Miracle-dz/UniFAR-FTUs huggingface dataset:
Integrated versus fragmented implementation of complex innovations in acute health care

Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations—those that require coordinated use across the adopting organization to have the intended benefits. Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. Methodology: We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. Findings: In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Practice Implications: Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and continual support for and evaluation of implementation, and (d) allowance for local customization within the general principles of standardization.
In vivo EPR extracellular pH‐metry in tumors using a triphosphonated trityl radical

The ability to assess the extracellular pH (pHe) is an important issue in oncology, because extracellular acidification is associated with tumor aggressiveness and resistance to cytotoxic therapies. In this study, a stable triphosphonated triarylmethyl (TPTAM) radical was qualified as a pHe electron paramagnetic resonance (EPR) molecular reporter.
Feasibility of collecting tumor samples of breast cancer patients diagnosed up to 50 years ago in the Child Health and Development Studies

Environmental exposures during pregnancy may increase breast cancer risk for mothers and female offspring. Tumor tissue assays may provide insight regarding the mechanisms. This study assessed the feasibility of obtaining tumor samples and pathology reports from mothers (F0) who were enrolled in the Child Health and Development Studies during pregnancy from 1959 to 1967 and their daughters (F1) who developed breast cancer over more than 50 years of follow-up. Breast cancer cases were identified through linkage to the California Cancer Registry and self-report. Written consent was obtained from 116 F0 and 95 F1 breast cancer survivors to access their pathology reports and tumor blocks. Of those contacted, 62% consented, 13% refused and 24% did not respond. We obtained tissue samples for 57% and pathology reports for 75%, and if diagnosis was made ⩽10 years we obtained tissue samples and pathology reports for 91% and 79%, respectively. Obtaining pathology reports and tumor tissues of two generations is feasible and will support investigation of the relationship between early-life exposures and molecular tumor markers. However, we found that more recent diagnosis increased the accessibility of tumor tissue. We recommend that cohorts request consent for obtaining future tumor tissues at study enrollment and implement real-time tissue collection to enhance success of collecting tumor samples and data.
Reconfigurable rainbow PIV for 3D flow measurement

In recent years, 3D Particle Imaging Velocimetry (PIV) has become more and more attractive due to its ability to fully characterize various fluid flows. However, 3D fluid capture and velocity field reconstruction remain a challenging problem. A recent rainbow PIV system encodes depth into color and successfully recovers 3D particle trajectories, but it also suffers from a limited and fixed volume size, as well as a relatively low light efficiency. In this paper, we propose a reconfigurable rainbow PIV system that extends the volume size to a considerable range. We introduce a parallel double-grating system to improve the light efficiency for scalable rainbow generation. A varifocal encoded diffractive lens is designed to accommodate the size of the rainbow illumination, ranging from 15 mm to 50 mm. We also propose a truncated consensus ADMM algorithm to efficiently reconstruct particle locations. Our algorithm is 5x faster compared to the state-of-the-art. The reconstruction quality is also improved significantly for a series of density levels. Our method is demonstrated by both simulation and experimental results.
Application of a synthetic human proteome to autoantigen discovery through PhIP-Seq

In this study, we improve on current autoantigen discovery approaches by creating a synthetic representation of the complete human proteome, the T7 “peptidome” phage display library (T7-Pep), and use it to profile the autoantibody repertoires of individual patients. We provide methods for 1) designing and cloning large libraries of DNA microarray-derived oligonucleotides encoding peptides for display on bacteriophage, and 2) analysis of the peptide libraries using high throughput DNA sequencing. We applied phage immunoprecipitation sequencing (PhIP-Seq) to identify both known and novel autoantibodies contained in the spinal fluid of three patients with paraneoplastic neurological syndromes. We also show how our approach can be used more generally to identify peptide-protein interactions and point toward ways in which this technology will be further developed in the future. We envision that PhIP-Seq can become an important new tool in autoantibody analysis, as well as proteomic research in general. unbiased proteome representation, peptide enrichment quantification, and a streamlined, multiplexed protocol requiring just one round of enrichment. We have applied PhIP-Seq to interrogate the autoantibody repertoire in the spinal fluid of patients with neurological autoimmunity and identified both known and novel autoantigens. We further demonstrate how PhIP-Seq can also be used more generally to identify peptide-protein interactions.
How to Split UL/DL Antennas in Full-Duplex Cellular Networks

To further improve the potential of full-duplex communications, networks may employ multiple antennas at the base station or user equipment. To this end, networks that employ current radios usually deal with self-interference and multi-user interference by beamforming techniques. Although previous works investigated beamforming design to improve spectral efficiency, the fundamental question of how to split the antennas at a base station between uplink and downlink in full-duplex networks has not been investigated rigorously. This paper addresses this question by posing antenna splitting as a binary nonlinear optimization problem to minimize the sum mean squared error of the received data symbols. It is shown that this is an NP-hard problem. This combinatorial problem is dealt with by equivalent formulations, iterative convex approximations, and a binary relaxation. The proposed algorithm is guaranteed to converge to a stationary solution of the relaxed problem with much smaller complexity than exhaustive search. Numerical results indicate that the proposed solution is close to the optimal in both high and low self-interference capable scenarios, while the usually assumed antenna splitting is far from optimal. For large number of antennas, a simple antenna splitting is close to the proposed solution. This reveals that the importance of antenna splitting diminishes with the number of antennas.
Origin of noise in liquid-gated Si nanowire troponin biosensors

Liquid-gated Si nanowire field-effect transistor (FET) biosensors are fabricated using a complementary metal-oxide-semiconductor-compatible top-down approach. The transport and noise properties of the devices reflect the high performance of the FET structures, which allows label-free detection of cardiac troponin I (cTnI) molecules. Moreover, after removing the troponin antigens the structures demonstrate the same characteristics as before cTnI detection, indicating the reusable operation of biosensors. Our results show that the additional noise is related to the troponin molecules and has characteristics which considerably differ from those usually recorded for conventional FETs without target molecules. We describe the origin of the noise and suggest that noise spectroscopy represents a powerful tool for understanding molecular dynamic processes in nanoscale FET-based biosensors.
Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke)

Background and Purpose— Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions. Methods— In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke), in-trial costs were measured for patients using detailed medical resource utilization and hospital billing data. Utility weights were assessed at 30 and 90 days using the EuroQol-5 dimension questionnaire. Post-trial costs and life-expectancy were estimated for each surviving patient using a model based on trial data and inputs derived from a contemporary cohort of ischemic stroke survivors. Results— Index hospitalization costs were $17 183 per patient higher for SST+tPA than for tPA ($45 761 versus $28 578; P<0.001), driven by initial procedure costs. Between discharge and 90 days, costs were $4904 per patient lower for SST+tPA than for tPA ($11 270 versus $16 174; P=0.014); total 90-day costs remained higher with SST+tPA ($57 031 versus $44 752; P<0.001). Higher utility values for SST+tPA led to higher in-trial quality-adjusted life years (0.131 versus 0.105; P=0.005). In lifetime projections, SST+tPA was associated with substantial gains in quality-adjusted life years (6.79 versus 5.05), cost savings of $23 203 per patient and was economically dominant when compared with tPA in 90% of bootstrap replicates. Conclusions— Among patients with acute ischemic stroke enrolled in the SWIFT-PRIME trial, SST increased initial treatment costs, but was projected to improve quality-adjusted life-expectancy and reduce healthcare costs over a lifetime horizon compared with tPA. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT01657461.
Eye-hand coordination using two irregular phosphene maps in simulated prosthetic vision for retinal prostheses

Clinical trials have shown different irregular characteristics of phosphene maps can be elicited by retinal prostheses. This study investigated the effect of distortion and dropout percentage on two novel eye-hand coordination tasks. 16 volunteers participated in two tasks on a touch screen: drawing geometric shapes and writing Chinese characters. The accuracy and efficiency in both tasks were recorded and compared while one irregular characteristic was changed. Results show that the accuracy and efficiency of both tasks decrease as the variability of distortion and dropout percentage increase, which may provide theoretical and practical significance for the clinical research on retinal prostheses.
Exacerbation of Thromboinflammation by Hyperglycemia Precipitates Cerebral Infarct Growth and Hemorrhagic Transformation

Background and Purpose— Admission hyperglycemia is associated with a poor outcome in acute ischemic stroke. How hyperglycemia impacts the pathophysiology of acute ischemic stroke remains largely unknown. We investigated how preexisting hyperglycemia increases ischemia/reperfusion cerebral injury. Methods— Normoglycemic and streptozotocin-treated hyperglycemic rats were subjected to transient middle cerebral artery occlusion. Infarct growth and brain perfusion were assessed by magnetic resonance imaging. Markers of platelet, coagulation, and neutrophil activation were measured in brain homogenates and plasma. Downstream microvascular thromboinflammation (DMT) was investigated by intravital microscopy. Results— Hyperglycemic rats had an increased infarct volume with an increased blood–brain barrier disruption and hemorrhagic transformation rate compared with normoglycemic rats. Magnetic resonance imaging scans revealed that hyperglycemia enhanced and accelerated lesion growth and was associated with hemorrhagic transformation originating from territories that were still not completely reperfused at 1 hour after middle cerebral artery recanalization. Intravital microscopy and analysis of brain homogenates showed that DMT began immediately after middle cerebral artery occlusion and was exacerbated by hyperglycemia. Measurement of plasma serotonin and matrix metalloproteinase-9 indicated that platelets and neutrophils were preactivated in hyperglycemic rats. Neutrophils from hyperglycemic diabetic patients showed increased adhesion to endothelial cells as compared with neutrophils from normoglycemic donors in flow chamber experiments. Conclusions— We show that hyperglycemia primes the thromboinflammatory cascade, thus, amplifying middle cerebral artery occlusion–induced DMT. DMT exacerbation in hyperglycemic rats impaired reperfusion and precipitated neurovascular damage, blood–brain barrier disruption, and hemorrhagic transformation. Our results designate DMT as a possible target for reduction of the deleterious impact of hyperglycemia in acute ischemic stroke.
K-nearest neighbour (KNN) approach using SAT based technique for rectilinear steiner tree construction

The Rectilinear Steiner Minimum Tree (RSMT) problem claims the minimum length interconnection among a given set of terminals within the rectilinear plane, is one of the basic problems in physical design automation, specifically in routing. Recently, the problem has drawn great attention due to the need for extremely scalable algorithms able to handle nets with large number of terminals. In this paper, a SAT based methodology is introduced for obtaining RSMTs for different nets with varying net degrees. But, the SAT based solutions degrades with the increasing number of Boolean variables. To overcome this scalability issue, a divide-and-conquer approach is proposed here to minimize the solution space. A k-d tree based nearest neighbor (NN) search algorithm is developed here for reducing the solution space and improving the solution quality. Experimental results indicates that the proposed approach are able to obtain a better run time and possess lesser wirelength.
9-cis-Epoxycarotenoid Dioxygenase 3 Regulates Plant Growth and Enhances Multi-Abiotic Stress Tolerance in Rice

Although abscisic acid (ABA) is an important hormone that regulates seed dormancy, stomatal closure, plant development, as well as responses to environmental stimuli, the physiological mechanisms of ABA response to multiple stress in rice remain poorly understood. In the ABA biosynthetic pathway, 9-cis-epoxycarotenoid dioxygenase (NCED) is the key rate-limiting enzyme. Here, we report important functions of OsNCED3 in multi-abiotic stress tolerance in rice. The OsNCED3 is constitutively expressed in various tissues under normal condition, Its expression is highly induced by NaCl, PEG, and H2O2 stress, suggesting the roles for OsNCED3 in response to the multi-abiotic stress tolerance in rice. Compared with wild-type plants, nced3 mutants had earlier seed germination, longer post-germination seedling growth, increased sensitivity to water stress and H2O2 stress and increased stomata aperture under water stress and delayed leaf senescence. Further analysis found that nced3 mutants contained lower ABA content compared with wild-type plants, overexpression of OsNCED3 in transgenic plants could enhance water stress tolerance, promote leaf senescence and increase ABA content. We conclude that OsNCED3 mediates seed dormancy, plant growth, abiotic stress tolerance, and leaf senescence by regulating ABA biosynthesis in rice; and may provide a new strategy for improving the quality of crop.
Do Combined Pharmacist and Prescriber Efforts on Medication Reconciliation Reduce Postdischarge Patient Emergency Department Visits and Hospital Readmissions?

BACKGROUND Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases. Patients who received an enhanced, Gold level, Med Rec bundle (including both admission Med Rec and interprofessional pharmacist-prescriber collaboration on discharge Med Rec) were assigned to the intervention group. Patients who received partial Med Rec services, Silver and Bronze level, comprised the control group. The primary outcome was hospital visits within 30 days of discharge. RESULTS Over a 57-month period, 9931 unique patient visits (n = 8678 patients) met the study criteria. The main analysis did not detect a difference in 30-day hospital visits between the intervention (Gold level bundle) and control (21.25% vs 19.26%; adjusted odds ratio, 1.06; 95% confidence interval [CI], 0.95–1.19). Propensity score adjustment also did not detect an effect (16.7% vs18.9%; relative risk of readmission, 0.88; 95% CI, 0.59–1.32). CONCLUSION A long-term, observational evaluation of interprofessional Med Rec did not detect a difference in 30-day postdischarge patient hospital visits between patients who received enhanced versus partial Med Rec patient care bundles. In future prospective studies, researchers could focus on evaluating high-risk populations and specific elements of Med Rec services on avoidable, medication-related hospital admissions and postdischarge adverse drug events.
Including Older Adults into the Design Process: Challenges and Lessons Learned

Technology is often not accessible to older adults, especially to those with cognitive impairments. Including people during the whole process of design can result in products or services that are more accessible and meaningful. This paper investigates how to include older adults with cognitive impairments in different phases of design. During 25 activities with a group of older adults, various challenges related to cognitive impairments emerged. We discuss these challenges present lessons learned as well as recommendations how to lead with these challenges.
Transcranial Direct Current Stimulation Potentiates Improvements in Functional Ability in Patients With Chronic Stroke Receiving Constraint-Induced Movement Therapy

Background and Purpose— Transcranial direct current stimulation may enhance effect of rehabilitation in patients with chronic stroke. The objective was to evaluate the efficacy of anodal transcranial direct current stimulation combined with constraint-induced movement therapy of the paretic upper limb. Methods— A total of 44 patients with stroke were randomly allocated to receive 2 weeks of constraint-induced movement therapy with either anodal or sham transcranial direct current stimulation. The primary outcome measure, Wolf Motor Function Test, was assessed at baseline and after the intervention by blinded investigators. Results— Both groups improved significantly on all Wolf Motor Function Test scores. Group comparison showed improvement on Wolf Motor Function Test in the anodal group compared with the sham group. Conclusions— Anodal transcranial direct current stimulation combined with constraint-induced movement therapy resulted in improvement of functional ability of the paretic upper limb compared with constraint-induced movement therapy alone. Clinical Trial Registration— URL: http://www.clinicaltrials. gov. Unique identifier: NCT01983319.
Biological Mechanisms for Learning: A Computational Model of Olfactory Learning in the Manduca sexta Moth, With Applications to Neural Nets

The insect olfactory system, which includes the antennal lobe (AL), mushroom body (MB), and ancillary structures, is a relatively simple neural system capable of learning. Its structural features, which are widespread in biological neural systems, process olfactory stimuli through a cascade of networks where large dimension shifts occur from stage to stage and where sparsity and randomness play a critical role in coding. Learning is partly enabled by a neuromodulatory reward mechanism of octopamine stimulation of the AL, whose increased activity induces synaptic weight updates in the MB through Hebbian plasticity. Enforced sparsity in the MB focuses Hebbian growth on neurons that are the most important for the representation of the learned odor. Based upon current biophysical knowledge, we have constructed an end-to-end computational firing-rate model of the Manduca sexta moth olfactory system which includes the interaction of the AL and MB under octopamine stimulation. Our model is able to robustly learn new odors, and neural firing rates in our simulations match the statistical features of in vivo firing rate data. From a biological perspective, the model provides a valuable tool for examining the role of neuromodulators, like octopamine, in learning, and gives insight into critical interactions between sparsity, Hebbian growth, and stimulation during learning. Our simulations also inform predictions about structural details of the olfactory system that are not currently well-characterized. From a machine learning perspective, the model yields bio-inspired mechanisms that are potentially useful in constructing neural nets for rapid learning from very few samples. These mechanisms include high-noise layers, sparse layers as noise filters, and a biologically-plausible optimization method to train the network based on octopamine stimulation, sparse layers, and Hebbian growth.
Relative power analysis of electroencephalograph rhythms in elderly with mild cognitive impairment

In this paper, in order to explore the main abnormal electroencephalograph(EEG) rhythms and lesions in the brain in patients with mild cognitive impairment(MCI), the EEG rhythms power of resting task, memory task and visuospatial task in elderly with MCI was computed and spatial distribution characteristics of it was analyzed to study the brain cognitive function in elderly with MCI. It was demonstrated that the relative power of theta rhythm in elderly with MCI was higher than that in normal aging significantly and the most obvious brain area with slowing of EEG rhythms in elderly with MCI was left temporal area. Thus, theta rhythm is the main abnormal EEG rhythm and left temporal area is the main lesion in the brain in elderly with MCI.