The Complex Relationship Between Serum Uric Acid, Endothelial Function and Small Vessel Remodeling in Humans

Aims: The relationship between serum uric acid (SUA) and microvascular remodeling in humans remains largely unexplored. We assessed whether SUA provides additional information on the severity of microvascular remodeling than that obtained from the European Heart Score (HS), the patterns of microvascular remodeling associated with changes in SUA levels and the mediation by endothelial function and nitric oxide (NO) availability on this relationship. Methods: A total of 162 patients included in the microvascular dataset of the Italian Society of Hypertension with available information on SUA, media-to-lumen (M/L) ratio, media cross-sectional area (MCSA), endothelial function, NO availability and HS were included in the analysis. The top tertile of M/L ratio and MCSA were used to define severe microvascular remodeling. Results: A U-shaped association was observed between SUA and both M/L ratio and MCSA. Adjustment for HS did not affect these associations. SUA was able to reclassify a significant number of subjects without, and with, severe M/L ratio and MCSA remodeling over the HS alone. The microvascular remodeling associated with SUA levels presented a predominant hypertrophic pattern. SUA was inversely associated with endothelial function and NO availability. Structural equation modeling analysis controlling for the HS suggested that the association of SUA with M/L ratio and MCSA was mediated through changes in endothelial function and NO availability. Conclusions: The addition of SUA to the HS improves the identification of subjects with greater microvascular remodeling. The relationship between SUA and microvascular remodeling is mediated by endothelial function and NO availability

Serum uric acid / serum creatinine ratio as a predictor of cardiovascular events. Detection of prognostic cardiovascular cut-off values

Objective: In the frame of the Uric Acid Right for Heart Health (URRAH) study, a nationwide multicenter study involving adult participants recruited on a regional community basis from all the territory of Italy under the patronage of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension, we searched for the cut-off values of the ratio between serum uric acid (SUA) and serum creatinine (sCr) able to predict cardiovascular (CV) events. Methods: Among 20 724 participants followed-up for 126 ± 64 months, after detecting cut-off by the receiver operating characteristic curves, we calculated by Cox models adjusted for confounders having CV events as dependent variable the hazard ratio (HR) of SUA/sCr > cut-off. We also verified if the role of cut-off varied with increasing SUA/sCr. Results: A plausible prognostic cut-off of SUA/sCr was found and was the same in the whole database, in men and in women (>5.35). The HR of SUA/sCr > cut-off was 1.159 (95% confidence interval [CI] 1.092-1.131, P < 0.03) in all, 1.161 (95% CI 1.021-1.335, P < 0.02) in men, and 1.444 (95% CI 1.012-1.113, P < 0.03) in women. In increasing quintiles of SUA/sCr the cut-offs were >3.08, >4.87, >5.35, >6.22 and >7.58, respectively. The HRs significantly increased from the 3rd to the 5th quintile (1.21, 95% CI 1.032-1.467, P = 0.018; 1.294, 95% CI 1.101-1.521, P = 0.002; and 1.642, 95% CI 1.405-1.919, P < 0.0001; respectively), that is, over 5.35, whereas the 2nd quintile was not significantly different from the 1st (reference). Conclusion: Having SUA/sCr >5.35 is an independent CV risk indicator both in men and women. The cut-off is dynamic and significantly increases with increasing SUA/sCr

Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

High serum uric acid (SUA) and triglyceride (TG) levels might promote high-cardiovascular risk phenotypes across the cardiometabolic spectrum. However, SUA predictive power in the presence of normal and high TG levels has never been investigated. We included 8124 patients from the URic acid Right for heArt Health (URRAH) study cohort who were followed for over 20 years and had no established cardiovascular disease or uncontrolled metabolic disease. All-cause mortality (ACM) and cardiovascular mortality (CVM) were explored by the Kaplan-Meier estimator and Cox multivariable regression, adopting recently defined SUA cut-offs for ACM (≥4.7 mg/dL) and CVM (≥5.6 mg/dL). Exploratory analysis across cardiometabolic subgroups and a sensitivity analysis using SUA/serum creatinine were performed as validation. SUA predicted ACM (HR 1.25 [1.12-1.40], p < 0.001) and CVM (1.31 [1.11-1.74], p < 0.001) in the whole study population, and according to TG strata: ACM in normotriglyceridemia (HR 1.26 [1.12-1.43], p < 0.001) and hypertriglyceridemia (1.31 [1.02-1.68], p = 0.033), and CVM in normotriglyceridemia (HR 1.46 [1.23-1.73], p < 0.001) and hypertriglyceridemia (HR 1.31 [0.99-1.64], p = 0.060). Exploratory and sensitivity analyses confirmed our findings, suggesting a substantial role of SUA in normotriglyceridemia and hypertriglyceridemia. In conclusion, we report that SUA can predict ACM and CVM in cardiometabolic patients without established cardiovascular disease, independent of TG levels

Software piracy and scientific publications: knowledge economy evidence from Africa

This paper is an extension of the debate on the nexus between the strength of IPRs and prospects for knowledge economy. It assesses the relationships between software piracy and scientific publications in African countries for which data is available. The findings which reveal a positive nexus are broadly consistent with the school of thought postulating that, the East Asian miracle has been largely due to weaker IPRs regimes at the early stages of development. As a policy implication, less stringent IPRs regimes on scientific-related software (at least in the short-run) will substantially boost contributions to and dissemination of knowledge through scientific and technical publications in Africa. IPRs laws (treaties) on scientific-oriented software should be strengthened in tandem with progress in: scientific and technical publications and; knowledge spillovers essential for economic growth and development. More policy implications are discussed

Back Officen toimintojen kehittäminen rahoitusalan yrityksessä

Työ muuttuu jatkuvasti maailman mukana ja yritysten tulee pysyä kehityksessä mukana. Toimintatapojen ja oman osaamisen kehittäminen on tärkeää, jotta työtä pystyy tekemään tehokkaasti. Ajanhallinta ja itsensä johtaminen ovat taitoja, jotka jokaisen työntekijän tulisi omata. Opinnäytetyö toteutettiin rahoitusalan yrityksen yritysrahoituksen osastolla. Tämän päiväkirjamuotoisen opinnäytetyön tavoitteena oli Back Officen prosessien parantaminen, uusien toimintatapojen löytäminen ja osaamisen kehittäminen. Tarkoituksena oli kehittää sekä tiimin toimintatapoja että omia taitojani työntekijänä erilaisten teemojen avulla. Opinnäytetyössä raportoitiin työtehtävistä kymmenen viikon ajan päiväkirjamuodossa. Jokaisen viikon päätteeksi kirjoitettiin kyseisen viikon valitusta teemasta analysoiden teemaa tietopohjan avulla. Tietopohjana on hyödynnetty erilaisia artikkeleita ja ammattikirjallisuutta. Raportoinnin aikana toteutettiin Back Officen työpaja, jossa luotiin tiimille uudet työnjaot. Opinnäytetyön avulla toimeksiantaja sai monia erilaisia kehitysehdotuksia Back Officen toimintojen kehittämiseen. Jokaisen viikon aikana syntyi uusia ideoita ja kehitysehdotuksia liittyen aina kyseisen viikon teemaan. Yksi kehitysehdotuksista oli ottaa käyttöön perehdytyssuunnitelma uusille työntekijöille. Tiimin muuttuessa on tärkeää, että uudet työntekijät pääsevät nopeasti mukaan tiimiin ja saavat hyvän perehdytyksen työtehtäviin