Higher order optical aberrations were measured in 273 cyclopleged Singaporean school children using a Bausch and Lomb Zywave aberrometer, with 268 of these subjects also undergoing corneal topography measurements (Tomey TMS 2 system). Subjects with low myopia (> -3.00 to -0.50 D) showed slightly, but significantly, less positive levels of spherical aberration than other refractive error groups. Chinese subjects also showed significantly higher amounts of aberrations than Malay subjects, particularly for vertical coma, but also for horizontal coma and spherical aberration. Anterior corneal spherical aberration (calculated from topography) was significantly correlated with whole eye spherical aberration, but did not vary significantly with refractive error or racial background. Residual spherical aberration (i.e. of posterior cornea and crystalline lens) did vary significantly with refractive error and race. Our results do not provide any evidence for aberration-driven form-deprivation as a major mechanism of myopia development.

Aim. For patients who have exhausted cephalic vein arteriovenous fistula (AVF) options, controversy exists on whether brachial-basilic AVF with transposition (BBTAVF) or a forearm arteriovenous graft (AVG) should be the next vascular access of choice. This study compared the outcomes of these two modalities. Methods. A retrospective study of 122 Asian multiethnic patients who underwent either a BBTAVF (81) or an AVG (41). Maturation time and intervention rates were analyzed. Functional primary, secondary, and overall patency rates were evaluated. Results. The maturation time for BBTAVFs was significantly longer than AVGs. There was also a longer deliberation time before surgeons abandon a failing BBTAVF compared to an AVG. Both functional primary and secondary patency rates were significantly higher in the BBTAVF group at 1-year follow-up: 73.2% versus 34.1% (p < 0.001) and 71.8% versus 54.3% (p = 0.022), respectively. AVGs also required more interventions to maintain patency. When maturation rates were considered, the overall patency of AVGs was initially superior in the first 25 weeks after creation and then became inferior afterwards. Conclusion. BBTAVFs had superior primary and functional patency and required less salvage interventions. The forearm AVG might have a role in patients who require early vascular access due to complications from central venous catheters or with limited life expectancy.

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Objectives: Postoperative atrial fibrillation (POAF) is a common problem of cardiac surgery. Beta-blockers are recognized as effective prophylactic agents available for POAF management. To better understand its effect on isolated atrial fibrillation after cardiac surgery, a meta-analysis was conducted. Methods: Randomized controlled trials (RCTs) were searched and filtered by comparing the efficacy of beta-blockers and control users in isolated POAF for cardiac surgery. Seventeen RCTs were identified and analyzed by typical meta-analysis methods. The search was performed from inception to May 31, 2020. Subgroup analyses were conducted for type of surgery and beta-blocker, starting time and route of administration of beta-blocker, and dosage of intravenous landiolol hydrochloride. Results: Beta-blockers were effective in reducing isolated POAF risk (risk ratio [RR], 0.52 [0.41, 0.66], P ¼ .31, I 2 ¼ 12%). In subgroup analyses, beta-blocker administration during postoperative period (RR, 0.43 [0.29, 0.62], P ¼ .84, I 2 ¼ 0%) and on-pump coronary artery bypass graft (RR, 0.34 [0.04, 3.15], P ¼ .56, I 2 ¼ 0%) had lowest risk of isolated POAF incidence. Intravenous landiolol hydrochloride at 2 mg/ kg/min also had low risk of isolated POAF occurrence. Conclusions: Beta-blocker treatment helps to reduce isolated atrial fibrillation incidence after cardiac surgery. Our subgroup analyses also reveal postoperative betablocker administration after on-pump coronary artery bypass graft surgery is most effective in reducing isolated POAF risk. Intravenous landiolol hydrochloride at a dosage of 2 mg/kg/min has also displayed favorable results. Further trials may be required to explore these factors.

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Background The purpose of this systematic review is to evaluate the efficacy of antifibrinolytics in non‐cardiac thoracic surgery. Methods We searched for all randomized controlled trials on this topic. A set of strict inclusion and exclusion criteria was developed. Six studies were meta‐analysed together then in subgroups of topical tranexamic acid and intravenous aprotinin. We compared postoperative chest drain output, transfusions requirements and duration of hospital stay where available to determine the efficacy of topical tranexamic acid or intravenous aprotinin in reducing blood loss. Results The use of antifibrinolytics reduces 24‐h chest drain output (−290.21 mL [−524.75, −55.66], P = 0.02, I2 = 98%), red blood cell transfusion requirements (−1.27 units [−2.24, −0.30], P = 0.01, I2 = 100%) and shortened duration of hospital stay (−1.81 days [−3.25, −0.36], P = 0.01, I2 = 96%). The subgroup analysis also supported this trend. Conclusion We conclude that the use of antifibrinolytics appears to reduce postoperative blood loss by reducing chest drain output, transfusion requirements and length of stay after thoracic surgery.

Objective. To explore the regulatory effect of ubiquitin specific protease 25 (USP25) on glioma cell proliferation, migration, invasion, and its underlying mechanism. Methods. The USP25-overexpressed and USP25-knockdown glioma cells were established on U251 and U87 cells, respectively. Glioma cell proliferation ability was evaluated by CCK-8 assay. Cell apoptosis and cell cycle were determined utilizing flow cytometry. The Transwell assay measured cell invasion with wound healing used for cell migration detection. Western blotting established key protein expression levels in the Wnt/β-catenin pathway. The coimmunoprecipitation was used to check Thankyrase 1 (TNKS1) ubiquitination levels. Results. TNKS1 expression levels were found to be considerably repressed in USP25-knockdown glioma cells and elevated in USP25-overexpressed glioma cells, accompanied by Wnt/β-catenin pathway key protein downregulation and upregulation, respectively. Glioma cell invasion, migration, and proliferation activity were dramatically inhibited in USP25-knockdown glioma cells and promoted in USP25-overexpressed glioma cells. TNKS1 ubiquitination level was knowingly increased in USP25-knockdown glioma cells and reduced in USP25-overexpressed glioma cells, suggesting TNKS1 ubiquitination levels were negatively regulated by USP25. Conclusion. USP25 facilitated glioma cell invasion, migration, and proliferation by regulating Wnt/β-catenin through the deubiquitination on TNKS1.