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Evaluation of the ocular surface in asymptomatic glaucoma patients on topical medications and following trabeculectomy – A cross-sectional study

Indian J Ophthalmol. 2023 Apr;71(4):1521-1525. doi: 10.4103/IJO.IJO_2812_22.

ABSTRACT

PURPOSE: This present prospective, cross-sectional study aims to comprehensively evaluate the ocular surface in asymptomatic patients with diffuse blebs after trabeculectomy versus chronic anti-glaucoma medication use and compare it with the age-matched normal population.

METHODS: Objective clinical evaluation was done by tear film break-up time (TBUT) and Schirmer’s test (ST) in the three groups-trabeculectomy >6 months with a diffuse bleb (Wurzburg bleb classification score ≧10), chronic anti-glaucoma medication (AGM >6 months) group, and normal population. In all groups, tear film osmolarity was checked with the TearLab® device (TearLab Corp., CA, USA), and subjective evaluation was performed by administering Ocular Surface Disease Index (OSDI) questionnaire. Patients already on chronic lubricants or any other drug for the treatment of dry eyes (viz. steroids, cyclosporin) or having symptoms suggestive of an abnormal ocular surface, who had undergone refractive or intraocular surgery, and contact lens users were excluded.

RESULTS: In total, 104 subjects/eyes were recruited over 6 weeks. Thirty-six eyes recruited in the trab group were compared with 33 eyes studied in the AGM group, and both these groups were compared to 35 normal eyes. When compared to normals, TBUT and ST were significantly lower (P = 0.003 and 0.014) and osmolarity and OSDI were statistically significantly higher (P = 0.007 and 0.003) in the AGM group, whereas only TBUT was statistically significantly different (P = 0.009) when the trab group was compared to normals. Also, when the trab group was compared to the AGM group, ST was found to be higher (P = 0.003) and osmolarity was lower (P = 0.034).

CONCLUSION: To conclude, ocular surface is affected even in asymptomatic patients on AGM but near normalcy is possible following trabeculectomy when blebs are diffuse.

PMID:37026294 | DOI:10.4103/IJO.IJO_2812_22

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Lid wiper epitheliopathy in symptomatic and asymptomatic dry eye subjects

Indian J Ophthalmol. 2023 Apr;71(4):1499-1502. doi: 10.4103/IJO.IJO_2709_22.

ABSTRACT

PURPOSE: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects.

METHODS: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi-square test was used for statistical analysis.

RESULTS: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2).

CONCLUSION: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.

PMID:37026290 | DOI:10.4103/IJO.IJO_2709_22

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Dietary behavior of video game players and esports players in Germany: a cross-sectional study

J Health Popul Nutr. 2023 Apr 6;42(1):29. doi: 10.1186/s41043-023-00373-7.

ABSTRACT

BACKGROUND: Video gaming and competitive gaming (esports) are gaining more and more recognition in society as well as in research. Increasingly, health-related topics are the focus of research on video game and esports players. Although video gaming is often associated with energy drinks and fast food, no studies have yet examined the players’ dietary behavior. Therefore, the aim of this cross-sectional study is to investigate the dietary behavior and additional health-related data of video game players and esports players in Germany.

METHODS: Between July and October 2020, 817 participants (87.1% male; 24.2 ± 6.9 years), divided into video game players and esports players, were surveyed via an online questionnaire about their dietary, health, and gaming behaviors. Descriptive statistics were performed on all questions. To investigate statistically significant differences between video game players and esports players, the Mann-Whitney-U-Test and Kruskall-Wallis-Test were used. Partial Spearman correlations were used to examine possible associations between dietary behavior, health status, well-being, and video game playing time.

RESULTS: Water was the primary source of fluid intake for the players (10.9 ± 7.0 l/week). The average weekly consumption of energy drinks was 0.4 ± 0.9 L. Energy drinks (rho = 0.14; p < 0.01) as well as soft drinks (rho = 0.14; p < 0.01) are positively correlated with the video game playing time. Participants ate 7.5 ± 10.4 servings of fast food per month, which has a positive association with video game playing time (rho = 0.13; p < 0.01). In contrast, vegetables (1.7 ± 1.6 servings/day) and fruits (0.9 ± 1.0 servings/day) are eaten almost daily.

CONCLUSION: In this survey, the dietary behavior of video game players and esports players is similar to that of the German general population. Nevertheless, there is a need for improvement. Especially energy drinks, which are already documented to have adverse health effects, should be limited. In addition, the consumption of fast food and meat should also be reduced, and healthier foods such as fruits and vegetables should be increased instead. Early education and support regarding the associated risks with unhealthy foods is important within the target group.

PMID:37024994 | DOI:10.1186/s41043-023-00373-7

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Identification of cell barcodes from long-read single-cell RNA-seq with BLAZE

Genome Biol. 2023 Apr 6;24(1):66. doi: 10.1186/s13059-023-02907-y.

ABSTRACT

Long-read single-cell RNA sequencing (scRNA-seq) enables the quantification of RNA isoforms in individual cells. However, long-read scRNA-seq using the Oxford Nanopore platform has largely relied upon matched short-read data to identify cell barcodes. We introduce BLAZE, which accurately and efficiently identifies 10x cell barcodes using only nanopore long-read scRNA-seq data. BLAZE outperforms the existing tools and provides an accurate representation of the cells present in long-read scRNA-seq when compared to matched short reads. BLAZE simplifies long-read scRNA-seq while improving the results, is compatible with downstream tools accepting a cell barcode file, and is available at https://github.com/shimlab/BLAZE .

PMID:37024980 | DOI:10.1186/s13059-023-02907-y

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The association between probationers’ addiction levels and socioeconomic-psychological characteristics

BMC Psychol. 2023 Apr 6;11(1):100. doi: 10.1186/s40359-023-01142-1.

ABSTRACT

OBJECTIVE: The aim of this study is to evaluate probationers’ addiction levels and associated socioeconomic and psychological features in Izmir Probation Directorate.

METHODS: This cross-sectional study was conducted in Izmir Probation Directorate between August 27, 2018 and November 27, 2018. The study’s dependent variable was adult probationers’ addiction level which was evaluated by the Addiction Profile Index-Clinical Version (API-C). The independent variables were individual factors, social environmental factors, API-C scale subdimensions and perceived social support. For paired comparisons, Student’s t test and ANOVA were used. Linear regression analysis was used for multiple comparisons. p < 0.05 was accepted as the limit of statistical significance.

RESULTS: A total of 200 male probationers participated in the study (82.3%, n = 243). The participants’ average age was 29.9 ± 7.7. The participants’ average addiction score was 5.65 ± 2.33. According to the results of the regression analysis; education level (B = 1.438, 95% CI 0.936, 1.941, p < 0.001) working status at a job (B = 2.687, 95% CI 1.428, 3.945, p < 0.001) father’s education level (B=-1.117, 95% CI -1.473, -0.762, p < 0.001) and anger management problems (B = 0.750, 95%CI 0.517, 0.982, p < 0.001) were explanatory for addiction level. The model was 50.8% explanatory of addiction level (p < 0.05).

CONCLUSION: Probationers who grew up with only their mother, whose father had a low education level, who had higher levels of anger management problems and who were unemployed had higher levels of addiction. These results emphasize the need for social work in the rehabilitation processes of individuals. Treating the risk factors indicated by the study results as screening and follow-up parameters in the probation population can be useful in improving the success of the probation program.

PMID:37024978 | DOI:10.1186/s40359-023-01142-1

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Goal-directed fluid therapy using uncalibrated pulse contour analysis and balanced crystalloid solutions during hip revision arthroplasty: a quality implementation project

J Orthop Surg Res. 2023 Apr 6;18(1):281. doi: 10.1186/s13018-023-03738-0.

ABSTRACT

BACKGROUND: To implement a goal-directed fluid therapy (GDFT) protocol using crystalloids in hip revision arthroplasty surgery within a quality management project at a tertiary hospital using a monocentric, prospective observational study.

METHODS: Adult patients scheduled for elective hip revision arthroplasty surgery were screened for inclusion in this prospective study. Intraoperatively stroke volume (SV) was optimized within a previously published protocol using uncalibrated pulse contour analysis and balanced crystalloids. Quality of perioperative GDFT was assessed by protocol adherence, SV increase as well as the rate of perioperative complications. Findings were then compared to two different historical groups of a former trial: one receiving GDFT with colloids (prospective colloid group) and one standard fluid therapy (retrospective control group) throughout surgery. Statistical analysis constitutes exploratory data analyses and results are expressed as median with 25th and 75th percentiles, absolute and relative frequencies, and complication rates are further given with 95% confidence intervals for proportions using the normal approximation without continuity correction.

RESULTS: Sixty-six patients underwent GDFT using balanced crystalloids and were compared to 130 patients with GDFT using balanced colloids and 130 controls without GDFT fluid resuscitation. There was a comparable increase in SV (crystalloids: 65 (54-74 ml; colloids: 67.5 (60-75.25 ml) and total volume infused (crystalloids: 2575 (2000-4210) ml; colloids: 2435 (1760-3480) ml; and controls: 2210 (1658-3000) ml). Overall perioperative complications rates were similar (42.4% (95%CI 30.3-55.2%) for crystalloids and 49.2% (95%CI 40.4-58.1%) for colloids and lower compared to controls: 66.9% (95%CI 58.1-74.9)). Interestingly, a reduced number of hemorrhagic complications was observed within crystalloids: 30% (95%CI 19.6-42.9); colloids: 43% (95%CI 34.4-52.0); and controls: 62% (95%CI 52.6-69.9). There were no differences in the rate of admission to the post-anesthesia care unit or intensive care unit as well as the length of stay.

CONCLUSIONS: Perioperative fluid management using a GDFT protocol with crystalloids in hip revision arthroplasty surgery was successfully implemented in daily clinical routine. Perioperative complications rates were reduced compared to a previous management without GDFT and comparable when using colloids.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01753050.

PMID:37024966 | DOI:10.1186/s13018-023-03738-0

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Reliability and validity of the English, Chinese, Korean, Indonesian, and Vietnamese versions of the public health research foundation stress checklist short form

Biopsychosoc Med. 2023 Apr 6;17(1):15. doi: 10.1186/s13030-023-00271-8.

ABSTRACT

BACKGROUND: Foreign nationals residing in Japan account for approximately 2% of the total population (i.e., approximately 2.6 million people). Of these, 12% are not proficient in speaking Japanese and 25% experience difficulty reading Japanese. Therefore, a simple, convenient, and accurate scale in the native language of foreign nationals is required to support their mental health. In this study, the Public Health Research Foundation Stress Checklist Short Form (PHRF-SCL (SF)) was translated into five languages and the reliability and validity of the translations were confirmed.

METHODS: The five translated versions of the PHRF-SCL (SF) have been reverse-translated into the original language, Japanese. The creator confirmed that there were no inconsistencies between the Japanese and reverse-translated versions. A total of 777 adults aged 18-64 years participated in the study. They were asked to complete the native language versions of the PHRF-SCL (SF) and Depression Anxiety Stress Scale 21 (DASS 21) online.

RESULTS: An exploratory factor analysis yielded the same four-factor structure as the original. Internal consistency was confirmed by the alpha coefficients of the subscales. Participants were classified into two groups on the basis of the severity classification obtained from each subscale of the DASS 21. Scores of PHRF-SCL (SF) are significantly higher in groups classified as symptomatic by DASS 21, thereby confirming construct validity. Concomitant validity was confirmed based on correlations with the DASS 21.

CONCLUSIONS: English, Chinese, Korean, Indonesian, and Vietnamese versions of the PHRF-SCL(SF) have been prepared. Although these versions are subject to further statistical analysis, the results were sufficiently substantiated for practical use. This scale is expected to contribute to the promotion of mental health services for people from these countries.

PMID:37024959 | DOI:10.1186/s13030-023-00271-8

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Medical instability in typical and atypical adolescent anorexia nervosa: a systematic review and meta-analysis

J Eat Disord. 2023 Apr 6;11(1):58. doi: 10.1186/s40337-023-00779-y.

ABSTRACT

This review investigates the relationship between weight and risk of medical instability (specifically bradycardia, hypotension, hypothermia, and hypophosphatemia) in adolescents with typical and atypical anorexia nervosa. Atypical anorexia nervosa, listed as an example under the DSM-5 category of Other Specified Feeding and Eating Disorders (OSFED), describes patients who are not clinically underweight but otherwise meet criteria for anorexia nervosa. There is a lack of empirical evidence exploring medical complications in adolescents presenting with atypical anorexia nervosa. The small number of studies that do exist in this area indicate that medical instability exists across a range of weights, with weight loss being associated with increased medical risk, independent of underweight. The aim of this review was to collate and analyse results from available studies and identify indicators of medical risk in these two groups of adolescents with restrictive eating disorders. Studies were identified by systematic electronic search of medical databases, including PubMed and EMBASE. All studies investigated the relationship between weight and medical instability and included adolescents diagnosed with anorexia nervosa or atypical anorexia nervosa. One randomised controlled trial, five cohort studies and three chart reviews were included, with a total sample size of 2331 participants. Between 29 and 42% of participants presented with medical instability requiring hospitalisation, in the absence of underweight. Underweight adolescents were significantly more likely to have lower blood pressures (p < 0.0001) and bradycardia was significantly associated with greater weight loss (p < 0.05). There were no statistically significant associations found between degree of underweight and heart rate, temperature, or rate of weight loss (p = 0.31, p = 0.46 and p = 0.16, respectively). Adolescents that were less than 70% median body mass index were significantly more likely to have hypophosphatemia (p < 0.05). The findings of this review support the hypothesis that medical instability can occur across a range of weights in adolescent eating disorders, with rapid weight loss being an important indicator of increasing medical risk. Results were limited by the small number of existing studies that contained data for statistical analysis. Rapid weight loss should be considered as an important indicator of medical instability in adolescents presenting with both typical and atypical anorexia nervosa.

PMID:37024943 | DOI:10.1186/s40337-023-00779-y

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Timing of bronchoscopy and application of scoring tools in children with severe pneumonia

Ital J Pediatr. 2023 Apr 7;49(1):44. doi: 10.1186/s13052-023-01446-3.

ABSTRACT

BACKGROUND: There is still a lack of effective scoring criteria for assessing the severity of pulmonary infection associated with changes in the endobronchial lining of the bronchus in children. This study aimed to ascertain the timing and value of endoscopic scoring of fibreoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in children with severe pneumonia.

METHOD: The clinical data of 229 children with severe pneumonia treated with BAL in the Pediatric Intensive Care Unit of the First Affiliated Hospital of Xinxiang Medical University between November 2018 and December 2021 were collected. According to the severity of the disease, patients were divided into an invasive ventilation group and a non-invasive ventilation group, as well as an early BAL group (receiving BAL within 1 day of admission) and a late BAL group (receiving BAL 2 days after admission). A Student’s t-test, Chi-square test, receiver operating characteristic (ROC) curve and survival curve were used to analyse the bronchitis score, aetiology of BAL fluid and survival data.

RESULTS: The scores of endoscopic mucosal oedema, erythema and pallor and the total score in the invasive ventilation group were higher than those in the non-invasive ventilation group (P < 0.05), and they were consistent with the Sequential Organ Failure Assessment (SOFA) scores. The secretion colour score was lower in the early BAL group than in the late BAL group (P < 0.05). On the bronchitis scores, which were evaluated using a ROC curve, the difference in the mucosal erythema, pallor, oedema and total score of the invasive and non-invasive groups was statistically significant (P < 0.05), which was consistent with the area under the ROC of the SOFA scores. Acute Physiology and Chronic Health Assessment II and SOFA scores after FOB were lower than those before treatment (P < 0.05). In terms of ICU hospitalisation days and total hospitalisation days, the time of the early FOB patients was shorter than that of the late FOB patients (P < 0.05). A total of 22 patients (9.61%) died. The Kaplan-Meier analysis and log-rank test showed that the survival rate of the non-invasive ventilation group was higher than that of the invasive ventilation group (P < 0.05).

CONCLUSION: This study found that FOB combined with BAL is an important method for the diagnosis and treatment of severe pneumonia. Early BAL can reduce hospitalisation and ICU time; however, it cannot improve the survival rate. The endoscopic score has a certain role to play in assessing the severity of pulmonary inflammation, but studies with a large sample are still needed to confirm this.

PMID:37024936 | DOI:10.1186/s13052-023-01446-3

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Genetic liability to age at first sex and birth in relation to cardiovascular diseases: a Mendelian randomization study

BMC Med Genomics. 2023 Apr 6;16(1):75. doi: 10.1186/s12920-023-01496-w.

ABSTRACT

BACKGROUND: Growing evidence suggests that various reproductive factors, including early menarche, early menopause, and age at first birth, may increase the risk of developing cardiovascular disease (CVD) later in life. However, the associations between reproductive factors and CVDs are inconsistent and controversial. Therefore, we conducted a two-sample Mendelian randomization (MR) analysis to explore the potential links between age at first sex (AFS) and age at first birth (AFB) and several CVDs.

METHODS: We obtained summary statistics for exposure from the largest genome-wide association studies of AFS and AFB. To serve as instrumental variables, we selected 259 SNPs associated with AFS and 81 SNPs associated with AFB at the genome-wide significance level. We employed a random-effects inverse-variance weighted method to pool estimates, and conducted multivariable MR analysis to determine the direct association between AFS and AFB with CVDs, while accounting for the effects of confounders.

RESULTS: The genetic liability to later AFS was associated with decreased risks of heart failure (odd ratio [OR] 0.700; 95% confidence interval [CI] 0.639-0.767; p = 2.23 × 10-14), coronary artery disease (OR 0.728; 95% CI 0.657-0.808; p = 1.82 × 10-9), myocardial infarction (OR 0.731; 95% CI 0.657-0.813; p = 8.33 × 10-9), stroke (OR 0.747; 95% CI 0.684-0.816; p = 6.89 × 10-11), and atrial fibrillation (OR 0.871; 95% CI 0.806-0.941; p = 4.48 × 10-4). The genetic liability to later AFB was also associated with decreased risks of CVDs, including myocardial infarction (OR 0.895; 95% CI 0.852-0.940; p = 8.66 × 10-6), coronary heart disease (OR 0.901; 95% CI 0.860-0.943; p = 9.02 × 10-6), heart failure (OR 0.925; 95% CI 0.891-0.961; p = 5.32 × 10-5), and atrial fibrillation (OR 0.944; 95% CI 0.911-0.978; p = 0.001). However, no association was found between AFB and stroke. The associations remained independent from the effects of AFS and AFB on potential confounders, including smoking, alcohol intake, body mass index, and depression. Mediation analysis suggested that education attainment partly mediates the link from AFS and AFB to CVD outcomes.

CONCLUSION: Our results observed a causal relationship between later AFS, AFB and lower CVDs risk; it emphasizes the importance of providing sex education since early sex and birth may have undesirable effects. Cardiovascular risk stratification that considers reproductive factors may help address CVD risk.

PMID:37024926 | DOI:10.1186/s12920-023-01496-w