Tag: pubmed

Korean J Ophthalmol. 2023 Oct 25. doi: 10.3341/kjo.2023.0092. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate repeatability and agreemeny of chord mu between Scheimpflug tomography (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) and swept-source optical coherence tomography-based optical biometer (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany).

METHOD: In this retrospective study, 63 eyes of 33 patients were included. Chord mu, X, and Y Cartesian distances between the corneal vertex and the pupil center (Px and Py), and the pupil diameter were compared using two instruments. Repeatability was evaluated using intraclass correlation coefficient (ICC), coefficient of variation (CoV), and within-subject standard deviation (Sw). Inter-device agreement was evaluated using paired t-tests and Bland-Altman plots.

RESULTS: Although Sw values for all parameters were similar between the two devices, CoV values of chord mu and pupil diameter were lower, and ICC values of those parameters were higher, in the IOLMaster 700 than in the Pentacam HR. Chord mu and pupil diameter values were higher in IOLMaster 700 than Pentacam HR (p < 0.01). The width of the 95% limit of agreement was wide for all parameters.

CONCLUSION: IOLMaster 700 showed better repeatability than Pentacam HR in chord mu, Px, Py, and pupil diameter values. Because there were statistically significant differences and a low level of agreement in chord mu and pupil diameter values between the two devices, they cannot be used interchangeably.

PMID:37899279 | DOI:10.3341/kjo.2023.0092

Int J Epidemiol. 2023 Oct 28:dyad150. doi: 10.1093/ije/dyad150. Online ahead of print.

ABSTRACT

BACKGROUND: When estimating the effect of time-varying exposures on longer-term outcomes, the assumption of conditional exchangeability or no uncontrolled confounding extends beyond baseline confounding to include time-varying confounding. We illustrate the structures and magnitude of uncontrolled time-varying confounding in exposure effect estimates obtained from g-computation when sequential conditional exchangeability is violated.

METHODS: We used directed acyclic graphs (DAGs) to depict time-varying uncontrolled confounding. We performed simulations and used g-computation to quantify the effects of each time-varying exposure for each DAG type. Models adjusting all time-varying confounders were considered the true (bias-adjusted) estimate. The exclusion of time-varying uncontrolled confounders represented the biased effect estimate and an unmet ‘no uncontrolled confounding’ assumption. True and biased estimates were compared across DAGs, with different magnitudes of uncontrolled confounding.

RESULTS: Time-varying uncontrolled confounding can present in several scenarios, including relationships into subsequently measured exposure(s), outcome, unmeasured confounder(s) and other measured confounder(s). In simulations, effect estimates obtained from g-computation were more biased in DAGs when the uncontrolled confounders were directly related to the outcome. Complex DAGs that included relationships between uncontrolled confounders and other variables and relationships where exposures caused uncontrolled confounders at the next time point resulted in the most biased effect estimates. In these complex DAGs, excluding uncontrolled confounders affected the multiple effect estimates.

CONCLUSIONS: Time-varying uncontrolled confounding has the potential to substantially impact observed effect estimates. Given the importance of longitudinal studies in advising public health, the impact of time-varying uncontrolled confounding warrants more recognition and evaluation using quantitative bias analysis.

PMID:37898996 | DOI:10.1093/ije/dyad150

Arch Environ Contam Toxicol. 2023 Oct 29. doi: 10.1007/s00244-023-01035-9. Online ahead of print.

ABSTRACT

In 2018, the dietary exposure bioaccumulation fish test of the Organization for Economic Co-operation and Development Test Guideline No. 305 was introduced into Japan’s Chemical Substances Control Law. The Japanese government has adopted a single definitive testing criterion for the absence of high bioaccumulation: the growth-corrected kinetic dietary magnification factor (BMF_Kg) must be less than 0.007. The aim of this study was to decrease regulatory restrictions in order to increase newly developed chemical substances and their subsequent approval of their manufacture and import, i.e., the present study was motivated by concerns over the criterion being too restrictive, rather than scientific concerns, such as uncertainty in criterion. We used statistical post-processing to assess the possibility of expanding the criteria for not being highly bioaccumulative. Based on our results, we proposed the criterion that the test substance should be considered not highly bioaccumulative if the following two conditions are met: (1) The ratio of the maximum to the minimum measured 5% lipid-standardized biomagnification factor at the end of the uptake phase (BMF_5%, n = 5) for the test substance and reference substance should be less than 3.0, and (2) For the measured BMF_5% of the test substance (n = 5), the probability that the next (the sixth) BMF_5% is below 0.0334 should exceed 95% based on statistical post-processing. It is worth noting that the BMF_5% values should only be applied for non-ionizable lipid soluble compounds. Application of our suggested approach to Japan implies that the criterion for chemical substances that are not highly bioaccumulative in the dietary exposure bioaccumulation fish test would be increased from 0.007 to 0.0149.

PMID:37898995 | DOI:10.1007/s00244-023-01035-9

J Anesth. 2023 Oct 29. doi: 10.1007/s00540-023-03273-6. Online ahead of print.

ABSTRACT

PURPOSE: There are few reports regarding the association between the neutrophil-lymphocyte ratio (NLR), uric acid, and the development of postoperative delirium (POD) in patients who are undergoing spine surgeries. We investigated the associations between the NLR, uric acid as a natural antioxidant, and POD in elderly patients undergoing degenerative spine surgery.

PATIENTS AND METHODS: This was a single-center, observational, and retrospective study conducted in Japan. We enrolled 410 patients who underwent degenerative spine surgery. POD was diagnosed after the surgeries by psychiatrists, based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). We performed a multivariable logistic regression analysis to clarify whether the NLR and uric acid values were associated with the development of POD in the patients.

RESULTS: 129 of the 410 patients were excluded from the analysis. Of the 281 patients (137 females, 144 males), 32 patients (11.4%) were diagnosed with POD. The multivariable logistic regression analysis revealed that the preoperative uric acid level (adjusted odds ratio [aOR]: 0.67, 95% confidence interval [CI]: 0.49-0.90, p = 0.008) and age (aOR: 1.09, 95% CI: 1.02-1.16, p = 0.008) were significantly associated with POD. The preoperative NLR (aOR: 0.82, 95% CI: 0.60-1.13, p = 0.227) and antihyperuricemic medication (aOR: 0.97, 95% CI: 0.24-3.82, p = 0.959) were not significantly associated with POD.

CONCLUSION: Our results demonstrated that in elderly patients undergoing degenerative spine surgery, the preoperative NLR was not significantly associated with POD, but a lower preoperative uric acid value was an independent risk factor for developing POD. Uric acid could have a neuroprotective impact on POD in patients with degenerative spine diseases.

PMID:37898990 | DOI:10.1007/s00540-023-03273-6

J Med Imaging Radiat Oncol. 2023 Oct 29. doi: 10.1111/1754-9485.13592. Online ahead of print.

ABSTRACT

INTRODUCTION: Malignant pleural mesothelioma is difficult to prognosticate. F18-Fluorodeoxyglucose positron emission tomography (FDG PET) shows promise for response assessment but is confounded by talc pleurodesis. F18-Fluorothymidine (FLT) PET is an alternative tracer specific for proliferation. We compared the prognostic value of FDG and FLT PET and determined the influence of talc pleurodesis on these parameters.

METHODS: Overall, 29 prospectively recruited patients had FLT PET, FDG PET and CT-scans performed prior to and post one chemotherapy cycle; 10 had prior talc pleurodesis. Patients were followed for overall survival. CT response was assessed using mRECIST. Radiomic features were extracted using the MiM software platform. Changes in maximum SUV (SUVmax), mean SUV (SUVmean), FDG total lesion glycolysis (TLG), FLT total lesion proliferation (TLP) and metabolic tumour volume (MTV) after one chemotherapy cycle.

RESULTS: Cox univariate analysis demonstrated FDG PET radiomics were confounded by talc pleurodesis, and that percentage change in FLT MTV was predictive of overall survival. Cox multivariate analysis showed a 10% increase in FLT tumour volume corresponded with 9.5% worsened odds for overall survival (P = 0.028, HR = 1.095, 95% CI [1.010, 1.187]). No other variables were significant on multivariate analysis.

CONCLUSION: This is the first prospective study showing the statistical significance of FLT PET tumour volumes for measuring mesothelioma treatment response. FLT may be better than FDG for monitoring mesothelioma treatment response, which could help optimise mesothelioma treatment regimes.

PMID:37898984 | DOI:10.1111/1754-9485.13592

Int J Health Plann Manage. 2023 Oct 29. doi: 10.1002/hpm.3721. Online ahead of print.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has stretched Bangladesh government’s capability for disaster engagement. As normalcy is interrupted, people’s confidence in the government in ending the crisis needs evaluation, especially considering the past vaccination successes in Bangladesh and growing worldwide vaccine hesitancy amidst the COVID-19 misinfodemic. This study assessed the level of public life disruption due to the pandemic at the micro-level and how much impact it had on people’s trust in the government’s capacity for successful national immunisation.

METHODS: Given the infectious nature of the pandemic, the study conducted an online survey of 2291 respondents, distributed proportionally across sex and income groups. We conducted bivariate analyses and fitted generalised linear models to assess disruption to respondents’ lives, and their trust in the government’s immunisation ability, which were measured using multiple parameters.

RESULTS: Nearly 50% of the respondents reported multifaceted disputations in their daily lives, with 90% suffering financially. Trust in the government was very low at the time of the survey as only 11.3% of respondents had faith that the government could successfully conduct a mass vaccination campaign. Rural residents and non-earning members of families found their lives to be less disrupted. Comparatively higher income families and highly educated individuals had lesser confidence in the government’s inoculation capabilities.

CONCLUSIONS: For the vaccine campaign to be successful, effective risk communication and timely display of data-driven decision-making efforts targeting the groups who are more sceptical of immunisation campaigns could be of significance to the Bangladesh government.

PMID:37898969 | DOI:10.1002/hpm.3721

Int Urol Nephrol. 2023 Oct 29. doi: 10.1007/s11255-023-03843-3. Online ahead of print.

ABSTRACT

OBJECTIVE: This review aimed to assess the utility of urinary N-acetyl-β-D-glucosaminidase (uNAG) as a prognostic biomarker for nephropathy in patients with type 2 diabetes mellitus.

METHODS: The search for relevant studies was conducted across multiple databases, including PubMed (Medline), EMBASE, LILACS, CENTRAL, IBECS, and gray literature. We employed a random effects model to calculate the standardized mean difference and 95% confidence interval. Furthermore, we assessed heterogeneity using Cochrane’s Q test and Higgins’ I2 statistics.

RESULTS: This review included a total of 16 articles involving 1669 patients, with 13 being case-control studies and three being cohorts. The meta-analysis conducted across all studies revealed significant heterogeneity. However, subgroup analysis of four studies indicated that an increase in uNAG among normoalbuminuric patients was associated with the development of macroalbuminuria (DMP = – 1.47; 95% CI = – 1.98 to 0.95; p < 0.00001; I² = 45%). Conversely, it did not demonstrate effectiveness in predicting the development of microalbuminuria (DMP = 0.26; 95% CI = – 0.08 to 0.60; p = 0.13; I² = 17%).

CONCLUSIONS: Elevated uNAG levels in normoalbuminuric patients may indicate an increased risk for the development of macroalbuminuria, but not microalbuminuria. However, the high heterogeneity observed among the studies highlights the necessity for further research to validate these findings.

PMID:37898960 | DOI:10.1007/s11255-023-03843-3

Wiad Lek. 2023;76(9):2103-2111. doi: 10.36740/WLek202309129.

ABSTRACT

OBJECTIVE: The aim: The article examines the peculiarities of the Ukrainian state policy in the field of digitalization, reveals the social challenges caused by this phenom¬enon, and outlines the ways to overcome them.

PATIENTS AND METHODS: Materials and Methods: The data collection was carried out using PubMed, Scopus, Google Scholar databases. Research papers were identified according to the search terms: “digitalization”, “digital transformations”, “Internet”, “digital services”, “smart city”, “smart urbanization”, “inclusion”, “social exclusion”, “community mental health”, “volunteering”, “social partnership”. The authors analyzed international and domestic official strategies, programs, and messages along with statistical data and social surveys conducted by foreign and Ukrainian institutions, public organizations, and analytical centers. The authors used the interdisciplinary approach along with the principles of objectivity, tolerance, and impartiality, and general scientific methods, such as induction, deduction, generalization, etc.

CONCLUSION: Conclusion: The rapid spread of digital technologies is associated with the growth of social cohesion, inclusion, solidarity, and the development of a healthy harmonious society that will provide all the conditions for a decent life for a human being and the comprehensive development of his/her abilities and talents. These hopes are not groundless, because digitalization is accompanied by a number of structural shifts in economics and public administration, which contribute to overcoming subjectivity in making management decisions and increasing the level of “intellectualization” of the environment. In addition, digitalization is becoming a significant driver of the sustainable growth in labor productivity, employment levels, personal and social well-being; and the spread of digital technologies provides an opportunity to overcome various social challenges. As the Ukrainian experience reveals, despite a number of positive shifts, digitalization can also give rise to destructive social trends, among which the digital gaps caused by the uneven access to digital technologies and services occupy a special place. People in the city outskirts, small towns, and especially in the remote rural areas often have extremely limited access to the Internet that significantly reduces their social opportunities. These problems became more acute after the full-scale invasion of the russian federation into Ukraine. The occupation of the part of Ukraine, hostilities, and missile attacks damaged the energy sector blocking telecommunication networks, which led to the social exclusion of a significant part of the population in some Ukrainian regions. The harsh living conditions during the war, the social exclusion as a result of the occupation, as well as the destruction of energy infrastructure and civilian objects fueled the activities of the Ministry of Digital Transformation of Ukraine. The proposed services and transformations provided social opportunities for a part of the population, while remaining unable to overcome social exclusion generated by the digital, social, or other gap. Volunteers and social activists usually help to bridge the gap and maintain mental health of the community, which has been suffering from the horrors of the war for more than a year. Their activities and public position lay the ground for the establishment of social partnership aimed at the harmonious development of every individual and the community as a whole.

PMID:37898951 | DOI:10.36740/WLek202309129

Wiad Lek. 2023;76(9):2047-2053. doi: 10.36740/WLek202309121.

ABSTRACT

OBJECTIVE: The aim is to study the dynamics of prostaglandins and cytokines in the blood and gingival fluid against the background of differential drug correction in patients with generalized periodontitis with different body reactivity.

PATIENTS AND METHODS: Materials and methods: 216 people aged 45 between 55 years with a diagnosis of generalized periodontitis of II, III degree of severity, chronic course were examined. Depending on the state of reactivity of the organism, the patients were divided into three groups: the first one consisted of people with normoreaction; the second group included patients with hyperreaction; the third group was made up of people with hyporeaction. The patients underwent patch surgery after the initial therapy. Initially, on the 1st, 2nd, 4th, 6th and 9th day after the operation, the content of prostaglandins (PG) E, E2, F2alpha and cytokines (IL-1β, IL-6, TNF, IL-4) in the blood and gingival fluid was performed. Patients with impaired body reactivity were treated with the proposed differential drug correction of cytokines and prostaglandins. Statistical processing of the obtained digital data was performed using the computer program Statistica 8.0.

RESULTS: Results: The proposed differential drug correction in patients with generalized periodontitis against the background of hyper- and hyporeactivity of the body brings the content of IL-1β, IL-6, TNF, IL-4 to that of normal body reactivity, which ultimately restores the disturbed balance of pro- and anti-inflammatory cytokines in the blood and gingival fluid. On the 9th day, the content of all proinflammatory cytokines in the main groups was normalized and was commensurate with that of the body’s normal response (p>0.05). Differential drug correction led to normalization of the prostaglandin balance index on day 9 after flap surgery (p>0.05), indicating the establishment of a normal balance of eicosanoids in the blood and approximating the values of pro- and anti-inflammatory fractions of prostaglandins to those of normal body reactivity.

CONCLUSION: Conclusion: Correction of altered parameters in patients with generalized periodontitis accompanied by impaired (hyper- and hypo-) reactivity of the body with bringing them to values that are typical for normoreactivity is considered to be a condition for optimizing mucosal wound healing after surgery and further stabilization of periodontal tissues.

PMID:37898943 | DOI:10.36740/WLek202309121

Wiad Lek. 2023;76(9):1992-1999. doi: 10.36740/WLek202309113.

ABSTRACT

OBJECTIVE: The aim: This study was conducted to compare the results of spider vein: sclerotherapy or radiofrequency thermocoagulation.

PATIENTS AND METHODS: Materials and methods: The study included 52 patients with spider veins, who were randomized into two treatment groups: sclerotherapy or radiofrequency thermocoagulation. Treatment outcomes were assessed using: a self-assessed questionnaire, CIVIQ 20 questionnaire, computer evaluation of images, registration relapses complications, negative manifestations, and intensity of the pain syndrome.

RESULTS: Results: Both methods showed a statistically significant difference in the quality of life indicators before and one month after treatment (p<0.001 for both groups). Radiofrequency thermocoagulation showed a greater impact on the patient’s quality of life (p = 0.003). The average length of spider veins in the treatment area decreased the most with radiofrequency thermocoagulation (by 92.1%), slightly less after sclerotherapy (by 73.4%) (p < 0,01).

CONCLUSION: Conclusions: Both treatments have shown good results for spider veins and were reasonably safe with few negative manifestations. Radiofrequency coagulation better eliminates small veins, less than 0.3 mm.

PMID:37898935 | DOI:10.36740/WLek202309113