Abstract
This study aimed to evaluate the scleral spur length (SSL) in response to different accommodation stimuli states, as well as the correlation with Schlemm’s canal (SC) and trabecular meshwork ...(TM). 74 children were recruited for this study. The 0D, − 4D, and − 8.0 D accommodation stimuli state was achieved by looking at a variable distance optotype. The ciliary muscle (CM), scleral spur (SS), SC, and TM were imaged by swept-source optical coherence tomography. The SSL (Method III) increased significantly from 221.56 ± 30.74 μm at base state to 234.99 ± 30.11 μm at − 4D accommodation stimuli state (
p
= 0.028) and increased to 250.09 ± 29.87 μm at − 8D accommodation stimuli state (
p
= 0.011). Method III had the largest areas under receiver operating characteristic (ROC) curves (0.798, 95% CI 0.721–0.875). Moreover, CM 1, SC, and trabecular meshwork length (TML) were significantly correlated with SSL (Method III) (
p
< 0.05). These findings suggest that the contractile ability and compliance of the SS play an important role in maintaining the morphology of the SC. Moreover, the force of accommodation regulates the SC size by increasing the length of SS.
We utilize the cross-quantilogram method to assess the predictive capacity of geopolitical risk (GPR) on volatility spillovers calculated by the time-varying parameter vector autoregressive model, ...across international commodity, exchange, and U.S. and Chinese stock markets. The findings yield three notable observations: First, we establish the directional predictive influence of GPR on net and net pairwise volatility spillovers, indicating discernible shifts in the risk roles of specific markets and transmission pathways. Second, these shifts, anticipated by GPR, manifest swiftly within a single day and subside within a quarter, albeit with varying durations contingent on market categories and transmission pathways. Third, disparities are evident in the predictive effectiveness of geopolitical acts and geopolitical threats. These findings remain robust even when considering factors such as economic policy uncertainty, alternative proxies, and other spillover models.
•We study predictive power of geopolitical risk for cross-market volatility spillovers.•Geopolitical risk has the capacity to forecast the direction of spillovers.•The Network structure changes subsequent to GPR intensification.•GPT’s predictive ability differs from GPA’s, resembling GPR’s more closely.
To investigate the formation and absorption of avascular subretinal hyperreflective material (avSHRM) in neovascular age-related macular degeneration (nAMD) based on optical coherence tomography ...angiography (OCTA) characteristics.
Prospective cohort study
This study included patients with treatment-naïve nAMD and followed up for 3 months. Subjects were classified into avSHRM group and non-avSHRM group based on the presence of avSHRM at baseline. Quantitative OCTA characteristics including explant area, perimeter, vessel area, density, length, junctions, endpoints, lacunarity, maximum vessel caliber, vessel dispersion, and fractal dimension were assessed, three-dimensional volume and optical density ratio (ODR) of avSHRM were measured. Comparison analyses, correlate coefficients and regression models were applied to explore factors associated with avSHRM formation and absorption.
88 eyes from 88 patients (39 females) were enrolled. Compared to non-avSHRM group, avSHRM group exhibit a more intricate vasculature, characterized by higher value of macular neovascularization (MNV) perimeter, vessel area, total vessel length, total number of junctions and total number of endpoints (all P < 0.05), as well as the maximum vessel caliber (P < 0.001). In the multivariate model, which has been adjusted for age, gender, and types of medications, avSHRM absorption was correlated with baseline average vessel length, maximum vessel caliber and avSHRM ODR (standardized β = 0.274, -0.367 and -0.334; P = 0.049, 0.010 and 0.018, respectively), with an adjusted R² of 0.453.
Quantitative OCTA measurements can be utilized for assessing the dynamics of avSHRM in nAMD. Patients with more complex vasculature are at a higher risk of avSHRM formation. Average vessel length, maximum vessel diameter and avSHRM ODR play a role in its absorption.
Nanopore targeted sequencing showed a higher positivity rate and a shorter turnaround time than did traditional culture in identifying pathogens in the intraocular fluid samples of patients with ...endogenous endophthalmitis.
To evaluate the feasibility of clinical application of nanopore targeted sequencing (NTS) for the identification of pathogens in patients with endogenous endophthalmitis, especially those with fungus-associated endophthalmitis.
In this retrospective study, medical records and etiological results of 27 patients (34 eyes) with endogenous endophthalmitis were reviewed. The intraocular fluid samples were examined using both NTS and microbial culture. The results included the differences in detection time, positivity rate of pathogen detection, and positivity rate of fungus identification between two methods.
NTS and microbial culture enabled the detection of etiologic agents in 89.28% and 35.71% of the samples, respectively. The difference of positivity rate between these methods was statistically significant ( P < 0.001). NTS also showed high sensitivity in both culture-positive and culture-negative samples (100% and 83.33%, respectively). Regarding culture-positive samples, the NTS results displayed a strong match with culture results. NTS showed a significantly higher positivity rate for fungal infection than did microbial culture (46.43% vs. 7.14%, P = 0.002). The average detection time of NTS was 1.11 ± 0.31 days, which was shorter than that of microbial culture (2.50 ± 0.58 days, Z = -4.686, P < 0.001). NTS technology facilitated an informed switch of intravitreal antimicrobial agents in 13 eyes.
NTS, as a sensitive, specific, and timely complementary method, can be used along with traditional methods for the identification of pathogenic microorganisms in the intraocular fluid of patients with endogenous endophthalmitis.
To investigate the correlation between morphological lesions and functional indicators in eyes with neovascular age-related macular degeneration (nAMD).
This was a prospective observational study of ...treatment-naïve nAMD eyes. Various morphological lesions and impaired retinal structures were manually measured at baseline and month-3 in three-dimensional optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images, including the volumes (mm3) of macular neovascularization (MNV), avascular subretinal hyperreflective material (avascular SHRM), subretinal fluid (SRF), intraretinal fluid (IRF), serous pigment epithelial detachment (sPED) and the impaired area (mm2) of ellipsoid zone (EZ), external limiting membrane (ELM) and outer nuclear layer (ONL).
Sixty-three eyes were included. The volume of avascular SHRM showed persistent positive associations with the area of EZ damage, both at baseline, month-3, and change values (all P < 0.001). Poor BCVA (month-3) was associated with larger volumes of baseline IRF (β = 0.377, P < 0.001), avascular SHRM (β = 0.306, P = 0.032), and ELM impairment area (β = 0.301, P = 0.036) in multivariate model. EZ and ELM impairment were primarily associated with baseline avascular SHRM (β = 0.374, p = 0.003; β = 0.388, P < 0.001, respectively), while ONL impairment primarily associated with MNV (β = 0.475, P < 0.001).
The utilization of three-dimensional measurements elucidates the intrinsic connections among various lesions and functional outcomes. In particular, avascular SHRM plays an important role in prognosis of nAMD.
•Three-dimensional measurement of lesion volume and impaired retinal structures revealing the critical role of avascular SHRM in nAMD prognosis.•Targeting avascular SHRM for nAMD treatment potentially encourage VA enhancement and offer promising outcome for photoreceptor regeneration.
Purpose
This paper aimed to assess the diagnostic utility of a newly developed gene-based technology-nanopore targeted sequencing (NTS) in suspected endophthalmitis patients.
Methods
This ...retrospective study included 43 patients (44 eyes) with suspected endophthalmitis. NTS was applied along with microbiological culture to detect unknown pathogens in intraocular fluid samples. The diagnostic utility of NTS was mainly evaluated from three aspects, including the positivity rate of bacterial/fungal presence, diagnostic turnaround time and the frequency of change in treatment based on etiology test results. Non-parametric, two-sided Wilcoxon rank sum test, the McNemar’s test and the kappa statistic were used for statistical comparisons.
Results
NTS showed significant advantages over traditional culture in positivity rates and diagnostic time (
P
< 0.001, kappa = 0.082;
Z
= −5.805,
P
< 0. 001). As regards antibiotic strategy, 17 patients (39.53%) and 5 patients (11.63%) underwent medication change following NTS and culture results respectively (
P
< 0.001, kappa = 0.335). With reasonable use of antibiotic and surgical intervention, most patients responded favorably, judged by significantly improved visual acuity (
Z
= −4.249,
P
< 0.001). The mean duration of hospitalization was 8.49 ± 2.45 days (range, 1–16 days).
Conclusion
The high efficiency feature of NTS in pathogen detection renders it a valuable supplementary to traditional culture. Additionally, it has facilitated patients’ management for the early and precise diagnosis of endophthalmitis.
Objective. To evaluate the clinical efficacy of nasal high-flow oxygen therapy in patients with acute left heart failure and hypoxemia. Methods. From July 2016 to November 2018, patients with acute ...left heart failure complicated with hypoxemia treated in the Department of Critical Medicine of Yantai Affiliated Hospital of Binzhou Medical University were retrospectively observed (a total of 140 cases met the inclusion criteria). They were randomly divided into two groups, with 70 cases in each group. Patients were given continuous ECG monitoring, improved blood gas analysis test, and recorded HR, RR, map, SaO2, pH, PaO2, PaCO2, and Lac, perfect examination and color Doppler echocardiography, and record NT-proBNP and EF before and 24 hours after treatment. The effective rates of the two groups before and after oxygen therapy were detected. Results. There were 67 patients with high-flow oxygen therapy group improvement, 95.7% improvement rate, and 55 patients with general oxygen therapy group improvement rate. The treatment improvement rate was 78.6%. A total of 67 patients were treated with high-flow oxygen therapy. After high-flow oxygen therapy, HR (t = 18.8, P≤0.05), RR (t = 19.7, P≤0.05), MAP (t = 12.1, P≤0.05), PaCO2 (t = 9.53, P≤0.05), Lac (t = 8.69, P≤0.05), and NT-proBNP (t = 7.03, P≤0.05) were significantly lower than before. SaO2 (t = −12.4, P≤0.05), pH (t = −12.2, P≤0.05), PaO2 (t = −17.7, P≤0.05), and EF (t = −13.4, P≤0.05) were significantly higher than before. A total of 55 patients were in the general oxygen therapy group. After administration of ordinary oxygen therapy, HR (t = 18.2, P≤0.05), RR (t = 10.8, P≤0.05), MAP (t = 13.1, P≤0.05), PaCO2 (t = 15.8, P≤0.05), Lac (t = 7.1, P≤0.05), and NT-proBNP (t = 10, P≤0.05) were significantly lower than before. SaO2 (t = −15.5, P≤0.05), pH (t = −4.5, P≤0.05), PaO2 (t = −20, P≤0.05), and EF value (t = −7.7, P≤0.05) were significantly higher than before. Conclusion. High-flow oxygen therapy and general oxygen therapy have an obvious curative effect on patients with acute left heart failure and hypoxemia. Compared with the two, high-flow oxygen therapy is more effective. After high-flow oxygen therapy and general oxygen therapy in patients with acute left heart failure and hypoxia, HR, RR, MAP, SaO2, pH, PaO2, PaCO2, Lac, EF, and NT-proBNP value all improved, and the improvement of high-flow oxygen therapy was greater.
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