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Designing a medical ethics curriculum in ophthalmology

Annals of eye Science 2024年第1期9卷 4-9页

作者： Matthew D.Gearinger Flaum eye Institute University of Rochester Medical CenterRochesterNYUSA

Ethical principles form a bedrock to medical practice in any specialty,guiding physicians to appropriate attitudes and behaviors.A formal ethics curriculum can be difficult to generate de novo in an ophthalmology training program.A number of barriers exist in most ophthalmology departments:trainees may think ethics is of secondary importance compared to core basic and clinical science topics;most ophthalmology faculty have no formal degree in medical ethics;there is limited didactic time with competing academic,clinical,and surgical priorities;work-hours regulations may limit the time available to deliver“para-professional”lectures;and there is a belief that the medical ethics lectures during medical school is a sufficient amount of coursework to last through a physician’s career with no need for continuing professional *** four pillars of medical ethics are beneficence,non-maleficence,autonomy,and *** addition,morals,ethics,and professionalism are important aspects of sound medical practice.A curriculum specific to medical ethics in ophthalmology can be developed in any of our sub-specialties and include lectures,curated readings,case rounds,and clinic wrap-up *** considerations are part of everyday clinical practice,and a structured ethics curriculum can be incorporated into ophthalmology training *** concept of backward design can be used to structure the curriculum,starting with the expected outcome,then designing authentic assessments,and finally putting together a learning plan that has students actively involved in ethical *** paper will provide a guide to developing an ethics curriculum for an ophthalmology training program utilizing the concept of backwards design and guide the reader through the process of developing expected learning outcomes,authentic assessments,and a unified learning plan.

关键词： medical ethics curriculum design medical education

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Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 822-830页

作者： Fang Ruan Wen-Jun Kong Qian Fan Hong-Wei Dong Wei Zhang Wen-Bin Wei Ying Jie Department of Ophthalmology Beijing You’an HospitalCapital Medical UniversityBeijing Infectious Eye Disease Diagnosis and Treatment CenterBeijing 100069China Beijing Tongren eye center Beijing Tongren HospitalCapital Medical UniversityBeijing Institute of OphthalmologyBeijing Ophthalmology and Visual Sciences Key LabBeijing 100730China Tianjin eye Hospital Tianjin Key Lab of Ophthalmology and Visual ScienceTianjin Eye InstituteNankai University Affiliated Eye HospitalNankai University Eye InstituteNankai UniversityClinical College of OphthalmologyTianjin Medical UniversityTianjin 300020China

AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 ***:A cross-sectional observational design was *** 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,*** Surface Disease Index(OSDI),Five-item Dry eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this ***:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.

关键词： COVID-19 dry eye disease recurrent infection mental health

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Clinical prediction of insufficient vaults after implantable collamer lens implantation

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International Journal of Ophthalmology(English edition) 2024年第7期17卷 1300-1306页

作者： Jun Zhu Dan Cheng Xue-Ying Zhu Fen-Fen Li Ye Yang Yu-Feng Ye National Clinical Research center for Ocular Diseases Eye HospitalWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina

AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(<250μm)after implantable collamer lens(ICL V4c;STAAR Surgical)***:The participants underwent ICL surger... 详细信息

AIM:To determine the factors related to preoperative ocular characters that are predictive of insufficient vault(eyes)and 36 patients(63 eyes)were in the low and normal vault groups,*** implantation procedures were uneventful with no cataract formation in the early postoperative *** sulcusto-sulcus lens rise(STSL)and iris ciliary angle(ICA)were correlated with vault at 3mo after *** 0.1 mm increase in STSL was associated with 38.9μm decrease in the postoperative 3-month vault.A rise of 1 degree in ICA is associated with a reduction of 4μm in ***:eyes with a narrow ciliary sulcus are associated with a higher rate of low vault after ICL implantation,suggesting a need for adjustments to the ICL size in these *** the characteristics of the ciliary sulcus contributes valuable information to predict low vault after surgery.

关键词： insufficient vault implantable collamer lens ciliary body posterior chamber

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Effect of low-degree astigmatism on the objective visual quality

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1086-1093页

作者： Ling-Ying Ye Shu-Feng Li Jing-Jing Zuo Jin Li Hui-Xiang Ma National Clinical Research center for Ocular Diseases Eye HospitalWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina

AIM:To evaluate the effect of low-degree astigmatism on objective visual quality through the Optical Quality Analysis System(OQAS).METHODS:This study enrolled 46 participants(aged 23 to 30y,90 eyes)with normal or corrected-to-normal *** cylindrical lenses(0,0.5,0.75,1.0,and 1.25 D)were placed at the axial direction(180°,45°,90°,and 135°)in front of the eyes with the best correction to form 16 types of regular low-degree *** was used to detect the objective visual quality,recorded as the objective scattering index(OSI),OQAS values at contrasts of 100%,20%,and 9%predictive visual acuity(OV100%,OV20%,and OV9%),modulation transfer function cut-off(MTFcut-off)and Strehl ratio(SR).The mixed effect linear model was used to compare objective visual quality differences between groups and examine associations between astigmatic magnitude and objective visual quality ***:Apparent negative relationships between the magnitude of low astigmatism and objective visual quality were *** increase of OSI per degree of astigmatism at 180°,45°,90°,and 135°axis were 0.38(95%CI:0.35,0.42),0.50(95%CI:0.46,0.53),0.49(95%CI:0.45,0.54)and 0.37(95%CI:0.34,0.41),*** decrease of MTFcut-off per degree of astigmatism at 180°,45°,90°,and 135°axis were-10.30(95%CI:-11.43,-9.16),-12.73(95%CI:-13.62,-11.86),-12.75(95%CI:-13.79,-11.70),and-9.97(95%CI:-10.92,-9.03),*** the same astigmatism degree,OSI at 45°and 90°axis were higher than that at 0°and 135°axis,while MTFcut-off were ***:Low astigmatism of only 0.50 D can significantly reduce the objective visual quality.

关键词： low-degree astigmatism objective visual quality Optical Quality Analysis System

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Patient-derived induced pluripotent stem cells with a MERTK mutation exhibit cell junction abnormalities and aberrant cellular differentiation potential

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World Journal of Stem Cells 2024年第5期16卷 512-524页

作者： Hang Zhang Ling-Zi Wu Zhen-Yu Liu Zi-Bing Jin Beijing Institute of Ophthalmology Beijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical UniversityBeijing 100730China

BACKGROUND Human induced pluripotent stem cell(hiPSC)technology is a valuable tool for generating patient-specific stem cells,facilitating disease modeling,and invest-igating disease ***,iPSCs carrying specific mutations may limit their clinical applications due to certain inherent *** To investigate the impact of MERTK mutations on hiPSCs and determine whether hiPSC-derived extracellular vesicles(EVs)influence anomalous cell junction and differentiation *** We employed a non-integrating reprogramming technique to generate peripheral blood-derived hiPSCs with and hiPSCs without a MERTK ***-somal karyotype analysis,flow cytometry,and immunofluorescent staining were utilized for hiPSC *** and proteomics were employed to elucidate the expression patterns associated with cell junction abnormalities and cellular differentiation ***,EVs were isolated from the supernatant,and their RNA and protein cargos were examined to investigate the involvement of hiPSC-derived EVs in stem cell junction and *** The generated hiPSCs,both with and without a MERTK mutation,exhibited normal karyotype and expressed pluripotency markers;however,hiPSCs with a MERTK mutation demonstrated anomalous adhesion capability and differentiation potential,as confirmed by transcriptomic and proteomic ***,hiPSC-derived EVs were involved in various biological processes,including cell junction and *** HiPSCs with a MERTK mutation displayed altered junction characteristics and aberrant differentiation ***,hiPSC-derived EVs played a regulatory role in various biological processes,including cell junction and differentiation.

关键词： Cell junction Cellular differentiation Extracellular vesicle Human induced pluripotent stem cells Transcriptomics Proteomics

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Neuroprotective effects of acteoside in a glaucoma mouse model by targeting Serta domain-containing protein 4

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International Journal of Ophthalmology(English edition) 2024年第4期17卷 625-637页

作者： Hui-Jie Hao Ya-Hong Li Bo Yu Xun Liu Yan Zhang Xiao-Li Xing Tianjin Key Laboratory of Retinal Functions and Diseases Tianjin Branch of National Clinical Research Center for Ocular DiseaseEye Institute and School of OptometryTianjin Medical University Eye HospitalTianjin 300384China

AIM:To explore the therapeutic effect and main molecular mechanisms of acteoside in a glaucoma model in DBA/2J ***:Proteomics was used to compare the differentially expressed proteins of C57 and DBA/2J *** acteoside administration in DBA/2J mice,anterior segment observation,intraocular pressure(IOP)monitoring,electrophysiology examination,and hematoxylin and eosin staining were used to analyze any potential ***(IHC)assays were used to verify the proteomics ***,retinal ganglion cell 5(RGC5)cell proliferation was assessed with cell counting kit-8(CCK-8)*** domain-containing protein 4(Sertad4)mRNA and protein expression levels were measured by qRT-PCR and Western blot analysis,***:Proteomics analysis suggested that Sertad4 was the most significantly differentially expressed *** with the saline group,the acteoside treatment group showed decreased IOP,improved N1-P1 wave amplitudes,thicker retina,and larger numbers of cells in the ganglion cell layer(GCL).The IHC results showed that Sertad4 expression levels in DBA/2J mice treated with acteoside were significantly lower than in the saline *** treatment could improve RGC5 cell survival and reduce the Sertad4 mRNA and protein expression levels after glutamate ***:Sertad4 is differentially expressed in DBA/2J *** can protect RGCs from damage,possibly through the downregulation of Sertad4,and has a potential use in glaucoma treatment.

关键词： glaucoma acteoside Serta domaincontaining protein 4 proteomics mice

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Strength and ductility optimization of HPDC AlSi8MgCuZn2 alloys by modifying pre-aging treatment

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China Foundry 2024年第4期21卷 343-351页

作者： Yuan-hang Jiang Hui-ting Zheng Fei Liu Hai-dong Zhao National Engineering Research center of Near-net Shape Forming for Metallic Materials South China University of TechnologyGuangzhou 510641China

Considering the components produced by high pressure die casting(HPDC)process usually with ultra-large sizes and complex morphologies,high temperature solid solution treatment is not a suitable method to further improve their mechanical *** this study,two-stage aging treatment with different pre-aging times was designed and employed to further improve the mechanical properties of HPDC Al8SiMgCuZn *** characteristics of precipitates were evaluated by a transmission electron microscope(TEM),and the precipitation strengthening mechanism was *** results reveal that the strengthening is mainly contributed by the precipitation ofβ″phase after two-stage aging,and the number density and size of the precipitates are significantly depended on the pre-aging *** number density of precipitates is increased with the pre-aging time prolonged from 0 h to 4 h,and then decreases with the further increase of pre-aging time from 4 h to 6 *** precipitates with the highest density and smallest size are observed after pre-aging for 4 *** pre-aged at 100℃for 4 h and then artificial aged at 200℃for 30 min,the yield strength of 207 MPa,ultimate tensile strength of 325 MPa and elongation of 7.6%are achieved.

关键词： high pressure die cast aluminum alloy microstructural heterogeneity mechanical properties precipitation strengthening two-stage aging

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Background diseases and the number of previous intravitreal aflibercept injections on immediate intraocular pressure increase and vitreous reflux rate in phakic eyes

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International Journal of Ophthalmology(English edition) 2024年第3期17卷 545-550页

作者： Tetsuya Muto Shigeki Machida Shinichiro Imaizumi Department of Ophthalmology Dokkyo Medical University Saitama Medical CenterKoshigaya 343-8555Japan Imaizumi eye Hospital Koriyama 963-8877Japan Fukushima medical University Fukushima 960-1295Japan

●AIM:To evaluate the effect of background diseases and number of previous intravitreal aflibercept injections(IVAIs)on immediate intraocular pressure(IOP)increase and vitreous reflux(VR)rate and to evaluate the correlation of both age and axial length with immediate IOP increase and VR rate.●METHODS:This study included 105 patients with cystoid macular edema secondary to retinal vein occlusion,35 patients with diabetic macular edema,69 patients with neovascular age-related macular degeneration(nAMD),and 12 patients with myopic choroidal neovascularization,which underwent first-time *** correlation of immediate IOP increase and VR rates with the four background diseases was ***,the correlation of age with immediate IOP increase and VR rate as well as correlation of axial length with immediate IOP increase and VR rate were ***,54 patients with nAMD were treated with IVAI>10 times(multiple IVAIs).Moreover,the correlation of immediate IOP increase and VR rates with first-time and multiple IVAIs in nAMD was determined.●RESULTS:The immediate IOP increase(P=0.16)and VR rates(P=0.50)were almost similar among the four background *** immediate postinjection IOP and age,VR rate and age,immediate postinjection IOP and axial length,or VR rate and axial length were not correlated in the four background *** immediate IOP increase(P=0.66)and VR rates(P=0.28)did not significantly differ between first-time and multiple IVAIs in nAMD.●CONCLUSION:Background diseases and number of previous IVAIs have no effect on immediate IOP increase and VR ***,age and axial length have no correlation on immediate IOP increase and VR rate.

关键词： aflibercept intraocular pressure vitreous reflux intravitreal injection

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Construction and validation of a neovascular glaucoma nomogram in patients with diabetic retinopathy after pars plana vitrectomy

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World Journal of Diabetes 2024年第4期15卷 654-663页

作者： Yi Shi Yan-Xin Zhang Ming-Fei Jiao Xin-Jun Ren Bo-Jie Hu Ai-Hua Liu Xiao-Rong Li Surgical Retina Tianjin Key Laboratory of Retinal Functions and DiseasesTianjin Branch of National Clinical Research Center for Ocular DiseaseEye Institute and School of OptometryTianjin Medical University Eye HospitalTianjin 300384China Glaucoma Tianjin Key Laboratory of Retinal Functions and DiseasesTianjin Branch of National Clinical Research Center for Ocular DiseaseEye Institute and School of OptometryTianjin Medical University Eye HospitalTianjin 300384China Ocular Trauma Tianjin Key Laboratory of Retinal Functions and DiseasesTianjin Branch of National Clinical Research Center for Ocular DiseaseEye Institute and School of OptometryTianjin Medical University Eye HospitalTianjin 300384China

BACKGROUND Neovascular glaucoma(NVG)is likely to occur after pars plana vitrectomy(PPV)for diabetic retinopathy(DR)in some patients,thus reducing the expected *** the risk factors for NVG occurrence and building effective risk prediction models are currently required for clinical *** To develop a visual risk profile model to explore factors influencing DR after *** We retrospectively selected 151 patients with DR undergoing *** patients were divided into the NVG(NVG occurrence)and No-NVG(No NVG occurrence)groups according to the occurrence of NVG within 6 months after *** risk factors for postoperative NVG were screened by logistic regression.A nomogram prediction model was established using R software,and the model’s prediction accuracy was verified internally and externally,involving the receiver operator characteristic curve and correction *** After importing the data into a logistic regression model,we concluded that a posterior capsular defect,preoperative vascular endothelial growth factor≥302.90 pg/mL,glycosylated hemoglobin≥9.05%,aqueous fluid interleukin 6(IL-6)≥53.27 pg/mL,and aqueous fluid IL-10≥9.11 pg/mL were independent risk factors for postoperative NVG in patients with DR(P<0.05).A nomogram model was established based on the aforementioned independent risk factors,and a computer simulation repeated sampling method was used to internally and externally verify the nomogram *** area under the curve(AUC),sensitivity,and specificity of the model were 0.962[95%confidence interval(95%CI):0.932-0.991],91.5%,and 82.3%,*** AUC,sensitivity,and specificity of the external validation were 0.878(95%CI:0.746-0.982),66.7%,and 95.7%,*** A nomogram constructed based on the risk factors for postoperative NVG in patients with DR has a high prediction *** study can help formulate relevant preventive and treatment measures.

关键词： Diabetic retinopathy Retinopathy Neovascular Glaucoma Risk factors Nomogram

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Ophthalmic exam and ophthalmology residents’ subspecialty preference

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 359-364页

作者： Ari Leshno Daf Shalev Daphna Landau Prat Goldschleger eye Institute Sheba Medical CenterTel Hashomer 5262000Israel Sackler Faculty of Medicine Tel Aviv UniversityTel Aviv 6997801Israel Department of Ophthalmology Edith Wolfson Medical CenterHolon 5822012Israel

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

关键词： residency subspecialty ophthalmic examination career choice ophthalmology

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