To investigate long-term clinical outcomes after acute angle closure in the Chinese population. A 10-year retrospective review of primary acute angle closure in Hong Kong Chinese to document patient ...demographics, treatment, and pre- and post-acute angle closure intraocular pressure (IOP) and visual acuity (VA). The year of attack was correlated with the timing of laser, last VA and IOP, and the number of anti-glaucoma eye drops. In 210 eyes (200 patients), 10 % had a simultaneous bilateral acute angle closure. VA improvement was noted in 68.6 % of eyes whilst 11.4 % were blinded. At 3.7 ± 2.4 years of follow-up, 49.5 % had IOP <21 mmHg with medication or surgery, 41.9 % needed anti-glaucoma eye drops, and 13.8 % had undergone trabeculectomy. The older the year of attack, the poorer the VA (
r
= 0.2,
p
= 0.03) and the longer the laser wait time (
r
= 0.3,
p
< 0.0001). VA outcome and laser promptness in acute angle closure has improved over the years. At 4 years after the attack, 50 % had normal IOP, 69 % had improved VA but 11 % were blinded.
We analyze the full Kepler phase curve of KOI-964, a binary system consisting of a hot white dwarf on an eclipsing orbit around an A-type host star. Using all 18 quarters of long-cadence photometry, ...we carry out a joint light-curve fit and obtain improved phase-curve amplitudes, occultation depths, orbital parameters, and transit ephemeris over the previous results of Carter et al. A periodogram of the residuals from the phase-curve fit reveals an additional stellar variability signal from the host star with a characteristic period of 0.620276 0.000011 days and a full amplitude of 24 2 ppm. We also present new Keck/HIRES radial velocity observations, which we use to measure the orbit and obtain a mass ratio of q = 0.106 0.012. Combining this measurement with the results of a stellar isochrone analysis, we find that the masses of the host star and white dwarf companion are 2.23 0.12 M and , respectively. The effective temperatures of the two components are K and 15,080 400 K, respectively, and we determine the age of the system to be Gyr. We use the measured system properties to compute predicted phase-curve amplitudes and find that while the measured Doppler-boosting and mutual illumination components agree well with theory, the ellipsoidal distortion amplitude is significantly underestimated. We detail possible explanations for this discrepancy, including interactions between the dynamical tide of the host star and the tidal bulge and possible nonsynchronous rotation of the host star.
Laser in‐situ keratomileusis (LASIK) is safe and effective laser refractive procedures in treating refractive errors. However, regression of treatment and iatrogenic keratectasia remain to be a major ...concern, especially in treating thin cornea with high ametropia. Collagen cross‐linking (CXL) is an effective method in stopping keratoconus progression through increasing the biomechanical strength of the cornea. Adjuvant cross‐linking to refractive procedures can theoretically help prevent regression and reduce the risk of keratectasia development by increasing the mechanical stability of cornea. During the procedure, riboflavin is directly applied to the corneal stroma, thereby reducing the need of de‐epithelialization as in the conventional protocol for keratoconus. Currently, there is still no consensus regarding the indication of CXL during refractive procedure, nor any standardized treatment protocol. This article aims to summarize the current evidence regarding the use of adjuvant CXL in LASIK.
Objective: To determine the association between incident proton pump inhibitor (PPI) use and Clostridium difficile infections across multiple countries
Method: National data covering the total ...population in Australia and Korea, the Canadian population over 65 years and a 3 million person random sample data set from Taiwan were assessed, as were data from a worker insurance population and a hospital inpatient/outpatient population in Japan. Sequence symmetry analysis was used to assess the association with oral vancomycin dispensing as the outcome of interest.
Results: 54,957 patients were included. Positive associations were observed in Australia; adjusted sequence ratio (ASR) 2.48 (95% CI 1.90, 3.12), Korea ASR 2.15 (95%CI 2.11, 2.19), Canada ASR 1.45 (95% CI 1.16, 1.79), Japan hospital dataset ASR 3.21 (95%CI 2.12, 4.55) and Japan worker insurance dataset ASR 5.40 (95% CI 2.73, 8.75). The pooled result was ASR 2.40 (95%CI 1.88, 3.05) and 3.16 (95%CI 1.95, 5.10) when limited to Japan, Korean and Taiwan. Results did not vary by individual PPI. The temporal analysis showed effects within the first two weeks of PPI initiation.
Conclusion: Our study confirms the association between PPI initiation and C. difficile infections across countries in the Asia-Pacific region.
The effect of sacubitril/valsartan on survival and hospitalization risk in older patients with heart failure has not been explored. We aimed to investigate the risk of hospitalization and mortality ...with the use of sacubitril/valsartan vs. enalapril in patients with heart failure.
This was a population-based cohort study using the Hong Kong-wide electronic healthcare database. Patients diagnosed with heart failure and newly prescribed sacubitril/valsartan or enalapril between July 2016 and June 2019 were included. The risk of primary composite outcome of cardiovascular mortality or heart failure-related hospitalization, all-cause hospitalization, heart failure-related hospitalization, cardiovascular mortality and all-cause mortality were compared using Cox regression with inverse probability treatment weighting. Additional analysis was conducted by age stratification.
Of the 44,503 patients who received sacubitril/valsartan or enalapril, 3,237 new users (sacubitril/valsartan,
= 1,056; enalapril,
= 2,181) with a diagnosis of heart failure were identified. Compared with enalapril, sacubitril/valsartan users were associated with a lower risk of primary composite outcome hazard ratio (HR) 0.58; 95% confidence interval (CI), 0.45-0.75, heart failure-related hospitalization (HR 0.59; 95% CI, 0.45-0.77), all-cause mortality (HR 0.51; 95% CI, 0.36-0.74) and borderline non-significant reductions in all-cause hospitalization (HR 0.85; 95% CI, 0.70-1.04) and cardiovascular mortality (HR 0.63; 95% CI, 0.39-1.02). The treatment effect of sacubitril/valsartan remains unaltered in the patient subgroup age ≥ 65 years (73%).
In real-world settings, sacubitril/valsartan was associated with improved survival and reduced heart failure-related hospitalization compared to enalapril in Asian patients with heart failure. The effectiveness remains consistent in the older population.
Abstract
The Lucy Mission is a NASA Discovery-class mission to send a highly capable and robust spacecraft to investigate seven primitive bodies near both the L
4
and L
5
Lagrange points with ...Jupiter: the Jupiter Trojan asteroids. These planetesimals from the outer planetary system have been preserved since early in solar system history. The Lucy mission will fly by and extensively study a diverse selection of Trojan asteroids, including all the recognized taxonomic classes, a collisional family member, and a near equal-mass binary. It will visit objects with diameters ranging from roughly 1 km to 100 km. The payload suite consists of a color camera and infrared imaging spectrometer, a high-resolution panchromatic imager, and a thermal infrared spectrometer. Additionally, two spacecraft subsystems will also contribute to the science investigations: the terminal tracking cameras will supplement imaging during closest approach and the telecommunication subsystem will be used to measure the mass of the Trojans. The science goals are derived from the 2013 Planetary Decadal Survey and include determining the surface composition, assessing the geology, determining the bulk properties, and searching for satellites and rings.
Owing to the dramatic mobile IPgrowth, the emerging Intemet of Things, andcloud-based applications, wireless network-ing is witnessing a paradigm shift. By fullyexploiting spatial degrees of freedom, ...mas-sive multiple-input-multiple-output （MIMO）systems promise significant gains in data ratesand link reliability. Although the researchcommunity has recognized the theoreticalbenefits of these systems, building the hard-ware of such complex systems is a challengein practice. This paper presents a time divisionduplex （TDD）-based 128-antenna massiveMIMO prototype system from theory to reali-ty. First, an analytical signal model is providedto facilitate the setup of a feasible massiveMIMO prototype system. Second, a link-lev-el simulation consistent with practical TDD-based massive MIMO systems is conducted toguide and validate the massive MIMO systemdesign. We design and implement the TDD-based 128-antenna massive MIMO prototypesystem with the guidelines obtained from thelink-level simulation. Uplink real-time videotransmission and downlink data transmissionunder the configuration of multiple single-an-tenna users are achieved. Comparisons withstate-of-the-art prototypes demonstrate theadvantages of the proposed system in termsof antenna number, bandwidth, latency, andthroughput. The proposed system is alsoequipped with scalability, which makes thesystem applicable to a wide range of massivescenarios.
There is a lack of knowledge regarding the incidence of serious adverse drug reactions (ADR) to the oral iron chelator deferiprone in Chinese children with transfusion-dependent thalassaemia. In this ...retrospective population-based cohort study, paediatric thalassaemia patients in Hong Kong were screened for serious and medically important adverse events related to deferiprone therapy using diagnosis codes, laboratory data and hospital admissions. Potential ADRs were assessed by reviewing concomitant medications, diagnoses and laboratory data and evaluated using standardised causality assessment. Eighty-seven patients contributing 169.8 person-years were included. Thirty ADRs were identified in 21 patients. Most ADRs (56.0%) occurred in the first three months of therapy. Neutropenia occurred in 11 patients (12.6%; incidence rate 6.5 per 100 patient-years) and severe neutropenia (agranulocytosis) was observed in 5 patients (5.7%, incidence rate 2.9 per 100 patient-years). Other identified ADRs involve severe arthropathy, elevated liver enzymes and mild thrombocytopenia. In conclusion, the safety profile of DFP therapy in Chinese children suffering from transfusion-dependent thalassaemia is in line with previous studies of non-Chinese children. However, unlike previous studies, we observed a relatively high incidence of agranulocytosis and neutropenia in patients with simultaneous combined therapy. Hence close monitoring for white blood cell counts is advised in Chinese children under combined iron chelation therapy. Further prospective clinical and pharmacogenetic studies are required to better evaluate this important safety signal.
• Half of the identified ADRs related to deferiprone therapy occurred during the first three months of treatment. • A relatively high incidence of agranulocytosis and neutropenia. Hence close monitoring for white blood cell counts is advised in Chinese children under combined iron chelation therapy.
To evaluate the prognostic value of baseline and restaging CT-based radiomics with features associated with gene expression in esophageal squamous cell carcinoma (ESCC) patients receiving neoadjuvant ...chemoradiation (nCRT) plus surgery.
We enrolled 106 ESCC patients receiving nCRT from two institutions. Gene expression profiles of 28 patients in the training set were used to detect differentially expressed (DE) genes between patients with and without relapse. Radiomic features that were correlated to DE genes were selected, followed by additional machine learning selection. A radiomic nomogram for disease-free survival (DFS) prediction incorporating the radiomic signature and prognostic clinical characteristics was established for DFS estimation and validated.
The radiomic signature with DE genes feature selection achieved better performance for DFS prediction than without. The nomogram incorporating the radiomic signature and lymph nodal status significantly stratified patients into high and low-risk groups for DFS (
< 0.001). The areas under the curve (AUCs) for predicting 5-year DFS were 0.912 in the training set, 0.852 in the internal test set, 0.769 in the external test set.
Genomics association was useful for radiomic feature selection. The established radiomic signature was prognostic for DFS. The radiomic nomogram could provide a valuable prediction for individualized long-term survival.
Corneal wound healing involves a complex cascade of cytokine-controlled cellular events, including inflammatory and angiogenesis responses that are regulated by transcriptional chromatin remodeling. ...Nuclear Ubiquitous Casein and cyclin-dependent Kinase Substrate (NUCKS) is a key chromatin modifier and transcriptional regulator of metabolic signaling. In this study, we investigated the role of NUCKS in corneal wound healing by comparing its effects on corneal alkali burn in NUCKS knockout (NKO) and NUCKS wild-type (NWT) mice. Our data showed that following alkali-injury, inhibition of NUCKS (NKO) accelerated ocular resurfacing and suppressed neovascularization; the cytokine profile of alkali burned corneas in NKO mice showed suppressed expression of inflammation cytokines (IL1A &IL1B); upregulated expression of antiangiogenic factor (Pigment Epithelium-derived Factor; PEDF); and downregulated expression of angiogenic factor (Vascular Endothelial Growth Factor, VEGF); in vitro, following LPS-induced NFκB activation, NKO corneal cells showed reduced expression of IL6, IP10 and TNFα. In vitro, corneal epithelial cells showed reduced NF-κb activation on silencing of NUCKS and corresponding NFκB-mediated cytokine expression was reduced. Here, we illustrate that inhibition of NUCKS played a role in cytokine modulation and facilitated corneal recovery. This reveals a potential new effective strategy for ocular burn treatment.
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