Miracle-dz/UniFAR-FTUs huggingface dataset:
Intravitreal bevacizumab versus panretinal photocoagulation for treatment‐naïve proliferative and severe nonproliferative diabetic retinopathy

floxacin 400 mg od po for 10 days. Prednisolone 1 mg ⁄kg od po was commenced after one day, providing the presence of fungi had been excluded on microscopy. Subsequent management depended on clinical course: a second intravitreal injection of the same antibiotics was performed at 48 hr if there was no improvement; vitrectomy was considered if there was no improvement after a further 48 hr. The primary outcome measure was the proportion of patients achieving a final best-corrected visual acuity (BCVA) of 20 ⁄ 40 or better. Seventy-two eyes of 72 patients were included in the study. The mean followup was 18 weeks (range, 8–150 weeks). Forty-eight patients were treated with ciprofloxacin and 24 with moxifloxacin. There were no significant differences between the two groups in terms of patient and surgical characteristics. Of the 72 cases, six (8%) were culture positive from the anterior chamber tap alone, 35 (49%) from the vitreous tap alone and 31 (43%) from both samples. The most common bacterial isolate was coagulase-negative staphylococci (CNS) (45 eyes, 63%). All Gram-negative organisms were susceptible to amikacin, and 98% of Gram-positive isolates were susceptible to vancomycin. Resistance to ciprofloxacin increased over the course of the study from 18% in 2000–2004 to 37% in 2005– 2009 (p = 0.04); only one isolate was resistant to moxifloxacin. Of the 72 eyes, 28 (39%) had a final BCVA of 20 ⁄ 40 or better, and 53 (74%) had a final BCVA of 20 ⁄ 200 or better. There were no recorded complications of ciprofloxacin or moxifloxacin. Resolution of hypopyon occurred quicker in the moxifloxacin group (mean, 2.6 days versus 4.3 days; p = 0.006), and there was a reduced need for repeat intravitreal injections (2 ⁄ 24 eyes (8%) versus 18 ⁄ 48 eyes (39%); p = 0.01), but not vitrectomy (5 ⁄ 24 eyes (21%) versus 6 ⁄ 48 eyes (13%); p = 0.49). Table 1 summarizes factors associated with having a final BCVA of 20 ⁄ 40 or better. In the univariate analyses, only a microbiological diagnosis of CNS was statistically significantly associated with good visual outcome. After controlling for potentially confounding variables including ciprofloxacin resistance, the detection of CNS and the use of oral moxifloxacin were all associated with a good visual outcome (OR for moxifloxacin, 4.07; p = 0.035). The role of systemic antibiotics in the management of acute-onset bacterial endophthalmitis following cataract surgery is controversial. The EVS reported that intravenous amikacin and ceftazidime made no difference to final visual acuity (Endophthalmitis Vitrectomy Study Group 1995), but, despite newer antibiotics with improved ocular penetration having become available, no large study has subsequently readdressed this question. Our study suggests that adjunctive moxifloxacin can have a beneficial impact on the clinical course of the infection and lead to an improved clinical outcome. To our knowledge, this is the first study to provide such evidence of the benefit of adjunctive oral antibiotics in this setting.
Determination of Colour Vision Using Ishihara and Dvorine Plates

Background : Colour vision is important in everyday life and colour vision deficiency generally lowers the quality of life. The objective of the study was to perform tests and measurements to investigate the prevalence of colour vision abnormalities within a normal sample population of the University of Jos. Methodology : Colour vision measurements were carried out using the Ishihara and Dvorine colour test plates. The visual acuity measurements were obtained using the Snellen letters. A total number of 115 subjects were tested. Results : A nalysis of the data resulted in a new empirical relationship for the Colour Deficiency Index (CDI) which was found to be equal to the product of the number of Ishihara plates missed (I) and the number of Dvorine plates missed (D) divided by the coded Visual Acuity number (A) given by the equation This relationship, indicated a colour problem for a CDI of more than 3, while an index of less than 3 indicated a 'normal' colour condition. The results of the physical measurements showed a prevalence of 9.6% colour vision deficiency. Conclusion : The percentage is high compared to the civilized world having 8.5% , primarily due to the fact that most were acquired and indicated a poor health care.
Ketamine attenuates cytochrome p450 aromatase gene expression and estradiol‐17β levels in zebrafish early life stages

Ketamine, a dissociative anesthetic, is a noncompetitive antagonist of N‐methyl‐D‐aspartate‐type glutamate receptors. In rodents and non‐human primates as well as in zebrafish embryos, ketamine has been shown to be neurotoxic. In cyclic female rats, ketamine has been shown to decrease serum estradiol‐17β (E2) levels. E2 plays critical roles in neurodevelopment and neuroprotection. Cytochrome p450 (CYP) aromatase catalyzes E2 synthesis from androgens. Although ketamine down‐regulates a number of CYP enzymes in rodents, its effect on the CYP aromatase (CYP19) is not known. Zebrafish have been used as a model system for examining mechanisms underlying drug effects. Here, using wild‐type (WT) zebrafish (Danio rerio) embryos, we demonstrate that ketamine significantly reduced E2 levels compared with the control. However, the testosterone level was elevated in ketamine‐treated embryos. These results are concordant with data from mammalian studies. Ketamine also attenuated the expression of the ovary form of CYP aromatase (cyp19a1a) at the transcriptional level but not the brain form of aromatase, cyp19a1b. Exogenous E2 potently induced the expression of cyp19a1b and vtg 1, both validated biomarkers of estrogenicity and endocrine disruption, but not cyp19a1a expression. Attenuation of activated ERK/MAPK levels, reportedly responsible for reduced human cyp19 transcription, was also observed in ketamine‐treated embryos. These results suggest that reduced E2 levels in ketamine‐treated embryos may have resulted from the suppression of cyp19a1a transcription. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
Comparison of macular pigment in patients with age‐related macular degeneration and healthy control subjects – a study using spectral fundus reflectance

Purpose: Previous studies have reported an age‐dependent decline of macular pigment optical density (MPOD) as well as a relative lack of MPOD in age‐related macular degeneration (AMD). Results are, however, strongly dependent on the technique used. In this study, we investigated the age dependence of MPOD using spectral fundus reflectance. In addition, we hypothesized that patients with AMD have a reduced MPOD as compared to healthy controls.
Life-Course Socioeconomic Position and Hippocampal Atrophy in a Prospective Cohort of Older Adults

Objective Low socioeconomic position (SEP) has been linked to an increased risk of dementia and cognitive decline. However, little is known about the association between SEP and morphologic brain changes in older age. This study examines the relationships between indicators of life-course SEP with both hippocampal volume (HcV) and HcV loss in a population-based cohort of 1328 older adults aged 65 to 80 years. Methods Multivariable linear regression models were used to estimate the associations of SEP with baseline HcV and the annual rate of HcV atrophy according to three life-course conceptual models: the sensitive/critical periods model (which explored SEP in specific periods: in childhood [using parental education], early adulthood [based on participants' education], and midlife [based on participants' socioprofessional group]); the accumulation-of-risk model (life-course cumulative SEP), and the social mobility model (life-course SEP trajectories). Results Participants with lower midlife SEP had smaller HcV (−0.08 cm3; 95% confidence interval, −0.15 to −0.01) and 0.17% (95% confidence interval, 0.04%–0.30%) faster hippocampal atrophy than participants with higher midlife SEP. Childhood and early adulthood SEPs were not related to hippocampal measures. The accumulation-of-risk and the social mobility models revealed that the accumulation of socioeconomic disadvantage and declining socioeconomic trajectories were related to faster hippocampal atrophy. Conclusions In this cohort of older adults, lower socioprofessional attainment in midlife and disadvantageous life-course socioeconomic position were associated with faster hippocampal atrophy, a cerebral change linked to cognitive disorders. Results support the hypothesized links between socioenvironmental exposures related to stress and/or cognitive enrichment and brain/cognitive reserve capacities.
Keeping the customer satisfied? Service users' perceptions of an Emergency Duty Team

Abstract Evocative accounts by service users along with increasing requirements from the government make a strong argument that Social Services Departments should consult with those who make use of services provided by them. This article describes a customer satisfaction survey carried Out by the Buckinghamshire Social Services Emergency Duty Team (EDT). Service users were asked to identify what they had found helpful or not with regard to responses to their contact and ways in which the service could be improved. The article highlights responses to these questions from a mother caring for her son with combined physical and mental disabilities, and a woman diagnosed with manic depression. While satisfaction was reported with the team's skill in acknowledging and containing difficulty and distress, pleas were made for access to more information, additional resources and for greater accessibility of localised services. Particular aspects of EDT work are highlighted and the value of reflecting on work undertaken from a different point of view to that usually adopted is illustrated. The article concludes that social workers can be positively challenged to think about their practice by consulting with those who receive services.
Joint Impact of Early Life Adversity and COMT Val158Met (rs4680) Genotypes on the Adult Cortisol Response to Psychological Stress

Objective Exposure to stress during critical periods of development can diminish stress reactivity by the hypothalamic-pituitary-adrenocortical axis. Genetic characteristics may further modify this effect of early adversity, leading to a gene by environment (G × E) interaction on stress reactivity in adulthood. Val-allele carriers of a common polymorphism of the COMT gene (Val158Met, rs4680) have rapid removal of catecholamines in the prefrontal cortex, limbic system, and reward centers. Carriers of the Val and Met alleles may therefore respond differently to the environment and differ in the long-term impact of exposure to early life adversity (ELA). Methods We measured saliva cortisol reactivity to public speaking and mental arithmetic stress in 252 healthy young adults exposed to low, medium, and high levels of ELA and who were genotyped for the Val158Met polymorphism. Results Cortisol responses showed a G × E interaction (F(4,243) = 2.78, p = . 028); simple effects tests showed that Met/Met carriers had progressively smaller cortisol responses with greater levels of ELA. In comparison, Val/Val homozygotes had blunted responses that did not vary with ELA exposure. Conclusions Met/Met homozygotes seem sensitive to stressful events in childhood and adolescence, leading to environmental programming of the stress axis. Glucocorticoid responsivity may represent a common pathway revealing targeted genetic vulnerabilities to the long-term effects of early life stress. The results suggest that further G × E studies of ELA are warranted in relation to health behaviors and health outcomes in adulthood.
Brain Structure and Response to Emotional Stimuli as Related to Gut Microbial Profiles in Healthy Women

Objective Brain-gut-microbiota interactions may play an important role in human health and behavior. Although rodent models have demonstrated effects of the gut microbiota on emotional, nociceptive, and social behaviors, there is little translational human evidence to date. In this study, we identify brain and behavioral characteristics of healthy women clustered by gut microbiota profiles. Methods Forty women supplied fecal samples for 16S rRNA profiling. Microbial clusters were identified using Partitioning Around Medoids. Functional magnetic resonance imaging was acquired. Microbiota-based group differences were analyzed in response to affective images. Structural and diffusion tensor imaging provided gray matter metrics (volume, cortical thickness, mean curvature, surface area) as well as fiber density between regions. A sparse Partial Least Square-Discrimination Analysis was applied to discriminate microbiota clusters using white and gray matter metrics. Results Two bacterial genus-based clusters were identified, one with greater Bacteroides abundance (n = 33) and one with greater Prevotella abundance (n = 7). The Prevotella group showed less hippocampal activity viewing negative valences images. White and gray matter imaging discriminated the two clusters, with accuracy of 66.7% and 87.2%, respectively. The Prevotella cluster was associated with differences in emotional, attentional, and sensory processing regions. For gray matter, the Bacteroides cluster showed greater prominence in the cerebellum, frontal regions, and the hippocampus. Conclusions These results support the concept of brain-gut-microbiota interactions in healthy humans. Further examination of the interaction between gut microbes, brain, and affect in humans is needed to inform preclinical reports that microbial modulation may affect mood and behavior.
Engagement in Pleasant Leisure Activities and Blood Pressure: A 5-Year Longitudinal Study in Alzheimer Caregivers

Objective Elevated blood pressure is a significant public health concern, particularly given its association with cardiovascular disease risk, including stroke. Caring for a loved one with Alzheimer disease has been associated with physical health morbidity, including higher blood pressure. Engagement in adaptive coping strategies may help prevent blood pressure elevation in this population. This 5-year longitudinal study examined whether greater participation in pleasant leisure activities was associated with reduced blood pressure in caregivers. Methods Participants were 126 in-home spousal Alzheimer's caregivers (M [SD] age = 74.2 [7.9] years) that completed five yearly assessments. Linear mixed-effects models analysis was used to examine the longitudinal relationship between pleasant leisure activities and caregivers' blood pressure, after adjusting for demographic and health characteristics. Results Greater engagement in pleasant leisure activities was associated with reduced mean arterial blood pressure (B = −0.08, SE = 0.04, p = .040). Follow-up analyses indicated that engagement in activities was significantly associated with reduced diastolic (B = −0.07, SE = 0.03, p = .030) but not systolic blood pressure (B = −0.10, SE = 0.06, p = .114). In addition, mean arterial blood pressure was significantly reduced when caregiving duties ended because of placement of care recipients in nursing homes (B = −3.10, SE = 1.11, p = .005) or death of the care recipient (B = −2.64, SE = 1.14, p = .021). Conclusions Greater engagement in pleasant leisure activities was associated with lowered caregivers' blood pressure over time. Participation in pleasant leisure activities may have cardiovascular health benefits for Alzheimer's caregivers.
Developmental toxicity and endocrine disruption of naphthenic acids on the early life stage of zebrafish (Danio rerio)

Oil sands process‐affected water (OSPW) has been reported to exhibit adverse effects on the environment and wildlife. Although the compounds responsible are unknown, naphthenic acids (NAs) have been considered to be implicated. The current study was designed to investigate whether NAs might cause developmental toxicity and endocrine disruption on the early life stage of zebrafish (Danio rerio). The success of embryo hatch was inhibited by 2.5 mg l–1 oil sands NAs (OS‐NAs) exposure, and both OSPW NAs and commercial NAs (C‐NAs) exposure resulted in a variety of developmental lesions in the fish larvae, such as yolk sac edema, pericardial edema and spinal malformation. The transcription of genes involved cytochrome P450 aromatase (CYP19a and CYP19b), estrogen receptors (ERα, ERβ1 and ERβ2), and vitellogenin (VTG) was analyzed to evaluate the endocrine disrupting effects of NAs. Significant up‐regulated gene expressions of CYP19b, ERα and VTG were observed in both OS‐NAs and C‐NAs groups, which indicated the deleteriously estrogenic potential of NAs. These results confirmed that NAs derived from crude petroleum could negatively impact the development and endocrine function of zebrafish, and be primarily responsible for the toxicity of OSPW. Copyright © 2015 John Wiley & Sons, Ltd.
A Quantitative Analysis of the Reactions of a Person After Loss of the Function of Both Inner Ears

IN previous papers the present authors have emphasized the importance of quantitative investigations into experiments on the function of the vestibular organ. A qualitative examination, the answer to the question of the presence or absence of certain phenomena, is anything but conclusive ; on the contrary, the results of qualitative investigations may be deceptive and misleading. The description of a case, apparently very simple, but giving us great difficulties and almost giving rise to serious mistakes concerning the functional diagnosis, may be an example of the necessity of quantitative measurements to avoid misinterpretations of facts.
Bisphenol A affects placental layers morphology and angiogenesis during early pregnancy phase in mice

Bisphenol A (BPA) is a widespread endocrine disrupter mainly used in food contact plastics. Much evidence supports the adverse effects of BPA, particularly on susceptible groups such as pregnant women. The present study considered placental development – relevant for pregnancy outcomes and fetal nutrition/programming – as a potential target of BPA. Pregnant CD‐1 mice were administered per os with vehicle, 0.5 (BPA05) or 50 mg kg−1 (BPA50) body weight day−1 of BPA, from gestational day (GD) 1 to GD11. At GD12, BPA50 induced significant degeneration and necrosis of giant cells, increased vacuolization in the junctional zone in the absence of glycogen accumulation and reduction of the spongiotrophoblast layer. In addition, BPA05 induced glycogen depletion as well as significant nuclear accumulation of β‐catenin in trophoblasts of labyrinthine and spongiotrophoblast layers, supporting the activation of the Wnt/β‐catenin pathway. Transcriptomic analysis indicated that BPA05 promoted and BPA50 inhibited blood vessel development and branching; morphologically, maternal vessels were narrower in BPA05 placentas, whereas embryonic and maternal vessels were irregularly dilated in the labyrinth of BPA50 placentas. Quantitative polymerase chain reaction evidenced an estrogen receptor β induction by BPA50, which did not correspond to downstream genes activation; indeed, the transcription factor binding sites analysis supported the AhR/Arnt complex as regulator of BPA50‐modulated genes. Conversely, Creb appeared as the main transcription factor regulating BPA05‐modulated genes. Embryonic structures (head, forelimb) showed divergent perturbations upon BPA05 or BPA50 exposure, potentially related to unbalanced embryonic nutrition and/or to modulation of genes involved in embryo development. Our findings support placenta as an important target of BPA, even at environmentally relevant dose levels. Copyright © 2015 John Wiley & Sons, Ltd.
Reconstituted high‐density lipoprotein can elevate plasma alanine aminotransferase by transient depletion of hepatic cholesterol: role of the phospholipid component

Human apolipoprotein A‐I preparations reconstituted with phospholipids (reconstituted high‐density lipoprotein [HDL]) have been used in a large number of animal and human studies to investigate the physiological role of apolipoprotein A‐I. Several of these studies observed that intravenous infusion of reconstituted HDL might cause transient elevations in plasma levels of hepatic enzymes. Here we describe the mechanism of this enzyme release. Observations from several animal models and in vitro studies suggest that the extent of hepatic transaminase release (alanine aminotransferase [ALT]) correlates with the movement of hepatic cholesterol into the blood after infusion. Both the amount of ALT release and cholesterol movement were dependent on the amount and type of phospholipid present in the reconstituted HDL. As cholesterol is known to dissolve readily in phospholipid, an HDL preparation was loaded with cholesterol before infusion into rats to assess the role of diffusion of cholesterol out of the liver and into the reconstituted HDL. Cholesterol‐loaded HDL failed to withdraw cholesterol from tissues and subsequently failed to cause ALT release. To investigate further the role of cholesterol diffusion, we employed mice deficient in SR‐BI, a transporter that facilitates spontaneous movement of cholesterol between cell membranes and HDL. These mice showed substantially lower movement of cholesterol into the blood and markedly lower ALT release. We conclude that initial depletion of hepatic cholesterol initiates transient ALT release in response to infusion of reconstituted HDL. This effect may be controlled by appropriate choice of the type and amount of phospholipid in reconstituted HDL. Copyright © 2015 John Wiley & Sons, Ltd.
Understanding Occupational Therapy: Nursing and Physician Assistant Students' Knowledge About Occupational Therapy

The purpose of this study was to discover whether nursing and physician's assistant students at a large Midwestern university get a sufficient overview in their professional curriculums about the role of occupational therapy and its implications in healthcare services. These professionals play an important role in the prescription of occupational therapy (OT). Attempts at targeting these populations for marketing the OT profession and increasing the awareness of its various roles is of critical value to the OT profession. This study involved a two part survey consisted of scaled and open-ended questions asking what the students know about OT, how they learned about the profession, and a checklist testing their actual knowledge level about occupational therapy's role in the healthcare system. Correlation between section one and section two of the survey was done to understand whether students who believe they are educated about the role of OT are in fact knowledgeable about the profession. Even though a low positive correlation was found between the physician assistant students' perceived knowledge of OT and their actual knowledge, the results were not statistically significant. It was also found that most students in both the nursing and physician's assistant curriculums responded to occupational therapy's role within a very narrow scope, consisting of mainly activities of daily living (ADLs). The authors emphasize the need for targeting other health professions for marketing OT.