Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of sacubitril/valsartan compared to olmesartan on cardiovascular remodelling in subjects with essential hypertension: the results of a randomized, double-blind, active-controlled study

Aims Progressive aortic stiffening eventually leads to left ventricular (LV) hypertrophy and heart failure if left untreated. Anti-hypertensive agents have been shown to reverse this to some extent. The effects of sacubitril/valsartan (LCZ696), a dual-action angiotensin receptor blocker (ARB), and neprilysin inhibitor, on arterial stiffness and LV remodelling have not been investigated. Methods and results This was a randomized, multi-centre, double-blind, double-dummy, active-controlled, parallel group, study to compare the effects on cardiovascular remodelling of sacubitril/valsartan with those of olmesartan in patients with hypertension and elevated pulse pressure. Magnetic resonance imaging scans were used to assess LV mass and local aortic distensibility, at baseline and at 12 and 52 weeks after initiation of treatment. Central pulse and systolic pressure were determined using a SphymoCor® XCEL device at each time point. A total of 114 patients were included, with 57 in each treatment group. The mean age was 59.8 years, and 67.5% were male. Demographic characteristics did not vary between the two sets of patients. Left ventricular mass index decreased to a greater extent in the sacubitril/valsartan group compared to the olmesartan group from baseline to 12 weeks (−6.36 vs. −2.32 g/m2; P = 0.039) and from baseline to 52 weeks (−6.83 vs. −3.55 g/m2; P = 0.029). These differences remained significant after adjustment for systolic blood pressure (SBP) at follow-up (P = 0.036 and 0.019 at 12 and 52 weeks, respectively) and similar signals (though formally non-significant) were observed after adjusting for changes in SBP (P = 0.0612 and P = 0.0529, respectively). There were no significant differences in local distensibility changes from baseline to 12 or 52 weeks between the two groups; however, there was a larger reduction in central pulse pressure for the sacubitril/valsartan group compared to the olmesartan group (P = 0.010). Conclusion Since LV mass change correlates with cardiovascular prognosis, the greater reductions in LV mass indicate valuable advantages of sacubitril/valsartan compared to olmesartan. The finding that LV mass index decrease might be to some extent independent of SBP suggests that the effect of the dual-acting agent may go beyond those due to its BP-lowering ability.
The Politics of Child Labour in Indonesia: Global Trends and Domestic Policy

Indonesia in 1949 prohibited children under 15 from working. But in 1987, to attract more investment, the country abolished this prohibition for "children forced to work for social or economic reasons. " By 1991, there were 2.8 million Indonesian children "bonded" to factories that is, mortgaged by parents to employers. U.S. Trade Representative Mickey Kantor recently announced that Indonesia would be given six months to improve worker-rights guarantees or lose dutyfree preferences in the U.S. market. Global agreements or U.S. trade law could increase the pressure to ban child labor. '
High Values of CXCL10 Serum Levels in Mixed Cryoglobulinemia Associated With Hepatitis C Infection

OBJECTIVES:No study has evaluated circulating CXCL10 in patients with mixed cryoglobulinemia (MC) and hepatitis C virus (HCV) chronic infection. The aim of this study is to measure inteferon-inducible protein 10 (CXCL10/IP-10), interferon-gamma (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha) (Th1 cytokines) in a series of cryoglobulinemic patients and to correlate this parameter to the clinical phenotype.METHODS:Serum CXCL10, IFN-gamma, and TNF-alpha were assayed in 102 patients with hepatitis C-associated cryoglobulinemia (MC + HCV), in 102 sex- and age-matched patients with type C chronic hepatitis without cryoglobulinemia (HCV+), and in 102 sex- and age-matched controls.RESULTS:Cryoglobulinemic patients showed significantly higher mean CXCL10 serum levels than controls (P < 0.0001) or HCV+ patients (P < 0.0001) (397 ± 132 pg/mL, 92 ± 53 pg/mL, 280 ± 149 pg/mL, respectively). Moreover, CXCL10 was significantly increased in 30 cryoglobulinemic patients with active vasculitis compared to those without it (460 ± 104 pg/mL vs 369 ± 139 pg/mL, respectively; P < 0.001). Both groups of MC + HCV patients with or without active vasculitis had serum CXCL10 significantly higher than HCV+ patients (P < 0.001, P= 0.02, respectively). IFN-gamma levels were not significantly different in MC + HCV than in HCV+ patients or controls. Serum TNF-alpha levels were significantly higher in MC + HCV than in HCV+ patients or controls (median [interquartile range]: 12.0 [9.8], 5.7 [5.4], 1.3 [2.1] pg/mL, respectively; P < 0.0001). CONCLUSIONS:The study demonstrates high CXCL10 and TNF-alpha serum levels in patients with hepatitis C-associated cryoglobulinemia. Moreover, in MC + HCV patients, increased CXCL10 levels were significantly associated with the presence of active vasculitis.
Speed-Based State-of-Charge Tracking Control for Metro Trains With Onboard Supercapacitors

This paper suggests a novel energy management control algorithm for metro trains based on speed measurement and acceleration estimation. The aim of the control is to recover in a supercapacitor (SC) storage device the maximum energy regenerated during train electrical braking and to limit the contact line peak current. The energy management control is integrated with the motor drive control, since discharge and charge of SC are connected to motoring and braking operations of the train. The algorithm is based on two nested loops on voltage and current of SC. The voltage and current references are calculated on the basis of the estimation of the train inertial force and acceleration, taking into account the power losses of the system. A simplified mathematical model of the whole electrical drive has been developed and the main features of the control strategy have been presented. Numerical simulations show the efficacy of suggested control and the energy saving obtained for metro trains. Experimental tests made on an electromechanical simulator fully confirm theoretical results.
A METHODOLOGY FOR INFORMATION QUALITY ASSESSMENT

Product Information Quality (PIQ) is critical in manufacturing enterprises. Yet, the field lacks comprehensive methodologies for its evaluation. In this paper, the authors attempt to develop such a methodology, which is called Activity-based Measuring and Evaluating of PIQ (AMEQ) to form a basis for PIQ measurement and evaluation. The methodology encompasses a road map to measure and improve PIQ, an indicator system based on characteristics and logic-temporal sequences of processes, and a set of models to quantificationally describe, operate and measure the designing and manufacturing processes of mechanical product information. The methodology is illustrated through a business case. The results of the methodology are useful for determining and reviewing the best area for PIQ improvement activities.
Transient hyperammonemia due to urea cycle enzyme deficiency in Irish wolfhounds.

BACKGROUND Irish Wolfhounds frequently have a congenital portosystemic shunt, but a considerable proportion of the 6- to 8-wk-old pups has hyperammonemia in the absence of portosystemic shunting. This hyperammonemia causes no signs and is transient, normalizing at the age of 3-4 months. HYPOTHESIS Transient hyperammonemia has a metabolic basis in Irish Wolfhounds. ANIMALS Two related (same sire) litters of Irish Wolfhounds (17 pups) and their parents were studied. METHODS Integrity of the portal circulation was examined by ultrasonography and scintigraphy. Absence of parenchymal liver disease was verified by liver biopsy. Amino acid profiles were measured in 4 pups and repeated in 2 of these pups when ammonia concentrations had normalized. The amino acid profiles were compared with those of healthy Irish Wolfhound pups. RESULTS Fasting venous ammonia concentrations were high (113-622 microg/dL, 65-345 micromol/L) in all pups, whereas bile acids were within reference range in all but 1. The ammonia and bile acid concentrations from all parents were within reference range. Portosystemic shunting was excluded in all but 1 pup. Liver biopsy excluded significant lesions in all 10 pups examined. Hypercitrullinemia was found and persisted even when ammonia had normalized, at the expense of an increase in glutamine and asparagine. CONCLUSIONS AND CLINICAL IMPORTANCE Citrulline concentrations are controlled by the urea cycle enzymes argininosuccinase and argininosuccinate synthetase, and a defect in either of these enzymes may be responsible for the transient hyperammonemia in Irish Wolfhounds. Resolution of the hyperammonemia is associated with increased activity of alternative metabolic pathways forming glutamine and asparagine. Confirmation requires measurement of enzyme activities in liver tissue.
Efficacy of Ace Inhibition with Zofenopril, Lisinopril, or Ramipril in Postacute Myocardial Infarction Patients With or Without Metabolic Syndrome: A Pooled Individual Data Analysis of Four Randomized, Double-Blind, Controlled, Prospective Studies

Abstract Background: The metabolic syndrome (MS) is a clustering of different cardiovascular (CV) risk factors, which further enhances the risk of death and CV complications in post-acute myocardial infarction (AMI) patients. In the present meta-analysis of individual data of the four randomized, prospective SMILE studies, we evaluated the efficacy of zofenopril vs. lisinopril, ramipril, and placebo on 1-year CV morbidity and mortality, according to the presence (+) or absence (−) of the MS. Methods: 2203 (63.2%) of the 3488 patients were classified as MS+, 1285 (36.8%) as MS−. Five hundred two MS+ and 380 MS− were treated with placebo, 1134 and 608 with zofenopril 30–60 mg/die, 340 and 175 with lisinopril 5–10 mg/die, and 227 and 122 with ramipril 10 mg/die. Treatment was continued for 6 to 48 weeks. Results: The 1-year risk of a major CV event was similar (P = 0.420) in MS+ (18.1%) and MS− (18.0%) patients [HR and 95% confidence interval: 0.92 (0.76–1.12)]. After accounting for MS+/MS−, the 1-year risk of CV events vs. placebo was significantly lower under zofenopril [0.79 (0.63–0.97); P = 0.028] and lisinopril [0.65 (0.47–0.89); P = 0.007], but larger under ramipril [2.57 (1.94–3.93); P = 0.0001]. Treatment with zofenopril was associated with a statistically significant (P = 0.0001) reduction in CV risk as compared with the other angiotensin-converting enzyme inhibitors [MS+: 0.52 (0.42–0.66); MS−: 0.52 (0.38–0.73)]. Conclusions: In post-AMI patients with MS, zofenopril treatment is associated with a clinically relevant reduction in long-term CV morbidity and mortality, compared with placebo, with an efficacy similar to lisinopril, but better than ramipril.
Acculturation and self-esteem among older Mexican Americans

Several researchers have examined how acculturation shapes the self-esteem of adolescents, but few studies have looked at the influence of acculturation for older Mexican Americans. The aim of this study was to examine how language acculturation shaped the self-esteem of older Mexican Americans. The data come from the baseline wave (N = 3050) of the ongoing Hispanic Established Populations for the Epidemiologic Studies of the Elderly (H-EPESE), a multistage area probability sample conducted in 1993 and 1994. Research revealed that language acculturation is positively associated with self-esteem. However, depressive symptoms mediate and moderate the association of acculturation on self-esteem. Language acculturation among older Mexican Americans is positively associated with self-esteem, even when individuals experience depressive symptoms. Findings suggest that acculturation influences multiple dimensions of mental health.
Neuroendocrine tumors of the pancreas: Spectrum of appearances on MRI

We reviewed our 8.5 year experience with magnetic resonance imaging (MRI) in the demonstration of neuroendocrine tumors of the pancreas using precontrast fat‐suppressed T1‐weighted, fat‐suppressed T2‐weighted, and serial post‐gadolinium T1‐weighted images, to describe the spectrum of appearances of these tumors. All MR examinations of patients with histogically proven neuroendocrine tumors were retrospectively reviewed. Histological type, tumor location, tumor diameter, signal intensity on precontrast images, enhancement patterns, and presence and appearance of metastases were determined. Twenty‐two patients had histologically proved neuroendocrine tumors detected by MRI over the 8.5 year period. Histological types were gastrinoma (n = 8), insulinoma (n = 3), glucagonoma (n = 2), somatostatinoma (n = 1), VIPoma (n = 1), ACTHoma (n = 1), carcinoid (n = 1), and five untyped tumors. Primary tumors ranged in diameter from 1 to 6.2 cm. There was one histopathology‐proven false‐positive neuroendocrine tumor. The positive predictive value for MRI in the detection of these tumors was 96%. The most common appearance on precontrast images was low signal intensity on T1‐weighted images and high signal intensity on T2‐weighted images, which was observed in tumors in 18 of 22 patients. Moderate or intense early enhancement of all or portions of the primary tumors was observed in tumors in 19 of 22 patients either as uniform homogeneous, ring, or diffuse heterogeneous enhancement. Enhancement was minimal on these images in the other three patients. Gastrinomas enhanced in a ring pattern in 7 of 8 patients whereas the majority (9 of 11 patients) of noninsulinoma‐nongastrinoma and untyped tumors enhanced in a diffuse heterogeneous fashion. Liver metastases were present in 13/22 patients including 3/8 with gastrinoma and 9/11 with noninsulinoma‐nongastrinoma tumors. Most neuroendocrine tumors of the pancreas are low signal intensity on fat‐suppressed T1‐weighted images and moderately high in signal intensity on fat‐suppressed T2‐weighted images, although variations do exist. Tumors most often enhance in an early moderately intense fashion. Gastrinomas are often different in appearance than other neuroendocrine tumors in that they usually enhance in a ring fashion whereas nongastrinoma‐noninsulinoma tumors usually enhance in a heterogeneous fashion. J. Magn. Reson. Imaging 2000;11:141–148. © 2000 Wiley‐Liss, Inc.
A Broadband Quadrature Power Splitter Using Metamaterial Transmission Line

A broadband quadrature power splitter (QPS) is developed using the metamaterial transmission line (MM TL). It consists of a Wilkinson power divider and two phase-adjusting TLs, namely a MM TL and a microstrip (MS). The slope of the phase-response curve of the MM TL is synthesized to be the same as that of the MS along with the 90deg phase increment at two design frequencies. Hence, the broadband quadrature phase difference over the desired frequency range can be obtained. In this letter, the QPS is developed at the center frequency of 2 GHz. Over the frequency range of 1.1-3.5 GHz, an amplitude imbalance of less than 0.9 dB and a phase error of less than plusmn5deg have been experimentally demonstrated.
Quantitative gated SPECT myocardial perfusion imaging with 201Tl: an assessment of the limitations

Gated SPECT (GSPECT) perfusion imaging has been increasing in popularity both with 99Tcm agents and 201Tl. However, both higher activities than administered in the UK and multi-headed cameras are often used. The aim of this study was to assess GSPECT imaging using lower activities of 201Tl with a single-headed camera. Seventy patients underwent stress and redistribution GSPECT imaging after a mean injected activity of 62±7 MBq 201Tl. These patients also underwent radionuclide ventriculography (RNVG) imaging. The Cedars Sinai Quantitative Gated SPECT (QGS) package was used to calculate left ventricular ejection fraction (LVEF) from the GSPECT studies. Comparison of ejection fractions calculated using GSPECT with those calculated using RNVG yielded a correlation coefficient of 0.70 for the stress studies and 0.71 for the redistribution studies. The width of the mean 95% prediction interval ranged from 22 to 74 percentage points for the stress studies and 22 to 86 percentage points for the redistribution studies. Ejection fractions calculated from stress and redistribution GSPECT studies showed a correlation of 0.80 with a mean 95% prediction interval of 42.6±0.4 percentage points. In conclusion, left ventricular ejection fractions calculated using the QGS algorithm from 201Tl GSPECT studies are inadequate for use in clinical practice.
Addition of adult‐to‐adult living donation to liver transplant programs improves survival but at an increased cost

Using outcomes data from the Adult‐to‐Adult Living Donor Liver Transplantation Cohort Study, we performed a cost‐effectiveness analysis exploring the costs and benefits of living donor liver transplantation (LDLT). A multistage Markov decision analysis model was developed with treatment, including medical management only (strategy 1), waiting list with possible deceased donor liver transplantation (DDLT; strategy 2), and waiting list with possible LDLT or DDLT (strategy 3) over 10 years. Decompensated cirrhosis with medical management offered survival of 2.0 quality‐adjusted life years (QALYs) while costing an average of $65,068, waiting list with possible DDLT offered 4.4‐QALY survival and a mean cost of $151,613, and waiting list with possible DDLT or LDLT offered 4.9‐QALY survival and a mean cost of $208,149. Strategy 2 had an incremental cost‐effectiveness ratio (ICER) of $35,976 over strategy 1, whereas strategy 3 produced an ICER of $106,788 over strategy 2. On average, strategy 3 cost $47,693 more per QALY than strategy 1. Both DDLT and LDLT were cost‐effective compared to medical management of cirrhosis over our 10‐year study period. The addition of LDLT to a standard waiting list DDLT program is effective at improving recipient survival and preventing waiting list deaths but at a greater cost. Liver Transpl 15:148–162, 2009. © 2009 AASLD.
Category Verbal Fluency Test Performance in Chinese Elderly with Alzheimer’s Disease

Introduction: The applicability of category verbal fluency test (VFT) as a screening test for Alzheimer’s disease (AD) in the Chinese population was studied. Methods: VFTs with categories of ‘animal’, ‘fruit’ and ‘vegetable’ were administrated to 72 subjects with AD and 81 aged-matched, community-dwelling, non-demented elderly (NC) in Hong Kong. Results: A significant difference in VFT scores between NC and AD groups was found (t-test, p < 0.05). CMMSE scores were significantly correlated with VFT performances in both subject groups. The correlation of combined VFT scores with age and educational level was significant only in the NC group (Pearson correlation, p < 0.05). At a cut-off score of 24/25, the sensitivity and specificity of the VFT in screening of dementia were 86.8 and 93.4% for subjects with no formal education. For literate subjects, an optimal cut-off score of 31/32 was identified across different educational levels. Conclusion: Although VFT performance was influenced by demographic factors like age and education, cognitive function was the most determining factor. With easy administration and satisfactory sensitivity and specificity, VFT is a useful and quick clinical screening test for AD in Chinese elderly.
The Assessment of Factorial Invariance in Need for Cognition Using Hispanic and Anglo Samples

The Need for Cognition Scale-Short Form (NCS-SF; J. T. Cacioppo, R. E. Petty, & C. F. Kao, 1984) is a commonly administered measure in the behavioral sciences, but little research has assessed its applicability across cultures. A sample of undergraduates in the southeastern United States and a sample of undergraduates at a southwestern U.S. university completed the NCS-SF. Hispanic respondents did not differ from Anglos in their mean NCS-SF scores. Confirmatory factor analysis revealed that factor parameter estimates and item intercepts were partially measurement invariant across samples.
GABAA receptor antagonism increases NMDA receptor inhibition by isoflurane at a minimum alveolar concentration.

OBJECTIVE At the minimum alveolar concentration (MAC), isoflurane potentiates GABAA receptor currents and inhibits NMDA receptor currents, and these actions may be important for producing anesthesia. However, isoflurane modulates GABAA receptors more potently than NMDA receptors. The objective of this study was to test whether isoflurane would function as a more potent NMDA receptor antagonist if its efficacy at GABAA receptors was decreased. STUDY DESIGN Prospective experimental study. ANIMALS Fourteen 10-week-old male Sprague-Dawley rats weighing 269 ± 12 g. METHODS Indwelling lumbar subarachnoid catheters were surgically placed in isoflurane-anesthetized rats. Two days later, the rats were anesthetized with isoflurane, and artificial CSF containing either 0 or 1 mg kg-1 picrotoxin, a GABAA receptor antagonist, was infused intrathecally at 1 μL minute-1. The baseline isoflurane MAC was then determined using a standard tail clamp technique. MK801 (dizocilpine), an NMDA receptor antagonist, was then administered intravenously at 0.5 mg kg-1. Isoflurane MAC was re-measured. RESULTS Picrotoxin increased isoflurane MAC by 16% compared to controls. MK801 significantly decreased isoflurane MAC by 0.72% of an atmosphere in controls versus 0.47% of an atmosphere in rats receiving intrathecal picrotoxin. CONCLUSIONS AND CLINICAL RELEVANCE A smaller MK801 MAC-sparing effect in the picrotoxin group is consistent with greater NMDA antagonism by isoflurane in these animals, since it suggests that fewer NMDA receptors are available upon which MK801 could act to decrease isoflurane MAC. Decreasing isoflurane GABAA potentiation increases isoflurane NMDA antagonism at MAC. Hence, the magnitude of an anesthetic effect on a given channel or receptor at MAC may depend upon effects at other receptors.
Survey of Academic Pulmonologists, Oncologists, and Infectious Disease Physicians on the Role of Bronchoscopy in Managing Hematopoietic Stem Cell Transplantation Patients With Pulmonary Infiltrates

Background:In the absence of evidence-based guidelines, there is potential for variability in the management of hematopoietic stem cell transplantation (HSCT) patients with pulmonary infiltrates. We decided to perform a nationwide survey of pulmonologists, oncologists, and infectious disease physicians on the role of bronchoscopy in managing HSCT patients. Methods:An 18-question survey was prepared, and after being internally reviewed it was sent through electronic mail to all hematology oncology, pulmonary and critical care, and infectious disease fellowship programs in the United States. Both faculty and fellows from all training programs were asked to electronically fill out the survey. Results:A total of 167 responses, representing 76 different institutions were collected (62 pulmonary, 49 oncology, 53 infectious disease). Pulmonologists felt that bronchoscopy was less likely to yield a positive result or change pharmacological therapy (P-value=0.02 and 0.02). With regard to timing for bronchoscopy in HSCT recipients, there was consensus between all the 3 groups that patients who are non-neutropenic and do not have cavitating infiltrates on chest computed tomography scan should receive bronchoscopy only after failure of empiric antimicrobial therapy. However, there was no agreement between the 3 groups on when neutropenic patients or those with cavitating lesions should receive bronchoscopy. Conclusions:In the absence of randomized clinical trials and evidence-based guidelines, disparities exist in the use of bronchoscopy in the management of infiltrates. These differences were observed within and between both specialties. This study reflects the need for further research to better define the role of bronchoscopy in these patients.