Miracle-dz/UniFAR-FTUs huggingface dataset:
Randomized Controlled Trial Comparing Cerebral Perfusion Pressure–Targeted Therapy Versus Intracranial Pressure–Targeted Therapy for Raised Intracranial Pressure due to Acute CNS Infections in Children*

Objective:In children with acute CNS infection, management of raised intracranial pressure improves mortality and neuromorbidity. We compared cerebral perfusion pressure–targeted approach with the conventional intracranial pressure–targeted approach to treat raised intracranial pressure in these children. Design:Prospective open-label randomized controlled trial. Setting:PICU in a tertiary care academic institute. Patients:Hundred ten children (1–12 yr) with acute CNS infections having raised intracranial pressure and a modified Glasgow Coma Scale score less than or equal to 8 were enrolled. Interventions:Patients were randomized to receive either cerebral perfusion pressure–targeted therapy (n = 55) (maintaining cerebral perfusion pressure ≥ 60 mm Hg, using normal saline bolus and vasoactive therapy—dopamine, and if needed noradrenaline) or intracranial pressure–targeted therapy (n = 55) (maintaining intracranial pressure < 20 mm Hg using osmotherapy while ensuring normal blood pressure). The primary outcome was mortality up to 90 days after discharge from PICU. Secondary outcome was modified Glasgow Coma Scale score at 72 hours after enrollment, length of PICU stay, duration of mechanical ventilation, and hearing deficit and functional neurodisability at discharge and 90-day follow-up. Measurements and Main Results:A 90-day mortality in intracranial pressure group (38.2%) was significantly higher than cerebral perfusion pressure group (18.2%; relative risk = 2.1; 95% CI, 1.09–4.04; p = 0.020). The cerebral perfusion pressure group in comparison with intracranial pressure group had significantly higher median (interquartile range) modified Glasgow Coma Scale score at 72 hours (10 [8–11] vs 7 [4–9], p < 0.001), shorter length of PICU stay (13 d [10.8–15.2 d] vs 18 d [14.5–21.5 d], p = 0.002) and mechanical ventilation (7.5 d [5.4–9.6 d] vs 11.5 d [9.5–13.5 d], p = 0.003), lower prevalence of hearing deficit (8.9% vs 37.1%; relative risk = 0.69; 95% CI, 0.53–0.90; p = 0.005), and neurodisability at discharge from PICU (53.3% vs 82.9%; relative risk = 0.37; 95% CI, 0.17–0.81; p = 0.005) and 90 days after discharge (37.8% vs 70.6%; relative risk = 0.47; 95% CI, 0.27–0.83; p = 0.004). Conclusion:Cerebral perfusion pressure–targeted therapy, which relied on more frequent use of vasopressors and lesser use of hyperventilation and osmotherapy, was superior to intracranial pressure–targeted therapy for management of raised intracranial pressure in children with acute CNS infection in reducing mortality and morbidity.
Structural resolution of a tandem hormone-binding element in the insulin receptor and its implications for design of peptide agonists

The C-terminal segment of the human insulin receptor α-chain (designated αCT) is critical to insulin binding as has been previously demonstrated by alanine scanning mutagenesis and photo-cross-linking. To date no information regarding the structure of this segment within the receptor has been available. We employ here the technique of thermal-factor sharpening to enhance the interpretability of the electron-density maps associated with the earlier crystal structure of the human insulin receptor ectodomain. The αCT segment is now resolved as being engaged with the central β-sheet of the first leucine-rich repeat (L1) domain of the receptor. The segment is α-helical in conformation and extends 11 residues N-terminal of the classical αCT segment boundary originally defined by peptide mapping. This tandem structural element (αCT-L1) thus defines the intact primary insulin-binding surface of the apo-receptor. The structure, together with isothermal titration calorimetry data of mutant αCT peptides binding to an insulin minireceptor, leads to the conclusion that putative “insulin-mimetic” peptides in the literature act at least in part as mimics of the αCT segment as well as of insulin. Photo-cross-linking by novel bifunctional insulin derivatives demonstrates that the interaction of insulin with the αCT segment and the L1 domain occurs in trans, i.e., these components of the primary binding site are contributed by alternate α-chains within the insulin receptor homodimer. The tandem structural element defines a new target for the design of insulin agonists for the treatment of diabetes mellitus.
Psychological distress, major depressive disorder, and risk of stroke

Background: Studies have suggested that mood status is associated with an increased risk of stroke, though mostly based on measures of depression defined by symptoms alone rather than diagnostic criteria representative of clinically important distress and impairment. We investigated this association based upon a large population-based prospective cohort study. Methods: Baseline assessment of major depressive disorder (MDD) and of mental health well-being (defined by the Mental Health Inventory, MHI-5) was completed by 20,627 stroke-free participants, aged 41 to 80 years, in the United Kingdom European Prospective Investigation into Cancer–Norfolk study. Results: During 8.5 years of follow-up, 595 incident (fatal and nonfatal) stroke endpoints were recorded. Neither past year nor lifetime MDD was associated with stroke. A one SD decrease in MHI-5 scale score (representing greater emotional distress) was associated with an 11% increased risk of stroke after adjustment for age, sex, cigarette smoking, systolic blood pressure, cholesterol, obesity, preexisting myocardial infarction, diabetes, social class, education, hypertension treatment, family history of stroke, and antidepressant medication use (hazard ratio 1.11, 95% CI 1.00 to 1.22). This association was consistent for men and for women, for fatal and nonfatal stroke, and conformed to a dose-response relationship. Conclusions: Findings from this large prospective cohort study suggest that increased psychological distress is associated with elevated stroke risk. Episodic major depressive disorder was not associated with incident stroke in this study.
Conformal Structures Associated to Generic Rank 2 Distributions on 5-Manifolds - Characterization and Killing-Field Decomposition

Given a maximally non-integrable 2-distribution D on a 5-manifold M, it was discovered by P. Nurowski that one can naturally associate a conformal structure (g)D of signature (2,3) on M. We show that those conformal structures (g)D which come about by this construction are characterized by the existence of a normal conformal Killing 2-form which is locally decomposable and satisfies a genericity condition. We further show that every conformal Killing field of (g)D can be decomposed into a symmetry of D and an almost Einstein scale of (g)D.
Natural course of visual functions in the Bardet-Biedl syndrome.

OBJECTIVE To determine the course of visual functions in patients with Bardet-Biedl syndrome. PATIENTS AND METHODS The 21 patients with Bardet-Biedl syndrome seen at Children's Hospital, Boston, Mass, had optotype and grating acuities and dark-adapted thresholds measured over time. Their ages at first visit ranged from 2 weeks to 23 years (median age, 6 years). The courses of the visual functions were analyzed with a random-effects model. RESULTS Substantial declines in visual functions were found. On average, grating and optotype acuities declined 0.09 log units (roughly 1 line) per year, and thresholds increased about 0.19 log units per year. The rates at which these visual functions were lost and the predicted level of the visual functions at ages 11 to 12 years (the mean ages of measurement) varied among individuals. CONCLUSIONS The visual prognosis for children with Bardet-Biedl syndrome is poor. The course of both central and peripheral visual functions is variable.
A Missed Summer Wave of the 1918–1919 Influenza Pandemic: Evidence From Household Surveys in the United States and Norway

Background. Reanalysis of influenza survey data from 1918 to 1919 was done to obtain new insights into the geographic and host factors responsible for the various waves. Methods. We analyzed the age- and sex-specific influenza morbidity, fatality, and mortality for the city of Baltimore and smaller towns and rural areas of Maryland and the city of Bergen (Norway), using survey data. The Maryland surveys captured the 1918 fall wave, whereas the Bergen survey captured 3 waves during 1918–1919. Results. Morbidity in rural areas of Maryland was higher than in the city of Baltimore during the fall of 1918, that was almost equal to that in Bergen during the summer of 1918. In Bergen, the morbidity in the fall was only half of that in the summer, with more females than males just above the age of 20 falling ill, as seen in both regions of Maryland. In contrast, more males than females fell ill during the summer wave in Bergen. Individuals <40 years had the highest morbidity, whereas school-aged children had the lowest fatality and mortality. Conclusion. A previously unrecognized pandemic summer wave may have hit the 2 regions of Maryland in 1918.
Definition of the Lateral Bulge Deformity After Primary Cleft Lip Repair Using Real-Time High-Resolution Ultrasound

The lateral bulge is a common secondary deformity after primary cleft lip repair; however, its underlying anatomy remains undefined. The purpose of this study was to use real-time high-resolution ultrasound to better understand the anatomy underlying the lateral bulge deformity. Twenty-three patients with a lateral bulge were included in addition to 12 patients without clefts to validate ultrasound measurements. Muscle and connective tissue dimensions were recorded at standardized landmarks using ultrasound, both at rest and with movement. The cleft and noncleft sides (right and left in noncleft patients) were compared within groups, and ratios between sides were compared across groups using parametric and nonparametric tests. Repeat measurements were recorded to calculate intrarater reliability. Orbicularis oris thickness was greater on the cleft side in the lateral bulge group at rest, both at the philtral column and alar crease (P < 0.001), and with facial movement at the corresponding landmarks (alar crease: smile P < 0.001 and pucker P = 0.003; philtral column: smile P < 0.001 and pucker P = 0.001). The ratio for levator width was also greater in the lateral bulge group (P < 0.001). No differences were identified between sides at the corresponding landmarks in the noncleft group. Ultrasound enabled real-time high-resolution evaluation of anatomic differences underlying the lateral bulge deformity. It was associated with greater orbicularis oris thickness and levator width on the cleft side. Findings from this study may guide future surgical correction of the lateral lip bulge.
Adsorption and Self-Assembly of Large Polycyclic Molecules on the Surfaces of TiO2 Single Crystals

Titanium dioxide is one of the most frequently studied metal oxides, and its (110) rutile surface serves as a prototypical model for the surface science of such materials. Recent studies have also shown that the (011) surface is relatively easy for preparation in ultra-high vacuum (UHV) and that both the (110) and (011) surfaces could be precisely characterized using scanning tunneling microscopy (STM). The supramolecular self-assembly of organic molecules on the surfaces of titanium dioxide plays an important role in nanofabrication, and it can control the formation and properties of nanostructures, leading to wide range of applications covering the fields of catalysis, coatings and fabrication of sensors and extends to the optoelectronic industry and medical usage. Although the majority of experiments and theoretical calculations are focused on the adsorption of relatively small organic species, in recent years, there has been increasing interest in the properties of larger molecules that have several aromatic rings in which functional units could also be observed. The purpose of this review is to summarize the achievements in the study of single polycyclic molecules and thin layers adsorbed onto the surfaces of single crystalline titanium dioxide over the past decade.
The organization of the lateral thalamus of the hooded rat

Analysis of cytoarchitecture and connectivity showed that the lateral thalamus of the hooded rat is composed of eight nuclei. An examination of the cytoarchitecture permitted the identification of seven cellular fields: nucleus suprageniculatus (sg), nucleus lateralis posterior pars caudomedialis (lpcm), nucleus lateralis posterior pars lateralis (lpl), nucleus lateralis posterior pars rostromedialis (lprm), intramedullary area (ima), nucleus lateralis dorsale pars ventrolateralis (ldvl), and nucleus lateralis dorsale pars dorsomedialis (lddm). An analysis of the connectivity showed that lpl is further divisible into a rostral (lplr) and a caudal (lplc) sector, bringing the total number of nuclei to eight. Nucleus suprageniculatus, the most caudal element of the lateral thalamus, is composed of medium to large, fusiform, and multipolar neurons. It contains a terminal field of the projection of the superficial layers of the ipsilateral superior colliculus. Nucleus lpcm, found rostrolateral to sg, is loosely packed with large multipolar neurons. A terminal field of the superficial layers of the superior colliculus of both sides fits precisely within its cytoarchitectural boundaries. Nucleus lpl, a long cellular territory found lateral to lpcm, extends from the caudal pole of the dorsal lateral geniculate nucleus to the caudal pole of ldvl and contains round cells which are smaller and more densely packed than those of lpcm. Its caudal portion (lplc) contains another terminal field of the ipsilateral superior colliculus while its rostral portion (lplr) contains a terminal field of the projection of Area 17. Area 18 also projects to lplr, whereas Area 18a projects to both lplr and lplc. The intramedullary area, which occupies the fibrous zone between lpl and the dorsal lateral geniculate nucleus, contains round and fusiform neurons and is innervated by Area 18a. Nucleus lprm, situated medial to lpl, is characterized by round neurons which are frequently found in clusters. It is innervated by Areas 17, 18, and 18a. Nucleus ldvl is evenly packed with moderately large, polygonal cells and contains the complete terminal fields of both Areas 17 and 18. It also receives inputs from Area 18a. Finally, lddm, tightly packed with small, round cells and lying medial to ldvl, receives inputs from Area 4.
Fiscal Multipliers in Recession and Expansion

In this paper, we estimate government purchase multipliers for a large number of OECD countries, allowing these multipliers to vary smoothly according to the state of the economy and using real-time forecast data to purge policy innovations of their predictable components. We adapt our previous methodology (Auerbach and Gorodnichenko, 2011) to use direct projections rather than the SVAR approach to estimate multipliers, to economize on degrees of freedom and to relax the assumptions on impulse response functions imposed by the SVAR method. Our findings confirm those of our earlier paper. In particular, GDP multipliers of government purchases are larger in recession, and controlling for real-time predictions of government purchases tends to increase the estimated multipliers of government purchases in recession. We also consider the responses of other key macroeconomic variables and find that these responses generally vary over the cycle as well, in a pattern consistent with the varying impact on GDP.
An Electronic Publication Dedicated to Early Stellar Evolution and Molecular Clouds from the Editor the Formation of the First Star in the Universe

The Star Formation Newsletter has since its inception been devoted to star formation processes, molecular clouds and the interstellar medium within our Galaxy. More recently, the Large and Small Magellanic Clouds were added, since we have reached the point where even individual low mass stars can be fruitfully studied in these neighboring galaxies (see the abstract of Wichmann et al. in this issue). However, increases in telescope sizes and developments in detector technology and in high-resolution techniques continue, and we are likely soon to see studies of young stellar populations in nearby galaxies which are highly relevant to the more detailed studies performed in our own Galaxy. Consequently, the Star Formation Newsletter will from now on accept abstracts dealing with star formation, molecular clouds and the interstellar medium also in nearby galaxies. In a way it would be desirable to include such studies for all galaxies, but practical constraints and a desire to keep the Newsletter within a manageable size precludes this. Thus a distance limit must be imposed, which necessarily will be somewhat arbitrary. For now I have chosen to say that abstracts dealing with star formation within the nearest 8 Mpc will be included, guided by the fact that our Local Group and most of the brightest galaxies in the sky are then included, and by a feeling that star formation studies in these nearby Galaxies are likely to be important for an understanding of star formation in our own Galaxy. The first such abstract is presented by Lamers et al. in this issue. We describe results from a fully self–consistent three dimensional hydrodynamical simulation of the formation of one of the first stars in the Universe. As dark matter dominated pre-galactic objects form because of gravitational instability from small initidal density perturbations. As they assemble via hierarchical merging, primordial gas cools through ro-vibrational lines of hydrogen molecules and sinks to the center of the dark matter potential well. The high redshift analog of a molecular cloud is formed. As the dense, central parts of the cold gas cloud become self-gravitating, a dense core of ∼ 100 M undergoes rapid contraction. At densities n > 10 9 cm −3 a 1 M proto-stellar core becomes fully molecular due to three–body H 2 formation. Contrary to analytical expectations this process does not lead to renewed fragmentation and only one star is formed. The calculation is stopped when optical depth …
Sleep transforms the cerebral trace of declarative memories

After encoding, memory traces are initially fragile and have to be reinforced to become permanent. The initial steps of this process occur at a cellular level within minutes or hours. Besides this rapid synaptic consolidation, systems consolidation occurs within a time frame of days to years. For declarative memory, the latter is presumed to rely on an interaction between different brain regions, in particular the hippocampus and the medial prefrontal cortex (mPFC). Specifically, sleep has been proposed to provide a setting that supports such systems consolidation processes, leading to a transfer and perhaps transformation of memories. Using functional MRI, we show that postlearning sleep enhances hippocampal responses during recall of word pairs 48 h after learning, indicating intrahippocampal memory processing during sleep. At the same time, sleep induces a memory-related functional connectivity between the hippocampus and the mPFC. Six months after learning, memories activated the mPFC more strongly when they were encoded before sleep, showing that sleep leads to long-lasting changes in the representation of memories on a systems level.
Objective and subjective evaluation of the influence of small amounts of delay and jitter on a recent first person shooter game

There have been several studies in the past years that investigate the impact of network delay on multi-user applications. Primary examples of these applications are real-time multiplayer games. These studies have shown that high network delays and jitter may indeed influence the player's perception of the quality of the game. However, the proposed test values, which are often high, are not always representative for a large percentile of on-line game players. We have therefore investigated the influence of delay and jitter with numbers that are more representative for typical access networks. This in effect allows us to simulate a setup with multiplayer game servers that are located at ISP level and players connected through that ISP's access network. To obtain further true-to-life results, we opted to carry out the test using a recent first person shooter (FPS) game, Unreal Tournament 2003. It can, after all, be expected that this new generation of games has built-in features to diminish the effect of small delay values, given the popularity of playing these games over the Internet. In this paper, we have investigated both subjective perceived quality and objective measurements and will show that both are indeed influenced by even these small delay and jitter values.
Security analysis of India's electronic voting machines

Elections in India are conducted almost exclusively using electronic voting machines developed over the past two decades by a pair of government-owned companies. These devices, known in India as EVMs, have been praised for their simple design, ease of use, and reliability, but recently they have also been criticized following widespread reports of election irregularities. Despite this criticism, many details of the machines' design have never been publicly disclosed, and they have not been subjected to a rigorous, independent security evaluation. In this paper, we present a security analysis of a real Indian EVM obtained from an anonymous source. We describe the machine's design and operation in detail, and we evaluate its security in light of relevant election procedures. We conclude that in spite of the machines' simplicity and minimal software trusted computing base, they are vulnerable to serious attacks that can alter election results and violate the secrecy of the ballot. We demonstrate two attacks, implemented using custom hardware, which could be carried out by dishonest election insiders or other criminals with only brief physical access to the machines. This case study carries important lessons for Indian elections and for electronic voting security more generally.
An objective algorithm for the identification of convective tropical cloud clusters in geostationary infrared imagery

Tropical cyclones trace their origins to disorganized groups of thunderstorms over tropical waters called "cloud clusters. " The transformation from cloud clusters into mature tropical cyclones is not well understood due to the remote location of these clusters (away from the main observation network) and the complexities of the smallerscale physics that occur during genesis. Several studies have used a catalog of cloud clusters to search for distinguishing features between those which develop into storms and those which do not. The creation of these datasets is cumbersome since they must be identified visually through the application of arbitrary and subjective rule. An automated algorithm is developed to identify tropical cloud clusters in geostationary infrared satellite imagery. The algorithm proposed here significantly reduces the time and effort needed to identify and catalog cloud clusters by applying objective search criteria in an automated way. This algorithm will enable the creation of a comprehensive, historical cloud cluster database that will have both research and operational applications. The database will be made available to the scientific community and will be updated in real-time.
Shape sensitivity analysis of eigenvalues revisited

S.A. NAZAROV AND J. SOKOLOWSKIA bstract . The paper can be considered as a complement to previous papersof the authors. An insight into applied asymptotic analysis of boundary valueproblems in singularly perturbed domains is presented. As a result, the asymp-totic expansions of eigenvalues are obtained and discussed in terms of integralattributes of the geometrical perturbations including the virtual mass tensor, po-larization tensor etc. The results are presented in such a way that can be easilyemployed in numerical methods for shape optimization and inverse problems.