Spin-state Conversion by Asymmetrical Orbital Hybridization in Ni-doped Co3 O4 to Boost Singlet Oxygen Generation for Microbial Disinfection.

Singlet oxygen (1 O2 ) plays a significant role in environmental and biomedical disinfection fields. Electrocatalytic processes hold great potential for 1 O2 generation, but remain challenging. Herein, a facile Ni doping converted spin-state transition approach is reported for boosting 1 O2 production. Magnetic analysis and theoretical calculations reveal that Ni occupied at the octahedral site of Co3 O4 can effectively induce a low-to-high spin-state transition. The high-spin Ni-Co3 O4 generate appropriate binding strength and enhance electron transfer between the Co centers with oxygen intermediates, thereby improving the catalytic activity of Ni-Co3 O4 for effective generating 1 O2 . In neutral conditions, 1×106  CFU mL-1 Gram-negative ESBL-producing Escherichia coli (E. coli) could be inactivated by Ni-Co3 O4 system within 5 min. Further antibacterial mechanisms indicate that 1 O2 can lead to cell membrane damage and DNA degradation so as to irreversible cell death. Additionally, the developed Ni-Co3 O4 system can effectively inactivate bacteria from wastewater and bioaerosols. This work provides an effective strategy for designing high-spin electrocatalysis to boost 1 O2 generation for disinfection process.

Association of different digital media experiences with paediatric dry eye in China: a population-based study.

OBJECTIVE: To investigate the ocular surface effects of different digital media experiences in Chinese elementary school students. DESIGN: Population-based cross-sectional study was used. SETTING: 14 randomly selected primary schools in Yuhuatai District, Nanjing, China PARTICIPANTS: 2,694 students between 7 and 8-year-old. OUTCOME MEASURES: Prevalence of and risk factors for different types of dry eye disease，and different digital media experience with different ocular signs. RESULTS: The prevalence of 'symptomatic DED' was 8.7% (95% CI 7.6% to 9.8%) and 'definite DED' prevalence rate was 5.5% (95% CI 4.7% to 6.4%). In multivariable logistic regression model, allergic conjunctivitis (OR=4.33, 95% CI (3.01 to 6.23), p<0.001), more than 1 hour per day on outdoor activity (OR=0.69, 95% CI (0.49 to 0.99), p=0.043), smartphone (OR=2.73, 95% CI (1.51 to 4.91), p=0.001), tablet (OR=2.09, 95% CI (1.07 to 4.07), p=0.030) and homework (OR=1.86, 95% CI (1.22 to 2.83), p=0.004) were independently associated with 'definite DED', while allergic conjunctivitis (OR=5.58, 95% CI (4.12 to 7.55), p<0.001), more than 1 hour per day on outdoor activity (OR=0.72, 95% CI (0.53 to 0.97), p=0.028), smartphone (OR=2.60, 95% CI (1.55 to 4.35), p<0.001), tablet (OR=1.84, 95% CI (1.02 to 3.34), p=0.044) and homework (OR=2.57, 95% CI (1.84 to 3.60), p<0.001) were independently associated with 'symptomatic DED'. CONCLUSIONS: Using smartphones or tablets for an average of more than 1 hour per day through the course of a year is independently associated with paediatric DED.

Treating Thyroid Associated Ophthalmopathy in Pediatric Patients.

Thyroid associated ophthalmopathy (TAO) is a common extra-thyroid clinical manifestation of Graves' disease. It is an inflammatory disease of the eye and orbital tissues. Up to one-third of pediatric Graves' disease patients could be diagnosed with TAO. The symptoms can be variable with remissions and exacerbations of pediatric Graves' disease, which has negative effects on the quality of life in children. Teprotumumab is a fully human IgG1κ type monoclonal antibody targeting insulin-like growth factor-1 receptor (IGF-1R), and was approved for the treatment of TAO as a "breakthrough therapy" by the FDA in 2020. Nevertheless, the safety and effectiveness have not been established in pediatric patients. IGF-1R plays an important role in human development, which raises concerns of developmental toxicity. As presented in the pharmacology review report, juvenile monkeys were tested in two separate repeated-dose toxicity studies and no NOAEL was identified. Teprotumumab affected the growth, thymus, spleen and decreased the bone growth. Younger animals seemed to be more sensitive to the effects on normal growth and normal thymus. Hearing impairment posed additional risk to the potential pediatric use, especially for school-age children. Considering the nature of the target, Teprotumumab should not be used empirically in children. More efforts would be made for the further development of teprotumumab for pediatric use.

Probing the molecular toxic mechanism of di-(2-ethylhexyl) phthalate with glutathione transferase Phi8 from Arabidopsis thaliana.

As the most widely used plasticizer, di-(2-ethylhexyl) phthalate (DEHP) has been extensively applied to agriculture. However, its excessive accumulation may cause the active oxygen damage in plants and further lead to the destruction of antioxidant enzymes. As a core component of the glutathione antioxidant enzyme system, glutathione S-transferases (GSTs) have been reported as biomarkers for assessing oxidative damage induced by environmental pollutants, but the underlying toxic molecular mechanism has rarely been exploited. In this article, the interaction mechanism of Arabidopsis thaliana glutathione S-transferase AtGSTF8 and plasticizer DEHP was investigated at the molecular level by multispectral methods. The enzyme activity changes of AtGSTF8 upon binding with DEHP were also evaluated. A single binding site of AtGSTF8 towards DEHP was predicted and the binding force was presumed mainly by Van der Waals' force and hydrogen bonding based on static quenching mechanism. Besides, the deconstructions of the protein skeleton were also deduced based on the multispectral results and the hazardous effects of DEHP on plants growth were further demonstrated. This work will help to clarify the functional mechanism between the plasticizer DEHP and the antioxidant enzyme AtGSTF8 at the molecular level, and providing useful information for further study of the toxic effects of DEHP on plant antioxidant systems.

Global prevalence of amblyopia and disease burden projections through 2040: a systematic review and meta-analysis.

PURPOSE: Amblyopia is a leading cause of vision impairment among children and young adults. Individual studies showed significant variations in the prevalence of amblyopia in different regions and age groups. This study is to estimate the global prevalence of amblyopia by pooling its prevalence from the previous studies and to project the number of people affected through 2040. METHODS: We performed a systematic review and meta-analysis on the prevalence of amblyopia using data published before 20 October 2018. We estimated the prevalence rate of amblyopia and its 95% CI globally and by subgroups (eg, region and age). The prevalence data were applied to United Nations World Population Prospects to derive the projected number with amblyopia through 2040. RESULTS: A meta-analysis of 60 studies (1 859 327 subjects) showed that the pooled prevalence rate of amblyopia was 1.44% (95% CI 1.17% to 1.78%). Prevalences in Europe (2.90%) and North America (2.41%) were higher than in Asia (1.09%) and Africa (0.72%). The highest prevalence was found in subjects over 20 years old (3.29%). There was no difference in the prevalence between genders. We estimated 99.2 (95% CI 71.7 to 146.1) million people with amblyopia in 2019 worldwide, increasing to 175.2 (95% CI 81.3 to 307.8) million by 2030 and 221.9 (95% CI 83.7 to 429.2) million by 2040. CONCLUSIONS: The amblyopia is becoming a significant vision problem worldwide. It is of great importance to design and implement amblyopia screening, treatment and related public health strategies.

Prevalence of amblyopia and strabismus in Hani school children in rural southwest China: a cross-sectional study.

PURPOSE: To determine the prevalence rate of amblyopia and strabismus in Chinese Hani ethnic school-aged children. METHODS: All grade 1 and grade 7 students in Mojiang Hani Autonomous County, located in southwest China, were invited for comprehensive eye examinations performed by experienced ophthalmologists and optometrists, including visual acuity, ocular alignment and movements, cycloplegic autorefraction, anterior segment and fundus examinations. Standard definitions of amblyopia and strabismus were applied to calculate their prevalence rate. RESULTS: A total of 1656 (91.0% response rate) grade 1 Hani students and 1394 (92.8% response rate) grade 7 Hani students participated in the study. Amblyopia was present in 25 Hani students (0.82%, 95% CI 0.55% to 1.20%), with no significant differences in grade (p=0.42) and gender (p=0.69). Among these 25 amblyopic children, 17 had unilateral amblyopia and eight had bilateral amblyopia, including 16 anisometropic, eight binocular refractive and one strabismic. Strabismus was found in 59 Hani students (1.93%, 95% CI 1.50% to 2.48%), including 47 with intermittent exotropia, six with constant exotropia, five with constant esotropia and one with unilateral superior oblique palsy. The prevalence rate of strabismus was higher in grade 7 students than grade 1 students with borderline significance (2.44%vs1.50%, p=0.07), but was similar by gender (2.16% in boys vs 1.68% in girls, p=0.36). CONCLUSION: The prevalence of amblyopia and strabismus in Chinese Hani school children are both lower than that previously reported for Chinese Han children in China and for many other racial/ethnic populations from non-China studies. Refractive error is the major cause for amblyopia and intermittent exotropia is the primary strabismus type.

Prevalence of amblyopia and its association with refraction in Chinese preschool children aged 36-48 months.

PURPOSE: To determine the prevalence of amblyopia and its association with refraction in Chinese preschool children. METHODS: The Yuhuatai Pediatric Eye Disease Study, a cross-sectional, population-based study, was conducted in children aged 36-48 months in Yuhuatai District, Nanjing, China, in 2015. Visual acuity was measured in 1695 eligible children. RESULTS: Of the 1695 subjects, manifested amblyopia was detected in 25 children (1.47%, 95% CI 0.90% to 2.05%), including 11 and 14 with bilateral and unilateral amblyopia, respectively. Amblyopia prevalence did not differ by gender (p=0.77). Significant refractive errors were found in 22 (88.0%) of children with amblyopia, and strabismus was found in 6 (24.0%) children with amblyopia. In multivariate analysis, amblyopia was significantly associated with hyperopia (≥+2.00 dioptres (D); OR 8.81, 95% CI 3.27 to 23.69, p<0.0001), astigmatism (≥2.00 D; OR 17.90, 95% CI 6.78 to 47.21, p<0.0001) and anisometropia (≥2.00 D; OR 5.87, 95% CI 1.52 to 22.77, p<0.05). CONCLUSIONS: The prevalence of amblyopia in children 36-48 months old in Eastern China was 1.47%. The refractive error is a major risk factor for amblyopia.

School-based assessment of amblyopia and strabismus among multiethnic children in rural China.

We aimed to determine the prevalence and possible ethnic variations in strabismus and amblyopia among multiethnic school-aged children in rural China. A total of 9,263 children (4,347 Han, 3,352 Yi, 799 Dai and 765 Bai) aged 6 to 14 years were analyzed. Comprehensive eye examinations including monocular distance visual acuity, anterior segment examination, autorefraction, cover testing and ocular motility were conducted. Manifested strabismus was detected in 3.53% of the overall population. The prevalence of strabismus was 3.29% in Han, 4.12% in Yi, 2.25% in Dai, and 3.66% in Bai ethnic groups with marginally inter-ethnic differences (P = 0.046). There was an increasing trend in the prevalence of strabismus with increasing age (P < 0.001). Amblyopia affected 132 children (1.43%) overall, with no statistical differences in gender and age. The prevalence of amblyopia was highest in Dai ethnic group (2.00%) and lowest in ethnic Yi ethnic group (1.04%) with no significant difference being detected (P = 0.062). Refractive error and strabismus were the two major factors associated with amblyopia. No significant ethnic differences in strabismus and amblyopia among Chinese ethnic minorities were observed. Refractive error and strabismus were the major causes for amblyopia in rural Chinese children.

Pupillary measurements and anisocoria in Chinese preschoolers 3-4 years of age screened using the plusoptiX A12C.

PURPOSE: To evaluate the distribution of the pupil diameter and distance and the incidence of anisocoria in a screening setting for Chinese preschoolers 3-4 years of age. METHODS: This was a cross-sectional, population-based study conducted in children aged 3-4 years in Nanjing, China. Plusoptix photoscreening was conducted without cycloplegia. Additional assessments were conducted, including light reaction test, reevaluation for anisocoria (in dim and bright light), swinging-flashlight test, and cocaine test, if necessary. RESULTS: A total of 1,818 children were screened. Pupillary measurements were conducted successfully in nearly all children (99.3% for the pupil diameter; 98.4% for the interpupillary distance). The pupil diameters of both eyes of each individual were highly correlated (5.9 ± 0.7 mm in both eyes; P < 0.0001; r = 0.93). The mean interpupillary distance was 50.1 ± 3.1 mm. The pupil diameters (6.0 mm in boys; 5.8 mm in girls) and interpupillary distance (50.6 mm in boys; 49.5 mm in girls) were correlated with sex (all P < 0.0001) but not age (P = 0.22; P = 0.68). General anisocoria of 0.5-0.9 mm in 7.8% of children and 1.0-1.2 mm in 0.4% of children was found. No child was diagnosed with pathological anisocoria, craniofacial trauma, or congenital malformation syndrome. CONCLUSIONS: The Plusoptix photoscreener is a useful tool for obtaining pupillary measurements and detecting anisocoria in a screening setting. For Chinese preschoolers 3-4 years of age the mean pupil diameter and distance were 5.9 and 50.1 mm, respectively, with sex-related difference; anisocoria of 0.5-0.9 mm is present in 7.8% of children.

Pediatric vision screening using the plusoptiX A12C photoscreener in Chinese preschool children aged 3 to 4 years.

This study evaluated the performance of plusoptiX A12C in detecting amblyopia risk factors (ARFs) in Chinese children aged 3-to-4-year. PlusoptiX examination was successfully conducted among 1,766 subjects without cycloplegia to detect refractive error, asymmetry and media opacity. Cycloplegic retinoscopy (CR) was conducted on 357 children suspected of having vision abnormalities. Statistical differences between CR and the device were confirmed using the mean spherical value (+1.41 ± 0.87 D versus +1.14 ± 0.81 D), cylindrical value (-0.47 ± 0.64 versus -0.84 ± 0.78) and spherical equivalent (SE) value (+1.17 ± 0.84 D versus +0.72 ± 0.64 D) (all P < 0.0001). In the emmetropia group, the differences were statistically significant for the cylinder and SE (all P < 0.0001) but not the sphere (P = 0.33). In the hyperopia group, the differences were statistically significant for the sphere, cylinder and SE (all P < 0.0001). For refractive and strabismic ARFs detection, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated, respectively.

The Development of the Chinese Intermittent Exotropia Questionnaire.

PURPOSE: The Intermittent Exotropia Questionnaire (IXTQ) is a child, proxy, and parent report of health-related quality of life specific to children with intermittent exotropia (IXT). The present study aimed to develop a Chinese-language version of the IXTQ (CIXTQ) and evaluate its validity and reliability when used in Chinese IXT children and their parents. METHODS: The IXTQ was translated into Chinese. One hundred seventy-five IXT children (2 to 17 years old) and 151 orthotropic control children (2 to 17 years old) along with one of their parents were recruited. Children 5 to 17 years old completed the 5- to 7-year-old or the 8- to 17-year-old child questionnaire of the CIXTQ according to their age. Parents of all children (2 to 17 years old) completed the proxy and parent questionnaires of the CIXTQ. Psychometric properties of the CIXTQ were examined for floor and ceiling effects, construct validity, item-internal consistency, discriminative validity, Cronbach α coefficient and test-retest reliability. RESULTS: No items were found to have strong floor or ceiling effects. Principal component analysis identified that the CIXTQ had a similar structure to the original English version. The median scores of each questionnaire in the CIXTQ among children with IXT and their parents were significantly lower than those among control subjects (P < .001). Cronbach α coefficients ranged from 0.869 to 0.931, and test-retest reliabilities ranged from 0.898 to 0.981, for each questionnaire in the CIXTQ. CONCLUSIONS: The CIXTQ is a useful tool to evaluate the influence of IXT on health-related quality of life among Chinese IXT children and their parents.

Ocular biometric parameters among 3-year-old Chinese children: testability, distribution and association with anthropometric parameters.

This survey was conducted to determine the testability, distribution and associations of ocular biometric parameters in Chinese preschool children. Ocular biometric examinations, including the axial length (AL) and corneal radius of curvature (CR), were conducted on 1,688 3-year-old subjects by using an IOLMaster in August 2015. Anthropometric parameters, including height and weight, were measured according to a standardized protocol, and body mass index (BMI) was calculated. The testability was 93.7% for the AL and 78.6% for the CR overall, and both measures improved with age. Girls performed slightly better in AL measurements (P = 0.08), and the difference in CR was statistically significant (P < 0.05). The AL distribution was normal in girls (P = 0.12), whereas it was not in boys (P < 0.05). For CR1, all subgroups presented normal distributions (P = 0.16 for boys; P = 0.20 for girls), but the distribution varied when the subgroups were combined (P < 0.05). CR2 presented a normal distribution (P = 0.11), whereas the AL/CR ratio was abnormal (P < 0.001). Boys exhibited a significantly longer AL, a greater CR and a greater AL/CR ratio than girls (all P < 0.001).

Prevalence and causes of reduced visual acuity among children aged three to six years in a metropolis in China.

PURPOSE: To determine the prevalence and possible causes for reduced visual acuity (VA) in preschool children in a metropolis in China. METHODS: A school-based paediatric eye survey including 5862 preschool children aged three to 6 years was conducted from 2011 to 2012 in Yuhuatai District, Nanjing, China, using an age-stratified random sampling procedure. Clinical examinations including ocular alignment, ocular motility, visual acuity, prism cover test, cycloplegic refraction, stereopsis screening, slit lamp examination and fundus examination were performed by trained study ophthalmologists and optometrists. Reduced VA was defined as presenting VA of worse than 0.30 logMAR (Snellen 6/12 or 20/40), for both better and worse eyes. RESULTS: 5667 (94.8%) children with complete VA data were included in the data analyses. Among them, 208 and 93 had reduced VA in the worse and better eye, respectively. Reduced VA was detected in 3.7% (95% confidence interval [CI] 3.2%-4.2%) in the worse eye and 1.6% (95% CI 1.3%-2.0%) in the better eye. No significant age and gender differences in reduced VA were observed (p > 0.05). Refractive errors and amblyopia were the principal causes for reduced VA in the worse eye which accounted for 66.8% and 32.7% of the total cases with reduced VA, respectively. Astigmatism and hyperopia were the major types of refractive errors causing reduced VA. CONCLUSIONS: The burden of reduced VA in preschool children in China was similar to that of Asian children of similar ages in the United States. Uncorrected refractive error and amblyopia were the principal causes for reduced VA among preschoolers (aged three to 6 years) in China.

Prevalence of amblyopia and strabismus in Eastern China: results from screening of preschool children aged 36-72†months.

PURPOSE: To determine the prevalence of amblyopia and strabismus in preschool children in Eastern China. METHODS: The Nanjing Pediatric Vision Project was a cross-sectional, population-based cohort study conducted in preschool children aged 36-72 months from 2011 to 2012 in Yuhua District, Nanjing, China, using an age-stratified random sampling procedure. A questionnaire totalling 117 items was sent to be completed by the corresponding parents or legal guardians of each eligible child. Comprehensive eye examinations, including visual acuity, anterior segment examination, autorefraction, cover test and ocular motility, were conducted. Postcycloplegic refraction and fundus examinations were performed if necessary. RESULTS: Amblyopia was present in 68 children (1.20%, 95% CI 0.92% to 1.48%), with no statistical differences in gender (p=0.903) and age (p=0.835). Among these, 27 had bilateral amblyopia and 41 had unilateral amblyopia, including 26 anisometropic without strabismus, 26 binocular refractive, 7 strabismic, 6 combined strabismic/anisometropic and 3 deprivation amblyopia. Strabismus was found in 320 children (5.65%, 95% CI 5.05% to 6.25%), including 43 with concomitant esotropia, 259 with concomitant exotropia (1 esotropia at near but exotropia at distance), 8 with microtropia (3 esotropia and 5 exotropia), 10 with pure vertical strabismus (3 dissociated vertical deviation and 7 oblique muscle dysfunction) and 1 with Type I Duane syndrome. The prevalence of strabismus had no statistical differences in gender (p=0.952), but had significant statistical differences between different age groups (p=0.021). CONCLUSIONS: The prevalence of amblyopia and strabismus in preschool children in Eastern China were 1.20% and 5.65%, respectively. The refractive and strabismus are the main factors associated with amblyopia.