Exploring Biomarkers Beyond Exercise Testing: The Impact of Smoking on Cardiovascular and Pulmonary Health among CKD Patients

Background: Chronic Kidney Disease (CKD) patients often face complex health challenges, including cardiovascular and pulmonary issues. Smoking is a recognized risk factor for these conditions, but its specific impact on CKD patients remains less understood. Materials and Methods: In this cross-sectional study, we investigated the relationship between smoking habits and cardiopulmonary health among CKD patients. We examined baseline characteristics, including demographics, medical history, and biochemical markers, in a cohort of CKD patients. Cardiopulmonary parameters were assessed during exercise testing, including oxygen consumption, ventilation rates, ventilation-perfusion matching markers, and oxygen saturation levels. Results: Our findings revealed no statistically significant differences in cardiopulmonary parameters between smokers and non-smokers within the CKD patient population. This suggests that the relationship between smoking and exercise capacity in CKD patients is complex and influenced by multiple factors. Our analysis of demographics, comorbidities, and medication history provided critical context for interpreting these results. Conclusion: This study contributes to our understanding of the intricate relationship between smoking habits and cardiopulmonary health in CKD patients. While smoking is recognized as a risk factor, its specific impact on exercise capacity within this population may be influenced by individual variables. Further research is needed to explore these relationships in larger and more diverse cohorts. These findings underscore the importance of considering multiple variables when assessing the impact of smoking on the health of CKD patients

Ocular Graft Versus Host Disease Following Allogeneic Stem Cell Transplantation: A Review of Current Knowledge and Recommendations

Graft versus host disease (GVHD) is a common complication of allogeneic stem cell transplantation (allo-SCT). Ocular GVHD develops in approximately 40-60% of patients following allo-SCT and its most common clinical manifestations include keratoconjunctivitis sicca and cicatricial conjunctivitis. Ocular GVHD may lead to severe ocular surface disease, which can significantly diminish quality of life and restrict daily activities. It is thus important to monitor the condition closely since with timely diagnosis, irreversible damage can be avoided. The current review will focus on updated information regarding ocular GVHD

Central Corneal Thickness in Highly Myopic Eyes: Inter-device Agreement of Ultrasonic Pachymetry, Pentacam and Orbscan II Before and After Photorefractive Keratectomy

Purpose To determine inter-device agreement for central corneal thickness (CCT) measurement among ultrasound pachymetry, rotating Scheimpflug imaging (Pentacam, Oculus, Wetzlar, Germany), and scanning slit corneal topography (Orbscan II, Bausch & Lomb, Rochester, NY, USA) in highly myopic eyes before and after photorefractive keratectomy (PRK). Methods: This prospective comparative study included 61 eyes of 32 patients with high myopia who underwent PRK. Six month postoperative CCT values were compared to preoperative values in 27 patients (51 eyes) who completed the follow up period. To determine the level of agreement, Pentacam and Orbscan II readings were compared to ultrasonic pachymetry measurements as the gold standard method. Results: Mean CCT measurements with ultrasound, Pentacam, and Orbscan II before PRK were 557µm, 556µm, and 564µm, respectively; and 451µm, 447µm, and 438µm 6 months after surgery in the same order. Preoperatively, the 95% limits of agreement (LoA) with ultrasound measurements were -20μm to 17μm for Pentacam and -21μm to 33μm for Orbscan II. Six months postoperatively, the 95% LoA were -30μm to 23μm for Pentacam and -69μm to 43μm for Orbscan II. Conclusion: Preoperatively, CCT measurements were higher with Orbscan II as compared to ultrasound. Postoperatively, both Pentacam and Orbscan II measurements were lower than those obtained with ultrasound, but Pentacam had better agreement. The use of ultrasound, as the gold standard method, or Pentacam both appear to be preferable over Orbscan II among patients with high myopia

Evaluating Research Centers In Minority Institutions: Framework, Metrics, Best Practices, and Challenges

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators’ Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual Model presents a practical ongoing approach to document RCMIs’ impacts on health disparities. Survey results identified 37 common metrics under four primary categories. Evaluation challenges were issues related to limited human resources, data collection, decision-making, defining metrics, cost-sharing, and revenue-generation. There is a need for further collaborative efforts across RCMI sites to engage program leadership and community stakeholders in addressing the identified evaluation challenges and measurement. Program leadership should be engaged to apply the Evaluation Conceptual Framework and common metrics to allow for valid inter-institutional comparisons and consortium-wide evaluations. Stakeholders could ensure evaluation metrics are used to facilitate community impacts

Interocular Symmetry Analysis of Corneal Elevation Using the Fellow Eye as the Reference Surface and Machine Learning

Unilateral corneal indices and topography maps are routinely used in practice, however, although there is consensus that fellow-eye asymmetry can be clinically significant, symmetry studies are limited to local curvature and single-point thickness or elevation measures. To improve our current practices, there is a need to devise algorithms for generating symmetry colormaps, study and categorize their patterns, and develop reference ranges for new global discriminative indices for identifying abnormal corneas. In this work, we test the feasibility of using the fellow eye as the reference surface for studying elevation symmetry throughout the entire corneal surface using 9230 raw Pentacam files from a population-based cohort of 4613 middle-aged adults. The 140 × 140 matrix of anterior elevation data in these files were handled with Python to subtract matrices, create color-coded maps, and engineer features for machine learning. The most common pattern was a monochrome circle (“flat”) denoting excellent mirror symmetry. Other discernible patterns were named “tilt”, “cone”, and “four-leaf”. Clustering was done with different combinations of features and various algorithms using Waikato Environment for Knowledge Analysis (WEKA). Our proposed approach can identify cases that may appear normal in each eye individually but need further testing. This work will be enhanced by including data of posterior elevation, thickness, and common diagnostic indices

Corneal thickness measurements with the Concerto on-board pachymeter

Purpose: To assess the Concerto excimer laser on-board pachymeter (COP) measurements of the central corneal thickness (CCT), central stromal thickness (CST) and flap thickness (FT) in terms of repeatability and agreement with the Pentacam and ultrasound pachymetery. Methods: Patients undergoing photorefractive keratectomy (PRK), PRK with mitomycin-C (MMC), and laser in situ keratomileusis (LASIK) were enrolled in the study. All eyes had CCT measurement with the Pentacam, the COP, and ultrasound, preoperatively. In the LASIK group, the CST was measured intraoperatively with the COP and ultrasound, after removing the flap. Each measurement was done 3 times to study the repeatability, and we calculated the 95% limits of agreement (LoA) for paired readings. Results: The study sample comprised of 82 eyes of 41 patients. All three devices showed excellent repeatability with intraclass correlation coefficients between 0.946 and 0.993. Mean CCT was 546 ± 31 μm with the COP, and 548 ± 32 μm and 548 ± 34 μm with the ultrasound and Pentacam, respectively. COP readings demonstrated high correlations with their paired ultrasound and Pentacam readings. The 95% LoA between COP and ultrasound were −16.6 μm to 12.0 μm for CCT, −25.6 μm to 26.2 μm for CST, and −29.5 to 21.3 μm for FT. The 95% LoA between COP and Pentacam CCT readings were −15.1 μm to 10.1 μm. Conclusions: COP generated repeatable readings that were highly correlated with their pair readings by the Pentacam and ultrasound. Although the agreement between COP and ultrasound was better with CCT measurements, the inter-device agreement for CST readings was not worse than that reported in other comparative studies of pachymeters