Renal responses to three types of renin-angiotensin system blockers in patients with diabetes mellitus on a high-salt diet: a need for higher doses in diabetic patients?

Objective Activation of the renal renin-angiotensin system in patients with diabetes mellitus appears to contribute to the risk of nephropathy. Recently, it has been recognized than an elevation of prorenin in plasma also provides a strong indication of risk of nephropathy. This study was designed to examine renin-angiotensin system control mechanisms in the patient with diabetes mellitus.Methods We enrolled 43 individuals with type 2 diabetes mellitus. All individuals were on a high-salt diet to minimize the contribution of the systemic renin-angiotensin system. After an acute exposure to captopril (25 mg), they were randomized to treatment with either irbesartan (300 mg) or aliskiren (300 mg) for 2 weeks.Results All agents acutely lowered blood pressure and plasma aldosterone, and increased renal plasma flow and glomerular filtration rate. Yet, only captopril and aliskiren acutely increased plasma renin and decreased plasma angiotensin II, whereas irbesartan acutely affected neither renin nor angiotensin II. Plasma renin and angiotensin II subsequently did increase upon chronic irbesartan treatment. When given on day 14, irbesartan and aliskiren again induced the above hemodynamic, renal and adrenal effects, yet without significantly changing plasma renin. Irbesartan at that time did not affect plasma angiotensin II, whereas aliskiren lowered it to almost zero.Conclusion The relative resistance of the renal renin response to acute (irbesartan) and chronic (irbesartan and aliskiren) renin-angiotensin system blockade supports the concept of an activated renal renin-angiotensin system in diabetes, particularly at the level of the juxtaglomerular cell, and implies that diabetic patients might require higher doses of renin-angiotensin system blockers to fully suppress the renal renin-angiotensin system. J Hypertens 29: 2454-2461 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Two Levels of Motivation and Two Types of Well-Being: Relations Between General and Goal-Specific Motivations, and Eudaimonic and Hedonic Well-Being

In this thesis I assess the individual and joint predictive associations and effects between multiple motivation and well-being concepts. In particular, three pairs of motivation concepts (intrinsic/extrinsic, approach/avoidance, and eudaimonic/hedonic) are assessed simultaneously at two levels of analysis (disposition and goal) and examined in relation to two types of well-being (eudaimonic and hedonic) in two studies, one correlational and the other experimental. Study 1: Using a correlational design, participants (N = 325, M age = 19.10, 87% female) completed self-report measures assessing six motivation and two well-being concepts. Exploratory factor analyses were used to assess patterns of associations among the motivational constructs. Results indicated that constructs displaying conceptual and empirical similarities co-occur, particularly, intrinsic, approach and eudaimonic motivation. Regression models were used to assess predictive relations between the motivational constructs and well-being. Both types of well-being were predicted by approach and avoidance dispositions, and hedonic goals. Additionally, eudaimonic well-being was uniquely predicted by eudaimonic dispositions and goals, and intrinsic dispositions; and hedonic well-being was uniquely predicted by extrinsic dispositions and approach goals. The patterns of associations among motivational constructs, and similarities and differences in the ways they predict each type of well-being, are discussed. Study 2: Using an experimental design, participants (N = 447, M age = 19.30, 88% female) were randomly assigned to one of eight experimental conditions, each involving a manipulation aimed at priming combinations of the three pairs of motivational constructs at the goal level. Participants then completed measures of both types of well-being. ANOVAs were used to assess the main effects and interactions of experimental condition for each of the three pairs of motivational constructs on well-being. Main effects of experimental conditions were non-significant. However, results indicated that focus on each of the three pairs of motivational constructs predicted well-being and that the manipulation impacted well-being indirectly, through experimentally-shifted motivational focus. Few interactions emerged. Implications for future experimental research and the conceptual integration of motivation and well-being constructs are discussed. In conclusion, Studies 1 and 2 inform the motivation and well-being fields in novel ways and provide preliminary steps towards studying these fields from an integrated and comprehensive motivational framework.

Reservoirs for irrigation, water-power and domestic water- supply ; with an account of various types of dams and the...

UANL

Types of relations between states and organized teachers as exemplified in education reform

Thèse diffusée initialement dans le cadre d'un projet pilote des Presses de l'Université de Montréal/Centre d'édition numérique UdeM (1997-2008) avec l'autorisation de l'auteur.

Leguminous cover crops differentially affect maize yields in three contrasting soil types of Kakamega, Western Kenya

Maize production in smallholder farming systems in Kenya is largely limited by low soil fertility. As mineral fertilizer is expensive, green manuring using leguminous cover crops could be an alternative strategy for farmers to enhance farm productivity. However due to variability in soil type and crop management, the effects of green manure are likely to differ with farms. The objectives of this study were to evaluate Mucuna pruriens and Arachis pintoi on (i) biomass and nitrogen fixation (^15N natural abundance), (ii) soil carbon and nitrogen stocks and (iii) their effects on maize yields over two cropping seasons in Kakamega, Western Kenya. Mucuna at 6 weeks accumulated 1–1.3 Mg ha^{-1} of dry matter and 33–56 kg ha^{-1} nitrogen of which 70% was nitrogen derived from the atmosphere (Ndfa). Arachis after 12 months accumulated 2–2.7 Mg ha^{-1} of dry matter and 51–74 kg N ha^{-1} of which 52-63 % was from Ndfa. Soil carbon and nitrogen stocks at 0–15 cm depth were enhanced by 2-4 Mg C ha^{-1} and 0.3–1.0 Mg N ha^{-1} under Mucuna and Arachis fallow, irrespective of soil type. Maize yield increased by 0.5-2 Mg ha^{-1} in Mucuna and 0.5–3 Mg ha^{-1} in Arachis and the response was stronger on Nitisol than on Acrisol or Ferralsol. We concluded that leguminous cover crops seem promising in enhancing soil fertility and maize yields in Kenya, provided soil conditions and rainfall are suitable.

Types of chart and storytelling

Two lectures, first part on charts, second on data stories

Distribution patterns of infection with multiple types of human papillomaviruses and their association with risk factors

Background: Infection with multiple types of human papillomavirus (HPV) is one of the main risk factors associated with the development of cervical lesions. In this study, cervical samples collected from 1,810 women with diverse sociocultural backgrounds, who attended to their cervical screening program in different geographical regions of Colombia, were examined for the presence of cervical lesions and HPV by Papanicolau testing and DNA PCR detection, respectively. Principal Findings: The negative binomial distribution model used in this study showed differences between the observed and expected values within some risk factor categories analyzed. Particularly in the case of single infection and coinfection with more than 4 HPV types, observed frequencies were smaller than expected, while the number of women infected with 2 to 4 viral types were higher than expected. Data analysis according to a negative binomial regression showed an increase in the risk of acquiring more HPV types in women who were of indigenous ethnicity (+37.8%), while this risk decreased in women who had given birth more than 4 times (-31.1%), or were of mestizo (-24.6%) or black (-40.9%) ethnicity. Conclusions: According to a theoretical probability distribution, the observed number of women having either a single infection or more than 4 viral types was smaller than expected, while for those infected with 2-4 HPV types it was larger than expected. Taking into account that this study showed a higher HPV coinfection rate in the indigenous ethnicity, the role of underlying factors should be assessed in detail in future studies.

Layers of generality and types of generalization in pattern activities. 'Niveles de generalidad y tipos de generalizaciones en actividades de patrones'.

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The influence of various types of question forms and test directions on the educational achievement of deaf and hearing children

This paper is a review of educational achievement tests and their suitability for hearing impaired children.