Miracle-dz/UniFAR-FTUs huggingface dataset:
Unexplained mechanism of subdural hematoma with convulsion suggests nonaccidental head trauma: A multicenter, retrospective study by the Japanese Head injury of Infants and Toddlers study (J-HITs) group

Objective The medical history of injury given by parents of infants and toddlers with head trauma may not be accurate or completely true. The purpose of this study was to examine the relationship between subdural hematoma (SDH) due to nonaccidental injury and mechanisms of injury provided by caregivers. Methods Our multicenter study group retrospectively reviewed the clinical records of children younger than 4 years with head trauma who have been diagnosed with any finding on head computed tomography (CT) and/or magnetic resonance imaging (MRI). A total of 84 cases of subdural hematomas with retinal findings, including cases reported to the child guidance center and traffic and birth injuries, were included in the study. They were classified by the mechanism of injury provided by the caregivers. Clinical findings were reviewed and classified into nonaccidental and accidental groups. The mechanisms of the injuries were examined by multivariable analysis to identify which ones were statistically associated with nonaccidental injuries. Results Of the 84 patients with SDHs, 51 were classified into the nonaccidental group, and 33 children were classified into the accidental group. In 19 patients with a chief complaint of convulsion who had SDH but no episode of trauma, 18 were classified into the nonaccidental group. On multivariable analysis, unexplained convulsions (odds ratio: 12.04, 95% confidence interval: 1.44–100.49) were significantly associated with increased odds of nonaccidental injury. Conclusions In the present study, there was a relationship between nonaccidental injury and unexplained SDH with a chief complaint of convulsion.
Daemons, the "Troitsk anomaly" in tritium beta spectrum, and the KATRIN experiment

The "Troitsk anomaly" is a strange bump at the end of the tritium beta spectrum observed in electron antineutrino mass measurements. It reveals a half-year variation. The nature of the anomaly can be accounted for by interaction of negative DArk Electric Matter Objects - daemons detected by us with the Nb-containing superconducting coils of the gaseous tritium source of the setup. In crossing the system, the daemons, whose flux varies with a half-year period, drag away Nb-containing clusters and excite their nuclei and electronic shells to produce emission of five Auger electron lines within E = 18566-18572 eV. This yields an estimate for the daemon flux ~10-7-10-6 cm-2s-1. It is shown that in the KATRIN system (KArlsruhe TRItium Neutrino experiment) presently under construction the ratio of the daemon-stimulated Auger bump signal to the useful beta-signal should be larger than that in the Troitsk experiment. The potential of using slightly modified systems at Troitsk and Karlsruhe to study the daemons is pointed out.
The Transform-and-Perform Framework: Explainable Deep Learning Beyond Classification

In recent years, visual analytics (VA) has shown promise in alleviating the challenges of interpreting black-box deep learning (DL) models. While the focus of VA for explainable DL has been mainly on classification problems, DL is gaining popularity in high-dimensional-to-high-dimensional (H-H) problems such as image-to-image translation. In contrast to classification, H-H problems have no explicit instance groups or classes to study. Each output is continuous, high-dimensional, and changes in an unknown non-linear manner with changes in the input. These unknown relations between the input, model and output necessitate the user to analyze them in conjunction, leveraging symmetries between them. Since classification tasks do not exhibit some of these challenges, most existing VA systems and frameworks allow limited control of the components required to analyze models beyond classification. Hence, we identify the need for and present a unified conceptual framework, the Transform-and-Perform framework (T&P), to facilitate the design of VA systems for DL model analysis focusing on H-H problems. T&P provides a checklist to structure and identify workflows and analysis strategies to design new VA systems, and understand existing ones to uncover potential gaps for improvements. The goal is to aid the creation of effective VA systems that support the structuring of model understanding and identifying actionable insights for model improvements. We highlight the growing need for new frameworks like T&P with a real-world image-to-image translation application. We illustrate how T&P effectively supports the understanding and identification of potential gaps in existing VA systems.
Bohmian Non-commutative Dynamics: History and New Developments

The reality of Bohm's intellectual journey is very different from what is often claimed by the proponents of "Bohmian Mechanics" and others as we will explain in this paper. He did not believe a mechanical explanation of quantum phenomena was possible. Central to his thinking, and incidentally to Bohr's also, was the notion of 'unbroken wholeness', a notion that is crucial for understanding quantum properties like quantum nonlocality. His proposals were based on a primitive notion of `process' or `activity', producing a more 'organic' approach to quantum phenomena. He published many papers outlining these new ideas, some plausible, some less so, but was not able to develop a coherent mathematical structure to support the work. Over the last ten years much of that missing mathematics has been put in place. This paper will report this new work, concentrating on providing a coherent overview of the whole programme.
Muscarinic receptors in the rat ovary are involved in follicular development but not in steroid secretion

Acetylcholine (ACh) may be involved in the regulation of ovarian functions. A previous systemic study in rats showed that a 4‐week, intrabursal local delivery of the ACh‐esterase blocker Huperzine‐A increased intraovarian ACh levels and changed ovarian follicular development, as evidenced by increased healthy antral follicle numbers and corpora lutea, as well as enhanced fertility. To further characterize the ovarian cholinergic system in the rat, we studied whether innervation may contribute to intraovarian ACh. We explored the cellular distribution of three muscarinic receptors (MRs; M1, M3, and M5), analyzed the involvement of MRs in ovarian steroidogenesis, and examined their roles in ovarian follicular development in normal conditions and in animals exposed to stressful conditions by employing the muscarinic antagonist, atropine. Denervation studies decreased ovarian norepinephrine, but ovarian ACh was not affected, evidencing a local, nonneuronal source of ACh. M1 was located on granulosa cells (GCs), especially in large antral follicles. M5 was associated with the ovarian vascular system and only traces of M3 were found. Ex vivo ovary organo‐typic incubations showed that the MR agonist Carbachol did not modify steroid production or expression of steroid biosynthetic enzymes. Intrabursal, in vivo application of atropine (an MR antagonist) for 4 weeks, however, increased atresia of the secondary follicles. The results support the existence of an intraovarian cholinergic system in the rat ovary, located mainly in follicular GCs, which is not involved in steroid production but rather via MRs exerts trophic functions and regulates follicular atresia.
Renin-Angiotensin System Inhibition in Advanced Chronic Kidney Disease.

BACKGROUND Renin-angiotensin system (RAS) inhibitors - including angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) - slow the progression of mild or moderate chronic kidney disease. However, the results of some studies have suggested that the discontinuation of RAS inhibitors in patients with advanced chronic kidney disease may increase the estimated glomerular filtration rate (eGFR) or slow its decline. METHODS In this multicenter, open-label trial, we randomly assigned patients with advanced and progressive chronic kidney disease (eGFR, <30 ml per minute per 1.73 m2 of body-surface area) either to discontinue or to continue therapy with RAS inhibitors. The primary outcome was the eGFR at 3 years; eGFR values that were obtained after the initiation of renal-replacement therapy were excluded. Secondary outcomes included the development of end-stage kidney disease (ESKD); a composite of a decrease of more than 50% in the eGFR or the initiation of renal-replacement therapy, including ESKD; hospitalization; blood pressure; exercise capacity; and quality of life. Prespecified subgroups were defined according to age, eGFR, type of diabetes, mean arterial pressure, and proteinuria. RESULTS At 3 years, among the 411 patients who were enrolled, the least-squares mean (±SE) eGFR was 12.6±0.7 ml per minute per 1.73 m2 in the discontinuation group and 13.3±0.6 ml per minute per 1.73 m2 in the continuation group (difference, -0.7; 95% confidence interval [CI], -2.5 to 1.0; P = 0.42), with a negative value favoring the outcome in the continuation group. No heterogeneity in outcome according to the prespecified subgroups was observed. ESKD or the initiation of renal-replacement therapy occurred in 128 patients (62%) in the discontinuation group and in 115 patients (56%) in the continuation group (hazard ratio, 1.28; 95% CI, 0.99 to 1.65). Adverse events were similar in the discontinuation group and continuation group with respect to cardiovascular events (108 vs. 88) and deaths (20 vs. 22). CONCLUSIONS Among patients with advanced and progressive chronic kidney disease, the discontinuation of RAS inhibitors was not associated with a significant between-group difference in the long-term rate of decrease in the eGFR. (Funded by the National Institute for Health Research and the Medical Research Council; STOP ACEi EudraCT number, 2013-003798-82; ISTRCTN number, 62869767.).
Complementary system vs conventional trifocal intraocular lens: comparison of optical quality metrics and unwanted light distribution

The complementary IOL system may yield better monocular intermediate VA compared with the conventional trifocal IOL. However, the effect of binocular summation still needs to be investigated. Purpose: To evaluate the ARTIS Symbiose complementary intraocular lens (IOL) system, consisting of the MID and PLUS models, in comparison with a conventional trifocal IOL (AcrySof IQ PanOptix). Setting: The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. Design: Laboratory investigation. Methods: Modulation and phase transfer functions were obtained in polychromatic light using an optical bench setup. Simulated visual acuity (VA) values were derived from optical quality metrics weighted by neural contrast sensitivity. United States Air Force (USAF) chart images were acquired and processed. Furthermore, the light distribution beyond the center of a polychromatic point spread function was assessed. Results: The peak simulated VA values of ARTIS Symbiose MID were at 0 diopters (D) of defocus (−0.02 logMAR) and at −1.5 D (0.00 logMAR); of ARTIS Symbiose PLUS, they were at 0 D of defocus (−0.01 logMAR) and at −2.5 D (0.01 logMAR). AcrySof IQ PanOptix demonstrated 3 peaks: at 0 D of defocus (−0.02 logMAR), at −1.75 D (0.03 logMAR), and at −2.5 D (0.02 logMAR). The summation of USAF chart images in the simulated binocular IOL system produced a slightly better image quality at −1.0 D and −1.5 D than AcrySof IQ PanOptix. The IOLs yielded comparable light spread across the studied range except for a localized intensity spike of the ARTIS Symbiose IOLs. Conclusions: The complementary IOL system may yield better monocular intermediate VA compared with the conventional trifocal IOL. However, the effect of binocular summation in terms of VA and the perception of photic phenomena still needs to be investigated.
Retinal layer segmentation in a cohort of healthy children via optical coherence tomography

Background High-resolution optical coherence tomography (OCT) allows the detection of macular pathology and involvement of the optic nerve in a wide spectrum of diseases. For the differentiation of diseased and healthy status, normal values of retinal layer segmentation are critical. Yet, normative values mostly cover adult populations with only sparse data for paediatric cohorts. We present data of retinal layer characteristics via OCT in a healthy paediatric cohort. Methods This prospective cross-sectional study screened 75 healthy children (male = 42, female = 33, range 4–17 years) without visual problems. OCT was performed with a peripapillary ring and macula scan protocol to determine paediatric normative values for routine parameters (peripapillary retinal nerve fibre layer thickness (pRNFL), total macular volume (TMV), macular retinal thickness (RT)). The macula scan (6mm grid) was segmented using the device-inherent automated segmentation software (Heidelberg Eye Explorer) for retinal layers: RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) in 9 segments each and mean of the 9 segments. Results We obtained OCT data of 72 children with mean age 12.49 years (standard deviation, SD, 2.18; minimum 3.93). Mean global pRNFL was 102.20 μm (SD 8.24), mean TMV 8.81 mm3 (0.30) and mean RT (all segments) 318.22 μm (10.19). Segmented macular retinal layer thicknesses (mean of all segments) were: RNFL 27.67 μm (2.14), GCL 41.94 μm (2.50), IPL 34.97 μm (2.10), INL 35.18 μm (2.15), OPL 29.06 μm (2.24), ONL 68.35 μm (6.20). Conclusion The OCT is a useful non-invasive imaging technique for the examination of the retina in children with short duration, high imaging resolution and no known adverse effects. Normative values may serve as a comparator for different neuropaediatric disorders and are first presented with this study using an up-to-date and standardized OCT imaging technique.
Organizational influences on the use of low-value care in primary health care – a qualitative interview study with physicians in Sweden

Abstract Aim The aim was (1) to explore organizational factors influencing the use of low-value care (LVC) as perceived by primary care physicians and (2) to explore which organizational strategies they believe are useful for reducing the use of LVC. Design Qualitative study with semi-structured focus group discussions (FGDs) analyzed using qualitative content analysis. Setting Six publicly owned primary health care centers in Stockholm. Subjects The participants were 31 primary care physicians. The number of participants in each FGD varied between 3 and 7. Main outcome measures Categories and subcategories reporting organizational factors perceived to influence the use of LVC and organizational strategies considered useful for reducing the use of LVC. Results Four types of organizational factors (resources, care processes, improvement activities, and governance) influenced the use of LVC. Resources involved time to care for patients, staff knowledge, and working tools. Care processes included work routines and the ways activities and resources were prioritized in the organization. Improvement activities involved performance measurement and improvement work to reduce LVC. Governance concerned organizational goals, higher-level decision making, and policies. Physicians suggested multiple strategies targeting these factors to reduce LVC, including increased patient–physician continuity, adjusted economic incentives, continuous professional development for physicians, and gatekeeping functions which prevent unnecessary appointments and guide patients to the appropriate point of care. Conclusion The influence of multiple organizational factors throughout the health-care system indicates that a whole-system approach might be useful in reducing LVC. KEY POINTS We know little about how organizational factors influence the use of low-value care (LVC) in primary health care. Physicians perceive organizational resources, care processes, improvement activities, and governance as influences on the use of LVC and LVC-reducing strategies. This study provides insights about how these factors influence LVC use. Strategies at multiple levels of the health-care system may be warranted to reduce LVC.
The impact of mild cognitive impairment on decision-making under explicit risk conditions: Evidence from the Personality and Total Health (PATH) Through Life longitudinal study

Abstract Objective: Previous research has indicated that cognition and executive function are associated with decision-making, however the impact of mild cognitive impairment (MCI) on decision-making under explicit risk conditions is unclear. This cross-sectional study examined the impact of MCI, and MCI subtypes, on decision-making on the Game of Dice Task (GDT), among a cohort of older adults. Method: Data from 245 older adult participants (aged 72–78 years) from the fourth assessment of the Personality and Total Health Through Life study were analyzed. A diagnostic algorithm identified 103 participants with MCI, with subtypes of single-domain amnestic MCI (aMCI-single; n = 38), multi-domain amnestic MCI (aMCI-multi; n = 31), and non-amnestic MCI (n = 33), who were compared with an age-, sex-, education-, and income-matched sample of 142 cognitively unimpaired older adults. Decision-making scores on the GDT (net score, single number choices, and strategy changes) were compared between groups using nonparametric tests. Results: Participants with MCI showed impaired performance on the GDT, with higher frequencies of single number choices and strategy changes. Analyses comparing MCI subtypes indicated that the aMCI-multi subtype showed increased frequency of single number choices compared to cognitively unimpaired participants. Across the sample of participants, decision-making scores were associated with measures of executive function (cognitive flexibility and set shifting). Conclusion: MCI is associated with impaired decision-making performance under explicit risk conditions. Participants with impairments in multiple domains of cognition showed the clearest impairments. The GDT may have utility in discriminating between MCI subtypes.
Optimization of high-temperature superconducting bilayer structures using a vortex dynamics simulation

We argue that the current carrying properties of high-temperature superconducting thin films can be further improved, in particular under the mid-field range (B ≈ 0.1–2 T), via introduction of multilayer structures that compromise between good zero field critical current and vortex pinning performance. In this work we focus on a simple bilayer structure consisting of two adjacent layers of pure YBa2Cu3O 6+x (YBCO) and BaZrO3 (BZO) doped YBCO under magnetic field within the mid-field range oriented parallel to the c-axis of the YBCO unit cell. We have utilized a computational model to simulate the vortex dynamics limited critical current separately from the associated zero field current, which is addressed analytically. The obtained results have allowed us to estimate the optimal layer thicknesses as a function of magnetic field. Our idealized model suggests that the thickness of the doped layer should be substantially smaller than the undoped one, that is around 30% of the total thickness of the film. We have estimated that the current carrying capability of the optimized bilayer structure can be up to 50% higher when compared with corresponding single layer films. Possible deviations from the obtained results associated with the idealized model, most prominently the effect of natural defects, are comprehensively discussed. Our results provide the foundation for the future experimental realization of the proposed bilayer structures. The comparison between the presented results and experimental realization would enable further study of the underlying primitive vortex interactions.
Behaviour‐based pain scales: Validity and interrater reliability of BPS‐NI and PAINAD‐G on general wards

Measuring pain intensity in patients unable to communicate is a challenge on general wards. Observation‐based pain scoring tools have been used for patients with dementia or in critically ill intensive care unit (ICU) patients. However, there is no established or validated assessment tool for non‐ICU patients without dementia related cognitive deficiencies who cannot communicate. The “Behavioural Pain Scale Non‐Intubated” (BPS‐NI) and the “Pain Assessment In Advanced Dementia‐German” (PAINAD‐G) are potential tools to fill this gap.
Intracranial human recordings reveal association between neural activity and perceived intensity for the pain of others in the insula

Based on neuroimaging data, the insula is considered important for people to empathize with the pain of others. Here, we present intracranial electroencephalographic (iEEG) recordings and single-cell recordings from the human insula while seven epilepsy patients rated the intensity of a woman’s painful experiences seen in short movie clips. Pain had to be deduced from seeing facial expressions or a hand being slapped by a belt. We found activity in the broadband 20–190 Hz range correlated with the trial-by-trial perceived intensity in the insula for both types of stimuli. Within the insula, some locations had activity correlating with perceived intensity for our facial expressions but not for our hand stimuli, others only for our hand but not our face stimuli, and others for both. The timing of responses to the sight of the hand being hit is best explained by kinematic information; that for our facial expressions, by shape information. Comparing the broadband activity in the iEEG signal with spiking activity from a small number of neurons and an fMRI experiment with similar stimuli revealed a consistent spatial organization, with stronger associations with intensity more anteriorly, while viewing the hand being slapped.
Decoding of Multiple Wrist and Hand Movements Using a Transient EMG Classifier

The design of prosthetic controllers by means of neurophysiological signals still poses a crucial challenge to bioengineers. State of the art of electromyographic (EMG) continuous pattern recognition controllers rely on the questionable assumption that repeated muscular contractions produce repeatable patterns of steady-state EMG signals. Conversely, we propose an algorithm that decodes wrist and hand movements by processing the signals that immediately follow the onset of contraction (i.e., the $\textit {transient}$ EMG). We collected EMG data from the forearms of 14 non-amputee and 5 transradial amputee participants while they performed wrist flexion/extension, pronation/supination, and four hand grasps (power, lateral, bi-digital, open). We firstly identified the combination of wrist and hand movements that yielded the best control performance for the same participant (intra-subject classification). Then, we assessed the ability of our algorithm to classify participant data that were not included in the training set (cross-subject classification). Our controller achieved a median accuracy of ~96% with non-amputees, while it achieved heterogeneous outcomes with amputees, with a median accuracy of ~89%. Importantly, for each amputee, it produced at least one $\textit {acceptable}$ combination of wrist-hand movements (i.e., with accuracy >85%). Regarding the cross-subject classifier, while our algorithm obtained promising results with non-amputees (accuracy up to ~80%), they were not as good with amputees (accuracy up to ~35%), possibly suggesting further assessments with domain-adaptation strategies. In general, our offline outcomes, together with a preliminary online assessment, support the hypothesis that the transient EMG decoding could represent a viable pattern recognition strategy, encouraging further online assessments.