Study of Serum Uric Acid levels in patients with Acute Myocardial Infarction and Its correlation with the severity assessed by Killip Classification and 2D Echocardiogram

BACKGROUND : Cardiovascular disease especially coronary artery disease is a part of major disease burden pan India. Coronary artery disease has attained epidemic proportions in India. In a developing country like India, for patients with acute Myocardial Infarction, a simple, cheap and easily available serum marker like uric acid could be an excellent tool in predicting the prognosis and long term management strategies. Our study was aimed at establishing a relationship between the levels of serum uric acid in various types of acute myocardial infarction and correlation of its levels with the degree of myocardial dysfunction as assessed by echocardiogram and the Killip, GRACE and TIMI scores. MATERIALS AND METHODS : it was prospective observational study conducted at Government Mohan Kumaramangalam Medical College Hospital during July 2015 to January 2016. 100 consecutive patients admitted to the Medical ICU, Coronary care unit and medical wards were evaluated with detailed history, examination and laboratory investigations. Serum uric acid levels were assessed on day 0 and day 3 of admission. Patients were followed up for a period of 7 – 15 days or discharge whichever was earlier to assess the major in hospital adverse cardiac events. RESULTS : In our study, the proportion of Hyperuricemics in acute MI was found to be 59%. 55 cases were STEMI and 45 cases were NSTEMI. 74.5% of STEMI had Hyperuricemia whereas it was only 40% in NSTEMI (p value 9mg/dl was observed in 100% (n=9) of the patients who succumbed to death. 24 per cent of the patients in study population had serum uric acid levels more than 9 mg/dl and 91.96% of this group belonged to Killip classes III and IV. The mean SUA levels in Killip classes III and IV were 9.72mg and 12.46 mg/dl respectively as compared to 5.68mg/dl and 7.36 mg/dl in Killip classes I and II (p value 0.0005). Statistically significant positive association was found between Hyperuricemia and Smoking (p value 0.003), Hypertension (p value 0.001) and Heart blocks (p value 0.003). No significant association was observed between and serum uric acid levels and diabetes mellitus (p value 0.119) nor with dyslipidemia (p value 0.508). The mean TIMI score in general was higher in hyperuricemic patients in both STEMI (7.56±2.5 vs 5.64±2.3) and NSTEMI (4.89±0.9 vs 3.89±0.8). The mean risk of in-hospital mortality in patients with hyperuricemic patients was 9.44% higher as compared to normouricemic patients (p value 0.0005). 100 percent (n=16) of the patients with serum uric acid > 9mg/dl had ejection fraction less than 30%. CONCLUSION : Serum uric acid levels were elevated in patients with acute myocardial infarction. There is a strong correlation between serum uric acid at the time of admission and in-hospital mortality and short term mortality in patients with acute myocardial infarction. Serum uric acid levels in a patient with acute myocardial infarction can be used as an independent predictor of mortality and morbidity in the form of major adverse cardiac events. Serum uric acid levels has a statistically significant linear relationship with TIMI and GRACE scores. Hyperuricemia patients with STEMI tend to have a higher rate of left systolic dysfunction

Prevalence and experiences of food insecurity among immigrant women connected to perinatal programs at a community-based organization in Edmonton, Canada

Purpose: The purpose of this paper is to investigate the prevalence of household food insecurity among immigrant women connected to perinatal programs offered through a community-based organization in Edmonton, and to explore their experiences in coping with food insecurity. Design/methodology/approach: This study utilized a mixed methods research design. A community-based participatory research approach was used to engage health workers who were connected to immigrant women and families through the Multicultural Health Brokers Cooperative in Edmonton. Through the health workers a sample of 213 immigrant women connected to their perinatal programs completed the Household Food Security Survey. Following the survey, 17 women completed semi-structured interviews which were analyzed using content analysis. Findings: The vast majority of women (94 percent (n=199)) lived in food insecure households, and 53 percent (n=112) in severely food insecure. In semi-structured interviews, women specifically described not having enough money to buy vegetables, fruit and meat, and perceiving a lack of control over foods they ate and offered to their families. Practical implications: This study highlights the need for support to be provided to immigrant families for acquiring healthy food in Canada. Originality/value: The mixed methods design with a decent sample of often underrepresented research participants highlights an area in need of further research and greater support

Blaming Bill Gates AGAIN! Misuse, overuse and misunderstanding of performance data in sport

Recently in Sport, Education and Society, Williams and Manley (2014) argued against the heavy reliance on technology in professional Rugby Union and elite sport in general. In summary, technology is presented as an elitist, ‘gold standard’ villain that management and coaches use to exert control and by which players lose autonomy, identity, motivation, social interactions and expertise. In this article we suggest that the sociological interpretations and implications offered by Williams and Manley may be somewhat limited when viewed in isolation. In doing so, we identify some core methodological issues in Williams and Manley’s study and critically consider important arguments for utilising technology; notably, to inform coach decision making and generate player empowerment. Secondly, we present a different, yet perhaps equally concerning, practice-oriented interpretation of the same results but from alternative coaching and expertise literature. Accordingly, we suggest that Williams and Manley have perhaps raised their alarm prematurely, inappropriately and on somewhat shaky foundations. We also hope to stimulate others to consider contrary positions, or at least to think about this topic in greater detail. More specifically, we encourage coaches and academics to think carefully about what technology is employed, how and why, and then the means by which these decisions are discussed with and, preferably, sold to players. Certainly, technology can significantly enhance coach decision making and practice, while also helping players to optimise their focus, empowerment and independence in knowing how to achieve their personal and collective goals

A neutralizing IL-11 antibody reduces vessel hyperplasia in a mouse carotid artery wire injury model

Vascular restenosis remains a major problem in patients with coronary artery disease (CAD) and peripheral artery disease (PAD). Neointimal hyperplasia, defined by post-procedure proliferation and migration of vascular smooth muscle cells (VSMCs) is a key underlying pathology. Here we investigated the role of Interleukin 11 (IL-11) in a mouse model of injury-related plaque development. Apoe−/− mice were fed a hyperlipidaemic diet and subjected to carotid wire injury of the right carotid. Mice were injected with an anti-IL11 antibody (X203), IgG control antibody or buffer. We performed ultrasound analysis to assess vessel wall thickness and blood velocity. Using histology and immunofluorescence approaches, we determined the effects of IL-11 inhibition on VSMC and macrophages phenotypes and fibrosis. Treatment of mice with carotid wire injury using X203 significantly reduced post-endothelial injury vessel wall thickness, and injury-related plaque, when compared to control. Immunofluorescence staining of the injury-related plaque showed that X203 treatment did not reduce macrophage numbers, but reduced the number of VSMCs and lowered matrix metalloproteinase 2 (MMP2) levels and collagen content in comparison to control. X203 treatment was associated with a significant increase in smooth muscle protein 22α (SM22α) positive cells in injury-related plaque compared to control, suggesting preservation of the contractile VSMC phenotype. Interestingly, X203 also reduced the collagen content of uninjured carotid arteries as compared to IgG, showing an additional effect on hyperlipidemia-induced arterial remodeling in the absence of mechanical injury. Therapeutic inhibition of IL-11 reduced vessel wall thickness, attenuated neointimal hyperplasia, and has favorable effects on vascular remodeling following wire-induced endothelial injury. This suggests IL-11 inhibition as a potential novel therapeutic approach to reduce arterial stenosis following revascularization in CAD and PAD patients

DNA replication stress restricts ribosomal DNA copy number

Ribosomal RNAs (rRNAs) in budding yeast are encoded by ~100–200 repeats of a 9.1kb sequence arranged in tandem on chromosome XII, the ribosomal DNA (rDNA) locus. Copy number of rDNA repeat units in eukaryotic cells is maintained far in excess of the requirement for ribosome biogenesis. Despite the importance of the repeats for both ribosomal and non-ribosomal functions, it is currently not known how “normal” copy number is determined or maintained. To identify essential genes involved in the maintenance of rDNA copy number, we developed a droplet digital PCR based assay to measure rDNA copy number in yeast and used it to screen a yeast conditional temperature-sensitive mutant collection of essential genes. Our screen revealed that low rDNA copy number is associated with compromised DNA replication. Further, subculturing yeast under two separate conditions of DNA replication stress selected for a contraction of the rDNA array independent of the replication fork blocking protein, Fob1. Interestingly, cells with a contracted array grew better than their counterparts with normal copy number under conditions of DNA replication stress. Our data indicate that DNA replication stresses select for a smaller rDNA array. We speculate that this liberates scarce replication factors for use by the rest of the genome, which in turn helps cells complete DNA replication and continue to propagate. Interestingly, tumors from mini chromosome maintenance 2 (MCM2)-deficient mice also show a loss of rDNA repeats. Our data suggest that a reduction in rDNA copy number may indicate a history of DNA replication stress, and that rDNA array size could serve as a diagnostic marker for replication stress. Taken together, these data begin to suggest the selective pressures that combine to yield a “normal” rDNA copy number

Understanding the process of psychological development in youth athletes attending an intensive wrestling camp

This study used a grounded theory methodology to understand if and how psychological development in youth athletes was facilitated by an ‘intensive’ summer wrestling camp experience. The theoretical sampling approach involved 10 athlete participants of the camp, nine parents of athletes, the director of the camp, and four camp staff members, who took part in a series of interviews before, during, and after the camp. Two researchers were also embedded in the camp and attended all sessions, took detailed notes, collected camp materials, and conducted observations. Following a grounded theory analysis approach, a model is presented that outlines how youth participants’ developed psychological qualities from the coach created hallenges and adversity that were systematically designed to facilitate sport performance enhancement and life skills. Variations emerged in psychological antecedents and characteristics, how the challenging wrestling camp environment was interpreted and experienced, and how learning was transferred to sport and life domains outside of the wrestling camp. This study provided insight into a unique youth sport context that was able to simultaneously develop psychological qualities to be used as sport performance enhancement and life skills

The Impact of Phenotypic and Genotypic G6PD Deficiency on Risk of Plasmodium vivax Infection: A Case-Control Study amongst Afghan Refugees in Pakistan

Analyses of a case-control study among Afghan refugees in Pakistan find that a G6PD (glucose-6-phosphate dehydrogenase) “Mediterranean” type deficiency confers substantial protection against Plasmodium vivax malaria

An intergenerational study of perceptions of changes in active free play among families from rural areas of Western Canada

Background: Children's engagement in active free play has declined across recent generations. Therefore, the purpose of this study was to examine perceptions of intergenerational changes in active free play among families from rural areas. We addressed two research questions: (1) How has active free play changed across three generations? (2) What suggestions do participants have for reviving active free play? Methods: Data were collected via 49 individual interviews with members of 16 families (15 grandparents, 16 parents, and 18 children) residing in rural areas/small towns in the Province of Alberta (Canada). Interview recordings were transcribed verbatim and subjected to thematic analysis guided by an ecological framework of active free play. Results: Factors that depicted the changing nature of active free play were coded in the themes of less imagination/more technology, safety concerns, surveillance, other children to play with, purposeful physical activity, play spaces/organized activities, and the good parenting ideal. Suggestions for reviving active free play were coded in the themes of enhance facilities to keep kids entertained, provide more opportunities for supervised play, create more community events, and decrease use of technology. Conclusions: These results reinforce the need to consider multiple levels of social ecology in the study of active free play, and highlight the importance of community-based initiatives to revive active free play in ways that are consistent with contemporary notions of good parentin

Additive manufacturing in SMEs: empirical evidences from Italy

Research on innovative technological methods in SMEs’ production processes is progressively receiving attention. However, little is known about the emerging phenomenon of Additive Manufacturing (AM), which may represent a significant strategic lever for fostering a company's competitiveness and performance, especially for SMEs. Our aim is to investigate the effects of AM on SMEs’ production process, in order to better understand the relative outcomes of such an innovative technique. We used latent content analysis for empirically analyzing SMEs present in one of the most important Italian gold jewelry districts. Our findings suggest that the AM introduction in a company’s production process effectively results in many positive outcomes, such as process innovation, customer satisfaction, costs, revenues, profits, and competitive advantage. Specifically, there is a positive linkage between AM and a company’s performance. Hence, such an innovative technique may be interpreted as a viable growth strategy for SMEs. Theoretical and managerial implications are discussed