Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Presentations and Comparative Outcomes of Delayed-Onset Low-Grade Endophthalmitis Managed with or Without Intraocular Lens Explantation

Purpose To compare the outcomes of delayed-onset low-grade endophthalmitis managed with and without intraocular lens (IOL) explantation. Setting Tertiary eye-care research institute in southern India. Design Retrospective comparative case series. Methods The study included all cases of post-cataract surgery delayed-onset endophthalmitis from January 1990 to January 2019. Time to endophthalmitis, duration of symptoms, presenting visual acuity, time to IOL explantation when performed, resolution after explantation, number of intravitreal injections, and final visual acuity were compared in the IOL non-explanted and IOL explanted groups. Results There were 115 eyes – 61 eyes in the IOL non-explant and 54 eyes in the IOL explant group. Between the two groups there was no statistically significant difference in age (58.37 ± 14.05 and 56.04 ± 14.96 years, respectively; p=0.35), vision at presentation (>20/400 in 29.5% and 29.6% eyes, respectively; p=0.98), and the duration of follow-up (14.38 ± 16.05, median 8.5 months and 7.06 ± 3.55, median 6 months respectively; p=0.43). There was a statistically significant difference between the IOL non-explant and IOL-explant groups in the time to resolution of inflammation (92.70 ± 36.28 and 45.33±11.2 days, respectively; p <0.0001) and the number of intravitreal injections (4.57 ± 0.75, median 5 and 2.79±2.11, median 2 respectively, p=0.005). Persistent/recurrent inflammation at 6 months was recorded in 18.03% and 5.55% in the IOL non-explant and IOL explant eyes, respectively (p=0.04). Favorable functional outcome was seen in 50.81% vs 68.51% in IOL non-explant and explant eyes, respectively (p=0.05). Conclusion IOL explantation in delayed-onset endophthalmitis helps in earlier resolution of inflammation, need for lesser number of intravitreal injections and a trend towards better functional outcomes.
Pediatric Liddle Syndrome Caused by a Novel SCNN1G Variant in a Chinese Family and Characterized by Early-Onset Hypertension

Abstract BACKGROUND Liddle syndrome (LS), an autosomal dominant disorder, is a common monogenic hypertension in pediatrics. In this study, we reported a novel SCNN1G variant in a Chinese family with pediatric LS, and conduct a systematic review of epithelial sodium channel (ENaC)-gene-positive LS cases to conclude the clinical genetic features of LS in childhood. METHODS Next-generation sequencing and in silico analysis were performed in the proband to discover candidate variants. Sanger sequencing was used to identify the predicted likely pathogenic variant. LS patients in this family were treated with amiloride. The Medline database was searched to summarize clinical features of pediatric LS cases whose age at genetic diagnosis was not more than 18 years. RESULTS Genetic analysis identified a novel SCNN1G missense variant (c.1874C>T, p.Pro625Leu) in the proband with LS in childhood. In silico analysis revealed this heterozygous variant was highly conserved and deleterious. A total of 38 publications described pediatric LS associated with 25 pathogenic variants in SCNN1B and SCNN1G in 54 children. Despite the phenotypic heterogeneity, early-onset hypertension is the most common feature. All LS patients in this family or the reviewed cases showed significantly improvements in hypertension and hypokalemia after treatment with ENaC inhibitors. CONCLUSIONS This study identified a novel SCNN1G missense variant in a patient with pediatric LS, expanding the genetic spectrum of SCNN1G and demonstrating the PY motif of γ-ENaC as a potential mutant region. Early identification and specific management of LS in children and adolescents are important to prevent the development of hypertensive end-organ disease.
Body mass index moderates the association between gait kinetics, body composition, and femoral knee cartilage characteristics

This study compared femoral cartilage characteristics between age‐ and sex‐matched individuals with (n = 48, age = 22.8 ± 3.5 years; body mass index [BMI] = 33.1 ± 4.1 kg/m2) and without obesity (n = 48 age = 22.0 ± 2.6 years; BMI = 21.7 ± 1.7 kg/m2) and evaluated the associations between body composition, quadriceps function, and gait kinetics with femoral cartilage characteristics. Medial and lateral femoral cartilage thickness, medial:lateral thickness ratio and medial and lateral cartilage echo intensity were measured using ultrasound imaging. Body composition was assessed using air displacement plethysmography. Quadriceps function was assessed via maximal isometric knee extension. Three‐dimensional gait biomechanics were recorded to extract peak external knee flexion and adduction moments, and peak loading rate of the vertical ground reaction force. Cartilage outcomes were compared between groups using one‐way multivariate analysis of variance. Stepwise moderated regression evaluated the association between body composition, quadriceps function, and gait kinetics with femoral cartilage outcomes in individuals with and without obesity. Medial (75.24 vs 65.84; P < .001, d = 1.02) and lateral (58.81 vs 52.22; P < .001, d = 0.78) femoral cartilage echo intensity were higher in individuals with compared with those without obesity. A higher body fat percentage was associated with higher medial and lateral cartilage echo intensity (ΔR2 = 0.09‐0.12) in individuals with obesity. A higher knee adduction moment was associated with a larger medial:lateral thickness ratio (ΔR2 = 0.09) in individuals without obesity. No associations were found between quadriceps function and cartilage outcomes. These findings suggest that high body fat in adults with obesity is associated with cartilage echo intensity. The obese body mass index was also associated with a lack of a positive relationship between cartilage thickness and joint loading during walking.
Inter‐segmental foot kinematics during gait in elderly females according to the severity of hallux valgus

The objective of this study was to find the effect of hallux valgus (HV) deformity on the inter‐segmental motion of the foot using an MFM with a 15‐marker set (DuPont Foot Model, DuFM) in comparison with age and sex controlled healthy adults. Fifty‐eight female symptomatic HV patients and 50 female asymptomatic older female volunteers were included in this study. According to the radiographic hallux valgus angle (HVA), the study population was divided into severe HV (SHV, HVA ≥ 40°, n = 25), moderate HV (MHV, 20° ≤ HVA < 40°, n = 47), and control (CON, n = 36). MHV group was divided into symptomatic MHV group (S‐MHV, n = 33) and asymptomatic MHV group (A‐MHV, n = 14) according to the symptoms associated with HV. For temporal parameters, gait speed and stride length were diminished according to the severity of HV deformity. Sagittal range of motion of hallux and hindfoot decreased significantly in SHV group. Loss of push‐off during the preswing phase was observed and forefoot adduction motion during terminal stance was decreased in SHV group. In a subgroup analysis of MHV, asymptomatic HV minimally affects gait and inter‐segmental motion during gait. HV deformity affects gait parameters and inter‐segmental motion of the foot during gait in proportion to the severity of the deformity. However, the effect of MHV itself on foot kinematics might be limited while pain or arthritic change of the joint might cause changes in gait in patients with symptomatic HV.
An engineered cell-laden adhesive hydrogel promotes craniofacial bone tissue regeneration in rats

A photocrosslinkable, cell-laden, adhesive hydrogel with tunable mechanical, osteoconductive, and biodegradative properties promotes bone formation. Building bone with a helpful hydrogel From a materials’ perspective, bone regeneration in craniofacial defects can be challenging, particularly considering the aqueous environment of the oral cavity. Hasani-Sadrabadi and colleagues developed an injectable alginate-based adhesive hydrogel that encapsulated aggregates of gingival mesenchymal stem cells and osteoconductive hydroxyapatite microparticles. In a rat model of peri-implantitis, the hydrogel promoted bone regeneration around dental implants. The hydrogel’s biodegradation and mechanical properties could be tuned, suggesting it could be a useful tool for tissue engineering. Cell-laden hydrogels are widely used in tissue engineering and regenerative medicine. However, many of these hydrogels are not optimized for use in the oral environment, where they are exposed to blood and saliva. To address these challenges, we engineered an alginate-based adhesive, photocrosslinkable, and osteoconductive hydrogel biomaterial (AdhHG) with tunable mechanical properties. The engineered hydrogel was used as an injectable mesenchymal stem cell (MSC) delivery vehicle for craniofacial bone tissue engineering applications. Subcutaneous implantation in mice confirmed the biodegradability, biocompatibility, and osteoconductivity of the hydrogel. In a well-established rat peri-implantitis model, application of the adhesive hydrogel encapsulating gingival mesenchymal stem cells (GMSCs) resulted in complete bone regeneration around ailing dental implants with peri-implant bone loss. Together, we have developed a distinct bioinspired adhesive hydrogel with tunable mechanical properties and biodegradability that effectively delivers patient-derived dental-derived MSCs. The hydrogel is photocrosslinkable and, due to the presence of MSC aggregates and hydroxyapatite microparticles, promotes bone regeneration for craniofacial tissue engineering applications.
Preparation of a thiols β-cyclodextring/gold nanoparticles-coated open tubular column for capillary electrochromatography enantioseparations.

Inspired by the distinct chemical and physical properties of nanoparticles, here a novel open-tubular capillary electrochromatography column was prepared by electrostatic assembly of poly (diallydimethylammonium chloride) onto the inner surface of a fused-silica capillary, followed by self-adsorption of negatively charged SH-β-cyclodextrin/gold nanoparticles. The formation of the SH-β-cyclodextrin/gold nanoparticles coated capillary was confirmed and characterized by scanning electron microscopy and energy dispersive spectrometry. The results of scanning electron microscopy and energy dispersive spectrometry studies indicated that SH-β-cyclodextrin/gold nanoparticles was successfully coated on the inner wall of the capillary column. The performance of the SH-β-cyclodextrin/gold nanoparticles coated capillary was validated by the analysis of six pairs of chiral drugs, namely zopiclone, carvedilol, salbutamol, terbutaline sulfate, phenoxybenzamine hydrochloride and ibuprofen. Satisfactory enantioseparation results were achieved, confirming the use of gold nanoparticles as the support could enhance the phase ratio of the open-tubular capillary column. Additionally, the stability and reproducibility of the SH-β-cyclodextrin/gold nanoparticles coated capillary column were also investigated. Then, this proposed method was well validated with good linearity (≥ 0.999), recovery (90.0-93.5%) and repeatability, and was successfully used for enantioseparation of Ibuprofen in spiked plasma samples, which indicated the new column's potential usage in biological analysis. This article is protected by copyright. All rights reserved.
Trends of Patients’ Characteristics Admitted Into a Multi-Professional Home Medical Care Service From 2000 to 2009 in Singapore

The main aim of this study is to present the socio-demographic, clinical, and functional characteristics of home medical care patients admitted into one of the oldest home care service over a 10-year period. Data were manually retrospectively extracted from the non-computerized medical records of all patients admitted into Code 4 Home Medical Service from January 1, 2000, to December 31, 2009. Records of 1,069 patients were examined. Over the 10-year period, there was an increasing proportion of patients older than 70 years (B [95% CI], 1.08 [0.43, 1.73]) and dependency on foreign domestic workers as primary caregivers (B [95% CI], 4.65 [3.71, 5.58]). Cognitive impairment and functional dependency of the patients increased over the years, as assessed using Abbreviated Mental Test score < 7 (B [95% CI], 1.73 [0.71-2.76]) and Barthel Index = 0 (B [95% CI], 4.32 [2.74-5.91]). Knowledge about these trends may be helpful to project future demands for home medical care in Singapore.
LATE-BREAKING ABSTRACT: Breathe free: Open source development of a breath sampler by a consortium of breath researchers

Background: There is emerging evidence for the use of exhaled volatile organic compounds (VOCs) in pulmonary disease. A major challenge in the field of breath metabolomics is lack of standardised capturing of breath VOCs (ERS taskforce). Hardware differences between groups prevent pooling of data and adequate comparison between analytical techniques. Methods: The Breathe Free Consortium (www.breathe-free.org) aims to solve this by combining the expertise of over 70 breath researchers with that of engineers and industrial designers in an open source development platform for a breath sampler. Results: Forum discussions resulted in a design that is flexible to match the requirements for a wide range of conditions. The current functional prototype allows sampling of nasal, oral, bronchial, alveolar and mixed breath through pressure and CO2 gating. Fig 1. displays functioning of the device during 5 breath cycles: the blue line indicating CO2%, red indicating exhalation/inhalation pressure and the green line indicating pump activity (pressure gated). Conclusion: The Consortium will be able to present the fully functional Breathe Free Sampler at the ERS in September. This can set a widely accepted standard for breath sampling that is freely available. The resulting pooling of datasets and comparison of different analytical techniques will strongly facilitate the integration of breath analysis into clinical practice.
Left-hemispheric predominance of nigrostriatal deficit in isolated REM sleep behavior disorder

Objective Unilateral onset of parkinsonism due to nigrostriatal damage of the contralateral hemisphere is frequent in Parkinson disease (PD). There is evidence for a left-hemispheric bias of motor asymmetry in right-handed patients with PD indicating a hemispheric dominance. Isolated REM sleep behavior disorder (IRBD) constitutes the prodromal stage of PD and other synucleinopathies. To test the hypothesis that right-handed patients with IRBD exhibit left-hemispheric predominance of subclinical nigrostriatal dysfunction, we evaluated this aspect using neuroimaging instruments. Methods In 167 right-handed patients with IRBD without parkinsonism, we evaluated in each hemisphere the integrity of the striatal dopaminergic terminals by dopamine transporter (DAT)-SPECT and the substantia nigra echogenicity by transcranial sonography. Results DAT-SPECT showed lower specific binding ratio (SBR) in the left striatum and left caudate nucleus than in the right striatum and right caudate nucleus. The percentage of patients with lower SBR was greater in the left striatum and left caudate nucleus than in the right striatum and right caudate nucleus. In those who developed a synucleinopathy in <5 years from DAT-SPECT, there was a lower SBR in the left putamen and left caudate nucleus than in the right putamen and right caudate nucleus. Substantia nigra echogenic size was greater in the left than in the right side in patients with hyperechogenicity and among individuals who phenoconverted in <5 years from transcranial sonography. Conclusion Right-handed patients with IRBD exhibit left-hemispheric predominance of subclinical nigrostriatal dysfunction. In premotor PD, the neurodegenerative process begins asymmetrically, initially impairing the nigrostriatal system of the dominant hemisphere.
Impact of blood glucose abnormalities on outcomes and disease severity in patients with severe sepsis: An analysis from a multicenter, prospective survey of severe sepsis

Background Dysglycemia is frequently observed in patients with sepsis. However, the relationship between dysglycemia and outcome is inconsistent. We evaluate the clinical characteristics, glycemic abnormalities, and the relationship between the initial glucose level and mortality in patients with sepsis. Methods This is a retrospective sub-analysis of a multicenter, prospective cohort study. Adult patients with severe sepsis (Sepsis-2) were divided into groups based on blood glucose categories (<70 (hypoglycemia), 70–139, 140–179, and ≥180 mg/dL), according to the admission values. In-hospital mortality and the relationship between pre-existing diabetes and septic shock were evaluated. Results Of 1158 patients, 69, 543, 233, and 313 patients were categorized as glucose levels <70, 70–139, 140–179, ≥180 mg/dL, respectively. Both the Acute Physiological and Chronic Health Evaluation II and Sequential Organ Failure Assessment (SOFA) scores on the day of enrollment were higher in the hypoglycemic patients than in those with 70–179 mg/dL. The hepatic SOFA scores were also higher in hypoglycemic patients. In-hospital mortality rates were higher in hypoglycemic patients than in those with 70–139 mg/dL (26/68, 38.2% vs 43/221, 19.5%). A significant relationship between mortality and hypoglycemia was demonstrated only in patients without known diabetes. Mortality in patients with both hypoglycemia and septic shock was 2.5-times higher than that in patients without hypoglycemia and septic shock. Conclusions Hypoglycemia may be related to increased severity and high mortality in patients with severe sepsis. These relationships were evident only in patients without known diabetes. Patients with both hypoglycemia and septic shock had an associated increased mortality rate.
Facility-Level Variation in Cardiac Stress Test Use Among Patients With Diabetes: Findings From the Veterans Affairs National Database

Cardiac stress testing in patients with diabetes mellitus (DM) is a topic of much debate (1,2). The clinical heterogeneity and varied interpretation of atypical symptoms in this population may lead to significant variation in cardiac stress testing with downstream implications in health care expenditure. We evaluated facility-level variation in cardiac stress test use among patients with DM across the Veterans Affairs (VA) health care system. We identified patients with DM aged ≥18 years with a primary care clinic visit during VA fiscal year 2014 at one of the 130 VA facilities and associated clinics. Patient demographics and medical history were identified using clinical data sources and ICD-9-CM codes. We calculated diagnostic cost group relative risk score (DCG-RRS), a validated surrogate for overall illness burden. Facility-level cardiac stress test use was defined as the number of stress tests performed per facility per 100 patients with DM in the preceding 365 days. Stress testing modalities evaluated included exercise treadmill test, stress echocardiography, and SPECT/PET MPI (myocardial perfusion imaging [single photon emission computed tomography or positron emission tomography]). Facilities with <10 studies/year were excluded. Median risk ratio (MRR), a well-established measure of facility-level variation (3), was derived by constructing multivariable hierarchical modified regression models adjusted for patient clustering and modeled patient characteristics as filter effects within each facility and individual facilities as a random effect (4). Unadjusted and adjusted MRRs (adjustment for patient, provider, and facility-level variables) were calculated for overall stress testing and individual stress modalities. MRR represents the likelihood of two …
Brain‐dead donor heart conservation with a preservation solution supplemented by a conditioned medium from mesenchymal stem cells improves graft contractility after transplantation

Hearts are usually procured from brain‐dead (BD) donors. However, brain death may induce hemodynamic instability, which may contribute to posttransplant graft dysfunction. We hypothesized that BD‐donor heart preservation with a conditioned medium (CM) from mesenchymal stem cells (MSCs) would improve graft function after transplantation. Additionally, we explored the PI3K pathway's potential role. Rat MSCs‐derived CM was used for conservation purposes. Donor rats were either exposed to sham operation or brain death by inflation of a subdural balloon‐catheter for 5.5 hours. Then, the hearts were explanted, stored in cardioplegic solution‐supplemented with either a medium vehicle (BD and sham), CM (BD + CM), or LY294002, an inhibitor of PI3K (BD + CM + LY), and finally transplanted. Systolic performance and relaxation parameters were significantly reduced in BD‐donors compared to sham. After transplantation, systolic and diastolic functions were significantly decreased, terminal deoxynucleotidyl transferase‐mediated dUTP nick end‐labeling (TUNEL)‐positive cells and endonuclease G positive cells were increased in the BD‐group compared to sham. Preservation of BD‐donor hearts with CM resulted in a recovery of systolic graft function (dP/dtmax: BD + CM: 3148 ± 178 vs BD: 2192 ± 94 mm Hg/s at 110 µL, P < .05) and reduced apoptosis. LY294002 partially lowered graft protection afforded by CM in the BD group. Our data suggest that PI3K/Akt pathway is not the primary mechanism of action of CM in improving posttransplant cardiac contractility and preventing caspase‐independent apoptosis.
When Tonight Is Not the Night: Sexual Rejection Behaviors and Satisfaction in Romantic Relationships

In most long-term romantic relationships, partners experience sexual conflicts of interest in which one partner declines the other partner’s sexual advances. We investigated the distinct ways people reject a partner’s advances (i.e., with reassuring, hostile, assertive, and deflecting behaviors) in Studies 1 and 2. Using cross-sectional (Study 3) and daily experience methods (Study 4), we investigated how perceptions of a partner’s rejection behaviors are linked with the rejected partner’s relationship and sexual satisfaction. We found robust evidence that perceived partner reassuring behaviors were associated with greater satisfaction, whereas perceived partner hostile behaviors were associated with lower levels of satisfaction. Perceived partner responsiveness was a key mechanism underlying the effects. Findings for assertive and deflecting behaviors were limited, but the effect of deflecting behaviors was qualified by levels of hostile behaviors for sexual satisfaction. Findings provide the first empirical investigation of the specific ways partners can decline one another’s advances to preserve satisfaction.