Impact of lymphedema on foot-health-related quality of life: a case-control investigation

Objective: To evaluate the foot-health-related quality of life in individuals with versus without lower-limb lymphedema. Methods: A case-control study was carried out in an academic clinic in Lisbon, Portugal. Eighty participants (40 controls and 40 with lymphedema) were included in the study. The researchers examined sociodemographic and clinical data and foot-health-related quality of life in both groups. In the group with lymphedema, lower-limb lymphedema was also characterized. Results: Individuals with lower-limb lymphedema had significantly lower scores on all dimensions of the Foot Health Status Questionnaire in comparison with the control group. Conclusions: Individuals with lower-limb lymphedema appear to have a poorer foot-health-related quality of life than the general population.info:eu-repo/semantics/publishedVersio

The impact of 25-hydroxyvitamin D and calcium on risk of age-related macular degeneration: a Mendelian randomization study

This study was supported by the National Natural Science Foundation of China (82122059).Background: The relationships between 25-hydroxyvitamin D [25(OH)D] and calcium and age-related macular degeneration (AMD) are unclear. Objectives: This study aimed to investigate the causal role of 25(OH)D concentrations, calcium concentrations, and dietary supplements use of vitamin D and calcium on the risk of AMD and its subtypes. Methods: Independent genetic variants associated with 25(OH)D and calcium concentrations were used as instrumental variables in published genome-wide association studies (GWASs) of European ancestry. The bidirectional 2-sample Mendelian randomization (MR) analyses were performed using summary-level data from the UK Biobank and FinnGen datasets. Sensitivity analyses were conducted to ensure the robustness of the MR results. The meta-analyses were conducted using fixed and random-effect models to provide comprehensive and reliable estimates. Results: A standard deviation increase in calcium concentrations was linked to a 14%, 17%, and 13% reduction in the likelihood of developing AMD (95% confidence interval [CI]: 0.77, 0.97), wet AMD (95% CI: 0.73, 0.95), and dry AMD (95% CI: 0.75, 1.00), respectively. No significant causal relationships were detected between genetically predicted 25(OH)D concentrations and AMD and its subtypes (all P > 0.05). The combined analyses showed that higher calcium concentrations were associated with a reduced risk of overall AMD, with an odds ratio of 0.89 (95% CI: 0.81, 0.98). Conclusions: This study supports the causal relationship between calcium concentrations and the risk of AMD and its subtypes, which may have important implications for the prevention, monitoring, and treatment of AMD.info:eu-repo/semantics/publishedVersio

Myths in myopia epidemiology and treatment

Practicing evidence-based medicine requires constant effort to acquire, assess, and implement new knowledge that improves our care. Since 2013, more than 1000 publications per year have discussed myopia,1 many challenging existing medical beliefs. As in other areas of medicine, ophthalmologists are expected to translate new knowledge into their clinical practice as well as manage their demanding clinical schedule. However, practicing clinicians, including ophthalmologists, are sometimes slow to discard medical myths contradicted by available evidence. This is especially true in fields with rapidly evolving research, such as myopia. The goal of this viewpoint is to highlight examples of common beliefs about myopia epidemiology and control that are not evidence-based and to consider corrective educational strategies.info:eu-repo/semantics/publishedVersio

Perceptions of LIS professionals on ACRL framework: understanding and fostering concepts, skills and attitudes in academic students

The recently translated Framework for Information Literacy for Higher Education is generating considerable interest among Portuguese professionals. As pedagogical approaches and constructivist learning gain prominence, librarians are recognizing the crucial role they play in facilitating research skills, employing diverse pedagogical methods, and fostering information literacy as essential elements of education. This study, conducted as part of a national project focused on information literacy for academic students, aims to analyze Portuguese librarians’ perceptions regarding the translated Framework. Through an extensive literature review and an online survey, the initial findings indicate that librarians possess a basic understanding of the topic while demonstrating a strong commitment to acting. Building upon the translated Framework, pedagogical materials and training opportunities have been introduced. As information literacy programs continue to be integrated, implemented, and evaluated in libraries and academic curricula, the Framework serves as a valuable reference document for information professionals and educators, offering inspiration and guidance.info:eu-repo/semantics/publishedVersio

Ultrathin DSAEK versus DMEK: review of systematic reviews

The efficacy and safety of Descemet's membrane endothelial keratoplasty (DMEK) and ultrathin Descemet stripping automated endothelial keratoplasty (UT-DSAEK) have been recently compared in several systematic reviews (SRs). This study aimed to assess the evidence quality of such SRs, to obtain a scientifically rigorous comparison between the two techniques. We performed a systematic review of SRs and meta-analyses comparing the efficacy and safety between UT-DSAEK and DMEK up to 24th March 2023, using 3 electronic databases (PubMed, Cochrane Library, Google Scholar) plus manual reference search. Specific outcomes analyzed included best-corrected visual acuity (BCVA), endothelial cell density (ECD), rebubbling rate, and other postoperative complications. Of 90 titles/abstracts screened, four SRs met the inclusion criteria. All SRs adequately analyzed potential bias of the included studies. One SR raised concern for potential literature search bias and two SRs have heterogeneity in some outcomes analyzed. All SRs found higher BCVA after DMEK, but one SR reported significant heterogeneity. All SRs found significant heterogeneity in ECD analysis, with one SR providing inconsistent analysis of this outcome. Three SRs analyzed rebubbling rates, favoring UT-DSAEK over DMEK. Three SRs concluded a higher overall complication rate after DMEK, although rebubbling may be a confounding factor. This systematic review clarifies the strengths and weaknesses of published SRs and reinforces the conclusion that DMEK leads to superior visual outcomes compared to UT-DSAEK, with the trade-off of higher rebubbling rates and possibly other postoperative complications. Studies with longer follow-up are needed to ascertain these differences between procedures.info:eu-repo/semantics/publishedVersio

Prevalence of levator ani muscle injuries in primiparous women after delivery and their influence on pelvic floor disorders: systematic review

Background: Studies show a significant association between the first vaginal delivery and injuries of the levator ani muscle (LAM), which can cause pelvic floor disorders (PFDs). Objectives: This study aims to identify the prevalence of short and long-term LAM injuries after vaginal delivery in primiparous women and its influence on PFDs. Method: A systematic review was conducted according to the PRISMA methodology. The databases used were Pubmed, Cochrane, and PEDro. The quality assessment of the evidence was carried out using the Critical Appraisal Skills Programme (CASP). Both the selection of studies and their evaluation were done by two researchers and a third reviewer in cases of disagreement. Results: From the search, 57 articles were gathered, and 19 were included to match the eligibility criteria. The prevalence of avulsion of the LAM was found in association with vaginal delivery between 13% and 28% ≤ 1 year after delivery and between 16% and 29% > 1 year after delivery. Ballooning was detected between 20% and 37% ≤ 1 year, and 33% of women > 1 year after delivery, appearing to be more common when compared to avulsion. Pelvic organ prolapse (POP) was considered the most common disorder associated with injuries of the LAM, and there seems to be some connection with sexual dysfunction. Conclusion: Avulsion of the LAM and ballooning of the hiatal area have a high prevalence in primiparous women after vaginal delivery and have a strong direct relation to the development of POP.info:eu-repo/semantics/publishedVersio

The use of effect biomarkers in chemical mixtures risk assessment: are they still important?

The author thanks to H&TRC- Health & Technology Research Center - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa; FCT/MCTES national support through the UIDP/05608/2020, UIDB/05608/2020, and IPL/2021/PLASCOGEN_ESTeSL.Human epidemiological studies with biomarkers of effect play an invaluable role in identifying the health effects of chemical exposures and in disease prevention. Effect biomarkers that measure genetic damage are potent tools to address the carcinogenic and/or mutagenic potential of chemical exposures, increasing confidence in regulatory risk assessment decision-making processes. The micronucleus (MN) test is recognized as one of the most successful and reliable assays to assess genotoxic events, which are associated with exposures that may cause cancer. To move towards the next generation of risk assessment it is crucial to establish bridges between standard approaches, new approach methodologies (NAMs), and tools for increasing the mechanistically-based biological plausibility in human studies, such as the adverse outcome pathways (AOPs) framework. This paper aims to highlight the still active role of MN as a biomarker of effect in the evolution and applicability of new methods and approaches in human risk assessment, with the positive consequence, that the new methods provide a deeper knowledge of the mechanistically-based biology of these endpoints.info:eu-repo/semantics/publishedVersio

Assessment of waste workers occupational risk to microbial agents and cytotoxic effects of mixed contaminants present in the air of waste truck cabin and ventilation filters

This research was funded by Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, grant number #2018–0016, and the H&TRC authors gratefully acknowledge the national support of FCT/MCTES through the UIDB/05608/2020 and UIDP/05608/2020.Workers in the waste-processing industry are potentially exposed to high concentrations of biological contaminants, leading to respiratory and digestive problems and skin irritations. However, few data on the exposure of waste collection truck (WCT) drivers are available. The goal was to document the microbial risk of the waste collection truck (WCT) workers while in the vehicle cab. Long-period sampling using the truck air filters (CAF) and short-time ambient air sampling in the cab were used. The potential release of microbial particles from CAFs was also investigated since it could contribute to the microbial load of the cabin air. A combination of analytical methods also helped assess the complex mixture of the biological agents. Aspergillus sections Fumigati and Flavi, E. coli, Enterobacter spp., and Legionella spp. were detected in the CAF of trucks collecting three types of waste. The highest levels of bacteria and fungi were found in the CAF from organic WCT. The highest endotoxin concentrations in CAF were 300 EU/cm2. Most of the CAF showed cytotoxic effects on both lung cells and hepatocytes. Only one mycotoxin was detected in a CAF. The maximal concentrations in the ambient WCT air varied according to the type of waste collected. The highest proportion (84%) of the air samples without cytotoxic effects on the lung cells was for the recyclable material WCTs. The results revealed the potential microbial risk to workers from a complex mixture of bio-contaminants in the cabs of vehicles collecting all types of waste. The sustained cytotoxic effect indicates the potential adverse health-related impact of mixed contaminants (biological and non-biological) for the workers. Overall, this study highlights the benefits of using a complementary sampling strategy and combined analytical methods for the assessment of the microbial risk in work environments and the need to implement protective measures for the workers. Implications: Exposure to microbial agents is a well-known occupational hazard in the waste management sector. No previous study had evaluated the cytotoxicity of ambient air and ventilation filters to document worker exposure to a combination of contaminants during waste collection. This research confirms the usefulness of ventilation filters for the long-term characterization of exposure to infectious agents, azole-resistant fungi, coliform bacteria, and mycotoxin. Overall, this study highlights the importance of using several sampling and analysis methods for a comprehensive assessment of microbial risk in work environments, as well as the need to implement appropriate protective measures for collection workers.info:eu-repo/semantics/publishedVersio

Intraocular lens opacification after Descemet’s membrane endothelial keratoplasty: risk factors and outcomes after intraocular lens exchange

Purpose: To determine risk factors for intraocular lens opacification (IOLop) after Descemet membrane endothelial keratoplasty (DMEK) and to analyze clinical outcomes after IOL exchange. Methods: Cross-Sectional Study: Analysis of all cases of IOL exchange because of post-DMEK IOLop with a minimum of 6-month postoperative follow-up observed in the clinic between November 2021 and April 2022. The main outcomes analyzed at the study visit were changes in the logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity after IOL exchange, endothelial cell loss (ECL), and graft survival. A historical cohort of 232 pseudophakic DMEK eyes was retrospectively analyzed to determine risk factors for post-DMEK IOLop. Results: Cross-Sectional Study: Four eyes were observed (median follow-up = 45 (35.5-86.8) months). IOL materials were hydrophilic acrylic IOLs in 2 eyes and hydrophobic-hydrophilic in the other 2. At the study visit, improvement in median best-corrected visual acuity after IOL exchange was statistically significant (0.25 (0.19-0.41) logMAR to 0.00 (0-0.10) logMAR; P = 0.041). ECL ranged between 57.7% and 85.3%, without cases of graft failure. In the historical cohort, 21 eyes (9.05%) had some IOLop. In the multivariate logistic regression model (105 eyes where IOL material data was available), IOLs with high water content material (odds ratio = 65.5, P = 0.0005) and rebubbling (odds ratio = 9.51, P = 0.0138) were independent risk factors for post-DMEK IOLop. Conclusions: Post-DMEK IOLop is infrequent, but a non-neglectable proportion of cases may require IOL explantation. IOL exchange is safe and effective in these eyes but may pose a risk for increased ECL. This study confirms that IOL material and the number of rebubblings are major risk factors for post-DMEK IOLop.info:eu-repo/semantics/publishedVersio

Spatial and multivariate statistics in assessing water quality in the North Sea

The Southern North Sea region plays a vital role in both the economy and society of the surrounding countries. Analyzing the quality of your water is a critical process that involves an assessment of physical, chemical, and biological parameters, essential to guarantee environmental sustainability and the health of local communities and marine ecosystems. Using Multivariate and Spatial Statistics methods, this study seeks to identify spatial patterns and autocorrelations to assess water quality in that region. The data set used was taken on a scientific cruise carried out in December 2020 aboard the RV Meteor vessel, led by a team of German researchers. The raw data went through pretreatment guided by the Data Quality Control protocol of SeaDataNet, an international oceanography project aimed at making European maritime data available. Spike and gradient tests were performed, in addition to data standardization and imputation through inverse distance weighting interpolation. For a better understanding of the scientific area, the data were aggregated by zones for certain analyses and were sometimes considered globally. An exploratory spatial data analysis (ESDA) was carried out to summarize its main characteristics. A reduction in the dimensionality of the original data was carried out through principal component analysis as an auxiliary tool for spatial analysis. The Spatial autocorrelation is analyzed by calculating global and local Moran’s I Statistics. The outcomes indicate a significant spatial autocorrelation for all variables considered in the freshwater areas and a notable range flattening of the variables in the open sea areas, which possibly caused the lack of significant spatial autocorrelation in those areas.info:eu-repo/semantics/publishedVersio