Background Stroke-induced transient immune suppression is believed to contribute to post-stroke infections.Theβ-adrenergic receptor antagonist,propranolol,has been shown to prevent stroke-associated pneumonia(SAP)via...Background Stroke-induced transient immune suppression is believed to contribute to post-stroke infections.Theβ-adrenergic receptor antagonist,propranolol,has been shown to prevent stroke-associated pneumonia(SAP)via reversing post-stroke immunosuppression in preclinical studies and in retrospective analysis in stroke patients.However,whether propranolol can reduce the risk of SAP has not been tested in prospective,randomised controlled trials.Aim To describe the rationale and design of a multicentre,prospective,open-label,endpoint-blinded,randomised controlled study to evaluate the safety and efficacy of propranolol hydrochloride injection for the prevention of SAP in patients with intracerebral haemorrhage(ICH)(PROCHASE).Design In this investigator-initiated trial,we compare the safety of the standard medical treatment to standard medical treatment plus intravenous propranolol hydrochloride administration(5 mg daily on days 1–7)in patients with ICH and the efficacy of this intervention to reduce the occurrence of SAP.All patients will be followed up for 90±7 days.Study outcomes The primary efficacy outcome is SAP within 7±1 days diagnosed by the defined algorithm based on a diagnosis of SAP recommendations from the pneumonia in stroke consensus group.The primary safety outcome is defined as severe or moderate bradycardia within 7±1 days.The secondary outcome is a modified Rankin score of 0–3 at 90±7 days after randomisation.Discussion The PROCHASE trial aims to generate clinical evidence regarding the safety and efficacy of propranolol in preventing SAP in patients with ICH.展开更多
Recent advances in deep learning have significantly improved image deblurring;however,existing approaches still suffer from limited global context modeling,inadequate detail restoration,and poor texture or edge percep...Recent advances in deep learning have significantly improved image deblurring;however,existing approaches still suffer from limited global context modeling,inadequate detail restoration,and poor texture or edge perception,especially under complex dynamic blur.To address these challenges,we propose the Multi-Resolution Fusion Network(MRFNet),a blind multi-scale deblurring framework that integrates progressive residual connectivity for hierarchical feature fusion.The network employs a three-stage design:(1)TransformerBlocks capture long-range dependencies and reconstruct coarse global structures;(2)Nonlinear Activation Free Blocks(NAFBlocks)enhance local detail representation and mid-level feature fusion;and(3)an optimized residual subnetwork based on gated feature modulation refines texture and edge details for high-fidelity restoration.Extensive experiments demonstrate that MRFNet achieves superior performance compared to state-of-the-art methods.On GoPro,it attains 32.52 dB Peak Signal-to-Noise Ratio(PSNR)and 0.071 Learned Perceptual Image Patch Similarity(LPIPS),outperforming MIMOWNet(32.50 dB,0.075).On HIDE,it achieves 30.25 dB PSNR and 0.945 Structural Similarity Index Measure(SSIM),representing gains of+0.26 dB and+0.015 SSIM over MIMO-UNet(29.99 dB,0.930).On RealBlur-J,it reaches 28.82 dB PSNR and 0.872 SSIM,surpassing MIMO-UNet by+1.19 dB and+0.035 SSIM(27.63 dB,0.837).These results validate the effectiveness of the proposed progressive residual fusion and hybrid attention mechanisms in balancing global context understanding and local detail recovery for blind image deblurring.展开更多
This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,post...This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,postoperative follow-up data,and a review of the pathological mechanisms of ocular injury caused by bee venom,this study comprehensively assesses the injury characteristics,treatment course,and visual outcomes.Bee venom induces severe complications such as corneal damage,uveitis,cataract,and secondary glaucoma through multiple mechanisms including direct cytotoxicity,immune-inflammatory responses,and enzymatic hydrolysis.Despite interventions including anterior chamber irrigation,phacoemulsification with intraocular lens implantation,and antiglaucoma surgery,the affected eye ultimately lost light perception.Forensic examination confirmed the absence of light perception in the left eye and abnormal visual pathway function,consistent with clinical observations.According to the relevant Chinese disability assessment standard(JR/T 0083-2013,Article 4.2.2),the injury was classified as grade 7 disability.This study provides an in-depth discussion of the mechanisms and key forensic identification points in bee-sting-induced blindness,offering a scientific reference for similar forensic clinical cases.展开更多
Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system di...Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.展开更多
When Dachung Wochen,a 35-year-old blind Tibetan,walks in the bustling streets of Lhasa,capital of the Xizang Autonomous Region,with his guide dog Fuju,people are amazed by their tacit cooperation.Fuju helps his master...When Dachung Wochen,a 35-year-old blind Tibetan,walks in the bustling streets of Lhasa,capital of the Xizang Autonomous Region,with his guide dog Fuju,people are amazed by their tacit cooperation.Fuju helps his master navigate every obstacle on the road.After spending only a year with him,he understands most of his commands in Tibetan.Dachung Wochen's journey with the four-year-old canine began in April 2024.After 28 days of professional training at the China Guide Dog Training Center in Dalian,Liaoning Province,Dachung,as he is called by friends and family,took Fuju to Xizang by air and rail.展开更多
The GRACE(Gravity Recovery and Climate Experiment)space mission recorded temporal variation characteristics of the global gravity field at decadal timescales.The gravity data have been shown to capture the dynamics of...The GRACE(Gravity Recovery and Climate Experiment)space mission recorded temporal variation characteristics of the global gravity field at decadal timescales.The gravity data have been shown to capture the dynamics of flows within the outer core and their effects on the core-mantle boundary.We first aim to remove global surface process gravity signals from the GRACE data.We then construct the global core magnetic field according to the CHAOS-7 model.Finally,we apply the blind source separation method to decompose the processed gravity signals and core magnetic signals and compute the power spectral density of the gravity and magnetic field signals by using the Lomb-Scargle periodogram approach.We have discovered a signal cycle(of~6 years)in the principal components of the core magnetic and gravity signals,potentially as a result of deep Earth processes.The main principal components of the core magnetic and gravity signals reveal that the variation trends in the second-order time derivative of the core magnetic field are similar to those in the gravity field.After 2014,the second-order time derivative of the core magnetic field exhibited linear and rapid change characteristics,which were the same as the change in the gravity field and are consistent with existing research results.展开更多
Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Ret...Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Retinal ganglion cell(RGC) degeneration occurs in blinding diseases such as glaucoma and other optic neuropathies.展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.展开更多
AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,C...AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,China.METHODS:A population-based,cross-sectional study was performed using the Rapid Assessment of Avoidable Blindness technique.Eight-seven clusters,each consisting of 50 people aged≥50y,were selected by probabilityproportionate-to-size sampling.Three outreach teams conducted door-to-door visits.Visual acuity(VA)was measured using a tumbling E chart.Lens status and causes of VI were assessed by ophthalmologists for individuals with a VA of<6/12 in either eye.A standardized questionnaire was used to collect information about cataract surgeries.RESULTS:Of 4350 eligible individuals,4120 were examined with a 94.7%response rate.Age-and genderadjusted prevalence of blindness,SVI,and VI were 0.5%(95%CI,0.3%–0.7%),0.7%(95%CI,0.4%–1.0%),and 4.8%(95%CI,4.2%–5.5%),respectively.Age was associated with an increased prevalence of VI,and the most common cause of VI was untreated cataracts,with the main barriers to cataract surgery being a lack of knowledge or awareness about cataracts.Of the 415 eyes operated on for cataracts,68(16.4%)eyes had a poor outcomes(VA<6/60)and 303(73.0%)had a good outcomes(VA>6/18).CONCLUSION:Prevalence rates of blindness,SVI,and VI in Yueqing are lower than other reported Chinese population-based studies.Cataracts remain the most common cause of blindness and VI.展开更多
Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a...Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.展开更多
This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system ci...This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system circuit is designed and fabricated,enabling the detection,acquisition,and calibration of weak solar-blind UV signals.Experimental results demonstrate that under zero bias conditions,with a UV light power density of 3.45μW/cm^(2) at 260 nm,the sample achieves a peak responsivity(R)of 0.085 A·W^(−1),an external quantum efficiency(EQE)of 40.7%,and a detectivity(D^(*))of 7.46×10^(12) cm·Hz^(1/2)·W^(−1).The system exhibits a bandpass characteristic within the 240–280 nm wavelength range,coupled with a high signal-to-noise ratio(SNR)of 39.74 dB.展开更多
My parents and I lived upstairs over my aged and infirm paternal grandparents.All of us helped make the grandparentsday⁃to⁃day lives as comfortable as possible.But Granny was gradually going blind and Gramps suffered ...My parents and I lived upstairs over my aged and infirm paternal grandparents.All of us helped make the grandparentsday⁃to⁃day lives as comfortable as possible.But Granny was gradually going blind and Gramps suffered from the effects of two strokes(中风).Grannys mind was sharp.展开更多
Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concern...Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concerns about data security and personal privacy protection. To alleviate these concerns, blind signature technology has emerged as an effective method to solve blindness and unforgeability. Unfortunately, most existing blind signature schemes suffer from the security risk of key leakage. In addition, traditional blind signature schemes are also vulnerable to quantum computing attacks. Therefore, it remains a crucial and ongoing challenge to explore the construction of key-secure, quantum-resistant blind signatures. In this paper, we introduce lattice-based forward-secure blind signature (LFSBS), a lattice-based forward-secure blind signature scheme for medical privacy preservation in BIoMT. LFSBS achieves forward security by constructing a key evolution mechanism using a binary tree structure. This mechanism ensures that even if future encryption keys are leaked, past data can still remain secure. Meanwhile, LFSBS realizes post-quantum security based on the hardness assumption of small integer solution (SIS), making it resistant to potential quantum computing attacks. In addition, we formally define and prove the security of LFSBS in a random oracle model, including blindness and forward-secure unforgeability. Comprehensive performance evaluation shows that LFSBS performs well in terms of computational overhead, with a reduction of 22%–73% compared to previous schemes.展开更多
Dogs make great pets,and some are also good workers.Some dogs help blind people.They lead blind people around and help them get to places safely.Police dogs help officers.They can find bad guys or look for drugs and o...Dogs make great pets,and some are also good workers.Some dogs help blind people.They lead blind people around and help them get to places safely.Police dogs help officers.They can find bad guys or look for drugs and other dangerous things.展开更多
The effect of gradient exhaust strategy and blind plate installation on the inhibition of backflow and thermal stratification in data center cabinets is systematically investigated in this study through numericalmetho...The effect of gradient exhaust strategy and blind plate installation on the inhibition of backflow and thermal stratification in data center cabinets is systematically investigated in this study through numericalmethods.The validated Re-Normalization Group(RNG)k-ε turbulence model was used to analyze airflow patterns within cabinet structures equipped with backplane air conditioning.Key findings reveal that server-generated thermal plumes induce hot air accumulation at the cabinet apex,creating a 0.8℃ temperature elevation at the top server’s inlet compared to the ideal situation(23℃).Strategic increases in backplane fan exhaust airflow rates reduce server 1’s inlet temperature from 26.1℃(0%redundancy case)to 23.1℃(40%redundancy case).Gradient exhaust strategies achieve equivalent server temperature performance to uniform exhaust distributions while requiring 25%less redundant airflow.This approach decreases the recirculation ratio from1.52%(uniformexhaust at 15%redundancy)to 0.57%(gradient exhaust at equivalent redundancy).Comparative analyses demonstrate divergent thermal behaviors:in bottom-server-absent configurations,gradient exhaust reduces top server inlet temperatures by 1.6℃vs.uniformexhaust,whereas top-serverabsent configurations exhibit a 1.8℃ temperature increase under gradient conditions.The blind plate implementation achieves a 0.4℃ top server temperature reduction compared to 15%-redundancy uniform exhaust systems without requiring additional airflow redundancy.Partially installed server arrangements with blind plates maintain thermal characteristics comparable to fully populated cabinets.This study validates gradient exhaust and blind plate technologies as effective countermeasures against cabinet-scale thermal recirculation,providing actionable insights for optimizing backplane air conditioning systems in mission-critical data center environments.展开更多
Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study...Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.展开更多
BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and...BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]展开更多
The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing...The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.展开更多
In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, differen...In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, different from that in the 4G LTE system, the cyclic redundancy check(CRC) in polar decoding plays both error correction and error detection roles. Consequently, the false alarm rates(FAR) may not meet the system requirements(FAR<1.52 × 10^(−5)). In this paper, to mitigate the FAR in polar code blind detection, we attach a binary classifier after the polar decoder to further remove the false alarm results and meanwhile retain the correct DCI. This classifier works by tracking the squared Euclidean distance ratio(SEDR) between the received signal and hypothesis. We derive an analytical method to fast compute proper classification threshold that is implementation-friendly in practical use. Combining the well-designed classifier, we show that some very short CRC sequences can even be used to meet the FAR requirements. This consequently reduces the CRC overhead and contributes to the system error performance improvements.展开更多
AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve under...AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.展开更多
文摘Background Stroke-induced transient immune suppression is believed to contribute to post-stroke infections.Theβ-adrenergic receptor antagonist,propranolol,has been shown to prevent stroke-associated pneumonia(SAP)via reversing post-stroke immunosuppression in preclinical studies and in retrospective analysis in stroke patients.However,whether propranolol can reduce the risk of SAP has not been tested in prospective,randomised controlled trials.Aim To describe the rationale and design of a multicentre,prospective,open-label,endpoint-blinded,randomised controlled study to evaluate the safety and efficacy of propranolol hydrochloride injection for the prevention of SAP in patients with intracerebral haemorrhage(ICH)(PROCHASE).Design In this investigator-initiated trial,we compare the safety of the standard medical treatment to standard medical treatment plus intravenous propranolol hydrochloride administration(5 mg daily on days 1–7)in patients with ICH and the efficacy of this intervention to reduce the occurrence of SAP.All patients will be followed up for 90±7 days.Study outcomes The primary efficacy outcome is SAP within 7±1 days diagnosed by the defined algorithm based on a diagnosis of SAP recommendations from the pneumonia in stroke consensus group.The primary safety outcome is defined as severe or moderate bradycardia within 7±1 days.The secondary outcome is a modified Rankin score of 0–3 at 90±7 days after randomisation.Discussion The PROCHASE trial aims to generate clinical evidence regarding the safety and efficacy of propranolol in preventing SAP in patients with ICH.
基金funded by Qinghai University Postgraduate Research and Practice Innovation Program of Funder,grant number 2025-GMKY-42.
文摘Recent advances in deep learning have significantly improved image deblurring;however,existing approaches still suffer from limited global context modeling,inadequate detail restoration,and poor texture or edge perception,especially under complex dynamic blur.To address these challenges,we propose the Multi-Resolution Fusion Network(MRFNet),a blind multi-scale deblurring framework that integrates progressive residual connectivity for hierarchical feature fusion.The network employs a three-stage design:(1)TransformerBlocks capture long-range dependencies and reconstruct coarse global structures;(2)Nonlinear Activation Free Blocks(NAFBlocks)enhance local detail representation and mid-level feature fusion;and(3)an optimized residual subnetwork based on gated feature modulation refines texture and edge details for high-fidelity restoration.Extensive experiments demonstrate that MRFNet achieves superior performance compared to state-of-the-art methods.On GoPro,it attains 32.52 dB Peak Signal-to-Noise Ratio(PSNR)and 0.071 Learned Perceptual Image Patch Similarity(LPIPS),outperforming MIMOWNet(32.50 dB,0.075).On HIDE,it achieves 30.25 dB PSNR and 0.945 Structural Similarity Index Measure(SSIM),representing gains of+0.26 dB and+0.015 SSIM over MIMO-UNet(29.99 dB,0.930).On RealBlur-J,it reaches 28.82 dB PSNR and 0.872 SSIM,surpassing MIMO-UNet by+1.19 dB and+0.035 SSIM(27.63 dB,0.837).These results validate the effectiveness of the proposed progressive residual fusion and hybrid attention mechanisms in balancing global context understanding and local detail recovery for blind image deblurring.
文摘This report presents a forensic evaluation of a case involving blindness(visual acuity grade 5)following a bee/wasp sting to the left eye.Through systematic analysis of the patient’s multiple hospital admissions,postoperative follow-up data,and a review of the pathological mechanisms of ocular injury caused by bee venom,this study comprehensively assesses the injury characteristics,treatment course,and visual outcomes.Bee venom induces severe complications such as corneal damage,uveitis,cataract,and secondary glaucoma through multiple mechanisms including direct cytotoxicity,immune-inflammatory responses,and enzymatic hydrolysis.Despite interventions including anterior chamber irrigation,phacoemulsification with intraocular lens implantation,and antiglaucoma surgery,the affected eye ultimately lost light perception.Forensic examination confirmed the absence of light perception in the left eye and abnormal visual pathway function,consistent with clinical observations.According to the relevant Chinese disability assessment standard(JR/T 0083-2013,Article 4.2.2),the injury was classified as grade 7 disability.This study provides an in-depth discussion of the mechanisms and key forensic identification points in bee-sting-induced blindness,offering a scientific reference for similar forensic clinical cases.
文摘Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.
文摘When Dachung Wochen,a 35-year-old blind Tibetan,walks in the bustling streets of Lhasa,capital of the Xizang Autonomous Region,with his guide dog Fuju,people are amazed by their tacit cooperation.Fuju helps his master navigate every obstacle on the road.After spending only a year with him,he understands most of his commands in Tibetan.Dachung Wochen's journey with the four-year-old canine began in April 2024.After 28 days of professional training at the China Guide Dog Training Center in Dalian,Liaoning Province,Dachung,as he is called by friends and family,took Fuju to Xizang by air and rail.
基金the National Natural Science Foundation of China(Grant Nos.42274003,41974007,and 41774019).
文摘The GRACE(Gravity Recovery and Climate Experiment)space mission recorded temporal variation characteristics of the global gravity field at decadal timescales.The gravity data have been shown to capture the dynamics of flows within the outer core and their effects on the core-mantle boundary.We first aim to remove global surface process gravity signals from the GRACE data.We then construct the global core magnetic field according to the CHAOS-7 model.Finally,we apply the blind source separation method to decompose the processed gravity signals and core magnetic signals and compute the power spectral density of the gravity and magnetic field signals by using the Lomb-Scargle periodogram approach.We have discovered a signal cycle(of~6 years)in the principal components of the core magnetic and gravity signals,potentially as a result of deep Earth processes.The main principal components of the core magnetic and gravity signals reveal that the variation trends in the second-order time derivative of the core magnetic field are similar to those in the gravity field.After 2014,the second-order time derivative of the core magnetic field exhibited linear and rapid change characteristics,which were the same as the change in the gravity field and are consistent with existing research results.
文摘Calcium (Ca^(2+)) is a key intracellular messenger involved in a variety of cellular functions.Intracellular Ca^(2+)dysregulation drives neuron cell death in multiple degenerative diseases and traumatic conditions.Retinal ganglion cell(RGC) degeneration occurs in blinding diseases such as glaucoma and other optic neuropathies.
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolites through metabolomics and other techniques is crucial for understanding their potential mechanisms.
基金Supported by Zhejiang Province Science and Technology Benefiting Project(No.2014H01007)Wenzhou Municipal Basic Research Project(No.Y20210208).
文摘AIM:To evaluate the prevalence and the causes of blindness,severe visual impairment(SVI),and visual impairment(VI)and to investigate the frequency of cataract surgery in people aged≥50y in Yueqing,Zhejiang Province,China.METHODS:A population-based,cross-sectional study was performed using the Rapid Assessment of Avoidable Blindness technique.Eight-seven clusters,each consisting of 50 people aged≥50y,were selected by probabilityproportionate-to-size sampling.Three outreach teams conducted door-to-door visits.Visual acuity(VA)was measured using a tumbling E chart.Lens status and causes of VI were assessed by ophthalmologists for individuals with a VA of<6/12 in either eye.A standardized questionnaire was used to collect information about cataract surgeries.RESULTS:Of 4350 eligible individuals,4120 were examined with a 94.7%response rate.Age-and genderadjusted prevalence of blindness,SVI,and VI were 0.5%(95%CI,0.3%–0.7%),0.7%(95%CI,0.4%–1.0%),and 4.8%(95%CI,4.2%–5.5%),respectively.Age was associated with an increased prevalence of VI,and the most common cause of VI was untreated cataracts,with the main barriers to cataract surgery being a lack of knowledge or awareness about cataracts.Of the 415 eyes operated on for cataracts,68(16.4%)eyes had a poor outcomes(VA<6/60)and 303(73.0%)had a good outcomes(VA>6/18).CONCLUSION:Prevalence rates of blindness,SVI,and VI in Yueqing are lower than other reported Chinese population-based studies.Cataracts remain the most common cause of blindness and VI.
基金supported by Science and Technology Planning Project of Guangzhou City(2024A04J4474).
文摘Objective:This study aimed to investigate the prevalence,causes,and influencing factors of vision impairment in the elderly population aged 60 years and above in Mangxin Town,Kashgar region,Xinjiang,China.Located in a region characterized by intense ultraviolet radiation and arid climatic conditions,Mangxin Town presents unique environmental challenges that may exacerbate ocular health issues.Despite the global emphasis on addressing vision impairment among aging populations,there remains a paucity of updated and region-specific data in Xinjiang,necessitating this comprehensive assessment to inform targeted interventions.Methods:A cross-sectional study was conducted from May to June 2024,involving 1,311 elderly participants(76.76%participation rate)out of a total eligible population of 1,708 individuals aged≥60 years.Participants underwent detailed ocular examinations,including assessments of uncorrected visual acuity(UVA)and best-corrected visual acuity(BCVA)using standard logarithmic charts,slit-lamp biomicroscopy,optical coherence tomography(OCT,Topcon DRI OCT Triton),fundus photography,and intraocular pressure measurement(Canon TX-20 Tonometer).A multidisciplinary team of 10 ophthalmologists and 2 local village doctors,trained rigorously in standardized protocols,ensured consistent data collection.Demographic,lifestyle,and medical history data were collected via questionnaires.Statistical analyses,performed using STATA 16,included multivariate logistic regression to identify risk factors,with significance defined as P<0.05.Results:The overall prevalence of vision impairment was 13.21%(95%CI:11.37%-15.04%),with low vision at 11.76%(95%CI:10.01%-13.50%)and blindness at 1.45%(95%CI:0.80%-2.10%).Cataract emerged as the leading cause,responsible for 68.20%of cases,followed by glaucoma(5.80%),optic atrophy(5.20%),and age-related macular degeneration(2.90%).Vision impairment prevalence escalated significantly with age:7.74%in the 60–69 age group,17.79%in 70–79,and 33.72%in those≥80.Males exhibited higher prevalence than females(15.84%vs.10.45%,P=0.004).Multivariate analysis revealed age≥80 years(OR=6.43,95%CI:3.79%-10.90%),male sex(OR=0.53,95%CI:0.34%-0.83%),and daily exercise(OR=0.44,95%CI:0.20%-0.95%)as significant factors.History of eye disease showed a non-significant trend toward increased risk(OR=1.49,P=0.107).Education level,income,and smoking status showed no significant associations.Conclusions:This study underscores cataract as the predominant cause of vision impairment in Mangxin Town’s elderly population,with age and sex as critical determinants.The findings align with global patterns but highlight region-specific challenges,such as environmental factors contributing to cataract prevalence.Public health strategies should prioritize improving access to cataract surgery,enhancing grassroots ophthalmic infrastructure,and integrating portable screening technologies for early detection of fundus diseases.Additionally,promoting health education on UV protection and lifestyle modifications,such as regular exercise,may mitigate risks.Future research should expand to broader regions in Xinjiang,employ advanced diagnostic tools for complex conditions like glaucoma,and explore longitudinal trends to refine intervention strategies.These efforts are vital to reducing preventable blindness and improving quality of life for aging populations in underserved areas.
基金supported by the Director’s Fund for the‘Climbing Plan’of the National Space Science Centre of the Chinese Academy of Sciences(No.E2PD10011S)the National Engineering Research Centre for Mobile Private Networks Project(No.BJTU20221102).
文摘This study begins with the fabrication and simulation of high-performance back-illuminated AlGaN-based solar-blind ultraviolet(UV)photodetectors.Based on the photodetectors,a low-noise,high-gain UV detection system circuit is designed and fabricated,enabling the detection,acquisition,and calibration of weak solar-blind UV signals.Experimental results demonstrate that under zero bias conditions,with a UV light power density of 3.45μW/cm^(2) at 260 nm,the sample achieves a peak responsivity(R)of 0.085 A·W^(−1),an external quantum efficiency(EQE)of 40.7%,and a detectivity(D^(*))of 7.46×10^(12) cm·Hz^(1/2)·W^(−1).The system exhibits a bandpass characteristic within the 240–280 nm wavelength range,coupled with a high signal-to-noise ratio(SNR)of 39.74 dB.
文摘My parents and I lived upstairs over my aged and infirm paternal grandparents.All of us helped make the grandparentsday⁃to⁃day lives as comfortable as possible.But Granny was gradually going blind and Gramps suffered from the effects of two strokes(中风).Grannys mind was sharp.
基金funded by the Yunnan Key Laboratory of Blockchain Application Technology(202105AG070005,202305AG340008)&YNB202301,NSFC(Grant Nos.72293583,72293580,62476007,62176273,62271234)the Open Foundation of State Key Laboratory of Networking and Switching Technology(Beijing University of Posts and Telecommunications)(SKLNST-2024-1-06)+2 种基金the Project of Science and Technology Major Project of Yunnan Province(202302AF080006)Open Foundation of State Key Laboratory of Public Big Data(Guizhou University)under Grant No.PBD2022-16Double First-Class Project for Collaborative Innovation Achievements inDisciplines Construction in Heilongjiang Province under Grant No.GXCG2022-054.
文摘Blockchain-enabled Internet of Medical Things (BIoMT) has attracted significant attention from academia and healthcare organizations. However, the large amount of medical data involved in BIoMT has also raised concerns about data security and personal privacy protection. To alleviate these concerns, blind signature technology has emerged as an effective method to solve blindness and unforgeability. Unfortunately, most existing blind signature schemes suffer from the security risk of key leakage. In addition, traditional blind signature schemes are also vulnerable to quantum computing attacks. Therefore, it remains a crucial and ongoing challenge to explore the construction of key-secure, quantum-resistant blind signatures. In this paper, we introduce lattice-based forward-secure blind signature (LFSBS), a lattice-based forward-secure blind signature scheme for medical privacy preservation in BIoMT. LFSBS achieves forward security by constructing a key evolution mechanism using a binary tree structure. This mechanism ensures that even if future encryption keys are leaked, past data can still remain secure. Meanwhile, LFSBS realizes post-quantum security based on the hardness assumption of small integer solution (SIS), making it resistant to potential quantum computing attacks. In addition, we formally define and prove the security of LFSBS in a random oracle model, including blindness and forward-secure unforgeability. Comprehensive performance evaluation shows that LFSBS performs well in terms of computational overhead, with a reduction of 22%–73% compared to previous schemes.
文摘Dogs make great pets,and some are also good workers.Some dogs help blind people.They lead blind people around and help them get to places safely.Police dogs help officers.They can find bad guys or look for drugs and other dangerous things.
基金financially supported by the Basic Research Funds for the Central Government“Innovative Team of Zhejiang University”under contract number(2022FZZX01-09).
文摘The effect of gradient exhaust strategy and blind plate installation on the inhibition of backflow and thermal stratification in data center cabinets is systematically investigated in this study through numericalmethods.The validated Re-Normalization Group(RNG)k-ε turbulence model was used to analyze airflow patterns within cabinet structures equipped with backplane air conditioning.Key findings reveal that server-generated thermal plumes induce hot air accumulation at the cabinet apex,creating a 0.8℃ temperature elevation at the top server’s inlet compared to the ideal situation(23℃).Strategic increases in backplane fan exhaust airflow rates reduce server 1’s inlet temperature from 26.1℃(0%redundancy case)to 23.1℃(40%redundancy case).Gradient exhaust strategies achieve equivalent server temperature performance to uniform exhaust distributions while requiring 25%less redundant airflow.This approach decreases the recirculation ratio from1.52%(uniformexhaust at 15%redundancy)to 0.57%(gradient exhaust at equivalent redundancy).Comparative analyses demonstrate divergent thermal behaviors:in bottom-server-absent configurations,gradient exhaust reduces top server inlet temperatures by 1.6℃vs.uniformexhaust,whereas top-serverabsent configurations exhibit a 1.8℃ temperature increase under gradient conditions.The blind plate implementation achieves a 0.4℃ top server temperature reduction compared to 15%-redundancy uniform exhaust systems without requiring additional airflow redundancy.Partially installed server arrangements with blind plates maintain thermal characteristics comparable to fully populated cabinets.This study validates gradient exhaust and blind plate technologies as effective countermeasures against cabinet-scale thermal recirculation,providing actionable insights for optimizing backplane air conditioning systems in mission-critical data center environments.
基金supported by grants from the National Natural Science Foundation of China(82000901,82171084).
文摘Background:Blindness and vision impairment(BVI)continue to pose significant global public health challenges,disproportionately impacting vulnerable populations and further widening socioeconomic disparities.This study conducts a comprehensive evaluation of the global burden of BVI and the socioeconomic inequalities in its distribution from 1990 to 2021,aiming to provide insights for targeted intervention strategies.Methods:Using data from Global Burden of Disease 2021,this study performed a multiscale analysis of BVI burden,examining patterns at the global,regional and national levels.We quantified the disease burden using disability-adjusted life years DALY and prevalence rates.Temporal trends were analyzed by calculating estimated annual percentage changes(EAPC).Stratified assessments were carried out by sex and age group across 21 regions and 204 countries.The study also included comparative analyses of six major eye conditions and evaluated their associations with socio-demographic index(SDI).Results:Globally,the age-standardized prevalence of BVI increased from 12,453.52 per million(95%UI:10,287.58-15,226.09)in 1990 to 15,784.33 per million(12,761.44-19,502.32)in 2021,with an EAPC of 1.09%(95%UI:0.97-1.20).During this period,global DALYs attributable to BVI increased by 37.7%.Disease trends exhibited significant divergence,with near vision loss showing the steepest increase(EAPC:1.47%),while the prevalence of glaucoma declined(EAPC:-0.73%).Geographic disparities were pronounced,with substantial improvements observed in Equatorial Guinea(EAPC:-1.75)and worsening burdens in Benin(+0.54).Disease distribution demonstrated strong regional clustering,with near vision loss being predominant in Sub-Saharan Africa(64.47%)and East Asia(50.97%),while cataract was the most common condition in Oceania(33.86%).Females consistently bore a higher burden,particularly in South Asia(646.3 vs 563.2 DALYs).Moreover,we identified a strong inverse correlation between SDI and BVI burden(Ρ=-0.772 for DALYs).Conclusions:This study highlights the severe global burden of BVI and the significant cross-country inequality,particularly in low-and middle-income countries.It emphasizes the urgent need for targeted interventions and the integration of eye care into universal health policies to promote global health equity in the post-pandemic era.
文摘BACKGROUND Globally,it’s estimated that at least 1 billion people have a near and/or distance vision impairment that could have been prevented or is yet to be addressed.The burden of unaddressed vision impairment and blindness is estimated to be four times higher in low and intermediate-resource settings than in high-income settings.[1]
文摘The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.
基金supported in part by National Natural Science Foundation of China(No.62471054)in part by National Natural Science Foundation of China(No.92467301)+3 种基金in part by the National Natural Science Foundation of China(No.62201562)in part by the National Natural Science Foundation of China(No.62371063)in part by the National Natural Science Foundation of China(No.62321001)in part by Liaoning Provincial Natural Science Foundation of China(No.2024–BSBA–51).
文摘In 5G new radio(NR), polar codes are adopted for e MBB downlink control channels where the blind detection is employed in user equipment(UE) to identify the correct downlink control information(DCI). However, different from that in the 4G LTE system, the cyclic redundancy check(CRC) in polar decoding plays both error correction and error detection roles. Consequently, the false alarm rates(FAR) may not meet the system requirements(FAR<1.52 × 10^(−5)). In this paper, to mitigate the FAR in polar code blind detection, we attach a binary classifier after the polar decoder to further remove the false alarm results and meanwhile retain the correct DCI. This classifier works by tracking the squared Euclidean distance ratio(SEDR) between the received signal and hypothesis. We derive an analytical method to fast compute proper classification threshold that is implementation-friendly in practical use. Combining the well-designed classifier, we show that some very short CRC sequences can even be used to meet the FAR requirements. This consequently reduces the CRC overhead and contributes to the system error performance improvements.
文摘AIM:To identify risk factors for postoperative blindness in patients with primary rhegmatogenous retinal detachment(RRD)at their first presentation to a tertiary center,using a large clinical database to improve understanding of this adverse outcome.METHODS:Electronic health records of patients with primary RRD from the Eye Hospital of Wenzhou Medical University were retrospectively analyzed.Postoperative blindness was defined according to the World Health Organization(WHO)criteria for legal blindness.Potential risk factors included demographic characteristics,preoperative clinical features,and surgical variables.Univariable and multivariable logistic regression analyses were performed to calculate odds ratios(ORs)and 95%confidence intervals(CIs)for each risk factor.RESULTS:A total of 532 patients were included in the cohort,of whom 62(12.0%;28 males,34 females)developed postoperative blindness at the final follow-up.Among these 62 patients,30 had high myopia and 32 did not.The mean age of participants was 49.0±16.4y,with 275 subjects(52%)being male and 133 patients(25%)having the condition in the right eye.In the multivariable model for all patients,the following factors were associated with an increased risk of postoperative blindness:higher preoperative logarithm of the minimum angle of resolution visual acuity(logMAR VA;OR=1.09 per 0.1 logMAR unit increase,95%CI 1.03-1.15);inferior or superior retinal breaks(OR=2.42,95%CI 1.12-5.24);and macular holes or superior retinal breaks(OR=8.46,95%CI 3.45-20.75).In the subgroup of patients with high myopia,risk factors for postoperative blindness included:pseudophakia/aphakia versus phakia(OR=6.33,95%CI 1.41-28.31);macular holes or superior retinal breaks(OR=15.15,95%CI 3.07-74.85);and proliferative vitreoretinopathy(PVR;OR=21.41,95%CI 2.14-214.57).In the subgroup of patients without high myopia,increased risk of postoperative blindness was associated with:higher preoperative logMAR VA(OR=1.11 per 0.1 logMAR unit increase,95%CI 1.04-1.18);and inferior or superior retinal breaks(OR=2.90,95%CI 1.19-7.06).CONCLUSION:Using a large real-world clinical database,we identified distinct risk factors for postoperative blindness in patients with primary RRD-including differences between those with and without high myopia.These findings emphasize the need to target specific risk factors in clinical practice to mitigate and reduce the incidence of postoperative blindness in this patient population.
