Potential Association Between Changes in Microbiota Level and Lung Diseases: A Meta-Analysis

Objective:Lung microbiota is increasingly implicated in multiple types of respiratory diseases. However, no study has drawn a consistent conclusion regarding the relationship between changes in the microbial community and lung diseases. This study verifies the association between microbiota level and lung diseases by performing a meta-analysis.Methods:Literature databases, including PubMed, ISI Web of Science, Embase, Google Scholar, PMC, and CNKI, were used to collect related articles published before March 20, 2021. The standard mean deviation (SMD) and related 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were also conducted.Results:Six studies, comprising 695 patients with lung diseases and 176 healthy individuals, were included in this meta-analysis. The results indicated that the microbiota level was higher in patients with lung diseases than in healthy individuals (SMD = 0.39, 95% CI = 0.22–0.55, I2 = 91.5%, P < 0.01). Subgroup analysis based on country demonstrated that the microbiota level was significantly higher in Chinese (SMD = 1.90, 95% CI = 0.87–2.93, I2 = 62.3%, P < 0.01) and Korean (SMD = 0.24, 95% CI = 0.13–0.35, I2 = 78.7%, P < 0.01) patients with lung diseases. The microbiota level of patients with idiopathic pulmonary fibrosis (IPF) (SMD = 1.40, 95% CI = 0.42–2.38, I2 = 97.3%, P = 0.005), chronic obstructive pulmonary disease (COPD) (SMD = 0.30, 95% CI = 0.09–0.50, I2 = 83.9%, P = 0.004), and asthma (SMD = 0.19, 95% CI = 0.06–0.32, I2 = 69.4%, P = 0.004) were significantly higher than those of the healthy group, whereas a lower microbiota level was found in patients with chronic hypersensitivity pneumonitis (CHP). The microbiota level significantly increased when the disease sample size was >50. Subgroup analysis based on different microbiota genera, indicated that Acinetobacter baumannii and Pseudomonas aeruginosa were significantly increased in COPD and asthma diseases.Conclusion:We observed that patients with IPF, COPD, and asthma had a higher microbiota level, whereas patients with CHP had a lower microbiota level compared to the healthy individuals. The level of A. baumannii and P. aeruginosa were significantly higher in patients with COPD and asthma, and thus represented as potential microbiota markers in the diagnosis and treatment of lung diseases.

Relationship of macular ganglion cell complex thickness to choroidal microvasculature drop-out in primary open-angle glaucoma

Background/aimsTo investigate the rate of ganglion cell complex (GCC) thinning in primary open-angle glaucoma (POAG) patients with and without deep-layer microvasculature drop-out (MvD).MethodsPOAG patients who had at least 1.5 years of follow-up and a minimum of three visits were included from the Diagnostic Innovations in Glaucoma Study. MvD was detected at baseline by optical coherence tomography angiography (OCT-A). Area and angular circumference of MvD were evaluated on en face choroidal vessel density images and horizontal B-scans. Rates of global and hemisphere GCC thinning were compared in MvD and non-MvD eyes using linear mixed-effects models.ResultsThirty-six eyes with MvD and 37 eyes without MvD of 63 patients were followed for a mean of 3.3 years. In 30 out of 36 eyes, MvD was localised in the inferotemporal region. While mean baseline visual field mean deviation was similar between the two groups (p=0.128), global GCC thinning was significantly faster in eyes with MvD than in those without MvD (mean differences: −0.50 (95% CI −0.83 to –0.17) µm/year; p=0.003)). Presence of MvD, area and angular circumference of MvD were independently associated with a faster rate of thinning (p=0.002, p=0.031 and p=0.013, respectively).ConclusionIn POAG eyes, GCC thinning is faster in eyes with MvD. Detection of MvD in OCT-A images can assist clinicians to identify patients who are at higher risk for central macula thinning and glaucomatous progression and may require more intensive management.

Feasibility and Accuracy of Thoracolumbar Pedicle Screw Placement Using an Augmented Reality Head Mounted Device

Background: To investigate the accuracy of augmented reality (AR) navigation using the Magic Leap head mounted device (HMD), pedicle screws were minimally invasively placed in four spine phantoms. Methods: AR navigation provided by a combination of a conventional navigation system integrated with the Magic Leap head mounted device (AR-HMD) was used. Forty-eight screws were planned and inserted into Th11-L4 of the phantoms using the AR-HMD and navigated instruments. Postprocedural CT scans were used to grade the technical (deviation from the plan) and clinical (Gertzbein grade) accuracy of the screws. The time for each screw placement was recorded. Results: The mean deviation between navigation plan and screw position was 1.9 ± 0.7 mm (1.9 [0.3–4.1] mm) at the entry point and 1.4 ± 0.8 mm (1.2 [0.1–3.9] mm) at the screw tip. The angular deviation was 3.0 ± 1.4° (2.7 [0.4–6.2]°) and the mean time for screw placement was 130 ± 55 s (108 [58–437] s). The clinical accuracy was 94% according to the Gertzbein grading scale. Conclusion: The combination of an AR-HMD with a conventional navigation system for accurate minimally invasive screw placement is feasible and can exploit the benefits of AR in the perspective of the surgeon with the reliability of a conventional navigation system.

Comparison of Alternate Part-time Patching and Pencil Push-up Training for Patients with Intermittent Exotropia

Background To compare the effect of alternate part-time patching and pencil push-up training on control ability in patients with intermittent exotropia. Methods Patients (3-7 years of age) with previously untreated intermittent exotropia were randomly assigned to receive alternate part-time patching, pencil push-up training or observation. Control ability was assessed using the Office Control Score. Stereoacuity at 40cm was evaluated with Titmus. Results were compared after 12-weeks follow-up. Results Ninety-two patients (28 in patching, 30 in pencil push-up and 34 in observation group) completed baseline and 12-week follow-up assessments. On the basis of 6-point scale, the mean deviation control was significantly better in patching and pencil push-up group after 12 weeks at distance (P=0.002 and 0.026, respectively). Furthermore, there was greater control changes in patching and pencil push-up groups in comparison with observation group from baseline to 12 weeks (P༜0.001;P=0.003, respectively). After 12 weeks of treatment, stereoacuity and stereoacuity changes were not significantly different between either of the intervention group and control group (P=0.140 and 0.393, respectively). Conclusions Based on the common office control scales, alternate part-time patching and pencil push-up training were effective treatment strategies for intermittent exotropia.

Visual field changes in glaucoma patients after blepharoptosis surgery

Purpose To examine changes in parameters of the visual field test before and after blepharoptosis surgery in patients with glaucoma. Methods Twenty-three eyes of 14 glaucoma patients who underwent blepharoptosis surgery at Toyama University Hospital between July 2015 and September 2020 were included in this study. Pre- and post-operative values for the mean deviation (MD), pattern standard deviation (PSD) and total deviation (TD) of the upper or lower hemi-visual field in the Humphrey visual field test, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and margin reflex distance (MRD)-1 were compared. Results MRD-1 showed a significant improvement after blepharoptosis surgery (preoperative MRD-1: 1.0 ± 0.82 mm, postoperative MRD-1: 3.26 ± 0.66 mm, p < 0.001). There were no significant differences in BCVA, IOP, MD and PSD values before and after surgery. On the other hand, there was a significant improvement in the superior TD (preoperative: −11.29 ± 6.57 dB, postoperative: −9.88 ± 7.31 dB, p = 0.044) although no significant difference was detected in the inferior TD postoperatively. The preoperative parameters of 2 groups (improvement and non-improvement groups of postoperative superior TD) were compared. Preoperative MD and superior TD were significantly lower in the improvement group (p = 0.03, p = 0.004, respectively), although there was no significant difference in preoperative PSD and inferior TD between the two groups. Conclusion In glaucoma patients, blepharoptosis may interfere with accurate visual field assessment, especially of superior TD.

Predictive value of OCT and MRI for postoperative visual recovery in patients with chiasmal compressive lesions

Purpose We aimed to investigate the predictive value of retinal thickness measured by optical coherence tomography (OCT) and mass biometrics measured using magnetic resonance image (MRI) for visual recovery after surgery for removal of a mass compressing the optic chiasm. Methods Consecutive patients who showed typical temporal visual field defect (VFD) with respect to the vertical meridian due to a chiasmal compressive mass and who underwent mass removal surgery were recruited. Ophthalmic examination was performed preoperatively and postoperatively. Retinal thickness was measured by the Cirrus OCT. The height and size of the mass and suprasellar extension (SSE) in both the sagittal and coronal planes were evaluated. Patients were divided into two groups based on the improvement in VFD (mean deviation [MD] change ≥ 5 dB: group R; others: group NR) and clinical characteristics were compared. Results Fifteen patients were included in the study. Eight (53.3%) patients were allocated into group R and others (7 patients, 46.7%) into group NR. Age, sex, initial visual acuity, initial MD was not different between the two groups. The retinal thicknesses were not different while tumor height, volume, and both sagittal and coronal SSE were significantly different between the two groups. (p = 0.029, 0.014, <0.001, and <0.001, respectively) All MRI parameters showed significant predictive value for the degree of MD recovery. Conclusion MRI showed better predictive value than OCT in predicting postoperative VFD recovery in patients with temporal VFDs due to chiasmal compressive disorder.

A Robust Feature Extraction and Deep Learning Approach for Cancer Gene Prognosis

Mutated genes are one of the prominent factors in origination and spread of cancer disease. Here we have used Genomic signal processing methods to identify the patterns that differentiate cancer and non-cancerous genes. Furthermore, Deep learning algorithms were used to model a system that automatically predicts the cancer gene. Unlike the existing methods, two feature extraction modules are deployed to extract six attributes. Power Spectral Density based module was used to extract statistical parameters like Mean, Median, Standard deviation, Mean Deviation and Median Deviation. Adaptive Functional Link Network (AFLN) based filter module was used to extract Normalized Mean Square Error (NMSE). The uniqueness of this paper is identification of six input features that differentiates cancer genes. In this work artificial neural network is developed to predict cancer genes. Comparison is done on three sets of datasets with 6 attributes, 5 attributes and one attribute. We performed all the training and testing on the Tensorflow using the Keras library in Python using Google Colab. The developed approach proved its efficiency with 6 attributes attaining an accuracy of 98% for 150 epochs. The ANN model was also compared with existing work and attained a 10 fold cross validation accuracy of 96.26% with an increase of 1.2%.

Risk Factors for Visual Field Progression in New-diagnosed Exfoliation Glaucoma Patients in Sweden.

Purpose: The present study aimed to identify risk factors for visual field progression in new-diagnosed exfoliation glaucoma patients. Methods: Prospective non-randomized cohort study. The study included patients with new-diagnosed exfoliation glaucoma. All patients were followed for at least three years with reliable visual fields. Both risk factors at inclusion and during the three years follow-up were considered. For inclusion, five reliable visual fields were needed. Exfoliation glaucoma was defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the 24-2 strategy of the Humphrey Field Analysis. Outcomes: Visual field progression. Three different approaches were used: mean deviation (MD), visual field index (VFI), and guided progression analysis (GPA). Results: The results were different in the three different models used (MD, VFI and GPA). The only variable that showed a significant association in the three models was age (p= 0.004; p=0.006; p=0.04). Significant variables in two models were: IOP at diagnose (p=0.02; p=0.04), IOP reduction in absolute terms (p=0.006; p=0.003), IOP reduction in relative terms (%) (p=0.04; p=0.009) and number of medicines (p=0.02; p=0.002). Significant variables in one model were: family history (p=0.04), smoking (p=0.03), cataract surgery (p=0.04) and SLT treatment (p=<0.001). Conclusion: Exfoliation glaucoma is fast progressive glaucoma. Age at diagnosing must be considered. Significant IOP reduction must be achieved to slow down progress in exfoliation glaucoma. The use of SLT treatment should be advised in exfoliation glaucoma patients.

A Method of Range Walk Error Correction in SiPM LiDAR with Photon Threshold Detection

A silicon photomultiplier (SiPM) LiDAR with photon threshold detection can achieve high dynamic performance. However, the number fluctuations of echo signal photons lead to the range walk error (RWE) in SiPM LIDARs. This paper derives the RWE model of SiPM LiDAR by using the LiDAR equation and statistical property of SiPM’s response. Based on the LiDAR system parameters and the echo signal intensity, which is obtained through the SiPM’s photon-number-resolving capability, the RWE is calculated through the proposed model. After that, we carry out experiments to verify its effectiveness. The result shows that the method reduces the RWE in TOF measurements using photon threshold detection from 36.57 cm to the mean deviation of 1.95 cm, with the number of detected photons fluctuating from 1.3 to 46.5.

Sleep disturbances in early clinical stages of psychotic and bipolar disorders: A meta-analysis

Objective: To provide a qualitative view and quantitative measure of sleep disturbances across and between early stages – clinical ultra high-risk and first episode – of psychotic and bipolar disorders. Methods: Electronic databases (PubMed, Cochrane, Embase, PsychINFO) were searched up to March 2021 for studies comparing sleep measures between individuals with an early stage and controls. Standard mean deviations (Cohen’s d effect sizes) were calculated for all comparisons and pooled with random-effects models. Chi-square tests were used for direct between-subgroups (ultra high-risk vs first episode) comparisons of standard mean deviations. The effects of age, sex ratio, symptoms and treatment were examined in meta-regression analyses. Results: A database search identified 13 studies that contrasted sleep measures between individuals with an early stage ( N = 537) and controls ( N = 360). We observed poorer subjective sleep quality (standard mean deviation = 1.32; 95% confidence interval, [1.01, 1.62]), shorter total sleep time (standard mean deviation =−0.44; 95% confidence interval, [−0.67, −0.21]), lower sleep efficiency (standard mean deviation = −0.72; 95% confidence interval, [−1.08, −0.36]), longer sleep onset latency (standard mean deviation = 0.75; 95% confidence interval, [0.45, 1.06]) and longer duration of wake after sleep onset (standard mean deviation = 0.49; 95% confidence interval, [0.21, 0.77]) were observed in early stages compared to controls. No significant differences were observed for any of the reported electroencephalographic parameters of sleep architecture. No significant between-subgroups differences were observed. Meta-regressions revealed a significant effect of the age and the antipsychotic status on subjective measures of sleep. Conclusion: The early stage population presents with significant impairments of subjective sleep quality continuity, duration and initiation. Systematic assessments of sleep in early intervention settings may allow early identification and treatment of sleep disturbances in this population.