514 research outputs found

    The Early History of the Aramaeans and Their Contacts with Israel up to the Divided Kingdom

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    Of the Old Testament races and peoples, who had contacts with God\u27s chosen people, the Aramaeans, or as the English Bible terms them, Syrians, are one or the most colorful and fascinating. This is especially true because the history and career of the Aramaean people runs nearly parallel with that of the Israelites. They both appear on the scene at approximately the same time, and the history of both Aram and Israel also terminates about the same time

    The Writ of Sequestration in Louisiana

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    Can a Usufruct by Stipulated for a Term?

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    Hypertension: Development of a prediction model to adjust self-reported hypertension prevalence at the community level

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    Abstract Background Accurate estimates of hypertension prevalence are critical for assessment of population health and for planning and implementing prevention and health care programs. While self-reported data is often more economically feasible and readily available compared to clinically measured HBP, these reports may underestimate clinical prevalence to varying degrees. Understanding the accuracy of self-reported data and developing prediction models that correct for underreporting of hypertension in self-reported data can be critical tools in the development of more accurate population level estimates, and in planning population-based interventions to reduce the risk of, or more effectively treat, hypertension. This study examines the accuracy of self-reported survey data in describing prevalence of clinically measured hypertension in two racially and ethnically diverse urban samples, and evaluates a mechanism to correct self-reported data in order to more accurately reflect clinical hypertension prevalence. Methods We analyze data from the Detroit Healthy Environments Partnership (HEP) Survey conducted in 2002 and the National Health and Nutrition Examination (NHANES) 2001–2002 restricted to urban areas and participants 25 years and older. We re-calibrate measures of agreement within the HEP sample drawing upon parameter estimates derived from the NHANES urban sample, and assess the quality of the adjustment proposed within the HEP sample. Results Both self-reported and clinically assessed prevalence of hypertension were higher in the HEP sample (29.7 and 40.1, respectively) compared to the NHANES urban sample (25.7 and 33.8, respectively). In both urban samples, self-reported and clinically assessed prevalence is higher than that reported in the full NHANES sample in the same year (22.9 and 30.4, respectively). Sensitivity, specificity and accuracy between clinical and self-reported hypertension prevalence were ‘moderate to good’ within the HEP sample and ‘good to excellent’ within the NHANES sample. Agreement between clinical and self-reported hypertension prevalence was ‘moderate to good’ within the HEP sample (kappa =0.65; 95% CI = 0.63-0.67), and ‘good to excellent’ within the NHANES sample (kappa = 0.75; 95%CI = 0.73-0.80). Application of a ‘correction’ rule based on prediction models for clinical hypertension using the national sample (NHANES) allowed us to re-calibrate sensitivity and specificity estimates for the HEP sample. The adjusted estimates of hypertension in the HEP sample based on two different correction models, 38.1% and 40.5%, were much closer to the observed hypertension prevalence of 40.1%. Conclusions Application of a simple prediction model derived from national NHANES data to self-reported data from the HEP (Detroit based) sample resulted in estimates that more closely approximated clinically measured hypertension prevalence in this urban community. Similar correction models may be useful in obtaining more accurate estimates of hypertension prevalence in other studies that rely on self-reported hypertension.http://deepblue.lib.umich.edu/bitstream/2027.42/112834/1/12913_2011_Article_2187.pd

    Biomarker profiles of acute heart failure patients with a mid-range ejection fraction

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    OBJECTIVES: In this study, the authors used biomarker profiles to characterize differences between patients with acute heart failure with a midrange ejection fraction (HFmrEF) and compare them with patients with a reduced (heart failure with a reduced ejection fraction [HFrEF]) and preserved (heart failure with a preserved ejection fraction [HFpEF]) ejection fraction. BACKGROUND: Limited data are available on biomarker profiles in acute HFmrEF. METHODS: A panel of 37 biomarkers from different pathophysiological domains (e.g., myocardial stretch, inflammation, angiogenesis, oxidative stress, hematopoiesis) were measured at admission and after 24 h in 843 acute heart failure patients from the PROTECT trial. HFpEF was defined as left ventricular ejection fraction (LVEF) of ≄50% (n = 108), HFrEF as LVEF of <40% (n = 607), and HFmrEF as LVEF of 40% to 49% (n = 128). RESULTS: Hemoglobin and brain natriuretic peptide levels (300 pg/ml [HFpEF]; 397 pg/ml [HFmrEF]; 521 pg/ml [HFrEF]; ptrend <0.001) showed an upward trend with decreasing LVEF. Network analysis showed that in HFrEF interactions between biomarkers were mostly related to cardiac stretch, whereas in HFpEF, biomarker interactions were mostly related to inflammation. In HFmrEF, biomarker interactions were both related to inflammation and cardiac stretch. In HFpEF and HFmrEF (but not in HFrEF), remodeling markers at admission and changes in levels of inflammatory markers across the first 24 h were predictive for all-cause mortality and rehospitalization at 60 days (pinteraction <0.05). CONCLUSIONS: Biomarker profiles in patients with acute HFrEF were mainly related to cardiac stretch and in HFpEF related to inflammation. Patients with HFmrEF showed an intermediate biomarker profile with biomarker interactions between both cardiac stretch and inflammation markers. (PROTECT-1: A Study of the Selective A1 Adenosine Receptor Antagonist KW-3902 for Patients Hospitalized With Acute HF and Volume Overload to Assess Treatment Effect on Congestion and Renal Function; NCT00328692)

    Particulate matter concentrations in residences: an intervention study evaluating stand‐alone filters and air conditioners

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    This study, a randomized controlled trial, evaluated the effectiveness of free‐standing air filters and window air conditioners (ACs) in 126 low‐income households of children with asthma. Households were randomized into a control group, a group receiving a free‐standing HEPA filter placed in the child’s sleeping area, and a group receiving the filter and a window‐mounted AC. Indoor air quality (IAQ) was monitored for week‐long periods over three to four seasons. High concentrations of particulate matter (PM) and carbon dioxide were frequently seen. When IAQ was monitored, filters reduced PM levels in the child’s bedroom by an average of 50%. Filter use varied greatly among households and declined over time, for example, during weeks when pollutants were monitored, filter use was initially high, averaging 84 ± 27%, but dropped to 63 ± 33% in subsequent seasons. In months when households were not visited, use averaged only 34 ± 30%. Filter effectiveness did not vary in homes with central or room ACs. The study shows that measurements over multiple seasons are needed to characterize air quality and filter performance. The effectiveness of interventions using free‐standing air filters depends on occupant behavior, and strategies to ensure filter use should be an integral part of interventions. Practical Implications Environmental tobacco smoke (ETS) increased particulate matter (PM) levels by about 14 Όg/m 3 and was often detected using ETS‐specific tracers despite restrictions on smoking in the house as reported on questionnaires administered to caregivers. PM concentrations depended on season, filter usage, relative humidity, air exchange ratios, number of children, outdoor PM levels, sweeping/dusting, and presence of a central air conditioner (AC). Free‐standing air filters can be an effective intervention that provides substantial reductions in PM concentrations if the filters are used. However, filter use was variable across the study population and declined over the study duration, and thus strategies are needed to encourage and maintain use of filters. The variability in filter use suggests that exposure misclassification is a potential problem in intervention studies using filters. The installation of a room AC in the bedroom, intended to limit air exchange ratios, along with an air filter, did not lower PM levels more than the filter alone.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91183/1/j.1600-0668.2011.00761.x.pd

    Acute Effects of Single Versus Combined Inhaled ÎČ2-Agonists Salbutamol and Formoterol on Time Trial Performance, Lung Function, Metabolic and Endocrine Variables

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    Background High prevalence rates of ÎČ2-agonist use among athletes in competitive sports makes it tempting to speculate that illegitimate use of ÎČ2-agonists boosts performance. However, data regarding the potential performance-enhancing effects of inhaled ÎČ2-agonists and its underlying molecular basis are scarce. Methods In total, 24 competitive endurance athletes (12f/12m) participated in a clinical double-blinded balanced four-way block cross-over trial to investigate single versus combined effects of ÎČ2-agonists salbutamol (SAL) and formoterol (FOR), to evaluate the potential performance enhancement of SAL (1200 ”g, Cyclocaps, Pb Pharma GmbH), FOR (36 ”g, Sandoz, HEXAL AG) and SAL + FOR (1200 ”g + 36 ”g) compared to placebo (PLA, Gelatine capsules containing lactose monohydrate, Pharmacy of the University Hospital Ulm). Measurements included skeletal muscle gene and protein expression, endocrine regulation, urinary/serum ÎČ2-agonist concentrations, cardiac markers, cardiopulmonary and lung function testing and the 10-min time trial (TT) performance on a bicycle ergometer as outcome variables. Blood and urine samples were collected pre-, post-, 3 h post- and 24 h post-TT. Results Mean power output during TT was not different between study arms. Treatment effects regarding lung function (p < 0.001), echocardiographic (left ventricular end-systolic volume p = 0.037; endocardial global longitudinal strain p < 0.001) and metabolic variables (e.g. NR4A2 and ATF3 pathway) were observed without any influence on performance. In female athletes, total serum ÎČ2-agonist concentrations for SAL and FOR were higher. Microarray muscle gene analysis showed a treatment effect for target genes in energy metabolism with strongest effect by SAL + FOR (NR4A2; p = 0.001). Of endocrine variables, follicle-stimulating hormone (3 h Post–Post-TT), luteinizing hormone (3 h Post–Pre-TT) and insulin (Post–Pre-TT) concentrations showed a treatment effect (all p < 0.05). Conclusions No endurance performance-enhancing effect for SAL, FOR or SAL + FOR within the permitted dosages compared to PLA was found despite an acute effect on lung and cardiac function as well as endocrine and metabolic variables in healthy participants. The impact of combined ÎČ2-agonists on performance and sex-specific thresholds on the molecular and cardiac level and their potential long-term performance enhancing or health effects have still to be determined. Trial registration: Registered at Eudra CT with the number: 2015-005598-19 (09.12.2015) and DRKS with number DRKS00010574 (16.11.2021, retrospectively registered)

    Screening of brazilian plants for the presence of peroxides

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    Extratos clorofĂłrmicos ou diclorometĂąnicos de 357 espĂ©cies vegetais de ocorrĂȘncia no sul do Brasil foram testados quanto Ă  presença de perĂłxidos, atravĂ©s de cromatografia em camada delgada, utilizando o reagente de detecção de Huber & Fröhlke. Das espĂ©cies testadas, 71 (20%) apresentaram resultado positivo, a maioria delas (56%) pertencentes Ă  famĂ­lia Asteraceae. A maioria das espĂ©cies testadas pertencia a Asteraceae, mas outras 55 famĂ­lias foram tambĂ©m testadas, abrangendo um total de 77 gĂȘneros.Chloroform or dichloromethane extracts of 357 southern Brazilian plant species were tested for the presence of peroxides by thinlayer chromatography, using the spray reagent from Huber & Fröhlke. From the species tested, 71 (20%) showed positive results and most of them (56%) are Asteraceae species. The species tested were mainly from Asteraceae, but 55 more families were screened, in a total of 77 genera surveyed
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