Nevin Manimala

Retina. 2023 Jan 23. doi: 10.1097/IAE.0000000000003749. Online ahead of print.

ABSTRACT

PURPOSE: We examined the effect of ranibizumab with or without laser photocoagulation on retinal sensitivity in eyes with branch retinal vein occlusion (BRVO).

METHODS: Prospective randomized control study. Thirty patients with BRVO received intravitreal injection of ranibizumab in a monthly pro re nata regimen. Fifteen patients received ranibizumab monotherapy alone (monotherapy group). The remaining 15 patients received rescue laser therapy at 3 or 9 months (combined group). The retinal sensitivity was measured at 32 points within central 8 degrees, and the average of the main occlusion side among the 16 upper or 16 lower points was defined as the affected area sensitivity.

RESULTS: In comparing the monotherapy group and the combined group, the number of injections during the 12 months was 5.4 vs. 4.9, the change in retinal thickness (µm) was -254 vs. -197, the ETDRS letters of improvement was +18.3 vs. +19.6, and the change in the affected area sensitivity (dB) was +7.1 vs. +4.6. At 12 months, all these results were significantly improved compared to their respective baselines, but none of the differences between the two groups reached statistical significance.

CONCLUSION: Retinal sensitivity at 12 months improved in both the monotherapy group and the combined group. The additional laser did not reduce the number of injections or further improve visual acuity, nor did it affect retinal sensitivity.

PMID:36696603 | DOI:10.1097/IAE.0000000000003749

J Am Acad Orthop Surg. 2023 Jan 24. doi: 10.5435/JAAOS-D-22-00752. Online ahead of print.

ABSTRACT

INTRODUCTION: As rates of anatomic and reverse total shoulder arthroplasty (SA) continue to grow, an increase in the number of osteoporotic patients undergoing SA, including those who have sustained prior fragility fractures, is expected. The purpose of this study was to examine short-term, implant-related complication rates and secondary fragility fractures after SA in patients with and without a history of fragility fractures.

METHODS: A propensity score-matched retrospective cohort study was done using the PearlDiver database to characterize the effect of antecedent fragility fractures in short-term complications after SA. Rates of revision SA, periprosthetic fractures, infection, and postoperative fragility fractures were evaluated using multivariate logistic regression analysis. Risks of these complications were also studied in patients with and without preoperative osteoporosis treatment. Statistical significance was set at P < 0.05.

RESULTS: A total of 91,212 SA patients were identified, with 13,050 (14.3%) experiencing a fragility fracture within the 3 years before SA. Two years after SA, there were increased odds of periprosthetic fracture (odds ratio [OR] 2.24, 95% confidence interval [CI] 1.68 to 2.99), fragility fracture (OR 9.11, 95% CI 8.43 to 9.85), deep infection (OR 1.68, 95% CI 1.34 to 2.12), and all-cause revision SA (OR 1.68, 95% CI 1.44 to 1.96) within those patients who had experienced a fragility fracture within 3 years before their SA. Patients who were treated for osteoporosis with bisphosphonates and/or vitamin D supplementation before their SA had similar rates of postoperative periprosthetic fractures, fragility fractures, and all-cause revision SA to those who did not receive pharmacologic treatment.

CONCLUSION: Sustaining a fragility fracture before SA portends substantial postoperative risk of periprosthetic fractures, infection, subsequent fragility fractures, and all-cause revision SA at the 2-year postoperative period. Pharmacotherapy did not markedly decrease the rate of these complications. These results are important for surgeons counseling patients who have experienced prior fragility fractures on the risks of SA.

PMID:36696566 | DOI:10.5435/JAAOS-D-22-00752

Cancer Nurs. 2023 Jan 26. doi: 10.1097/NCC.0000000000001205. Online ahead of print.

ABSTRACT

BACKGROUND: Dysphagia is a leading cause of aspiration pneumonia and negatively affects tolerance of chemoradiotherapy in patients with esophageal cancer.

OBJECTIVE: This study aimed to assess a protocol for preventing the occurrence of aspiration pneumonia for adult patients with esophageal cancer experiencing swallowing dysfunction.

METHODS: This study tested a dysphagia intervention that included high-risk patients confirmed by the Eating Assessment Tool questionnaire and Water Swallowing Test. A protocol guide (Interventions for Esophageal Dysphagia [IED]) to prevent aspiration pneumonia during chemoradiotherapy was also implemented. Thirty participants were randomly assigned to an intervention or control group. The study period was 50 days; participants were visited every 7 days for a total of 7 times. Instruments for data collection included The Eating Assessment Tool, Water Swallowing Test, and personal information. The IED was administered only to the experimental group. All data were managed using IBM SPSS statistics version 21.0.

RESULTS: The IED significantly reduced the occurrence of aspiration pneumonia (P = .012), delayed the onset of aspiration pneumonia (P = .005), and extended the survival time (P = .007) in the experimental group.

CONCLUSION: For patients with esophageal cancer undergoing chemoradiotherapy, this protocol improved swallowing dysfunction and reduced aspiration pneumonia.

IMPLICATION FOR PRACTICE: The IED protocol should be included in continuous educational training for clinical nurses to help them become familiar with these interventions and to provide these strategies to patients.

PMID:36696534 | DOI:10.1097/NCC.0000000000001205

PLoS One. 2023 Jan 25;18(1):e0273181. doi: 10.1371/journal.pone.0273181. eCollection 2023.

ABSTRACT

BACKGROUND/AIM: The ever-increasing population and life expectancy worldwide increase the prevalence of ophthalmic diseases, and the need for ophthalmic research expands accordingly. In our study, we aimed to evaluate many aspects of the barriers, especially gender disparities, confronting ophthalmologists who aspire to conduct scientific research (SR).

MATERIALS AND METHODS: In this descriptive quantitative study, we distributed an online questionnaire to ophthalmologists in Turkey with 21 questions presented on a five-point Likert scale and two open-ended questions. The survey was prepared with Google forms. Participants were recruited via e-mail and social networks. A multicenter survey was conducted between January 29 and February 20, 2021, and a total of 210 valid responses were recorded.

RESULTS: Participants’ responses were grouped into four types of barriers: motivation, time constraints, research support, and competence. Participants’ motivation to conduct research was above average (3.54±0.96), but most stated that they have time constraints (3.74±0.97). Participants did not agree that there is adequate support for research (2.35±0.76), and they self assessed their level of the required competence to be average (2.87±1.08). Women were more motivated to do SR than men (p = 0.008), but there were no statistically significant differences between women and men in terms of time constraints, research support, and level of competence (p = 0.853, p = 0.482, and p = 0.558, respectively). Although there is no statistically significant difference between men and women regarding time constraints, female physicians mentioned more about the barriers arising from their personal responsibilities (p = 0.038).

CONCLUSIONS: Our study revealed that ophthalmologists are enthusiastic about doing SR but encounter obstacles with regard to time availability and research support. In addition, there is a need to reinforce competence in SR. Although female physicians are more motivated than men, they must deal with competing domestic responsibilities.

PMID:36696420 | DOI:10.1371/journal.pone.0273181

PLoS One. 2023 Jan 25;18(1):e0280724. doi: 10.1371/journal.pone.0280724. eCollection 2023.

ABSTRACT

BACKGROUND: Smartphone and social media use are supposed to be integral parts of university students’ daily lives. More specifically, smartphones and social media are frequently used for communication in daily life during the COVID-19 pandemic. Nonetheless, uninterrupted and persistent use of these technologies may lead to several psychological problems. Even though smartphones and social media were used more frequently during the pandemic, there is no evidence suggesting that the studies were not undertaken in low-income countries, including Ethiopia. Therefore, the current study aimed to assess problematic smartphone use and social media use among undergraduate university students in southern Ethiopia.

METHODS: A cross-sectional study was carried out among 1,232 university students using a simple random sampling technique. The Bergen Social Media Addiction Scale and Smartphone Application-Based Addiction Scale were used to collect data on social media and smartphone use, respectively. The Beck Depression Inventory, Generalized Anxiety Assessment Tool, Rosenberg Self-Esteem Scale, and Pittsburg Sleep Quality Index were standardized tools used to measure other independent variables. To identify factors, simple and multiple linear regression analyses were performed. A p-value of 0.05 was used to determine statistical significance.

RESULTS: The overall response rate was 95%. The mean scores for problematic smartphone and problematic social media use were 17 ± 3.3/36 and 12.7 ± 2.2/30, respectively. A linear regression model revealed that being female, first-year students and poor sleep quality were significantly associated with problematic smartphone use. Factors associated with problematic social media use (PSMU) were depression, substance use, and urban residence.

CONCLUSIONS: This study identified significant problems with smartphone and social media use among university students. Therefore, it is preferable to provide psychological counselling, educate students about safe, beneficial, and healthy internet use, and focus on recognized high-risk groups in order to give them special attention. It is also preferable to seek counselling about substance use. It is preferable to regularly screen and treat individuals with psychological problems in collaboration with stakeholders.

PMID:36696412 | DOI:10.1371/journal.pone.0280724

PLoS One. 2023 Jan 25;18(1):e0280929. doi: 10.1371/journal.pone.0280929. eCollection 2023.

ABSTRACT

BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in postmenopausal women. Early menarche may be associated with an increased risk of metabolic diseases such as diabetes and cardiovascular disease. This study aimed to investigate the effect of menarche age and the risk of diabetes and metabolic syndrome in Korean postmenopausal women.

METHODS: We analyzed 4,933 postmenopausal women (mean age: 64.7 years) using the Korean National Health and Nutritional Examination Survey 2016-2018. Subjects were divided into three groups according to menarche age (early menarche: ≤ 12 years (n = 451), reference: 13-16 years (n = 3,421), and late menarche: ≥ 17 years (n = 1,061)). Logistic regression analysis was used to estimate the odds ratio (OR) for diabetes and metabolic syndrome.

RESULTS: Women with an early menarche age were younger, more educated, and had higher income than the other groups (p-value < 0.001). There were no differences in body mass index, blood pressure, fasting glucose, HbA1c, and cholesterol levels among the three groups. After adjusting for potential confounding factors, early menarche age was significantly associated with the risk of diabetes (OR 1.435, 95% confidence interval (CI): 1.069-1.928). The prevalence of metabolic syndrome in all subjects was 41.1%. After adjusting for potential confounding factors, the OR of metabolic syndrome in the early menarche group was 1.213 (95% CI: 0.971-1.515).

CONCLUSION: The risk of diabetes was 1.43 times higher in postmenopausal Korean women with early menarche. Although the risk of metabolic syndrome was not statistically significant, it showed a tendency to increase in the early menarche group. Our results suggest that age at menarche may be helpful in diabetes risk stratification and early interventions for postmenopausal women.

PMID:36696408 | DOI:10.1371/journal.pone.0280929

PLoS One. 2023 Jan 25;18(1):e0280960. doi: 10.1371/journal.pone.0280960. eCollection 2023.

ABSTRACT

Human milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.

PMID:36696407 | DOI:10.1371/journal.pone.0280960

Birth. 2023 Jan 25. doi: 10.1111/birt.12708. Online ahead of print.

ABSTRACT

INTRODUCTION: Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030.

METHODS: We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia’s National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia.

RESULTS: Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019.

CONCLUSION: Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.

PMID:36696404 | DOI:10.1111/birt.12708

PLoS One. 2023 Jan 25;18(1):e0280951. doi: 10.1371/journal.pone.0280951. eCollection 2023.

ABSTRACT

The use of publicly available sequencing datasets as controls (hereafter, “public controls”) in studies of rare variant disease associations has great promise but can increase the risk of false-positive discovery. The specific factors that could contribute to inflated distribution of test statistics have not been systematically examined. Here, we leveraged both public controls, gnomAD v2.1 and several datasets sequenced in our laboratory to systematically investigate factors that could contribute to the false-positive discovery, as measured by λΔ95, a measure to quantify the degree of inflation in statistical significance. Analyses of datasets in this investigation found that 1) the significantly inflated distribution of test statistics decreased substantially when the same variant caller and filtering pipelines were employed, 2) differences in library prep kits and sequencers did not affect the false-positive discovery rate and, 3) joint vs. separate variant-calling of cases and controls did not contribute to the inflation of test statistics. Currently available methods do not adequately adjust for the high false-positive discovery. These results, especially if replicated, emphasize the risks of using public controls for rare-variant association tests in which individual-level data and the computational pipeline are not readily accessible, which prevents the use of the same variant-calling and filtering pipelines on both cases and controls. A plausible solution exists with the emergence of cloud-based computing, which can make it possible to bring containerized analytical pipelines to the data (rather than the data to the pipeline) and could avert or minimize these issues. It is suggested that future reports account for this issue and provide this as a limitation in reporting new findings based on studies that cannot practically analyze all data on a single pipeline.

PMID:36696392 | DOI:10.1371/journal.pone.0280951

PLoS One. 2023 Jan 25;18(1):e0280512. doi: 10.1371/journal.pone.0280512. eCollection 2023.

ABSTRACT

In this article, an improved slime mould algorithm (SMA-CSA) is proposed for solving global optimization and the capacitated vehicle routing problem (CVRP). This improvement is based on the mixed-strategy optimization of Cauchy mutation and simulated annealing to alleviate the lack of global optimization capability of the SMA. By introducing the Cauchy mutation strategy, the optimal solution is perturbed to increase the probability of escaping from the local extreme value; in addition, the annealing strategy is introduced, and the Metropolis sampling criterion is used as the acceptance criterion to expand the global search space to enhance the exploration phase to achieve optimal solutions. The performance of the proposed SMA-CSA algorithm is evaluated using the CEC 2013 benchmark functions and the capacitated vehicle routing problem. In all experiments, SMA-CSA is compared with ten other state-of-the-art metaheuristics. The results are also analyzed by Friedman and the Wilcoxon rank-sum test. The experimental results and statistical tests demonstrate that the SMA-CSA algorithm is very competitive and often superior compared to the algorithms used in the experiments. The results of the proposed algorithm on the capacitated vehicle routing problem demonstrate its efficiency and discrete solving ability.

PMID:36696386 | DOI:10.1371/journal.pone.0280512