Purpose
To investigate whether optical quality could be improved by cylindrical correction for low astigmatic eyes with different amounts and axis orientations in patients with myopia up to − 3.00 ...diopters (D).
Methods
A cross-sectional study enrolling healthy young eyes with 0 to − 3.00 D myopia and − 0.50 to − 0.75 D myopic astigmatism was implemented. With a repeated-measures design, outcome measures were sequentially obtained for each subject under two correction modalities: spherocylindrical correction and spherical correction. Subjective refraction was used to determine the refractive prescriptions accordingly in the two correction modalities to obtain optimal subject-reported visual acuity. Primary outcomes were optical quality parameters including objective scatter index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR), and a simulated contrast visual acuity-optical quality analysis system (OQAS) values (OV) obtained by a double-pass system. Corrected distance visual acuity (CDVA) was measured as a secondary outcome. Outcome comparisons between the two correction modalities were performed by grouping in different amounts (− 0.50 D, − 0.75 D) and axes (with the rule, WTR; against the rule, ATR; oblique, OBL) of astigmatism.
Results
A total of 194 eyes of 194 subjects were evaluated. Significantly better CDVA were shown by spherocylindrical correction for all types of astigmatism except for − 0.50 D WTR astigmatism (
P
= 0.831). For eyes with − 0.50 D WTR astigmatism, better outcome was only shown in OSI with spherocylindrical correction (
P
= 0.019). For eyes with − 0.50 D ATR and OBL astigmatism, spherocylindrical correction demonstrated better outcomes in all parameters except for SR (
P
> 0.05). For eyes with − 0.75 D astigmatism, significantly better outcomes in all optical quality parameters were shown with spherocylindrical correction regardless of the axis (
P
< 0.05).
Conclusions
Eyes with ATR or OBL myopic astigmatism may benefit in optical quality and visual acuity by combining a cylindrical correction even with a low amount down to − 0.50 D. However, optical quality and visual acuity improvement are limited for WTR astigmatic eyes when the amount of astigmatism is less than − 0.75 D.
This study is the first part of the "Binocular Vision Anomalies after Cataract Surgery" study that aimed to investigate the impact of cataract surgery on binocular vision status in adults with ...age-related cataract. This study aimed to investigate the preoperative binocular vision status of participants with age-related cataract.
Patients who elected to undergo bilateral cataract surgery (≥50 years of age) were recruited. Clinical measures of binocular vision including stereopsis, ocular alignment, fusional vergence, vergence facility, convergence amplitude and a symptom survey related to binocular vision anomalies were administered. A detailed classification protocol was established to identify the presence of binocular vision anomalies. The frequency of specific binocular vision anomalies and normative data of binocular vision measures were reported.
A total of 73 subjects were evaluated. No strabismus was detected in the cohort. Non-strabismic binocular vision anomalies were detected in 24 subjects (32.9%), of whom 18 (24.7%) had convergence insufficiency, 3 (4.1%) had basic exophoria, 2 (2.7%) had convergence excess, and 1 (1.4%) had fusional vergence dysfunction. Decreased vergence facility and convergence amplitude were more common compared to the pre-presbyopes (P < 0.01).
Binocular vision problems, especially convergence insufficiency, are common in the adults with age-related cataract. The study results demonstrate that the lack of normative binocular vision data for the presbyopic population is a significant gap in the literature and suggest the need for a study of normative data for this population.
The study was registered at ClinicalTrials.gov (NCT03592615, USA).
Background
Systemic chemotherapy or chemoradiation therapy has proven to be effective in treating advanced biliary tract carcinoma (BTC). However, its efficacy in the adjuvant setting remains ...controversial. Therefore, this study aimed to determine the prognostic significance of genomic biomarkers in resected BTC and their potential role in stratifying patients for adjuvant treatment.
Methods
We retrospectively reviewed 113 BTC patients who underwent curative‐intent surgery and had available tumor sequencing data. Disease‐free survival (DFS) was the primary outcome examined and univariate analysis was used to identify gene mutations with prognostic value. Favorable and unfavoratble gene subsets were distinguished from the selected genes through grouping, respectively. Multivariate Cox regression was used to identify independent prognostic factors of DFS.
Results
Our results indicated that mutations in ACVR1B, AR, CTNNB1, ERBB3, and LRP2 were favorable mutations, while mutations in ARID1A, CDKN2A, FGFR2, NF1, NF2, PBRM1, PIK3CA, and TGFBR1 were unfavorable mutations. In addition to age, sex, and node positive, favorable genes (HR = 0.15, 95% CI = 0.04–0.48, p = 0.001) and unfavorable genes (HR = 2.86, 95% CI = 1.51–5.29, p = 0.001) were identified as independent prognostic factors for DFS. Out of the 113 patients, only 35 received adjuvant treatment whereas the majority (78) did not. For patients with both favorable and unfavorable mutations undetected, adjuvant treatment showed negative effect on DFS (median DFS: S441 vs. 956 days, p = 0.010), but there was no significant difference in DFS among those in other mutational subgroups.
Conclusions
Genomic testing might be useful in guiding the decisions regarding adjuvant treatment in BTC.
In this work, the applicability of three different methods, denoted as the direct method, the indirect method, and the simple empirical method based on uniaxial creep damage tolerance parameter, λ, ...for the determination of multiaxial stress rupture criterion (MSRC) is assessed. The assessment involves four commonly-used MSRCs, the Sdobyrev and Hayhurst-Leckie (denoted as SHL), the Cane, the Nix and the Huddleston MSRCs. To this end, creep tests on both uniaxial and circumferentially-notched tension (CNT) specimens of 316H stainless steel are carried out at three net-section stress levels, that is, 300 MPa, 320 MPa and 340 MPa, and at 600 °C. The results show that all the three methods are suitable for the determination of MSRC for the steel examined. Of these, the direct method data-based simple empirical equation is attractive as it takes good advantage of uniaxial creep data in terms of reflecting the operative creep failure mechanism, and therefore may serve as an alternative for the determination of the SHL MSRC, particularly when multiaxial test data is not available. Moreover, the determined SHL, Cane and Huddleston MSRCs are found to be equally effective in the creep life prediction of both uniaxial and CNT specimens, while the effectiveness of the Nix MSRC in life prediction depends on position for stress output and material. In addition, factors influencing the determination of MSRC for stainless steels are discussed in terms of experimental data available in the literature.
•All three methods are suitable for the determination of MSRC.•Empirical method becomes attractive if multiaxial test data is not available.•SHL, Cane and Huddleston MSRCs are equally effective in creep life prediction.•Effectiveness of the Nix MSRC depends on position for stress output and material.•Factors influencing the determination of MSRC for stainless steels are analyzed.
Pathologic complete response (pCR) following preoperative systemic therapy is associated with improved outcomes after subsequent liver transplant/resection in hepatocellular carcinoma (HCC). However, ...the relationship between radiographic and histopathological response remains unclear.
We retrospectively examined patients with initially unresectable HCC who received tyrosine kinase inhibitor (TKI) plus anti-programmed death 1 (PD-1) therapy before undergoing liver resection between March 2019 and September 2021 across 7 hospitals in China. Radiographic response was evaluated using mRECIST. A pCR was defined as no viable tumor cells in resected samples.
We included 35 eligible patients, of whom 15 (42.9%) achieved pCR after systemic therapy. After a median follow-up of 13.2 months, tumors recurred in 8 non-pCR and 1 pCR patient. Before resection, there were 6 complete responses, 24 partial responses, 4 stable disease cases, and 1 progressive disease case, per mRECIST. Predicting pCR by radiographic response yielded an area under the receiver operating characteristic curve (AUC) of 0.727 (95% CI: 0.558-0.902), with an optimal cutoff value of 80% reduction in the enhanced area in MRI (called major radiographic response), which had a 66.7% sensitivity, 85.0% specificity, and a 77.1% diagnostic accuracy. When radiographic response was combined with α-fetoprotein response, the AUC was 0.926 (95% CI: 0.785-0.999); the optimal cutoff value was 0.446, which had a 91.7% sensitivity, 84.6%, specificity, and an 88.0% diagnostic accuracy.
In patients with unresectable HCC receiving combined TKI/anti-PD 1 therapy, major radiographic response alone or combined with α-fetoprotein response may predict pCR.
Uremic pruritus (UP) is a common and tormenting symptom in end-stage renal disease patients undergoing maintenance hemodialysis. An increasing number of studies have been published in recent years to ...support the effectiveness of montelukast for UP. We will conduct a comprehensive systematic review and meta-analysis to evaluate effectiveness of montelukast for UP in hemodialysis patients.
The following electronic databases were searched: Pubmed, Embase, Web of Science, Cochrane Library, the China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and China Science and Technology Journal Database. The range of publication time was from the inception of the database to December 2020. Two reviewers will independently conduct article selection, data collection, and assessment of risk of bias. Any disagreement will be resolved by discussion with the third reviewer. Meta-analysis will be performed by Review Manager 5.3. The Cochrane Collaboration tool will be used to assess the risk of bias.
This study will provide a systematic synthesis of current published data to explore the effectiveness of montelukast for UP in hemodialysis patients.
This systematic review and meta-analysis will provide clinical evidence for the effectiveness of montelukast for UP in hemodialysis patients and inform our understanding of the value of montelukast in improving pruritus symptoms. This study will help clinicians, patients, and policy makers to make better decisions regarding the appropriate role of montelukast as a part of patient management routines.
INPLASY2020100043.
Human infections with vaccinia virus (VACV), mostly from laboratory accidents or contact with infected animals, have occurred since smallpox was eradicated in 1980. No recent cases have been reported ...in China. We report on an outbreak of VACV from occupational exposure to rabbit skins inoculated with VACV.
Rapamycin is an attractive approach for the treatment and prevention of HCC recurrence after liver transplantation. However, the objective response rates of rapamycin achieved with single-agent ...therapy were modest, supporting that rapamycin resistance is a frequently observed characteristic of many cancers. Some studies have been devoted to understanding the mechanisms of rapamycin resistance, however, the mechanisms are cell-type-dependent and studies on rapamycin resistance in HCC are extremely limited.
The anti-tumor sensitivity of rapamycin was modest in vitro and in vivo. In both human and rat HCC cells, rapamycin up-regulated the expression and phosphorylation of PDGFRβ in a time and dose-dependent manner as assessed by RT-PCR and western blot analysis. Using siRNA mediated knockdown of PDGFRβ, we confirmed that subsequent activation of AKT and ERK was PDGFRβ-dependent and compromised the anti-tumor activity of rapamycin. Then, blockade of this PDGFRβ-dependent feedback loop by sorafenib enhanced the anti-tumor sensitivity of rapamycin in vitro and in an immunocompetent orthotopic rat model of HCC.
Activation of PI3K/AKT and MAPK pathway through a PDGFRβ-dependent feedback loop compromises the anti-tumor activity of rapamycin in HCC, and blockade of this feedback loop by sorafenib is an attractive approach to improve the anti-tumor effect of rapamycin, particularly in preventing or treating HCC recurrence after liver transplantation.
To evaluate and compare the effect of decentration and tilt on the optical quality of monofocal and trifocal intraocular lenses (IOL).
Optical quality of a monofocal IOL (AcrySof IQ SN60WF; Alcon ...Laboratories, Inc., USA) and a trifocal IOL (AcrySof IQ PanOptix; Alcon Laboratories, Inc., USA) was assessed using an in vitro optical bench (OptiSpheric IOL R Trioptics GmbH, Germany). At apertures of 3.0 mm and 4.5 mm, modulation transfer function (MTF) at spatial frequency of 50 lp/mm, MTF curve and the United States Air Force (USAF) resolution test chart of the two IOLs were measured and compared at their focus with different degrees of decentration and tilt. Optical quality at infinity, 60 cm and 40 cm and the through-focus MTF curves were compared when the two IOLs were centered at apertures of 3.0 mm and 4.5 mm. Spectral transmittance of the two IOLs was measured by the UV-visible spectrophotometer (UV 3300 PC; MAPADA, China).
The SN60WF and the PanOptix filtered blue light from 400 to 500 nm. Both IOLs at the far focus and the PanOptix at the intermediate focus showed a decrease in optical quality with increasing decentration and tilt. The PanOptix demonstrated enhanced optical quality compared to the previous gradient at the near focus at a decentration range of 0.3-0.7 mm with a 3.0 mm aperture, and 0.5 mm with a 4.5 mm aperture, whereas other conditions exhibited diminished optical quality with increasing decentration and tilt at the focus of both IOLs. When the two IOLs were centered, the SN60WF had better optical quality at infinity, while the PanOptix had better optical quality at 60 cm and 40 cm defocus. The optical quality of the SN60WF exceeded that of the PanOptix at far focus, with a 3 mm aperture decentration up to 0.7 mm and a 4.5 mm aperture decentration up to 0.3 mm; this observation held true for all tilts, irrespective of aperture size. As both decentration and tilt increased, the optical quality of the SN60WF deteriorated more rapidly than that of the PanOptix at the far focal point.
The SN60WF showed a decrease in optical quality with increasing decentration and tilt. Optical quality of the PanOptix at the near focus increased in some decentration conditions and decreased in some conditions, while it showed a decrease at the other focuses with increasing decentration. While tilt only had a negative effect on optical quality. When both IOLs were centered, the PanOptix provided a wider range of vision, while the SN60WF provided better far distance vision. At the far focus, the SN60WF has better resistance to tilt than the PanOptix, but the optical quality degrades more quickly when decentered and tilted.
Adoptive transfer of genetically engineered chimeric antigen receptor (CAR) T cells is becoming a promising treatment option for hematological malignancies. However, T cell immunotherapies have ...mostly failed in individuals with solid tumors. Here, with a CRISPR-Cas9 pooled library, we performed an in vivo targeted loss-of-function screen and identified ST3 β-galactoside α-2,3-sialyltransferase 1 (ST3GAL1) as a negative regulator of the cancer-specific migration of CAR T cells. Analysis of glycosylated proteins revealed that CD18 is a major effector of ST3GAL1 in activated CD8
T cells. ST3GAL1-mediated glycosylation induces the spontaneous nonspecific tissue sequestration of T cells by altering lymphocyte function-associated antigen-1 (LFA-1) endocytic recycling. Engineered CAR T cells with enhanced expression of βII-spectrin, a central LFA-1-associated cytoskeleton molecule, reversed ST3GAL1-mediated nonspecific T cell migration and reduced tumor growth in mice by improving tumor-specific homing of CAR T cells. These findings identify the ST3GAL1-βII-spectrin axis as a major cell-intrinsic program for cancer-targeting CAR T cell migration and as a promising strategy for effective T cell immunotherapy.
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