Comparison of newer Kane formula with Sanders Retzlaff Kraff/Theoretical and Barrett Universal II for calculation of intraocular lens power in Indian eyes

Purpose:To compare the efficacy of Kane formula with Sanders Retzlaff Kraff/Theoretical (SRK/T) and Barrett Universal II in predicting intraocular lens (IOL) power in Indian eyes.Methods:This retrospective study conducted in a tertiary care eye hospital. Data from patients having uneventful cataract surgery with Tecnis ZCB00 IOL implantation were obtained from Lenstar and electronic medical records. Eyes were divided into subgroups based on axial length (AL) as short (<22.0 mm), medium (22–24 mm), and long (>24 mm). The predicted refractive outcome for each patient was calculated after optimizing the lens constant. Prediction error was calculated by subtracting the predicted spherical equivalent from achieved spherical equivalent 1 week post-surgery. The mean absolute error (MAE) and median absolute error (MedAE) and percentage of eyes within 0.25, 0.5, 1, and 2 D were calculated for each formula. Friedman test, Cochrane Q test were used for statistical analysis.Results:Out of the 350 eyes included in the study, we found that without lens constant optimization, Barrett formula performed better than SRK/T and Kane (P < 0.0001). Over the entire range of axial lengths, Kane formula performed slightly inferior compared to Barrett and SRK-T, both of which performed equally well (P = 0.006). On subgroup analysis, Kane formula performed inferiorly for medium eyes as compared to the other two. No significant differences were noted between the formulae for short and long eyesConclusion:Kane formula did not outperform Barrett Universal II and SRK/T in Indian eyes.     

Evaluation of emotional reactions to oral contraceptive use

A review of available clinical studies indicates that 10 to 40 per cent of oral contraceptive users may suffer mild to moderate depression syndromes. Clinical and animal data indicate that a variety of mechanisms may be involved, including alterations in folate, pyridoxine, and vitamin B₁₂ metabolism, as well as related effects on biogenic amine metabolism. Interactive effects may result, such as impairment of usual coping mechanisms and psychological defenses by altered central nervous system function.     

Accuracy of the Kane Formula for Intraocular Lens Power Calculation in Comparison with Existing Formulas: A Retrospective Review

PurposeTo evaluate the accuracy of the Kane formula for intraocular lens (IOL) power calculation in comparison with existing formulas by incorporating optional variables into calculation.Materials and MethodsThis retrospective review consisted of 78 eyes of patients who had undergone uneventful phacoemulsification with intraocular implantation at Severance Hospital in Seoul, Korea between February 2020 and January 2021. The Kane formula was compared with six of the existing IOL formulas (SRK/T, Hoffer-Q, Haigis, Holladay1, Holladay2, Barrett Universal II) based on the mean absolute error (MAE), median absolute error (MedAE), and the percentages of eyes within prediction errors of ±0.25D, ±0.50D, and ±1.00D.ResultsThe Barrett Universal II formula demonstrated the lowest MAEs (0.26±0.17D), MedAEs (0.28D), and percentage of eyes within prediction errors of ±0.25D, ± 0.50D, and ±1.00D, although there was no statistically significant difference between Barrett Universal II-SRK/T (p=0.06), and Barrett Universal II-Kane formula (p<0.51). Following the Barrett Universal II formula, the Kane formula demonstrated the second most accurate formula with MAEs (0.30±0.19D) and MedAEs (0.28D). However, no statistical difference was shown between Kane-Barrett Universal II (p=0.51) and Kane-SRK/T (p=0.14).ConclusionAlthough slightly better refractory outcome was noted in the Barrett Universal II formula, the performance of the Kane formula in refractive prediction was comparable in IOL power calculation, marking its superiority over many conventional IOL formulas, such as HofferQ, Haigis, Holladay1, and Holladay2.     

Mitochondrial function, oxygen extraction, epicardial S-T segment changes and tritiated digoxin distribution after reperfusion of ischemic myocardium.

This study examines the effect of 2 hours of reperfusion on transiently ischemic myocardium in pigs. Indexes of myocardial viability measured were mitochondrial function, oxygen extraction, epicardial S-T segment change and distribution of tritiated digoxin. Results were as follows: (1) Mitochondrial function was markedly impaired in the reperfused area after 60 minutes or more of coronary occlusion. The defect would seem to be a block in electron flow near site I, which can be partially bypassed with succinate. (2) An apparent inability of the reperfused myocardium to extract oxygen did not improve with 2 hours of reperfusion. (3) Epicardial S-T segment mapping suggested that necrosis occurred during reperfusion. (4) There was an altered distribution of tritiated digoxin in the reperfused area. The results show that reperfusion for 2 hours did not improve myocardial viability after 60 minutes or more of ischemia.     

基于COM平衡恢复响应的人体滑跌步态分析

针对人体行走过程的滑跌现象,提出了利用基于质心位置(COM)恢复响应来分析滑跌过程的方法。该方法以基于Kane方程的下肢行走动力学模型为基础,能够实现行走过程中每个步态周期动力学参数的快速检测,能对滑跌过程的任一瞬时平衡状态进行分析,并据此绘制滑动和跌倒过程的COM特性曲线,利用此曲线对滑跌步态原因、阶段及进程进行判断。当COM在基础支撑(BOS)区域投影点与其压力中心距离大于0.012～0.015m,则人体步态处于发生滑跌的阀值域;COM速度响应曲线域在0.9～2.1m/s之间时,步态处于稳定期。不同年龄段的两组步态滑跌实验数据表明,该方法能够利用基于COM恢复响应特性曲线对滑跌过程进行预测和干预。     

Creation and Validation of Tool to Assess Resident Competence in Neonatal Resuscitation

BackgroundThe American Board of Pediatrics requires that pediatricians be able to initiate stabilization of a newborn. After residency, 45% of general pediatricians routinely attend deliveries. However, there is no standard approach or tool to measure resident proficiency in newborn resuscitation across training programs. In a national survey, we found a large variability in faculty assessment of the amount of supervision trainees need for various resuscitation scenarios. Objective documentation of trainee performance would permit competency-based decisions on the level of supervision required and facilitate feedback on trainee performance.MethodsA simplified tool was created following the Neonatal Resuscitation Program (NRP) algorithm, with emphasis on communication, leadership, knowledge of equipment, and initial stabilization. To achieve content validity, the tool was evaluated by the NRP steering committee. To assess internal structure of the tool, we filmed 10 simulated resuscitation scenarios, 9 of which contained errors. Experienced resuscitation team members used the tool to assess performance of the team leader in the videos. To evaluate the response process, the tool was used to assess experienced resuscitators in real time at academic and non-academic sites.ResultsThe NRP steering committee approved the tool, providing evidence of content validity. Performance of the team leader in the simulated videos was assessed by 16 evaluators using the tool. There was an intraclass coefficient of 0.86, showing excellent agreement. There was no statistical difference in scores between 102 resuscitations led by experienced resuscitators at academic and nonacademic hospitals (P = .98), which demonstrates generalizability.ConclusionsThe tool we have developed to assess performance in initiating newborn resuscitation shows evidence of construct validity based on assessment of content and internal structure (interobserver agreement, response processes, and generalizability).     

Complications after use of elastomeric pressure-indicating media at 24-hour follow-up visit for immediate maxillary complete removable dental prosthesis: A clinical report

Various pressure-indicating media are available to assess the adaptation of the intaglio surface of a removable dental prosthesis at the insertion and follow-up appointments. This clinical report describes the use of an elastomer that entered the maxillary sinus through an undetected oroantral communication at the 24-hour follow-up for an immediate maxillary complete removable dental prosthesis. A Caldwell-Luc sinusotomy procedure was required to remove the material, and the patient required over 1 year of healing time before his reported symptoms resolved.     

Disinfection procedures and infection control in the outpatient oral surgery practice

The infection control and disinfection procedures employed by 434 oral surgeons were surveyed. Gloving practices varied substantially, with 55% of respondents wearing gloves during ?10% of patient contacts and only 24% wearing gloves routinely. Gloving practices correlated strongly with having been taught in dental school or during residency training to wear gloves. While 100% of participants had received instruction in the use of intravenous fluids in dental school or residency training, usage patterns differed substantially from those currently recommended in hospitals and in outpatient, nondental surgical settings. Of the respondents who used intravenous fluids in an office setting, 68% used a single bag or bottle for more than one patient. The median number of patients receiving intravenous fluid from a single bag or bottle was 12, and the median duration of use of a single unit was three days. It was noted that infection control and disinfection procedures varied significantly by type of practice (private vs. other nonmilitary vs. military practices).