http://hdl.handle.net/10453/35218 2026-06-26T12:07:18Z http://hdl.handle.net/10453/195377 Title: Atropine or Cyclopentolate to Diagnose Premyopia in Preschool Children. Authors: Wu, H; Wang, Y; Lu, Q; Rose, KA; Morgan, IG; Ni, Z; Xiang, K; Qi, Z; Zhang, B; Wang, J; Chen, J; Xu, X; He, X Abstract: IMPORTANCE: Sufficient cycloplegia is essential for reliable refraction in preschool children. The choice of cycloplegic agent may affect refraction and diagnosis outcomes. OBJECTIVE: To evaluate the objective refraction outcomes after cycloplegia in preschool children given either atropine or cyclopentolate. DESIGN, SETTING, AND PARTICIPANTS: This was a post hoc analysis of the 2024 Preschool Children Refractive Development Pattern and Influencing Factors Study (PRDP-IFS), in which children were given atropine, and the 2013 to 2014 Elaborative Shanghai Childhood Ocular Refractive Development Study (E-SCORDS), in which children were given cyclopentolate. These were population-based studies. Eyes in each group were included via propensity score matching. Study data were analyzed from December 2024 to July 2025. EXPOSURES: Cycloplegia induced by either 1% atropine (twice daily for 4 days with an additional dose on day 5) or 1% cyclopentolate (dual administration 5 minutes apart) eye drops. MAIN OUTCOMES AND MEASURES: Difference between the noncycloplegic and cycloplegic spherical equivalent (DSE) and the prevalence of refractive states were compared in the atropine and cyclopentolate groups. Refractive states (moderate to high hyperopia, low hyperopia, premyopia, and myopia) were determined by cycloplegic spherical equivalent (SE) using an autorefractor. RESULTS: A total of 1761 children and their 3048 eyes were included in this study. There were 773 children (1524 eyes) in the atropine group (mean [SD] age, 4.62 [0.92] years; 406 male [52.5%]) and 988 children (1524 eyes) in the cyclopentolate group (mean [SD] age, 4.62 [0.93] years; 530 male [53.6%]). There were a total of 1524 eyes in each group. The mean (SD) noncycloplegic SE was 0.30 (0.92) diopters (D) and 0.31 (0.76) D in the atropine and cyclopentolate groups, respectively (mean difference, -0.01 D; 95% CI, -0.07 to 0.05 D; P = .72). Mean (SD) DSE in the atropine group was 1.56 (0.72) D and in the cyclopentolate group was 0.97 (0.70) D. The mean difference in DSE between the 2 groups was 0.59 D (95% CI, 0.54-0.64 D; P < .001). The difference in the percentages of refractive states between the atropine and cycloplegic groups was as follows: moderate to high hyperopia (7.2% vs 2.7% = 4.5%; 95% CI, 2.9%-6.0%; P < .001), low hyperopia (82.8% vs 74.0% = 8.8%; 95% CI, 6.0%-11.8%; P < .001), premyopia (8.7% vs 21.6% = -12.9%; 95% CI, -15.4% to -10.4%; P < .001), and myopia (1.3% vs 1.8% = -0.5%; 95% CI, -1.3% to 0.4%; P = .30). CONCLUSIONS AND RELEVANCE: This study found that use of atropine for cycloplegia in preschool children was associated with less myopic refraction compared with cyclopentolate and may potentially avoid overestimation of premyopia prevalence; however, this investigation did not evaluate each cycloplegic agent in the same children. 2025-11-01T00:00:00Z http://hdl.handle.net/10453/195373 Title: Association of Sex With All-Cause and Cause-Specific Peritoneal Dialysis Discontinuation. Authors: Sabanayagam, D; Lopez, P; Boroumand, F; Chau, K; Au, EH; Gately, R; Bakar, KS; Zhu, L; Teixeira-Pinto, A; Lim, WH; Wong, G Abstract: RATIONALE & OBJECTIVE: Little is known about the association between sex and specific causes of peritoneal dialysis (PD) discontinuation. This study assessed the association of sex with all-cause and cause-specific PD discontinuation and explored the factors mediating these relationships. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: All patients with kidney failure who started PD between 2005 and 2019 in Australia. EXPOSURE: Sex. OUTCOME: All-cause (transfer to hemodialysis for≥30 days or death) PD discontinuation, PD discontinuation related to inadequate dialysis, and PD discontinuation related to infection. ANALYTICAL APPROACH: Adjusted cause-specific proportional hazards regression models were used to assess the association of sex with all-cause and cause-specific PD discontinuation. Counterfactual mediation analysis was conducted to explore potential mediators (sociodemographic status, geographical remoteness, cardiovascular disease, diabetes, history of peritonitis, late referral, smoking status, and body mass index) of these associations. Sensitivity analyses using the Fine and Gray method were implemented to address the competing risks of death, kidney transplantation, and other causes of PD discontinuation. RESULTS: Of 9,748 incident patients, 6,001 experienced PD discontinuation from any cause (2,098 died, 793 were inadequate dialysis related, 1,442 were infection related, and 1,668 were other cause), with a median follow-up of 1.47 years (IQR, 0.67-2.73). Men were more likely to experience PD discontinuation from any cause (HR, 1.09 [95% CI, 1.03-1.14], P=0.002) or for inadequate dialysis (HR, 1.71[95% CI, 1.47-1.99], P<0.001) but not for infection (HR, 0.95[95% CI, 0.85-1.05], P=0.3). The mediation analyses found that 76.9% of the total effect of sex on all-cause PD discontinuation was explained by mediators, including cardiovascular disease, smoking status, and diabetes, whereas less than 10% of the total effect of sex on PD discontinuation from inadequate dialysis was explained by mediators. LIMITATIONS: Residual and unmeasured confounders, such as biological differences, behavioral patterns, hospitalizations, frailty, and severity of comorbidities. CONCLUSIONS: Men were more likely than women to experience PD discontinuation from any cause and from inadequate dialysis. This relationship was mediated by multiple morbidities for PD discontinuation from any cause but not for PD discontinuation for inadequate dialysis. These findings may inform future studies evaluating biological and sociodemographic factors that may contribute to these observed sex differences. PLAIN-LANGUAGE SUMMARY: Sex and gender differences can influence kidney disease risk, progression, access to care, and outcomes. However, their role in peritoneal dialysis (PD) discontinuation is not well understood. We studied the association between sex and PD discontinuation in Australian patients with kidney failure from 2005 to 2019, and whether sociodemographic factors and comorbidities influenced this relationship. We found that men were more likely to discontinue PD overall and because of inadequate dialysis but not because of infectious complications. Cardiovascular disease, smoking, and diabetes explained most of the differences between men and women for all-cause PD discontinuation but not for discontinuation due to inadequate dialysis. These findings may inform future studies evaluating biological and sociodemographic factors that may contribute to these observed sex differences. 2025-10-01T00:00:00Z http://hdl.handle.net/10453/195312 Title: Impact of birth weight on cardiovascular disease and mediating role of metabolic traits: a Mendelian randomisation study. Authors: Zhuang, J; Chen, S; Long, J; Ding, D; Lam, LT; Li, J; An, R Abstract: BACKGROUND: Birth weight (BW) has been linked to cardiometabolic diseases, but causal associations with a comprehensive range of cardiovascular outcomes and underlying metabolic mechanisms remain unclear. METHODS: We applied a two-sample Mendelian randomisation (MR) approach to evaluate causal relationships between genetically predicted BW and 16 distinct cardiovascular diseases (CVD). We further conducted a two-step MR mediation analysis to quantify the mediating roles of 24 metabolic traits covering body composition, glucose metabolism, lipid metabolism, blood pressure, fatty acids and amino acids. RESULTS: Genetically lower BW was associated with higher risks of coronary heart disease (OR 0.72, 95% CI 0.65 to 0.81), myocardial infarction (OR 0.71, 95% CI 0.63 to 0.80) and angina pectoris (OR 0.81, 95% CI 0.72 to 0.90). These effects were partly mediated by type 2 diabetes, systolic blood pressure, total cholesterol and triglycerides, explaining 11.76-33.33% of the total associations. In contrast, genetically higher BW increased the risk of aortic aneurysm (OR 1.46, 95% CI 1.21 to 1.75), venous thromboembolism (OR 1.22, 95% CI 1.09 to 1.36) and atrial fibrillation (OR 1.34, 95% CI 1.21 to 1.48). These associations were partly explained by body composition traits, with appendicular lean mass and body mass index mediating 10.53-26.32% of the effect on aortic aneurysm, 15.79-68.42% of the effect on venous thromboembolism and 10.34-58.62% of the effect on atrial fibrillation. CONCLUSIONS: Our study provides robust evidence of distinct causal pathways linking BW with adult cardiovascular risks through specific metabolic mediators. These findings highlight the importance of optimal fetal growth and lifelong metabolic health management as critical strategies to reduce CVD burden. 2025-10-31T00:00:00Z http://hdl.handle.net/10453/195292 Title: Anticandidal Effects of Ocimum basilicum and Ocimum sanctum: Unveiling in vitro and in vivo Efficacy against Systemic Candidiasis. Authors: Gupta, S; Nagar, L; Singla, M; Smriti,; Singh, SK; Gupta, G; Bhojraj, S; Syed, RU; Alshammari, A; Alshammari, MD; Alshammari, NNO; Alshammari, ANO; Alhaidan, EM Abstract: BACKGROUND: This research explored the antimicrobial, antifungal, and in vivo anticandidal activities of two herbal extracts: Ocimum basilicum (HEOB) and Ocimum sanctum (HEOS). Additionally, the study analyzed the phytochemical components of these extracts. AIM: To examine the efficacy of HEOB and HEOS extracts in terms of their antimicrobial, antifungal, and anti-candidal activities and analyze their phytochemical composition, antioxidant potential, and immunomodulatory properties in vivo. METHODS: Dried flowers and leaves from Ocimum basilicum and Ocimum sanctum were extracted using a cold maceration process with a 1:1 ethanol-water solution. Phytochemical analysis followed established protocols, and the total phenolic and flavonoid contents were measured using colourimetric methods. HPLC was used to determine the concentrations of specific compounds, including rosmarinic acid, rutin, eugenol, and quercetin. Antioxidant activity, specifically nitric oxide (NO) scavenging and antimicrobial properties, was assessed in vitro using the cup plate method. In vivo studies were conducted on immunocompromised mice with systemic candidiasis, treated with plant extracts at 200 and 400 mg/kg or with ketoconazole as a control. Survival rates, tissue histology, and leukocyte counts were evaluated, and statistical analysis was performed using ANOVA. RESULTS: HEOB and HEOS extracts possess strong antimicrobial and antioxidant activities, largely due to flavonoids such as rutin, quercetin, rosmarinic acid and eugenol. In vivo experiments revealed that both extracts effectively reduced fungal load, increased survival rates, and alleviated immunosuppression in mice with systemic candidiasis. The extracts also exhibited significant immunomodulatory properties by boosting cellmediated immune responses. At higher concentrations, the antifungal performance of HEOB and HEOS was similar to that of ketoconazole. CONCLUSION: HEOB and HEOS exhibited strong antibacterial, antifungal, and anticandidal properties, showing significant effectiveness in treating systemic candidiasis. Their immunomodulatory effects and ability to boost cell-mediated immunity make these extracts promising options for addressing systemic candidiasis, particularly in individuals with weakened immune systems. This research offers valuable insights and sets the stage for future investigations into the treatment of oral and vaginal candidiasis. 2026-01-01T00:00:00Z