Miracle-dz/UniFAR-FTUs huggingface dataset:
Non-Compliance and Microbial Contamination in Orthokeratology

Purpose. To determine the rates of microbial contamination of solutions and lens accessories of existing ortho-k lens wearers and the effect on contamination rates of monthly replacement and warnings. To investigate self-reported levels of compliance with care of the lenses and lens accessories and correlation of these levels with the rates of microbial contamination. Methods. Asymptomatic ortho-k lens wearers with at least 6-month successful use were requested to bring their lenses, solutions, and accessories to their next aftercare visit. All items, except the lenses, were replaced at each data collection visit. Samples collected from the lens surface, solution, and accessories were cultured for pathogens. These procedures were repeated twice at 1-month intervals. At the first visit, each subject and/or parent was interviewed about the care/use of the lens and accessories. Results. Thirty-eight subjects completed the study. Initial contamination rates of the lenses, lens cases, and tweezers were 29, 34, and 46%, respectively. Rates of contamination dropped for lenses, suction holders, and tweezers during the three-visit intervention. Contact lens solutions, except lens cleaner were contaminated on all occasions with the most contaminated product being artificial tears [33% (n = 18)]. There was no improvement in the contamination rate of the lens cases. The most common pathogens isolated were Staphylococcus aureus and Serratia marcescens. Compliance was lowest for care of lens cases and highest for care of lenses. However, correlation between reported compliance and presence of pathogens failed to reach significance. Conclusions. Subjects’ awareness of the importance of lens cleanliness is high and can be improved by regular reinforcements. However, attitudes toward cleaning of accessories was far less satisfactory and while replacement and warnings resulted in significant improvements of contamination rates of tweezers and suction holders, more emphasis should be placed on educating patients on correct care of lens accessories.
Dental implants modified with drug releasing titania nanotubes: therapeutic potential and developmental challenges

ABSTRACT Introduction: The transmucosal nature of dental implants presents a unique therapeutic challenge, requiring not only rapid establishment and subsequent maintenance of osseointegration, but also the formation of resilient soft tissue integration. Key challenges in achieving long-term success are sub-optimal bone integration in compromised bone conditions and impaired trans-mucosal tissue integration in the presence of a persistent oral microbial biofilm. These challenges can be targeted by employing a drug-releasing implant modification such as TiO2 nanotubes (TNTs), engineered on titanium surfaces via electrochemical anodization. Areas covered: This review focuses on applications of TNT-based dental implants towards achieving optimal therapeutic efficacy. Firstly, the functions of TNT implants will be explored in terms of their influence on osseointegration, soft tissue integration and immunomodulation. Secondly, the developmental challenges associated with such implants are reviewed including sterilization, stability and toxicity. Expert opinion: The potential of TNTs is yet to be fully explored in the context of the complex oral environment, including appropriate modulation of alveolar bone healing, immune-inflammatory processes, and soft tissue responses. Besides long-term in vivo assessment under masticatory loading conditions, investigating drug-release profiles in vivo and addressing various technical challenges are required to bridge the gap between research and clinical dentistry.
Studying the Flow Dynamics of a Karst Aquifer System with an Equivalent Porous Medium Model

The modeling of groundwater flow in karst aquifers is a challenge due to the extreme heterogeneity of its hydraulic parameters and the duality in their discharge behavior, that is, rapid response of highly conductive karst conduits and delayed drainage of the low‐permeability fractured matrix after recharge events. There are a number of different modeling approaches for the simulation of the karst groundwater dynamics, applicable to different aquifer as well as modeling problem types, ranging from continuum models to double continuum models to discrete and hybrid models. This study presents the application of an equivalent porous model approach (EPM, single continuum model) to construct a steady‐state numerical flow model for an important karst aquifer, that is, the Western Mountain Aquifer Basin (WMAB), shared by Israel and the West‐Bank, using MODFLOW2000. The WMAB was used as a catchment since it is a well‐constrained catchment with well‐defined recharge and discharge components and therefore allows a control on the modeling approach, a very rare opportunity for karst aquifer modeling. The model demonstrates the applicability of equivalent porous medium models for the simulation of karst systems, despite their large contrast in hydraulic conductivities. As long as the simulated saturated volume is large enough to average out the local influence of karst conduits and as long as transport velocities are not an issue, EPM models excellently simulate the observed head distribution. The model serves as a starting basis that will be used as a reference for developing a long‐term dynamic model for the WMAB, starting from the pre‐development period (i.e., 1940s) up to date.
Reciprocal Effects of Self-Concept and Performance From a Multidimensional Perspective: Beyond Seductive Pleasure and Unidimensional Perspectives

We (Marsh & Craven, 1997) have claimed that academic self-concept and achievement are mutually reinforcing, each leading to gains in the other. Baumeister, Campbell, Krueger, and Vohs (2003) have claimed that self-esteem has no benefits beyond seductive pleasure and may even be detrimental to subsequent performance. Integrating these seemingly contradictory conclusions, we distinguish between (a) older, unidimensional perspectives that focus on global self-esteem and underpin the Baumeister et al. review and (b) more recent, multidimensional perspectives that focus on specific components of self-concept and are the basis of our claim. Supporting the construct validity of a multidimensional perspective, studies show that academic achievement is substantially related to academic self-concept, but nearly unrelated to self-esteem. Consistent with this distinction, research based on our reciprocal-effects model (REM) and a recent meta-analysis show that prior academic self-concept (as opposed to self-esteem) and achievement both have positive effects on subsequent self-concept and achievement. We provide an overview of new support for the generality of the REM for young children, cross-cultural research in non-Western countries, health (physical activity), and nonelite (gymnastics) and elite (international swimming championships) sport. We conclude that future reviews elucidating the significant implications of self-concept for theory, policy, and practice need to account for current research supporting the REM and a multidimensional perspective of self-concept.
Diagnostic modalities for nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and associated fibrosis

Nonalcoholic fatty liver disease (NAFLD) is a spectrum comprised of isolated steatosis, nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. The majority of NAFLD subjects do not have NASH and do not carry a significant risk for liver‐related adverse outcomes (cirrhosis and mortality). Globally, the prevalence of NAFLD is approximately 25%. In Asia, a gradient of high to low prevalence rates is noted from urban to rural areas. Given the prevalence of NAFLD, the clinical and economic burden of NAFLD and NASH can be substantial. With increasing recognition of NASH as an important liver disease, the diagnosis of NASH still requires a liver biopsy that is suboptimal. Although liver biopsy is the most accurate modality to diagnose and stage the severity of NASH, this method suffers from being invasive, costly, associated with potential complications, and plagued with interobserver variability of individual pathological features. A number of noninvasive modalities to diagnose NASH and stage liver fibrosis are being developed. These modalities include predictive models (NAFLD fibrosis score) and serum biomarkers such as enhanced liver fibrosis (ELF). Other tests are based on radiological techniques, such as transient elastography (TE) or magnetic resonance elastography (MRE), which are used to estimate liver stiffness as a potential surrogate of hepatic fibrosis. Although a dynamic field of research, most of these diagnostic modalities have area under the curve ranging between 0.76 and 0.90%, with MRE having the best predictive performance. In summary, developing safe and easily accessible noninvasive modalities to accurately diagnose and monitor NASH and associated fibrosis is of utmost importance in clinical practice and clinical research. These tests are not only important to risk stratify subjects at the greatest risk for progressive liver disease, but also to serve as appropriate surrogate endpoints for therapeutic clinical trials of NASH. (Hepatology 2018;68:349‐360).
Study of Theories about Myopia Progression (STAMP) Design and Baseline Data

Purpose. The Study of Theories about Myopia Progression (STAMP) is a 2-year, double-masked, randomized clinical trial of myopic children 6 to 11 years of age. STAMP will evaluate the 1-year effect of progressive addition lenses (PALs) compared with single vision lenses (SVLs) on central refraction, peripheral refraction in four quadrants, and accommodative response and convergence. STAMP will also evaluate any changes 1 year after discontinuing PALs. Baseline characteristics of enrolled children are reported. Methods. Eligible children had a high accommodative lag and either low myopia (less myopic than −2.25 diopter (D) spherical equivalent) or high myopia (more myopic than −2.25 D spherical equivalent) and esophoria at near. Children were randomly assigned to wear either PALs or SVLs for 1 year to determine the difference in myopia progression in the PAL group relative to the SVL group. All children will then wear SVLs for the 2nd year to evaluate the permanence of any treatment effect. Complete ocular biometric data are collected at 6-month intervals. Results. Over 17 months, 192 children were screened, and 85 (44%) were eligible and enrolled. Of these 85 children, 44 (52%) were girls, and 54 (64%) were esophoric at near. The mean age (± SD) was 9.8 ± 1.3 years. The right eye mean cycloplegic spherical equivalent refractive error was −1.95 ± 0.78 D. Horizontal relative peripheral hyperopia (30° nasal retina + 0.56 ± 0.59 D; 30° temporal retina + 0.61 ± 0.77 D) and vertical relative peripheral myopia (30° superior retina −0.36 ± 0.92 D; 20° inferior retina −0.48 ± 0.83 D) were found. Conclusions. The baseline data for STAMP are reported. Asymmetry between vertical and horizontal meridian relative peripheral refraction was found. STAMP will use the ocular biometric changes associated with the PAL treatment effect to attempt to elucidate the mechanism responsible for the treatment effect.
The Basic-Systems Model of Episodic Memory

Behavior, neuropsychology, and neuroimaging suggest that episodic memories are constructed from interactions among the following basic systems: vision, audition, olfaction, other senses, spatial imagery, language, emotion, narrative, motor output, explicit memory, and search and retrieval. Each system has its own well-documented functions, neural substrates, processes, structures, and kinds of schemata. However, the systems have not been considered as interacting components of episodic memory, as is proposed here. Autobiographical memory and oral traditions are used to demonstrate the usefulness of the basic-systems model in accounting for existing data and predicting novel findings, and to argue that the model, or one similar to it, is the only way to understand episodic memory for complex stimuli routinely encountered outside the laboratory.
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis

ABSTRACT Introduction: Vedolizumab is an anti-integrin approved for the treatment of Crohn’s disease and ulcerative colitis. By binding the α4β7-integrin heterodimer, vedolizumab blocks leukocyte translocation into gastrointestinal tissue. Areas covered: This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. Other medications available for the treatment of ulcerative colitis are also discussed. Expert opinion: Vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from TNF-α inhibitors and immune suppressants, allowing it to be used in cases of TNF-α inhibitor failure or non-response, or as a first-line biologic drug. Available safety data suggests that vedolizumab is not associated with an increased risk of infection or malignancy; however, additional post-marketing data are required to confirm these initial reports. Vedolizumab is likely to be used in growing numbers of patients over the coming years.
Participation in, and Barriers to, Training: the Experience of Older Adults

Abstract. It is widely recognised that older workers are less likely to gain access to job‐related training than younger workers. This article reviews evidence on the extent of age‐based training differentials in Australia and the main barriers that inhibit older workers from accessing training. It is concluded that governments in Australia need to do far more to ensure that older workers are not denied access to training opportunities.
Individualized, patient-centered use of lixisenatide for the treatment of type 2 diabetes mellitus

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease associated with hyperglycemia, which can lead to serious vascular complications. Current treatment guidelines place particular emphasis on personalization of therapy. Within this guidance, the use of various second-line therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), is recommended under certain circumstances. Areas covered: Factors influencing glucose homeostasis, including gastric emptying and the associated cardiovascular (CV) risk when homeostasis is not maintained, are reviewed. Physiology relating to the mechanism of action of GLP-1 RAs is summarized, with a particular focus on lixisenatide. In addition, an overview of efficacy and safety data for lixisenatide is presented and the CV effects of GLP-1 RAs are examined. Finally, the rationale and clinical data supporting the combination of lixisenatide and basal insulin are explored. Expert opinion: GLP-1 analogs meet a need for better glycemic control, with the added benefits of reduced hypoglycemic risk and body weight. The combination of a short-acting GLP-1 RA, such as lixisenatide, with a basal insulin, exploits the complementary effects of both of these therapies and seems well suited for the treatment of T2DM. However, further studies are needed to establish the associated CV risks and/or benefits of GLP-1 RAs.
Living with chronic illness: A phenomenological study of the health effects of the patient–provider relationship

Purpose: To understand the patient–healthcare provider (HCP) relationship from the lived experience of women with chronic disease and determine how this relationship affects women’s health. Data sources: Narrative accounts of 25 women’s relationships with HCPs in repeated group and individual interviews were audio‐taped and transcribed verbatim. Interpretive phenomenology was used to explore the data using three interconnected modes of paradigm cases, exemplars, and themes. Conclusions: Women with chronic disease believed their health was significantly affected by their relationships with HCPs. They experienced a greater sense of well‐being and security in connected relationships and had more confidence and motivation to manage their illness. Implications for practice: This research suggests that for women with chronic disease, relationships with HCPs that are connected, and characterized by partnership, and personableness result in the women feeling better in many dimensions. The context of today’s healthcare system often pushes the nurse practitioner (NP) to provide care more attuned to medical issues, leaving little time for the development of connected relationships. In spite of this pressure, NPs need to strive to develop relationships with patients that are intersubjective/connected.
Future Directions in Non-Invasive Measurements of Tear Film Surface Kinetics

Purpose. To review the methods for dynamic, non-invasive, and objective assessment of tear film surface quality and to outline their current state-of-the-art and their future potential. Methods. Among the methods available, high-speed videokeratoscopy, lateral shearing interferometry, and dynamic wavefront sensing are being considered. Results. The principles of operations, their advantages and disadvantages, and limitations of each method are being outlined. The possible future directions of each method are also discussed. Conclusions. To gain a better understanding of tear film, its structure and function, it is essential to combine macroimaging technologies with those focusing on tear film microstructure. In this way, one can envisage a clinical device that could help, in future, early diagnosis of dry eye syndrome and development of better materials for contact lenses and eye lubricants.
Two hundred years of dependence on antianxiety drugs

Dependence has developed in the case of each antianxiety drugs introduced into clinical practice during the last two hundred years. Throughout this time there has been a reluctance to accept that anxiolytics are drugs of dependence and this has led to prolonged delays in the recognition of the problem. New compounds have been used to treat addiction to older drugs, even after the new drugs themselves have been shown to be addictive. The limitations of existing methods of assessing addictive potential should be more widely recognised and patients treated with new antianxiety drugs should be monitored more intensely and for a sufficiently long period to decide definitely that the drug does not cause dependence. It is hoped that drugs free from addictive potential will one day be produced, but it is possible that dependence is an unavoidable price that has to be paid for having antianxiety drug in our pharmacological armamentarium.
Macrophages come on tap for liver fibrosis therapy

Liver cirrhosis was once considered an intractable disease, but some clinical data and murine studies suggested that fibrosis can be reversed. Bone-marrow– derived cell therapies, principally with macrophages, have appeared the most promising. Now, Haideri et al. have shown that mononuclear phagocytes, generated on a large scale from pluripotent embryonic stem cells, are functionally similar to monocyte-derived cells (MCs) and injected intravenously can reduce fibrosis in a CCL4 model of liver injury. This demonstration opens up the possibility of an “off-the-shelf” product for the treatment of liver fibrosis. Most models of fibrosis have used mice given twiceweekly injections of CCL4 for up to 8 weeks, with bone marrow cells (BMCs) administered midway through the dosing schedule. Early studies indicated that these BMCs were responsible for fibrosis reduction by virtue of matrix metalloproteinase (MMP) expression. However, further investigation hinted that endogenous inflammatory cells were also major players in fibrosis resolution, finding their number in the liver peaked at the time of maximum fibrosis but subsequently declined with fibrosis resolution. Furthermore, granulocyte colony-stimulating factor (G-CSF) administration enhanced this cell migration and accelerated regression of liver fibrosis. Using the same model, King et al. administered three infusions of purified hematopoietic stem cells (c-Kit/Sca-1/Lin [KLS]) after 6 weeks of biweekly CCl4 injections. (5) Benefits of KLS cell infusion were 3-fold, with a 50% reduction in liver scarring, fewer alpha-smooth muscle actin (a-SMA)-positive myofibroblasts, and a proregenerative reaction as measured by an increase in the pan-CK-positive area (a ductular reaction). Significantly, the same effect was achieved when lymphoid progenitors lacking myeloid potential were infused and was associated with a recruitment of endogenous mononuclear phagocytes and neutrophils; thus, activation of endogenous repair pathways by paracrine action of the infused cells could be a major factor in reparative response. Against this background, a phase 2 clinical study administering subcutaneous GCSF with or without intravenously infused CD133positive hematopoietic stem cells failed to show any benefits in predominantly compensated patients with cirrhosis with Model for End-Stage Liver Disease (MELD) scores between 11.0 and 15.5; insufficient numbers of infused cells reaching the liver because the peripheral venous route of administration could have been responsible.
Wearable inertial sensors for human movement analysis

ABSTRACT Introduction: The present review aims to provide an overview of the most common uses of wearable inertial sensors in the field of clinical human movement analysis. Areas covered: Six main areas of application are analysed: gait analysis, stabilometry, instrumented clinical tests, upper body mobility assessment, daily-life activity monitoring and tremor assessment. Each area is analyzed both from a methodological and applicative point of view. The focus on the methodological approaches is meant to provide an idea of the computational complexity behind a variable/parameter/index of interest so that the reader is aware of the reliability of the approach. The focus on the application is meant to provide a practical guide for advising clinicians on how inertial sensors can help them in their clinical practice. Expert commentary: Less expensive and more easy to use than other systems used in human movement analysis, wearable sensors have evolved to the point that they can be considered ready for being part of routine clinical routine.