Efficacy of Posterior Scleral Reinforcement in Treating Anisometropic Amblyopia Associated With Unilateral High Myopia in Children.

The aim of this study is to examine the effectiveness and safety of posterior scleral reinforcement (PSR) for treating anisometropic amblyopia and myopia associated with high myopia in children. Children with unilateral high myopia (uHM) and anisometropic amblyopia who underwent PSR in their highly myopic eyes were included in this study. The treated eye was designated as the PSR group, whereas the healthier eye served as the control, and paired comparisons were made. Thirteen patients (13 eyes in each group) were included, with an average age of 5.85±2.08 years. Cross-sectional comparisons between the groups showed that within 2 to 3 years after surgery, the PSR group had a significantly greater increase in best-corrected visual acuity per month compared with the control group (P=0.03), a significantly lower increase in axial length per month (P=0.007), and a significantly smaller absolute value of the increase in SE per month (P=0.002). Temporal longitudinal comparisons within the PSR group indicated that the increase in axial length per month 2 to 3 years after surgery was significantly slower than 1 year before surgery (P=0.045). The increase in best-corrected visual acuity per month was higher than 1 year before surgery, although not significantly (P=0.859). PSR is a safe and effective treatment for refractory anisometropic amblyopia caused by uHM, and for controlling axial length and the degree of myopia.

Evaluation of Early Accommodation Outcomes Following Femtosecond Laser-Assisted in situ Keratomileusis and Small Incision Lenticule Extraction.

PURPOSE: The aim of this study is to assess the changes and differences in early postoperative binocular accommodative function following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE). METHODS: In this retrospective study, 120 patients (240 eyes) diagnosed with low-to-moderate and high myopia, who underwent either FS-LASIK or SMILE procedures were included. The assessment encompassed measurements of accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio using a smart flipper. Measurements were taken preoperatively, as well as at 1 day, 1 week, and 1 month postoperatively. Additionally, the visual fatigue scale score was assessed and compared at the 1 month mark post-surgery. Changes in parameters were quantified by calculating the difference between preoperative values and those recorded at each postoperative time point. RESULTS: At 1 month post-surgery, both FS-LASIK and SMILE procedures demonstrated potential for recovery or even improvement in accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio compared to preoperative levels. The FS-LASIK group exhibited a greater magnitude of change in accommodative facility postoperatively compared to the SMILE group. In the low-to-moderate myopia subgroup, the FS-LASIK group exhibited lower changes in accommodation time and visual fatigue scale score at 1 month post-surgery compared to the SMILE group, with all associated p-values <0.05. CONCLUSIONS: Early postoperative recovery of accommodation function was slower following SMILE compared to FS-LASIK. Additionally, the severity of visual fatigue at 1 month post-surgery was greater in the SMILE group than in the FS-LASIK group. This difference in visual fatigue levels may be attributed to the delayed recovery observed in postoperative SMILE procedures.

Prime Editing of Vascular Endothelial Growth Factor Receptor 2 Attenuates Angiogenesis In Vitro.

Vascular endothelial growth factor receptor (VEGFR)-2 is a key switch for angiogenesis, which is observed in various human diseases. In this study, a novel system for advanced prime editing (PE), termed PE6h, is developed, consisting of dual lentiviral vectors: (1) a clustered regularly interspaced palindromic repeat-associated protein 9 (H840A) nickase fused with reverse transcriptase and an enhanced PE guide RNA and (2) a dominant negative (DN) MutL homolog 1 gene with nicking guide RNA. PE6h was used to edit VEGFR2 (c.18315T>A, 50.8%) to generate a premature stop codon (TAG from AAG), resulting in the production of DN-VEGFR2 (787 aa) in human retinal microvascular endothelial cells (HRECs). DN-VEGFR2 impeded VEGF-induced phosphorylation of VEGFR2, Akt, and extracellular signal-regulated kinase-1/2 and tube formation in PE6h-edited HRECs in vitro. Overall, our results highlight the potential of PE6h to inhibit angiogenesis in vivo.

Effects of common eye diseases in children and their treatment measures on ocular surface homeostasis: A review.

Ocular surface homeostasis plays a vital role in maintaining of eye health. Dry eye disease is one of the prominent and typical manifestations of disruption of ocular surface homeostasis that leads to the worsening of ocular surface homeostasis that leads to the worsening of ocular surface disease when it interacts with other pathogenic factors. However, disruption in ocular surface homeostasis in children is often overlooked because of the current methods of assessing ocular surface homeostasis. This review summarizes the main factors affecting ocular surface homeostasis in children, with the aim of drawing the attention of clinicians to the disruption of ocular surface homeostasis in children when dealing with such diseases. Ocular surface homeostasis involves several interrelated components, each of which plays a nonnegligible role in ocular surface homeostasis. Unlike adults, children have a stronger lacrimal gland secretion capacity and milder symptoms when there is a slight disruption of the ocular surface homeostasis. In addition, children's expressive abilities were weaker. Therefore, dry eye in children is often ignored by doctors and parents, and clinicians should pay more attention to the protection of ocular surface homeostasis when treating children with these diseases. Therefore, there is a need for diagnostic criteria for dry eye disease specific to children.

Deficits of the "Good" Eye in Amblyopia: Processing Geometric Properties.

Purpose: Although fellow eyes of amblyopia are typically considered normal, recent studies have revealed impairments in certain aspects of vision. However, it remains unclear at which level of object processing these impairments occur. This study aims to investigate the functional level of visual perception impairment in the fellow eye of children and adults with amblyopia using the geometric functional hierarchy discrimination task based on Klein Mathematics methodology. Methods: Seventy-six patients with amblyopia (40 children and 36 adults) and 77 age-matched healthy controls (40 children and 37 adults) were recruited for this study. The participants completed four sets of geometric hierarchies (in ascending order of stability: Euclidean, affine, projective, and topology) and one set of color discrimination tasks. They were instructed to rapidly and accurately select a distinct shape from the four quadrants. Results: The participants' performance was evaluated using the inverse efficiency (IE) score (IE = response time (RT)/accuracy). The results of IEs show that the fellow eye of children with amblyopia exhibits normal topological processing, yet displays higher IEs in other geometric properties and color processing, suggesting impairments in these specific discrimination abilities. However, adults with amblyopia did not show deficits on any discrimination types compared with adult controls. Conclusions: The lack of compromised topological processing suggests that amblyopia may not have inflicted any damage to the subcortical visual pathways. Furthermore, these deficits observed in the fellow eye tend to diminish significantly during adulthood, implying that amblyopia may potentially hinder the maturation process of the fellow eye.

Thromboelastography-Guided Antiplatelet Therapy for Patients with Ischemic Cerebrocardiovascular Diseases: A Systematic Review and Meta-Analysis.

INTRODUCTION: The effectiveness of thromboelastography (TEG)-guided antiplatelet therapy in patients with ischemic cerebrocardiovascular diseases is not well-established. This systematic review evaluates the efficacy and safety of TEG-guided antiplatelet therapy compared to standard treatment in patients with ischemic cerebrocardiovascular diseases. METHODS: Randomized controlled trials (RCTs) and observational studies comparing TEG-guided antiplatelet therapy with standard therapy in patients suffering from ischemic stroke (IS) or coronary artery disease (CAD) were identified. The primary efficacy measure was a composite of ischemic and hemorrhagic events. Secondary efficacy measures included any ischemic events, while safety was assessed by the occurrence of bleeding events. RESULTS: Ten studies involving 4 RCTs and 6 observational studies with a total of 1,678 patients were included. When considering a composite of ischemic and hemorrhagic events in RCTs, a significant reduction was observed in IS or CAD patients under TEG-guided therapy compared to standard therapy (OR: 0.45, 95% CI: 0.27-0.75, p = 0.002). After pooling RCTs and observational studies together, compared to standard antiplatelet therapy, TEG-guided therapy significantly reduced the risk of a composite of ischemic and hemorrhagic events (OR: 0.26, 95% CI: 0.19-0.37; p < 0.00001), ischemic events (OR: 0.28, 95% CI: 0.19-0.41; p < 0.00001), and bleeding events (OR: 0.31, 95% CI: 0.16-0.62; p = 0.0009) in patients with IS or CAD. CONCLUSION: TEG-guided antiplatelet therapy appears to be both effective and safe for patients with IS or CAD. These findings support the use of TEG testing to tailor antiplatelet therapy in individuals with ischemic cerebrocardiovascular diseases.

Overcoming cancer drug-resistance calls for novel strategies targeting abnormal alternative splicing.

Abnormal gene alternative splicing (AS) events are strongly associated with cancer progression. Here, we summarize AS events that contribute to the development of drug resistance and classify them into three categories: alternative cis-splicing (ACS), alternative trans-splicing (ATS), and alternative back-splicing (ABS). The regulatory mechanisms underlying AS processes through cis-acting regulatory elements and trans-acting factors are comprehensively described, and the distinct functions of spliced variants, including linear spliced variants derived from ACS, chimeric spliced variants arising from ATS, and circRNAs generated through ABS, are discussed. The identification of dysregulated spliced variants, which contribute to drug resistance and hinder effective cancer treatment, suggests that abnormal AS processes may together serve as a precise regulatory mechanism enabling drug-resistant cancer cell survival or, alternatively, represent an evolutionary pathway for cancer cells to adapt to changes in the external environment. Moreover, this review summarizes recent advancements in treatment approaches targeting AS-associated drug resistance, focusing on cis-acting regulatory elements, trans-acting factors, and specific spliced variants. Collectively, gaining an in-depth understanding of the mechanisms underlying aberrant alternative splicing events and developing strategies to target this process hold great promise for overcoming cancer drug resistance.

The optimal atropine concentration for myopia control in Chinese children: a systematic review and network Meta-analysis.

AIM: To figure out whether various atropine dosages may slow the progression of myopia in Chinese kids and teenagers and to determine the optimal atropine concentration for effectively slowing the progression of myopia. METHODS: A systematic search was conducted across the Cochrane Library, PubMed, Web of Science, EMBASE, CNKI, CBM, VIP, and Wanfang database, encompassing literature on slowing progression of myopia with varying atropine concentrations from database inception to January 17, 2024. Data extraction and quality assessment were performed, and a network Meta-analysis was executed using Stata version 14.0 Software. Results were visually represented through graphs. RESULTS: Fourteen papers comprising 2475 cases were included; five different concentrations of atropine solution were used. The network Meta-analysis, along with the surface under the cumulative ranking curve (SUCRA), showed that 1% atropine (100%)>0.05% atropine (74.9%) >0.025% atropine (51.6%)>0.02% atropine (47.9%)>0.01% atropine (25.6%)>control in refraction change and 1% atropine (98.7%)>0.05% atropine (70.4%)>0.02% atropine (61.4%)>0.025% atropine (42%)>0.01% atropine (27.4%)>control in axial length (AL) change. CONCLUSION: In Chinese children and teenagers, the five various concentrations of atropine can reduce the progression of myopia. Although the network Meta-analysis showed that 1% atropine is the best one for controlling refraction and AL change, there is a high incidence of adverse effects with the use of 1% atropine. Therefore, we suggest that 0.05% atropine is optimal for Chinese children to slow myopia progression.

Effect and safety posterior scleral reinforcement on controlling myopia in children: a meta-analysis.

PURPOSE: The aim of this meta-analysis was to assess the efficacy of posterior scleral reinforcement (PSR) on the control of pediatric myopia. Electronic databases were systematically searched. METHODS: Standardized mean differences (SMDs) of outcomes were calculated. Eight studies with 357 patients with pediatric myopia were included. The SMD for the increase in mean axial length (AL) in the PSR and control group was - 1.19 (95% CI - 1.71, - 0.68). RESULTS: The SMD for decrease of best-corrected visual acuity (BCVA) LogMAR in the PSR and control group was 0.85 (95% CI 0.28, 1.43). The SMD for change in intraocular pressure (IOP) at the time of surgery and at the end of the follow-up period in the PSR group was - 0.01 (95% CI - 0.48, 0.47). CONCLUSION: This meta-analysis indicates that PSR surgery may be an effective therapeutic strategy to control the progression of myopia in childhood with acceptable adverse effects.

CircRNA and Stroke: New Insight of Potential Biomarkers and Therapeutic Targets.

Stroke, the second-largest cause of death and the leading cause of disability globally, presents significant challenges in terms of prognosis and treatment. Identifying reliable prognosis biomarkers and treatment targets is crucial to address these challenges. Circular RNA (circRNA) has emerged as a promising research biomarkers and therapeutic targets because of its tissue specificity and conservation. However, the potential role of circRNA in stroke prognosis and treatment remains largely unexplored. This review briefly elucidate the mechanism underlying circRNA's involvement in stroke pathophysiology. Additionally, this review summarizes the impact of circRNA on different forms of strokes, including ischemic stroke and hemorrhagic stroke. And, this article discusses the positive effects of circRNA on promoting cerebrovascular repair and regeneration, maintaining the integrity of the blood-brain barrier (BBB), and reducing neuronal injury and immune inflammatory response. In conclusion, the significance of circRNA as a potential prognostic biomarker and a viable therapeutic target was underscored.

GIS-based landslide susceptibility zoning using a coupled model: a case study in Badong County, China.

Landslide susceptibility zoning is necessary for landslide risk management. This study aims to conduct the landslide susceptibility evaluation based on a model coupled with information value (IV) and logistic regression (LR) for Badong County in Hubei Province, China. Through the screening of landslide predisposing factors based on correlation analysis, a spatial database including 11 landslide factors and 588 historical landslides was constructed in ArcGIS. The IV, LR and their coupled model were then developed. To validate the accuracy of the three models, the receiver operating characteristic curves (ROC) and the landslide density curves were correspondingly created. The results showed that the areas under the receiver operating characteristic curve (AUCs) of the three models were 0.758, 0.786 and 0.818, respectively. Moreover, the landslide density increased exponentially with the landslide susceptibility, but the coupled model exhibited a higher growth rate among the three models, indicating good performance of the proposed model in landslide susceptibility evaluation. The landslide susceptibility map generated by the coupled model demonstrated that the high and very high landslide susceptibility area mainly concentrated along rivers and roads. Furthermore, by counting the landslide numbers and analyzing the landslide susceptibility within each town in Badong County, it was discovered that Yanduhe, Xinling, Dongrangkou and Guandukou were the main landslide-prone areas. This research will contribute to landslide prevention and mitigation and serve as a reference for other areas.

Hippo pathway in intestinal diseases: focusing on ferroptosis.

The incidence of intestinal diseases, such as inflammatory bowel disease, gastric cancer, and colorectal cancer, has steadily increased over the past decades. The Hippo pathway is involved in cell proliferation, tissue and organ damage, energy metabolism, tumor formation, and other physiologic processes. Ferroptosis is a form of programmed cell death characterized by the accumulation of iron and lipid peroxides. The Hippo pathway and ferroptosis are associated with various intestinal diseases; however, the crosstalk between them is unclear. This review elaborates on the current research on the Hippo pathway and ferroptosis in the context of intestinal diseases. We summarized the connection between the Hippo pathway and ferroptosis to elucidate the underlying mechanism by which these pathways influence intestinal diseases. We speculate that a mutual regulatory mechanism exists between the Hippo pathway and ferroptosis and these two pathways interact in several ways to regulate intestinal diseases.

Measurement and analysis of water ecological carrying capacity in the Yangtze River Economic Belt, China.

Water ecological carrying capacity (WECC) is a crucial index for measuring regional sustainable development. To investigate the evolution of WECC in the Yangtze River Economic Belt (YREB), this study constructed a comprehensive index system consisting of 23 indicators from six interconnected dimensions of water systems. The back propagation neural network (BPNN) model was used to quantify WECC in YREB from 2010 to 2021, and ArcGIS was utilized to visualize the distribution of WECC. To identify sensitive indicators under subsystems, sensitivity analysis was conducted based on the one-at-a-time (OAT) method. Additionally, time-series prediction of WECC was performed using the exponential smoothing (ES) method. Finally, the coupling coordinated degree (CCD) of subsystems in each province from 2010 to 2021 was calculated. The results indicated that the average WECC in YREB gradually increased from 2010 to 2021, with significant provincial differences. Sensitivity analysis revealed that R1, U2, Q4, S2, M3 and B1 had the most substantial impacts on the WECC of subsystems (Sub-CC). The fitting curve between the CCD and WECC showed that as CCD increased, the growth rate of WECC gradually slowed down. Based on these findings, relevant suggestions were proposed to improve WECC and promote the regional sustainable development in YREB.

A Study on the Effectiveness of 650-nm Red-Light Feeding Instruments in the Control of Myopia.

INTRODUCTION: This study analyzed the effectiveness of 650-nm red-light feeding instruments in the control of myopia. METHODS: In this study, 164 school-aged participants diagnosed with myopia in the city of Shenzhen were enrolled in a red-light feeding instrument study. Of these, 41 were enrolled in the mild-to-moderate myopia group that received red-light feeding (RLMM group), 65 were enrolled in the mild-to-moderate myopia group that received single-vision spectacle treatment (SVSMM group), and 58 were included in the severe myopia group that received red-light feeding (RLS group). RESULTS: After the baseline values of the three groups were matched, the right eye data were used for statistical analysis. The average return visit time of each group was 60.42 days, and changes in the observation indexes before treatment and after follow-up treatment were compared. As the primary outcome, the axial length changes in the right eye of the SVSMM group (0.08 ± 0.40 mm), the RLMM group (-0.03 ± 0.11 mm), and the RLS group (-0.07 ± 0.11 mm) were compared and showed a statistical result of p < 0.001. CONCLUSION: The study results verified that red light had a noticeable effect on the control of myopia and that low-level red-light therapy played a vital role in the treatment of severe myopia.

Research on regional water environmental carrying capacity based on GIS and TOPSIS comprehensive evaluation model.

Water environmental carrying capacity (WECC) is an important indicator for assessing the coordination between the water environment and the social-economic-resources and environment subsystems. In this study, to determine the WECC of Changsha-Zhuzhou-Xiangtan urban agglomeration in Xiang River Basin, a three-level index system was established using an analytic hierarchy process. Because the previous evaluation system lacked continuous indicators, the results could not reflect the differences of WECC within the administrative units, thus, this study selected 4 continuous indicators, and finally an evaluation index system including 15 indicators was established. Based on the TOPSIS model and logistic regression model, the current situation and change trend of WECC in the study area were obtained in ArcGIS. The results showed that the comprehensive WECC in this region was inferior in 2020, particularly in urban concentrated areas, and it was extremely uneven in spatial distribution. The WECC decreased significantly from 2011 to 2014 and gradually improved from 2014 to 2020. According to the prediction results, the WECC will increase in the future, with an average value of 0.54 in 2025 and 0.60 in 2035. This study will have important guiding implications for the protection and improvement of the water environment in the study area and related areas.

The Effects of Binocular Visual Function Training after Concomitant Exotropia Surgery.

PURPOSE: This study investigated the effect and long-term efficacy of binocular visual function training after concomitant exotropia surgery. METHODS: A total of 92 patients who underwent concomitant exotropia surgery were randomly divided into group A (the training group) (n = 54), who received binocular four-dimensional (4D) visual function training after surgery, and group B (control group) (n = 38). The patients in group A received personalized 4D visual function training 2 weeks after surgery and were followed up for 12 months. The eye position, distant and near stereo acuity, respectively, and postoperative efficacy were compared with those of the patients in group B. RESULTS: The normal eye position rate in group A was higher than in group B at the end of the overall follow-up period (p < .05), and the near stereo acuity rate was higher than the distant stereo acuity rate in both groups A and B at 2 weeks after surgery and at the end of follow up. The distant and near stereo acuity rates of the patients in group A were higher than those in group B (p < .05) at the end of the follow-up period, and the distant stereo acuity of group A was significantly improved (p < .05). The functional complete and incomplete response rates of group A were significantly higher than those of group B at the end of the follow-up period (p < .05). CONCLUSIONS: Four-dimensional visual function training for patients after concomitant exotropia surgery could facilitate the recovery of postoperative binocular visual function, as well as prevent the recurrence of exotropia after surgery.

Exploring the Relationship Between Binocular Imbalance and Myopia: Refraction with a Virtual Reality Platform.

To explore the relationship between binocular imbalance (BI) and the abnormal development of binocular refraction. BI data were collected by enrolling the first 1,000 adolescents and children aged 6-18 years in Shenzhen Eye Hospital from April 2020 to January 2021. In this cross-sectional study, the imbalance value (IV) did not show a statistical correlation with the spherical equivalent (SE) (oculus dexter [OD]: r = 0.022, p = 0.586; oculus sinister [OS]: r = -0.021, p = 0.606), and had little correlation with the uncorrected visual acuity (VA) (OD: r = -0.084, p = 0.039; OS: r = -0.034, p = 0.408). The proportion of binocular contrast imbalance (BCI) (the absolute value) maintained the highest level (from 54.42 to 79.17 percent) with the increase of bilateral SE difference in the four subcategories (binocular balance, monocular suppression, binocular rivalry, and BCI). From -100 to +100 of IV, the SE of the left eye tends to increase negatively when compared with the right eye (from -95 < IV ≦ -80, SE difference = -0.83 ± 1.58, to -20 < IV ≦ -10, SE difference = -0.14 ± 0.61; from 10 ≦ IV <20, SE difference = -0.05 ± 0.80, to 80 ≦ IV <95, SE difference = 1.48 ± 2.77). BI widely exists within the general pediatric population. The BI did not show significant correlation with the unilateral eye refractive state and the VA. However, the BI may be accompanied by imbalanced development of the eye refractive system. Furthermore, the SE of the dominant eye (from the prospective of BI) tends to be more negative than that of the opposite eye as the value increases. Clinical Trial Registration number: ChiCTR2100045457.

Experimental Study of Multi-Angle Effects of Micron-Silica Fume on Micro-Pore Structure and Macroscopic Mechanical Properties of Rock-like Material Based on NMR and SEM.

The experiment of rock-like material plays an important role in the simulation of engineering fractured rock mass. To further understand the influence of raw materials on rock-like materials, this paper carried out the indoor mechanical properties test and the micro-pore structure detection combining NMR and SEM. The effects of micron-silica fume (SF) on microporous structure parameters and macroscopic mechanical properties under different conditions of water-cement ratio (WCR) and sand-cement ratio (SCR) were discussed. The intrinsic relationship between parameters of different scales was analyzed. The experimental results showed that the porosity parameters of different radii gradually decreased with the increase in SF. The reduction rate of macroporous porosity was the greatest, and the decreasing rate of microporous porosity was the smallest. With the increase in SF, the microscopic characteristics of the internal surface changed from more pores, complex morphological distribution, rough surface to fewer pores, regular morphological distribution and flat and uniform surface. The box fractal dimension also showed a decreasing trend. Micro-pore structure makes a valuable contribution to the influence of SF on mechanical properties. The compressive strength and tensile strength increased with the increase in SF. The box fractal dimension and porosity of different radii were negatively correlated with mechanical strength. Different porosity parameters conformed to a good exponential relationship with mechanical properties. The research results can provide reference value and research space for subsequent rock-like material research.