Individual patient meta-analysis of exercise training effects on systemic brain natriuretic peptide expression in heart failure

Background: Brain natriuretic peptide (BNP) predicts exercise performance and exercise training may modulate BNP and its N-terminal portion (NT-pro-BNP), we therefore conducted an individual patient analysis of exercise training effects on BNP and NT-pro-BNP. Aims: To use an individual patient meta-analysis to relate changes in BNP, NT-pro-BNP, and peak VO2; to link these changes to volume parameters of exercise training programmes (intensity etc.); and to identify patient characteristics likely to lead to greater improvements in BNP, NT-pro-BNP, and peak VO2. Design: Individual patient meta-analysis. Methods: A systematic search was conducted of Med line (Ovid), Embase.com, Cochrane Central Register of Controlled Trials, and CINAHL (until July 2008) to identify randomized controlled trials of aerobic and/or resistance exercise training in systolic heart failure patients measuring BNP and/or NT-pro-BNR Primary outcome measures were change in BNP, NT-pro-BNP, and peak VO2. Subanalyses were conducted to identify (I) patient groups that benefit most and (2) exercise programme parameters enhancing favourable changes in primary outcome measures. Results: Ten randomized controlled studies measuring BNP or NT-pro-BNP met eligibility criteria, authors provided individual patient data for 565 patients (313 exercise and 252 controls). Exercise training had favourable effects on BNP (-28.3%, p < 0.0001), NT-pro-BNP (-37.4%, p = 0.0001), and peak VO2 (17.8%, p < 0.0001). The analysis showed a significant change in primary outcome measures; moreover, change in BNP (r = 0.31, p < 0.0001) and NT-pro-BNP (r = 0.22, p < 0.0001) were correlated with peak VO2 change. Conclusion: Exercise training has favourable effects on BNP, NT-pro-BNP, and peak VO2 in heart failure patients and BNP/NT-pro-BNP changes were correlated with peak VO2 changes

Między kryzysem a współpracą gospodarczą: przykłady wyzwań i problemów w stosunkach międzynarodowych końca pierwszej dekady XXI wieku

Praca recenzowana / peer-reviewed paper Materiały z IX Międzynarodowej Konferencji Naukowej Krakowskiej Akademii im. Andrzeja Frycza Modrzewskiego "Państwo - Gospodarka - Społeczeństwo

Unsicherheits- und Sensitivitaetsanalyse von Anwendungen des Programmsystems PARK

The (PARK) program package for assessment and abatement of off-site radiological consequences of nuclear accidents establishes radiologic analyses and prognoses on the basis of the measured data obtained by the IMIS system for ambient radiation monitoring. A probabilistic uncertainty and sensitivity analysis has been performed of the PARK-based mean specific activities of fodder and food and the potential radiation exposure of the population. Uncertainties were expressed in model input parameters, i.e. in measured values and radioecologic parameters via subjective probability distributions, within the framework of various emission scenarios (nuclide spectra describing two release modes, dry and wet deposition, and at three times over a one-year period). The resulting output data distributions were determined by Monte Carlo simulations. As a rule, the results of the analyses depend on the selected emission scenario. Measured values proved to be the major source of uncertainties (especially from in-situ soil activity measurements), and also the activity transfer data from fodder to food. As for wet deposition, uncertainties were added by the parameters used for determination of the interception factors. As the measuring stations cannot correlate their measured gamma dose rates with meteorologic data (precipitations), derived information relating to larger areas such as a ''Kreis'' (administrative district) is very much subject to uncertainties. The uncertainties of the PARK results are increasing with assessed increases in rainfall. (orig.)Das Programmsystem zur Abschaetzung und Begrenzung radiologischer Konsequenzen (PARK) erstellt radiologische Analysen und Prognosen aufgrund von Messdaten, welche im Rahmen des Integrierten Mess- und Informationssystems zur Ueberwachung der Umweltradioaktivitaet (IMIS) erhoben werden. Es wurde eine probabilistische Unsicherheits- und Sensitivitaetsanalyse fuer die in PARK berechneten mittleren spezifischen Aktivitaeten von Futter- und Lebensmitteln und potentiellen Strahlenexpositionen der Bevoelkerung durchgefuehrt. Fuer verschiedene Immissions-Szenarien (Nuklidspektren fuer zwei Freisetzungsarten, fuer nasse und fuer trockene Ablagerung und fuer drei Zeitpunkte im Jahr) wurden die Unsicherheiten in Modell-Inputparametern, d.h. Messwerten und radiooekologischen Parametern durch subjektive Wahrscheinlichkeitsverteilungen ausgedrueckt. Die daraus resultierenden Verteilungen der Outputgroessen wurden mit Monte Carlo Simulationen bestimmt. Die Ergebnisse der Unsicherheits- und Sensitivitaetsanalyse haengen im allgemeinen von dem betrachteten Immissions-Szenario ab. Die groessten Beitraege zur Unsicherheit der berechneten Groessen kamen in den meisten Faellen von Messwerten (insbesondere der in-situ Messung der Bodenaktivitaet) und vom Aktivitaetstransfer vom Futter zum Nahrungsmittel. Im Fall der nassen Deposition kommen die Unsicherheiten von Parametern hinzu, die zur Bestimmung des Interzeptionsfaktors (Anteil der nass deponierten Aktivitaet, der vom Plfanzenbestand zurueckgehalten wird) dienen. Die an Mess-Stationen der Gammadosisleistung fehlende Information ueber Niederschlaege macht die Aussagen auf Kreisebene sehr unsicher. Der Unsicherheitsbereich der PARK-Rechenergebnisse nimmt mit der abgeschaetzten Regenmenge zu. (orig.)SIGLEAvailable from FIZ Karlsruhe / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Bonn (Germany)DEGerman

Managing enterprise and regional development: selected ecological and social aspects

Praca recenzowana / peer-reviewed pape