Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical, tomographic, and topometric outcomes of progressive thickness intracorneal ring segment implantations in duck-type keratoconus

Purpose: To evaluate the visual, refractive, tomographic, and topometric outcomes of progressive thickness intracorneal ring segment (PT-ICRS) implantation in duck-type keratoconus. Methods: This retrospective study included eyes with oval (duck-type) keratoconus treated with PT-ICRS implantation. After the femtosecond laser tunnel creation, one PT-ICRS (Keraring AS 5 with 160° arc length) was implanted along the ectatic, inferior half of the cornea. Data of uncorrected and corrected distance visual acuity (UDVA and CDVA), refraction, asphericity (Q value), and keratometry (K) were compared pre- and postoperatively. Additionally, changes in the topometric indices of corneal irregularity were also evaluated after PT-ICRS implantation. Results: Thirty-one eyes of 30 patients were included in the study with a mean follow-up time of 9.06 months (ranging between 6 and 18 months). UDVA improved from 0.85 ± 0.36 to 0.27 ± 0.14 logMAR (P = 0.001), and CDVA improved from 0.37 ± 0.22 to 0.13 ± 0.11 logMAR (P = 0.001). The mean spherical error decreased from −3.66 ± 2.60 to −1.60 ± 1.42 D (P = 0.001), and the mean cylindrical error decreased from −4.91 ± 2.65 to − 1.41 ± 1.31 D (P = 0.001). All topographic parameters measured from the anterior cornea demonstrated statistically significant improvements after PT-ICRS implantation (P = 0.001). K mean, K maximum, corneal astigmatism, and Q value showed a significant decrease. Besides the index of height asymmetry, all topometric indices were significantly reduced after PT-ICRS implantation. There were no loss of lines and no complications. Conclusion: PT-ICRS implantation in duck-type keratoconus is an effective and safe treatment. This intervention improves the visual acuity, refractive error, topographical, and topometric parameters significantly by decreasing both eccentricity and steepness of the cone.
Knowledge and attitude on sexually transmitted infections and contraceptive use among university students in Bhutan

Objectives The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under Royan University of Bhutan (RUB). Methods This was a cross-sectional study using an online questionnaire. The questionnaire was developed in Google forms and the link was shared through the college WeChat groups. The questionnaire consisted of four parts on socio-demographic, sexual behaviour and contraceptive use, knowledge, and attitude on STIs. All the students under RUB were invited to participate voluntarily in this study. The socio-demography was presented in frequency and proportion. Result A total of 1,283 students participated in this survey and 55.0% (701) were females. Of this, 29.4% (377) were sexually active and 94.4% reported using modern contraception. Commonly used contraceptives were: condoms (83.8%, 316) and emergency contraceptives (20.6%, 78), respectively. The mean knowledge and attitude scores on STI were 9.94 (range 2–20) and 12 (range 2–14), respectively. Good knowledge and attitude on STI were reported in 53.2% (683) and 70.1% (899) of participants. Conclusion Students reported average knowledge and a good attitude towards STI. Contraceptive use among university students was low. There is a need to strengthen health education on STIs in schools and universities. All forms of contraceptives especially condoms should be made easily available to sexually active people.
Exploring the development of adaptive expertise through the lens of threshold concepts

While expert clinical practice requires a flexible approach to problem solving, evidence shows that medical clerks tend to focus on knowledge acquisition as the key to expertise. It is not until residency training that learners shift their understanding of expertise towards developing adaptive approaches to clinical problems. This raises the possibility that adaptive expertise is a threshold concept and that authentic clinical experiences involving complex problem solving are required to create the liminal state that enables transformation to an adaptive expertise mindset. With this possibility in mind, the current study examined the conceptualisations of expertise held by recently graduated physical therapists using the framework of threshold concepts as a sensitising lens.
Current concepts in the management of childhood myopia

Myopia or short-sightedness is an emerging pandemic affecting more than 50% population in South-Asian countries. It is associated with several sight-threatening complications, such as retinal detachment and choroidal neovascularization, leading to an increased burden of visual impairment and blindness. The pathophysiology of myopia involves a complex interplay of numerous environmental and genetic factors leading to progressive axial elongation. Environmental factors such as decreased outdoor activity, reduced exposure to ambient light, strenuous near work, and role of family history of myopia have been implicated with increased prevalence of this refractive error. While multiple clinical trials have been undertaken to devise appropriate treatment strategies and target the modifiable risk factors, there is no single treatment modality with ideal results; therefore, formulating a comprehensive approach is required to control the myopia epidemic. This review article summarizes the epidemiology, dynamic concepts of pathophysiology, and evolution of the treatment modalities for myopia such as pharmacological (atropine and other agents) and optical methods (spectacles, contact lenses, and orthokeratology).
Human iPSC-derived astrocytes generated from donors with globoid cell leukodystrophy display phenotypes associated with disease

Globoid cell leukodystrophy (Krabbe disease) is a fatal neurodegenerative, demyelinating disease caused by dysfunctional activity of galactosylceramidase (GALC), leading to the accumulation of glycosphingolipids including psychosine. While oligodendrocytes have been extensively studied due to their high levels of GALC, the contribution of astrocytes to disease pathogenesis remains to be fully elucidated. In the current study, we generated induced pluripotent stem cells (iPSCs) from two donors with infantile onset Krabbe disease and differentiated them into cultures of astrocytes. Krabbe astrocytes recapitulated many key findings observed in humans and rodent models of the disease, including the accumulation of psychosine and elevated expression of the pro-inflammatory cytokine IL-6. Unexpectedly, Krabbe astrocytes had higher levels of glucosylceramide and ceramide, and displayed compensatory changes in genes encoding glycosphingolipid biosynthetic enzymes, suggesting a shunting away from the galactosylceramide and psychosine pathway. In co-culture, Krabbe astrocytes negatively impacted the survival of iPSC-derived human neurons while enhancing survival of iPSC-derived human microglia. Substrate reduction approaches targeting either glucosylceramide synthase or serine palmitoyltransferase to reduce the sphingolipids elevated in Krabbe astrocytes failed to rescue their detrimental impact on neuron survival. Our results suggest that astrocytes may contribute to the progression of Krabbe disease and warrant further exploration into their role as therapeutic targets.
Unlikely influence of ABO blood group polymorphism on antibody response to COVID‐19 mRNA vaccine against SARS‐CoV‐2 spike protein

We [1] and others proposed two possible mechanisms of the association between ABO blood groups and SARS-CoV-2 susceptibility/COVID-19 severity. The consensus is higher and lower risk for people in groups A and O, respectively. First, viruses can express A/B glycans on the spike protein, reflecting the ABO phenotype of the host cells in which they are produced, and natural antibodies can react to corresponding antigens and inhibit interpersonal infection, at least partially, resembling ‘ABOmatched’ and ‘ABO-unmatched’ transfusion (Figure 1). Second, lower serum levels of von Willebrand factor and factor VIII, essential for blood clot formation, could explain a lower risk of thrombosis, pulmonary embolism and venous thromboembolism in group O individuals. After reviewing the literature, Le Pendu et al. [2] concluded that the ABO polymorphism could play a role in the COVID-19 pandemic at the population level despite modest differences in risk between ABO groups. In the recent issue of Vox Sang, Vicentini et al. [3] published a letter to the editor entitled ‘Does ABO blood group influence antibody response to SARS-CoV-2 vaccination? ’. The authors examined IgG titre against spike protein in 85 medical students who completed a full two-dose Pfizer/BNT162b2 mRNA vaccination and found no significant difference between ABO groups. There are four main categories of COVID-19 vaccines: whole virus, protein subunit, viral vector and nucleic acid (Figure 2). An immune
Combinatorial optimization : packing and covering

Preface 1. Clutters 2. T-Cuts and T-Joins 3. Perfect Graphs and Matrices 4. Ideal Matrices 5. Odd Cycles in Graphs 6. 0,+1 Matrices and Integral Polyhedra 7. Signing 0,1 Matrices to Be Totally Unimodular or Balanced 8. Decomposition by k-Sum 9. Decomposition of Balanced Matrices 10. Decomposition of Perfect Graphs Bibliography Index.
Association of Endocrine Therapy Initiation Timeliness With Adherence and Continuation in Low-Income Women With Breast Cancer

Key Points Question How are adjuvant endocrine therapy initiation timelines associated with adherence and continuation of treatment in low-income women with breast cancer? Findings In this cohort study of 1711 women with breast cancer enrolled in Medicaid, longer time to initiation of adjuvant endocrine therapy was associated with lower odds of short-term and long-term adherence as well as short-term continuation. Meaning These results suggest that interventions that focus on improving timeliness of treatment initiation may also improve adherence to treatment and therefore further improve outcomes, bringing benefits of advances to all women with breast cancer.
Attitudes of Patients With Chronic Heart Failure Toward Digital Device Data for Self-documentation and Research in Germany: Cross-sectional Survey Study

Background In recent years, the use of digital mobile measurement devices (DMMDs) for self-documentation in cardiovascular care in Western industrialized health care systems has increased. For patients with chronic heart failure (cHF), digital self-documentation plays an increasingly important role in self-management. Data from DMMDs can also be integrated into telemonitoring programs or data-intensive medical research to collect and evaluate patient-reported outcome measures through data sharing. However, the implementation of data-intensive devices and data sharing poses several challenges for doctors and patients as well as for the ethical governance of data-driven medical research. Objective This study aims to explore the potential and challenges of digital device data in cardiology research from patients’ perspectives. Leading research questions of the study concerned the attitudes of patients with cHF toward health-related data collected in the use of digital devices for self-documentation as well as sharing these data and consenting to data sharing for research purposes. Methods A cross-sectional survey of patients of a research in cardiology was conducted at a German university medical center (N=159) in 2020 (March to July). Eligible participants were German-speaking adult patients with cHF at that center. A pen-and-pencil questionnaire was sent by mail. Results Most participants (77/105, 73.3%) approved digital documentation, as they expected the device data to help them observe their body and its functions more objectively. Digital device data were believed to provide cognitive support, both for patients’ self-assessment and doctors’ evaluation of their patients’ current health condition. Interestingly, positive attitudes toward DMMD data providing cognitive support were, in particular, voiced by older patients aged >65 years. However, approximately half of the participants (56/105, 53.3%) also reported difficulty in dealing with self-documented data that lay outside the optimal medical target range. Furthermore, our findings revealed preferences for the self-management of DMMD data disclosed for data-intensive medical research among German patients with cHF, which are best implemented with a dynamic consent model. Conclusions Our findings provide potentially valuable insights for introducing DMMD in cardiovascular research in the German context. They have several practical implications, such as a high divergence in attitudes among patients with cHF toward different data-receiving organizations as well as a large variance in preferences for the modes of receiving information included in the consenting procedure for data sharing for research. We suggest addressing patients’ multiple views on consenting and data sharing in institutional normative governance frameworks for data-intensive medical research.
Structure of Quasar Continuum Emission Regions and Cosmology from Optical and X-Ray Microlensing in Gravitationally Lensed Quasars

Abstract : Quasars are the most energetic objects in the universe. They are thought to be powered by the accretion of gas onto super-massive black holes at the centers of galaxies. The structure of these exotic objects is poorly understood because their central engines cannot be resolved with ordinary telescopes. Gravitational telescopes, however, provide the necessary resolution to study the structure of quasar central engines. This project analyzed the microlensing variability in five gravitationally lensed quasar systems to probe the structure of the continuum emission regions at optical and X-ray wavelengths and make time delay estimates in the systems in which sufficient data were available. The flux of each component of the multiply-imaged quasars was measured in many seasons of ground-based optical imagery. Lightcurves were constructed from the flux measurements, and Monte Carlo methods were used to analyze the microlensing variability in the lightcurves. The results of the Monte Carlo routine were analyzed with Bayesian methods, yielding estimates of the time delays and the sizes of the quasar accretion disks in QJ0158 4325 and HE1104 1805.
Response to ‘Unlikely influence of ABO blood group polymorphism on antibody response to COVID‐19 mRNA vaccine against SARS‐CoV‐2 spike protein’

We, the authors, want to thank the working group of Yamamoto et al., which provided interesting insights into the interpretation of our results [1, 2]; in our study, we failed to identify a significant difference in antibody titres among patients of different blood groups who underwent a full mRNA vaccination course (ComiRNAty PFIZER-BioNTech). We did not assess the influence of ABO type on natural SARS-CoV-2 infection. Our work was based on the hypothesis that there could be differences in the antibody response elicited by the vaccine, regardless of the A/B glycosylation of the spike protein. Other authors have also hypothesized a difference in the behaviour of the immune system in response to COVID-19 vaccines in patients with different blood types. In a letter from Sgherza et al., the authors start from the same hypothesis and describe how, even in their sample, there are no differences in response to the ComiRNAty vaccine based on the patient’s ABO group [3]. These data are consistent with the assertion by Yamamoto et al. that the absence of pre-existing glycosylation in mRNA-induced spike proteins avoids an ABO-based difference in immune response following vaccination. Yamamoto et al. also provide an overview of the effect that the glycosylation of the spike protein of SARS-CoV-2, induced by the blood group of the host in which the virus is replicating, can have both on infectivity and clinical outcome. These statements add to a growing body of literature, which, similarly to SARS-CoV, suggests that patients with blood group A are at greater risk of infection than group O patients. Amoroso et al. found, in a study conducted on transplant patients or on transplant wait-listed individuals, that blood group A patients had a higher incidence of COVID-19, possibly due to a lack of protection induced by the absence of anti-A agglutinins. If the fact that group O patients are at lower risk of infection fits well with the protection afforded by agglutinins against viruses generated in ABO individuals not identical to the host, protection from disease progression once the individual is infected (and therefore produces viruses with ABO identical glycosylation) could instead be explained by a lower propensity to thrombosis in group O patients. In a recent paper, Sardu et al. compared the incidence of cardiac injury, pro-thrombotic index levels and death among group O versus non-O hypertensive and COVID-19 patients; in the non-O group, the incidence of these pathologies was significantly increased [4]. As this study is focalized on O versus non-O patients, applying the considerations discussed by Yamamoto et al., the results could also be attributed to the reduced levels of von Willebrand factor and factor VIII in group O patients [5].
Contributions to Reliability.

Abstract : Chapter 1 of the report gives an estimate of the reciprocal of the Weibull shape parameter based on two order statistics. The exact properties are obtained for sample sizes up to 26. In Chapter 2 the properties of distributions with a designated quantile are studied. In Chapter 3 the interrelationships and properties of distributions which are respectively IHR (Increasing Hazard Rate), IHRA (Increasing Hazard Rate Average) and DMR (Decreasing Mean Residual Life) are discovered. A number of properties of life distributions that were restricted to the IHR family are shown to hold true for a wider class of hazard rate families. Finally, in Chapter 4, families of distributions that contain IHR, DHR (Decreasing Hazard Rate), constant rate (exponential) and combinations thereof, giving rise to the classical bath-tub shape hazard rate curves are characterized in a closed form and methods of estimating the parameters are discussed. (Author)
Gravitation and cosmology : proceedings of the ICGC-95 Conference, held at IUCAA, Pune, India, on December 13-19, 1995

Plenary Lectures. The Gravitational Instability Picture and the Epoch of Galaxy Formation P.J.E. Peebles. Active Galaxies at Large Redshifts M.S. Longair. Nonlinear Gravitational Clustering in Expanding Universe T. Padmanabhan. Covariant Cosmology G.F. R. Ellis. Inspiraling Compact Binaries L. Blanchet. The Virgo Project J.-Y. Vinet. Gravitational Wave Astronomy L.S. Finn. The Internal Time Formalism in Canonical Gravity C.G. Torre. Numerical Relativity E. Seidel. Integral Constraints in Cosmology J. Katz. Topological Censorship and Chronology Protection J.L. Friedman. Quantizing Dilatonic Black Holes M. Varadarajan. The Decoherent Histories Approach to Quantum Mechanics J.J. Halliwell. Canonical Quantum Gravity with New Variables and Loops: A Report J. Pullin. Workshop Reports. Observational Cosmology -- Aspect and Issues V. Sahni, G.F. R. Ellis. Alternative Cosmologies K.C. Wali. Quantum Gravity T.P. Singh, J.J. Halliwell. Gravitational Waves B.R. Iyer, K.D. Kokkotas. Classical General Relativity N. Dadhich, M.A.H. MacCallum. Conference Summary M.A.H. MacCallum.
Comparison of clinical outcomes of trifocal intraocular lens (AT LISA, Eyecryl SERT trifocal) versus extended depth of focus intraocular lens (Eyhance, Eyecryl SERT EDOF)

Purpose: To compare four different types of intra ocular lenses (IOLs), namely, AT LISA, Eyecryl SERT trifocal, Eyhance, Eyecryl SERT extended depth of focus (EDOF) with respect to their clinical outcomes. Methods: This is a retrospective comparative study in which patients who underwent surgery and one of the four types of IOL were implanted. Postoperative evaluation was recorded at one month, postoperatively. The monocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (6 m), uncorrected intermediate visual acuity (UIVA) (60 cm), distance-corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA) (40 cm), and corrected near visual acuity (CNVA) were assessed postoperatively on post operative day 30, for all four IOL groups. Defocus curve and contrast sensitivity were also compared. Results: With regards to UDVA and CDVA, P value was not statistically significant. (P = 0.534 and 0.421, respectively). EDOF group of IOLs had statistically significant better UIVA and CIVA than trifocal IOL group. (P < 0.001, 0.012, <0.001) and EDOF group had statistically significant worse P value pertaining to UNVA and CNVA (P < 0.001, 0.070, <0.001, 0.190). Pertaining to contrast sensitivity, EDOF group had better contrast sensitivity than Trifocal IOL group (P < 0.001). Conclusion: All four IOLs compared in this study had good comparable distant visual acuity. Near visual acuity was better with AT LISA and Eyecryl SERT trifocal IOL while intermediate vision was better with Eyhance and Eyecryl SERT EDOF IOL. Contrast sensitivity was better in EDOF IOLs than in both trifocal IOLs.
Enhanced mitochondrial activity reshapes a gut microbiota profile that delays NASH progression

Background and Aims: Recent studies suggest that mitochondrial dysfunction promotes progression to NASH by aggravating the gut‐liver status. However, the underlying mechanism remains unclear. Herein, we hypothesized that enhanced mitochondrial activity might reshape a specific microbiota signature that, when transferred to germ‐free (GF) mice, could delay NASH progression. Approach and Results: Wild‐type and methylation‐controlled J protein knockout (MCJ‐KO) mice were fed for 6 weeks with either control or a choline‐deficient, L‐amino acid–defined, high‐fat diet (CDA‐HFD). One mouse of each group acted as a donor of cecal microbiota to GF mice, who also underwent the CDA‐HFD model for 3 weeks. Hepatic injury, intestinal barrier, gut microbiome, and the associated fecal metabolome were then studied. Following 6 weeks of CDA‐HFD, the absence of methylation‐controlled J protein, an inhibitor of mitochondrial complex I activity, reduced hepatic injury and improved gut‐liver axis in an aggressive NASH dietary model. This effect was transferred to GF mice through cecal microbiota transplantation. We suggest that the specific microbiota profile of MCJ‐KO, characterized by an increase in the fecal relative abundance of Dorea and Oscillospira genera and a reduction in AF12, Allboaculum, and [Ruminococcus], exerted protective actions through enhancing short‐chain fatty acids, nicotinamide adenine dinucleotide (NAD+) metabolism, and sirtuin activity, subsequently increasing fatty acid oxidation in GF mice. Importantly, we identified Dorea genus as one of the main modulators of this microbiota‐dependent protective phenotype. Conclusions: Overall, we provide evidence for the relevance of mitochondria–microbiota interplay during NASH and that targeting it could be a valuable therapeutic approach.