Practice patterns among ophthalmic surgeons in treating concomitant oculoplastic conditions in preoperative period:A questionnaire-based study

BACKGROUND Addressing oculoplastic conditions in the preoperative period ensures both the safety and functional success of any ophthalmic procedure.Some oculoplastic conditions,like nasolacrimal duct obstruction,have been extensively studied,whereas others,like eyelid malposition and thyroid eye disease,have received minimal or no research.AIM To investigate the current practice patterns among ophthalmologists while treating concomitant oculoplastic conditions before any subspecialty ophthalmic intervention.METHODS A cross-sectional survey was disseminated among ophthalmologists all over India.The survey included questions related to pre-operative evaluation,anaesthetic and surgical techniques preferred,post-operative care,the use of adjunctive therapies,and patient follow-up patterns.RESULTS A total of 180 ophthalmologists responded to the survey.Most practitioners(89%)felt that the ROPLAS test was sufficient during pre-operative evaluation before any subspecialty surgery was advised.The most common surgical techniques employed were lacrimal drainage procedures(Dacryocystorhinostomy)(63.3%),eyelid malposition repair(36.9%),and ptosis repair(58.7%).Post-operatively,47.7%of respondents emphasized that at least a 4-week gap should be maintained after lacrimal drainage procedures and eyelid surgeries.Sixty-seven percent of ophthalmologists felt that topical anaesthetic procedures should be preferred while performing ocular surgeries in thyroid eye disease patients.CONCLUSION Approximately 50%of ophthalmologists handle prevalent oculoplastic issues themselves,seeking the expertise of an oculoplastic surgeon under particular conditions.Many ophthalmologists still favor using ROPLAS as a preliminary screening method before proceeding with cataract surgery.Eyelid conditions and thyroid eye disease are not as commonly addressed before subspecialty procedures compared to issues like nasolacrimal duct obstruction and periocular infections.

Diversity, Abundance and Distribution Patterns of Epibenthic Echinoderms in Dungonab Bay, Red Sea, Sudan

The abundance, distribution and diversity of epibenthic echinoderm were investigated at Dungonab Bay in the Red Sea coastal water of the Sudan. Four permanent line transects were chosen. Eight (30 × 2) square metre belt transects along each permanent line transect at 20 metre intervals were used to collect data. The data were subjected to univariate and multivariate analyses. Spatial variations of epibenthic echinoderm abundance were assessed with one-way analysis of variance. Hierarchical agglomerative clustering was used to identify and illustrate the similarities in echinoderm abundance between line transects and between belt transects. Indices of richness (d), diversity (H'), evenness (J') and dominance (C) were used to explain the diversity of epibenthic echinoderm species. The distribution pattern of each echinoderm species was determined in each permanent line transect. A total of 986 individuals were recorded within sixteen species of epibenthic echinoderms in the four line transects. Holothuriidae was the dominant family (5 species and 342 individuals). The most abundant echinoderms species was Pearsonothuria graeffei (77 individuals, about 7.81%). Abundances intra-transects and intra-families were insignificant (f = 1.67, p = 0.183, df = 3 and f = 3.24, p = 0.083, df = 9, respectively). The highest values of Shannon-Wiener diversity index (H'), Pielou evenness index (J'), Margalef species richness index (d), and Simpson Dominance index (C) were 2.738, 0.9875, 2.791 and 0.07159, respectively. The distribution patterns of all species in the study transects varied between clumped and uniform, with the exception of Asthenosoma varium of the Echinothuridae family, which had clumped distribution patterns in all transects. The study concluded that Dungonab Bay supports rich and diverse communities of epibenthic echinoderms.

Surface crack evolution patterns in freeze-thaw damage of fissured rock bodies

To explore the effects of freeze‒thaw cycles on the mechanical properties and crack evolution of fissured sandstone,biaxial compression experiments were carried out on sandstone subjected to freeze‒thaw cycles to characterize the changes in the physical and mechanical properties of fissured sandstone caused by freeze‒thaw cycles.The crack evolution and crack change process on the surface of the fissured sandstone were recorded and analysed in detail via digital image technology(DIC).Numerical simulation was used to reveal the expansion process and damage mode of fine-scale cracks under the action of freeze‒thaw cycles,and the simulation results were compared and analysed with the experimental data to verify the reliability of the numerical model.The results show that the mass loss,porosity,peak stress and elastic modulus all increase with increasing number of freeze‒thaw cycles.With an increase in the number of freeze‒thaw cycles,a substantial change in displacement occurs around the prefabricated cracks,and a stress concentration appears at the crack tip.As new cracks continue to sprout at the tips of the prefabricated cracks until the microcracks gradually penetrate into the main cracks,the displacement cloud becomes obviously discontinuous,and the contours of the displacement field in the crack fracture damage area simply intersect with the prefabricated cracks to form an obvious fracture.The damage patterns of the fractured sandstone after freeze‒thaw cycles clearly differ,forming a symmetrical"L"-shaped damage pattern at zero freeze‒thaw cycles,a symmetrical"V"-shaped damage pattern at 10 freeze‒thaw cycles,and a"V"-shaped damage pattern at 20 freeze‒thaw cycles.After 20 freeze‒thaw cycles,a"V"-shaped destruction pattern and"L"-shaped destruction pattern are formed;after 30 freeze‒thaw cycles,an"N"-shaped destruction pattern is formed.This shows that the failure mode of fractured sandstone gradually becomes more complicated with an increasing number of freeze‒thaw cycles.The effects of freeze‒thaw cycles on the direction and rate of crack propagation are revealed through a temperature‒load coupled model,which provides an important reference for an in-depth understanding of the freeze‒thaw failure mechanisms of fractured rock masses.

Modal Frequency Prediction of Chladni Patterns Using Machine Learning

The introduction of machine learning (ML) in the research domain is a new era technique. The machine learning algorithm is developed for frequency predication of patterns that are formed on the Chladni plate and focused on the application of machine learning algorithms in image processing. In the Chladni plate, nodes and antinodes are demonstrated at various excited frequencies. Sand on the plate creates specific patterns when it is excited by vibrations from a mechanical oscillator. In the experimental setup, a rectangular aluminum plate of 16 cm x 16 cm and 0.61 mm thickness was placed over the mechanical oscillator, which was driven by a sine wave signal generator. 14 Chladni patterns are obtained on a Chladni plate and validation is done with modal analysis in Ansys. For machine learning, a large number of data sets are required, as captured around 200 photos of each modal frequency and around 3000 photos with a camera of all 14 Chladni patterns for supervised learning. The current model is written in Python language and model has one convolution layer. The main modules used in this are Tensor Flow Keras, NumPy, CV2 and Maxpooling. The fed reference data is taken for 14 frequencies between 330 Hz to 3910 Hz. In the model, all the images are converted to grayscale and canny edge detected. All patterns of frequencies have an almost 80% - 99% correlation with test sample experimental data. This approach is to form a directory of Chladni patterns for future reference purpose in real-life application. A machine learning algorithm can predict the resonant frequency based on the patterns formed on the Chladni plate.

Characteristic atom occupation patterns of Au_3Cu,AuCu_3,AuCuI and AuCuII based on experimental data of disordered alloys

The potential energies, volumes and electronic structures of characteristic atoms coordinated by neighboring configurations were obtained from the experimental heats of formation and lattice parameters of disordered Au1-xCux alloys. From characteristic atom occupation （CAO） patterns of L12-Au3Cu, L12-AuCu3 and Llo-AuCu compounds, their electronic structures, volumetric and energetic properties were calculated. The CAO pattern of Johasson-Linde（J-L） model shows that the transition AuCuI→AuCulI is an exothermic and volume contraction reaction, which is opposite from experimental phenomena. According to CAO pattern of Guymont-Feutelais-Legendre（G-F-L） model, the AuCulI cell consists of two periodic antidirection （PAD） AuCuI regions and two PAD boundary regions. The equations derived from CAO pattern of G-F-L model can be used to calculate energetic properties, volumetric properties and ordering degrees of the PAD AuCuI region and PAD boundary region, as well as corresponding average properties of the AuCulI phase. The results are consistent with experimental phenomena.

Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.

Extreme Meteorological Drought Events over China(1951-2022):Migration Patterns,Diversity of Temperature Extremes,and Decadal Variations

Recently,extreme meteorological droughts have affected China,causing terrible socioeconomic impacts.Despite previous research on the spatiotemporal characteristics and mechanisms of drought,two crucial issues remain seldom explored.First,an event-oriented drought chronology with detailed spatiotemporal evolutions is urgently required.Second,the complex migration patterns and diversity of synchronous temperature extremes need to be quantitatively investigated.Accordingly,the main achievements of our investigation are as follows.We produced an event-oriented set of extreme meteorological droughts over China through the application of a newly developed 3D DBSCAN-based detection method(deposited on https://doi.org/10.25452/figshare.plus.25512334),which was verified with a historical atlas and monographs on a case-by-case basis.In addition,distinctive migration patterns(i.e.,stationary/propagation types)are identified and ranked,considering the differences in latitudinal zones and coastal/inland locations.We also analyze the diversity of synchronous temperature extremes(e.g.,hotness and coldness).Notably,an increasing trend in hot droughts occurred over China since the late 1990s,predominantly appearing to the south of 30°N and north of 40°N.All drought events and synchronous temperature extremes are ranked using a comprehensive magnitude index,with the 2022 summer-autumn Yangtze River hot drought being the hottest.Furthermore,Liang-Kleeman information flow-based causality analysis emphasizes key areas where the PDO and AMO influenced decadal variations in coverages of droughts and temperature extremes.We believe that the achievements in this study may offer new insights into sequential mechanism exploration and prediction-related issues.

Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

Histologic features and genomic alterations of primary colorectal adenocarcinoma predict growth patterns of liver metastasis

BACKGROUND Different histological growth patterns(HGPs)of colorectal carcinoma(CRC)liver metastasis are associated with patients’prognosis and response to antiangiogenic therapy.However,the relationship between HGPs of liver metastasis and clinicopathological and genomic characteristics of primary cancer has not been well established.AIM To assess whether certain clinicopathological and genomic features of primary CRC could predict the HGPs of liver metastasis.METHODS A total of 29 patients with paired resections of both primary CRC and liver metastasis were divided into two groups:A(15 cases with desmoplastic liver metastasis)and B(14 cases with replacement liver metastasis).Clinical information was obtained from patients’charts.Mismatch repair proteins,BRAFV600E,and PD-L1 were evaluated by immunohistochemistry.Five cases were selected randomly from each group for whole exome sequencing(WES)analysis.RESULTS In the primary tumor,expanding growth pattern,low tumor budding score(TBS),and Crohn’s disease-like response(CDR)were associated with desmoplastic liver metastasis and better overall survival,whereas infiltrating growth pattern alone of primary carcinoma could predict the replacement liver metastasis and worse overall survival(P<0.05).On WES analysis,primary carcinoma with desmoplastic liver metastasis showed mutations in APC(4/5);TP53(3/5);KRAS,PIK3CA,and FAT4(2/5);BRCA-1,BRCA2,BRAF,and DNAH5(1/5),whereas primary carcinoma with replacement liver metastasis showed mutations in APC and TP53(3/5);KRAS,FAT4,DNH5,SMAD,ERBB2,ERBB3,LRP1,and SDK1(1/5).CONCLUSION The HGPs,TBS,and CDR of primary CRC as well as the presence of specific genetic mutations such as those in PIK3CA could be used to predict the HGPs of liver metastasis,response to therapy,and patients’prognosis.

Seismogenic fault and topography control on the spatial patterns of landslides triggered by the 2017 Jiuzhaigou earthquake

Jiuzhaigou National Park, located in northwest plateau of Sichuan Province, is a UNESCO World Heritage Site, and one of the most popular scenic areas in China. On August 8, 2017, a Mw 6.5 earthquake occurred 5 km to the west of a major scenic area, causing 25 deaths and injuring 525, and the Park was seriously affected. The objective of this study was to explore the controls of seismogenic fault and topographic factors on the spatial patterns of these landslides. Immediately after the main shock, field survey, remote-sensing investigations, and statistical and spatial analysis were undertaken. At least 2212 earthquake-triggered landslides were identified, covering a total area of 11.8 km^2. Thesewere mainly shallow landslides and rock falls. Results demonstrated that landslides exhibited a close spatial correlation with seismogenic faults. More than 85% of the landslides occurred at 2200 to 3700 m elevations. The largest quantity of landslides was recorded in places with local topographic reliefs ranging from 200 to 500 m. Slopes in the range of ~20°-50° are the most susceptible to failure. Landslides occurred mostly on slopes facing east-northeast(ENE), east(E), east-southeast(ESE), and southeast(SE), which were nearly vertical to the orientation of the seismogenic fault slip. The back-slope direction and thin ridge amplification effects were documented. These results provide insights on the control of the spatial pattern of earthquake-triggered landslides modified by the synergetic effect of seismogenic faults and topography.

Ecological Effects of Land Use Patterns in Red Soil HillyRegion

Plant biomass and biodiversity, element accumulation and return, water loss and soil erosion, and changesin soil properties were studied for up to 10 years after conversion of sparse tree-shrubby grass land into thefollowing four land use patterns: masson pine (Pznvs massonzana Lamb.) land, beautiful sweetgum (Ltq-uidambar fomosana Hance) land, vegetation reservation land, and artificial mowing land. The annualbiomass production of the masson pine land was 5060 kg ha￣-1 being 4.9, 2.1, and 6.0 times that of the beau-tiful sweetgum land, the vegetation reservation land, and the artificial mowing land, respectively. Comparedwith the background values, the number of plant species for the vegetation reservation land increased by 10species after 10 years of land utilization, while for the masson pine and the beautiful sweetgum decreased by4, and for the artificial mowing land by 9. For masson pine land, total amount of N, P, K, Ca, and Mg neededfor producing 1000 kg dry matter was only 3.5 kg, annual element return through litter was 22 kg ha￣-1, bothof which were much lower than those of the other patterns. Vegetation reservation was an effective measureto conserve soil and water and improve soil fertility in the red soil hilly region. Artificial mowing arousedserious degradation of vegetation and soil. Some measures and suggestions for management and exploitationof the red soil hilly region such as masson pine planting, closing hills for afforestation, and stereo-agricultureon one hill are proposed.

Forest phenological patterns of Northeast China inferred from MODIS data

The role of remote sensing in phenological studies is increasingly regarded as a key to understand large area seasonal phenomena. This paper describes the application of Moderate Resolution Imaging Spectroradiometer (MODIS) time series data for forest phenological patterns. The forest phenological phase of Northeast China (NE China) and its spatial characteristics were inferred using 1-km 10-day MODIS normalized difference vegetation index (NDVI) datasets of 2002. The threshold-based method was used to estimate three key forest phenological variables, which are the start of growing season (SOS), the end of growing season (EOS) and growing season length (GSL). Then the spatial patterns of forest phenological variables of NE China were mapped and analyzed. The derived phenological variables were validated by the field observed data from published papers in the same study area. Results indicate that forest phenological phase from MODIS data is comparable with the observed data. As the derived forest phenological pattern is related to forest type distribution, it is helpful to discriminate between forest types.

Study on Epidemiological Profile, Clinical Profile, and Angiographic Patterns in Acute Coronary Syndrome Patients in a Tertiary Health Care Center in Haryana

Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) from India. Our aim is to study the clinical and epidemiological profile of ACS PATIENTS presenting to our institute, including their angiographic features. Methods: This hospital-based observational, single tertiary care center, prospective study was conducted on patients admitted in the Department of Cardiology at a tertiary care center in Haryana. The study included 400 patients aged greater than 18 years who were admitted with the diagnosis of ACS, and it was carried out for 1 year. The epidemiological profile, clinical history, risk factors, electrocardiogram findings, and angiographic pattern were studied and analyzed with appropriate statistical tools. Results: The mean age of the study population was 55.12 ± 11.78 years. Male and female ratio was 2.4:1. The majority of the patients came from rural background (80%);24% of the patients were illiterate. Smoking was the most common risk factor (51.5%) in our study population followed by hypertension (40%) and diabetes (28%). Unstable angina was the most common type of ACS, which was found in 68.25% of patients. Premature CAD was found in 27.8% of patients and obstructive CAD was found in 63% of patients. Coronary angiography revealed that 39% had single vessel disease (SVD), 23.5% had double vessel disease (DVD), and 27.5% had triple vessel disease (TVD). LAD was more commonly involved, followed by RCA and LCX. Within the first 24 hours, 67% of patients sought medical assistance and only 38.5% received definitive treatment, suggesting a delay in seeking definitive treatment in our study population. Conclusion: The study suggests that unstable angina is the most common form of ACS in the study population, which is mostly of rural background with significant delay in seeking medical help. Smoking is the most common risk factor in the study population.

Tuning the diffusion constant to optimize the readout of positional information of spatial concentration patterns

Positional information encoded in spatial concentration patterns is crucial for the development of multicellular organisms.However,it is still unclear how such information is affected by the physically dissipative diffusion process.Here we study one-dimensional patterning systems with analytical derivation and numerical simulations.We find that the diffusion constant of the patterning molecules exhibits a nonmonotonic effect on the readout of the positional information from the concentration patterns.Specifically,there exists an optimal diffusion constant that maximizes the positional information.Moreover,we find that the energy dissipation due to the physical diffusion imposes a fundamental upper limit on the positional information.

Temporal and spatial evolution of global major grain trade patterns

The complex and volatile international landscape has significantly impacted global grain supply security. This study uses a complex network analysis model to examine the evolution and trends of the global major grain trade from 1990 to 2020, focusing on network topology, centrality ranking, and community structure. There are three major findings. First, the global major grain trade network has expanded in scale, with a growing emphasis on diversification and balance. During the study period, the United States, Canada, China, and Brazil were the core nodes of the network. Grain-exporting countries were mainly situated in Asia, the Americas, and Europe, and importing countries in Asia, Africa, and Europe. Second, a significant increase in the number of high centrality countries with high export capacity occurred, benefiting from natural advantages such as fertile land and favorable climates. Third, the main global grain trade network is divided into four communities, with the Americas-Europe community being the largest and most widespread. The formation of the community pattern was influenced by geographic proximity, driven by the core exporting countries. Therefore, the world needs to enhance the existing trade model, promote the multi-polarization of the grain trade network, and establish a global vision for the future community. Countries and regions should participate actively in global grain trade security governance and institutional reform, expand trade links with other countries, and optimize import and export policies to reduce trade risks.

Bioinspired Multiscale Wrinkling Patterns on Curved Substrates:An Overview

The surface wrinkling of biological tissues is ubiquitous in nature.Accumulating evidence suggests that the mechanical force plays a significant role in shaping the biological morphologies.Controlled wrinkling has been demonstrated to be able to spontaneously form rich multiscale patterns,on either planar or curved surfaces.The surface wrinkling on planar substrates has been investigated thoroughly during the past decades.However,most wrinkling morphologies in nature are based on the curved biological surfaces and the research of controllable patterning on curved substrates still remains weak.The study of wrinkling on curved substrates is critical for understanding the biological growth,developing threedimensional(3D)or four-dimensional(4D)fabrication techniques,and creating novel topographic patterns.In this review,fundamental wrinkling mechanics and recent advances in both fabrications and applications of the wrinkling patterns on curved substrates are summarized.The mechanics behind the wrinkles is compared between the planar and the curved cases.Beyond the film thickness,modulus ratio,and mismatch strain,the substrate curvature is one more significant parameter controlling the surface wrinkling.Curved substrates can be both solid and hollow with various 3D geometries across multiple length scales.Up to date,the wrinkling morphologies on solid/hollow core-shell spheres and cylinders have been simulated and selectively produced.Emerging applications of the curved topographic patterns have been found in smart wetting surfaces,cell culture interfaces,healthcare materials,and actuators,which may accelerate the development of artificial organs,stimuli-responsive devices,and micro/nano fabrications with higher dimensions.

Memristors-coupled neuron models with multiple firing patterns and homogeneous and heterogeneous multistability

Memristors are extensively used to estimate the external electromagnetic stimulation and synapses for neurons.In this paper,two distinct scenarios,i.e.,an ideal memristor serves as external electromagnetic stimulation and a locally active memristor serves as a synapse,are formulated to investigate the impact of a memristor on a two-dimensional Hindmarsh-Rose neuron model.Numerical simulations show that the neuronal models in different scenarios have multiple burst firing patterns.The introduction of the memristor makes the neuronal model exhibit complex dynamical behaviors.Finally,the simulation circuit and DSP hardware implementation results validate the physical mechanism,as well as the reliability of the biological neuron model.

Assessing the influence of the minimum measured diameter on forest spatial patterns and nearest neighborhood relationships

Forest structure analysis is important for understanding the properties and development of a forest community,and its outcomes can be influenced by how trees are measured in sampled plots.Although there is a general consensus on the height at which tree diameter should be measured[1.3 m:diameter at breast height(DBH)],the minimum measureddiameter(MMD)often varies in different studies.In this study,we assumed that the outcomes of forest structure analysis can be influenced by MMD and,to this end,we applied g(r)function and stand spatial structural parameters(SSSPs)to investigate how different MMDs affect forest spatial structure analysis in two pine-oak mixed forests(30 and 57 years old)in southwest China and one old-growth oak forest(>120years old)from northwest China.Our results showed that 1)MMD was closely related to the distribution patterns of forest trees.Tree distribution patterns at each observational scale(r=0-20 m)tended tobecome random as the MMD increased.The older the community,the earlier this random distribution pattern appeared.2)As the MMD increased,neighboring trees became more regularly distributed around a reference tree.In most cases,however,nearest neighbors of a reference tree were randomly distributed.3)Tree species mingling decreased with increasing diameter,but it decreased slowly in older forests.4)No correlations can be found between individual tree size differentiation and MMD.We recommend that comparisons of spatial structures between communities would be more effective if using a unified MMD criterion.

Intravitreal injection practice patterns among Chinese ophthalmologists

AIM:To describe the practice patterns of intravitreal injections(IVIs)among ophthalmologists in China.METHODS:This was a cross-sectional online survey.Ophthalmologists who had performed accumulated more than 100 injections were contacted by the Brightness Center,a hospital-based national network,to complete an anonymous,24-question,internet-based survey.They were surveyed on practices in injection techniques,pre-,and post-injections procedures.RESULTS:A total of 333 ophthalmologists from 28 provinces/municipalities/autonomous regions responded to the survey(50.68%response rate).The 91.29%of the respondents evaluated systemic risk factors by medical history,electrocardiogram(ECG)and blood test.All the respondents used pre-injection prophylactic antibiotics.Most checked intraocular pressure(IOP,99.1%)and blood pressure(96.1%)before injections.A majority of the respondents performed injections in the operating room(98.8%),wore masks(99.7%),gloves(99.4%)and sterile surgical clothing(96.1%),performed topical anesthetics(97.9%),and applied povidone-iodine(95.8%)pre-injection.The 61.26%of the respondents dilated pupil.About half of the respondents(51.05%)performed bilateral injections in the same setting.Superior temporal quadrant(40.54%)was the most frequent site of injection.Around three quarters used 30-gauge needles.Most respondents(97.9%)measured the site of injection from limbus.More than half(53.45%)performed conjunctiva displacement prior to injection.The 32.43%of the respondents checked IOP post-injection and 87.99%physicians checked hand motion(HM)or counting fingers(CF)after injection,while 36.94%observed optic nerve perfusion.All participants used topical antibiotics post-injections.Most physicians(91.89%)reviewed patients on the following day.CONCLUSION:This study provides a description of the real-world practice patterns in IVIs in China and offers critical information regarding education and training of ophthalmologists and amendment of local society guidelines.

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.