Miracle-dz/UniFAR-FTUs huggingface dataset:
“Mending fractured personalities”: A photography-based cultural study of recovery from mental distress in Romania

This study explored the lived experiences and meanings of recovery from mental distress from the perspective of mental health service users in Romania, along with investigating cultural particularities of recovery in this country. Research in this area is essential in the context of Romania's mental health reform marked by a transition from institutionalised mental health services to a recovery-based approach, and profound social and economic changes during the post-communist era. Subscribing to the recovery framework, this study employed a qualitative phenomenological design involving 15 adults with mental health problems purposively recruited from a community day centre in Romania. The phenomenological background was enriched with elements of participatory photography to elicit subjective experiences and meanings of recovery. The outcome of this study was a better understanding of recovery in Romanian adults living with mental distress, as a complex and multi-layered phenomenon. Three key themes were identified through Interpretative Phenomenological Analysis: awakening, healing, and reconstructing life. The findings add to the current recovery models by showing that recovery cannot be fully understood unless situated in a socio-political, cultural, and historical context. Implications for mental health practice in Romania are discussed and directions for future research are recommended.
Stromal Tumor Infiltrating Lymphocytes (sTILs) Were Associated with a Higher Grade and a Lower Stage of Indonesian Triple Negative Breast Cancers

Objective: This study aimed to investigate the association of sTILs with clinicopathological parameters and overall survival (OS) in patients with triple negative breast cancer (TNBC). Methods: One hundred and twenty-five paraffin embedded tissue of patients with TNBC, collected from Dr. Sardjito General Hospital Yogyakarta, Indonesia, between 2008-2017, were used in this study. Stromal TILs were examined from hematoxylin and eosin (H&E)-stained samples, and classified as either low or high score using 20% cut-off. Analysis of the association of sTILs with clinicopathological parameters, relative risk (RR) and OS used 95% confidence interval (CI) with significance set as p<0.05. Results: The higher proportion of TNBC patients in this study were ≥40 years old (83.3%), high tumor grade (68%), tumor stage >IIIa (56%), alive (50.4%), and with low sTILs (54.4%). The results showed significant association between sTILs and a higher grade or a lower stage of tumor (B = 0.259, 95%CI = 0.090-0.468, p = 0.004 and B = -0.255, 95%CI = -0.433 - -0.080, p = 0.005, respectively ). Meanwhile sTILs were not associated with age at diagnosis (B = 0.027, 95%CI = -0.193 – 0.264 p = 0.758 nor 3-year OS of patients (HR = 0.342, 95%CI = 0.41 - 1.43 p = 0.402). Conclusion: The results indicate that sTILs may serve as an additional pathological parameter for TNBC.
Inferior Clinical Outcomes of Pediatric Rhabdomyosarcoma in Thailand: A 16-Year Experience in a Single Tertiary Institution

Introduction: There is limited data available on the treatment outcomes of pediatric rhabdomyosarcoma (RMS) in Asian populations. Therefore, we aimed to review the baseline characteristics, clinical outcomes, and prognostic factors in children with RMS from Thailand. Methods: The data of children under 15 years of age diagnosed with RMS between 2003 and 2019 from a large tertiary hospital in Southern Thailand were retrospectively reviewed. Descriptive statistics were utilized to describe the clinical characteristics. The Kaplan–Meier method was utilized to estimate survival. Cox proportional hazards regression analysis was utilized to determine prognostic factors that affect survival. Results: A total of 42 children RMS were included in this study. The median age at diagnosis was 6.4 years (IQR, 2.4–10.2). Among these patients, 11 (26%) were older than 10 years, and 13 (31%) presented with metastatic disease at diagnosis. The 5-year overall survival (OS) rate was 39% for all children. Age greater than 10 years (hazard ratio (HR): 3.3, 95% CI: 1.2–9.2) and metastatic disease at diagnosis (hazard ratio (HR): 2.8, 95% CI: 1.1–7.5) were independently associated with poorer survival. The 3-year OS for children with metastatic disease (stage IV) was 15% (95% CI: 4.3–55). Conclusion: The percentage of metastatic disease in our cohort was higher than that in previous reports and may have contributed to a poorer outcome. Age greater than 10 years and metastatic disease at diagnosis were noted as adverse prognostic factors.
An Evaluation of the Prognosticative Value of Hyalinization in the Biological Behaviour of Oral Lesions Using Image Analysis

Objective: To evaluate the efficacy of artificial intelligence-based analysis of polychromatic staining in oral premalignant and malignant lesions and to predict their biological behavior. The study also aims to evaluate the prognostic value of collagen in these oral lesions. Methods: In this study, a total of 45 histopathologically diagnosed normal (15), Premalignant lesions (n-15), and oral squamous cell carcinoma (n=15) were included. The tissue sections were subjected to routine Hematoxylin and Eosin (H and E) staining and a differential staining technique- Herovici’s stain. The stained slides were viewed under 10x magnification in the microscope and images of these sections were captured. The images were labelled, transferred and stored in the computer for image analysis. The collagen content in the photomicrographs were analysed using Image J software. The results were tabulated and subjected to Kruskal- Wallis test using the SPSS software. Results: A significant increase in the amount of type III (blue stained) collagen fibers, compared to type I collagen fibers, was seen as the lesion progressed from premalignant disorders to oral squamous cell carcinoma. Normal mucosa showed predominantly type I (red stained) collagen fibers. The difference in the ratio of type I and III collagen fibers between the three groups was found to be statistically significant (P= 0.00). Conclusion: The study concluded that a significant change in stromal collagen composition exists, with an increase in the amount of type III collagen, that can be correlated to the lesion’s progression from premalignant to oral squamous cell carcinoma. Differential staining is an inexpensive and highly reproducible method of evaluating the composition of the stroma and using Image analysis to carry out this analysis makes the process more objective and renders it bias free.
Average weighted nucleotide diversity is more precise than pixy in estimating the true value of π from sequence sets containing missing data

Nucleotide diversity remains an important statistic in population genetic/genomic studies. Although recent advances in massive sequencing make generating sequence data sets cheaper and faster, currently used technologies often introduce substantial amounts of missing nucleotides in their output. A novel method of estimating π from data sets containing missing data – pixy ‐ has also recently been proposed. In this study, the pixy estimator, πpixy, was compared to average weighted nucleotide diversity, πW. The estimators were tested both on sequences simulated in fastsimcoal and real sequence sets. Both sets were modified by random insertion of missing nucleotides. Weighted nucleotide diversity performed better in all pairwise comparisons. It was characterized by a smaller error and a narrower distribution of the results. πpixy tends to overestimate the nucleotide diversity when both the proportion of missing data and the level of variation is low. Of the two estimators, only πW estimated the true nucleotide diversity in a part of the simulations. A simple formula for estimating πW allows for easy integration of the estimator in packages such as pixy, which would allow obtaining more precise estimates of nucleotide diversity either in a sliding window or for discrete genomic regions.
Minor histocompatibility antigens HA‐8 and PANE1 in the TUNISIAN population

Minor histocompatibility antigens (mHAgs) are endogenous immunogenic peptides initially identified due to complications detected in several contexts of HLA geno‐identical hematopoietic stem cell transplantation (HSCT). In this study, we chose to examine the molecular polymorphism of the mHAgs HA‐8 and PANE1 in the Tunisian population.
ONE-TIME PAROXYSM of ARTISTIC TALENT in FOCAL EPILEPSY

ABSTRACT Despite having unremarkable artistic talent, an 8-year-old male with chronic focal epilepsy from the right lateral frontal lobe drew a complex visual pattern during a 15-minute spell when he looked physically unwell. He underwent epilepsy surgery shortly thereafter and has been seizure-free since. In the ensuing 16 years of follow-up there have been no other such artistic incidents. We deduce that emergence of paroxysmal de novo artistic ability in our patient was caused by seizure discharge disinhibiting the ipsilateral parietal cortex and/or transient ictal engagement of distant salience and default mode sites.
Sources of Information about Pre-Exposure Prophylaxis (PrEP) and Associations with PrEP Stigma, Intentions, Provider Discussions, and Use in the United States

ABSTRACT The amount and type of information individuals receive about HIV pre-exposure prophylaxis (PrEP) may influence PrEP uptake. We surveyed 331 HIV-negative sexual and gender minorities who have sex with men at a Midwestern Pride festival in 2018 (M age = 32, 68% White, 87% cisgender men) to assess sources and perceived tone of PrEP information and associated outcomes. Most participants (88%) had heard about PrEP. The most common sources were the internet (70%), social media (59%), and friends (54%). Messages from health campaigns were perceived as most positive and those from religious institutions as least positive. Sources differed based on demographics. Controlling for indications for PrEP use, those who heard about PrEP from health campaigns and those who heard more positive messages reported lower levels of PrEP stigma, βs = −0.27––0.23, ps < . 05. Non-users who heard about PrEP from the internet had stronger intentions to use PrEP, β = 0.28, p < . 05. Those who heard about PrEP from sexual partners and health campaigns were more likely to discuss PrEP with providers, PRs = 1.60–1.80, ps < . 01. Finally, those who heard about PrEP from friends and partners were more likely to use PrEP, PRs = 2.01–2.24, ps < . 05. Leveraging sexual partners, social network members, and health campaigns are promising avenues to advance PrEP implementation.
The Good, the Bad, and the Vision: Exploring the Mental Health Care Experiences of Transitional-Aged Youth Using the Photovoice Method

Transitional-aged youth (TAY) between the ages of 16 and 24 experience higher rates of mental distress than any other age group. It has long been recognized that stability, consistency, and continuity in mental health care delivery are of paramount importance; however, the disjointed progression from paediatric to adult psychiatric services leaves many TAY vulnerable to deleterious health outcomes. In Spring 2019, eight TAY living with mental health challenges participated in a Photovoice study designed to: (1) illuminate their individual transition experiences; and, (2) support a collective vision for optimal mental health care at this nexus. Participants took photographs that reflected three weekly topics—the good, the bad, and the vision—and engaged in a series of three corresponding photo-elicitation focus group sessions. Twenty-four images with accompanying titles and captions were sorted into nine participant-selected themes. Findings contribute to an enhanced awareness of psychiatric service delivery gaps experienced by TAY, and advocate for seamless and supportive transitions that more effectively meet the mental health care needs of this population.
Effect of Repeat Vaccination on Immunogenicity of Quadrivalent Cell-Culture and Recombinant Influenza Vaccines Among Healthcare Personnel Aged 18–64 Years: A Randomized, Open-Label Trial

Abstract Background Antibody responses to non–egg-based standard-dose cell-culture influenza vaccine (containing 15 µg hemagglutinin [HA]/component) and recombinant vaccine (containing 45 µg HA/component) during consecutive seasons have not been studied in the United States. Methods In a randomized trial of immunogenicity of quadrivalent influenza vaccines among healthcare personnel (HCP) aged 18–64 years over 2 consecutive seasons, HCP who received recombinant-HA influenza vaccine (RIV) or cell culture–based inactivated influenza vaccine (ccIIV) during the first season (year 1) were re-randomized the second season of 2019–2020 (year 2 [Y2]) to receive ccIIV or RIV, resulting in 4 ccIIV/RIV combinations. In Y2, hemagglutination inhibition antibody titers against reference cell–grown vaccine viruses were compared in each ccIIV/RIV group with titers among HCP randomized both seasons to receive egg-based, standard-dose inactivated influenza vaccine (IIV) using geometric mean titer (GMT) ratios of Y2 post-vaccination titers. Results Y2 data from 414 HCP were analyzed per protocol. Compared with 60 IIV/IIV recipients, 74 RIV/RIV and 106 ccIIV/RIV recipients showed significantly elevated GMT ratios (Bonferroni corrected P < .007) against all components except A(H3N2). Post-vaccination GMT ratios for ccIIV/ccIIV and RIV/ccIIV were not significantly elevated compared with IIV/IIV except for RIV/ccIIV against A(H1N1)pdm09. Conclusions In adult HCP, receipt of RIV in 2 consecutive seasons or the second season was more immunogenic than consecutive egg-based IIV for 3 of the 4 components of quadrivalent vaccine. Immunogenicity of ccIIV/ccIIV was similar to that of IIV/IIV. Differences in HA antigen content may play a role in immunogenicity of influenza vaccination in consecutive seasons. Clinical Trials Registration NCT03722589.
The Efficacy and Safety of a 755-nm Picosecond Laser in the Treatment of Physiologic Lip Hyperpigmentation in Thai Patients

BACKGROUND Physiologic lip hyperpigmentation is a common aesthetic concern, especially in Southeast Asia. There is limited data on the application of the picosecond laser for this condition. OBJECTIVE To evaluate the efficacy and safety of using a 755-nm picosecond laser in the treatment of physiologic lip hyperpigmentation. METHODS Twenty healthy patients with physiologic lip hyperpigmentation received 5 bi-weekly treatments with a 755-nm picosecond laser using a 6-mm spot size, fluence of 0.71 J/cm2 at 5 Hz. Subjective and objective evaluation on the improvement of lip hyperpigmentation were obtained at baseline, 2 weeks after each treatment and at 1, 3, and 6 months after the final treatment. Patient self-assessment, pain score, and adverse reactions were also recorded. RESULTS All patients completed the study and attended all follow-ups. Most (52.6%) patients presented with moderate clinical improvement at 6-month follow-up. The average melanin index decreased significantly after the fourth treatment (p = .048) and at 1-month follow-up (p = .026). More than half the patients (70%) reported moderate-to-marked improvement at 6-month follow-up. Only 1 patient presented with a transient adverse reaction of lip edema. CONCLUSION The 755-nm picosecond laser is safe and effective for the treatment of physiologic lip hyperpigmentation in Thai patients.
Efficacy and Safety of an Extravascular Implantable Cardioverter-Defibrillator.

BACKGROUND The extravascular implantable cardioverter-defibrillator (ICD) has a single lead implanted substernally to enable pause-prevention pacing, antitachycardia pacing, and defibrillation energy similar to that of transvenous ICDs. The safety and efficacy of extravascular ICDs are not yet known. METHODS We conducted a prospective, single-group, nonrandomized, premarket global clinical study involving patients with a class I or IIa indication for an ICD, all of whom received an extravascular ICD system. The primary efficacy end point was successful defibrillation at implantation. The efficacy objective would be met if the lower boundary of the one-sided 97.5% confidence interval for the percentage of patients with successful defibrillation was greater than 88%. The primary safety end point was freedom from major system- or procedure-related complications at 6 months. The safety objective would be met if the lower boundary of the one-sided 97.5% confidence interval for the percentage of patients free from such complications was greater than 79%. RESULTS A total of 356 patients were enrolled, 316 of whom had an implantation attempt. Among the 302 patients in whom ventricular arrhythmia could be induced and who completed the defibrillation testing protocol, the percentage of patients with successful defibrillation was 98.7% (lower boundary of the one-sided 97.5% confidence interval [CI], 96.6%; P<0.001 for the comparison with the performance goal of 88%); 299 of 316 patients (94.6%) were discharged with a working ICD system. The Kaplan-Meier estimate of the percentage of patients free from major system- or procedure-related complications at 6 months was 92.6% (lower boundary of the one-sided 97.5% CI, 89.0%; P<0.001 for the comparison with the performance goal of 79%). No major intraprocedural complications were reported. At 6 months, 25 major complications were observed, in 23 of 316 patients (7.3%). The success rate of antitachycardia pacing, as assessed with generalized estimating equations, was 50.8% (95% CI, 23.3 to 77.8). A total of 29 patients received 118 inappropriate shocks for 81 arrhythmic episodes. Eight systems were explanted without extravascular ICD replacement over the 10.6-month mean follow-up period. CONCLUSIONS In this prospective global study, we found that extravascular ICDs were implanted safely and were able to detect and terminate induced ventricular arrhythmias at the time of implantation. (Funded by Medtronic; ClinicalTrials.gov number, NCT04060680.).
Effects of accessible information amount and judgment times on human diagnostic performance of nuclear power plant faults

Abstract Information is key to the process of diagnosis, so it is necessary to understand how information amount may influence human performance. The current study investigated this issue through an experiment where participants diagnosed an accident in a simulated nuclear power plant. The amount of accessible information and the times of making judgments were manipulated. The results showed that increasing the amount of accessible information led the participants to seek more and think shallower, and thus decreased diagnostic accuracies, whereas no significant effects were found for multiple judgement times. The authors argue that the disadvantages of more accessible information could be attributed not simply to ‘information overload’, but partly to the diagnosticians’ unwise choice of information processing strategies. The findings imply that system designers should restrain the ever-growing amount of information while users should make more efficient use of information rather than take in more. Practitioner summary: Current research on diagnosis by humans was mostly limited to outcome performance. This study empirically investigated factors influencing its detailed process. The results showed that increasing accessible information amount impaired both process and outcome performances.
Hip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion

Background: Symptomatic patients with femoroacetabular impingement (FAI) have limitations in daily activities and sports and report the exacerbation of hip pain in deep flexion. Yet, the exact impingement location in deep flexion and the effect of femoral version (FV) are unclear. Purpose: To investigate the acetabular and femoral locations of intra- or extra-articular hip impingement in flexion in patients with FAI with and without femoral retroversion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An institutional review board–approved retrospective study involving 84 hips (68 participants) was performed. Of these, symptomatic patients (37 hips) with anterior FAI and femoral retroversion (FV <5°) were compared with symptomatic patients (21 hips) with anterior FAI (normal FV) and with a control group (26 asymptomatic hips without FAI and normal FV). All patients were symptomatic, had anterior hip pain, and had positive anterior impingement test findings. Most of the patients had hip/groin pain in maximal flexion or deep flexion or during sports. All 84 hips underwent pelvic computed tomography (CT) to measure FV as well as validated dynamic impingement simulation with patient-specific CT-based 3-dimensional models using the equidistant method. Results: In maximal hip flexion, femoral impingement was located anterior-inferior at 4 o’clock (57%) and 5 o’clock (32%) in patients with femoral retroversion and mostly at 5 o’clock in patients without femoral retroversion (69%) and in asymptomatic controls (76%). Acetabular intra-articular impingement was located anterior-superior (2 o’clock) in all 3 groups. In 125° of flexion, patients with femoral retroversion had a significantly (P < .001) higher prevalence of anterior extra-articular subspine impingement (54%) and anterior intra-articular impingement (89%) compared with the control group (29% and 62%, respectively). Conclusion: Knowing the exact location of hip impingement in deep flexion has implications for surgical treatment, sports, and physical therapy and confirms previous recommendations: Deep flexion (eg, during squats/lunges) should be avoided in patients with FAI and even more in patients with femoral retroversion. Patients with femoral retroversion may benefit and have less pain when avoiding deep flexion. For these patients, the femoral location of the impingement conflict in flexion was different (anterior-inferior) and distal to the cam deformity compared with the location during the anterior impingement test (anterior-superior). This could be important for preoperative planning and bone resection (cam resection or acetabular rim trimming) during hip arthroscopy or open hip preservation surgery to ensure that the region of impingement is appropriately identified before treatment.