Dietary Micronutrient Intake and Micronutrient Status in Patients With Chronic Stable Heart Failure: An Observational Study.

BACKGROUND: Observational studies suggest that patients with heart failure have a tendency to a reduced status of a number of micronutrients and that this may be associated with an adverse prognosis. A small number of studies also suggest that patients with heart failure may have reduced dietary intake of micronutrients, a possible mechanism for reduced status.

OBJECTIVE: The aims of this study were to assess dietary micronutrient intake and micronutrient status in a group of patients with heart failure.

METHODS: Dietary intake was assessed in 79 outpatients with chronic stable heart failure with a reduced ejection fraction using a validated food frequency questionnaire. Blood concentrations of a number of micronutrients, including vitamin D, were measured in fasting blood samples, drawn at the time of food frequency questionnaire completion.

RESULTS: More than 20% of patients reported intakes less than the reference nutrient intake or recommended intake for riboflavin, vitamin D, vitamin A, calcium, magnesium, potassium, zinc, copper, selenium, and iodine. More than 5% of patients reported intakes less than the lower reference nutrient intake or minimum recommended intake for riboflavin, vitamin D, vitamin A, calcium, magnesium, potassium, zinc, selenium, and iodine. Vitamin D deficiency (plasma total 25-hydroxy-vitamin D concentration <50 nmol/L) was observed in 75.6% of patients.

CONCLUSIONS: Vitamin D deficiency was common in this group of patients with heart failure. Based on self-reported dietary intake, a substantial number of individuals may not have been consuming enough vitamin D and a modest number of individuals may not have been consuming enough riboflavin, vitamin A, calcium, magnesium, potassium, zinc, copper, selenium, or iodine to meet their dietary needs.

Severe acute liver failure as the initial manifestation of haematological malignancy.

Acute liver failure is rarely secondary to lymphoma or leukaemia and it is extremely uncommon as the initial presentation of malignancy. We report a case of a young adult patient with severe acute liver failure referred for liver transplant, in which a Burkitt acute lymphoblastic leukaemia was diagnosed by bone marrow examination. A complete recovery and long remission were obtained with chemotherapy.

Fulminant hepatic failure: a Portuguese experience

BACKGROUND: Fulminant hepatic failure (FHF) is a rare condition. Several series have been reported either by individual centres or in multicentre studies but, to our knowledge, this is the first report from a Portuguese population and might be a good example of FHF cases in a SouthWestern European population. AIMS: To present the experience in FHF of a Portuguese Hepatogastroenterological Intensive Care Unit. MATERIALS AND METHODS: Retrospective study of 61 cases of FHF consecutively admitted between February 1992 and October 2006. Definition and classification of FHF were those suggested by Trey and Davidson (1970) and O'Grady et al. (1993), respectively. Criteria and contraindications for hepatic transplantation (HT) were those proposed by Bernuau et al. (1991) and Muñoz (1993), respectively. RESULTS: Fifty-seven per cent of patients were women and median age was 37 years (range: 8-73). Most common cause of FHF was indeterminate (26%) followed by viral (23%) and drug-induced (23%), with 51% of cases with a hyperacute evolution. Global HT rate was 54% with criteria for HT present in 87% of the patients resulting in an applicability rate of 62%. Overall survival was 69% and transplant-free survival was 15%; transplanted patients had survival rates of 70 and 68% at 6 and 12 months, respectively. CONCLUSIONS: Drug-induced and viral agents were responsible for almost half of FHF cases with a clear predominance of hyperacute presentation. The HT rate was 54% and the applicability rate was 62%. The overall 1 year survival of 69% might reflect the adequacy of the HT criteria used.

The First Government of Northern Ireland, Education Reform, and the Failure of Anti-populist Unionism, 1921–1925

This article examines education reform under the first government of Northern Ireland (1921–5). This embryonic period offered the Ulster Unionist leadership a chance to construct a more inclusive society, one that might diminish sectarian animosities, and thereby secure the fledgling state through cooperation rather than coercion. Such aspirations were severely tested by the ruling party’s need to secure the state against insurgency, and, more lastingly, to assuage the concerns of its historic constituency. The former led to a draconian security policy, the latter to a dependency on populist strategies and rhetoric. It is argued here, however, that this dependency was not absolute until July 1925. Before that, the Belfast government withstood growing pressure from populist agitators to reverse controversial aspects of its education reforms, only relenting when Protestant disaffection threatened the unity of the governing party and the existence of the state.

Predicting Risk of Re-hospitalization for Congestive Heart Failure Patients

Thesis (Master's)--University of Washington, 2012

Internationalization’s Effect on Marketing Learning: A Study of Syrian Firms

The aim of the present study is to understand the effects of international expansion on firms’ acquisition of marketing learning. This study’s focus on marketing learning complements previous research on the impact of internationalization on the development of foreign-market and technological knowledge. The research finds that the scope of a firm’s international activities, perception of gaps in marketing knowledge, and external social capital positively influence firms’ acquisition of marketing learning. However, firm’s age at initial international market entry appears not to be a significant factor. The study adds to the very limited body of research on the marketing learning outcomes of international expansion, while also offering rare empirical insights from the Middle East on this important subject matter. The paper discusses implications for international managers, policy makers, and future researchers.

Moment of stasis: the successful failure of a constitution for Europe

The 2005 French and Dutch negative votes on the Constitution open up a space of conceptualisation, not only of Europe's relation to its demos, but significantly to its failures. Through a critical analysis of mainly Niklas Luhmann's systems theory, the article proposes taking a distance from traditional constitutional dogmatics that are no longer capable of dealing with the paradox of contemporary society, and more specifically with the eventual resurgence of the European project as one of absence and stasis: the two terms are used to explain the need, on the one hand, to maintain the 'absent community' of Europe, and, on the other, to start realising that any conceptualisation of the European project will now have to take place in that space of instability and contingency revealed by the constitutional failure. The relation between law and politics, the location of a constitution, the distinction between social and normative legitimacy, the connection between European identity and demos, and the concept of continuity between constitutional text and context are revisited in an attempt to trace the constitutional failure as the constitutional moment par excellence.

Intervention Recommendations to Minimize the 30-Day Risk-of-Readmission for Heart Failure

Thesis (Master's)--University of Washington, 2015

Exploring the intangible impacts of cultural events on the creative sector: Experiences from the Cultural Olympiad programmes of Torino 2006 and London 2012

This paper engages with the debates around the Olympic legacy by exploring the qualitative, intangible impacts of the Cultural Olympiad programme on local small creative firms in Torino, Italy and London, UK. The research objectives are achieved through a qualitative study of local small creative firms’ perceptions of the impacts of the Olympic Games’ cultural programme on their activities. To achieve this, Torino 2006 and London 2012 are used as case studies. The findings of this exploratory study show that cultural events can impact the creative sector. They do this by providing opportunities for mutual learning and access to initiatives that may generate ideas and new skills, as well as contributing to the development of a creative field. The study also explores the weaknesses and missed opportunities linked to the Cultural Olympiad programme, as perceived by creative practitioners. These include the lack of information and failure to engage smaller businesses. Based on qualitative analysis and discussion, recommendations for future organizers and further research are provided.

Telaprevir or boceprevir based therapy for chronic hepatitis C infection: Development of resistance-associated variants in treatment failure

The use of triple-therapy, pegylated-interferon, ribavirin and either of the first generation hepatitis C virus (HCV) protease inhibitors telaprevir or boceprevir, is the new standard of care for treating genotype 1 chronic HCV. Clinical trials have shown response rates of around 70–80%, but there is limited data from the use of this combination outside this setting. Through an expanded access programme, we treated 59 patients, treatment naïve and experienced, with triple therapy. Baseline factors predicting treatment response or failure during triple therapy phase were identified in 58 patients. Thirty seven (63.8%) of 58 patients had undetectable HCV RNA 12 weeks after the end of treatment. Genotype 1a (p = 0.053), null-response to previous treatment (p = 0.034), the rate of viral load decline after 12 weeks of previous interferon-based treatment (p = 0.033) were all associated with triple-therapy failure. The most common cause of on-treatment failure for telaprevir-based regimens was the development of resistance-associated variants (RAVs) at amino acids 36 and/or 155 of HCV protease (p = 0.027) whereas in boceprevir-based regimens mutations at amino acid 54 were significant (p = 0.015). SVR12 rates approaching 64% were achieved using triple therapy outside the clinical trial setting, in a patient cohort that included cirrhotics.

Diversification, size and risk: The case of bank acquisitions of nonbank financial firms

We investigate the risk effects of bank acquisitions of insurance companies and securities firms between 1991 and 2012 using a newly constructed dataset of M&A deals. We examine risk changes before and after deal announcements by decomposing risk into systematic and idiosyncratic components. Subsequently, we investigate the relationship between risk and diversification by modelling the determinants of risks. We find that bank combinations with securities firms yield higher risks than combinations with insurance companies. Bank size is an important and consistent determinant of risk whereas diversification is not. Our results inform the continuing debate on diversification versus functional separation of bank activities.

The motives and performance of cross-border acquirers from emerging economies: Comparison between Chinese and Indian firms

During the recent decade, the world has witnessed the rapid growth of MNEs from emerging economies. Their increasing participation in cross-border mergers and acquisitions has raised great attention in the extant literature. This study evaluates the value creation from these cross-border transactions from two representative emerging countries, namely China and India, and determines factors that result in the different performance of these international acquisition activities. Cross-border acquisitions conducted by these countries’ companies indeed lead to significant shareholder wealth creation. Furthermore, Indian shareholders are more likely to benefit from deals in small cultural distance countries, while Chinese investors gain from the cross-border expansion of manufacturing companies. Location also affects the performance of cross-border acquisitions, with acquisitions into developed countries generating higher returns to shareholders. Our sample consists of 203 Indian and 63 Chinese cross-border deals over the period 2000–2010 and our results hold after controlling for various deal-level and firm-level characteristics.