Unveiling enamel demineralization mechanisms by sensitive dielectric differentiation based on terahertz nanospectroscopy.

The early stage of dental caries, i.e. demineralization, has always been a topic of concern to dentists. Understanding the essential mechanism of its occurrence is of great significance for the prevention and treatment of dental caries. However, owing to limitations in resolution and the detection capabilities of diagnostic tools, the study of enamel demineralization has always been a challenge. Terahertz (THz) technology, especially the combination of scanning near-field optical microscopy (s-SNOM) and THz time-domain spectroscopy (TDS), due to its nanoscale resolution, has shown great advantages in the field of biological imaging. Here, a THz s-SNOM system is used to perform near-field imaging of enamel before and after demineralization at the nanoscale. It can be found that near-field signals decrease significantly after demineralization. This is due to the changes of the crystal lattice and the transfer of mineral ions during demineralization, which leads to a decrease in the permittivity of the enamel. The novel approach in this study reveals the essence of demineralization and lays the groundwork for additional research and potential interventions.

A Novel Rational PROTACs Design and Validation via AI-Driven Drug Design Approach.

The rational design of novel drug candidates presents a formidable challenge in modern drug discovery. Proteolysis-targeting chimeras (PROTACs) drug design is particularly demanding due to their limited crystal structure availability and design of a viable small molecule to bridge the protein of interest (POI) and ubiquitin-protein ligase (E3). An integrated approach that combines superimposition techniques and deep neural networks is demonstrated in this study to leverage the power of deep learning and structural biology to generate structurally diverse molecules with enhanced binding affinities. The superimposition technique ensures the congruence of initial and new protein-ligand pairs, which are evaluated via subsequent comprehensive screening using the root-mean-square deviation (RMSD), binding free energy (BFE), and buried solvent-accessible surface area (SASA). The final candidates are subjected to the incorporation of molecular dynamics (MD) and free energy perturbation (FEP) simulations to provide a quantitative evaluation of relative binding energies, reinforcing the efficacy and reliability of the generated molecules. The outcomes of the generated novel PROTACs molecules exhibit comparable structural attributes while demonstrating superior binding affinities within the binding pockets when contrasted with those of the established cocrystal ternary complexes. To enhance the generalizability of the workflow, we chose the ternary structure of the cellular inhibitor of apoptosis protein 1 (cIAP1) and Bruton's Tyrosine Kinase (BTK) for validating the chemical properties generated from the processes. The new linker molecules additionally showed superior affinity from the simulations. In summary, this methodology serves as an effective workflow to align computational predictions with current limitations, thereby introducing a novel paradigm in AI-driven drug design.

Cation Vacancy Strategy Activated Layered Double Hydroxides: Enhanced Electrochemical Performance and Longevity.

The defect design strategy has been extensively employed to enhance the reaction kinetics of layered double hydroxide (LDH) electrode materials. Furthermore, it is anticipated to improve the cyclic stability of LDHs through this approach, serving a dual purpose. However, the potential mechanisms of cation vacancies' impact on the electrochemical performance of electrodes at the atomic scale still need further clarification. In this study, a typical aluminum-vacancy LDH material via a simple alkaline etching method was demonstrated. Electrochemical in situ Raman spectroscopy, ex situ X-ray diffraction (XRD), and first-principles calculations were utilized to elucidate the mechanism of Faradaic reactions. The findings indicate that this cation vacancy strategy not only enhances the electrochemical reaction kinetics of the electrodes but also effectively reduces the energy barrier for the α to γ phase transition of LDHs during the charge-discharge processes, thereby enhancing its longevity. To further validate the practical application of this defect design, an asymmetric solid-state supercapacitor was formed, which maintains 93.9% capacity after 20 000 charge-discharge cycles. This research offers technical guidance for the development of a new generation of high-performance and long-life LDH electrode materials based on a cation vacancy strategy.

Radiation Dose-Induced Carotid Artery Stenosis and Brain Necrosis in Head and Neck Cancer-A Real World Cohort Study.

Objective: This study aims to examine whether radiation therapy doses are related to incidences of carotid artery stenosis and brain necrosis in a large-scale real-world database. Methods: We identified a cohort of HNC patients from the catastrophic illness patient dataset using ICD-9 or ICD-10 to compare the incidence and risks of carotid artery stenosis (CAS) and brain necrosis (RIBN) in patients who received a radiation therapy dose of ≥5400 cGy/30 fractions (group A) with those who received a radiation therapy dose of <5400 cGy/30 fractions (group B). The incidence and hazard ratios were quantified using Cox proportional hazards models. Results: A total of 19,964 patients were identified in group A and group B. Among them, 965 and 863 cases of CAS and 435 and 359 cases of RIBN were identified in group A and group B, respectively. There was no statistically significant association between the two groups for CAS risk, whereas there was a statistically significant association between the two groups for RIBN risk. The most common primary site of head and neck cancers was the nasopharynx (1144 of 19,964, 5.73%). Conclusions: Our study suggests that RT may increase the risk of carotid stenosis and brain necrosis in patients with NPC. To ensure patient safety during treatment, the optimal balance between tumor control and toxicity prevention in individual patients through minimization of the radiation dose to all relevant OARs must be properly understood.

Enhanced immune response with baculovirus-expressed BoHV-1 glycoprotein D in vaccine development.

Bovine herpesvirus 1 (BoHV-1), a significant pathogen in the alpha-herpesvirus subfamily, primarily infects cattle and causes the upper respiratory disease known as infectious bovine rhinotracheitis (IBR). In silico studies evaluated the BoHV-1 D protein to be non-allergenic, non-toxic, and highly antigenic, highlighting its potential as an antigen for vaccine development. Therefore, this study aimed to evaluate the efficacy of a subunit vaccine using the ectodomain of glycoprotein D (gD34-380) as an antigen. The truncated gD was successfully cloned and expressed in both Escherichia coli (E. coli, termed EgD) and baculovirus (termed BgD) systems, with expected molecular weights of 65 kDa and 50 kDa, respectively. For the vaccine formulation, the gD proteins were used either alone or in combination with in-house inactivated BoHV-1. Vaccination of mice and bovines showed that baculovirus-expressed gD34-380 accelerated the antibody response. Moreover, the BgD-vaccinated group also showed significantly higher neutralizing antibody levels against BoHV-1 than the control group (p<0.0001). In conclusion, our study found that BgD from BoHV-1 can increase the immune response and enhance vaccine efficacy.

HSP90/LSD1 dual inhibitors against prostate cancer as well as patient-derived colorectal organoids.

The rational installation of pharmacophores targeting HSP90 and LSD1 axes has achieved significant anti-cancer capacity in prostate and colorectal cancer. Among the series of hybrids, inhibitor 6 exhibited remarkable anti-proliferative activity against prostate cancer cell lines PC-3 and DU145, with GI50 values of 0.24 and 0.30 µM, respectively. It demonstrated notable efficacy in combinatorial attack and cell death initiation towards apoptosis. The cell death process was mediated by PARP induction and γH2AX signaling, and was also characterized as caspase-dependent and Bcl-xL/Bax-independent. Notably, no difference in eye size or morphology was observed in the zebrafish treated with compound 6 compared to the reference group (AUY922). The profound treatment response in docetaxel-resistant PC-3 cells highlighted the dual inhibitory ability in improving docetaxel sensitivity. Additionally, at a minimum concentration of 1.25 µM, compound 6 effectively inhibited the growth of patient-derived colorectal cancer (CRC) organoids for up to 10 days in vitro. Together, the designed HSP90/LSD1 inhibitors present a novel route and significant clinical value for anti-cancer drug therapy.

Syntheses of LSD1/HDAC Inhibitors with Demonstrated Efficacy against Colorectal Cancer: In Vitro and In Vivo Studies Including Patient-Derived Organoids.

Precedential evidence ascertaining the overexpression of LSD1 and HDACs in colorectal cancer spurred us to design a series of dual LSD1-HDAC inhibitors. Capitalizing on the modular nature of the three-component HDAC inhibitory model, tranylcypromine as a surface recognition motif was appended to zinc-binding motifs via diverse linkers. A compendium of hydroxamic acids was generated and evaluated for in vitro cytotoxicity against HCT-116 cells (human colorectal cancer cell lines). The most potent cell growth inhibitor 2 (GI50 = 0.495 µMm HCT-116 cells) shows promising anticancer effects by reducing colony formation and inducing cell cycle arrest in HCT-116 cells. It exhibits preferential inhibition of HDAC6, along with potent inhibition of LSD1 compared to standard inhibitors. Moreover, Compound 2 upregulates acetyl-tubulin, acetyl-histone H3, and H3K4me2, indicative of LSD1 and HDAC inhibition. In vivo, it demonstrates significant antitumor activity against colorectal cancer, better than irinotecan, and effectively inhibits growth in patient-derived CRC organoids.

Development and validation of deep learning models for identifying the brand of pedicle screws on plain spine radiographs.

Background: In spinal revision surgery, previous pedicle screws (PS) may need to be replaced with new implants. Failure to accurately identify the brand of PS-based instrumentation preoperatively may increase the risk of perioperative complications. This study aimed to develop and validate an optimal deep learning (DL) model to identify the brand of PS-based instrumentation on plain radiographs of spine (PRS) using anteroposterior (AP) and lateral images. Methods: A total of 529 patients who received PS-based instrumentation from seven manufacturers were enrolled in this retrospective study. The postoperative PRS were gathered as ground truths. The training, validation, and testing datasets contained 338, 85, and 106 patients, respectively. YOLOv5 was used to crop out the screws' trajectory, and the EfficientNet-b0 model was used to develop single models (AP, Lateral, Merge, and Concatenated) based on the different PRS images. The ensemble models were different combinations of the single models. Primary outcomes were the models' performance in accuracy, sensitivity, precision, F1-score, kappa value, and area under the curve (AUC). Secondary outcomes were the relative performance of models versus human readers and external validation of the DL models. Results: The Lateral model had the most stable performance among single models. The discriminative performance was improved by the ensemble method. The AP + Lateral ensemble model had the most stable performance, with an accuracy of 0.9434, F1 score of 0.9388, and AUC of 0.9834. The performance of the ensemble models was comparable to that of experienced orthopedic surgeons and superior to that of inexperienced orthopedic surgeons. External validation revealed that the Lat + Concat ensemble model had the best accuracy (0.9412). Conclusion: The DL models demonstrated stable performance in identifying the brand of PS-based instrumentation based on AP and/or lateral images of PRS, which may assist orthopedic spine surgeons in preoperative revision planning in clinical practice.

A High-Throughput Visual Screen for the Directed Evolution of C ß -stereoselectivity of L-threonine Aldolase.

L-Threonine aldolase (L-TA) is a pyridoxal phosphate-dependent enzyme that catalyzes the reversible condensation of glycine and aldehydes to form ß-hydroxy-α-amino acids. The combination of directed evolution and efficient high-throughput screening methods is an effective strategy for enhancing the enzyme's catalytic performance. However, few feasible high-throughput methods exist for engineering the Cß-stereoselectivity of L-TAs. Here, we present a novel method of screening for variants with improved Cß-stereoselectivity; this method couples an L-threo-phenylserine dehydrogenase, which catalyzes the specific oxidation of L-threo-4-methylsulfonylphenylserine (L-threo-MTPS), with the concurrent synthesis of NADPH, which is easily detectable via 340-nm UV absorption. This enables the visual detection of L-threo-MTPS produced by L-TA through the measurement of generated NADPH. Using this method, we discover an L-TA variant with significantly higher diastereoselectivity, increasing from 0.98% de (for the wild-type) to 71.9% de.

Interventions and behaviour change techniques for improving physical activity level in working-age people (18-60 years) with type 2 diabetes: A systematic review and network meta-analysis.

BACKGROUND: The escalating prevalence of type 2 diabetes within the working-age population (18-60 years) imposes a substantial societal burden. Whilst physical activity is crucial for diabetes management, limited evidence exists to inform optimal strategies for promoting physical activity in this population. We aimed to evaluate and compare the effect of interventions for increasing physical activity in working-age adults with type 2 diabetes. METHODS: We searched Web of Science, the Cochrane Library, Medline, Embase, PsycINFO, ClinicalTrials.gov, and ICTRP from inception to April 30, 2023. Randomised controlled trials that reported the effect of interventions (education, training or behavioural) to promote physical activity (either self-reported or objective) in people aged 18-60 years were included. Two independent reviewers conducted summary data extraction and quality assessment. Pairwise random-effects, Frequentist network meta-analyses, and subgroup analysis were used to obtain pooled effects. RESULTS: A total of 52 trials were included in this systematic review. Compared to control group, the physical activity interventions demonstrated statistically significant effects on objectively measured physical activity (SMD 0.77, 95 % CI 0.27-1.27), self-reported physical activity (SMD 0.88, 95 % CI 0.40-1.35), and overall physical activity (SMD 0.82, 95 % CI 0.48-1.16); a statistically and clinically meaningful reduction on glycated haemoglobin A1c (HbA1c) was also identified (MD -0.50 %, 95 % CI -0.66, -0.35). In terms of intervention types, education interventions exerted the largest effect on objectively measured physical activity; however, psychological interventions had the largest effects on overall physical activity compared to other intervention types. Four behaviour change techniques were related to statistically significant reduction in HbA1c: goal setting (outcome), information about health consequences, demonstration of the behaviour, and prompts/cues. Subgroup analysis showed that delivery mode, intervention setting, and facilitator were associated with statistically significant effect on physical activity and HbA1c. CONCLUSIONS: Psychologically modelled education incorporating behaviour change techniques may be the most beneficial way to promote physical activity and glycaemic control in working-age adults with type 2 diabetes. Delivery mode, intervention setting, and facilitator type should be considered when designing interventions for improving physical activity level in working-age people with type 2 diabetes.

Integrating traditional Chinese Medicine reduced the risk of hip fracture in patients with dementia.

BACKGROUND/PURPOSE: The high incidence of hip fracture is an important problem among dementia patients because of their higher risk of falls and balance deficits due to a lack of physical activity. The aim of this study was to investigate whether traditional Chinese medicine (TCM) therapy could reduce the risk of hip fracture in dementia patients. METHODS: We identified 38,071 patients who were first diagnosed with dementia from January 1, 2000, to December 31, 2017, from the database of the 2000 Longitudinal Generation Tracking Database (LGTD 2000) provided by the Health and Welfare Data Science Center (HWDC) in Taiwan. Patients who received TCM treatment after the initial diagnosis of dementia were assigned to the TCM group, and patients who never received TCM treatment were assigned to the non-TCM group. After performing 1:1 propensity score matching (1:1) based on age, sex, comorbidities and medication between the TCM and non-TCM groups, there were 902 patients in each group. Patients were followed up to December 31, 2018, and incidences of hip fracture after the initial diagnosis of dementia between the two groups were compared with Cox regression analysis. RESULTS: Ninety-four patients in the non-TCM group (10.42%) and 58 patients in the TCM group (6.43%) suffered from hip fracture during the follow-up period. Patients in the TCM group had a lower incidence of hip fracture than those in the non-TCM group (adjusted hazard ratio = 0.54, 95% confidence interval = 0.38-0.76). CONCLUSIONS: Integrating TCM health care for dementia patients might reduce the risk of hip fracture.

Dual Caregiving and Mental Health Among Long-Term Care Nursing Assistants: The Moderating Role of Social Support.

AIM: To investigate the association of long-term care nursing assistants' dual caregiving roles with mental health and to determine whether social support moderates this relationship. DESIGN: A cross-sectional survey. METHODS: We surveyed 962 certified long-term care nursing assistants working in long-term care and medical facilities across Taiwan from October 2022 to July 2023. 'Dual caregiving roles' denote the fulfilment of caregiving duties both at work and within families. Mental health was evaluated using the 5-item Brief Symptom Rating Scale. Logistic regression analysis was utilized to investigate the association of dual caregiving roles and psychological job demands with poor mental health. Moreover, we explored whether family, colleague, and supervisor support moderated the association between dual caregiving roles and poor mental health. RESULTS: Among long-term care nursing assistants, 15% had dual caregiving responsibilities. Individuals with both dual caregiving roles and high psychological job demands faced the highest risk of poor mental health compared to those without dual caregiving roles and low psychological job demands. Having dual caregiving roles was associated with poor mental health compared to workers without such roles. Additionally, support from family, colleagues, and supervisors mitigates the association between caregivers' dual caregiving roles and poor mental health. CONCLUSION: A substantial proportion of long-term care nursing assistants had dual caregiving roles, leading to an additional mental health burden when combined with high psychological job demands. High social support attenuated this association. IMPLICATIONS FOR THE PROFESSION: Long-term care nursing assistants with dual caregiving roles had poorer mental health outcomes. Yet, support from family, colleagues, and supervisors mitigated these effects. These results emphasize the importance of enhancing social support to protect the mental well-being of long-term care nursing assistants managing both formal and informal caregiving duties. REPORTING METHOD: This study adheres to the STROBE guideline of reporting. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Tetraphenylborate enhanced enzymatic production of γ-cyclodextrin: System construction and its mechanism.

γ-Cyclodextrin (γ-CD) is an attractive material among the natural cyclodextrins owing to its excellent properties. γ-CD is primarily produced from starch by γ-cyclodextrin glycosyltransferase (γ-CGTase) in a controlled system. However, difficulty in separation and low conversion rate leads to high production costs for γ-CD. In this study, γ-CGTase from Bacillus sp. G-825-6 STB17 was used in γ-CD production from cassava starch. With the introduction of sodium tetraphenylborate (NaBPh4), the total conversion rate was promoted from an initial 18.07 % to 50.49 % and the γ-CD ratio reached 78.81 % with a yield of 39.79 g/L. Furthermore, the mechanism was conducted via the determination of binding constant, which indicated that γ-CD exhibited much stronger binding strength with NaBPh4 than ß-CD. The reformation of water molecules and the chaotropic effect might be the main driving forces for the interaction. Additionally, the conformations of CD complexes were depicted by NMR and molecular docking. The results further verified different binding patterns between CDs and tetraphenylborate ions, which might be the primary reason for the specific binding. This system not only guides γ-CD production with an efficient and easy-to-remove production aid but also offers a new perspective on the selection of complexing agents in CD production.

Nanosecond laser annealing processed surface-structured hyperdoped silicon for efficient near-infrared detection.

Surface-structured engineering of hyperdoped silicon can effectively facilitate the absorption of sub-bandgap photons in pristine single-crystal silicon (sc-Si). Here, we conducted different annealing approaches of ordinary thermal annealing (OTA) and nanosecond laser annealing (NLA) on modification of titanium-hyperdoped silicon (Si:Ti) surface structure, to achieve efficient near-infrared detection. It is presented that both OTA and NLA processes can improve the crystallinity of Si:Ti samples. In detail, atomic-resolved STEM characterization illustrates that NLA treatment will further eliminate the amorphous phase on Si:Ti surface to varying degrees. While one-dimensional periodic stacking fault structure of 9R-Si phase is formed at the surface of sc-Si and embedded in the Si matrix during the OTA process, which reveals the seamless interface of 9R-Si/sc-Si along with [11¯0] direction. Due to the high sub-bandgap light absorption and good crystal structure, the Si:Ti photodetector after NLA treatment with an energy density of 2.6 J cm-2exhibited the highest responsivity, reaching 151 mA W-1at 1550 nm even at a low operating voltage of 1 V. We assume the performance enhancement of NLA processed Si:Ti photodetectors can be attributed to two aspects, the one is NLA can reduce the recombination of photo-generated charge carriers in amorphous surface layer by improving crystallization, and the other is that NLA process can weaken the diffusion of titanium impurities due to the extremely rapid heating and cooling rates. This study presents prospects towards surface-structured silicon in infrared light detection.

Design, synthesis and inhibition evaluation of novel chalcone amide α-glucosidase inhibitors.

Aim: The purpose of this study is to design and synthesize a series of novel chalcone amide α-glucosidase (AG) inhibitors (L1-L10) based on virtual screening and molecular dynamics (MD) simulation. Materials & methods: Target compounds (L1-L10) were synthesized from 2-hydroxyacetophenone and methyl 4-formylbenzoate. Results: In vitro activity test shows that most compounds have good AG inhibition. Specially, compound L4 (IC50 = 8.28 ± 0.04 µM) had the best inhibitory activity, superior to positive control acarbose (IC50 = 8.36 ± 0.02 µM). Molecular docking results show that the good potency of L4 maybe attributed to strong interactions between chalcone skeleton and active site, and the torsion of carbon nitrogen bond in amide group. Conclusion: Compound L4 maybe regard as a good anti-Type II diabetes candidate to preform further study.

[Box: see text].

Cobalt-Catalyzed Intramolecular Markovnikov Hydrocarbonylation of Unactivated Alkenes via Hydrogen Atom Transfer.

A cobalt-catalyzed intramolecular Markovnikov hydroalkoxycarbonylation and hydroaminocarbonylation of unactivated alkenes has been developed, enabling highly chemo- and regioselective synthesis of α-alkylated γ-lactones and α-alkylated γ-lactams in good yields. The mild reaction conditions allow use of mono-, di- and trisubstituted alkenes bearing a variety of functional groups. Preliminary mechanistic studies suggest the reaction proceeds through a CO-mediated hydrogen atom transfer (HAT) and radical-polar crossover (RPC) process, in which a cationic acylcobalt(IV) complex is proposed as the key intermediate.

The Relationship between Trait Emotional Intelligence and Creative Self-Efficacy in Gifted Children: A Cross-Lagged and Cross-Temporal Mediation Analysis.

The present study aimed to investigate the causal relationship between trait emotional intelligence and creative self-efficacy in gifted children and to explore the cross-temporal mediating role of self-concept between these two variables. A total of 177 gifted children aged 10-13 years (M = 11.29, SD = 0.68) were selected from an experimental class of gifted children in a middle school. The results showed that (1) the trait emotional intelligence and creative self-efficacy of gifted children decreased with age and that (2) trait emotional intelligence at time 1 (T1) positively and significantly predicted creative self-efficacy at time 2 (T2). The Self-Description Questionnaire was added at the second follow-up, which revealed that (3) T2 non-academic self-concept fully mediated the relationship between T1 trait emotional intelligence and T2 creative self-efficacy. This study revealed a lasting positive effect of trait emotional intelligence on the development of creative self-efficacy in gifted children. Additionally, trait emotional intelligence was found to indirectly influence creative self-efficacy through non-academic self-concept.

Promoted Stability and Reaction Kinetics in Ni-Rich Cathodes via Mechanical Fusing Multifunctional LiZr2(PO4)3 Nanocrystals for High Mass Loading All-Solid-State Lithium Batteries.

Sulfide all-solid-state lithium battery (ASSLB) with nickel-rich layered oxide as the cathode is promising for next-generation energy storage system. However, the Li+ transport dynamic and stability in ASSLB are hindered by the structural mismatches and the instabilities especially at the oxide cathode/sulfide solid electrolyte (SE) interface. In this work, we have demonstrated a simple and highly effective solid-state mechanofusion method (1500 rpm for 10 min) to combine lithium conductive NASICON-type LiZr2(PO4)3 nanocrystals (∼20 nm) uniformly and compactly onto the surface of the single crystallized LiNi0.8Co0.1Mn0.1O2, which can also attractively achieve Zr4+ doping in NCM811 and oxygen vacancies in the LZPO coating without solvent and annealing. Benefiting from the alleviated interface mismatches, sufficient Li+ ion flux through the LZPO coating, promoted structural stabilities for both NCM811 and sulfide SE, strong electronic coupling effect between the LZPO and NCM811, and enlarged (003) d-spacing with enriched Li+ migration channels in NCM811, the obtained LZPO-NCM811 exhibits superior stability (185 mAh/g at 0.1C for 200 cycles) and rate performance (105 mAh/g at 1C for 1300 cycles) with high mass loading of 27 mgNCM/cm2 in sulfide ASSLB. Even with a pronounced 54 mgNCM/cm2, LZPO-NCM811 manifests a high areal capacity of 9.85 mAh/cm2. The convenient and highly effective interface engineering strategy paves the way to large-scale production of various coated cathode materials with synergistic effects for high performance ASSLBs.

Adjunctive aspiration technique for the surgical management of deep orbital cavernous hemangioma.

ABSTRACT: To propose a needle aspiration technique for the surgical removal of orbital cavernous hemangioma. In this retrospective case series, we enrolled 13 patients with orbital cavernous hemangioma, who underwent excisional surgery assisted with needle aspiration technique from June 2013 to April 2022. Preoperative symptoms, clinical examination, and imaging features were recorded. Surgical outcomes, including the improvement of visual acuity, proptosis, and ocular motility, were assessed. Postoperative complications were also reported. There were 11 female and two male patients, with a mean age of 50.2 ± 8.0 years (range: 38-61 years). The most common symptom was proptosis (12 cases, 92%), followed by blurred vision (6 cases, 46%). The diameter of the lesions was between 1.8 and 3.2 cm on preoperative imaging. The surgical approaches included sub-brow orbitotomy in 11 patients and the inferior transconjunctival approach in two cases. All the tumors were removed successfully after needle aspiration of 1-3 cc of intralesional blood to reduce the tumor size. Preoperative proptosis, blurred vision, and diplopia improved after the surgery in all cases. There were no serious complications or recurrence of orbital hemangioma. The study presented an effective application of the needle aspiration technique in the surgical management of orbital cavernous hemangioma. Such an innovative method can bring significant benefits, especially for those with large cavernous hemangioma within the deep orbital region.

Evaluating the risk of new-onset glaucoma in chronic kidney disease patients: a nationwide cohort study.

BACKGROUND: A better understanding of the association between chronic kidney disease (CKD) and glaucoma is required to optimize clinical outcomes. Therefore, this study aimed to investigate the association of chronic kidney disease (CKD) with new diagnoses of glaucoma over time from January 2009 to December 2019. METHOD: This retrospective propensity-matched cohort study utilizing Taiwanese electronic health records examined the incidence of newly diagnosed glaucoma in patients with and without chronic kidney disease (CKD). The exposure variable was the diagnosis of CKD, identified through diagnostic codes. The primary outcome was the incidence of new-onset glaucoma. Subgroup analyses on glaucoma risk included age, gender, comorbidities, glaucoma subtypes, and dialysis status. Statistical analyses included Kaplan-Meier analysis, Cox proportional hazards models, and Poisson regression models, with the associated hazard ratios and confidence intervals reported. RESULTS: Seven hundred twenty-three thousand two hundred sixteen patients with CKD (42.3% female; mean [SD] age at index, 66.3 [15.6] years) and 723,216 patients without CKD (42.3% female; mean [SD] age at index, 66.3 [15.7]) were recruited. We showed a significantly increased risk of glaucoma irrespective of subtypes in CKD patients compared to those without CKD (HR: 1.29 [CI: 1.26-1.32], p < 0.001). Kaplan-Meier curves revealed a significantly increased glaucoma risk in both the dialytic subtype and non-dialytic CKD patients when compared to their non-CKD counterparts (p < 0.001). We also showed that all genders (aHR 1.17 [CI: 1.13-1.21] for females vs. aHR 1.39 [CI:1.35-1.43] for males), all ages (< = 49: aHR 1.49 [CI: 1.37-1.62]; 50-59: aHR 1.48 [CI: 1.40-1.56]; 60-69: aHR 1.30 [CI: 1.25-1.6]; 70-79: aHR 1.21 [CI: 1.17-1.26]; > 80: aHR 1.29 [CI: 1.21-1.37]); all income brackets and all urbanization status were associated with significantly increased risk of glaucoma from among the CKD cohort when compared to their respective non-CKD cohort (p < 0.001). CONCLUSIONS: Our cohort study spanning 12 years showed an elevated glaucoma risk following a CKD diagnosis compared to a frequency-matched non-CKD cohort. Our findings have relevance for the clinical practice of at-risk CKD patients. TRIAL REGISTRATION: Due to the retrospective nature of the study, no registration was necessary.