Development and validation of a nomogram for assessment postoperative sodium disturbance in PAs patients: a retrospective cohort study.

Background: Pituitary adenomas (PAs) are neuroendocrine tumors located in the sellar region. Surgery, being the primary treatment option for most PAs, is known to cause disruptions in sodium metabolism. Objective: To develop and validate a nomogram for assessment the incidence of postoperative sodium disturbance (SD) in patients with PAs. Methods: In this retrospective study, 208 patients with PAs who underwent resection surgery between 2013 and 2020 were included. Various demographic characteristics, clinical features and laboratory data were analyzed as potential predictors of postoperative sodium disturbance (SD). LASSO regression were used to identify independent preoperative variables associated with SD. Logistic regression was employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). A nomogram was constructed to visualize these results and evaluated using metrics such as the area under the curve (AUC) for discrimination, the Hosmer-Lemeshow test for calibration and decision curve for usefulness assessment. Results: The incidence of SD was 44.23% (92 cases out of 208). Six preoperative factors, including sex, types of PAs, phosphocreatine kinase (CK), serum iron (Fe), free fatty acids (NEFA) and mean corpuscular volume (MCV), were identified for constructing a predictive nomogram. The nomogram showed high accuracy, with AUC values of 0.851 (95% CI [0.799-0.923]) and 0.771 (95% CI [0.681-0.861]) in the training and validation datasets, respectively. Calibration assessment and decision curve analysis confirmed its good agreement and clinical utility. Conclusion: A practical and effective nomogram for predicting SD after PAs surgery is presented in this study.

Wide-field swept-source OCTA in the assessment of retinal microvasculature in early-stage diabetic retinopathy.

BACKGROUND: To perform a quantitative analysis of retinal microvasculature in patients with early-stage diabetic retinopathy (DR) using wide-field swept-source optical coherence tomography angiography (SS-OCTA).  METHODS: One hundred nineteen eyes of 119 patents (67 eyes with no DR and 52 eyes with mild-moderate nonproliferative diabetic retinopathy (NPDR)) were enrolled in this observational and cross-sectional cohort study, and an age-matched group consisting of 39 eyes of 39 non-diabetic subjects were set as the control. Each participant underwent a full ophthalmic examination, including wide-field SS-OCTA imaging. On OCTA scans (12 mm * 12 mm), the mean perfusion area (PA) and vessel density (VD) were independently measured in all 16 Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. Linear regression analyses were conducted to evaluate the influences of PA. RESULTS: In the central ring, there were no significant differences in the average PA and VD among the groups. In the 3 mm radius, the PA and VD of the no DR and mild-moderate NPDR were significantly decreased compared with the control group in superior and inferior quadrants. In the wide-field scans (9 and 12 mm radius), there was no significant difference in average PA and VD between the groups in each sectors (p > 0.05). Regression analysis found that the effect of VD on PA was statistically different (b = 1.311, p < 0.001). CONCLUSION: Wide-field OCTA imaging is useful for evaluating peripheral capillary perfusion in eyes with early-stage DR. Decrease in PA and VD was greater in the S3 and I3 sectors, and reductions in PA and VD were uneven in wide-filed sectors (9 and 12 mm radius).

Assessment of cadmium bioaccessibility to predict its bioavailability in contaminated soils.

In vitro assays have been developed to determine metal bioaccessibility in contaminated soils; however, their application to Cd is limited. To assess their suitability to determine Cd relative bioavailability (RBA), Cd-RBA in 12 contaminated soils containing 3.00-296mgkg(-1) Cd were determined using a mouse model and compared with Cd bioaccessibility data based on four assays including the UBM, SBRC, IVG, and PBET. After being administered feed amended with soil or CdCl2 for 10-day, the Cd concentrations in the mouse liver and/or kidneys were used as biomarkers to estimate Cd-RBA. Cd-RBA was comparable at 34-90% and 40-78% based on mouse liver and kidneys with RSD of 7.10-8.99%, and 37-84% based on mouse liver plus kidneys with lower RSD of 5.8%. Cadmium bioaccessibility in soils varied with assays, with 61-99, 59-103, 54-107, and 35-97% in the gastric phase and 20-56, 38-77, 42-88, and 19-64% in the intestinal phase of the UBM, SBRC, IVG and PBET assays. Based on the combined biomarker of liver plus kidneys, better correlation was observed for PBET (r(2)=0.61-0.70) than those for IVG, UBM and SBRC assays (0.12-0.52). The monthly Cd intake in children was 0.24-23.9µgkg(-1) using total Cd concentration in soils, which was reduced by 43% to 0.18-12.3µgkg(-1) using bioavailable Cd. Our data suggest it is important to consider Cd-RBA to assess risk associated with contaminated soils and the PBET may have potential to predict Cd-RBA in contaminated soils.

Bioaccessibility, sources and health risk assessment of trace metals in urban park dust in Nanjing, Southeast China.

Arsenic, Cd, Co, Cr, Cu, Mn, Ni, Pb, V, and Zn total concentrations and bioaccessibilities in 15 urban park dust samples were determined. The oral bioaccessibility measured by the Simple Bioaccessibility Extraction Test (SBET) decreased in the order of Pb>Cd>Zn>Mn>Cu>Co>V>Ni>As>Cr. The Tomlinson pollution load index (PLI) and geoaccumulation index (I(geo)) were calculated to evaluate the pollution extent to which the samples were contaminated. Sources were identified using principal component analysis and Pb isotope compositions. Most elements except Co and V were considered to mainly originate from anthropogenic sources. Non-carcinogenic and carcinogenic risks to humans through urban park dust exposure were assessed using the oral bioaccessibilities of the elements. Ingestion was the main pathway for non-carcinogenic risk. The hazard quotients were below the safe level (=1) for all elements, however, Pb (0.154) and As (0.184) posed potential higher risks to children than adults. The carcinogenic effects occurring were below the acceptable level (10(-4)) for As and <10(-6) for Cd, Co, Cr, and Ni.

Toxic metals in children's toys and jewelry: coupling bioaccessibility with risk assessment.

A total of 45 children's toys and jewelry were tested for total and bioaccessible metal concentrations. Total As, Cd, Sb, Cr, Ni, and Pb concentrations were 0.22-19, 0.01-139, 0.1-189, 0.06-846, 0.14-2894 and 0.08-860,000 mg kg(-1). Metallic products had the highest concentrations, with 3-7 out of 13 samples exceeding the European Union safety limit for Cd, Pb, Cr, or Ni. However, assessment based on hazard index >1 and bioaccessible metal showed different trends. Under saliva mobilization or gastric ingestion, 11 out of 45 samples showed HI >1 for As, Cd, Sb, Cr, or Ni. Pb with the highest total concentration showed HI <1 for all samples while Ni showed the most hazard with HI up to 113. Our data suggest the importance of using bioaccessibility to evaluate health hazard of metals in children's toys and jewelry, and besides Pb and Cd, As, Ni, Cr, and Sb in children's products also deserve attention.