Effect of anterior segment structure on vault and position after implantable collamer lens implantation.

PURPOSE: To evaluate the effect of anterior-segment structure on vault and position after implantable collamer lens (ICL) implantation using ultrasound biomicroscopy. METHODS: The retrospective case-control study included insufficient vault eyes (<250 µm), ideal vault eyes (250-750 µm), and excessive vault eyes (>750 µm). The preoperative biometric parameters of the anterior-segment structure and basic data between the three groups were analyzed using one-way analysis of variance. RESULTS: There were significant differences ( P < 0.05) between the three groups in maximum ciliary body thickness (CBT max ), iris-zonule distance (IZD), and trabecular-ciliary angle (TCA). The vault gradually decreased as CBT max decreased and TCA increased. In the pairwise comparison, the CBT max comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant ( P = 0.024, 95% CI: -0.17-0.017 µm); the TCA comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant ( P = 0.005, 95% CI: 1.78°-12.15°); The IZD comparison between the insufficient vault (<250 µm) group and the excessive vault (>750 µm) group was statistically significant ( P = 0.037, 95% CI: 0.0027-0.1119 µm). The analysis of 284 ICL haptics locations showed that there were 16.67%, 32.69%, and 70.83% haptics located in the ciliary sulcus in three groups, respectively. CONCLUSION: The vault and ICL haptics position are related to anterior-segment structure. A thinner and posteriorly positioned ciliary body would increase the risk of low vault and fewer ICL haptics located in the ciliary sulcus after ICL implantation. This provides guidance for the selection of the ICL size and placement position before surgery.

UPLC-Q-TOF-MS, network analysis, and molecular docking to investigate the effect and active ingredients of tea-seed oil against bacterial pathogens.

Object: This research intended to probe the antibacterial effect and pharmacodynamic substances of Tea-Seed Oil (TSO) through the use of ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) analysis, network analysis, and molecular docking. Methods: The major chemical components in the methanol-extracted fractions of TSO were subjected to UPLC-Q-TOF-MS. Network pharmacology and molecular docking techniques were integrated to investigate the core components, targets, and potential mechanisms of action through which the TSO exert their antibacterial properties. To evaluate the inhibitory effects, the minimum inhibitory concentration and diameter of the bacteriostatic circle were calculated for the potential active ingredients and their equal ratios of combinatorial components (ERCC) against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. Moreover, the quantification of the active constituents within TSO was achieved through the utilization of high-performance liquid chromatography (HPLC). Results: The methanol-extracted fractions contained a total of 47 chemical components, predominantly consisting of unsaturated fatty acids and phenolic compounds. The network pharmacology analysis and molecular docking analysis revealed that various components, including gallocatechin, gallic acid, epigallocatechin, theophylline, chlorogenic acid, puerarin, and phlorizin, have the ability to interact with critical core targets such as serine/threonine protein kinase 1 (AKT1), epidermal growth factor receptor (EGFR), a monoclonal antibody to mitogen-activated protein kinase 14 (MAPK14), HSP90AA1, and estrogen receptor 1 (ESR1). Furthermore, these components can modulate the phosphatidylinositol-3-kinase protein kinase B (PI3K-AKT), estrogen, MAPK and interleukin 17 (IL-17) signaling pathways, hereby exerting antibacterial effects. In vitro validation trials have found that seven components, namely gallocatechin, gallic acid, epigallocatechin, theophylline, chlorogenic acid, puerarin, and phloretin, displayed substantial inhibitory effects on E. coli, S. aureus, P. aeruginosa, and C. albicans, and are typically present in tea oil, with a total content ranging from 15.87∼24.91 µg·g-1. Conclusion: The outcomes of this investigation possess the possibility to expand our knowledge base concerning the utilization of TSO, furnish a theoretical framework for the exploration of antibacterial drugs and cosmetics derived from inherently occurring TSO, and establish a robust groundwork for the advancement and implementations of TOS products within clinical settings.

Antibiotic resistance genes and the association with bacterial community in biofilms occurring during the drinking water granular activated carbon (GAC) sandwich biofiltration.

The granular activated carbon (GAC) sandwich modification to slow sand filtration could be considered as a promising technology for improved drinking water quality. Biofilms developed on sand and GAC surfaces are expected to show a functional diversity during the biofiltration. Bench-scale GAC sandwich biofilters were set-up and run continuously with and without antibiotic exposure. Surface sand (the schmutzdecke) and GAC biofilms were sampled and subject to high-throughput qPCR for antibiotic resistance gene (ARG) analysis and 16 S rRNA amplicon sequencing. Similar diversity of ARG profile was found in both types of biofilms, suggesting that all ARG categories decreased in richness along the filter bed. In general, surface sand biofilm remained the most active layer with regards to the richness and abundance of ARGs, where GAC biofilms showed slightly lower ARG risks. Network analysis suggested that 10 taxonomic genera were implicated as possible ARG hosts, among which Nitrospira, Methyloversatilis and Methylotenera showed the highest correlation. Overall, this study was the first attempt to consider the whole structure of the GAC sandwich biofilter and results from this study could help to further understand the persistence of ARGs and their association with the microbial community in drinking water biofiltration system.

Long-term observation on safety and visual quality of implantable collamer lens V4c implantation for myopia correction: a 5-year follow-up.

AIM: To elucidate the safety and visual quality of implantable collamer lens with central hole (ICL V4c) implantation for correcting moderate and high myopia for at least 5y. METHODS: This retrospective study was conducted on 58 patients (114 eyes) who were followed up for at least 5y after ICL V4c implantation. The observation was done before and on 1d, 1mo, 1 and 5y or more after the surgical procedure. The visual acuity, subjective refraction, intraocular pressure, vault, axial length, central hole position, pupil diameter, visual quality, and adverse events were analyzed. The visual quality includes aberration, the modulation transfer function cutoff frequency (MTF cutoff), objective scattering index (OSI), Stroller's ratio (SR), and visual quality questionnaire. RESULTS: The average follow-up period was 69.25±3.80mo (range 60-82mo) and the preoperative spherical equivalent (SE) was -8.66±1.97 D. At 5y after operation, the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was -0.65±0.63 D. The 59.6% of the eyes achieved an uncorrected distance visual acuity of 20/20, 76.3% of the eyes had SE within ±1.0 D at the last visit. The axial length increased by 0.29±0.71 mm 5y after the surgery (t=-3.843, P<0.001). The mean vault at the last follow-up was 510.59±245.61 µm. The central hole was on the temporal side in 80 eyes (84.2%). The visual quality questionnaire showed that 98.2% patients were satisfied with the surgical procedure. Adverse events occurred in 4 eyes (3.5%), including the posttraumatic toric ICL rotation (2 eyes), iris incarceration (1 eye), and posttraumatic ICL displacement (1 eye) at the last follow-up. CONCLUSION: Long-term ICL V4c implantation is safe, effective, and stable for correcting moderate and to high myopia, and the visual quality with patients is excellent and satisfactory, but the progression of axial length still needs attention after surgery.

A Directly Moldable, Highly Compact, and Easy-for-Integration 3D Micromixer with Extraordinary Mixing Performance.

Micromixers are a critical component in microfluidics. However, most 2D passive micromixers produce optimal mixing at a high flow rate range and 3D micromixers require mm-scale channels or a complex assembly that is unsuitable for microfluidic applications. Here, we reported a 3D PDMS micromixer based on the splitting-stretching-recombination (SSR) of streams to facilitate molecular diffusion, which can effectively and rapidly mix solutions with low Reynolds numbers (0.01-10). The fabrication of our micromixer is convenient with only two steps─two-photon polymerization (2PP) 3D printing and soft lithography, with high resolution, reproducibility, and ease for integration. We investigated the mixing performance of the micromixer by CFD simulations and experimental studies under a confocal microscope; the results confirmed its better performance and higher chip miniaturization than others. It can achieve a mixing efficiency above 0.90 (which is generally regarded as complete mixing) for low-Re solutions (flow rates ≤60 µL/min) with a mixing volume smaller than 20 nL. The time for complete mixing is in the range of milliseconds (e.g., 21 ms for Re = 10, 194 ms for Re = 0.88). The device shows negligible degradation in mixing performance for highly viscous solutions (∼50 times more viscous than water), macromolecule solutions, and colloidal solutions of nanoparticles.

Late-onset toxic anterior segment syndrome after ICL implantation: two case reports.

BACKGROUND: Toxic anterior segment syndrome (TASS) is a non-infectious inflammation that can occur after any anterior segment procedure. This case report presents two relatively rare late-onset TASS cases after V4c implantable collamer lens (ICL) operation. CASE PRESENTATION: One 25-year-old woman and one 31-year-old woman suddenly had vision loss in monocular for 1 week after biocular V4c ICL operations and with no subjective complaints. They both presented fibrin formation in the anterior chamber such as keratic precipitates and white pus on the surface of the ICL. Fundus examination was normal. After 4 to 5 weeks of topical and oral steroid treatment, visual acuity and fibrin formation in the anterior chamber improved during the follow-up. CONCLUSIONS: TASS should be suspected in any patient during the late period following ICL surgery; Once TASS is diagnosed, adequate treatment with intensive steroid therapy can be implemented.

Carbodiimide crosslinked decellularized lenticules as a drug carrier for sustained antibacterial eye treatments.

In this study, the drug-loading and antibacterial activity of carbodiimide/N-hydroxysuccinimide (EDC/NHS) crosslinked decellularized lenticules (CDLs) were evaluated. Small incision lenticule extraction derived lenticules were decellularized and modified with crosslinking concentrations of 0.00 (E/L00, non-crosslinked), 0.01 (E/L01), 0.05 (E/L05) and 0.25 mmol (E/L25) EDC per mg lenticules at 5:1 EDC/NHS ratios with non-decellularized non-crosslinked lenticules (NDLs) as controls. NDLs and EDC/NHS CDLs had similar water contents. The light transmittance percentages (400-800 nm) were 91.55 ± 1.16%, 88.68 ± 1.19%, 80.86 ± 1.94%, 85.12 ± 2.42% and 85.62 ± 2.84% for NDLs, E/L00, E/L01, E/L05 and E/L25, respectively (P< 0.01). The EDC/NHS CDLs (diameter: 6.36 ± 0.18 mm; central thickness: 117.31 ± 3.46 µm) were soaked in 3% (wt./vol.) levofloxacin (LEV) solution for 3 h. The drug release concentrations of LEV-impregnated EDC/NHS CDLs were determined by high-performance liquid chromatography. Zone inhibition (ZOI) againstStaphylococcus aureusof E/L01, E/L05 and E/L25 were superior to E/L00 CDLs (P< 0.01) and among the different crosslinked groups, E/L05 lenticules produced the largest ZOIs and their drug concentration release over 21 d was the highest. EDC/NHS crosslinking can improve the drug-loading effect and antibacterial activity of decellularized lenticules. LEV-impregnated EDC/NHS CDLs are promising drug delivery carriers.

The best choice for low and moderate myopia patients incapable for corneal refractive surgery: implantation of a posterior chamber phakic intraocular lens.

PURPOSE: This study aims to evaluate the early clinical outcomes of central hole phakic posterior chamber intraocular lens(ICLV4c) implantation for low and moderate myopia correction. METHODS: This retrospective clinical study included 27 patients(47 eyes)who underwent ICLV4c implantation to correct myopia with spherical equivalent (SE) between - 1.75D and -6.0D. The uncorrected visual acuity (UCVA), intraocular pressure(IOP), central anterior chamber depth (ACD), vault, and endothelial cell density (ECD) were evaluated after surgery. RESULTS: At one year follow-up, the postoperative UCVA of patients was higher than the preoperative CDVA and showed a stable trend. There was no significant difference in ECD (p > 0.05) one month after the surgery, the vault was 0.77 ± 0.32 mm, which decreased to 0.63 ± 0.26 mm after one year of surgery. Similarly, ACD was 3.24 ± 0.25 mm in the preoperative, which decreased significantly to 2.05 ± 0.39 mm at one month, while rose to 2.2 ± 0.39 mm at one year after surgery. There was no significant correlation between IOP and ACD and vault at one month and one year after surgery. The correlation coefficient between ACD and vault was found to be - 0.72 at one month after surgery, while the same -0.71 after one year. One patient developed visual fatigue, one with glare, and while no other complications were observed with the rest of the patients. CONCLUSION: The ICL implantation is a safe, effective and stable method to correct low and moderate myopia, and may be a good alternative for patients with low and moderate myopia who cannot undergo corneal refractive surgery.

Cyclosporine A (0.05%) Ophthalmic Gel in the Treatment of Dry Eye Disease: A Multicenter, Randomized, Double-Masked, Phase III, COSMO Trial.

Purpose: To confirm the efficacy and safety of a novel ophthalmic cyclosporine A gel (CyclAGel, 0.05% CsA) in treating patients with moderate-to-severe dry eye disease (DED). Patients and Methods: The COSMO trial was a randomized, multicenter, double-masked, vehicle-controlled, phase III trial. Patients with moderate-to-severe DED were enrolled in 37 hospitals in China between November 2020 and April 2021. Eligible patients were randomized 1:1 to receive CyclAGel 0.05% or vehicle eye drops once nightly (QD). The primary endpoint was the proportion of subjects with at least a 1-point improvement in ICSS at day 84. Treatment-emergent adverse events (TEAEs) were recorded. Results: The full analysis set (FAS) included 315 and 312 participants in the CyclAGel and vehicle groups, respectively. The primary efficacy endpoint was achieved. The proportion of subjects with at least a 1-point improvement in ICSS from baseline to day 84 was significantly higher in the CyclAGel group than in the vehicle group (73.7% [232/315] vs 53.2% [166/312], P<0.0001). Significant improvements relative to the vehicle were also observed in the ICSS and Oxford scale scoring of corneal and conjunctival fluorescein staining at day 14, 42, and 84. The Schirmer tear test results were significantly higher in the CyclAGel group than in the vehicle group on days 14 and 84 (all P<0.05). The CyclAGel 0.05% was well tolerated, and the TEAEs were mostly mild. The most frequent treatment-related TEAE was eye pain (6.9% vs 1.6% in the CyclAGel and vehicle groups, respectively). No serious treatment-related TEAEs were reported. Conclusion: Clinically and statistically significant improvements in ICSS, tear production, and symptoms were observed in participants administered CyclAGel 0.05% QD for moderate-to-severe DED. CyclAGel 0.05% QD is a new effective, safe, and well-tolerated therapeutic option that might bring additional benefits of convenience and compliance as a once-A-day treatment for DED.

Fenton pre-oxidation of natural organic matter in drinking water treatment through the application of iron nails.

This study investigated for the first time the efficiency of an advanced oxidation process (AOP) zero valent iron/hydrogen peroxide (ZVI/H2O2) employing iron nails for the removal of Natural Organic Matter (NOM) from natural water of Regent's Park lake, London, UK. The low cost of nails and their easy separation from the water after the treatment make this AOP attractive for water utilities in low- and middle-income countries. The process was investigated as a pre-oxidation step for drinking water treatment. Results showed that UV254 removal in the natural water was lower than that of simulated water containing commercial humic acid (HA), indicating a matrix effect. Statistical analysis confirmed the maximum removal of dissolved organic carbon (DOC) in natural water depends on the initial pH (best at 4.5) and H2O2 dosage (best at 100% excess of stoichiometric dosage). DOC and UV254 removals under this operational condition were 51% and 89%, respectively. Molecular weight (MW) and specific UV absorbance (SUVA254) were significantly reduced to 74% and 78%, respectively. Formation of Chloroform THM in natural water sample after the ZVI/H2O2 process (initial pH 4.5) was below the limit for drinking water, and 48% less than the THM formation in the same water not subjected to pre-oxidation. Characterization of oxidation products on the iron-nail-ZVI surface after the ZVI/H2O2 treatment by SEM, XRD, and XPS identified the formation of magnetite and lepidocrocite. Results suggest that the investigated ZVI/H2O2 process is a promising technology for removing NOM and reducing THM formation during drinking water treatment.

Combined effect of coal chemical wastewater and PC on preparing of coal-to-liquids residue-based alkali activated materials.

Aimed to achieve "waste control by waste" of coal-to-liquids (CTL) industry, coal gasification residue (CGR), the most typical CTL residue, and coal chemical wastewater (CCW) were used as aluminosilicate precursor and auxiliary activator respectively to prepare alkali activated materials (AAMs). CGR-based AAMs using a less concentrated NaOH solution than conventional, with CCW as mixing water were synthesized. The results showed that CCW benefited the compressive strength of CGR-based AAMs significantly, but demonstrating slight reduction over time. The combined effect of CCW and Portland cement (PC) supplied continuous increase of strength and eliminated the strength reduction with age. The mechanisms behind the improved performance of the AAMs due to the introduction of CCW and PC were discussed by XRD, FTIR, TG-DSC, MIP and ESEM. It was found that the increased alkali content due to the introduction of the CCW, supplied more extensive dissolution of active aluminosilicate and progressive geopolymerization of CGR. The coexistence of both N-A-S-H gel and C-A-S-H gel (originated from the introduced PC) in hardened AAM pastes reduced the proportion of pores larger than 100 nm to less than 30%, and provided denser structure.

The Roles of Skin Fibroblasts at Local Acupoints in Chrono-Acupuncture.

Objective: The aim of this study was to demonstrate the peripheral mechanisms of chrono-acupuncture by observing acupuncture at different time points affecting relative proteins to regulate the cytoskeleton of fibroblasts differently. Methods: A total of 108 male SD rats (180-220 g) that have basic pain threshold within 3-10 s were selected and randomly divided into group A (n = 72) and control group (n = 36). After the succession of modeling with CFA injection, the rats in group A were randomly divided into model group and acupuncture group, each group containing 36 rats. Then according to the different treatment time, each group was randomly classified into 6 subgroups (ZT0, ZT4, ZT8, ZT12, ZT16, and ZT20), each subgroup containing 6 rats (n = 6). On the second day of successful modeling, the rats in the acupuncture group received acupuncture treatment at the corresponding time point, while the control group and the model group were only tied up at the corresponding time point without any treatments. Methods of operation: use 0.5-inch needles, puncture the rats' "Zusanli" on the affected limb, with Twirling manipulation for a minute after every five minutes; the treatment lasts thirty minutes in total. After 7 days of treatments, the skin and subcutaneous tissue of rats' acupoint area of "Zusanli" on the affected limb were taken and then stained by immunofluorescence double staining method to observe the expression of the fibroblast cytoskeleton F-actin and ß-tubulin under the LSCM while using western blot to observe the expression of P38MAPK/P-P38MAPK. Results: The expression of the cytoskeleton F-actin and ß-tubulin at acupoint area in the acupuncture group was significantly higher than that in the control and model group. The effect of acupuncture on the restructure of the fibroblast cytoskeleton is different at different time points, the most effective time point was at ZT12 while the least at ZT16. Acupuncture can decrease the high expression of P-P38MAPK/P38MAPK in the model group, and the effect has time differences. The expression of P-P38MAPK/P38MAPK increased more significantly at ZT16 than ZT12. Conclusion: The remodeling difference of fibroblast cytoskeleton after receiving acupuncture treatment could be one of the peripheral bases of the chrono-acupuncture.

Analysis of Clinical and Regional Distribution Characteristics of Obstructive Meibomian Gland Dysfunction in China: A Multicenter Study.

Purpose: To analyze the clinical and regional distribution characteristics of obstructive meibomian gland dysfunction (OMGD) in China. Methods: A total of 2900 patients (2900 eyes) diagnosed with OMGD were enrolled in this multicenter, cross-sectional, observational study. The Ocular Surface Disease Index (OSDI), tear film breakup time (FBUT), Schirmer test (SI), lipid layer thickness (LLT), OMGD grade, meibomian gland loss score (Meiboscore), meibum expressibility score (MES), meibum quality score (MQS), Lid margin abnormality score(LMS) and other tear film stability markers were evaluated. Results: The prevalence of dry eye in OMGD patients was 89%. There were gender differences among OMGD patients in the 30-39 and 50-59 years age groups (p < .05), and FBUT, Meiboscore, MES and MQS were significantly different among different OMGD grades (p < .05). There were significant differences in the detection indexes of OMGD patients in the six regions (p < .05), except LLT (p = .329). According to the Qinling-Huaihe River in China, OMGD patients were divided into the North Group (Shenyang and Beijing) and South Group (Wuhan, Changsha, Chongqing, and Chengdu). There was a significant difference in the detection indexes, except LLT (p = .600), between the two groups (p < .05). FBUT was significantly correlated with the OSDI (r = -0.131; p < .000). Meiboscore and LLT were significantly correlated with the OMGD grade (r = 0.299 and r = 0.106; p < .001). Age, LMS and MQS were significantly correlated with Meiboscore (r = 0.415, r = 0.256 and r = 0.328; p < .001). Conclusions: The prevalence of dry eye was high among OMGD patients. OMGD patients in different age groups may show different gender distributions. The symptoms of patients showed variation among subgroups with different OMGD grades and among different regions.

A personalized computational model predicts cancer risk level of oral potentially malignant disorders and its web application for promotion of non-invasive screening.

BACKGROUND: Despite their high accuracy to recognize oral potentially malignant disorders (OPMDs) with cancer risk, non-invasive oral assays are poor in discerning whether the risk is high or low. However, it is critical to identify the risk levels, since high-risk patients need active intervention, while low-risk ones simply need to be follow-up. This study aimed at developing a personalized computational model to predict cancer risk level of OPMDs and explore its potential web application in OPMDs screening. METHODS: Each enrolled patient was subjected to the following procedure: personal information collection, non-invasive oral examination, oral tissue biopsy and histopathological analysis, treatment, and follow-up. Patients were randomly divided into a training set (N = 159) and a test set (N = 107). Random forest was used to establish classification models. A baseline model (model-B) and a personalized model (model-P) were created. The former used the non-invasive scores only, while the latter was incremented with appropriate personal features. RESULTS: We compared the respective performance of cancer risk level prediction by model-B, model-P, and clinical experts. Our data suggested that all three have a similar level of specificity around 90%. In contrast, the sensitivity of model-P is beyond 80% and superior to the other two. The improvement of sensitivity by model-P reduced the misclassification of high-risk patients as low-risk ones. We deployed model-P in web.opmd-risk.com, which can be freely and conveniently accessed. CONCLUSION: We have proposed a novel machine-learning model for precise and cost-effective OPMDs screening, which integrates clinical examinations, machine learning, and information technology.

Gut Microbiota: A New Strategy to Study the Mechanism of Electroacupuncture and Moxibustion in Treating Ulcerative Colitis.

Previous studies have confirmed that acupuncture and moxibustion is an effective way for treating ulcerative colitis (UC). However, the exact mechanism is unclear yet. In this study, DSS-induced UC mice were treated by electroacupuncture and moxibustion, and the genome of intestinal flora was subsequently detected by high-throughput sequencing in order to explore the detailed mechanism in terms of intestinal flora. The results indicated that the alpha diversity indices and beta diversity of intestinal flora were improved by electroacupuncture and moxibustion treatments, especially by the moxibustion treatment. These treatments inhibited Streptococcus, Odoribacter, and Allobaculum whereas it facilitated Lactobacillus on genus level. Further correlation analysis showed that the alpha diversity indices were positively correlated with the percentage of Treg cells in CD4+ cells but negatively correlated with the percentage of Th17 in CD4+ cells. These data indicated that both electroacupuncture and moxibustion can promote the intestinal flora diversity, providing a new view to understand the relationship between host and microbiome when using some external therapies.

Microdistortions in Bowman's Layer 3 Years After SMILE for Myopia.

PURPOSE: To investigate the characteristics and changes in microdistortions in Bowman's layer 3 years after small incision lenticule extraction (SMILE). METHODS: In this non-randomized, prospective study, 50 eyes of 28 patients who received SMILE with a mean spherical equivalent of -6.72 ± 1.41 diopters (D) were divided into a thin lenticule group (lenticule thickness ⩽ 135 µm) and a thick lenticule group (lenticule thickness > 135 µm). Examinations were performed preoperatively and 1 day, 1 month, and 3 years after SMILE. Microdistortions in Bowman's layer determined via optical coherence tomography were analyzed digitally. RESULTS: All patients completed the follow-up with no complications. Three years after SMILE, no eyes exhibited loss of corrected distance visual acuity. The safety index was 1.20 ± 0.15 and the efficacy index was 1.01 ± 0.10. The respective mean lengths of microdistortions at 1 day, 1 month, and 3 years after SMILE were 2,397.47 ± 1,777.22, 3,444.87 ± 2,145.82, and 1,283.81 ± 1,184.43 µm. The respective mean microdistortion lengths at each time-point were 1,781.29 ± 17,78.15, 2,617.78 ± 1,949.67, and 1,112.95 ± 1,245.88 µm in the thin lenticule group and 2,692.10 ± 1,825.20, 3,739.20 ± 2,072.60, and 1,332.44 ± 1,137.33 µm in the thick lenticule group. CONCLUSIONS: Microdistortions in Bowman's layer can remain 3 years after SMILE, but their lengths decrease over time. Thicker lenticules were associated with the early occurrence of microdistortions, but this effect decreased in the long term. [J Refract Surg. 2019;35(2):96-101.].

The application of GAC sandwich slow sand filtration to remove pharmaceutical and personal care products.

Lab-scale GAC sandwich slow sand filters with different GAC layer depths were evaluated for the first time to remove selected pharmaceutical and personal care products (PPCPs) (namely DEET, paracetamol, caffeine and triclosan, 25 µg/L). Coarse sand (effective grain size of 0.6 mm) was used instead of conventional fine sand. In addition to single sand and GAC filters, GAC sandwich filters were assessed at three filtration rates (i.e. 5 cm/h, 10 cm/h and 20 cm/h) to compare removals. Sandwich filter with 20 cm GAC achieved the best average PPCP removal (98.2%) at 10 cm/h rate. No significant difference of average PPCP removal was found between 10 and 20 cm/h filtration rates for the three GAC sandwich filters (p > 0.05). Among the selected PPCPs, DEET, the recalcitrant compound, was most effectively removed by the GAC sandwich filters. Combining the GAC layers with the slow sand filters significantly enhanced the removal of the target PPCP compounds (p < 0.05), demonstrating that both adsorption and biodegradation contributed to the removals. Furthermore, pseudo-second-order equation (Type 1) could best represent the adsorption kinetics of the four target PPCP compounds onto GAC. In relation to other quality parameters, sandwich filter with 20 cm of GAC also showed good average removals of chemical oxygen demand (COD) of 65.8% and total organic carbon (TOC) of 90.3%, but occurrence of ammonium up to 0.76 mg/L concentration indicated inapplicability of filtration rate of 5 cm/h. No significant difference was found between 10 cm/h and 20 cm/h filtration rates for nitrogen and phosphate removals (p > 0.05). Results of this lab-scale investigation show that GAC sandwich slow sand filter is potentially an effective process for removing PPCPs from tertiary wastewater.

Species-specific interaction of trihalomethane (THM) precursors in a scaled-up distribution network using response surface methodology (RSM).

Response surface methodology (RSM) with central composite design (CCD) was used to monitor and optimize species-specific interaction of trihalomethane (THM) precursors in a scaled-up distribution network (DN). Independent variables such as applied chlorine (Cl2), contact time (t), humic acid (HA) and bromide ions (Br-) were analyzed using full factorial CCD. Analysis of variance revealed a good agreement between experimental data and proposed a two-factor interaction model (p = .04, R2 = 0.7983). As a precursor, Cl- and Br- interaction with HA affected THMs' speciation. These precursor molecules were perceived least significant as discrete elements but HA: Br- and pH product significantly impacted total trihalomethane (TTHM) formation (r = 0.998, p = .007). This mutual interactive fraction was observed pH-dependent and influenced TTHM yield. Dibromochloromethane and bromoform formation was observed pH-dependent provided sufficient Br- in the system. Applied chlorine had significant (p = .01), while time had insignificant (p = .75) effect. Multiple response optimization suggested pH range between 6.0 and 7.6 and HA: Br- ratio between 1.3 and 5.9 were satisfactory for maintaining TTHM below ≤80 µg/L in DN with 0.88 desirability function (D). Their respective concentration may be minimized by changing precursor's individual concentration and possible combinations.

Removal of selected emerging PPCP compounds using greater duckweed (Spirodela polyrhiza) based lab-scale free water constructed wetland.

Greater duckweed (Spirodela polyrhiza) based lab-scale free water constructed wetland (CW) was employed for removing four emerging pharmaceuticals and personal care products (PPCPs) (i.e. DEET, paracetamol, caffeine and triclosan). Orthogonal design was used to test the effect of light intensity, aeration, E.coli abundance and plant biomass on the target compounds. Synthetic wastewater contaminated with the target compounds at concentration of 25 µg/L was prepared, and both batch and continuous flow experiments were conducted. Up to 100% removals were achieved for paracetamol (PAR), caffeine (CAF) and tricolsan (TCS) while the highest removal for DEET was 32.2% in batch tests. Based on orthogonal Duncan analysis, high light intensity (240 µmolmm-2s-1), full aeration, high plant biomass (1.00 kg/m2) and high E.coli abundance (1.0 × 106 CFU/100 mL) favoured elimination of the PPCPs. Batch verification test achieved removals of 17.1%, 98.8%, 96.4% and 95.4% for DEET, PAR, CAF and TCS respectively. Continuous flow tests with CW only and CW followed by stabilization tank (CW-ST) were carried out. Final removals of the PPCP contaminants were 32.6%, 97.7%, 98.0% and 100% for DEET, PAR, CAF and TCS, respectively, by CW system alone, while 43.3%, 97.5%, 98.2% and 100%, respectively, were achieved by CW-ST system. By adding the ST tank, PPCP concentrations decreased significantly faster (p < 0.05) compared with continuous flow CW alone. In addition, after removing aerators during continuous flow CW experiments, the treatment systems presented good stability for the PPCP removals. CW-ST showed better chemical oxygen demand (COD) and total organic carbon (TOC) removals (89.3%, 91.2%, respectively) than CW only (79.4%, 85.2%, respectively). However, poor DEET removal (<50%) and high E.coli abundance (up to 1.7 log increase) in the final treated water indicated further treatment processes may be required. Statistical analysis showed significant correlations (p < 0.05) between PPCPs and water quality parameters (e.g. COD, nitrate, phosphate), and between the four PPCP compounds for the continuous flow CW and CW-ST systems. Positive results encourage further test of Greater duckweed at pilot scale CW using real wastewater.

[Effects of acupuncture on ANP and CNP in adrenal gland and CORT in plasma in rats with chronic emotional stress anxiety].

OBJECTIVE: To analyze the effects of acupuncture on the level of atrial natriuretic peptide (ANP), C-type natriuretic peptide (CNP) in adrenal gland and the content of corticosterone (CORT) in plasma in rats withchronic emotional stress anxiety, and to explore the partial action mechanism of acupuncture on anxiety disorder. METHODS: Thirty-two healthy Sprague-Dawley (SD) rats, after 7 days of feeding and domestication, were randomly divided into a blank group (10 rats), a model group (11 rats) and an acupuncture group (11 rats). The rats inthe model group and acupuncture group were treated with unpredictable chronic emotional stress (CES) method toestablish the model of anxiety. Rats in the acupuncture group were treated with acupuncture at "Neiguan" (PC 6)and "Shenmen" (HT 7), once every other day, 30 minutes each time. The model establishment and treatment lasted 15 days. Rats in the blank group were treated with identical immobilization but no treatment was given. Theelevated plus maze was used to test the behavioral changes of rats with anxiety; the level of CORT in plasma wasdetected by ELISA, and the expression level of CNP and ANP in adrenal cortex and medulla was detected by immunohistochemical method. RESULTS: (1) The percentage of open-arms time in total time (OT%) in elevated plus maze in the model group was significantly lower than that in the blank group (P<0. 05); the OT% in the acupuncture group was significantly higher than that in the model group (P<0.01). (2) The content of CORT in plasma in the model group was higher than that in the blank group (P<0. 05), while that in the acupuncture group was significantly lower than that in the model group (P<0. 05). (3) The expression of ANP in adrenal medulla and cortex in the model group was lower than that in the blank group (P<0. 01), while the expression of CNP in adrenal medulla and cortex in the model group was higher than that in the blank group (P<0. 01). CONCLUSION: The effects of acupuncture against anxiety are likely to be related to the regulation on the expression of ANP and CNP in adrenal medulla, affecting the release of CORT and inhibition on the activity !f hypothalamic-pituitary-adrenal axis (HPA axis).