Combination of Isosorbide Dinitrate and Hydralazine in Blacks with Heart Failure

BACKGROUND We examined whether a fixed dose of both isosorbide dinitrate and hydralazine provides additional benefit in blacks with advanced heart failure, a subgroup previously noted to have a favorable response to this therapy. METHODS A total of 1050 black patients who had New York Heart Association class III or IV heart failure with dilated ventricles were randomly assigned to receive a fixed dose ofisosorbide dinitrate plus hydralazine or placebo in addition to standard therapy for heart failure. The primary end point was a composite score made up of weighted values for death from any cause, a first hospitalization for heart failure, and change in the quality of life. RESULTS The study was terminated early owing to a significantly higher mortality rate in the placebo group than in the group given isosorbide dinitrate plus hydralazine (10.2 percent vs. 6.2 percent, P=0.02). The mean primary composite score was significantly better in the group given isosorbide dinitrate plus hydralazine than in the placebo group (-0.1±1.9 vs. -0.5±2.0, P=0.01; range of possible values, -6 to + 2), as were its individual components (43 percent reduction in the rate of death from any cause [hazard ratio, 0.57; P=0.01] 33 percent relative reduction in the rate of first hospitalization for heart failure [16.4 percent vs. 22.4 percent, P=0.001], and an improvement in the quality of life [change in score, -5.6±20.6 vs. -2.7±21.2, with lower scores indicating better quality of life; P=0.02; range of possible values, 0 to 105]). CONCLUSIONS The addition ofa fixed dose of isosorbide dinitrate plus hydralazine to standard therapy for heart failure including neurohormonal blockers is efficacious and increases survival among black patients with advanced heart failure

Open Challenges in Modelling, Analysis and Synthesis of Human Behaviour in Human--Human and Human--Machine Interactions

Modelling, analysis and synthesis of behaviour are the subject of major efforts in computing science, especially when it comes to technologies that make sense of human–human and human–machine interactions. This article outlines some of the most important issues that still need to be addressed to ensure substantial progress in the field, namely (1) development and adoption of virtuous data collection and sharing practices, (2) shift in the focus of interest from individuals to dyads and groups, (3) endowment of artificial agents with internal representations of users and context, (4) modelling of cognitive and semantic processes underlying social behaviour and (5) identification of application domains and strategies for moving from laboratory to the real-world products

Bericht über den Besuch einiger interessanten Gärten und öffentlichen Anlagen auf einer Ferienreise im August und September 1879

Von Professor Dr. Ferdinand Coh