Prediction of calculated future cardiovascular disease by monocyte count in an asymptomatic population

Deirdre F Waterhouse1, Ronan A Cahill2, Frances Sheehan2, CJ McCreery11Department of Cardiovascular Medicine, St Vincent’s University Hospital, Dublin, Ireland; 2Department of Preventative Medicine, Blackrock Clinic, Dublin, IrelandIntroduction: Although atherogenesis is clearly entwined with systemic inflammation, the risk-predictive relationship between preclinical and overt cardiovascular disease (CVD) and systemic white blood cell (WBC) subtypes remains unclear. Implication of an association would greatly facilitate cardiac risk prediction, assessment and monitoring.Methods: 1383 asymptomatic individuals (795 men, 588 women) attending for executive health screening were examined clinically as well as with phlebotomy and exercise stress testing to determine their ten-year risk of developing overt cardiovascular disease (as estimated by both Framingham and SCORE calculations). The significance of their association with overall WBC and subtypes were determined using both univariate and multiple regression modeling.Results: Of all WBC subtypes, monocyte count was found to have the strongest, independentrelationship with overall CVD risk by backwards linear regression modeling (Framingham: β = 0.057; p = 0.03; SCORE: β = 0.128; p = <0.0005). Independent associations with BMI (β = 5.214; p = <0.0005), waist circumference (β = 21.866; p = <0.0005), systolic blood pressure (β = 10.738; p = 0.003), HDL cholesterol (β = −0.639; p = <0.0005) and triglyceride concentrations (β = 0.787; p = <0.0005) were also evident. Overall WBC along with neutrophils, lymphocytes and basophil subfractions were variably (but less strongly) associated with such dependents and outcome measures.Conclusions: In conclusion, monocyte count, a simple inexpensive test, may provide useful predictive cardiovascular risk information in asymptomatic individuals to inform and guide attempts at interrupting CVD development at a preclinical stage.Keywords: leukocyte, white cell count, monocyte, cardiovascular risk, asymptomatic populatio

Spontaeneous subacute portomesenteric venous thrombosis: a case report

Although uncommon and often asymptomatic, portal venous thrombosis can have catastrophic consequences for the individual it afflicts, particularly when the process propagates to involve the superior mesenteric vein. Familiarity with the condition's pathogenesis and presentation however permits early diagnosis and allows aggressive conservative management to achieve a successful outcome. Here we describe the successful outcome of such management for a 42-year-old male patient who developed this condition spontaneously

Oxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial

Objectives To determine the effects of adding an oxytocin infusion to bolus oxytocin on blood loss at elective caesarean section

Moderate-intensity aerobic and resistance exercise is safe and favorably influences body composition in patients with quiescent Inflammatory Bowel Disease: a randomized controlled cross-over trial

peer-reviewedBackground Overweight and metabolic problems now add to the burden of illness in patients with Inflammatory Bowel Disease. We aimed to determine if a program of aerobic and resistance exercise could safely achieve body composition changes in patients with Inflammatory Bowel Disease. Methods A randomized, cross-over trial of eight weeks combined aerobic and resistance training on body composition assessed by Dual Energy X-ray Absorptiometry was performed. Patients in clinical remission and physically inactive with a mean age of 25 ± 6.5 years and Body Mass Index of 28.9 ± 3.8 were recruited from a dedicated Inflammatory Bowel Disease clinic. Serum cytokines were quantified, and microbiota assessed using metagenomic sequencing. Results Improved physical fitness was demonstrated in the exercise group by increases in median estimated VO2max (Baseline: 43.41mls/kg/min; post-intervention: 46.01mls/kg/min; p = 0.03). Improvement in body composition was achieved by the intervention group (n = 13) with a median decrease of 2.1% body fat compared with a non-exercising group (n = 7) (0.1% increase; p = 0.022). Lean tissue mass increased by a median of 1.59 kg and fat mass decreased by a median of 1.52 kg in the exercising group. No patients experienced a deterioration in disease activity scores during the exercise intervention. No clinically significant alterations in the α- and β-diversity of gut microbiota and associated metabolic pathways were evident. Conclusions Moderate-intensity combined aerobic and resistance training is safe in physically unfit patients with quiescent Inflammatory Bowel Disease and can quickly achieve favourable body compositional changes without adverse effects. Trial registration The study was registered at ClinicalTrials.gov; Trial number: NCT02463916

L&D professionals in organisations: much ambition, unfilled promise

This monograph reports a study investigating the roles of learning and development (L&D) professionals in Irish, UK European and US organisations. The study investigates the contextual factors influencing L&D roles in organisations, the strategic and operational roles that L&D professionals play in organisations, the competencies and career trajectories of L&D professionals, the perceptions of multiple internal stakeholders of the effectiveness of L&D and the relationships between context, L&D roles, competencies/expertise, and perceived effectiveness. We gathered data using multiple methods: survey (n=440), Delphi study (n=125) and semi-structured interviews (n=30). The analysis revealed that L&D professionals increasingly respond to a multiplicity of external and internal contextual influences and internal stakeholders perceived the effectiveness of L&D professionals differently with significant gaps in perceptions of what L&D contributes to organisational effectiveness. L&D professionals perform both strategic and operational roles in organisations and they progress through four career levels. Each L&D role and career level requires a distinct and unique set of foundational competencies and L&D expertise. Finally, we found that different contextual predictors were important in explaining the perceived effectiveness of L&D roles and the importance attached to different foundational competencies and areas of L&D expertise. We discuss the implications for theory, research and practice

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Alcohol abuse: prevalence and detection in general hospital.

Alcohol abuse and dependence commonly go undetected in hospital inpatients, despite a high prevalence of alcohol-related disabilities and the availability of cost-effective interventions. In a university teaching hospital, three well validated screening methods for sensitivity and specificity were compared; the Alcohol Use Disorders Identification Test (AUDIT, with various cut-off scores), CAGE (a four-question screening tool), and a 10-question version of the Michigan Alcoholism Screening Test (BMAST). A subset of patients also completed the DSM IV structured clinical interview for diagnosis. 1133 adult patients were randomly selected from all hospital admissions, excluding day cases and patients too ill to be interviewed. Two-thirds of the patients were interviewed, the remainder were unavailable at the time. 30% of the men and 8% of the women met the DSM IV criteria for alcohol abuse or dependence. Sensitivities and specificities of the screening tools were as follows: AUDIT (with cut-off score >8) 89% and 91%; CAGE 77% and 99%; BMAST 37% and 100%. 255 case records of patients scoring above the cut-off on one or more questionnaires were subsequently reviewed. The admitting team recognised an alcohol problem in only 46, of whom 17 were referred for appropriate follow up. As in previous hospital surveys, alcohol abuse and dependence was not receiving proper attention. The most efficient screening tool was the CAGE questionnaire

Innovation and human resource development (HRD)

Purpose – The purpose of this paper is to provide a prologue to the issue of human resource development (HRD) and innovation which has been under-researched despite the widespread recognition of the critical role of innovation for sustained national, regional and organisational competitiveness. Design/methodology/approach – The paper provides an overview of the evolution of innovation within the economic and management literatures. It then examines previous work on human resource management (HRM), HRD and innovation. The paper then provides a brief overview of the articles for this issue focussing on HRD and innovation. Findings – HRD interventions can positively contribute to organisation's innovation activities. HRD is also found to positively influence employee engagement, leadership, manager's motivation to learn, the promotion of a learning culture, and social capital development all of which are positively associated with innovation. Informal HRD and access to mentors and coaches is shown to be critical for innovation in SMEs. Originality/value – This paper provides an introduction to this special issue on HRD and innovation. It shows that this has been an under-researched area and it also emphasises that HRD and its relationship with innovation must be analysed within the context of the organisation's culture, its context, and its leadership capabilities. The four conceptual contributions provide a rich road map for future research on HRD and innovation

Sustainability, corporate social responsibility and HRD

Purpose – The purpose of this paper is to provide a prologue to the issue of sustainability, corporate social responsibility (CSR) and human resource development (HRD). Although issues of sustainability and CSR have become an important topic of research, there are few studies on this topic in the field of HRD. To address this gap, we edited a special issue of European Journal of Training and Development that explicitly focuses attention on sustainability and CSR issues in HRD. Design/methodology/approach – The paper provides an overview of the conceptualisation of sustainability and CSR and their relevance for the concept of sustainable HRD. We then outline the contributions of the authors of the six papers that make up the special issue. Findings – There are issues related to the conceptualisation and measurement of sustainability, CSR and sustainable HRD. The role that HRD plays in contributing to sustainability and CSR in organisations is not well understood. Originality/value – The paper introduces the special issue on sustainability, CSR and HRD. It shows that this is an under-researched area. However, we propose that a focus on sustainability and CSR will serve to advance the field of HRD and contribute to enhancing practices within organisations