Miracle-dz/UniFAR-FTUs huggingface dataset:
Increasing Healthcare Resource Utilization After Coronary Artery Bypass Graft Surgery in the United States

Background—Despite declining lengths of stay, postdischarge healthcare resource utilization may be increasing because of shifts to nonacute care settings. Although changes in hospital stay after coronary artery bypass graft (CABG) surgery have been described, patterns of discharge remain unclear. Our objective was to determine patterns of discharge disposition after CABG surgery in the United States. Methods and Results—We examined discharge disposition after CABG procedures from 1988 to 2005 using the Nationwide Inpatient Sample. Discharges with a “nonroutine” disposition defined patients discharged with continued healthcare needs. Multivariable regression models were constructed to assess trends and factors associated with nonroutine discharge. Median length of stay among 8 398 554 discharges decreased from 11 to 8 days between 1988 and 2005 (P<0.0001). There was a simultaneous increase in nonroutine discharges from 12% in 1988 to 45% in 2005 (P<0.0001), primarily comprising home healthcare and long-term facility use. Multivariable regression models showed age, female gender, comorbidities, concurrent valve surgery, and lower-volume hospitals more likely to be associated with nonroutine discharge. Conclusions—We found a significant increase in nonroutine discharges after CABG surgery across the United States from 1988 to 2005. The significant shortening of length of stay during CABG may be counterbalanced by the increased requirement for additional postoperative healthcare services. Nonacute care institutions are playing an increasingly significant role in providing CABG patients with postdischarge healthcare and should be considered in investigations of postoperative healthcare resource utilization. The impact of these changes on long-term outcomes and net resource utilization remain unknown.
Thrombotic Occlusion of the Middle Cerebral Artery

Background and Purpose: Epidemiological study of middle cerebral artery occlusion is important because the indication for extracranial-intracranial arterial bypass remains in dispute. To help clarify this issue, we investigated the prognosis of thrombotic middle cerebral artery occlusion in Japanese patients. Methods: We studied 40 patients with thrombotic middle cerebral artery occlusion who were selected on the basis of clinical features, computed tomographic findings, and angiographic findings. Patients with causes of embolism (i.e., cardiomyopathy, valvular heart disease, cardiac arrhythmia, and carotid ulceration) were excluded. The 40 patients were classified into three groups according to the site of middle cerebral artery occlusion: there were 13 patients with occlusion of the proximal portion of the Ml segment, 13 with distal Ml segment occlusion, and 14 with occlusion of the M2 segment. Results: Good collateral circulation was associated with improved outcomes both clinically and by computed tomography in patients with occlusion of the proximal and distal portions of the Ml segment but not in those with M2 occlusion. Conclusions: It is reasonable to assume that not only collateral circulation but also the site of occlusion plays an important role in the outcome of middle cerebral artery occlusion. Our finding that good collateral circulation improves the outcome for thrombotic occlusion of the proximal and distal Ml segments supports the possible benefits of such surgery.
Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility

Objective: Anxiety is associated with increased physiological reactivity and also increased “interoceptive” sensitivity to such changes in internal bodily arousal. Joint hypermobility, an expression of a common variation in the connective tissue protein collagen, is increasingly recognized as a risk factor to anxiety and related disorders. This study explored the link between anxiety, interoceptive sensitivity and hypermobility in a sub-clinical population using neuroimaging and psychophysiological evaluation. Methods: Thirty-six healthy volunteers undertook interoceptive sensitivity tests, a clinical examination for hypermobility and completed validated questionnaire measures of state anxiety and body awareness tendency. Nineteen participants also performed an emotional processing paradigm during functional neuroimaging. Results: We confirmed a significant relationship between state anxiety score and joint hypermobility. Interoceptive sensitivity mediated the relationship between state anxiety and hypermobility. Hypermobile, compared to non-hypermobile, participants displayed heightened neural reactivity to sad and angry scenes within brain regions implicated in anxious feeling states, notably insular cortex. Conclusions: Our findings highlight the dependence of anxiety state on bodily context, and increase our understanding of the mechanisms through which vulnerability to anxiety disorders arises in people bearing a common variant of collagen.
Visual Campus Road Detection for an UGV Using Fast Scene Segmentation and Rapid Vanishing Point Estimation

Abstract Vision-based road detection plays a key role for Unmanned Ground Vehicles (UGVs) working in an unknown outdoor environment. The estimation of the vanishing point is a practical solution for general road detection using monocular vision, which however is not good enough for robust road detection in a campus environment due to the strong noises of texture orientations generated from roadside trees and buildings. In this paper, a novel system framework is proposed by combining the fast scene segmentation (FSS) and the rapid vanishing point detection. The proposed FSS algorithm can segment a single image into road and non-road regions based on the similarity analysis of color histogram, which can eliminate the inherent noises in the trees and buildings and improve the robustness of road detection effectively. Before voting for the vanishing point, we use Canny algorithm to extract the edges in the road region roughly segmented in FSS step. Since most of the strong texture orientations exist in the extracted edges, the computational complexity in the voting stage can be reduced significantly. Experimental results implemented on a real UGV platform show the validity and robustness of the proposed approach.
Vibration Energy Harvesting for Disaster Asset Monitoring Using Active RFID Tags

This paper highlights the importance of energy harvesting in high-value asset monitoring applications involving use of active RFID tags. The paper begins by highlighting advantages of active tags including improved range and read rate in electromagnetically unfriendly environments. Although a battery can substantially improve performance, it limits maintenance-free operational life. Therefore, harvesting energy from sources such as vibration is shown to address this shortcoming but these sources must be adequate, available throughout the life of the application, and highly efficient. Piezoelectric vibration energy harvesting design procedures and components for such systems are identified. This includes three key components, namely, the energy harvesting transducer, power management circuit, and energy storage device. Each component of the energy harvesting system is described and important design criteria are highlighted. Finally, the paper concludes by analyzing vibration data from high value assets used during disaster relief, and describing preliminary results of an energy harvesting prototype with details on system form factors, efficiency, and life.
Computer-generated pen-and-ink illustration of trees

We present a method for automatically rendering pen-and-ink illustrations of trees. A given 3-d tree model is illustrated by the tree skeleton and a visual representation of the foliage using abstract drawing primitives. Depth discontinuities are used to determine what parts of the primitives are to be drawn; a hybrid pixel-based and analytical algorithm allows us to deal efficiently with the complex geometric data. Using the proposed method we are able to generate illustrations with different drawing styles and levels of abstraction. The illustrations generated are spatial coherent, enabling us to create animations of sketched environments. Applications of our results are found in architecture, animation and landscaping.
Genomic Comparisons Reveal Microevolutionary Differences in Mycobacterium abscessus Subspecies

Mycobacterium abscessus, a rapid-growing non-tuberculous mycobacterium, has been the cause of sporadic and outbreak infections world-wide. The subspecies in M. abscessus complex (M. abscessus, M. massiliense, and M. bolletii) are associated with different biologic and pathogenic characteristics and are known to be among the most frequently isolated opportunistic pathogens from clinical material. To date, the evolutionary forces that could have contributed to these biological and clinical differences are still unclear. We compared genome data from 243 M. abscessus strains downloaded from the NCBI ftp Refseq database to understand how the microevolutionary processes of homologous recombination and positive selection influenced the diversification of the M. abscessus complex at the subspecies level. The three subspecies are clearly separated in the Minimum Spanning Tree. Their MUMi-based genomic distances support the separation of M. massiliense and M. bolletii into two subspecies. Maximum Likelihood analysis through dN/dS (the ratio of number of non-synonymous substitutions per non-synonymous site, to the number of synonymous substitutions per synonymous site) identified distinct genes in each subspecies that could have been affected by positive selection during evolution. The results of genome-wide alignment based on concatenated locally-collinear blocks suggest that (a) recombination has affected the M. abscessus complex more than mutation and positive selection; (b) recombination occurred more frequently in M. massiliense than in the other two subspecies; and (c) the recombined segments in the three subspecies have come from different intra-species and inter-species origins. The results lead to the identification of possible gene sets that could have been responsible for the subspecies-specific features and suggest independent evolution among the three subspecies, with recombination playing a more significant role than positive selection in the diversification among members in this complex.
Does host plant richness explain diversity of ectomycorrhizal fungi? Re‐evaluation of Gao et al. (2013) data sets reveals sampling effects

The generally positive relationship between biodiversity of groups of directly or indirectly interacting organisms is one of the most important ecological concepts (Gaston, 2000 Nature, 405, 220–227; Scherber C, Eisenhauer N, Weisser WW et al., 2010 Nature, 468, 553–556). In a recent issue of Molecular Ecology, Gao C, Shi N‐N, Liu Y‐X et al. (2013: 22, 3403–3414) reported that the richness of plants and ectomycorrhizal fungi is positively correlated both at local and at global scales. Here, we challenge these findings by re‐analysis of data and ascribe the reported results to sampling effect and poor data compilation.
All-Chalcogenide Raman-Parametric Laser, Wavelength Converter, and Amplifier in a Single Microwire

Compact, power efficient, and fiber-compatible lasers, wavelength converters, and amplifiers are vital devices for the future of fiber-optic systems and networks. Nonlinear optical effects, like Raman scattering and parametric four-wave mixing, offer a way to realize such devices. Here, we use a single chalcogenide microwire to realize a device that provides the functions of a Stokes Raman-parametric laser, a four-wave mixing anti-Stokes wavelength converter, an ultra-broadband Stokes/anti-Stokes Raman amplifier and a supercontinuum generator. The device operation relies on ultrahigh Raman and Kerr gain that are up to five orders of magnitude larger than in silica fibers, precisely engineered chromatic dispersion, and high photosensitivity of the chalcogenide microwire. Owing to the underlying principle of nonlinear optical processes, the device is anticipated to operate over the entire transmission window of the chalcogenide glass (λ ~ 1-10 μm).
Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury.

RATIONALE Despite the recognition that acute lung injury (ALI) can elevate pulmonary artery (PA) pressure and right ventricular afterload, the impact of pulmonary vascular dysfunction on outcomes of these patients is not well defined. OBJECTIVES To investigate the impact of pulmonary vascular dysfunction in patients with acute lung injury. METHODS Secondary analysis of the Fluid and Catheter Treatment Trial. A total of 501 patients who received a PA catheter were evaluated for associations between increases in transpulmonary gradient (TPG) (PA mean pressure - PA occlusion pressure) or pulmonary vascular resistance index (PVRi) and 60-day mortality, ventilator-, intensive care unit (ICU)-, and cardiovascular-free days (days with mean arterial pressure ≥ 60 mm Hg off vasopressor support). MEASUREMENTS AND MAIN RESULTS We were able to measure the TPG in 475 (95%) and the PVRi in 470 (92%) patients. Patients with an elevated baseline TPG had an increased 60-day mortality (30 versus 19%; P = 0.02), and lower numbers of median ventilator- [25-75% quartiles] (15 [0-22] versus 19 [7-24]; P = 0.005), ICU- (14 [0-21] versus 18 [5-22]; P = 0.005), and cardiovascular-free days (23 [12-27] versus 25 [18-27]; P = 0.03). The median PVRi (305 [204-431] dyne s/cm⁵/m²) was elevated early in the course of ALI. PVRi was statistically higher in patients who died (326 [209-518] versus 299 [199-416]; P = 0.01). In individual multivariate models, TPG and PVRi remained independent risk factors for 60-day mortality and decrease in the number of ventilator-, ICU-, and cardiovascular-free days. CONCLUSIONS Pulmonary vascular dysfunction is common in ALI, and is independently associated with poor outcomes. Future trials targeting pulmonary vascular dysfunction may be indicated.
Conversion from mild cognitive impairment to probable Alzheimer's disease predicted by brain magnetic resonance spectroscopy.

OBJECTIVE Mild cognitive impairment has been regarded as a pre-Alzheimer condition, but some patients do not develop dementia. Given the available therapies for Alzheimer's disease, early diagnosis is of paramount importance. The authors' objective was to determine whether findings from magnetic resonance spectroscopy (MRS) of the hippocampus and other cortical areas would predict conversion from amnestic mild cognitive impairment to probable Alzheimer's disease. METHOD A longitudinal inception cohort of 53 consecutive and incident subjects fulfilling the criteria of amnestic mild cognitive impairment was followed for a mean period of 3 years. At baseline, a neuropsychological examination (Mini-Mental State Examination, Blessed Dementia Rating Scale, Clinical Dementia Rating, verbal fluency test, and memory tests) and standard blood tests were performed, and three cortical areas were examined by proton MRS: left hippocampus, right parietal cortex, and left occipital cortex. The patients were evaluated periodically to detect conversion to probable Alzheimer's disease. The statistical analysis of predictions was based on receiver operating characteristic curves. RESULTS By the follow-up assessment that occurred on average after 3 years, 29 patients (55%) had developed probable Alzheimer's disease. An occipital cortex N-acetylaspartate/creatine ratio < or =1.61 predicted dementia at 100% sensitivity and 75% specificity (area under the curve=0.91, 95% CI=0.80-0.97). The positive predictive value was 83%, and the negative predictive value was 100%, with an overall cross-validated classification accuracy of 88.7%. None of the values in the hippocampus and parietal cortex had significant predictive value. CONCLUSIONS MRS of the brain performed on patients with mild cognitive impairment is a valuable tool in predicting conversion to probable Alzheimer's disease. Occipital values were more reliable than hippocampal values in this prediction.
Effects of Greenhouse Gas Increase and Stratospheric Ozone Depletion on Stratospheric Mean Age of Air in 1960–2010

The relative impacts of greenhouse gas (GHG) increase and stratospheric ozone depletion on stratospheric mean age of air in the 1960–2010 period are quantified using the Goddard Earth Observing System Chemistry‐Climate Model. The experiment compares controlled simulations using a coupled atmosphere‐ocean version of the Goddard Earth Observing System Chemistry‐Climate Model, in which either GHGs or ozone depleting substances, or both factors evolve over time. The model results show that GHGs and ozone depleting substances have about equal contributions to the simulated mean age decrease, but GHG increases account for about two thirds of the enhanced strength of the lower stratospheric residual circulation. It is also found that both the acceleration of the diabatic circulation and the decrease of the mean age difference between downwelling and upwelling regions are mainly caused by GHG forcing. The results show that ozone depletion causes an increase in the mean age of air in the Antarctic summer lower stratosphere through two processes: (1) a seasonal delay in the Antarctic polar vortex breakup that inhibits young midlatitude air from mixing with the older air inside the vortex, and (2) enhanced Antarctic downwelling that brings older air from middle and upper stratosphere into the lower stratosphere.
Helicopter Transport of Stroke Patients and Its Influence on Thrombolysis Rates: Data From the Austrian Stroke Unit Registry

Background and Purpose— Acute stroke management requires minimization of prehospital time. This study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis. Methods— Prospective data collection and prespecified evaluation of data from 32 stroke units between 2003 and 2009 were used. We distinguished between patients transported either directly to a stroke unit or transferred indirectly via a peripheral hospital. Thus, there were 6 transport groups: helicopter emergency service (HEMS) direct and indirect, ambulance accompanied by an emergency physician direct and indirect, and ambulance without physician direct and indirect. Demographic and clinical factors, time delays, and rates of thrombolysis of patients transported by helicopter were compared with factors of patients transported otherwise. Results— Of 21 712 ischemic stroke patients, 905 patients (4.1%) were transported by helicopter. Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS. Thrombolysis rates were highest for HEMS (24% direct, 29% indirect) transport, followed by ambulance accompanied by an emergency physician (18% direct, 15% indirect). The probability of receiving thrombolysis was highest for indirect HEMS transport (OR 3.6, 2.2–6.0), followed by indirect ambulance accompanied by an emergency physician transport (OR 1.5, 1.1–1.9). The shortest times, 90 minutes or less from stroke onset to hospital arrival, were achieved with direct AMBP and direct HEMS transport. Conclusions— The shortest hospital arrival times and highest thrombolysis rates were seen in ischemic stroke patients transported by helicopter.
A Feedback-Based Approach to DVFS in Data-Flow Applications

Runtime frequency and voltage adaptation has become very attractive for current and next generation embedded multicore platforms because it allows handling the workload variabilities arising in complex and dynamic utilization scenarios. The main challenge of dynamic frequency adaptation is to adjust the processing speed of each element to match the quality-of-service requirements in the presence of workload variations. In this paper, we present a control theoretic approach to dynamic voltage/frequency scaling for data-flow models of computations mapped to multiprocessor systems-on-chip architectures. We discuss, in particular, nonlinear control approaches to deal with general streaming applications containing both pipeline and parallel stages. Theoretical analysis and experiments, carried out by means of a cycle-accurate energy-aware multiprocessor simulation platform, are provided. We have applied the proposed control approach to realistic streaming applications such as Data Encryption Standard and software-based FM radio.
Beyond blood pressure: evidence for cardiovascular, cerebrovascular, and renal protective effects of renin–angiotensin system blockers

For patients with hypertension, effective control of blood pressure (BP) reduces cardiovascular (CV), and renal risk. Antihypertensive agents that offer benefits that extend beyond those associated with BP reduction alone, to include tissue protective effects and effects on the vasculature, may be of benefit for many patients with increased CV risk due to comorbidities or prior history of CV events. Renin–angiotensin system (RAS) blockers [angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs)] are guideline-recognized, highly effective antihypertensive agents that exert their BP-lowering action through different mechanisms at different levels of the RAS. Large-scale clinical studies suggest that small, between-treatment differences in BP lowering do not account for observed outcome differences between RAS blockers and other antihypertensive agents. Analysis of data from seminal clinical studies and meta-analyses identify that, controlling for effects on BP control, RAS blockers may be more effective than calcium channel blockers (CCBs) in reducing risk of myocardial infarction and congestive heart failure; ARBs may be more effective than either ACEIs or β blockers in stroke prevention; CCBs may be more effective than RAS blockers in stroke prevention; and ARBs may be more effective than β blockers in reducing left ventricular hypertrophy. This review considers the rationale and evidence for benefits of RAS blockade beyond BP lowering, and highlights the differences between ARBs and ACEIs, and between agents within these drug classes.