BackgroundTo determine the change in refractive error and the incidence of myopia among school-aged children in the Yongchuan District of Chongqing City, Western China.MethodsA population-based cross-sectional survey was initially conducted in 2006 among 3070 children aged 6 to 15 years. A longitudinal follow-up study was then conducted 5 years later between November 2011 and March 2012. Refractive error was measured under cycloplegia with autorefraction. Age, sex, and baseline refractive error were evaluated as risk factors for progression of refractive error and incidence of myopia.ResultsLongitudinal data were available for 1858 children (60.5%). The cumulative mean change in refractive error was −2.21 (standard deviation [SD], 1.87) diopters (D) for the entire study population, with an annual progression of refraction in a myopic direction of −0.43 D. Myopic progression of refractive error was associated with younger age, female sex, and higher myopic or hyperopic refractive error at baseline. The cumulative incidence of myopia, defined as a spherical equivalent refractive error of −0.50 D or more, among initial emmetropes and hyperopes was 54.9% (95% confidence interval [CI], 45.2%–63.5%), with an annual incidence of 10.6% (95% CI, 8.7%–13.1%). Myopia was found more likely to happen in female and older children.ConclusionsIn Western China, both myopic progression and incidence of myopia were higher than those of children from most other locations in China and from the European Caucasian population. Compared with a previous study in China, there was a relative increase in annual myopia progression and annual myopia incidence, a finding which is consistent with the increasing trend on prevalence of myopia in China.

Background: To investigate the prognostic value of clinical features and metabolic parameters in pretreatment 18 F-2-fluoro-2-deoxy-D-glucose ( 18 F-FDG) positron emission tomography/X-ray computed tomography (PET/CT) scans of patients with angiosarcoma, a rare neoplasm that has not been well characterized.Methods: In this retrospective study, 19 patients with a histopathologically confirmed diagnosis of angiosarcoma who had undergone pretreatment 18 F-FDG PET/CT scans were enrolled. We recorded the age at presentation, sex, underlying diseases, sites of primary tumors, Karnofsky Performance Status (KPS) score, Eastern Cooperative Oncology Group (ECOG) score, time from onset to diagnosis, laboratory examinations, sites and sizes of primary tumors, treatment modalities, histologic features and American Joint Committee on Cancer (AJCC) stage, maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of primary tumors and the whole body.Univariate and multivariate survival analyses for overall survival were performed according to the metabolic parameters and other clinical variables.Results: Patients ranged in age from 27 to 79 years (median: 59 years) with different angiosarcoma types covering all tumor grades and subtypes. Seven (7/19) patients had anemia of varying degrees of severity.Lymph node metastases (n=10) and/or distant metastases (n=11) of angiosarcoma were common. Bone or bone marrow (10/19) and lung (8/19) were the most common distant metastatic organs. Patients with bone metastases, low hemoglobin levels and high ferritin levels had significantly poorer overall survival than those with non-bone metastases, normal hemoglobin levels and normal ferritin levels by the log-rank test, with P values of 0.027, 0.030 and 0.015, respectively. Patients with multiple organ metastases had significantly poorer overall survival than those with single organ metastasis (log-rank P=0.008). In multivariate survival analysis, only whole-body metabolic tumor volume using SUV max cut-off value of 2.5 (wMTV 2.5 ) was a significant independent prognostic factor. For wMTV 2.5 , 870.3 cm 3 was the best cut-off point to discriminate between a good and poor prognosis (log-rank P=0.01). Conclusions:The systemic 18 F-FDG PET/CT with high sensitivity and specificity has significant ^ ORCID: 0000-0003-3388-7907. advantages in the evaluation of angiosarcoma, particularly in detecting occult metastases. Bone metastases on 18 F-FDG PET/CT, low hemoglobin levels and high ferritin levels were all associated with a poorer prognosis. MTV 2.5 of the whole body is a significant independent metabolic prognostic factor for overall survival in patients with angiosarcoma.

SIGNIFICANCEWe used an Akeso device to record the visual behavior of children with myopia in two learning modes. We found that online class mode may increase near-viewing time and reduce outdoor time compared with the traditional school mode and may be responsible for accelerating myopia progression.PURPOSEWe aimed to explore the effects of visual behavior in different learning modes on myopia progression among children 9 to 11 years old.METHODSForty-nine children were included and requested to use a wearable device to objectively record visual behavior in real time from November 2019 to November 2020; participants took online classes from mid-February to early May 2020 during this period. Data (including glasses-wearing time, outdoor time, and near-viewing time) were collected during two 14-day periods, which included the online class learning mode (March 2 to 15, 2020) and the traditional school mode (May 20 to June 2, 2020). Spherical equivalent refraction and axial length were obtained at baseline, at 6-month intervals, and 1 year later.RESULTSOutdoor time during online class mode (median, 9.5 minutes; interquartile range, 0.75 to 48 minutes) was significantly lower than during the school mode (median, 29 minutes; interquartile range, 11.50 to 50 minutes; P < .001). The mean ± standard deviation of near-viewing time was significantly different between online class mode (396.58 ± 114.41 minutes) and school mode (376.52 ± 93.99 minutes; P = .007, F = 19.56). In comparison with the baseline examination (−2.33 ± 0.81 D), mean spherical equivalent refraction in oculus dexter corresponding to the 6-month examination was decreased (−2.94 ± 0.83 D, P = .001), indicating a significant increase in myopia during online class mode.CONCLUSIONSThis study provides evidence of the association of learning mode and myopia progression. Accelerated progression of myopia in online class mode may be related to increased near-viewing time and decreased time spent in outdoor activities.

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This project was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-CCC-12002184).