Structural Factors That Determine the Amylolytic Properties of Starch-Lipid Complexes.

Structural factors that determine the amylolysis of starch-lipid complexes have remained unclear. Understanding the relationship between the structure and amylolysis of starch-lipid complexes is important for the design and preparation of complexes with predictable digestibility. In this study, the multiscale structures and amylolytic properties of complexes formed under different conditions between debranched high-amylose starch (DHAMS) and lauric, myristic, palmitic, and stearic acids were investigated. Higher complexing temperatures facilitated the formation of DHAMS-fatty acid (FA) complexes, especially the more stable type II crystallites. Longer complexing times also promoted the formation of complexes and the type II crystallites, except for DHAMS-lauric acid (LA). Molecular dynamics simulations showed that the binding free energy for the formation of DHAMS-LA complexes (10 kJ/mol) was lower than those for the other three DHAMS-FA complexes (20-50 kJ/mol), accounting for the lower stability of DHAMS-LA complexes at longer complexing times. The rate and extent of enzymatic digestion of the DHAMS-FA complexes were much lower in comparison to those of gelatinized HAMS. Correlation analyses showed that the rate and extent of enzymic digestion of DHAMS-FA complexes were mainly determined by the degree of crystallite perfection of the complexes.

Topographic and Surgical Risk Factors for Early Myopic Regression between Small Incision Lenticule Extraction and Laser In Situ Keratomileusis.

Our objective was to evaluate the topographic and surgical factors of early myopic regression between laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A retrospective case-control study was conducted, and 368 and 92 eyes were enrolled in the LASIK and SMILE groups via propensity score matching (PSM). Visual acuity, refractive status, axial length, and topographic/surgical parameters were collected. Multiple linear regression was applied to the yield coefficient and the 95% confidence interval (CI) of the parameters. The cumulative incidence of early myopic regression was higher in the LASIK group (p < 0.001). In the SMILE group, a lower central corneal thickness (CCT) thinnest value and a higher corneal cylinder associated with early myopic regression were observed; meanwhile, in the LASIK group, a lower CCT thinnest value, a higher steep corneal curvature, a larger optic zone, and a lower flap thickness related to early myopic regression were observed (all p < 0.05). In the SMILE group, a higher CCT difference correlated with early myopic regression was observed compared to the LASIK group (p = 0.030), and higher steep corneal curvature and lower cap/flap thickness (both p < 0.05) correlated with early myopic regression were observed in the LASIK group compared to the SMILE group. In conclusion, CCT differences significantly influence early myopic regression in the SMILE group; meanwhile, corneal curvature and flap thickness affect early myopic regression principally in the LASIK group.

Refraction and topographic risk factors for early myopic regression after small-incision lenticule extraction surgery.

We sought to evaluate the topographic risk factors for early myopic regression after small-incision lenticule extraction (SMILE). A retrospective case‒control study was conducted, and individuals who underwent SMILE surgery were enrolled. Among them, 406 and 14 eyes were categorized into the nonregression and regression groups, respectively. The preoperative and postoperative parameters in the two groups were collected, including spherical refraction (SE), axial length (AXL) and topographic data. A generalized linear model was adopted to analyze the difference in each parameter between the two groups. After 6 months, UCVA decreased in the regression group, and SE increased in the regression group (both P < 0.05). The increase in the CCT at the thinnest point (P = 0.044), flat corneal curvature (P = 0.012) and TCRP (P = 0.001) were significantly greater in the regression group. Regarding the risk factors for myopic regression, preoperative SE, preoperative sphere power, preoperative AXL, preoperative flat corneal curvature, preoperative SA, early postoperative SE, early postoperative sphere power, early postoperative AXL and early postoperative CCT difference were significantly greater in the regression group (all P < 0.05). The SE, sphere power, AXL, preoperative flat corneal curvature, preoperative SA, and postoperative CCT difference correlate with early myopic regression after SMILE.

Photocatalytic Generation of H2O2 Via a Hydrogen-Abstraction Pathway by Bi2.15WO6 under Visible Light.

Photocatalytic technology is a popular research area for converting solar energy into environmentally friendly chemicals and is considered the greenest approach for producing H2O2. However, the corresponding reactive oxygen species (ROS) and pathway involved in the photocatalytic generation of H2O2 by the Bi2.15WO6-glucose system are still not clear. Quenching experiments have established that neither •OH nor h+ contribute to the formation of H2O2, and show that the formed surface superoxo (≡Bi-OO•) and peroxo (≡Bi-OOH) species are the predominant ROS in H2O2 generation. In addition, various characterizations indicate the enhanced electron-transfer on the surface of Bi2.15WO6 with increasing contents of glucose via the ligand-to-metal charge transfer pathway, confirming H-transfer from glucose to ≡Bi-OO• or ≡Bi-OOH. The increased production of H2O2 with decreasing bond dissociation energy (BDEO-H) values of various phenolic compounds again supports the H-transfer mechanism from phenolic compounds to ≡Bi-OO• and then to ≡Bi-OOH. DFT calculations further reveal that on the Bi2.15WO6 surface, oxygen is sequentially reduced to ≡Bi-OO• and ≡Bi-OOH, while H-transfer from H2O or glucose to ≡Bi-OO• and ≡Bi-OOH, resulting in the production of H2O2. The lower energy barrier of H-transfer from adsorbed glucose (0.636 eV) than that from H2O (1.157 eV) indicates that H-transfer is more favorable from adsorbed glucose. This work gives new insight into the photocatalytic generation of H2O2 by Bi2.15WO6 in the presence of glucose/phenolic compounds via the H-abstraction pathway.

New Insight into the Effects of Endogenous Protein and Lipids on the Enzymatic Digestion of Starch in Sorghum Flour.

The effects of endogenous lipids and protein in sorghum flour on starch digestion were studied following the depletion of lipids and/or protein and after the reconstitution of separated fractions. The removal of protein or lipids moderately increases the digestibility of starch in raw (uncooked) sorghum flour to values close to those for purified starch. Rapid Visco Analyzer data (as a model for the cooking process) show that cooked sorghum flours with lipids have a lower starch digestibility than those without lipids after RVA processing, due to the formation of starch-lipid complexes as evidenced by their higher final viscosity and larger enthalpy changes. Additionally, the formation of a starch-lipid-protein ternary complex was identified in cooked sorghum flour, rather than in a reconstituted ternary mixture, according to the unique cooling stage viscosity peak and a greater enthalpy of lipid complexes. After heating, the sorghum flour showed a lower digestibility than the depleted flours and the reconstituted flours. The results indicate that the natural organization of components in sorghum flour is an important factor in facilitating the interactions between starch, lipids, and protein during RVA processing and, in turn, reducing the starch digestion.

A novel method for quantifying the short-range order in non-crystalline starch by Raman spectroscopy.

A quantitative method was developed to characterize the short-range order in non-crystalline starch by Raman spectroscopy. The Raman spectra of three forms of non-crystalline starches (just-gelatinized starch, which was heated to the point of having just lost its long-range order but still retaining essentially all of its short-range order, gelatinized starch and amorphous starch) were resolved into subspectra to calculate the short-range ordered phases. By deducting the spectra of amorphous starch using a subtraction technique, the areas of subspectra for short-range ordered phases in just-gelatinized and gelatinized starches were obtained. The ratio of the area for short-range ordered phases in gelatinized starch relative to that in just-gelatinized starch was negatively correlated with water content for gelatinization. Based on this, we propose that this ratio of areas provides a quantitative measure for assessing the short-range order in non-crystalline starch. This study provides an alternative and simpler method to an X-ray diffraction protocol proposed previously.

The influence of short-range molecular order in gelatinized starch on the formation of starch-lauric acid complexes.

A model system of gelatinized wheat starch (GWS) and lauric acid (LA) was used to examine the effect of residual short-range molecular order in GWS on the formation of starch-lipid complexes. The extent of residual short-range molecular order, as determined by Raman spectroscopy, decreased with increasing water content or heating duration of gelatinization. The enthalpy changes, crystallinity, short-range molecular order and the in vitro enzymic digestion of GWS-LA complexes increased initially to a maximum and then declined as the short-range molecular order in GWS decreased, showing that there was an optimal amount of residual short-range molecular order in GWS for maximizing GWS-LA complexes formation. Below this optimum amount, the limited disruption of short-range molecular order may constrain the mobility of amylose chains for complexation with LA, whereas with excessive disruption above this amount the amylose chains may be too disorganized or entangled to form complexes with LA. The susceptibility of GWS-LA complexes to enzymatic hydrolysis was influenced by both long- and short-range structural order, and to a lesser extent the amounts of complexes. This study showed clearly the role of short-range molecular order in gelatinized starch in influencing the formation of GWS-LA complexes.

Molecular Mechanisms Underlying the Effects of Small Intestinal Fermentation on Enhancement of Prebiotic Characteristics of Cellulose in the Large Intestine.

Knowledge about the prebiotic characteristics of cellulose by in vitro fermentation is not complete due to the neglect of small intestinal fermentation. This study investigated the effects of small intestinal fermentation on the prebiotic characteristics of cellulose in the large intestine and potential mechanisms through an approach of combined in vivo small intestinal fermentation and in vitro fermentation. The structural similarity between cellulose in feces and after processing by the approach of this study confirmed the validity of the approach employed. Results showed that small intestinal fermentation of cellulose increased both acetate and propionate content and enriched Corynebacterium selectively. Compared to in vitro fermentation after in vitro digestion of cellulose, the in vitro fermentation of cellulose after in vivo small intestinal fermentation produced higher contents of acetate and propionate as well as the abundance of probiotics like Ruminococcaceae_UCG-002, Blautia, and Bifidobaterium. The changes in the structural features of cellulose after in vivo small intestinal fermentation were more obvious than those after in vitro digestion, which may account for the greater production of short-chain fatty acids (SCFAs) and the abundance of probiotics. In summary, small intestinal fermentation enhanced the prebiotic characteristics of cellulose in the large intestine by predisrupting its structure.

Topographic and surgical risk factors for high postoperative residual astigmatism after small incision lenticule extraction in patients with different degrees of myopia: a retrospective cohort study.

BACKGROUND: To evaluate the possible topographic and surgical risk factors for high postoperative residual astigmatism in patients who undergo small-incision lenticule extraction (SMILE) surgery and have different myopia degrees. METHODS: A retrospective cohort study was conducted, and patients who underwent SMILE surgery were enrolled. A total of 80 and 150 eyes from 40 to 75 individuals, respectively, were selected as the low myopia and high myopia groups. The demographic data, visual acuity, refraction, topographic parameters and surgical settings were recorded. Multiple linear regression with interaction tests were performed to survey the risk factors for high postoperative residual astigmatism in each group. RESULTS: Five (6.25%) and 9 (6.00%) eyes presented with high postoperative residual astigmatism in the low myopia and high myopia groups, respectively, but these differences were not significant (P = 0.569). A steep corneal curvature was correlated with a greater risk of high postoperative residual astigmatism in the low myopia group (P = 0.015), while a higher degree of cycloplegic cylinder power, steeper corneal curvature, greater topographic cylinder power, smaller optic zone and longer incision length were associated with a high rate of postoperative residual astigmatism in the high myopia group (all P < 0.05). In addition, the interaction effects of cycloplegic and topographic cylinder power and longer incision length on the incidence of high postoperative residual astigmatism development were more evident in the high myopia group than in the low myopia group (all P < 0.05). CONCLUSIONS: A steep corneal curvature correlates with a high risk of high postoperative residual astigmatism after SMILE surgery, and a higher degree of cycloplegic and topographic cylinder and longer incision are associated with high postoperative residual astigmatism in individuals with high myopia.

Electroencephalogram-based machine learning models to predict neurologic outcome after cardiac arrest: A systematic review.

AIM OF THE REVIEW: The primary aim of this systematic review was to investigate the most common electroencephalogram (EEG)-based machine learning (ML) model with the highest Area Under Receiver Operating Characteristic Curve (AUC) in two ML categories, conventional ML and Deep Neural Network (DNN), to predict the neurologic outcomes after cardiac arrest; the secondary aim was to investigate common EEG features applied to ML models. METHODS: Systematic search of medical literature from PubMed and engineering literature from Compendex up to June 2, 2023. One reviewer screened studies that used EEG-based ML models to predict the neurologic outcomes after cardiac arrest. Four reviewers validated that the studies met selection criteria. Nine variables were manually extracted. The top-five common EEG features were calculated. We evaluated each study's risk of bias using the Quality in Prognosis Studies guideline. RESULTS: Out of 351 identified studies, 17 studies met the inclusion criteria. Random Forest (RF) (n = 7) was the most common ML model in the conventional ML category (n = 11), followed by Convolutional Neural Network (CNN) (n = 4) in the DNN category (n = 6). The AUCs for RF ranged between 0.8 and 0.97, while CNN had AUCs between 0.7 and 0.92. The top-three commonly used EEG features were band power (n = 12), Shannon's Entropy (n = 11), burst-suppression ratio (n = 9). CONCLUSIONS: RF and CNN were the two most common ML models with the highest AUCs for predicting the neurologic outcomes after cardiac arrest. Using a multimodal model that combines EEG features and electronic health record data may further improve prognostic performance.

Urolithin C alleviates pancreatic ß-cell dysfunction in type 1 diabetes by activating Nrf2 signaling.

AIMS: Type 1 diabetes (T1D) is an autoimmune disorder that destroys insulin-generating pancreatic ß-cells. Preserving pancreatic ß-cell function is important for treating T1D. Our study aims to explore the mechanism underlying urolithin C (UC)-mediated regulation of ß-cell function. METHODS: Non-obese diabetic (NOD) mice were administrated with UC to evaluate UC-mediated protection of T1D. The inflammation of the pancreas islets was examined by hematoxylin and eosin staining. Glucose-stimulated insulin secretion (GSIS) assay and oral glucose tolerance test were applied to evaluate the progression of T1D. MIN6 cells were treated with TNF-α, IL-1ß and IFN-γ in the presence of UC. Cell viability was analyzed by CCK-8. Cell apoptosis, proliferation and DNA fragmentation were examined by Annexin V-FITC and PI staining, EdU incorporation and comet assays. Keap1, Nrf2, HO-1 and NQO1 were examined by western blot. Immunofluorescence staining was applied to detect Nrf2 and insulin. RESULTS: UC administration significantly reduced diabetes incidence, attenuated insulitis, elevated insulin levels and GSIS and reduced blood glucose and AUC in NOD mice. Cytokine treatment suppressed MIN6 cell viability and proliferation but enhanced apoptosis and DNA damage, and these detrimental effects were relieved by UC treatment. Furthermore, UC administration inhibited Keap1 expression and promoted the expression of Nrf2, HO-1 and NQO1 in NOD mice. Nrf2 signaling has been reported to be implicated in preventing the onset of diabetes, and HO-1 and NQO1 are phase II antioxidant enzymes that are regulated by Nrf2 signaling. Cytokine treatment upregulated Keap1 and downregulated Nrf2, HO-1 and NQO1 in MIN6 cells, but it was reversed by UC. The nuclear translocation of Nrf2 was prevented by cytokine treatment, but UC promoted its nuclear translocation. UC-mediated upregulation of Nrf2, HO-1 and NQO1, decreased cell apoptosis and increased proliferation and insulin secretion were abolished by silencing of Nrf2. CONCLUSION: UC improves pancreatic ß-cell function by activating Nrf2 signaling, thereby alleviating T1D progression.

Ferroptosis: A potential target of macrophages in plaque vulnerability.

Plaque vulnerability has been the subject of several recent studies aimed at reducing the risk of stroke and carotid artery stenosis. Atherosclerotic plaque development is a complex process involving inflammation mediated by macrophages. Plaques become more vulnerable when the equilibrium between macrophage recruitment and clearance is disturbed. Lipoperoxides, which are affected by iron levels in cells, are responsible for the cell death seen in ferroptosis. Ferroptosis results from lipoperoxide-induced mitochondrial membrane toxicity. Atherosclerosis in ApoE(-/-) mice is reduced when ferroptosis is inhibited and iron intake is limited. Single-cell sequencing revealed that a ferroptosis-related gene was substantially expressed in atherosclerosis-modeled macrophages. Since ferroptosis can be regulated, it offers hope as a non-invasive method of treating carotid plaque. In this study, we discuss the role of ferroptosis in atherosclerotic plaque vulnerability, including its mechanism, regulation, and potential future research directions.

Reimagining the Rheumatology Fellowship Interview: Using Participatory Design-Thinking Process to Create a More Applicant-Centered Experience.

OBJECTIVE: Design thinking is a creative problem-solving process used to better understand users' needs and experiences so that a product or service can be improved. Its emphasis on empathy, iterative prototyping, and participatory collaboration make it an ideal methodology for innovation in medical education. We apply this framework to the virtual rheumatology fellowship interview process so that interviews can become more applicant centered. METHODS: This educational quality improvement project uses a design-thinking framework to identify opportunities and challenges for rheumatology fellowship applicants. The investigators use the 5-step process (Empathize, Define, Ideate, Prototype, Test) and incorporate rapid qualitative analysis of semistructured interviews to innovate the interview experience. The iterative and collaborative nature of this process has empowered participants to codesign an applicant-centered interview experience. RESULTS: Interviews with fellowship applicants (n = 9), fellow physicians (n = 4), and faculty members (n = 3) identified three major dynamics of the interview process: (1) Is it a safe environment to ask questions? (2) How do I exchange information effectively? and (3) How do I fit all these data into the bigger picture? Creative brainstorming techniques at a series of three workshops yielded four prototypes emphasizing customization, hybridization, facilitation, and preparation. A finalized applicant-centered interview template was devised in preparation for the 2023-2024 application season. CONCLUSION: Design thinking has yielded insights into three important dynamics that drive applicant experiences. These insights allow for a redesign of processes so that virtual interviews can be more applicant centered. This framework allows for further iterations and modifications as the needs of applicants and programs evolve over time.

Effects of different sources of proteins on the formation of starch-lipid-protein complexes.

In the present study, the influence of different sources of proteins on the formation of complexes with starch and lipid were investigated. A model system containing wheat starch (WS), palmitic acid (PA) and four proteins (whey protein isolate, egg white protein, soy protein isolate and pea protein isolate) was used to prepare the complexes by Rapid Visco Analyzer. The addition of PA in the pasted WS-protein systems resulted in higher cooling viscosity compared to the pasted WS-PA systems, which was interpreted as being due to the formation of WS-PA-protein complexes. Analyses from differential scanning calorimetry, X-ray diffraction and Raman spectroscopy showed that more complexes were formed in WS-PA-protein systems than in WS-PA systems, especially in the WS-PA-whey protein isolate. The better emulsifying action of whey protein isolate was proposed to be accountable for the greater amounts of complexes formed compared to other three proteins. This study provides important information about the formation of starch-lipid-protein complexes in regard to the selection of proteins for food processing.

[Spatiotemporal Variation Characteristics of Main Pollutant Fluxes in the Yangtze River Basin from 2017 to 2020].

Based on the monitoring data of various pollutants at important water system points in the Yangtze River Basin from 2017 to 2020, research on the flux change law of the main and tributary water systems in the Yangtze River Basin was carried out at the spatiotemporal scale, and the spatial change response, interannual change trend, and flux correlation analysis were analyzed from the aspects of water quantity, quality, and flux so as to reveal the spatial-temporal contribution characteristics of pollutant flux in the upper, middle, and lower reaches of the Yangtze River Basin. The results showed that over the past four years, the concentration of major pollutants in the Yangtze River Basin showed an overall downward trend. The concentration of total phosphorus (TP) and ammonia (NH+4-N) decreased significantly. The concentration of total nitrogen (TN) and total phosphorus (TP) in the main stream gradually increased from west to east. The annual concentration of permanganate index in the upper, middle, and lower reaches decreased by 18.5%, 16.0%, and 14.0%, respectively, from 2017 to 2020, with the highest decline in the upper reaches. The four-year average value of the spatial distribution of runoff significantly increased from 466×108 m3 to 9923×108 m3. The two lake basins in the tributary river lake water system had the largest contribution to the water volume. The fluxes of permanganate index, total phosphorus (TP), and total nitrogen (TN) among the main pollutants showed an annual increase and then decrease trend. The pollutant fluxes in the Minjiang River, Tuojiang River, Jialing River, and the middle reaches of the two lakes contributed greatly to the river inflow. There were differences in fluxes in different regional water environments. The results of correlation and hierarchical cluster analysis showed that the permanganate index and TP fluxes were highly significantly correlated with water volume, and there was a significant correlation between biochemical oxygen demand (BOD5) and total nitrogen (TN), total phosphorus (TP), and chemical oxygen demand (COD). The main pollutants showed strong differences in the flood and non-flood periods and had a significant response in the flood season from July to September. The research results can provide scientific basis and theoretical support for the integrated management and precise prevention and control of the aquatic environment in the Yangtze River Basin.

Same-Day Bilateral Intravitreal Dexamethasone Implants for the Treatment of Diabetic Macular Edema.

INTRODUCTION: The aim of this study was to evaluate the outcomes and complications associated with the use of same-day bilateral intravitreal dexamethasone (DEX) implants for the treatment of diabetic macular edema (DME). METHODS: This retrospective analysis of an open-label, multicenter, consecutive case series included 130 eyes of 65 patients with bilateral DME who were treated with intravitreal DEX implants. The patients were divided into two groups: a control group (comprising 40 eyes treated with an alternating unilateral regimen) and a study group (comprising 90 eyes treated with concomitant bilateral DEX implants). All patients were followed up monthly after implantation. The changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to sixth month after implantation, and ocular adverse effects such as intraocular pressure, cataract, and tolerability of bilateral implantation were reviewed. The primary endpoint was to assess the safety of the same-day bilateral treatment protocol. The secondary endpoints focused on evaluating the functional and anatomical changes associated with bilateral simultaneous or alternating implantations. RESULTS: At 6 months after implantation, mean BCVA increased and CRT decreased in both groups. Moreover, no serious ocular adverse effects were observed. In addition, no differences were observed between the two groups in the number of patients who required extra follow-up visits or the number of extra visits made in addition to the treatment schedule. CONCLUSIONS: Same-day bilateral intravitreal DEX implants are associated with a low complication rate and are well tolerated by patients. This safe practice may optimize efficiency and reduce the burden on both the health-care system and patients, when used to treat bilateral DME.

Synergy of Adsorption and Photocatalytic Reduction for Efficient Removal of Cr(VI) with Polyvinylidene Fluoride@Polyvinyl Alcohol-FeC2O4/Bi2.15WO6.

Although the photocatalytic reduction of Cr(VI) to Cr(III) by traditional powder photocatalysts is a promising method, the difficulty and poor recovery of photocatalysts from water hinder their wide practical applications. Herein, we present that FeC2O4/Bi2.15WO6 (FeC2O4/BWO) composites were tightly bonded to modified polyvinylidene fluoride (PVDF) membranes by chemical grafting with the aid of polyvinyl alcohol (PVA) to form photocatalytic composite membranes (PVDF@PVA-FeC2O4/BWO). The contact angle of PVDF@PVA-FeC2O4/BWO (0.06 wt % of FeC2O4/BWO) is 48.0°, which is much lower than that of the pure PVDF membrane (80.5°). Meanwhile, the permeate flux of 61.43 g m-2 h-1 and water flux of 250.60 L m-2 h-1 were observed for PVDF@PVA-FeC2O4/BWO composite membranes. The tensile strength of composite membranes reached 48.84 MPa, which was 9.8 times higher than that of PVDF membrane. It was found that the PVDF@PVA-FeC2O4/BWO membrane exhibited excellent photocatalytic Cr(VI) reduction performance under both simulated and real sunlight irradiation. The adsorption for Cr(VI) by PVDF@PVA-FeC2O4/BWO can reach 47.6% in the dark process within 30 min, and the removal percentage of Cr(VI) could reach 100% with a rate constant k value of 0.2651 min-1 after 10 min of light exposure, indicating a synergistic effect of adsorption and photoreduction for Cr(VI) removal by the composite membrane. The PVDF@PVA-FeC2O4/BWO membrane had good stability and reusability after seven consecutive cycles. Most importantly, the influences of foreign ions on Cr(VI) reduction were investigated to mimic real sewage, which revealed that no obvious adverse effects can be found with the presence of common foreign ions in sewage. The photocatalytic membrane material developed in this study provides a new idea for treating Cr(VI)-containing wastewater and has a more significant application prospect.

The Association Between Ocular Residual Astigmatism and the Efficacy of Astigmatism Correction Via Small Incision Lenticule Extraction (SMILE).

INTRODUCTION: Astigmatism correction after small-incision lenticule extraction (SMILE) surgery is affected by several factors, including ocular residual astigmatism (ORA), which accounts for the vector difference between refractive and corneal astigmatism. Previous studies revealed the relationship between ORA and astigmatism correction after laser-assisted in situ keratomileusis (LASIK). However, in SMILE surgery, no comprehensive study exploring the link between these two variables has been performed. We have therefore assessed the association between ORA and astigmatism correction after SMILE. METHODS: This was a retrospective, single-centered study. Patients with myopia or myopic astigmatism who underwent SMILE surgery using the 500-kHz Visumax laser platform and were followed up for at least 3 months were included. Patients' demographic and clinical characteristics, such as visual acuity, refractive status and corneal tomography, were recorded. ORA was calculated using Alpins Statistical System for Ophthalmic Refractive Surgery Techniques (ASSORT) Ocular Residual Astigmatism calculator. RESULTS: A total of 888 eyes (408 eyes from males and 480 eyes from females) from 444 patients (mean age [standard deviation] 32.4 ± 7.1 years) were included in our study. Mean (± SD) preoperative sphere and cylinder were - 5.45 ± 1.98 (range - 10.00-0.00) diopter (D) and - 0.89 ± 0.70 (range - 4.00-0.00) D, respectively. Calculated mean ORA was 0.68 ± 0.35 (range 0.07-3.53) D. Postoperative logMAR uncorrected visual acuity was 0.03 ± 0.31. Mean postoperative sphere and cylinder were - 0.10 ± 0.56 (range - 1.5 to 1.0) D and - 0.51 ± 0.37 (- 1.5 to 0.0) D, respectively. The Pearson correlation test revealed preoperative sphere, steep keratometry (steep-K) and ORA were statistically correlated with the amplitude of astigmatism correction (P < 0.001), and the generalized estimating equations analysis showed that ORA was negatively correlated with the amplitude of astigmatism correction (P < 0.001). CONCLUSION: The results of our study suggest that preoperative higher ORA may be associated with a lower magnitude of astigmatism correction after SMILE surgery in patients with all levels of astigmatism preoperative. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05604872. Registered 3 November 2022-Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT05604872.