The outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome: case series.

PURPOSE: To summarize the outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome (SJS). METHODS: This is a retrospective analysis of a consecutive case series. Twenty-four eyes of 18 SJS patients were included in this study. The ocular parameters, surgical procedures, postoperative complications, and additional treatments of the cases were reviewed. RESULTS: A total of 29 corneal sight rehabilitating surgeries, which consists of 9 keratoplasties, 8 Keratolimbal allograft (KLAL) and 12 combined surgeries (keratoplasty and KLAL simultaneously) were performed on the 24 eyes. All patients were treated with glucocorticoid eyedrops and tacrolimus eyedrops for anti-rejection treatment without combining systemic immunosuppression, except two patients who were prescribed prednisone tablets for the management of systemic conditions. The mean follow-up period was 50.6 ± 28.1 months. The optimal visual acuity (VA) (0.74 ± 0.60 logarithm of the minimum angle of resolution [logMAR]) and endpoint VA (1.06 ± 0.82 logMAR) were both significantly better than the preoperative VA (1.96 ± 0.43 logMAR) (95% CI, p = 0.000). 57.1% patients (8/14) were no longer in the low vision spectrum, and 88.9% patients (8/9) were no longer blind. The mean epithelialization time was 7.1 ± 7.6 weeks. The success rate was 86.7%. Additional treatments for improving epithelialization included administration of serum eyedrops (n = 10), contact lens (n = 15), amniotic membrane transplantation (n = 6), and tarsorrhaphy (n = 8). Complications included delayed epithelialization (n = 4, over 12 weeks), glaucoma (n = 11), and severe allograft opacity (n = 4). Only one graft rejection was observed. CONCLUSIONS: Keratoplasty and KLAL can remarkably enhance VA and improve low vision or even eliminate blindness for ocular complications of SJS. The outcome of the surgeries was correlated with the preoperative ocular situation and choice of operative methods.

Bis(benzoselenadiazol)ethane: A π-Extended Acceptor-Dimeric Unit for Ambipolar Polymer Transistors with Hole and Electron Mobilities Exceeding 10†cm2 V-1 s-1.

The lack of ambipolar polymers with balanced hole (µh) and electron mobilities (µe) >10 cm2 V-1 s-1 is the main bottleneck for developing organic integrated circuits. Herein, we show the design and synthesis of a π-extended selenium-containing acceptor-dimeric unit, namely benzo[c][1,2,5]selenadiazol-4-yl)ethane (BBSeE), to address this dilemma. In comparison to its sulfur-counterpart, BBSeE demonstrates enlarged co-planarity, selective noncovalent interactions, polarized Se-N bond, and higher electron affinity. The successful stannylation of BBSeE offers a great opportunity to access acceptor-acceptor copolymer pN-BBSeE, which shows a narrower band gap, lower-lying lowest unoccupied molecular orbital level (-4.05 eV), and a higher degree of backbone planarity. Consequently, the pN-BBSeE-based organic transistors display an ideally balanced ambipolar transporting property with µh and µe of 10.65 and 10.72 cm2 V-1 s-1, respectively. To the best of our knowledge, the simultaneous µh/µe values >10.0 cm2 V-1 s-1 are the best performances ever reported for ambipolar polymers. In addition, pN-BBSeE shows an excellent shelf-storage stability, retaining over 85 % of the initial mobility values after two months storage. Our study demonstrates the π-extended acceptor-dimeric BBSeE is a promising acceptor building block for constructing high-performance ambipolar polymers applied in next-generation organic integrated circuit.

Development and validation of a diagnostic model for the identification of chronic ocular graft-versus-host disease (oGVHD).

Purpose: To verify the International Chronic Ocular Graft-Versus-Host Disease (ICCGVHD) Group diagnostic criteria and establish an easy-to-use and reliable diagnosis model for quick identification of chronic oGVHD. Methods: This study included 180 patients (355 eyes) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) and visited the Peking University Third Hospital Cornea and Ocular Surface Disease Specialist Clinic from July 2020 to February 2021. The proportion of chronic oGVHD was 76.06% (279/355). Results: Five complaints, including eye dryness, photophobia, foreign body sensation, eye redness, and burning sensation; six ophthalmic examinations, including Ocular Surface Disease Index (OSDI) score, corneal fluorescein staining (CFS), tear break-up time (TBUT), Schirmer's test score without anesthesia, conjunctival score, tear meniscus height, and non-ocular GVHD-involved organs were significantly different between patients with chronic oGVHD and control group (p < 0.05). Binary logistic regression (backward LR algorithm) selection demonstrated that three variables retained diagnostic significance for chronic oGVHD: CFS (OR = 2.71 (1.92-3.81), p < 0.001), Schirmer's test score without anesthesia (OR = 0.83 (0.76-0.91), p < 0.001), and conjunctival score (OR = 1.96 (1.13-3.42), p = 0.031). A nomogram for the identification of chronic oGVHD was developed, and its performance was examined using an internal validation cohort (118 eyes). The areas under the curve (AUCs) for the three-variable-based nomogram were 0.976 (95% CI (0.959-0.992), p < 0.01) and 0.945 (95% CI (0.904-0.986), p < 0.01) in the development and internal validation cohorts, respectively. Conclusion: This concise three-variable-based nomogram based on ICCGVHD criteria could serve as an easy-to-use and reliable tool for rapid screening of chronic oGVHD.

Identification of Lithium Compounds on Surfaces of Lithium Metal Anode with Machine-Learning-Assisted Analysis of ToF-SIMS Spectra.

Detailed knowledge about contamination and passivation compounds on the surface of lithium metal anodes (LMAs) is essential to enable their use in all-solid-state batteries (ASSBs). Time-of-flight secondary ion mass spectrometry (ToF-SIMS), a highly surface-sensitive technique, can be used to reliably characterize the surface status of LMAs. However, as ToF-SIMS data are usually highly complex, manual data analysis can be difficult and time-consuming. In this study, machine learning techniques, especially logistic regression (LR), are used to identify the characteristic secondary ions of 5 different pure lithium compounds. Furthermore, these models are applied to the mixture and LMA samples to enable identification of their compositions based on the measured ToF-SIMS spectra. This machine-learning-based analysis approach shows good performance in identifying characteristic ions of the analyzed compounds that fit well with their chemical nature. Moreover, satisfying accuracy in identifying the compositions of unseen new samples is achieved. In addition, the scope and limitations of such a strategy in practical applications are discussed. This work presents a robust analytical method that can assist researchers in simplifying the analysis of the studied lithium compound samples, offering the potential for broader applications in other material systems.

Preisolation measures and clinical features for pediatric patients with suspicious COVID-19.

Background: In December 2019, many cases of COVID-19 were reported in Wuhan City, Hubei Province, China. In the following 3 months, the disease out broke in China. Preisolation measures was used to screen out COVID-19 patients in the pediatric respiratory ward of our hospital. Aims: To investigate the new measures for screening COVID-19 patients and to analyze the clinical features of children with suspicious COVID-19. Methods: A total of 50 preisolated children with suspicious COVID-19 who were admitted to our hospital in Mianyang, China, between January 28 and March 5, 2020, were included. Patients presented with fever and cough or fever accompanied by vomiting and diarrhea. A detailed epidemiological history screening was performed. A real-time reverse-transcriptase-polymerase-chain-reaction (RT-PCR) was used to detect SARS-COV-2 nucleic acid. Low-dose chest computed tomography (CT) was applied when pneumonia was suspicious. Routine blood tests were performed to rule out COVID-19. Patients' data were collected, and the basic clinical features, epidemiological history, clinical manifestations, auxiliary examination results, and outcomes were analyzed and summarized. Results: No definite cases were detected, while two patients were suspected of having COVID-19. The pathogenic results of the 50 patients mainly included Mycoplasma pneumoniae, followed by Epstein-Barr virus, and rotavirus. Thirty-five patients suffered from bronchopneumonia. The preisolated patients had similar clinical and epidemiological characteristics as patients with fever, cough, vomiting, and diarrhea. Conclusions: Preisolation measures combined with pathogen screening can minimize the risk of hospital-acquired infections by preventing patients with suspicious COVID-19 from contacting other patients before they are explicitly excluded. Clinical analysis of the patients was helpful for clinical nursing management.

Assessment of Corneal Epithelial Changes and Related Factors in Ocular Chronic Graft-Versus-Host Disease (GVHD) by in Vivo Confocal Microscopy.

PURPOSE: To evaluate corneal epithelial changes and related factors in chronic ocular graft-versus-host disease (oGVHD) patients. METHODS: 21 patients (35 eyes) with chronic oGVHD and 8 patients (12 eyes) without oGVHD after bone marrow transplantation were recruited for assessment involving in vivo confocal microscopy (IVCM) analysis, ocular surface parameter determination and tear cytokine level analysis. The IVCM corneal epithelial scoring system was used to evaluate corneal epithelial changes. RESULTS: There was a significant difference in the corneal epithelial score (p = .001) between the two groups. The corneal epithelial scores were significantly correlated with the corneal fluorescein staining scores (CFS, r = 0.463, p < .001), Schirmer's test (r = -0.389, p = .009) and tear cytokine levels of EGF (r = -0.491, p < .001) and APRIL (r = -0.318, p = .030). CONCLUSIONS: The depth of corneal epithelial defects can be estimated by the CFS. Corneal epithelial changes of chronic oGVHD are considered to be associated with lacrimal deficiency and a lack of EGF.

Tear Cytokines Associated With Therapeutic Effects in Chronic Ocular Graft-Versus-Host Disease.

PURPOSE: The local application of antiinflammatory and immunosuppressive agents is an effective method for the treatment of ocular graft-versus-host disease (oGVHD); however, we noticed that some patients with oGVHD did not respond to topical therapy as well as many others. This study aimed to determine whether tear cytokines were associated with therapeutic effects in oGVHD. METHODS: Forty patients with chronic oGVHD were enrolled and grouped as responders (n = 24) and nonresponders (n = 16) based on the clinical response to 1 month of topical treatment. Tear samples were collected from each participant before and after treatment, and the tear concentrations of 7 cytokines (IL-2, IL-6, IL-8, IL-10, IL-17A, TNF-α, and ICAM-1) were measured using microsphere-based immunoassay analysis. Differences between pretreatment and posttreatment tear samples were analyzed using the Wilcoxon test. RESULTS: No significant differences in ophthalmic symptoms or cytokine levels were observed between responders and nonresponders at baseline. After 1 month of topical treatment, ocular surface parameters (including Ocular Surface Disease Index, National Institutes of Health eye score, best-corrected visual acuity, corneal fluorescein staining score, and fluorescein tear film break-up time) were significantly ameliorated in responders, but not in nonresponders. Moreover, none of the cytokines exhibited significant alteration in nonresponders, whereas the tear levels of IL-6 (P = 0.031) and IL-8 (P = 0.037) exhibited significant decreases in responding patients. CONCLUSIONS: Our results revealed that tear IL-6 and IL-8 levels were significantly altered in response to topical oGVHD treatment.

Ecological stoichiometry, salt ions and homeostasis characteristics of different types of halophytes and soils.

Studying eco-stoichiometric and salt ions characteristics of halophytes and soils is helpful to understand the distribution mechanism of nutrients and salts in halophytes and their adaptation strategies to salinized habitats. In this study, three different types of halophytes (Phragmites communis-salt repellent, Suaeda salsa-salt accumulating, and Aeluropus sinensis- salt secreting) and soils were selected to analyze the differences and correlations of C, N, P stoichiometry and salt accumulation. Results showed that: (1) the total nitrogen (TN) and total phosphorus (TP) contents of the three halophytes' leaves were significantly higher than those of the roots and stems, and the C: N ratios were contrary to the difference mentioned above. The growth of P. communis and S. salsa was mainly limited by P, whereas A. sinensis was limited by both N and P. S. salsa had a stronger absorption capacity for Na+ and Mg2+ than P. communis and A. sinensis. The interrelationship between salt ions and C, N and P ecological stoichiometry of halophyte organs was influenced by the type of halophytes. (2) The TC, TN, and N: P contents of the three halophyte communities in the surface soil (0-20 cm) were significantly higher than the other soil layers, while P did not differ significantly among soil layers. The planting of different halophytes affected the TC, TN, C: N, N: P values and the content of seven ions in the surface soil. SO4 2-was positively correlated with soil TC, TN, N:P, and Na+ were positively correlated with soil TC in three halophytes. (3) The P. communis TC and A. sinensis TN contents were negatively correlated with soil TC, TN, C: P, and N: P, whereas TC contents of S. salsa were positively correlated with the aforementioned soil indicators. The P. communis and A. sinensis TC contents were negatively correlated with soil K+, while this correlation was opposite between S. salsa and soil. (4) The homeostasis of C, N, and P elements in all three halophytes showed that C > N > P, the homeostasis was strongest in A. sinensis and weakest in S. salsa. The results provide a theoretical basis for the restoration of saline land in the Yellow River Delta.

Biomarkers in Ocular Graft-Versus-Host Disease: Implications for the Involvement of B Cells.

Graft-versus-host disease (GVHD) is an immune-mediated inflammatory disease resulting from destruction of host tissue by donor immunoreactive cells and occurs in 30% to 70% of post-hematopoietic stem cell transplantation (HSCT) patients. Ocular involvement occurs in up to 60% to 90% of patients with chronic GVHD. T cells have long been recognized as a key driver of alloreactivity in chronic ocular GVHD (oGVHD). However, the role of B-cells has not been elucidated. To further explore the involvement of B-cells in the immune mechanism of chronic oGVHD and to uncover more sensitive biomarker indicators, we conducted this study on the tear cytokine analysis of chronic oGVHD. The study enrolled 18 patients (27 eyes) diagnosed with chronic oGVHD and 11 patients (22 eyes) diagnosed with dry eye disease (DED) as a control group. The microsphere-based immunoassay was used to determine 29 tear cytokines in both groups. Spearman's test was used to analyze the correlation between cytokine levels and different ophthalmic indexes (National Institutes of Health eye score, fluorescein tear film break-up time, corneal fluorescein staining, and Schirmer's test). Receiver operating characteristic curves were used to assess the predictive potential of the identified cytokines for chronic oGVHD. Twenty tear cytokine levels were elevated in patients with chronic oGVHD compared to those with DED (P < .05). Proliferation-inducing ligand (APRIL) and epidermal growth factor showed lower levels in patients with chronic oGVHD. Ultimately, IL-2, 6, and 8, ICAM-1 (CD54), E-selectin (CD62E), neuropilin-1, and B-cell activation factor (BAFF) levels had a strong correlation with ophthalmic indexes and an area under the curve (AUC) > 0.85. BAFF/APRIL exhibited superior diagnostic capabilities (AUC = 0.995; 95% confidence interval, 0.983-1.000). Our study identified IL-2, 6, 8, ICAM-1, CD62E, E-selectin, neuropilin-1, and BAFF as promising tear biomarkers that can indicate the severity of chronic oGVHD. Notably, APRIL/BAFF shows superior diagnostic capabilities, revealing that B cells may play an important role as immune substrates in chronic oGVHD. © 2023 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Rheological properties of transglutaminase-treated concentrated pea protein under conditions relevant to high-moisture extrusion processing.

At present, the structural changes of extruded materials under thermal-mechanical stress during high-moisture extrusion are still unclear. In this study, the transglutaminase (TG) treatments on the structure of pea protein isolate (PPI) under conditions relevant to high-moisture extrusion processing (50 wt% PPI at 30°C, 120°C and heated to 120°C and subsequently cooled to 30°C) was studied by using a closed cavity rheometer. Strain and frequency sweeping were carried out under various temperature conditions, and the information obtained was drawn into a texture map. Lissajous curves combined with energy dissipation ratio were introduced to characterize the nonlinear response of the samples. The results showed that the storage modulus of PPI increased with the increase of TG concentration during heat treatment. After cooling to 30°C, PPI with 0.25-1%TG could enhance the elasticity, but treating by 2% TG could inhibit the formation of disulfide bonds, the uniform development of the protein network, thus showing the "tough" character. These findings can help to better understand the relationships of material-structure during the extrusion process, and also provide help for further optimization of the quality of meat substitutes.

Ophthalmic manifestations are associated with reduced tear lymphotoxin-α levels in chronic ocular graft-versus-host disease.

PURPOSE: To determine the role tear lymphotoxin-α (LT-α) in chronic ocular graft-versus-host disease (oGVHD). METHODS: Twenty-two chronic oGVHD and 17 control tear samples were collected, and commercial test strips were used to detect LT-α concentrations. Concentration differences between patients with and without oGVHD were determined via Mann-Whitney U test. The correlation between LT-α levels and ophthalmic parameters was analyzed using Spearman's test. RESULTS: The concentration of LT-α was significantly lower in oGVHD patients than in controls. LT-α levels were significantly correlated with OSDI, NIH eye score, T-BUT, and CFS among all participants. ROC analysis revealed that the area under the curve of LT-α was 0.847, and the cutoff value for chronic oGVHD diagnosis was 0.203 ng/mL. CONCLUSION: Our study revealed the significant decrease of tear LT-α in oGVHD, and suggested LT-α as a promising marker for chronic oGVHD diagnosis.