Miracle-dz/UniFAR-FTUs huggingface dataset:
Occupational biopsychosocial factors associated with neck pain intensity, neck-disability, and sick leave: a cross-sectional study of construction labourers in an African population

Introduction The burden and impact of neck pain is high in African countries including Nigeria. This study investigated the occupational biomechanical and occupational psychosocial factors associated with neck pain intensity, neck disability and sick leave amongst construction labourers in an urban Nigerian population. Methods This cross-sectional study measured clinical neck pain outcomes, occupational biomechanical factors, and occupational psychosocial factors. Descriptive, and univariate/multivariate inferential statistical analyses were conducted. Results Significant independent factors associated with neck pain intensity were order and pace of tasks being dependent on others (b= 0.35; p<0.0001); inability to take breaks in addition to scheduled breaks (b= 0.25; p<0.0001); inability to work because of unexpected events (b= 0.21; p<0.0001); inability to control the order and pace of tasks (b= 0.20; p<0.0001); and weight of load (b= 0.17; p<0.0001); accounting for 53% of the variance in neck pain intensity. Significant independent factors associated with neck disability were weight of load (b= 0.30; p<0.0001); duration of load carriage (b= 0.16; p=0.01); working under time pressure/deadlines (b= 0.16; p=0.02); and accounting for 20% of the variance in neck disability. Significant independent factor associated with sick leave was duration of load carriage ({beta}=0.15; p= 0.04), in a non-significant regression model explaining -4% of the variance in sick leave. Addition of pain intensity significantly explained more variance in neck disability (31.0%) but less variance in sick leave (-5%), which was not statistically significant(F (10, 190)= 0.902, p=0.533). Conclusions Occupational biomechanical factors may be more important than occupational psychosocial factors in explaining neck disability and sick leave. In contrast, occupational psychosocial factors may be more important than occupational biomechanical factors in explaining neck pain intensity in this population in Nigeria.
Job Demands, Social Support, and Burnout among Public Senior High School Teachers, Ghana

This study aimed to investigate the extent to which job demands and social support predict burnout of public senior high school (S.H.S.) teachers in Ghana, and to determine the mediating effect of job resources in the relation between job demands and burnout among these teachers. Employing a quantitative survey, 1028 public S.H. S. teachers were selected using purposive and voluntary sampling methods. A questionnaire adopted from pre-existing standardized instruments yielded composite reliability between 0.94 and 0.98. Data was analyzed using mean, standard deviation, and multiple linear regression. Results revealed a high level of job demands (M = 3.23, SD = 0.43), social support (M = 3.02, SD = 0.54), and burnout (M = 3.33, SD = 0.92) among the teachers. Also, multiple linear regression results indicate that job demands, and social support predict burnout of the teachers. Furthermore, social support is a partial mediator of the effect of job demands on teachers burnout. Therefore, perceived high level of burnout is an effect of high levels of job demands, which poses a serious threat to the health and well-being of these teachers and compromises teaching quality in Ghanas S.H. S. However, this challenge can be prevented or reduced by providing more social support to the teachers. Hence, government, management, and other educational stakeholders need to provide a strong safety leadership in all matters that concerns teachers health and safety. The school administrators and teachers are also encouraged to promote social support vertically and horizontally.
A Lifelike guided journey through the pathophysiology of pulmonary hypertension - from measured metabolites to the mechanism of action of drugs

Pulmonary hypertension (PH) is a pathological condition that affects approximately 1% of the population. The prognosis for many patients is poor, even after treatment. Our knowledge about the pathophysiological mechanisms that cause or are involved in the progression of PH is incomplete. Additionally, the mechanism of action of many drugs used to treat pulmonary hypertension, including sotatercept, requires elucidation. Using our graph-powered knowledge mining software Lifelike in combination with a very small patient metabolite data set, we demonstrate how we derive detailed mechanistic hypotheses on the mechanisms of PH pathophysiology and clinical drugs. In PH patients, the concentration of hypoxanthine, 12(S)-HETE, glutamic acid, and sphingosine 1 phosphate is significantly higher, while the concentration of L-arginine and L-histidine is lower than in healthy controls. Using the graph-based data analysis, gene ontology, and semantic association capabilities of Lifelike, led us to connect the differentially expressed metabolites with G-protein signaling and SRC. Then, we associated SRC with IL6 signaling. Subsequently, we found associations that connect SRC, and IL6 to Activin and BMP signaling. Lastly, we analyzed the mechanisms of action of several existing and novel pharmacological treatments for PH. Lifelike elucidated the interplay between G-protein, interleukin 6, activin, and BMP signaling. Those pathways regulate hallmark pathophysiological processes of PH, including vasoconstriction, endothelial barrier function, cell proliferation, and apoptosis. The results highlight the importance of SRC, ERK1, AKT, and MLC activity in PH. The molecular pathways affected by existing and novel treatments for PH also converge on these molecules. Importantly, sotatercept affects SRC, ERK1, AKT, and MLC simultaneously. The present study shows the power of mining knowledge graphs using Lifelike's diverse set of data analytics functionalities for developing knowledge-driven hypotheses on PH pathophysiological and drug mechanisms and their interactions. We believe that Lifelike and our presented approach will be valuable for future mechanistic studies of PH, other diseases, and drugs.
Evaluating and mitigating unfairness in multimodal remote mental health assessments

Research on automated mental health assessment tools has been growing in recent years, often aiming to address the subjectivity and bias that existed in the current clinical practice of the psychiatric evaluation process. Despite the substantial health and economic ramifications, the potential unfairness of those automated tools was understudied and required more attention. In this work, we systematically evaluated the fairness level in a multimodal remote mental health dataset and an assessment system, where we compared the fairness level in race, gender, education level, and age. Demographic parity ratio (DPR) and equalized odds ratio (EOR) of classifiers using different modalities were compared, along with the F1 scores in different demographic groups. Post-training classifier threshold optimization was employed to mitigate the unfairness. No statistically significant unfairness was found in the composition of the dataset. Varying degrees of unfairness were identified among modalities, with no single modality consistently demonstrating better fairness across all demographic variables. Post-training mitigation effectively improved both DPR and EOR metrics at the expense of a decrease in F1 scores. Addressing and mitigating unfairness in these automated tools are essential steps in fostering trust among clinicians, gaining deeper insights into their use cases, and facilitating their appropriate utilization.
Rifampin Mono-Resistant Tuberculosis in New York City, 2010–2021: A Retrospective Case Series

Abstract Background Although relatively rare, rifampin mono-resistant tuberculosis (RMR TB) poses important challenges to effective TB treatment and control. Information on the burden of RMR TB and treatment outcomes is needed to inform diagnosis and management. Methods Standardized variables were collected from the New York City (NYC) tuberculosis surveillance system for patients treated for RMR TB in NYC during 2010–2021. Results Of 7097 TB cases reported in 2010–2021, 31 (<1%) were treated clinically as RMR TB. Five (16%) of these patients had HIV. Seventeen patients (55%) had TB that was rifampin-resistant by both molecular and phenotypic drug susceptibility testing; 2 (6%) had rifampin resistance by phenotypic tests, and molecular tests were not done; and 12 (39%) were identified based only on molecular tests. Among these 12, 7 were rifampin-sensitive by phenotypic tests, and phenotypic testing could not be done for the other 5. Ten of the 31 (32%) were diagnosed in 2010–2015; the other 21 (including 10/12 diagnosed by molecular tests alone) were diagnosed in 2016–2021. Of the 31 patients, 21 (68%) completed treatment (median treatment duration of 18 months). Although the interval between tuberculosis treatment initiation and change to a non-rifamycin-containing regimen decreased significantly during the study period, the overall duration of treatment did not decrease significantly between 2010 and 2021. Conclusions Molecular drug susceptibility tests identified cases of RMR TB that were not detected by phenotypic testing and helped enable timely adjustment of tuberculosis treatment regimens. Short-course regimens are needed to reduce duration of treatment for RMR TB.
Key processes required for the different stages of fungal carnivory by a nematode-trapping fungus

Nutritional deprivation triggers a switch from a saprotrophic to predatory lifestyle in soil-dwelling nematode-trapping fungi (NTF). In particular, the NTF Arthrobotrys oligospora secretes food and sex cues to lure nematodes to its mycelium and is triggered to develop specialized trapping devices. Captured nematodes are then invaded and digested by the fungus, thus serving as a food source. In this study, we examined the transcriptomic response of A. oligospora across the stages of sensing, trap development, and digestion upon exposure to the model nematode Caenorhabditis elegans. A. oligospora enacts a dynamic transcriptomic response, especially of protein secretion–related genes, in the presence of prey. Two-thirds of the predicted secretome of A. oligospora was up-regulated in the presence of C. elegans at all time points examined, and among these secreted proteins, 38.5% are predicted to be effector proteins. Furthermore, functional studies disrupting the t-SNARE protein Sso2 resulted in impaired ability to capture nematodes. Additionally, genes of the DUF3129 family, which are expanded in the genomes of several NTF, were highly up-regulated upon nematode exposure. We observed the accumulation of highly expressed DUF3129 proteins in trap cells, leading us to name members of this gene family as Trap Enriched Proteins (TEPs). Gene deletion of the most highly expressed TEP gene, TEP1, impairs the function of traps and prevents the fungus from capturing prey efficiently. In late stages of predation, we observed up-regulation of a variety of proteases, including metalloproteases. Following penetration of nematodes, these metalloproteases facilitate hyphal growth required for colonization of prey. These findings provide insights into the biology of the predatory lifestyle switch in a carnivorous fungus and provide frameworks for other fungal–nematode predator–prey systems.
The dimensionality reductions of environmental variables have a significant effect on the performance of species distribution models

Abstract How to effectively obtain species‐related low‐dimensional data from massive environmental variables has become an urgent problem for species distribution models (SDMs). In this study, we will explore whether dimensionality reduction on environmental variables can improve the predictive performance of SDMs. We first used two linear (i.e., principal component analysis (PCA) and independent components analysis) and two nonlinear (i.e., kernel principal component analysis (KPCA) and uniform manifold approximation and projection) dimensionality reduction techniques (DRTs) to reduce the dimensionality of high‐dimensional environmental data. Then, we established five SDMs based on the environmental variables of dimensionality reduction for 23 real plant species and nine virtual species, and compared the predictive performance of those with the SDMs based on the selected environmental variables through Pearson's correlation coefficient (PCC). In addition, we studied the effects of DRTs, model complexity, and sample size on the predictive performance of SDMs. The predictive performance of SDMs under DRTs other than KPCA is better than using PCC. And the predictive performance of SDMs using linear DRTs is better than using nonlinear DRTs. In addition, using DRTs to deal with environmental variables has no less impact on the predictive performance of SDMs than model complexity and sample size. When the model complexity is at the complex level, PCA can improve the predictive performance of SDMs the most by 2.55% compared with PCC. At the middle level of sample size, the PCA improved the predictive performance of SDMs by 2.68% compared with the PCC. Our study demonstrates that DRTs have a significant effect on the predictive performance of SDMs. Specifically, linear DRTs, especially PCA, are more effective at improving model predictive performance under relatively complex model complexity or large sample sizes.
Predator evasion: the behavioral response of moose to a wolf-like predator

Predation is a strong selective force favoring the individual with the most successful survival strategy. Predators affect prey through direct predation and through the costs of anti-predator behavioral. In Sweden moose (Alces alces) is an important game species annual harvest is ~100 000 animals. Wolves (Canis lupus) returned to Sweden in the 1980s. Wolves’ main prey in Sweden is moose and can be as much as 95% of the consumed biomass. Because booth humans and wolves are important agents of mortality they are likely to affect the behavior of moose. I tested differences in moose flight response when hunted with loose dog, and if this was related to the amount their previous wolf exposure. I hypothesize that a high exposure to wolves would affect the flight behavior of moose. Disturbance trials were conducted with GPS collared dog and GPS collared moose. Wolf data was retrieved from GPS collared wolves. Several movement metrics such as speed, distance, duration and sinuosity were used to detect patterns of moose flight behavior. Results were also compared with a similar study conducted in Vasterbotten where moose had no recent experience of exposure to wolves. I did not find support for my hypothesis that wolf exposure affect moose escape behavior when hunted with loose dog. Results from Grimso and Vasterbotten showed a similar response pattern in overall response by moose to disturbance. Differences between Grimso and Vasterbotten were found in net displacement and movement rate Differences are likely due to low sample size and environmental differences and not the presence of wolf at Grimso. Moose flight behavior is likely shaped by a combination of both recent human hunting practices and previous predation by wolves and brown bears.
Infection prevention knowledge and practices among healthcare workers at a health facility in Makurdi, Benue State, Nigeria

The ongoing COVID-19 pandemic has highlighted the critical importance of Infection prevention practices among healthcare workers. Prioritizing this crucial aspect of healthcare can mitigate the spread of infectious diseases and ensure the well-being of our healthcare heroes and their communities. The purpose of the research was to investigate the knowledge and practice of Infection prevention and control. The study was a cross-sectional study that used self-administered paper-based questionnaires. The study sample of 316 eligible healthcare workers were selected using stratified sampling. Data was entered into EPI Info version 7.2 and exported to SPSS version 27 for analysis. The ethics committees of the University and the Hospital approved the study. The majority of participants 116 (36.7%) were nurses. The mean age was 34.79 years ± 8.37, 118 (37.30%) were male while 198 (62.7%) were female. Only 169 (53.9%) knew the recommended duration for hand washing. 132 (41.8%) of healthcare workers believed needles should be recapped following use. Healthcare workers were twice as likely to wash their hands before contact and five times more likely to wash their hands after contact with a patient, their bedding, or after a procedure (AOR 1.82, 95%CI 1.04-3.20), (AOR 4.51, 95%CI 1.76-11.54) respectively. Personal protective equipment (PPEs) were twice as likely to be unavailable (AOR 2.39, 95%CI 1.31-4.37). The findings revealed suboptimal knowledge and practice of hand hygiene indicating the need for healthcare workers to be trained on IPC. PPE(s) must be provided for healthcare workers to improve compliance with IPC practices.
A Randomized Trial of Dolutegravir Plus Darunavir/Cobicistat as a Switch Strategy in HIV-1-Infected Patients With Resistance to at Least 2 Antiretroviral Classes

Abstract Background Suppressed patients with drug-resistant HIV-1 require effective and simple antiretroviral therapy to maintain treatment adherence and viral suppression. Methods This randomized, open-label, noninferiority, multicenter pilot study involved HIV-infected adults who met the following criteria: confirmed HIV-1 RNA <50 copies/mL for ≥6 months preceding the study randomization, treatment with at least 3 antiretroviral drugs, and a history of drug resistance mutations against at least 2 antiretroviral classes but remaining fully susceptible to darunavir (DRV) and integrase inhibitors. Participants were randomized 1:1 to switch to dolutegravir (DTG; 50 mg once per day) plus DRV boosted with cobicistat (DRV/c; 800/150 mg once per day; 2D group) or continue with their baseline regimen (standard-of-care [SOC] group). The primary endpoint was the proportion of patients with HIV-1 RNA <50 copies/mL at week 48 relative to time to loss of virologic response, with a noninferiority margin set at −12.5%. Virologic failure was defined as confirmed HIV-1 RNA ≥50 copies/mL or a single determination of HIV-1 RNA >50 copies/mL followed by antiretroviral therapy discontinuation. Results Forty-five participants were assigned to the 2D group and 44 to the SOC group. Time to loss of virologic response showed no difference in the proportion maintaining HIV-1 RNA <50 copies/mL at week 48: 39 of 45 (86.7%; 95% CI, 73.21%–94.95%) in the 2D group vs 42 of 44 (95.4%; 95% CI, 84.53%–99.44%) in the SOC group (log-rank P = .159) with an estimated difference of −8.7 (95% CI, −22.72 to 5.14). Only 2 (4.5%) in the SOC group experienced virologic failure, and 3 participants from the 2D group experienced adverse events leading to treatment discontinuation. Conclusions In suppressed patients with at least 2 resistant antiretroviral classes, noninferiority could not be demonstrated by fully active DRV/c plus DTG. Nevertheless, there were no unexpected adverse events or virologic failure. DRV/c plus DTG may be considered a once-daily therapy option only for well-selected patients. Clinical Trials Registration. ClinicalTrials.gov (NCT03683524).
Staged revascularization and multi-modal mechanical circulatory supports in a patient with severe cardiogenic shock due to acute-on-chronic coronary syndrome

Abstract Acute coronary syndrome with cardiogenic shock is a life-threatening condition, but with planned staged treatment combined with coronary revascularization and mechanical circulatory supports its management is increasingly possible. Here, we present our successful life-saving case. A 76-year-old male patient was diagnosed with ST-elevation myocardial infarction with cardiogenic shock due to severe stenosis of the left main coronary artery based on the severe triple vessel disease. We initially introduced Impella CP and performed a percutaneous coronary intervention without stenting on the patient. We maintained hemodynamics with Impella CP and performed coronary artery bypass grafting after a week. Intraoperatively, Impella CP was left to function as a left ventricular vent. The patient required upgrading to Impella 5.5 plus veno-arterial extracorporeal membrane oxygenation postoperatively, but his condition gradually improved, all mechanical circulatory supports could be weaned off, and he eventually survived.
segmented: An R package to Fit Regression Models with Broken-Line Relationships

Segmented or broken-line models are regression models where the relationships between the response and one or more explanatory variables are piecewise linear, namely represented by two or more straight lines connected at unknown values: these values are usually referred as breakpoints, changepoints or even joinpoints. Hereafter we use such words indistinctly. Broken-line relationships are common in many fields, including epidemiology, occupational medicine, toxicology, and ecology, where sometimes it is of interest to assess threshold value where the effect of the covariate changes (Ulm, 1991; Betts et al., 2007).
Effect of exercise interventions on hospital length of stay and admissions during cancer treatment: a systematic review and meta-analysis

Objective To assess the effect of participating in an exercise intervention compared with no exercise during cancer treatment on the duration and frequency of hospital admissions. Design Systematic review and meta-analysis. Data sources MEDLINE, EMBASE, PEDro and Cochrane Central Registry of Randomized Controlled Trials. Eligibility criteria for selecting studies Randomised studies published until August 2023 evaluating exercise interventions during chemotherapy, radiotherapy or stem cell transplant regimens, compared with usual care, and which assessed hospital admissions (length of stay and/or frequency of admissions). Study appraisal and synthesis Study quality was assessed using the Cochrane Risk-of-Bias tool and Grading of Recommendations Assessment, Development and Evaluation assessment. Meta-analyses were conducted by pooling the data using random-effects models. Results Of 3918 screened abstracts, 20 studies met inclusion criteria, including 2635 participants (1383 intervention and 1252 control). Twelve studies were conducted during haematopoietic stem cell transplantation regimens. There was a small effect size in a pooled analysis that found exercise during treatment reduced hospital length of stay by 1.40 days (95% CI: −2.26 to −0.54 days; low-quality evidence) and lowered the rate of hospital admission by 8% (difference in proportions=−0.08, 95% CI: −0.13 to −0.03, low-quality evidence) compared with usual care. Conclusion Exercise during cancer treatment can decrease hospital length of stay and admissions, although a small effect size and high heterogeneity limits the certainty. While exercise is factored into some multidisciplinary care plans, it could be included as standard practice for patients as cancer care pathways evolve.