CAS Scores Research Articles

Clinical Characteristics and Underlying Pathophysiology in 4 Subtypes of Dysthyroid Optic Neuropathy Patients

Objective: To analyze different subtypes, clinical characteristics, and pathophysiologies of dysthyroid optic neuropathy (DON) based on orbital fat and extraocular muscle (EOM) volume increases on orbital CT images. Methods: The author retrospectively reviewed the medical records of 80 patients (152 eyes) who were diagnosed with DON and treated at Anam, Guro, or Ansan hospitals of the Korea University College of Medicine from February 2006 to December 2023. Clinical features, ophthalmic examination, demographic characteristics, thyroid status, and radiographic findings from computed tomography scans (prevalence of fat or muscle volume increases) were analyzed. Results: Four groups were designated based on EOM volume (MV) and orbital fat volume (FV). Group 1 had no increase in MV or FV (5.3%, 8 eyes), group 2 had increased FV only (8.66%, 13 eyes), group 3 had an increase in MV only (52.6%, 80 eyes), while group 4 had both MV and FV increase (33.6%, 51 eyes). Patients in group 1 were younger and had low diplopia scores than patients in the other groups. Decreases in visual acuity, color vision abnormalities, diplopia score, and apical crowding were less frequent in groups 1 and 2 than groups 3 and 4 (P=0.000). Patients in groups 3 and 4 had significantly more apical crowding and higher diplopia scores and CAS scores than patients in groups 1 and 2 (P=0.000 and 0.013, respectively). The number of patients who underwent decompression surgery was significantly higher in groups 3 and 4 than groups 1 and 2 (P=0.000). Conclusion: Extraocular muscle enlargement occurred in 86% of DON patients and compression of the optic nerve due to enlargement of EOMs at the orbital apex is the main cause of DON. Optic nerve stretch and vascular insufficiency due to increased orbital pressure are other potential mechanisms underlying DON in groups without an increase in FV or MV. Although decreased visual acuity, color vision abnormalities, and diplopia were less frequent in these groups, greater attention should be paid to the timely diagnosis of DON.

Exploring Cognitive Skills and Academic Outcomes of Poverty-Affected English Language Learners in Indian Primary Schools

This study investigates the cognitive performance of primary school children in India who are English Language Learners (ELL) and live in poverty. Cognitive performance was assessed using the Das-Naglieri Cognitive Assessment System (CAS2 was not constructed). There is a scarcity of studies on participants who are both ELL and live in poverty, and many such children are often found to be intellectually deficient. This study examines the performance in PASS measures (Planning, Attention, Simultaneous, Successive) and their correlation with academic achievement, particularly in reading and mathematics. We assessed the performance of 80 primary school students residing in slum areas (mean age: 9.8 years), matched in age and grade with 70 regular school students from areas outside the slum (mean age: 9.11 years). It was hypothesized that ELL regular school students would exhibit average Das-Naglieri CAS scores as per established American norms.

A multifactorial screening model based on the Graves ophthalmopathy quality of life scores in dysthyroid optic neuropathy.

To validate the Graves ophthalmopathy quality of life (GO-QOL) questionnaire in screening DON and to construct an effective model. A total of 194 GO patients were recruited and divided into DON and non-DON (mild and moderate-to-severe) groups. Eye examinations were performed, and quality of life was assessed by the GO-QOL questionnaire. The random forest, decision tree model, receiver operator characteristic (ROC) curve, accuracy and Brier score were determined by R software. In GO-QOL, age, best corrected visual acuity (BCVA), exophthalmos, CAS, severity, and Gorman score were found to be factors related to visual function scores. On the appearance scale, gender, duration of GO, BCVA, exophthalmos, CAS and severity of GO were relevant. Both the visual function scores and appearance scores were significantly lower in DON groups than in non-DON groups (33.18 ± 24.54 versus 81.26 ± 17.39, 60.08 ± 24.82 versus 76.14 ± 27.56). The sensitivity, specificity, and AUC of the visual function scores were 91.1%, 81.7% and 0.939, respectively Visual function scores were used to construct a decision tree model. The sensitivity, specificity, and AUC of the model were 92.9%, 88.0% and 0.941, respectively, with an accuracy of 89.7% and a Brier score of 0.024. Visual function scores were qualified as a screening method for DON, with a cutoff point of 58. A multifactorial screening model based on visual function scores was constructed.

Yoga as an adjunct therapy in elderly patients of chronic constipation

Background: Constipation being very prevalent and common complaint in elderly people, an effective measure is needed to get the relief along with drugs for constipation used by clinicians. Our aim was to search out the potential applicability and effectiveness of yoga. Methods: 30 elderly patients visiting medicine OPD for chronic constipation were included in study. Yoga group (15) was offered selected yogic practices in addition to drugs and control group drugs only. Patients kept record of drug intake on paper for 2 months of study. Data was obtained by using CAS score and frequency of drug intake. Data were analysed using t test. Results: Baseline CAS scores for the yoga and control groups were 11.92±1.59 and 12.07±1.68 respectively. Post yoga CAS score for the yoga and control groups were 3.50±1.40 and 4.14±1.5 respectively. Frequency of drug intake in yoga and control groups in first month of yoga was 17.57±2.31 and 19.14±2.38 respectively. In 4th month of yoga practice frequency of drug intake in yoga and control groups was 11.07±2.16 and 18.35±2.56, which was highly significant. Conclusions: Selected yoga practices can be used as an adjuvant therapy to treat chronic constipation in case of elderly. They can be effective in decreasing drug requirement in patients of chronic constipation. Yoga practices should be advised for patients of chronic constipation.

Evaluation and treatment of constipation in pregnancy:Examination using the Japanese version of the constipation evaluation scale.

No study has examined the effects of new constipation treatment drugs released in recent years in pregnant women. This prospective cohort study aimed to examine and compare the perinatal prognosis, efficacy rate, and safety of drugs frequently used to treat constipation. The study included 211 perinatally managed individuals who answered a self-administered questionnaire during the second trimester and after delivery. The Japanese version of the constipation evaluation scale (Constipation Assessment Scale [CAS] long-term [LT] version) was used for the subjective evaluation of defecation status. Participants aware of constipation had significantly higher CAS scores than those who were unaware. Some participants with a CAS score of 5 points (treatment range) had no subjective symptoms of constipation, whereas some participants with a CAS score of ≤ 5 points were aware of constipation. Regarding the time of onset, 60% of those who had constipation before pregnancy had a high rate of constipation during pregnancy and after delivery. No significant difference was noted in conventional magnesium oxide and polyethylene glycol, a relatively new daily treatment drug, in perinatal prognosis or side effects. Polyethylene glycol preparations alleviate constipation without inducing diarrhea, making them an appropriate therapeutic option for pregnant women.

PREVALENCE OF THYROID EYE DISEASE IN PATIENTS WITH THYROID DYSFUNCTION IN A TERTIARY CARE HOSPITAL OF CENTRAL NEPAL

Background: Thyroid eye disease is the most common extra thyroidal manifestation of Graves’ disease. The pattern and prevalence of thyroid eye disease vary widely from a mild disorder characterized by dry eye symptoms and ocular irritation to a severe disfiguring form of orbitopathy. Thyroid eye disease is a frequently encountered Ophthalmological morbidity in Nepal and across the globe. The aim of this study was to ascertain the prevalence of thyroid eye disease in subjects with thyroid dysfunction in a tertiary care hospital in central Nepal.. Methods: This was a prospective cross-sectional study, conducted in Chitwan medical college Teaching hospital (CMCTH), department of Ophthalmology. Subjects presenting to Ophthalmology department or referred patients from different departments with thyroid dysfunction were enrolled in the study. The data thus collected was analyzed using SPSS version 26 and the data was presented as frequency and percentage. Results: Among 320 subjects screened for Thyroid eye disease prevalence, 106 (33.3%) were hyperthyroid, 207 (64.7%) were hypothyroid whereas, 7 (2.2%) were euthyroid. The prevalence of Thyroid eye disease was 40% and this was more prevalent among hypothyroid. Among the 320 patients with thyroid eye disease, 126 (39.4%), 95 (29.7%), 53 (16.6%), 24 (7.5%), 15 (4.7%), 5 (1.6%) and 2 (0.6%) had CAS score of 1,2,3,4,5,6 and 7 respectively. Similarly, NOSPECS score (American Thyroid Association) 243 (75.9%), 57 (17.8%), 1 (0.3%), 7 (2.2%), 8 (2.5%), 3(0.9%) and 1 (0.3%) were graded from 0-6 accordingly respectively. Conclusions: Thyroid eye disease was more prevalent in hypothyroid middle-aged females and the overall prevalence of Thyroid Eye disease was more in hypothyroid patients. Though sight threatening complications didn’t exist in our study, close workup by endocrinologist and ophthalmologist can decrease ocular morbidity.

A - 122 Coronavirus Anxiety, Mood, and Subjective Cognition in Post-Acute Sequelae of COVID-10.

Coronavirus anxiety (CA) is associated with depression, general anxiety, and subjective cognitive dysfunction (SCD) in community samples. Furthermore, individuals with SARS-CoV-2 infection (acute & post-acute) report greater CA and SCD. No study to date has examined CA in patients diagnosed with post-acute sequelae of COVID-19 (PASC). We evaluated the prevalence of CA amongst individuals diagnosed with PASC and its associations with mood and SCD. Participants were 72 patients diagnosed with PASC [M age = 48.8 ± 11.9years, 72.2% female, 93.1% White] who were referred for clinical neuropsychological evaluation between May 2021 and February 2023. Participants completed the Coronavirus Anxiety Scale (CAS; range = 0-20, clinical cutoff: ≥9), BDI-II, BAI, BRIEF-A, and Neurobehavioral Symptom Inventory (NSI). Overall, CAS scores were low (M = 1.29, SD = 2.69, 4.2% clinically elevated). In contrast, depression scores were high (M = 23.2, SD = 11.2, 72.2% clinically elevated), as were anxiety scores (M = 19.7, SD = 12.2, 72.2% clinically elevated). CAS scores tended to decline over the course of the study; however, scores on the BDI-II or BAI did not. Higher CAS scores were associated with higher scores on the BDI-II (rs = 0.344, p = 0.005), BAI (rs = 0.321, p = 0.009), and BRIEF-A Global Executive Composite (rs = 0.407, p = 0.001) but not for the NSI Cognitive Factor (rs = 0.139, p = 0.256). Findings suggest clinically significant CA is not particularly prevalent in individuals with PASC, but perhaps is more salient for acute infection. Results also highlight the presence of clinically elevated psychiatric distress in patients with PASC and the need for proper screening and intervention.

The Human Library and the development of cultural awareness and sensitivity in occupational therapy students: a mixed methods study.

Monash university in Australia has adopted the Human Library as a teaching activity aimed at enhancing occupational therapy (OT) students' cultural awareness and sensitivity; however, its effect on cultural competence in healthcare profession students has not been previously investigated. To examine whether participation in a Human Library can facilitate the development of OT students' cultural awareness and sensitivity and to understand the factors contributing to changes in cultural competence from the students' perspective. This is a mixed-method study. Quantitative data was collected by participant characteristic survey and pre/post-Human Library cultural competence assessment (CCA). The quantitative data was used to inform the selection of participants and questions for the second qualitative phase. Quantitative data were analyzed using independent samples and paired t-tests, analysis of variance and Pearson correlation. Qualitative data were analyzed using coding reliability thematic analysis. Statistically significant increases were noted in CAS, CCB and overall CCA scores from pre- to post-Human Library. Participant characteristics such as gender, work experience in aged care and the health sector had a positive effect on pre-Human Library CCA results. Qualitative data demonstrated that participants perceived they had a level of cultural competence prior to attending the Human Library however, still made gains in cultural awareness and sensitivity and were motivated and inspired to provide culturally congruent healthcare. The Human Library can be considered for inclusion within a suite of learning methods for healthcare professional student curricula as a cost-effective, flexible teaching method for the development of competencies for culturally congruent healthcare.

Factors associated with somatic symptoms perception in patients living with heart failure

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): University Review Board of the American University of Beirut Background Heart Failure [HF] affects 64.3 million individuals globally and despite its decreasing global burden it remains dramatically high in countries of the Eastern Mediterranean Region. Self-care is highly recommended to improve HF patient outcomes and an integral aspect for effective HF self-care is symptom perception. This involves body listening, symptom recognition and monitoring, and interpreting and labeling the meaning of these symptoms. Purpose To identify factors related to HF symptom burden as perceived by patients living with HF and using the Heart Failure Somatic Perception [HFSP] scale. Methods This was a secondary analysis of a cross-sectional correlational study that recruited dyads living with HF. Patients were assessed for symptom burden measured by the HFSP scale, depression measured using the Patient Health Questionnaire [PHQ-9], perceived control measured using the Control Attitudes Scale [CAS], and quality of life measured using the Minnesota Living with HF [MLWHF] questionnaire. Independent t-Test and Pearson correlation were used for analysis. Results A total of 109 HF patients [mean age 63.24 ± 10.77 years, 69.7% males] were included. The mean score of HFSP scale was 27.96 ± 19.43. Symptomatic HF patients [New York Functional Class (NYHA) I and II] had significantly higher HFSP than asymptomatic patients [NYHA III and IV] indicating higher symptom burden [32.90 ± 19.65 versus 23.16 ± 17.79; p = 0.11]. Likely, higher symptom burden was associated with lower total quality of life [higher MLWHF score; r = .802; p <.001], lower physical quality of life [r = .802; p <.001], lower emotional quality of life [r = .384; p <.001], more depression [higher PHQ-9 score; r = .464; p <.001], and lower perceived control over symptoms and disease process [lower CAS score; r = -.506; p <.001]. Predictors were retained in the regression model if they contributed significantly to the model or were conceptually relevant and did not negatively affect the variance. Worse quality of life and lower perceived control explained about 60% of the variance in symptom burden [F = 49.189; p = 0.001]. Conclusion Results of this secondary analysis suggest that patients’ somatic perception of their illness has an independent and substantial relationship to their functionality, quality of life, and perceived control over illness. Illness perceptions are amenable to change, and healthcare providers are tasked with developing and testing targeted interventions aimed to modify these as this may be helpful for improving quality of life and control over disease process.

Investigation into the psychological impact of the COVID-19 pandemic for people living with HIV.

People living with HIV (PLWH) report high levels of anxiety. This study assessed the prevalence of COVID-19-related anxiety in PLWH. Participants were recruited from two UK HIV clinics (01/03/2020 - 30/05/2022) and asked to complete the Coronavirus Anxiety Scale. The proportion with scores ≥9 (cut-off for dysfunctional pandemic-related anxiety) and ≥1 (reporting of any pandemic-related anxiety) were analysed. 115 PLWH were included, predominantly identifying as male (83.5%, n = 96), white (58.3%, n = 67) and reporting post-secondary education (82.6%, n = 95), with a median age of 51 years (range 22-93). Median CAS score was 0, with 4.4% scoring ≥9 (n = 5). More women scored ≥9 than men (16.7% (n = 3) and 2.1% (n = 2) respectively). Black African (13.6%, n = 3) and Other Ethnic Minority PLWH (25%, n = 2) had a greater proportion of scores ≥9 than White/Asian PLWH (both 0%). SARS-CoV-2 exposure was associated with scores greater than 1 but not greater than 9. CAS score was not associated with lower CD4 (<350 cells/mm3), detectable HIV viral load (≥50 copies/ml), or a history of pre-pandemic anxiety. Pandemic-related anxiety was low, but we identified a sub-population reporting dysfunctional pandemic related anxiety. Future work should further investigate the psychological impact of the pandemic on this group.

A possible combined appraisal pattern: predicting the prognosis of patients after esophagectomy

ObjectiveTo investigate the predictive merit of combined preoperative nutritional condition and systemic inflammation on the prognosis of patients receiving esophagectomy, with the assessment of model construction to extract a multidisciplinary phantom having clinical relevance and suitability.MethodsThe software of R 4.1.2 was utilized to acquire the survival optimal truncation value and the confusion matrix of survival for the continuity variables. SPSS Statistics 26 was employed to analyze the correlation of parameters, where including t-test, ANOVA and the nonparametric rank sum test shall. Pearson chi-square test was used for categorical variables. The survival curve was retrieved by Kaplan–Meier method. Univariate analysis of overall survival (OS) was performed through log-rank test. Cox analysis was for survival analyze. The performance of the prediction phantom through the area under curve (AUC) of receiver operating characteristic curve (ROC), decision curve analysis (DCA), nomogram and clinical impact curve (CIC) was plotted by R.ResultsThe AUC value of albumin-globulin score and skeletal muscle index (CAS) is markedly superior. Patients with diminished AGS and greater SMI were associated with improved overall survival (OS) and recurrence-free survival (RFS) (P < 0.01). The CAS composite evaluation model was calibrated with better accuracy and predictive performance. The DCA and CIC indicated a relatively higher net revenue for the prediction model.ConclusionsThe prediction model including the CAS score has excellent accuracy, a high net revenue, and favorable prediction function.

Alterations of brain gray matter volume in children with obstructive sleep apnea.

Obstructive sleep apnea (OSA) seriously affects the children's cognitive functions, but the neuroimaging mechanism of cognitive impairment is still unclear. The purpose of our study was to explore the difference in brain local gray matter volume (GMV) between children with OSA and non-OSA, and the correlation between the difference regions of brain gray matter volume and cognitive, the severity of OSA. Eighty-three children aged 8-13 years were recruited in our study, 52 children were diagnosed as OSA by polysomnography, and 31 as the non-OSA. All the subjects were underwent high-resolution 3-dimensional T1-weighted magnetic resonance images. The voxel-based morphometry (VBM) was be used to analyse the local GMV. The Das-Naglieri cognitive assessment system (DN: CAS) was used to assess the subjects' cognitive. The difference of local GMV between the two groups was analyzed by two-sample T-test. The PSG variables and the scores of DN: CAS between the OSA group and non-OSA group were compared by independent samples t-tests. Pearson correlation was used to calculate the association between the difference areas of gray matter volumes in brain and DN: CAS scores, obstructive apnea/hypopnea index (OAHI, an index of the severity of OSA). The gray matter volume of the right Middle Frontal Gyrus (MFG_R) in OSA children were larger than the non-OSA children, and the OSA children had lower scores of the Word Series in DN: CAS. There was negative correlation between the scores of Expressive Attention in DN: CAS and the gray matter volume of the right middle frontal gyrus, and it was no significantly correlation between OAHI and the gray matter volume of the right middle frontal gyrus. Our results suggest that the development of gray matter volume in frontal cortex, which associated with attention, were sensitive to the effects of OSA, provides neuroimaging evidence for cognitive impairment in children with OSA.

Hazardous alcohol use, drinking motives and COVID-19-related anxiety in college students

Objective This study examined the associations of anxiety and drinking motives with hazardous and binge alcohol use among young adults. Participants We recruited young adults (N = 182, mean age 25) between November 2020 and December 2020. Methods Linear regressions were used to evaluate relationships among hazardous alcohol use (US Alcohol Use Disorders Identification Test-C [USAUDIT-C]), binge drinking (Alcohol Intake Questionnaire [AIQ]), PROMIS-Anxiety, COVID-19 related anxiety (CAS), and the drinking to cope with depression and anxiety subscales of the Modified Drinking Motives Questionnaire. Results Sixty-two percent of participants reported hazardous drinking (USAUDIT-C score > 4). PROMIS Anxiety and CAS scores were 63.7 and 1.0, respectively. Scores were positively associated with drinking patterns. However, the drinking to cope with depression motive significantly mediated these associations. Conclusions After the onset of the pandemic, hazardous and binge drinking patterns among young adults were associated with drinking to cope with depression rather than anxiety.

COVID-19 anxiety and associated factors among university students in Bangladesh

Cross-sectional data were collected from 787 Bangladeshi students ages 18 to 27 years, to assess dysfunctional COVID-19 anxiety using the Coronavirus anxiety Scale or CAS and to identify factors influencing their anxiety. Results indicated that 53% of the respondents attained CAS scores in the clinical range. Women reported a significantly higher anxiety than men. Additionally, not having a steady family income, having poor physical health, having relatives or acquaintances infected with COVID-19, and being highly worried about becoming infected were associated with COVID-19 anxiety. Psychosocial interventions should be adopted to mitigate the anxiety of these high-risk groups and to deter harmful behavior during this emergency.

Complementary adversarial mechanisms for weakly-supervised temporal action localization

Weakly supervised Temporal Action Localization (WTAL) aims to locate the start and end boundaries of action instances and recognize their corresponding categories. Classical methods mainly rely on random erasure mechanisms, attention mechanisms, or imposing loss constraints. Despite their great progress, there are still two challenges of incomplete positioning and context confusion. Therefore, we propose a framework with complementary adversarial mechanisms to address these issues. In the adversarial learning stage, for an input snippet, we roughly determine its proper duration, by matching it with the specified multi-scaled anchors based on CAS score loss; then, it undergoes a frame-level iterative regression to precisely figure out its boundary, which can reject none closely related frames merged in, and ensures no overlapping between different action proposals. Subsequently, the GCN module explicitly enhances the feature representation for this fine localized snippet, aiming to strengthen the exclusiveness between different action snippets. Afterward, our complementary learning module calculates the similarity between the original input video Vg and the video Vr reconstructed with the above localization refined snippets, aiming to ensure no closely relevant frames missing, this checking mechanism works as feedback to guide the regression module for more accurate localization regression. Finally, each refined snippet undergoes multi-instance learning to obtain its classification score, and the top-k strategy is used to aggregate temporally adjacent snippets based on their content similarity, which can avoid fragmentation of an action proposal. This method is tested on datasets of THUMOS14 and ActivityNet1.2, and their average accuracy is 64.68% and 32.94% respectively, its comparisons with other articles prove its effectiveness.

A case of Tocilizumab-induced thrombocytopenia in steroid-resistant Graves orbitopathy

Abstract Introduction Graves’ orbitopathy (GO) is the main extrathyroidal manifestation of Graves’ disease (GD). It is more common in women, but men have more severe evolution of the disease. GO appears in 25–70% of patients with GD and can have a severe evolution in 5% cases and even lead to sight loss. In mild forms local treatment is often sufficient to alleviate eye symptoms. However, in moderate-to-severe cases systemic glucocorticoids are used, combined or not with immunosuppressive drugs. In moderate-to-severe glucocorticoid-refractory cases, conventional and biological immunosuppressive drugs have been used, among which is treatment with Tocilizumab (TCZ) – a monoclonal antibody targeting the interleukin-6 receptor, involved in GO's pathogenesis. Clinical Case A 49 years old former smoking Caucasian man was admitted to the endocrinology unit with asymmetrical bilateral exophthalmos, spontaneous and movement induced retrobulbar pain, hyperlacrimation. He has been diagnosed with Graves disease 9 months prior to the admission to our clinic. At that time the patient was treated with antithyroid drugs and oral prednisolone. The clinical activity score – CAS 7/7 points confirmed an active form of GO. Laboratory findings revealed a suppressed TSH 0.01 UI/ml, increased freeT4 40,1 pmol/l, positive TR-Ab (30,04 IU/L). Treatment with high-dose regimen of i.v. methylprednisolone (Mt), cumulative dose 5.75 g in 12 weeks was applied. The patient was soon thereafter admitted repeatedly for evaluation: a non-response to Mt has been established, occurrence of diplopia, convergent strabismus, therefore a second-line treatment with tocilizumab (TCZ) was considered. His blood platelet count before TCZ was 158×10*9. The patient received the first 8 mg/kg dose of i.v. TCZ and showed an improvement in the CAS score (5/7 points), however 1 month later, the platelet count had decreased to 48×10*3 and further treatment with TCZ has been postponed until thrombocyte count increases above 100×10*9. His oral medicines were thiamazole and levothyroxine. Other causes of thrombocytopenia (HIV, Hepatitis C, Ebstein-Barr virus, Helicobacter pylori, liver disease) have been excluded. 7 weeks later thrombocyte count increased spontaneously to 102×10*3 and TCZ treatment has been resumed. Discussion. The mechanism of thrombocytopenia induced by TCZ is dependent on its effect on IL-6 receptor, which stimulates thrombopoiesis through thrombopoietin induction. Clinical studies prove the effectiveness of TCZ in the treatment of GO, but side effects limit its use. Older age and low platelet count before TCZ treatment were associated with the development of thrombocytopenia after treatment. Conclusion Thrombocytopenia induced by tocilizumab is tolerable. However, in patients with known risk factors, close monitoring of platelet counts is recommended. An individual approach is appropriate, considering the high cost of the drug, side effects and comorbidities.

Dietary Supplementation Practices Among Undergraduate Students in Greece During the COVID-19 Pandemic and Their Association with COVID-19-related Anxiety.

Despite the lack of evidence-based guidance on supplement use for the prevention and treatment of COVID-19, consumption of dietary supplements has been shown to increase in many countries. This study aimed to explore the use of dietary supplements among undergraduate students. An online cross-sectional survey was conducted between May and June 2021, involving a total of 536 participants (57.8% female) aged between 18-30 years in two university towns in central and northern Greece. Two validated questionnaires were used regarding dietary supplements and stress during COVID-19. The prevalence of dietary supplement use was 67.5%. The three most popular supplements consumed were vitamin C (65.2%), followed by vitamin D (58.3%), and multivitamin and mineral supplements (56.9%). The use of CAS-5 indicated that 13.1% of students were classified as having dysfunctional anxiety due to COVID-19 (CAS-5 score ≥5). Logistic regression analysis showed that those who exhibited CAS-5 ≥5 were over two times more likely to consume supplements compared to no-stress participants (OR 2.29, 95%CI: 1.09-4.82). Particularly vitamin D use was associated with CAS score ≥5 (OR 2.18, 95%CI 1.22-3.89) a finding that was not observed with other types of dietary supplements. Women, passive smokers, and those who believe that DS are necessary during the COVID-19 pandemic were also more likely to consume dietary supplements. The use of dietary supplements is widespread among Greek students. Future studies should be conducted to monitor whether these increases in DS use are maintained.

Dietary Supplementation Practices Among Undergraduate Students in Greece During the COVID-19 Pandemic and Their Association with COVID-19-related Anxiety.

Despite the lack of evidence-based guidance on supplement use for the prevention and treatment of COVID-19, consumption of dietary supplements has been shown to increase in many countries. This study aimed to explore the use of dietary supplements among undergraduate students. An online cross-sectional survey was conducted between May and June 2021, involving a total of 536 participants (57.8% female) aged between 18-30 years in two university towns in central and northern Greece. Two validated questionnaires were used regarding dietary supplements and stress during COVID-19. The prevalence of dietary supplement use was 67.5%. The three most popular supplements consumed were vitamin C (65.2%), followed by vitamin D (58.3%), and multivitamin and mineral supplements (56.9%). The use of CAS-5 indicated that 13.1% of students were classified as having dysfunctional anxiety due to COVID-19 (CAS-5 score ≥5). Logistic regression analysis showed that those who exhibited CAS-5 ≥5 were over two times more likely to consume supplements compared to no-stress participants (OR 2.29, 95%CI: 1.09-4.82). Particularly vitamin D use was associated with CAS score ≥5 (OR 2.18, 95%CI 1.22-3.89) a finding that was not observed with other types of dietary supplements. Women, passive smokers, and those who believe that DS are necessary during the COVID-19 pandemic were also more likely to consume dietary supplements. The use of dietary supplements is widespread among Greek students. Future studies should be conducted to monitor whether these increases in DS use are maintained.

Association between coronary artery calcium score and COVID-19 prognosis

Background: Research has examined the relationships between coronary artery calcium (CAC) scores and mortality, mechanical ventilation, and intensive care unit admissions. This paper summarizes the predictive value of coronary artery calcification scoring for hospitalized COVID-19 patients in terms of mortality, mechanical ventilation, and intensive care unit admission. Methods: The patients in this single-center retrospective analysis have COVID-19 and were hospitalized at the Firouzabadi hospital in Tehran between 2019 and 2020. coronary artery calcificationscore was estimated based on chest non-contrast CT scans on the day of admission. Based on the coronary artery calcification score, the patients were categorized into Very Low, Mild to Moderate, and Moderate to Severe. After a univariate analysis of the critical factors, odds ratio (OR) analysis and multivariate analysis of variables that could be linked to COVID-19 advancement were carried out. Results: a total of 719 patients were examined. Among them, 414 patients were men. Mortality with a 17.1 % prevalence was statistically significant between CAS score levels (P &lt; 0.001). This factor has high OR with mild to moderate and moderate to severe CAS (OR: 2.14; 95% CI: 1.71 to 3.06, and OR: 2.31; 95% CI: 1.84 to 3.57). Oxygen saturation was a significant statistic between CAS score levels (P = 0.02). This factor has a high OR with mild to moderate and moderate to severe CAS (OR: 1.09; 95% CI: 0.71 to 3.60, and OR: 2.38; 95% CI: 0.89 to 2.9). There was no statistical difference between the groups’ outcomes of mechanical ventilation and admission types. Conclusion: In this study, the coronary artery calcification scores of patients with COVID-19 were compared, while the outcomes of interest mortality, mechanical ventilation, and intensive care unitU admission were closely investigated. In light of these findings, coronary artery calcificationscoring can help in patient stratification, enabling earlier therapies for disorders to progress quickly.

Evaluation of the corneal biomechanical properties and corneal thickness in patients with Graves' orbitopathy.

To evaluate the corneal biomechanical properties and central corneal thickness in patients with Graves' orbitopathy (GO). A total of 132 eyes of 66 patients with GO and 108 eyes of 54 healthy subjects were enrolled. Eyes with GO were classified as high score clinical activity score (CAS, ≥ 3) (Group 1, n = 64) and low CAS score (< 3) (Group 2, n = 68). Corneal biomechanical parameters [corneal hysteresis (CH), corneal resistance factor (CRF)], Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc) levels were measured with Ocular Response Analyzer (ORA, Reichert Ophthalmic Instruments, Buffalo, NY) and compared between the groups. The mean CH values were found as 9.6 ± 1mmHg in Group 1, 10.2 ± 0.9mmHg in Group 2, and 11.4 ± 1.7mmHg in the Control Group (p < 0.001). In post hoc analysis the mean CH was significantly lower in Group 1 than Group 2 and Control Group (Group 1-Group 2, p < 0.001; Group 1-Control Group, p < 0.001). The mean CRF was found as 10.5 ± 2.1 in Group 1, 10.4 ± 2.2 in Group 2, and 10.43 ± 2.0 in the Control group. There was no statistically significant difference between the groups in CRF measurements (p = 0.959). The mean IOPcc values were found as 17.1 ± 3.6mmHg in Group 1, 15.8 ± 4.0mmHg in Group 2 and 15.2 ± 4.1mmHg in the Control Group. The IOPcc and IOPg measurements between all groups were statistically significant (p = 0.009, p = 0.027, respectively). Corneal biomechanical measurements were different in the GO patients with varying CAS scores compared to healthy individuals.