Estimation of Effective Lens Position Using a Method Independent of Preoperative Keratometry Readings

Purpose To evaluate the validity of a keratometry (K)-independent method of estimating effective lens position (ELP) before phacoemulsification cataract surgery. Setting Institute of Eye Surgery, Whitfield Clinic, Waterford, Ireland. Design Evaluation of diagnostic test or technology. Methods The anterior chamber diameter and corneal height in eyes scheduled for cataract surgery were measured with a rotating Scheimpflug camera. Corneal height and anterior chamber diameter were used to estimate the ELP in a K-independent method (using the SRK/T [ELPrs] and Holladay 1 [ELPrh] formulas). Results The mean ELP was calculated using the traditional (mean ELPs 5.59 mm ± 0.52 mm [SD]; mean ELPh 5.63 ± 0.42 mm) and K-independent (mean ELPrs 5.55 ± 0.42 mm; mean ELPrh ± SD 5.60 ± 0.36 mm) methods. Agreement between ELPs and ELPrs and between ELPh and ELPrh were represented by Bland-Altman plots, with mean differences (± 1.96 SD) of 0.06 ± 0.65 mm (range −0.59 to +0.71 mm; P=.08) in association with ELPrs and −0.04 ± 0.39 mm (range −0.43 to +0.35 mm; P=.08) in association with ELPrh. The mean absolute error for ELPs versus ELPrs estimation and for ELPh versus ELPrh estimation was 0.242 ± 0.222 mm (range 0.001 to 1.272 mm) and 0.152 ± 0.137 mm (range 0.001 to 0.814 mm), respectively. Conclusion This study confirms that the K-independent ELP estimation method is comparable to traditional K-dependent methods and may be useful in post-refractive surgery patients

Patient-reported outcomes in patients with vitreous floaters:A systematic literature review

Seeking treatment for bothersome vitreous floaters is patient driven. To measure the impact of floaters and treatment on an individual's quality of life, patient-reported outcome measurements (PROMs) are essential. We review all studies using a PROM for patients with floaters. We evaluated content coverage against quality-of-life domains previously identified in other ophthalmic disorders, and against a qualitative study investigating quality-of-life issues in patients with floaters. We assessed measurement properties of PROMs using an extensive range of psychometric quality criteria. We identified 59 studies using 28 different PROMs. Many PROMs were not specifically developed for patients with floaters. Floater-specific PROMs were mostly based on content validation from an ophthalmologist or researcher perspective; two included a patient perspective. Using the outcomes of the qualitative study, we found that the floater-specific PROMs were narrow in their content coverage, with most items relating to visual symptoms and activity limitations. Testing the psychometric quality of PROMs was rare, and when employed mostly limited to responsiveness and known group validity. The remarkable high number of floater-specific PROMs reveals a need for such measurements in ophthalmology. Unfortunately, reporting on psychometric quality is limited, and content development is most often done without patient involvement.</p

Euro+Med-Checklist Notulae, 14

Abstract: This is the fourteenth of a series of miscellaneous contributions, by various authors, where hitherto unpublished data relevant to both the Med-Checklist and the Euro+Med (or Sisyphus) projects are presented. This instalment deals with the families Apocynaceae, Compositae, Crassulaceae, Cyperaceae, Euphorbiaceae, Gramineae, Leguminosae, Nyctaginaceae, Onagraceae, Orobanchaceae, Rubiaceae, Solanaceae and Umbelliferae. It includes new country and area records and taxonomic and distributional considerations for taxa in Acalypha, Bupleurum, Carex, Datura, Epilobium, Eragrostis, Galium, Leontodon, Mirabilis, Nerium, Orobanche, Phelipanche, Rhinanthus, Saccharum, Sedum, Trifolium, Tripleurospermum and Willemetia. Citation For the whole article: Raab-Straube E. von &amp; Raus Th. (ed.) 2021: Euro+Med-Checklist Notulae, 14.-Willdenowia 51: 355-369. For a single contribution (example): Bergmeier E. 2021: Leontodon longirostris (Finch &amp; P. D. Sell) Talavera-Pp. 356-357 in: Raab-Straube E. von &amp; Raus Th. (ed.), Euro+Med-Checklist Notulae, 14.-Willdenowia 51: 355-369. https://doi.org/10.3372/wi.51.51304 Version of record first published online on 30 November 2021 ahead of inclusion in December 2021 issue

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Genomic variants in the FTO gene are associated with sporadic amyotrophic lateral sclerosis in Greek patients

Background: Amyotrophic lateral sclerosis (ALS) is a devastating disease whose complex pathology has been associated with a strong genetic component in the context of both familial and sporadic disease. Herein, we adopted a next-generation sequencing approach to Greek patients suffering from sporadic ALS (together with their healthy counterparts) in order to explore further the genetic basis of sporadic ALS (sALS). Results: Whole-genome sequencing analysis of Greek sALS patients revealed a positive association between FTO and TBC1D1 gene variants and sALS. Further, linkage disequilibrium analyses were suggestive of a specific diseaseassociated haplotype for FTO gene variants. Genotyping for these variants was performed in Greek, Sardinian, and Turkish sALS patients. A lack of association between FTO and TBC1D1 variants and sALS in patients of Sardinian and Turkish descent may suggest a founder effect in the Greek population. FTO was found to be highly expressed in motor neurons, while in silico analyses predicted an impact on FTO and TBC1D1 mRNA splicing for the genomic variants in question. Conclusions: To our knowledge, this is the first study to present a possible association between FTO gene variants and the genetic etiology of sALS. In addition, the next-generation sequencing-based genomics approach coupled with the two-step validation strategy described herein has the potential to be applied to other types of human complex genetic disorders in order to identify variants of clinical significance

Sensing, measuring and modelling the mechanical properties of sandstone

We present a hybrid framework for simulating the strength and dilation characteristics of sandstone. Where possible, the grain-scale properties of sandstone are evaluated experimentally in detail. Also, using photo-stress analysis, we sense the deviator stress (/strain) distribution at the microscale and its components along the orthogonal directions on the surface of a V-notch sandstone sample under mechanical loading. Based on this measurement and applying a grain-scale model, the optical anisotropy index K0 is inferred at the grain scale. This correlated well with the grain contact stiffness ratio K evaluated using ultrasound sensors independently. Thereafter, in addition to other experimentally characterised structural and grain-scale properties of sandstone, K is fed as an input into the discrete element modelling of fracture strength and dilation of the sandstone samples. Physical bulk scale experiments are also conducted to evaluate the load-displacement relation, dilation and bulk fracture strength characteristics of sandstone samples under compression and shear. A good level of agreement is obtained between the results of the simulations and experiments. The current generic framework could be applied to understand the internal and bulk mechanical properties of such complex opaque and heterogeneous materials more realistically in future

Experimental characterisation of shear and compaction band mechanisms in porous sandstone by a combination of AE and 3D-DIC

Shear and compaction bands represent two fundamental failure modes in sandstones. The identification of these features in both the natural outcrops and the laboratory scale yields useful insights into the mechanisms of localised deformation. Several conventional and advanced experimental full-field methods have been developed in order to shed light into the processes involved, as well as qualify and quantify parameters such as the orientation of these localised bands. In this paper, we present results of two triaxial tests, investigating shear and compaction bands in porous sandstone, using analysis of Acoustic Emission recorded during deformation and 3Dvolumetric Digital Image Correlation based on pre- and post deformation x-ray tomography images