiple enemies. I show that the three Ranid larvae respond differently to the trade-off imposed by the presence of both fish predators and trematode parasites within the environment. The two more permanent pond breeders (L. clamitans and L. catesbeianus) increased activity when in the combined presence of predators and parasites. In contrast, the temporary pond breeder (L. sylvaticus) decreased activity in the combined presence of predator and parasites, in the same manner as they responded to fish alone. Further, the presence of fish along with parasites increased the susceptibility of both L. sylvaticus and L. clamitans to trematode infection, whereas parasite infection in L. catesbeianus was unaffected by the presence of fish. A second experiment to assess palatability of the three anuran species to fish, revealed a range of palatabilities, with L. catesbeianus being least palatable, L. clamitans being somewhat unpalatable, and L. sylvaticus being highly palatable. This result helps to explain the species differences in tthe observed behaviour to the combined presence of fish and parasites. In conclusion, the results from this study highlight the importance of considering multiple selective pressures faced by organisms and how this shapes their behaviour.

The Impact of Mindfulness Meditation on Educator Growth and Professional Development: A Personal Account

This study examined the use of mindfulness meditation in educator growth and professional development. The purpose was to create recommendations for an effective mindfulness meditation practice for educators. To this end, as the researcher is an educator as well as an experienced mindfulness meditation practitioner, the research methodology was self-study through narrative inquiry. The exploration of mindfulness meditation on the researcher’s personal and professional development was viewed through the lenses of Maslow’s hierarchy of needs and Mezirow’s transformational learning theory. These theories provided an analytical framework that guided this research. Themes were drawn from the exploration and connected with academic literature. The results were a mindfulness meditation framework for educators that is based on the Socratic Method, and utilizes the conceptual frameworks of Maslow’s hierarchy of needs and Mezirow’s transformational learning theory.

Impact of neonatal total parenteral nutrition and early glucose-enriched diet on glucose metabolism and physical phenotypes in Guinea Pig

Les oxydants infusés avec la nutrition parentéral (NP) néonatale induisent une modification du métabolisme des lipides et du glucose, donnant lieu à l’âge adulte à un phénotype de carence énergétique (faible poids, baisse de l’activité physique). L’hypothèse qu’une diète précoce riche en glucose prévient ces symptômes plus tard dans la vie, fut évalué chez le cobaye par un ANOVA en plan factoriel complet à deux facteurs (p < 0:05) : NP du jour 3 à 7, suivit d’une nourriture régulière (chow) (NP+) vs. chow à partir du 3ième jour (NP-), combiné avec une eau de consommation enrichie en glucose (G+) ou non (G-) à partir de la 3ième semaine. Les paramètres suivant ont été mesurés à l’âge de 9 semaine: taux de croissance, activité physique, activité de phosphofructokinase-1 et glucokinase (GK), niveau hépatique de glucose-6-phosphate (G6P), glycogène, pyruvate et potentiel redox du glutathion, poids du foie, glycémie, tolérance au glucose, concentrations hépatiques et plasmatiques en triacylglycérides (TG) et cholestérol. Le groupe G+ (vs. G-) avait un taux de croissance plus bas, une activité de GK et une concentration en G6P plus élevée, et un potentiel redox plus bas (moins oxydé). Le niveau plasmatique de TG était moins élevé dans le groupe NP+ (vs. NP-). Les traitements n’eurent aucun effet sur les autres paramètres. Ces résultats suggèrent qu’indépendamment de la NP, une alimentation riche en glucose stimule la glycolyse et déplace l’état redox vers un statut plus réduit, mais ne surmonte pas les effets de la NP sur le phénotype physique de carence énergétique.

Impact of pesticides on indicator and pathogenic microorganism persistence under laboratory and field conditions

On s’intéresse aux impacts des pesticides sur la microflore des plantes surtout dans le contexte des légumes contaminés par des agents pathogènes. Le but de cette étude est d'évaluer l'impact de certains pesticides sur la persistance de micro-organismes indicateurs et pathogènes. En laboratoire, la persistance d’E. coli et de Salmonella en présence de quatre pesticides (Ripcord 400EC, Copper 53W, Bioprotec CAF, Serenade MAX) a été étudiée. Les plaques de Pétrifilm et le milieu sélectif XLD sont utilisés pour énumérer les populations d’E. coli et de Salmonella. Il a été démontré que le Serenade MAX favorisait la croissance microbienne, le Bioprotec CAF et le Ripcord 400EC soutenaient la survie microbienne et le Copper 53W inhibait la croissance, à la fois d’E. coli et de Salmonella. En conditions terrain, Ripcord 400EC, Copper 53W, Bioprotec CAF ont été étudiés sur une culture de brocoli irriguée avec de l'eau expérimentalement contaminée par E. coli. Dans tous les traitements, un impact de l’irrigation a été observé sur les populations de levures et de moisissures (diminution) et les bactéries aérobies totales (augmentation). Une prévalence supérieure d’E. coli a été observée dans les parcelles traitées avec le Bioprotec CAF comparativement aux traitements au Copper 53W, ce qui est en accord avec les résultats observés lors de l'essai en laboratoire. Cependant, l'analyse statistique n'a montré aucune différence significative entre les traitements appliqués. Les effets directs des pesticides sur les micro-organismes sont confirmés dans des conditions de laboratoire mais demeurent méconnus dans les conditions expérimentales au champ.

Impact of the elderly on household health expenditure in Bihar and Kerala, India

Dans le contexte d’une population vieillissante, nous avons étudié l’impact de la présence de personnes âgées sur les dépenses catastrophiques de santé (DCS), ainsi que leur impact sur trois effets reliés (le fait d’éviter des traitements, la perte de revenu, et l’utilisation de sources de financement alternatives). Nous avons utilisé les données d’une enquête du National Sample Survey Organization (Inde) en 2004, portant sur les dépenses reliées à la santé. Nous avons choisi un état développé (Kerala) et un état en voie de développement (Bihar) pour faire une comparaison des effets de la présence de personnes âgées sur les ménages. Nous avons trouvé qu’il y avait plus de DCS au Kerala et que ceci était probablement lié à la présence accrue de personnes âgées au Kerala ce qui mène à plus de maladies chroniques. Nous avons supposé que l’utilisation de services de santé privés serait lié à une augmentation de DCS, mais l’effet a varié en fonction de l’état, du présence d’une personne âgée, et du type de service utilisé (ambulatoire ou hospitalisation). Nous avons aussi trouvé que les femmes âgées au Bihar utilisait les services de santé moins qu’elle ne devrait, que les ménages ayant plus de 4 personnes ont possiblement un effet protecteur pour les personnes âgées, et que certains castes et group religieux ont dû emprunter plus souvent que d’autres groupes pour payer les frais de santé. La présence de personnes âgées, les maladies chroniques, et l’utilisation de services de santé privées sont tous liés aux DCS, mais, d’après nos résultats, d’autres groupes retardent les conséquences économiques en empruntant ou évitant les traitements. Nous espérons que ces résultats seront utilisés pour approfondir les connaissances sur l’effet de personnes âgées sur les dépenses de santé ou qu’ils seront utilisés dans des discussions de politiques de santé.

Geophysical Constraints on Structure and Tectonics of the Eastern Arabian Sea and the Adjoining West Coast of India with Special Reference to the Kerala Basin

The main objective of the present study is to model the gravity fields in terms of lithospheric structure below the western continental margin of India (WCMI) identify zones of crustal mass anomalies and attempt to infer the location of Ocean Continent transition in the Arabian Sea. In this study, the area starting from the western shield margin to the region covering the deep oceanic parts of the Arabian Sea which is bounded by Carlsberg and Cerg and Central Indian ridges in the south, eastern part of the Indus Cone in the west and falling between 630E and 800E longitudes, and 50N - 240N latitudes has been considered. The vast amount of seismic reflection and refraction data in the form of crustal velocities, basement configuration and crustal thicknesses available for the west coast as well as the eastern Arabian Sea has been utilized for this purpose

Development of an instrument to assess Human Resource Quality (HRQ) and measuring the impact of TQM efforts on HRQ using the instrument

This research is aimed at developing an instrument for measuring human resource quality in organizations. The researcher has developed the instrument for measuring HRQ based on extensive literature survey and expert opinion. Statistical validity of the Instrument has also been established. This instrument was used to measure the changes in Human Resource Quality in selected organizations wherein quality management practices are being implemented. Data collected was analyzed and presented in this thesis. It has been found that there are significant changes in all the indicators of Human Resource Quality. There is improvement in Cultural Change Index(CCI), Quality of Work Life Index(QWLI) and Employee Satisfaction Index(ESI). The Human Resource Quality index has also increased significantly in all the organizations. It has been observed from the study that implementation of TQM leads to significant changes in Human Resource Quality. This instrument is capable of measuring minor variations in each indicator of HRQ and can be used to identify areas of weakness and strength in the case of Human Resource Quality. The instrument can further be modified by future research. This research work provided excellent opportunities for the researcher for self-development and has made him confident to undertake such activities for the benefit of the learning community.

Impact of zinc substitution on the structural and magnetic properties of chemically derived nanosized manganese zinc mixed ferrites

Mn1-xZnxFe2O4 nanoparticles (x=0-1) were synthesized by wet chemical co-precipitation techniques. X-ray diffraction, transmission electron microscopy and high-resolution transmission electron microscopy were effectively utilized to investigate the different structural parameters. The elemental analysis was conducted using energy-dispersive spectrum and inductively coupled plasma analysis. The magnetic properties such as magnetization and coercivity were measured using vibrating sample magnetometer. The observed magnetization values of the nanoparticles were found to be lower compared to the bulk counterpart. The magnetization showed a gradual decrease with zinc substitution except for a small increase from x=0.2 to 0.3. The Curie temperature was found to be enhanced in the case of ferrites in the nanoregime. The variation in lattice constant, reduced magnetization values, variation of magnetization with zinc substitution, the presence of a net magnetic moment for the zinc ferrite and the enhancement in Curie temperature in Mn1-xZnxFe2O4 all provide evidence to the existence of a metastable cation distribution together with possible surface effects at the nanoregime.