581 research outputs found
Urinary Sodium Profiling in Chronic Heart Failure to Detect Development of Acute Decompensated Heart Failure
OBJECTIVES This study sought to determine the relationship between urinary sodium (U-na) concentration and the pathophysiologic interaction with the development of acute heart failure (AHF) hospitalization. BACKGROUND No data are available on the longitudinal dynamics of U-na concentration in patients with chronic heart failure (HF), including its temporal relationship with AHF hospitalization. METHODS Stable, chronic HF patients with either reduced or preserved ejection fraction were prospectively included to undergo prospective collection of morning spot U-na samples for 30 consecutive weeks. Linear mixed modeling was used to assess the longitudinal changes in U-na concentration. Patients were followed for the development of the clinical endpoint of AHF. RESULTS A total of 80 chronic HF patients (71 +/- 11 years of age; an N-terminal pro-B-type natriuretic peptide [NT-proBNP] concentration of 771 [interquartile range: 221 to 1,906] ng/l; left ventricular ejection fraction [LVEF] 33 +/- 7%) prospectively submitted weekly pre-diuretic first void morning U-na samples for 30 weeks. A total of 1,970 U-na samples were collected, with mean U-na concentration of 81.6 +/- 41 mmol/l. Sodium excretion remained stable over time on a population level (time effect p = 0.663). However, interindividual differences revealed the presence of high (88 mmol/l U-na [n = 39]) and low (73 mmol/l U-na [n = 41]) sodium excreters. Only younger age was an independent predictor of high sodium excretion (odds ratio [OR]: 0.91; 95% confidence interval [CI]: 0.83 to 1.00; p = 0.045 per year). During 587 +/- 54 days of follow-up, 21 patients were admitted for AHF. Patients who developed AHF had significantly lower U-na concentrations (F-[1.80] = 24.063; p <0.001). The discriminating capacity of U-na concentration to detect AHF persisted after inclusion of NT-proBNP and estimated glomerular filtration rate (eGFR) measurements as random effects (p = 0.041). Furthermore, U-na concentration dropped (U-na = 46 +/- 16 mmol/l vs. 70 +/- 32 mmol/l, respectively; p = 0.003) in the week preceding the hospitalization and returned to the individual's baseline (U-na = 71 +/- 22 mmol/l; p = 0.002) following recompensation, while such early longitudinal changes in weight and dyspnea scores were not apparent in the week preceding decompensation. CONCLUSIONS Overall, U-na concentration remained relatively stable over time, but large interindividual differences existed in stable, chronic HF patients. Patients who developed AHF exhibited a chronically lower U-na concentration and exhibited a further drop in U-na concentration during the week preceding hospitalization. Ambulatory U-na sample collection is feasible and may offer additional prognostic and therapeutic information. (C) 2019 by the American College of Cardiology Foundation
Recommended from our members
Bioavailability in soils
The consumption of locally-produced vegetables by humans may be an important exposure pathway for soil contaminants in many urban settings and for agricultural land use. Hence, prediction of metal and metalloid uptake by vegetables from contaminated soils is an important part of the Human Health Risk Assessment procedure. The behaviour of metals (cadmium, chromium, cobalt, copper, mercury, molybdenum, nickel, lead and zinc) and metalloids (arsenic, boron and selenium) in contaminated soils depends to a large extent on the intrinsic charge, valence and speciation of the contaminant ion, and soil properties such as pH, redox status and contents of clay and/or organic matter. However, chemistry and behaviour of the contaminant in soil alone cannot predict soil-to-plant transfer. Root uptake, root selectivity, ion interactions, rhizosphere processes, leaf uptake from the atmosphere, and plant partitioning are important processes that ultimately govern the accumulation ofmetals and metalloids in edible vegetable tissues. Mechanistic models to accurately describe all these processes have not yet been developed, let alone validated under field conditions. Hence, to estimate risks by vegetable consumption, empirical models have been used to correlate concentrations of metals and metalloids in contaminated soils, soil physico-chemical characteristics, and concentrations of elements in vegetable tissues. These models should only be used within the bounds of their calibration, and often need to be re-calibrated or validated using local soil and environmental conditions on a regional or site-specific basis.Mike J. McLaughlin, Erik Smolders, Fien Degryse, and Rene Rietr
Back to the Eneolithic: Exploring the Rudki-type ornaments from Poland
For a long time, the Eneolithic attribution of the Rudki-type double spiral ornaments was contested by a wide academic audience, and therefore, this new and extraordinary category of the copper metalwork seemed to have fallen into scientific oblivion. In this paper, we contribute to the debate about cultural attribution of the Rudki-type double spiral ornaments considering their chemical and isotope characteristics (using ED XRF and MC-ICP-MS) and the manufacturing technology (OM, X-ray, CT). Noticeably, this study represents the first documented implementation of the lead isotope analysis (LIA) for the Eneolithic metalwork from Poland. The new scientific analyses give ground to the hypothesis that the Rudki-type double spiral ornaments were produced by the Baden culture metalworker(s) who practiced somewhere in the Carpathian Basin and who have used copper ore mined in the Slovak Ore Mountains (Spania Dolina-Banska Bystrica-Kremnica mine complex). These ornaments were redistributed towards the northern ecumene of the Baden culture complex. The new owners, the Funnel Beaker (TRB) culture communities from the region of modern Poland, deposited the ornaments in hoards (Kaldus, Przeuszyn and Rudki) during the mid-4th millennium BC. The results, furthermore, indicate that the so-called Baden spiral metalwork package must be now complemented by the Rudki-type double spiral ornaments. Remarkably, this package also found an echo in pottery decoration, as documented by a narrative scene incised on an amphora from Kaldus, which could be also interpreted as one of the earliest known proofs for the wagon transport in Europe, alongside the famous ones reported from Bronocice or Flintbek.Material Culture Studie
Collateral Quality and Loan Default Risk: The Case of Vietnam
In the transition economy of Vietnam, financial market is dominated by banking sector but commercial banks heavily rely on collateral-based lending. While the relationship between collateral and implied credit risk is still in debate, this paper provides additional empirical evidence regarding the heterogeneous effects and transmission channels of collateral characteristics on loan delinquency. Applying instrumental variable probit analysis on a unique dataset of 2295 internal loan accounts in Vietnam, we find the significantly negative impact of collateral quality on the probability of default of consumer loans, supporting the dominance of borrower selection and risk-shifting over lender selection effects. The finding implies that high-quality collateral not only signals more credible borrower but also fosters good behavior in using loan, enabling bank to mitigate adverse selection and moral hazard problems
Determinants of Banking System Fragility: A Regional Perspective
Abstract: Banking systems are fragile not only within one country but also within and across regions. We study the role of regional banking system characteristics for regional banking system fragility. We find that regional banking system fragility reduces when banks in the region jointly hold more liquid assets, are better capitalized, and when regional banking systems are more competitive. For Asia and Latin-America, a greater presence of foreign banks also reduces regional banking fragility. We further investigate the possibility of contagion within and across regions. Within region banking contagion is important in all regions but it is substantially lower in the developed regions compared to emerging market regions. For cross-regional contagion, we find that the contagion effects of Europe and the US on Asia and Latin America are significantly higher compared to the effect of Asia and Latin America among themselves. Finally, the impact of cross-regional contagion is attenuated when the host region has a more liquid and more capitalized banking sector.
Toxic effects of Pb2+ on growth of cowpea (Vigna unguiculata)
A concentration as low as 1 mu M lead (Pb) is highly toxic to plants, but previous studies have typically related plant growth to the total amount of Pb added to a solution. In the present experiment, the relative fresh mass of cowpea (Vigna unguiculata) was reduced by 10% at a Pb2+ activity of 0.2 mu M for the shoots and at a Pb2+ activity of 0.06 mu M for the roots. The primary site of Pb2+ toxicity was the root, causing severe reductions in root growth, loss of apical dominance (shown by an increase in branching per unit root length), the formation of localized swellings behind the root tips (due to the initiation of lateral roots), and the bending of some root tips. In the root, Pb was found to accumulate primarily within the cell walls and intercellular spaces. (C) 2007 Elsevier Ltd. All rights reserved
Capital structure revisited. Do crisis and competition matter in a Keiretsu corporate structure?
The file attached to this record is the author's final peer reviewed version.open accessWe investigate firm-level determinants of capital structure using a large sample of 4,284 Japanese firms over a nineteen-year period (i.e., over 61,000 firm-year observations), a hitherto less examined sample for this purpose. We conduct our analysis and interpret our findings predominantly within the pecking order, the trade-off and the agency theoretical frameworks. We uncover three new findings. First, our evidence indicates that insights derived from the extant literature on capital structure are cross-national and are applicable in the context of Japan, despite the unique characteristics of Japanese firms. Second, financial crisis significantly impacts the relationship between leverage and firm-level determinants, particularly accentuating the effect of asset tangibility and growth. Third, product market competition significantly impacts the observed relationship between firm-level determinants and leverage. Our results are robust, controlling for the joint effects of competition and crisis
Democracy in trade unions, democracy through trade unions?
Since the Webbs published Industrial Democracy at the end of the nineteenth century, the principle that workers have a legitimate voice in decision-making in the world of work – in some versions through trade unions, in others at least formally through separate representative structures – has become widely accepted in most west European countries. There is now a vast literature on the strengths and weaknesses of such mechanisms, and we review briefly some of the key interpretations of the rise (and fall) of policies and structures for workplace and board-level representation. We also discuss the mainly failed attempts to establish broader processes of economic democracy, which the eclipse of nationally specific mechanisms of class compromise makes again a salient demand. Economic globalization also highlights the need for transnational mechanisms to achieve worker voice (or more radically, control) in the dynamics of capital-labour relations. We therefore examine the role of trade unions in coordinating pressure for a countervailing force at European and global levels, and in the construction of (emergent?) supranational industrial relations. However, many would argue that unions cannot win legitimacy as democratizing force unless manifestly democratic internally. We therefore revisit debates on and dilemmas of democracy within trade unions, and examine recent initiatives to enhance democratization
Toxic effects of Pb2+ on the growth and mineral nutrition of signal grass (Brachiaria decumbens) and Rhodes grass (Chloris gayana)
Although grasses are commonly used to revegetate sites contaminated with lead (Pb), little is known regarding the Pb-tolerance of many of these species. Using dilute solution culture to mimic the soil solution, the growth of signal grass (Brachiaria decumbens Stapf cv. Basilisk) and Rhodes grass (Chloris gayana Kunth cv. Pioneer) was related to the mean activity of Pb2+ {Pb2+} in solution. There was a 50% reduction in fresh mass of signal grass shoots at 5 mu M {Pb2+} and at 3 mu M {Pb2+} for the roots. Rhodes grass was considerably more sensitive to Pb in solution, with shoot and root fresh mass being reduced by 50% at 0.5 mu M {Pb2+}. The higher tolerance of signal grass to Pb appeared to result from the internal detoxification of Pb, rather than from the exclusion of Pb from the root. At toxic {Pb2+}, an interveinal chlorosis developed in the shoots of signal grass (possibly a Pb-induced Mn deficiency), whilst in Rhodes grass, Pb2+ caused a bending of the root tips and the formation of a swelling immediately behind some of the root apices. Root hair growth did not appear to be reduced by Pb2+ in solution, being prolific at all {Pb2+} in both species
- …