Settling characteristics of scleral lenses in Chinese adults with refractive error.

PURPOSE: To investigate the settling characteristics of a scleral lens in Chinese adults with refractive error and to provide guidance for its clinical application. METHODS: A total of 21 healthy Chinese adults (27.2 ± 4.1 years) with refractive error were enrolled in this study. The average spherical equivalent was -5.50 ± 2.92 D. Subjects were fitted with 15.6 mm diameter scleral lenses. The central post-lens tear thickness (PoLTT) was measured immediately after lens placement, 30, 60, 120, and 240 min after lens insertion at the dispensing visit and immediately after lens placement and 240 min after three months through optical coherence tomography. Statistical analyses were conducted using repeated measures analysis of variance and paired-t test. RESULTS: At the dispensing visit, the amount of settling after 240 min of lens wear was 126 ± 33 µm. After three months, the amount of settling was 98 ± 55 µm after 240 min. No significant difference was detected in the PoLTT immediately after lens placement between the dispensing visit and after three months (t = -0.246, p = 0.807), while a significant difference was noted at 240 min after lens insertion (t = -6.575, p < 0.001). The amount of settling was higher at the dispensing visit than that after three months (average difference = 28 ± 63 µm, t = 2.733, p = 0.01). The prediction model of PoLTT over time was y = 26.263-0.690 × t + 0.001 × t2 + 0.926 × y30 (R2 = 0.939), where y denotes the predicted PoLTT at t min after lens insertion, y30 denotes the PoLTT at 30 min after lens insertion. CONCLUSION: For the investigated small-diameter scleral lens (material: Boston XO, diameter: 15.6 mm, four-zone and periphery toric design), the PoLTT decreased over time after lens insertion in Chinese adults with refractive error, and the amount of settling varied among individuals (range: 71-204 µm). The amount of settling did not increase further after three months, indicating the long-term fitting stability of the scleral lens. Practitioners could estimate the PoLTT using the prediction model based on the PoLTT at 30 min after wearing lenses.

Metrics of Anterior Sclera in Normal Chinese Adults: Anterior Segment Imaging Using the Swept-Source Optical Coherence Tomography.

PURPOSE: To measure the corneoscleral limbus and anterior sclera parameters of normal Chinese adults by swept-source optical coherence tomography (OCT). MATERIALS AND METHODS: In this cross-sectional study, a total of 56 Chinese subjects with ametropia were evaluated in the Eye Hospital of Wenzhou Medical University from September 2020 to December 2020, including 26 (46.4%) men, with an average age of 24.7±1.8 years old. The OCT SS-1000 (CASIA, Tomey, Tokyo, Japan) was used to measure the sagittal height, corneoscleral junction (CSJ) angle, and scleral angle. RESULTS: The chord was across the corneal center and the line connecting the center of the cornea and the center of the chord was perpendicular to the chord. The mean sagittal height at chord lengths of 10.0, 12.3, and 15.0 mm were 1,756±72, 2,658±110, and 3,676±155 µm, respectively. The absolute values of the differences between horizontal and vertical meridians at three chord lengths were 54±40, 70±67, and 117±95 µm, respectively. One-way analysis of variance showed that the differences of CSJ angles at 12.3-mm chord and scleral angles at 15.0-mm chord in the four segments were statistically significant ( F values were 32.01 and 13.37, respectively, both P <0.001). The CSJ angles from low to high were 176.53±2.14° (nasal), 178.66±1.84° (inferior), 179.13±1.20° (temporal), and 179.31±1.68° (superior), and 87.5% of the nasal angles were less than 179°. The scleral angles from high to low were 38.35±2.47° (temporal), 38.26±3.37° (superior), 35.37±3.10° (nasal), and 35.30±4.71° (inferior). CONCLUSIONS: The morphology of corneoscleral limbus and anterior sclera is asymmetrical in normal Chinese adults. The nasal side of the corneoscleral limbus has the largest angle, and the superior and temporal sides of the scleral angle are larger.

Low vision aids and age are associated with Müller-Lyer illusion in congenital visually impaired children.

Background: The correlation between visual impairment and Müller-Lyer illusion is not yet elucidated. This study aimed to explore the connection between visual status, age, and the intensity of Müller-Lyer illusion in congenitally visually impaired and visually healthy children aged 4-17 years. Additionally, the developmental trends were compared. Methods: This cross-sectional study included 125 visually impaired children (age: 10.59 ± 4.05 years), among them, 53 had utilized low vision aids (LVAs) and 133 healthy controls (age: 11.33 ± 3.39 years). The participants were presented with Müller-Lyer illusion stimuli via binocular and engaged in a two-alternative forced choice task to quantify the illusion intensity. Pertinent factors including age, gender, residence, binocular distant best-corrected visual acuity and LVAs usage history, were assessed. Results: The visually impaired group exhibited significantly elevated illusion intensity compared to the healthy group (9.74 ± 2.89% vs. 5.42 ± 3.81%, p < 0.001), and visually impaired participants who had used LVAs exhibited significantly lower intensity compared to those had not (9.13 ± 3.00% vs. 10.19 ± 2.74%, p = 0.043). Multivariate generalized estimation equations revealed that visual impairment [odds ratio (OR) = 2.75, p < 0.001] and age (OR = 0.60, p < 0.001) were associated with illusion intensity in all participants, while history of LVAs usage (OR = 0.49, p = 0.045) and age (OR = 0.61, p < 0.001) were negatively correlated in visually impaired group. A significantly negative correlation was found between illusion intensity and age 4-17 years in the subgroups of visually impaired who had used LVAs (Y = -0.54X + 15.06, R2 = 0.56), who had not used (Y = -0.49X + 15.24, R2 = 0.51), and healthy controls (Y = -0.50X + 11.18, R2 = 0.21); all p-values were < 0.001. Conclusion: Children aged 4-17 years afflicted with congenital visual impairment exhibited a heightened intensity of Müller-Lyer illusion compared to visually normal counterparts, LVAs usage experience could reduce this higher intensity. The developmental trajectory of illusion intensity declined consistently with age across all three groups. The abnormal visual experiences during early-life may adversely affect integration in congenitally visually impaired children, and LVAs could facilitate this functional development.

Development of a new 17-item Asthenopia Survey Questionnaire using Rasch analysis.

AIM: To develop the 17-item Asthenopia Survey Questionnaire (ASQ)-17 by Rasch analysis, and to generate a predictiveness score. METHODS: Totally 739 participants were recruited and 680 were involved in the result analysis in this prospective, cross-sectional study. Three rounds of Rasch analysis were used to analyze the psychometric characteristics of items and options. RESULTS: Phase 1 assessed the original ASQ-19, adjusted the item scoring mode to a four-point Likert response rating scale and combined the 18th and 19th items into a new item. Phase 2 deleted the 11th item. Phases 3 and 4 assessed the new ASQ-17. All the evaluation indexes of ASQ-17 were acceptable. The Infit and Outfit MnSq values of items were 0.67-1.48, the variance explained by the principal component and the unexplained variance explained by the first contrast were 53.90%-59.40% and 1.50-1.80 in three dimensions. The curve peaks of scores in each dimension were separated and in the same order. The PSR and PSI values were 2.80 and 0.89, respectively. The mean scores of dimensions A (9.5±4.1 vs 3.5±3.2), B (7.3±3.3 vs 2.5±2.7), C (4.3±2.2 vs 1.4±2.0) and total (21.1±8.1 vs 7.4±7.0) in asthenopia participants were significantly higher than those without asthenopia (all P<0.001). The area under the curve in two groups was 0.899 (P<0.001). Youden's index was up to the maximum value of 0.784 when the cut-off value was 12.5. CONCLUSION: ASQ-17 has stronger option sorting and suitability than ASQ-19. It is an effective assessment tool for asthenopia with an optimal cut-off threshold value of 12.5, which is suitable for diagnosis and curative effect evaluation.

Associations of 10 trace element levels in the whole blood with risk of three types of obesity in the elderly.

BACKGROUND: Currently, over 2 billion people worldwide suffer from obesity, which poses a serious health risk. More and more attention is being given to the effects of trace elements on obesity in recent years. Synergistic or antagonistic interactions among these elements can adversely or positively impact human health. However, epidemiological evidence on the relationship between trace element exposure levels and obesity has been inconclusive. METHODS: Baseline data of 994 participants from the Cohort of Elderly Health and Environment Controllable Factors were used in the present study. ICP-MS was used to measure the concentrations of 10 trace elements in the whole blood of the older population. Binary logistic regression, restricted cubic splines (RCS) models, and Bayesian kernel machine regression (BKMR) models were employed to assess single, nonlinear, and mixed relationships between 10 trace element levels and three types of obesity based on body mass index (BMI), waist circumference (WC), and body fat percentage (BFP) in the elderly. RESULTS: Based on BMI, WC and BFP, 51.8% of the included old population were defined as general overweight/obesity, 67.1% as abdominal obesity, and 36.2% as having slightly high/high BFP. After multivariable adjustment, compared with the lowest tertile, the highest tertile of blood selenium (Se) concentration was associated with an increased risk of all three types of obesity. Additionally, compared with the lowest tertile, higher tertiles of strontium (Sr) concentrations were associated with a lower risk of general overweight/obesity and having slightly high/high BFP, and the highest tertile of barium (Ba) was associated with a lower risk of having slightly high BFP, while higher tertiles of arsenic (As) concentrations were associated with an increased risk of having slightly high/high BFP, and the highest tertile of manganese (Mn) was associated with a higher risk of abdominal obesity. BKMR analyses showed a strong linear positive association between Se and three types of obesity. Higher blood levels of trace element mixture were associated with increased obesity risks in a dose-response pattern, with Se having the highest value of the posterior inclusion probability (PIP) within the mixture. CONCLUSIONS: In this study, we found higher Se levels were associated with an elevated risk of obesity and high levels of Ba, Pb and Cr were associated with a decreased risk of obesity. Studies with larger samples are needed to confirm these findings.

Progranulin modulates the progression of non-small cell lung cancer through lncRNA H19.

OBJECTIVE: This study aimed to explore the specific mechanism of action of Progranulin (PGRN) in non-small cell lung cancer (NSCLC) and its interaction with lncRNA H19. METHODS: Normal and cancerous lung tissues were collected from patients with NSCLC and healthy volunteers. We assessed the expression of PGRN in both groups using immunohistochemistry, quantitative-reverse transcription-polymerase chain reaction (qRT-PCR), and western blotting (WB). RESULTS: Compared to the controls, PGRN expression was noticeably higher in tumor tissues. The high expression of PGRN in patients with NSCLC was inversely correlated to the prognosis and strongly associated with the biological features and clinicopathologic data. High PGRN expression significantly improved the ability of NSCLC cells to proliferate and migrate and was positively correlated with tumor formation, based on in vitro and in vivo cellular tests. Expression of lncRNA H19 was also found to be elevated in NSCLC tissue and cells. The expression of H19 was correlated with tumor growth in vivo and in vitro, and H19 regulated PGRN by mediating the expression of miR-29b-3p. CONCLUSIONS: H19 and PGRN can serve as biomarkers and therapeutic targets in NSCLC.

Value of contrast-enhanced magnetic resonance imaging-T2WI-based radiomic features in distinguishing lung adenocarcinoma from lung squamous cell carcinoma with solid components >8 mm.

Background: Radiomics is one of the research frontiers in the field of imaging and has excellent diagnostic performance. However, there is a lack of magnetic resonance imaging (MRI)-based omics studies on identifying pathological subtypes of lung cancer. Here we explored the value of the contrast-enhanced MRI-T2-weighted imaging (T2WI)-based radiomic analysis in distinguishing adenocarcinoma (Ade) from squamous cell carcinoma (Squ) with solid components >8 mm. Methods: A retrospective analysis was performed of a total of 71 lung cancer patients who undergoing contrast-enhanced MRI and computed tomography (CT) before treatment, and the nodules had solid components ≥8 mm in our center from January 2020 to September 2021. All enrolled patients were divided into Squ and Ade groups according to the pathological results. In addition, the two groups were randomly divided into training set and validation set in a ratio of about 7:3. Radiomics software was used to extract the relevant radiomic features. The least absolute shrinkage and selection operator (Lasso) was used to screen radiomic features that were most relevant to lung cancer subtypes, thus calculating the radiomic scores (Rad-score) and constructing the radiomic models. Multivariate logistic regression was used to combine relevant clinical features with Rad-score to form combined model nomograms. The receiver operating characteristic (ROC) curves. the area under the ROC curve (AUC), the decision curve analysis (DCA) and the DeLong's test were used to evaluate the clinical application potentials. Results: The sensitivity and specificity of the clinical model based on smoking was 75.0% and 93.8%. The AUC of the constructed magnetic resonance (MR)-Rad model for differentiating the pathological subtypes of lung cancer was 0.8651 in the validation sets. The AUC of the CT-Rad model in the validation set were 0.9286. The combined model constructed by combining clinical features and Rad-score had AUC of 0.8016, for identifying the 2 pathological subtypes of lung cancer in the validation set. There was no significant difference in diagnostic performance between MR-Rad model and CT-Rad model (P>0.05). Conclusions: The MR-Rad model has a diagnostic performance similar to that of CT-Rad model, while the diagnostic performance of the combined mode was better than the single MR model.

Starting up anammox system with high efficiency nitrogen removal at low temperatures: Performance optimization, sludge characterization and microbial community analysis.

Anaerobic ammonia oxidation (anammox) has potential advantages for nitrogen removal when operating at medium temperatures, but the increased operation costs of heating limit its application. It would be advantageous to start and operate anammox at low temperatures, the feasibility of which was studied here on a lab scale. Two identical expanded granular sludge bed (EGSB) reactors were inoculated at 35 ± 1 °C (Amed) and 15 ± 3 °C (Alow). Results showed that anammox was successful after 138 d for Alow, only 7 d longer than Amed. Stable operation to 194 d in Alow, the nitrogen loading rate (NLR) increased to 1.01 kg m-3·d-1, giving a high nitrogen removal efficiency (NRE) of 85%, which was only slightly lower than that of Amed (90%). More extracellular polymeric substance (EPS) was produced by the microbes of Alow compared to Amed, which prevented anaerobic ammonia oxidizing bacteria (AnAOB) against low temperature stress. Microbial community revealed presence of Candidatus Jettenia in Amed with relative abundance 7.4%, while the "cold-tolerant" Candidatus Kuenenia with 4% was the dominant anammox bacteria in Alow. The anammox granules adapted well to low temperatures and demonstrated high efficiency in anammox process without heating. Therefore, constructing an energy-saving and cost-effective anammox system in high latitudes or high altitudes can be considered.

Prevalence and determinants of asthenopia among ophthalmologists in China: a national cross-sectional survey.

Introduction: The role of ophthalmologists is defined by tasks requiring visual effort, emphasizing the importance of examining their condition within the realm of occupational visual health. Our goal was to explore the occurrence of asthenopia among Chinese ophthalmologists and identify contributing factors through the use of a reliable and validated survey instrument. Methods: A national cross-sectional online survey was carried out in June 2017, involving 6,220 practicing ophthalmologists in China. Utilizing an 11-item Asthenopia Survey Questionnaire with established reliability and validity. Prevalence rates of asthenopia among subgroups categorized by age, gender, hospital classification, physician level, daily near vision activity duration, sleep duration, sleep quality, presbyopia status, and history of eye surgery were determined using the independent t-test, chi-square test and bonferroni test. Multiple logistic regression analysis was employed to pinpoint independent factors linked to asthenopia. Results: Out of the 5,009 ophthalmologists who completed the survey, a 40.7% prevalence of asthenopia was identified. Multivariate analysis revealed that good sleep quality (OR: 0.24, 95%CI: 0.20-0.30), moderate sleep quality (OR: 0.47, 95%CI: 0.38-0.59), engaging in daily near vision activities for less than 7 h (OR: 0.76, 95%CI: 0.68-0.86), having daily sleep duration exceeding 7 h (OR: 0.87, 95%CI: 0.77-0.98), and working in tertiary hospitals (OR: 0.88, 95%CI: 0.78-0.99) were protective factors against asthenopia. Conversely, presbyopia was identified as a risk factor (OR: 1.33, 95%CI: 1.04-1.70). All calculated p values were below 0.05. Age, gender, physician level, and eye surgery history were not related factors. Conclusion: Asthenopia is prevalent among Chinese ophthalmologists, with employment in tertiary hospitals providing a protective effect and presbyopia is a risk factor. Preventive strategies include improving sleep quality, restricting daily near vision activity to under 7 h, and extending daily sleep duration to over 7 h. Further investigation is needed to explore the protective implications of working in tertiary hospitals.

Application of computed tomography-based radiomics combined with clinical factors in the diagnosis of malignant degree of lung adenocarcinoma.

Background: As an emerging technology, radiomics is being widely used in the diagnosis of early lung cancer due to its excellent diagnostic performance. However, there is a lack of studies that apply radiomics to the diagnosis of malignancy of lung adenocarcinoma. Thus, we used computed tomography (CT)-based radiomics to construct a model for the diagnosis of high-risk lung adenocarcinoma. Methods: Data of 170 patients who underwent surgical treatment at the First Affiliated Hospital of Soochow University and had a maximum nodule diameter ≤2 cm on preoperative CT images between January 2020 and December 2021 were retrospectively analyzed. All enrolled patients were randomly divided into experimental and validation groups according to the ratio of 7:3. The diagnosis of lung adenocarcinoma was based on postoperative pathological results. The region of interest was delineated on preoperative CT images, and the radiomics features were extracted. The least absolute shrinkage and selection operator (LASSO) was used to screen the radiomics features thus obtaining the radiomics score (Radscore), which was the basis of the radiomics model. Based on the multivariate regression analysis, independent predictors were screened from the clinical baseline data and imaging features thus constructing clinical model. Multivariate logistic regression was used to combine independent predictors and the Radscore to form a comprehensive nomogram. The diagnostic performance of constructed models was evaluated based on receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Results: The sensitivity and specificity of the clinical model based on consolidation-to-tumor ratio (CTR), lobulated signs and vascular anomaly signs was 70.0% and 76.7% in the validation group. The radiomics model [area under the curve (AUC) 0.926; 95% confidence interval (CI): 0.857-0.995] and the comprehensive model (AUC 0.922; 95% CI: 0.851-0.992) performed better than clinical model (AUC 0.839; 95% CI: 0.720-0.958) in the validation group. The sensitivity and specificity of the comprehensive model was 85.0% and 80.0% in the validation group. DCA of radiomics model and comprehensive model suggested they have better net survival benefit than clinical model. Conclusions: Compared with clinical model, radiomics model and comprehensive model had better diagnostic performance in distinguishing malignant degree of lung adenocarcinoma.