Miracle-dz/UniFAR-FTUs huggingface dataset:
Magnetic resonance imaging reveals possible cause of diplopia after Baerveldt glaucoma implantation

Purpose To assess if ocular motility impairment, and the ensuing diplopia, after Baerveldt Glaucoma device (BGI) implantation, is related to the presence of a large fluid reservoir (bleb), using Magnetic Resonance Imaging (MRI). Methods In a masked observational study (CCMO-registry number: NL65633.058.18), the eyes of 30 glaucoma patients with (n = 12) or without diplopia (n = 18) who had previously undergone BGI implantation were scanned with a 7 Tesla MRI-scanner. The substructures of the BGI-complex, including both blebs and plate, were segmented in 3D. Primary outcomes were a comparison of volume and height of the BGI-complex between patients with and without diplopia. Comparisons were performed by using an unpaired t-test, Fisher’s Exact or Mann-Whitney test. Correlations were determined by using Spearman correlation. Results The median volume and height of the BGI-complex was significantly higher in patients with compared to patients without diplopia (p = 0.007 and p = 0.025, respectively). Six patients had an excessively large total bleb volume (median of 1736.5mm3, interquartile range 1486.3–1933.9mm3), four of whom experienced diplopia (33% of the diplopia patients). Fibrotic strands through the BGI plate, intended to limit the height of the bleb, could be visualized but were not related to diplopia (75% versus 88%; p = 0.28). Conclusions With MRI, we show that in a significant number of diplopia cases a large bleb is present in the orbit. Given the large volume of these blebs, they are a likely explanation of the development of diplopia in at least some of the patients with diplopia after BGI implantation. Additionally, the MR-images confirm the presence of fibrotic strands. As these strands are also visible in patients with a large bleb, they are apparently not sufficient to restrict the bleb height.
One-sided complete stable minimal surfaces

We prove that there are no complete one-sided stable minimal surfaces in the Euclidean 3-space. We classify least area surfaces in the quotient of R by one or two linearly independent translations and we give sharp upper bounds of the genus of compact twosided index one minimal surfaces in non-negatively curved ambient spaces. Finally we estimate from below the index of complete minimal surfaces in flat spaces in terms of the topology of the surface.
Retinopathy of prematurity screening: A narrative review of current programs, teleophthalmology, and diagnostic support systems

PURPOSE: Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergence of teleophthalmology screening programs and artificial intelligence (AI) technologies represents promising methods to address this growing unmet demand in ROP screening. An improved understanding of current ROP screening programs may inform the adoption of these novel technologies in ROP care. METHODS: A critical narrative review of the literature was carried out. Publications that were representative of established or emerging ROP screening programs in high-, middle-, and low-income countries were selected for review. Screening programs were reviewed for inclusion criteria, screening frequency and duration, modality, and published sensitivity and specificity. RESULTS: Screening inclusion criteria, including age and birth weight cutoffs, showed significant heterogeneity globally. Countries of similar income tend to have similar criteria. Three primary screening modalities including binocular indirect ophthalmoscopy (BIO), wide-field digital retinal imaging (WFDRI), and teleophthalmology were identified and reviewed. BIO has documented limitations in reduced interoperator agreement, scalability, and geographical access barriers, which are mitigated in part by WFDRI. Teleophthalmology screening may address limitations in ROP screening workforce distribution and training. Opportunities for AI technologies were identified in the context of these limitations, including interoperator reliability and possibilities for point-of-care diagnosis. CONCLUSION: Limitations in the current ROP screening include scalability, geographical access, and high screening burden with low treatment yield. These may be addressable through increased adoption of teleophthalmology and AI technologies. As the global incidence of ROP continues to increase, implementation of these novel modalities requires greater consideration.
Prognostic nutritional index as a novel marker for diabetic retinopathy in individuals with type 2 diabetes mellitus

PURPOSE: In recent years, the prognostic nutritional index (PNI), an easily obtainable nutritional inflammatory marker, has been introduced as an independent prognostic indicator for various types of cancers and cardiovascular diseases. However, its clinical importance in the area of ophthalmology is not well known yet. We aimed to elucidate the association between the PNI and the occurrence of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). METHODS: In this cross-sectional study, the PNI was applied to 128 consecutive patients with T2DM. The relationship between the PNI and the occurrence of DR was examined. PNI was calculated as 10× (serum albumin) + 0.005 × (total lymphocyte count). The risk factors for DR were evaluated using multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve analysis of PNI for predicting DR was performed. RESULTS: Patients with DR had significantly lower levels of PNI than those without DR (41.20 ± 4.81 and 44.49 ± 3.10, respectively, P < 0.001). Multivariate regression analysis indicated that PNI, together with the duration of diabetes and creatinine, was an independent factor for DR occurrence (odds ratio, 0.885; 95% confidence interval: 0.735–0.971; P = 0.017). ROC curve analysis revealed that the best cutoff value of PNI was 43 (area under the curve: 0.713; sensitivity: 74%; specificity: 64%). CONCLUSION: A lower PNI value is common among T2DM patients with DR and is strongly associated with the occurrence of DR. The PNI might be a useful biomarker for identifying DR to improve the risk stratification and management of T2DM patients.
Perceived empowerment and the impact of negative effects of the COVID-19 pandemic on the quality of life of persons with severe mental illness

Purpose Beyond its direct effects on physical health the COVID-19 pandemic has been shown to have negative effects on the living situation of people with severe mental illness (SMI). To date, there has been little research on resilience factors preventing people with SMI from experiencing negative effects of the COVID-19 pandemic. The objective of this study was to investigate the role of perceived empowerment (PE) as a resilience factor, preventing people with SMI from experiencing negative effects of the COVID-19 pandemic on daily living. Methods We investigated negative effects of the COVID-19 pandemic on daily living in 931 persons with SMI at two times within six month between June 2020 and Mai 2021. To take into account the longitudinal structure of the data we applied mixed effects regression analyses and longitudinal path models. Results A majority of participants experienced negative effects of the COVID-19 pandemic on several dimensions of daily living. Negative effects increased with rising levels of illness-related impairment but decreased as the level of PE rose. While negative effects of the COVID-19 pandemic at follow-up were negatively associated with overall subjective quality of life baseline, PE was negatively associated with the negative impact of the pandemic and positively with quality of life. Conclusion Patients with SMI need support to reduce negative effects of the COVID-19 pandemic on their quality of life. The promotion of PE could help strengthen resilience in this target group. Trial registration German Clinical Trial Register, DRKS00019086, registered on 3 January 2020. (https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00019086).
Physicians’ awareness of oral-systemic links and its association with physician-reported patient referral to dentists

Introduction Physicians promote oral health by screening for oral pathologies, providing emergency help, and referring patients to dentists. The literature consistently reports a robust association between periodontal disease and systemic diseases. However, it is not fully known if physicians in Saudi Arabia are aware of the oral-systemic disease links. Therefore, the study aimed to evaluate physicians’ awareness of the oral-systemic disease links and their association with patients’ referral to dentists and patients’ access to oral care. Methods This cross-sectional study was conducted (June 2019-January 2020) on physicians working in private and public hospitals in the Eastern province of Saudi Arabia. The physicians (n = 333) responded to a paper-based self-administered and pilot-tested questionnaire which inquired about their awareness of oral-systemic disease links and patient referral to dentists. The reliability of items of oral-systemic disease links was evaluated by calculating Cronbach’s alpha (0.84). Results Most participants (92.8%) agreed/strongly agreed that oral health is associated with systemic health. Half of the sample (50.8%) referred patients to dentists during the last month. Almost 80.5% believed that more patients will be referred to the dentists because of their awareness of the oral-systemic disease links and 84% believed that more patients will access oral care services if patients were aware of the oral-systemic disease links. The participants who referred patients to the dentists during the last month (P = 0.038), believed that more patients will be referred (P = 0.001), and believed that more patients will access oral care (P = 0.003) demonstrated significantly higher oral-systemic disease links awareness score. The adjusted model showed patients’ referral to dentist (OR = 1.96.10, P = 0.006) and believing in more patients accessing oral care (OR = 2.05, P = 0.044) were associated with significantly increased awareness of the oral-systemic disease links. Conclusion Most physicians in the study were aware of the oral-systemic disease links. Increased awareness of the oral-systemic disease links was significantly associated with the referral of patients to dentists and belief in improved patients’ access to oral care services.
PAX8 as a Potential Target for Ovarian Cancer: What We Know so Far

Abstract The Fallopian tube epithelium harbors the origin cells for the majority of high-grade serous ovarian carcinomas (HGSCs), the most lethal form of gynecologic malignancies. PAX8 belongs to the paired-box gene family of transcription factors and it is a marker of the FTE secretory cell lineage. Its role has been investigated in migration, invasion, proliferation, cell survival, stem cell maintenance, angiogenesis and tumor growth. In this review, we focus on the pro-tumorigenic role of PAX8 in ovarian cancer; in this context, PAX8 possibly continues to exert its transcriptional activity on its physiological targets but may also function on newly available targets after the tumorigenic hits. Acquiring new insights into the different PAX8 mechanism(s) of action in the tumor microenvironment could uncover new viable therapeutic targets and thus improve the current treatment regimen.
The effect of a telephone-based intervention on physical activity after stroke

Despite the effectiveness of telephone-based interventions for medical adherence and improved blood pressure, studies on the effect of such interventions on physical activity (PA) are needed. Therefore, we investigated the impact of a telephone-based intervention on PA in patients with subacute stroke. This pre-post study included patients who participated in an education program for stroke rehabilitation before being discharged to home, with a modified Rankin scale (mRS) score of ≤ 3. Patients hospitalized in 2020 (intervention group) received a nurse-led telephone-based intervention with a PA measurement once monthly during the 3 months after discharge. Those hospitalized in 2019 (historical controls) only received a PA measurement 3 months after discharge. Physical activity was assessed via a questionnaire by phone. In addition, demographics, medical history, smoking, mRS scores, and Patient Health Questionnaire-9 data were collected. The study included 139 participants (73 in intervention, 66 in control). The intervention group had a higher proportion of patients with mRS of 0–1 and a shorter length of hospital stay than the historical controls. Three months post-discharge, a significantly higher proportion of participants were physically active in the intervention group (48 [71.6%] vs. control group, 25 [34.7%]). In addition, the intervention group had a significantly higher median energy expenditure (924 vs. 297 MET-min/week) than the control group. The OR of the intervention for achieving ‘physically active’ individuals was 4.749 (95% CI, 2.313–9.752) before and 5.222 (95% CI, 1.892–14.419) after adjusting for possible confounders. A telephone-based intervention improved PA three months after stroke. Further studies with larger sample size and long-term follow-up are needed.
Factors associated with delayed diagnosis of appendicitis in adults: A single-center, retrospective, observational study

Appendicitis is one of the most common causes of acute abdominal pain; yet the risk of delayed diagnosis remains despite recent advances in abdominal imaging. Understanding the factors associated with delayed diagnosis can lower the risk of diagnostic errors for acute appendicitis. These factors, including physicians’ specialty as a generalist or non-generalist, were evaluated through a retrospective, observational study of adult acute appendicitis cases at a single center, between April 1, 2014, and March 31, 2021. The main outcome was timely diagnosis, defined as "diagnosis at the first visit if the facility had computed tomography (CT) capability" or "referral to an appropriate medical institution promptly after the first visit for a facility without CT capability," with all other cases defined as delayed diagnosis. The frequency of delayed diagnosis was calculated and associated factors evaluated through multivariate and exploratory analyses. The overall rate of delayed diagnosis was 26.2% (200/763 cases). Multivariate analysis showed that tenderness in the right lower abdominal region, absence of diarrhea, a consultation of ≤6 h after symptom onset, and consultation with a generalist were associated with a decreased risk of delayed diagnosis of acute appendicitis. Exploratory analysis found that generalists performed more physical findings related to acute appendicitis, suggesting that this diagnostic approach may be associated with timely diagnosis. Future studies should adjust for other potential confounding factors, including patient complexity, consultation environment, number of physicians, diagnostic modality, and physician specialties.
Ablative Fractional Laser-assisted Low-irradiance Photodynamic Therapy for Treatment of Actinic Keratoses in Organ Transplant Recipients: A Prospective, Randomized, Intraindividual Controlled Trial

Pain and inferior efficacy are major limiting factors of conventional photodynamic therapy for the field treatment of actinic keratoses in immunosuppressed organ transplant recipients. This prospective randomized controlled study evaluates the efficacy and tolerability of ablative fractional laser system pretreatment combined with low-irradiance photodynamic therapy (18.5 mW/cm2) compared with conventional photodynamic therapy (61.67 mW/cm2) in the treatment of actinic keratoses on the face and scalp in organ transplant recipients, using a red light-emitting diode lamp at a total light dose of 37 J/cm2. Low-irradiance photodynamic therapy combined with Er:YAG pretreatment achieved a significantly superior lesion response rate (mean ± standard deviation 77.3 ± 23.6%) compared with conventional photodynamic therapy (61.8 ± 21.4%; p = 0.025) in intra-individual fields at 3 months without negatively impacting pain (p = 0.777) or cosmetic outcome (p = 0.157).
Performance of deep-learning artificial intelligence algorithms in detecting retinopathy of prematurity: A systematic review

PURPOSE: Artificial intelligence (AI) offers considerable promise for retinopathy of prematurity (ROP) screening and diagnosis. The development of deep-learning algorithms to detect the presence of disease may contribute to sufficient screening, early detection, and timely treatment for this preventable blinding disease. This review aimed to systematically examine the literature in AI algorithms in detecting ROP. Specifically, we focused on the performance of deep-learning algorithms through sensitivity, specificity, and area under the receiver operating curve (AUROC) for both the detection and grade of ROP. METHODS: We searched Medline OVID, PubMed, Web of Science, and Embase for studies published from January 1, 2012, to September 20, 2021. Studies evaluating the diagnostic performance of deep-learning models based on retinal fundus images with expert ophthalmologists' judgment as reference standard were included. Studies which did not investigate the presence or absence of disease were excluded. Risk of bias was assessed using the QUADAS-2 tool. RESULTS: Twelve studies out of the 175 studies identified were included. Five studies measured the performance of detecting the presence of ROP and seven studies determined the presence of plus disease. The average AUROC out of 11 studies was 0.98. The average sensitivity and specificity for detecting ROP was 95.72% and 98.15%, respectively, and for detecting plus disease was 91.13% and 95.92%, respectively. CONCLUSION: The diagnostic performance of deep-learning algorithms in published studies was high. Few studies presented externally validated results or compared performance to expert human graders. Large scale prospective validation alongside robust study design could improve future studies.
Changes in Antimicrobial Resistance and Etiology of Blood Culture Isolates: Results of a Decade (2010–2019) of Surveillance in a Northern Region of Colombia

Background Bloodstream infections (BSI) are important causes of morbidity and mortality worldwide. Antimicrobial surveillance is essential for identifying emerging resistance and generating empirical treatment guides, the purpose of this study is to analyze trends in antimicrobial susceptibility of BSI from 2010 to 2019 in healthcare institutions from Medellin and nearby towns in Colombia. Methods A Whonet database was analyzed from the GERMEN antimicrobial surveillance network; frequency and antibiotic susceptibility trends were calculated on more frequent microorganisms using Mann Kendall and Sen’s Slope Estimator Test. Results 61,299 isolates were included; the three microorganisms more frequent showed a significant increasing trend through time E. coli (Sen’s Slope estimator = 0.7 p = <0.01) S. aureus (Sen’s Slope estimator = 0.60 p = <0.01) and K. pneumonia (Sen’s Slope estimator = 0.30 p = <0.01). E. coli showed a significant increase trend in cefepime and ceftazidime resistance, while K. pneumoniae showed a significant increase in resistance to cefepime, ciprofloxacin, and gentamicin. P. aeruginosa increases its susceptibility to all analyzed antibiotics and S. aureus to oxacillin. No increasing trend was observed for carbapenem resistance. Conclusion An upward trends was observed in more frequent microorganisms and resistance to third and fourth-generation cephalosporins for E. coli and K pneumoniae; in contrast, not increasing trends in antibiotic resistance was observed for P. aeruginosa and S. aureus. The essential role of AMR-surveillance programs is to point out and identify these trends, which should improve antibiotic resistance control.
African American English speaking 2nd graders, verbal–s, and educational achievement: Event related potential and math study findings

A number of influential linguistic analyses hold that African American English (AAE) has no verbal–s, the–s that, for example, turns drink into drinks in more mainstream English varieties.On such accounts, sentences like Mary drinks coffee are ungrammatical in AAE. Previous behavioral studies suggest that in addition to being ungrammatical, AAE speaking children find these sentences cognitively demanding, and that their presence in mathematical reasoning tests can depress scores. Until now, however, no online sentence processing study nor investigation of neurophysiological markers has been done to support these findings. Aimed at addressing this gap in the literature, the auditory ERP experiment described herein revealed two different processes associated with AAE speaking 2nd graders listening to this type of sentence: a morphosyntactic structure building problem, reflected in a bilateral early anterior-central negativity; and an increase in working memory load, indicated by a bilateral late long-lasting anterior-central negativity. Study participants also took an orally administered test of math word problems. Consistent with previous findings, results showed they answered fewer questions correctly when those questions contained verbal–s than when they did not.
Bond disproportionation and dynamical charge fluctuations in the perovskite rare-earth nickelates

We present a theory describing the local electronic properties of the perovskite rare-earth nickelates\char22{}materials which have negative charge transfer energies, strong O $2p$ \char21{} Ni $3d$ covalence, and breathing-mode lattice distortions at the origin of highly studied metal-insulator and antiferromagnetic ordering transitions. Utilizing a full-orbital, full-correlation double-cluster approach, we find strong charge fluctuations, in agreement with a bond disproportionation interpretation. The double-cluster formulation permits the inclusion of necessary orbital degeneracies and Coulomb interactions to calculate resonant x-ray spectral responses, with which we find excellent agreement with well-established experimental results. This previously absent, crucial link between theory and experiment provides validation of the recently proposed bond disproportionation theory, and provides an analysis methodology for spectroscopic studies of engineered phases of nickelates and other high-valence transition-metal compounds.
Anti-vascular endothelial growth factor therapy in retinopathy of prematurity: An updated literature review

Laser photocoagulation can still be considered the gold standard for treatment for retinopathy of prematurity (ROP). However, anti-vascular endothelial growth factor (anti-VEGF) therapy has increasingly become an important option that plays a significant role in the treatment of ROP. Major clinical trials have been published regarding the anti-VEGF use in ROP, along with multiple other studies looking into the different agents, doses, techniques, and possible complications. Anti-VEGF therapies can be considered as a safe and effective option for managing ROP. More longitudinal randomized clinical trials are necessary to evaluate the preferred treatment agent, the appropriate dose, best follow-up protocol, and the long-term ocular and systemic outcomes following treatment.