Miracle-dz/UniFAR-FTUs huggingface dataset:
Magnetic Resonance Imaging of Myocardial Perfusion and Viability Using a Blood Pool Contrast Agent

Rationale and Objectives:A comprehensive cardiac magnetic resonance (MR) examination should comprise imaging of myocardial perfusion, viability, and the coronary arteries. Blood pool contrast agents (BPCAs) improve coronary MR angiography, whereas their potential for imaging of perfusion and viability is unknown. The abilities to noninvasively image myocardial perfusion and viability using the BPCA P792 (Guerbet, France) were tested in a closed-chest model of nonreperfused myocardial infarction in 5 pigs. Materials and Methods:Two to 3 days after instrumentation, myocardial perfusion imaging with a saturation-recovery steady-state free precession technique and viability imaging with an inversion-recovery fast low-angle shot sequence were conducted on a 1.5-T MR scanner using the extracellular contrast agents (ECCA) Gd-DOTA (0.1 mmol Gd/kg) and blood pool contrast agent (BPCA) P792 (0.013 mmol Gd/kg). Results:Perfusion defects were visualized in all pigs with good correlation between the ECCA and the BPCA (1.77 ± 1.16 cm2 vs. 1.80 ± 1.19 cm2, r = 0.959, P < 0.01). Reduced myocardial perfusion was detected using the ECCA up to 80 seconds after injection. In contrast, BPCA administration enabled visualization of perfusion defects on equilibrium perfusion imaging in all cases for 10 minutes. The size of myocardial infarction detected with viability MR imaging correlated well between the standard method (ECCA) and delayed-enhancement imaging with the BPCA (5.40 ± 3.16 versus 5.52 ± 3.13 cm3, r = 0.994, P < 0.002). Conclusions:The BPCA investigated in this study allows both reliable detection of perfusion defects on first pass and equilibrium perfusion imaging and characterization of viability after myocardial infarction. Thus, this contrast agent is suitable for a comprehensive cardiac MR examination.
Cognitive dysfunction in early onset parkinsonism

Cognitive functions of 24 patients with early onset parkinsonism (age of onset before 40 years) and 24 controls were investigated by a battery of neuropsychological tests. Patients were shown to be impaired in performance IQ (PIQ), conceptual ability and regulation behavior, memory, visuospatial perception, and manual dexterity. Patients were also shown to have a higher Zung Depression score. However, analysis of the testing scores appeared to indicate that only a small portion of poor performance on neuropsychological tests are depression related. The results demonstrated that patients with early onset parkinsonism, in whom the factor of aging is not as important, still show cognitive dysfunction and suggested that Parkinson's disease itself can cause cognitive impairment
Effect of Dietary Lysine Restriction and Energy Density on Performance, Nutrient Digestibility and Meat Quality in Finishing Pigs

This experiment evaluated the effects of dietary lysine restriction and energy density on growth performance, nutrient digestibility and meat quality of finishing pigs. A 2x2 factorial arrangement of treatments was utilized in a randomized complete block (RCB) design, and factor 1 was lysine restriction and factor 2 was energy density. The control diet was formulated to contain 3.265 Mcal of ME/kg, 0.75% lysine in the early-finishing phase and 3.265 Mcal of ME/kg, 0.60% lysine in the late-finishing phase and other nutrients met or exceeded NRC (1998) standards. Compared to the control diet (CON), lysine levels of experimental diets were restricted to 15% (treatment EL, EEL) or 30% (treatment ELL, EELL), whereas energy level of experimental diets was increased by 0.100 or 0.200 Mcal of ME/kg. A total of 100 crossbred pigs ([YorkshirexLandrace]×Duroc), with average initial body weight of 58.47±1.42 kg, were allotted to 5 dietary treatments based on sex and body weight. Each treatment had 5 replicates with 4 pigs (two barrows and two gilts) per pen. ADG, ADFI and feed efficiency were calculated in an 8-week growth trial. In the late finishing period (5-8 weeks), pigs fed ELL or EELL diets had decreased ADG and feed efficiency (p 0.05). In a metabolic trial, 15 pigs were used to evaluate the effect of dietary lysine restriction and energy density on nutrient digestibility. The digestibility of dry matter, crude fat and crude ash was not improved by restricting dietary lysine or energy density. However, crude protein digestibility was decreased (p<0.05) as dietary lysine was restricted. When dietary lysine was restricted, fecal nitrogen was increased whereas nitrogen retention was decreased. BUN concentration was affected by dietary lysine restriction; treatments ELL and EELL had higher BUN values than other treatments (p<0.01). Carcass characteristics and meat quality were measured when average body weight of pigs reached 107.83±1.50 kg. Treatment ELL had higher last rib backfat depth (p<0.05) than treatment CON, but ELL and EEL did not differ significantly. The ELL and EEL treatments had higher (p<0.05) subjective marbling score than treatment CON. Treatment EEL showed higher longissimus fat content than treatment EL and CON (p<0.01). The results indicated that finishing pigs fed a diet with 15% lysine restriction and 3.465 Mcal of ME/kg energy density had no detrimental effects on growth performance and N utilization, and could achieve substantial increases in marbling and longissimus fat content of pork.
Out of Scandinavia: Alternative Approaches to Software Design and System Development

This study set out to delineate the Scandinavian Approach to the development of computer-based systems. We aimed to help derive new ideas for human-oriented technology design in other countries. The study is based on the relevant literature, scientific contacts, and two field trips, and covers work in Denmark, Norway, and Sweden. The study focuses on methodological questions and their theoretical foundations, on explicit strategies for social implementation, and on innovative design illustrated by reference to concrete projects. Though it makes no claim to present a sociopolitical analysis of Scandinavian technology design, the sociocultural background is given due consideration. There is no general agreement among Scandinavians as to whether or not there is a well-defined Scandinavian Approach. We have come to identify such an approach in certain common features shared by the different schools of thought. These include efforts toward humanization and democratization as overriding design goals, in keeping with the aim of building an egalitarian society.
Malignancies in Women with HIV Infection

Women with HIV infection have an increased risk of developing certain malignancies. These malignancies are commonly human papillomavirus (HPV)-related, reflecting the high rate of coinfection with HPV in women with underlying HIV infection. These women also have a high incidence of premalignant HPV-related changes, such as high-grade squamous intraepithelial lesions as diagnosed on Pap smears and cervical intraepithelial neoplasia on cervical biopsy. Screening recommendations for HIV-infected women reflect the need for vigilance in detecting and treating these lesions early. In addition, recent interest has focused on the use of cervical cancer screening, employing HPV-testing techniques, and on HPV vaccination in younger women to prevent initial infection and the subsequent development of cervical and other HPV-related cancers. The incidence of other types of malignancies, such as Hodgkin's and non-Hodgkin's lymphoma, is also increased in HIV-infected individuals. When these lymphomas occur, they tend to be of advanced stage and high-grade histologies. The advent of highly active antiretroviral therapy has been associated with a marked decrease in the incidence of some of these cancers. The use of therapy has been associated with marked improvement in response rates and overall survival of affected patients.
A 4-year prospective study of eating disorder NOS compared with full eating disorder syndromes.

OBJECTIVE To examine the course of Eating Disorder NOS (EDNOS) compared with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHOD Prospective study of 385 participants meeting DSM-IV criteria for AN, BN, BED, and EDNOS at three sites. Recruitment was from the community and specialty clinics. Participants were followed at 6-month intervals during a 4-year period using the Eating Disorder Examination as the primary assessment. RESULTS EDNOS remitted significantly more quickly that AN or BN but not BED. There were no differences between EDNOS and full ED syndromes, or the subtypes of EDNOS, in time to relapse following first remission. Only 18% of the EDNOS group had never had or did not develop another ED diagnosis during the study; however, this group did not differ from the remaining EDNOS group. DISCUSSION EDNOS appears to be a way station between full ED syndromes and recovery, and to a lesser extent from recovery or EDNOS status to a full ED. Implications for DSM-V are examined.
Generic Consistency of the Break-Point Estimators Under Specification Errors in a Multiple-Break Model

This paper considers the estimation of multiple-structural-break models under specification errors. A common example in economics is that the true model is measured in level, but a linear-log model is estimated. We show that, under specification errors, if there are more than one break points and if a single-break model is estimated, the estimated break point is consistent for one of the true break points. This consistency result applies to models with multiple regressors where some or all of the regressors are misspecified. Another important contribution of this paper is that we have constructed a Sup-Wald test whose limiting distribution is not affected by model misspecification. Using this robust test, we show that the break points can be estimated sequentially one at a time. Simulation evidence and an empirical application are provided. Copyright © 2008 The Author(s). Journal compilation © Royal Economic Society 2008
Fine-scale analyses of diving energetics in king penguins Aptenodytes patagonicus: how behaviour affects costs of a foraging dive

Heart rate data loggers were implanted into king penguins Aptenodytes patagonicus undertaking foraging trips at sea during three austral summers. Data were obtained from a total of 20 king penguins. Our aim was to investigate variations in mean heart rate over the dive cycle (i.e. dive plus the subsequent surface period) with changes in diving behaviour, at the scale of the individual for- aging dive. From these heart rate values, energetic costs were estimated in terms of rate of oxygen consumption. Shorter dive durations and longer surface durations were associated with statistically significantly higher mean heart rates, and hence energetic costs, over the dive cycle. A decrease in the duration of the bottom period of dives was also associated with an increase in heart rate and energetic costs. In contrast to model predictions that power requirements of swimming in penguins increase rapidly with increasing speed, in the main, the number of wiggles (i.e. intensive prey pursuits lasting several seconds) in a dive did not affect mean heart rate. Furthermore, the shape of the dive did not affect mean heart rate. Diving behaviour and mean heart rates over the dive cycle of birds during 2 austral summers was compared. While the birds in the earlier austral summer undertook considerably longer foraging trips than did the birds in the latter summer, mean mass gain while at sea was similar. Birds during the latter summer exhibited statistically significantly longer dive durations and bottom durations and dived to statistically significantly shallower depths than birds during the earlier summer. However, this did not translate into a statistically significantly lower mean heart rate over the dive cycle in these birds. This suggests that the differences in dive time budgeting between the two sum- mers had only a relatively subtle effect on mean heart rate. In turn the relationship between diving behaviour and foraging success in king penguins may be more obvious than that between diving behaviour and mean heart rate over the dive cycle.
Clinical governance and genetic medicine. Specialist genetic centres and the Confidential Enquiry into Counselling for Genetic Disorders by non-geneticists (CEGEN)*

Editor ### CLINICAL GOVERNANCE The concept of clinical governance1 followed the search in most countries for accessible, effective, and economically efficient health services. In England, the NHS Executive’s definition2 of clinical governance includes the rapid detection of adverse events, which are openly investigated, and from which lessons are learned. Confidential enquiries are a way of studying adverse events, for example maternal deaths and perioperative deaths. These enquiries are an established part of British health care because they are a potential tool for improvement and are to be included within the remit of the newly established National Institute of Clinical Excellence (NICE). Their acceptance has depended on their being entirely non-censorious and governed by strict confidentiality. Their effectiveness is being tested3 and is presumably enhanced by regular reports which are covered by the national media. Starting in 1991, the UK Confidential Enquiry into Counselling for Genetic Disorders has shown that the study of adverse events can be applied to the bulk of counselling which is part of the routine work of many specialities. ### THE STRUCTURE AND PROCESS OF THE SPECIALITY OF MEDICAL GENETICS The speciality of medical genetics has been extensively documented in the UK.4-11 (“Medical genetics” is here used synonymously with “clinical genetics” to distinguish the speciality; the term “genetic medicine” is used to describe counselling and genetic technologies in many specialities.) In addition, an up to date overview of the strengths, weaknesses, opportunities, and threats to genetic services in 31 nations in Europe12 showed remarkable international agreement about most important issues concerning clinical, technical, educational, research, and ethi-cal matters. In contrast, there is much variation of access, many deficiencies, and poor coordination of services and resources for patients and families with genetic problems. In …
BASIC RESEARCH

: To evaluate the microtensile bond strength (µTBS) of two resin cements to 3D printed and milled CAD/CAM resins used for provisional fixed partial dentures. Blocks (5 x 5 x 5 mm) of three 3D-printed resins (Cosmos3DTemp / Yller; Resilab3D Temp / Wilcos and SmartPrint BioTemp, / MMTech) were printed (Photon, Anycubic Technology Co.). A milled material (VitaCAD-Temp, VITA) was used as control. Half the specimens were sandblasted and the rest were untreated. Two blocks were bonded with the corresponding resin cement: PanaviaV5 (Kuraray Noritake) and RelyX Ultimate (3M Oral Care). After 24 hours, the bonded blocks were sectioned into 1 x 1 mm side sticks. Half the beams were tested for µTBS and the other half was thermocycled (5000 cycles, 30s dwell-time, 5s transfer time) before µTBS testing. A four way Generalized Linear Model (material*sandblasting*cement*aging) analysis was applied. VITA exhibited the lowest µTBS, regardless of the cement, sandblasting and thermocycling.
Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation.

In uncontrolled studies, noninvasive positive pressure ventilation (NPPV) was found useful in avoiding endotracheal intubation in patients with acute respiratory failure (ARF) caused by severe community-acquired pneumonia (CAP). We conducted a prospective, randomized study comparing standard treatment plus NPPV delivered through a face mask to standard treatment alone in patients with severe CAP and ARF. Patients fitting the American Thoracic Society criteria for severe CAP were included in presence of ARF (refractory hypoxemia and/or hypercapnia with acidosis). Exclusion criteria were: severe hemodynamic instability, requirement for emergent cardiopulmonary resuscitation, home mechanical ventilation or oxygen long-term supplementation, concomitant severe disease with a low expectation of life, inability to expectorate or contraindications to the use of the mask. Fifty-six consecutive patients (28 in each arm) were enrolled, and the two groups were similar at study entry. The use of NPPV was well tolerated, safe, and associated with a significant reduction in respiratory rate, need for endotracheal intubation (21% versus 50%; p = 0.03), and duration of intensive care unit (ICU) stay (1.8 ± 0.7 d versus 6 ± 1.8 d; p = 0.04). The two groups had a similar intensity of nursing care workload, time interval from study entry to endotracheal intubation, duration of hospitalization, and hospital mortality. Among patients with chronic obstructive pulmonary disease (COPD), those randomized to NPPV had a lower intensity of nursing care workload (p = 0.04) and improved 2-mo survival (88.9% versus 37.5%; p = 0.05). We conclude that in selected patients with ARF caused by severe CAP, NPPV was associated with a significant reduction in the rate of endotracheal intubation and duration of ICU stay. A 2-mo survival advantage was seen in patients with COPD.
HDL Cholesterol as a Residual Risk Factor for Vascular Events and All-Cause Mortality in Patients With Type 2 Diabetes

OBJECTIVE To evaluate whether low HDL cholesterol (HDL-c) levels are a risk factor for cardiovascular disease and mortality in patients with type 2 diabetes and whether it remains a residual risk factor when attaining low LDL cholesterol (LDL-c) treatment goals or when LDL-c is treated with intensive lipid-lowering therapy. RESEARCH DESIGN AND METHODS We performed a prospective cohort study of 1,829 patients with type 2 diabetes included in the Second Manifestations of ARTerial disease (SMART) cohort. Cox proportional hazard models were used to evaluate the risk of HDL-c on cardiovascular events and all-cause mortality. Analyses were performed in strata of LDL-c levels (<2.0, 2.0–2.5, and >2.5 mmol/L) and lipid-lowering therapy intensity and were adjusted for age, sex, BMI, smoking, alcohol, LDL-c, triglycerides, systolic blood pressure, estimated glomerular filtration rate, glucose, and HbA1c. RESULTS A total of 335 new cardiovascular events and 385 deaths occurred during a median follow-up of 7.0 years (interquartile range 3.9–10.4). No relation was found between plasma HDL-c and cardiovascular events (hazard ratio [HR] 0.97, 95% CI 0.93–1.01) or all-cause mortality (HR 0.99, 95% CI 0.96–1.03). Subgroup analysis supported effect modification by plasma LDL-c levels. In patients with LDL-c levels <2.0 mmol/L, higher HDL-c was related to higher risk for all-cause mortality (HR 1.14, 95% CI 1.07–1.21). Higher HDL-c was also related to higher risk for cardiovascular events in patients with LDL-c levels <2.0 mmol/L (HR 1.10, 95% CI 1.07–1.21) in contrast to patients with LDL-c levels between 2.0 and 2.5 mmol/L (HR 0.85, 95% CI 0.75–0.95) and >2.5 mmol/L (HR 0.96, 95% CI 0.91–1.00). CONCLUSIONS In high-risk patients with type 2 diabetes with LDL-c levels <2.0 mmol/L, higher HDL-c at baseline is unexpectedly related to a higher risk for cardiovascular events and all-cause mortality in contrast to high-risk patients with type 2 diabetes with LDL-c levels between 2.0 and 2.5 mmol/L.
Cross-sectional Assessment of the Consequences of a GTP Cyclohydrolase 1 Haplotype for Specialized Tertiary Outpatient Pain Care

ObjectivesReduced-function variants of the guanosine triphosphate cyclohydrolase gene (GCH1) have been associated with reduced pain in well-defined cohorts of patients and healthy volunteers. We addressed the question whether this genetic association plays a role in outpatient pain therapy. MethodsIn a cross-sectional observational study, 523 patients were enrolled in 3 different tertiary care outpatient pain centers at German University hospitals. Of the 519 Caucasian patients, data from 424 could be analyzed for functional associations of the formerly named “pain-protective” GCH1 haplotype with the key characteristics of pain therapy being (1) actual pain, (2) opioid dosing, and (3) pain therapy duration. ResultsWith an allelic frequency of 14.2% the pain-protective haplotype was not rarer among pain patients than in the general population (P=0.344). However, a tendency toward gene dose-dependent effects of the GCH1 haplotype was observed in all the 3 therapy parameters. Carriers of the haplotype tended to have lower actual 24-hour pain scores (n=424; P=0.18), require lower opioid doses (P=0.096), and were significantly shorter on specialized pain therapy (P=0.004). The latter applied predominantly to differences between homozygous carriers and heterozygous (α-corrected t test: P=0.06) or non-carriers (P=0.011) of the haplotype. ConclusionsThe results strength the support for a modest yet reproducible and consistent pain-protective effect associated with a GCH1 haplotype known to reduce GCH1 and thus BH4 up-regulation. Pending independent verification, the results might point to a prophylactic role of decreased GCH1 up-regulation delaying the need for pain therapy.
Timing of Late Quaternary glaciation along the southwestern slopes of the Qilian Shan, Tibet

Moraines along the southwestern slopes of the Qilian Shan were dated using cosmogenic radionuclide (CRN) surface exposure techniques to help define the timing of glaciation in northernmost Tibet. The CRN data show glaciers extending 5–10 km beyond their present positions during the global Last Glacial Maximum (LGM) and probably maintained at their maximum extent until the Lateglacial. These data help support the view that glaciers throughout Tibet and the Himalaya were maintained at or near their maximum LGM extent until the Lateglacial. An optically stimulated luminescence date of 11.8 ± 1.0 ka on silt that caps a latero‐frontal moraine shows that glaciers had retreated significantly by the end of the Pleistocene and that loess was beginning to form in this region in response to the changing climate during and after the Younger Dryas Stade.
Chemical composition and biological value of spray dried porcine blood by-products and bone protein hydrolysate for young chickens

1. The chemical composition of spray dried porcine blood by-products is characterised by wide variation in crude protein contents. In spray dried porcine blood plasma (SDBP) it varied between 670–780 g/kg, in spray dried blood cells (SDBC) between 830–930 g/kg, and in bone protein hydrolysate (BPH) in a range of 740–780 g/kg. Compared with fish meal, these feeds are poor in Met and Lys. Moreover, in BPH deep deficits of Met, Cys, Thr and other amino acids were found. 2. The experiment comprised 7 dietary treatments: SDBP, SDBC, and BPH, each at an inclusion rate of 20 or 40 g/kg diet, plus a control. The addition of 20 or 40 g/kg of the analysed meals into feeds for very young chickens (1–28 d post hatch) significantly decreased the body weight (BW) of birds. Only the treatments with 40 g/kg of SDBP and SDBC showed no significant difference in BW as compared with the control. There were no significant differences between treatments and type of meal for feed intake, haematocrit and haemoglobin concentrations in blood. 3. Addition of bone protein and blood cell meals to feed decreased the IgG concentration in blood and caused shortening of the femur and tibia bones. However, changes in the mineral composition of bones were not significantly affected by the type of meal used. 4. The blood by-products, which are rich in microelements, improved retention of Ca and Cu only. In comparison to control chickens, significantly better accretion of these minerals was found in treatments containing 20 g/kg of SDBP or 40 g/kg of SDBC. 5. Great variability in apparent ileal amino acid digestibility in chickens was determined. In this respect, some significant differences related to the type of meal fed were confirmed for Asp, Pro, Val, Tyr and His. In general, the apparent ileal digestibility of amino acids was about 2–3 percentage units better in chickens fed on diets containing the animal by products than in control birds.