Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of a Two-Tier Screening Pathway for Congenital Adrenal Hyperplasia in the New South Wales Newborn Screening Programme

In Australia, all newborns born in New South Wales (NSW) and the Australia Capital Territory (ACT) have been offered screening for rare congenital conditions through the NSW Newborn Screening Programme since 1964. Following the development of the Australian Newborn Bloodspot Screening National Policy Framework, screening for congenital adrenal hyperplasia (CAH) was included in May 2018. As part of the assessment for addition of CAH, the national working group recommended a two-tier screening protocol determining 17α-hydroxyprogesterone (17OHP) concentration by immunoassay followed by steroid profile. A total of 202,960 newborns were screened from the 1 May 2018 to the 30 April 2020. A threshold level of 17OHP from first tier immunoassay over 22 nmol/L and/or top 2% of the daily assay was further tested using liquid chromatography tandem mass spectrometry (LC-MS/MS) steroid profiling for 17OHP (MS17OHP), androstenedione (A4) and cortisol. Samples with a ratio of (MS17OHP + A4)/cortisol > 2 and MS17OHP > 200 nmol/L were considered as presumptive positive. These newborns were referred for clinical review with a request for diagnostic testing and a confirmatory repeat dried blood spot (DBS). There were 10 newborns diagnosed with CAH, (9 newborns with salt wasting CAH). So far, no known false negatives have been notified, and the protocol has a sensitivity of 100%, specificity of 99.9% and a positive predictive value of 71.4%. All confirmed cases commenced treatment by day 11, with none reported as having an adrenal crisis by the start of treatment.
Evaluation of the Safety of Bilateral Same-Day Intravitreal Injections of Anti-Vascular Endothelial Growth Factor Agents: Experience of a Large Korean Retina Center

Purpose To evaluate the short-term ophthalmic side effects of bilateral same-day intravitreal anti-vascular endothelial growth factor (VEGF) injections. Patients and Methods We retrospectively analyzed patients who received intravitreal bevacizumab, ranibizumab, and aflibercept injections in both eyes on the same day between January 2014 and June 2019. The patients were followed up for 1 day, 1 week, and 1 month after the injections. Results A total of 323 patients (646 eyes) received 1418 bilateral same-day intravitreal anti-VEGF injections. The patients’ mean age was 62.47 ± 13.97 years. The most common cause of bilateral injection was age-related macular degeneration (54.80%), followed by complications due to diabetic retinopathy (35.33%), retinal vein occlusion (2.40%), and central serious chorioretinopathy (1.27%). There were 22 cases of subconjunctival hemorrhage, 17 cases of temporary elevation of intraocular pressure, and no case of endophthalmitis. Twenty-one patients showed acute intraocular inflammation after the bilateral injection. All patients showed complete improvement within 2 weeks after the injection. Conclusion Bilateral same-day intravitreal anti-VEGF injection is a well-tolerated procedure on short-term follow-up. It is one of the more convenient approaches for both the patient and ophthalmologist.
Genetic diversity, starch physicochemical properties and cyanide levels of farmer preferred cassava landraces in the Eastern zone of Tanzania

Cassava is an ideal „climate change‟ crop valued for the efficient production of the starch stored in its roots. Here, the physicochemical properties and functionality of starches isolated from six cassava landraces were explored to determine (i) how they varied compared to those described in published studies of cultivated cassava, (ii) the extent of variation in starches among the landraces, and (iii) their potential utility as value-added food and biomaterials. For most parameters assayed, the landraces exhibited a narrower range of values compared to published data, perhaps indicating a local preference for a certain cassava-type. Among landraces, dry matter (30-39%), amylose (11-19%), starch (74-80%) and reducing sugars content (1-3%) varied when expressed on a dry weight basis (p≤0.05); however, only one of the six genotypes differed in crystallinity and mean starch granule particle size, while glucan chain distribution and granule morphology were the same. In contrast, the starch functionality features measured: swelling power, solubility, syneresis, and digestibility differed (p≤0.05). This was supported by Partial least square discriminant analysis, which highlighted the divergence among the cassavas based on starch functionality, permitting suggestions for the targeted uses of these starches in diverse industries.
The Dacini fruit fly fauna of Sulawesi fits Lydekker’s line but also supports Wallacea as a biogeographic region (Diptera, Tephritidae)

Abstract Although there is scientific consensus on most of the major biogeographic regions in the world, the demarcation of the area connecting Southeast Asia with Australia and Oceania remains debated. Two candidate boundaries potentially explain faunistic diversity patterns in the regions: Lydekker’s and Wallace’s lines. The islands in between both ‘lines’ are jointly termed Wallacea, with Sulawesi as the largest landmass. We surveyed Dacini fruit flies (Tephritidae: Dacinae) in Sulawesi between 2016 and 2019 using traps baited with male lures, resulting in 4,517 collected flies. We identified all specimens to species level, which adds 15 new species records to the island, bringing the total number of Dacini species in Sulawesi to 83. The biogeographic affinity of species in the updated checklist reveals a strong connection with former ‘Sunda’ (41% of species); validating Lydekker’s line, but also a high level of endemism (47% of species), confirming the uniqueness of Wallacea as a biogeographic region. We further describe a new species, Bactrocera (Bactrocera) niogreta Doorenweerd, sp. nov. and discuss the taxonomy of several interesting species.
Combined Expression of CD34 and FLT3-Internal Tandem Duplication Mutation Predicts Poor Response to Treatment in Acute Myeloid Leukemia

Background Acute myeloid leukemia (AML) is a common hematological malignancy associated with different cytogenetic and genetic abnormalities. Methods FLT3-internal tandem duplication (FLT3/ITD) mutation and CD34 expression levels were assessed in the bone marrow (BM) aspirates of 153 de novo AML patients. Data were correlated with relevant clinic-pathological features of the patients, response to treatment, disease-free survival (DFS), and overall free survival (OS) rates. Results FLT3-ITD mutation was detected in 27/153 (17.6%) AML patients (P=0.001), and CD34 was expressed in 83/153 (54.2%) patients (P=0.293) compared to those with wild FLT3 and CD34− expression, respectively. Patients with FLT3-ITD mutation showed increased peripheral blood and BM blast cells, abnormal cytogenetics, poor DFS and OS compared to those with wild FLT3 (P=0.013, P<0.001, P=0.010, P=0.008 and P=0.004, respectively), while there was no significant association with response to treatment (P=0.081). There was no significant association between CD34 expression and response to treatment, DFS, and OS (P>0.05). FLT3-ITD mutation and FAB subtypes were independent prognostic factors for DFS. Older age ≥39 years, HB <7 mg/dL PB blast ≥54%, and FLT3-ITD mutation were independent prognostic factors for poor OS in AML patients. The presence of both FLT3-ITD mutation and CD34 expression associated significantly with resistance to therapy (P=0.024), short DFS and OS rates (P=0.006, P=0.037, respectively). Conclusion Combined expression of both FLT3-ITD mutation and CD34 expression is an important prognostic and predictive factor for poor disease outcome in AML patients.
Functional comparison of cardiac troponin C from representatives of three vertebrate taxa: Investigating the evolution of cardiac contractile regulation

FUNCTIONAL COMPARISON OF CARDIAC TROPONIN C FROM REPRESENTATIVES OF THREE VERTEBRATE TAXA: INVESTIGATING THE EVOLUTION OF CARDIAC CONTRACTILE FUNCTION Elizabeth Jane Sears Advisor: University of Guelph, 2014 Dr. Todd E. Gillis Trout cardiac troponin C (cTnC) contains differences in amino acid sequence that are partially responsible for the disparity in function between trout and mammalian hearts. Interestingly, the physiological temperature and amino acid sequence of cTnC from Xenopus laevis are intermediate between trout and mammals. As a result, the study of Xenopus cTnC may provide insight into the influence of physiological temperature on the evolution of cardiac function. Circular dichroism demonstrated that the melting temperature of the rat troponin complex was 6°C higher than one containing trout components, with Xenopus falling between. Ca-binding measurements indicated that Xenopus and trout troponin components increase the Ca-affinity of the troponin complex. The Ca off-rates (koff) of the complexes containing trout and Xenopus components were also lower than the rat complex. This suggests that the Ca-affinity and thermal stability of the troponin complex are both related to the physiological temperature of the species.
The Success of a Screening Program Is Largely Dependent on Close Collaboration between the Laboratory and the Clinical Follow-Up of the Patients

Neonatal screening for congenital adrenal hyperplasia due to 21-hydroxylase deficiency is now performed in an increasing number of countries all over the world. The main goal of the screening is to achieve early diagnosis and treatment in order to prevent neonatal salt-crisis and death. The screening laboratory can also play an important role in increasing the general awareness of the disease and act as the source of information and education for clinicians to facilitate improved initial care, ensure prompt and correct glucocorticoid dosing to optimize the long-term outcome for the patients. A National CAH Registry and CYP21A2 genotyping provide valuable information both for evaluating the screening program and the clinical outcome. The Swedish experience is described.
Synergistic Nanocomposites of Different Antibiotics Coupled with Green Synthesized Chitosan-Based Silver Nanoparticles: Characterization, Antibacterial, in vivo Toxicological and Biodistribution Studies

Purpose The present study reports chitosan functionalized green synthesized CS-AgNPs, conjugated with amoxicillin (AMX), cefixime (CEF), and levofloxacin (LVX) for safe and enhanced antibacterial activity. Methods The CS-AgNPs and conjugates CS-AgNPs+AMX CS-AgNPs+CEF, and CS-AgNPs+LVX were characterized by UV–Vis, FTIR, SEM, TEM, EDX spectroscopy. The size distribution and zeta potential were measured using the dynamic light scattering (DLS) technique. The interaction between CS-AgNPs and antibiotic molecules was also investigated using UV–Vis spectroscopy at the concentrations of 5, 50, 500, and 5000 µM for each antibiotic. Antibacterial activity and synergism were assessed by the Fractional Inhibitory Concentration (FIC) index. The mechanism for synergistic activity was investigated by the detection of hydroxyl species based on the chemiluminescence of luminol. The biocompatibility index (BI) was calculated from IC50 using the HeLa cell line. In vivo toxicity and tissue distribution of silver ions were evaluated on Sprague Dawley rats. Physical interactions of antibiotics and significant (P<0.05) antibacterial activity were observed after loading on CS-AgNPs surfaces. Results The spherical shape nanocomposites of CS-AgNPs with different antibiotics were prepared with mean size ranges of 80–120 nm. IC50 of antibiotics-conjugated CS-AgNPs decreased compared to CS-AgNPs. The biocompatibility (BI) index showed that antibiotics-conjugated CS-AgNPs have high antibacterial potential and low toxicity. Highly significant (P<0.005) increase in the generation of hydroxyl species indicated the radical scavenging mechanism for synergistic activity of CS-AgNPs after combined with different antibiotics. Biochemical analysis and histopathological examinations confirmed low toxicity with minor hepatotoxicity at higher doses. After oral administration, extensive distribution of Ag ion was observed in spleen and liver. Conclusion The study demonstrates positive attributes of antibiotics-conjugated CS-AgNPs, as a promising antibacterial agent with low toxicity.
Comparative Study of Fentanyl vs Dexmedetomidine as Adjuvants to Intrathecal Bupivacaine in Cesarean Section: A Randomized, Double-Blind Clinical Trial

Purpose Effective postoperative analgesia is essential in cesarean section. This study aimed to compare postoperative analgesia and hemodynamic changes after intrathecal use of fentanyl or dexmedetomidine combined with bupivacaine. Patients and Methods This study involved 110 pregnant women with ASA I and II and gestational age ≥37 weeks who were candidates for elective cesarean section. They were randomly divided into two groups of 55; Group B-D received 10 mg bupivacaine (0.5%) + 5 μg dexmedetomidine and Group B-F received 10 mg bupivacaine (0.5%) + 25 μg fentanyl, intrathecally. The onset of block, duration of analgesia, the score of pain intensity, hemodynamic changes, Apgar scores, and any adverse events were evaluated. P-value <0.05 was considered statistically significant. Results Patients in two groups were similar in terms of demographic characteristics and ASA classification. Duration of analgesia in the B-D group was significantly longer than B-F group (428.64±73.39 vs 273.18±61.91 min; P<0.001). The score of pain intensity during recovery time in the B-D group was significantly lower than that of B-F group (0.33±0.84 vs 0.51±0.57 min; P=0.004). The onset of block was also faster in the B-D group than B-F group (98.27±35.95 vs 110.45±37.69 seconds; P=0.036). The two groups did not show significant differences in hemodynamic changes and other variables (P>0.05). Conclusion Compared with fentanyl, it seems that adding 5 μg dexmedetomidine to bupivacaine has a better effect on postoperative pain management in cesarean section under spinal anesthesia.
A morphological and phylogenetic evaluation of Marasmius sect. Globulares (Globulares-Sicci complex) with nine new taxa from the Neotropical Atlantic Forest

The largest and most recently emended Marasmius sect. Globulares (Globulares-Sicci complex) has increased in number of species annually while its infrasectional organization remains inconclusive. During forays in remnants of the Atlantic Rainforest in Brazil, 24 taxa of Marasmius belonging to sect. Globulares were collected from which nine are herein proposed as new: Marasmius altoribeirensis, M. ambicellularis, M. hobbitii, M. luteoolivaceus, M. neotropicalis, M. pallidibrunneus, M. pseudoniveoaffinis, M. rhabarbarinoides and M. venatifolius. We took this opportunity to evaluate sect. Globulares sensu Antonín & Noordel. in particular, combining morphological examination and both single and multilocus phylogenetic analyses using LSU and ITS data, including Neotropical samples to a broader and more globally distributed sampling of over 200 strains. Three different approaches were developed in order to better use the genetic information via Bayesian and Maximum Likelihood analyses. The implementation of these approaches resulted in: i) the phylogenetic placement of the new and known taxa herein studied among the other taxa of a wide sampling of the section; ii) the reconstruction of improved phylogenetic trees presenting more strongly supported resolution especially from intermediate to deep nodes; iii) clearer evidence indicating that the series within sect. Sicci and sect. Globulares in the traditional concept are non-monophyletic by this more stringent evaluation; and iv) the existence of several monophyletic suprespecific groups equivalent to the stirpes of Singer – clusters of morphologically similar species. These two latter points corroborate with findings of previous studies implementing analyses with the entire genus. Based on these results, we proposed a new infrasectional classification elevating Singer’s concept of stirpes to series. Thirteen new series, the emendation of three extant series and three subsections gathering these series based on the major clades are proposed.
A Culturally Sensitive and Supportive Maternity Care Service Increases the Uptake of Maternity Waiting Homes in Ethiopia

Background Maternal delays in utilization of emergency obstetric care are impacting on a high maternal mortality, especially in the poor resource countries including Ethiopia. Different strategies are designed and employed to reduce those maternal delays, and one of such strategies employed to overcome the geographic barriers and improve maternal and neonatal health outcomes is utilization of maternity waiting homes (MWHs). Studies related to the utilization of MWHs and associated factors are limited in Ethiopia and there were none in the study area. Objective The aim of this study was to assess the utilization of maternity waiting homes and associated factors. Methods and Materials A community-based cross-sectional study design was conducted, using multistage sampling technique. Logistic regression analysis with 95% CI for odds ratio (OR) was used to identify significant factors. Results A total of 379 women participated in this study, making a response rate of 85%. Of the total participants, 42.5% (95% CI=38–48) of women utilized MWHs. After controlling for potential confounders, women’s decision-making capacity (AOR=12.74; 95% CI=6.18–26.26), women having someone who can care for their children and/or husband at home (AOR=2.71; 95% CI=1.44–5.09), MWHs offering food service (AOR=4.03; 95% CI=2.07– 7.85), offering and/or allowing women to practice their own cultural ceremony (allowing to cook their own food type, porridge, coffee, etc) (AOR=9.55; 95% CI=4.45–20.47), and women’s attitude towards MWHs (AOR=0.09; 95% CI=0.03–0.23) were factors significantly associated with the utilization of MWHs. Conclusion Compared to its contribution in reducing maternal and perinatal mortality, the utilization of MWHs was low in this study area. The integration of culturally sensitive and supportive maternity services, along with community participatory approach, would increase utilization of MWHs and consequently contribute in achieving the SDGs related to maternal and neonatal health.
Health-Related Quality of Life and its Associated Factors in COVID-19 Patients

Objectives Health-related quality of life (HRQoL) is one of the most important outcome measures for patients. The purpose of this study was to evaluate HRQoL and related factors in Coronavirus disease 2019 (COVID-19) patients. Methods A total of 420 COVID-19 patients who had been discharged from hospital were selected using a systematic sampling. The EuroQol 5-dimensional-5 levels (EQ-5D-5L) questionnaire along with medical records of the patients were used to gather the data. The t test and analysis of variance were employed to test the difference between mean EQ-5D-5L scores, and the BetaMix model was used to investigate factors associated with EQ-5D-5L scores. Results The mean score for the patients who completed the EQ-5D-5L questionnaire (n = 409) was 0.6125. The EQ-5D-5L scores were significantly higher in males, patients with younger age, those with a low level of education, the employed, patients who worked in uncrowded workplaces, patients without diabetes, and those who were not admitted to intensive care unit. The BetaMix model showed that gender, age, education, employment status, having diabetes, heart failure, and admission to the intensive care unit were significant independent predictors of the EQ-5D-5L index values. Conclusion The mean score for EQ-5D-5L in COVID-19 patients was low in this study. Some of the factors, especially aging and having diabetes, should be considered in the aftercare of patients to improve their HRQoL.
Comparison of Effectiveness of Mobile App versus Conventional Educational Lectures on Oral Hygiene Knowledge and Behavior of High School Students in Saudi Arabia

Objective This study aimed to evaluate the impact of two different oral health education approaches, a mobile application (the Brush DJ app) and conventional educational lectures, on the oral hygiene knowledge and behavior of high school children. Methods The research was a cross‐sectional study of 271 students from two public schools in Jeddah City, Saudi Arabia. An eighteen-item questionnaire was used for this purpose. Those who completed the baseline questionnaire were allocated to one of two groups: (1) mobile application and (2) educational lecture. A follow-up survey was later conducted at three months, which repeated eight of the eighteen questions asked in the baseline survey. The change in oral hygiene attitude and behaviors was compared across both groups. Results The Brush DJ app was found to be equally effective compared to educational lectures in changing oral health knowledge, attitude and behavior. Both groups showed significant improvements in almost all aspects of oral health, except for the frequency and duration of tooth brushing in the app group. There was no change in twice daily tooth brushing of app users, and less than 40% reported brushing their teeth for 2 minutes. A statistically significant change, however, was noted among lecture group participants in these two areas of oral hygiene routine. The app was also found to be more difficult in usability than educational lectures (p = 0.037). Conclusion The Brush DJ app may be a valuable tool to improve oral health knowledge, attitude and behavior. However, the app needs some improvements. The content and features of the app need to be structured in a way that it allows for personalization and is more interactive, practical and user-friendly.
The Technique of Intradiscal Injection: A Narrative Review

Background Low back pain (LBP) is one of the most common spine diseases and represents the most frequent cause of absence from work in developed countries. Approximately 40% of chronic LBP is related to discogenic origin. The goal of the study is producing a review of literature to describe analytically the techniques of intradiscal injections. Methods PubMed database was searched for clinical studies with the different key terms: “intradiscal”, “injection”, “steroid” “procedures”, “techniques”, “CT”, “MRI”, “fluoroscopy”, “fluoroscopic”, “guidance”, “ozone”, “ultrasound”, “images”. Only studies written in English, French, or Italian in which the intradiscal injection represents the main procedure for the low back discopathy treatment on humans were considered. We excluded the articles that do not mention this procedure; those which indicated that the intradiscal injection had happened accidentally during other treatments; those reporting the patient’s pain was determined by other causes than the discopathy (facet joint syndrome, tumor, spondylodiscitis). Results Thirty-one articles dated from 1969 to 2018 met the criteria. The examined population was 6843 subjects, 52.3% male and 47.7% female, with a mean age of 45.9±10.1 years. The techniques are highly variable in terms of procedure: different operators, needle guidance, injection sites, drugs, tilt angle of the needle). Conclusion The efficacy and the safety of the intradiscal procedures are not easily comparable due to different types of studies and their limited number. Further studies are needed to standardize the intradiscal injection technique/procedure to improve safety, repeatability and effectiveness, and last but not least to reduce peri- and postoperative care and health-care costs.