Miracle-dz/UniFAR-FTUs huggingface dataset:
Firefighter Well-Being Defined and Operationalized at the Organizational and Worker Level

Firefighters in career fire departments define well-being as being content with oneself and being able to balance ones emotional, mental, and physical health. Three main themes emerged characterizing organizational- and worker-level factors that impact firefighter well-being: 1) the nature of firefighting; 2) the influence of others; and 3) physical health. Objective The aim of the study is to define and explore organizational- and worker-level factors of firefighter well-being. Methods Qualitative data were collected using interviews and focus group sessions among 17 career firefighters across 4 fire departments. Interviews were recorded and transcribed, and a general inductive approach was used to code similar concepts into themes. Results Firefighters defined well-being as being content with oneself and being able to balance ones’ emotional, mental, and physical health. Themes contributing to firefighter well-being include the nature of the job, the influence of others, and physical health. Subthemes mapping to themes include dealing with trauma, compartmentalizing work and home life, coworkers and station culture, the role of superiors on attitudes and practices, being a reliable firefighter, and lack of sleep. Conclusions Career firefighters describe well-being as a holistic approach to balancing emotional, mental, and physical health.
Interactive Medical Image Labeling Tool to Construct a Robust Convolutional Neural Network Training Data Set: Development and Validation Study

Background Skin ulcers are an important cause of morbidity and mortality everywhere in the world and occur due to several causes, including diabetes mellitus, peripheral neuropathy, immobility, pressure, arteriosclerosis, infections, and venous insufficiency. Ulcers are lesions that fail to undergo an orderly healing process and produce functional and anatomical integrity in the expected time. In most cases, the methods of analysis used nowadays are rudimentary, which leads to errors and the use of invasive and uncomfortable techniques on patients. There are many studies that use a convolutional neural network to classify the different tissues in a wound. To obtain good results, the network must be trained with a correctly labeled data set by an expert in wound assessment. Typically, it is difficult to label pixel by pixel using a professional photo editor software, as this requires extensive time and effort from a health professional. Objective The aim of this paper is to implement a new, fast, and accurate method of labeling wound samples for training a neural network to classify different tissues. Methods We developed a support tool and evaluated its accuracy and reliability. We also compared the support tool classification with a digital gold standard (labeling the data with an image editing software). Results The obtained comparison between the gold standard and the proposed method was 0.9789 for background, 0.9842 for intact skin, 0.8426 for granulation tissue, 0.9309 for slough, and 0.9871 for necrotic. The obtained speed on average was 2.6, compared to that of an advanced image editing user. Conclusions This method increases tagging speed on average compared to an advanced image editing user. This increase is greater with untrained users. The samples obtained with the new system are indistinguishable from the samples made with the gold standard.
Virtual Balint Groups During COVID-19: Exploring Race and Equity in a CHC-Based Family Medicine Residency Program

The Lawrence Family Medicine residency was created in the 1990s as the first community health center- sponsored residency with the goal of reducing health disparities. Balint groups have been a part of the wellbeing and behavioral health curriculum for many years. The population of Lawrence, MA is primarily a resource-poor, Latinx, immigrant population. In March of 2020, the Covid pandemic highlighted health disparities in this community. The spike in cases in 2020 also impacted the residency community with overwhelming needs of sick and dying patients in newly created, resident and faculty-run Covid units. Our early ignorance about transmission, prophylaxis, treatment and even prognosis made the work incredibly difficult. George Floyd’s murder added the additional stress of social unrest in response to a persistent pattern of racism and unequal justice. To help process trauma residents felt working in terrifying conditions, often in medically futile situations with patients who spent their last hours without family at the bedside, we turned to biweekly Balint groups and added additional resident support sessions on the off weeks. Residents seamlessly adopted videoconferencing as the Balint platform, allowing them to attend a group session without risk of infection. The residents, being a diverse group, were able to offer multiple perspectives and process the traumatic issues of disproportionate suffering for their patients, uncertainty and frustration of the COVID-19 pandemic and systemic racism. We found a video Balint group permitted residents to explore their divergent experiences and feelings and offer support to each other in a very uncertain time.
Effects of Engagement with a Social Media Campaign for Mothers to Prevent Indoor Tanning by Teens in a Randomized Trial

In a social media campaign aimed at reducing mothers’ permissiveness for indoor tanning (IT) by their teenage daughters, a secondary analysis of campaign engagement effects on IT outcomes was performed. Mothers (n = 869) with daughters aged 14–17 were recruited in 34 states that did not ban IT by minors under age 18 for a randomized trial with follow-up at 12 months (end of intervention) and 18 months (6 months after intervention) post-randomization. Daughters’ (n = 469) baseline and follow-up responses were analyzed too. Mothers received a Facebook feed on adolescent health topics that included posts about preventing IT (intervention) or prescription drug misuse (control). Engagement was measured by extracting reactions (e.g., like, sad, etc.) and comments posted by mothers to the campaign posts. Overall, 76.4% of posts received a reaction and/or comment. Mothers who engaged with IT posts were less permissive of daughters’ IT immediately at the conclusion of the campaign (permit IT: −0.39, p < .05; facilitate IT: −0.29, p < .05) and 6 months after intervention (permit IT: −0.32, p < .05; facilitate IT: −0.31, p < .05) than mothers who did not engage with posts. Engagement with posts was essential to the success of a social media campaign for preventing IT by minors by reducing mothers’ permissiveness.
Anxiety disrupts performance monitoring: integrating behavioral, event-related potential, EEG microstate, and sLORETA evidence

Abstract Anxiety impacts performance monitoring, though theory and past research are split on how and for whom. However, past research has often examined either trait anxiety in isolation or task-dependent state anxiety and has indexed event-related potential components, such as the error-related negativity or post-error positivity (Pe), calculated at a single node during a limited window of time. We introduced 2 key novelties to this electroencephalography research to examine the link between anxiety and performance monitoring: (i) we manipulated antecedent, task-independent, state anxiety to better establish the causal effect; (ii) we conducted moderation analyses to determine how state and trait anxiety interact to impact performance monitoring processes. Additionally, we extended upon previous work by using a microstate analysis approach to isolate and sequence the neural networks and rapid mental processes in response to error commission. Results showed that state anxiety disrupts response accuracy in the Stroop task and error-related neural processes, primarily during a Pe-related microstate. Source localization shows that this disruption involves reduced activation in the dorsal anterior cingulate cortex and compensatory activation in the right lateral prefrontal cortex, particularly among people high in trait anxiety. We conclude that antecedent anxiety is largely disruptive to performance monitoring.
Value of Additional Instrumented Fusion in the Treatment of Thoracic Ossification of the Ligamentum Flavum

Objective The ossification of the ligamentum flavum (OLF) is one of the major causes of thoracic myelopathy. Surgical decompression with or without instrumented fusion is the mainstay of treatment. However, few studies have reported on the added effect of instrumented fusion. The objective of this study was to compare clinical and radiological outcomes between surgical decompression without instrumented fusion (D-group) and that with instrumented fusion (F-group). Methods A retrospective review was performed on 28 patients (D-group, n=17; F-group, n=11) with thoracic myelopathy due to OLF. The clinical parameters compared included scores of the Japanese Orthopedic Association (JOA), the Visual analogue scale of the back and leg (VAS-B and VAS-L), and the Korean version of the Oswestry disability index (K-ODI). Radiological parameters included the sagittal vertical axis (SVA), the pelvic tilt (PT), the sacral slope (SS), the thoracic kyphosis angle (TKA), the segmental kyphosis angle (SKA) at the operated level, and the lumbar lordosis angle (LLA; a negative value implying lordosis). These parameters were measured preoperatively, 1 year postoperatively, and 2 years postoperatively, and were compared with a linear mixed model. Results After surgery, all clinical parameters were significantly improved in both groups, while VAS-L was more improved in the F-group than in the D-group (-3.4±2.5 vs. -1.3±2.2, p=0.008). Radiological outcomes were significantly different in terms of changes in TKA, SKA, and LLA. Changes in TKA, SKA, and LLA were 2.3°±4.7°, -0.1°±1.4°, and -1.3°±5.6° in the F-group, which were significantly lower than 6.8°±6.1°, 3.0°±2.8°, and 2.2°±5.3° in the D-group, respectively (p=0.013, p<0.0001, and p=0.037). Symptomatic recurrence of OLF occurred in one patient of the D-group at postoperative 24 months. Conclusion Clinical improvement was achieved after decompression surgery for OLF regardless of whether instrumented fusion was added. However, adding instrumented fusion resulted in better outcomes in terms of lessening the progression of local and regional kyphosis and improving leg pain. Decompression with instrumented fusion may be a better surgical option for thoracic OLF.
Immune Responses and Immunosuppressive Strategies for Adeno-Associated Virus-Based Gene Therapy for Treatment of Central Nervous System Disorders: Current Knowledge and Approaches

Adeno-associated viruses (AAVs) are being increasingly used as gene therapy vectors in clinical studies especially targeting central nervous system (CNS) disorders. Correspondingly, host immune responses to the AAV capsid or the transgene-encoded protein have been observed in various clinical and preclinical studies. Such immune responses may adversely impact patients' health, prevent viral transduction, prevent repeated dosing strategies, eliminate transduced cells, and pose a significant barrier to the potential effectiveness of AAV gene therapy. Consequently, multiple immunomodulatory strategies have been used in attempts to limit immune-mediated responses to the vector, enable readministration of AAV gene therapy, prevent end-organ toxicity, and increase the duration of transgene-encoded protein expression. Herein we review the innate and adaptive immune responses that may occur during CNS-targeted AAV gene therapy as well as host- and treatment-specific factors that could impact the immune response. We also summarize the available preclinical and clinical data on immune responses specifically to CNS-targeted AAV gene therapy and discuss potential strategies for incorporating prophylactic immunosuppression regimens to circumvent adverse immune responses.
Media pressure and the process of Westernization in the context of body self-assessment among young heterosexual and gay Polish men

Mass media and social networks portray a unified image of the perfect male body. The intensity and universality of this influence is an important element of the process of Westernization, especially in traditional cultures such as that of Poland. The main aim of the present study was to investigate the differences between Polish gay and heterosexual men in terms of the role played by self-esteem and the level of internalization of sociocultural standards of body appearance as predictors of the development of their body images. The research study was conducted by reference to 19- to 29-year-old Polish heterosexual (n = 287) and gay (n = 97) men. The variables were measured using Polish versions of the Sociocultural Attitudes towards Appearance Scale-3, the Self-Esteem Scale, and the Multidimensional Body–Self Relations Questionnaire. Statistical analyses identified several variables as the main predictors of body image in both heterosexual and gay young men: self-esteem, information-seeking, perceived pressure and the internalization of sociocultural standards regarding an athletic body image drawn from mass media. The only significant difference between the two groups was the fact that self-esteem, perceived pressure and the internalization of sociocultural standards from mass media did not play a predictive role with respect to Appearance Orientation among the group of gay men.
Evidence for Different Virulence Determinants and Host Response after Infection of Turkeys and Chickens with Highly Pathogenic H7N1 Avian Influenza Virus

Infection with HPAIV in chickens and turkeys, two closely related galliform species, results in severe disease and death. Although the presence of a polybasic cleavage site (pCS) in the hemagglutinin of AIV is a major virulence determinant for the transition of LPAIV to HPAIV, there are knowledge gaps on the genetic determinants (including pCS) and the host responses in turkeys compared to chickens. ABSTRACT Wild birds are the reservoir for all avian influenza viruses (AIV). In poultry, the transition from low pathogenic (LP) AIV of H5 and H7 subtypes to highly pathogenic (HP) AIV is accompanied mainly by changing the hemagglutinin (HA) monobasic cleavage site (CS) to a polybasic motif (pCS). Galliformes, including turkeys and chickens, succumb with high morbidity and mortality to HPAIV infections, although turkeys appear more vulnerable than chickens. Surprisingly, the genetic determinants for virulence and pathogenesis of HPAIV in turkeys are largely unknown. Here, we determined the genetic markers for virulence and transmission of HPAIV H7N1 in turkeys, and we explored the host responses in this species compared to those of chickens. We found that recombinant LPAIV H7N1 carrying pCS was avirulent in chickens but exhibited high virulence in turkeys, indicating that virulence determinants vary in these two galliform species. A transcriptome analysis indicated that turkeys mount a different host response than do chickens, particularly from genes involved in RNA metabolism and the immune response. Furthermore, we found that the HA glycosylation at residue 123, acquired by LP viruses shortly after transmission from wild birds and preceding the transition from LP to HP, had a role in virus fitness and virulence in chickens, though it was not a prerequisite for high virulence in turkeys. Together, these findings indicate variable virulence determinants and host responses in two closely related galliformes, turkeys and chickens, after infection with HPAIV H7N1. These results could explain the higher vulnerability to HPAIV of turkeys compared to chickens. IMPORTANCE Infection with HPAIV in chickens and turkeys, two closely related galliform species, results in severe disease and death. Although the presence of a polybasic cleavage site (pCS) in the hemagglutinin of AIV is a major virulence determinant for the transition of LPAIV to HPAIV, there are knowledge gaps on the genetic determinants (including pCS) and the host responses in turkeys compared to chickens. Here, we found that the pCS alone was sufficient for the transformation of a LP H7N1 into a HPAIV in turkeys but not in chickens. We also noticed that turkeys exhibited a different host response to an HPAIV infection, namely, a widespread downregulation of host gene expression associated with protein synthesis and the immune response. These results are important for a better understanding of the evolution of HPAIV from LPAIV and of the different outcomes and the pathomechanisms of HPAIV infections in chickens and turkeys.
“Living in the Darkness”: Technology-Facilitated Coercive Control, Disenfranchised Grief, and Institutional Betrayal

This article draws on interviews with 20 Australian women subjected to technology-facilitated coercive control (TFCC), foregrounding their accounts of grief and institutional betrayal. Findings show that while the harms of TFCC were significant, survivors’ experiences were often minimized and dismissed by justice institutions. Women experienced grief due to abuse and separation from partners who had betrayed them. This loss was compounded when seeking help. We propose that disenfranchised grief is an underexplored response to domestic violence and institutional betrayal as well as a potential intervention site, particularly in relation to technology-facilitated abuse.
Risks of serious adverse events associated with non‐steroidal anti‐inflammatory drugs in gastrointestinal surgery. A protocol for a systematic review with meta‐analysis and trial sequential analysis

Post‐operative pain is frequent following gastrointestinal surgery and may result in prolonged hospitalisation, delayed recovery, and lower quality of life. Non‐steroidal anti‐inflammatory drugs (NSAIDs) are effective analgesics and recommended by Enhanced Recovery After Surgery guidelines as part of opioid‐sparing multimodal treatment. However, perioperative NSAID treatment may be associated with increased risk of harm. We will investigate the risks of serious adverse events associated with perioperative NSAID treatment in patients undergoing gastrointestinal surgery.
Adolescent and parent experiences with Tele-Active Rehabilitation for concussion: an exploratory qualitative study

ABSTRACT Purpose To explore the experiences of adolescents with concussion and their parents who participated in a novel remotely delivered Tele-Active Rehabilitation (Tele-AR) intervention involving sub-symptom threshold exercise, education, and support. Specifically, we aimed to elicit perspectives regarding the remote delivery approach, valued aspects of the program, and perceived benefits of the intervention. Methods This qualitative study took place within the context of a larger mixed-methods project exploring the feasibility of the Tele-AR intervention. A descriptive qualitative design was utilized. Semi-structured interviews were conducted with adolescents (n = 3; ages 14–17 years) with concussion and one of their parents (n = 3) within one week of completing the six-week Tele-AR intervention. Data were analyzed using thematic analysis. Results Four themes were identified that capture participant experiences in the intervention: (1) Enabling access to active rehabilitation; (2) Focusing on individual needs; (3) Learning to take responsibility for recovery; and (4) Convenience and comfort of engaging in rehabilitation from home. Conclusions A small sample of 3 adolescents with concussion and their parents were satisfied with the Tele-AR intervention and appreciated the convenience and comfort of engaging in rehabilitation from home, which facilitated adolescents taking responsibility for their own recovery. Findings support continued study of Tele-AR, which may be an accessible intervention to facilitate recovery in adolescents with concussion.
The β-Grasp Domain of Proteasomal ATPase Mpa Makes Critical Contacts with the Mycobacterium tuberculosis 20S Core Particle to Facilitate Degradation

The Pup-proteasome system in Mycobacterium tuberculosis is critical for this species to cause lethal infections in mice. Investigating the molecular mechanism of how the Mpa ATPase recruits and unfolds pupylated substrates to the 20S proteasomal core particle for degradation will be essential to fully understand how degradation is regulated, and the structural information we report may be useful for the development of new tuberculosis chemotherapies. ABSTRACT Mycobacterium tuberculosis possesses a Pup-proteasome system analogous to the eukaryotic ubiquitin-proteasome pathway. We have previously shown that the hexameric mycobacterial proteasome ATPase (Mpa) recruits pupylated protein substrates via interactions between amino-terminal coiled-coils in Mpa monomers and the degradation tag Pup. However, it is unclear how Mpa rings interact with a proteasome due to the presence of a carboxyl-terminal β-grasp domain unique to Mpa homologues that makes the interaction highly unstable. Here, we describe newly identified critical interactions between Mpa and 20S core proteasomes. Interestingly, the Mpa C-terminal GQYL motif binds the 20S core particle activation pocket differently than the same motif of the ATP-independent proteasome accessory factor PafE. We further found that the β-hairpin of the Mpa β-grasp domain interacts variably with the H0 helix on top of the 20S core particle via a series of ionic and hydrogen-bond interactions. Individually mutating several involved residues reduced Mpa-mediated protein degradation both in vitro and in vivo. IMPORTANCE The Pup-proteasome system in Mycobacterium tuberculosis is critical for this species to cause lethal infections in mice. Investigating the molecular mechanism of how the Mpa ATPase recruits and unfolds pupylated substrates to the 20S proteasomal core particle for degradation will be essential to fully understand how degradation is regulated, and the structural information we report may be useful for the development of new tuberculosis chemotherapies.
The influence of sex, BMI, and age on cellular and humoral immune responses against measles after a 3rd dose of MMR vaccine.

BACKGROUND A third dose of measles-mumps-rubella vaccine (MMR3) is recommended in mumps outbreak scenarios, but the immune response and the need for widespread use of MMR3 remain uncertain. Herein, we characterized measles-specific immune responses to MMR3 in a cohort of 232 healthy subjects. METHODS Serum and PBMCs were sampled at Day 0 and Day 28 after MMR3. Measles-specific binding and neutralizing antibodies were quantified in sera by ELISA and a microneutralization assay, respectively. PBMCs were stimulated with inactivated measles virus, and the release of cytokines/chemokines was assessed by a multiplex assay. Demographic variables of subjects were examined for potential correlations with immune outcomes. RESULTS 95.69% and 100% of subjects were seropositive at Day 0 and Day 28, respectively. Antibody avidity significantly increased from 38.08% at Day 0 to 42.8% at Day 28 (p = 0.00026). Neutralizing antibodies significantly enhanced from 928.7 at Day 0 to 1,289.64 mIU/mL at Day 28 (p = 0.0001). Meanwhile, cytokine/chemokine responses remained largely unchanged. BMI was significantly correlated with the levels of inflammatory cytokines/chemokines. CONCLUSION Measles-specific humoral immune responses, but not cellular responses, were enhanced after MMR3 receipt, extending current understanding of immune responses to MMR3 and supporting MMR3 administration to seronegative or high-risk individuals.