Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis

BACKGROUND & AIMS: The prognostic value of the different causes of renal failure in cirrhosis is not well established. This study investigated the predictive value of the cause of renal failure in cirrhosis. METHODS: Five hundred sixty-two consecutive patients with cirrhosis and renal failure (as defined by serum creatinine 1.5 mg/dL on 2 successive determinations within 48 hours) hospitalized over a 6-year period in a single institution were included in a prospective study. The cause of renal failure was classified into 4 groups: renal failure associated with bacterial infections, renal failure associated with volume depletion, hepatorenal syndrome (HRS), and parenchymal nephropathy. The primary end point was survival at 3 months. RESULTS: Four hundred sixty-three patients (82.4%) had renal failure that could be classified in 1 of 4 groups. The most frequent was renal failure associated with infections (213 cases; 46%), followed by hypovolemia-associated renal failure (149; 32%), HRS (60; 13%), and parenchymal nephropathy (41; 9%). The remaining patients had a combination of causes or miscellaneous conditions. Prognosis was markedly different according to cause of renal failure, 3-month probability of survival being 73% for parenchymal nephropathy, 46% for hypovolemia-associated renal failure, 31% for renal failure associated with infections, and 15% for HRS (P .0005). In a multivariate analysis adjusted for potentially confounding variables, cause of renal failure was independently associated with prognosis, together with MELD score, serum sodium, and hepatic encephalopathy at time of diagnosis of renal failure. CONCLUSIONS: A simple classification of patients with cirrhosis according to cause of renal failure is useful in assessment of prognosis and may help in decision making in liver transplantation.

Product Perfect Codes and Steganography

A new coding technique to be used in steganography is evaluated. The performanceof this new technique is computed and comparisons with the well-known theoreticalupper bound, Hamming upper bound and basic LSB are established.

First enantioselective synthesis of isagarin, a natural product isolated from Pentas longiflora Oliv.

For the first time, an enantioselective synthesis of both 1R,4S-isagarin 1a and 1S,4R-isagarin 1b was achieved starting from 1,4-dimethoxy-2-vinylnaphtalene 2. The key steps involve a Sharpless asymmetric dihydroxylation and reaction with an acetonylating pyridinium ylid.

Translation as a Process and Translation as a Product in Teaching Translation

L'ensenyament de la traducció s'ha utilitzat tradicionalment en algunes titulacions de filologia com a eina d'aprenentatge d'habilitats de la llengua. Aquesta circumstància, però, no ha d'estar renyida amb la producció d'una traducció acceptable. En aquest article es pretén analitzar si pot aconseguir-se aquest objectiu mitjançant la incorporació d'informació extratextual en l'enunciat de l'exercici de traducció. Els resultats obtinguts amb un grup d'estudiants de filologia mostren que en les seves decisions lingüístiques va tenir un pes important el tipus d'informació extratextual adjunta als textes originals anglesos. Si bé caldria fer un esforç investigador més sistemàtic per poder afirmar-ho categòricament, aquest estudi intenta esbossar la qüestió tan discutida de fins on l'aprenentatge d'una llengua s'ha de realitzar junt amb l'aprenentatge de la traducció. Aquest estudi, també, planteja la necessitat d'incorporar informació extratextual en l'aprenentatge de la traducció, independentment de la titulació que en aquests estudis s'insereixen.

Agency problems with non-smooth decision profiles: the case of monopoly under product quality

A method for dealing with monotonicity constraints in optimal control problems is used to generalize some results in the context of monopoly theory, also extending the generalization to a large family of principal-agent programs. Our main conclusion is that many results on diverse economic topics, achieved under assumptions of continuity and piecewise differentiability in connection with the endogenous variables of the problem, still remain valid after replacing such assumptions by two minimal requirements.

The Significance of Business Exit for Future Entrepreneurial Activity

Purpose: The purpose of this paper is to analyse the impact of business exits on future dimensions of entrepreneurial activity at the macroeconomic level. Design/methodology/approach: This research uses the Global Entrepreneurship Monitor (GEM) data for 41 countries and the Generalized Method of Moments (GMM) to carry out the analysis. The paper differentiates the effect of the two components of total entrepreneurial activity, and the two motivations for it – opportunity and necessity entrepreneurship. Findings: The results presented here show a positive and significant effect of the coefficient associated with exits in all models. This means that the levels of entrepreneurial activity exceed business exits. The robustness of the models are tested, including other variables such as the fear of failure, the Gross Domestic Product, role models, entrepreneurial skills and the unemployment variables. The main hypothesis which stated that at national level business exits imply greater rates of opportunity-driven entrepreneurship is corroborated. Originality/value: One would expect that unemployment rates would imply higher levels of necessity entrepreneurship. However, results show that unemployment rates do in fact favour opportunity entrepreneurship levels. This could be due to those government policies that are aimed at promoting entrepreneurship through the capitalization of unemployment to be totally invested in a new start-up. To the best of our knowledge, this is the first panel data study to link previous exit rates to future dimensions of entrepreneurial activity. Keywords: Entrepreneurship, business exits, social values, industrial organization Paper type: Research paper

Cost-effectiveness analysis of cardiac resynchronization therapy in patients with NYHA I and NYHA II heart failure in Spain

Objectives: The aim of the study was to combine clinical results from the European Cohort of the REVERSE study and costs associated with the addition of cardiac resynchronization therapy (CRT) to optimal medical therapy (OMT) in patients with mild symptomatic (NYHA I-II) or asymptomatic left ventricular dysfunction and markers of cardiac dyssynchrony in Spain. Methods: A Markov model was developed with CRT + OMT (CRT-ON) versus OMT only (CRT-OFF) based on a retrospective cost-effectiveness analysis. Raw data was derived from literature and expert opinion, reflecting clinical and economic consequences of patient"s management in Spain. Time horizon was 10 years. Both costs (euro 2010) and effects were discounted at 3 percent per annum. Results: CRT-ON showed higher total costs than CRT-OFF; however, CRT reduced the length of hospitalization in ICU by 94 percent (0.006 versus 0.091 days) and general ward in by 34 percent (0.705 versus 1.076 days). Surviving CRT-ON patients (88.2 percent versus 77.5 percent) remained in better functional class longer, and they achieved an improvement of 0.9 life years (LYGs) and 0.77 years quality-adjusted life years (QALYs). CRT-ON proved to be cost-effective after 6 years, except for the 7th year due to battery depletion. At 10 years, the results were 18,431 per LYG and 21,500 per QALY gained. Probabilistic sensitivity analysis showed CRT-ON was cost-effective in 75.4 percent of the cases at 10 years. Conclusions: The use of CRT added to OMT represents an efficient use of resources in patients suffering from heart failure in NYHA functional classes I and II.

Prognostic Importance of the Cuse of Renal Failure in Patients With Cirrhosis

BACKGROUND & AIMS: The prognostic value of the different causes of renal failure in cirrhosis is not well established. This study investigated the predictive value of the cause of renal failure in cirrhosis. METHODS: Five hundred sixty-two consecutive patients with cirrhosis and renal failure (as defined by serum creatinine 1.5 mg/dL on 2 successive determinations within 48 hours) hospitalized over a 6-year period in a single institution were included in a prospective study. The cause of renal failure was classified into 4 groups: renal failure associated with bacterial infections, renal failure associated with volume depletion, hepatorenal syndrome (HRS), and parenchymal nephropathy. The primary end point was survival at 3 months. RESULTS: Four hundred sixty-three patients (82.4%) had renal failure that could be classified in 1 of 4 groups. The most frequent was renal failure associated with infections (213 cases; 46%), followed by hypovolemia-associated renal failure (149; 32%), HRS (60; 13%), and parenchymal nephropathy (41; 9%). The remaining patients had a combination of causes or miscellaneous conditions. Prognosis was markedly different according to cause of renal failure, 3-month probability of survival being 73% for parenchymal nephropathy, 46% for hypovolemia-associated renal failure, 31% for renal failure associated with infections, and 15% for HRS (P .0005). In a multivariate analysis adjusted for potentially confounding variables, cause of renal failure was independently associated with prognosis, together with MELD score, serum sodium, and hepatic encephalopathy at time of diagnosis of renal failure. CONCLUSIONS: A simple classification of patients with cirrhosis according to cause of renal failure is useful in assessment of prognosis and may help in decision making in liver transplantation.

Structuration and branding of a religious tourism product: Catalonia sacra

This article aims to provide an overview of the products Catalonia has to offer in terms of religious tourism. The growing interest in this kind of tourism worldwide, and in Catalonia itself, along with the region's wealth of religious heritage (particularly connected to the Christian Church) contrast with the lack of religion-based tourism products available, which results in its absence from the region's image as a tourism destination. In view of this, the Faculty of Tourism (University of Girona), the Vic Bishopric's Albergueria-Centre for Cultural Dissemination and the Tarraconense Episcopal Conference's Interdiocese Secretariat for the Custody and Promotion of Holy Art (SICPAS) decided to address the situation with the help of funding from the Autonomous Government of Catalonia. In order to re-position Christian religious heritage in the image of Catalonia as a tourist destination, the aforementioned parties embarked upon a project to set up a series of routes throughout the region, branded under the name Catalonia Sacra

Shaping urban traffic patterns through congestion charging : What factors drive success or failure?

Congestion costs are emerging as one of the most important challenges faced by metropolitan planners and transport authorities in first world economies. In US these costs were as high as 78 million dollars in 2005 and are growing due to fast increases in travel delays. In order to solve the current and severe levels of congestion the US department of transportation have recently started a program to initiate congestion pricing in five metropolitan areas. In this context it is important to determine those factors helping its implementation and success, but also the problems or difficulties associated with charging projects. In this article we analyze worldwide experiences with urban road charging in order to extract interesting and helpful lessons for policy makers engaged in congestion pricing projects and for those interested in the introduction of traffic management tools to regulate the entrance to big cities.

Organic chicken product authentication: state-of-the-art and future perspectives

Organic food products are highly susceptible to fraud. Currently, administrative controls are conducted to detect fraud, but having an analytical tool able to verify the organic identity of food would be very supportive. The state-of-the-art in food authentication relies on fingerprinting approaches that find characteristic analytical patterns to unequivocally identify authentic products. While wide research on authentication has been conducted for other commodities, the authentication of organic chicken products is still in its infancy. Challenges include finding fingerprints to discriminate organic from conventional products, and recruiting sample sets that cover natural variability. Future research might be oriented towards developing new authentication models for organic feed, eggs and chicken meat, keeping models updated and implementing them into regulations. Meanwhile, these models might be very supportive to the administrative controls directing inspections towards suspicious fraudulent samples.

Informed recommender: basing recommendations on consumer product reviews

Recommender systems attempt to predict items in which a user might be interested, given some information about the user's and items' profiles. Most existing recommender systems use content-based or collaborative filtering methods or hybrid methods that combine both techniques (see the sidebar for more details). We created Informed Recommender to address the problem of using consumer opinion about products, expressed online in free-form text, to generate product recommendations. Informed recommender uses prioritized consumer product reviews to make recommendations. Using text-mining techniques, it maps each piece of each review comment automatically into an ontology

Bio-based composites from stone groundwood applied to new product development

This paper deals with the product design, engineering, and material selection intended for the manufacturing of an eco-friendly chair. The final product is expected to combine design attributes with technical and legal feasibility with the implementation of new bio-based materials. Considering the industrial design, a range of objectives and trends were determined after setting the market requirements, and the final concept was proposed and modeled. The product geometry, production technology, and legal specifications were the input data for product engineering. The material selection was based on the technical requirements. Polypropylene (PP) composite materials based on coupled-fiberglass, sized-fiberglass, and coupled-stone ground wood reinforcements were prepared and characterized. Final formulations based on these PP composites are proposed and justified