Influence of Mediation on Estate Planning Decisions: Evidence from Indian Survey Data

Background: Intestate death can lead to the distribution of assets against the personal wishes of the deceased and is a problem in India, as 80% of Indians die without making a last will. Following the concepts of decision theory (i.e., the theory of choice), stewardship theory, agency theory, and signaling theory, the purpose of this study is to examine the influence of meditation on estate planning decisions. This study also seeks to extend previous findings on the influence of religious beliefs on the estate planning decisions of Canadians to that of Indians. Methods: Employed and self-employed individuals from India were surveyed regarding their perceptions of meditation and estate planning decisions. Results: The survey indicates that mediation positively influences the estate planning decisions while individuals who practice meditation have greater preferences for estate planning compared with those who do not. The findings suggest that individual assets, family size, and education positively influence the estate planning decisions of Indians. Conclusion: Reported meditation, individual assets, family size, location, education, and gender are positively correlated with the estate planning decisions of Indians

Factors Affecting Ethical Sources of External Debt Financing for Indian Agribusiness Firms

Majority of the Indian farmers are financially constrained and pay very high interest rate to private moneylenders which has a negative impact on the survivability and growth of agribusiness firms. Because of less strict debt financing requirements farmers become prey to predatory lenders from private lending institutions that are not controlled by the central bank and may not behave in an ethical way. The study investigates factors affecting ethical sources of external debt financing by taking a sample of Indian agribusiness firms. Owners of agribusiness firms were interviewed through personal visits and telephone calls regarding the factors affecting ethical sources of external debt financing. The findings show that several factors affect ethical sources of external debt financing for agribusiness firms in India. This study contributes to the literature on the factors that affect ethical sources of external debt financing. This study also provides recommendations to improve access to ethical sources of external debt financing. The findings may be useful for agribusiness owners (farmers), financial managers, investors, agribusiness management consultants, entrepreneurs, and other stakeholders

Impaired glucose tolerance or newly diagnosed diabetes mellitus diagnosed during admission adversely affects prognosis after myocardial infarction: An observational study

Objective To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI). Research Design and Methods Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on predischarge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE. Results Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06–2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42–3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points. Conclusion Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention

The adrenal cortex and the kidney

The adrenal cortex regulates renal function in a number of important ways; indeed, normal renal function cannot be understood without recognition of such regulation. Well-recognized examples of such regulation are the control of body fluid tonicity through regulation of urinary solute concentration-a function controlled “primarily” by vasopressin, but secondarily and importantly by the adrenal cortex-and control of body sodium-a function controlled primarily by renal tubular sodium reabsorption but regulated by sodium-retaining steroids.The kidney can regulate adrenal function by changing reabsorption of sodium and secretion of potassium, and also by release of renin. The primary target of such regulation is the secretion of aldosterone, which may be influenced by body fluid volume, potassium ion and angiotensin II.Because of these interrelationships, the pathophysiology of certain disease states may be described as aberrations in feedback loops between adrenal cortex and kidney. In this paper we will consider this “system” in some detail, and attempt to explain four disorders as examples of errors in control.In the form of “primary” aldosteronism resulting from hyperplasia of all adrenal cortical tissue, overproduction of aldosterone persists in the absence of all known stimulatory factors. In renovascular hypertension, angiotensin and aldosterone production may persist despite systemic hypertension. In the non-salt-losing form of the adrenogenital syndrome of congenital adrenal hyperplasia without treatment, failure of feedback inhibition by Cortisol may result in overproduction of adrenocorticotropic hormone (ACTH) which, in turn, may lead to overproduction of progesterone. Progesterone may cause sodium loss and overproduction of renin and aldosterone while blocking their effects. In the syndrome of juxtaglomerular hyperplasia with normal blood pressure, overproduction of renin may result from unresponsiveness of blood vessels leading to a lack of feedback inhibition by pressure rise. Under certain circumstances sodium loss can potentiate both the overproduction and the unresponsiveness. Excessive renin leads to aldosteronism and potassium loss

Intravenous digital subtraction angiography in the assessment of patients with left to right shunts before and after surgical correction

Pre- and postoperative structural changes and pulmonary to systemic flow (QP/QS) ratios were assessed using digital angiography in 34 patients documented to have a left to right shunt at cardiac catheterization. There were 16 men and 18 women whose ages ranged from 4 months to 60 years. The radiographic single mask mode was used for all digital subtraction angiographic studies with a typical radiographic sequence being 80 to 100 kV, 5 to 10 mA/frame at six frames/s for 15 seconds. Renografin-76 was used as a bolus injection at 0.5 to 1.0 ml/kg via an arm vein in most patients. The level of the left to right shunt and any associated anomalies were noted and compared with results from cardiac catheterization. Digital subtraction angiographic flow curves were generated from the pulmonary arteries, and QP/QS ratios were calculated pre- and postoperatively using the gamma variate fit method and compared with the QP/QS ratio from first pass radionuclide studies.A strong correlation between preoperative digital subtraction angiographically derived QP/QS ratio and radionuclide-derived QP/QS ratio was found, with an r value equal to 0.89, p < 0.0001. Postoperatively, all patients had a QP/QS ratio less than 1.2:1.0 for both digital subtraction angiography and radionuclide studies. The level of left to right shunt was accurately assessed in all patients, and its absence observed postoperatively. Associated anomalies, such as a persistent left superior vena cava, coarctation of the aorta and partial anomalous venous return, were identified in all cases.Intravenous digital subtraction angiography provides accurate quantitative and anatomic data in patients with a left to right shunt, is potentially an important outpatient method to assess adequate surgical correction and may suffice preoperatively to proceed to cardiac surgery without preoperative cardiac catheterization

Tables and graphs of measurements made across four Cape Cod beaches 1957-1958

Originally issued as Reference No. 61-4, series later renamed WHOI-.The primary purpose of this report is to present tables of measurements made across four Cape Cod beaches.The field work was supported entirely by the Geography Branch of the Office of Naval Research under contract number Nonr-1254 (00) (NR-388 - 018)

Intracranial Myeloid Sarcoma Metastasis Mimicking Acute Subdural Hematoma

Myeloid sarcoma, a rare consequence of myeloproliferative disorders, is rarely seen in the central nervous system, most commonly in the pediatric population. Although there are a handful of case reports detailing initial presentation of CNS myeloid sarcoma in the adult population, we have been unable to find any reports of CNS myeloid sarcoma presenting as a large mass lesion in a herniating patient. Here, we present the case of a patient transferred to our facility for a very large subdural hematoma. Based on imaging characteristics, it was felt to be a spontaneous hematoma secondary to coagulopathy. No coagulopathy was found. Interestingly, he did have a history of acute myeloid leukemia (AML) diagnosed 2 months previously, and intraoperatively he was found to have a confluent white mass invading both the subdural and subarachnoid spaces. There was minimal associated hemorrhage and final pathology showed myeloid sarcoma. This is the first report we are aware of in which CNS myeloid sarcoma presented as a subdural metastasis and also the first report in which we are aware of this etiology causing a herniation syndrome secondary to mass effect

Molecular characterization of articular cartilage from young adults with femoroacetabular impingement

BACKGROUND: Femoroacetabular impingement is a frequent cause of hip pain and may lead to secondary osteoarthritis, yet little is known about the molecular events linking mechanical hip impingement and articular cartilage degeneration. The first goal of this study was to quantify the expression of inflammatory cytokine and chemokine, matrix-degrading, and extracellular matrix genes in articular cartilage harvested from control hips and hips with femoroacetabular impingement and end-stage osteoarthritis. The second goal was to analyze the relative expression of these genes in articular cartilage harvested at various stages of osteoarthritis. METHODS: Cartilage samples were obtained from thirty-two hips undergoing hip preservation surgery for femoroacetabular impingement or hip arthroplasty. Three control cartilage samples were also analyzed. Specimens were graded intraoperatively with regard to the severity of cartilage damage, the radiographic osteoarthritis grade was recorded, and quantitative RT-PCR (real-time polymerase chain reaction) was performed to determine relative gene expression. RESULTS: Except for interleukin-1β (IL-1β) and CXCL2, the mRNA (messenger RNA) expression of all other chemokine (IL-8, CXCL1, CXCL3, CXCL6, CCL3, and CCL3L1), matrix-degrading (matrix metalloproteinase [MMP]-13 and ADAMTS-4), and structural matrix (COL2A1 [collagen, type II, alpha] and ACAN [aggregan]) genes was higher overall in cartilage from hips with femoroacetabular impingement compared with hips with osteoarthritis and normal controls. The differences reached significance (p ≤ 0.05) for seven of these ten quantified genes, with CXCL3, CXCL6, and COL2A1 being elevated in the femoroacetabular impingement group compared with only the control group and IL-8, CCL3L1, ADAMTS-4, and ACAN being elevated compared with both the osteoarthritis and control groups. When samples were grouped according to the stage of the degenerative cascade, mRNA expression was relatively higher in one of the two middle stages of femoroacetabular impingement (chondromalacia or cleavage/thinning), with the difference reaching significance for IL-8, CXCL2, CXCL3, CCL3L1, and ACAN. ACAN expression was diminished in hips with osteoarthritis compared with femoroacetabular impingement but elevated compared with the control articular cartilage. CONCLUSIONS: Articular cartilage from the impingement zone of hips with femoroacetabular impingement (and particularly those hips in the cleavage/thinning stage) expressed higher levels of certain inflammatory, anabolic, and catabolic genes, representing a heightened metabolic state. CLINICAL RELEVANCE: The articular cartilage from the impingement zone of hips with femoroacetabular impingement was metabolically hyperactive, supporting the concept that such impingement is a structural precursor to hip osteoarthritis