Miracle-dz/UniFAR-FTUs huggingface dataset:
Compliance and its evaluation in patients with hypertension

• Compliance has been evaluated from a wide range of scientific perspectives since 1950. The fact that there are many concepts referring to ‘compliance’ (such as ‘adherence’ and ‘commitment’) and that there is no agreement on a commonly accepted definition of the concept complicates evaluation. • This paper aims to describe the ways in which the compliance of hypertensive patients has been defined and evaluated in earlier studies. The material was collected from the MEDLINE and CINAHL databases and analysed using content analysis. • The review indicates that the concepts used in evaluating compliance of hypertensive patients vary considerably and that the most commonly used is ‘compliance’. Regardless of the concept used, the methods of measurement and results of the studies indicate that compliance is conceived as observance of health-related advice given by healthcare personnel. • This knowledge can be used in the evaluation of hypertensive patients’ compliance in general and in developing the measurement of compliance.
Straining Emergency Rooms by Expanding Health Insurance

A randomized trial shows that patients newly covered by Medicaid increased their emergency room visits by 40%. The crowded, chaotic emergency room (ER) is often invoked as a symbol of all that's wrong with the American health care system. The uninsured, the story goes, cram into ERs—legally prohibited from turning away patients—for routine medical attention that could be provided more cost-effectively through primary care providers (also known as general practitioners in many countries). It's an image of America's dysfunctional approach to providing “free” health care for those who cannot afford it. In policy circles, this take on ER medicine has been cited by, among others, Health and Human Services Secretary Kathleen Sebelius, as justification for universal health coverage, because the current system “has forced too many uninsured Americans to depend on the emergency room for the care they need. ”
Multiscale models of thrombogenesis

To restrict the loss of blood follow from the rupture of blood vessels, the human body rapidly forms a clot consisting of platelets and fibrin. However, to prevent pathological clotting within vessels as a result of vessel damage, the response must be regulated. Clots forming within vessels (thrombi) can restrict the flow of blood causing damage to tissues in the flow field. Additionally, fragments dissociating from the primary thrombus (emboli) may lodge and clog vessels in the brain (causing ischemic stroke) or lungs (resulting in pulmonary embolism). Pathologies related to the obstruction of blood flow through the vasculature are the major cause of mortality in the United States. Venous thromboembolic disease alone accounts for 900,000 hospitalizations and 300,000 deaths per year and the incidence will increase as the population ages (Wakefield et al. J Vasc Surg 2009, 49:1620–1623). Thus, understanding the interplay between the many processes involved in thrombus development is of significant biomedical value. In this article, we first review computational models of important subprocesses of hemostasis/thrombosis including coagulation reactions, platelet activation, and fibrin assembly, respectively. We then describe several multiscale models integrating these subprocesses to simulate temporal and spatial development of thrombi. The development of validated computational models and predictive simulations will enable one to explore how the variation of multiple hemostatic factors affects thrombotic risk providing an important new tool for thrombosis research. WIREs Syst Biol Med 2012 doi: 10.1002/wsbm.1160
Evaluation of ethanol lock therapy in pediatric patients on long-term parenteral nutrition.

BACKGROUND Pediatric home parenteral nutrition (PN) patients present a unique challenge with risks of catheter-associated bloodstream infections (CABSIs), sometimes requiring subsequent catheter removal. Recurrent infections can lead to line removal and potential loss of venous access in the future. OBJECTIVE Demonstrate that weekly ethanol lock therapy decreases CABSIs in long-term home PN patients and decreases line removals due to infections. METHODS Beginning August 2007, patients receiving PN with a history of multiple previous CABSIs were started on ethanol lock therapy. Seventy percent ethanol solution was instilled into the central venous catheter (CVC) for 2 hours weekly. Episodes of CABSIs and catheter removal due to infection were documented in patients prior to and after ethanol lock therapy. RESULTS Fourteen patients were followed for an average of 690 days after ethanol lock therapy was initiated. These patients were found to average 9.8 CABSIs per 1000 catheter days prior to starting ethanol lock therapy and only 2.7 CABSIs per 1000 catheter days after ethanol lock therapy (P < .001). Prior to ethanol lock therapy, the group averaged 4.3 catheter removals per 1000 catheter days but only 1.0 catheter removal per 1000 catheter days after ethanol lock therapy. CONCLUSION Our group of patients showed a 73% reduction in CABSIs and a 77% reduction in catheter removal due to infection after ethanol lock therapy. In our patient population, weekly ethanol lock therapy for 2 hours is an effective technique to reduce CABSIs and catheter removal in long-term home PN patients.
Distinct Profiles of Myelin Distribution Along Single Axons of Pyramidal Neurons in the Neocortex

Patchy Insulation Myelin insulates neuronal axons such that their electrical signals travel faster and more efficiently. However, not all axons are myelinated equally. Tomassy et al. (p. 319; see the Perspective by Fields) obtained detailed images from two snippets of the adult mouse brain and generated three-dimensional reconstructions of individual neurons and their myelination patterns. The images show that some axons have long, unmyelinated stretches, which might offer sites for building new connections. Thus, myelination is not an all-or-none phenomenon but rather is a characteristic of what may be a specific dialogue between the neuron and the surrounding myelin-producing cells. Mouse neurons display different and distinctive patterns of myelination. [Also see Perspective by Fields] Myelin is a defining feature of the vertebrate nervous system. Variability in the thickness of the myelin envelope is a structural feature affecting the conduction of neuronal signals. Conversely, the distribution of myelinated tracts along the length of axons has been assumed to be uniform. Here, we traced high-throughput electron microscopy reconstructions of single axons of pyramidal neurons in the mouse neocortex and built high-resolution maps of myelination. We find that individual neurons have distinct longitudinal distribution of myelin. Neurons in the superficial layers displayed the most diversified profiles, including a new pattern where myelinated segments are interspersed with long, unmyelinated tracts. Our data indicate that the profile of longitudinal distribution of myelin is an integral feature of neuronal identity and may have evolved as a strategy to modulate long-distance communication in the neocortex.
Two-particle quantum interference in tunnel-coupled optical tweezers

Bosons of a feather flit together Bosons are a type of particle that likes to congregate. This property has a major effect on the behavior of identical bosons. Kaufman et al. demonstrated quantum interference of two bosonic Rb atoms placed in two neighboring quantum wells (see the Perspective by Thompson and Lukin). They prepared the atoms in exactly the same state so that there would be no way to tell them apart except for which well each atom was in. They then monitored the probability of the two atoms still being in separate wells. At certain times, the probability had a characteristic dip signifying that the bosons preferred to be in the same well. Science, this issue p. 306; see also p. 272 Two bosonic rubidium atoms in coupled quantum wells are prepared in a symmetrical state and allowed to interfere. [Also see Perspective by Thompson and Lukin] The quantum statistics of atoms is typically observed in the behavior of an ensemble via macroscopic observables. However, quantum statistics modifies the behavior of even two particles. Here, we demonstrate near-complete control over all the internal and external degrees of freedom of two laser-cooled 87Rb atoms trapped in two optical tweezers. This controllability allows us to observe signatures of indistinguishability via two-particle interference. Our work establishes laser-cooled atoms in optical tweezers as a promising route to bottom-up engineering of scalable, low-entropy quantum systems.
From Hospital to Home and Back Again: A Study in Hospital Admissions and Deaths for Home Care Patients

In this study, the authors examined causes of deaths or hospitalizations of adult home care patients during an 18-month period using a retrospective medical record audit. The site of the study was the home care program of a three-hospital system. Of 4,303 cases, 101 adult patients met study criteria of hospitalization or death. The death rate in the sample was 0.48%, and the hospitalization rate was 1.9%. Wound deterioration and falling accidents were principal causes for rehospitalizing patients. Increasing age and number of medications were significantly correlated with falls resulting in hospitalization. Patients who died were found to suffer from terminal illnesses and frailty, with care providers having little influence over outcomes. Opportunities to improve clinical care processes (e.g., discharge planning, patient status monitoring, signs and symptoms reporting, interdisciplinary communicating and coordinating) were also identified. The authors concluded that nearly 21% of hospitalizations were potentially preventable.
Highly Multiplexed Subcellular RNA Sequencing in Situ

Transcripts Visualized in Situ Despite advances, current methods for single-cell sequencing are unable to resolve transcript location within the cell, so Lee et al. (p. 1360, published online 27 February) developed a method of fluorescent in situ RNA sequencing (FISSEQ) that works in vivo to show messenger RNA localization within cells. The method amplifies complementary DNA targets by rolling circle amplification, and then in situ cross-linking locks amplicons to produce ample, highly localized templates for three-dimensional sequencing. The technique was tested in fibroblasts to reveal the differences between individual cells during wound repair. Reads of cellular RNA transcripts demonstrate spatial expression differences during simulated wound healing. Understanding the spatial organization of gene expression with single-nucleotide resolution requires localizing the sequences of expressed RNA transcripts within a cell in situ. Here, we describe fluorescent in situ RNA sequencing (FISSEQ), in which stably cross-linked complementary DNA (cDNA) amplicons are sequenced within a biological sample. Using 30-base reads from 8102 genes in situ, we examined RNA expression and localization in human primary fibroblasts with a simulated wound-healing assay. FISSEQ is compatible with tissue sections and whole-mount embryos and reduces the limitations of optical resolution and noisy signals on single-molecule detection. Our platform enables massively parallel detection of genetic elements, including gene transcripts and molecular barcodes, and can be used to investigate cellular phenotype, gene regulation, and environment in situ.
Parallel differential evolution approach for cloud workflow placements under simultaneous optimization of multiple objectives

The recent rapid expansion of Cloud computing facilities triggers an attendant challenge to facility providers and users for methods for optimal placement of workflows on distributed resources, under the often-contradictory impulses of minimizing makespan, energy consumption, and other metrics. Evolutionary Optimization techniques that from theoretical principles are guaranteed to provide globally optimum solutions, are among the most powerful tools to achieve such optimal placements. Multi-Objective Evolutionary algorithms by design work upon contradictory objectives, gradually evolving across generations towards a converged Pareto front representing optimal decision variables - in this case the mapping of tasks to resources on clusters. However the computation time taken by such algorithms for convergence makes them prohibitive for real time placements because of the adverse impact on makespan. This work describes parallelization, on the same cluster, of a Multi-Objective Differential Evolution method (NSDE-II) for optimization of workflow placement, and the attendant speedups that bring the implicit accuracy of the method into the realm of practical utility. Experimental validation is performed on a reallife testbed using diverse Cloud traces. The solutions under different scheduling policies demonstrate significant reduction in energy consumption with some improvement in makespan.
Chemical potential and quantum Hall ferromagnetism in bilayer graphene

Breaking down graphene degeneracy Bilayer graphene has two layers of hexagonally arranged carbon atoms stacked on top of each other in a staggered configuration. This spatial arrangement results in degenerate electronic states: distinct states that have the same energy. Interaction between electrons can cause the states to separate in energy, and so can external fields (see the Perspective by LeRoy and Yankowitz). Kou et al., Lee et al., and Maher et al. used three distinct experimental setups that clarify different parameter regimes of bilayer graphene. Science, this issue p. 55, p. 58, p. 61; see also p. 31 One graphene bilayer is used to tune and study the electronic properties of another. [Also see Perspective by LeRoy and Yankowitz] Bilayer graphene has a distinctive electronic structure influenced by a complex interplay between various degrees of freedom. We probed its chemical potential using double bilayer graphene heterostructures, separated by a hexagonal boron nitride dielectric. The chemical potential has a nonlinear carrier density dependence and bears signatures of electron-electron interactions. The data allowed a direct measurement of the electric field–induced bandgap at zero magnetic field, the orbital Landau level (LL) energies, and the broken-symmetry quantum Hall state gaps at high magnetic fields. We observe spin-to-valley polarized transitions for all half-filled LLs, as well as emerging phases at filling factors ν = 0 and ν = ±2. Furthermore, the data reveal interaction-driven negative compressibility and electron-hole asymmetry in N = 0, 1 LLs.
Differences between women and men in survival after myocardial infarction. Biology or methodology

To examine the impact of gender on survival after myocardial infarction, we performed a retrospective cohort study of 332 women and 790 men. Women who had a myocardial infarction were older and more often had hypertension, diabetes, previous heart failure, and impaired left ventricular function on admission. Cumulative 3-year mortality and in-hospital mortality rates were significantly higher in women than men, but mortality among hospital survivors was similar. After multivariate adjustment for baseline differences, mortality rates were not significantly different between women and men for in-hospital deaths, and mortality at 3 years among hospital survivors tended to be lower among women. We conclude that higher observed mortality rates following a myocardial infarction in women are related to differences in known risk factors for subsequent mortality and that gender should not be considered an independent risk factor for mortality after myocardial infarction. (JAMA. 1990;263:1092-1096)
Protein Requirements for Critically Ill Patients With Renal and Liver Failure

Diseases leading to critical illness induce proteolysis resulting in muscle wasting and negative nitrogen balance. Muscle wasting has been associated with poor intensive care unit (ICU)–related outcomes, including an increased risk for mortality. Acute kidney injury (AKI) represents a common organ dysfunction associated with ICU-related disorders, such as sepsis, trauma, and respiratory failure. AKI and renal replacement therapy lead to amino acid loss. Decompensated liver cirrhosis (DLC) and acute liver failure (ALF) represent more severe forms of liver dysfunction leading to ICU admission. DLC and ALF are associated with proteolysis and amino acid loss. AKI, DLC, and ALF uniquely contribute to negative nitrogen balance. The purpose of this review is to outline proteolysis associated with critical illness; define specific protein abnormalities in AKI, DLC, and ALF; define protein requirements in AKI, DLC, and ALF; and discuss barriers associated with optimal protein supplementation in these disorders.
Greater Sensitivity to Drought Accompanies Maize Yield Increase in the U.S. Midwest

Predicting Responses to Drought The U.S. Corn Belt accounts for a sizeable portion of the world's maize growth. Various influences have increased yields over the years. Lobell et al. (p. 516; see the Perspective by Ort and Long) now show that sensitivity to drought has been increasing as well. It seems that as plants have been bred for increased yield under ideal conditions, the plants become more sensitive to non-ideal conditions. A key factor may be the planting density. Although today's maize varieties are more robust to crowding and the farmer can get more plants in per field, this same crowding takes a toll when water resources are limited. Selective breeding focused on increasing corn and soybean yields has left a weakness in corn drought tolerance. [Also see Perspective by Ort and Long] A key question for climate change adaptation is whether existing cropping systems can become less sensitive to climate variations. We use a field-level data set on maize and soybean yields in the central United States for 1995 through 2012 to examine changes in drought sensitivity. Although yields have increased in absolute value under all levels of stress for both crops, the sensitivity of maize yields to drought stress associated with high vapor pressure deficits has increased. The greater sensitivity has occurred despite cultivar improvements and increased carbon dioxide and reflects the agronomic trend toward higher sowing densities. The results suggest that agronomic changes tend to translate improved drought tolerance of plants to higher average yields but not to decreasing drought sensitivity of yields at the field scale.
The STAT3-Binding Long Noncoding RNA lnc-DC Controls Human Dendritic Cell Differentiation

L[i]nc to Dendritic Cell Activation Long noncoding RNAs (lncRNAs) are important regulators of gene expression, but whether they are important regulators of the immune system is poorly understood. Wang et al. (p. 310) identify a lncRNA expressed exclusively in human dendritic cells (DC), called lnc-DC, that is required for optimal DC differentiation from human monocytes and that regulates DC activation of T cells. Lnc-DC interacts with the transcription factor STAT3, which is also required for DC development and function, to prevent interaction with and to block dephosphorylation by tyrosine phosphatase SHP1. A long noncoding RNA regulates dendritic cell differentiation and function. Long noncoding RNAs (lncRNAs) play important roles in diverse biological processes; however, few have been identified that regulate immune cell differentiation and function. Here, we identified lnc-DC, which was exclusively expressed in human conventional dendritic cells (DCs). Knockdown of lnc-DC impaired DC differentiation from human monocytes in vitro and from mouse bone marrow cells in vivo and reduced capacity of DCs to stimulate T cell activation. lnc-DC mediated these effects by activating the transcription factor STAT3 (signal transducer and activator of transcription 3). lnc-DC bound directly to STAT3 in the cytoplasm, which promoted STAT3 phosphorylation on tyrosine-705 by preventing STAT3 binding to and dephosphorylation by SHP1. Our work identifies a lncRNA that regulates DC differentiation and also broadens the known mechanisms of lncRNA action.
Climate change and wind intensification in coastal upwelling ecosystems

Strong winds, upwelling, and teeming shores Climate warming has produced stronger winds along some coasts, a result of growing differences in temperature and pressure between land and sea. These winds cause cold nutrient-rich seawater to rise to the surface, affecting climate and fueling marine productivity. Sydeman et al. examined data from the five major world regions where upwelling is occurring. Particularly in the California, Humboldt, and Benguela upwelling systems, winds have become stronger over the past 60 years. These regions represent up to a fifth of wild marine fish catches and are hot spots of biodiversity. Science, this issue p. 77 Increasing greenhouse gas concentrations have caused windier conditions in most major coastal upwelling regions. In 1990, Andrew Bakun proposed that increasing greenhouse gas concentrations would force intensification of upwelling-favorable winds in eastern boundary current systems that contribute substantial services to society. Because there is considerable disagreement about whether contemporary wind trends support Bakun’s hypothesis, we performed a meta-analysis of the literature on upwelling-favorable wind intensification. The preponderance of published analyses suggests that winds have intensified in the California, Benguela, and Humboldt upwelling systems and weakened in the Iberian system over time scales ranging up to 60 years; wind change is equivocal in the Canary system. Stronger intensification signals are observed at higher latitudes, consistent with the warming pattern associated with climate change. Overall, reported changes in coastal winds, although subtle and spatially variable, support Bakun’s hypothesis of upwelling intensification in eastern boundary current systems.
Energy-efficient off-body communication nodes with receive diversity

Off-body wireless communication applications range from fall-detection systems for the elderly to monitoring networks for rescue workers. Further development of practical body-worn systems requires compact, low-cost and low-power battery-powered equipment. A versatile wearable network node offering all these features, including a powerful microcontroller for data processing and additional memory for local data logging was designed and implemented. The node allows receive diversity, mitigating the negative impact of fading, which is typically present in indoor propagation environments. Channel measurements are performed for an indoor Non Line-of-Sight communication between two nodes. Mobile-to-base-station as well as mobile-to-mobile links are considered. A statistical analysis of the performance determines outage probability with and without receiver diversity for both link types, showing a significant diversity gain in all cases. Correlation properties, level crossing rate and average fade duration are also determined.