Miracle-dz/UniFAR-FTUs huggingface dataset:
Evaluation of Meibomian Gland Dysfunction Among Ophthalmic Healthcare Workers

Purpose To evaluate the prevalence of meibomian gland dysfunction (MGD) among ophthalmic healthcare workers. Setting A tertiary ophthalmic center. Design Prospective, observational study. Methods Forty-four volunteer ophthalmologists and ophthalmic nurses were recruited. Information including demographics, contact lens wear, history of refractive surgery and symptom score based on Standardized Patient Evaluation of Eye Dryness (SPEED) II Questionnaire for Dry Eye Disease/Ocular Surface Disease were recorded. Lipid layer thickness (LLT), meibomian glands dropout and dilation grades, and proportion of partial blinking were evaluated using an ocular surface interferometer with dynamic meibomian imaging (LipiView, Johnson & Johnson). Based on the chance of MGD, meibomian gland dropout and dilation, selected subjects also underwent treatment with a thermal pulsation system (LipiFlow, Johnson & Johnson) in one or both eyes. Results Eighty-eight eyes of 44 volunteers were evaluated during the study period. The mean LLT was 60.0nm. Twenty-seven (61.4%) subjects had a 90% or high chance of MGD and their mean lower lid meibomian gland dropout and dilation grades were 1.2 and 1.7, respectively. Twenty-eight eyes of 16 volunteers received treatment with the thermal pulsation system. Following treatment, the mean LLT improved from 50.3nm to 61.0nm (Wilcoxon’s signed rank test, p=0.001). Conclusion Despite being more knowledgeable to MGD and more accessible to treatment, MGD is a highly prevalent condition among ophthalmic healthcare workers, with a 61.4% prevalence among the recruited subjects. This is similar to reported prevalence in Asian populations of up to 74.5%. Targeted therapy based on dynamic meibomian imaging is effective in improving both objective and subjective measures of MGD.
Effects of dietary inorganic chromium supplementation on broiler growth performance: a meta-analysis

Background A meta-analysis was conducted to assess dietary inorganic chromium supplementation on broiler growth performance and determine if these effects are regulated by strains, sex, or contextual factors such as study area and time. Methods Eligible studies were identified by searching Web of Science, Springer, Elsevier, Science Direct, Taylor & Francis online databases. The weighted average difference with corresponding 95% confidence interval was computed with a random-effects model. We performed subgroup analyses stratified by study locations, published years, broiler sex, and strains. The publication bias was assessed with Egger’s test method. A total of nine studies were eligible for inclusion. Results The meta-analysis results indicated that inorganic chromium supplementation significantly improved the broiler’s growth performance, with a lower feed conversion ratio (FCR) and a higher average daily feed intake (ADFI). Through subgroup analyses, we found that the result of average daily gain (ADG) in Iran or published in the 2010s, the results of ADFI in Egypt, and the results of FCR in China had significant responses to chromium supplementation. We also found that Cobb 500 broilers and male broilers might be more sensitive to the addition of inorganic chromium by subgroup analyses. A model was used to obtain the amount of chromium addition under the optimal growth performance. The results showed that the adjusted ADFI and FCR presented a quadratic relationship with chromium supplementation except for average daily gain (ADG). The growth performance improved when the inorganic chromium addition ranged from 1.6 to 2.3 mg/kg. The result of sensitivity analyses showed low sensitivity and high stability. Also, there was little indication of publication bias for studies. Conclusions Our study showed that the males and Cobb 500 broilers might be more sensitive to chromium supplementation and provided more accurate inorganic chromium supplementation for broiler management practice. The fewer included studies may lead to higher heterogeneity, and no subgroup analyses of environmental stress conditions was conducted due to the lack of related information. Therefore, this study still has some limitations, and we look forward to the follow-up researches.
Magnitude and Associated Factors of Undernutrition Among Children Aged 6–59 Months in Ethiopian Orphanage Centres

Background Children without parental care are at high risk for under-nutrition. Ethiopia counts as one of the largest populations of orphans in the world. However, there is no information about the nutritional status of children in Ethiopian orphanage centers. Thus, we aimed to assess magnitude and associated factors of undernutrition among children aged 6–59 months in Ethiopian orphanage centres. Methods Institution-based descriptive and analytical cross-sectional study was conducted on 227 children aged 6–59 months in selected orphanage centers of Addis Ababa, Ethiopia from July to August 2019. A simple random sampling technique was used to select the study participants. Interviewer administered structured pretested questionnaire, document review and anthropometric measurements were used to collect the data. Epi info version 7.2. 1.0 and SPSS version 23.0 were used for data entry and analysis respectively. Anthropometric indices were generated using the WHO Anthro software version 3.2. 2. A cut-off point below -2 standard deviation used to determine under-nutrition (stunting, underweight, and wasting). All variables with p-value < 0.25 in the bivariable analysis were considered for further multivariable binary logistic regression analysis. The level of statistical significance was declared at a p-value <0.05. Results The prevalence of wasting, underweight, and stunting were 4.4%, 12.3%, and 34.8%, respectively. Being a double orphaned child [AOR= 2.9 (1.201, 7.167)] and lack of vitamin A supplement in the last six months (AOR=1.9 (1.049, 3.799) were significant predictors of stunting and illness in the last two weeks before the survey [AOR= 4.9 (1.345, 1.865)] was a significant predictor of wasting. Conclusion The prevalence of stunting was high when compared with WHO’s classification. Being a double orphaned, lack of vitamin A supplement, and illness in the last two weeks were associated with undernutrition. Therefore, intensified efforts to increase rates of vitamin A supplementation and as well as other disease prevention measures should be strengthened by the orphanage administrators and the health authorities.
Role and Therapeutic Potential of Melatonin in Various Type of Cancers

Abstract Cancer is a large group of diseases and the second leading cause of death worldwide. Lung, prostate, colorectal, stomach, and liver cancers are the most common types of cancer in men, whereas breast, colorectal, lung, cervical, and thyroid cancers are the most common among women. Presently, various treatment strategies, including surgical resection combined with chemotherapy, radiotherapy, nanotherapy, and immunotherapy, have been used as conventional treatments for patients with cancer. However, the clinical outcomes of advanced-stage disease remain relatively unfavorable owing to the emergence of chemoresistance, toxicity, and other undesired detrimental side effects. Therefore, new therapies to overcome these limitations are indispensable. Recently, there has been considerable evidence from experimental and clinical studies suggesting that melatonin can be used to prevent and treat cancer. Studies have confirmed that melatonin mitigates the pathogenesis of cancer by directly affecting carcinogenesis and indirectly disrupting the circadian cycle. Melatonin (MLT) is nontoxic and exhibits a range of beneficial effects against cancer via apoptotic, antiangiogenic, antiproliferative, and metastasis-inhibitory pathways. The combination of melatonin with conventional drugs improves the drug sensitivity of cancers, including solid and liquid tumors. In this manuscript, we will comprehensively review some of the cellular, animal, and human studies from the literature that provide evidence that melatonin has oncostatic and anticancer properties. Further, this comprehensive review compiles the available experimental and clinical data analyzing the history, epidemiology, risk factors, therapeutic effect, clinical significance, of melatonin alone or in combination with chemotherapeutic agents or radiotherapy, as well as the underlying molecular mechanisms of its anticancer effect against lung, breast, prostate, colorectal, skin, liver, cervical, and ovarian cancers. Nonetheless, in the interest of readership clarity and ease of reading, we have discussed the overall mechanism of the anticancer activity of melatonin against different types of cancer. We have ended this report with general conclusions and future perspectives.
Photosymbiosis in Late Triassic scleractinian corals from the Italian Dolomites

During the Carnian, oligotrophic shallow-water regions of the western Tethys were occupied by small, coral-rich patch reefs. Scleractinian corals, which already contributed to the formation of the reef structure, owed their position most probably to the symbiosis with dinoflagellate algae (zooxanthellae). Using microstructural (regularity of growth increments) and geochemical (oxygen and carbon stable isotopes) criteria of zooxanthellae symbiosis, we investigated whether this partnership was widespread among Carnian scleractinians from the Italian Dolomites (locality Alpe di Specie). Although corals from this locality are renowned from excellent mineralogical preservation (aragonite), their skeletons were rigorously tested against traces of diagenesis Irrespective of their growth forms, well preserved skeletons of corals from the Dolomites, most frequently revealed regular growth bands (low values of coefficient of variation) typical of modern zooxanthellate corals. Paradoxically, some Carnian taxa (Thamnasteriomorpha frechi and Thamnasteriomorphasp.)with highly integrated thamnasterioid colonies which today are formed exclusively by zooxanthellate corals, showed irregular fine-scale growth bands (coefficient of variation of 40% and 41% respectively) that could suggest their asymbiotic status. However, similar irregular skeletal banding is known also in some modern agariciids (Leptoseris fragilis) which are symbiotic with zooxanthellae. This may point to a similar ecological adaptation of Triassic taxa with thamnasterioid colonies. Contrary to occasionally ambiguous interpretation of growth banding, all examined Carnian corals exhibited lack of distinct correlation between carbon (δ13C range between 0.81‰ and 5.81‰) and oxygen (δ18O values range between −4.21‰ and −1.06‰) isotope composition of the skeleton which is consistent with similar pattern in modern zooxanthellates. It is therefore highly likely, that Carnian scleractinian corals exhibited analogous ecological adaptations as modern symbiotic corals and that coral-algal symbiosis that spread across various clades of Scleractinia preceded the reef bloom at the end of the Triassic.
The Endonasal Endoscopic Management of Cerebrospinal Fluid Rhinorrhea

Introduction Cerebrospinal fluid (CSF) rhinorrhea is the result of a bony defect at the skull base with disruption of the arachnoid, dura mater, and sinonasal mucosa that leads to an active CSF leak and flow of clear fluid from the nose. The endoscopic repair of CSF leaks and skull defects have been used by an increasing number of surgeons and is the standard of care for repairing CSF leaks. Materials and methods We conducted a retrospective study of all cases of CSF leaks managed via the endonasal endoscopic approach from 2010 to 2020 at a tertiary referral hospital of King Fahad Specialist Hospital, Dammam (KFSH-D). Results Over 10 years, 61 procedures were performed on a total of 56 patients (average age, 39.9 years) with 26 spontaneous CSF leaks and 30 traumatic CSF leaks. The leak sites were frontal bone in 14% of the cases, the roof of the ethmoid in 25%, the cribriform plate of ethmoid in 39%, and the walls of sphenoid sinus in 21%; multiple site defects were found in eight patients. The defect was localized by high-resolution computed tomography (CT) of the paranasal sinuses and skull base and magnetic resonance imaging (MRI) in all patients. CT cisternography, intrathecal fluorescein injection, and topical application of fluorescein dye were used in patients as required. A combination of free grafts and flaps materials were used in most patients. A middle and inferior turbinate graft was used in 12 patients, a septal cartilage graft in 18 patients, and a pedicled nasoseptal flap in 12 patients. The success rate was 92% after the first closure attempt. A recurrence of CSF leaks was observed in four patients. The mean hospitalization time was 6.5 days. The postoperative follow-up period ranged from one year to 10 years with a mean postoperative follow-up time of three years. Conclusions The endonasal endoscopic approach is the current standard of care for repairing most CSF leaks and skull base defects. We have had an excellent experience with endonasal endoscopic CSF leak repair, with high success rates and low morbidity. Our results support the effectiveness and safety of this technique and should encourage otolaryngologists to apply the procedure in cases of CSF leak.
Response to the Letter to the Editor Regarding Our Feature “Burnout and Associated Factors Among Medical Students in a Public University in Uganda: A Cross-Sectional Study” [Response to Letter]

1Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Medical, Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda Dear editor We wish to welcome the insightful comments by Lam, Parkes, and Wang regarding our study on the burden of burnout among medical students in a public university in Uganda. We especially appreciate this contribution and we believe that reaching a consensus will help in promoting future medical students’ well-being together with that of their patients. In performing this study, we wanted to start a conversation around the occurrence of burnout in Ugandan medical students aiming to build on this as our base-line dataset to inform future medical studentcentered interventional studies. The readers raised several important comments. Firstly, the need to conduct more in-depth research on why choosing medicine may lead to burnout in Ugandan medical students and to explore if this single factor was the sole cause of burnout in our study population. We agree with the readers that this was somewhat an expected and a surprising finding. However, it is consistent with a report published about a decade ago by Pagnin and others. In their study, Pagnin et al investigated the predictive role of career choice motivation on burnout dimensions by attempting to find the association between burnout and the various factors underlying choosing of a career in medicine such as intellectual curiosity, professional autonomy, economic concern, illness or death experiences, altruism, the influence of someone, and interest in human relationships. This study found no correlation between these motivation factors and burnout, expect for medical students in whom career choice were motivated by experiences of illness/death of family members or personal illness that were found to have greater emotional exhaustion. We would thus also like to call for qualitative studies to explore such phenomena and longitudinal studies to make associations more clear in our setting and to thus help us underpin medical career selection factors associated with high risks of development of psychological distress in medical students to which specific context-based interventions would now need to be targeted if possible before even students joined medical school. Correspondence: Jonathan Kajjimu Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda Tel +256759719384 Email jonathkebenz37@gmail.com
The Current Status of Gene Therapy for the Treatment of Cancer

Abstract Gene therapy is the administration of foreign genomic material into the host tissue to modify the expression of a gene product or to change the biological properties of cells for therapeutic use. Initially, the major objective of gene therapy was to manage genetic diseases, but now different disorders with several patterns of acquired and inherited disorders are targets of gene therapy. Over three decades, the advancement of Genome engineering technologies facilitated gene therapy for the prevention and management of intractable diseases. Researchers are advancing with cautious optimism that safe and effective treatment will give to patients with single-gene disorders and complex acquired disorders. To date, over 3000 genes associates with disease-causing mutations, and about 2600 gene therapy trials are undergoing for the management of various disorders. This review summarizes the principles of genome-editing approaches, such as zinc finger nucleases, transcription activator-like effector nucleases, meganucleases, and the CRISPR/Cas9 system with the underlying mechanisms. This review also explains the types of gene delivery systems as viral [adenoviral, adeno association, herpes simplex virus] and nonviral delivery systems (physical: DNA bombardment, electroporation) and (chemical: Cationic lipids, cationic polymers). Finally, this review summarizes gene therapy medicines approved to treat cancer in detail, including names, indications, vectors, and mode of gene therapy. Gene therapy becomes an alternative to an existing management for different diseases. Therefore, gene products with safe vectors and better biotechnologies play a significant role in the prophylaxis and management of various disorders in the future.
Crystallization of calcium carbonate accompanying chemical absorption

Etude de la cristallisation de CaCO 3 accompagant l'absorption de CO 2 seul ou melange a SO 2 , dans des solutions aqueuses de Ca(OH) 2 , dans un appareil agite a interface gaz-liquide plane. Les vitesses de nucleation et de croissance determinees par analyse de la distribution granulometrique des cristaux formes dans un cristalliseur parfaitement agite, sont reliees a diverses conditions operatoires
Divergent morphological responses to millennia of climate change in two species of bats from Hall’s Cave, Texas, USA

How species will respond to ongoing and future climate change is one of the most important questions facing biodiversity scientists today. The fossil record provides unparalleled insight into past ecological and evolutionary responses to climate change, but the resource remains virtually untapped for many organisms. We use geometric morphometrics and a 25,000 year fossil record to quantify changes in body size and mandible shape through time and across climate regimes for two bat species present in Quaternary paleontological deposits of central Texas: Myotis velifer, a bat distributed throughout the Southwestern US and Mexico that is still found in central Texas today, and Eptesicus fuscus, a bat widely distributed throughout North America that has been extirpated in central Texas. Because of ecogeographic rules like Bergmann’s rule, which posits that endotherms are larger in colder environments, we hypothesized that both species were larger during cooler time intervals. Additionally, we hypothesized that both species would show variation in dental morphology across the studied sequence as a response to climate change. While we found a decrease in centroid size–a proxy for body size–through time for both species, we could not establish a clear relationship between centroid size and temperature alone. However, we did find that specimens from drier environments were significantly larger than those from wetter ones. Furthermore, we found significant dental shape variation between environments reflecting different temperature levels for both species. Yet only M. velifer exhibited significant variation between environments of varying precipitation levels. This result was surprising because present-day populations of E. fuscus are highly variable across both temperature and precipitation gradients. We determined that the morphological change experienced by M. velifer through time, and between warmer and cooler temperatures, was associated with the coronoid process, condylar process, and the mandibular symphysis. These parts play a pivotal role in bite force, so changes in these features might relate to changes in diet. We show that long-term datasets derived from fossil material provide invaluable insight not only into the validity of ecogeographic rules, but also into the adaptive capacities of extant taxa when faced with environmental changes. Our results highlight diverging responses to a variety of climate factors that are relevant to consider in biodiversity research given ongoing global change.
Machine learning compared with rule‐in/rule‐out algorithms and logistic regression to predict acute myocardial infarction based on troponin T concentrations

Computerized decision‐support tools may improve diagnosis of acute myocardial infarction (AMI) among patients presenting with chest pain at the emergency department (ED). The primary aim was to assess the predictive accuracy of machine learning algorithms based on paired high‐sensitivity cardiac troponin T (hs‐cTnT) concentrations with varying sampling times, age, and sex in order to rule in or out AMI.
The Diabetes Syndrome – A Collection of Conditions with Common, Interrelated Pathophysiologic Mechanisms

Abstract The four basic pathophysiologic mechanisms which damage the β-cell within diabetes (ie, genetic and epigenetic changes, inflammation, an abnormal environment, and insulin resistance [IR]) also contribute to cell and tissue damage and elevate the risk of developing all typical diabetes-related complications. Genetic susceptibility to damage from abnormal external and internal environmental factors has been described including inflammation and IR. All these mechanisms can promote epigenetic changes, and in total, these pathophysiologic mechanisms interact and react with each other to cause damage to cells and tissues ultimately leading to disease. Importantly, these pathophysiologic mechanisms also serve to link other common conditions including cancer, dementia, psoriasis, atherosclerotic cardiovascular disease (ASCVD), nonalcoholic fatty liver disease (NAFLD), and nonalcoholic steatohepatitis (NASH). The “Diabetes Syndrome”, an overarching group of interrelated conditions linked by these overlapping mechanisms, can be viewed as a conceptual framework that can facilitate understanding of the inter-relationships of superficially disparate conditions. Recognizing the association of the conditions within the Diabetes Syndrome due to common pathophysiologies has the potential to provide both benefit to the patient (eg, prevention, early detection, precision medicine) and to the advancement of medicine (eg, driving education, research, and dynamic decision-based medical practice).