Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Medication Reconciliation and Review on Clinical Outcomes

Objective: To examine the evidence regarding the effectiveness of medication reconciliation and review and to improve clinical outcomes in hospitals, the community, and aged care facilities. Data Source: This systematic review was undertaken in concordance with the PRISMA statement. Electronic databases, including MEDLINE, PsycINFO, EMBASE, and CINAHL were searched for relevant articles published between January 2000 and March 2014. Study Selection and Data Extraction: Randomized and nonrandomized studies rating the severity of medication discrepancies and medication-related problems identified during medication reconciliation and/or review were considered for inclusion. Data were extracted independently by 2 authors using a data collection form. Data Synthesis: Of the 5292 articles identified, 83 articles met the inclusion criteria. Medication reconciliation identified unintentional medication discrepancies in 3.4% to 98.2% of patients. There is limited evidence of the potential of these discrepancies to cause harm. Medication reviews identified medication-related problems or possible adverse drug reactions in 17.2% to 94.0% of patients. The studies reported conflicting findings regarding the impact of medication review on length of stays, readmissions, and mortality. Conclusions: The evidence demonstrates that medication reconciliation has the potential to identify many medication discrepancies and reduce potential harm, but the impact on clinical outcomes is less clear. Similarly, medication review can detect medication-related problems in many patients, but evidence of clinical impact is scant. Overall, there is limited evidence that medication reconciliation and medication review processes, as currently performed, significantly improve clinical outcomes, such as reductions in hospital readmissions.
Learning From Hidden Traits: Joint Factor Analysis and Latent Clustering

Dimensionality reduction techniques play an essential role in data analytics, signal processing, and machine learning. Dimensionality reduction is usually performed in a preprocessing stage that is separate from subsequent data analysis, such as clustering or classification. Finding reduced-dimension representations that are well-suited for the intended task is more appealing. This paper proposes a joint factor analysis and latent clustering framework, which aims at learning cluster-aware low-dimensional representations of matrix and tensor data. The proposed approach leverages matrix and tensor factorization models that produce essentially unique latent representations of the data to unravel latent cluster structure-which is otherwise obscured because of the freedom to apply an oblique transformation in latent space. At the same time, latent cluster structure is used as prior information to enhance the performance of factorization. Specific contributions include several custom-built problem formulations, corresponding algorithms, and discussion of associated convergence properties. Besides extensive simulations, real-world datasets such as Reuters document data and MNIST image data are also employed to showcase the effectiveness of the proposed approaches.
Comparison of two- and three-dimensional transvaginal ultrasound in the visualisation of intrauterine devices

The aims of the study were to evaluate whether three-dimensional transvaginal ultrasound (3D TV US) is superior to two-dimensional transvaginal ultrasound (2D TV US) at visualising intrauterine devices and determining their position. This prospective study included 52 participants with an intrauterine device fitted, who underwent 2D TV US and 3D TV US. 2D TV US and 3D-reconstructed coronal images were reviewed by two gynaecological radiologists to assess ease of visualisation and position of the intrauterine devices. Statistical analysis was performed using Wilcoxon signed-rank, McNemar and Chi-squared tests. The inter-observer agreement was measured using Cohen’s Kappa. Intrauterine device visualisation scores were significantly higher with 2D TV US compared with 3D TV US (Radiologist 1 p = <0.001, Radiologist 2 p = 0.007). A significant number of T-arms appeared to perforate into the adjacent myometrium on the 3D-reconstructed coronal image, but were normal on the 2D images (Radiologist 1 p = <0.001, Radiologist 2 p = 0.008). Radiologist 1 found 19 perforated T-arms on 3D TV US compared with four on 2D TV US. Radiologist 2 found 13 perforated T-arms on 3D TV US compared with five on 2D TV US. Both radiologists agreed on the positions of the intrauterine devices substantially with 3D TV US (Kappa = 0.69) and moderately with 2D TV US (Kappa = 0.55). The 3D TV US did not visualise an intrauterine device better than 2D TV US. The 3D-reconstructed coronal image of the uterus can reliably display cases of T-arm perforation into the adjacent myometrium, which could be missed on 2D TV US images. The 3D TV US should be used in addition to 2D TV US in all cases where an intrauterine device is under evaluation.
Genome‐wide and gene‐based association implicates FRMD6 in alzheimer disease

Genome‐wide association studies (GWAS) that allow for allelic heterogeneity may facilitate the discovery of novel genes not detectable by models that require replication of a single variant site. One strategy to accomplish this is to focus on genes rather than markers as units of association, and so potentially capture a spectrum of causal alleles that differ across populations. Here, we conducted a GWAS of Alzheimer disease (AD) in 2,586 Swedes and performed gene‐based meta‐analysis with three additional studies from France, Canada, and the United States, in total encompassing 4,259 cases and 8,284 controls. Implementing a newly designed gene‐based algorithm, we identified two loci apart from the region around APOE that achieved study‐wide significance in combined samples, the strongest finding being for FRMD6 on chromosome 14q (P = 2.6 × 10−14) and a weaker signal for NARS2 that is immediately adjacent to GAB2 on chromosome 11q (P = 7.8 × 10−9). Ontology‐based pathway analyses revealed significant enrichment of genes involved in glycosylation. Results suggest that gene‐based approaches that accommodate allelic heterogeneity in GWAS can provide a complementary avenue for gene discovery and may help to explain a portion of the missing heritability not detectable with single nucleotide polymorphisms (SNPs) derived from marker‐specific meta‐analysis. Hum Mutat 33:521–529, 2012. © 2011 Wiley Periodicals, Inc.
Effects of Sequence Variations in Innate Immune Response Genes on Infectious Outcome in Trauma Patients: A Comprehensive Review

ABSTRACT Infectious complications, sepsis, and multiple organ dysfunction syndrome (MODS) remain important causes for morbidity and mortality in patients who survive the initial trauma. Increasing evidence suggests that genetic variants, particularly single nucleotide polymorphisms (SNPs), are critical determinants for interindividual differences in both inflammatory responses and clinical outcome in sepsis patients. Although the effect of SNPs on sepsis and MODS has been studied in many populations and diseases, this review aimed to summarize the current knowledge on the effect of SNPs on infectious complication specifically in trauma patients. A review of available literature was performed in PubMed database. The following genes have been studied in populations of trauma patients: CD14, HMGB1, IFNG, IL1A, IL1B, IL1RN, IL4, IL6, IL8, IL10, IL17F, IL18, MBL2, MASP2, FCN2, TLR1, TLR2, TLR4, TLR9, TNF, LTA, GR, MYLK, NLRP3, PRDX6, RAGE, HSPA1B, HSPA1L, HSP90, SERPINE1, IRAK1, IRAK3, VEGFA, LY96, ANGPT2, LBP, MicroRNA, and mtDNA. In this review, we discuss the genes of the Pattern Recognition Receptors, Signal Transducing Adaptor Proteins, and Inflammatory Cytokines of the innate immune system. A number of genetic variations have so far been studied in cohorts of trauma patients. Studies are often unique and numbers sometimes small. No definitive conclusions can be reached at this time about the influence of specific sequence variations on outcome in trauma patients.
Towards practical automated trust negotiation

Exchange of attribute credentials is a means to establish mutual trust between strangers that wish to share resources or conduct business transactions. Automated Trust Negotiation (ATN) is an approach to regulate the exchange of sensitive credentials by using access control policies. Existing ATN work makes unrealistic simplifying assumptions about credential-representation languages and credential storage. Moreover while existing work protects the transmission of credentials, it fails to hide the contents of credentials, thus providing uncontrolled access to potentially sensitive attributes. To protect information about sensitive attributes, we introduce the notion of attribute acknowledgment policies (Ack policies). We then introduce the trust target graph (TTG) protocol, which supports a more realistic credential language, Ack policies, and distributed storage of credentials.
A two-scale Stefan problem arising in a model for tree sap exudation

The study of tree sap exudation, in which a (leafless) tree generates elevated stem pressure in response to repeated daily freeze-thaw cycles, gives rise to an interesting multi-scale problem involving heat and multiphase liquid/gas transport. The pressure generation mechanism is a cellular-level process that is governed by differential equations for sap transport through porous cell membranes, phase change, heat transport, and generation of osmotic pressure. By assuming a periodic cellular structure based on an appropriate reference cell, we derive an homogenized heat equation governing the global temperature on the scale of the tree stem, with all the remaining physics relegated to equations defined on the reference cell. We derive a corresponding strong formulation of the limit problem and use it to design an efficient numerical solution algorithm. Numerical simulations are then performed to validate the results and draw conclusions regarding the phenomenon of sap exudation, which is of great importance in trees such as sugar maple and a few other related species. The particular form of our homogenized temperature equation is obtained using periodic homogenization techniques with two-scale convergence, which we investigate theoretically in the context of a simpler two-phase Stefan-type problem corresponding to a periodic array of melting cylindrical ice bars with a constant thermal diffusion coefficient. For this reduced model, we prove results on existence, uniqueness and convergence of the two-scale limit solution in the weak form, clearly identifying the missing pieces required to extend the proofs to the fully nonlinear sap exudation model. Numerical simulations of the reduced equations are then compared with results from the complete sap exudation model.
Self-Assembled Magnetic Matrices for DNA Separation Chips

When a constant, homogenous magnetic field is applied to a suspension of superparamagnetic particles confined in a thin gap perpendicular to the field, the particles self-organize into a fixed, quasi-regular array of columns ([Fig. 1][1]A) ([1][2]). The array returns to a liquid suspension
Virus-Enabled Synthesis and Assembly of Nanowires for Lithium Ion Battery Electrodes

The selection and assembly of materials are central issues in the development of smaller, more flexible batteries. Cobalt oxide has shown excellent electrochemical cycling properties and is thus under consideration as an electrode for advanced lithium batteries. We used viruses to synthesize and assemble nanowires of cobalt oxide at room temperature. By incorporating gold-binding peptides into the filament coat, we formed hybrid gold–cobalt oxide wires that improved battery capacity. Combining virus-templated synthesis at the peptide level and methods for controlling two-dimensional assembly of viruses on polyelectrolyte multilayers provides a systematic platform for integrating these nanomaterials to form thin, flexible lithium ion batteries.
Effect of perspired moisture and material properties on evaporative cooling and thermal protection of the clothed human body exposed to radiant heat

Perspired moisture plays a crucial role in the thermal physiology and protection of the human body wearing thermal protective clothing. Until now, the role of continuous sweating on heat transfer, when simultaneously considering internal and external heat sources, has not been well-investigated. To bridge this gap, a sweating torso manikin with 12 thermal protective fabric systems and a radiant heat panel were applied to mimic firefighting. The results demonstrated how the effect of radiant heat on heat dissipation interacted with amount of perspired moisture and material properties. A dual effect of perspired moisture was demonstrated. For hydrophilic materials, sweating induced evaporative cooling but also increased radiant heat gain. For hydrophilic station uniforms, the increment of radiant heat gain due to perspired moisture was about 11% of the increase of heat dissipation. On the other hand, perspired moisture can increase evaporative cooling and decrease radiant heat gain for hydrophobic materials. In addition to fabric thermal resistance (Rct) and evaporative resistance (Ret), material hydrophilicity and hydrophobicity, emissivity and thickness are important when assessing metabolic heat dissipation and radiant heat gain with profuse sweating under radiant heat. The results provide experimental evidence that Rct and Ret, the general indicators of the clothing thermo-physiological effect, have limitations in characterizing thermal comfort and heat strain during active liquid sweating in radiant heat. This paper offers a more complete insight into clothing thermal characteristics and human thermal behaviors under radiant heat, contributing to the accurate evaluation of thermal stress for occupational and general individuals.
Objective surveillance definitions for ventilator-associated pneumonia*

Objectives:The subjectivity and complexity of surveillance definitions for ventilator-associated pneumonia preclude meaningful internal or external benchmarking and therefore hamper quality improvement initiatives for ventilated patients. We explored the feasibility of creating objective surveillance definitions for ventilator-associated pneumonia. Design:We identified clinical signs suitable for inclusion in objective definitions, proposed candidate definitions incorporating these objective signs, and then applied these definitions to retrospective clinical data to measure their frequencies and associations with adverse outcomes using multivariate regression models for cases and matched controls. Setting:Medical and surgical intensive care units in eight U.S. hospitals (four tertiary centers, three community hospitals, and one Veterans Affairs institution). Patients:Eight thousand seven hundred thirty-five consecutive episodes of mechanical ventilation for adult patients. Interventions:We evaluated 32 different candidate definitions composed of different combinations of the following signs: three thresholds for respiratory deterioration defined by sustained increases in daily minimum positive end-expiratory pressure or FIO2 after either 2 or 3 days of stable or decreasing ventilator settings, abnormal temperature, abnormal white blood cell count, purulent pulmonary secretions defined by neutrophils on Gram stain, and positive cultures for pathogenic organisms. Measurements and Main Results:Ventilator-associated pneumonia incidence, attributable ventilator days, hospital days, and hospital mortality. All candidate definitions were significantly associated with increased ventilator days and hospital days, but only definitions requiring objective evidence of respiratory deterioration were significantly associated with increased hospital mortality. Significant odds ratios for hospital mortality ranged from 1.9 (95% confidence interval 1.2–2.9) to 6.1 (95% confidence interval 2.2–17). Requiring additional clinical signs beyond respiratory deterioration alone decreased event rates, had little impact on attributable lengths of stay, and diminished sensitivity and positive predictive values for hospital mortality. Conclusions:Objective surveillance definitions that include quantitative evidence of respiratory deterioration after a period of stability strongly predict increased length of stay and hospital mortality. These definitions merit further evaluation of their utility for hospital quality and safety improvement programs.
The utility of measuring anti-Müllerian hormone in predicting menopause

Menopause is a relevant phase in a woman's reproductive life. Accurate estimation of the time of menopause could improve the preventive management of women's health. Reproductive hormones reflect the activity of follicle pools and provide information about ovarian aging. Anti-Mu llerian hormone (AMH) is secreted from small antral follicles and its level is correlated to the ovarian reserve. AMH declines with age, and data suggest that it can provide information on menopausal age and reproductive lifespan. Serum AMH levels become low approximately 5 years before the final menstrual period and are undetectable in postmenopausal women. The majority of studies indicate that AMH is relatively stable throughout the menstrual cycle; however, there are interindividual variabilites of serum AMH concentration under different conditions. AMH is an independent predictor of time to menopause. AMH coupled with age for menopause prediction provides stronger information than using age alone. Ongoing research is focused on constructing a multivariate model including AMH values, genes related to follicular recruitment and maternal age of menopause that would predict more precisily time to menopause.
Response compaction with any number of unknowns using a new LFSR architecture

This paper presents a new test response compaction technique with any number of unknown logic values (X's) in the test response bits. The technique leverages an X-tolerant response compactor (X-compact), and forces X's that are not tolerated by X-Compact to known values. The data required to designate the X's not tolerated by the X-compactor, also called mask data, is stored in a compressed format on the tester and decompressed on-chip. The authors applied this technique to four industrial designs and obtained 26-fold to 60-fold reduction in test response data volume with no impact on test quality.
Adipocyte-Derived Hormone Leptin Is a Direct Regulator of Aldosterone Secretion, Which Promotes Endothelial Dysfunction and Cardiac Fibrosis

Background— In obesity, the excessive synthesis of aldosterone contributes to the development and progression of metabolic and cardiovascular dysfunctions. Obesity-induced hyperaldosteronism is independent of the known regulators of aldosterone secretion, but reliant on unidentified adipocyte-derived factors. We hypothesized that the adipokine leptin is a direct regulator of aldosterone synthase (CYP11B2) expression and aldosterone release and promotes cardiovascular dysfunction via aldosterone-dependent mechanisms. Methods and Results— Immunostaining of human adrenal cross-sections and adrenocortical cells revealed that adrenocortical cells coexpress CYP11B2 and leptin receptors. Measurements of adrenal CYP11B2 expression and plasma aldosterone levels showed that increases in endogenous (obesity) or exogenous (infusion) leptin dose-dependently raised CYP11B2 expression and aldosterone without elevating plasma angiotensin II, potassium or corticosterone. Neither angiotensin II receptors blockade nor &agr; and &bgr; adrenergic receptors inhibition blunted leptin-induced aldosterone secretion. Identical results were obtained in cultured adrenocortical cells. Enhanced leptin signaling elevated CYP11B2 expression and plasma aldosterone, whereas deficiency in leptin or leptin receptors blunted obesity-induced increases in CYP11B2 and aldosterone, ruling out a role for obesity per se. Leptin increased intracellular calcium, elevated calmodulin and calmodulin-kinase II expression, whereas calcium chelation blunted leptin-mediated increases in CYP11B2, in adrenocortical cells. Mineralocorticoid receptor blockade blunted leptin-induced endothelial dysfunction and increases in cardiac fibrotic markers. Conclusions— Leptin is a newly described regulator of aldosterone synthesis that acts directly on adrenal glomerulosa cells to increase CYP11B2 expression and enhance aldosterone production via calcium-dependent mechanisms. Furthermore, leptin-mediated aldosterone secretion contributes to cardiovascular disease by promoting endothelial dysfunction and the expression of profibrotic markers in the heart.
Determination of Phytoestrogen Content in Fresh-Cut Legume Forage

Simple Summary Phytoestrogens comprise a group of substances negatively influencing the development and function of animal reproductive organs. Their appearance in forage crops can reduce feeding values, cause dietary disorders, and lead to animal health damage. This study evaluated the occurrence of individual phytoestrogens in various species of annual and perennial legumes and their levels in dry forage. It appeared that feeding large amounts of red clover presents a potential risk, but red clover can be replaced with the annual Persian clover, in which markedly lower phytoestrogen levels were detected. Abstract The aim of the study was to determine phytoestrogen content in fresh-cut legume forage. This issue has been much discussed in recent years in connection with the health and safety of feedstuffs and thus livestock health. The experiments were carried out on two experimental plots at Troubsko and Vatín, Czech Republic during June and July in 2015. Samples were collected of the four forage legume species perennial red clover (variety “Amos”), alfalfa (variety “Holyně”), and annuals Persian clover and Alexandrian clover. Forage was sampled twice at regular three to four day intervals leading up to harvest and a third time on the day of harvest. Fresh and wilted material was analyzed using liquid chromatography–mass spectrometry (LC-MS). Higher levels (p < 0.05) of isoflavones biochanin A (3.697 mg·g−1 of dry weight) and formononetin (4.315 mg·g−1 of dry weight) were found in red clover than in other species. The highest isoflavone content was detected in red clover, reaching 1.001% of dry matter (p < 0.05), representing a risk for occurrence of reproduction problems and inhibited secretion of animal estrogen. The phytoestrogen content was particularly increased in wilted forage. Significant isoflavone reduction was observed over three to four day intervals leading up to harvest.