Miracle-dz/UniFAR-FTUs huggingface dataset:
Aldosterone Receptor Antagonists in Cardiovascular Disease: A Review of the Recent Literature and Insight Into Potential Future Indications

Randomized controlled trials demonstrate the efficacy of aldosterone receptor antagonists (spironolactone and eplerenone) as a useful pharmacologic intervention specifically in patients with New York Heart Association (NYHA) class III and IV heart failure, in patients with an ejection fraction <40% after myocardial infarction, and most recently in patients with mildly symptomatic heart failure. However, aldosterone receptor antagonists may be beneficial in a broader patient population. Aldosterone receptor antagonists can potentially serve as an antiarrhythmic pharmacologic agent for atrial and ventricular arrhythmias, an anti‐ischemic medication in coronary artery disease through prevention of myocardial fibrosis and vascular damage, and as an agent in people with asymptomatic and mild heart failure (NYHA classes I and II) and diastolic heart failure. However, many clinicians remain reluctant to prescribe this highly efficacious pharmacologic therapy for a variety of reasons, including concerns about polypharmacy and hyperkalemia. Recent observational analysis demonstrates that less than one‐third of eligible patients hospitalized with heart failure actually received aldosterone antagonist therapy. This article will review the current and potential future uses of aldosterone receptor antagonists across the entire spectrum of cardiovascular disease.
Parents' perceptions and attitudes on childhood obesity: A Q‐methodology study

Purpose: The purpose of this study was to investigate parents of young children for their perceptions on the causes of obesity, the impact of childhood obesity on health, and the barriers to successful prevention of childhood obesity. Data sources: The target population included parents who attended a clinic for their well‐baby check‐up. The study was conducted in two phases. Using Q‐methodology, 33 parents were classified into two groups representing two viewpoints: “confident in delivering healthy nutrition” and “family physical activity focused. ” Conclusion: This work indicates that parents have varying foci on causation of obesity, and differ in focus on nutrition and physical activity. Most of the parents in this study were aware of healthy nutrition, and about one third of them believed in the benefits of physical activity for children and did not see being overweight or obese as a barrier to physical activity. The first group was confident in being able to deliver healthy nutrition to their family, and the second group was characterized by a focus on physical activity and its role in childhood obesity. Both groups agreed that exercising and sports are very important to a child's health status. Implications for practice: Nurse practitioners have a unique role in the health system and are one of the best facilitators to deliver health messages to the public; thus, they are able to educate parents and increase their awareness about the causes and consequences of childhood obesity.
Immature Multipotent Hemopoietic Progenitors Lacking Long-Term Bone Marrow-Reconstituting Activity in the Aorta-Gonad-Mesonephros Region of Murine Day 10 Fetuses1

Previous studies indicated that multipotent progenitors exist in early fetuses that do not contain long-term reconstituting (LTR) activity. However, it remained unclear whether these multipotent progenitors are committed to the hemopoietic lineage or are immature mesodermal cells or hemangioblasts. In this study, we have succeeded in enriching the multipotent progenitors that are capable of generating myeloid, T, and B cells in the LFA-1− subpopulation of TER-119−c-kit+CD45+ cells from the aorta-gonad-mesonephros (AGM) region of day 10 fetuses. We found that these day 10 AGM LFA-1− cells do not show the LTR activity, whereas day 11 AGM LFA-1− cells do have such an activity. These results strongly suggest that multipotent progenitors lacking LTR activity emerge as CD45+ hemopoietic progenitor cells in the AGM region on the 10th day of gestation, and such p-Multi mature into hemopoietic stem cells by acquiring LTR activity.
Molecular signatures of amyotrophic lateral sclerosis disease progression in hind and forelimb muscles of an SOD1(G93A) mouse model.

AIMS This study utilized proteomics, biochemical and enzymatic assays, and bioinformatics tools that characterize protein alterations in hindlimb (gastrocnemius) and forelimb (triceps) muscles in an amyotrophic lateral sclerosis (ALS) (SOD1(G93A)) mouse model. The aim of this study was to identify the key molecular signatures involved in disease progression. RESULTS Both muscle types have in common an early down-regulation of complex I. In the hindlimb, early increases in oxidative metabolism are associated with uncoupling of the respiratory chain, an imbalance of NADH/NAD(+), and an increase in reactive oxygen species (ROS) production. The NADH overflow due to complex I inactivation induces TCA flux perturbations, leading to citrate production, triggering fatty acid synthase (FAS), and lipid peroxidation. These early metabolic changes in the hindlimb followed by sustained and comparatively higher metabolic and cytoskeletal derangements over time precede and may catalyze the progressive muscle wasting in this muscle at the late stage. By contrast, in the forelimb, there is an early down-regulation of complexes I and II that is associated with the reduction of oxidative metabolism, which promotes metabolic homeostasis that is accompanied by a greater cytoskeletal stabilization response. However, these early compensatory systems diminish by a later time point. INNOVATION The identification of potential early- and late-stage disease molecular signatures in an ALS model: muscle albumin, complex I, complex II, citrate synthase, FAS, and phosphoinositide 3-kinase functions as diagnostic markers and peroxisome proliferator-activated receptor γ co-activator 1α (PGC1α), Sema-3A, and Rho-associated protein kinase 1 (ROCK1) play the role of disease progression markers. CONCLUSION The differing pattern of cellular metabolism and cytoskeletal derangements in the hind and forelimb identifies the potential dysmetabolism/hypermetabolism molecular signatures associated with disease progression, which may serve as diagnostic/disease progression markers in ALS patients.
A Stepwise-Clustered Simulation Approach for Projecting Future Heat Wave Over Guangdong Province

A heat wave is an important meteorological extreme event related to global warming, but little is known about the characteristics of future heat waves in Guangdong. Therefore, a stepwise-clustered simulation approach driven by multiple global climate models (i.e., GCMs) is developed for projecting future heat waves over Guangdong under two representative concentration pathways (RCPs). The temporal-spatial variations of four indicators (i.e., intensity, total intensity, frequency, and the longest duration) of projected heat waves, as well as the potential changes in daily maximum temperature (i.e., Tmax) for future (i.e., 2006–2095) and historical (i.e., 1976–2005) periods, were analyzed over Guangdong. The results indicated that Guangdong would endure a notable increasing annual trend in the projected Tmax (i.e., 0.016–0.03°C per year under RCP4.5 and 0.027–0.057°C per year under RCP8.5). Evaluations of the multiple GCMs and their ensemble suggested that the developed approach performed well, and the model ensemble was superior to any single GCM in capturing the features of heat waves. The spatial patterns and interannual trends displayed that Guangdong would undergo serious heat waves in the future. The variations of intensity, total intensity, frequency, and the longest duration of heat wave are likely to exceed 5.4°C per event, 24°C, 25 days, and 4 days in the 2080s under RCP8.5, respectively. Higher variation of those would concentrate in eastern and southwestern Guangdong. It also presented that severe heat waves with stronger intensity, higher frequency, and longer duration would have significant increasing tendencies over all Guangdong, which are expected to increase at a rate of 0.14, 0.83, and 0.21% per year under RCP8.5, respectively. Over 60% of Guangdong would suffer the moderate variation of heat waves to the end of this century under RCP8.5. The findings can provide decision makers with useful information to help mitigate the potential impacts of heat waves on pivotal regions as well as ecosystems that are sensitive to extreme temperature.
Effects of cholecalciferol on functional, biochemical, vascular, and quality of life outcomes in hemodialysis patients.

BACKGROUND AND OBJECTIVES Observational studies suggest that calciferol supplementation may improve laboratory and patient-level outcomes of hemodialysis patients with reduced 25-hydroxyvitamin D [25(OH)D] levels. This randomized controlled trial examined effects of cholecalciferol supplementation in patients on hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Sixty patients with 25(OH)D levels ≤24 ng/ml (≤60 nmol/L) were randomized to receive 50,000 IU oral cholecalciferol or placebo, once weekly for 8 weeks and then monthly for 4 months. At baseline (autumn 2011) and 6 months, testing evaluated muscle strength, functional capacity, laboratory parameters, pulse wave velocity (PWV), and health-related quality of life (HRQOL) using the Kidney Disease Quality of Life-36 survey. RESULTS Patients were well matched by treatment allocation. Median age was 62 years (range, 20-86), 52% were women, 55% had a history of diabetes, and mean serum 25(OH)D was 17±5 ng/ml (43±13 nmol/L). Patients were assessed over 6 months by repeated-measures ANOVA. Patients allocated to cholecalciferol had significantly higher values of 25(OH)D (P<0.001), 1,25-dihydroxyvitamin D (P=0.04), and tartrate-resistant acid phosphatase-5b) (P=0.04) and a greater reduction in phosphorus values (P=0.03) than placebo-treated patients Values of serum calcium, intact parathyroid hormone, and episodes of hypercalcemia and hyperphosphatemia did not differ significantly between the groups. No significant differences were detected in muscle strength, functional capacity, PWV, or HRQOL. CONCLUSIONS In this randomized controlled trial, patients supplemented with cholecalciferol had higher 25(OH)D, 1,25-dihydroxyvitamin D, and tartrate-resistant acid phosphatase-5b levels, without increased calcium or phosphorus values. However, no effects were detected in muscle strength, functional capacity, PWV, or HRQOL.
Bacterial diversity in the surface sediments of the hypoxic zone near the Changjiang Estuary and in the East China Sea

Changjiang (Yangtze River) Estuary has experienced severe hypoxia since the 1950s. In order to investigate potential ecological functions of key microorganisms in relation to hypoxia, we performed 16S rRNA‐based Illumina Miseq sequencing to explore the bacterial diversity in the surface sediments of the hypoxic zone near the Changjiang Estuary and in the East China Sea (ECS). The results showed that numerous Proteobacteria‐affiliated sequences in the sediments of the inner continental shelf were related to both sulfate‐reducing and sulfur‐oxidizing bacteria, suggesting an active sulfur cycle in this area. Many sequences retrieved from the hypoxic zone were also related to Planctomycetes from two marine upwelling systems, which may be involved in the initial breakdown of sulfated heteropolysaccharides. Bacteroidetes, which is expected to degrade high‐molecular‐weight organic matter, was abundant in all the studied stations except for station A8, which was the deepest and possessed the largest grain size. In addition, dissolved organic carbon, water depth, percentage ratio of clay to silt, salinity, and sedimentary grain size were environmental effectors that shaped the sedimentary microbial community structure. Our results showed that putative Gammaproteobacteria‐affiliated sulfur‐oxidizing bacteria may not only detoxify hydrogen sulfide produced by sulfate‐reducing prokaryotes, but also serve as the primary producers in the marine sediments. Specific groups of aerobic Bacteroidetes and Planctomycetes participated in degrading organic matter, which might contribute to the oxygen depletion in the hypoxic zones.
Eigen-Distortions of Hierarchical Representations

We develop a method for comparing hierarchical image representations in terms of their ability to explain perceptual sensitivity in humans. Specifically, we utilize Fisher information to establish a model-derived prediction of sensitivity to local perturbations of an image. For a given image, we compute the eigenvectors of the Fisher information matrix with largest and smallest eigenvalues, corresponding to the model-predicted most- and least-noticeable image distortions, respectively. For human subjects, we then measure the amount of each distortion that can be reliably detected when added to the image. We use this method to test the ability of a variety of representations to mimic human perceptual sensitivity. We find that the early layers of VGG16, a deep neural network optimized for object recognition, provide a better match to human perception than later layers, and a better match than a 4-stage convolutional neural network (CNN) trained on a database of human ratings of distorted image quality. On the other hand, we find that simple models of early visual processing, incorporating one or more stages of local gain control, trained on the same database of distortion ratings, provide substantially better predictions of human sensitivity than either the CNN, or any combination of layers of VGG16.
Changes in albumin, α‐fetoprotein and collagen gene transcription in ccl4‐induced hepatic fibrosis

In efforts to understand mechanisms of liver dysfunction in cirrhosis, transcription of specific genes important to liver function has been measured in the rat model of CCl4‐induced hepatic fibrosis. The relative transcription rates of albumin, α‐fetoprotein and pro‐α1‐collagen genes were studied during development of fibrosis and after fibrosis was established. During the initial phase of CCl4 administration, there was a decrease in albumin transcription associated with increased α‐fetoprotein transcription, indicative of active liver regeneration. However, later during development of fibrosis, the response pattern of these genes was different, as albumin gene transcription was normal or increased and α‐fetoprotein gene transcription was no longer increased. Three weeks after completion of CCl4 treatment (fully established cirrhosis), albumin genes responded normally or hypernormally to an acute regenerative stimulus, but the α‐fetoprotein gene was again not measurably responsive. Pro‐α1‐collagen gene transcription increased during the entire fibrogenic process and remained elevated after cirrhosis was established. These studies suggest that a switch from albumin to α‐fetoprotein gene transcription can serve as a marker of liver regenerative capacity, and that this process is altered during and after development of hepatic fibrosis. The fibrogenic process is also associated with elevated transcription of collagen genes.
Mesozoic–Cenozoic Uplift/Exhumation History of the Qilian Shan, NE Tibetan Plateau: Constraints From Low-Temperature Thermochronology

The Qilian Shan, which is located along the northeastern margin of the Tibetan Plateau, plays a key role in understanding the dynamics of the outward and upward growth of the plateau. However, when and how tectonic deformation evolved into the geographic pattern which is currently observed in the Qilian Shan are still ambiguous. Here, apatite fission track (AFT) thermochronology and sedimentology were conducted to interpret the low-temperature tectonic deformation/exhumation events in well-dated Late Miocene synorogenic sediment sequences in the Xining Basin, which is adjacent to the southern flank of the Qilian Shan. These new low-temperature thermochronological results suggest that the Qilian Shan experienced four stages of tectonic exhumation during the late Mesozoic–Cenozoic. The Late Cretaceous exhumation events in the Qilian Shan were caused by the diachronous Mesozoic convergence of the Asian Plate and Lhasa Block. In the early Cenozoic (ca. 68–48 Ma), the Qilian Shan quasi-synchronously responded to the Indian–Asian plate collision. Subsequently, the mountain range experienced a two-phase deformation during the Eocene–Early Miocene due to the distal effects of ongoing India–Asia plate convergence. At ca. 8 ± 1 Ma, the Qilian Shan underwent dramatic geomorphological deformation, which marked a change in subsidence along the northeastern margin of the Tibetan Plateau at that time. Our findings suggest that the paleogeographic pattern in the northeastern Tibetan Plateau was affected by the pervasive suture zones in the entire Qilian Shan, in which the pre-Cenozoic and Indian–Asian plate motions reactivated the transpressional faults which strongly modulated the multiperiodic tectonic deformation in northern Tibet during the Cenozoic. These observations provide new evidence for understanding the dynamic mechanisms of the uplift and expansion of the Tibetan Plateau.
"I don't want to die like that ...": the impact of significant others' death quality on advance care planning.

PURPOSE OF THE STUDY I examine whether 5 aspects of a significant other's death quality (pain, decision-making capacity, location, problems with end-of life care, and preparation) affect whether one does advance care planning (ACP). I also identify specific aspects of others' deaths that respondents say triggered their own planning. DESIGN AND METHODS Data are from the New Jersey End of Life study, a survey of 305 adults age 55+ seeking care at 2 major New Jersey medical centers. I estimate multivariate logistic regression models for a subsample of 253 participants who recently lost a loved one and provide descriptive findings from an open-ended question regarding the motivation for one's ACP. RESULTS Multivariate analyses revealed "positive" role model effects; persons who witnessed significant others' deaths that occurred at home, were free of problems associated with end-of-life care, and where advance directives were used are more likely to make end-of-life preparations. Open-ended data showed that 19% cited others' deaths as the main trigger for their own planning, with most citing negative factors (pain, connection to machines, coma) that they hoped to avoid. IMPLICATIONS Practitioners should encourage patients to use conversations about others' deaths as springboards for discussions about one's own end-of-life care, and to engage in ACP together with family. Implications for health care reform are highlighted.
A Parallel Monte Carlo Method for Optimum Allocation of Distributed Generation

This paper presents a procedure for estimating the optimum allocation of distributed generation (DG) units in large distribution systems by using a multicore computing environment. The main goal of this work is to explore the application of a refined parallel Monte Carlo method for energy loss minimization in three-phase distribution systems when considering the intermittent nature of some distributed resources and the time varying shape of the loads. The procedure has been implemented in an open environment in which OpenDSS is driven from MATLAB. Some examples illustrate the scope of the proposed procedure.
Cervical pessary placement for prevention of preterm birth in unselected twin pregnancies: a randomized controlled trial.

BACKGROUND Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. OBJECTIVE The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. STUDY DESIGN This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20(+0)-24(+6) weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth <34 weeks. Secondary outcomes included perinatal death and a composite of adverse neonatal outcomes (intraventricular haemorrhage, respiratory distress syndrome, retinopathy of prematurity or necrotizing enterocolitis) or need for neonatal therapy (ventilation, phototherapy, treatment for proven or suspected sepsis, or blood transfusion). Analysis was by intention to treat. This trial is registered in the ISRCTN registry, number 01096902. RESULTS A total of 1,180 (56.0%) of the 2,107 eligible women agreed to take part in the trial; 590 received cervical pessary and 590 had expectant management. Two of the former and one of the latter were lost to follow up. There were no significant differences between the pessary and control groups in rates of spontaneous birth <34 weeks (13.6% vs. 12.9%; relative risk 1.054, 95% confidence interval [CI] 0.787-1.413; p=0.722), perinatal death (2.5% vs. 2.7%; relative risk 0.908, 95% CI 0.553-1.491; p=0.702), adverse neonatal outcome (10.0 vs. 9.2%; relative risk 1.094, 95% CI 0.851-1.407; p=0.524) or neonatal therapy (17.9% vs. 17.2%; relative risk 1.040, 95% CI 0.871-1.242; p=0.701). A post hoc subgroup analysis of 214 women with short cervix (≤25 mm) showed no benefit from the insertion of a cervical pessary. CONCLUSION In women with twin pregnancy, routine treatment with cervical pessary does not reduce the rate of spontaneous early preterm birth.
Cytogenetic analysis of 5572 patients referred for suspected chromosomal abnormalities in Morocco.

OBJECTIVES The aim of this study was (1) to identify the profile of patients being referred for cytogenetic analysis in Morocco, (2) to determine the prevalence and type of chromosomal abnormalities in the different groups, (3) to compare the results with those of similar studies done in other countries. MATERIAL AND METHODS 5572 patients ranging from newborns to 50 years of age were referred to the department of medical genetics, of the Moroccan National Institute of Health between 1993 and 2010, with a variety of clinical disorders such as mental retardation; multiple congenital malformations; clinical features of Down syndrome, Turner's syndrome, and Klinefelter syndrome; ambiguous sex; sterility; amenorrhea; recurrent miscarriage; and chromosome breakage syndromes. RESULTS Of the 5572 cases studied, 4068 (73%) had a normal karyotype and 1504 (27%) had chromosomal abnormalities. Various types of chromosomal anomalies were found. The most common autosomal abnormalities were Down syndrome (1095 cases) and Turner's syndrome (122 cases) in abnormalities of sex chromosomes. CONCLUSION This study compares the results of cytogenetic analysis of chromosomal abnormalities in the Moroccan population with other countries and research centers. This comparison will help Moroccan clinicians to determine the priority for requesting a cytogenetic analysis in individual cases.