Miracle-dz/UniFAR-FTUs huggingface dataset:
Early results with the EyeCryl Phakic Toric intraocular lens implantation in keratoconus patients

Objective: Refractive management in keratoconus is challenging. Although some kinds of phakic intraocular lenses have been studied in keratoconus so far, no study evaluated the results of EyeCryl Phakic Toric intraocular lenses in this kind of patients. Materials and Methods: This is a retrospective chart review study, including all keratoconus patients implanted with an EyeCryl Phakic Toric intraocular lens in at least one of their eyes by an experienced cornea surgeon in Colombia. Follow-up to 6 months after surgery was also included. Results: A total of 20 eyes of 14 patients were included, with an average age of 29.3 ± 4.2 years. Spherical equivalent improved from a pre-surgical value of –10.31 D to +0.09 D at 6 months. 65% of the patients improved at least one line in the best-corrected distance visual acuity. At 6 months, 70% of the patients were within ± 0.50 D of spherical equivalent emmetropia. No complications occurred in any of the patients. Conclusion: EyeCryl Phakic intraocular lenses are an excellent option in keratoconus patients with high refractive error. Abbreviations: KC = Keratoconus, P-IOL = phakic intraocular lenses, ICL = Implantable Collamer Lens, WTW = White to White, SD = standard deviation, ANOVA = an analysis of variance, UDVA = monocular uncorrected distance visual acuity, CDVA = corrected distance visual acuity
High-resolution images in macular disorders

Objective: This study analyzed and compared the results of adaptive optics (AO) and fundus autofluorescence (FAF) in various maculopathies. Methods: The study included four different types of maculopathy: central serous chorioretinopathy (CSC), retinitis pigmentosa (RP), Stargardt disease (STGD) and phototoxic retinopathy. In all four cases, cone mosaic and cone density were obtained using AO fundus camera. Further, the high-resolution images were compared with the FAF and optical coherence tomography (OCT) results. Results: In CSC, FAF and AO, changes could be shown in the macula even two years after the subretinal fluid resorption, as opposed to a normal OCT. The improvement of FAF and cone mosaic appearance was concomitant with the visual acuity growth. Several cone mosaic phenotypes were observed in RP and STGD. In RP, the cone density was 24.240 cones /mm2 in the center, and decreased to 8.163 cones/ mm2 in the parafoveal area. In STGD, the cone density was lower in the center, 9.219 cones/ mm2, and higher at the periphery, 12.594 cones/ mm2. In the case of phototoxic retinopathy, AO and OCT were more effective than FAF in highlighting the photoreceptor and retinal pigment epithelium lesions. Conclusions: FAF and AO are very useful tools in macular pathologies examination. FAF can offer a true picture of the metabolic changes in the macula, while AO allows the view of changes up to the cellular level. Abbreviations: STGD = Stargardt disease, CSC = central serous chorioretinopathy, RP = retinitis pigmentosa, AO = adaptive optics, FAF = fundus autofluorescence
Home-Care Nurses’ Experiences of Caring for Older Adults With Type 2 Diabetes Mellitus and Urinary Incontinence: An Interpretive Description Study

Introduction A third of older adults with diabetes receiving home-care services have daily urinary incontinence. Despite this high prevalence of urinary incontinence, the condition is typically not recognized as a complication and thereby not detected or treated. Diabetes and urinary incontinence in older adults are associated with poorer functional status and lower quality of life. Home-care nurses have the potential to play an important role in supporting older adults in the management of these conditions. However, very little is known about home-care nurses’ care of this population. Objective The objective of this study was to explore how nurses care for older home-care clients with diabetes and incontinence. Methods This was an interpretive description study informed by a model of clinical complexity, and part of a convergent, mixed methods research study. Fifteen nurse participants were recruited from home-care programs in southern Ontario, Canada to participate in qualitative interviews. An interpretive description analytical process was used that involved constant comparative analysis and attention to commonalities and variance. Results The experiences of home-care nurses caring for this population is described in three themes and associated subthemes: (a) conducting a comprehensive nursing assessment with client and caregiver, (b) providing holistic treatment for multiple chronic conditions, and (c) collaborating with the interprofessional team. The provision of this care was hampered by a task-focused home-care system, limited opportunities to collaborate and communicate with other health-care providers, and the lack of health-care system integration between home care, primary care, and acute care. Conclusion The results suggest that nursing interventions for older adults with diabetes and incontinence should not only consider disease management of the individual conditions but pay attention to the broader social determinants of health in the context of multiple chronic conditions. Efforts to enhance health-care system integration would facilitate the provision of person-centred home care.
Return to Play After Open Calcaneoplasty for Insertional Achilles Tendinopathy With Haglund Deformity in Competitive Professional Athletes

Background: Surgical treatment of insertional Achilles tendinopathy with Haglund deformity in highly competitive professional athletes has not been previously investigated. Purpose: To assess clinical outcomes, including return to play (RTP), after surgical treatment of insertional Achilles tendinopathy in professional athletes. Study Design: Case-control study; Level of evidence, 3. Methods: This retrospective study included 20 professional athletes who were surgically treated for insertional Achilles tendinopathy and had at least 2 years of follow-up. An open longitudinal lateral approach was used for the operation, without violation of the Achilles tendon. Outcome evaluation included American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, subjective patient satisfaction, mean time of return to competition (RTC), and rate of RTP. We defined RTC as return to an official match for at least 1 minute and RTP rate as the percentage of patients who were able to participate in at least 2 full seasons. A subgroup analysis was performed to compare the RTP and no-RTP groups. Results: The AOFAS score improved significantly from preoperatively to the final follow-up (from 65.1 to 88.4; P < .001), and 75% of the patients reported good to excellent satisfaction. The mean time of RTC was 7.45 months (range, 4-18 months), and the rate of RTP was 60%. The RTP group had a significantly lower mean body mass index than did the no-RTP group (22.03 vs 23.86, respectively; P = .005) and faster mean RTC (5.0 vs 11.1 months, respectively; P < .001). Conclusion: Open calcaneoplasty for surgical treatment of insertional Achilles tendinopathy with Haglund deformity in highly competitive professional athletes should be approached cautiously. Our patients had a 7.5-month recovery period before return to their first official match, and only 60% of the patients returned to their sports activity and participated in at least 2 full seasons. Lower body mass index and a faster RTC after surgery were related to longer functional maintenance.
Increased microRNA-30a levels in bronchoalveolar lavage fluid as a diagnostic biomarker for lung cancer

Background MicroRNA-30a (miRNA-30a) levels have been shown to increase in the plasma of lung cancer patients. Herein, we evaluated the miRNA-30a levels in the bronchoalveolar lavage fluid (BALF) of lung cancer patients as a potential biomarker for lung cancer diagnosis. Methods BALF miRNA-30a expression of 174 subjects was quantified using quantitative real-time reverse transcription-polymerase chain reaction and compared between lung cancer patients and control patients with benign lung diseases. Moreover, its diagnostic value was evaluated by performing receiver operating characteristic (ROC) curve analysis. Results The relative BALF miRNA-30a expression was significantly higher in the lung cancer patients than in the controls (0.74 ± 0.55 versus 0.07 ± 0.48, respectively, p < 0.001) as well as in lung cancer patients with stage I–IIA disease than in those with stage IIB–IV disease (0.98 ± 0.64 versus 0.66 ± 0.54, respectively, p < 0.05). Additionally, miRNA-30a distinguished benign lung diseases from lung cancers, with an area under the ROC curve (AUC) of 0.822. ROC analysis also revealed an AUC of 0.875 for the Youden index-based optimal cut-off points for stage I–IIA adenocarcinoma. Thus, increased miRNA-30a levels in BALF may be a useful biomarker for non-small-cell lung cancer diagnosis.
Characterization and phylogenetic analysis of the complete chloroplast genome of Ophiorrhiza pumila (Rubiaceae)

Abstract Ophiorrhiza pumila (Rubiaceae) is an herbaceous plant that grows streamside in forest gullies or wetlands in the shade. Complete chloroplast genome of O. pumila was obtained and analyzed its phylogeny relationship within Rubiaceae plants. The results showed that the genome had a typical quadripartite structure of 154,385 bp, and contained a total of 112 unique genes, including 79 protein-coding genes, 29 tRNA genes, and 4 rRNA genes. Phylogenetic analysis suggested that O. pumila is sister to a highly supported clade composed of 10 species including Morinda officinalis, Gynochthodes cochinchinensis, Saprosma merrillii, Hedyotis ovata, Foonchewia guangdongensis, Dunnia sinensis, Paederia scandens, Leptodermis scabrida, Rubia cordifolia, and Galium mollugo. The complete chloroplast genome provides valuable information for the phylogenetic analysis of O. pumila.
Is Antiplatelet Therapy Contraindicated After Platelet-Rich Plasma Treatment? A Narrative Review

Background: Antiplatelet therapies are often withheld before and after platelet-rich plasma product (PRPP) administration due to theoretical concerns that therapies that inhibit the function of platelets would inhibit the effects of PRPP. Purpose/Hypothesis: The purpose of this study was to evaluate the effect that antiplatelet therapies have on the ability of PRPP to stimulate wound healing and tissue regeneration. Our hypothesis was that antiplatelet therapies would have highly heterogeneous effects on the biological activity of PRPP. Study Design: Narrative review. Methods: The Medline database was searched via PubMed to identify all studies related to PRPP and antiplatelet therapies, yielding 1417 publications. After the search was confined to articles published after 1995, there were 901 articles remaining. All abstracts were then screened to identify animal or human clinical studies that focused on growth factor or inflammatory cytokine production or treatment outcomes. We limited our analysis to studies reporting on orthopaedic pathologies and in vitro studies of antiplatelet therapies. Ultimately, 12 articles fit the search criteria. Results: The majority of studies reported on the use of nonsteroidal anti-inflammatory drugs as antiplatelet therapy. The majority of studies were in vitro analyses of growth factors, inflammatory cytokines, or cell viability, whereas 1 study examined clinical outcomes in an animal model. None of the studies investigated clinical outcomes in humans. All of the studies showed no effect or mixed effects of antiplatelet therapies on PRPP efficacy. One study showed PRPP recovery to baseline function after a 1-week washout period. Conclusion: The literature did not provide support for the common clinical practice of withholding antiplatelet therapies in patients being treated with PRPP.
Clinical Microbiology in the Intensive Care Unit: Time for Intensivists to Rejuvenate this Lost Art

Abstract We live in an era of evolving microbial infections and equally evolving drug resistance among microorganisms. In any healthcare facility, intensivists play the most pivotal role with critically ill patients under their direct care. Majority of the critically ill patients already harbor a microorganism at admission or acquire one in the form of healthcare-associated infections during their course of intensive care unit stay. It is therefore rather imperative for intensivists to possess sound knowledge in clinical microbiology. On a negative note, most clinicians have very meager and remote knowledge acquired during their undergraduate years. This knowledge is rather theoretical than applied and wanes over the years becoming nonbeneficial in intensive patient care. We, therefore, intend to explore important concepts in applied microbiology and infection control that intensivists should know and implement in their clinical practice on a day-to-day basis. How to cite this article: Princess I, Vadala R. Clinical Microbiology in the Intensive Care Unit: Time for Intensivists to Rejuvenate this Lost Art. Indian J Crit Care Med 2021;25(5):566–574.
Relationship between intensity and recovery in post-stroke rehabilitation: a retrospective analysis

INTRODUCTION Work in animal models suggests highintensity rehabilitationbased training that starts soon after stroke is the most effective approach to promote recovery. In humans, the interaction between treatment onset and intensity remains unclear. It has been suggested that reducing daily treatment duration below 3 hours at the acute and subacute stages leads to a poorer prognosis, while there may also be an upper bound beyond which highintensity motor rehabilitation at the acute stage might lead to unwanted side effects. Designing optimal rehabilitation treatment programmes for stroke patients will not be possible until we understand ‘how much’, ‘when’ and ‘what’ treatment should be delivered. In this retrospective analysis, we assessed patients’ responsiveness to highintensity and lowintensity rehabilitation protocols across different stages of chronicity poststroke to address the ‘how much’ and ‘when’ questions.
Neonatal DNA methylation and childhood low prosocial behavior: An epigenome‐wide association meta‐analysis

Low prosocial behavior in childhood has been consistently linked to later psychopathology, with evidence supporting the influence of both genetic and environmental factors on its development. Although neonatal DNA methylation (DNAm) has been found to prospectively associate with a range of psychological traits in childhood, its potential role in prosocial development has yet to be investigated. This study investigated prospective associations between cord blood DNAm at birth and low prosocial behavior within and across four longitudinal birth cohorts from the Pregnancy And Childhood Epigenetics (PACE) Consortium. We examined (a) developmental trajectories of “chronic‐low” versus “typical” prosocial behavior across childhood in a case–control design (N = 2,095), and (b) continuous “low prosocial” scores at comparable cross‐cohort time‐points (N = 2,121). Meta‐analyses were performed to examine differentially methylated positions and regions. At the cohort‐specific level, three CpGs were found to associate with chronic low prosocial behavior; however, none of these associations was replicated in another cohort. Meta‐analysis revealed no epigenome‐wide significant CpGs or regions. Overall, we found no evidence for associations between DNAm patterns at birth and low prosocial behavior across childhood. Findings highlight the importance of employing multi‐cohort approaches to replicate epigenetic associations and reduce the risk of false positive discoveries.
Expression of Cds4/5 of Arabidopsis chloroplasts in E. coli reveals the membrane topology of the C‐terminal region of CDP‐diacylglycerol synthases

CDP‐diacylglycerol synthases (Cds) are conserved from bacteria to eukaryotes. Bacterial CdsA is involved not only in phospholipid biosynthesis but also in biosynthesis of glycolipid MPIase, an essential glycolipid that catalyzes membrane protein integration. We found that both Cds4 and Cds5 of Arabidopsis chloroplasts complement cdsA knockout by supporting both phospholipid and MPIase biosyntheses. Comparison of the sequences of CdsA and Cds4/5 suggests a difference in membrane topology at the C‐termini, since the region assigned as the last transmembrane region of CdsA, which follows the conserved cytoplasmic domain, is missing in Cds4/5. Deletion of the C‐terminal region abolished the function, indicating the importance of the region. Both 6 × His tag attachment to CdsA and substitution of the C‐terminal 6 residues with 6 × His did not affect the function. These 6 × His tags were sensitive to protease added from the cytosolic side in vitro, indicating that this region is not a transmembrane one but forms a membrane‐embedded reentrant loop. Thus, the C‐terminal region of Cds homologues forms a reentrant loop, of which structure is important for the Cds function.
Spatial organization and transitions of spontaneous neuronal activities in the developing sensory cortex

The sensory cortex underlies our ability to perceive and interact with the external world. Sensory perceptions are controlled by specialized neuronal circuits established through fine‐tuning, which relies largely on neuronal activity during the development. Spontaneous neuronal activity is an essential driving force of neuronal circuit refinement. At early developmental stages, sensory cortices display spontaneous activities originating from the periphery and characterized by correlated firing arranged spatially according to the modality. The firing patterns are reorganized over time and become sparse, which is typical for the mature brain. This review focuses mainly on rodent sensory cortices. First, the features of the spontaneous activities during early postnatal stages are described. Then, the developmental changes in the spatial organization of the spontaneous activities and the transition mechanisms involved are discussed. The identification of the principles controlling the spatial organization of spontaneous activities in the developing sensory cortex is essential to understand the self‐organization process of neuronal circuits.
Antibacterial Activity of Electrospun Nanocomposites Fabricated by In Situ Chitosan/Silver Nanoparticles

The process of disinfection of wastewater must use friendly materials with the environment that achieve the inhibition of bacterial growth, aiming to improve the quality of the water. In this study, electrospun nanocomposites CS (chitosan)/AgNPs (silver nanoparticles) was developed for wastewater disinfection through filtration. First, AgNPs were synthesized by a green synthesis method using aloe vera (Aloe Barbadensis Miller) extract as a reducing agent, and AgNO3 as metal precursor. AgNPs were characterized by UV-Vis spectroscopy with a SPR band at 420 nm. Transmission Electron Microscopy (TEM) demonstrates the formation of semispherical AgNPs with a diameter ca. 16 nm. The nanocomposites fibers CS/AgNPs were analyzed by scanning electron microscopy (SEM), with the presence of uniform fibers (diameter ca. 120 nm) and embedded AgNPs, determined by EDS and elemental mapping. Surface topography of CS/AgNPs fibers was evaluated by Atomic Force Microscopy (AFM), where the surface roughness of fibers is increased with the NPs content. Finally, the antibacterial activity (AA) of CS/AgNPs nanocomposites was evaluated against S. aureus and P. aeruginosa during 1 and 2 h of contact, obtaining an AA of 90 % in CS/AgNPs-2 mM after 2 h with P. aeruginosa. The fabrication of electrospun nanocomposites with silver nanoparticles represents a platform to the fabrication of multifunctional polymer membranes for wastewater disinfection.
Excimer Laser Coronary Angioplasty in Coronary Lesions

Supplemental Digital Content is available in the text. Background: Excimer laser coronary angioplasty (ELCA) uses an ultraviolet laser catheter for the treatment of coronary artery disease. ELCA has been used for various coronary lesions, but current safety and frequency of use are unknown. Methods: We performed a retrospective, registry-based study of ELCA use during coronary interventions reported to the National Cardiovascular Data Registry/CATH percutaneous coronary intervention registry from 2009 to 2018 (n=6 043 596 total interventions evaluated). The primary safety end point was the combination of any perforation, dissection, tamponade, or death. ELCA use per 10 000 interventions was evaluated for the study duration. Subgroups of interest were identified including in-stent restenosis lesions, saphenous vein graft lesions, chronic total occlusions, and thrombotic lesions. Results: A total of 19 688 lesions were identified with ELCA use (0.3% of all lesions). The rate of ELCA use increased across the study period from 14 ELCAs performed per 10 000 interventions in 2009 to 70 ELCAs performed per 10 000 interventions in 2018. The primary safety end point occurred in 4.2% of lesions and was higher than in cases where no ELCA was used (3.0% P<0.001). After adjusting for baseline differences among the subgroups who received ELCA, the in-stent restenosis group had the lowest rate of complications (odds ratio, 0.51 [95% CI, 0.42–0.63]), followed by the saphenous vein graft group (odds ratio, 0.72 [95% CI, 0.5–1]). The chronic total occlusion group had a higher risk for complications (odds ratio, 2.01 [95% CI, 1.61–2.40]). Conclusions: The use of ELCA has remained low but has increased in recent years. Complications are significantly higher when ELCA is used, but this effect is variable with respect to lesion subtype. ELCA is frequently used to treat in-stent restenosis with a low risk of complication. ELCA use during chronic total occlusion interventions is associated with a 2-fold increased risk of complications. Together these findings provide guidance for lesion selection to optimize safety with ELCA use.
Glial‐derived neurotrophic factor in human airway smooth muscle

Airway smooth muscle (ASM) cells modulate the local airway milieu via production of inflammatory mediators and growth factors including classical neurotrophins, such as brain‐derived neurotrophic factor (BDNF). The glial cell‐derived neurotrophic factor (GDNF) family of ligands (GFLs) are nonclassical neurotrophins and their role in the airway is barely understood. The major GFLs, GDNF and Neurturin (NRTN) bind to GDNF family receptor (GFR) α1 and α2 respectively that pair with Ret receptor to accomplish signaling. In this study, we found GDNF is expressed in human lung and increased in adult asthma, while human ASM expresses GDNF and its receptors. Accordingly, we used human ASM cells to test the hypothesis that ASM expression and autocrine signaling by GFLs regulate [Ca2+]i. Serum‐deprived ASM cells from non‐asthmatics were exposed to 10 ng/ml GDNF or NRTN for 15 min (acute) or 24 h (chronic). In fura‐2 loaded cells, acute GDNF or NRTN alone induced [Ca2+]i responses, and further enhanced responses to 1 µM ACh or 10 µM histamine. Ret inhibitor (SPP86; 10 µM) or specific GDNF chelator GFRα1‐Fc (1 µg/ml) showed roles of these receptors in GDNF effects. In contrast, NRTN did not enhance [Ca2+]i response to histamine. Furthermore, conditioned media of nonasthmatic and asthmatic ASM cells showed GDNF secretion. SPP86, Ret inhibitor and GFRα1‐Fc chelator markedly decreased [Ca2+]i response compared with vehicle, highlighting autocrine effects of secreted GDNF. Chronic GDNF treatment increased histamine‐induced myosin light chain phosphorylation. These novel data demonstrate GFLs particularly GDNF/GFRα1 influence ASM [Ca2+]i and raise the possibility that GFLs are potential targets of airway hyperresponsiveness.