Miracle-dz/UniFAR-FTUs huggingface dataset:
Are medical students in prehospital care at risk of moral injury?

Background The term ‘moral injury’ may be useful in conceptualising the negative psychological effects of delivering emergency and prehospital medicine as it provides a non-pathological framework for understanding these effects. This is in contrast to concepts such as burnout and post-traumatic stress disorder which suggest practitioners have reached a crisis point. We conducted an exploratory, pilot study to determine whether the concept of moral injury resonated with medical students working in emergency medicine and what might mitigate that injury for them. Methods Structured interviews and focus groups were carried out with medical students involved in the delivery of prehospital and emergency medicine. The study was carried out at Barts and the London School of Medicine and Dentistry in May and June 2017. The data were analysed using theoretically driven thematic analysis. Results Concepts of moral injury such as witnessing events which contravene one’s moral code, especially those involving children, or acts of violence, resonated with the experiences of medical students in this study. Participants stated that having more medical knowledge and a clear sense of a job to do on scene helped reduce their distress at the time. While social support was a protective factor, not all students found the process of debrief easy to access or undergo, those with more established relationships with colleagues fared better in this regard. Conclusions The term moral injury is useful in exploring the experience of medical students in emergency medicine. More effort should be made to ensure that students effectively access debrief and other support opportunities. It is hoped that future work will be undertaken with different professional groups and explore the potential psychological and neuropsychological impact of witnessing trauma.
Gratitude, resignation and the desire for dignity: lived experience of food charity recipients and their recommendations for improvement, Perth, Western Australia

Abstract Objective The present study explored recipients’ perceptions of food charity and their suggested improvements in inner-city Perth, Western Australia. Design In-depth interviews were conducted with charitable food service (CFS) recipients. Transcripts were thematically analysed using a phenomenological approach. Setting Interviews were conducted at two CFS in inner-city Perth. Subjects Fourteen adults. Results The recipients’ journeys to a reliance on CFS were varied and multifactorial, with poverty, medical issues and homelessness common. The length of time recipients had relied on food charity ranged from 8 months to over 40 years. Most were ‘grateful yet resigned’, appreciative of any food and resigned to the poor quality, monotony and their unmet individual preferences. They wanted healthier food, more variety and better quality. Accessing services was described as a ‘full-time job’ fraught with unreliable information and transport difficulties. They called for improved information and assistance with transport. ‘Eroded dignity’ resulted from being fed without any choice and queuing for food in public places, often in a volatile environment. ‘Food memories and inclusion’ reflected a desire for commensality. Recipients suggested services offer choice and promote independence, focusing on their needs both physical and social. Conclusions Although grateful, long-term CFS recipients described what constitutes a voluntary failure. Their service improvement recommendations can help meet their nutritional and social needs. A successful CFS provides a food service that prioritises nutritious, good-quality food and individual need, while promoting dignity and social inclusion, challenging in the current Australian context.
GLP-1 Analogue Liraglutide Enhances SP-A Expression in LPS-Induced Acute Lung Injury through the TTF-1 Signaling Pathway

The reduction of pulmonary surfactant (PS) is essential for decreased pulmonary compliance and edema in acute lung injury (ALI). Thyroid transcription factor-1 (TTF-1) plays a major role in the regulation of surfactant protein-A (SP-A), the most abundant protein component of PS. Simultaneously, the glucagon-like peptide-1 (GLP-1) analogue can enhance SP-A expression in the lung. However, the underlying mechanism is still unknown. The purpose of this study was to explore whether liraglutide, a GLP-1 analogue, upregulates SP-A expression through the TTF-1 signaling pathway in ALI. In vivo, a murine model of ALI was induced by lipopolysaccharide (LPS). Pulmonary inflammation, edema, insulin level, ultrastructural changes in type II alveolar epithelial (ATII) cells, and SP-A and TTF-1 expression were analyzed. In vitro, rat ATII cells were obtained. SP-A and TTF-1 expression in cells was measured. ShRNA-TTF-1 transfection was performed to knock down TTF-1 expression. Our data showed that LPS-induced lung injury and increase in insulin level, and LPS-induced reduction of SP-A and TTF-1 expression in both the lung and cells, were significantly compromised by liraglutide. Furthermore, we also found that these effects of liraglutide were markedly blunted by shRNA-TTF-1. Taken together, our findings suggest that liraglutide enhances SP-A expression in ATII cells and attenuates pulmonary inflammation in LPS-induced ALI, most likely through the TTF-1 signaling pathway.
Multigenerational and transgenerational effects of paternal exposure to drugs of abuse on behavioral and neural function

Addictions are highly heritable disorders, with heritability estimates ranging from 39% to 72%. Multiple studies suggest a link between paternal drug abuse and addiction in their children. However, patterns of inheritance cannot be explained purely by Mendelian genetic mechanisms. Exposure to drugs of abuse results in epigenetic changes that may be passed on through the germline. This mechanism of epigenetic transgenerational inheritance may provide a link between paternal drug exposure and addiction susceptibility in the offspring. Recent studies have begun to investigate the effect of paternal drug exposure on behavioral and neurobiological phenotypes in offspring of drug‐exposed fathers in rodent models. This review aims to discuss behavioral and neural effects of paternal exposure to alcohol, cocaine, opioids, and nicotine. Although a special focus will be on addiction‐relevant behaviors, additional behavioral effects including cognition, anxiety, and depressive‐like behaviors will be discussed.
On the Resilience of RTL NN Accelerators: Fault Characterization and Mitigation

Machine Learning (ML) is making a strong resurgence in tune with the massive generation of unstructured data which in turn requires massive computational resources. Due to the inherently compute and power-intensive structure of Neural Networks (NNs), hardware accelerators emerge as a promising solution. However, with technology node scaling below 10nm, hardware accelerators become more susceptible to faults, which in turn can impact the NN accuracy. In this paper, we study the resilience aspects of Register-Transfer Level (RTL) model of NN accelerators, in particular, fault characterization and mitigation. By following a High-Level Synthesis (HLS) approach, first, we characterize the vulnerability of various components of RTL NN. We observed that the severity of faults depends on both i) application-level specifications, i.e., NN data (inputs, weights, or intermediate) and NN layers and ii) architectural-level specifications, i.e., data representation model and the parallelism degree of the underlying accelerator. Second, motivated by characterization results, we present a low-overhead fault mitigation technique that can efficiently correct bit flips, by 47.3% better than state-of-the-art methods.
A Multi-Modal Chinese Poetry Generation Model

Recent studies in sequence-to-sequence learning demonstrate that RNN encoder-decoder structure can successfully generate Chinese poetry. However, existing methods can only generate poetry with a given first line or user’s intent theme. In this paper, we proposed a three-stage multi-modal Chinese poetry generation approach. Given a picture, the first line, the title and the other lines of the poem are successively generated in three stages. According to the characteristics of Chinese poems, we propose a hierarchy-attention seq2seq model which can effectively capture character, phrase, and sentence information between contexts and improve the symmetry delivered in poems. In addition, the Latent Dirichlet allocation (LDA) model is utilized for title generation and improve the relevance of the whole poem and the title. Compared with strong baseline, the experimental results demonstrate the effectiveness of our approach, using machine evaluations as well as human judgments.
The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia.

Purpose The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval. Method We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning. Results The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition. Conclusions The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic-lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical-phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.
Genome-Wide Association Studies of Autoimmune Thyroid Diseases, Thyroid Function, and Thyroid Cancer

Thyroid diseases, including autoimmune thyroid diseases and thyroid cancer, are known to have high heritability. Family and twin studies have indicated that genetics plays a major role in the development of thyroid diseases. Thyroid function, represented by thyroid stimulating hormone (TSH) and free thyroxine (T4), is also known to be partly genetically determined. Before the era of genome-wide association studies (GWAS), the ability to identify genes responsible for susceptibility to thyroid disease was limited. Over the past decade, GWAS have been used to identify genes involved in many complex diseases, including various phenotypes of the thyroid gland. In GWAS of autoimmune thyroid diseases, many susceptibility loci associated with autoimmunity (human leukocyte antigen [HLA], protein tyrosine phosphatase, non-receptor type 22 [PTPN22], cytotoxic T-lymphocyte associated protein 4 [CTLA4], and interleukin 2 receptor subunit alpha [IL2RA]) or thyroid-specific genes (thyroid stimulating hormone receptor [TSHR] and forkhead box E1 [FOXE1]) have been identified. Regarding thyroid function, many susceptibility loci for levels of TSH and free T4 have been identified through genome-wide analyses. In GWAS of differentiated thyroid cancer, associations at FOXE1, MAP3K12 binding inhibitory protein 1 (MBIP)-NK2 homeobox 1 (NKX2-1), disrupted in renal carcinoma 3 (DIRC3), neuregulin 1 (NRG1), and pecanex-like 2 (PCNXL2) have been commonly identified in people of European and Korean ancestry, and many other susceptibility loci have been found in specific populations. Through GWAS of various thyroid-related phenotypes, many susceptibility loci have been found, providing insights into the pathogenesis of thyroid diseases and disease co-clustering within families and individuals.
Drosophila model of myosin myopathy rescued by overexpression of a TRIM-protein family member

Significance The majority of mutations residing within the rod domain of myosin have been associated with skeletal myopathy with or without cardiomyopathy. However, the molecular mechanisms underlying the variation in clinical and pathological phenotypes of myopathies associated with the MYH7 mutation are still poorly understood. We used CRISPR/Cas9-mediated genome engineering to develop a fly model for Laing distal myopathy to investigate the pathological mechanisms of the recurrent L1729del MYH7 mutation. This study unveils structural and functional phenotypes associated with this mutation in skeletal and heart muscles, and identifies a mechanism that alleviates the pathological phenotype, suggesting that E3-ligase modifier gene activity may reduce or enhance the impact of this myosin mutation in patients. Myosin is a molecular motor indispensable for body movement and heart contractility. Apart from pure cardiomyopathy, mutations in MYH7 encoding slow/β-cardiac myosin heavy chain also cause skeletal muscle disease with or without cardiac involvement. Mutations within the α-helical rod domain of MYH7 are mainly associated with Laing distal myopathy. To investigate the mechanisms underlying the pathology of the recurrent causative MYH7 mutation (K1729del), we have developed a Drosophila melanogaster model of Laing distal myopathy by genomic engineering of the Drosophila Mhc locus. Homozygous MhcK1728del animals die during larval/pupal stages, and both homozygous and heterozygous larvae display reduced muscle function. Flies expressing only MhcK1728del in indirect flight and jump muscles, and heterozygous MhcK1728del animals, were flightless, with reduced movement and decreased lifespan. Sarcomeres of MhcK1728del mutant indirect flight muscles and larval body wall muscles were disrupted with clearly disorganized muscle filaments. Homozygous MhcK1728del larvae also demonstrated structural and functional impairments in heart muscle, which were not observed in heterozygous animals, indicating a dose-dependent effect of the mutated allele. The impaired jump and flight ability and the myopathy of indirect flight and leg muscles associated with MhcK1728del were fully suppressed by expression of Abba/Thin, an E3-ligase that is essential for maintaining sarcomere integrity. This model of Laing distal myopathy in Drosophila recapitulates certain morphological phenotypic features seen in Laing distal myopathy patients with the recurrent K1729del mutation. Our observations that Abba/Thin modulates these phenotypes suggest that manipulation of Abba/Thin activity levels may be beneficial in Laing distal myopathy.
Periostin and CA242 as potential diagnostic serum biomarkers complementing CA19.9 in detecting pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant tumor with few biomarkers to guide treatment options. Carbohydrate antigen 19.9 (CA19.9), the most frequently used biomarker for PDAC, is not sensitive and specific enough for the detection of the disease. This study aimed to evaluate serum periostin (POSTN) and CA242 as potential diagnostic biomarkers complementing CA19.9 in detecting pancreatic cancer. Blood samples were from 362 participants, including 213 patients with different stages of PDAC, 75 patients with benign pancreatic disease, and 74 healthy individuals. All samples were randomly divided into a training set and a validation set. Carbohydrate antigen 19.9, CA242, POSTN, as well as carcinoembryonic antigen, were measured by ELISA or automated immunoassay. The receiver operating characteristic curve analysis revealed that the performance of CA19.9 in the validation group were improved by the marker panel composed of CA19.9, POSTN, and CA242, to discriminate early stage PDAC not only from healthy controls (area under the curve [AUC]CA19.9 = 0.94 vs AUCCA19.9 + POSTN + CA242 = 0.98, P < .05) but also from benign conditions (AUCCA19.9 = 0.87 vs AUCCA19.9 + POSTN + CA242 = 0.90, P < .05). In addition, POSTN retained significant diagnostic capabilities to distinguish PDAC CA19.9‐negative from healthy controls (AUCPOSTN = 0.87) as well as from benign conditions (AUCPOSTN = 0.84) in the whole set. This study suggested that POSTN and CA242 are potential diagnostic serum biomarkers complementing CA19.9 in detecting early pancreatic cancer.
The Light Chain IgLV3-21 Defines a New Poor Prognostic Subgroup in Chronic Lymphocytic Leukemia: Results of a Multicenter Study

Purpose: Unmutated (UM) immunoglobulin heavy chain variable region (IgHV) status or IgHV3-21 gene usage is associated with poor prognosis in chronic lymphocytic leukemia (CLL) patients. Interestingly, IgHV3-21 is often co-expressed with light chain IgLV3-21, which is potentially able to trigger cell-autonomous BCR-mediated signaling. However, this light chain has never been characterized independently of the heavy chain IgHV3-21. Experimental Design: We performed total RNA sequencing in 32 patients and investigated IgLV3-21 prognostic impact in terms of treatment-free survival (TFS) and overall survival (OS) in 3 other independent cohorts for a total of 813 patients. IgLV3-21 presence was tested by real-time PCR and confirmed by Sanger sequencing. Results: Using total RNA sequencing to characterize 32 patients with high-risk CLL, we found a high frequency (28%) of IgLV3-21 rearrangements. Gene set enrichment analysis revealed that these patients express higher levels of genes responsible for ribosome biogenesis and translation initiation (P < 0.0001) as well as MYC target genes (P = 0.0003). Patients with IgLV3-21 rearrangements displayed a significantly shorter TFS and OS (P < 0.05), particularly those with IgHV mutation. In each of the three independent validation cohorts, we showed that IgLV3-21 rearrangements—similar to UM IgHV status—conferred poor prognosis compared with mutated IgHV (P < 0.0001). Importantly, we confirmed by multivariate analysis that this was independent of IgHV mutational status or subset #2 stereotyped receptor (P < 0.0001). Conclusions: We have demonstrated for the first time that a light chain can affect CLL prognosis and that IgLV3-21 light chain usage defines a new subgroup of CLL patients with poor prognosis. Clin Cancer Res; 24(20); 5048–57. ©2018 AACR.
TEMPORAL DYNAMICS OF EMOTION REGULATION STRATEGIES: AN ERP STUDY

Distraction and cognitive reappraisal are two widely used types of emotional regulation strategies that are thought to be reliable when down-regulating our emotions to negative or unpleasant stimuli. Gross‘s process model of emotion generation (Gross, 1998) holds that they differ in the time they intervene in the emotiongenerative process and also how they impact emotional responses when they are used to regulate negative emotions. Distraction which involves attentional deployment is expected to operate earlier than reappraisal that entails meaning evaluation and reevaluation. Cognitive reappraisal encompasses various strategies that are used to regulate our emotions through reinterpretation. Self-focused and situation-focused reappraisal are two of them. The former is considered more efficient and thus would lead to a greater attenuation of the LPP than the latter. To test this prediction, electrocortical responses to angry faces when using these strategies were measured using the late positive potential (LPP). Twenty four healthy participants were recruited for the study and were cued to down-regulate their emotions using these strategies while angry and neutral facial stimuli were seen on a computer screen. Contrary to prediction, distraction did not modulate the LPP earlier than reappraisal. However, supporting our hypothesis self-focused strategies largely modulated the LPP than situation-focused strategy. The pattern of result suggests that reappraisal might have an influence on the early neural processes of emotion generation and that the subcategories of cognitive reappraisal have a differential effect on emotional regulation.
Deictic Image Maps: An Abstraction For Learning Pose Invariant Manipulation Policies

In applications of deep reinforcement learning to robotics, it is often the case that we want to learn pose invariant policies: policies that are invariant to changes in the position and orientation of objects in the world. For example, consider a pegin-hole insertion task. If the agent learns to insert a peg into one hole, we would like that policy to generalize to holes presented in different poses. Unfortunately, this is a challenge using conventional methods. This paper proposes a novel state and action abstraction that is invariant to pose shifts called deictic image maps that can be used with deep reinforcement learning. We provide broad conditions under which optimal abstract policies are optimal for the underlying system. Finally, we show that the method can help solve challenging robotic manipulation problems.
Unsupervised Learning of Sensorimotor Affordances by Stochastic Future Prediction

Recently, much progress has been made building systems that can capture static image properties, but natural environments are intrinsically dynamic. For an intelligent agent, perception is responsible not only for capturing features of scene content, but also capturing its \textit{affordances}: how the state of things can change, especially as the result of the agent's actions. We propose an unsupervised method to learn representations of the sensorimotor affordances of an environment. We do so by learning an embedding for stochastic future prediction that is (i) sensitive to scene dynamics and minimally sensitive to static scene content and (ii) compositional in nature, capturing the fact that changes in the environment can be composed to produce a cumulative change. We show that these two properties are sufficient to induce representations that are reusable across visually distinct scenes that share degrees of freedom. We show the applicability of our method to synthetic settings and its potential for understanding more complex, realistic visual settings.