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Myopia is a major public health issue and occurs at young ages. Apart from its high prevalence, myopia results in high costs and irreversible blinding diseases. Accurate prediction of the risk of myopia onset is crucial for its precise prevention. We aimed to develop and validate an effective nomogram for predicting myopia onset in schoolchildren.School-based prospective cohort study.A total of 1073 schoolchildren were enrolled from November 2014 to May 2019 in China, and were divided into the training and validation cohorts. Myopia was defined as a spherical equivalent refraction (SER) ≤-0.5 diopters. Predictors of myopia were determined through the least absolute shrinkage and selection operator regression and multivariable Cox proportional hazard model based on the training cohort. The predictive performance of the nomogram was validated internally through time-dependent receiver operating characteristic (ROC) curves, calibration plot, decision curve analysis, and Kaplan-Meier curves.Independent predictors at baseline including gender, SER, axial length, corneal refractive power, and positive relative accommodation were included in the nomogram prediction model. This nomogram demonstrated excellent calibration, clinical net benefit, and discrimination, with all the area under the ROC curves (AUCs) between 0.74 and 0.86 in the training and validation cohorts. The Kaplan-Meier curves showed that 3 distinct risk groups stratified through X-tile analysis were well discriminated and robust among subgroups. The Harrell's C-index and net reclassification improvement demonstrated that the nomogram substantially improved compared with previous models. An online myopia risk calculator was generated for better individual prediction.The nomogram provides accurate and individual prediction of myopia onset in schoolchildren. External validation is needed to verify the generalizability of this nomogram.

To investigate whether the treatment zone (TZ) decentration in orthokeratology (OK) lenses affects retinal expansion in Chinese children with myopia.Children aged 8 to 13 years (n = 30) were assessed over 13 months comprising 12 months of OK lens wear followed by discontinuation of lens wear for 1 month. Corneal topography was measured at 0, 1, 3, 6, 9, 12 and 13 months. TZ decentration of the OK lens was calculated, and subjects were subdivided into a small decentration group (group S) and a large decentration group (group L) based on the median value of the weighted average decentration (dMean AL growth for one year was 0.28 ± 0.17 mm. In a multiple linear regression model, AL elongation was related to the baseline age (β = -0.41, p = 0.01) and the dGreater TZ decentration with the use of OK lenses was associated with slower axial growth and a more oblate retinal shape. TZ decentration caused local defocusing changes, which may inhibit myopic progression. These findings may have important implications for improving optical designs for myopia control.

Purpose To compare peripheral defocus, higher-order aberrations (HOAs), and contrast visual acuity (CVA) in myopic children wearing orthokeratology (OK) lenses and multifocal soft contact lenses (MSCLs) designed with highly addition. Methods This is a prospective, nonrandomized, controlled study. Subjects at 8 to 13 years of age with spherical equivalent refraction from − 1.00 to − 5.00 dioptres (D) were included in the OK group (n = 30) and MSCL group (n = 23). Relative peripheral corneal defocus (RPCD) and relative peripheral refraction (RPR) were measured before and after wearing lenses. HOAs including spherical aberration (SA), coma, trefoil, and total HOAs, and high (100%) and low (10%) CVA were compared between the groups. Axial length (AL) was measured before and after wearing the lenses for 1 year. Results After wearing the lenses, subjects in the MSCL group had RPCD and RPR values similar to the OK group at the paracentral (within 2 mm of the cornea or 20° of the retina, all p > 0.05) but larger than the OK group at the periphery (all p p p p = 0.02 and p = 0.004). After 1 year, AL elongation was 0.37 mm (SD = 0.16) in the MSCL group and 0.28 mm (0.16) in the OK group (p = 0.06). Conclusion MSCL produced larger myopic defocus at the periphery, increased less HOAs and had worse CVA than OK lens. The high addition of this MSCL did not result in better myopia control efficacy Trial registration Chinese Clinical Trial Registry: ChiCTR1800018564. Registered 25 September 2018; retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=31376

This study aimed to investigate the effect of orthokeratology (OK) on accommodative function and aberrations, to explore the correlations between them and determine what role they play in myopia control.In this prospective case-controlled study, 61 children were divided into an OK (n = 30) and a single-vision spectacles (SVS) (n = 31) group. Accommodation and ocular wavefront aberrations in the OK group were measured at baseline and after 1, 3, 6, 9 and 12 months of OK wear, and again at 1 month after stopping OK (13During OK wear, the accommodative lag area at each visit was lower than the baseline level (all p 0.01); all aberrations at each visit were higher than pre-treatment (all p 0.001). After 1 month of OK treatment, changes in accommodative lag area and SA did not show significant correlation (p = 0.16), but after OK cessation these changes were correlated (p = 0.01). In the OK group, multivariate regression analysis showed changes in accommodative lag area were associated with AL progression in the first 6 months but not in the 1-year analysis. For the SVS group, there were no significant changes in the accommodative lag area or any aberrations during the study period.Increased HOAs and improved accommodative accuracy were observed during OK treatment, but began to regress after the cessation of OK. A significant positive correlation between improved accommodative accuracy and slowed axial elongation was only observed during the first 6 months of treatment.

COVID-19 quarantine provides the largest intervention data of myopia progression in schoolchildren. We found grade is an important risk factor, and COVID-19-induced modifications of student’s online time and outdoor activity time sufficiently change myopia progression.

Purpose: Reading speed in intermittent exotropia (IXT) children has been minimally examined. We assessed reading speed in school-age children with IXT and determined clinical characteristics of IXT that impacted their reading ability.Methods: A total of 63 school-age (10-16 years) children with intermittent exotropia and a group of 44 age-matched normal children were recruited. All children underwent ophthalmologic and binocular function evaluations. Reading speed was assessed with the International Reading Speed Texts (IReST). We compared reading speed of children with IXT to that of normal counterparts. In addition, the correlation between reading speed and clinical characteristics of IXT (i.e., angle of deviation, binocular function, fusion control) were evaluated.Results: Reading speed in children with IXT (231 ± 51 CPM) was much slower than their normal counterparts (257 ± 33 CPM, p=0.002). For further analysis, we divided the group of IXT patients into slow and non-slow reading groups. The average reading speed in the Slow group was significantly slower than that in the Non-slow group (158±25 CPM vs. 250±37 CPM, p < 0.001). After adjusting for the age and gender, we found a significant correlation between the LogTNO and reading speed in IXT group (r=-0.244, p=0.054). Age, gender and LogTNO were found to be factors associated with reading speed in children with IXT based on a generalized linear model. Conclusion: Our finding suggests that reading speed was slower in school-age children with IXT assessed with the International Reading Speed Texts. When age and gender were adjusted, poor stereo function at near was found to be related with a slower reading speed, and the stereoacuity at near was found to be associated with reading speed in children with IXT.

This essay establishes three factors, i.e. organic fertilizer, chemical fertilizer and organic fertilizer with cow carbide. The purpose of the present study was to elucidate influence of organic fertilizer and chemical fertilizer on yield and inner quality in spinach with fifteen treatments at five levels. The results showed that the contents of reducing sugar and nitrate nitrogen of spinach in organic fertilizer handling area was less than those in chemical fertilizer. No significant difference was found among the fresh weight, total sugar content and vitamin C content by utilization of organic fertilizer or chemical fertilizer.

Background Myopia is the most common visual impairment in children and adolescents worldwide. This study described an economical and effective population-based screening pipeline and performed the project of a million scale children and adolescents myopia survey (CAMS), which will shed light on the further study of myopia from the level of epidemiology and precision medicine. Methods We developed a novel population-based screening pattern, an intelligent screening process and internet-based information transmission and analysis system to carry out the survey consisting of school children in Wenzhou, China. The examination items include unaided distance visual acuity, presenting distance visual acuity, and non-cycloplegic autorefraction. Myopia and high myopia were defined as spherical equivalent (SE) ≤ − 1.00 diopters (D) and SE ≤ − 6.00 D, respectively. Next, the reports of the vision checking were automatically sent to parents and the related departments. The CAMS project will be done two to four times annually with the support of the government. An online eyesight status information management system (OESIMS) was developed to construct comprehensive and efficient electronic vision health records (EVHRs) for myopia information inquiry, risk pre-warning, and further study. Results The CAMS completed the first-round of screening within 30 days for 99.41% of Wenzhou students from districts and counties, in June 2019. A total of 1,060,925 participants were eligible for CAMS and 1,054,251 (99.37% participation rate) were selected through data quality control, which comprised 1305 schools, and 580,609, 251,050 and 170,967 elementary, middle, and high school students. The mean age of participants was 12.21 ± 3.32 years (6–20 years), the female-to-male ratio was 0.82. The prevalence of myopia in elementary, middle, and high school students was 38.16%, 77.52%, and 84.00%, respectively, and the high myopia incidence was 0.95%, 6.90%, and 12.98%. Conclusions The CAMS standardized myopia screening model involves automating large-scale information collection, data transmission, data analysis and early warning, thereby supporting myopia prevention and control. The entire survey reduced 90% of staff, cost, and time consumption compared with previous surveys. This will provide new insights for decision support for public health intervention.

The aim was to compare the repeatability of subjective accommodative amplitude (AA) measurements obtained using the modified push-up and minus-lens methods and determine the agreement with objective AA by an autorefractor.The right eyes of 47 adults aged 22-30 years (mean 25.1 ± 1.9) were measured by subjective AA using the modified push-up and minus-lens methods. Subjective AAs with first sustained blur and unreadable criteria were obtained with an average of three consecutive measurements. Measurements of the objective AA were simulated by the minus lens using an open-field autorefractor. The repeatability of two subjective AA methods and the agreement among the different methods was assessed.The AA value was dependent on the measuring method (F = 139.68, p 0.001). The AA of the minus-lens method with first sustained blur criterion (10.10 ± 1.71 D) was closest to the objective AA (9.01 ± 1.49 D). The minus-lens method with unreadable criterion had the best repeatability. The agreement between the minus-lens method and the objective methods was better than that between the modified push-up and the objective methods based on the difference and 95 per cent limits of agreement. The agreement was highest between the minus-lens method with the first sustained blur criterion and the objective method, which had the lowest average difference and a narrow 95 per cent limits of agreement.The subjective minus-lens method was more accurate for assessing the subjective AA in adults than the modified push-up method. The minus-lens method with the first sustained blur criterion was the optimal method for subjective AA. The minus-lens method with unreadable criterion can also be applied to clinical measurements, although it was approximately 0.95 D larger than the minus-lens method with the first sustained blur criterion.

ObjectiveSpectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) showed effective myopia control. This study was to investigate their effects on macular choroidal thickness (ChT) in myopic children.MethodsExploratory analysis from a 2-year, double-masked, randomised trial. 170 children aged 8–13 years with myopia between −0.75D and −4.75D, astigmatism of 1.50D or less, and anisometropia of 1.00D or less were recruited. Participants were randomly assigned in a 1:1:1 ratio to receive HAL, SAL or single vision spectacle lenses (SVL). The subfoveal, parafoveal and perifoveal ChT were evaluated every 6 months.Results154 participants completed all examinations. The ChT showed significant changes over time in all three groups in all regions (all pConclusionsThe ChT of the macula decreased after 2 years of myopia progression with SVL. Wearing spectacle lenses with aspherical lenslets reduced or abolished the ChT thinning and HAL had a more pronounced effect.Trial registration numberChiCTR1800017683.

Highly expressed in the retinal pigment epithelium (RPE), the RPE-specific 65-kDa (RPE65) enzyme is indispensable to generate 11-cis-retinal (11cRAL), a chromophore for rhodopsin and cone photopigments. RPE65 deficiency can lead to Leber congenital amaurosis type 2 (LCA2), in which the isomerization of photobleached all-trans-retinal into photosensitive 11cRAL is blocked, ultimately causing severe retinal dysfunction and degeneration. The related mouse models, which are constructed through gene knockout or caused by spontaneous mutations, morphologically present with early-onset and rapid retinal cone cells degeneration, including loss of short-wavelength-sensitive cone opsins (S-opsins) and mislocalization of medium-wavelength-sensitive cone opsins (M-opsins). Studies have shown that routine Rpe65 gene replacement therapy, mediated by an adeno-associated virus (AAV) vector, can restore RPE65 protein. However, AAV transfection and Rpe65 transgene expression require at least one to two weeks, and the treatment cannot fully block the early-onset cone degeneration. To determine the feasibility of delaying cone degeneration before gene therapy, we investigated the impact of 11cRAL treatment in an early-age LCA2 retinal degeneration 12 (rd12) mouse model. Similar to human patients, the mouse model carries a spontaneous mutation in the Rpe65 gene, which results in disrupted endogenous 11cRAL regeneration. We found that RPE65 deficiency did not notably affect rodent retinal vessels. Under red light illumination, the rd12 mice were intraperitoneally injected with exogenous 11cRAL from postnatal day (P) 14 to P21. Three days after the last injection, a notable recovery of retinal function was observed using scotopic and photopic electroretinograms. Using optical coherence tomography and histological analyses of the deficient retinas, we found changes in the thickness of the photoreceptor outer segment (OS); this change could be rescued by early 11cRAL treatment. In addition, the treatment notably preserved M- and S-opsins, both of which maintained appropriate localization inside cone cells, as shown by the wild-type mice. In contrast, the age-matched untreated rd12 mice were characterized by retinal S-opsin loss and M-opsin mislocalization from the photoreceptor OS to the inner segment, outer nuclear layer, or outer plexiform layer. Notably, 11cRAL treatment could not maintain retinal function for a long time. Ten days after the last injection, the rod and M-cone electroretinograms significantly decreased, and S-cone responses almost extinguished. Our findings suggest that early 11cRAL treatment is useful for restoring retinal function and rescuing morphology in the rd12 mouse model, and the early-onset and rapid cone degeneration can be delayed before gene therapy.

Purpose This prospective study assessed the influence of wearing and then discontinuing orthokeratology (OK) lenses on retinal shape and peripheral refraction in myopic children. Methods Fifty-eight myopic children (age 8–12 years) were equally divided into an OK group and a single vision spectacles (SVS) group. After 12 months of OK, it was discontinued for 1 month. Peripheral eye length (PEL), relative peripheral refraction (RPR), and corneal parameters were measured in the right eye on the nasal and temporal retinal sides at baseline, 6 months, and 12 months (13 months in OK group) visits. Results In the SVS group, faster elongation of the temporal side PEL made the eyes more asymmetric and prolate, developing a temporal pointed shape. In the OK group, the nasal retinal side PEL grew faster, the nasal RPR developed less hyperopic defocus, and the eye shape became more symmetric and less prolate. The central cornea became thinner and flattened, while the peripheral cornea became steeper. Changes in corneal thickness, relative peripheral corneal power, and K-values were no significant differences for the OK and SVS groups at 12 months. Conclusions The cornea reverted to be no difference with myopic children with SVS after 1 month discontinuation of OK. The retinal shape of SVS eyes became more asymmetric and prolate with myopia progression. OK remodelled retinal shape to be less asymmetric and less prolate.

We used swept-source (SS) optical coherence tomography (OCT) and OCT angiography (OCTA) to investigate the effects of moderate physical exercise on retinal and choroidal vessel densities (VDs) and thicknesses in children. One eye in each of 40 myopic children (mean age, 11.70 years) and 18 emmetropic children (mean age, 11.06 years) were included. SS-OCT 6 × 6-mm radial scans and SS-OCTA 3 × 3-mm images were centered on the macula. Heart rate (HR), systolic and diastolic blood pressure, and intraocular pressure (IOP) were recorded before and immediately after a 20-min stationary cycling exercise and after a 30-min rest. The subfoveal choroidal thickness (SFCT), choroidal thickness (CT), and VD at the superficial and deep retinal layers, choriocapillaris, and deeper choroidal vessels were determined. SFCT and CT were significantly lower at all locations immediately after exercise (p p p = 0.02) and higher in the superficial layer after rest (p = 0.03) in myopic eyes while it was higher in the superficial (p p p = 0.04 and p = 0.03, respectively). Exercise increased retinal VD after rest in emmetropic eyes, and caused significant CT thinning that lasted for at least 30 min in both emmetropic and myopic eyes.

Reducing myopia progression can reduce the risk of associated ocular pathologies.To evaluate whether spectacle lenses with higher lenslet asphericity have a higher myopia control efficacy throughout 2 years.This double-masked randomized clinical trial was conducted between July 2018 and October 2020 at the Eye Hospital of Wenzhou Medical University in Wenzhou, China. Children aged 8 to 13 years with a cycloplegic spherical equivalent refraction (SER) of -0.75 D to -4.75 D and astigmatism with less than -1.50 D were recruited. A data and safety monitoring committee reviewed findings from a planned interim analysis in 2019.Participants were randomly assigned in a 1:1:1 ratio to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL).Two-year changes in SER and axial length and their differences between groups.Of 157 participants who completed each visit (mean [SD] age, 10.4 [1.2] years), 54 were analyzed in the HAL group, 53 in the SAL group, and 50 in the SVL group. Mean (SE) 2-year myopia progression in the SVL group was 1.46 (0.09) D. Compared with SVL, the mean (SE) change in SER was less for HAL (by 0.80 [0.11] D) and SAL (by 0.42 [0.11] D; P ≤ .001). The mean (SE) increase in axial length was 0.69 (0.04) mm for SVL. Compared with SVL, increase in axial length was slowed by a mean (SE) of 0.35 (0.05) mm for HAL and 0.18 (0.05) mm for SAL (P ≤ .001). Compared with SVL, for children who wore HAL at least 12 hours every day, the mean (SE) change in SER was slowed by 0.99 (0.12) D, and increase in axial length slowed by 0.41 (0.05) mm.In this study, HAL and SAL reduced the rate of myopia progression and axial elongation throughout 2 years, with higher efficacy for HAL. Longer wearing hours resulted in better myopia control efficacy for HAL.Chinese Clinical Trial Registry Identifier: ChiCTR1800017683.

AimsTo evaluate the 1-year efficacy of two new myopia control spectacle lenses with lenslets of different asphericity.MethodsOne hundred seventy schoolchildren aged 8–13 years with myopia of −0.75 D to −4.75 D were randomised to receive spectacle lenses with highly aspherical lenslets (HAL), spectacle lenses with slightly aspherical lenslets (SAL), or single-vision spectacle lenses (SVL). Cycloplegic autorefraction (spherical equivalent refraction (SER)), axial length (AL) and best-corrected visual acuity (BCVA) were measured at baseline and 6-month intervals. Adaptation and compliance questionnaires were administered during all visits.ResultsAfter 1 year, the mean changes in the SER (±SE) and AL (±SE) in the SVL group were −0.81±0.06 D and 0.36±0.02 mm. Compared with SVL, the myopia control efficacy measured using SER was 67% (difference of 0.53 D) for HAL and 41% (difference of 0.33 D) for SAL, and the efficacy measured using AL was 64% (difference of 0.23 mm) for HAL and 31% (difference of 0.11 mm) for SAL (all pConclusionsSpectacle lenses with aspherical lenslets effectively slow myopia progression and axial elongation compared with SVL. Myopia control efficacy increased with lenslet asphericity.Trial registration numberChiCTR1800017683.

This study shows accommodative accuracy and distance accommodation facility in myopic children do not play a role in myopia progression. In 144 subjects, the monocular distance accommodative facility (DAF) and continuous accommodative stimulus–response curves (ASRCs) were measured at the enrolment. Retrospective and prospective refraction with regard to the enrolment visit were obtained from the outpatient database system based on noncycloplegic subjective spherical equivalent refraction (SER). The rate of myopic progression at enrolment was the first derivative of the Gompertz function, which was fitted with each subject's longitudinal refractive error data, including at least four records of SER with an interval of more than 6 months between each visit. A mixed linear model for multilevel repeated-measures data was used to explore the associations between the rate of myopia progression and accommodative parameters. The mean rate of myopia progression at enrolment was -0.61 ± 0.31 D/y with a mean age of 12.27 ± 1.61 years. By adjusting for age and SER, it was shown that the myopic progression rate was not associated with the accommodative lag (F = 0.269, P = 0.604), accommodative lag area (F = 0.086, P = 0.354), slope of ASRC (F = 0.711, P = 0.399), and DAF (F = 0.619, P = 0.432).

CuO was induced into red mud oxygen carrier materials to balance the temperature difference between the fuel and air reactors in chemical looping combustion. Considering the lower melting point of CuO, surface sintering and agglomeration might be inevitable, and only a low loading was applied in this work. The addition of CuO did not lower the overall redox activity, as demonstrated by both thermogravimetric analysis (TGA) and a bench-scale fluidized bed reactor. Instead, the oxygen transfer capacity was improved. A variety of characterization techniques were used to compare the crystal structure, surface morphology and physical properties before and after long-term reactions. The present results provide a potential strategy for the design and development of oxygen carriers with high stability and reactivity that maintain a lower required circulation rate.

Ilmenite ore is one of the promising oxygen carriers (OCs) used for coal-fueled Chemical-Looping Combustion (CLC) for electricity generation and CO2 capture. However, the low reactivity and natural activation of ilmenite OC are two major constrains impeding its application. This effort is to improve ilmenite OC’s performance by introducing a small amount of foreign elements, including alkali or alkaline earth metals (K and Ca) and transition metals (Cu, Mn, and Ni). Coating and re-granulation methods were used to prepare OCs where ilmenite ore was the primary constituent. The reactivity, transport capacity, and selectivity of these ilmenite-based OCs with wet syngas, as well as their performances in coal char-fueled CLC were investigated using a TGA, fixed- and fluidized-bed reactors. The addition of K-element significantly improved the OC’s reactivity with wet syngas and coal char. The strong catalytic function for WGSR from K-added OCs was found to play a vital role. Cu-coating hindered effectively Fe-element segregation on the surface of ilmenite OC during cyclic reaction, and the OC structural integrity was well maintained. Ca-, Ni- and Mn-added ilmenite OCs did not show promising prospects. The gasification rate and combustion efficiency could be respectively correlated to the reactivity and selectivity of different OCs except for the K-added samples.

Coal-based Pressurized Chemical Looping Combustion Combined Cycle (PCLC-CC) is the second generation of coal-fueled CLC plant, which possesses much higher plant efficiency and lower-CO2 capture cost compared to the first generation - Coal-based CLC combined solely with steam cycle. PCLC-CC has a similar plant configuration to the Pressurized Fluidized Bed Combined Cycle (PFBC), and is composed of a PCLC Island, gas turbine, Heat Recovery Steam Generator (HRSG) and steam cycle. In the fuel reactor of PCLC Island, the metal-based oxygen carrier (OC) supplies oxygen for coal combustion and in-situ CO2 capture. The air reactor of PCLC Island, where the OC is re-oxidized by air, serves as a combustion reactor to produce oxygen-depleted air of high temperature and high pressure to drive the gas turbine and the following steam cycle for large-scale power generation. This research provides an initial understanding of the complex reactions in the fuel reactor of the solid-fueled PCLC Island in the pressures range of 1–6 bars. Experiments conducted in the TGA apparatus and the fixed- and fluidized-bed reactors demonstrated the effects of operational pressure, coal char reactivity and different iron-based OCs behavior on the performance of PCLC.

Purpose The aim was to evaluate the repeatability of dynamic measurement of the accommodative stimulus–response curve (ASRC) at three different dioptric speeds using a modified instrument and its agreement with two other methods. Methods Twenty‐nine adults (23.5 ± 2.0 years) were enrolled in the study. ASRC was measured monocularly using three methods: dynamic and static measurement using a motorised Badal system mounted on an open‐field auto‐refractor (WAM‐5500, Grand Seiko Co., Ltd, Japan) and the minus lens technique. Dynamic measurements were conducted at three dioptric stimulus speeds to simulate continuous stimuli for ASRC (0.25, 0.40 and 0.55 D/s), with three repetitions for each speed. All three types of ASRCs were fitted with third‐degree polynomial equations. The slope and objective accommodative amplitude of the ASRC were analysed. Results The repeatability of objective accommodative amplitude worsened as the speed of the stimuli increased. The repeatability of the slope was best at a speed of 0.40 D/s and worst at 0.55 D/s. The measurement method significantly influenced the objective accommodative amplitude values and slope (both, p 0.05) and the slope was lowest at 0.55 D/s. Conclusion The accommodative stimulus–response curve values are method‐dependent and the significant differences between three methods used to determine the ASRC based on slope and accommodative amplitude indicate that these methods are non‐interchangeable. Using dynamic measurements, accommodative behaviour varies with the speed of dioptric‐change of the stimulus. A speed of 0.40 D/s appears to be the best compromise in terms of time, results and repeatability for dynamic ASRC measurement.

Background/aimsTo evaluate the predictive performance of various predictors, including non-cycloplegic refractive error, for risk of myopia onset under pragmatic settings.MethodsThe Wenzhou Medical University Essilor Progression and Onset of Myopia Study is a prospective cohort study of schoolchildren aged 6–10 years from two elementary schools in Wenzhou, China. Non-cycloplegic refraction, ocular biometry and accommodation measurements were performed. Myopia was defined as spherical equivalent (SE) ≤−0.5 diopter (D). ORs using multivariable logistic regression were determined. Area under the curve (AUC) evaluation for predictors was performed.ResultsSchoolchildren who attended both baseline and 2-year follow-up were analysed (N=1022). Of 830 non-myopic children at baseline, the 2-year incidence of myopia was 27.6% (95% CI, 24.2% to 31.3%). Female gender (OR=2.2), more advanced study grades (OR=1.5), less hyperopic SE (OR=11.5 per D), longer axial length (AL; OR=2.3 per mm), worse presenting visual acuity (OR=2.3 per decimal), longer near work time (OR=1.1 per hour/day) and lower magnitude of positive relative accommodation (PRA; OR=1.4 per D) were associated with myopia onset. PRA (AUC=0.66), SE (AUC=0.64) and AL (AUC=0.62) had the highest AUC values. The combination of age, gender, parental myopia, SE, AL and PRA achieved an AUC of 0.74.ConclusionApproximately one in four schoolchildren had myopia onset over a 2-year period. The predictors of myopia onset include lower magnitude of PRA, less hyperopic SE, longer AL and female gender. Of these, non-cycloplegic SE and PRA were the top single predictors, which can facilitate risk profiling for myopia onset.

Chemical looping combustion (CLC) is an energy conversion technology that can produce concentrated CO2 stream without the need for a gas separation step, and thus, has the potential to drastically reduce the energy consumption and cost associated with CO2 capture in power generation. The coal-direct chemical looping (CDCL) process is a CLC technology that uses a moving bed reducer configuration that can directly consume coal as a feedstock without requiring an upstream gasification step. An integrated 250 kWth CDCL pilot unit using iron-based oxygen carriers was constructed and demonstrated for over 1000 h of testing. The principles for the CDCL pilot unit design and operation are summarized in this article. During the 288-hour continuous operation testing, the CDCL pilot unit achieved >96% coal conversion with a CO2 purity of >97%. Low carbon carryover into the combustor, i.e.

s Chemical looping combustion (CLC) is an advanced technology developed to achieve highly efficient fuel combustion with in-situ CO2 capture. In this process, metal oxide particles are used as an oxygen carrier (OC) to transport lattice oxygen for fuel combustion. In this process, a stream of CO2 and steam is produced by successful separation of atmospheric N2 and the gaseous product of combustion. In CLC of solid fuel, metal oxide particles are physically mixed and react with solid fuel at high temperature using gasification enhancer, such as steam, or CO2. A full understanding of the reaction mechanism between the OC and solid fuel is vital for OC development and the fuel reactor design. Several reactions may be involved in solid-fueled CLC when an iron-based OC is used, including (1) solid fuel devolatilization/gasification, (2) OC reduction with intermediate syngas, (3) the solid-solid reaction between OC and solid fuel via direct contact, and (4) the homogeneous water-gas shift reaction. The former two reactions have been extensively studied in recent years. This study focuses on the third reaction, the solid-solid reaction, which occurs thermodynamically at typical operational temperatures of CLC. The direct solid-solid reaction between coal char and two iron-based OCs via random particle collision in a fluidization bed regime was investigated and focuses on the reaction kinetics and the carbon conversion at different temperature. The contribution of the solid-solid reaction to the global carbon conversion was estimated for steam-gasified CLC at different temperature. The solid-solid reaction via static contact in a thermal-gravimetric analyzer (TGA) was also tested to evaluate the role of different OCs and to better understand the reaction mechanism between the two solid particles.

Chemical looping combustion (CLC) is an advanced technology with inherent CO2 capture in which a solid oxygen carrier circulates between an air reactor and a fuel reactor. For coal-fueled CLC, the existence of solid impurities requires the oxygen carrier not only to have good reactivity but also to be contaminant-resistant, low-cost, and readily available. Therefore, the development of cost-effective and well-performing oxygen carriers is very meaningful for the coal-fueled CLC process. Natural red mud, a byproduct from the aluminum industry, was found to function well as an oxygen carrier and has also been found to have in situ coal catalytic gasification behavior. A thorough study on the long-term cyclic performance of red mud with coal char in a fluidized reactor was conducted in this work. For the purpose of comprehensively understanding the functions of inert supports as well as the sodium content in red mud, the effect of various inert oxides (Al2O3, SiO2, TiO2, and CaO) and the addition of sodium w...

PURPOSE To compare personalized near addition values for myopic children that induce a reasonable phoria (Ph) (meeting Sheard's criterion) and induce a null lag of accommodation at near and to evaluate changes in these metrics after lens adaptation. METHODS Fifty-three myopic children participated in this study. Accommodative response, Ph, and fusional amplitudes (FAs) were measured at 33 cm through multiple addition lenses (0D, +1.00D, +1.50D, +2.00D, +2.50D, +3.00D). The adaptation effect on measured parameters was evaluated after 6 min of near work with each addition. The FA/Ph ratios were calculated for each addition and fitted using a rational function to obtain the optimal addition value satisfying Sheard's criterion (FA/Ph ≥ 2). Lag of accommodation change in association with addition value was assessed using linear regressions to obtain the addition values inducing a null lag. RESULTS Lag of accommodation (r = -0.987, p < 0.001) and Ph (r = -0.999, p < 0.001) decreased linearly with addition value. The 6-min adaptation induced a small but significant increase in accommodative lag and an exophoric shift (p < 0.05). Three FA/Ph patterns with respect to addition lenses were observed based on the near Ph: orthophoria/exophoria, low esophoria, and large esophoria. Addition values based on Sheard's criterion (mean ± SD, +2.16 ± 0.79D) were significantly lower than those based on null lag (+2.83 ± 0.44D, t = 19.86, p < 0.001). The FA/Ph ratio was less than 2.0 in 75.5% of subjects with additions determined through null accommodative lag. Additions determined through FA/Ph ≥ 2 induced a lag of accommodation of 0.38 ± 0.42D. CONCLUSIONS Personalized near addition values using Sheard's criterion were lower than those obtained through null lag of accommodation. These values should allow a better binocular balance especially for exophoric children.