Correlation between weather and incidence of selected ophthalmological diagnoses: a database analysis

Purpose: Our aim was to correlate the overall patient volume and the incidence of several ophthalmological diseases in our emergency department with weather data. Patients and methods: For data analysis, we used our clinical data warehouse and weather data. We investigated the weekly overall patient volume and the average weekly incidence of all encoded diagnoses of "conjunctivitis", "foreign body", "acute iridocyclitis", and "corneal abrasion". A Spearman's correlation was performed to link these data with the weekly average sunshine duration, temperature, and wind speed. Results: We noticed increased patient volume in correlation with increasing sunshine duration and higher temperature. Moreover, we found a positive correlation between the weekly incidences of conjunctivitis and of foreign body and weather data. Conclusion: The results of this data analysis reveal the possible influence of external conditions on the health of a population and can be used for weather-dependent resource allocation

Association of Blue Light-Filtering Intraocular Lenses With All-Cause and Traffic Accident-Related Injuries Among Patients Undergoing Bilateral Cataract Surgery in Finland

IMPORTANCE Blue light-filtering (BLF) intraocular lenses (IOLs) have been widely used in clinical practice for more than 20 years and have been implanted in millions of patients with cataracts worldwide. However, little evidence on the association of BLF IOLs with injuries is available. OBJECTIVE To assess the association of BLF IOLs with all-cause and traffic accident-related injuries and quality of vision while driving after bilateral cataract surgery. DESIGN, SETTING, AND PARTICIPANTS This retrospective registry-based cohort study included patients who underwent bilateral cataract surgery between September 3, 2007, and December 14, 2018, and were followed until December 14, 2021. Surgery was performed at the Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. The 4986 participants received non-BLF IOLs (n = 2609) or BLFIOLs (n = 2377) in both eyes. Patients undergoing bilateral surgery between 2015 to 2016 with non-BLFIOLs (n = 102) or BLF IOLs (n = 91) and currently driving a car were interviewed using a structured questionnaire for visual performance while driving. EXPOSURES Follow-up for a mean (SD) of 2166 (1110) days after second eye surgery. MAIN OUTCOMES AND MEASURES Kaplan-Meier and multivariable Cox proportional hazards regression analyses for the risk of all-cause and traffic accident-related injuries after surgery in the second eye obtained from the patient medical records were assessed. To improve follow-up precision, both death and the end of the follow-up were used as censoringevents. RESULTS A total of 4986 patients were included in the analysis (1707 [34.2%] men and 3279 [65.8%] women; mean [SD] age, 73.2 [8.6] years at the first surgery and 74.3 [8.8] years at the second). Injury-free survival rates preceding the first eye surgery were comparable between the non-BLF and BLF IOL groups (hazard ratio adjusted for age and sex, 0.95 [95% CI, 0.81-1.13; P = .57]). In multivariable Cox proportional hazards regression analysis controlling for age and sex, the use of BLFIOLs showed no advantage in overall injuries compared with the use of non-BLF IOLs (hazard ratio, 0.99 [95% CI. 0.88-1.11]; P = .85) or in any injury subtype. Subjective visual performance parameters for driving were all comparable between the non-BLF and BLF IOL groups except for glare when driving in the dark (evening or night), which occurred among 9 of 80 patients with BLF IOLs compared with 0 of 83 non-BLF IOLs (P < .001). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that use of BLF IOLs was not associated with reduced risk of injuries, whereas glare during nighttime driving was significantly worse in the BLF IOL group with pseudophakia.Peer reviewe

Modulation of Inflammation Driven Wound Healing after Glaucoma Surgery

Dysregulated wound healing contributes to most currently unanswered ophthalmological morbidity. Opacification and structure altering contractures compromise the delicate ocular anatomy upon which ocular function and healthy vision are reliant. Glaucoma filtration surgery, corneal stromal injury, proliferative vitreoretinopathy and age-related macular degeneration are major contributors to ocular morbidity – all with myofibroblast transdifferentiation and pathognomonic scarring activity at their core. This thesis aims to revaluate the means by which dysregulated ocular wound healing is combated with evidence describing a novel strategy to mitigate its effects. A translational approach was used. An initial retrospective analysis of over ten thousand glaucoma surgeries found that perioperative NSAID exposure was significantly associated with surgical success. The current standard of care, corticosteroids, showed no such association. This was surprising and provided impetus to evaluate these clinical findings within the basic science lab. The subsequent project examined the relative effects of NSAIDs to that of corticosteroids on the in vitro wound healing activity of ocular fibroblasts. Relative to steroids, NSAID exposure resulted in more ordered extracellular matrix remodelling, less cell-mediated collagen contraction and greater impairment of myofibroblast associated protein expression. We hypothesized that these differences were due to NSAIDs more specific targeting of COX enzyme activity. By sparing lipoxygenase activity, competitive NSAIDs leave intact the biosynthetic machinery responsible for signaling the endogenous resolution of inflammation. This system involves the collective effects of the pro-resolving superfamily of lipid mediators and promotes the active resolution of inflammatory processes. To assess the anti-fibrotic potential of inducing resolution within inflammation-induced ocular fibroblasts, two COX2 Ser516 acetylating molecules were utilized to modify the COX2 enzyme such that it: 1) ceases prostaglandin production, and 2) gains the capacity to produce pro-resolving lipid mediators. When applied to inflammation-induced ocular fibroblasts, a reduction in in vitro wound healing phenomena was observed with a corresponding shift in pro-/anti-fibrogenic transcription factor expression and downregulation of myofibroblast associated proteins. Together these findings suggest that the resolution of inflammation and the resolution of fibroproliferation may be controlled by a common signaling system, and that interventions promoting the production of resolving lipid mediators could have significant anti-cicatrizing properties

Development of a predictive risk model for all-cause mortality in patients with diabetes in Hong Kong

Introduction Patients with diabetes mellitus are risk of premature death. In this study, we developed a machine learning-driven predictive risk model for all-cause mortality among patients with type 2 diabetes mellitus using multiparametric approach with data from different domains. Research design and methods This study used territory-wide data of patients with type 2 diabetes attending public hospitals or their associated ambulatory/outpatient facilities in Hong Kong between January 1, 2009 and December 31, 2009. The primary outcome is all-cause mortality. The association of risk variables and all-cause mortality was assessed using Cox proportional hazards models. Machine and deep learning approaches were used to improve overall survival prediction and were evaluated with fivefold cross validation method. Results A total of 273 678 patients (mean age: 65.4±12.7 years, male: 48.2%, median follow-up: 142 (IQR=106–142) months) were included, with 91 155 deaths occurring on follow-up (33.3%; annualized mortality rate: 3.4%/year; 2.7 million patient-years). Multivariate Cox regression found the following significant predictors of all-cause mortality: age, male gender, baseline comorbidities, anemia, mean values of neutrophil-to-lymphocyte ratio, high-density lipoprotein-cholesterol, total cholesterol, triglyceride, HbA1c and fasting blood glucose (FBG), measures of variability of both HbA1c and FBG. The above parameters were incorporated into a score-based predictive risk model that had a c-statistic of 0.73 (95% CI 0.66 to 0.77), which was improved to 0.86 (0.81 to 0.90) and 0.87 (0.84 to 0.91) using random survival forests and deep survival learning models, respectively. Conclusions A multiparametric model incorporating variables from different domains predicted all-cause mortality accurately in type 2 diabetes mellitus. The predictive and modeling capabilities of machine/deep learning survival analysis achieved more accurate predictions

International Olympic Committee consensus statement: Methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension -the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in-and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting. © Author(s) (or their employer(s)) 2020

Risk factors of dementia in type 2 diabetes mellitus: The Hong Kong diabetes study

This population-based cohort study investigated the risk factors of incident dementia and vascular dementia in type 2 diabetic patients (≥45 years old) attending the Hong Kong Hospital Authority between 1st January and 31st December 2009.Of the 273,876 patients included,9994 showed incident dementia (median follow-up: 4245 days). Multivariable Cox regression identified older age (HR: 1.09 [95% CI: 1.08–1.10]) and antiplatelet use (HR: 1.36 [1.14–1.62]) as risk factors for incident dementia, and older age (HR: 1.07 [1.06–1.08]), ischemic stroke (HR: 1.47 [1.09–1.98]), fasting blood glucose (HR: 1.10 [1.01–1.20]), antiplatelets (HR: 1.92 [1.51–2.44]), and calcium channel blocker (HR: 1.28 [1.04–1.57]) use as risk factors of incident vascular dementia

Methods of data collection and definitions of cardiac outcomes in the Rotterdam Study

The prevalence of cardiovascular diseases is rising. Therefore, adequate risk prediction and identification of its determinants is increasingly important. The Rotterdam Study is a prospective population-based cohort study ongoing since 1990 in the city of Rotterdam, The Netherlands. One of the main targets of the Rotterdam Study is to identify the determinants and prognosis of cardiovascular diseases. Case finding in epidemiological studies is strongly depending on various sources of followup and clear outcome definitions. The sources used for collection of data in the Rotterdam Study are diverse and the definitions of outcomes in the Rotterdam Study have changed due to the introduction of novel diagnostics and therapeutic interventions. This article gives the methods for data collection and the up-to-date definitions of the cardiac outcomes based on international guidelines, including the recently adopted cardiovascular disease mortality definitions. In all, detailed description of cardiac outcome definitions enhances the possibility to make comparisons with other studies in the field of cardiovascular research and may increase the strength of collaborations