Miracle-dz/UniFAR-FTUs huggingface dataset:
Intravitreal Therapy for Diabetic Macular Edema: An Update

Diabetic macular edema (DME) represents a prevalent and disabling eye condition. Despite that DME represents a sight-threatening condition, it is also among the most accessible to treatment. Many different treatment options including photocoagulation, intravitreal medical treatment (either vascular endothelial growth factor inhibitors or corticosteroids therapies), and surgical removal are currently available. Although laser has been considered as the gold standard for many years, over the past several years vascular endothelial growth factor inhibitors (anti-VEGFs) have become first-line therapy. However, many patients do not adequately respond to them. With the development of sustained-release corticosteroid devices, steroids have gained a presence in the management of the DME. We review and update the role of anti-VEGF and intravitreal sustained-release corticosteroid management of DME. According to the currently available scientific evidence, the choice of one anti-VEGF over another critically depends on the baseline best-corrected visual acuity (BCVA). While aflibercept may be the drug of choice in low baseline BCVA, the three anti-VEGFs (bevacizumab, ranibizumab, and aflibercept) provided similar functional outcomes when the baseline BCVA was higher. DEX implants are a valuable option for treating DME, although they are usually seen as a second choice, particularly in those eyes that have an insufficient response to anti-VEGF. The new evidence suggested that, in eyes that did not adequately respond to anti-VEGF, switching to a DEX implant at the time to 3 monthly anti-VEGF injections provided better functional outcomes.
A Five-Year Trend of Intestinal Parasite Prevalence among Students Attending Clinic at University of Gondar, Northwest Ethiopia

Background Intestinal parasitic infections are the cause of the highest worldwide infectious disease and the major public health problems in developing countries. Among the cases, children and younger age are at high risk and the major victims. The aim of this study was to assess the five-year trend of intestinal parasite prevalence among University of Gondar students. Method A retrospective cross-sectional study was conducted to assess the trend of intestinal parasite prevalence among students at the University of Gondar. The data was collected from students who have studied at the University of Gondar from 2014 to 2018 and who visited the student's clinic and had recorded results of stool sample diagnosis on the laboratory logbook. Stool specimens were examined using direct saline wet mount methods. The data was analyzed by using SPSS version 20 software, and P value < 0.05 was considered as statistically significant. Moreover, chi-square was used to assess the association of different variables. Result During the study period, a total of 6244 stool samples were requested for intestinal parasite diagnosis and it was found that 2850 specimens were positive for intestinal parasites, representing an overall prevalence of 45.6% with a fluctuating trend. Ten different parasites were reported with Entamoeba histolytica/dispar (20.3%) and Giardia lamblia (8.2%), the most frequently detected intestinal parasites. The prevalence of intestinal parasitic infections was higher in males (35.4%) than females (10.2%) (P = 0.02). Conclusions Intestinal parasitic infection was highly prevalent, and there were fluctuations in the prevalence of intestinal parasites from 2014 to 2018. Environmental sanitation improvement and health education schemes at the University of Gondar can be considered quite indispensable for the prevention and control of parasitic infections in the area.
Risk Factors Screening for Gestational Diabetes Mellitus Heterogeneity in Chinese Pregnant Women: A Case–Control Study

Purpose To study the risk factors of gestational diabetes mellitus (GDM) heterogeneity, and to evaluate the correlation between the risk factors and obesity. Methods We performed a case–control study of 452 women with GDM and 516 women with normal glucose tolerance (NGT) at the first and second trimester. We defined GDM women as GDM-resistance subtype, GDM-dysfunction subtype, and GDM-mixed subtype, according to their simultaneous insulin-release test with predominant insulin-sensitivity defect, insulin-secretion defect, or both defects. Results We found that higher maternal age, family history of diabetes, the elevated level of fasting blood glucose in the first trimester (≥5.1 mmol/L) were risk factors of all GDM subtypes. Pre-pregnancy overweight/obesity and the increased gestational weight gain (GWG) in the first-trimester are risk factors of the GDM-resistance subtype. Indicators including younger age at first menstruation, the elevated levels of alanine aminotransferase (ALT), total bile acid (TBA), triglyceride (TG), and the decreased level of high-density lipoprotein cholesterol (HDL-C) are risk factors of the GDM-resistance subtype. However, the associations between those risk factors and GDM-resistance subtype attenuated after adjusted by pre-pregnancy body mass index (pre-BMI) and gestational weight gain (GWG) in the first trimester. Nonalcoholic fatty liver disease (NAFLD) and the improved level of TG are independent risk factors for the GDM-resistance subtype and the GDM-mixed subtype, respectively. Conclusion Women with GDM exhibited heterogeneity based on glycemic physiology and their risk factors are not all the same. Some obesity-related risk factors are specific to the GDM-resistance subtype, which are mediated by pre-pregnancy overweight/obesity and the elevated GWG the first-trimester.
Women’s Satisfaction and Its Associated Factors with Antenatal Care Services at Public Health Facilities: A Cross-Sectional Study

Background Regular monitoring and evaluation improves the quality of health services. Client satisfaction is an indicator of the quality of a health service. Poor maternal satisfaction with antenatal care services has negative outcomes. Currently, women’s satisfaction with antenatal care services is below standard in low-income countries such as Ethiopia. Therefore, this study aimed to assess women’s satisfaction and its associated factors with antenatal care services. Methods A facility-based cross-sectional study was conducted from September 23 to October 23, 2019. A total of 405 women were involved in the study. A systematic random sampling technique was used. The data were coded manually and checked visually for completeness. The data were entered using Epi Info version 7 and exported to SPSS version 20 for analysis. Descriptive statistic was computed. Thechi-squared test was performed and factors associated with women’s satisfaction with antenatal care services were selected for multiple logistic regression at a probability value (p-value) of <0.2 in the chi-squared analysis. Statistically significant associated factors were identified at a p-value of ≤0.05, and with adjusted odds ratios and 95% confidence intervals. Results Among 405 participants, 53.8% (95% CI=48.7–59%) of women were satisfied with the antenatal care services. Age of mothers (AOR=6.04, 95% CI=2.3–15.9), advice on danger signs in pregnancy (AOR=4.53, 95% CI=2.7–7.52), previous antenatal care visits (AOR=3.8, 95% CI=2.0–7.52), respectful maternity care (AOR=8.2, 95% CI=3.3–20.4), and planned pregnancy (AOR=2.8, 95% CI=1.6–4.8) were statistically significantly associated with women’s satisfaction with antenatal care services. Conclusion About half of the participants were satisfied with the antenatal care services. Age of participants, respectful maternity care, advice on danger signs in pregnancy, previous antenatal care visits, and planned pregnancy were found to be predictors of women’s satisfaction with antenatal care services.
Online Medical Education in India – Different Challenges and Probable Solutions in the Age of COVID-19

Introduction During the COVID-19 pandemic, most educational institutions have opted for online education rather than traditional modes of education to protect their employees and students. Online education has been gaining momentum in almost all countries around the world. This coincides with the recently introduced competency-based medical education in India which has embraced online education. This poses a new challenge for the institutions involved, the instructors or teachers, and the students since they must adapt quickly to the new mode of learning. Online education requires teachers to improve their competency in three major areas; pedagogy, technology, and content knowledge. Some of the challenges include; lack of technological skill, poor time management and lack of infrastructure. As technology rapidly advances, health care education systems must also advance in tandem. To implement the new competency-based system and online education, the institutions and the individuals must realize the importance of online education, identify the barriers and quickly work on solutions for success. Methods This review was conducted based on various research papers on the topic of online medical education, the challenges faced by faculty members, and the opinion of students on this dilemma. Search terms included online medical education, COVID19, competency-based medical education. Conclusion This review identified various challenges posed by online education on the current medical curriculum, faced by both faculty members and students, especially under the light of the Competency-Based Undergraduate Curriculum for Indian Graduates. Different solutions were proposed to overcome these challenges.
Clinical and Prognostic Value of Immunogenetic Characteristics in Anti-LGI1 Encephalitis

Objective Antibodies against leucine-rich glioma-inactivated 1 (LGI1-Abs) characterize a limbic encephalitis (LE) strongly associated with HLA-DRB1*07:01, although some patients lack LGI1-Abs in CSF or do not carry this allele. Whether they represent a different subtype of disease or have different prognoses is unclear. Methods Retrospective analysis of clinical features, IgG isotypes, and outcome according to LGI1-Ab CSF positivity and DRB1*07:01 in a cohort of anti-LGI1 LE patients. Results Patients with LGI1-Abs detected in both CSF and serum (105/134, 78%) were compared with those who were CSF negative (29/134, 22%). Both groups had similar clinical features and serum levels, but CSF-positive patients had shorter diagnostic delay, more frequently hyponatremia, inflammatory CSF, and abnormal MRI (p < 0.05). Human leukocyte antigen (HLA) genotyping was performed in 72/134 (54%) patients and 63/72 (88%) carried DRB1*07:01. Noncarriers (9/72, 12%) were younger, more commonly women, and had less frequently psychiatric and frontal symptoms (p < 0.05). No difference in IgG isotypes according to CSF positivity or HLA was found (p > 0.05). HLA and IgG isotypes were not associated with poor outcome (mRS >2 at last follow-up) in univariate analyses; CSF positivity was only identified as a poor outcome predictor in the multivariate analysis including the complete follow-up, whereas age and female sex also remained when just the first year was considered. Conclusions LE without CSF LGI1-Abs is clinically indistinguishable and likely reflects just a lesser LGI1-Ab production. HLA association is sex and age biased and presents clinical particularities, suggesting subtle differences in the immune response. Long-term outcome depends mostly on demographic characteristics and the intensity of the intrathecal synthesis.
The Aftermath of COVID-19 Lockdown on Daily Life Activities in Orthopaedic Patients

Purpose Following the 2019 coronavirus (COVID-19) pandemic, many reports have investigated the psychosocial effects of the lockdown. The aim of our study was to investigate the effects of the lockdown on the daily life habits of orthopaedic patients. Patients and Methods Around 30 days after the start of the Italian lockdown, from April 17th to the end of the containment measures on May 18th, the Sapienza University of Rome carried out a 19-item survey on the effects the lockdown caused in patients suffering from an orthopaedic pathology (with regard to changes in lifestyle, pain, treatment) by stratifying the sample by age, sex, profession, pain location, pathogenesis and prior surgeries. Results A total of 292 subjects with orthopaedic pathologies took part in the survey. Taking into consideration the totality of the sample, physical activity was significantly reduced (p <0.001). The increase of a sedentary lifestyle was statistically significant (p <0.001), as well as an increase in pain (p <0.001) and the need to adjust the pharmacological treatment (p <0.001). The increase in pain was particularly significant in the 50–70 age group, among workers, and in polyarthralgic patients. About 55.48% stated that the lockdown period worsened their underlying pathological condition and 53.77% expressed the need to undergo a new clinical evaluation at the end of the lockdown. Conclusion The impact of the COVID-19 pandemic lockdown and resulting sudden changes in lifestyle led to a change in patient perception of orthopedic pathology including a worsening of musculoskeletal pain requiring an adjustment or change in pharmacological and physical therapy.
Benefit/Risk Profile of Single-Inhaler Triple Therapy in COPD

Abstract Chronic obstructive pulmonary disease (COPD) is associated with major healthcare and socioeconomic burdens. International consortia recommend a personalized approach to treatment and management that aims to reduce both symptom burden and the risk of exacerbations. Recent clinical trials have investigated single-inhaler triple therapy (SITT) with a long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA), and inhaled corticosteroid (ICS) for patients with symptomatic COPD. Here, we review evidence from randomized controlled trials showing the benefits of SITT and weigh these against the reported risk of pneumonia with ICS use. We highlight the challenges associated with cross-trial comparisons of benefit/risk, discuss blood eosinophils as a marker of ICS responsiveness, and summarize current treatment recommendations and the position of SITT in the management of COPD, including potential advantages in terms of improving patient adherence. Evidence from trials of SITT versus dual therapies in symptomatic patients with moderate to very severe airflow limitation and increased risk of exacerbations shows benefits in lung function and patient-reported outcomes. Moreover, the key benefits reported with SITT are significant reductions in exacerbations and hospitalizations, with data also suggesting reduced all-cause mortality. These benefits outweigh the ICS-class effect of higher incidence of study-reported pneumonia compared with LAMA/LABA. Important differences in trial design, baseline population characteristics, such as exacerbation history, and assessment of outcomes, have significant implications for interpreting data from cross-trial comparisons. Current understanding interprets the blood eosinophil count as a continuum that can help predict response to ICS and has utility alongside other clinical factors to aid treatment decision-making. We conclude that treatment decisions in COPD should be guided by an approach that considers benefit versus risk, with early optimization of treatment essential for maximizing long-term benefits and patient outcomes.
The Impacts of Hospital Effluent Discharges on the Physico-chemical Water Quality of a Receiving Stream at Ile-Ife, Southwestern Nigeria

In order to contribute to the understanding of the impact of wastewater discharges from a Hospital in south-western Nigeria on the receiving water bodies, the physico-chemical qualities of the two wastewater point sources from the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile–Ife were characterized, and their impacts on the water quality of the receiving Elekete stream were assessed. Eight sampling stations were selected for the study: three, were located each on the unimpacted and impacted sections of the receiving Elekete stream while one each was located on the two wastewater point sources from OAUTHC. The physico-chemical parameters investigated include: oxygen parameters, major cations, major anions, nutrient compounds, physical parameters (temperature, turbidity, solids) as well as pH and conductivity. Samples were collected from each sampling station fortnightly for nine months and analysed using standardised laboratory methods. The results were analysed using relevant statistical methods. The result showed significant difference (P < 0.05) for all parameters between the impacted and unimpacted sections of effluent receiving stream. SO42-, Total Organic Carbon, NH4+, PO43-, and BOD5 were more than three times higher in the impacted section than in the unimpacted section while sample colour, turbidity, total suspended solids, total dissolved solids, total solids, conductivity, alkalinity, acidity, Ca2+, Mg2+, Na+, K+, Cl-, HCO3-, NO3-, and NO2- were about two times higher in the impacted section of the receiving stream than in the unimpacted section. The overall mean concentrations of 293 mg l-1 and 270 mg l-1 BOD5 in the two effluent streams indicate the medium/ strong strength of the wastewater discharges from OAUTHC. This study showed that the wastewater discharge from the (OAUTHC) Ile-Ife has significant impact on the water quality of the receiving streams. The implications are discussed.
The PanOptix Trifocal IOL vs the ReSTOR 2.5 Active Focus and ReSTOR 3.0-Add Multifocal Lenses: A Study of Patient Satisfaction, Visual Disturbances, and Uncorrected Visual Performance

Purpose To compare spectacle independence, patient-reported outcomes (PROs), and dysphotopsia after multifocal intraocular lens (IOL) implantation with the AcrySof PanOptix trifocal or the ReSTOR +2.5/3.0 D or ReSTOR +2.5 D mini-monovision multifocal IOL. Patients and Methods Prospective, open-label, multicenter analysis of PROs, spectacle independence, and satisfaction among patients undergoing cataract surgery who had been implanted at least 1 month previously with AcrySof IQ PanOptix or PanOptix Toric trifocal (n = 59) IOLs bilaterally. Results were compared to outcomes from a similar study with the AcrySof ReSTOR 2.5/3.0 or the ReSTOR ActiveFocus 2.5 mini-monovision lens [n = 191]). Results Spectacle independence was significantly higher in the PanOptix cohort, with 83% of patients “never” needing glasses for any activity versus 36% in the ReSTOR 2.5 mini-monovision and 34% in the ReSTOR 2.5/3.0 cohorts. No significant differences in patient satisfaction rates were reported between the three cohorts. Glare and halo were rated “extremely” noticeable more with the PanOptix (10%) than with the ReSTOR 2.5 mini-monovision (1%) or ReSTOR 2.5/3.0 (3%). BCVA differences were not statistically significant, and no new safety concerns were reported. Conclusion The AcrySof PanOptix trifocal provides significantly greater spectacle independence across all measured activities than the AcrySof ReSTOR multifocal IOLs.
Obstructive Sleep Apnea is Related with the Risk of Retinal Vein Occlusion

Background Retinal vein occlusion (RVO) was a vision-threatening retinal vascular disorder, however, the relationship between obstructive sleep apnea (OSA) and RVO risk remained unclear. Methods A total of 45 RVO cases and 45 controls between April 2018 and April 2020 were included. All the participants underwent full-night polysomnography (PSG) and thus detected the severity of OSA. Besides, the relationship between the apnea–hypopnea index (AHI) and oxidative and inflammatory biomarkers, including 8-hydroxy-2 deoxyguanosine (8-OHdG), C-reactive protein (CRP), interleukin 1 beta (IL1β), interleukin 6 (IL6) and tumor necrosis factor alpha (TNFα) were detected. The incidences of macular edema (ME) and neovascular glaucoma (NVG) were detected in a three-months follow-up. Results In this case–control study, it was found that OSA incidence was increased in the RVO cases comparing with the cataract controls. Advanced analyses about the RVO subtypes demonstrated that incidence of OSA was higher in the central RVO (CRVO) cases comparing with branch RVO (BRVO) cases. Plasma samples from OSA cases demonstrated relatively higher concentrations of oxidative stress parameters and inflammatory biomarkers, including 8-OHdG, CRP, IL1β, and IL6, in the RVO cases. Significant linear correlations between AHI and oxidative/inflammatory biomarkers were detected, and advanced analyses on the OSA subtypes demonstrated that these biomarkers were significantly higher in cases with later stages of OSA. In a three months follow-up, an impaired visual activity improvement rate and increased ME incidence in the OSA group among all the RVO cases were detected. Conclusion OSA was related with an increased incidence of RVO. Besides, OSA would lead to increased oxidative and inflammatory biomarkers concentrations in the RVO cases. OSA could be used as a harmful prognostic factor of visual activity improvement and ME incidences. These findings highlighted the role of OSA in the development of RVO.
Encapsulation effect and its influence on bond-valence parameters

Structural geometry of anion-centered tetrahedra [XA 4 ] (X = O, N; A = Pb, REE, etc.) is controlled by both A . A interactions and X-A bonds. If the A 4 cage has an interstition smaller than the X atom, the encapsulation of X into A 4 results in a bond strain caused by stretching of A . A contacts and compressing of X-A ones. As a consequence, A-X bond-valence parameters for encapsulated X atoms are decreased in comparison with standard ones.
Sources and risk assessment of metal contamination in soils at the international airport of Shanghai, China

Concentrations of Cd, Pb, Zn, Cr, Cu, and Ni in soils at the Pudong International Airport (PIA) of Shanghai, China, were determined to assess the sources and potential ecological risks. Compared to the soil background values of Shanghai, 31 soil samples out of 33 were highly contaminated with Cd, and 76% were moderately contaminated by Cr, Ni, Pb, and Zn. Principal component analysis and clustering analysis indicated that Pb and Cd mainly originated from anthropogenic sources, while Zn, Cr, Ni, and Cu were mainly from natural sources. Relatively high concentrations of Cd and Pb were observed at sampling points near the landing or take-off sites or a close-by highway. Both air and highway traffic affected the quality of the soils at PIA.
DNA-functionalized colloids: Physical properties and applications

The specificity and reversibility of the hydrogen-bonding between two complementary strands in DNA make this bio-molecule a unique binding agent. When DNA is grafted to nano-and micrometer sized colloids it can lead to specific binding between particles coated with complementary strands of single-stranded DNA. DNA-coated colloids hold great promise as the building blocks of a new generation of complex, self-assembling colloidal materials. This brief review sketches the recent developments and present status of the research on DNA-coated colloids with special emphasis on their role as potential building blocks in complex, self-assembling materials and as highly sensitive bio-sensors. Although the present review cannot be comprehensive, it hopefully highlights the promise of DNA-coated colloids as versatile and still largely unexplored form of soft matter.