Miracle-dz/UniFAR-FTUs huggingface dataset:
Normative Misperceptions of Peer Seat Belt Use Among High School Students and Their Relationship to Personal Seat Belt Use

Objectives: This research examined gender-specific perceptions of peer seat belt use norms among high school students and their relationship with one's own seat belt use. We expected that students would underestimate the seat belt use of their peers and that these perceptions would be positively associated with their own seat belt use. Methods: High school students from 4 schools (N = 3348; 52% male) completed measures assessing perceived seat belt use and personal seat belt use. Results: Findings demonstrated that students perceived that others engaged in less seat belt use than they do and that perceived norms were positively associated with one's own seat belt use. Conclusions: Peer influences are a strong predictor of behavior, especially among adolescents. Ironically, adolescents’ behaviors are often influenced by inaccurate perceptions of their peers. This research establishes the presence of a misperception related to seat belt use and suggests that misperception is associated with own behaviors. This research provides a foundation for social norms–based interventions designed to increase seat belt use by correcting normative misperceptions among adolescents.
The specificity of interferon-γ-based blood tests in the identification of latent tuberculosis infection

To the Editors: I have read with interest several papers describing the use of cellular interferon (IFN)-γ-based blood tests, including the editorial by Davies and Drobniewski 1. Whilst reviewing the study by Lee et al. 2, Davies and Drobniewski 1 indicate that the T-SPOT. TB assay has higher sensitivity than QuantiFERON-TB Gold, but that the QuantiFERON-TB Gold may have better specificity. I do not agree with this tentative conclusion as the study by Lee et al. 2 does not report the true specificity of the two tests, as the control group of 15- and 16-yr-old students used to examine the specificity of the assays, although healthy, had a defined risk of existing tuberculosis (TB) infection. This was acknowledged by Lee et …
Pedestrian Fatalities Resulting From Train–Person Collisions

Objective: Train–person collisions have a significant impact in our society, due to their negative economic and psychological effects. This work aims to study fatalities resulting from train–person collisions in Portugal. Methods: A retrospective study was conducted based on the analysis of autopsy reports related to train–person fatalities performed in the North Branch of the National Institute of Legal Medicine and Forensic Sciences. Results: Suicide was responsible for most of the cases, and males were more often involved in train–person collisions than females. Victims, between 40 and 59 years old, were found to be involved in a high percentage (39%) of the cases, and people older than 65 accounted for a significant percentage (40%) of the accidents. No seasonality was observed in suicide cases, but a decrease in accident numbers was registered in summer. Regarding weekday and time of day, afternoon and non–rush hour were the times when most suicides were observed, whereas accidents did not showed a specific weekday or time of day, except for rush hour, during which they were more frequent. Alcohol-positive blood analysis accounting for 25% of the cases. Conclusions: Differences from other European studies were found, which may be related to the different cultures of the countries/regions, as well as to the differences in the railway systems. More extensive studies must be performed in order to develop strategies to prevent train–person collisions.
Identifying Crash Patterns on Roundabouts

Objectives: Roundabouts are a type of circular intersection control generally associated with a favorable influence on traffic safety. International studies of intersections converted to roundabouts indicate a strong reduction in injury crashes, particularly for crashes with fatal or serious injuries. Nevertheless, some crashes still occur at roundabouts. The present study aims to improve the understanding of roundabout safety by identifying crash types, locations, and factors that are associated with roundabout crashes. Methods: An analysis of 399 crashes on 28 roundabouts in Flanders, Belgium, was carried out based on detailed crash descriptions; that is, crash data and collision diagrams. The crashes are sampled from police-reported crashes at roundabouts in the region of Flanders, Belgium. Collision diagrams of the registered crashes were used to distinguish 8 different crash types. The roundabout itself is divided into 11 detailed and different typical segments, according to previously established knowledge on the occurrence of crashes at roundabouts. The 8 roundabout crash types are examined by injury severity, crash location within the roundabout, type of roundabout, type of cycle facility, and type of involved road user. Results: Four dominant crash types are identified: rear-end crashes, collisions with vulnerable road users, entering–circulating crashes, and single-vehicle collisions with the central island. Crashes with vulnerable road users and collisions with the central island are characterized by significantly higher proportions of injury crashes. About 80% of the crashes occurred on the entry lanes and the circulatory road (segments 1–4). Road users who are the most at risk to be involved in serious injury crashes at roundabouts are cyclists and moped riders. Conclusions: The main goal of this study was to identify and analyze dominant crash types at roundabouts by taking into account detailed information on the crash location. Some connections between certain roundabout crash types, their crash location, and roundabout design characteristics have been found.
Design and Analysis

IT IS clear that the problems of design I and analysis in epidemiological studies of long-term disease are so varied and complex that nothing short of a lengthy treatise could provide adequate coverage. Such a treatise has not yet been written, and its formulation is clearly outside the capabilities of an ad hoc committee meeting for a limited period. The committee has concerned itself, therefore, with a small number of rather general problems which appear to be recurring ones in this type of investigation. These are dealt with under two main headings: I. General Problems of Definition and Design, and II. Measurement Problems. The committee has also considered it necessary to confine its attention to those studies which are based on the clinical or pathological examination of individuals, thus omitting from consideration the types of studies based primarily on information secured by lay interviewers from household informants (morbidity surveys) and the types of studies based primarily on information from death certificates (mortality studies).
Sustained virological response prevents the development of insulin resistance in patients with chronic hepatitis C

Hepatitis C virus (HCV) infection is associated with insulin resistance (IR), which is a condition known to influence the progression of liver fibrosis and the response to pegylated interferon (PEG‐IFN)/ribavirin (RBV) therapy. We aimed to assess whether a sustained virological response (SVR) after antiviral therapy prevents the development of IR in the long term. Members of the Milan Safety Tolerability study cohort, who received PEG‐IFNα2a/RBV or PEG‐IFNα2b/RBV, underwent a homeostasis model assessment (HOMA) at the baseline and 24 months after treatment completion. For all patients (n = 431), a liver biopsy sample was scored for grading, staging (Ishak), and steatosis. At the baseline, IR (HOMA value > 2) was detected in 48 patients (12%), and it was associated with body weight (P = 0.03), an HCV load < 0.6 × 106 IU/L (P = 0.006), fibrosis staging ≥ 4 (P = 0.01), and moderate to severe steatosis (P = 0.03). IR did not influence the rates of end‐of‐treatment response (75% versus 69%, P = 0.4), SVR (63% versus 60%, P = 0.8), or relapse (19% versus 24%, P = 0.5). After treatment, IR developed in 49 of the 384 nondiabetic patients (14%). Although the mean baseline and posttreatment HOMA values were similar in SVR patients (1.11 ± 0.8 versus 1.18 ± 1.1, P = 0.25), patients experiencing treatment failure showed a significant increase in the mean HOMA value at the follow‐up visit (1.20 ± 0.85 versus 1.49 ± 1.3, P = 0.007), and there was an increased rate of de novo IR in non‐SVR patients versus SVR patients (17% versus 7%, P = 0.007). According to a logistic regression analysis, treatment failure (odds ratio = 2.81, 95% confidence interval = 1.39‐5.67, P = 0.004) and a 10% body mass index increase (odds ratio = 6.42, 95% confidence interval = 1.69‐24.3, P = 0.006) were significantly associated with the development of de novo IR. Conclusion: In nondiabetic patients with chronic HCV, the achievement of SVR with PEG‐IFN and RBV prevents the development of de novo IR. (HEPATOLOGY 2012;56:1681–1687)
Plasmacytoid dendritic cells induce efficient stimulation of antiviral immunity in the context of chronic hepatitis B virus infection

The immune control of hepatitis B virus (HBV) infection is essential for viral clearance. Therefore, restoring functional anti–HBV immunity is a promising immunotherapeutic approach to treatment of chronic infection. Plasmacytoid dendritic cells (pDCs) play a crucial role in triggering antiviral immunity through their ability to capture and process viral antigens and subsequently induce adaptive immune responses. We investigated the potential of pDCs to trigger antiviral cellular immunity against HBV. We used a human leukocyte antigen A (HLA–A)*0201+ pDC line loaded with HLA–A*0201‐restricted peptides derived from hepatitis B core/hepatitis B surface (HBc/HBs) antigens to amplify specific CD8 T cells ex vivo from chronic HBV patients and established a Hepato‐HuPBL mouse model to address the therapeutic potential of the strategy in vivo. Stimulation of PBMCs or liver‐infiltrating lymphocytes from HLA–A*0201+ chronic HBV patients by HBc peptide‐loaded pDCs elicited up to 23.1% and 76.1% HBV‐specific CD8 T cells in 45.8% of cases. The specific T cells from the “responder” group secreted interferon‐γ, expressed CD107 upon restimulation, and efficiently lysed HBV antigen‐expressing hepatocytes. Circulating hepatitis B e antigen (HBeAg) was found to distinguish the group of patients not responding to the pDC stimulation. The therapeutic efficacy of the pDC vaccine was evaluated in immunodeficient NOD‐SCID β2m−/− mice reconstituted with HBV patients' PBMCs and xenotransplanted with human HBV‐transfected hepatocytes. Vaccination of Hepato–HuPBL mice with the HBc/HBs peptide–loaded pDCs elicited HBV‐specific T cells able to specifically lyse the transfected hepatocytes and reduce the systemic viral load. Conclusion: pDCs loaded with HBV–derived peptides can elicit functional virus‐specific T cells. HBeAg appears to be critical in determining the outcome of immunotherapies in chronic HBV patients. A pDC‐based immunotherapeutic approach could be of interest in attempts to restore functional antiviral immunity, which is critical for the control of the virus in chronic HBV patients. (HEPATOLOGY 2012;56:1706–1718)
A Roadside Study of Observable Driver Distractions

Objective: This study investigated the prevalence of observable distractions while driving and the effect of drivers’ characteristics and time-related variables on their prevalence. Methods: Using roadside observation, 2 independent observers collected data at 4 randomly selected locations in St. Albans, UK. Results: Of the 10,984 drivers observed, 16.8% were engaged in a secondary task, with talking to passengers being the most common distraction (8.8%), followed by smoking (1.9%) and talking on a hands-free mobile phone (1.7%). An additional 1.0% were observed talking on a handheld phone, and the rest of the distractions (e.g., texting, drinking) were recorded in less than 1% of the drivers observed. Gender-related differences were found for a number of different distractions (i.e., talking to passengers, drinking, and handheld mobile phone conversations), but age emerged as a significant predictor for most secondary tasks, including talking to passengers, smoking, hands-free mobile phone use, handheld mobile phone use, texting/keying numbers, drinking, and engagement in any type of distraction (all distractions combined). The overall pattern for age was that middle-aged and older drivers were less likely to be distracted than younger drivers. Conclusions: This work provides further evidence of the relatively high rate of distracted driving in the UK. The findings clearly indicate that younger drivers are more likely to drive distracted, which probably contributes to their higher crash rates.
Awareness Tool for Safe and Responsible Driving (OSCAR): A Potential Educational Intervention for Increasing Interest, Openness and Knowledge About the Abilities Required and Compensatory Strategies Among Older Drivers

Objective: This pilot study aimed to verify the impact of the awareness tool for safe and responsible driving (OSCAR) on older adults’ (1) interest, openness, and knowledge about the abilities and compensatory strategies required for safe driving; (2) awareness of changes that have occurred in their own driving abilities; and (3) actual utilization of compensatory strategies. Methods: A preexperimental design, including a pretest (T0) and posttest (T1) 8 to 10 weeks after exposure to the intervention, was used with 48 drivers aged between 67 and 84. The participants had a valid driving license and drove at least once a week. Results: Overall, the results demonstrate that OSCAR increased interest, openness, and knowledge about the abilities and compensatory strategies of older drivers (P <.01). After exposure to OSCAR, the majority of the participants confirmed that changes had occurred in at least one of their abilities. Moreover, half of the older drivers reported having started using 6 or more compensatory strategies. Conclusion: In summary, in addition to increasing older adults’ interest, openness, and knowledge to discussion about driving, OSCAR also improved awareness of the changes that could negatively impact safe driving and enhanced utilization of compensatory strategies. While promoting safe driving and the prevention of crashes and injuries, this intervention could ultimately help older adults maintain or increase their transportation mobility. More studies are needed to further evaluate OSCAR and identify ways to improve its effectiveness.
Organizational Effects on Patient Satisfaction in Hospital Medical-Surgical Units

Objective: The purpose of this study was to examine the relationships between hospital context, nursing unit structure, and patient characteristics and patients' satisfaction with nursing care in hospitals. Background: Although patient satisfaction has been widely researched, our understanding of the relationship between hospital context and nursing unit structure and their impact on patient satisfaction is limited. Methods: The data source for this study was the Outcomes Research in Nursing Administration Project, a multisite organizational study conducted to investigate relationships among nurse staffing, organizational context and structure, and patient outcomes. The sample for this study was 2,720 patients and 3,718 RNs in 286 medical-surgical units in 146 hospitals. Results: Greater availability of nursing unit support services and higher levels of work engagement were associated with higher levels of patient satisfaction. Older age, better health status, and better symptom management were also associated with higher levels of patient satisfaction. Conclusions: Organizational factors in hospitals and nursing units, particularly support services on the nursing unit and mechanisms that foster nurses' work engagement and effective symptom management, are important influences on patient satisfaction.
Concussion, Diffuse Axonal Injury, and AIS4+ Head Injury in Motor Vehicle Crashes

Purpose: This is a descriptive study of the annual incidence of brain injuries in motor vehicle crashes by type, seat belt use, and crash severity (delta V) using national accident data. The risk for concussion, diffuse axonal injury (DAI), and severe head injury was determined. Methods: 1994–2011 NASS-CDS was analyzed to estimate the number of brain injuries annually in nonejected adults involved in motor vehicle crashes. Crashes were grouped by front, side, rear, and rollover, and the effect of belt use was investigated. Light vehicles were included with model year 1994+. Head injuries were identified as concussion, DAI, severe head injury (Abbreviated Injury Scale [AIS] 4+), and skull fracture. The annual incidence, risk, and rate for different types of head injury were estimated with standard errors. Results: Motor vehicle crashes involved 33,191 ± 7,815 occupants with concussion, 5,665 ± 996 with AIS 4+ head injuries, 986 ± 446 with DAI, and 3,300 ± 531 with skull fracture annually. The risk was 1.64 ± 0.39% for concussion, 0.28 ± 0.05% for severe head injury (AIS 4+), 0.05 ± 0.02% for DAI, and 0.16 ± 0.03% for skull fracture in tow-away crashes. The risk for severe head injury (AIS 4+) was highest in rollovers (0.74 ± 0.16%) and lowest in rear impacts (0.17 ± 0.05%). Head injury risk depended on seat belt use, crash type, and crash severity (delta V). Seat belt use lowered the risk for AIS 4+ head injury by 74.8% and skull fracture by 73.2%. Conclusions: Concussions occur in about one out of 61 occupants in tow-away crashes. The risk was highest in rollover crashes (4.73 ± 1.09%) and it was reduced 69.2% by seat belt use. Severe brain injuries occurred less often and the risk was also reduced by seat belt use.
Risk factors affecting the severity of traffic accidents at Shanghai river-crossing tunnel

ABSTRACT Objective: With increasing traffic volume and urban development, increasing numbers of underground tunnels have been constructed to relieve conflict between strained land and heavy traffic. However, as more long tunnels are constructed, tunnel traffic safety is becoming increasingly serious. Thus, it is necessary to acquire their implications and impacts. This study examined 4,539 traffic accidents that have occurred in 14 Shanghai river-crossing tunnels for the period 2011–2012 and analyze the correlation between potential factors and accident injury severity. Methods: An ordered logit model was developed to examine the correlation between potential factors and accident injury severity. Results: Results show that increased injury severity is associated with male drivers, drivers aged 65 years or older, accident time from midnight to dawn, weekends, wet road surface, goods vehicles, 3 or more vehicles, 4 or more lanes, middle speed limits (50–79 km/h), zone 3, extra-long tunnels (over 3,000 m), and maximum longitudinal gradient. Conclusions: This article aims to provide useful information for engineers to develop interventions and countermeasures to improve tunnel safety in China.
Drug target validation of the trypanothione pathway enzymes through metabolic modelling

A kinetic model of trypanothione [T(SH)2] metabolism in Trypanosoma cruzi was constructed based on enzyme kinetic parameters determined under near‐physiological conditions (including glutathione synthetase), and the enzyme activities, metabolite concentrations and fluxes determined in the parasite under control and oxidizing conditions. The pathway structure is characterized by a T(SH)2 synthetic module of low flux and low catalytic capacity, and another more catalytically efficient T(SH)2‐dependent antioxidant/regenerating module. The model allowed quantification of the contribution of each enzyme to the control of T(SH)2 synthesis and concentration (flux control and concentration control coefficients, respectively). The main control of flux was exerted by γ‐glutamylcysteine synthetase (γECS) and trypanothione synthetase (TryS) (control coefficients of 0.58–0.7 and 0.49–0.58, respectively), followed by spermidine transport (0.24); negligible flux controls by trypantothione reductase (TryR) and the T(SH)2‐dependent antioxidant machinery were determined. The concentration of reduced T(SH)2 was controlled by TryR (0.98) and oxidative stress (−0.99); however, γECS and TryS also exerted control on the cellular level of T(SH2) when they were inhibited by more than 70%. The model predicted that in order to diminish the T(SH)2 synthesis flux by 50%, it is necessary to inhibit γECS or TryS by 58 or 63%, respectively, or both by 50%, whereas more than 98% inhibition was required for TryR. Hence, simultaneous and moderate inhibition of γECS and TryS appears to be a promising multi‐target therapeutic strategy. In contrast, use of highly potent and specific inhibitors for TryR and the antioxidant machinery is necessary to affect the antioxidant capabilities of the parasites.
A High School Counselor's Leadership in Providing School-Wide Screenings for Depression and Enhancing Suicide Awareness:

The prevalence of mental health issues and suicidal thoughts and actions among school-aged children and adolescents is a serious issue. This article examines the scope of the problem nationwide and provides a brief overview of the literature regarding the effectiveness of school-wide screening programs for depression and suicide risk. The authors describe a suicide prevention program that has been implemented by the first author (a high school counselor in Minnesota) that combines classroom guidance, screening, and referrals for outside mental health services. This article includes recommendations for school counselors interested in implementing a school-wide screening and prevention program.
Performance status in patients with hepatocellular carcinoma: Determinants, prognostic impact, and ability to improve the Barcelona Clinic Liver Cancer system

Performance status is included in the Barcelona Clinic Liver Cancer (BCLC) system for hepatocellular carcinoma (HCC). Few studies specifically evaluated the role of performance status in patients with HCC. This study investigated its distribution, determinants, and prognostic impact, aiming to improve the performance of the BCLC system. A total of 2,381 HCC patients were enrolled. Performance status was determined according to the Eastern Cooperative Oncology Group scale. The prognostic ability of the original and three modified BCLC systems in HCC patients was compared by the Akaike information criterion (AIC). There were 60, 17, 11, 8, and 4% of patients who were classified as performance status 0, 1, 2, 3, and 4, respectively. A worse performance status significantly correlated with age, alcoholism, hypoalbuminemia, hyperbilirubinemia, renal insufficiency, hyponatremia, and prothrombin time prolongation (all P < 0.001). Larger tumor burden, poorer residual liver function, more frequent vascular invasion, and diabetes mellitus were also observed in patients with worse performance status (all P < 0.001). Patients with poorer performance status more often received best supportive care (P < 0.001). In the Cox proportional hazards model, performance status was an independent prognostic predictor and the long‐term survival tended to be worse in patients with progressively poor performance status (all P < 0.05). Reassigning patients with performance status 0 or 1 to stage B provided the lowest AIC among the four BCLC‐based staging systems.