Abnormal Systemic and Ocular Responses to the Valsalva Manoeuvre in Primary Open-Angle Glaucoma: A Case for Autonomic Failure?

OBJECTIVE: This study aimed to examine the association of primary open-angle glaucoma (POAG) with autonomic dysfunction by assessing the differences in systemic and ocular responses to an autonomic provocation test, the Valsalva manoeuvre (VM), between POAG patients and normal subjects. METHODS: Forty POAG and forty control subjects were subjected to the VM. Systemic and ocular parameters were measured at baseline, phase 2, and phase 4 of the VM (VM2 and VM4), where VM2 and VM4 are sympathetic and parasympathetic nervous activation states, respectively. Heart rate variability was used to assess the autonomic nervous activity, among which the high-frequency component (HF) and the low-frequency (LF)/HF ratio were used as indices of parasympathetic and sympathetic activation, respectively. RESULTS: POAG patients demonstrated higher sympathetic activation (LF/HF ratio median: 2.17 vs. 1.53, P=0.000) than controls at baseline and exhibited attenuated sympathetic and parasympathetic responses (a smaller change in LF/HF and HF values) during the VM than controls. During VM, the intraocular pressure (IOP), mean blood pressure (MAP), mean ocular perfusion pressure (MOPP), and the Schlemm's canal area (SCAR) increased from baseline to VM2 and then decreased from VM2 to VM4 in both the POAG and control groups (all P<0.05). However, when we compared the changes above, the fluctuations in IOP, MAP, and MOPP were more pronounced in POAG than in controls (all P<0.05), while the changes in amplitudes of SCAR were smaller in POAG (P<0.05). Furthermore, from VM2 to VM4, the choroid thickness (ChT) in the POAG group was significantly decreased, while it was unchanged in normal subjects (P=0.258). A regression analysis showed a significant correlation of the baseline LF/HF with IOP change values (ΔIOP) from baseline to VM2 in POAG (R2=0.147, P=0.014). CONCLUSION: Patients with POAG showed more pronounced fluctuations in IOP, MAP, MOPP and ChT during the VM than controls. These reactions could be associated with autonomic dysfunction in POAG.

Artificial intelligence method based on multi-feature fusion for automatic macular edema (ME) classification on spectral-domain optical coherence tomography (SD-OCT) images.

Purpose: A common ocular manifestation, macular edema (ME) is the primary cause of visual deterioration. In this study, an artificial intelligence method based on multi-feature fusion was introduced to enable automatic ME classification on spectral-domain optical coherence tomography (SD-OCT) images, to provide a convenient method of clinical diagnosis. Methods: First, 1,213 two-dimensional (2D) cross-sectional OCT images of ME were collected from the Jiangxi Provincial People's Hospital between 2016 and 2021. According to OCT reports of senior ophthalmologists, there were 300 images with diabetic (DME), 303 images with age-related macular degeneration (AMD), 304 images with retinal-vein occlusion (RVO), and 306 images with central serous chorioretinopathy (CSC). Then, traditional omics features of the images were extracted based on the first-order statistics, shape, size, and texture. After extraction by the alexnet, inception_v3, resnet34, and vgg13 models and selected by dimensionality reduction using principal components analysis (PCA), the deep-learning features were fused. Next, the gradient-weighted class-activation map (Grad-CAM) was used to visualize the-deep-learning process. Finally, the fusion features set, which was fused from the traditional omics features and the deep-fusion features, was used to establish the final classification models. The performance of the final models was evaluated by accuracy, confusion matrix, and the receiver operating characteristic (ROC) curve. Results: Compared with other classification models, the performance of the support vector machine (SVM) model was best, with an accuracy of 93.8%. The area under curves AUC of micro- and macro-averages were 99%, and the AUC of the AMD, DME, RVO, and CSC groups were 100, 99, 98, and 100%, respectively. Conclusion: The artificial intelligence model in this study could be used to classify DME, AME, RVO, and CSC accurately from SD-OCT images.

Biomechanically and biochemically functional scaffold for recruitment of endogenous stem cells to promote tendon regeneration.

Tendon regeneration highly relies on biomechanical and biochemical cues in the repair microenvironment. Herein, we combined the decellularized bovine tendon sheet (DBTS) with extracellular matrix (ECM) from tendon-derived stem cells (TDSCs) to fabricate a biomechanically and biochemically functional scaffold (tECM-DBTS), to provide a functional and stem cell ECM-based microenvironment for tendon regeneration. Our prior study showed that DBTS was biomechanically suitable to tendon repair. In this study, the biological function of tECM-DBTS was examined in vitro, and the efficiency of the scaffold for Achilles tendon repair was evaluated using immunofluorescence staining, histological staining, stem cell tracking, biomechanical and functional analyses. It was found that tECM-DBTS increased the content of bioactive factors and had a better performance for the proliferation, migration and tenogenic differentiation of bone marrow-derived stem cells (BMSCs) than DBTS. Furthermore, our results demonstrated that tECM-DBTS promoted tendon regeneration and improved the biomechanical properties of regenerated Achilles tendons in rats by recruiting endogenous stem cells and participating in the functionalization of these stem cells. As a whole, the results of this study demonstrated that the tECM-DBTS can provide a bionic microenvironment for recruiting endogenous stem cells and facilitating in situ regeneration of tendons.

Molecular data provide new insights into the phylogeny of Cladonotinae (Orthoptera: Tetrigoidea) from China with the description of a new genus and species.

Considerable effort has been devoted to elucidating the phylogenetic relationships of tetrigides. However, there is still no commonly accepted phylogenetic hypothesis. Therefore, the phylogenetic relationships among some subfamilies remain unclear; e.g., Cladonotinae is a controversial group, in which the phylogenetic relationships between genera and the boundaries of some of the included genera are unclear, causing some of the taxa to be difficult to identify. Therefore, an in-depth phylogenetic analysis of Cladonotinae is urgently needed. In this study, a robust phylogenetic framework for the tetrigides was reconstructed based on the combined mitochondrial cytochrome oxidase subunit I (COI), 16S ribosomal RNA (16S rRNA), and nuclear 18S ribosomal RNA (18S rRNA) gene sequences of 25 species belonging to 16 genera of Tetrigoidea from China, which included 13 species from 8 genera of Cladonotinae. Phylogenetic inferences were performed using the combined dataset and Bayesian inference (BI) and Maximum Parsimony (MP) methods, and the phylogenetic tree of Cladonotinae was reconstructed. All inferences based on the results of the present study supported the Cladonotinae subfamily as a polyphyletic group; within the Cladonotinae subfamily, Tetradinodula, and Tuberfemurus were closely related to Tetriginae, while Austrohancockia and Gibbotettix showed a close relationship to the Scelimenidae subfamily. Additionally, a new genus and new species of the Cladonotinae subfamily are described and illustrated: Hainantettix Deng, gen. nov. and Hainantettix strictivertex Deng, sp. nov.

An annotated catalogue of the pygmy grasshoppers of the genus Criotettix Bolívar, 1887 (Orthoptera: Tetrigidae) with two new Criotettix species from China.

The tetrigid genus Criotettix Bolívar, 1887 from China is taxonomically reviewed. The genus now includes 39 species from China, in which two new species are described and illustrated, namely: Criotettix longispinus Deng, sp. nov. and Criotettix undatifemurus Deng, sp. nov..Their distribution and an annotated identification key to Chinese species are provided.

A review of the genus Systolederus Bolivar (Orthoptera: Metrodorinae) from China.

The tetrigid genus Systolederus Bolivar, 1887 from China is taxonomically reviewed. The genus now includes 16 species from China, in which one new species is described and illustrated, namely: Systolederus aspinus Deng, sp. nov.. Their distribution and an annotated identification key to Chinese species are provided.

Novel approach to synthesizing hydrophobically associating copolymer using template copolymerization: the synthesis and behaviors of acrylamide and 4-(omega-propenoyloxyethoxy) benzoic acid copolymer.

Hydrophobically associating copolymers of acrylamide (AM) with a small amount of 4-(omega-propenoyloxyethoxy) benzoic acid (PEBA, <2.5%) were synthesized by template copolymerization in the presence of poly(allylammonium chloride) (PAAC) as a template in an aqueous medium. These template copolymers exhibited remarkable thickening properties due to the effective hydrophobic association, which were similar to those copolymers with a multiblock structure obtained by the micellar process. The pH of the reaction medium and the molecular weight of the template strongly influenced the thickening properties of the products. In the experimental range, the higher the PEBA content, the larger the thickening capacity of these hydrophobic copolymers. The aggregate behaviors of these copolymers were studied by fluorescence, transmission electron microscopy (TEM), and light scattering techniques. The apparent critical interpolymer aggregate concentration (cac) of the copolymer solution was about 0.5 g/dL. As the concentration of the copolymer became higher than the cac, the aggregates changed their morphology from small hollow spheres to big flower-shaped aggregates. All the above results indicated that the template copolymerization gave access to a very simple and powerful means for the preparation of hydrophobically associating copolymers and other functional polymer materials.