Miracle-dz/UniFAR-FTUs huggingface dataset:
The health economic impact of posterior capsule opacification in Finland comparing the two single‐piece intraocular lenses: a cost–consequence analysis

Editor, P osterior capsule opacification (PCO) is the most common postsurgical complication of cataract surgery with an incidence ranging from <5% to as high as 50% (Fong et al. 2014). Clinically significant PCO is treated by Nd:YAG laser capsulotomy. This treatment bears a cost, and its provision can place a burden on resource-constrained healthcare systems (Cullin et al. 2014). Furthermore, although generally considered a safe procedure, Nd:YAG laser capsulotomy is associated with a risk of complications such as elevated intraocular pressure, cystoid macular oedema, intraocular lens (IOL) dislocation and retinal detachment (Cullin et al. 2014). The objective of this research was to estimate the health economic impact of PCO, according to the choice of IOL (AcrySof SN60WF, Alcon and Tecnis ZCB00, Johnson & Johnson Vision) from both the hospital and the Finnish healthcare system perspectives. The original study was carried out as a retrospective cohort study at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland (Lindholm et al. 2019). This research adapts the findings of the original competing risks survival analysis to include an economic assessment which focuses on the reported Nd: YAG laser capsulotomy rates of the two single-piece acrylic IOLs (Andersen et al. 2012). A cost–consequence model was developed comparing healthcare resource utilization and costs associated with PCO. Cumulative incidence of Nd:YAG laser capsulotomy at 5 years postcataract surgery with SN60WF (11.5%) and ZCB00 (18.1%) from the RWE study findings underpinned the analysis. The average number of annual cataract procedures at the study site was used for the hospital-level analysis and Eurostat for the national estimate. The Nd: YAG procedure and associated additional consultation visit costs (0.5 preoperatively and 1.0 postoperatively) were assumed to be € 150 and € 95, respectively. An adjustment was made to account for 25% immediate sequential bilateral Nd:YAG laser capsulotomies. Indirect costs, such as travel, and caregivers’ time were not considered in the analysis. In the hospital-level analysis, assuming 2080 annual cataract procedures, AcrySof SN60WF was associated with a reduction of 103 Nd:YAG procedures, 5 years postcataract surgery compared to Tecnis ZCB00. Extrapolating to the national level resulted in a reduction of 2969 Nd: YAG procedures. Translated into potential cost savings for the hospital Fig. 1. Intraoperative snapshot showing hydrated merocel sponge held at the port of 23 G cutter. Acta Ophthalmologica 2019
Why the static allometry of sexually-selected traits is so variable: the importance of function.

Sexually-selected traits often show positive static allometry, with large individuals bearing disproportionately large structures. But many other sexually-selected traits show isometry or even negative allometry, with trait size varying relatively little with body size. We recently proposed that the functions of these traits (as aggressive signals, weapons, courtship signals, and contact courtship devices) determine their allometries. Positive allometry is generally favored for aggressive signals, because aggressive signals are selected to emphasize body size (and thus fighting prowess). In contrast, the biomechanics of force application in weapons only sometimes select for positive allometry; the content of courtship signals is even less often related to body size; and contact courtship devices are selected to be relatively invariant across body sizes. Here we summarize the arguments in favor of this "functional allometry" hypothesis and expand a comparative test of its predictions. Our results indicate that sexual traits have the allometric slopes predicted by our hypothesis, regardless of which body part bears the structure.
Age-related changes in resting-state functional connectivity in older adults

Age-related changes in the brain connectivity of healthy older adults have been widely studied in recent years, with some differences in the obtained results. Most of these studies showed decreases in general functional connectivity, but they also found increases in some particular regions and areas. Frequently, these studies compared young individuals with older subjects, but few studies compared different age groups only in older populations. The purpose of this study is to analyze whole-brain functional connectivity in healthy older adult groups and its network characteristics through functional segregation. A total of 114 individuals, 48 to 89 years old, were scanned using resting-state functional magnetic resonance imaging in a resting state paradigm and were divided into six different age groups (< 60, 60–64, 65–69, 70–74, 75–79, ≥ 80 years old). A partial correlation analysis, a pooled correlation analysis and a study of 3-cycle regions with prominent connectivity were conducted. Our results showed progressive diminution in the functional connectivity among different age groups and this was particularly pronounced between 75 and 79 years old. The oldest group (≥ 80 years old) showed a slight increase in functional connectivity compared to the other groups. This occurred possibly because of compensatory mechanism in brain functioning. This study provides information on the brain functional characteristics of every age group, with more specific information on the functional progressive decline, and supplies methodological tools to study functional connectivity characteristics. Approval for the study was obtained from the ethics committee of the Comisión de Bioética de la Universidad de Barcelona (approval No. PSI2012-38257) on June 5, 2012, and from the ethics committee of the Barcelona’s Hospital Clínic (approval No. 2009-5306 and 2011-6604) on October 22, 2009 and April 7, 2011 respectively.
Lower dietary fibre intake, but not total water consumption, is associated with constipation: a population-based analysis.

BACKGROUND Associations between constipation and dietary fibre and water intake, as well as various lifestyle factors, have not been fully evaluated. The present study aimed to investigate associations between fibre and water intake and constipation, as well as other possible risk factors for constipation, in a large adult population. METHODS Data obtained from 14 024 adults aged ≥20 years from three cycles of the National Health and Nutrition Examination Survey (NHANES) 2005-2010, who had completed a bowel health questionnaire, were included in this cross-sectional population-based study. Variables included demographics, lifestyle and dietary factors, comorbidities and laboratory parameters. Logistic regression analyses were performed to determine associations between potential risk factors and constipation. RESULTS Among 17 132 participants ≥20 years, 2401 (14%) did not complete bowel health questionnaires and were excluded, along with pregnant women (n = 461) and participants without dietary sample weight on day 1 (n = 246), leaving data from 14 024 participants available for analysis. Multivariate analysis revealed that black race/ethnicity [odds ratio (OR) = 1.380, 95% confidence interval (CI) = 1.054-1.809], a lower than 12th grade education (OR = 1.420, 95% CI = 1.154-1.749) or high school education (OR = 1.339, 95% CI = 1.057-1.697), lower income/poverty ratios (1.3-3.49 versus ≥3.5: OR = 1.261, 95% CI = 1.015-1.567), normal weight (OR = 1.913, 95% CI = 1.534-2.386) or overweight (OR = 1.536, 95% CI = 1.207-1.955), depression (OR = 1.610, 95% CI = 1.119-2.315) and poor teeth (OR = 1.441, 95% CI = 1.100-1.888) were associated with an increased risk for constipation. Lower dietary fibre intake was associated with a greater risk of constipation. Total water consumption was significantly associated an with an increased risk of constipation in univariate analysis, but not in multivariate analysis. CONCLUSIONS Lower dietary fibre intake, but not poor water consumption, was associated with a greater risk of constipation in US adults.
Simulated optical performance of soft contact lenses on the eye

Purpose To evaluate the impact of soft contact lens eye-fit on optical power by computational modelling and to produce correction maps for reversing this impact during the design process. Methods Finite element models of spherical and toric hydrogel contact lenses at varying nominal powers of -20 D to +20 D, base curves radii (R1b) of 8.2, 8.5, 8.8 mm, and overall diameters (d3) of 14.5, 15.0, 15.5 mm were generated. Lenses were fitted to computational eye models generated with human eyes’ topography data. Combined eye-lens simulations were run under the boundary conditions of the tears’ surface tension between the contact lens and the eye in addition to the eyelid blink pressure. Lens optical zone power changes were calculated through computational light-ray tracing methods following each simulation. Results Effective power changes (EPC) were affected negatively for all toric simulated lenses with power varying from -20 D to +20 D. Spherical lenses demonstrated similar behaviour, however with some positive EPC over the power range from -20 D to -10 D for spherical power (SPH) lenses. EPC assessment was between +0.25 D and -0.5 D for most lenses, however, lenses with prescriptions from +10 D to +20 D incurred EPC outside this range. The spherical lenses showed a maximum effective power change of +1.046 ± 0.338 D (Average Eye), and a minimum of -3.278 ± 0.731 D (Steep Eye). Similarly, the toric lenses showed a maximum of +1.501 ± 0.338 D (Average Eye), and a minimum of -3.514 ± 0.731 D (Steep Eye). EPC trends, along with minimum and maximum power, generally increased negatively as nominal lens prescription increased positively. Contact lens base curve selection affected the assessed effective power change for both spherical and toric lenses. The effect from lens total diameter for spherical lenses was less substantial than that for toric lenses. Conclusions This study considered the impact of soft contact lens design parameters on effective optical power changes (EPC) after eye-fit. Spherical lenses experienced more EPC of clinical significance (>0.25 D) than toric lenses. Both types of lenses, spherical and toric (simple astigmatism), demonstrated similar trends in EPC on fitting from -20 D to +20 D, with lenses in the extremely positive and the extremely negative prescriptions demonstrating the highest EPCs. The lens base curve impacted the extent of EPC observed, with flatter base curves experiencing less power change. Diameter proved to impact toric lenses more than spherical ones, however generally the diameter has less effect on power change than base curve selection.
Cytomorphologic comparison of type 1 and type 2 papillary renal cell carcinoma: A retrospective analysis of 28 cases

Papillary renal cell carcinoma (pRCC) is classified as type 1 or type 2 on the basis of histomorphologic features. Type 1 pRCC typically carries a better prognosis, and renal cell carcinoma is often diagnosed by fine‐needle aspiration (FNA). Thus, this study was designed to characterize cytomorphologic features present in FNA cases that could be used to discriminate between type 1 and type 2 pRCC.
Extract of ice plant (Mesembryanthemum crystallinum) ameliorates hyperglycemia and modulates the gut microbiota composition in type 2 diabetic Goto-Kakizaki rats.

Ice plant (Mesembryanthemum crystallinum) extract (IPE) is a rich source of d-pinitol, which is widely known to have potential anti-diabetic effects. In the present study, response surface methodology (RSM) was used to optimize d-pinitol extraction conditions with the Box-Behnken design. We then evaluated the anti-diabetic effects properties of IPE that was extracted under optimized conditions (53 °C, 119 min extraction time, and 1 : 11 dilution) in type 2 diabetic Goto-Kakizaki (GK) rats. IPE (400 mg kg-1 day-1) effectively controlled the increased fasting blood glucose level (decreased by 45% vs. GK-control rats) and impaired glucose tolerance (decreased area under curve (AUC) of glucose values by 24%, p < 0.05 vs. GK-control rats) after eight weeks of treatment. Furthermore, IPE significantly improved pancreatic islet morphology, β-cell survival, and insulin secretion in diabetic rats, thus contributing to the antihyperglycemic effect. Finally, prebiotic effects of IPE on gut microbiota were observed and included increased abundance of the beneficial bacteria Bacteroidales_S24-7 and Ruminococcaceae_UCG-014 and decreased abundance of Treponema_2 and Lactobacillus. Overall, IPE has a substantial effect on attenuating hyperglycemia and modulating gut microbiota composition in diabetic GK rats. Therefore, IPE might be a promising functional food for the prevention of diabetes.
Signals trigger state-specific transcriptional programs to support diversity and homeostasis in immune cells

Single-cell data reveal the major transcriptional regulators for distinct macrophage states. Defining macrophage states Macrophages are immune cells that play a major role in maintaining tissue homeostasis. Because of their high plasticity, macrophages can rapidly respond to various external and internal cues, such as exposure to infectious agents or metabolic stress. Through single-cell analyses of mRNA and proteins in macrophage populations and computational analysis, Fischer et al. characterized the differential transcriptional programs driven by the microbial product LPS and the free fatty acid palmitate, both of which engage the same cell surface receptor, TLR4. These data helped to characterize the pro- and anti-inflammatory macrophage states induced by both stimuli, determine how antagonistic genes interacted with each other, and measure transcriptional signaling efficiency in these cells. Macrophages play key roles in the immune systems of humans and other mammals. Here, we performed single-cell analyses of the mRNAs and proteins of human macrophages to compare their responses to the signaling molecules lipopolysaccharide (LPS), a component of Gram-negative bacteria, and palmitate (PAL), a free fatty acid. We found that, although both molecules signal through the cell surface protein Toll-like receptor 4 (TLR4), they stimulated the expression of different genes, resulting in specific pro- and anti-inflammatory cellular states for each signal. The effects of the glucocorticoid receptor, which antagonizes LPS signaling, and cyclic AMP–dependent transcription factor 3, which inhibits PAL-induced inflammation, on inflammatory response seemed largely determined by digital on-off events. Furthermore, the quantification of transcriptional variance and signaling entropy enabled the identification of cell state–specific deregulated molecular pathways. These data suggest that the preservation of signaling in distinct cells might confer diversity on macrophage populations essential to maintaining major cellular functions.
Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths

Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change.
An update on medication management of women with schizophrenia in pregnancy

ABSTRACT Introduction: Women with schizophrenia and their babies are at high risk of adverse outcomes in pregnancy and childbirth. A better understanding of the specific risks conferred by the illness itself and by the treatment provided will help guide more effective care of these women. Areas covered: Herein, the authors review genetic, demographic, socioeconomic, nutritional and lifestyle risks associated with schizophrenia in pregnancy. They also cover specific risks associated with typical antipsychotic medications, specific risks associated with atypical antipsychotic medications, risks associated with polypharmacy and risks of developmental delay in children exposed to antipsychotic medications in utero. Expert opinion: Our understanding of the risks that women with schizophrenia face in pregnancy from their illness and from the treatment they receive continues to evolve. As our ability to analyze data progresses, the risks conferred by antipsychotic medication treatment appear to lessen in clinical and statistical significance, whilst the true risks to these women and their babies from their experience of disadvantage continue to set them aside from the general population. Reducing polypharmacy and providing comprehensive and supportive care can minimize harm to women with schizophrenia and their babies.
Risk Factors for Initial and Subsequent Core or Lower Extremity Sprain or Strain Among Collegiate Football Players.

CONTEXT Exposure to game conditions and previous injury are known to increase the risk of injury, but little available evidence pertains to modifiable factors that may mediate dynamic control of body segments, such as core muscle endurance and neurocognitive capabilities. OBJECTIVE To identify potentially modifiable factors associated with the occurrence of a core or lower extremity sprain or strain during participation in football. DESIGN Prospective cohort study. SETTING National Collegiate Athletic Association Division I Football Bowl Subdivision football program. PATIENTS OR OTHER PARTICIPANTS All team members who participated for the duration of 1 season or both of 2 consecutive seasons (n = 142). MAIN OUTCOME MEASURE(S) Predictors of injury occurrence were derived from analysis of preparticipation data that included the results of front plank hold (FPH) and neurocognitive tests. Receiver operating characteristic analysis was used to establish binary classifications of injury risk. Logistic regression analyses were conducted to build multivariable injury-prediction models for optimal discriminatory power. RESULTS Exceptionally good discrimination between injured and noninjured participants was provided by models that included the results of the FPH and ImPACT neurocognitive tests. A high level of exposure to game conditions and injury during the preceding year magnified the effects of other risk factors. A model for identifying players with an elevated risk for injury occurrence during both of 2 consecutive seasons included FPH ≤120 seconds, verbal memory score ≤87, composite reaction time ≥560 milliseconds, and starter status. Having ≥2 of the 4 risk factors demonstrated 44% sensitivity and 91% specificity, with an odds ratio = 8.40. CONCLUSIONS Core muscle endurance and neurocognitive processes may both play important roles in generating anticipatory muscle stiffness during participation in collegiate football. These factors may be particularly important for players who sustained an injury during the previous year and those who have a high level of game exposure.
Acute lower limb ischemia as the initial symptom of acute myeloid leukemia

Although coagulatory system disorders are well recognized in patients with acute leukemia, these usually present with either hemorrhagic complications or thrombosis of small vessels. Large vessel thrombosis is a very rare clinical presentation. We present a patient with previously undiagnosed acute myeloid leukemia (M5), who was referred to our hospital with symptoms of acute ischemia of his right lower limb. Occlusion of the right external iliac artery due to a combination of leucostasis and coagulation disorders was noted and successfully treated with urgent leukapheresis, immediate chemotherapy and surgical thromboembolectomy.
New Simian Immunodeficiency Virus Infecting De Brazza's Monkeys (Cercopithecus neglectus): Evidence for a Cercopithecus Monkey Virus Clade

ABSTRACT Nearly complete sequences of simian immunodeficiency viruses (SIVs) infecting 18 different nonhuman primate species in sub-Saharan Africa have now been reported; yet, our understanding of the origins, evolutionary history, and geographic distribution of these viruses still remains fragmentary. Here, we report the molecular characterization of a lentivirus (SIVdeb) naturally infecting De Brazza's monkeys (Cercopithecus neglectus). Complete SIVdeb genomes (9,158 and 9,227 bp in length) were amplified from uncultured blood mononuclear cell DNA of two wild-caught De Brazza's monkeys from Cameroon. In addition, partial pol sequences (650 bp) were amplified from four offspring of De Brazza's monkeys originally caught in the wild in Uganda. Full-length (9,068 bp) and partial pol (650 bp) SIVsyk sequences were also amplified from Sykes's monkeys (Cercopithecus albogularis) from Kenya. Analysis of these sequences identified a new SIV clade (SIVdeb), which differed from previously characterized SIVs at 40 to 50% of sites in Pol protein sequences. The viruses most closely related to SIVdeb were SIVsyk and members of the SIVgsn/SIVmus/SIVmon group of viruses infecting greater spot-nosed monkeys (Cercopithecus nictitans), mustached monkeys (Cercopithecus cephus), and mona monkeys (Cercopithecus mona), respectively. In phylogenetic trees of concatenated protein sequences, SIVdeb, SIVsyk, and SIVgsn/SIVmus/SIVmon clustered together, and this relationship was highly significant in all major coding regions. Members of this virus group also shared the same number of cysteine residues in their extracellular envelope glycoprotein and a high-affinity AIP1 binding site (YPD/SL) in their p6 Gag protein, as well as a unique transactivation response element in their viral long terminal repeat; however, SIVdeb and SIVsyk, unlike SIVgsn, SIVmon, and SIVmus, did not encode a vpu gene. These data indicate that De Brazza's monkeys are naturally infected with SIVdeb, that this infection is prevalent in different areas of the species' habitat, and that geographically diverse SIVdeb strains cluster in a single virus group. The consistent clustering of SIVdeb with SIVsyk and the SIVmon/SIVmus/SIVgsn group also suggests that these viruses have evolved from a common ancestor that likely infected a Cercopithecus host in the distant past. The vpu gene appears to have been acquired by a subset of these Cercopithecus viruses after the divergence of SIVdeb and SIVsyk.