Miracle-dz/UniFAR-FTUs huggingface dataset:
Preventability and Causes of Readmissions in a National Cohort of General Medicine Patients.

IMPORTANCE Readmission penalties have catalyzed efforts to improve care transitions, but few programs have incorporated viewpoints of patients and health care professionals to determine readmission preventability or to prioritize opportunities for care improvement. OBJECTIVES To determine preventability of readmissions and to use these estimates to prioritize areas for improvement. DESIGN, SETTING, AND PARTICIPANTS An observational study was conducted of 1000 general medicine patients readmitted within 30 days of discharge to 12 US academic medical centers between April 1, 2012, and March 31, 2013. We surveyed patients and physicians, reviewed documentation, and performed 2-physician case review to determine preventability of and factors contributing to readmission. We used bivariable statistics to compare preventable and nonpreventable readmissions, multivariable models to identify factors associated with potential preventability, and baseline risk factor prevalence and adjusted odds ratios (aORs) to determine the proportion of readmissions affected by individual risk factors. MAIN OUTCOME AND MEASURE Likelihood that a readmission could have been prevented. RESULTS The study cohort comprised 1000 patients (median age was 55 years). Of these, 269 (26.9%) were considered potentially preventable. In multivariable models, factors most strongly associated with potential preventability included emergency department decision making regarding the readmission (aOR, 9.13; 95% CI, 5.23-15.95), failure to relay important information to outpatient health care professionals (aOR, 4.19; 95% CI, 2.17-8.09), discharge of patients too soon (aOR, 3.88; 95% CI, 2.44-6.17), and lack of discussions about care goals among patients with serious illnesses (aOR, 3.84; 95% CI, 1.39-10.64). The most common factors associated with potentially preventable readmissions included emergency department decision making (affecting 9.0%; 95% CI, 7.1%-10.3%), inability to keep appointments after discharge (affecting 8.3%; 95% CI, 4.1%-12.0%), premature discharge from the hospital (affecting 8.7%; 95% CI, 5.8%-11.3%), and patient lack of awareness of whom to contact after discharge (affecting 6.2%; 95% CI, 3.5%-8.7%). CONCLUSIONS AND RELEVANCE Approximately one-quarter of readmissions are potentially preventable when assessed using multiple perspectives. High-priority areas for improvement efforts include improved communication among health care teams and between health care professionals and patients, greater attention to patients' readiness for discharge, enhanced disease monitoring, and better support for patient self-management.
Molecular imaging of cancer microenvironment

In the last decades, researchers have been focusing on cancer cells looking for novel targets, however, tumours grow in a host environment that either contribute to or inhibit tumour expansion and metastatization. Several efforts have been focused on cancer microenvironment for diagnostic and therapeutic purposes. Nuclear medicine can contribute to understand the complexity and role of tumour microenvironment by imaging several of its components (chemokine receptors, immune cells, stromal antigens, vascular factors, etc). In a tumour, each microenvironment component offers many potential targets for several drugs or radiopharmaceuticals. Cancer may be studied using different strategies from different viewpoints: imaging tumour markers or differentiating markers for diagnostic purposes in order to plan personalized therapies (receptor agonists or superagonists); imaging tumour stroma and vascularization to monitor cell adhesion, metastases, angiogenesis and hypoxia; imaging the host response of cancer cells to monitor the efficacy of immunotherapeutic strategies.
A directional coupler based on Spoof MIM plasmonic structures

We propose a directional coupler at microwave frequencies based on spoof metal-insulator-metal (MIM) plasmonic structures. The spoof MIM structures consists of specially-designed metal gratings with finite thickness. The coupling length increases almost linearly with the wavelength. The full-wave simulations have been implemented in the microwave frequencies to verify the coupler.
An Empirical Investigation Of Relationship Between Industrial Structure And Exchange Rate Regime

The choice for the adoption of an exchange rate regime is considered very important in a globalized economy. This selection is affected with the evolution of industrial structure of the economy. The changes in exports and industrial base of the economy emphasize the need to redefine the parameters of international financial market. We have studied the relationship between the choice of an exchange rate regime and the development of industrial structure. In our analysis we have defined exchange rate regime as floating and fixed; and have used logistic regression analysis for a set of 33 countries in two time sets. The development of industrial base especially the tertiary industry has triggered the adoption of a liberal, floating exchange rate regime. The results support our hypothesis of a positive relationship between the evolution of industrial structure and movement towards a liberal exchange rate regime.
Preservative-free Treatment in Glaucoma: Who, when, and why?

Purpose To review and summarize the available literature on the effect of preservatives on the eye, to provide practical guidance for the clinical assessment of the ocular surface in glaucoma patients, and to define patient populations that might benefit from preservative-free topical intraocular pressure (IOP)–lowering agents. Methods This manuscript is based on a combination of a literature review on preservatives and the eye and expert opinion from glaucoma specialists with an interest in ocular surface disease. Results There is an increasingly recognized association between eyedrop preservatives and ocular surface disease. Preservative-free therapy is now available for a wide range of active compounds, although there are still some misconceptions regarding their appropriate use. For patients treated topically for glaucoma or ocular hypertension, a rough estimate could be that 20% may need treatment with topical IOP-reducing agents that are free from preservatives. Conclusions This review provides an up-to-date account of the literature regarding preservatives and the eye, as well as suggestions and recommendations on to when to use preservative-free antiglaucoma treatment.
Evaluation of the vaccination efficacy against H5N1 in domestic poultry in the Red River Delta in Vietnam

SUMMARY The domestic poultry population in Vietnam has been vaccinated against highly pathogenic avian influenza (HPAI) H5N1 since 2005. Since then, outbreaks have continued to occur without a clear understanding of the mechanisms involved. The general objective of this study was to understand the epidemiology of the disease in the context of vaccination and to draw some conclusions about vaccination efficacy in the domestic poultry population of the Red River Delta area. Five cross-sectional surveys to measure the serological and virological prevalence in vaccinated and unvaccinated poultry were performed from the end of 2008 to June 2010. The global seroprevalence was 24% (95% confidence interval 19·9–28·2). Determinants of vaccine immunogenicity were identified separately in chickens and ducks as well as determinants of the seroconversion in unvaccinated birds. The results highlight the difficulties in maintaining good flock immunity in poultry populations using inactivated vaccine in the field with two vaccination rounds per year, and in preventing circulation of virus in co-existing unvaccinated poultry.
A novel sequence-specific DNA-binding protein, LCP-1, interacts with single-stranded DNA and differentially regulates early gene expression of the human neurotropic JC virus

We have identified a novel brain-derived single-stranded-DNA-binding protein that interacts with a region of the human neurotropic JC virus enhancer designated the lytic control element (LCE). This nuclear factor, LCP-1 (for lytic control element-binding protein 1), specifically recognizes the LCE, as determined by gel retardation assays. Alkylation interference showed that specific nucleotides within the LCE were contacted by LCP-1. Subsequent experiments revealed that point mutations within the LCE differentially affected LCP-1 binding. UV cross-linking and competition analysis suggested that the LCP-1 DNA-protein complexes were 50 to 52 and 100 to 120 kDa in size. Promoter mutations that affected LCP-1 binding reduced early mRNA transcription during the early phase of the lytic cycle. However, upon DNA replication in the presence of JC virus T antigen, when early mRNA initiation shifts to new locations indicative of the late phase, the LCP-1 mutations had no effect. We suggest that the JC virus early transcription unit is differentially regulated by LCP-1 prior to but not after DNA replication, suggesting a novel mechanism by which DNA structure regulates eukaryotic gene expression.
The Value of Domestic Building Energy Efficiency – Evidence from Ireland

Following the transposition of the EU Energy Performance of Buildings Directive into Irish law, all properties offered for sale or to let in Ireland are obliged to have an energy efficiency rating. This paper analyses the effect of energy efficiency ratings on the sale and rental prices of properties in the Republic of Ireland. Using the Heckman selection technique we model the decision to advertise the energy efficiency rating of a property and the effect of energy efficiency ratings on property values. Our results show that energy efficiency has a positive effect on both the sales and rental prices of properties, and that the effect is significantly stronger in the sales segment of the property market. We also analyse the effect of energy efficiency across different market conditions and we find that the effect of the energy rating is stronger where market conditions are worse.
Universality in the Evolution of Orientation Columns in the Visual Cortex

Orientation Columns In the brain's visual cortex, certain neurons respond to vertical lines and others to horizontal lines, with a range in between. Such orientation of neurons tends to be organized in columns reflecting similar responses, and the columns are organized in pinwheels representing the range of responses. Kaschube et al. (p. 1113, published online 4 November; see the Perspective by Miller) looked at the organization of orientation columns in diverse placental mammals and discovered a similarity of organizational principles. Analysis of evolutionarily divergent species highlights constraint on brain structure imposed by self-organizing neural networks. The brain’s visual cortex processes information concerning form, pattern, and motion within functional maps that reflect the layout of neuronal circuits. We analyzed functional maps of orientation preference in the ferret, tree shrew, and galago—three species separated since the basal radiation of placental mammals more than 65 million years ago—and found a common organizing principle. A symmetry-based class of models for the self-organization of cortical networks predicts all essential features of the layout of these neuronal circuits, but only if suppressive long-range interactions dominate development. We show mathematically that orientation-selective long-range connectivity can mediate the required interactions. Our results suggest that self-organization has canalized the evolution of the neuronal circuitry underlying orientation preference maps into a single common design.
Progression from normal glucose tolerance to type 2 diabetes in a young girl: longitudinal changes in insulin sensitivity and secretion assessed by the clamp technique and surrogate estimates

Abstract: The pathophysiology of type 2 diabetes (T2DM) involves insulin resistance and relative insulin deficiency in at‐risk youth. We‐report longitudinal changes in insulin sensitivity and secretion in a high‐risk African‐American youth with obesity and polycystic ovary syndrome who progressed from normal glucose tolerance to impaired glucose tolerance to T2DM within 5 yr. This report demonstrates that in our patient: (i) insulin resistance was the pre‐existing abnormality, but it was the marked decline in insulin secretion which led to T2DM and (ii) surrogate estimates of insulin sensitivity using fasting glucose and insulin concentrations were not reliable indices in reflecting the changes in in vivo insulin sensitivity in this case.
Fracture healing as a post‐natal developmental process: Molecular, spatial, and temporal aspects of its regulation

Fracture healing is a specialized post‐natal repair process that recapitulates aspects of embryological skeletal development. While many of the molecular mechanisms that control cellular differentiation and growth during embryogenesis recur during fracture healing, these processes take place in a post‐natal environment that is unique and distinct from those which exist during embryogenesis. This Prospect Article will highlight a number of central biological processes that are believed to be crucial in the embryonic differentiation and growth of skeletal tissues and review the functional role of these processes during fracture healing. Specific aspects of fracture healing that will be considered in relation to embryological development are: (1) the anatomic structure of the fracture callus as it evolves during healing; (2) the origins of stem cells and morphogenetic signals that facilitate the repair process; (3) the role of the biomechanical environment in controlling cellular differentiation during repair; (4) the role of three key groups of soluble factors, pro‐inflammatory cytokines, the TGF‐β superfamily, and angiogenic factors, during repair; and (5) the relationship of the genetic components that control bone mass and remodeling to the mechanisms that control skeletal tissue repair in response to fracture. J. Cell. Biochem. 88: 873–884, 2003. © 2003 Wiley‐Liss, Inc.
Performance of bispectral index and auditory evoked potential monitors in detecting loss of consciousness during anaesthetic induction with propofol with and without fentanyl

Background and objective: To investigate and compare the performance of bispectral index (BIS) and auditory evoked response index (AAI) in detecting the transition from consciousness to unconsciousness during anaesthesia induction by propofol, alone and in combination with fentanyl. Methods: Anaesthesia was induced with either an intravenous infusion of 30 mg kg−1 h−1 of propofol plus 2 μg kg−1 of fentanyl (Group PF, n = 20) or an intravenous infusion of 30 mg kg−1 h−1 of propofol plus normal saline (Group P, n = 20). BIS, AAI and the doses of propofol administered were recorded at the end-point of unresponsiveness to verbal commands. The propofol plasma concentration was also measured. Results: The propofol dose and plasma propofol concentration required to achieve loss of consciousness were significantly lower in patients pretreated with fentanyl (P < 0.001). The mean BIS value at loss of consciousness was significantly different between the two groups (74.10 in Group PF vs. 60.80 in Group P) (P < 0.001). However, no difference in the AAI was seen between the two groups at loss of consciousness (32.90 in Group PF vs. 31.80 in Group P) (P > 0.05). In both groups, the regression analysis values (r-values) between BIS and plasma propofol concentrations at the onset of unconsciousness were higher than those between AAI and propofol concentrations (0.553 vs. 0.180 in Group P; 0.432 vs. 0.308 in Group PF). Conclusions: These results show that a fentanyl bolus is effective in augmenting the hypnotic effect of propofol during anaesthesia induction. AAI appears to be able to measure the transition from consciousness to unconsciousness at similar values, regardless of whether or not fentanyl pretreatment is used whereas the BIS values were not independent of fentanyl pretreatment. This suggests that AAI may be a better indicator of conscious status during propofol/fentanyl anaesthesia, where it appears to be independent of the anaesthesia regimen.
Lyapunov density for almost attraction of nonlinear time-varying systems: A condition without assuming local stability

Stability analysis of nonlinear systems based on Lyapunov densities has been receiving a considerable amount of attention after the original work of Rantzer for almost attraction of nonlinear time-invariant systems. Though a stability criterion has been proposed also for nonlinear time-varying systems, the assumption of local stability of the equilibrium is needed in the previous result. The purpose of this paper is to provide a condition in terms of Lyapunov densities under which the nonlinear time-varying system is almost attractive, i. e. almost all of the trajectories of the system converge to the equilibrium, where the proposed condition does not need an assumption on local stability of the system.
Nonlinear Dynamics and the Evolution of Semelparous and Iteroparous Reproductive Strategies

One of the questions in the evolution of life histories is the fitness trade-off between reproducing only once (semelparity) or reproducing repeated times (iteroparity) during a lifetime. This problem has been posed repeatedly since Cole’s (1954) influential treatise on the topic (Murphy 1968; Charnov and Schaffer 1973; Goodman 1974; Stearns 1976, 1992; Horn 1978; Emlen 1984; Bulmer 1985, 1994; Roff 1992; Charlesworth 1994). A major leap forward in addressing the question of whether to reproduce once or repeatedly per lifetime was due to Charnov and Schaffer (1973). They proposed the following model to account for the temporal dynamics of semelparous, S, and iteroparous, I, reproducers:
An attempt to estimate the minimal number of Poles infected and treated for malaria in Poland and abroad.

BACKGROUND Malaria is one of the three most dangerous infectious diseases in the world. According to official statistics, there are a few dozen cases in Poland annually while the number of Poles treated abroad or self-treating remains unknown. Poland has been declared to be malaria-free since 1963 and nowadays all cases are imported. The aim of the study is to determine the minimal number of malaria cases in Poles at home and abroad in the last decade. MATERIALS AND METHODS The medical records of 4,710 patients tested for malaria in the Department of Tropical Parasitology in the years 2003-2012 were analysed. Two spreadsheets were created, which only included people with a history of malaria diagnosed in the reference centre where indirect immunofluorescent-antibody assay (IFA) for Plasmodium falciparum antigen proved positive. The minimum number of Poles who have had malaria at home and abroad was calculated on the basis of positive IFA results; the rate of all treated malaria patients in Poland in relation to those treated in the reference centre and the actual number of Poles with malaria diagnosed at home was calculated. RESULTS A group of 376 people with positive serologic tests results in indirect immunofluorescent antibody assay with titre ≥ 1:20 were received, including 227 patients with positive serologic results with titre ≥ 1:80. The rate of the overall number of malaria cases in Poland compared to the number of malaria cases in the University Centre for Maritime and Tropical Medicine Hospital was determined as 3.47:1. It was demonstrated that every year at least 174 to 211 Poles staying abroad may suffer from malaria. CONCLUSIONS This is the first attempt to estimate the minimal number of Poles infected and treated for malaria in Poland and abroad. The estimated number is 8-10 times greater than the number of registered cases in Poland.
Chromosomal Instability and Copy Number Alterations in Barrett's Esophagus and Esophageal Adenocarcinoma

Purpose: Chromosomal instability, as assessed by many techniques, including DNA content aneuploidy, loss of heterozygosity, and comparative genomic hybridization, has consistently been reported to be common in cancer and rare in normal tissues. Recently, a panel of chromosome instability biomarkers, including loss of heterozygosity and DNA content, has been reported to identify patients at high and low risk of progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EA), but required multiple platforms for implementation. Although chromosomal instability involving amplifications and deletions of chromosome regions have been observed in nearly all cancers, copy number alterations (CNA) in premalignant tissues have not been well characterized or evaluated in cohort studies as biomarkers of cancer risk. Experimental Design: We examined CNAs in 98 patients having either BE or EA using Bacterial Artificial Chromosome (BAC) array comparative genomic hybridization to characterize CNAs at different stages of progression ranging from early BE to advanced EA. Results: CNAs were rare in early stages (less than high-grade dysplasia) but were progressively more frequent and larger in later stages (high-grade dysplasia and EA), including high-level amplifications. The number of CNAs correlated highly with DNA content aneuploidy. Patients whose biopsies contained CNAs involving >70 Mbp were at increased risk of progression to DNA content abnormalities or EA (hazards ratio, 4.9; 95% confidence interval, 1.6-14.8; P = 0.0047), and the risk increased as more of the genome was affected. Conclusions: Genome-wide analysis of CNAs provides a common platform for the evaluation of chromosome instability for cancer risk assessment as well as for the identification of common regions of alteration that can be further studied for biomarker discovery.
From Higher Party Schools to Academies of State Service: The Marketization of Bureaucratic Training in Russia

What does a postcommunist regime do with its bureaucratic inheritance? Without a replacement bureaucracy at hand, the political leadership in Russia had no choice but to govern through state employees whose values and patterns of behavior were instilled in the Soviet era. Given this reality, one might have expected Russian reformers—and their overseas supporters— to have developed an aggressive and comprehensive policy on retraining officials of state. But instead of a coordinated effort to educate new and existing personnel in a spirit of public, rather than state, service, one finds only a gradual and haphazard reform of bureaucratic training. In this article, Eugene Huskey argues that the driving force behind such training has been the market in higher and continuing education and not a conscious and consistent policy emanating from the presidency or other central institutions of state. The major player in that market is the system of state service academies, which inherited many of their faculty and facilities from the old Higher Party Schools of the communist era. But the market, taken together with the fragmentation of state power, has consistently undermined attempts by the academies to serve as the sole purveyors of training to the bureaucracy. What is as yet unclear is whether the marketization of bureaucratic education and re-education, which discourages the emergence of a coherent national approach to remaking the bureaucracy, is facilitating or impeding the modernization and liberalization of Russian officialdom.
Output-feedback shared-control for fully actuated linear mechanical systems

This paper presents an output feedback shared-control algorithm for fully-actuated, linear, mechanical systems. The feasible configurations of the system are described by a group of linear inequalities which characterize a convex admissible set. The properties of the shared-control algorithm are established with a Lyapunov-like analysis. Simple numerical examples demonstrate the effectiveness of the strategy.