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PURPOSE: Investigations into the correction of presbyopia have considered lens design, clinical implications and the development of objective metrics such as the visual Strehl ratio. This study investigated the Jacobi-Fourier phase mask as an ophthalmic element in the correction of presbyopia. The goal was to develop a contact or intraocular lens whose performance was largely insensitive to changes in pupil diameter. METHODS: Numerical simulations based on Fourier optics were performed to evaluate three different Jacobi-Fourier polynomials, with the aim of providing a range of clear vision (1 Dioptre (D)). Performance was evaluated for three pupil sizes (6, 4 and 2 mm), while polychromatic images were simulated using three different wavelengths (656.3, 587.6 and 486.1 nm). The Neural Transfer function was included in the simulation. To validate the method and results, we used the Visual Strehl combined objective metric (VSCombined) currently used in visual optics. This metric gives more weight to the phase transfer function and is more suitable for non-symmetrical phase functions. RESULTS: Numerical validation showed the suitability of the Jacobi-Fourier phase masks for extending the range of clear vision of presbyopic eyes, providing a visual acuity of at least 0.10 logMAR (6/7.5 Snellen) at all distances between 1 and 6 m. The results show a range of clear vision of 1D was not affected by changes in pupil size, an increase in retinal image contrast accompanied by image artefact reduction by increasing the radial order of the Jacobi-Fourier phase mask and a reduction of wavelength dependence of the retinal images. These results are supported by simulated images and the objective criterion VSCombined. CONCLUSIONS: The use of Jacobi-Fourier phase masks as ophthalmic elements for presbyopic correction show promising results, with a good range of clear vision and reduced dependence on pupil size and chromatic aberration.

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Purposes: The magnesium alloy bionic cannulated screw (MABCS) was designed in a previous study promoting cortical-cancellous biphasic healing of femoral neck fractures. The main purpose was to analyze the bore diameters that satisfy the torsion standards and further analyze the optimal pore and implantation direction for stabilizing femoral neck fractures. Methods: The MABCS design with bionic holes with a screw diameter of less than 20% met the torsion standard for metal screws. The MABCS was utilized to repair the femoral neck fracture via Abaqus 6.14 software, which simulated the various stages of fracture healing to identify the optimal biomechanical environment for bionic hole size (5%, 10%, 15%, and 20%) and implantation direction (0°, 45°, 90°, and 135°). Results: The stress distribution of the MABCS fracture fixation model is significantly improved with an implantation orientation of 90°. The MABCS with a bionic hole and a screw diameter of 10% provides optimal stress distribution compared with the bionic cannulated screw with diameters of 5%, 15%, and 20%. In addition, the cannulated screw fixation model with a 10% bionic hole size has optimal bone stress distribution and better internal fixation than the MABCS fixation models with 5%, 15%, and 20% screw diameters. Conclusion: In summary, the MABCS with 10% screw diameter bionic holes has favorable biomechanical characteristics for stabilizing femoral neck fractures. This study provides a biomechanical foundation for further optimization of the bionic cannulated screw.

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BACKGROUND: The Impella 5.5® is commonly inserted via the axillary artery (AX) in patients with cardiogenic shock. The right AX has traditionally been preferred to avoid crossing the aortic arch, and a minimum diameter of 7 mm has been recommended to accommodate the device (21 Fr). There is limited data on choice of laterality of access and AX size required, both in terms of technicality of the procedure as well as outcomes. METHODS: We performed a single-center retrospective cohort analysis of patients who underwent Impella 5.5® implantation between December 2020 and February 2024 (N = 75). Data including demographics and outcomes were stratified both by diameter (small, <7 mm vs. normal, ≥7 mm) and laterality of access (right vs. left). Adverse events included stroke, limb ischemia, procedural bleeding or infection, and unplanned explant due to complications. Delivery time was defined as time from advancing the first wire to activation of the device. RESULTS: AX approach was attempted in all (N = 74) but one requiring innominate access, with a technical success rate of 95.9% (N = 71/74). The mean age was 58.8 ± 13.3 years, with 81.1% males. The median delivery time was 7.0 (25th, 75th percentiles: 4.0, 11.5) min with a median support duration of 13 (7.7, 24) days. Ten patients (13.5%) had a small AX, with a mean diameter of 6.3 ± 0.5 mm and were more likely to be younger compared to the normal AX group. Fifty-nine patients (79.7%) had insertion via the right AX. Median delivery time was comparable across all groups (small, 5.4 [3.5, 10.9] vs. normal, 7 [4.0, 12.1] min, p = 0.59) and (right, 10.4 [5.3, 15.2] vs. left, 6 [3.7, 10.4] min, p = 0.35). There was no difference between the rates of stroke, ischemia, bleeding, or infection when comparing by size or laterality. Survival to discharge was 59.5%, with 21.1% mortality on support, all in patients with a normal AX diameter, but with no difference between right versus left. CONCLUSION: In our study, laterality and a small diameter of AX access did not affect outcomes of Impella 5.5®, with a similar safety profile.

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Transthoracic echocardiography is widely used in intensive care unit (ICU) to manage patients with acute circulatory failure. Recently, automated ultrasound (US) measurement applications have been developed but their clinical performance has not been evaluated yet. The aim of this study was to assess the agreement between automated and manual measurements of the velocity-time integral in the left ventricular outflow tract (VTI-LVOT) using the auto-VTI® tool. This prospective, single-center, interventional study included ICU patients with acute circulatory failure. The examination involved two successive manual measurements of VTI-LVOT (mean of 3 consecutive heartbeats in regular sinus rhythm, and 5 heartbeats in irregular rhythm), followed by a measurement using auto-VTI® software. In patients receiving a fluid challenge, trending ability in detecting fluid responsiveness was also evaluated. Seventy patients were included between January 19, 2020, and September 24, 2020, at the Nîmes University Hospital. The feasibility of the auto-VTI® was 94%. The mean difference between the two methods was 11% with limits of agreement from - 19% to 42%. The proportion of agreement at the 15% difference threshold was 68% [58%; 80%]. The precision and least significant change measured for the manual measurement of VTI were 7.4 and 10.5%, respectively, and by inference for the automated method 28% and 40%. The new auto-VTI® tool, despite interesting feasibility, demonstrated an insufficient agreement with a systematic bias and an insufficient precision limiting its implementation in critically ill patients.Clinical trial registration: ClinicalTrials.gov identifier: NCT04360304.

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OBJECTIVES: Type A acute aortic dissection (TAAAD) is a life-threatening condition often requiring emergency surgery, with approximately 30% of patients needing reoperation. This study aimed to identify predictors of long-term aortic events from early postoperative computed tomography (CT) examinations. METHODS: A total of 336 cases underwent TAAAD surgery at two institutions between 2002 and 2018. Of these, 302 patients received CT examinations immediately after initial TAAAD surgery. Predictors of aortic events were evaluated from these early postoperative CT exams. Aortic events were defined as any events involving aortic-related death, open surgery, reoperation, endovascular stenting, or thoracic aorta diameter enlargement to ≥ 55 mm. RESULTS: Excluding 34 in-hospital deaths (10.1%; 34/336), the 1-, 5-, and 10-year actuarial survival rates after primary TAAAD surgery were 98.2%, 88.6%, and 81.7%, respectively. Over a mean follow-up period of 7.4 ± 5.1 years, 67 aortic events (proximal: 19, distal: 45, both: 3) were observed. Freedom from proximal aortic events was 98.6%, 93.9%, and 85.2% at 1, 5, and 10 years, respectively. Proximal anastomosis new entry was identified as a significant risk factor for aortic events, with a 92% vs. 42% incidence at 10 years (p < 0.001). Freedom from distal aortic events was 99.6%, 84.5%, and 67.2% at 1, 5, and 10 years, respectively. A false/true area ratio greater than 1 and distal anastomosis new entry were significant risk factors for aortic events (low-risk group: 83.3% vs. high-risk group: 42.3% at 10 years, p < 0.001). CONCLUSIONS: Detailed analysis of early postoperative CT scans following primary TAAAD surgery may help identify predictors of subsequent aortic events, potentially improving long-term patient management and outcomes.

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Changes in vapour pressure deficit (VPD) can lead to the depletion and replenishment of stem water pools to buffer water potential variations in the xylem. Yet, the precise velocity at which stem water pools track environmental cues remains poorly explored. Nine eucalyptus seedlings grown in a glasshouse experienced high-frequency environmental oscillations, and their stem radial variations (ΔR) were monitored at a 30-second temporal resolution in upper and lower stem locations and on the bark and xylem. The stem ΔR response to VPD changes was nearly instantaneous (< 1 minute), while temperature lagged behind stem ΔR. No temporal differences in the stem ΔR response were observed between locations. Punctual gravimetric measurements confirmed the synchrony between transpiration and stem ΔR dynamics. These results indicate (i) that stem-stored water can respond to the atmospheric evaporative demand much faster than commonly assumed and (ii) that the origin of the water released to the transpiration stream seems critical in determining time lags in stem water pool dynamics. Near-zero time lags may be explained by the high elasticity of eucalyptus woody tissues and the predominant water use from the xylem, circumventing the hydraulic radial barriers to water flow from/to the outer tissues.

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The small-diameter high-speed submersible permanent magnet synchronous motor (SHS-PMSM) is essential equipment for rodless oil and gas extraction in slimhole wells and high-water content oil wells. The SHS-PMSM typically operates for extended periods of time underground in high temperatures. Because of its compact size, the heat is difficult to dissipate, which increases the risk of motor overheating and damage. In order to accurately predict temperature, the method of magnetic-heat-flow multiphysics bidirectional coupling is studied in this paper. A SHS-PMSM with an outer diameter of ø89mm is taken as the object, and its copper loss, friction loss and convective heat transfer coefficient are studied by analytical derivation. The relationship between them and temperature are expressed by functions which can be compiled into User-Defined Functions (UDFs) as variable during the calculation process of finite volume method. Both coupling calculations and experiments are conducted. The temperature calculated by magnetic-heat-flow bidirectional connection is higher than that produced by the conventional method and more in line with experimental results after the results of both simulations and experiments are carried out and compared. The accuracy of the magnetic-heat-flow bidirectional coupling method is verified and the design basis of temperature for SHS-PMSM can be provided.

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This study evaluated the influence of the apical limit and the diameter of the instrumentation on the extrusion of the irrigating solution. Sixty human lower premolars were distributed into 5 groups according to the apical limit and diameter of the root canal instrumentation (n = 12): (G-140) R40 instrument 1 mm above the tooth length (TL) (Control); (G-150) R50 instrument 1 mm above the TL; (GF25) R25 instrument at the TL; (GF40) R40 instrument at the root canal length and (GF50) R50 instrument at the TL. A space of 33.5 ± 1 mm3 was created for storage of the extruded solution. Omnipaque contrast was added to the NaOCl solution in a 1:2 ratio, totaling 15 mL of solution to allow its visualization when extruded in microcomputed tomography. Final irrigation was performed with a syringe and needle and activated with a passive ultrasonic irrigation (PUI). Three activation cycles were performed. Data were tabulated and statistically analyzed (one-way ANOVA) with a significance level set at 5%. It was observed irrigating solution extrusion after final irrigation in all groups. However, there were no statistically significant differences among experimental groups, regardless of the diameter or apical limit of root canal instrumentation (p > 0.05). The different apical limits and diameters of root canal instrumentation did not influence the volume of extruded irrigating solution using passive ultrasonic irrigation.

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A high vascular patency was realized in the bulk or surface heparinized small-diameter in situ tissue-engineered vascular grafts (TEVGs) via a rabbit carotid artery replacement model in our previous studies. Those surface heparinized TEVGs could reduce the occurrence of aneurysms, but with a low level of the remodeled elastin, whereas those bulk heparinized TEVGs displayed a faster degradation and an increasing occurrence of aneurysms, but with a high level of the regenerated elastin. To combine the advantages of the bulk and surface graft heparinization to boost the remodeling of elastin and defer the occurrence of aneurysms, a coaxial electro-spinning technique was used to fabricate a kind of small-diameter core/shell fibrous structural in situ TEVGs with a faster degradable poly(lactic-co-glycolic acid) (PLGA) as a core layer and a relatively lower degradable poly(ε-caprolactone) (PCL) as a shell layer followed by the surface heparinization. The in vitro mechanical performance and enzymatic degradation tests revealed the resulting PLGA@PCL-Hep in situ TEVGs possessing not only a faster degradation rate, but also the mechanical properties comparable to those of human saphenous veins. After implanted in the rat abdominal aorta for 12 months, the good endothelialization, low inflammation, and no calcification were evidenced. Furthermore, the neointima layer of regenerated new blood vessels was basically constructed with a well-organized arrangement of elastin and collagen proteins. The results showed the great potential of these in situ TEVGs to be used as a novel type of long-term small-diameter vascular grafts.

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OBJECTIVE: To evaluate the predictive efficacy of the platelets-to-spleen diameter ratio (PSDR) for developing esophagogastric varices (EV) in patients with cirrhosis due to hepatitis B virus (HBV). METHODS: We conducted a retrospective cohort study using data from patients treated for HBV induced cirrhosis at Xi'an No. 3 Hospital, the Affiliated Hospital of Northwest University, from June 2020 to August 2023. Patients were categorized into two groups based on endoscopic evidence of EV: an EV group and a non-EV group. Clinical, sonographic, and hematological findings were compared within and between these groups. Stratified analyses based on the severity of varices were performed, and multivariate logistic regression was used to identify predictors of EV. Receiver Operating Characteristic (ROC) curve analysis assessed the diagnostic accuracy of PSDR in predicting EV. RESULTS: The study included 139 patients diagnosed with HBV induced cirrhosis, divided into an EV group (86 patients, with 48 low-risk and 38 high-risk) and a non-EV group (53 patients). Significant differences were found between the groups in several parameters: Child-Pugh classification, Child-Pugh score, portal vein diameter, hepatic vein deceleration index, spleen thickness, and PSDR (all P<0.001). These variables also varied significantly across the different risk categories within the EV group (all P<0.001). Multivariate logistic regression indicated PSDR as an independent predictor of EV development (Odds Ratio [OR]=3.569, 95% Confidence Interval [CI]: 0.970-1.001, P<0.001). ROC curve analysis showed that PSDR had an Area Under the Curve (AUC) of 0.865 (95% CI: 0.764-0.965) for predicting EV, with an optimal threshold of 1013.2, achieving 88.46% sensitivity and 69.23% specificity. For high-risk EV, PSDR showed an AUC of 0.763 (95% CI: 0.670-0.856), with a threshold of 883.5, sensitivity of 79.17%, and specificity of 54.17%. CONCLUSION: The PSDR is a significant risk marker and demonstrates strong predictive utility for both the presence and severity of EV in patients with HBV-induced cirrhosis. PSDR provides a valuable, non-invasive diagnostic tool for anticipating the development of EV in this patient population.

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Purpose: Primary surgery failure of macular holes causes poor visual acuity outcomes. Several studies indicate that small-medium idiopathic full-thickness macular holes (iFTMH) have consistent and high anatomical closure rates after vitrectomy and internal limiting membrane (ILM) peeling, regardless of iFTMH diameters. However, there is no systematic analysis examining the relationship between iFTMH diameters and anatomical closure rates. Methods: In this systematic review and meta-regression, we searched PubMed, Embase, and Web of Science databases on October 24th, 2022. We included studies regarding iFTMH, with ILM peeling/inverted flap technique, long-lasting gas tamponade, and face-down position after surgery. Univariable meta-regression with a restricted cubic spline model and component-plus-residual plot after covariables adjustment were used to explore non-linear association. Results: A total of 7257 participants from 19 randomized controlled trials and 49 observational studies were included in this meta-analysis. In ILM peeling group, every 100-µm increment in diameter was associated with a 3.8 % (95 % confidence interval [CI], 1.8%-5.7 %, P < 0.001) relatively lower anatomical closure rate. Yet, among studies using the inverted flap technique, baseline iFTMH diameter was not associated with a lower anatomical closure rate (0.2 %, 95%CI, -4.2 %-4.5 %, P > 0.9). The restricted cubic spline model and component-plus-residual plot controlling for age, sex, and symptom duration prior to surgery showed no evident non-linearity in both surgical techniques. Conclusions: The iFTMH diameter is linear and inversely associated with the anatomical closure rate after the ILM peeling technique, but not with the inverted flap technique. The present study supports the use of advanced techniques, e.g., inverted flap technique, in small-medium iFTMH to improve anatomical closure rates.

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BACKGROUND: Neuromonitoring in medical intensive care units is challenging as most patients are unfit for invasive intracranial pressure (ICP) modalities or unstable to transport for imaging. Ultrasonography-based optic nerve sheath diameter (ONSD) is an attractive option as it is reliable, repeatable and easily performed at the bedside. It has been sufficiently validated in traumatic brain injury (TBI) to be incorporated into the guidelines. However, currently the data for non-TBI patients is inconsistent for a scientific recommendation to be made. AIM: To compile the existing evidence for understanding the scope of ONSD in measuring ICP in adult non-traumatic neuro-critical patients. METHODS: PubMed, Google Scholar and research citation analysis databases were searched for studies in adult patients with non-traumatic causes of raised ICP. Studies from 2010 to 2024 in English languages were included. RESULTS: We found 37 articles relevant to our search. The cutoff for ONSD in predicting ICP varied from 4.1 to 6.3 mm. Most of the articles used cerebrospinal fluid opening pressure followed by raised ICP on computed tomography/magnetic resonance imaging as the comparator parameter. ONSD was also found to be a reliable outcome measure in cases of acute ischaemic stroke, intracerebral bleeding and intracranial infection. However, ONSD is of doubtful utility in septic metabolic encephalopathy, dysnatremias and aneurysmal subarachnoid haemorrhage. CONCLUSION: ONSD is a useful tool for the diagnosis of raised ICP in non-traumatic neuro-critically ill patients and may also have a role in the prognostication of a subset of patients.

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BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) is the definitive therapy of choice for abdominal aortic aneurysms worldwide. However, current literature regarding the anatomic changes in the common femoral artery (CFA) post-PEVAR is sparse and contradictory, and a significant proportion of these studies did not control for the potential confounding effects of ethnicity. Thus, this study aims to investigate the anatomical effects of PEVAR on the CFA using an Asian study cohort. METHODS: Between January 2019 and September 2023, the records of 113 patients who received PEVAR were reviewed. Groins with previous surgical interventions were excluded. The most proximate pre- and postoperative CT angiography of patients receiving PEVAR via the Perclose ProGlide™ Suture-Mediated Closure System were retrospectively analysed for changes in both the CFA inner luminal diameter (ID) and outer diameter (OD), the latter also encompassing the arterial walls. Access site complications within 3 months post-PEVAR were also recorded per patient. RESULTS: One hundred seventeen groins from 60 patients were included in this study, with 1 report of pseudoaneurysm. The CFA ID exhibited a 0.167 mm decrease (p-value = 0.0403), while the OD decreased by 0.247 mm (p-value = 0.0107). This trend persisted when the data was separately analysed with the common cardiovascular risk factors of diabetes mellitus, hypertension and hyperlipidaemia. CONCLUSION: Our analysis demonstrated a statistically significant decrease in the CFA diameters post-PEVAR. However, the percentage changes were below established flow-limiting values, as reflected by the single access site complication reported. Hence, our findings give confidence in the safety profile of this procedure, even with the reported smaller baseline CFA lumen size in Asians. Moving forward, similar longer-term studies should be considered to characterise any late postoperative effects.

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In order to address the problem of poor localization in electrochemical machining (ECM), a coaxial megasonic assisted jet ECM method was proposed. Based on theoretical analysis, experiments were conducted to compare the effects of various electrolyte flow rates, electrolytic voltage and megasonic power levels on pit ECM. The results indicate that, in the range of experimental parameters, the increase of electrolyte flow rate and megasonic power can increase the machining depth, so as to improve the depth-diameter ratio of ECM pits. The use of coaxial megasonic-assisted jet ECM can enhance the depth-diameter ratio of etched pits compared to the without megasonic one. When applying a megasonic power of 22 W, the dimensions of the ECM pit were measured as 0.81 mm in depth and 5.73 mm in diameter, resulting in an depth-diameter ratio of 0.140. Under the same conditions, without megasonic assistance, the pit diameter is reduced to 0.65 mm while the pit depth increases to 6.36 mm, resulting in a depth-diameter ratio of 0.102. Additionally, The results also demonstrate that, the increase of electrolytic voltage makes the depth to diameter ratio of pit further increase on the original basis. With an electrolyte flow rate of 0.9 L/min and a megasonic power of 22 W, the use of electrolysis voltage of 50 V increased the depth-diameter ratio of etched pits to 0.173. Using the above preferred parameters, electrolytic milling of the wide groove is carried out. The depth-diameter ratio of the wide groove is increased from 0.039 to 0.059 by appending coaxial megasonic. This further verified the effectiveness of the coaxial megasonic-assisted jet ECM method.

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Investigating the quantity and spatiotemporal dynamics of metabolite release from plant roots is essential if we are to understand the ecological significance of root exudates in the rhizosphere; however, this is difficult to quantify. In the present study, we quantified in situ root exudation rates during three incubation periods (0-24, 24-48, and 48-72 h) and fine roots within four diameter ranges (<0.8, 0.8-1.0, 1.0-1.2, and 1.2-2.0 mm), and also measured nine morphological traits in the fine roots of Pinus massoniana. Higher root carbon (C) exudation rates were detected during the 0-24 h period. During the 0-24 h and 24-48 h periods, nitrogen (N) uptake rates were higher than N exudation rates, while during the 48-72 h period, N exudation rates exceeded uptake rates. As C exudation increased during 0-48h incubation period, the uptake of N tended to level out. We concluded that the 24-48 h incubation period was the most suitable for capturing root exudates from P. massoniana. The exudation of C from the roots was positively associated with root mass, length, surface area, volume, the number of root tips, and the root tissue density, when incubated for 0-24 h and 24-48 h. Furthermore, length-specific C exudation rates, along with N exudation and uptake rates, all increased as the diameter of the fine roots increased. The release of root exudates could be efficiently predicted by the fine root morphological traits, although the accuracy of prediction depended on the incubation period. Higher values for fine root morphological traits were generally indicative of higher nutrient requirements and tissue investment, as well as higher C exudation rates.

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OBJECTIVE: Late adverse events (LAE) are common among initially uncomplicated type B aortic dissection (uTBAD), however, identifying those patients at highest risk of LAE remains a significant challenge. Early false lumen (FL) growth has been suggested to increase risk, but confident determination of growth is often hampered by error in 2D clinical measurements. Semi-automated 3D mapping of aortic growth, such as by vascular deformation mapping (VDM), can potentially overcome this limitation using CT angiograms (CTA). We hypothesized that FL growth in the early pre-dissection phase by VDM can accurately predict LAEs. METHODS: We performed a two-centre retrospective study of uTBAD patients, with paired CTAs in the acute (1-14 days) and subacute/early chronic (1-6 months) periods. VDM analysis was used to map 3D growth. Standard clinical CT measures (i.e., aortic diameters, tear characteristics) were also collected. Multivariate analysis was conducted using a decision tree and Cox proportional hazards model. LAEs were defined as aneurysmal FL (>55mm); rapid growth (>5mm within 6 months); aorta-specific mortality, rupture, or re-dissection. RESULTS: 107 (69% male) initially uTBAD patients met inclusion criteria with a median follow-up of 7.3 (IQR 4.7-9.9) years. LAEs occurred in 72 patients (67%) at 2.5 (IQR 0.7-4.8) years after the initial event. A multivariate decision tree model identified VDM growth (>2.1 mm) and baseline diameter (>42.7 mm) as optimal predictors of LAEs (AUC-ROC = 0.94), achieving an 87% accuracy (sensitivity of 93%, specificity of 76%) after leave-one-out validation. Guideline reported high-risk features were not significantly different between groups. CONCLUSION: Early growth of the FL in uTBAD was the best tested indicator for LAEs and improves upon the current gold-standard of baseline diameter in selecting patients for early prophylactic TEVAR.

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BACKGROUND AND OBJECTIVES: To assess the agreement between Anterion AS-OCT and three optical devices in measuring the white-to-white (WTW) diameter in candidates for refractive surgery. METHODS: In this cross-sectional prospective study, 129 right eyes of 129 normal individuals underwent consecutive scans with the Anterion, the Pentacam AXL, the IOLMaster 700, and the Orbscan IIz. Mean difference (MD), 95% limits of agreement (LoA), and concordance correlation coefficient (CCC) were calculated to assess agreement and interchangeability. RESULTS: The mean age of participants was 30.4 ± 5.9 (range: 21-47) years. The mean WTW distance measured by the different instruments was as follows: 12.00 ± 0.42 mm (range, 10.57 to 13.05) using the Anterion, 11.87 ± 0.34 (11.10 to 12.80) using the Pentacam, 12.12 ± 0.44 (11.00 to 13.30) using the IOLMaster, and 11.73 ± 0.37 (11.00 to 13.10) using the Orbscan. The MD and 95% LoA for Anterion vs. Pentacam, IOLMaster, or Orbscan were [0.11; -0.31 to 0.54 mm], [-0.13; -0.93 to 0.66], and [0.25; -0.28 to 0.78], respectively. The corresponding CCCs were 0.803, 0.514, and 0.631. CONCLUSIONS: This study found weak agreement between Anterion and Pentacam AXL, IOLMaster 700, and Orbscan IIz devices regarding WTW distance measurements in refractive surgery candidates. Therefore, it is not recommended to use Anterion's WTW measurements interchangeably with the other three devices, particularly for phakic intraocular lens sizing.

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PURPOSE: This study aimed to compare the effect of intravitreal aflibercept (IVA) and ranibizumab (IVR) on the maximal diameter of the largest intraretinal cyst (mdIRC), indicating chronicity in patients with diabetic cystoid macular edema (CME). METHODS: This retrospective, comparative study included a subgroup of patients from the MARMASIA Study with treatment-naïve diabetic CME who had IVA (IVA group) or IVR (IVR group) on a pro re nata regimen after a loading dose of 3-monthly injections and followed-up for 24 months. Best-corrected visual acuity (logMAR), central macular thickness (CMT, µm), and mdIRC (µm) and their changes during the study period in the IVA and IVR groups were compared. RESULTS: A total of 175 eyes (65 [37.1%] in IVA and 110 [62.9%] in IVR group) of 113 patients were included in the study analysis. Both groups had statistically significant improvements in BCVA and CMT during the follow-up (p < 0.05 for all), which were comparable between the groups at each time point. However, the mean reduction in mdIRCs was consistently and significantly higher in the IVA group compared to the IVR group at each follow-up examination (F[1, 3.52] = 6.93, p = 0.009). CONCLUSION: IVA seems to have a greater impact in reducing cyst sizes than IVR in diabetic CME.

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OBJECTIVE: We explored the use of ultrasonography in determining the minimal transverse diameter of the subglottic airway (MTDSA) for the purpose of choosing an appropriate model of reinforced cuffed endotracheal tube. METHODS: A total of 110 pediatric patients who received general anesthesia and tracheal intubation for selective surgeries at the hospital from February 2019 to February 2022 were chosen. They were then randomly assigned to three groups: 39 in the MTDSA group, 35 in the age formula group, and 36 in the height formula group. We assessed how accurately the appropriate endotracheal tube model was predicted in each group and compared their predictive performance. RESULTS: The age range of the enrolled pediatric patients was 3-6 years old. The ultrasonic measurement method demonstrated a prediction accuracy of 87.18%, while the age formula method and height formula method exhibited lower accuracy rates of 54.29% and 47.22%, respectively. Notably, the ultrasonic measurement method outperformed the other two methods significantly (P < 0.05). In the MTDSA group, 2 patients had their catheters changed during anesthesia, and the proportion of patients who changed their catheters was 5.13%. In the MTDSA group, 6 catheters were replaced, and the frequency of catheter replacement was 15.38%. In contrast, these percentages were much higher in the age formula group, at 31.43% and 45.71%, and in the height formula group, at 36.11% and 52.78%. The latter two groups had significantly higher values than the MTDSA group (P < 0.05). Regarding complications such as hoarseness, laryngeal edema, aspiration, and laryngospasm, the MTDSA group experienced a notably lower total incidence of 7.69% compared to the 37.14% in the age formula group and 41.67% in the height formula group, demonstrating statistical significance (P < 0.05). CONCLUSION: The ultrasonic measurement technique employed in MTDSA exhibits impressive precision when it comes to forecasting the specific model of a reinforced cuffed endotracheal tube for pediatric patients. This enhanced accuracy contributes significantly to minimizing the need for tube replacements during anesthesia and the associated complications. It holds immense importance in assisting clinicians in selecting the most appropriate pediatric endotracheal tube model for anesthesia induction.

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Coronary artery bypass grafting is acknowledged as a major clinical approach for treatment of severe coronary artery atherosclerotic heart disease. This procedure typically requires autologous small-diameter vascular grafts. However, the limited availability of the donor vessels and associated trauma during tissue harvest underscore the necessity for artificial arterial alternatives. Herein, decellularized bovine intercostal arteries were successfully fabricated with lengths ranging from 15 to 30 cm, which also closely match the inner diameters of human coronary arteries. These decellularized arterial grafts exhibited great promise following poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC) grafting from the inner surface. Such surface modification endowed the decellularized arteries with superior mechanical strength, enhanced anticoagulant properties and improved biocompatibility, compared to the decellularized bovine intercostal arteries alone, or even those decellularized grafts modified with both heparin and vascular endothelial growth factor. After replacement of the carotid arteries in rabbits, all surface-modified vascular grafts have shown good patency within 30 days post-implantation. Notably, strong signal was observed after α-SMA immunofluorescence staining on the PMPC-grafted vessels, indicating significant potential for regenerating the vascular smooth muscle layer and thereby restoring full structures of the artery. Consequently, the decellularized bovine intercostal arteries surface modified by PMPC can emerge as a potent candidate for small-diameter artificial blood vessels, and have shown great promise to serve as viable substitutes of arterial autografts.