Miracle-dz/UniFAR-FTUs huggingface dataset:
Effect of priming on adjunctive repetitive transcranial magnetic stimulation in treatment of late-life depression: protocol of a prospective randomized sham-controlled study

Abstract Objective Priming stimulation, which involves high-frequency repetitive transcranial magnetic stimulation (rTMS) followed by low-frequency, has been shown to enhance neural response and is one of the novel paradigms found beneficial in adult patients with depression and has not been studied in late-life depression (LLD). This study aims to compare the effect of adjunctive priming vis-a-vis no priming rTMS over right dorso-lateral prefrontal cortex (DLPFC), on treatment of LLD. Methods This trial is registered in Clinical Trial Registry-India (CTRI) on www.ctri. nic.in. CTRI registration number: CTRI/2020/08/027230. Forty patients of LLD who are symptomatic after an adequate antidepressant trial will be randomized into 2 groups (active priming and sham priming rTMS); each receiving 10 sessions of rTMS over 2 weeks. Patients will remain blind to treatment allocation. Assessments will be done using Hamilton rating scale for depression, Geriatric Depression Scale, Hamilton rating scale for Anxiety, Somatic Symptom Severity Scale 8, Hindi Mental Status Examination, and Clinical Global Impression scale at baseline, week 1, 2, and 4. Side effect checklist will be applied after each session in both groups and at the end of 4 weeks. Result Data will be analyzed using statistical software Statistical Package for Social Sciences. Both the groups (active and sham groups) will be compared at the four given timepoints. Also, the baseline characteristics will be compared with the 3 follow-up points for any change. Conclusion The findings of the study will give an insight to the possible role of priming to augment the effect of low-frequency rTMS in LLD.
Association of anaemia with long-term mortality among patients with hypertensive crisis in the emergency department

Abstract Background Anaemia is frequent in patients with cardiovascular disease and is significantly associated with poor prognosis. However, the prognostic significance of anaemia in hypertensive crisis remains unknown. We conducted this study to determine whether anaemia is a risk factor for all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED). Methods This retrospective study included patients who visited the ED between 2016 and 2019 for hypertensive crisis, which was defined as systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥110 mmHg. A total of 5,512 patients whose serum haemoglobin levels were checked were included in this study and were classified into three groups according to their serum haemoglobin levels at admission to the ED: moderate/severe anaemia (haemoglobin <11 g/dL), mild anaemia (haemoglobin 11 to <13 g/dL in men and 11 to <12 g/dL in women), and non-anaemia (haemoglobin ≥13 g/dL in men and ≥12 g/dL in women). Results Among 5,512 patients, 665 (12.1%) and 668 (12.1%) were classified into the moderate/severe anaemia and mild anaemia groups, respectively. The three-year all-cause mortality rates in the moderate/severe anaemia, mild anaemia, and non-anaemia groups were 46.0, 29.2, and 12.0%, respectively. After accounting for relevant covariates, patients with moderate/severe anaemia group (hazard ratio [HR], 2.15; 95% confidence interval [CI], 1.75–2.64) and mild anaemia group (HR, 1.32; 95% CI, 1.07–1.63) had a higher risk of 3-year all-cause mortality than the non-anaemia group. Conclusion Anaemia is independently associated with 3-year all-cause mortality in patients with hypertensive crisis. A comprehensive therapeutic approach through more in-depth examination and close follow up are required for patients with hypertensive crisis with anaemia. KEY MESSAGES Anaemia is independently associated with 3-year all-cause mortality in patients with hypertensive crisis. A comprehensive therapeutic approach through more in-depth examination and close follow up are required for patients with hypertensive crisis with anaemia.
EVIDENCE FOR A NUCLEAR RADIO JET AND ITS STRUCTURE DOWN TO ≲100 SCHWARZSCHILD RADII IN THE CENTER OF THE SOMBRERO GALAXY (M 104, NGC 4594)

The Sombrero galaxy (M 104, NGC 4594) is associated with one of the nearest low-luminosity active galactic nuclei (AGNs). We investigated the detailed radio structure of the Sombrero nucleus using high-resolution, quasi-simultaneous, multi-frequency, phase-referencing Very Long Baseline Array observations. We obtained high-quality images of this nucleus at seven frequencies, where those at 15, 24, and 43 GHz are the first clear very long baseline interferometry detections. At 43 GHz, the nuclear structure was imaged on a linear scale under 0.01 pc or 100 Schwarzschild radii, revealing a compact, high-brightness-temperature (≳ 3 × 109 K) radio core. We discovered the presence of the extended structure emanating from the core on two sides in the northwest and southeast directions. The nuclear radio spectra show a clear spatial gradient, which is similar to that seen in more luminous AGNs with powerful relativistic jets. Moreover, the size and position of the core tend to be frequency dependent. These findings provide evidence that the central engine of the Sombrero is powering radio jets and the jets are overwhelming the emission from the underlying radiatively inefficient accretion flow over the observed frequencies. Based on these radio characteristics, we constrained the following physical parameters for the M 104 jets: (1) the northern side is approaching, whereas the southern one is receding; (2) the jet viewing angle is relatively close to our line-of-sight (≲ 25°); and (3) the intrinsic jet velocity is highly sub-relativistic (≲ 0.2c). The derived pole-on nature of the M 104 jets is consistent with the previous argument that this nucleus contains a true type II AGN, i.e., the broad line region is actually absent or intrinsically weak if the plane of the circumnuclear torus is perpendicular to the jet axis.
Evidence for Magnetar Formation in Broad-lined Type Ic Supernovae1998bw and 2002ap

Broad-lined type Ic supernovae (SNe Ic-BL) are peculiar stellar explosions that are distinct from ordinary SNe. Some SNe Ic-BL are associated with long-duration ( ) gamma-ray bursts (GRBs). Black holes and magnetars are two types of compact objects that are hypothesized to be central engines of GRBs. In spite of decades of investigations, no direct evidence for the formation of black holes or magnetars has yet been found for GRBs. Here we report the finding that the early peak ( ) and late-time ( ) slow decay displayed in the light curves of SNe 1998bw (associated with GRB 980425) and 2002ap (not GRB-associated) can be attributed to magnetar spin-down with an initial rotation period , while the intermediate-time ( ) exponential decline is caused by the radioactive decay of 56Ni. The connection between the early peak and late-time slow decline in the light curves is unexpected in alternative models. We thus suggest that GRB 980425 and SN 2002ap were powered by magnetars.
Evolving Hybrid Partial Genetic Algorithm Classification Model for Cost-effective Frailty Screening: Investigative Study

Background A commonly used method for measuring frailty is the accumulation of deficits expressed as a frailty index (FI). FIs can be readily adapted to many databases, as the parameters to use are not prescribed but rather reflect a subset of extracted features (variables). Unfortunately, the structure of many databases does not permit the direct extraction of a suitable subset, requiring additional effort to determine and verify the value of features for each record and thus significantly increasing cost. Objective Our objective is to describe how an artificial intelligence (AI) optimization technique called partial genetic algorithms can be used to refine the subset of features used to calculate an FI and favor features that have the least cost of acquisition. Methods This is a secondary analysis of a residential care database compiled from 10 facilities in Queensland, Australia. The database is comprised of routinely collected administrative data and unstructured patient notes for 592 residents aged 75 years and over. The primary study derived an electronic frailty index (eFI) calculated from 36 suitable features. We then structurally modified a genetic algorithm to find an optimal predictor of the calculated eFI (0.21 threshold) from 2 sets of features. Partial genetic algorithms were used to optimize 4 underlying classification models: logistic regression, decision trees, random forest, and support vector machines. Results Among the underlying models, logistic regression was found to produce the best models in almost all scenarios and feature set sizes. The best models were built using all the low-cost features and as few as 10 high-cost features, and they performed well enough (sensitivity 89%, specificity 87%) to be considered candidates for a low-cost frailty screening test. Conclusions In this study, a systematic approach for selecting an optimal set of features with a low cost of acquisition and performance comparable to the eFI for detecting frailty was demonstrated on an aged care database. Partial genetic algorithms have proven useful in offering a trade-off between cost and accuracy to systematically identify frailty.
Global diffusion of cosmic rays in random magnetic fields

The propagation of charged particles, including cosmic rays, in a partially ordered magnetic field is characterized by a diffusion tensor whose componentsdepend on the particle’s Larmor radius RL and the degree of order in the magnetic field. Most studies of the particle diffusion presuppose a scale separation between the mean and random magnetic fields (e.g., there being a pronounced minimum in the magnetic power spectrum at intermediate scales). Scale separation is often a good approximation in laboratory plasmas, but not in most astrophysical environments such as the interstellar medium (ISM). Modern simulations of the ISM have numerical resolution of order 1pc, so the Larmor radius of the cosmic rays that dominate in energy density is at least 10 6 times smaller than the resolved scales. Large-scale simulations of cosmic ray propagationin the ISM thus rely on oversimplifiedformsof the diffusiontensor. We take the first steps towards a more realistic description of cosmic ray diffusion for such simulations, obtaining direct estimates of the diffusion tensor from test particle simulations in random magnetic fields (with the Larmor radius scale being fully resolved), for a range of particle energies corresponding to 10 2 . RL/lc . 10 3 , where lc is the magnetic correlation length. We obtain explicit expressions for the cosmic ray diffusion tensor for RL/lc ≪ 1, that might be used in a sub-grid model of cosmic ray diffusion. The diffusion coefficients obtained are closely connected with existing transport theories that include the random walk of magnetic lines.
Evaluation of Early Cognitive Functions in Patients With COVID-19 Infection

Abstract In December 2019, some pneumonia cases emerged in Wuhan, China. It was named as Coronavirus 2019 (COVID-19) by the World Health Organization. Patients developed anxiety and sleep problems after treatment. Patients with confirmed COVID-19 (n = 57) admitted to our study and whose treatment was completed 3 months ago were included in the study. This is a case-control study, and 22 patients included the control group. We found statistical significance between the average score of Beck anxiety and Pittsburgh Sleep Quality Index (p = 0.03, p = 0.01). In our study, we investigated the psychological conditions that may occur in the postacute COVID-19 period. We recommend that patients should be directed to appropriate clinics for rehabilitation. Clinicians must be aware that prompt and correct diagnosis with careful management is essential for recovery.
COMPACT REMNANT MASS FUNCTION: DEPENDENCE ON THE EXPLOSION MECHANISM AND METALLICITY

The mass distribution of neutron stars and stellar-mass black holes provides vital clues into the nature of stellar core collapse and the physical engine responsible for supernova explosions. A number of supernova engines have been proposed: neutrino- or oscillation-driven explosions enhanced by early (developing in 10–50 ms) and late-time (developing in 200 ms) convection as well as magnetic field engines (in black hole accretion disks or neutron stars). Using our current understanding of supernova engines, we derive mass distributions of stellar compact remnants. We provide analytic prescriptions for both single-star models (as a function of initial star mass) and for binary-star models—prescriptions for compact object masses for major population synthesis codes. These prescriptions have implications for a range of observations: X-ray binary populations, supernova explosion energies, and gravitational wave sources. We show that advanced gravitational radiation detectors (like LIGO/VIRGO or the Einstein Telescope) will be able to further test the supernova explosion engine models once double black hole inspirals are detected.
Importance of Delayed Reperfusions in Patients With Incomplete Thrombectomy

Background: There is paucity of data regarding the effects of delayed reperfusion (DR) on clinical outcomes in patients with incomplete reperfusion following mechanical thrombectomy. We hypothesized that DR has a strong association with clinical outcome in patients with incomplete reperfusion after mechanical thrombectomy (expanded Thrombolysis in Cerebral Infarction, 2a–2c). Methods: Single-institution’s stroke registry retrospective analysis of patients admitted from February 2015 to December 2020. DR was defined as the absence of any perfusion delay on ≈24-hour contrast-enhanced follow-up perfusion imaging, whereas persistent perfusion deficit denotes a perfusion delay corresponding to the catheter angiographic deficit directly after the intervention. The association of perfusion outcome (DR versus persistent perfusion deficit) with the occurrence of new infarcts and 90-day functional independence (modified Rankin Scale score 0–2) was evaluated using logistic regression analyses. Comparison of predictive accuracy was evaluated by calculating area under the curve for models with and without perfusion outcome. Results: In 566 patients (mean age 74, 49.6% female), new infarcts in the incomplete reperfusion areas were less common in DR versus persistent perfusion deficit patients (small punctiform: 17.1% versus 25%, large confluent: 7.9% versus 63.2%; P=0.001). After adjustment for confounders, DR was a strong predictor of functional independence (adjusted odds ratio, 2.37 [95% CI 1.34–4.23]). There was a significant improvement in predictive accuracy of functional independence when perfusion outcome was added to expanded Thrombolysis in Cerebral Infarction alone (area under the curve 0.57 versus 0.62, P=0.01). Conclusions: Occurrence of DR is closely associated with tissue outcome and functional independence. DR may be an independent prognostic parameter, suggesting it as a potential outcome surrogate for medical rescue therapies.
An Adaptation of the COPE Intervention for Adolescent Bullying Victimization Improved Mental and Physical Health Symptoms

Objective: One in five children report experiencing bullying. Bullying in childhood affects the physical and emotional health and functioning of youth with immediate consequences, including depression, anxiety, somatic complaints, and suicidal ideation. Schools overwhelmingly are tasked with addressing bullying; however, school-based programs are often focused on preventing bullying from occurring. There is a paucity of evidence-based interventions for adolescents who have directly experienced bullying and suffer from adverse health outcomes, especially when they present to the mental health setting. Methods: This pre-experimental study examined the feasibility, acceptability, and preliminary effects of the MINDSTRONG to Combat Bullying Program for adolescents who have experienced bullying with concurrent mental health symptoms. Results: Twenty adolescents and their parent dyads enrolled in the MINDSTRONG to Combat Bullying program. Significant reductions were found over time in adolescent self-reported depressive, anxiety and somatic symptoms as well as bullying victimization frequency, with large positive effect sizes for the intervention. Significant increases in adolescent personal beliefs also were found. Conclusions: Although several of the intervention sessions needed to be rescheduled and many of the adolescents did not complete their weekly skills building homework, MINDSTRONG to Combat Bullying was found to be a highly acceptable intervention for adolescents that was effective in reducing physical and mental health symptoms as well as perceptions of bullying victimization.
Early Impacts of College, Interrupted: Considering First-Year Students’ Narratives About COVID and Reports of Adjustment During College Shutdowns

The COVID-19 pandemic has threatened lives and livelihoods, imperiled families and communities, and disrupted developmental milestones globally. Among the critical developmental disruptions experienced is the transition to college, which is common and foundational for personal and social exploration. During college shutdowns (spring 2020), we recruited 633 first-year U.S. students (mean age = 18.83 years, 71.3% cisgender women) to provide narratives about the impacts of the pandemic. We tested the ways narrative features were associated with concurrent and longitudinal COVID stressors, psychosocial adjustment, and identity development. Narrative growth expressed in spring 2020 was positively associated with psychosocial adjustment and global identity development and was negatively associated with mental health concerns. Associations were supported concurrently and at 1-year follow-up. Growth partly explained associations between COVID stressors and students’ adjustment. Our findings reinforce the importance of growth for resilience and underscore the importance of connective reasoning as people navigate a chronic stress.
Early Universe cosmology with mirror dark matter

Mirror matter is a stable self‐collisional dark matter candidate. If exact mirror parity is a conserved symmetry of nature, there could exist a parallel hidden (mirror) sector of the Universe which has the same kind of particles and the same physical laws of our (visible) sector. The two sectors interact each other predominantly via gravity, therefore mirror matter is naturally “dark”. Here I briefly review the cosmological signatures of mirror dark matter, as Big Bang nucleosynthesis, primordial structure formation and evolution, cosmic microwave background and large scale structure power spectra, together with its compatibility with the interpretation of the DAMA annual modulation signal in terms of photon‐mirror‐photon kinetic mixing. Summarizing the present status of research and comparing theoretical results with observations/experiments, it emerges that mirror matter is not just a viable, but a promising dark matter candidate.
A weakly random Universe

Cosmic microwave background (CMB) radiation is characterized by well-established scales, the 2.7 K temperature of the Planckian spectrum and the 10 −5 amplitude of the temperature anisotropy. These features were instrumental in indicating the hot and equilibrium phases of the early history of the Universe and its large-scale isotropy, respectively. We now reveal one more intrinsic scale in CMB properties. We introduce a method developed originally by Kolmogorov, which quantifies a degree of randomness (chaos) in a set of numbers, such as measurements of the CMB temperature in a given region. Considering CMB as a composition of random and regular signals, we solve the inverse problem of recovering of their mutual fractions from the temperature sky maps. Deriving the empirical Kolmogorov’s function in the Wilkinson Microwave Anisotropy Probe’s maps, we obtain the fraction of the random signal to be about 20 per cent; i.e., the cosmological sky is a weakly random one. The paper is dedicated to the memory of Vladimir Arnold (1937–2010).
MAJOR GALAXY MERGERS ONLY TRIGGER THE MOST LUMINOUS ACTIVE GALACTIC NUCLEI

Using multiwavelength surveys of active galactic nuclei (AGNs) across a wide range of bolometric luminosities (1043 < Lbol (erg s−1) <5 × 1046) and redshifts (0 < z < 3), we find a strong, redshift-independent correlation between the AGN luminosity and the fraction of host galaxies undergoing a major merger. That is, only the most luminous AGN phases are connected to major mergers, while less luminous AGNs appear to be driven by secular processes. Combining this trend with AGN luminosity functions to assess the overall cosmic growth of black holes, we find that ∼50% by mass is associated with major mergers, while only 10% of AGNs by number, the most luminous, are connected to these violent events. Our results suggest that to reach the highest AGN luminosities—where the most massive black holes accreted the bulk of their mass—a major merger appears to be required. The luminosity dependence of the fraction of AGNs triggered by major mergers can successfully explain why the observed scatter in the M–σ relation for elliptical galaxies is significantly lower than in spirals. The lack of a significant redshift dependence of the Lbol–fmerger relation suggests that downsizing, i.e., the general decline in AGN and star formation activity with decreasing redshift, is driven by a decline in the frequency of major mergers combined with a decrease in the availability of gas at lower redshifts.
Trimodality Therapy vs Definitive Chemoradiation in Older Adults With Locally Advanced Esophageal Cancer

Abstract Background The comparative effectiveness of trimodality therapy vs definitive chemoradiation for treating locally advanced esophageal cancer in older adults is uncertain. Existing trials lack generalizability to older adults, a population with heightened frailty. We sought to emulate a hypothetical trial comparing these treatments using real-world data. Methods A cohort of adults aged 66-79 years diagnosed with locally advanced esophageal cancer between 2004 and 2017 was identified in the Surveillance Epidemiology and End Results–Medicare database. The clone-censor-weight method was leveraged to eliminate time-related biases when comparing outcomes between treatments. Outcomes included overall mortality, esophageal cancer–specific mortality, functional adverse events, and healthy days at home. Results A total of 1240 individuals with adenocarcinomas and 661 with squamous cell carcinomas were identified. For adenocarcinomas, the standardized 5-year risk of mortality was 73.4% for trimodality therapy and 83.8% for definitive chemoradiation (relative risk [RR] = 0.88, 95% confidence interval [CI] = 0.82 to 0.95). Trimodality therapy was associated with mortality risk reduction for squamous cell carcinomas (RR = 0.87, 95% CI = 0.70 to 1.01). The 1-year incidence of functional adverse events was higher in the trimodality group (adenocarcinomas RR = 1.40, 95% CI = 1.22 to 1.65; squamous cell carcinomas RR = 1.21, 95% CI = 1.00 to 1.49). Over 5 years, trimodality therapy was associated with 160 (95% CI = 67 to 229) and 177 (95% CI = 51 to 313) additional home days in individuals with adenocarcinomas and squamous cell carcinomas, respectively. Conclusions Compared with definitive chemoradiation, trimodality therapy was associated with reduced mortality but increased risk of function-related adverse events. Discussing these tradeoffs may help optimize care plans.