Tag: pubmed

Zhonghua Yan Ke Za Zhi. 2025 Jun 11;61(6):434-441. doi: 10.3760/cma.j.cn112142-20240626-00282.

ABSTRACT

Objective: To investigate the consistency between automatic corneal marking using a surgical navigation system and manual corneal marking assisted by a slit-lamp microscope. Methods: This was a retrospective case series study. Patient data from the Ophthalmology Outpatient Department of Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, from June 2021 to July 2023 were continuously collected. All patients underwent manual corneal marking assisted by a slit-lamp microscope, followed by automatic marking using a surgical navigation system. Patients were divided into two groups: the manual marking group and the automatic marking group. The manual marking group was further divided into three subgroups based on the marking measurement methods: manual marking (upper to lower edge), manual marking (lower to upper edge), and manual marking (midpoint). The horizontal meridian angle and the deviation of the central axis were calculated for the four marking methods using the image processing software. Statistical differences among the measurement methods were compared, and the consistency was evaluated using the Bland-Altman plots and intraclass correlation coefficient (ICC). Results: A total of 143 cataract patients (201 eyes) were included in the study, with an average age of (60.27±19.13) years, including 58 males and 85 females. The absolute mean deviations of the horizontal meridian angle for manual marking (upper to lower edge), manual marking (lower to upper edge), manual marking (midpoint), and automatic marking were 3.61°, 4.76°, 3.20°, and 2.45°, respectively, with statistically significant differences among them (P<0.001). The differences between automatic marking and the three manual marking methods were also statistically significant (P<0.05). The mean deviations of the central axis were 2.35, 2.35, 2.24, and 0.40 mm, respectively, with statistically significant differences among them (P<0.001). The deviation of the automatic marking method was significantly lower than that of the manual marking methods (P<0.001), while no significant difference was observed between the three edge-based manual marking methods (P>0.05). The ICC for the horizontal meridian angle between manual marking (midpoint) and automatic marking was 0.88, while the ICC for the central axis deviation was -0.04, indicating good consistency in the horizontal meridian angle between manual marking (midpoint) and automatic marking, but poor consistency in the central axis deviation. Conclusions: The horizontal meridian angle values of automatic corneal marking using a surgical navigation system and manual corneal marking (midpoint) assisted by a slit-lamp microscope showed good consistency. However, digital navigation automatic marking demonstrated significantly better control in the centralization of the radial offset, providing a robust basis for accurate axis positioning during toric intraocular lens implantation.

PMID:40484852 | DOI:10.3760/cma.j.cn112142-20240626-00282

Zhonghua Yi Xue Za Zhi. 2025 Jun 10;105(22):1840-1846. doi: 10.3760/cma.j.cn112137-20250212-00318.

ABSTRACT

Objective: To explore the association of lean body mass (LBM), lean body mass index(LBMI), fat mass (FM) and fat mass index(FMI) with depressive symptoms in adults aged 65 and above in 18 longevity areas in China. Methods: A cross-sectional study. The study participants were from the Chinese Longitudinal Healthy Longevity Biomarker Cohort Study, comprising elderly individuals aged 65 years and above. Demographic characteristics, lifestyle factors, physical function status, and disease history were collected. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9). LBM and FM were measured to calculate LBMI and FMI, respectively. Participants were categorized into the depressive group and non-depressive group based on whether the PHQ-9 score≥10 points, and the differences in LBM, LBMI, FM, and FMI between the two groups were compared. Restricted cubic spline models were used to illustrate exposure-response relationships between LBM, LBMI, FM, FMI and the presence of depressive symptoms. Participants were categorized into low, moderate, and high groups based on the tertiles of LBM, LBMI, FM and FMI, respectively, and multivariable logistic regressions were applied to examine the associations of LBM, LBMI, FM, and FMI with depressive symptoms. Results: A total of 4 246 older adults were included, with 2 034 males (47.9%) and a mean age of (81.8±10.2) years. In the non-depressive group (n=4 008), the mean age was (81.9±10.2) years, with 1 957 males (48.8%). In the depressive group (n=238), the mean age was (80.8±9.6) years, with 77 males (32.4%). The LBM of the depvessive group was lower than that of the non-depressive group [(36.8±6.8) kg vs (39.0±7.5) kg, P<0.001]. Restricted cubic spline analysis indicated no non-linear exposure-response relationships between LBM, LBMI, FM, FMI, and the presence of depressive symptoms (all P>0.05). Multifactor logistic regression analysis showed that LBM and LBMI were negatively associated with the risk of depression (all P<0.05). Compared with the low LBM (or LBMI) group, the high LBM group (OR=0.458, 95%CI: 0.291-0.715) and the high LBMI group (OR=0.646, 95%CI: 0.442-0.939) had a lower likelihood of experiencing depressive symptoms. No statistically significant associations were found between FM, FMI, and depressive symptoms (all P>0.05). Conclusion: Among adults aged 65 years and above in longevity regions of China, higher LBM and LBMI are negatively associated with the risk of depressive symptoms.

PMID:40484846 | DOI:10.3760/cma.j.cn112137-20250212-00318

Zhonghua Yi Xue Za Zhi. 2025 Jun 10;105(22):1820-1826. doi: 10.3760/cma.j.cn112137-20250422-00995.

ABSTRACT

Objective: To investigate the value of short-term ¹⁸F-fluorodeoxyglucose (FDG) total-body (TB) dynamic PET(dPET)-CT scanning in the diagnosis of Takayasu arteritis (TA). Methods: A retrospective analysis was performed on 8 TA patients underwent dPET-CT scanning in the First Affiliated Hospital of Shandong First Medical University from March to October 2022, who met the diagnostic criteria for TA proposed by the American College of Rheumatology in 1990. Patients were divided into active inflammation and inactive inflammation groups according to National Institutes of Health (NIH) criteria. All patients underwent 1 h TB dPET scan and 2 h delayed scan, and 1 h static PET was reconstructed by dPET scan for 50-60 min, and nineteen regions of interest in the arterial wall were delineated for each patient. One hour dPET scan images were reconstructed into 10, 20, 30, 40 and 60 min K_i parameter images and compared with 1 h static and 2 h delayed PET images. The clinical data of patients in the active inflammation group and the inactive inflammation group were compared. The image quality of dPET and static PET at different scanning times [including lesion target ratio (TBR), lesion contrast-to-noise ratio (CNR)] and the detection rate of active lesions were compared. Results: A total of 152 branch vessels of 8 patients were included, including 3 males and 5 females, aged 21 to 40 years old. A total of 68 (89.5%) diseased blood vessels were detected in 4 patients in the active inflammation group, and a total of 50 (65.8%) diseased blood vessels were detected in 4 patients in the inactive inflammation group (P=0.001). The TBRs of dPET at 10, 20, 30, 40 and 60 min were 1.870 (1.301, 2.815), 2.991 (1.926, 4.265), 3.310 (2.308, 4.786), and 3.315 (2.333, 4.361), 2.986 (2.177, 4.344)), respectively. The CNRs were -0.799 (-1.356, 0.300), 0.691 (-0.212, 1.900), 1.563 (0.550, 2.778), 2.236 (1.012, 3.271), and 2.344 (1.324, 4.134), respectively. Both TBR and CNR gradually increased (both P_trend<0.001). Pairwise comparisons revealed that the dPET TBR at 30, 40, and 60 minutes and the dPET CNR at 40 and 60 minutes were all higher than those of the 1-hour static and 2-hour delayed PET, respectively (all P<0.001). The differences in the detection rates of diseased blood vessels between the active inflammation group and the inactive inflammation group at different scanning times of dPET, 1-hour static PET, and 2-hour delayed PET were all statistically significant (all P<0.05). Pairwise comparisons revealed that the detection rates of diseased blood vessels in the 30-and 40-minute dPET scans between the two groups of patients were 60.5% (46 lesions), 31.6% (24 lesions), 81.6% (62 lesions), and 44.7% (34 lesions), respectively. All were higher than 42.1% (32 pieces) and 9.2% (7 pieces) of 1-hour static PET (all P<0.05); the detection rates of diseased blood vessels in 40-minute dPET scans were both higher than 50.0% (38 lesions) and 30.3% (23 lesions) in 2-hour delayed PET scans (both P<0.001). Conclusions: It is feasible to shorten the time of dPET scanning for the assessment of arterial activity in TA patients, and parametric images with higher image quality and diseased blood vessels detection rate can be obtained by dPET scanning for 30 min.

PMID:40484843 | DOI:10.3760/cma.j.cn112137-20250422-00995

Zhonghua Yi Xue Za Zhi. 2025 Jun 3;105(21):1728-1736. doi: 10.3760/cma.j.cn112137-20250317-00652.

ABSTRACT

Objective: To evaluate the efficacy and safety of sulodexide in preventing venous thromboembolism (VTE) in high-risk populations and reducing recurrence in established VTE patients. Methods: A literature search was conducted in databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Periodical Database, China Biology Medicine disc, PubMed, Embase, the Cochrane Library, and Web of Science to retrieve relevant literature on sulodexide in the treatment of VTE, with the retrieval time frame set from the establishment of the databases to April 2024. According to the inclusion and exclusion criteria, two researchers independently screened the literature and extracted the data. The Cochrane risk of bias tool or the Newcastle-Ottawa Scale was used to evaluate the quality of the included studies. Meta-analysis was performed using Revman5.4.1 software, with the RR value as the effect measure. The trial group comprised high-risk individuals or VTE patients treated with sulodexide, while the control group consisted of patients treated with other traditional anticoagulants or placebos. The outcome measures included the incidence and recurrence rate of VTE, the incidence of post-thrombotic syndrome (PTS), and the risk of bleeding, among others. Results: A total of 11 articles involving 11 studies and 3 364 patients were included according to the inclusion and exclusion criteria. For high-risk populations of VTE, prophylactic use of sulodexide was more effective than the control group in reducing the incidence of VTE in high-risk individuals [2.2% (3/138) vs 10.9% (15/138), RR=0.25, 95%CI: 0.09-0.72, P=0.010]. For VTE patients, sulodexide was more effective than control group in reducing the recurrence rate of VTE [5.6% (56/996) vs 9.7% (198/2 043), RR=0.59, 95%CI: 0.44-0.80, P<0.001]. There was no statistically significant difference in the incidence of PTS between patients treated with sulodexide and those treated with other traditional anticoagulants [14.0% (36/257) vs 16.6% (149/897), RR=0.86, 95%CI: 0.61-1.20, P=0.370]. Moreover, the incidence of bleeding events was lower in patients treated with sulodexide compared to those treated with other traditional anticoagulants [0.8% (2/251) vs 6.1% (40/656), RR=0.11, 95%CI: 0.03-0.37, P<0.001]. Conclusion: Sulodexide exhibits favorable efficacy and safety for VTE prevention in high-risk populations and recurrence reduction in VTE patients.

PMID:40484836 | DOI:10.3760/cma.j.cn112137-20250317-00652

Age Ageing. 2025 May 31;54(6):afaf154. doi: 10.1093/ageing/afaf154.

ABSTRACT

BACKGROUND: Comorbidities and polypharmacy are common in people with dementia, leading to a higher risk of adverse outcomes. While the impact of anticholinergic properties has been extensively investigated, less is known about other cross-category properties of medications.

OBJECTIVE: To investigate whether medications with dizziness or hypotension as a side effect are associated with adverse outcomes in older adults with dementia.

DESIGN: Retrospective cohort study.

SETTING AND PARTICIPANTS: From a South London catchment, 15 210 patients diagnosed with dementia between 2008 and 2017.

METHODS: Medications with dizziness and/or hypotension listed as a side effect were compiled and quantified in the cohort. Multivariable Cox regression models were run to determine the risk of mortality, all-cause emergency hospitalisation and hospitalisation due to falls. Generalised estimating equations were applied to investigate cognitive decline. The final model adjusted for 19 potential confounders, including physical and mental health measures.

RESULTS: Of the patients, 82.2% were receiving at least one dizziness-associated medication and 71.2% at least one hypotension-associated medication. For each additional medication associated with dizziness or hypotension, there was a 4% increased risk of all-cause emergency hospitalisation. No associations were found with hospitalised falls specifically or with mortality or cognitive decline.

CONCLUSION: Medications that potentially cause dizziness or hypotension were associated with an increased risk of hospitalisation, although not specifically hospitalisation caused by falls. More systematic attention should be paid to coprescribing around the time of dementia diagnosis and the potential for rationalising this to minimise adverse drug events.

PMID:40483728 | DOI:10.1093/ageing/afaf154

Age Ageing. 2025 May 31;54(6):afaf148. doi: 10.1093/ageing/afaf148.

ABSTRACT

BACKGROUND AND OBJECTIVE: Research on the impact of spousal caregiving on caregivers’ frailty remains limited. This study aimed to examine this association between spousal caregiving and frailty, explore how this association varies with care intensity, and investigate potential gender differences.

METHODS: This study utilized data from four waves of the China Health and Retirement Longitudinal Study, including 3,987 participants aged 50 and above. Frailty was assessed using a composite mean score based on 41 indicators aligned with Rockwood’s frailty criteria. These indicators included self-reported health, medically diagnosed conditions, medical symptoms, functional activities assessment, activities of daily living and instrumental activities of daily living. Samples were stratified by gender, and a growth curve model with random intercepts was employed to examine the associations between spousal caregiving status, care intensity and frailty trajectories over time.

RESULTS: Among females, compared to non-caregivers, spousal caregiving was significantly associated with the increased frailty index when adjusted by all covariates, and frailty accelerated at a higher rate for caregivers. Providing care at all three intensity levels was associated with higher frailty, although depression attenuated these associations. Additionally, caregiving at lower intensity showed an accelerating rate of frailty progression over time. Among males, only providing higher-care intensity was associated with higher frailty.

CONCLUSIONS: This study highlights the importance of care intensity as well as the gendered effects of spousal caregiving on frailty-caregiving exacerbates frailty, particularly among females and among higher-intensity male caregivers. Our findings suggest the need for targeted supportive measures to alleviate psychological stress.

PMID:40483727 | DOI:10.1093/ageing/afaf148

Multivariate Behav Res. 2025 Jun 8:1-18. doi: 10.1080/00273171.2025.2512345. Online ahead of print.

ABSTRACT

The assumption of a normal distribution for latent traits is a common practice in item response theory (IRT) models. Numerous studies have demonstrated that this assumption is often inadequate, impacting the accuracy of statistical inferences in IRT models. To mitigate this issue, Gaussian mixture modeling (GMM) for latent traits, known as GMM-IRT, has been proposed. Moreover, the GMM-IRT models can also serve as powerful tools for exploring the heterogeneity of latent traits. However, the computation of GMM-IRT model estimation encounters several challenges, impeding its widespread application. The purpose of this paper is to propose a reliable and robust computing method for GMM-IRT model estimation. Specifically, we develop a mixed stochastic approximation EM (MSAEM) algorithm for estimating the three-parameter normal ogive model with GMM for latent traits (GMM-3PNO). Crucially, the GMM-3PNO is augmented to be a complete data model within the exponential family, thereby substantially streamlining the computation of the MSAEM algorithm. Furthermore, the MSAEM algorithm adeptly avoid the label-switching issue, ensuring its convergence. Finally, simulation and empirical studies are conducted to validate the performance of the MSAEM algorithm and demonstrate the superiority of the GMM-IRT models.

PMID:40483708 | DOI:10.1080/00273171.2025.2512345

Clin Transplant. 2025 Jun;39(6):e70186. doi: 10.1111/ctr.70186.

ABSTRACT

BACKGROUND: Transplantation of hepatitis C virus (HCV) nucleic acid (NAT) positive organs is associated with shorter time to transplant and decreased risk of death on the waiting list. Treatment for HCV post-transplant is well-tolerated, successful, and leads to similar transplant outcomes to patients transplanted with HCV NAT- organs. Despite these outcomes, not all patients consent to receive HCV NAT+ organs, and factors associated with consent are not well-known.

METHODS: This retrospective single-center study of adult patients listed for heart, liver, lung, and kidney transplant aimed to determine whether sociodemographic and organ-specific disparities exist in consent for HCV NAT+ donor organs.

RESULTS: Of 2788 transplant candidates, 44% (N = 1229) consented to receive an HCV NAT+ organ. Patients who designated English as their preferred language were more likely to consent compared to a non-English preference (45% vs. 19%, p < 0.001). Consent rates were highest amongst patients listed for liver transplantation compared to kidney, heart, and lung transplants (67%, N = 319 vs. 42%, N = 602 vs. 38%, N = 159 vs. 32%, N = 149; p < 0.001).

CONCLUSIONS: Overall, more efforts are needed to ensure that all patients who may benefit from consenting for HCV NAT+ organs are appropriately educated in their language of choice on the risks and benefits.

PMID:40483705 | DOI:10.1111/ctr.70186

Aging Ment Health. 2025 Jun 8:1-10. doi: 10.1080/13607863.2025.2515181. Online ahead of print.

ABSTRACT

Older adults receiving home and community based services have been found more vulnerable to mental health distress and suicidal ideation due to loneliness and social isolation. This study evaluated the effectiveness of an eight-week standardized, manualized warm calling phone intervention intended to combat loneliness and social isolation by fostering reciprocally caring relationships. Natural helpers from the Aging Services Network, home-delivered meals (HDM) volunteers who had ongoing interactions with individuals at risk for suicide, were trained to provide supportive phone outreach. Using descriptive statistics and consensual qualitative research (CQR) methodology, results from 78 older adult experiences were explored based on data collected at one-month follow-up to assess what they may have liked, what could be improved, and any takeaways from the program. Five domains and nineteen categories emerged revealing older adults had lasting positive impacts from program participation. Particularly trained helper qualities contributed to these improvements; further, older adults reported key takeaways from the program, increased help-seeking behavior, as well as potential program improvements. Implications for practice and future research are provided.

PMID:40483699 | DOI:10.1080/13607863.2025.2515181

Spine Deform. 2025 Jun 8. doi: 10.1007/s43390-025-01123-x. Online ahead of print.

ABSTRACT

PURPOSE: Vertebral body tethering (VBT) for lumbar curves may have wider application than for thoracic curves due to greater growth potential than thoracic spine and benefits of preserved flexibility. Predicting long-term correction remains challenging, with high revision rates and complications (14-32%) including under-/over-correction, tether breakage, adding-on. This study aimed to validate a planning tool for lumbar VBT using a patient-specific finite element model (FEM) integrating mechanobiological growth modulation as a function of preoperative skeletal maturity.

METHODS: Thirty-five retrospective idiopathic scoliosis patients who underwent lumbar VBT, with or without concomitant thoracic VBT, were included. A personalized FEM calibrated to preoperative spine deformity, flexibility and weight was created using 3D radiographic reconstructions. The FEM was linked to an algorithm integrating spine growth and mechanobiological growth modulation, calibrated using preoperative Sanders score. VBT surgery was simulated to replicate immediate postoperative correction and predict two-year correction. Simulated Cobb angles, sagittal curves, and apical axial rotation were compared to actual two-year radiographic measurements.

RESULTS: Preoperative Cobb angles averaged 37 ± 12° (thoracic) and 48 ± 9° (thoraco-lumbar/lumbar). Immediate postoperative correction was 38 ± 15% and 59 ± 16%, with two-year corrections of 44 ± 24% and 73 ± 21%, respectively. Simulated postoperative correction was accurate within 3° (Cobb angles), while simulated 2-year outcomes were accurate within 3° (Cobb), 2° (kyphosis), 4° (lordosis), and 3° (axial rotation), showing no significant differences from reference results (p < 0.05; statistical power 90%).

CONCLUSION: The patient-specific FEM and growth modulation algorithm accurately predicted two-year correction. This tool can support preoperative planning, reduce surgeon variability, and potentially improve VBT outcomes by providing a predictive tool to help surgical planning.

PMID:40483668 | DOI:10.1007/s43390-025-01123-x