Miracle-dz/UniFAR-FTUs huggingface dataset:
Role of optical coherence tomography-angiography in diabetes mellitus: Utility in diabetic retinopathy and a comparison with fluorescein angiography in vision threatening diabetic retinopathy

Purpose: To determine the utility of optical coherence tomography-angiography (OCT-A) in diabetic retinopathy (DR) and comparison versus fluorescein angiography (FA) in vision-threatening diabetic retinopathy (VTDR). Methods: In this cross-sectional observational study, 60 eyes with no DR (NDR), 60 eyes with non-proliferative diabetic retinopathy (NPDR), and 60 eyes with proliferative diabetic retinopathy (PDR) underwent OCT-A. FA was done in VTDR. OCT-A of the NDR eyes was analyzed by two independent retina specialists. Vessel density (VD) (mm/mm2), perfusion density (PD) (%), and foveal avascular zone (FAZ) (mm2) area was analyzed among the groups. Montage angiography with vitreoretinal interface (VRI) segmentation was done in PDR. A qualitative comparison was done between OCT-A and FA for features of DR. Results: OCT-A detected 16.66% of the eyes with microaneurysm and 57.5% of the patients with capillary non-perfusion (CNP) areas in the NDR group. The inter-grader coefficient between the two observers was 0.820 for microaneurysm and 0.880 for CNP. The mean VD in NDR, NPDR, and PDR was 16.865, 13.983, and 11.643 mm/mm2. The mean PD in NDR, NPDR, and PDR was 30.595, 26.853, and 23.193%. The VD and PD values were statistically significant (P < 0.001). The mean FAZ area was not statistically significant (NPDR and PDR) (P > 0.05). The VRI showed elevated neovascularization in four eyes. OCT-A delineated microaneurysm and FAZ in 97/97 eyes who underwent FA. The FA failed to delineate FAZ in 2/37 NPDR eyes and 13/60 PDR eyes. The CNP areas (OCT-A) were detectable in all eyes. The FA demonstrated CNP areas in 17/37 and 36/60 eyes in NPDR and PDR, respectively. The FA could show peripheral CNP. Conclusion: The OCT-A helps in the early diagnosis of DR by providing vascular indices which are consistent with disease progression. OCT-A is non-invasive and ideal for follow-up. FA is a dynamic test with a larger field of view.
Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Purpose: To evaluate the clinical profile, visual outcomes, and complications among young adult patients with type 1 diabetes mellitus (insulin-dependent DM-T1DM) in comparison with patients with type 2 diabetes mellitus (T2DM) undergoing vitrectomy for complications of proliferative diabetic retinopathy (PDR). Methods: A retrospective review of patients between 18 and 45 years with T1DM undergoing vitrectomy for complications of PDR between June 2017 and June 2019, with a minimum follow-up of 12 months. Consecutive patients between 30 and 45 years with type 2 diabetes (non-insulin-dependent DM-T2DM) who underwent vitrectomy for the same indications were retrospectively enrolled as the control group. Results: There were 42 eyes (28 patients) in the T1DM group and 58 eyes (47 patients) in the T2DM group. The average age at operation was 35.9 ± 6.88 years and 39.8 ± 3.03 years, respectively (P < 0.001). At the end of follow-up, the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 1.53 ± 0.55 to 1.30 ± 0.93 (P value 0.07) in the T1DM group and from 1.59 ± 0.46 to 1.00 ± 0.78 in the T2DM group (P = 0.0001). The rate of the primary and final reattachment was 76.2% and 88.1% in the T1DM group and 84.5% and 96.6% in the T2DM group. Preoperative macular tractional retinal detachment (MTRD) and neovascular glaucoma (NVG) in both the groups, chronic kidney disease (CKD) and lack of preoperative Pan retinal photocoagulation (PRP) in the T1DM group, hypertension (HTN) and, resurgery in the T2DM group, were risk factors for poor vision at the final follow-up. Conclusion: The visual and anatomic outcomes were poorer in the T1DM patients which could be due to the longer duration of diabetes with worse glycemic control, associated comorbidities like CKD, and a higher incidence of MTRD.
The influence of season phase on multivariate load relationships in professional youth soccer

ABSTRACT The purpose of this research was to assess relationships between subjective and external measures of training load in professional youth footballers, whilst accounting for the effect of the stage of the season. Data for ratings of perceived exertion (RPE) and seven global positioning systems (GPS) derived measures were collected from 20 players (age = 17.4 ± 1.3 yrs, height = 178.0 ± 8.1 cm, mass = 71.8 ± 7.2 kg) across a 47-week season. The season was categorised by a pre-season phase, and two competitive phases (Comp1, Comp2). The structure of the data were investigated using principal component analysis. An extraction criterion of component with eigenvalues ≥1.0 was used. Two components were retained for the pre-season period explaining a cumulative variance of 77.1%. Single components were retained for both Comp1 and Comp2 explaining 73.3% and 74.3% of variance, respectively. Identification of single components may suggest that measures are related and can be used interchangeably, however these interpretations should be considered with caution. The identification of multiple components in the pre-season phase suggests that univariate measures may not be sufficient when considering load experienced. These results suggest that factoring load based on measures of volume and intensity should be considered.
Soda Consumption Among Mexican Construction Workers in the Context of the Sugar-Sweetened Beverage Tax

This study explored the psychosocial determinants of consumption of soda and other taxed sugar-sweetened beverages (SSBs) in Mexican construction workers (CWs) and whether consumption changed as a result of the 2014 SSB tax. We conducted a qualitative case study involving in-depth interviews and focus groups (FGs) with 30 Mexican CWs; supplemented with descriptions of the food and beverages consumed during lunch breaks. We used NVivo 10 to classify information according to the analysis categories, primarily informed by the Reasoned Action Approach (RAA). CWs reported not having changed their consumption of soda and other taxed SSBs as a result of the SSB tax, despite the price increase and “knowing” the potential negative consequences of soda drinking. The most important determinants of soda consumption are a deep-seated social norm of soda drinking and use of soda drinking as part of their professional identity; their likeness for soda; a wide availability of soda in their environments; and a low perceived behavioral control (because they thought themselves as addicted to it). Participants indicated that the best way for them not to consume soda would be if it were not available. These findings lend support for the tight regulation of the availability of SSBs. To have a meaningful impact on these consumers, the SSB tax may need to be much higher. Policy-level interventions should be coupled with interventions at the individual and community levels that aim at denormalizing soda consumption, create new meanings in relation to water consumption, and develop behavioral control to decrease soda consumption.
Antimicrobial Susceptibility Testing for Staphylococcus lugdunensis

Evaluation of penicillin and oxacillin susceptibility testing was conducted on 200 Staphylococcus lugdunensis isolates. Disc diffusion with penicillin 1 IU (P1, EUCAST) and penicillin 10 IU (P10, CLSI) was compared with nitrocefin discs (Cefinase) and automated broth microdilution (Vitek 2). ABSTRACT Evaluation of penicillin and oxacillin susceptibility testing was conducted on 200 Staphylococcus lugdunensis isolates. Disc diffusion with penicillin 1 IU (P1, EUCAST) and penicillin 10 IU (P10, CLSI) was compared with nitrocefin discs (Cefinase) and automated broth microdilution (Vitek 2). Oxacillin susceptibility was extrapolated from cefoxitin (FOX; 30 μg) disc diffusion and compared with Vitek 2 results. The reference methods were blaZ and mecA PCR. Penicillin zone diameter and zone edge correlated with blaZ PCR results in all except two P10-susceptible isolates (very major error [VME]) and one P1-resistant isolate (major error [ME]). A total of 148 isolates were blaZ negative, of which 146 and 149 isolates were susceptible by P1 and P10, respectively. A total of 127 were penicillin susceptible by Vitek 2. Vitek 2 overcalled resistance in 21 blaZ-negative, 20 P1-susceptible, and 22 P10-susceptible isolates (Vitek 2 ME rate, 14.2%). Two mecA-positive isolates were oxacillin resistant by FOX disc and Vitek 2 methods (categorical agreement). However, 18 FOX-susceptible mecA-negative isolates tested resistant by Vitek 2. In conclusion, Vitek 2 overestimated penicillin and oxacillin resistance compared with disc diffusion and PCR results. In our study, disc diffusion with zone edge interpretation was more accurate and specific than automated broth microdilution for S. lugdunensis.
Rationalities of Space and Drug-Related Harms: Accounts of People Who Inject Drugs in Nigeria

ABSTRACT Background Studies have examined how people who inject drugs (PWID) navigate public spaces for drug consumption, but little is known about consumption of drugs in private apartments. This study explores social, structural and physical environment factors influencing injecting practices and the rationalities shaping how PWID make decisions about where to consume drugs. Methods The study is based on qualitative data from 41 in-depth interviews conducted with both homeless and housed PWID recruited through snowball sampling in Uyo, Nigeria. Thematic analysis, framed by the theoretical constructs of structural and everyday violence, and situated rationality theories, was undertaken on transcripts. Results Analysis revealed different socio-spatial rationalities underlying decisions about where to use drugs: avoidance of police arrest, convenience and relaxation, avoidance of drug sharing, avoidance of drug-scene violence, and stigma and shame. These factors show the impacts of social, structural and physical environment factors on the lived experiences of PWID. Injecting in private apartments potentially offset the risk of stigma, police arrest and violence linked to public injecting, but increase the risk of overdose and sharing of drugs and needle-syringes based on social relations of trust. Conclusions Findings show that PWID chose between competing risks when deciding on where to inject drugs. Interventions should consider the situated contexts of risk, and adapt harm reduction measures to the risk profile of different populations of PWID.
Are interventions delivered by healthcare professionals effective for weight management? A systematic review of systematic reviews

Abstract Objective: There are many systematic reviews of weight management interventions delivered by healthcare professionals (HCP), but it is not clear under what circumstances interventions are effective due to differences in review methodology. This review of systematic reviews synthesises the evidence about: (a) the effectiveness of HCP-delivered weight management interventions and (b) intervention and sample characteristics related to their effectiveness. Design: The review of reviews involved searching six databases (inception – October 2020). Reviews were included if they were (a) systematic, (b) weight management interventions delivered, at least partially, by HCP, (c) of randomised controlled trials and (d) written in English. Data regarding weight management outcomes (e.g. weight) and moderating factors were extracted. Secondary analyses were conducted using study-level data reported in each of the reviews. Setting: The review included studies that were delivered by HCP in any clinical or non-clinical setting. Participants: Not applicable. Results: Six systematic reviews were included (forty-six unique studies). First-level synthesis showed that weight management interventions delivered by HCP are effective. The second-level synthesis found that interventions are only successful for up to 6 months, are most effective for women, non-Caucasians and adults and are most effective if they have at least six sessions. Conclusions: As interventions are only successful for up to 6 months, they are not sufficient for achieving and maintaining a healthy weight.
Report of clinical presentations and two novel mutations in patients with Wiskott-Aldrich syndrome/X-linked Thrombocytopenia

Abstract Wiskott-Aldrich syndrome (WAS)/X-linked thrombocytopenia (XLT) is a rare X-linked disease characterized by thrombocytopenia, eczema, and recurrent infection. In addition, WAS/XLT increases incidence of autoimmune diseases and malignancies. We reported 7 male patients, 2 with WAS and 5 with XLT, from 6 different families. Two novel mutations, p.Gly387GlufsTer58 and p.Ala134Asp, were identified in patients with WAS. Both patients had severe clinical phenotypes compatible with classic WAS and developed lethal outcomes with intracranial hemorrhage. Other than that, one patient with XLT developed pineoblastoma.
Effect of untethering on occult tethered cord syndrome: a systematic review

Abstract Background and objectives Despite the evident clinical, neurological, orthopedic, and urodynamic dysfunctions, neuroanatomic imaging is normal in patients with occult tethered cord syndrome (OTCS). Therefore, the diagnosis of OTCS can be very complex. In this regard, this systematic review aimed to determine the main clinical features (i.e. neurological, musculoskeletal, and urological abnormalities) and improvement rates of these symptoms in patients with OTCS after the section of the filum terminale (SFT). Materials and methods All the papers published in three electronic databases, namely Google Scholar, PubMed, and Web of Science, were searched for the purposes of this study. The searching process started on 15 October and lasted until 9 November 2020. Eventually, 10 reports were found about the clinical outcomes of SFT for the management of the OTCS. Results The included studies were carried out on a total of 234 patients with OTCS, all of whom had undergone SFT. Evaluation of urologic symptoms revealed that 40–100% of patients with OTCS suffered from urinary instability. Moreover, its improvement rate after SFT was estimated at 59–100%. Evaluation of neurological symptoms indicated that 25–69% of patients with OTCS suffered from back/leg pain, And its improvement rate, the symptoms of back/leg pain of all patients were resolved or improved after SFT. Lower extremity weakness was found in 9–40% of patients with OTCS which was resolved or improved after SFT in about 25–100% of patients. Nevertheless, surgical indications for occult tight filum terminale syndrome remain controversial. Conclusion Although it seems that the SFT in OTCS patients is promising in treating neurologic, orthopedic and urological symptoms, usage of surgical untethering for patients with OTCS is a controversial issue. Clinical evaluation and urodynamic testing can be used to identify patients with OTCS. However, a multidisciplinary diagnostic work-up is strongly recommended for every child with OTCS.
Response to comment on “Genomic epidemiology of superspreading events in Austria reveals mutational dynamics and transmission properties of SARS-CoV-2”

Description Further analysis of SARS-CoV-2 genome sequencing data identifies several highly recurrent genetic variants with low allele frequencies, which, if filtered out, provide estimates consistent with tighter transmission bottlenecks. Further analysis of SARS-CoV-2 genome sequencing data identifies several highly recurrent genetic variants with low allele frequencies, which, if filtered out, provide estimates consistent with tighter transmission bottlenecks.
A Systematic Review of Teaching Games for Understanding Intervention Studies From a Practice-Referenced Perspective

ABSTRACT According to the theory of practice architecture, every practice enacted in classrooms is a result of interaction between social, physical and spatial elements. In relation, from a practice-referenced perspective, it is necessary to know which teaching-learning implementation features could help teachers/coaches/researchers to assemble Teaching Games for Understanding (TGfU) interventions in relation to the institutional environment. Purpose: This review aimed to explore from a practice-referenced perspective how TGfU researchers reported their interventions based on the teaching-learning implementation features (intervention design as a function of the context, intervention length, lesson content, basic lesson elements, lesson alignment, teacher/coach experience with the approach, and lesson validation and treatment verification) and their association with learners’ outcomes. Results: We found 20 studies that included some of the teaching-learning implementation features, but none of the studies included all of these features. We also found that studies of TGfU measured and reported learners’ outcomes in a variety of ways. This creates difficulties for drawing conclusions about the relationships between the presence of teaching-learning implementation features and student learning outcomes. Conclusion: Further TGfU interventions should be planned to consider the following: (a) that lessons need to be designed as a function of the context; (b) the number of intervention lessons, their duration and the duration of each lesson task; (c) the concrete tactical and technique contents and goals per lesson; (d) the modified games, questions and achievable challenges as basic lesson elements; (e) the alignment between the basic lesson elements and the structure of lessons, based on the goals of each lesson; (f) that teachers/coaches need to have previous experience in TGfU and be trained on the specific study purpose; (g) that lessons should be validated before implementation and verified during intervention; (h) researchers should regulate the ways in which learners’ outcomes are measured and reported within TGfU studies.
Association of the Level of Neurofilament Light With Disease Severity in Patients With Spinocerebellar Ataxia Type 2

Background and Objectives Few biochemical markers have been identified in spinocerebellar ataxia type 2 (SCA2). This study aimed to determine the levels of neurofilament light (NfL) in patients with SCA2 and to identify whether they are associated with disease severity. Methods Participants were recruited from 1 medical center in China, and individuals with SCA2 were genetically diagnosed. NfL levels were assessed with the single molecule array method. Disease severity was evaluated with the Scale for the Assessment and Rating of Ataxia (SARA), the International Cooperative Ataxia Rating Scale (ICARS), and the Inventory of Non-Ataxia Symptoms (INAS). Cerebellum and brainstem volumes were calculated from neuroimaging measurements. We used the Pearson correlation and partial correlation for correlation analyses. Results Forty-nine patients with manifest SCA2, 10 preclinical individuals with SCA2, and 92 controls were enrolled. A high consistency was identified between serum and CSF NfL (r = 0.868, p < 0.0001). In individuals with SCA2, levels of serum NfL were associated with disease severity (SARA: r = 0.425, p = 0.003; ICARS: r = 0.383, p = 0.009; INAS:, r = 0.390, p = 0.007; cerebellum volume: r = −0.393, p = 0.024) after adjustment for age. NfL levels were higher close to the expected age at onset in preclinical individuals with SCA2 (R2 = 0.43, p = 0.04). Discussion Levels of serum NfL were correlated with disease intensity in individuals with SCA2 and were higher close to the estimated age at onset in preclinical SCA2. Therefore, NfL is a potential serum biomarker of disease severity in SCA2. Classification of Evidence This study provides Class II evidence that elevated NfL levels are associated with disease severity in individuals with SCA2.
Adverse Side Effects Associated with Corticosteroid Therapy: A Study in 39 Patients with Generalized Myasthenia Gravis

Background The tolerability of high-dose oral corticosteroids in patients with generalized myasthenia gravis (gMG) has not been systematically assessed. We evaluated adverse side effects (ASEs) of corticosteroid treatment in patients with gMG. Material/Methods Retrospective analysis was conducted of ASEs reported as being related to corticosteroid treatment in 39 patients with gMG who were treated with oral corticosteroids for ≥1 year. Results Median (interquartile range [IQR]) age was 60 (21) years, 53.8% of patients were women, and 66.7% were aged ≤65 years. Median (IQR) prednisone treatment duration was 14 (2) months; median (IQR) daily dose was 40 (15) mg. The median number of ASEs reported as corticosteroid-related was 2/patient (IQR, 1). Pre-diabetes and weight gain were most common (each 43.6% of patients). Bruising, insomnia, and osteoporosis were more prevalent in patients aged >65 years, while irritability, osteopenia, and pre-diabetes were more common in patients aged ≤65 years, although differences were not statistically significant. Irritability and weight gain were more prevalent in women (P=0.010 for irritability); osteoporosis and pre-diabetes more common in men (P=0.015 for osteoporosis). ASEs were generally more common in the high-dose prednisone group (>30 mg/day), but were only statistically significant for irritability (P=0.001). Conclusions Corticosteroid-related ASEs were common in patients with gMG. Some of these ASEs can have serious medical consequences, and certain ASEs appeared to be associated with specific patient characteristics. Demographics and comorbidities of patients with gMG must be carefully considered before corticosteroid initiation. Potential ASEs, such as unanticipated osteoporosis in men, require extra vigilance.
Androgen abuse and the brain

Supplemental Digital Content is available in the text Purpose of review The purpose of this review is to examine the recent evidence regarding the effects of exogenous androgens on the brain. Understanding these effects is of high importance, as the consequences of androgens on the reproductive and endocrine system are well documented, while fewer studies have focused on the neural and cerebral consequences of androgen use. Recent findings Supraphysiological doses of androgens have been shown to contribute to neurodegeneration, decreased brain-derived neurotrophic factor, increased inflammation and decreased neuronal density in animal studies, which may correspond to changes in mood, cognition and aggression. Findings from human studies suggest that similar behavioural and cognitive deficits may occur as a result of prolonged use of androgens. Additional evidence suggests that androgen use, particularly in high doses, may contribute to brain ageing and cerebrovascular problems. Summary Findings from recent human and animal studies indicate that androgen use likely contributes to brain alterations, which may cause the frequently observed deficits in cognitive and emotional functioning. Although exogenous testosterone in appropriate doses for therapeutic purposes likely have some neurobiological benefits for certain populations, supraphysiological doses may cause multiple mental and physical health problems, indicating a need for additional large-scale studies in humans.