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Inherited retinal diseases (IRDs) comprise a phenotypically and genetically heterogeneous group of ocular disorders that cause visual loss via progressive retinal degeneration. Here, we report the genetic characterization of 1210 IRD pedigrees enrolled through the Japan Eye Genetic Consortium and analyzed by whole exome sequencing. The most common phenotype was retinitis pigmentosa (RP, 43%), followed by macular dystrophy/cone- or cone-rod dystrophy (MD/CORD, 13%). In total, 67 causal genes were identified in 37% (448/1210) of the pedigrees. The first and second most frequently mutated genes were EYS and RP1, associated primarily with autosomal recessive (ar) RP, and RP and arMD/CORD, respectively. Examinations of variant frequency in total and by phenotype showed high accountability of a frequent EYS missense variant (c.2528GA). In addition to the two known EYS founder mutations (c.4957dupA and c.8805CG) of arRP, we observed a frequent RP1 variant (c.5797CT) in patients with arMD/CORD.

Context: Strengthening of ankle plantar flexor muscles is one of the important components in the rehabilitation of many lower limb injuries and disorders. However, there are few simple methods to evaluate ankle plantar flexor strength in clinical situations without using equipment. The purpose of this study was to verify the intraexaminer and interexaminer reliability and the concurrent validity of a novel ankle isometric plantar flexion (PF) strength test (PF break test [PFBT]). Design: Case–control study. Methods: The intraexaminer and interexaminer reliabilities of the PFBT were evaluated in 57 orthopedic patients and 30 healthy adults. The range of motion of the ankle joint and the number of heel raises were compared between positive and negative PFBT cases. Then, isometric ankle PF torque (ankle PF of 0°, 15°, and 30°) was compared in knee extension and in the 50° flexion position between positive and negative PFBT cases in 30 healthy adults. Results: The intraexaminer reliability (κ) of the PFBT was .81 to .94, and the interexaminer reliability (κ) was .37 to .74. The PFBT positive group had a significantly smaller range of motion in the ankle joint (P P P P Conclusion: The PFBT is considered a simple and valid method to evaluate isometric ankle PF strength in the clinical setting.

In this study, we applied the reverse time migration (RTM) method to ultrasonic defect imaging in anisotropic materials. RTM offered that the defect shape could be uniquely determined by calculating a cross correlation of the incident and the reverse propagated waves from the array transducer. 2D simulations demonstrated that defect imaging by the RTM method requires an accurate numerical setup. We validated our technique using measured scattered waves from a slit in unidirectional solidified 316L stainless steel. By using the elastic constants determined from the ultrasonic wavefield data, the slit shape was correctly reconstructed. This provides a proof of principle that the RTM method is effective in nondestructive imaging of composite structures containing anisotropic materials.

The number of awake craniotomies is increasing because of its beneficial features. However, not enough information is available regarding the current status of awake craniotomy in Japan. To evaluate the current status of awake craniotomy in institutes, a nationwide questionnaire survey was conducted. From June to August 2019, we conducted a questionnaire survey on awake craniotomy in the neurosurgery department of 45 institutes that perform awake craniotomies in Japan. Responses were obtained from 39 institutes (response rate, 86.7%). The main methods of awake craniotomy were almost the same in all institutes. Twenty-six institutes (66.7%) had fewer than 10 awake craniotomies (low-volume institutes) per year, and 13 high-volume institutes (33.3%) performed more than 10 awake craniotomies annually. Some institutes experienced a relatively high frequency of adverse events. In 11 institutes (28.2%), the frequency of intraoperative seizures was more than 10%. An intraoperative seizure frequency of 1%-9%, 10%-29%, and over 30% was identified in 12 (92%), 0 (0%), and 1 (8%) of the high-volume institutes, which was significantly less than in 16 (62%), 10 (38%), and 0 (0%) of the low-volume institutes (p = 0.0059). The routine usage of preoperative antiepileptic drugs was not different between them, but the old type was used more often in the low-volume institutes (p = 0.0022). Taken together, the annual number of awake craniotomies was less than 10 in over two-thirds of the institutes. Fewer intraoperative seizures were reported in the high-volume institutes, which tend not to preoperatively use the old type of antiepileptic drugs.

To determine the area of the surface foveal avascular zone (FAZ) in children with posterior microphthalmos (PM), high hyperopia, and normal eyes using optical coherence tomography (OCT) and OCT angiography (OCTA).Thirty-six children were studied including 6 cases 12 eyes of PM (mean age 9.5 ± 5.2 years), 15 cases 30 eyes of high hyperopia (6.9 ± 1.5 years), and 15 cases 30 eyes of healthy individuals (8.7 ± 1.7 years). The B- and C-scan images in all children were recorded by OCT and OCTA with a scanning area of 3.0 × 3.0 mm centered on the fovea. All images were corrected for axial length differences, and the area of the FAZ surface and central macular thickness (CMT) was measured manually and compared.The area of FAZ in the PM group was 0.007 ± 0.003 mmThese findings indicate that patients with PM have a hypoplastic macular region, which must be considered in any treatment of these eyes.

Background Metastatic lung tumor with a tumor thrombus in the peripheral pulmonary vein is very rare. We present a case of a metastatic lung tumor from hepatocellular carcinoma (HCC) with tumor thrombus invasion in the pulmonary vein that was diagnosed preoperatively and underwent complete resection by segmentectomy. Case presentation A 77-year-old man underwent laparoscopic lateral segment hepatectomy for HCC eight years ago. Protein induced by vitamin K absence or antagonist-II remained elevated from two years ago. Contrast-enhanced chest computed-tomography (CT) showed a 27 mm nodule in the right apical segment (S1). He was pathologically diagnosed with a metastatic lung tumor from HCC via transbronchoscopic biopsy. We planned to perform right S1 segmentectomy. Before surgery, contrast-enhanced CT in the pulmonary vessels phase for three-dimensional reconstruction showed that the tumor extended into the adjusting peripheral pulmonary vein, and we diagnosed tumor thrombus invasion in V1a. The surgery was conducted under 3-port video-assisted thoracic surgery. First, V1 was ligated and cut. A1 and B1 were cut. The intersegmental plane was cut with mechanical staplers. Pathological examination revealed moderately-differentiated metastatic HCC with tumor thrombus invasions in many pulmonary veins, including V1a. No additional postoperative treatments were performed. Conclusions As malignant tumors tend to develop a tumor thrombus in the primary tumor, it might be necessary to perform contrast-enhanced CT in the pulmonary vessel phase to check for a tumor thrombus before the operation for metastatic lung tumors.

Purpose: The protracted coronavirus disease (COVID-19) pandemic has caused an unprecedented global health, social, economic, and psychological crisis. COVID-19 is transmitted via droplets, which include volatile organic compounds (VOCs) emitted by COVID-19 carriers. As a result, medical healthcare workers interacting with COVID-19 patients are at a high risk of infection. In this study, we measured the concentration of total VOCs (TVOCs) in the droplets of patients during conversations. Methods: Thirty patients aged 20–88 years were enrolled in this study. The amounts of VOCs, formaldehyde (HCHO), and carbon dioxide (CO2) as surrogate parameters for the patient’s droplets were measured at a distance of 1 m from the patients under the following conditions: 1) no conversation with a mask on, 2) conversation with a mask on, 3) conversation without a mask on, and 4) no conversation without a mask on. Results: The average concentrations of TVOCs (mg/m3), HCHO (mg/m3), and CO2 (ppm) were all the lowest before the masked conversation (1.79 ± 1.72, 0.25 ± 0.25, 1193 ± 516), increased during the masked conversation (1.99 ± 1.87, 0.29 ± 0.24, 1288 ± 555), were the highest during the unmasked conversation (3.10 ± 1.86, 0.45 ± 0.28, 1705 ± 729), and decreased to baseline after the unmasked conversation (1.89 ± 1.88, 0.26 ± 0.27, 1191 ± 518, respectively). Variations in TVOC and HCHO concentrations were positively correlated with patient age (TVOC: r = 0.42, p = 0.019 and HCHO: r = 0.47, p = 0.008). Conclusion: Wearing a mask reduced the VOC concentrations measured during conversations more than when a mask was not worn. Therefore, wearing a mask can reduce the emission of airborne droplet-derived VOCs and thereby reduce the risk of transmission of unknown patient-derived infections. Clinical Trial Registration no: The Clinical Trial Registration no: (UMIN000039595)

Highly purified specimen of saltpetre, kept in two glass jars are stored in the collections of the Natural History Museum, London, United Kingdom. Historic catalogs of the specimen collection record their acquisition date as 17th March, 1881. The specimen represent heritage of the saltpetre industry during the times of the colonial British India. Chemical analysis shows that they are highly refined, containing only traces of impurities. Dual isotopic composition (δ15N and δ18O) of nitrate implies their intrinsic origin as British India. In addition, relative to highly radiogenic signature of Sr widespread throughout India, less radiogenic strontium (87Sr/86Sr = 0.707859–0.714168) in the specimens suggests that final stages of the refining took place in western India where relevant waters containing pristine Sr were used. Stable isotope geochemistry in combination with history and socio-economy provide new insights into this research area which is not yet fully understood.

The liver has been thought to protect against oxidative stress through mechanisms involving reduced glutathione (GSH) that consumes high-energy phosphor-nucleotides on its synthesis. However, hepatoprotective mechanisms in acute liver failure (ALF) where the phosphor-nucleotides are decreased in remain to be solved. Liver tissues were collected from patients with ALF and liver cirrhosis (LC) and living donors (HD) who had undergone liver transplantation. Tissues were used for metabolomic analyses to determine metabolites belonging to the central carbon metabolism, and to determine sulfur-containing metabolites. ALF and LC exhibited a significant decline in metabolites of glycolysis and pentose phosphate pathways and high-energy phosphor-nucleotides such as adenosine triphosphate as compared with HD. Conversely, methionine, S-adenosyl-l-methionine, and the ratio of serine to 3-phosphoglycerate were elevated significantly in ALF as compared with LC and HD, suggesting a metabolic boost from glycolysis towards trans-sulfuration. Notably in ALF, the increases in hypotaurine (HTU) + taurine (TU) coincided with decreases in the total amounts of reduced and oxidized glutathione (GSH + 2GSSG). Plasma NH3 levels correlated with the ratio of HTU + TU to GSH + 2GSSG. Increased tissue levels of HTU + TU vs total glutathione appear to serve as a biomarker correlating with hyperammonemia, suggesting putative roles of the HTU-TU pathway in anti-oxidative protective mechanisms.

Awake craniotomy enables mapping and monitoring of brain functions. For successful procedures, rapid awakening and the precise evaluation of consciousness are required. A prospective, observational study conducted to test whether intraoperative hand strength could be a sensitive indicator of consciousness during the awake phase of awake craniotomy. Twenty-three patients who underwent awake craniotomy were included. Subtle changes of the level of consciousness were assessed by the Japan Coma Scale (JCS). The associations of hand strength on the unaffected side with the predicted plasma concentration (Cp) of propofol, the bispectral index (BIS), and the JCS were analyzed. Hand strength relative to the preoperative maximum hand strength on the unaffected side showed significant correlations with the Cp of propofol (ρ = − 0.219, p = 0.007), the BIS (ρ = 0.259, p = 0.002), and the JCS (τ = − 0.508, p = 0.001). Receiver operating characteristic curve analysis for discriminating JCS 0–1 and JCS ≥ 2 demonstrated that the area under the curve was 0.76 for hand strength, 0.78 for Cp of propofol, and 0.66 for BIS. With a cutoff value of 75% for hand strength, the sensitivity was 0.76, and the specificity was 0.67. These data demonstrated that hand strength is a useful indicator for assessing the intraoperative level of consciousness during awake craniotomy., 握力が覚醒下開頭手術中の覚醒度の指標となる. 京都大学プレスリリース. 2022-01-11.

Purpose: A new 1-day disposable soft contact lens (SCL), verofilcon-A, constructed of silicone hydrogel material, has recently become available in Japan. This SCL has a very smooth surface produced by using the SMARTSURFACE ® Technology, and it was expected that pollen particles and protein components would not adhere easily to its surface. We examined the degree of pollen adhesion to the surface of the verofilcon-A material SCL and compared the results with those of other 1-day disposable SCLs (1DSCL). Methods: To determine the number of pollen grains attached to the surface of different types of SCLs, 0.01 mg/ml of cedar pollen solution was dropped onto the surface of 13 types of 1DSCL. After 24 h, each 1DSCL was rinsed in a shaker and washed five times with saline (n = 10 for each 1DSCL type). The number of pollen particles adhered to the 1DSCL and the percentage of surface area occupied by pollen was determined. Results: The number of pollen particles on the 1DSCLs ranged from 0 to 185 in the 200 × 200 µm area. The number of particles was lowest in the delefilcon-A and verofilcon-A SCLs with 0 particles, and the number was higher in the other 11 1DSCLs. The number of pollen particles was negatively correlated with the water content (r = −0.48), oxygen permeability (Dk; r = −0.43), oxygen transmissibility (r = −0.42), and center thickness (r = −0.33) of the 1DSCLs. The pollen adhesion area ranged from 0.0% to 3.1% and was lowest in the delefilcon-A and verofilcon-A 1DSCLs. There were significant differences in the pollen adhesion area between colored 1DSCLs (2.73 ± 1.97%) and clear 1DSCLs (1.03 ± 1.01%, PP Conclusion: These findings indicate that the verofilcon-A 1DSCL processed with SMARTSURFACE™ Technology is an excellent option for SCL users with allergic conjunctivitis during the high pollen season.

Background It is unclear what interventions can sustain long-term higherphysical activity (PA) to improve breast cancer outcomes. Thus, this study aimed to evaluate the long-term effects of interventions on PA after breast cancer treatment. Methods This was an open-label randomized controlled trial for patients with stage 0-III breast cancer evaluating the efficacy of exercise and educational programs on long-term PA compared with usual care. The primary endpoint was proportion of patients with recreational PA (RPA) ≥5 metabolic equivalents(METs)/week at 1 year after registration. Results From 01/03/2016 to 15/03/2020, breast cancer patients were registered in the control (n = 120), education (n = 121), or exercise (n = 115) group. There were no significant differences in proportion of RPA ≥5 METs/week at 1 year between the exercise and control groups (54% and 53%, P = 0.492) and between the education and control groups (62% and 53%, P = 0.126). Significant difference in reductions from baseline at 1 year were noted on body weight (P = 0.0083), BMI (P = 0.0034), and body fat percentage (P = 0.0027) between education and control groups. Similarly, the exercise group showed significant difference in reduction in body fat percentage (P = 0.0038) compared to control group. Conclusions Although there were no significant effects on RPA 1 year after exercise and educational programs for breast cancer survivors, both interventions reduced body composition. Future studies on PA should investigate appropriate interventions to improve overall survival. Trial registration UMIN000020595 at UMIN Clinical Trial Registry Date of first registration: 01/03/2016

A mutation in the chromatin remodeler chromodomain helicase DNA-binding 7 (CHD7) gene causes the multiple congenital anomaly CHARGE syndrome. The craniofacial anomalies observed in CHARGE syndrome are caused by dysfunctions of neural crest cells (NCCs), which originate from the neural tube. However, the mechanism by which CHD7 regulates the function of human NCCs (hNCCs) remains unclear. We aimed to characterize the cis-regulatory elements governed by CHD7 in hNCCs by analyzing genome-wide ChIP-Seq data and identifying hNCC-specific CHD7-binding profiles. We compared CHD7-binding regions among cell types, including human induced pluripotent stem cells and human neuroepithelial cells, to determine the comprehensive properties of CHD7-binding in hNCCs. Importantly, analysis of the hNCC-specific CHD7-bound region revealed transcription factor AP-2α as a potential co-factor facilitating the cell type-specific transcriptional program in hNCCs. CHD7 was strongly associated with active enhancer regions, permitting the expression of hNCC-specific genes to sustain the function of hNCCs. Our findings reveal the regulatory mechanisms of CHD7 in hNCCs, thus providing additional information regarding the transcriptional programs in hNCCs.

Sodium nitrate ores from the Atacama Desert in South America were economically important as they represented huge natural resources for the fertilizer and explosives industries during the early nineteenth to early twentieth centuries. Nitrogen and oxygen isotope ratios (δ15N and δ18O) of these desert nitrates generally show unique compositions (from close to 0 and up to ca. +50 ‰, respectively). The nitrates indicate the provenance as atmospheric in origin due to the mass-independent photochemical reaction of nitric oxide (NO) with ozone (O3) in the atmosphere to produce nitrate (NO3-). This paper examines the previously existing isotope data for specimens acquired from the Atacama Desert. It then reports new data from dual isotope analysis of historic nitrate specimens archived in museums in the UK. In the stable isotope signatures for nitrates from two areas of the Atacama Desert, Tarapaca in the north and Antofagasta in the south, were examined, and this analysis enabled a more detailed definition of their isotopic compositional ranges. This improved database is useful for tracing the provenance of the historic nitrates used in gunpowder and saltpetre, and also the cause of nitrate pollution in natural environments for which routine chemistry alone cannot provide the definite evidence for the origin.

Purpose: The purpose of this study is to compare the aqueous humor level of Silent Information Regulator T1 (SIRT1) between patients with Age-related Macular Degeneration (AMD) and cataract patients. Materials and Methods: Aqueous humor level of SIRT1 was measured by enzyme-linked immunosorbent assay in 13 patients with wet-type AMD (n=13, AMD group) and 13 patients with cataracts (cataract group). In addition, the thickness of each retinal layer was determined by optical coherence tomography. Results: The aqueous humor level of SIRT1 was significantly lower in the AMD group than in the cataract group (p=0.007). In the AMD group, the SIRT1 level was positively correlated with the thickness of the retinal ganglion cell layer (r=0.31) and the inner nuclear layer (r=0.76). Conclusion: The aqueous level of SIRT1 decreased as the ganglion cell layer and inner nuclear layer became thinner, suggesting that reduction of SIRT1 activity might be involved in the pathogenesis of this disease.

Purpose: The purpose of this study was to determine the effect of brilliant blue G (BBG) staining of the inner limiting membrane (ILM) on macular function. Method: Fourteen eyes of 14 patients consisting of 9 men and 5 women who underwent vitreous surgery with ILM peeling were studied. The mean age of the patients was 68.8 ± 9.14 years. Three eyes had a macular hole and eleven eyes had an epiretinal membrane. The ILM was made more visible by spraying 0.25% BBG into the vitreous cavity. The macular function was assessed by recording intraoperative focal macular electroretinograms (iFMERGs) before and after the intravitreal spraying of the BBG dye. The iFMERGs were recorded three times after core vitrectomy. The first recording was performed before the BBG injection (Phase 1, baseline), the second recording was performed after the spraying of the BBG and washing out the excess BBG (Phase 2), and the third recording was performed after the ILM peeling (Phase 3). All recordings were performed after 5 min of light-adaptation and stabilization of the intraocular conditions. The iFMERGs were recorded twice at each phase. The implicit times and amplitudes of the a- and b-wave, the PhNR, and the d-wave were measured. Wilcoxon signed-rank test were used to determine the significance of differences of the findings at Phase 2 vs. Phase 1 and Phase 3 vs. Phase 1. A p value < 0.05 was taken to be statistically significant. Results: The average implicit times of the a-wave, b-wave, PhNR, and d-wave were not significantly different in Phase 1, 2, and 3. The average a-wave, b-wave, PhNR, and d-wave amplitudes at Phase 1 did not differ significantly from that at Phase 2 and at Phase 3. Conclusions: The results indicated that the intravitreal injection of BBG does not alter the physiology of the macula, and we conclude that BBG is safe. We also conclude that iFMERGs can be used to monitor the macular function safely during intraocular surgery.

Tatsuya Mimura,1 Hiroshi Fujishima,2 Eichi Uchio,3 Kazumi Fukagawa,4,5 Yuji Inoue,1 Makoto Kawashima,1 Kazuma Kitsu,1 Atsushi Mizota1 1Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan; 3Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan; 4Ryogoku Eye Clinic, Sumida-Ku, Tokyo, Japan; 5Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanCorrespondence: Tatsuya Mimura, Tel +81-3-3964-1211, Fax +81-3-3964-1402, Email mimurat-tky@umin.ac.jpPurpose: Asian dust poses a serious global health hazard. Airborne particles adhering to contact lenses may cause substantial damage to the ocular surface. The recently released one-day disposable silicone hydrogel soft contact lens (SCL), the verofilcon A, has a smooth surface with SMARTSURFACE® technology, which is designed to prevent adhesion of protein components and foreign bodies. The purpose of this study was to verify the protective quality of verofilcon A SCL against adhesion of Asian dust particles to its surface.Methods: Verofilcon A and etafilcon A (control lens) SCLs were used (n=16 per group), and 0.2 mL of physiological saline containing 0.01 mg/mL of Asian dust particles was dropped on the surface of SCLs, allowed to stand for 1 hour, shaken for 1 minute, and rinsed three times with saline (after rinsing). In addition, the samples were agitated by a vortex mixer for 1 minute and rinsed three times with saline (after vortex). The number of Asian dust particles adhering to the SCLs and percentage of the surface area occupied by the Asian dust particles was determined before washing, after rinsing, and after vortexing.Results: The number of adherent Asian dust particles was lower on verofilcon A SCL (297 ± 116 after rinsing, and 5 ± 14 after vortexing) than on etafilcon A SCL (523 ± 212 after rinsing, p=0.003, and 378 ± 268 after vortexing, p< 0.001). The Asian dust adhesion area was also lower on verofilcon A SCL (3.6 ± 2.3% after rinsing and 0.0 ± 0.1% after vortexing than on etafilcon A (10.2 ± 2.1% after rinsing, p=0.002, and 5.2 ± 3.0% after vortexing, p< 0.001).Conclusion: These findings indicate that verofilcon A SCL has the property of low adhesion of Asian dust particles. Verofilcon A SCL can be recommended for SCL wearers during windy and Asian dust days.Keywords: Asian dust, daily soft contact lens, etafilcon A, silicone hydrogel, verofilcon A

Purpose: To evaluate the effect of Rho-associated kinase inhibitor (ripasudil hydrochloride hydrate; ripasudil) eye drops on postoperative intraocular pressure (IOP) after trabeculectomy in eyes with uveitic glaucoma. Design: This was a prospective, observational, controlled, and randomized study. Methods: Sixteen eyes of 16 patients with uveitic glaucoma who underwent trabeculectomy without mitomycin C were randomly treated without ripasudil (8 eyes) and with ripasudil (8 eyes). Postoperative IOP and surgical outcomes 3 months after surgery were compared between the two groups. Results: No patient discontinued treatment due to the lack of efficacy or adverse effects of ripasudil during the 3-month study period in the ripasudil group. The mean IOP (mmHg) in the control and ripasudil groups were 42.5 ± 9.8 mmHg /43.9 ± 11.7 mmHg (p = 0.82) at baseline, 14.3 ± 4.9 mmHg /9.0 ± 3.7 mmHg (p = 0.04) at 1 week, 16.3 ± 4.2 mmHg /10.6 ± 3.0 mmHg (p = 0.01) at 1 month, and 16.0 ± 3.4 mmHg /12.5 ± 2.3 mmHg (p = 0.04) at 3 months. The number of laser suture lysis procedures (2.0 ± 0.5 vs 0.4 ± 0.7), the rate of bleb revision by needling (50.0% vs 0.0%), and the mean number of antiglaucoma medications (1.6 ± 1.5 vs. 0.1 ± 0.3) after trabeculectomy were higher in the control group than in the ripasudil group (all p < 0.05). A multivariate analysis showed that the IOP reduction rate at 3 months after surgery was associated with the use of ripasudil and baseline IOP (all p < 0.05). Conclusion: This study demonstrated the therapeutic efficacy, safety, and tolerability of ripasudil for 3 months postoperatively. Ripasudil may effectively reduce postoperative IOP and increase the success rate of trabeculectomy in patients with uveitic glaucoma.

Purpose:Coronavirus disease (COVID-19) has been declared a pandemic and the number of infected individuals and deaths continue to increase globally. COVID-19 is transmitted through airborne droplets formed during coughing and sneezing and from the saliva of infected patients. Medical healthcare workers are often at risk of infection. This study measured the aerosol derived from the droplets of patients during the conversation.Methods:Overall, 25 patients aged 21 to 87 years were enrolled. The amount of droplets from the patient was measured under the following four conditions: 1) no conversation with the mask on; 2) conversation with the mask on; 3) conversation without the mask; and 4) no conversation without the mask. Particulate matter (PM) with an aerodynamic diameter of 2.5 μm or less (PM2.5) and PM with a diameter of 10 μm or less (PM10) were measured as representative aerosols at a position of 1 meter from the patients.Results:The concentrations of PM2.5 (µg/m3) were as follows: 22.7 ± 10.2 before the conversation with the mask, 24.2 ± 10.2 during the conversation with the mask, 32.3 ± 14.7 during the conversation without the mask, and 23.1 ± 9.9 after the conversation without the mask. The concentrations of PM10 (µg/m3) were as follows: 39.8 ± 18.2 before conversation with the mask, 41.9 ± 18.5 during conversation with the mask, 55.5 ± 27.2 during conversation without the mask, and 40.4 ± 17.8 after conversation without the mask. The variations in the PM2.5 and PM10 correlated negatively with the age of patients (PM2.5: r = -0.51, p = 0.0009 and PM10: r = -0.53, p = 0.0063).Conclusion:Wearing a mask can prevent airborne droplet formation and reduce transmission of infection.

Somnolence during brain function mapping is one of the factors that inhibit the accomplishment of the goals of awake craniotomy. We examined the effect of anesthesia depth measured by bispectral index (BIS) during pre-awake phase on somnolence during brain function mapping and also explored the factors associated with somnolence. We examined the association between BIS values during pre-awake phase and somnolence during the first 30 min of brain function mapping in 55 patients who underwent awake craniotomy at Kyoto University Hospital from 2015 to 2018. The pre-awake BIS value was defined as the mean BIS value for 60 min before the removal of the airway. Somnolence during brain function mapping was the primary outcome, defined as either of the following conditions: inability to follow up, disorientation, or inability to assess speech function. Additionally, we compared patient or perioperative variables between patients with/without somnolence. Somnolence occurred in 14 patients (25.5%), of which 6 patients (10.9%) were unable to complete brain function mapping. There was no significant difference in the pre-awake BIS value between patients with/without somnolence (median: 46 vs. 49, P = 0.192). Somnolence was not significantly associated with age, gender, and the number of preoperative anticonvulsive drugs, but patients with somnolence had a significantly lower preoperative Western Aphasia Battery (WAB) aphasia quotient score (median 93.8 vs. 98.6, P = 0.011). We did not find an association between pre-awake BIS value and somnolence during brain function mapping. Somnolence likely occurs in patients with a low preoperative WAB aphasia quotient score.

An umpolung reaction with α-hydrazonoesters was investigated, and it was found that α-N,N-dialkylaminoamides could be directly synthesized in yields up to 92% via a concomitant rearrangement of dialkylamino groups. As an application, a short synthesis of an inhibitor of glycine type-1-transporter was accomplished via subsequent functional group transformations in 28% overall yield.

Anisometropic amblyopia is decreased visual acuity in one eye, and treatment consists of wearing complete corrective spectacles. Aniseikonia occurs with complete correction of anisometropia using spectacles. Aniseikonia has been ignored when treating pediatric anisometropic amblyopia because of the prevailing belief that anisometropic symptoms are suppressed by adaptation. However, the conventional direct comparison method for evaluating aniseikonia significantly underestimates the degree of aniseikonia. This study investigated whether the adaptation occurs due to long-term anisometropic amblyopia treatment in patients who have had successful amblyopia treatment using a spatial aniseikonia test with high accuracy and repeatability compared with the conventional direct comparison method. The amount of aniseikonia was not significantly different between the patients with successful amblyopia treatment and individuals with anisometropia without a history of amblyopia. In both groups, the aniseikonia per 1.00 D of anisometropia and the aniseikonia per 1.00 mm of aniso-axial length were comparable. The repeatability of the amount of aniseikonia using the spatial aniseikonia test did not differ significantly between the two groups, indicating a high degree of agreement. These findings suggest that aniseikonia is not adapted to amblyopia treatment and that aniseikonia increases as the difference between spherical equivalent and axial length increases.

Heteroatom-doped hard carbon is a popular method to optimize the electrochemical performance of anode electrodes for sodium-ion batteries. Herein, phosphorus-doped hollow carbon nanorods (P-HCNs) are obtained by a one-step synthesis with a high phosphorus content of 7.5 atom %. By controlling the P configuration, the P-HCNs03 exhibits reversible capacity as high as 260 mA h g-1 at the current density of 1.0 A g-1 after 500 cycles with an initial Coulombic efficiency (ICE) of 73%. When the amount of phosphorus in the as-prepared materials is changed, the different structures of the P-doped carbon lattices are analyzed by X-ray diffraction, Raman spectroscopy, and X-ray photoelectron spectroscopy. Based on the first-principles calculation, although the P-O bond has the most configurations, the excellent reversible capacity of the electrode is attributed to the strong Na-absorption ability of P═O and P-C bonds. The sodium-based dual-ion batteries (NDIBs) assembled with P-HCNs03 as an anode and expanded graphite as a cathode (P-HCNs03//EG) exhibited a high energy density of 138 W h kg-1 at a power density of 159 W kg-1. The results provide an important angle to optimize the performance of hard carbons with other functionalized heteroatoms.

Tatsuya Mimura,1 Hiroshi Fujishima,2 Eiichi Uchio,3 Kazumi Fukagawa,4,5 Makoto Kawashima,1 Kazuma Kitsu,1 Hiroaki Horikawa,1 Atsushi Mizota1 1Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology, Tsurumi University School of Dental Medicine, Yokohama, Kanagawa, Japan; 3Department of Ophthalmology, Fukuoka University School of Medicine, Fukuoka, Japan; 4Ryogoku Eye Clinic, Tokyo, Japan; 5Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanCorrespondence: Tatsuya Mimura Tel +81-3-3964-1211Fax +81-3-3964-1402Email mimurat-tky@umin.ac.jpPurpose: Pollen and proteins attached to soft contact lenses (SCLs) exacerbate allergic conjunctivitis. The material of SCLs may affect the pollen adhesion to the SCLs. The factors associated with the number of pollen particles that are adherent to daily disposable SCL were investigated.Methods: Pollen particles were experimentally exposed to the contact lens surface of 12 types of SCLs for 1 hour, and the SCLs were washed and rinsed with a physiological saline (n=10 for each SCL type). A total of 120 contact lenses were used in this study. The pollen particles attached to the SCL were observed and photographed under a microscope. The influence of the materials of the SCLs on the degree of pollen adhesion were investigated.Results: The number of residual pollen particles attached to SCLs was in the range from 0– 293/area of 200× 200 μm. Percentage of pollen adhesion area of the surface of the SCL was in the range from 0.01% to 3.25%. There were significant differences in both the number and adhesion area of pollen particles among the 12 types of SCLs tested (P< 0.0001 and P< 0.0001, respectively). The number of pollen particles adhered to SCLs was significantly higher in colored SCLs than clear SCLs (unpaired t-test, p< 0.001). The portion of pollen adhesion area was the lowest in the silicone hydrogel SCLs made with delefilcon-A (0.01 ± 0.02%).Conclusion: Pollen adhesion in daily disposable SCLs depends on the characteristics and materials of the SCLs and was high in colored SCLs and lowest in delefilcon-A silicone hydrogel SCL. These results suggest that colored SCLs are not preferred during pollen season.Keywords: daily soft contact lens, delefilcon-A, pollen, silicone hydrogel

Background Sarcoid-like reaction (SLR) is a histological pattern of granulomatous inflammation that is clinically differentiated from sarcoidosis. Since SLR is known to occur in several neoplasias and occasionally causes lymphadenopathy and mimics metastatic malignancy, it needs to be considered whether lymphadenopathy is due to metastasis or SLR for the choice of cancer treatment. Few cases of hepatocellular carcinoma (HCC) with SLR have been reported. Here, a case of HCC with lymphadenopathy diagnosed as SLR without metastasis is presented. Case presentation A 69-year-old woman was admitted to our hospital because of upper abdominal pain. She tested positive for hepatitis C virus ribonucleic acid. Imaging modalities showed an 81 × 65-mm-sized tumor with multiple nodules in segment 3 and a 17 × 12-mm-sized tumor in segment 5 with a common HCC enhancement pattern. In addition, a lymph node in the hepatoduodenal ligament was enlarged at 13 mm in size, suggesting the metastasis of HCC. Hepatectomy of the lateral segment and segment 5 and lymph node dissection in the hepatoduodenal ligament were performed. Both tumors in segments 3 and 5 were pathologically diagnosed as HCC without vessel invasion. The tumors contained necrotic cells and epithelioid cell granulomas with multinucleated giant cells, which is typically observed in sarcoidosis. The dissected lymph nodes also contained epithelioid cell granulomas, as well as giant cells with asteroid bodies. There was no malignancy in the lymph nodes. The pathological findings suggested the coexistence of malignancy and sarcoidosis. However, since the patient did not show any typical findings of pulmonary or cardiac sarcoidosis, the case was diagnosed as HCC with SLR in the primary lesion and regional lymph nodes. Conclusions SLR needs to be considered in the differential diagnosis when a cancer patient develops lymphadenopathy. However, lymphadenopathy due to SLR is indistinguishable from that due to metastasis even when using multiple imaging modalities. Pathological examinations may be helpful for the diagnosis.

Eye checkups have become increasingly important to maintain good vision and quality of life. As the population requiring eye checkups increases, so does the clinical work burden of clinicians. An automatic screening algorithm to reduce the clinicians’ workload is necessary. Machine learning (ML) has recently become one of the chief techniques for automated image recognition and is a helpful tool for identifying ocular diseases. However, the accuracy of ML models is lower in a clinical setting than in the laboratory. The performance of ML models depends on the training dataset. Eye checkups often prioritize speed and minimize image processing. Data distribution differs from the training dataset and, consequently, decreases prediction performance. The study aim was to investigate an ML model to screen for retinal diseases from low-quality optical coherence tomography (OCT) images captured during actual eye chechups to prevent a dataset shift. The ensemble model with convolutional neural networks (CNNs) and random forest models showed high screening performance in the single-shot OCT images captured during the actual eye checkups. Our study indicates the strong potential of the ensemble model combining the CNN and random forest models in accurately predicting abnormalities during eye checkups.

Submitted by Mariela Tamada (marielatamada@gmail.com) on 2022-08-31T22:47:13Z No. of bitstreams: 3 Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7193190 bytes, checksum: e91612f2ca40af286d5d6ba17cc2a948 (MD5) CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Approved for entry into archive by PPGI Inform??tica (secretariappgi@icomp.ufam.edu.br) on 2022-09-01T18:21:37Z (GMT) No. of bitstreams: 3 Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7193190 bytes, checksum: e91612f2ca40af286d5d6ba17cc2a948 (MD5) CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Rejected by Divis??o de Documenta????o/BC Biblioteca Central (ddbc@ufam.edu.br), reason: Corrigir Ficha Catalogr??fica (alterar apenas o que foi solicitado e manter as demais informa????es): a) T??tulo - deve come??ar com a primeira letra mai??scula e as demais min??sculas, exceto quando forem siglas ou nomes pr??prios (Ex.: Economia circular no Polo Industrial de Manaus); b) Palavras-chave - devem come??ar com a primeira letra mai??scula e as demais min??sculas, exceto quando forem siglas ou nomes pr??prios (Ex.: Manuten????o da bolha; Efic??cia); on 2022-09-02T17:11:29Z (GMT) Submitted by Mariela Tamada (marielatamada@gmail.com) on 2022-09-02T17:57:01Z No. of bitstreams: 3 CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7189200 bytes, checksum: 0287592044600eea7581ce85c5d4aeec (MD5) Approved for entry into archive by PPGI Inform??tica (secretariappgi@icomp.ufam.edu.br) on 2022-09-15T14:32:41Z (GMT) No. of bitstreams: 3 CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7189200 bytes, checksum: 0287592044600eea7581ce85c5d4aeec (MD5) Approved for entry into archive by Divis??o de Documenta????o/BC Biblioteca Central (ddbc@ufam.edu.br) on 2022-09-16T14:40:03Z (GMT) No. of bitstreams: 3 CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7189200 bytes, checksum: 0287592044600eea7581ce85c5d4aeec (MD5) Made available in DSpace on 2022-09-16T14:40:03Z (GMT). No. of bitstreams: 3 CartaEncaminhamentoTCC-TESE-DISSERTA????O-PreenchidaAssinada.pdf: 250231 bytes, checksum: 0205cf3e90c18e0742400256ca10c7fb (MD5) _73 ATA de Defesa - Mariela Mizota_27.06.2022_Assinada.pdf: 534934 bytes, checksum: d9359cff4d4acc100c4fe3aa45bbcebc (MD5) Monografia_MMT_Predi????o de risco de evas??o.final.pdf: 7189200 bytes, checksum: 0287592044600eea7581ce85c5d4aeec (MD5) Previous issue date: 2022-06-27 Educational Data Mining integrates numerous techniques that support the processing and analysis of data generated and collected from Learning Management Systems (LMS). It aims to extract relevant information in the school environment and uses Machine Learning as its main technique. The general objective of this thesis is to define a methodology that helps educational managers in detecting the risk of dropout of students in distance education, based on changes in behavior characteristics extracted by Machine Learning techniques. Due to the dynamic context of the educational environment, the proposed models are built at different times of the course, with data collected from the students??? interactions with the LMS at 10%, 25%, 50% and 75% of the two-year duration of technical courses. To provide better predictors, a two-step technique is presented, with an unsupervised approach to group students without defining a number of groups a priori, and then a supervised approach in which the cluster assigned to each student is a new input attribute to a classification model. Unsupervised techniques are also employed as a tool to study the data domain. As a result, the K-means clustering algorithm revealed the presence of four coherent groups of students according to their behavior toward the LMS, and contributes to the improvement of the prediction of students at risk of dropping out, with a return of the F1 metric above 80% in the different classifiers tested. The results show a high correlation with the completion or non-completion of the course and bring insights and new knowledge about the students. This work addresses these two techniques in cascade or in two stages, and no research with that approach has been found in Distance Education. In addition to these results, this work is relevant due to being focused on technical courses, which are considered of great importance for the social and economic development of the country, despite research and studies focusing on this level of education being scarce. A Minera????o de Dados Educacionais integra in??meras t??cnicas que d??o suporte a processamento e an??lises de dados gerados e coletados nos Ambientes Virtuais de Aprendizagem (AVA). Ela tem o intuito de extrair informa????es relevantes no ambiente escolar e emprega como principal t??cnica o Aprendizado de M??quina. O objetivo geral desta tese ?? definir uma metodologia que auxilie os gestores educacionais na detec????o do risco de evas??o de estudantes em EaD, com base nas mudan??as das caracter??sticas de comportamento extra??das por t??cnicas de Aprendizado de M??quina. Devido ao contexto din??mico do ambiente educacional, os modelos propostos s??o constru??dos em diferentes momentos do curso, com dados coletados das intera????es dos estudantes com o AVA aos 10%, 25%, 50% e 75% dos 2 anos de dura????o de cursos t??cnicos. Para uma melhor predi????o, apresenta-se uma t??cnica em duas etapas, com abordagem n??o supervisionada para agrupar estudantes sem definir um n??mero de grupos a priori, e ent??o uma abordagem supervisionada na qual o cluster atribu??do a cada estudante ?? um novo atributo de entrada para um modelo de classifica????o. As t??cnicas n??o supervisionadas tamb??m s??o utilizadas como ferramenta para estudar o dom??nio dos dados. Como resultados, o algoritmo de agrupamento K-means revelou a presen??a de quatro grupos coerentes de estudantes pelas suas caracter??sticas de comportamento no AVA aos 10% do andamento do curso, e contribui na melhora de predi????o dos alunos em risco de evas??o, com retorno da m??trica F1 acima de 80% nos diferentes classificadores testados. Os resultados mostram alta correla????o com a conclus??o ou n??o conclus??o do curso e traz insights e novos conhecimentos sobre os estudantes. Este trabalho aborda essas duas t??cnicas em cascata ou em duas etapas, e n??o tem se encontrado pesquisas com essa abordagem em Educa????o a Dist??ncia. Al??m desses resultados, este trabalho ?? relevante por pesquisar os cursos t??cnicos, que s??o considerados de grande import??ncia para o desenvolvimento social e econ??mico do pa??s, embora sejam escassos pesquisas e estudos que foquem nesse n??vel de ensino. tudo ??timo!

Visualization of aqueous humor flow in MR contrast images using gadolinium is challenging because of the delayed contrast effects associated with the blood-retinal and blood-aqueous humor barriers. However, oxygen-17 water (HTo observe the distribution of HProspective.Six ophthalmologically normal volunteers (20-37 years, six females).A 3 T/dynamic T2-weighted MRI.HA paired t-test was used to compare the flow-related values and temporal changes in signal intensity. P-values 0.05 were considered statistically significant.Significantly decreased signal intensity was observed in the right anterior chamber but not the right vitreous body (P = 0.39). The nAC signal intensity decreased significantly and then recovered. The inflow and outflow constants were 0.36-0.94 minH2 TECHNICAL EFFICACY STAGE: 2.

We describe a protocol for a live-cell luciferase assay system for continuously monitoring fibroblast growth factor (FGF) signal disruption in human-induced pluripotent stem cells (iPSCs). Signal disrupting effects of chemicals are used as an indicator to evaluate toxicity. The assay is reliably predictive of the effects of limb malformation chemicals (AUC = 0.93). The current approach is limited to FGF signal disruption, and combinations with other types of signaling will be required to detect the effects of different toxicants. For complete details on the use and execution of this protocol, please refer to Kanno et al. (2022a).

Aberrant regulation of the Wnt/β-catenin signaling pathway is one of the major causes of colorectal cancer (CRC). In this study, we examined the effect of polymethoxyflavones present in citrus peels on Wnt/β-catenin signaling in the HCT116 CRC cell line. We found that 5,7,3',4'-tetra-methoxyflavone (TMF) and 7,8,3',4'-TMF inhibited the expression of target genes of Wnt/β-catenin signaling and the transcriptional activities of β-catenin/Tcf and suppressed the motility of HCT116 cells. Because the binding of β-catenin to Tcf-4 was disrupted by 5,7,3',4'-TMF and 7,8,3',4'- TMF, we suggest that they are inhibitors of the Wnt/β-catenin signaling and may have potential applications in CRC prevention.

In the evaluation of smooth pursuit eye movements (SPEMs), recording the stimulus onset time is mandatory. In the laboratory, the stimulus onset time is recorded by electrical signal or programming, and video-oculography (VOG) and the visual stimulus are synchronized. Nevertheless, because the examiner must manually move the fixation target, recording the stimulus onset time is challenging in daily clinical practice. Thus, this study aimed to develop an algorithm for evaluating SPEMs while testing the nine-direction eye movements without recording the stimulus onset time using VOG and deep learning–based object detection (single-shot multibox detector), which can predict the location and types of objects in a single image. The algorithm of peak fitting–based detection correctly classified the directions of target orientation and calculated the latencies and gains within the normal range while testing the nine-direction eye movements in healthy individuals. These findings suggest that the algorithm of peak fitting–based detection has sufficient accuracy for the automatic evaluation of SPEM in clinical settings.

BackgroundData on the effects of intraoperative end-tidal carbon dioxide (EtCO2) levels on postoperative organ dysfunction are limited. Thus, this study was designed to investigate the relationship between the intraoperative EtCO2 level and postoperative organ dysfunction in patients who underwent major abdominal surgery under general anesthesia.MethodsWe conducted a retrospective cohort study involving patients who underwent major abdominal surgery under general anesthesia at Kyoto University Hospital. We classified those with a mean EtCO2 of less than 35 mmHg as low EtCO2. The time effect was determined as the minutes when the EtCO2 value was below 35 mmHg, whereas the cumulative effect was evaluated by measuring the area below the 35-mmHg threshold. The outcome was postoperative organ dysfunction, defined as a composite of at least one organ dysfunction among acute renal injury, circulatory dysfunction, respiratory dysfunction, coagulation dysfunction, and liver dysfunction within 7 days after surgery.ResultsOf the 4,171 patients, 1,195 (28%) had low EtCO2, and 1,428 (34%) had postoperative organ dysfunction. An association was found between low EtCO2 and increased postoperative organ dysfunction (adjusted risk ratio, 1.11; 95% confidence interval [CI], 1.03–1.20; p = 0.006). Additionally, long-term exposure to EtCO2 values of less than 35 mmHg (≥224 min) was associated with postoperative organ dysfunction (adjusted risk ratio, 1.18; 95% CI, 1.06–1.32; p = 0.003) and low EtCO2 severity (area under the threshold) (adjusted risk ratio, 1.13; 95% CI, 1.02–1.26; p = 0.018).ConclusionsIntraoperative low EtCO2 of below 35 mmHg was associated with increased postoperative organ dysfunction.

2,3-Dimethoxy-2,3-dimethyl-1,4-dioxane readily prepared from biacetyl serves as a stable precursor to 2,3-dimethylene-1,4-dioxane which undergoes a [4+2] cycloaddition reaction with dienophiles to give functionalized cyclohexene derivatives. The cycloaddition adducts obtained by the present procedure are transformed into potentially useful intermediates for biologically important materials.

Theoretical calculation of the reactivity of α-imino thioesters indicates that they are very reactive substrates for Umpolung N-alkylation. In fact, treatment of α-aldimino thioesters with dialkylzinc reagents in the presence of aldehydes or imines gives three-component coupling products in good yields.

Among the types of acute thyroiditis, subacute thyroiditis (SAT) is rare in children, and there is limited knowledge regarding its characteristics in pediatric cases. We present a case of SAT in a 6-yr-old boy who was brought to our hospital with high fever and pain in the front portion of the neck. Acute suppurative thyroiditis (AST), which is common in children, was suspected initially. Tenderness observed in the thyroid corresponded to a hypoechoic region on ultrasonography. The tenderness subsequently shifted to the isthmus, which was evident as a hypoechoic region on ultrasonography. Movement of hypoechoicity is typical of creeping thyroiditis, wherein the pain and tenderness can be unilateral or may start on one side and subsequently shift to the contralateral side after days or even weeks. Based on this characteristic and changes in laboratory parameters, the patient was diagnosed as a case of creeping thyroiditis. Improvement was observed in the patient without the use of anti-inflammatory drugs. At the 2-yr follow-up, the patient did not have thyrotoxicosis or relapse. Although AST is more prevalent than SAT in children, ultrasonography findings of creeping thyroiditis may be an important indicator for the diagnosis of SAT in pediatric patients.

Silicon (Si) is considered to be the most promising anode material to replace graphite due to its higher theoretical capacity. Nanotechnology has played an important role in addressing the serious ...

Introduction: To present our findings of the porcine ocular surface that were obtained with an ultra-compact hand-held microscope that weighs less than 500 g, we examined the corneal epithelial cells with this hand-held microscope. Methods: This device is equipped with an automatic focusing mechanism that enabled us to observe living cells in macro to micro magnifications with a series of operations. The focus is semi-automatically adjusted by the infrared and ultrasonic distance sensor. The instrument has a commercially-available microscope objective lens of 20x or 40x magnification and has a high-resolution 2K Complementary Metal-Oxide-Semiconductor (CMOS) camera. The theoretical spatial resolution is around 300 nm with a higher Numerical Aperture (high-NA) lenses. The widefield reflectance-based imaging system is equipped with three-color visible Light-Emitting Diodes (LEDs) for use in bright environments and an infrared LED for dark environments. Ten normal and two injured porcine corneas were examined with this hand-held microscope. Results: Our observations showed that the corneal and conjunctival epithelial cells could be continuously observed. The epithelial cells of the central cornea, limbus, and conjunctiva were clearly seen. The epithelial cells on the injured corneal surface were also easily and clearly observed. Conclusion: This hand-held microscopic imaging device allows medical health care workers such as ophthalmologists and endoscopists to obtain real-time in vivo optical biopsies without collecting tissues and cells. Our system enables us to observe single cells in the superficial layers without any fluorescein or other dyes.