Miracle-dz/UniFAR-FTUs huggingface dataset:
The Etiology of Injuries in US Army Initial Entry Training.

BACKGROUND US Army initial entry training (IET) trainees engage in intense physical activities for 10 or more weeks prior to their assignment to operational units. Many trainees succumb to injury during IET. Injuries to the lower extremities and back have historically been the most common, and thus have been the focus of routine health surveillance. OBJECTIVES The primary goal of this analysis was to verify the training-related injuries of greatest concern and to update the clinical diagnostic codes (ICD-10-CM) used in surveillance. The investigation also aimed to develop a sense of the financial magnitude of these injuries. METHODS The distribution of all IET injuries was determined using a comprehensive injury taxonomy. Injuries were categorized based on causal energy source (mechanical, thermal, radiant, nuclear, chemical, or electrical). Mechanical energy transfers included acute trauma and cumulative microtrauma ("overuse"). Injury ICD-10-CM codes were identified in calendar year 2016 IET trainees' electronic healthcare records. Injury frequencies were reported for gender, body region, and injury type. Costs were calculated from medical encounters and estimated lost training time using the most frequently injured anatomical site as a baseline. RESULTS Among 106,367 trainees, 65,026 separate injuries were identified. Mechanical energy transfers to lower extremities caused 75% of all injuries; most (65%) were cumulative microtraumatic. The most frequently injured anatomical site (the knee, 20% of injuries), is estimated to have cost over $39 million. CONCLUSIONS Lower extremity injuries, followed by those of the low back continue to be leading "training-related injuries". This suggests the need to ensure distances and/or frequencies of weight-bearing activities (running, foot-marching) are not increased too rapidly or too excessively, and that trainees' fitness prior to IET is adequate. Medical costs and lost training time should be included in future monitoring.
Mitigating the Harmful Effect of Perceived Organizational Compliance on Trust in Top Management: Buffering Roles of Employees’ Personal Resources

Abstract This study considers how employees’ POC—defined as their beliefs that the organizational climate stifles change and values compliance with the status quo—reduce their trust in top management, as well as how this negative relationship might be buffered by access to two personal resources that support organizational change: openness to experience and affective commitment to change. Data from a sample of Pakistan-based organizations reveal that POC reduce trust in top management, but this effect is weaker at higher levels of openness to experience and affective commitment to change. These findings are significant in that they indicate that employees who operate in organizational climates marked by “yea-saying” can counter the difficulty of improving their job situation by drawing from adequate personal resources.
Vacuolar Sequestration of Azoles, a Novel Strategy of Azole Antifungal Resistance Conserved across Pathogenic and Nonpathogenic Yeast

Target alteration and overproduction and drug efflux through overexpression of multidrug transporters localized in the plasma membrane represent the conventional mechanisms of azole antifungal resistance. Here, we identify a novel conserved mechanism of azole resistance not only in the budding yeast Saccharomyces cerevisiae but also in the pathogenic yeast Candida albicans. ABSTRACT Target alteration and overproduction and drug efflux through overexpression of multidrug transporters localized in the plasma membrane represent the conventional mechanisms of azole antifungal resistance. Here, we identify a novel conserved mechanism of azole resistance not only in the budding yeast Saccharomyces cerevisiae but also in the pathogenic yeast Candida albicans. We observed that the vacuolar-membrane-localized, multidrug resistance protein (MRP) subfamily, ATP-binding cassette (ABC) transporter of S. cerevisiae, Ybt1, could import azoles into vacuoles. Interestingly, the Ybt1 homologue in C. albicans, Mlt1p, could also fulfill this function. Evidence that the process is energy dependent comes from the finding that a Mlt1p mutant version made by converting a critical lysine residue in the Walker A motif of nucleotide-binding domain 1 (required for ATP hydrolysis) to alanine (K710A) was not able to transport azoles. Additionally, we have shown that, as for other eukaryotic MRP subfamily members, deletion of the conserved phenylalanine amino acid at position 765 (F765Δ) results in mislocalization of the Mlt1 protein; this mislocalized protein was devoid of the azole-resistant attribute. This finding suggests that the presence of this protein on vacuolar membranes is an important factor in azole resistance. Further, we report the importance of conserved residues, because conversion of two serines (positions 973 and 976, in the regulatory domain and in the casein kinase I [CKI] consensus sequence, respectively) to alanine severely affected the drug resistance. Hence, the present study reveals vacuolar sequestration of azoles by the ABC transporter Ybt1 and its homologue Mlt1 as an alternative strategy to circumvent drug toxicity among pathogenic and nonpathogenic yeasts.
The discursive construction of low-risk to sexually transmitted diseases between women who are sexually active with women

Abstract This paper uses a discursive analytical method to explore dominant discourses concerning the sexual health of women who have sex with women. In-depth interviews were conducted with a cross-cultural sample of women from England and Brazil. Sex between women was discursively constructed as ‘safe’, and women who have sex with women were seen as being at low to negligible risk of contracting/transmitting sexually transmitted infections. Analysis identified two discourses underlying these constructions: a binaries discourse which focused on dichotomies of gender, sexuality and risk; and a sexual double-standard discourse, which focused on the positioning of sex between women as safe and the use of barrier methods of protection as indicative of not engaging in or fully enjoying the sexual act.
Identifying gene‐environment interactions incorporating prior information

For many complex diseases, gene‐environment (G‐E) interactions have independent contributions beyond the main G and E effects. Despite extensive effort, it still remains challenging to identify G‐E interactions. With the long accumulation of experiments and data, for many biomedical problems of common interest, there are existing studies that can be relevant and informative for the identification of G‐E interactions and/or main effects. In this study, our goal is to identify G‐E interactions (as well as their corresponding main G effects) under a joint statistical modeling framework. Significantly advancing from the existing studies, a quasi‐likelihood–based approach is developed to incorporate information mined from the existing literature. A penalization approach is adopted for identification and selection and respects the “main effects, interactions” hierarchical structure. Simulation shows that, when the existing information is of high quality, significant improvement can be observed. On the other hand, when the existing information is less informative, the proposed method still performs reasonably (and hence demonstrates a certain degree of “robustness”). The analysis of The Cancer Genome Atlas (TCGA) data on cutaneous melanoma and glioblastoma multiforme demonstrates the practical applicability of the proposed approach and also leads to sensible findings.
Azelaic acid-loaded nanoemulsion with hyaluronic acid – a new strategy to treat hyperpigmentary skin disorders

Abstract Objective: To develop an azelaic acid (AzA)-loaded nanoemulsion with hyaluronic acid (HA) as a double targeting strategy to increase drug retention and tyrosinase inhibition activity. Significance: Dermic melasma is a recalcitrant disease. Therefore, the development of new technologies that allow a deeper penetration in the skin while enhancing the efficacy of a safe and well-known dermatological active, like AzA, is a very promising alternative to improve the treatment of this disease. Methods: An oil-in-water nanoemulsion was developed and characterized according to its droplet size distribution, zeta potential, pH value, drug content, encapsulation efficiency, spectroscopic characteristics, morphology, and stability. In vitro mushroom tyrosinase inhibition assay, cytotoxicity, and permeation studies were performed. A descriptive sensory evaluation was also carried out. Results: Drug content was 10 mg/ml, particle size 419 ± 23 nm with monomodal distribution, encapsulation efficiency was 84.65%, zeta potential −10.9 ± 0.44 mV and pH 5.01 ± 0.01. The nanoemulsion was stable for 30 days (30 °C/65% RH). The nanoemulsion decreased tyrosinase activity and permeated through the skin, reaching viable epidermis and dermis and did not show signs of cytotoxicity. Sensory evaluation profile showed a higher spreadability with lesser whitening residue. Conclusion: The nanoemulsion presented characteristics within the nanoscale and reached the deeper layers of the skin while improving in vitro tyrosinase inhibition; hence, it could be a promising treatment to dermic melasma.
Coarse-to-Fine Adaptive People Detection for Video Sequences by Maximizing Mutual Information †

Applying people detectors to unseen data is challenging since patterns distributions, such as viewpoints, motion, poses, backgrounds, occlusions and people sizes, may significantly differ from the ones of the training dataset. In this paper, we propose a coarse-to-fine framework to adapt frame by frame people detectors during runtime classification, without requiring any additional manually labeled ground truth apart from the offline training of the detection model. Such adaptation make use of multiple detectors mutual information, i.e., similarities and dissimilarities of detectors estimated and agreed by pair-wise correlating their outputs. Globally, the proposed adaptation discriminates between relevant instants in a video sequence, i.e., identifies the representative frames for an adaptation of the system. Locally, the proposed adaptation identifies the best configuration (i.e., detection threshold) of each detector under analysis, maximizing the mutual information to obtain the detection threshold of each detector. The proposed coarse-to-fine approach does not require training the detectors for each new scenario and uses standard people detector outputs, i.e., bounding boxes. The experimental results demonstrate that the proposed approach outperforms state-of-the-art detectors whose optimal threshold configurations are previously determined and fixed from offline training data.
Alternative payment models and hospital engagement in health information exchange.

OBJECTIVES To assess whether hospital participation in alternative payment models (APMs) is associated with greater engagement in health information exchange (HIE) along 4 dimensions: volume of patients for whom information is exchanged, diversity of information types, breadth of partner types, and depth of technical approach. STUDY DESIGN Pooled, cross-sectional analysis of data on US hospitals from 2014 to 2015. METHODS APM participation came from Leavitt Partners data, Medicare public use files, and the American Hospital Association (AHA) Annual Survey. We used Medicare data to measure HIE volume for 798 hospitals attesting to stage 2 Meaningful Use and the AHA Information Technology Supplement to measure HIE diversity, breadth, and depth for 1730 hospitals. We used mixed-effects regression to estimate the association between participation in APMs and each dimension of HIE. RESULTS Compared with nonparticipating hospitals, full-year APM participation was associated with lower HIE volume (data were sent for 11 percentage points fewer discharges; P = .003), greater HIE diversity (of 4 data types, 0.3 more were transmitted; P <.001), greater HIE breadth (of 3 partner types, data were sent to 0.3 more; P <.001), and greater HIE depth (the odds of using a push and pull approach were 1.68 times greater; P = .004). CONCLUSIONS Our finding that APM participation was associated with greater HIE diversity, breadth, and depth suggests that value-based payment may be spurring improvements in HIE infrastructure. However, our finding that APM participation is associated with lower HIE volume suggests that there may be an incentive to focus HIE investments on a limited number of partners.
Marked reduction in fertility among African women with urogenital infections: A prospective cohort study

Background There is paucity of data on risk factors for reduced fertility in low-income countries. Objective To investigate factors associated with fertility among women in rural north eastern Tanzania. Subjects and methods A cohort of 1248 non-pregnant women was followed with urine pregnancy testing every third month or more regularly if they reported a missed menstrual period. Pregnancy was confirmed with trans-abdominal ultrasound. Information regarding general health, socioeconomic status and obstetric-gynaecological history was collected. Factors associated with conceiving within 180 days were identified using multivariate logistic regression analyses. Results Among the 1248 women, 736 were followed for 180 days and 209 of these had an ultrasound confirmed pregnancy. During the follow-up period, 169/736 women were diagnosed with urogenital infections, including suspected sexually transmitted or reproductive tract infections, urinary tract infection, and vaginal candidiasis. Urogenital infections were significantly associated with reduced odds of conceiving within 180 days (adjusted OR (AOR) 0.21, 95% CI 0.11–0.36). Being above 30 years of age was also negatively associated with odds of conceiving (AOR 0.45, 95% CI 0.26–0.77). In contrast, women who recently stopped using hormonal contraceptives (AOR 2.86, 95% CI 1.45–5.70) and women with low socioeconomic status (AOR 1.56, 95% CI 1.04–2.33) were significantly more likely to become pregnant within 180 days. Conclusion Urogenital infection seems to be a major health factor associated with reduced chances of conceiving. Considering the availability of effective treatment options for these diseases, public health authorities should increase awareness of diagnostic tools in settings with limited resources in order to improve fertility.
Neonatal Skin Emergencies.

Although the majority of neonatal skin rashes can be safely monitored without intervention, there are a significant few that are dermatologic emergencies. When called to assess a neonate, it is important to distinguish what requires immediate diagnosis and treatment from those that represent benign etiologies. The skin may be the first clue to certain infections such as herpes simplex virus, syphilis, varicella, cytomegalovirus, fungal infections, and staphylococcal scalded skin syndrome, all of which require immediate testing and some of which may lead to severe sequelae. Cutaneous findings in neonates may also indicate the need for further evaluation. Purpura fulminans, sclerema neonatorum, neonatal lupus, and blueberry muffin rash can be indications of other underlying disorders and are reviewed as well. This article outlines these potential neonatal dermatologic emergencies and highlights the important clinical clues to each. [Pediatr Ann. 2019;48(1):e36-e42. ].
A systematic review of the literature reporting on randomised controlled trials comparing treatments for faecal incontinence in adults

Abstract Aim: To perform a review of the literature reporting on randomised controlled trials (RCTs) comparing treatments for faecal incontinence (FI) in adults. Methods: A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify RCTs reporting on treatments for FI. Results: The review included 60 RCTs reporting on 4838 patients with a mean age ranging from 36.8 to 88 years. From the included RCTs, 32 did not identify a significant difference between the treatments compared. Contradictory results were identified in RCTs comparing percutaneous posterior tibial nerve stimulation and transcutaneous tibial nerve stimulation versus sham stimulation, biofeedback-pelvic floor muscle training (BF-PFMT) versus PFMT, and between bulking agents such as PTQTM versus Durasphere®. In two separate RCTs, combination treatment of amplitude-modulated medium frequency stimulation and electromyography-biofeedback (EMG-BF), was noted to be superior to EMG-BF and low-frequency electrical stimulation alone. Combination of non-surgical treatments such as BF with sphincteroplasty significantly improved continence scores compared to sphincteroplasty alone. Surgical treatments were associated with higher rates of serious adverse events compared to non-surgical interventions. Conclusions: The current evidence has not identified significant differences between treatments for FI, and where differences were identified, the results were contradictory between RCTs.
Prevalence, survival outcomes, and clinicopathologic factors associated with negative high risk human papillomavirus in surgical specimens of cervical cancer with pretreatment negative DNA genotype test

Objective The aim of this study was to detect high risk human papillomavirus in cervical cancer with a pretreatment negative high risk human papillomavirus DNA genotype test and to evaluate clinicopathologic characteristics and survival outcomes according to high risk human papillomavirus status. Methods We investigated high risk human papillomavirus status in surgical specimens from 30 cases of cervical cancer using polymerase chain reaction. Polymerase chain reaction primers were set to detect the presence of the common L1 and E7 regions of human papillomavirus types 16, 18, 31, 33, 45, 52, and 58. We analyzed the following clinicopathologic parameters to evaluate their relationships with high risk human papillomavirus status: age, histology, stage, tumor size, invasion depth, lymphovascular invasion, and recurrent status. Results Among 30 cases with a pretreatment negative DNA genotype test, high risk human papillomavirus was detected in 12 (40.0%), whereas 18 (60.0%) were negatives. Of 12 high risk human papillomavirus positive cases, 10 (33.3%) were positive for the L1 region, 6 (20.0%) of the 7 types were positive for the E7 region, and 4 (13.1%) were positive for both L1 and E7 regions. According to a multiple logistic regression model, tumor size (odds ratio 7.80; 95% confidence interval 1.476 to 41.216; P=0.0097) and stage (odds ratio 7.00; 95% confidence interval 1.293 to 37.910; P=0.0173) were associated with negative high risk human papillomavirus DNA status. Kaplan–Meier survival plots showed that negative high risk human papillomavirus status was associated with worse disease free survival in contrast with positive high risk human papillomavirus status (P=0.0392). Conclusions Negative high risk human papillomavirus was found in 60% of cervical cancers with a pretreatment negative DNA genotype test. Moreover, the negative high risk human papillomavirus group was associated with worse survival outcome.
NMR‐based lipoprotein analysis for patients with severe hypercholesterolemia undergoing lipoprotein apheresis or PCSK9‐inhibitor therapy (NAPALI‐Study)

Taking into account the discordance between low‐density lipoprotein cholesterol (LDL‐C) and LDL particle (LDL‐P) number, cardiovascular risk more closely correlates with LDL‐P in patients. The aim of our study was to evaluate the number of lipid particles in patients with severe hypercholesterolemia treated with different lipid‐lowering regimens. Four groups of patients differing with respect to lipid‐lowering therapy were recruited from hypercholesterolemic outpatients and lipoprotein apheresis (LA) facilities, and were treated with statins alone (group A), with statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors (PCSK9i) (group B), with statins and LA (group C), or with statins, PCSK9i, and LA (group D). Cholesterol, triglycerides, LDL‐C, high‐density lipoprotein cholesterol (HDL‐C), LDL‐P number and size, HDL‐P number and size were determined using nuclear magnetic resonance spectroscopy. The lowest LDL‐P number was achieved at the end of LA sessions in combination with statins or in combination with statins and a monoclonal PCSK9i (median; 25th and 75th percentile) (group C: 244 nmoL/L: 237, 244, P < 0.05; group D: 244 nmoL/L: 99, 307, P < 0.05). Comparing LDL‐P number at the start of LA (group C: 978 nmoL/L: 728, 1404; group D: 954 nmoL/L: 677, 1521) to the other patient groups (groups A and B), the lowest LDL‐P number was measured in patients treated with PCSK9i and a statin (group B): LDL‐P (762 nmoL/L: 604, 1043, P < 0.05), large LDL‐P (472 nmoL/L: 296, 574, P < 0.05), and small LDL‐P (342 nmoL/L: 152, 494, P < 0.05). Very low‐density lipoprotein and HDL particle sizes remained approximately the same in all groups. LA in combination with statins or in combination with statins and PCSK9i most reduced LDL‐P numbers in hypercholesterolemic patients.
Association Between Work-Related Factors and Diet: A Review of the Literature

The quality of workers’ dietary intake could be influenced by their working conditions. This review aimed to summarize the published literature examining the association between work-related factors, such as work hours, shift work, physical strain, mental strain, job strain, support, and diet quality. The literature search, conducted in PubMed, was limited to articles published from 2000 to 2017, written in English, available online, and among workers employed in high-income countries. The search resulted in 16 articles that met the criteria. Although there was some evidence of unhealthy diet among shift workers, data on the diet quality in association with other work-related factors, such as number of hours worked, physical, mental, and job strain, and worksite support were scarce. Further studies are need for purposes better defining the association between work-related factors and quality of workers’ diet.
Functionally defined white matter of the macaque monkey brain reveals a dorso-ventral attention network

Classical studies of attention have identified areas of parietal and frontal cortex as sources of attentional control. Recently, a ventral region in the macaque temporal cortex, the posterior infero-temporal dorsal area PITd, has been suggested as a third attentional control area. This raises the question of whether and how spatially distant areas coordinate a joint focus of attention. Here we tested the hypothesis that parieto-frontal attention areas and PITd are directly interconnected. By combining functional MRI with ex-vivo high-resolution diffusion MRI, we found that PITd and dorsal attention areas are all directly connected through three specific fascicles. These results ascribe a new function, the communication of attention signals, to two known fiber-bundles, highlight the importance of vertical interactions across the two visual streams, and imply that the control of endogenous attention, hitherto thought to reside in macaque dorsal cortical areas, is exerted by a dorso-ventral network.