Incidence and influencing factors of urinary incontinence in stroke patients: A meta-analysis.

BACKGROUND: The incidence of stroke in China ranks first in the world and is the leading cause of death and disability in adults. Urinary incontinence is an independent risk factor leading to poor prognosis of stroke. However, studies on the incidence of urinary incontinence in stroke patients and its influencing factors are different, fluctuate greatly, and there is no unified basis. OBJECTIVE: To quantitatively analyze the incidence of urinary incontinence in stroke patients and its related influencing factors, and further make public health strategic decisions to reduce the occurrence of adverse outcomes. METHODS: Computer searches were conducted in PubMed, Medline, Web of Science, Cochrane Library, Embase, CLNAHL Complete, China National Knowledge Infrastructure (CNKI), Chinese Biomedical database(CBM), Wan Fang Database, VIP Database, observational studies such as cohort studies, case-control studies or cross-sectional studies on the incidence or influencing factors of urinary incontinence in stroke patients from the establishment of the database to the publication in August 2023. Studies selection, quality evaluation and data extraction were conducted independently by two researchers according to the established search strategy. Stata 14.0 statistical software was used for meta-analysis. RESULTS: A total of 21 manuscripts were included, with a cumulative sample size of 7327 cases, including 2887 patients with urinary incontinence. Meta-analysis results showed that the incidence of urinary incontinence in stroke patients was 38% [95% confidence interval (34%, 41%)], including married patients and lacunar infarction were the protective factors for urinary incontinence in stroke patients, while age, chaperone, low educational level, chronic cough, lesion sites (parietal lobe, frontal lobe, and temporal lobe), stroke type (cerebral hemorrhage, subarachnoid hemorrhage and cerebral hemorrhage complicated with subarachnoid hemorrhage), dysfunction (aphasia dyslexia, dysphagia, eye movement abnormalities, leg muscle disorders), post-stroke depression, the higher the NIHSS score, the lower the Bachmann index (BI) score, OCSP classification (total anterior circulation infarction) and other 11 items were risk factors for urinary incontinence in stroke patients. CONCLUSION: The incidence of urinary incontinence in stroke patients is 38%. Marriage and lacunar infarction are the protective factors of urinary incontinence. Age, carer, low educational level, chronic cough, lesion site (parietal, frontal and temporal lobes), stroke type (cerebral hemorrhage, subarachnoid hemorrhage, cerebral hemorrhage combined with subarachnoid hemorrhage), dysfunction (aphasia and dysarthria syndrome, dysphagia, eye movement abnormalities, leg muscle disorders), post-stroke depression, and higher NIHSS score, Lower BI score and OCSP classification (total anterior circulation infarction) were risk factors for urinary incontinence in stroke patients.

Evaluation of improvement of cognitive impairment in older adults with probiotic supplementation: A systematic review and meta-analysis.

OBJECTIVE: This study aimed to evaluate the improvement of cognitive impairment in older adults through probiotic supplementation. METHODS: A literature review on probiotic supplementation for treating cognitive impairment in older adults was conducted using English and Chinese databases from 1984 to 2023. Two researchers extracted relevant data independently, and a meta-analysis was performed with RevMan software. RESULTS: A comprehensive analysis of ten pertinent papers was conducted, involving a sample of 702 old adults with cognitive impairment. The findings from this study revealed that probiotic supplementation exhibited a positive impact on cognitive symptoms, specifically memory (MD = 0.14, 95% CI :0.05～0.22, P = 0.001) and overall cognitive function (SMD = 0.73, 95% CI: 0.25～1.21, P=0.003), as well as oxidative stress levels, including total antioxidant capacity (MD=52.54, 95% CI:39.52～65.56, P < 0.01), malondialdehyde (MD=-0.11, 95% CI:-0.15～-0.07, P < 0.01), and glutathione (MD=17.08, 95% CI:8.65～25.5, P < 0.01). However, probiotic supplementation failed to enhance patients' psychological symptoms (SMD =0.18, 95% CI:-0.56～0.92, P = 0.64). CONCLUSIONS: Probiotic supplementation can enhance cognitive symptoms and decrease oxidative stress in older adults with cognitive impairment. However, it does not improve psychological symptoms. More research is needed to determine the effects of probiotic supplementation on gastrointestinal symptoms and sleep quality in this population. Further supplementation and improvement will be necessary once high-quality literature becomes available.

OPK_SNCA: Optimized prior knowledge via sparse non-convex approach for cone-beam X-ray luminescence computed tomography imaging.

BACKGROUND: The development of Cone-beam X-ray luminescence computed tomography (CB-XLCT) has allowed the quantitative in-depth biological imaging, but with a greatly ill-posed and ill-conditioned inverse problem. Although the predefined permissible source region (PSR) is a widely used way to alleviate the problem for CB-XLCT imaging, how to obtain the accurate PSR is still a challenge for the process of inverse reconstruction. METHODS: We proposed an optimized prior knowledge via a sparse non-convex approach (OPK_SNCA) for CB-XLCT imaging. Firstly, non-convex Lp-norm optimization model was employed for copying with the inverse problem, and an iteratively reweighted split augmented lagrangian shrinkage algorithm was developed to obtain a group of sparse solutions based on different non-convex p values. Secondly, a series of permissible regions (PRs) with different discretized mesh was further achieved, and the intersection operation was implemented on the group of PRs to get a reasonable PSR. After that, the final PSR was adopted as an optimized prior knowledge to enhance the reconstruction quality of inverse reconstruction. RESULTS: Both simulation experiments and in vivo experiment were performed to evaluate the efficiency and robustness of the proposed method. CONCLUSIONS: The experimental results demonstrated that our proposed method could significantly improve the imaging quality of the distribution of X-ray-excitable nanophosphors for CB-XLCT.

Comparison of Aphakic Refraction and Biometry-Based Formulae for Secondary In-The-Bag and Sulcus-Implanted Intraocular Lens Power Estimation in Children.

PURPOSE: The aim of the study was to compare the accuracy of refractive outcomes in children undergoing secondary in-the-bag or cilliary sulcus intraocular lens (IOL) implantation, using aphakic refraction (AR)-based formulae (Hug and Khan) and biometry-based formulae (Holladay 1, Hoffer Q, SRK/T, and SRK II). METHODS: In this retrospective study, a total of 65 eyes of 44 patients who underwent secondary in-the-bag or cilliary sulcus IOL implantation were included and divided into 2 groups: 39 eyes of the in-the-bag IOL group and the other 26 eyes of the sulcus-implanted IOL group. Holladay 1, Hoffer Q, SRK/T, and SRK II formulae were employed depending on the biometric data, while Hug and Khan formulae were used based on preoperative AR. The prediction error (PE) and the absolute value of predicted error (APE) were compared between the 2 groups and formulae. RESULTS: In the in-the-bag IOL group, nonsignificant differences of APE were found among the 6 formulae, while the Holladay 1, Hoffer Q, SRK/T, and SRK II all demonstrated a significant hyperopic shift of median PE value compared to the Hug formula (p < 0.05, all), and Holladay 1 and SRK II also showed a significant hyperopic shift of PE compared to the Khan formula (p < 0.05, both). Higher percentages of eyes with PE <1 D were found using Hoffer Q and SRK/T. In the sulcus-implanted group, the Holladay 1, Hoffer Q, and SRK/T had a significantly smaller median value of APE than the Hug and Khan formulae (p < 0.05, all), and the SRK II had a significantly smaller median value of APE than the Hug formula (p < 0.05), while Holladay 1 had the lowest value of APE. Higher percentages of eyes within PE <1 D were found using Holladay 1, Hoffer Q, and SRK/T, while the highest one was SRK/T. Significantly larger hyperopic shifts of median PE value using all the 6 formulae were found in eyes with sulcus-implanted IOL than eyes with in-the-bag implanted IOL (p < 0.05, all). In the eyes of with in-the-bag implanted IOL, the Hug and Khan formulae had significantly smaller APE values when compared with the eyes with sulcus-implanted IOL (p < 0.05, both). CONCLUSIONS: Whether IOL was in the bag or implanted in the sulcus, almost all the formulae showed hyperopic shift, SRK/T showed the best accuracy. Biometry-based formulae were superior to AR-based formulae in accuracy of IOL power calculation, especially when IOL was implanted in the sulcus. In-the-bag IOL implantation should always be with higher priorities, especially when using AR-based formulae in IOL power calculation.

Comparison of the Accuracy of IOL Power Calculation Formulas for Pediatric Eyes in Children of Different Ages.

PURPOSE: This study aims to compare the accuracy of five intraocular lens (IOL) power calculation formulas (SRK/T, Hoffer Q, Holladay 1, Haigis, and Holladay 2) for pediatric eyes in children of different ages. METHODS: In this prospective study, patients who received cataract surgery and IOL implantation in the capsular bag were enrolled. We compared the calculation accuracy of 5 formulas at 1 month postoperatively and performed subgroup analysis with the patients divided into three groups according to their ages at the time of surgery as follows: group 1 (age ≤ 2 years, 35 eyes), group 2 (2 years < age < 5 years, 38 eyes), and group 3 (age > 5 years, 29 eyes). RESULTS: 75 patients (102 eyes) were enrolled in this study. The Haigis formula got the smallest PE among all formulas in all three groups. With regard to APE, there were no statistical differences among the formulas except group 2, with the SRK/T formula a little smaller, the Holladay 2 formula a little larger in group 1, and the Haigis formula a little smaller in group 3. In group 2, the Haigis formula had the lowest APE (0.87 ± 0.61 D), while the Holladay 2 formula had the largest (1.71 ± 1.20 D, p < 0.001), followed by the Holladay 1 formula (1.51 ± 1.07 D, p=0.002). On comparing the percentage of APE within 0.5 D and 1.0 D obtained with 5 formulas in each group, there were no statistical differences. The SRK/T formula and the Holladay 1 formula showed the highest percentage (40.00% and 60.00%) in group 1. While the Haigis formula got the highest percentage in less than 0.5 D (34.21%) and less than 1 D (60.53%) in group 2. In group 3, the Holladay 2 formula and the Haigis formula got the highest percentage less than 0.5 D (58.62%) and less than 1 D (79.31%). The multiple linear regression indicated that the age at the time of surgery was a significant factor affecting the accuracy of APE; after removing the age, AL was the only factor that affected the accuracy of APE. CONCLUSION: The SRK/T and the Holladay 1 formulas were relatively accurate in patients younger than 2 years old, while the Haigis formula performed better in patients older than 2.

Postoperative Changes in Central Corneal Thickness and Intraocular Pressure in a Prospective Cohort of Congenital Cataract Patients.

PURPOSE: To evaluate changes in central corneal thickness (CCT) and intraocular pressure (IOP) in children after surgery for congenital cataracts and to investigate the association between CCT and IOP. METHODS: For this prospective observational cohort study, we recruited patients undergoing surgery for unilateral or bilateral congenital cataracts. CCT and IOP were measured before surgery and 1, 3, 6, 12, and 24 months after surgery. RESULTS: Seventy-six children (152 eyes) were enrolled; 33 eyes were unaffected by cataracts, 77 were aphakic, and 42 were pseudophakic. In aphakic eyes, mean CCT increased by 31.14 ± 44.32 µm at 12 months postoperation and 33.09 ± 35.42 µm at 24 months postoperation; this increase was significantly higher than that in pseudophakic eyes 12 months after surgery (8.36 ± 19.91 µm; P < 0.001) and 24 months after surgery (0.31 ± 14.19 µm; P = 0.024). However, no significant differences in IOP were found between the different phakic states at 12 and 24 months postoperation (P = 0.672 and P = 0.080, respectively). There were also no significant differences in CCT and IOP before and after surgery in the unaffected eyes. CONCLUSIONS: Mean CCT peaked at 12 months, and the mean IOP remained normal in both the aphakic and pseudophakic eyes during this study. CCT and IOP were positively correlated, regardless of the phakic status or age, a relationship which suggests that both parameters should be monitored closely in postsurgical patients for up to 12 months and in this time, may impact the ability to diagnose glaucoma.

Influence of angle kappa and angle alpha on visual quality after implantation of multifocal intraocular lenses.

PURPOSE: To assess the influence of angle kappa (κ) and angle alpha (α) on visual quality after multifocal intraocular lens (IOL) implantation. SETTING: Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. DESIGN: Prospective case series. METHODS: Patients with cataract had phacoemulsification with TECNIS Symfony IOL implantation. The preoperative angle κ and angle α were measured using the iTrace device. Distance, intermediate, and near visual acuities were recorded 3 months postoperatively. The Optical Quality Analyzing System was used to measure the objective scatter index (OSI), modulation transfer function (MTF) cutoff frequency, and Strehl ratio. A patient questionnaire was also administered. RESULTS: The study comprised 29 patients (57 eyes). Monocularly, the mean postoperative logarithm of the minimum angle of resolution (logMAR) uncorrected distance, intermediate, and near visual acuities were 0.03 ± 0.09 (SD), 0.05 ± 0.11, and 0.11 ± 0.09, respectively. The mean postoperative logMAR corrected distance, distance-corrected intermediate, and distance-corrected near visual acuities were -0.01 ± 0.05, 0.04 ± 0.09, and 0.11 ± 0.08, respectively. The mean OSI, MTF cutoff, and Strehl ratio were 1.27 ± 0.84, 32.03 ± 10.80 cycles per degree, and 0.17 ± 0.05, respectively. The OSI (r = 0.398, P = .005), MTF (r = -0.437, P = .002), and Strehl ratio (r = -0.419, P = .003) values were significantly correlated with angle κ. There was no correlation with angle α. CONCLUSIONS: Angle κ affected the objective visual quality multifocal after IOL implantation. The decision to implant a multifocal IOL should be carefully considered for patients with a large angle κ.