Hypomorphic and hypermorphic mouse models of Fsip2 indicate its dosage-dependent roles in sperm tail and acrosome formation.

Loss-of-function mutations in multiple morphological abnormalities of the sperm flagella (MMAF)-associated genes lead to decreased sperm motility and impaired male fertility. As an MMAF gene, the function of fibrous sheath-interacting protein 2 (FSIP2) remains largely unknown. In this work, we identified a homozygous truncating mutation of FSIP2 in an infertile patient. Accordingly, we constructed a knock-in (KI) mouse model with this mutation. In parallel, we established an Fsip2 overexpression (OE) mouse model. Remarkably, KI mice presented with the typical MMAF phenotype, whereas OE mice showed no gross anomaly except for sperm tails with increased length. Single-cell RNA sequencing of the testes uncovered altered expression of genes related to sperm flagellum, acrosomal vesicle and spermatid development. We confirmed the expression of Fsip2 at the acrosome and the physical interaction of this gene with Acrv1, an acrosomal marker. Proteomic analysis of the testes revealed changes in proteins sited at the fibrous sheath, mitochondrial sheath and acrosomal vesicle. We also pinpointed the crucial motifs of Fsip2 that are evolutionarily conserved in species with internal fertilization. Thus, this work reveals the dosage-dependent roles of Fsip2 in sperm tail and acrosome formation.

MRI-based endplate bone quality score independently predicts cage subsidence after anterior cervical corpectomy fusion.

BACKGROUND: To reduce the amount of radiation that patients receive during surgery, surgeons can evaluate the quality of the bone prior to surgery using computed tomography (CT) or dual-energy X-ray absorptiometry. Recently, lumbar spine vertebral bone quality has been evaluated using an MRI-based scoring system. However, few studies have investigated the connection between cage subsidence in patients following cervical interbody fusion and site-specific MRI bone evaluation. It is unknown how cage subsidence following anterior cervical corpectomy decompression and fusion is related to MRI-based endplate bone quality assessment. PURPOSE: To create a similar MRI-based cervical spine scoring system (C-EBQ) and to investigate the predictive value of the MRI cervical endplate bone quality (C-EBQ) score for cage subsidence after ACCF. METHODS: The patients' demographic, surgical, and radiological data were collected. Cage subsidence was defined as fusion segment height loss ≥ 3 mm. Multivariate logistic regression models were developed to determine correlations between potential risk factors and subsidence, and simple linear regression analyses of statistically significant indicators were performed. RESULTS: Among the patients who underwent single-level ACCF, 72 met the requirements for inclusion. The C-VBQ scores also improved from 2.28 ± 0.12, indicating no subsidence, to 3.27 ± 0.35, which indicated subsidence, and the C-EBQ scores improved in both the nonsubsidence group (1.95 ± 0.80) and the subsidence group (2.38 ± 0.54). There was a statistically significant difference (p < 0.05) among the groups. Higher C-EBQ scores were strongly correlated with subsidence in the multivariate analysis (odds ratio [OR] = 17.249, 95% CI = 2.269 to 7.537, P < 0.001), and the C-VBQ score was the major independent predictor of subsidence following ACCF ([OR] = 4.752, 95% CI = 3.824 to 8.781, P < 0.05). The C-EBQ score outperformed the C-VBQ score (75.6%) in terms of predictive accuracy, with a ROC curve indicating an 89.4% score. CONCLUSIONS: After ACCF, cage subsidence was strongly correlated with higher C-EBQ scores on preoperative MRI. Assessing C-EBQ before ACCF may be a useful way to estimate the likelihood of postoperative subsidence.

A novel cervical vertebral bone quality score can independently predict cage subsidence after anterior cervical corpectomy and fusion.

OBJECTIVES: To optimize cervical vertebral bone quality (C-VBQ) score and explore its effectiveness in predicting cage subsidence in Anterior Cervical Corpectomy and Fusion (ACCF) and identify a new method for evaluating subsidence without different equipment and image scale interference. METHODS: Collecting demographic, imaging, and surgical related information. Measuring Cage Subsidence with a new method. Multifactorial logistic regression was used to identify risk factors associated with subsidence. Pearson's correlation was used to determine the relationship between C-VBQ and computed tomography (CT) Hounsfield units (HU). The receiver operating characteristic (ROC) curve was used to assess C-VBQ predictive ability. Correlations between demographics and C-VBQ scores were analyzed using linear regression models. RESULTS: 92 patients were included in this study, 36 (39.1%) showed subsidence with a C-VBQ value of 2.05 ± 0.45, in the no-subsidence group C-VBQ Value was 3.25 ± 0.76. The multifactorial logistic regression showed that C-VBQ is an independent predictor of cage subsidence with a predictive accuracy of 93.4%. Pearson's correlation analysis showed a negative correlation between C-VBQ and HU values. Linear regression analysis showed a positive correlation between C-VBQ and cage subsidence. Univariate analyses showed that only age was associated with C-VBQ. CONCLUSIONS: The C-VBQ values obtained using the new measurements independently predicted postoperative cage subsidence after ACCF and showed a negative correlation with HU values. By adding the measurement of non-operated vertebral heights as a control standard, the results of cage subsidence measured by the ratio method are likely to be more robust, perhaps can exclude unavoidable errors caused by different equipment and proportional.

Cognitive inflexibility is linked to abnormal frontoparietal-related activation and connectivity in obsessive-compulsive disorder.

Although it was acknowledged that patients with obsessive-compulsive disorder (OCD) would exhibit cognitive inflexibility, the underlying neural mechanism has not been fully clarified. Therefore, this study aimed to investigate the neural substrates involved in cognitive inflexibility among individuals with OCD. A total of 42 patients with OCD and 48 healthy controls (HCs) completed clinical assessment and functional magnetic resonance imaging (fMRI) data collection during cued task switching. Behavioral performances and fMRI activation were compared between the OCD group and the HC group. Psychophysiological interactions (PPIs) analyses were applied to explore functional connectivity related to task switching. Pearson correlation was used to investigate the relationships among behavioral performance, fMRI activity, and obsessive-compulsive symptoms in OCD. The OCD group had a greater switch cost than HCs (χ2 = 5.89, p < .05). A significant difference in reaction time was found during switch (χ2 = 17.72, p < .001) and repeat (χ2 = 16.60, p = .018) between the two groups, while there was no significant difference in group accuracy. Comparison of group differences showed that the OCD group had increased activation in the right superior parietal cortex (rSPL) during task switching, and exhibited increased connectivity of frontoparietal network/default mode network (FPN-DMN; i.e., middle frontal gyrus [MFG]/inferior parietal cortex-precuneus, MFG-middle/posterior cingulate gyrus) and within the FPN (inferior parietal cortex-postcentral gyrus). In the OCD group, the compulsion score was positively correlated with accuracy during switch (r = .405, p = .008, FDRq <.05), and negatively correlated with activation of rSPL (r = -.328, p = .034, FDRq >.05). Patients with OCD had impaired cognitive flexibility and cautious response strategy. The neural mechanism of cognitive inflexibility in OCD may involve increased activation in the rSPL, as well as hyperconnectivity within the FPN and between the FPN and DMN.

In-depth analysis reveals complex molecular aetiology in a cohort of idiopathic cerebral palsy.

Cerebral palsy is the most prevalent physical disability in children; however, its inherent molecular mechanisms remain unclear. In the present study, we performed in-depth clinical and molecular analysis on 120 idiopathic cerebral palsy families, and identified underlying detrimental genetic variants in 45% of these patients. In addition to germline variants, we found disease-related postzygotic mutations in ∼6.7% of cerebral palsy patients. We found that patients with more severe motor impairments or a comorbidity of intellectual disability had a significantly higher chance of harbouring disease-related variants. By a compilation of 114 known cerebral-palsy-related genes, we identified characteristic features in terms of inheritance and function, from which we proposed a dichotomous classification system according to the expression patterns of these genes and associated cognitive impairments. In two patients with both cerebral palsy and intellectual disability, we revealed that the defective TYW1, a tRNA hypermodification enzyme, caused primary microcephaly and problems in motion and cognition by hindering neuronal proliferation and migration. Furthermore, we developed an algorithm and demonstrated in mouse brains that this malfunctioning hypermodification specifically perturbed the translation of a subset of proteins involved in cell cycling. This finding provided a novel and interesting mechanism for congenital microcephaly. In another cerebral palsy patient with normal intelligence, we identified a mitochondrial enzyme GPAM, the hypomorphic form of which led to hypomyelination of the corticospinal tract in both human and mouse models. In addition, we confirmed that the aberrant Gpam in mice perturbed the lipid metabolism in astrocytes, resulting in suppressed astrocytic proliferation and a shortage of lipid contents supplied for oligodendrocytic myelination. Taken together, our findings elucidate novel aspects of the aetiology of cerebral palsy and provide insights for future therapeutic strategies.

Proteome Characterization of Glaucoma Aqueous Humor.

Glaucoma is the leading cause of irreversible blindness worldwide. The proteome characterization of glaucoma is not clearly understood. A total of 175 subjects, including 57 primary acute angle-closure glaucoma (PAACG), 50 primary chronic angle-closure glaucoma (PCACG), 35 neovascular glaucoma (NVG), and 33 cataract patients, were enrolled and comparison proteomic analysis was provided. The samples were randomly divided into discovery group or validation group, whose aqueous humor proteome was analyzed by data-independent acquisition or by parallel reaction monitoring. The common proteome features of three types of glaucoma were immune response, lipid metabolism, and cell death. Three proteins, VTN, SERPIND1, and CD14, showed significant upregulation in glaucoma and could discriminate glaucoma from cataract. Mutual differential proteomic analysis of PAACG, PCACG, and NVG showed different proteome characterization of the three types of glaucoma. NVG was characterized with activated angiogenesis. PAACG was characterized with activation of inflammation response. SERPIND1 was discovered to play vital role in glaucoma occurrences, which is associated with eye transparency decrease and glucose metabolism. This study would provide insights in understanding proteome characterization of glaucoma and benefit the clinical application of AH proteome.

Rapid Inference of Nitrogen Oxide Emissions Based on a Top-Down Method with a Physically Informed Variational Autoencoder.

Accurate timely estimation of emissions of nitrogen oxides (NOx) is a prerequisite for designing an effective strategy for reducing O3 and PM2.5 pollution. The satellite-based top-down method can provide near-real-time constraints on emissions; however, its efficiency is largely limited by efforts in dealing with the complex emission-concentration response. Here, we propose a novel machine-learning-based method using a physically informed variational autoencoder (VAE) emission predictor to infer NOx emissions from satellite-retrieved surface NO2 concentrations. The computational burden can be significantly reduced with the help of a neural network trained with a chemical transport model, allowing the VAE emission predictor to provide a timely estimation of posterior emissions based on the satellite-retrieved surface NO2 concentration. The VAE emission predictor successfully corrected the underestimation of NOx emissions in rural areas and the overestimation in urban areas, resulting in smaller normalized mean biases (reduced from -0.8 to -0.4) and larger R2 values (increased from 0.4 to 0.7). The interpretability of the VAE emission predictor was investigated using sensitivity analysis by modulating each feature, indicating that NO2 concentration and planetary boundary layer (PBL) height are important for estimating NOx emissions, which is consistent with our common knowledge. The advantages of the VAE emission predictor in efficiency, flexibility, and accuracy demonstrate its great potential in estimating the latest emissions and evaluating the control effectiveness from observations.

NONINVASIVE DIAGNOSTIC STRATEGY OF OCULAR TOXOCARIASIS BASED ON CLINICAL FEATURES.

PURPOSE: To develop a noninvasive diagnostic strategy based on the clinical manifestations of ocular toxocariasis (OT) and evaluate its sensitivity and specificity. METHODS: Patients with unilateral OT-like lesions were enrolled retrospectively and classified into OT and non-OT groups according to the immunologic diagnosis criterion of anti-OT immunoglobulin G. Nine clinical manifestations were recorded and compared between the groups. Among them, the retrolental membrane, branch-like vitreous strands, and retinal granulomas were the most common, which were further classified into three categories, including at least 1 of three signs, at least two of three signs, and all three signs positive. Diagnostic sensitivity and specificity were calculated for each strategy. RESULTS: There were 105 immunologically confirmed patients with OT and 70 patients with non-OT uveitis/vitreoretinopathy. Retinal granulomas, retrolental membrane, and branch-like vitreous strands were significantly more frequent in OT patients than in non-OT patients. At least 1 of 3 signs positive strategy showed the highest sensitivity (100.0%) but the lowest specificity (62.0%). At least 2 of 3 signs positive strategies showed 80.0% sensitivity and 94.3% specificity. All 3 signs positive strategies had the lowest sensitivity (46.7%) and the highest specificity (100.0%). The cutoff point of this revealed an area under the curve of 0.85 and a 95% confidence interval of 0.79 to 0.91. CONCLUSION: A comprehensive strategy based on at least two out of three positive signs showed excellent sensitivity and specificity and could serve as a noninvasive and fast screening strategy for the clinical diagnosis of OT.

Mimicking atmospheric photochemical modelling with a deep neural network.

Fast and accurate prediction of ambient ozone (O3) formed from atmospheric photochemical processes is crucial for designing effective O3 pollution control strategies in the context of climate change. The chemical transport model (CTM) is the fundamental tool for O3 prediction and policy design, however, existing CTM-based approaches are computationally expensive, and resource burdens limit their usage and effectiveness in air quality management. Here we proposed a novel method (noted as DeepCTM) that using deep learning to mimic CTM simulations to improve the computational efficiency of photochemical modeling. The well-trained DeepCTM successfully reproduces CTM-simulated O3 concentration using input features of precursor emissions, meteorological factors, and initial conditions. The advantage of the DeepCTM is its high efficiency in identifying the dominant contributors to O3 formation and quantifying the O3 response to variations in emissions and meteorology. The emission-meteorology-concentration linkages implied by the DeepCTM are consistent with known mechanisms of atmospheric chemistry, indicating that the DeepCTM is also scientifically reasonable. The DeepCTM application in China suggests that O3 concentrations are strongly influenced by the initialized O3 concentration, as well as emission and meteorological factors during daytime when O3 is formed photochemically. The variation of meteorological factors such as short-wave radiation can also significantly modulate the O3 chemistry. The DeepCTM developed in this study exhibits great potential for efficiently representing the complex atmospheric system and can provide policymakers with urgently needed information for designing effective control strategies to mitigate O3 pollution.

Olfactory impairment as an early marker of Parkinson's disease in REM sleep behaviour disorder: a systematic review and meta-analysis.

Olfactory impairment and rapid eye movement sleep behaviour disorder (RBD) are prodromal symptoms of Parkinson's disease (PD) that may be associated with each other. This review aims to investigate the significance of olfaction in the diagnosis and prognosis of patients with RBD and to assess moderating factors affecting olfactory performance. We searched articles on olfaction in RBD and PD in five electronic databases. We identified 32 studies for the systematic review and used 28 of those, including 2858 participants for meta-analysis. Results revealed significant deficits in odour identification (g=-1.80; 95% CI: -2.17 to -1.43), threshold (g=-1.29; 95% CI: -1.67 to -0.91), discrimination (g=-1.08; 95% CI: -1.28 to -0.87) and overall olfactory function (g=-1.64; 95% CI: -1.94 to -1.35) in patients with RBD. Except for the Unified Parkinson's Disease Rating Scale Part III scores, none of the known moderating variables (including age, sex, disease duration and years of education) accounted for the olfactory function heterogeneity in patients with RBD. We identified similar olfactory impairments in patients with RBD and patients with PD (either with or without underlying RBD). These findings suggest that olfactory impairment may be a sensitive and stable diagnostic biomarker of RBD and appears to be useful for identifying patients with idiopathic RBD at high risk for early conversion to PD.

Proteomics and single-cell RNA analysis of Akap4-knockout mice model confirm indispensable role of Akap4 in spermatogenesis.

Sperm fibrous sheath, a unique cytoskeletal structure, is implicated in various sperm physiological functions, such as sperm maturation, motility and capacitation. AKAP4 has been described to be required for structural and functional integrity of the fibrous sheath. We generated Akap4-knockout mice line using CRISPR-Cas9 system. Cytomorphology and motility of sperm and testes were studied, confirming loss of Akap4 led to abnormal sperm morphology, motility and infertility. The proteomic components of testes were studied and Akap4 was found to be significantly decreased in the Akap4-knockout mice. Testis single-cell RNA sequencing and analysis revealed three genes with significant change in the general cell population, i.e., Akap4, Haspin, and Ccdc38. The single-cell RNA expression profiles also showed that the major difference between Akap4-knockout and wild-type testes existed in the elongating cell cluster, where in the Akap4-knockout testes, a subgroup of elongating cells with marker genes involved in cell adhesion and migration were increased, while a subgroup of elongating cells marked by mitochondrial sheath genes were decreased. Our results revealed the complex and well-coordinated procedures of spermatogenesis, and substantiated Akap4's indispensable roles in the integrity of sperm flagellum and the step-wise maturation of spermatozoa.

Deep Learning for Prediction of the Air Quality Response to Emission Changes.

Efficient prediction of the air quality response to emission changes is a prerequisite for an integrated assessment system in developing effective control policies. Yet, representing the nonlinear response of air quality to emission controls with accuracy remains a major barrier in air quality-related decision making. Here, we demonstrate a novel method that combines deep learning approaches with chemical indicators of pollutant formation to quickly estimate the coefficients of air quality response functions using ambient concentrations of 18 chemical indicators simulated with a comprehensive atmospheric chemical transport model (CTM). By requiring only two CTM simulations for model application, the new method significantly enhances the computational efficiency compared to existing methods that achieve lower accuracy despite requiring 20+ CTM simulations (the benchmark statistical model). Our results demonstrate the utility of deep learning approaches for capturing the nonlinearity of atmospheric chemistry and physics and the prospects of the new method to support effective policymaking in other environment systems.

Gamma-aminobutyric acid enhances tolerance to iron deficiency by stimulating auxin signaling in cucumber (Cucumis sativusL.).

Iron deficiency severely affects crop yield and quality. Gamma-aminobutyric acid (GABA) plays a vital role in plant responses to multifarious stresses. However, the role of GABA in Fe deficiency responses and the potential mechanisms remain largely unknown in cucumber. Here, we found that Fe deficiency raised the GABA levels in leaves and roots of cucumber. To probe the role of GABA in Fe deficiency, the seedlings were subjected to five levels of GABA concentrations (0, 5, 10, 20 and 40 mmol L-1) for 7 days under Fe deficiency. The results demonstrated that 20 mM GABA in alleviating the Fe deficiency-induced stress was the most effective. GABA pretreatment reduced the Fe deficiency-induced chlorosis and inhibition of photosynthesis and growth, and significantly enhanced the contents of iron in shoots and roots. Exogenous GABA significantly decreased the pH of nutrient solution and increased ferric-chelate reductase (FCR) activity induced by Fe deficiency and the transcript levels of Fe uptake-related genes HA1, FRO2 and IRT1 in roots. GABA also increased the content of auxin (IAA) and expression of auxin biosynthesis (YUC4), response (IAA1), and transport (PIN1) genes under Fe deficiency. Furthermore, exogenous the auxin transport inhibitor 1-naphthylphthalamic acid (NPA) application abolished the GABA-induced changes in Fe deficiency. In summary, we found that GABA improves tolerance to iron deficiency via an auxin-dependent mechanism in cucumber.

[Current status of surgical treatment for angular kyphosis in spinal tuberculosis].

Objective: To review current status of surgical treatment for angular kyphosis in spinal tuberculosis and provide reference for clinical treatment. Methods: The literature on the surgical treatment for angular kyphosis of spinal tuberculosis in recent years was extensively reviewed and summarized from the aspects of surgical indications, surgical contraindications, surgical approach, selection of osteotomy, and perioperative management. Results: Angular kyphosis of spine is a common complication in patients with spinal tuberculosis. If kyphosis progresses gradually, it is easy to cause neurological damage, deterioration, and delayed paralysis, which requires surgical intervention. At present, surgical approaches for angular kyphosis of the spine include anterior approach, posterior approach, and combined anterior and posterior approaches. Anterior approach can be performed for patients with severe spinal cord compression and small kyphotic Cobb angle. Posterior approach can be used for patients with large kyphotic Cobb angle but not serious neurological impairment. A combined anterior and posterior approaches is an option for spinal canal decompression and orthosis. Osteotomy for kyphotic deformity include Smith-Peterson osteotomy (SPO), pedicle subtraction osteotomy (PSO), vertebral column resection(VCR), vertebral column decancellation (VCD), posterior vertebral column resection (PVCR), deformed complex vertebral osteotomy (DCVO), and Y-shaped osteotomy. SPO and PSO are osteotomy methods with relatively low surgical difficulty and low surgical risks, and can provide 15°-30° angular kyphosis correction effect. VCR or PVCR is a representative method of osteotomy and correction. The kyphosis correction can reach 50° and is suitable for patients with severe angular kyphosis. VCD, DCVO, and Y-shaped osteotomy are emerging surgical techniques in recent years. Compared with VCR, the surgical risks are lower and the treatment effects also improve to varying degrees. Postoperative recovery is also a very important part of the perioperative period and should be taken seriously. Conclusion: There is no consensus on the choice of surgical treatment for angular kyphosis in spinal tuberculosis. Osteotomy surgery are invasive, which is a problem that colleagues have always been concerned about. It is best to choose a surgical method with less trauma while ensuring the effectiveness.

Index construction and application of digital transformation in the insurance industry: Evidence from China.

In the context of digitization, the insurance industry's value chain is undergoing significant shifts. However, the existing research on its comprehension and measurement remains relatively limited. This study constructs an index system for digital transformation in the insurance industry (DTII) on three components: digital infrastructure, digital platform, and digital applications. Utilizing data from 31 provinces in China, this study employs the entropy weight method, analytic hierarchy process method and minimum relative entropy method to measure the weights of indicators, empirically applying this index system. The results show that DTII in China experiences rapid advancement with an average annual growth rate of 20.46% from 2014 to 2020 and there exists strong regional convergence. In addition, the spatial agglomeration and spatial effects of DTII are mainly concentrated in the life insurance industry and the eastern region. This study provides an index system and empirical evidence for evaluating the DTII, providing policy insights for exploring the sustainable development path of the insurance industry in the digital era.

Safety and effectiveness of intravitreal dexamethasone implant in patients with ocular toxocariasis.

AIMS: To evaluate the safety and effectiveness of intravitreal dexamethasone (DEX) implant in patients with active uveitis due to ocular toxocariasis (OT). METHODS: Seventy-eight patients with OT were recruited in this retrospective study, including 51 patients in DEX group treated with intravitreal DEX implant and 27 patients in control group without intervention. The reduction of vitreous haze scores (VHS), the best-corrected visual acuity (BCVA) changes, intraocular pressure (IOP) and cataract progression and formation were recorded at baseline (V0), 1 (V1), 3 (V3) and 6 months (V6) after treatment in DEX group, and V0 and V6 in control group. RESULTS: There was no change in VHS and BCVA in control group between V0 and V6. Better VHS (p=0.001) and BCVA (p=0.022) was achieved in DEX group; the rate of VHS=0 was 0%, 67.4%, 42.9% and 44.9% at V0, V1, V3 and V6, respectively (p＜0.001), and the mean BCVA was improved from logMAR 1.5±0.9 to 1.2±0.9 at V1, 1.4±1.0 at V3 and 1.4±1.2 at V6. A favourable BCVA at V1 was associated with older age (p=0.038) and uninvolved macula (p=0.000) in DEX group. No significant difference in IOP elevation ≥10 mm Hg, cataract progression and formation between groups. More eyes needed retinal surgery in control group (p<0.001). CONCLUSIONS: This was the first study to investigate use of intravitreal DEX implant in OT patients, which can efficiently reduce ocular inflammation and improve BCVA in macular uninvolved patients.

How does perceived overqualification promote employees' creative deviance: The role of leadership emergence and job autonomy.

Inspiring the creative potential of overqualified employees can facilitate a mutually beneficial outcome for both the company and the employees. However, further investigation is required to ascertain how to stimulate the perceived overqualification of employees to carry out creative deviance. Drawing upon role theory, this study explores the impact mechanism of perceived overqualification on employee creative deviance, with leadership emergence as the mediating variable, and further examines the moderating role of job autonomy. Adopting a two-stage design, 362 valid data samples were collected from various companies, and analysis was conducted using partial least squares structural equation modeling. The results indicate a positive correlation between perceived overqualification and creative deviance. Perceived overqualification not only positively influences leadership emergence but it also indirectly affects creative deviance through leadership emergence. Furthermore, when individuals with perceived overqualification and possess a greater level of job autonomy, they are more likely to engage in creative deviant behavior. The findings contribute to understanding the mediating mechanisms and boundary conditions of employees' perceived overqualification influencing creative deviance from a positive perspective, offering valuable managerial insights for organizations.

Paediatric staphyloma classification: new perspectives via ultrawide field three-dimensional swept-source optical coherence tomographic angiography.

AIM: To employ ultrawide field three-dimensional swept-source optical coherence tomographic angiography (UWF 3D SS-OCTA) modality, integrating novel strategies, posterior eye curvature maps and posterior eye height maps, in characterising the features and disease associations of posterior staphyloma in paediatric patients. This study seeks to compare paediatric staphylomas to established adult classifications, identify distinct paediatric patterns and introduce a new classification system for paediatric staphyloma using advanced multimodal imaging. METHODS: UWF 3D SS-OCTA imaging, integrating posterior eye curvature maps and posterior eye height maps strategies, was employed to analyse staphyloma presentations in the paediatric cohort. These data were then set against the traditionally established adult classifications. Additionally, the aetiology of staphylomas was investigated. RESULTS: The UWF 3D SS-OCTA modality, when integrated with posterior eye curvature maps and posterior eye height map, showcased superior imaging detail and better classification compared with UWF scanning laser ophthalmoscope, offering a more nuanced view of staphyloma patterns in paediatric patients. Specifically, only 54.7% of the paediatric cohort fit into previously recognised categories. The paediatric group displayed prominent temporal and inferior temporal staphylomas, likely linked to the high prevalence of peripheral vascular diseases. The study led to the proposal of five unique paediatric staphyloma classifications. CONCLUSIONS: The UWF 3D SS-OCTA modality with posterior eye curvature maps and posterior eye height maps offers unparalleled insights into staphyloma patterns, especially in paediatric patients. Paediatric staphylomas exhibit a unique presentation, divergent from adults, with two novel types identified. The findings underline the importance of updating classification systems, ensuring they reflect the realities observed in paediatric pathology and diagnostics.

Toxocara canis infection in multiple types of animals: ophthalmological and pathological observations.

Human ocular toxocariasis (OT), caused by pet roundworm Toxocara canis (Nematoda Ascaridoidea), is a worldwide ocular parasitic infection that poses a severe threat to eyesight, especially in school-aged children. However, the infection process and pathological mechanism of Toxocara are difficult to study in the human body. This study was designed to explore long-term ocular manifestations in different rodents infected with Toxocara canis, uncovering the specific pathological mechanism and migration pathway of larvae after infection. The three types of experimental animals we selected were C57BL/6 mice, Mongolian gerbils and Brown Norway rats. Mice were randomly divided into five groups and infected orally with 1000, 2000, 4000, 8000 and 10,000 T. canis eggs; gerbils were randomly divided into four groups and infected orally with 1000, 2000, 4000 and 10,000 T. canis eggs; rats were randomly divided into three groups and infected orally with 2000, 6000 and 10,000 T. canis eggs. Their ocular changes were closely observed and recorded for at least 2 months. We also enucleated the eyeballs of some animals to perform pathological sectioning and hematoxylin-eosin staining. After 3 dpi (days post-infection), hemorrhagic lesions, mechanical injury of the retina and larval migration could be observed in some infected animals. The ocular infection and mortality rates tended to be stable at 7 dpi. Larval tissue, structure disorder and inflammation could be observed in the pathological sections. In conclusion, the mice infected with 2000 T. canis eggs and gerbils infected with 1000, 2000 and 4000 T. canis eggs showing obvious ocular lesions and lower mortality rates could provide a basis for long-term observation.

Two-level Anterior Cervical Corpectomy and Fusion versus Posterior Open-door Laminoplasty for the Treatment of Cervical Ossification of Posterior Longitudinal Ligament: A Comparison of the Clinical Impact on the Occipito-Atlantoaxial Complex.

OBJECTIVE: Both two-level anterior cervical corpectomy and fusion (t-ACCF) and posterior open-door laminoplasty (ODLP) are effective surgical procedures for the treatment of ossification of the posterior longitudinal ligament (OPLL). Previous studies have identified different effects of different surgical procedures on the upper and subaxial cervical spine (UCS, SCS), however, there are no studies on the effects of t-ACCF and ODLP on the occipito-atlantoaxial complex. Therefore, the purpose of this study is to compare the changes in sagittal parameters and range of motion (ROM) of the occipito-atlantoaxial complex in OPLL patients treated with t-ACCF and ODLP. METHODS: This was a retrospective study that included 74 patients who underwent t-ACCF or ODLP for the treatment of OPLL from January 2012 to August 2022 at our institution. Preoperative, 3-month, and 1-year postoperative cervical neutral, flexion-extension, and lateral flexion radiographs were taken. Sagittal parameters including Cobb angle of C2-7, C0-2, C0-1, C1-2, C2 slope, and the ROM were measured. The clinical outcome was assessed using the JOA, VAS, and NDI scores preoperatively and at 3 and 12 months postoperatively. Multiple linear regression was employed to identify factors influencing changes in UCS. RESULTS: In the ODLP group, the SCS (C2-7) Cobb angle was significantly reduced (12.85 ± 10.0 to 7.68 ± 11.27; p < 0.05), and the UCS (C0-2) Cobb angle was significantly compensated for at 1 year postoperatively compared with the t-ACCF group (3.05 ± 4.09 vs 0.79 ± 2.62; p < 0.01). The SCS and lateral flexion ROM of the ODLP group was better maintained than t-ACCF (14.51 ± 6.00 vs 10.72 ± 3.79; 6.87 ± 4.56 vs 3.81 ± 1.67; p < 0.01). The compensatory increase in C0-2, C0-1, and C1-2 ROM was pronounced in both groups, especially in the ODLP group. The results of multiple linear regression showed that only the surgical procedure was a significant factor influencing UCS. CONCLUSION: The loss of the SCS Cobb angle was more pronounced in ODLP relative to t-ACCF, resulting in a significant compensatory increase in UCS and atlantoaxial Cobb angle. The ROM of the UCS, atlantooccipital, and atlantoaxial joints was significantly increased in both groups, this may accelerate degenerative changes in the occipital-atlantoaxial complex, may leading to poorer outcomes in the long-term; of these, ODLP should receive more attention. In contrast, t-ACCF better maintains normal curvature of the SCS and occipito-atlantoaxial complex but loses more ROM.