Ophthalmic exam and ophthalmology residents’ subspecialty preference

AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.

Development and research status of intelligent ophthalmology in China

This paper analyzes the current status,technological developments,academic exchange platforms,and future challenges and solutions in the field of intelligent ophthalmology(IO)in China.In terms of technology,significant progress has been made in various areas,including diabetic retinopathy,fundus image analysis,quality assessment of medical artificial intelligence products,clinical research methods,technical evaluation,and industry standards.Researchers continually enhance the safety and standardization of IO technology by formulating a series of clinical application guidelines and standards.The establishment of domestic and international academic exchange platforms provides extensive collaboration opportunities for professionals in various fields,and various academic journals serve as publication platforms for IO research.However,challenges such as technological innovation,data privacy and security,lagging regulations,and talent shortages still pose obstacles to future development.To address these issues,future efforts should focus on strengthening technological research and development,regulatory framework construction,talent cultivation,and increasing patient awareness and acceptance of new technologies.By comprehensively addressing these challenges,IO in China is poised to further lead the industry’s development on a global scale,bringing more innovation and convenience to the field of ophthalmic healthcare.

Improving the training abilities of ophthalmic educators: the Ophthalmology Foundation’s initiatives

Our goal as medical educators is for our students to learn what they need to know and competently perform ophthalmic procedures.In addition,the students need to have good communication skills and behave professionally and ethically(1,2).Most medical educators are not taught how to teach but rather learn by role-modeling their mentors.This can be good or bad depending on the mentor!In addition,the amount of knowledge and numbers of surgical procedures is ever increasing and yet,in most countries,the amount of time to train and become competent is not changing.Thus,our goal of creating competent ophthalmologists is ever more challenging.

Socialization Development of ESG Business Models in Representative Asia-Pacific Countries:A State-of-the-Art Review and Recommendation

The integration of environmental,social,and governance(ESG)principles has become a pivotal factor in shaping sustainable and responsible corporate practices.The present study investigates the integration of ESG principles within corporate governance models in Asia-Pacific countries,focusing on socialization.By examining the governance culture,legal frameworks,and corporate practices in these representative countries,the paper delineates a strategic framework for embedding social governance into corporate strategies.The study introduces a Cultural,Economic,Legal,and Political(CELP)framework to assess corporate social governance,investigating the correlation between business practices and social changes.Through a systematic literature review and detailed thematic analysis,this paper aims to offer actionable insights and recommendations,guiding corporations in their transition towards more sustainable and socially responsible business practices.

Thoughts on Establishment of the Agricultural Products Quality and Safety(Standards) Cooperation Center in Asia-Pacific Region

The establishment of agricultural products quality and safety cooperation mechanism and the research demonstration center in the Asia-Pacific reg coordinating each other, is not only of great ening cooperation with countries in Asia-Pacific region and for agricultural production safety of those countries in Asia- Pacific region, but also very necessary for our country to build a responsible image in the quality and safety of agricultural products, protection of the benefit of agriculture-related enterprises, increasing exports, ensuring imported food safety and China＇s national food security, as Well as nice exploration of establishing the global agricultural＇ products quality and safety cooperation center.

Stem Cell Ophthalmology Treatment Study(SCOTS) for retinal and optic nerve diseases: a case report of improvement in relapsing auto-immune optic neuropathy

We present the results from a patient with relapsing optic neuropathy treated within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board ap- proved clinical trial and has become the largest ophthalmology stem cell study registered at the National Institutes of Health to date （www.clinicaltrials.gov Identifier NCT 01920867）. SCOTS utilizes autologous bone marrow-derived stem cells （BMSCs） for treatment of retinal and optic nerve diseases. Pre-treatment and post-treatment comprehensive eye exams of a 54 year old female patient were performed both at the Florida Study Center, USA and at The Eye Center of Columbus, USA. As a consequence of a relapsing optic neuritis, the patient＇s previously normal visual acuity decreased to between 20/350 and 20/400 in the right eye and to 20/70 in the left eye. Significant visual field loss developed bilaterally. The patient underwent a right eye vitrectomy with injection of BMSCs into the optic nerve of the right eyeand retrobulbar, subtenon and in- travitreal injection of BMSCs in the left eye. At 15 months after SCOTS treatment, the patient＇s visual acuity had improved to 20/150 in the right eye and 20/20 in the left eye. Bilateral visual fields improved markedly. Both macular thickness and fast retinal nerve fiber layer thickness were maximally improved at 3 and 6 months after SCOTS treatment. The patient also reduced her mycophenylate dose from 1,500 mg per day to 500 mg per day and required no steroid pulse therapy during the 15-month follow up.

Application of artificial intelligence in ophthalmology

Artificial intelligence is a general term that means to accomplish a task mainly by a computer, with the least human beings participation, and it is widely accepted as the invention of robots. With the development of this new technology, artificial intelligence has been one of the most influential information technology revolutions. We searched these English-language studies relative to ophthalmology published on PubMed and Springer databases. The application of artificial intelligence in ophthalmology mainly concentrates on the diseases with a high incidence, such as diabetic retinopathy, agerelated macular degeneration, glaucoma, retinopathy of prematurity, age-related or congenital cataract and few with retinal vein occlusion. According to the above studies, we conclude that the sensitivity of detection and accuracy for proliferative diabetic retinopathy ranged from 75% to 91.7%, for non-proliferative diabetic retinopathy ranged from 75% to 94.7%, for age-related macular degeneration it ranged from 75% to 100%, for retinopathy of prematurity ranged over 95%, for retinal vein occlusion just one study reported ranged over 97%, for glaucoma ranged 63.7% to 93.1%, and for cataract it achieved a more than 70% similarity against clinical grading.

Ophthalmology simulation for undergraduate and postgraduate clinical education

This is a review education paper on the current ophthalmology simulators utilized worldwide for undergraduate and postgraduate training. At present, various simulators such as the EYE Exam Simulator （Kyoto Kagaku Co. Ltd., Kyoto, Japan）, Eyesi direct ophthalmoscope simulator （VRmagic, GmbH, Mannheim, Germany）, Eyesi indirect ophthalmoscope simulator （VRmagic, GmbH, Mannheim, Germany） and Eyesi cataract simulators （VRmagic, GmbH, Mannheim, Germany）. These simulators are thought to be able to reduce the initial learning curve for the ophthalmology training but further research will need to be conducted to assess the effectiveness of the simulation-assisted ophthalmology training. Future research will be of great value to assess the medical students and residents responses and performance regarding the usefulness of the individual eye simulator.

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects,health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745(Sb) and Lactobacillus rhamnosus GG(LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of(with the indicated strains): antibiotic-associated diarrhea(LGG or Sb); Clostridium difficile-induced diarrhea(Sb); nosocomial diarrhea(LGG); infantile colic(L reuteri) and as adjunct treatment of Helicobacter pylori(Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological,socioeconomical and health system conditions,similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.

Stem Cell Ophthalmology Treatment Study(SCOTS) for retinal and optic nerve diseases: a preliminary report

In this report, we present the results of a single patient with optic neuropathy treated within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and is the largest ophthalmology stem cell study registered at the National Institutes of Health to date- www.clinicaltrials.gov Identifier NCT 01920867. SCOTS utilizes autologous bone marrow-derived stem cells in the treatment of optic nerve and retinal diseases. Pre- and post-treatment comprehensive eye exams were independently performed at the Wilmer Eye Institute at the Johns Hopkins Hospital, USA. A 27 year old female patient had lost vision approximately 5 years prior to enrollment in SCOTS. Pre-treatment best-corrected visual acuity at the Wilmer Eye Institute was 20/800 Right Eye （OD） and 20/4,000 Left Eye （OS）. Four months following treatment in SCOTS, the central visual acuity had improved to 20/100 OD and 20/40 OS.

Trends in ophthalmology journals： a five-year bibliometric analysis （2009-2013）

AIM： To explore the trends in the ophthalmic literature over a 5-year period in relation to country, research expenditure and demographics. METHODS： Articles published between 2009 and 2013 by the 20 highest-contributing countries in the 20 top- ranked ophthalmology journals were identified by their country of affiliation. The number of articles published and mean impact factor were measured per country for each year and trends explored using regression analysis with 5-year and 10-year forecasts calculated. Data on research expenditure was collected and tested for correlation with the number of articles and mean impact factor. RESULTS： The analysis included 19 338 articles. The USA, UK and Europe accounted for 60.2% of articles published, with the USA contributing 7388 articles （34.0%）. The USA also demonstrated the highest mean impact factor （3.5）. Research expenditure was significantly correlated with both research output （r=0,86, P〈0.001） and scholarly impact （r=0.42, P〈0.001）. China （P〈0.01）, Korea （P〈0.01） and India （P〈0.02） demonstrated a significant growth in research output over the study period. The research contribution of these three countries combined is forecasted to overtake that of Europe within ten years, with China expected to be the second-largest contributor within five years. These countries were also among those demonstrating the greatest growth in research expenditure. CONCLUSION： While the USA and European countries are major contributors of ophthalmic research, the productivity of some Asian countries is growing impressively. The contribution of China, Korea and Indiais forecasted to outweigh that of Europe by 2023. Research expenditure is highly correlated with research productivity and these trends reflect the differing economic priorities across the world.

Guidelines on clinical research evaluation of artificial intelligence in ophthalmology(2023)

With the upsurge of artificial intelligence(AI)technology in the medical field,its application in ophthalmology has become a cutting-edge research field.Notably,machine learning techniques have shown remarkable achievements in diagnosing,intervening,and predicting ophthalmic diseases.To meet the requirements of clinical research and fit the actual progress of clinical diagnosis and treatment of ophthalmic AI,the Ophthalmic Imaging and Intelligent Medicine Branch and the Intelligent Medicine Committee of Chinese Medicine Education Association organized experts to integrate recent evaluation reports of clinical AI research at home and abroad and formed a guideline on clinical research evaluation of AI in ophthalmology after several rounds of discussion and modification.The main content includes the background and method of developing this guideline,an introduction to international guidelines on the clinical research evaluation of AI,and the evaluation methods of clinical ophthalmic AI models.This guideline introduces general evaluation methods of clinical ophthalmic AI research,evaluation methods of clinical ophthalmic AI models,and commonly-used indices and formulae for clinical ophthalmic AI model evaluation in detail,and amply elaborates the evaluation methods of clinical ophthalmic AI trials.This guideline aims to provide guidance and norms for clinical researchers of ophthalmic AI,promote the development of regularization and standardization,and further improve the overall level of clinical ophthalmic AI research evaluations.

Utility of the Asia-Pacific colorectal screening scoring system and the presence of metabolic syndrome components in screening for sporadic colorectal cancer

AIM: To determine the utility of the Asia-Pacific colorectal screening (APCS) scoring system and metabolic syndrome components in individual screening for sporadic colorectal cancer.