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Harelimana, Jean Bosco y Patrick Gayawira. "Impact of electronic billing machine (ebm) on vat compliance among small and medium sized -enterprises in rwanda". Journal of Management and Science 10, n.º 1 (20 de febrero de 2020): 87–109. http://dx.doi.org/10.26524/jms.2020.9.
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This study aimed at assessing the impact of Electronic billing machine on VAT compliance on Small and Medium -Size Enterprises in Rwanda. The main challenge in the administration of Value Added Tax (VAT) in many countries, has mainly been tax evasion by non-issuance of tax invoices especially by small to medium taxpayers. Electronic Billing Machines (EBMs) enable revenue authorities to monitor formal business transactions and thus offer the potential to improve VAT compliance, however , because firms can choose not to issue receipts or issue false receipts, EBMs have limited benefits to VAT collections. Descriptive method was used to collect data, data gathered was analyzed, interpreted and presented. A sample size of 159 people grouped into Medium taxpayers, Small taxpayers and staff of RRA Musanze station was randomly selected from a population of 709 VAT registered taxpayers located in Tax centre of Musanze. Primary and secondary data was used in this research. Given the findings of this study, there is positive relationship between the adoption of mandatory usage of EBMs and VAT compliance indicators with a correlation coefficient of 0.586 . It was established that after the adoption of EBMs, late filing and non-filing rate of VAT has reduced by 14% and 20% respectively, timely payment of VAT liabilities has increased by 20%, reporting of sales has increased by 737 %, VAT collections were increased by 732 % and voluntary VAT registration has increased by 346 %. To improve VAT compliance through EBMs. RRA is recommended to come up with plan integrating EBMs within broader tax compliance frameworks that create the environment which will best ensure taxpayers’ voluntarily compliance.
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Vitalaru, Bianca y Carmen Valero-Garcés. "MOOC as a free, digital tool for different profiles providing introductory trainingin PSIT". Translation and Translanguaging in Multilingual Contexts 6, n.º 2 (12 de mayo de 2020): 183–210. http://dx.doi.org/10.1075/ttmc.00053.val.
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Abstract In this article we present the results of the implementation of a MOOC providing an introduction in Public Service Interpreting and Translation (PSIT) for a variety of backgrounds and profiles, from people working with foreign population, to people who have no formal training and are ad-hoc interpreters, as well as people interested in learning about PSIT. The ultimate goal of the MOOC is to provide general information and to raise awareness about the complexity of the field, as well as to offer the possibility of learning and practicing some of the principles and strategies presented so that those interested in deepening their knowledge and skills may do so with more formal training. It is in this context that the article presents some of the findings obtained since its implementation given the variety of personal profiles and student backgrounds registered in the course as well as the evaluation of aspects related to its design such as duration, access to information, difficulties and, in general, aspects that enabled us to identify students’ perceptions on the usefulness, effectiveness and applicability of the course.
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Rahm, Henrik, Magdalena Andersson y Anna-Karin Edberg. "The collective voice: Legitimation strategies in focus group discussions with nurses in municipal palliative care for older people in Sweden". Communication and Medicine 11, n.º 2 (17 de agosto de 2015): 167–77. http://dx.doi.org/10.1558/cam.v11i2.20116.
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This paper explores focus group discussions of registered nurses in municipal palliative care for older people, using data collected by researchers with an interest in health sciences. The linguistically based discourse analyis builds on a combination of Bakhtinian notions of dialogicity, the Other and addressivity, the use of quotations, and also van Leeuwen’s framework for legitimation in discourse. The aim is to investigate strategies of addressing and legitimizing palliative care. Three types of narrative are discerned: the cautionary tale, fictionalization of professional experiences and the enactment of a fictive dialogue. The other professions involved (physicians, assistant nurses) are positioned as the Other as a means of legitimizing the perspectives of the registered nurses. As the patients and their next of kin are the objects of professional activities, the notion of the Third (connecting to the Other) is proposed. The objectification is a manifestation of commitment with routinized and professional distance to the patients.
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Zhao, Mei, Xiaozhen Lv, Maimaitirexiati Tuerxun, Jincai He, Benyan Luo, Wei Chen, Kai Wang et al. "Delayed help seeking behavior in dementia care: preliminary findings from the Clinical Pathway for Alzheimer's Disease in China (CPAD) study". International Psychogeriatrics 28, n.º 2 (3 de julio de 2015): 211–19. http://dx.doi.org/10.1017/s1041610215000940.
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ABSTRACTBackground:The prevalence and factors associated with delays in help seeking for people with dementia in China are unknown.Methods:Within 1,010 consecutively registered participants in the Clinical Pathway for Alzheimer's Disease in China (CPAD) study (NCT01779310), 576 persons with dementia (PWDs) and their informants reported the estimated time from symptom onset to first medical visit seeking diagnosis. Univariate analysis of general linear model was used to examine the potential factors associated with the delayed diagnosis seeking.Results:The median duration from the first noticeable symptom to the first visit seeking diagnosis or treatment was 1.77 years. Individuals with a positive family history of dementia had longer duration (p= 0.05). Compared with other types of dementia, people with vascular dementia (VaD) were referred for diagnosis earliest, and the sequence for such delays was: VaD < Alzheimer's disease (AD) < frontotemporal dementia (FTD) (p< 0.001). Subtypes of dementia (p< 0.001), family history (p= 0.01), and education level (p= 0.03) were associated with the increased delay in help seeking.Conclusions:In China, seeking diagnosis for PWDs is delayed for approximately 2 years, even in well-established memory clinics. Clinical features, family history, and less education may impede help seeking in dementia care.
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Solomon, Rukundo. "Margaret Akiiki Rwaheru v Uganda Revenue Authority". Journal of African Law 64, n.º 2 (21 de mayo de 2020): 287–96. http://dx.doi.org/10.1017/s002185532000011x.
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AbstractValue Added Tax (VAT) is a tax on the value added at each stage of the production and distribution process and on the importation of goods. VAT registered importers in Uganda are charged the statutory VAT rate of 18 per cent, however, importers that are not VAT registered are charged both the 18 per cent and an additional 15 per cent, which is designated “Domestic VAT”. The statutory basis of the 15 per cent is unclear. Domestic VAT appears to be a tax created by the Uganda Revenue Authority in a bid to raise revenue from a largely non-compliant base. The legality of the tax was challenged in Margaret Akiiki Rwaheru and 13,945 Others v Uganda Revenue Authority. The court ruled that Domestic VAT was irregular when applied to importers who qualified to register for VAT but had not registered, but was illegal when applied to importers who did not qualify to register for VAT. Despite this ruling, the URA has continued to charge all importers Domestic VAT, regardless of whether they qualify to register for VAT. This article seeks to re-examine the legality of Domestic VAT.
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Farrell, Frank B. "Putnam and the vat-people". Philosophia 16, n.º 2 (agosto de 1986): 147–60. http://dx.doi.org/10.1007/bf02380261.
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Raja, Tasneem, Helena Tuomainen, Jason Madan, Dipesh Mistry, Sanjeev Jain y Swaran Singh. "Psychiatric hospital reform in low-income and middle-income countries Structured Individualised inTervention And Recovery (SITAR): a two-arm pragmatic randomised controlled trial study protocol". BMJ Open 10, n.º 5 (mayo de 2020): e035753. http://dx.doi.org/10.1136/bmjopen-2019-035753.
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IntroductionLow-income and middle-income settings like India have large treatment gaps in mental healthcare. People with severe mental disorders face impediments to their clinical and functional recovery, and have large unmet needs. The infrastructure and standards of care are poor in colonial period psychiatric hospitals, with no clear pathways to discharge and successfully integrate recovered individuals into the community. Our aim is to study the impact of psychiatric hospital reform on individual patient outcomes in a psychiatric hospital in India.Methods and analysisStructured Individualised inTervention And Recovery (SITAR) is a two-arm pragmatic randomised controlled trial, focusing on patients aged 18–60 years with a hospital stay of 12–120 months and a primary diagnosis of psychosis. It tests the effectiveness of structural and process reform with and without an individually tailored recovery plan on patient outcomes of disability (primary outcome WHO Disability Assessment Scale), symptom severity, social and occupational functioning and quality of life. A computer-generated permuted block randomisation schedule will allocate recruited subjects to the two study arms. We aim to recruit 100 people into each trial arm. Baseline and outcome measures will be undertaken by trained researchers independent to the case managers providing the individual intervention. A health economic analysis will determine the costing of implementing the individually tailored recovery plan.Ethics and disseminationThe study will provide answers to important questions around the nature and process of reforms in institutional care that promote recovery while being cognizant of protecting human rights, and dignity. Ethical approval for SITAR was obtained from a registered ethics committee in India (Institutional Ethics Committee VikasAnvesh Foundation, VAF/2018-19/012 dated 6 December 2018) and the University of Warwick’s Biomedical and Scientific Research Ethics Committee (REGO-2019–2332, dated 21 March 2019), and registered on the Central Trial Registry of India (CTRI/2019/01/017267). Trial results will be published in accordance to CONSORT guidelines.
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Vorobiov, Anatolii y Stanislav Golubov. "A possibility of the short-term strong earthquakes forecasting on materials of cloudiness anomalies satellite surveys". Ukrainian journal of remote sensing, n.º 19 (31 de diciembre de 2018): 4–11. http://dx.doi.org/10.36023/ujrs.2018.19.139.
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For a prediction of sharp growth of seismicity level and preservation of many people life the most important the short-term forecast of strong earthquakes (ZTR) is the appearance of cloudiness anomalies before strong earthquakes. Today the science has certain achievements in this area.
One of criteria of the short-term forecasting is emergence of cloudiness anomalies before strong earthquakes. Results of identification by means of satellite surveys of linear anomalies of cloudiness which were observed before strong earthquakes in Asia Minor are given in work. The archival images registered by a sensor of MODIS which is established on the meteorological AQUA and TERRA satellites were used. The task consisted in that at the known time and the place of a strong earthquake, to carry out the analysis of cloudiness in the satellite images registered in previous days for the purpose of detection of cloudiness anomalies (in particular linear) to define time difference between emergence of anomalies of cloudiness and a strong earthquake. It turned out that this time difference is obviously connected with a geological structure of the region. For example, cloudiness anomalies near the city of Anapa (Russia) were observed before a strong earthquake (on November 9, 2002, the magnitude of 4.4 points) in 2 days, and cloudiness anomalies before an earthquake on October 23, 2011, magnitude 7.2 near the lake Van (Turkey) began to be observed in 10 days before earthquake, and the most accurate and extended linear cloudiness anomaly was observed in 5 days prior to this earthquake.
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Roggen, Inge, Gerlant van Berlaer, Geert Gijs y Ives Hubloue. "Clinical Characteristics of the Inhabitants of an Internally Displaced Persons Camp in Brazzaville, Republic of Congo After the Arms Dump Blast on March 4, 2012". Prehospital and Disaster Medicine 29, n.º 5 (27 de agosto de 2014): 516–20. http://dx.doi.org/10.1017/s1049023x14000892.
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AbstractBackgroundOn March 4, 2012, an arms dump exploded in a densely populated area in Brazzaville, Republic of the Congo. At least 250 people were killed, 2,500 wounded, and 13,800 left homeless, of which 5,000 were relocated to a newly constructed internally displaced person (IDP) camp.AimTo describe the medical complaints of persons presenting to the IDP camp for medical evaluation.Patients and MethodsAll patients seen and treated by the Belgian First Aid and Support Team (B-FAST) in the IDP camp on March 10 and 11, 2012 were included. A unique number, age, gender, and inventory of complaints were registered on standard World Health Organization (WHO) forms.ResultsOut of 245 presenting patients, 242 files were processed. One in two patients were minors (<18 years-old), the male/female ratio was 50/50 in minors and 28/72 in adults; median (range) age in minors was three years (0-17) and for adults was 32.5 years (18-68). Twenty percent of the children were determined to be malnourished. Signs and symptoms related to infectious diseases were present in 75% of minors and 53% of adults. Trauma was present in 12% of minors and 21% of adults.ConclusionsOne week following the disaster event, after people had relocated to IDP camps, infectious diseases became the predominate reason for seeking medical evaluation. Less than one in five people presenting to the medical post had injuries directly related to the event. Demographic data showed that around 50% of people in the IDP camp presenting for medical care were children, of which one in five was malnourished.RoggenI,van BerlaerG,GijsG,HubloueI.Clinical characteristics of the inhabitants of an internally displaced persons camp in Brazzaville, Republic of Congo after the arms dump blast on March 4, 2012.Prehosp Disaster Med.2014;29(5):1-5.
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Miron, Gabriela Monica. "The Influence of VAT Variation on the Damages Resulting from Fraud in the Romanian Economy". Studia Universitatis „Vasile Goldis” Arad – Economics Series 30, n.º 4 (1 de diciembre de 2020): 111–31. http://dx.doi.org/10.2478/sues-2020-0027.
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AbstractThe purpose of this article is to determine the influence of the VAT rates variation, on different fields of activity of national economy, on the damage caused to the state's consolidated budget, from the point of view of the damage caused and damage recovered the damage that is caused by economical-financial offenses. Between 2011 and 2019, the VAT rate registered a continuous decrease from 24% to 19%, which significantly reduces the amount of damage caused and recovered.Our study intends to point out the fact that in Romania, the various VAT rate had a major income on the damage caused as well as the damage recovered, thus leading to a decrease in several fields of activity. On the opposite side, there were fields of activity where a major increase of damage was registered, considering that the VAT rate decreased all along the period of time analyzed, such is the case of recycled materials. In some cases, the VAT decrease determined significant diminution of the damage caused and not of the damage recovered and in other cases, it had an effect only on the damage recovered or had no effect at all.
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Arrey, Sally K., Marilynne N. Kirshbaum y Vincent Finn. "In search of care strategies for distressed people with communication difficulties and a learning disability in palliative care settings: the lived experiences of registered learning disability nurses and palliative care professionals". Journal of Research in Nursing 24, n.º 6 (31 de mayo de 2018): 386–400. http://dx.doi.org/10.1177/1744987118764532.
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AimsThe aim of this study was to gain an in-depth phenomenological understanding of the care strategies used by registered learning disability nurses (RNLDs) and palliative care professionals (PCPs) to identify and respond to the distress of people with communication difficulties and a learning disability (PCDLD) in palliative care settings. The objective was to critically explore the lived experiences of RNLDs and PCPs who care for distressed PCDLD in palliative care settings.MethodsA single-phase hermeneutic phenomenological study following Van Manen provided the framework for the synthesis and structuring of the hermeneutic phenomenological text. Participants were drawn from learning disability nursing homes, community learning disabilities teams and hospices. Purposive sampling was used, and 13 participants comprising eight RNLDs and five PCPs were interviewed. Data were collected by semi-structured, audio-recorded interviews, field notes and a demographic questionnaire. Hermeneutic data analysis was used. Ethical approval was gained from the University Research Ethics Panel and from individual research locations.ResultsThe primary strategies used by the participants to identify and respond to the distress of PCDLD were encapsulated by seven main themes: knowing by building relationships; positivity in successful caring outcomes; humane care; moral duty of care; time to care; comfortable care environment; and future perspectives.ConclusionsEffective care strategies based on the above-mentioned findings can reduce the dilemma professionals encounter in addressing the distress of PCDLD and enhance their confidence to care.
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Majoni, Blessings. "VAT withholding tax and its impact on vat compliance: evidence from the Zimbabwe revenue authority". African Multidisciplinary Tax Journal 2021, n.º 1 (febrero de 2021): 228–43. http://dx.doi.org/10.47348/amtj/2021/i1a13.
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Value-added tax (VAT) withholding tax is a key instrument used in various tax administrations to curb revenue leakages that emanate from clients that charge VAT on their services and supplies and then fail to remit it to revenue authorities. The Zimbabwe Revenue Authority (ZIMRA) implemented VAT withholding in 2017 with the expectation that it would positively affect VAT compliance. The motivation of this study therefore arises from the knowledge that a number of developing countries are considering implementing a withholding tax mechanism on VAT. In addition, a number of developing countries such as the Philippines, Ethiopia and Ghana, have implemented VAT withholding tax with varying outcomes. Public finance literature on the empirical analysis of VAT withholding tax is, however, limited as it requires administrative data that most tax researchers are not privy to. This paper sought to undertake a more comprehensive empirical investigation of the direct effect of the introduction of VAT withholding tax on VAT compliance. To estimate the empirical effect of VAT withholding tax on VAT compliance, this paper exploited data of VAT registered clients in ZIMRA over a 24-month period. The study used an ordinary least squares (OLS) multiple regression analysis to investigate the effects of VAT withholding tax on VAT revenue. The study further used a difference-in-differences estimator by classifying VAT taxpayers into two groups. Empirical evidence indicates that there is a positive significant relationship between implementing VAT withholding tax and VAT revenue in the ZIMRA scenario.
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Kwon, Hyung-Min, Jong-Ho Park, Jin Ho Park, Han-Yeong Jeong, Jae-Sung Lim, Han-Gil Jeong, Dong Wook Shin, Jae Moon Yun y Hyejin Lee. "Visceral Fat Is an Independent Predictor of Cerebral Microbleeds in Neurologically Healthy People". Cerebrovascular Diseases 42, n.º 1-2 (2016): 90–96. http://dx.doi.org/10.1159/000445300.
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Background: Obesity has a significant contribution to the risk of intracerebral hemorrhage (ICH). However, little is known about the association between central obesity and the presence of cerebral microbleeds (CMBs), a precursor of ICH. We sought to assess whether visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) are associated with the presence of CMB. Methods: We conducted a cross-sectional study of 1,737 neurologically healthy people (mean age 55.9 ± 9.1; 790 men), who underwent brain MRI and abdominal CT. Risk factors, anthropometric parameters and clinical information were obtained. CMBs were evaluated through T2*-weighted gradient-recalled echo MRI. The cross-sectional surface areas of the abdominal fat compartments were calculated. Study subjects were stratified into quartiles according to the distribution of VAT/SAT ratio. Results: A total of 75 (4.3%) subjects were found to have CMBs. Subjects with a greater quartile of VAT/SAT ratio were more likely to have higher numbers of CMBs (0 to ≥2; p = 0.001). In multivariable analysis, age and history of hypertension were associated with the presence of CMB (OR 1.09, 95% CI 1.06-1.13, p < 0.001; OR 1.70, 95% CI 1.01-2.84, p = 0.046, respectively). A dose-response relationship was observed between the extent of VAT/SAT quartile and CMB: compared to the lowest VAT/SAT quartile, OR 2.14 (95% CI 0.86-5.35) for second VAT/SAT quartile; OR 2.26 (95% CI 0.86-5.92) for third VAT/SAT quartile; and OR 2.91 (95% CI 1.04-8.12) for the highest VAT/SAT quartile (p for trend 0.03). Conclusion: In our study, higher VAT/SAT ratios were found to be independent predictors of CMBs in neurologically healthy people. This finding strengthens previous data, suggesting that visceral fat distribution is an important contributor to cerebral small vessel disease.
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Kuria, Dr John. "EFFECT OF VAT INCENTIVES ON THE PERFORMANCE OF EPZ FIRMS IN KENYA". American Journal of Finance 3, n.º 1 (20 de abril de 2018): 31. http://dx.doi.org/10.47672/ajf.324.
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Purpose: The purpose of this study was to determine the effect of VAT Incentive on the performance of EPZ firms in Kenya.Methodology: This research used correlation research design. Sample size of all the 86 registered EPZs firms was used in this study. Primary data was obtained using questionnaires. Secondary data from the registered firms was collected on; ROA, number and value of jobs and the length of stay of the firms. The study used both descriptive and inferential statistics to conduct data analysis.Results: The results of study revealed that at 5% significance level, VAT incentives had a positive and significant relationship with performance of EPZ firms measured using ROA. The results further revealed that at 5% significance level, VAT incentives were found to have positive and significant relationship with performance of EPZ firms measured using the number of total jobs created in Kenya. The results also revealed that at 5% significance level, VAT incentives were found to have positive and significant relationship with performance of EPZ firms measured using the number of years in operationUnique contribution to theory, practice and policy Based on the study findings, it was recommended that the government should reconsider its VAT policy by encouraging more VAT rebates to firms in order to boost their productivity and increase the volume of exports. The study also recommends that the government should introduce a strong monitoring unit to oversee the administration of tax incentives. Government should equally pay attention to the issue of security and infrastructure which are basic in order to maximize the benefits of tax incentives.
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Dias, Katrin A., Joyce S. Ramos, Matthew P. Wallen, Peter S. W. Davies, Peter A. Cain, Gary M. Leong, Charlotte B. Ingul, Jeff S. Coombes y Shelley E. Keating. "Accuracy of Longitudinal Assessment of Visceral Adipose Tissue by Dual-Energy X-Ray Absorptiometry in Children with Obesity". Journal of Obesity 2019 (3 de noviembre de 2019): 1–12. http://dx.doi.org/10.1155/2019/2193723.
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Background. Increased visceral adipose tissue (VAT) is strongly associated with cardiometabolic risk factors. Accurate quantification of VAT is available through magnetic resonance imaging (MRI), which incurs a significant financial and time burden. We aimed to assess the accuracy of dual-energy X-ray absorptiometry- (DXA-) derived VAT (DXA-VAT) against a gold standard MRI protocol (MRI-VAT) in children with normal weight and obesity cross-sectionally, and over the course of a lifestyle intervention. Methodology. MRI-VAT and DXA-VAT were quantified in 61 children (30 normal weight and 31 with obesity) at baseline. Children with obesity entered a three-month exercise and/or nutrition intervention after which VAT was reassessed. MRI- and DXA-VAT cross-sectional area, volume, and mass were quantified, and associations were calculated at baseline (n = 61) and pre-post intervention (n = 28, 3 participants dropped out). Method agreement was assessed through Bland–Altman analysis, linear regression, and Passing–Bablok regression. Results. At baseline, all DXA- and MRI-VAT outcomes were strongly associated (r = 0.90, P<0.001). However, there were no significant associations between absolute or relative change in DXA- and MRI-VAT outcomes (r = 0.25–0.36, P>0.05). DXA significantly overestimated VAT CSA (cross-sectional area), volume, and mass when compared with MRI (P<0.001) at baseline. Significant proportional bias was observed for all DXA-VAT outcomes at baseline and for relative longitudinal changes in DXA-VAT. Conclusions. Although DXA-VAT outcomes were strongly associated with MRI-VAT outcomes at baseline, estimates were subject to proportional bias in children with obesity and normal weight. DXA lacks validity for detecting changes in VAT among children with obesity. This trial is registered with NCT01991106.
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Šálková, Daniela, Petr Kučera y Lukáš Moravec. "Effect of Introducing Second Reduced Rate of VAT on Consumer Purchase Behaviour with Gluten‑free Food". Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis 65, n.º 3 (2017): 1045–53. http://dx.doi.org/10.11118/actaun201765031045.
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The aim of the paper is to assess the effect of introducing the second reduced rate of VAT of 10 % since 1 January 2015 on consumer behaviour when purchasing gluten‑free food. Monitoring the effect of the VAT rate reduction on selected gluten‑free food and products was a part of a research focused on gluten‑free consumer preferences when eating in restaurants (960 respondents were interviewed). Further research which was focused on the effect of the VAT rate reduction and which surveyed the consumer criteria when purchasing gluten‑free products addressed a total of 160 respondents with a gluten‑free diet. According to the respondents’ experience, the introduction of the second reduced VAT rate of 10 % has not significantly affected the prices for the final consumers. The reason for that may be the fact that the second reduced VAT rate applies mostly to ingredients used in gluten‑free production and only a few final products. A large group of coeliacs is not even aware of or has not registered the VAT change.
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Salia, Hussein. "The Effect of Value Added Tax on Corporate Cash Flow in Ghana". International Journal of Business and Management 11, n.º 7 (21 de junio de 2016): 303. http://dx.doi.org/10.5539/ijbm.v11n7p303.
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<p>This study investigated whether there is a relationship between value added tax (VAT) and corporate cash flow. In order to conduct the study, corporate entities registered with the Large Tax Payer Unit (LTU) of the Ghana Revenue Authority (GRA) were selected, and data from January 1, 2009, through December 31, 2011, were analyzed. The purpose of this study was to establish if there is a statistically significant relationship between VAT and corporate cash flow. Apart from providing empirical evidence of VAT effect on corporate cash flow, the study was expected to establish the major tax and corporate policy implications to decision makers. This will aid governments in making a choice between VAT and corporate tax—as sufficient literature on the effect of corporate income tax (CIT) on organizational cash flow already exists. The findings clearly suggested that there is a statistically significant difference in cash flow patterns between organizations that pay VAT and entities that do not pay VAT. The study further established that, apart from sales, all other selected independent variables had a negative relationship with VAT. However, the findings contradicted the assertion that the VAT burden is fully borne by only the final consumer. researcher on the factors influencing employees’ performance.</p>
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Li, Minghui, Longlong Hu, Lihua Hu, Xiao Huang, Xi Liu, Wei Zhou, Tao Wang, Lingjuan Zhu, Huihui Bao y Xiaoshu Cheng. "Visceral Adiposity Index Is Inversely Associated with Renal Function in Normal-Weight Adults with Hypertension: The China H-Type Hypertension Registry Study". Journal of Nutrition 151, n.º 6 (10 de marzo de 2021): 1394–400. http://dx.doi.org/10.1093/jn/nxab022.
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ABSTRACT Background Risk of chronic kidney disease (CKD) is higher in normal-weight metabolically unhealthy people, especially when combined with hypertension. In this context, whether the visceral adiposity index (VAI), which reflects body fat distribution and metabolism, can be used to identify the risk of CKD among normal-weight hypertensive patients is unclear. Objectives This study aimed to evaluate the association between VAI and renal function in normal-weight hypertensive patients. Methods In this cross-sectional study, 8591 hypertensive patients with normal BMI from the China H-type Hypertension Registry Study were analyzed. The VAI was calculated with serum triglycerides, serum HDL cholesterol, waist circumference, and BMI. VAI was ln-transformed for analysis on account of the skewed distribution. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration equation. CKD was defined as an eGFR <60 mL · min−1 · 1.73 m−2. Multivariable linear and multivariable logistic regression analyses were performed to evaluate the association of VAI with eGFR and CKD. Results The prevalence rate of CKD was 10.1%. Multivariable linear regression analyses showed that an elevated lnVAI reduced eGFR by 2.63 mL · min−1 · 1.73 m−2 (95% CI: −3.54, −1.72 mL · min−1 · 1.73 m−2). Multivariable logistic regression analysis showed that an elevated lnVAI was independently associated with the prevalence of CKD (OR: 1.59; 95% CI: 1.31, 1.93). As possible confounding factors were removed the association became greater. The higher the VAI was, the greater the decrease in eGFR and the higher the risk of CKD. No significant interactions were found in any of the subgroups (age, sex, physical activity, current smoking, current drinking, fasting glucose, LDL cholesterol, blood pressure, and antihypertensive drugs). Conclusions VAI, as a simple surrogate measure of visceral fat accumulation, is independently and inversely associated with renal function in normal-weight Chinese hypertensive adults. This trial was registered at chictr.org.cn as ChiCTR1800017274.
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Çınar, Fadime y Fatma Eti Aslan. "Evaluation of Anatolian Alevi people living in Istanbul with “Purnell' Cultural Competence Model”İstanbul’da yaşayan Anadolu Alevilerinin Purnell’in Kültürel Yeterlilik Modeli ile değerlendirilmesi". Journal of Human Sciences 15, n.º 1 (11 de febrero de 2018): 98. http://dx.doi.org/10.14687/jhs.v15i1.4653.
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The purpose of this study is to evaluate Anatolian Alevi People Living In Istanbul With Cultural “Purnell' Cultural Competence Model”. Sample of this qualitative conducted study includes total 30 Alevi people aging between 19 and 56, registered at Ümraniye Ihlamurkuyu djemevi. Snowball sampling method was used to select sample. The research data were collected in the form of a semi-structured interview form, written recordings and voice recordings, which included the topics included in Purnell's cultural competence model to assess cultural features.Focus group interviews were conducted between January and March 2017. Data were collected by using voice and written records. Collected data were analyzed by using descriptive analysis and semiotics methods. It is reported that early marriage, marriage with relatives and early pregnancy are common, and alcohol and smoking are rare in Alevi population. In addition, it was also reported that there are some negative perceiving such as double standard in society, low health service opportunity, and religious discrimination. Results found in the research showed that there are not significant differences between Anatolian Alevi and Turkish population on social demographic and social structures. In order to decrease this perceiving, more social and cultural combining programs may be conducted.Extended English summary is in the end of Full Text PDF (TURKISH) file.ÖzetBu araştırmanın amacı, İstanbul’da Yaşayan Anadolu Alevilerinin Purnell’in Kültürel Yeterlilik Modeline bağlı olarak değerlendirmektir. Niteliksel türde desenlenen araştırmanın evrenini, Ümraniye Ihlamurkuyu cem evine kayıtlı olan Türk kökenli 19-56 yaş arası toplam 30 alevi oluşturdu. Örneklem seçiminde kartopu örnekleme yöntemi kullanıldı. Araştırma verileri, kültürel özellikleri değerlendirmek için Purnell’in kültürel yeterlilik modelinde yer alan temaları içeren yarı-yapılandırılmış görüşme formu ile yazılı kayıt ve ses kaydı şeklinde toplandı. Odak grup görüşmeleri Ocak-Mart 2017 tarihleri arasında gerçekleştirildi. Elde edilen veriler betimsel analiz ve gösterge bilimsel analiz yöntemleri ile değerlendirildi. Araştırma sonuçlarına göre Alevilerde erken yaşta evlilik, akraba evliliği ve erken gebe kalmanın yaygın olduğu, alkol ve sigara kullanımının az olduğu ifade edildi. Araştırmada elde edilen bulgular, Türk Alevilerinin aslında sosyo demografik ve sosyal yapılarının Türk toplumunun genel yapısından farklı olmadığını, temelde inanç farklılığı üzerinden, Türk toplumunda var olan olumsuzlukların buna yorulduğu görüldü. Bu algının azaltılması için, daha fazla sosyal ve kültürel kaynaşma programlarına yer verilebilir.
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Hansford, Ann, John Hasseldine y Carole Howorth. "Factors Affecting the Costs of UK VAT Compliance for Small and Medium-Sized Enterprises". Environment and Planning C: Government and Policy 21, n.º 4 (agosto de 2003): 479–92. http://dx.doi.org/10.1068/c0319.
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As firms grow, taxation and, in particular, value added tax (VAT), is one of the first areas in which they must deal with government regulations. It has been argued in the United Kingdom that regulatory requirements are burdensome and can even be a constraint on the development and growth of small and medium-sized enterprises (SMEs). The authors focus on SMEs and link the literature on VAT regulations and compliance costs to wider issues relating to SMEs. The costs of complying with VAT regulations are separated into core costs and total costs. Core costs are the mandatory costs that SMEs have to incur in order to comply with the VAT legislation and regulations. Total costs include VAT planning and one-off costs. For SMEs core costs represent a larger proportion of total compliance costs than is the case for larger businesses. A reduction in core costs would have a significant impact on the total VAT-compliance costs for SMEs. Factors expected to be associated with higher compliance costs are identified and tested in a multivariate framework. Empirical data were obtained from a survey of 4796 firms resulting in a final sample of 1085 firms and a response rate of 25.1%. Higher compliance costs (in absolute terms) are associated, inter alia, with increased turnover, newly registered firms, and increased complexity. Firms with higher compliance costs also perceived high psychological costs of VAT compliance. Compliance costs were also higher for individuals who did not have English as their first language, and individuals with special needs. The important implications of the findings for policy are highlighted.
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Pelletier, Chelsea A., Maryam Omidvar, Masae Miyatani, Lora Giangregorio y B. Catharine Craven. "Participation in moderate-to-vigorous leisure time physical activity is related to decreased visceral adipose tissue in adults with spinal cord injury". Applied Physiology, Nutrition, and Metabolism 43, n.º 2 (febrero de 2018): 139–44. http://dx.doi.org/10.1139/apnm-2017-0304.
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Increased visceral adiposity places individuals with chronic spinal cord injury (SCI) at increased risk of cardiometabolic disease. The purpose of this study was to identify if people with chronic SCI who participate in any moderate- to vigorous-intensity leisure time physical activity (LTPA) have lower visceral adipose tissue (VAT) area compared with those who report none. Participants included 136 adult men (n = 100) and women (n = 36) with chronic (mean (±SD) 15.6 ± 11.3 years post-injury) tetraplegia (n = 66) or paraplegia (n = 70) recruited from a tertiary rehabilitation hospital. VAT area was assessed via whole-body dual-energy X-ray absorptiometry using a Hologic densitometer and the manufacturer’s body composition software. Moderate-to-vigorous LTPA was assessed using the Leisure Time Physical Activity Questionnaire for People with SCI (LTPAQ-SCI) or the Physical Activity Recall Assessment for People with SCI (PARA-SCI). Summary scores were dichotomized into any or no participation in moderate-to-vigorous LTPA to best represent the intensity described in current population-specific physical-activity guidelines. Data were analyzed using univariate and multiple regression analyses to identify the determinants of VAT. Overall, the model explained 67% of the variance in VAT area and included time post-injury, age-at-injury, android/gynoid ratio, waist circumference, and moderate-to-vigorous LTPA. Participation in any moderate-to-vigorous LTPA was significantly (95% confidence interval: –34.71 to –2.61, p = 0.02) associated with VAT after controlling for injury-related and body-composition correlates. Moderate-to-vigorous LTPA appears to be related to lower VAT area, suggesting potential for LTPA to reduce cardiometabolic disease risk among individuals with chronic SCI.
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Du, Xuan, Wen Lu, Zijun Lu, Xinyu Shao, Chunhong Hu y Bimin Shi. "Exenatide with Metformin Ameliorated Visceral Adiposity and Insulin Resistance". Journal of Diabetes Research 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/4019248.
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Background. To study the effectiveness of exenatide with metformin and sequential treatment with exenatide and glargine added to metformin and their influence on insulin sensitivity and adipose distribution. Methods. 20 newly diagnosed obese type 2 diabetic patients were enrolled, and 2-month washout treatment of metformin, 6-month exenatide treatment, and 6-month glargine treatment were administrated sequentially accompanied with previous metformin. Glucolipid metabolic parameters were compared among groups. Adipose distribution was quantified with computerized tomography according to anatomy, dividing into visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), adding up to total adipose tissue (TAT). Results. The 6-month exenatide treatment dramatically ameliorated the glucose and lipid profile, improved insulin sensitivity, and mainly decreased VAT and also the ratio of VAT/SAT (RVS). The following 6-month glargine treatment increased VAT. The whole 12-month sequential treatment with exenatide and glargine added to metformin basically improved the insulin sensitivity and glucolipid control though VAT rebounded at the end, however without deteriorating the other parameters. Conclusion. Exenatide is an ideal treatment for obese type 2 diabetic patients in the aspect of adipose tissue distribution. Sequential treatment of exenatide and glargine could be an alternative for low-income patients who cannot afford GLP-1 agonist for long time. This trial is registered with ChiCTR-OOC-17013679.
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Prasetyo, Kristian Agung y Muhammad Djufri. "PENGGUNAAN BENFORD'S LAW UNTUK MENENTUKAN PRIORITAS AUDIT PAJAK PERTAMBAHAN NILAI". Scientax 1, n.º 2 (27 de abril de 2020): 167–83. http://dx.doi.org/10.52869/st.v1i2.40.
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Value Added Tax has contributed significantly in Indonesia’s tax revenue and continually to progress in the term of its role in increasing the tax revenue. Unfortunately, the phenomenon of VAT fraud, intended to minimize VAT payment, would give consequences in violating the tax revenue. In order to minimize this phenomenon, DGT has been maximizing the use of technology in VAT administration. Since the 1st of July 2016, the use of e-Faktur has been enforced to all registered Taxable Entrepreneurs. The enforcement of the e-Faktur has been effectively reducing the number of counterfeit tax invoices. Nonetheless, the e-Faktur is still not be able to capture the accuracy of transactions in Tax Invoices. As a result, DGT relies heavily on the approach of conventional audit for auditing taxpayers’ VAT compliance. This approach is considered to be less effective and become a problem since DGT does not have sufficient tax auditors. The number of tax invoices that needs to be audited could be piled up whilst the amount of tax credits to be audited are also high. This paper aims to discuss this problem by using a statistical technique namely Benford's law. It is recognized in the forensic audit literature that Benford's law can be a tool to help an early fraud examination of many transactions. By using particular statistical procedures, this paper will argue that Benford's Law can be used to analyze the accuracy of VAT value on tax invoices that is reported on the monthly VAT Return.
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van Eekelen, Esther, Anouk Geelen, Marjan Alssema, Hildo J. Lamb, Albert de Roos, Frits R. Rosendaal y Renée de Mutsert. "Sweet Snacks Are Positively and Fruits and Vegetables Are Negatively Associated with Visceral or Liver Fat Content in Middle-Aged Men and Women". Journal of Nutrition 149, n.º 2 (16 de enero de 2019): 304–13. http://dx.doi.org/10.1093/jn/nxy260.
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ABSTRACT Background Visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) are major risk factors for cardiometabolic diseases. Objective We aimed to investigate the association of dietary intake of the main food groups with VAT and HTGC in middle-aged men and women. Methods We used data from the Netherlands Epidemiology of Obesity study, a population-based study including 6671 participants aged 45–65 y at baseline. In this cross-sectional analysis, VAT and HTGC were assessed by magnetic resonance imaging and spectroscopy, respectively, as the primary outcomes. Habitual intake of main food groups (dairy, meat, fish, fruits and vegetables, sweet snacks, and fats and oils) was estimated through the use of a food-frequency questionnaire. We examined associations of intake of different food groups with VAT and HTGC by linear regression analysis stratified by sex and adjusted for age, smoking, education, ethnicity, physical activity, basal metabolic rate, energy-restricted diet, menopausal state, and total energy intake. Results In women, a 100-g/d higher intake of dairy was associated with 2.0 cm2 less VAT (95% CI: −3.4, −0.7 cm2) and a 0.95-fold lower HTGC (95% CI: 0.90-, 0.99-fold). Moreover, a 100-g/d higher intake of fruit and vegetables was associated with 1.6 cm2 less VAT (95% CI: −2.9, −0.2 cm2) in women. Fruit and vegetables were negatively associated (0.95; 95% CI: 0.91, 1.00) with HTGC, and sweet snacks were positively associated (1.29; 95% CI: 1.03, 1.63). Patterns were weaker but similar in men. Fish intake was not associated with VAT or HTGC and plant-based fat and oil intake were only associated with VAT after adjustment for total body fat. Conclusions Despite some variation in the strength of the associations between men and women, dietary intake of sweet snacks was positively associated with HTGC, and fruit and vegetable intake were negatively associated with visceral and liver fat content. Prospective studies are needed to confirm these results. The Netherlands Epidemiology of Obesity study is registered at clinicaltrials.gov with identifier NCT03410316.
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Gower, Amanda y High Peak. "Older people deserve registered nurses". Nursing Standard 21, n.º 13 (6 de diciembre de 2006): 32. http://dx.doi.org/10.7748/ns.21.13.32.s40.
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SIDOROVA, Elena Yu y Aleksei A. ARTEM'EV. "Value added tax in case of exports from the special economic zone in the Kaliningrad Oblast". National Interests: Priorities and Security 17, n.º 8 (16 de agosto de 2021): 1433–48. http://dx.doi.org/10.24891/ni.17.8.1433.
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Subject. The article focuses on the value added tax in case of exports from the special economic zone in the Kaliningrad Oblast. Objectives. We study methodological aspects of VAT in case of exports from the special economic zone in the Kaliningrad Oblast. Methods. We conducted the content analysis of available sources. The comparative analysis helped confirm the reasonableness, reliability and the relevance of methodological guidelines for determining economically adequate tax implications in terms of VAT in case of exports from the special economic zone in the Kaliningrad Oblast. Results. Importing foreign goods into the special economic zone of the Kaliningrad region and letting them pass the customs procedure of free economic zones, a Kaliningrad-registered legal entity was found to exempt from customs payments, including VAT as part of customs payments under the above procedure. Being transported to elsewhere in the EAEU, any goods in the free economic zone should be treated as foreign goods, unless their status as the EAEU goods is corroborated with documents. The effective tax and customs regulations provide for VAT to be paid on imports into the Russian Federation, including as part of customs payments, and subsequently VAT on the sale of goods in the Russian Federation. VAT on imports, inter alia, as part of customs payments is subject to tax deductions as per Articles 171, 172 of the Russian Tax Code. Conclusions and Relevance. The taxation mechanism herein is identical to that applying to exports from the free economic zone to elsewhere in the customs area of the EAEU if there were not tax clauses envisaged in Federal Law № 72-ФЗ. Hence, the above clauses seem reasonable to be excluded.
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Ruddy Kabwe. "The VAT Treatment of Cryptocurrencies in South Africa: Lessons From Australia". Obiter 41, n.º 4 (24 de marzo de 2021): 767–86. http://dx.doi.org/10.17159/obiter.v41i4.10487.
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Cryptocurrencies are revolutionary digital currencies used by people on a peer to peer network. Cryptocurrencies are predominantly used as a payment method in business transactions. However, challenges arise with cryptocurrency borne transactions due to the lack of universal accepted classification of cryptocurrencies, the result of which leads to unintended tax consequences for cryptocurrency users. This article examines the recent amendment to the Value-Added Tax (VAT) 89 of 1991 pertaining specifically to the VAT treatment of cryptocurrencies in South Africa. Currently, transactions in cryptocurrencies are deemed to be financial services in South Africa. This means that a supply of any cryptocurrency in South Africa is exempt from VAT. This article makes a comparison with the Australian legislative framework to determine how cryptocurrencies are treated for VAT/GST purposes in that country. Although the move to regulate cryptocurrencies is welcomed, this article argues that cryptocurrency activities are incorrectly legislated as financial services in the VAT Act.
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Dorling, James L., Christoph Höchsmann, Catrine Tudor-Locke, Robbie Beyl y Corby K. Martin. "Effect of an office-based intervention on visceral adipose tissue: the WorkACTIVE-P randomized controlled trial". Applied Physiology, Nutrition, and Metabolism 46, n.º 2 (febrero de 2021): 117–25. http://dx.doi.org/10.1139/apnm-2020-0175.
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Office-based activity reduces sedentariness, yet no randomized controlled trials (RCTs) have assessed how such activity influences visceral adipose tissue (VAT). This study examined the effect of an office-based, multicomponent activity intervention on VAT. The WorkACTIVE-P RCT enrolled sedentary office workers (body mass index: 31.4 (standard deviation (SD) 4.4) kg/m2) to an intervention (n = 20) or control (n = 20) group. For 3 months, the intervention group received an office-based pedal desk, further to an intervention promoting its use and increased walking. The control group maintained habitual activity. At baseline and follow-up, VAT, cardiometabolic disease risk markers, physical activity, and food intake were measured. Steps/day were not altered relative to control (P ≥ 0.51), but the pedal desk was utilized for 127 (SD 61) min/day. The intervention reduced VAT relative to control (−0.15 kg; 95% confidence interval (CI) = −0.29 to −0.01; P = 0.04). Moreover, the intervention decreased fasting glucose compared with control (−0.29 mmol/L; 95% CI = −0.51 to −0.06; P = 0.01), but no differences in other cardiometabolic disease markers or food intake were revealed (P ≥ 0.11). A multicomponent intervention decreased VAT in office workers who were overweight or obese. Though longer-term studies are needed, office-based, multicomponent activity regimens may lower cardiometabolic disease risk. Trial registered at ClinicalTrials.gov (NCT02561611). Novelty: In WorkACTIVE-P, a multicomponent activity intervention decreased visceral adipose tissue relative to control in office workers. The intervention also reduced glucose compared with control, though other metabolic risk markers and food intake were not altered. Such multicomponent interventions could help reduce cardiometabolic disease risk, but longer studies are needed.
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Horobets, N. S. "Specific Features of Counteracting VAT Evasion: Experience of Ukraine and Foreign Countries". Bulletin of Kharkiv National University of Internal Affairs 91, n.º 4 (20 de diciembre de 2020): 121–29. http://dx.doi.org/10.32631/v.2020.4.11.
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The article is focused on determining specific features of counteracting VAT evasion in Ukraine and foreign countries. It has been found out that the presence of VAT in the tax system of any state is a prerequisite for such a state to become a member of the European Union and it is due to its broad tax base and more neutral impact on economic decision-making on investment and consumption issues. It has been noted that the joint search by the states for the ways to combat VAT evasion is due to the need to minimize the damage caused to the financial and economic interests of the state by such actions, to increase the efficiency of value added tax, to increase the competitiveness level of domestic producers, to stimulate priority economic activities in the state. The content of value added tax as an indirect tax in accordance with the provisions of scientific doctrine has been revealed. Specific features of legal and illegal (tax crime) types of VAT evasion have been studied. The list of the methods to evade value added tax in Ukraine and foreign countries has been provided. The specifics of general and special ways to counteract this action have been revealed. The emphasis has been placed on such methods of counteracting VAT evasion as enshrining legal liability for VAT evasion at the legislative level; exercising tax control over the entities that are registered as value added taxpayers; usage of electronic document management and other opportunities of the digital economy, which allows to identify risks in the activities of taxpayers during their initial registration, etc. It has been concluded that there is no unified approach to the implementation of counteraction to value added tax evasion by state-authorized agencies; and the emphasis has been placed on the feasibility of existence of a basic list of the methods to counteract value added tax evasion.
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Kabakambira, J. Damascene, Rafeal L. Baker Jr, Sara M. Briker, Amber B. Courville, Lilian S. Mabundo, Christopher W. DuBose, Stephanie T. Chung, Robert H. Eckel y Anne E. Sumner. "Do current guidelines for waist circumference apply to black Africans? Prediction of insulin resistance by waist circumference among Africans living in America". BMJ Global Health 3, n.º 5 (octubre de 2018): e001057. http://dx.doi.org/10.1136/bmjgh-2018-001057.
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BackgroundTo lower the risk of diabetes and heart disease in Africa, identification of African-centred thresholds for inexpensive biomarkers of insulin resistance (IR) is essential. The waist circumference (WC) thresholds that predicts IR in African men and women have not been established, but investigations recently conducted in Africa using indirect measures of IR suggest IR is predicted by WC of 80–95 cm in men and 90–99 cm in women. These WC cannot be used for guidelines until validated by direct measurements of IR and visceral adipose tissue (VAT). Therefore, we determined in a group of African-born black people living in America (A) the WC, which predicts IR and (B) the influence of abdominal fat distribution on IR.MethodsThe 375 participants (age 38±10 years (mean±SD), 67% men) had IR determined by HOMA-IR and Matsuda index. VAT and subcutaneous adipose tissue (SAT) were measured by abdominal CT scans. Optimal WC for the prediction of IR was determined in sex-specific analyses by area under the receiver operating characteristic (AUC-ROC) and Youden index.ResultsWomen had more SAT (203±114 vs 128±74 cm2) and less VAT than men (63±48 vs 117±72 cm2, p<0.001). Optimal WC for prediction of IR in men and women were: 91 cm (AUC-ROC: 0.80±0.03 (mean±SE)) and 96 cm (AUC-ROC: 0.81±0.08), respectively. Regression analyses revealed a significant sex–VAT interaction (p<0.001). Therefore, for every unit increase in VAT, women had a 0.94 higher unit increase in SAT and 0.07 higher unit increase in WC than men.ConclusionWorking with a group of African-born black people living in America, we accessed technology, which validated observations made in Africa. Higher SAT at every level of VAT explained why the WC that predicted IR was higher in women (96 cm) than men (91 cm). For Africans to benefit from WC measurements, convening a panel of experts to develop evidence-based African-centred WC guidelines may be the way forward.
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Koroleva, Lyudmila P. "VAT and its influence on Russian macroindicators". Tyumen State University Herald. Social, Economic, and Law Research 6, n.º 1 (2020): 199–215. http://dx.doi.org/10.21684/2411-7897-2020-6-1-199-215.
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The importance of this research links to the controversial discussion about the role of the value-added tax (VAT) in the sphere of macroeconomic regulation. The assumption of its neutral influence on economic growth has led to increasing VAT rate in Russia from 18% to 20%. However, the reduction of consumer expenditures, revenues, and profits is a possible negative effect. In addition, people criticize the mechanism of VAT refund for the absence of any impact on export and investment. Thus, the goal of this research lies in verifying the most popular visions on VAT’s influence on Russian macroindicators. The methodology of the research comes from the concepts recognizing taxes as an effective tool. The author applies general scientific and econometric methods (correlation, analysis of variance, and regression analysis) using MS Excel. The author formulates four hypotheses that have shown stable views about VAT’s influence on macroeconomy. They have been tested via six equations of linear regression; the significance of the equations has been estimated via the coefficient of determination, Fisher criterion, the average error of approximation; the significance of the coefficients d — via p-value and Student’s t-criterion. Each equation is statistically significant reliably reflecting the relationship between the resulting and factor. The obtained results have proven the 2nd and 4th hypotheses. Conclusion: VAT is directly related to consumer spending, gross profit and gross mixed income, intermediate consumption, and export. VAT refund stimulates export and investments to capital assets. The results of research could be considered as an arguments of proposals to changing the procedure for calculating and paying VAT in Russia.
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Elbashir, K., R. Gore, C. Bloem, P. Roblin, G. Ostrovskiy, T. Abuaaraki, M. Yousif y B. Arquilla. "(A316) Pre-Hospital Emergency Care in Sudan - Current Practices in Disaster Management (DM)". Prehospital and Disaster Medicine 26, S1 (mayo de 2011): s89. http://dx.doi.org/10.1017/s1049023x11003001.
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IntroductionThe problems of pre-hospital care and training in the developing world are very similar – resource limitations and training deficiencies. Humanitarian conditions in the Sudan have been among the worst in the world including both man-made and natural disasters. Effectively responding to emergencies is of paramount importance.MethodsThe information was collected by a group of Sudanese physicians working in the emergency department at a large urban public hospital in Khartoum, Sudan and in the U.S. for the purpose of establishing structured training programs for pre-hospital responders.ResultsThere are currently 37 registered state operated mini-van ambulances serving ∼8 million people in the capital city of Khartoum. There is 1 central dispatching command center operated by the state Ministry of Health (MOH) that serves 29 hospitals. Services are available by calling a central “999” emergency response number. There are no private ambulances in Khartoum; however, most patients are transported by private or public transportation. Ambulance transport teams consist of ∼2 ambulance emergency assistants with limited medical training. Ambulance transport costs are covered either by insurance for the insured; however, the majority of patients are self paid. Emergencies are also managed by the Department of Civil Defense, which is a branch of the Sudanese MOH that responds to natural and man-made disasters. There are 2 layers of this team; 420 physician with masters degrees in DM and emergency rescue workers. These emergency rescue workers do not have formalized training. Other important findings are: lack of training centers for first emergency responders, no standardized practice guide lines among pre-hospital care personnel.ConclusionEmergency response in the Sudan is a relatively new practice but has shown a promising trend for the continued development of a highly advanced and functional pre-hospital/emergency response system. More structured training through collaborative efforts and substantial resources are needed.
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Hunter, Stephanie, Robert Considine y Richard Mattes. "The Effects of Long Term Almond Consumption in Adults with Different Body Fat Distributions on Anthropometric Characteristics and HbA1c". Current Developments in Nutrition 4, Supplement_2 (29 de mayo de 2020): 638. http://dx.doi.org/10.1093/cdn/nzaa049_031.
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Abstract Objectives The purpose of this study was to determine if the mixed evidence of almond consumption on long term glycemic control stems from testing people with different body fat distributions. Methods A 6-month randomized controlled trial in 118 adults was conducted. Participants were randomly assigned to the almond or control group based on their body fat distribution. Those in the almond group consumed 0.75 oz of almonds with their breakfast and as their afternoon snack (1.5 oz almonds/day) every day, and were instructed not to consume any other nuts or nut products. Those in the control group continued their habitual breakfast and afternoon snack routines, but were instructed not to consume any nuts or nut products. Anthropometric characteristics, HbA1c, and glycemic and lipemic responses to a meal tolerance test were collected at baseline and 6 months. Appetite and dietary intake data were collected at baseline, 2, 4, and 6 months as was a blood sample for compliance testing. Body weight was measured every two weeks. A preliminary linear mixed model analysis on the anthropometric characteristics and HbA1c change values and pairwise comparisons with Bonferroni correction for significant main effects was performed. Results Preliminary results indicate that there was a trend towards a difference in visceral adipose tissue (VAT) mass with the almond group losing more VAT mass compared to the control group in those with high truncal subcutaneous adipose tissue (SAT) (P = 0.054). Additionally, there was a significant difference in change of VAT mass between the high SAT and high VAT (P = 0.02) and high gluteal-femoral adipose tissue (P = 0.41) control groups. There were no significant differences in any other anthropometric variables or HbA1c. Conclusions Preliminary results indicate that while almond consumption may decrease VAT mass in those with high SAT, testing people with different body fat distributions may not be why there is mixed evidence on almond consumption on long term glycemic control. Funding Sources This research is funded by the Almond Board of California.
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Wood, Tristan. "Supporting People: Issues facing registered social landlords". Housing, Care and Support 7, n.º 1 (febrero de 2004): 4–6. http://dx.doi.org/10.1108/14608790200400002.
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Montaño-Arias, Susana Adriana, Sara Lucía Camargo-Ricalde, Rosaura Grether y David Díaz-Pontones. "Distribución conocida y potencial de dos taxa del género Mimosa (Leguminosae) endémicos de México". Revista de Biología Tropical 66, n.º 1 (13 de diciembre de 2017): 321. http://dx.doi.org/10.15517/rbt.v66i1.27910.
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Mimosa aculeaticarpa var. aculeaticarpa and M. luisana are endemic to Mexico, and are considered as multipurpose plants, due to the diverse services they offer to ecosystems and to local people. Additionally, they are appreciated for their potential to restore tropical environments; hence, the objective of this study was to model the present and potential distribution of these taxa. In 2014, species registers were obtained from two databases (CONABIO and MEXU); each register was taxonomically, geographically and statistically validated. Once validated, the present and potential distribution of M. aculeaticarpa var. aculeaticarpa (based on 99 registers) and M. luisana (based on 50 registers) were obtained using the MAXENT algorithm. For both taxa, the present distribution was overlapped using the layers of: elevation, climate, soil, biogeographic provinces, and hydrologic basins. Mimosa aculeaticarpa var. aculeaticarpa showed a wide distribution in Mexico (16 states); whilst M. luisana was restricted to the states of Puebla and Oaxaca. M. aculeaticarpa var. aculeaticarpa establishes between 1 900 and 2 700 masl, and M. luisana between 500 and 1 760 masl. Both species were established in arid and semiarid climates; however, M. aculeaticarpa var. aculeaticarpa can also be found in temperate and mesic climates. Moreover, both taxa are distributed in calcareous regosol soils; although, M. aculeaticarpa var. aculeaticarpa is also found in eutric regosol, chromic vertisol and haplic phaeozem. The distribution of M. aculeaticarpa var. aculeaticarpa includes eight biogeographic provinces and three hydrologic basins; whilst M. luisana was only located in three provinces and two hydrologic basins; both are present in the Eje Volcánico and Sierra Madre del Sur provinces. The potential distribution models are considered as excellent ones due to an AUC of 0.91 and 0.97, respectively; these models indicated that the temperature and precipitation conditions would be suitable for the enlargement of their distribution. Likewise, these models can be considered an approach to the potential distribution knowlegment of the Mexican mimosas. Nevertheless, it is important to note that the models are static and do not take into account any biotic interaction; therefore, their relationship with reality can vary. Thus, it is recommended to analyze the models through different climate change and land use scenarios.
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Shah, R. K. "Value Added Tax in Nepal: An Empirical Assessment". Tribhuvan University Journal 27, n.º 1-2 (30 de diciembre de 2010): 131–42. http://dx.doi.org/10.3126/tuj.v27i1-2.26396.
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In developing economies, resource gap is critical and widening resulting tohuge fiscal and budgetary deficits. Therefore, revenue mobilization is challenging proposition in an economy like Nepal where majority of the people live in abject poverty. Tax administration lacks innovative mechanism to identify new tax payers and bring them into tax-net. Tax reform agenda was the reform package and program of the government after the restoration of multiparty democracy system. In Nepal, VAT was introduced in 1997 to improve revenue mobilization through broadening the tax base and modernizing the tax system. In this process, the government had to face new problems that came along with the adoption of VAT. Thus, the purpose of this study is to analyze the structure and responsiveness of VAT in Nepal empirically and compare it with that of old system of sales taxes. The old system of sales taxes refers to the combined sales, entertainment, contracts, hotels, and air flight taxes received by the government before 1997/98.
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Gannon, Bryan M., Marshall J. Glesby y Saurabh Mehta. "3394 Alpha-1-acid glycoprotein as outcome, independent predictor, and effect modifier in a randomized, placebo-controlled, factorial trial of recombinant human growth hormone and rosiglitazone in people living with HIV". Journal of Clinical and Translational Science 3, s1 (marzo de 2019): 33. http://dx.doi.org/10.1017/cts.2019.80.
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OBJECTIVES/SPECIFIC AIMS: In a randomized controlled trial in participants with HIV infection, recombinant human growth hormone (rhGH) reduced visceral adipose tissue (VAT); addition of rosiglitazone to rhGH prevented the accompanying decline in insulin sensitivity (SI). Within this parent RCT, we sought to determine the effect of rosiglitazone and rhGH intervention on alpha-1-acid glycoprotein (AGP), a biomarker of inflammation. We also investigated AGP as an independent risk factor for SI and VAT changes along with any potential effect modification by AGP of the intervention. METHODS/STUDY POPULATION: Participants with HIV-infection (n = 72) with abdominal adiposity and insulin resistance were randomized to rosiglitazone, rhGH, combination, or placebo for 12 weeks (NCT00130286). SI was determined by frequently sampled intravenous glucose tolerance test, and VAT by whole body MRI. AGP concentrations were determined by immunoturbidimetric assay in available serum samples at baseline (time 0), 4, and 12 weeks (n = 41 participants with samples at all 3 time points). A linear mixed model was used to assess the impact of intervention over time on AGP concentrations. General linear models were used to assess baseline AGP concentrations as an independent predictor of SI and VAT changes by treatment group with the model initially including age quartile, gender, race, ethnicity, BMI, HIV RNA <400 copies/mL, antiretroviral regimen, CD4 count, Stavudine use, and zidovudine use with step-by-step removal of least significant predictors. Effect modification was assessed by adding an interaction term between AGP and assigned intervention. RESULTS/ANTICIPATED RESULTS: AGP did not differ among treatment groups at baseline; overall median (Q1, Q3): 0.608 (.526,.727) g/L, P = 0.92. Treatment with rosiglitazone, rhGH, or the combination significantly reduced AGP concentrations from baseline to week 12, compared to placebo (time by treatment interaction, P = 0.0038). Baseline AGP was not a significant predictor or effect modifier of SI change in response to treatment (P ≥ 0.50). Baseline AGP (g/L) was an independent predictor of VAT change (L) (β = 1.91, SE = 0.89, P = 0.038) in addition to a treatment effect (P < 0.001) and age quartile effect (P < 0.001). No other predictors or interactions were significant, including effect modification of AGP (AGP by treatment interaction P = 0.50). DISCUSSION/SIGNIFICANCE OF IMPACT: It is known that immune and metabolic pathways are highly integrated, and biomarkers of inflammation have predictive abilities for cardiovascular and metabolic disease outcomes. This analysis provides data showing that treatment with rosiglitazone or rhGH in the context of HIV reduces AGP concentrations, indicating efficacy in reducing systemic inflammation. Baseline AGP was an independent risk factor for VAT changes as those with lower AGP at baseline showed a greater reduction in VAT in response to treatment. Biomarkers of inflammation may provide prognostic information for individualized patient outcomes to help guide treatment and follow-up.
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Julyan, L. "Value‐added tax on new residential properties: A comparative study regarding developers registered for VAT purposes". Meditari Accountancy Research 12, n.º 1 (abril de 2004): 119–36. http://dx.doi.org/10.1108/10222529200400007.
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Rahman, Farah, Marilyn de Chantal, Pedro Mesquita y Judith A. Aberg. "935. Effect of Tesamorelin in People with HIV with and without Dorsocervical Fat: Post Hoc Analysis of Phase III Double Blind Placebo Control Trial". Open Forum Infectious Diseases 7, Supplement_1 (1 de octubre de 2020): S500—S501. http://dx.doi.org/10.1093/ofid/ofaa439.1121.
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Abstract Background Lipohypertrophy is defined as excess fat deposition in abdominal defined as visceral adipose tissue (VAT) as well as in the dorsocervical region, breasts, trunk, and along with possible fat deposition in liver, muscle, myocardium and epicardium. Multiple factors have been described as contributing to lipohypertrophy in people living with HIV (PLWH), including patient characteristics, antiretroviral therapy (ART) and also impaired growth hormone (GH) secretion. Tesamorelin, a synthetic form of growth-hormone-releasing hormone (GHRH), is indicated for reduction of excess abdominal fat in PLWH with lipodystrophy Methods Post-hoc analysis was done on phase 3 randomized, double-blind, multicenter trials. Patients were eligible if between 18 and 65 years of age, had confirmed HIV infection, had evidence of excess abdominal fat accumulation and on stable ART regimen for 8 weeks or more. Participants were randomized to receive tesamorelin 2 mg daily or placebo daily for 26 weeks. Only tesamorelin responders, defined as patients with at least 8% decrease in VAT and who were adherent to the medication, were used for this analysis. Results are reported for patients with and without dorsocervical (DC) fat deposition. Results Demographic characteristics of responders at week 26 are shown according to presence or absence of DC fat (Table 1). At week 26, on average, the patients with DC fat deposition had higher BMI and waist circumference (WC) than the group without DC fat. Most patients in both groups had lipoatrophy. Metabolic and anthropometric parameters were measured at week 26 in patients with and without DC fat (Table 2). There was a decrease in VAT and also an improvement in their WC at week 26 in both groups. Table 1: Baseline Characteristics of Tesamorelin Responder Subjects at Week 26, by Dorsocervical Status Table 2: Change in Abdominal Adiposity, Insulin-Like Growth Factor-1 Levels, and Metabolic Parameters Between Baseline and Week 26 Among Tesamorelin Responders Conclusion This data demonstrates that tesamorelin is effective at reducing VAT in both patients with and without DC fat. The medication was well tolerated without significant changes to metabolic based measurements. Treatment of excessive VAT with tesamorelin has seemingly positive results in fat reduction in patients with or without DC fat deposition and our study contributes to the growing literature. Disclosures Marilyn de Chantal, PhD, Theratechnologies Inc (Employee) Pedro Mesquita, PhD, Theratechnologies, Inc. (Employee) Judith A. Aberg, MD, Theratechnology (Consultant)
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Lake, J. E., P. Debroy, D. Ng, K. M. Erlandson, L. A. Kingsley, F. J. Palella, M. J. Budoff, W. S. Post y T. T. Brown. "Associations between subcutaneous fat density and systemic inflammation differ by HIV serostatus and are independent of fat quantity". European Journal of Endocrinology 181, n.º 4 (octubre de 2019): 451–59. http://dx.doi.org/10.1530/eje-19-0296.
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Objectives Adipose tissue (AT) density measurement may provide information about AT quality among people living with HIV. We assessed AT density and evaluated relationships between AT density and immunometabolic biomarker concentrations in men with HIV. Design Cross-sectional analysis of men enrolled in the Multicenter AIDS Cohort Study. Methods Abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) density (Hounsfield units, HU; less negative = more dense) were quantified from computed tomography (CT) scans. Multivariate linear regression models described relationships between abdominal AT density and circulating biomarker concentrations. Results HIV+ men had denser SAT (−95 vs −98 HU HIV−, P < 0.001), whereas VAT density was equivalent by HIV serostatus men (382 HIV−, 462 HIV+). Historical thymidine analog nucleoside reverse transcriptase inhibitor (tNRTI) use was associated with denser SAT but not VAT. In adjusted models, a 1 s.d. greater SAT or VAT density was associated with higher levels of adiponectin, leptin, HOMA-IR and triglyceride:HDL cholesterol ratio and lower hs-CRP concentrations in HIV− men. Conversely, in HIV+ men, each s.d. greater SAT density was not associated with metabolic parameter improvements and was significantly (P < 0.05) associated with higher systemic inflammation. Trends toward higher inflammatory biomarker concentrations per 1 s.d. greater VAT density were also observed among HIV+ men. Conclusions Among men living with HIV, greater SAT density was associated with greater systemic inflammation independent of SAT area. AT density measurement provides additional insight into AT density beyond measurement of AT quantity alone, and may have implications for metabolic disease risk.
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Fonvig, Cilius E., Dorthe S. Bille, Elizaveta Chabanova, Tenna R. H. Nielsen, Henrik S. Thomsen y Jens-Christian Holm. "Muscle fat content and abdominal adipose tissue distribution investigated by magnetic resonance spectroscopy and imaging in obese children and youths". Pediatric Reports 4, n.º 1 (9 de enero de 2012): 11. http://dx.doi.org/10.4081/pr.2012.e11.
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The degree of fat deposition in muscle and its implications for obesity-related complications in youth are not well understood. One hundred and fifty-nine patients (mean age: 13.3 years; range: 6-20) with a body mass index (BMI) >90th percentile for age and sex were included. Muscle fat content (MFC) was measured in the psoas muscle by proton magnetic resonance spectroscopy. The patients were assigned to two groups: MFC <5% or ³5%. Visceral adipose tissue volume (VAT) and subcutaneous adipose tissue volume (SAT) were measured by magnetic resonance imaging. Blood samples were obtained from 119 patients, and liver enzyme concentrations and other variables were measured. The data were analysed to detect any associations between MFC and BMI standard deviation scores, VAT and SAT, blood values, and physical activity levels. The mean BMI standard deviation score (SDS) was 3.04 (range 1.32-5.02). The mean MFC was 8.9% (range 0.8-46.7), and 118 (74.2%) of 159 patients had an MFC ³5%. Children with a high MFC had a higher BMI SDS (P=0.03) and had a higher VAT, but not SAT or SAT/VAT ratio. Both intramyocellular lipid (IMCL) and extramyocellular lipid (EMCL) content were elevated in patients with an MFC ³5%. Blood values and physical activity levels did not differ between the two groups. Severely obese children and adolescents tend to have a high MFC, which is associated with elevated VAT and IMCL and EMCL content. An increased MFC may be associated with impaired metabolic processes, which may predispose young people to obesity-related complications.
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TRANDAFIR, Adina. "THE EFFECTS OF LABOUR COSTS REDUCTION ON FOREIGN INVESTMENT IN ROMANIA". Annals of Spiru Haret University. Economic Series 19, n.º 3 (1 de octubre de 2019): 129–37. http://dx.doi.org/10.26458/19310.
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This article addresses the issue of changes in tax legislation in our country over the last 20 months, in view of the effect they have on the level of foreign investment. The article presents, besides the actual legislative changes and the evolution registered in this period by foreign investments, also the fiscal pressure in the field of contributions, VAT and corporate income tax. The paper presents an econometric analysis that seeks to highlight the impact of the fiscal pressure of the above mentioned taxes on the FDI level recorded in Romania between January 2017 and August 2018.
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Mukherjee, Sacchidananda y R. Kavita Rao. "Value Added Tax and Informality: Determinants of Registration of Enterprises under State VAT in India". Margin: The Journal of Applied Economic Research 13, n.º 1 (6 de diciembre de 2018): 21–48. http://dx.doi.org/10.1177/0973801018800086.
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Unincorporated enterprises often bypass formal regulations in general and taxation in particular. Bringing unincorporated enterprises under the taxation system is a challenge often faced by tax administrators, and it is in this regard that the present study explores the factors which influence the decision of unincorporated enterprises to register with the state value added tax (VAT)/sales tax authority across states in India. This analysis is limited to the decision regarding registration. It is not necessary that enterprises that are registered pay taxes and/or file returns—however, the process of registration does provide some information to the tax department for follow ups. The study throws up some interesting results for policymakers and tax administrators. JEL Classification: H25, H32, H26, L53
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Baloyi, Magezi Elijah. "THE “VAT-EN-SIT” UNIONS AS A THREAT TO THE STABILITY OF AFRICAN MARRIAGE IN SOUTH AFRICA: AFRICAN THEOLOGICAL PASTORAL PERSPECTIVE". Phronimon 17, n.º 2 (9 de febrero de 2017): 1–16. http://dx.doi.org/10.25159/2413-3086/1955.
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A serious issue, that needs to be addressed if we wish to achieve moral regeneration in South Africa, is the devaluation of the institution of marriage in the African community in South Africa. Attempts to inculcate the upcoming generation with norms and values are hampered because marriage is not regularised among black people and can, therefore, not solve African problems. This paper identifies the so-called “vat-en-sit” custom or cohabitation as a factor that threatens and violates marriage. Although other factors also undermine marriage, this paper focuses on vat-en-sit because it puts African marriage under serious attack. This paper argues from an African-Christian perspective that marital unions which have not been legalised in accordance with African values do not only undermine the institution of marriage, but also attempt to destroy marriages that conform to African legal values.
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Akhil, M. P. "Goods and Services Tax (GST): A Revolutionary Step towards Economic Unification". Asian Review of Social Sciences 8, S1 (5 de febrero de 2019): 67–70. http://dx.doi.org/10.51983/arss-2019.8.s1.1491.
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GST is a comprehensive tax system that subsumed all indirect taxes of states and central governments and unified economy into a seamless national market .Under the erstwhile indirect tax regime, there were a number of taxes. Prof. Kelkar Committee has proposed a uniform Goods and Services Tax (GST) to do away with the issues and problems of VAT. Based on Kelkar Committee recommendations, the Govt of India has brought a Bill in 2011 through the Constitution (115th Amendment) (GST) Bill, 2011. However the bill was not passed due to dissolution of 15th Lok Sabha. Again, Constitution (122nd Amendment) (GST) Bill, 2014 was presented in the Lok Sabha and this Bill has been passed in the Lok Sabha as well as Rajyasabha. Goods and service tax is a new story of VAT which gives a widespread setoff for input tax credit and subsuming many indirect taxes from state and national level. The Government’s GST regime seeks to replace excise duty, import duties, VAT and service tax regulations, along with other Cess and surcharges, with three separate legislations namely CGST, SGST and IGST. GST would be applicable to all transactions of goods and service, and it to be paid to the accounts of the Centre and the States separately. The biggest advantage of GST is economic unification of India. It has potential to end the longstanding distortions arising out of the differential treatment of the manufacturing and service sectors. It is an issue if people are still unaware or confuse with the tax system of GST and become worst when people ignore and boycott not to pay the tax.
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VLASENKO, Viktoriia, Svitlana ARABULI, Valentyna KUCHERENKO, Arsenii ARABULI, Petro SMERTENKO y Natalia LEVYTSKA. "DESIGN OF TEXTILE UV-SHIELDS BY VAT DYES MODIFICATION". TEXTEH Proceedings 2019 (5 de noviembre de 2019): 59–62. http://dx.doi.org/10.35530/tt.2019.13.
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The problem of human being protecting against UV radiation is becoming more and more significant from year to year and requires urgent solutions. Just UVB causes 50-90% of skin cancer and especially affects children, adolescents and older people. Textile screens are the simplest and most effective means to protect against the negative effects of UV radiation (UVR). Usually, white cotton and linen fabrics are used for summer clothes. However, these materials have a low ultraviolet protective factor (UPF ~ 5). Known developments that relate to the modification of textile materials to protect against UV radiation, suggest the use of dense woven structures; modification with some metals oxides; the use of UV absorbers that are derivats of harmful chemicals (for example, o-hydroxybenzophenones). But these methods do not always provide the sufficiently level of UV protection. In our paper, the effectiveness of vat dyes using to create textile screens for UV protection was investigated. In this study was investigated cotton fabrics dyed with some vat dyes: turquoise, blue, yellow. UVR transmittance studies were performed on optical spectrometer Solar SL40-2 (PSI-Line software). A high pressure discharge lamp DRT-125 was used. As studies have shown, the most effective is a cotton textile screen, dyed with vat blue.
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Kantor, Jiří, Lucia Kantorová, Jana Marečková, Danping Peng y Zdeněk Vilímek. "Potential of Vibroacoustic Therapy in Persons with Cerebral Palsy: An Advanced Narrative Review". International Journal of Environmental Research and Public Health 16, n.º 20 (16 de octubre de 2019): 3940. http://dx.doi.org/10.3390/ijerph16203940.
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Vibroacoustic therapy (VAT) is a treatment method that uses sinusoidal low-frequency sound and music. The purpose of this narrative review is to describe the effects of VAT on motor function in people with spastic cerebral palsy (CP) according to study design as well as providing information about the age of the participants, measurement tools, and sound frequencies that were used. The systematic search strategy based on the first two steps of a standard evidence-based approach were used: (1) formulation of a search question and (2) structured documented search including assessment of the relevance of abstracts and full texts to the search question and inclusion criteria. Out of 823 results of the search in 13 scholarly databases and 2 grey literature sources, 7 papers were relevant. Most of the relevant studies in children and adults presented significant improvement of motor function. According to the study design, only five experimental studies and two randomized controlled trial (RCT) studies were available. In the discussion, findings of this review are compared to other related methods that use mechanical vibrations without music. The authors recommend continuing to research the effects of VAT on motor function and spasticity in adolescents and young adults with spastic CP.
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Druzhilov, M. A. y T. Yu Kuznetsova. "Internal obesity as a risk factor for arterial hypertension". Russian Journal of Cardiology, n.º 4 (8 de mayo de 2019): 7–12. http://dx.doi.org/10.15829/1560-4071-2019-4-7-12.
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Aim. To assess the role of ultrasound parameters of the extent of abdominal and epicardial visceral adipose tissue (VAT) as prognostic tools for determining the probability of arterial hypertension (AH) development in normotensive patients with obesity.Material and methods. We studied 526 normotensive (according to the results of daily monitoring of blood pressure (BP)) men (age 45,1±5,0 years) without cardiovascular diseases and type 2 diabetes mellitus, with a SCORE risk <5% and abdominal obesity (waist circumference >94 cm). We analyzed glycemia, lipid spectrum, blood creatinine and urine albumin level. Echocardiography with an assessment of epicardial fat thickness (EFT), triplex scanning of the brachiocephalic arteries, ultrasound assessment of the thickness of abdominal VAT and subcutaneous fat (SCF) were carried out. At the end of the observational phase of the study (duration 46,3±5,1 months), repeated daily monitoring of blood pressure was performed.Results. Of the 406 available patients, hypertension was detected in 157 (38,7%), including 72 (31,7%) of the initial age group of 35-45 years and 85 (47,5%) of the initial age group 46-55 years. These patients were characterized by initially higher values of EFT (5,2±0,7 mm vs 4,4±1,0 mm, p<0,001) and the ratio of the thickness of abdominal VAT to the thickness of the SCF (2,9±0,6 vs 2,5±0,6, p<0,001). In the group of individuals with developed AH, the initial incidence of epicardial and abdominal visceral obesity was higher (58,0% vs 23,4%, p<0,001 and 44,6% vs 25,1%, p<0,001, respectively). Ultrasound parameters of abdominal and ectopic (epicardial) VAT were included in mathematical models of the probability of development of AH with a high level of statistical significance and maximum standardized coefficients of regression equations.Conclusion. Ultrasonic parameters of the severity of abdominal and epicardial VAT can be an additional tools for AH predicting in normotensive people with overweight and obesity.
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Devin, Jessica K., Hui Nian, Jorge E. Celedonio, Patricia Wright y Nancy J. Brown. "Sitagliptin Decreases Visceral Fat and Blood Glucose in Women With Polycystic Ovarian Syndrome". Journal of Clinical Endocrinology & Metabolism 105, n.º 1 (15 de septiembre de 2019): 136–51. http://dx.doi.org/10.1210/clinem/dgz028.
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Abstract Context Women with polycystic ovarian syndrome (PCOS) have decreased growth hormone (GH), which can result in increased visceral adiposity (VAT) and impaired vascular function. GH-releasing hormone, a dipeptidyl peptidase-4 (DPP4) substrate, stimulates GH secretion. Objective We tested the hypothesis that DPP4 inhibition increases GH and improves glucose levels and vascular function in women with PCOS. Methods Eighteen women with PCOS participated in a double-blind, crossover study. They received sitagliptin either 100 mg or placebo daily for 1 month, with crossover treatments separated by an 8-week washout. During each treatment, women underwent a 75-gram oral glucose tolerance test (OGTT) and assessments of vascular function and body composition. Overnight GH secretion was assessed via venous sampling every 10 minutes for 12 hours and analyzed using an automated deconvolution algorithm. Results During OGTT, sitagliptin increased glucagon-like peptide-1 (P < 0.001), early insulin secretion (from mean [± SD] insulinogenic index 1.9 ± 1.2 to 3.2 ± 3.1; P = 0.02), and decreased peak glucose (mean −17.2 mg/dL [95% CI, −27.7 to −6.6]; P < 0.01). At 1 month, sitagliptin decreased VAT (from 1141.9 ± 700.7 to 1055.1 ± 710.1 g; P = 0.02) but did not affect vascular function. Sitagliptin increased GH half-life (from 13.9 ± 3.6 to 17.0 ± 6.8 min, N = 16; P = 0.04) and interpulse interval (from 53.2 ± 20.0 to 77.3 ± 38.2 min, N = 16; P < 0.05) but did not increase mean overnight GH (P = 0.92 vs placebo). Conclusions Sitagliptin decreased the maximal glucose response to OGTT and VAT. Sitagliptin did not increase overnight GH but increased GH half-life and the interpulse interval. Clinical Trial Registration This study was registered at www.clinicaltrials.gov as NCT02122380 prior to enrollment of the first participant.
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Bauer, Witold, Edyta Adamska-Patruno, Urszula Krasowska, Monika Moroz, Joanna Fiedorczuk, Przemyslaw Czajkowski, Dorota Bielska, Maria Gorska y Adam Kretowski. "Dietary Macronutrient Intake May Influence the Effects of TCF7L2 rs7901695 Genetic Variants on Glucose Homeostasis and Obesity-Related Parameters: A Cross-Sectional Population-Based Study". Nutrients 13, n.º 6 (4 de junio de 2021): 1936. http://dx.doi.org/10.3390/nu13061936.
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Transcription factor-7–like 2 (TCF7L2) is one of the most important susceptibility genes for type 2 diabetes mellitus (T2DM). The aim of our cross-sectional population-based study was to analyze whether daily macronutrient intake may influence the effects of the TCF7L2 rs7901695 genotype on glucose homeostasis and obesity-related parameters. We recruited 810 participants (47.5% men and 52.5% women), 18–79 years old (mean age, 42.1(±14.5) years), who were genotyped for the common TCF7L2 rs7901695 single-nucleotide polymorphism (SNP), and anthropometric measurements, body composition, body fat distribution (visceral (VAT) and subcutaneous adipose tissue (SAT) content), blood glucose and insulin concentrations after fasting and during OGTTs, and HbA1c were assessed. The VAT/SAT ratio, HOMA-IR (homeostatic model assessment of insulin resistance), HOMA-B (homeostatic model assessment of β-cell function), and CIR30 (corrected insulin response) were calculated. The daily macronutrient intake was evaluated based on 3-day food-intake diaries. Daily physical activity was evaluated based on a validated questionnaire. We performed ANOVA or Kruskal–Wallis tests, and multivariate linear regression models were created to evaluate the effects of dietary macronutrient intake on glucose homeostasis and obesity-related parameters in carriers of the investigated genotypes. This study was registered at ClinicalTrials.gov as NCT03792685. The TT-genotype carriers stratified to the upper protein intake quantiles presented higher HbA1c levels than the CT- and CC-genotype participants in the same quantiles (p = 0.038 and p = 0.022, respectively). Moreover, we observed higher HOMA-IR (p = 0.014), as well as significantly higher blood glucose and insulin concentrations, during the OGTTs for those in the upper quantiles, when compared to subjects from the lower quantiles of protein intake, while the CC-genotype carriers presented significantly lower HbA1c (p = 0.033) and significantly higher CIR30 (p = 0.03). The linear regression models revealed that an increase in energy derived from proteins in TT carriers was associated with higher HbA1c levels (β = 0.37 (95% CI: 0.01–0.74, p = 0.05)), although, in general, carrying the TT genotype, but without considering protein intake, showed an opposite tendency—to lower HbA1c levels (β = −0.22 (95% CI: 0.47 to −0.01, p = 0.05). Among the subjects stratified to the lower quantile of carbohydrate intake, the TT-genotype individuals presented higher HbA1c (p = 0.041), and the CC-genotype subjects presented higher VAT (p = 0.033), lower SAT (p = 0.033), and higher VAT/SAT ratios (p = 0.034). In both the CC- and TT-genotype carriers, we noted higher VAT (p = 0.012 and p= 0.0006, respectively), lower SAT (p = 0.012 and p= 0.0006, respectively) and higher VAT/SAT ratios (p = 0.016 and p= 0.00062, respectively) when dietary fat provided more than 30% of total daily energy intake, without any differences in total body fat content. Our findings suggest that associations of the common TCF7L2 SNP with glucose homeostasis and obesity-related parameters may be dependent on daily macronutrient intake, which warrants further investigations in a larger population, as well as interventional studies.