Development status of novel spectral imaging techniques and application to traditional Chinese medicine

Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and reliable means for evaluating the efficacy and quality of TCM.Because spectral techniques are noninvasive,convenient,and sensitive,they have been widely applied to in vitro and in vivo TCM evaluation systems.In this paper,previous achievements and current progress in the research on spectral technologies(including fluorescence spectroscopy,photoacoustic imaging,infrared thermal imaging,laser-induced breakdown spectroscopy,hyperspectral imaging,and surface enhanced Raman spectroscopy)are discussed.The advantages and disadvantages of each technology are also presented.Moreover,the future applications of spectral imaging to identify the origins,components,and pesticide residues of TCM in vitro are elucidated.Subsequently,the evaluation of the efficacy of TCM in vivo is presented.Identifying future applications of spectral imaging is anticipated to promote medical research as well as scientific and technological explorations.

Bioactive Components of Chinese Herbal Medicines in the Treatment of Glucose and Lipid Metabolism Disorders:Evidence and Potential Mechanisms

Disturbed cholesterol and glucose homeostasis play crucial roles in the development of various diseases such as cardiovascular diseases,cerebrovascular diseases,central nervous system diseases,and cancer.An increasing number of studies have shown that excessive body fat accumulation is associated with type 2 diabetes or insulin resistance in a vicious cycle.This vicious cycle promotes the occurrence and development of the aforementioned diseases.Therefore,stabilizing the blood lipids and blood glucose of patients is the predominant strategy for improving the symptoms of patients with cardiovascular,cerebrovascular,and central nervous system diseases.Traditional Chinese medicine,mainly Chinese herbal medicine(CHM),has a history of more than 2000 years in China,which has established a unique theory and accumulated a great wealth of clinical experience.Moreover,CHM has been widely used in China and other countries for the treatment of cardiovascular and cerebrovascular diseases,with the advantages of preventing and curing hyperlipidemia,diabetes,hypertension,and other diseases.However,the use of CHM in Western countries remains rather limited,partly because of the incomplete understanding of multiple complex components and uncertain pharmacological mechanisms.Herein,we review and discuss the benefits,molecular mechanisms,and clinical research progress of bioactive components of CHM and their preparations as therapeutics for hyperlipidemia and hyperglycemia.

High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross- sectional survey

Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare workers.Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues,as well as the social,workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic.Methods A nationwide,voluntary,anonymous,single timepoint,online survey was conducted between 27 August and 23 October 2020.Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate.Participants were recruited through health organisations,professional associations or colleges,universities,government contacts and national media.Demographics,home and work situation,health and psychological well-being data were collected.Results A total of 9518 survey responses were received;of the 9518 participants,7846(82.4%)participants reported complete data.With regard to age,4110(52.4%)participants were younger than 40 years;6344(80.9%)participants were women.Participants were nurses(n=3088,39.4%),doctors(n=2436,31.1%),allied health staff(n=1314,16.7%)or in other roles(n=523,6.7%).In addition,1250(15.9%)participants worked in primary care.Objectively measured mental health symptoms were common:mild to severe anxiety(n=4694,59.8%),moderate to severe burnout(n=5458,70.9%)and mild to severe depression(n=4495,57.3%).Participants were highly resilient(mean(SD)=3.2(0.66)).Predictors for worse outcomes on all scales included female gender;younger age;pre-existing psychiatric condition;experiencing relationship problems;nursing,allied health or other roles;frontline area;being worried about being blamed by colleagues and working with patients with COVID-19.Conclusions The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers.Crisis preparedness together with policies and practices addressing psychological well-being are needed.

Accessing acute medical care to protect health: the utility of community treatment orders

Background The conclusion that people with severe mental llness require involuntary care to protect their health(including threats due to physical-nonpsychiatric-illness)is challenged by findings indicating that they often lack access to general healthcare and the assertionthat theywould access suchcarevoluntarily if available and effective.Victoria,Australia's single-payer healthcare system provides accessible medical treatment;therefore,it is an excellent context in which to test these challenges.AimsThis study replicates aprevious investigation in considering whether,in Australia's easy-access singlepayer healthcare system,patients placed on community treatment orders,specifically involuntary community treatment,are more likelyto access acute medical care addressing potentially life-threatening physical illnesses than voluntary patients with and without severe mental illness.Methods Replicating methods used in 2000-2010,for the years 2010-2017,this study compared the acute medical care access of three new cohorts:7826 hospitalised patientswith severemental illnesswho received a post-hospitalisation,community treatment order;13896 patients with severe mental illness released from the hospital without a community treatment order and 12101outpatients who were never psychiatrically hospitalised(individuals with less morbidity risk who were not considered to have severe mental llness)during periods when they were under versus outside community mental health supervision.Logistic regression was used to determine the influence of community-based community mental health supervision and the type of community mental health supervision(community treatment order vs non-community treatment order)on the likelihood of receiving an initial diagnosis of a life-threatening physical illness requiringacutecare.Results Validating their shared elevated morbidity risk,43.7%and 46.7%,respectively,of each hospitalised cohort(community treatment order and non-community treatment order patients)accessed an initial acute-care diagnosis for a life-threatening condition vs 26.3%of outpatients.Outside community mental health supervision,the likelihood that a community treatment order patient would receive a diagnosis of physical illness was 36%lower than non-community treatment order patients-1.30 times that of outpatients.Under community mental health supervision,their likelihood was two times greater than that of non-community treatment order patients and 6.6 times that of outpatients.Each community treatment order episode was associated with a 14.6% increasein the likelihood of a community treatment order patient receiving a diagnosis.The results replicate those found in an independent 2000-2010 cohort comparison.Conclusions Community mental health supervision,notably community treatment order supervision,in two independent investigations overtwodecades appeared to facilitate access to physical healthcare in acute care settings for patients with severe mental illness who were refusing treatmenta group that has been subject to excess morbidity and mortality.

Amyloid-beta and tau protein beyond Alzheimer's disease

The aggregation of amyloid-beta peptide and tau protein dysregulation are implicated to play key roles in Alzheimer's disease pathogenesis and are considered the main pathological hallmarks of this devastating disease.Physiologically,these two proteins are produced and expressed within the normal human body.However,under pathological conditions,abnormal expression,posttranslational modifications,conformational changes,and truncation can make these proteins prone to aggregation,triggering specific disease-related cascades.Recent studies have indicated associations between aberrant behavior of amyloid-beta and tau proteins and various neurological diseases,such as Alzheimer's disease,Parkinson's disease,and amyotrophic lateral sclerosis,as well as retinal neurodegenerative diseases like Glaucoma and age-related macular degeneration.Additionally,these proteins have been linked to cardiovascular disease,cancer,traumatic brain injury,and diabetes,which are all leading causes of morbidity and mortality.In this comprehensive review,we provide an overview of the connections between amyloid-beta and tau proteins and a spectrum of disorders.

Does playing a sports active video game improve object control skills of children with autism spectrum disorder?

Background: Active video games(AVGs) encourage whole body movements to interact or control the gaming system, allowing the opportunity for skill development. Children with autism spectrum disorder(ASD) show decreased fundamental movement skills in comparison with their typically developing(TD) peers and might benefit from this approach. This pilot study investigates whether playing sports AVGs can increase the actual and perceived object control(OC) skills of 11 children with ASD aged 6–10 years in comparison to 19 TD children of a similar age.Feasibility was a secondary aim.Methods: Actual(Test of Gross Motor Development) and perceived OC skills(Pictorial Scale of Perceived Movement Skill Competence for Young Children) were assessed before and after the intervention(6 × 45 min).Results: Actual skill scores were not improved in either group. The ASD group improved in perceived skill. All children completed the required dose and parents reported the intervention was feasible.Conclusion: The use of AVGs as a play-based intervention may not provide enough opportunity for children to perform the correct movement patterns to influence skill. However, play of such games may influence perceptions of skill ability in children with ASD, which could improve motivation to participate in physical activities.

Do medical students studying in the United Kingdom have an adequate factual knowledge of basic life support?

BACKGROUND: Healthcare professionals have a duty to maintain basic life support(BLS) skills. This study aims to evaluate medical students' factual knowledge of BLS and the training they receive.METHODS: A cross-sectional, closed-response questionnaire was distributed to the fi rst-and fourth-year students studying at institutions in the United Kingdom. The paper questionnaire sought to quantify respondent's previous BLS training, factual knowledge of the BLS algorithm using five multiple choice questions(MCQs), and valuate their desire for further BLS training. Students received 1 point for each correctly identifi ed answer to the 5 MCQ's.RESULTS: A total of 3,732 complete responses were received from 21 medical schools. Eighty percent(n=2,999) of students completed a BLS course as part of their undergraduate medical studies. There was a signifi cant difference(P<0.001) in the percentage of the fourth-year students selecting the correct answer in all the MCQ's compared to the fi rst-year students except in identifyingthe correct depth of compressions required during CPR(P=0.095). Overall 10.3%(95% CI 9.9% to 10.7%) of respondents correctly identified the answer to 5 MCQ's on BLS: 9% of the first-year students(n=194) and 12% of the fourth-year students(n=190). On an institutional level the proportion of students answering all MCQ's correctly ranged from 2% to 54% at different universities. Eighty-one percent of students(n=3,031) wished for more BLS training in their curriculum.CONCLUSION: Factual knowledge of BLS is poor among medical students in the UK. There is a disparity in standards of knowledge across institutions and respondents indicating that they would like more training.

High-flow oxygen via oxygenating mouthguard in short upper gastrointestinal endoscopy:A randomised controlled trial

BACKGROUND Anaesthetic care during upper gastrointestinal(GI)endoscopy has the unique challenge of maintaining ventilation and oxygenation via a shared upper airway.Supplemental oxygen is recommended by international society guidelines,however,the optimal route or rate of oxygen delivery is not known.Various oxygen delivery devices have been investigated to improve oxygenation during upper GI endoscopy,however,these are limited by commercial availability,costs and in some cases,the expertise required for insertion.Anecdotally at our centre,higher flows of supplemental oxygen can safely be delivered via an oxygenating mouthguard routinely used during upper GI endoscopic procedures.AIM To assess the incidence of hypoxaemia(SpO2<90%)in patients undergoing upper GI endoscopy receiving supplemental oxygen using an oxygenating mouthguard at 20 L/min flow compared to standard nasal cannula(SNC)at 2 L/min flow.METHODS A single centre,prospective,randomised clinical trial at two sites of an Australian tertiary hospital between October 2020 and September 2021 was conducted.Patients undergoing elective upper gastrointestinal endoscopy under deep sedation were randomised to receive supplemental oxygen via high-flow via oxygenating mouthguard(HFMG)at 20 L/min flow or SNC at 2 L/min flow.The primary outcome was the incidence of hypoxaemia of any duration measured by pulse oximetry.Intraprocedural-related,procedural-related,and sedation-related adverse events and patient-reported outcomes were also recorded.RESULTS Three hundred patients were randomised.Eight patients were excluded after randomisation.292 patients were included in the intention-to-treat analysis.The incidence of hypoxaemia was significantly reduced in those allocated HFMG.Six patients(4.4%)allocated to HFMG experienced an episode of hypoxaemia,compared to thirty-four(22.1%)patients allocated to SNC(P value<0.001).No significant difference was observed in the rates of adverse events or patient-reported outcome measures.CONCLUSION The use of HFMG offers a novel approach to reducing the incidence of hypoxaemia during short upper gastrointestinal endoscopic procedures in low-risk patients undergoing deep sedation.

Acceptability,usefulness,and satisfaction with a web-based video-tailored physical activity intervention:The TaylorActive randomized controlled trial

Purpose:This study aimed to examine the usage,acceptability,usability,perceived usefulness,and satisfaction of a web-based video-tailored physical activity(PA)intervention(TaylorActive)in adults.Methods:In 2013-2014,501 Australian adults aged 18+years were randomized into a video-tailored intervention,text-tailored intervention,or control group.Over 3 months,the intervention groups received access to 8 sessions of personally tailored PA advice delivered via the TaylorActive website.Only the delivery method differed between the intervention groups:video-tailored vs.text-tailored.Google Analytics and telephone surveys conducted at post intervention(3 months)were used to assess intervention usage,acceptability,usability,perceived usefulness,and satisfaction.Quantitative and qualitative process data were analyzed using descriptive statistics and thematic content analysis.Results:Of 501 recruited adults,259 completed the 3-month post-intervention survey(52%retention).Overall,usage of the TaylorActive website with respect to number of website visits,intervention sessions,and action plans completed was modest in both the video-tailored(7.6士7.2 visits,mean±SD)and text-tailored(7.3±5.4 visits)groups with no significant between-group differences.The majority of participants in all groups used the TaylorActive website less than once in 2 weeks(66.7%video-tailored,62.7%text-tailored,87.5%control;p<0.001).Acceptability was rated mostly high in all groups and in some instances,significantly higher in the intervention groups compared to the control group(p<0.010).Usability was also rated high;mean Systems Usability Scores were 77.3(video-tailored),75.7(text-tailored),and 74.1(control)with no significant between-group differences.Perceived usefulness of the TaylorActive intervention was low,though mostly rated higher in the intervention groups compared to the control group(p<0.010).Satisfaction with the TaylorActive website was mixed.Participants in both intervention groups liked its ease of use,personalized feedback,and tracking of progress,but also found completing action plans and survey questions for each session repetitive and tedious.Conclusion:Providing personally tailored PA advice on its own(through either video or text)is likely insufficient to ensure good retention,usage,perceived usefulness,and satisfaction with a web-based PA intervention.Strategies to address this may include the incorporation of additional intervention components such as activity trackers,social interactions,gamification,as well as the use of advanced artificial intelligence and machine learning technologies to allow more personalized dialogue with participants.

加强人畜(禽)共患传染病的预防和控制

1 新世纪人畜(禽)共患传染病疫情聚焦[1] 世界上已经证实的新老人畜(禽)共患传染病有200余种.2001年以来,WHO确认了1 100多起具有全球影响的传染病,其中超过70%是人畜(禽)共患传染病.2001年1-4月刚果(金)共报告143例埃博拉出血热,死亡128例,病死率89%,大猩猩和森林羚羊是传染源.同年8月埃及开罗北部暴发裂谷热,委内瑞拉西部和几内亚暴发黄热病.……

全球行动,抗击热带寄生虫(体)病

2006年10月26日,WHO及其伙伴组织在华盛顿发布了一项新策略:全球动员、群策群力,共同抗击吞噬穷人生命与健康、又被人们忽视的热带寄生虫(体)病.本文对有关资料进行综述.……

基于MRI和血流动力学仿真的主动脉缩窄计算机辅助诊断系统

目前用于心脑血管系统疾病的计算机辅助诊断系统比较少,本研究基于参加欧盟FP7 euHeart项目所做的工作,以对主动脉缩窄的处理为例,介绍一个基于核磁共振成像(MRI)和血流动力学计算的心脑血管疾病计算机辅助诊断系统,对系统的结构、功能和工作流程进行详细描述。该系统以患者病变血管的MRI图像和在颈动脉和股动脉处测得的血压波形为输入信息,通过图像处理模块、生理数据处理模块、计算网格生成模块以及流体动力学计算模块对这些数据进行分析处理,输出跨缩窄段的压差以辅助评估对患者进行干预手术的必要性,并输出病变血管段的流速分布、剪切应力分布等血流状态信息用于估算血流异常对血管内皮以及血细胞造成潜在机械损伤的程度。以一个典型病例的处理结果为例,对所开发的系统进行初步测试,结果表明所开发的系统运行结果准确可靠。本系统对于开发其他心脑血管疾病计算机辅助诊断系统具有借鉴意义。

Koena, a Novel Compound That Dampens Inflammation in the Skin

Inflammatory skin diseases are characterized by the activation of the innate and adaptive immune system via the production of pro-inflammatory cytokines. The main proinflammatory cytokines responsible for this development include TNF-alpha, Interleukin 1, 6 and 17, also the transcription factor NF-kappa B. Small molecule anti-inflammatory compounds such as those detailed in the paper, show much promise in dealing with these skin disorders. Four nutraceutical molecules that are well characterized by their capacity to interact with many of the pro-inflammatory cytokines, importantly IL-17, are found in an Australian product, Koena. Koena has been shown to not only decrease these cytokines but also help increase the production of Interleukin 10 and important anti-inflammatory cytokines. This paper reports clinical benefits of Koena in a variety of circumstances;eczema and psoriasis;insect bites and sting;solar damaged skin and keratosis. An analysis of patient/purchaser reviews via the website Koena.com.au to ascertain what condition they purchased the product for, if any, and the satisfaction rating after use. More than 35% of reviewers reported purchasing Koena to help with inflamed skin. Those reporting being satisfied with the result was 95% for this use. This paper reports on the benefit of small molecule anti-inflammatories in modulating and not blocking an immune response. It also illustrates the benefits of multitherapy when dealing with complex inflammatory responses as opposed to monotherapy.

Promises and pitfalls of targeted agents in chronic lymphocytic leukemia

Targeted agents have significantly improved outcomes for patients with chronic lymphocytic leukemia,particularly high-risk subgroups for whom chemoimmunotherapy previously offered limited efficacy.Two classes of agent in particular,the Bruton tyrosine kinase inhibitors(e.g.,ibrutinib)and the B-cell lymphoma 2 inhibitor,venetoclax,induce high response rates and durable remissions in the relapsed/refractory and frontline settings.However,maturing clinical data have revealed promises and pitfalls for both agents.These drugs induce remissions and disease control in the majority of patients,often in situations where modest efficacy would be expected with traditional chemoimmunotherapy approaches.Unfortunately,in the relapsed and refractory setting,both agents appear to be associated with an inevitable risk of disease relapse and progression.Emerging patterns of resistance are being described for both agents but a common theme appears to be multiple sub-clonal drivers of disease progression.Understanding these mechanisms and developing effective and safe methods to circumvent the emergence of resistance will determine the longer-term utility of these agents to improve patients’quality and length of life.Rational drug combinations,optimised scheduling and sequencing of therapy will likely hold the key to achieving these important goals.

Effectiveness of Frequent Viral Load Testing Plus Additional Interventions to Prevent HIV Transmission in Heterosexual,Serodiscordant Couples—Yunnan Province,China,2019-2021

Summary What is already known about this topic?HIV transmission among serodiscordant couples remains a persistent issue in China.However,the practice of combining counseling with antiretroviral therapies(ART)to enhance ART adherence is not widely implemented or recommended in Chinese health guidelines.What is added by this report?

Light at night and lung cancer risk:A worldwide interdisciplinary and time-series study

Background:Light at night(LAN)has become a concern in interdisciplinary research in recent years.This global interdisciplinary study aimed to explore the exposure-lag-response association between LAN exposure and lung cancer incidence.Methods:LAN data were obtained from the Defense Meteorological Satellite Program’s Operational Linescan System.Data of lung cancer incidence,socio-demographic index,and smoking prevalence of populations in 201 countries/territories from 1992 to 2018 were collected from the Global Burden of Disease Study.Spearman correlation tests and population-weighted linear regression analysis were used to evaluate the correlation between LAN exposure and lung cancer incidence.A distributed lag nonlinear model(DLNM)was used to assess the exposure-lag effects of LAN exposure on lung cancer incidence.Results:The Spearman correlation coefficients were 0.286-0.355 and the population-weighted linear regression correlation coefficients were 0.361-0.527.After adjustment for socio-demographic index and smoking preva-lence,the Spearman correlation coefficients were 0.264-0.357 and the population-weighted linear regression correlation coefficients were 0.346-0.497.In the DLNM,the maximum relative risk was 1.04(1.02-1.06)at LAN exposure of 8.6 with a 2.6-year lag time.After adjustment for socio-demographic index and smoking prevalence,the maximum relative risk was 1.05(1.02-1.07)at LAN exposure of 8.6 with a 2.4-year lag time.Conclusion:High LAN exposure was associated with increased lung cancer incidence,and this effect had a specific lag period.Compared with traditional individual-level studies,this group-level study provides a novel paradigm of effective,efficient,and scalable screening for risk factors.

Emodin alleviates cardiac fibrosis by suppressing activation of cardiac fibroblasts via upregulating metastasis associated protein 3

Excess activation of cardiac fibroblasts inevitably induces cardiac fibrosis. Emodin has been used as a natural medicine against several chronic diseases. The objective of this study is to determine the effects of emodin on cardiac fibrosis and the underlying molecular mechanisms. Intragastric administration of emodin markedly decreased left ventricular wall thickness in a mouse model of pathological cardiac hypertrophy with excess fibrosis induced by transaortic constriction(TAC) and suppressed activation of cardiac fibroblasts induced by angiotensin II(AngII). Emodin upregulated expression of metastasis associated protein 3(MTA3) and restored the MTA3 expression in the setting of cardiac fibrosis. Moreover, overexpression of MTA3 promoted cardiac fibrosis;in contrast, silence of MTA3 abrogated the inhibitory effect of emodin on fibroblast activation. Our findings unraveled the potential of emodin to alleviate cardiac fibrosis via upregulating MTA3 and highlight the regulatory role of MTA3 in the development of cardiac fibrosis.

Should I take aspirin?A qualitative study on the implementation of a decision aid on taking aspirin for bowel cancer prevention

Objectives Australian guidelines recommend 50-70 years consider taking aspirin to reduce their bowel cancer risk.We trialled a decision aid in general practice to facilitate the implementation of these guidelines into clinical practice.This publication reports on the qualitative results from the process evaluation of the trial.We aimed to explore general practitioners’(GPs)and their patients’approach to shared decision-making(SDM)about taking aspirin to prevent bowel cancer and how the decision aids were used in practice.Methods Semistructured interviews were conducted with 17 participants who received the decision aid and 12 GPs who participated in the trial between June and November 2021.The interviews were coded inductively,and emerging themes were mapped onto the Revised Programme Theory for SDM.Results The study highlighted the dynamics of SDM for taking aspirin to prevent bowel cancer.Some participants discussed the decision aid with their GPs as advised prior to taking aspirin,others either took aspirin or dismissed it outright without discussing it with their GPs.Notably,participants’trust in their GPs,and participants’diverse worldviews played pivotal roles in their decisions.Although the decision aid supported SDM for some,it was not always prioritised in a consultation.This was likely impacted during the trial period as the COVID-19 pandemic was the focus for general practice.Conclusion In summary,this study illustrated the complexities of SDM through using a decision aid in general practice to implement the guidelines for low-dose aspirin to prevent bowel cancer.While the decision aid prompted some participants to speak to their GPs,they were also heavily influenced by their unwavering trust in the GPs and their different worldviews.In the face of the COVID-19 pandemic,SDM was not highly prioritised.This study provides insights into the implementation of guidelines into clinical practice and highlights the need for ongoing support and prioritisation of cancer prevention in general practice consultations.

Tricking the tumour microenvironment into becoming our best rational drug design factory:reversal of immune suppression

The immune cellular components of the tumour microenvironment are a diverse group of cells that paradoxically are now appreciated to have a coordinated opposing duality of either promoting or retarding tumour growth.Manipulating this seemingly dynamic interaction for therapeutic benefit is a hotbed of much research.Recent findings in tumour immunology(both preclinical and clinical)build on more than a century of insights and provide a way forward to improving patient outcomes,long term survival and the predictability of“cures”.This opinion piece attempts to summarise some of these historical and contemporary insights with a view to describing eminently testable therapeutic solutions.

Identification of novel loci influencing refractive error in East Asian populations using an extreme phenotype design

The global "myopia boom" has raised significant international concerns. Despite a higher myopia prevalence in Asia, previous large-scale genome-wide association studies(GWASs) were mostly based on European descendants. Here, we report a GWAS of spherical equivalent(SE) in 1852 Chinese Han individuals with extreme SE from Guangzhou(631 <-6.00 D and 574 > 0.00 D) and Wenzhou(593 <-6.00 D and54 >-1.75 D), followed by a replication study in two independent cohorts with totaling 3538 East Asian individuals. The discovery GWAS and meta-analysis identify three novel loci, which show genome-wide significant associations with SE, including 1 q25.2 FAM163 A, 10 p11.22 NRP1/PRAD3, and 10 p11.21 ANKRD30 A/MTRNR2 L7, together explaining 3.34% of SE variance. 10 p11.21 is successfully replicated.The allele frequencies of all three loci show significant differences between major continental groups(P < 0.001). The SE reducing(more myopic) allele of rs10913877(1 q25.2 FAM163 A) demonstrates the highest frequency in East Asians and much lower frequencies in Europeans and Africans(EAS = 0.60,EUR = 0.20, and AFR = 0.18). The gene-based analysis additionally identifies three novel genes associated with SE, including EI24, LHX5, and ARPP19. These results provide new insights into myopia pathogenesis and indicate the role of genetic heterogeneity in myopia epidemiology among different ethnicities.