A study of anemia and iron deficiency in chronic systolic heart failure

Background: Iron deficiency (ID) is an emerging problem in patients with chronic systolic heart failure and can be a potential therapeutic target. However, not much is known about the frequency, predictors of iron deficiency and anemia in patients with chronic heart failure. Objectives: The primary objective of this study was to determine the frequency of iron deficiency in chronic systolic heart failure patients who were follow up in Hospital Universiti Sains Malaysia. The secondary objectives included were to determine the frequency of anemia in the same study population, correlation between ejection fraction and blood parameters and determining risk factors for anemia in chronic systolic heart failure. Methods: A total of 81 patients who were followed up in Hospital Universiti Sains Malaysia were recruited into this cross sectional study using purposive sampling method. These patients had history of chronic systolic heart failure for more than 6 months with left ventricular ejection fraction less than 45% as assessed by echocardiography using Simpson’s planimetric method. 10mls of venous blood was drawn from each participant and analyzed. Results: Thirty three patients were anemic (40.7%) as compared to 48 patients (59.3%) who did not. Sixteen patients were iron deficient (19.8%). All iron deficiency patients were anemic patients. There were positive correlation between serum ferritin (r=0.624, p<0.001), transferrin saturation (r= 0.346, p<0.001) and hemoglobin (r=0.528, p<0.001) with ejection fraction, respectively. Anemia in chronic systolic heart failure was independently associated with serum ferritin (OR 0.974, 95% CI 0.959, 0.988), transferrin saturation (OR 0.831, 95% CI 0.726, 0.952), and diabetes mellitus (OR 6.680, 95% CI 1.599, 27.897) based on multiple logistic regression analysis. Conclusion: This study demonstrated high frequency of anemia in chronic systolic heart failure patients. Majority of anemic patients were iron deficient. Besides that, serum hemoglobin and serum ferritin and transferrin saturation were positively correlated with left ventricular ejection fraction. It is recommended in future, an appropriately powered randomized trials with correction of anemia using erythropoietin and intravenous iron be carried out to validate the study findings

The impact of Group Intelligence software on enquiry-based learning

Despite the increasing use of groupware technologies in education, there is little evidence of their impact, especially within an enquiry-based learning (EBL) context. In this paper, we examine the use of a commercial standard Group Intelligence software called GroupSystems®ThinkTank. To date, ThinkTank has been adopted mainly in the USA and supports teams in generating ideas, categorising, prioritising, voting and multi-criteria decision-making and automatically generates a report at the end of each session. The software was used by students carrying out an EBL project, set by employers, for a full academic year. The criteria for assessing the impact of ThinkTank on student learning were those of creativity, participation, productivity, engagement and understanding. Data was collected throughout the year using a combination of interviews and questionnaires, and written feedback from employers. The overall findings show an increase in levels of productivity and creativity, evidence of a deeper understanding of their work but some variation in attitudes towards participation in the early stages of the project

Synthesis And Characterization Of Magnetite And Magnetite-Epoxy Polymers Nanocomposites And Their Thermal And Electrical Behaviors [QC176.8.N35 T161 2007 f rb].

Nanozarah magnetit (Fe3O4) disintesis melalui pemendakan beralkali. Kesan pelbagai aditif dan persekitaran akues-organik terhadap saiz, keseragaman saiz dan morfologi zarah magnetit dikaji. Magnetite (Fe3O4) nanoparticles are synthesized via alkaline precipitation. The effect of different additives and aqueous-organic environment on the size, size uniformity and morphology of magnetite particles is studied

Catalytic dehydrochlorination of 2-chlorobutane

The catalytic dehydrochlorination of 2-chlorobutane has been studied using promoted alumina catalysts. The modified alumina (AI2O 3-HCI, K-AI2O3), zirconia-alumina (Zr02-Al203) and silver-alumina (Ag/AC) catalysts were synthesized and characterised before being tested for catalyst activity. In addition, silver-silica (Ag/SiC) and silver-zirconia-alumina (Ag/ZrCVAhOs) were also prepared as different supported silver catalysts for dehydrochlorination of 2-chlorobutane. y-alumina catalysts were active for the dehydrochlorination reaction due to the presence of Lewis acid sites. The catalyst performance and the acid-base properties suggest the reaction was acid-catalysed. Doping K or Na on y-alumina inhibited the activity due to the loss of acidic sites from the alumina surface. Despite the inhibition effect of the alkaline doped catalyst, acid-base bifunctional catalysis was proposed over zirconia-alumina catalysts. The presence of Al-O-Zr surface structural defects on zirconia- alumina controlled the acid-base properties which relate to the catalytic activity. The role of basic sites is to stabilise the carbonium ion and activates the C-H bond, while the acid sites encourage the abstraction of CI-ions. A correlation between the ratio of base/acid sites and conversion is suggested, depending on the reaction conditions (i.e. space velocity). Finally, the silver-promoted catalysts were prepared, emphasis placed on the metal-support interaction. The results suggest that as well as the active species distribution which is important for the reaction, the acid-base properties of the support are vital

トレーサブル超精密寸法測定に関する研究

要約のみTohoku University高偉課

Doctor of Philosophy

dissertationPhysical inactivity is an increasing problem among children and adolescents. The TAKE 10!® program, which integrates physical activity (PA) into academic subjects, was implemented in one elementary school in Magna, Utah to increase children's daily in-school PA. A three-study approach was used to examine: (a) effects of TAKE 10!® on elementary school students' PA and physical fitness levels, (b) effects of TAKE 10!® on elementary school students' on-task behavior, and (c) teachers' experiences in implementing TAKE 10!®. Two hundred thirteen students and 9 teachers from nine classes (3rd to 5th grades) participated in the project for 12 weeks (4 weeks baseline; 8 weeks intervention). Students wore pedometers and accelerometers for 4 days during week 1 (baseline), week 8 (mid-intervention), and week 12 (end-intervention) to examine their PA levels. Systematic observation was used to examine students' on-task behavior during weeks 1 to 4 (baseline) and weeks 8 to 12 (intervention). Teachers were interviewed regarding their experiences implementing TAKE 10!® at the end of the intervention and 5 months after the intervention. Results from the first study indicated that students' steps counts increased significantly by 672 steps from baseline to mid-intervention. Furthermore, students' average time spent in moderate to vigorous intensity PA and vigorous intensity PA increased significantly by approximately 2 minutes from baseline to end-intervention. Results from the second study showed that there was a significant decrease in mean percentage on-task behavior from pre-no TAKE 10!® (91.2 ± 3.4) to post-no TAKE 10!® (83.5 ± 4.0) during baseline, whereas there was a significant increase in mean percentage on-task behavior from pre-TAKE 10!® (82.3 ± 4.5) to post-TAKE 10!® (89.5 ± 2.7) during intervention. The five major themes identified from the third study were: (a) barriers, (b) benefits, (c) what worked, (d) personal attributes, and (e) doing it in the present and in the future. In conclusion, the TAKE 10!® program is effective in increasing students' in-school PA levels and on-task behavior. Despite experiencing barriers to implementing TAKE 10!®, teachers were generally positive about the benefits of the program, and a majority of them reported implementing the program after the study had ended

Financial Disintermediation in the 1990s : Implications on Monetary Policy in Malaysia

The increased financial disintermediation that characterizes the Malaysia's financial system since the early 1990s has contributed towards changes in the dynamics of monetary transmission mechanism. Using quarterly data from 1980: 1 to 2005: 4, we found a greater effectiveness of monetary policy during the pre-1990:3 period, but the post-1990:3 period poses much difficulty for the conduct of monetary policy. Innovations in the financial market appeared to have led to lower output variability. Further, when the real interest rate is made a function of financial disintermediation, the real interest rate appeared to have lost its significance in influencing real variables in the post-1990: 3 period. This study did not, however, find evidence in support of the significance of the real interest rate in affecting real variables through the direct financing channel via the capital market.bank lending channel, capital market, cointegration, VAR

The Use Of WebQLM To Enhance Writing Performance In Argumentative Writing

This study focused on the development of a constructivist web-based learning tool known as WebQuest Learning Module or WebQLM and investigated the effects of WebQLM on students’ writing performance and their level of engagement in all the activities in WebQLM. Penyelidikan ini menumpukan kepada pembinaan sebuah alat pembelajaran konstruktivis yang berasaskan web dikenali sebagai Modul Pembelajaran WebQuest atau WebQLM. Penyelidikan ini menyelidik kesan-kesan WebQLM terhadap pencapaian penulisan pelajar dalam penulisan penyanggahan serta tahap penglibatan mereka dalam aktiviti-aktiviti WebQLM

Conscious investigation and Investigative-Oriented Learning (IOL) in Language Teaching

This article focuses on the need for a particular English Language Teaching methodology termed Investigative-Oriented Learning (IOL) which is absent in foreign language teaching. IOL is meant to develop investigative questioning in language learners so as to empower them with skills of Conscious Investigation. Empowerment means that opportunities are given to language learners to develop strategies and skills for learning language which can be transferred outside of the language classroom. The skills that could be developed are those of Noticing, Hypothesising and Experimentation. It is argued in this paper that Conscious Investigation is especially important in heightening the awareness of learners about the usage of common idiomatic and metaphorical expressions which are prevalent in native British English. As a result, authentic language material such as those found in corpora, newspapers, advertisements, recordings of spoken communication, etc are valuable resources for the development of tasks used in IOL activities. The language payoff would be that through the development of the Noticing, Hypothesising and Experimentation skills learnt in IOL, foreign language learners are able to make informed choices of language use in a foreign language environment. Furthermore, they are also able to make comparisons between the foreign language and their own language, cultural and world experiencesEste artículo se centra en lo necesario de una metodología en particular para la enseñanza del inglés llamada Aprendizaje Orientado a lo Investigativo (IOL) que no se halla presente en la enseñanza de lengua extranjera. El sentido de IOL es el desarrollo de cuestionamientos investigativos en los alumnos de idiomas con objeto de equiparlos con destrezas de Investigación Consciente. Este equipamiento quiere decir darle a los alumnos de idiomas oportunidad de desarrollar estrategias y destrezas para el aprendizaje de la lengua que puedan ser transferidas fuera del aula de idiomas. Las destrezas que podrían desarrollarse son las de Percepción, Formulación de hipótesis y Experimentación. Este artículo defiende que la Investigación Consciente es especialmente importante para elevar la conciencia de los alumnos acerca del uso de expresiones idiomáticas y metafóricas corrientes que son predominantes en inglés británico. En consecuencia, los materiales lingüísticos auténticos como los que se encuentran en corpus, periódicos, publicidad, registros de comunicación hablada, etcétera, son valiosos recursos para el desarrollo de tareas utilizadas en actividades IOL. El resultado en cuanto a la lengua sería que a través del desarrollo de las destrezas de Percepción, Formulación de hipótesis y Experimentación que se aprenden en IOL, los alumnos de lengua extranjera sean capaces de tomar decisiones informadas en cuanto al uso de la lengua en el entorno de la lengua extranjera. Aún más, también serán capaces de establecer comparaciones entre la lengua extranjera y su propia experiencia lingüística, cultural y global.MÉ Cet article est centré sur le besoin d’une méthodologie spécifique pour l’enseignement de l’anglais dit Apprentissage Orienté à la Recherche (IOL) qui n’existe pas dans l’enseignement d’une langue étrangère. Le sens de IOL est le développement de mises en question de recherche chez les élèves de langues modernes dans le but de les équiper avec des skills de Recherche Consciente. Cet équipement veut dire donner aux élèves de langues l’opportunité de développer des stratégies et des adresses pour l’apprentissage de la langue pouvant être transférées en dehors de la classe de langues modernes. Les adresses qui pourraient être dévelopées sont celles de Perception, Formulation d’hypothèses et Expérimentation. Cet article défend que la Recherche Consciente est particulièrement importante por élever la conscience des élèves à propos d’expressions idiomatiques et métaphoriques courantes prédominantes en anglais britannique. En consé- quence, les matériaux linguistiques authentiques tels qu’on les trouve dans des corpus, des journaux, de la publicité, des enregistrements de communication parlée, etcetera, sont des recours précieux pour le développement de tâches employées dans des activités IOL. Le résultat, quant à la langue, en serait qu’à travers le développement des adresses de Perception, Formulation d’hypothèses et Expérimentation que l’on apprend en IOL, les élèves d’une langue étrangère soient capables de prendre des décisions exactes quant à l’emploi de la langue dans l’environnement de la langue étrangère, plus encore, ils seront aussi capables d’établir des comparaisons entre la langue étrangère et leur propre expérience linguistique, culturelle et globale

On the location of plumes and lateral movement of thermochemical structures with high bulk modulus in the 3-D compressible mantle

The two large low shear velocity provinces (LLSVPs) at the base of the lower mantle are prominent features in all shear wave tomography models. Various lines of evidence suggest that the LLSVPs are thermochemical and are stable on the order of hundreds of million years. Hot spots and large igneous province eruption sites tend to cluster around the edges of LLSVPs. With 3-D global spherical dynamic models, we investigate the location of plumes and lateral movement of chemical structures, which are composed of dense, high bulk modulus material. With reasonable values of bulk modulus and density anomalies, we find that the anomalous material forms dome-like structures with steep edges, which can survive for billions of years before being entrained. We find that more plumes occur near the edges, rather than on top, of the chemical domes. Moreover, plumes near the edges of domes have higher temperatures than those atop the domes. We find that the location of the downwelling region (subduction) controls the direction and speed of the lateral movement of domes. Domes tend to move away from subduction zones. The domes could remain relatively stationary when distant from subduction but would migrate rapidly when a new subduction zone initiates above. Generally, we find that a segment of a dome edge can be stationary for 200 million years, while other segments have rapid lateral movement. In the presence of time-dependent subduction, the computations suggest that maintaining the lateral fixity of the LLSVPs at the core-mantle boundary for longer than hundreds of million years is a challenge