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Purpose: To characterize the performance of traditional and contemporary statistics tests for analysis of spherical equivalent prediction error (SEQ-PE) after cataract surgery, with regard to test significance and self-consistency., Design: Comparison of the utility of statistical tests., Subjects: Eyes from 5 academic centers and 2 private practices that had cataract surgery and postoperative manifest refraction between March, 2011 and December, 2022., Methods: SEQ-PE data were randomly divided into sub-sets with sample sizes of 100, 300, 500, 700, and 2600 eyes. Mean absolute error (MAE), median absolute error (MedAE), standard deviation (SD), root mean squared absolute error (RMSAE), and the proportion of eyes within 0.50 D of predicted were calculated for six power prediction formulas and analyzed using Friedman post hoc Dunn, Cochran Q post hoc McNemar, Eyetemis, and Wilcox-Holladay-Wang-Koch (WHWK) statistical tests. All tests were corrected for multiple comparisons using the Holm correction., Main Outcome Measures: The percentage of significant relationships (Percent Significance), proportion of inconsistencies (Inconsistency Ratio), and proportion of self-consistent significant relationships (Significance Index) for each statistical test., Results: Analysis was performed on 7,839 eyes of 7,839 patients. WHWK.MAE (42%), WHWK.SD (41%), Eyetemis.MAE (40%), WHWK.RMSAE (39%), and Dunn.MAE (34%) were more robust, respectively, than the remaining three tests by Percent Significance (all p < 0.001). Dunn.MAE had the best Inconsistency Ratio (0.11) in the 100-eye subsets. The same top five tests were most robust by Significance Index (0.39, 0.35, 0.35, 0.34, and 0.31, respectively; all p < 0.02). WHWK.SD and WHWK.RMSAE had the best Significance Indices (both 0.77) in the 2600-eye subsets. McNemar had the poorest Significance Index overall (0.09)., Conclusions: The five high-performing tests produced significant results more often and were also self-consistent. WHWK.MAE and McNemar were highest and lowest performing overall, respectively. Dunn.MAE may be useful in sample sizes < 150 eyes., Competing Interests: Declaration of competing interest Nathan T Cannon, MD reports a relationship with Carl Zeiss Meditec Inc that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with Alcon Laboratories Inc that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with Johnson and Johnson that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with SIFI SpA that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with Théa Pharma that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with Carl Zeiss Meditec Inc that includes: consulting or advisory. Giacomo Savini, MD reports a relationship with IRCCS Bietti Foundation that includes: funding grants. Seth M Pantanelli, MD, MS reports a relationship with Alcon Laboratories Inc that includes: funding grants. Seth M Pantanelli, MD, MS reports a relationship with Bausch and Lomb that includes: consulting or advisory and funding grants. Seth M Pantanelli, MD, MS reports a relationship with Carl Zeiss Meditec Inc that includes: consulting or advisory and funding grants. Kamran Riaz, MD reports a relationship with Audiodigest that includes: speaking and lecture fees. Kamran Riaz, MD reports a relationship with CorneaGen that includes: speaking and lecture fees. Kamran Riaz, MD reports a relationship with Bausch and Lomb that includes: consulting or advisory and speaking and lecture fees. Kamran Riaz, MD reports a relationship with Ambrx Inc that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with Exelixis Inc that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with ImmunoGen Inc that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with Neumora Therapeutics Inc that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with Springer Publishing Company LLC that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with Wolter Kleuwer Publishing that includes: consulting or advisory. Kamran Riaz, MD reports a relationship with Elselvier Publishing that includes: consulting or advisory. Kazuno Negishi, MD reports a relationship with Santen Pharmaceutical Co Ltd that includes: funding grants and speaking and lecture fees. Kazuno Negishi, MD reports a relationship with Senju Pharmaceutical Co Ltd that includes: speaking and lecture fees. Kazuno Negishi, MD reports a relationship with Chugai Pharmaceutical Co Ltd that includes: speaking and lecture fees. Kazuno Negishi, MD reports a relationship with Carl Zeiss Meditec Inc that includes: consulting or advisory. Kazuno Negishi, MD reports a relationship with Ins Holdings Inc that includes: funding grants. Kazuno Negishi, MD reports a relationship with Seed Co Ltd that includes: funding grants. Kazuno Negishi, MD reports a relationship with Alcon Laboratories Inc that includes: funding grants. Kazuno Negishi, MD reports a relationship with Johnson and Johnson that includes: funding grants. Kazuno Negishi, MD reports a relationship with Hoya Corporation that includes: funding grants. Kazuno Negishi, MD reports a relationship with Kowa Company Ltd that includes: funding grants. Kazuno Negishi, MD reports a relationship with Bristol-Myers Squibb Co that includes: funding grants. Kazuno Negishi, MD reports a relationship with Yakult Bio-Science Foundation that includes: funding grants. Kazuno Negishi, MD reports a relationship with Asahi Glass Foundation that includes: funding grants. Kazuno Negishi, MD reports a relationship with Daiwa Securities Health Foundation that includes: funding grants. Kazuno Negishi, MD reports a relationship with Cellusion that includes: funding grants. Kazuno Negishi, MD reports a relationship with Restore Vision that includes: funding grants. David L Cooke, MD reports a relationship with Heidelberg Engineering Inc that includes: speaking and lecture fees. David L Cooke, MD has patent licensed to Moptim. Author Kenneth Hoffer, MD licenses the registered trademark name Hoffer® to ensure accurate programming of his formulas to almost all commercial optical biometers manufacturers and almost all A-scan biometer manufacturers. The contribution of IRCCS Bietti Foundation was supported by Fondazione Roma and the Italian Ministry of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Inc.)

Background: To investigate the functional results of the AcrySof IQ Vivity (Alcon, Fort Worth, TX) extended depth-of-focus intraocular lens (EDoF-IOL) and explore correlations between the preoperative biometric parameters and the postoperative functional outcomes., Methods: In a prospective, single-center, non-randomized study, axial length, keratometry, anterior chamber depth, scotopic and photopic pupil diameters, pupil decentration, corneal asphericity, corneal higher-order aberrations (HOAs), coma and spherical aberration were measured preoperatively. The EDoF-IOL was implanted bilaterally. Three months postoperatively, manifest refraction, monocular and binocular uncorrected and corrected visual acuity at 4 m, 66 cm and 40 cm, binocular defocus curve, binocular contrast sensitivity, halometry and Strehl ratio were measured. Visual disturbances and spectacle independence were assessed with McAlinden and IOLSAT questionnaires, respectively. Assuming a minimum Pearson r correlation coefficient between variables of 0.5 with a power of 80% and a P value less than 0.05, a minimum sample size of 29 (58 eyes) cases was required., Results: Forty-three patients were enrolled. Binocular distance corrected visual acuity was lower than 0.1 logMAR for a defocus between + 1.0 and - 1.5 D. The mean values at 66 cm and 40 cm were - 0.07 ± 0.06 and 0.19 ± 0.13 logMAR, respectively. McAlinden's questionnaire revealed mean scores close to zero for all questions. The IOLSAT questionnaire showed that spectacles were never used for distance and intermediate vision. Regression analysis did not disclose any significant correlation between the preoperatively measured variables and the postoperative outcomes, with a few exceptions: preoperative higher order corneal aberrations were correlated to halometry area (r 2  = 0.2592, P = 0.0006) and the Q value to contrast sensitivity (r 2  = 0.1717, P = 0.00574) under photopic conditions with glare at a spatial frequency of 18 cpd and without glare for all spatial frequencies (P < 0.01); it was also correlated to contrast sensitivity under mesopic conditions without glare at a spatial frequency of 12 cpd (r 2  = 0.2311, P = 0.0011)., Conclusions: In healthy unoperated eyes, the visual outcomes for this EDoF-IOL are independent of most of the patients' preoperative parameters. Attention should be paid to preoperative corneal aberrations and asphericity, which did not lead to visual disturbances, but may be potential sources of halo and reduced contrast sensitivity., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the Comitato Etico di Area (No. 345–2021-DISP-AUSLBO), Bologna, Italy. Consent for publication: Not applicable. Competing interests: Giacomo Savini has received personal fees from Alcon (TX), Johnson & Johnson (FL), SIFI (Italy), Thea (France) and Zeiss (Germany) and is an editorial member of Eye and Vision. CC has received personal fees from Zeiss (Germany). For the other authors, no financial interests were declared., (© 2025. The Author(s).)

Background: To assess the repeatability and reproducibility of the Colombo IOL biometer (Moptim, China), which utilizes spectral-domain optical coherence tomography (SD-OCT), in measuring ocular parameters of normal subjects and to compare its agreement with the swept-source optical coherence tomography (SS-OCT)-based IOLMaster 700 biometer (Carl Zeiss Meditec AG, Germany)., Methods: This prospective study included 91 eyes from 91 normal subjects. The evaluated parameters were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), anterior chamber depth (ACD), lens thickness (LT), flattest and steepest meridian keratometry (Kf and Ks), mean keratometry (Km), astigmatism (AST) magnitude, white-to-white (WTW) distance, and pupil diameter (PD). The within-subject standard deviation (S w ), test-retest repeatability (TRT), coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were calculated to determine the repeatability and reproducibility. Paired t-tests and Bland-Altman plots with 95% limits of agreement (LoA) were employed to assess the agreement., Results: With respect to intraobserver repeatability, the S w and TRT values of all evaluated parameters were low. Except J 45 and PD, the ICCs were all higher than 0.928. The reproducibility S w and TRT values of Colombo IOL were also low, and ICCs were not lower than 0.900. Comparing Colombo IOL and IOLMaster 700, the 95% LoA of AL, CCT, AQD, ACD, LT, Kf, Ks, Km, AST, J 0 , J 45 , WTW and PD ranged from - 0.08 to 0.03 mm, - 21.58 to 5.09 μm, 0.01 to 0.15 mm, - 0.01 to 0.14 mm, - 0.05 to 0.10 mm, - 0.14 to 0.59 D, - 0.31 to 0.40 D, - 0.13 to 0.40 D, - 0.68 to 0.32 D, - 0.09 to 0.34 D, - 0.07 to 0.25 D, 0.11 to 1.47 mm, and - 0.97 to 2.31 mm, respectively., Conclusion: The new SD-OCT-based Colombo IOL biometer demonstrates excellent repeatability and reproducibility. Moreover, it generally agrees well with the SS-OCT-based IOLMaster 700, except for the WTW and PD measurements., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Ethics Committee of the Eye and ENT Hospital of Fudan University (No. 2021175). Consent for publication: Not applicable. Competing interests: Giacomo Savini is an editorial board member of the journal. The other authors declare that they have no competing interests., (© 2025. The Author(s).)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Bluetongue virus (BTV) and epizootic haemorrhagic disease virus (EHDV) are Culicoides-transmitted viruses, circulating in multiple serotypes, that cause two relevant WOAH-listed diseases of ruminants. Following its first identification in Tunisia in 2021, a novel EHDV strain belonging to serotype 8 has been detected in cattle showing BTV-like symptoms in Italy and Spain in 2022, and soon after in Portugal and France. These are European regions with recurrent circulations of different BTV serotypes. Hence, in this study we describe the validation of a TaqMan RT-qPCR panBTV/panEHDV assay, based on well-established primers and probes sets, able to simultaneously detect and distinguish between BTV and EHDV. The implemented assay, characterized by high sensitivity, specificity and good reproducibility, can be successfully applied for the rapid and affordable diagnosis needed in the current epidemiological situation and represents a powerful tool to be employed in surveillance and control strategies with a significant reduction of costs., Competing Interests: Declaration of Competing Interest Authors declare that no competing interests exist. Mention of trade names or commercial products in this article is solely for providing specific information and does not imply recommendation or endorsement by the IZSAM., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: To compare the accuracy of intraocular lens (IOL) power calculation formulas for myopic eyes requiring negative diopter-powered IOLs., Design: Retrospective case series., Setting: Kim's Eye Hospital, College of Medicine, Konyang University, Seoul, South Korea and Yeouido St. Mary Hospital, Seoul, South Korea., Methods: 61 eyes that underwent phacoemulsification with implantation of a negative power IOL were investigated. The trueness, precision, and accuracy of IOL power calculation were assessed for the Barrett Universal II (BUII), EVO 2.0, Haigis, Hoffer QST, Holladay 1, and SRK/T formulas using the Eyetemis online tool. The analysis was performed using (1) the ULIB IOL constants and (2) after constant optimization., Results: With ULIB constants, the Haigis, Holladay 1, and SRK/T resulted in a hyperopic mean prediction error (PE) >1.00 diopter (D), which was significantly different from zero (adjusted P < .05). The mean PE of the remaining formulas was closer to zero. The absolute PE was significantly higher with the Holladay 1 and SRK/T (adjusted P < .05) with respect to the remaining formulas. After constant optimization, the outcomes of traditional formulas improved and no statistically significant differences were found among any of the formulas in trueness, precision, and accuracy. The percentage of eyes with an absolute PE within 0.50 D was low (<50%) even after constant optimization., Conclusions: With ULIB constants, the BUII, EVO 2.0, and Hoffer QST were more accurate than traditional formulas in eyes with negative diopter IOLs. The results of IOL power calculation in these eyes remain poor even after constant optimization., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Background and Objectives: Understanding and managing seizure activity is crucial in neuro-oncology, especially for highly epileptogenic lesions like isocitrate dehydrogenase (IDH)-mutant gliomas. Advanced MRI techniques such as diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) have been used to describe microstructural changes associated with epilepsy. However, their role in tumor-related epilepsy (TRE) remains unclear. This study aims to investigate the role of DTI and NODDI tumor-derived metrics in defining TRE and predicting postoperative seizure outcomes in patients undergoing surgical resection for IDH-mutant grade 2 and 3 gliomas., Methods: This was a single-center retrospective study. Preoperative DTI parameters included fractional anisotropy and mean diffusivity. NODDI parameters included neurite density index (NDI), orientation dispersion index, and free-water fraction (FWF). These metrics were calculated within three volumes of interest (fluid-attenuated inversion recovery [FLAIR] tumor volume, FLAIR peripheral zone, and FLAIR central zone [Fcz]) and correlated with seizure presentation, type, and postoperative control, which was reported according to the Engel classification system., Results: Fifty-seven patients were included in this study. Increased NODDI-derived FWF-Fcz (P = .031) and NDI-Fcz (P = .046) values correlated with preoperative generalized seizure presentation, although only the FWF-Fcz confirmed its statistical significance (P = .047) in the multivariate analysis. Lower mean diffusivity-FLAIR tumor volume correlated with poor postoperative seizure control both in the univariate (P = .015, P = .026) and multivariate analyses (P = .024, P = .036), while a trend toward significance was found between higher NDI-FLAIR peripheral zone and worse seizure control (P = .055)., Conclusion: DTI and NODDI tumor-derived quantitative parameters may define TRE and predict postoperative seizure outcomes in patients with IDH-mutant gliomas. Notably, DTI metrics were found to be independent predictors of postoperative seizure outcomes, while preoperative NODDI parameters correlated with seizure presentation. Further research is warranted to validate our findings and to better understand the underlying mechanisms driving TRE., (Copyright © Congress of Neurological Surgeons 2025. All rights reserved.)

Objective: Demonstrate the variability of the spherical and toric ratios between the refraction at the intraocular lens (IOL) plane and the refraction at the spectacle plane when the sphere and the cylinder power of toric piggyback IOLs are calculated. Also, a comparison of the results of piggyback power calculation with variable ratios, to the power calculation performed by a major manufacturer online calculator using a fixed ratio., Design: Experimental study with theoretical eye models., Setting: Private practice, Buenos Aires Argentina., Methods: Schematic eyes with different values of pseudophakic anterior chamber depth (ACD), refractive cylinder and sphere were used to calculate the exact toric and spherical power of the IOL needed to achieve emmetropia., Results: The toric ratio could range between 0.88 and 1.6, while the spherical ratio between 1.01 and 1.61. Therefore, using fixed ratios can lead to errors in IOL power calculation up to 1 diopter. The most likely errors are undercorrection in eyes with deep ACD and low amounts of sphere and astigmatism and overcorrections in eyes with shallow ACD and high preoperative sphere and/or cylinder., Conclusion: Manufacturers that calculate the power of piggyback IOLs with a fixed ratio of toricity and sphere should develop calculators that change this ratio according to the preoperatively measured variables. An excel file with the calculator used is provided., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2025. Published by Elsevier Inc.)

Objective : The aim of this study was to evaluate the effect of a surgical technique for managing post-penetrating keratoplasty (PK) ectasia complicated by late endothelial failure (LEF). Methods : A single-center pilot case series was conducted regarding consecutive patients affected by post-PK ectasia with late graft failure. Using a microkeratome, a single donor cornea was dissected to prepare a two-piece graft, comprising a larger anterior lamella made up of anterior stroma and a smaller posterior lamella made up of posterior stroma, Descemet's membrane, and endothelium. The two lamellae were then positioned on the appropriately prepared recipient cornea. The technique was applied to 15 patients between 2022 and 2023, and data were retrospectively collected from preoperative evaluations and at 1, 6, and 12 months, post-operatively. At each visit, patients underwent standard clinical evaluation, corneal topography, and endothelial cell density evaluation, and visual acuity was measured using a LogMAR chart. Results : The technique restored normal corneal curvature and achieved a clear graft in all patients, leading to the resolution of preoperative ectasia and improved corneal pachymetry. At the one-year follow-up, the average K was reduced from 51.1 ± 4.5 D to 43.5 ± 1.1 D; the best corrected visual acuity (BCVA) was improved from 1.1 ± 0.4 to 0.3 ± 0.2 LogMAR; the central corneal thickness was reduced from 629 ± 39 μm to 532 ± 45 µm; and the endothelial cell density was 1926 ± 199 cells/mm 2 . None of the patients developed severe complications. Conclusions : The two-piece manual mushroom PK may represent an effective technique for managing complex post-PK ectasia cases combined with endothelial decompensation.

Purpose: To present a reproducible method to calculate the toricity needed at the intraocular lens (IOL) plane with toric phakic IOLs (ICL, Staar Surgical) and compare its results with those obtained with the online calculator provided by the manufacturer., Design: Retrospective case series., Setting: Private practice, Buenos Aires, Argentina., Methods: The formula originally described by Holladay to calculate the IOL power in phakic eyes was used to calculate the required spherical power along the less refractive meridian and along the more refractive meridian. Meridional analysis was applied to calculate the required toricity at the IOL plane and the surgically induced corneal astigmatism was incorporated into the calculations. The refractive cylinder predicted by this method and by the online calculator of the manufacturer were compared to the postoperative refractive cylinder by means of vector analysis. The possible changes in the ratio of toricity in patients with different amounts of astigmatism and anterior chamber depth are assessed in a theoretical section., Results: In 35 eyes, the measured mean postoperative refractive cylinder was 0.09 D @ 99°, the mean predicted postoperative refractive astigmatism was 0.04 D @ 102° according to the manufacturer's online calculator and 0.09 D @100° according to our method. With both methods, 91.43% of eyes had an absolute cylinder prediction error within ±0.50 diopters., Conclusions: The method described in this article to calculate the toricity of phakic IOLs has a refractive accuracy similar to that of the original calculator developed by the manufacturer., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To describe a novel method called "three variable optimization" that entails a process of doing just one calculation to zero out the mean prediction error of an entire dataset (regardless of size), using only 3 variables: (1) the constant used, (2) the average intraocular lens (IOL) power, and (3) the average prediction error (PE as actual refraction - predicted refraction)., Design: Development, evaluation, and testing of a method to optimize personal IOL constants., Methods: A dataset of 876 eyes was used as a training set, and another dataset of 1,079 eyes was used to test the method. The Barrett Universal II, Cooke K6, Haigis, RBF 3.0, Hoffer Q, Holladay 1, Holladay 2, SRK/T, and T2 were analyzed. The same dataset was also divided into 3 subgroups (short, medium, and long eyes). The three variable optimization process was applied to each dataset and subset, and the obtained optimized constants were then used to obtain the mean PE of each dataset. We then compared those results with those obtained by zeroing out the mean PE in the classical method., Results: The three variable optimization showed similar results to classical optimization with less data needed to optimize and no clinically significant difference. Dividing the dataset into subsets of short, medium and long eyes, also shows that the method is useful even in those situations. Finally, the method was tested in multiple formulas and it was able to reduce the PE with no clinically significant difference from classical optimization., Conclusion: This method could then be applied by surgeons to optimize their constants by reducing the mean prediction error to zero without prior technical knowledge and it is available online for free at http://wwww.ioloptimization.com., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The diagnosis of West Nile virus (WNV) is challenging due to short-term and low-level viremia, flavivirus cross-reactivity, and long immunoglobulin M (IgM) persistence., Aim: To evaluate different methods for WNV detection [reverse transcription-polymerase chain reaction (RT-PCR), IgM/IgG antibodies, IgG avidity] in serum, cerebrospinal fluid (CSF), and urine samples of patients with confirmed WNV infection., Methods: The study included patients with confirmed WNV neuroinvasive infection ( n = 62), asymptomatic WNV seropositive individuals ( n = 22), and individuals with false-positive WNV IgM antibodies ( n = 30). WNV RNA was detected using RT-PCR. A commercial ELISA was used to detect WNV IgM/IgG antibodies with confirmation of cross-reactive samples using a virus neutralization test (VNT). IgG-positive samples were tested for IgG avidity., Results: The WNV-RNA detection rates were significantly higher in the urine (54.5%)/serum (46.4%) than in CSF (32.2%). According to the sampling time, the WNV-RNA detection rates in urine collected within 7 days/8-14/≥ 15 days were 29.4/66.6/62.5% ( P = 0.042). However, these differences were not observed in the CSF. The median RT-PCR cycle threshold values were significantly lower in urine (32.5, IQR = 28-34) than in CSF (34.5, IQR = 33-36). The frequency of positive WNV IgM and IgG significantly differed according to the sampling time in serum but not in CSF. Positive IgM/IgG antibodies were detected in 84.3/9.3% of serum samples collected within 7 days, 100/71.1% of samples collected 8-14, and 100% samples collected after ≥ 15 days. Recent WNV infection was confirmed by low/borderline avidity index (AI) in 13.6% of asymptomatic individuals. A correlation between ELISA and AI was strong negative for IgM and strong positive for IgG. No significant correlation between ELISA IgG and VNT was found., Conclusion: The frequency of WNV RNA and antibody detection depends on the sampling time and type of clinical samples. IgG avidity could differentiate recent WNV infections from long-persisting IgM antibodies., Competing Interests: Conflict-of-interest statement: All authors reported no conflicts of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

West Nile virus (WNV) is a mosquito-borne pathogen that can infect humans, equids, and many bird species, posing a threat to their health. It consists of eight lineages, with Lineage 1 (L1) and Lineage 2 (L2) being the most prevalent and pathogenic. Italy is one of the hardest-hit European nations, with 330 neurological cases and 37 fatalities in humans in the 2021-2022 season, in which the L1 re-emerged after several years of low circulation. We assembled a database comprising all publicly available WNV genomes, along with 31 new Italian strains of WNV L1 sequenced in this study, to trace their evolutionary history using phylodynamics and phylogeography. Our analysis suggests that WNV L1 may have initially entered Italy from Northern Africa around 1985 and indicates a connection between European and Western Mediterranean countries, with two distinct strains circulating within Italy. Furthermore, we identified new genetic mutations that are typical of the Italian strains and that can be tested in future studies to assess their pathogenicity. Our research clarifies the dynamics of WNV L1 in Italy, provides a comprehensive dataset of genome sequences for future reference, and underscores the critical need for continuous and coordinated surveillance efforts between Europe and Africa.

Bluetongue (BT) and Epizootic Hemorrhagic Disease (EHD) are two notifiable animal diseases transmitted to ruminants by small hematophagous midges belonging to the Culicoides genus. The etiological agents, Bluetongue virus (BTV) and Epizootic hemorrhagic disease virus (EHDV), are both members of the Sedoreoviridae family and Orbivirus genus, which include double-stranded (ds) RNA segmented genomes (10 segments). By the end of the summer 2023, first's outbreaks of EHD were reported from the south west of France, concurrently with unexpectedly severe BT cases in Central France and Corsica. Within a few weeks, numerous BT and EHD outbreaks were recorded with significant sanitary and economic impact on cattle and sheep farms (no sanitary impact of EHD for sheep). Using a customized SISPA approach and the nanopore sequencing technology we successfully recovered genomic sequences from viral isolates and blood samples from infected animals from EHD and BT outbreaks. Three different viruses were responsible for these outbreaks: EHDV-8, BTV-8 and BTV-4. The EHDV-8 strain detected in France corresponded to the strain circulating in Tunisia, Sardinia and Spain since 2021 and 2022. A new BTV-8 strain of unknown origin, clearly different from the enzootic strain circulating in France since 2015, was responsible of the BT outbreaks in domestic ruminants in 2023 on both mainland France and Corsica. A second BTV, BTV-4, also involved in BT outbreaks in Corsica, corresponded to a BTV-4 strain occasionally detected on Corsica island since 2016, suggesting either a new introduction of this strain or a silent circulation on the field. The exceptional nature of orbivirus epizootics in France in 2023, including new introduction, emergence or incursions, raises numerous questions regarding BTV and EHDV dynamics and epidemiology and stresses out the need to identify factors involved in these emergences., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Bluetongue (BT) is a vector-borne disease affecting wild and domestic ruminants in many parts of the world. Although bluetongue virus (BTV) is widespread in ungulates in Africa, available epidemiological information on BT in this continent is limited. This systematic review and meta-analysis aimed to estimate the seroprevalence of BTV and summarize information on associated risk factors in domestic ruminants and camels in Africa. Systematic searches were conducted from the inception of the database to November 2022 on PubMed/MEDLINE, ScienceDirect, Web of Science, and Google/Google Scholar. Forty-four eligible publications were identified, published in the range from 1973 to 2020, and statistically analyzed. The pooled overall seroprevalence of BTV was 45.02% (95% confidence interval [CI]: 36.00-54.00%). The pooled seroprevalence was 49.70% (95% CI: 34.50-65.00%) in cattle, 47.00% (95% CI: 29.90-64.50%) in goats, 40.80% (95% CI: 19.60-63.90%) in camels, and 36.30% (95% CI: 29.00-44.90%) in sheep. The pooled seroprevalence decreased after 1990 and increased again after 2010. The highest pooled overall seroprevalence was found in the southeastern region, and the highest pooled overall seroprevalence was obtained by Competitive Enzyme-Linked Immunosorbent Assay. Finally, the seroprevalence in females (53.30%, 95% CI: 34.80-71.00%) was significantly higher than in males (28.10%, 95% CI: 17.40-40.30%) ( p  < 0.05). We showed that antibodies against BTV were common in African ruminants and camels. Monitoring the seroprevalence of BTV, as well as systematic and continuous surveillance of the Culicoides population, are encouraged to prevent and control the spread of BT.

Bluetongue virus (BTV) is the causative agent of the bluetongue disease (BT), an infectious disease of domestic and wild ruminants that is primarily transmitted by Culicoides biting midges. In recent years, several novel BTV serotypes (often referred to as "atypical" BTVs) have been documented. These strains are usually asymptomatic in animals and seem to be unable to replicate efficiently in the arthropod vector. Here we report the detection of two putative atypical BTV strains in the Governorate of Gafsa, in the southwest region of Tunisia. Specifically, we recognised the recurrence of an atypical BTV strain (BTV-Y TUN2022) and a novel BTV-W TUN2022., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Mention of trade names or commercial products in this article is solely for the purpose of providing specific information and does not imply recommendation or endorsement by the IZSAM., (Copyright © 2024. Published by Elsevier B.V.)

West Nile Virus, an arthropod-borne RNA virus, may result in severe neurological disease. West Nile neuroinvasive disease is characterized by meningitis, encephalitis, and possible acute flaccid paralysis. Here, we report a case of neuroinvasive WNV in a 65-year-old woman hospitalized for hyperpyrexia, chills, intense asthenia, and continuous vomiting. Within days, her clinical condition worsened with the onset of severe neurological symptoms, leading to her death within 10 days despite supportive therapies being administered. The diagnosis of West Nile disease was made through nucleic acid amplification testing (NAAT) on blood and cerebrospinal fluid. However, in the final stages of the illness, cerebrospinal fluid collection was not possible due to the patient's critical condition, and a nasopharyngeal swab was used instead. The nasopharyngeal swab facilitated the collection of a sample, which was subsequently analyzed for the presence of the virus and allowed for sequencing, showing that it was a strain that had been circulating in Sardinia for some time and had demonstrated its pathogenicity by causing the death of a hawk in 2021. This case report highlights the rapid progression and severity of WNV infection, particularly in vulnerable individuals, and suggests the potential utility of nasopharyngeal swabs as a less invasive option for sample collection. It also underscores the potential for the zoonotic transmission of the virus from birds to humans through vectors, emphasizing the importance of monitoring and controlling WNV outbreaks, especially in regions where such circulation is observed.

Purpose: To evaluate prediction accuracy of formulas included in the ESCRS online intraocular lens (IOL) calculator using standard keratometry (K) or total keratometry (TK)., Setting: Hospital-based academic practice., Design: Retrospective case-series., Methods: 523 patients with cataract (523 eyes) were included in this study. The outcome measures were trimmed means of the spherical equivalent prediction error (SEQ-PE, trueness), precision and absolute SEQ-PE (accuracy) of all 7 formulas available on the ESCRS online IOL calculator, as well as mean (Mean-All) and median (Median-All) of the predicted SEQ refraction of all formulas. Subgroup analyses evaluated the effect of axial length on formula accuracy., Results: Trimmed-mean SEQ-PE range of all formulas varied from -0.075 to +0.071 diopters (D) for K-based and from -0.003 to +0.147 D for TK-based calculations, with TK-based being more hyperopic in all formulas ( P < .001). Precision ranged from 0.210 to 0.244 D for both K-based and TK-based calculations. Absolute SEQ-PE ranged from 0.211 to 0.239 D for K-based and from 0.218 to 0.255 D for TK-based calculations. All formulas, including Mean-All and Median-All, showed high accuracy, with 84% to 90% of eyes having SEQ-PEs within 0.50 D.Myopic trimmed-mean SEQ-PEs significantly different from zero were observed in long eyes for Pearl DGS (-0.110 D, P = .005), Hill RBF (-0.120 D, P < .001), and Hoffer QST (-0.143 D, P = .001) and in short eyes for EVO 2.0 (-0.252 D, P = .001), Kane (-0.264 D, P = .001), Hoffer QST (-0.302 D, P < .001), Mean-All (-0.122 D, P = .038), and Median-All (-0.125 D, P = .043)., Conclusions: Prediction accuracy of all ESCRS IOL calculator formulas was high and globally comparable. TK-based calculations did not increase prediction accuracy and tended toward hyperopia. Observations indicating formula superiority in long and short eyes merit further evaluation., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: To investigate whether standard keratometry (K) or total corneal power (TCP) leads to more accurate refractive outcomes for intraocular lens (IOL) power calculation., Setting: Public hospital., Design: Retrospective evaluation of a diagnostic test instrument., Methods: Preoperatively, all patients underwent optical biometry with Anterion, a swept-source optical coherence tomography device providing both K and TCP. The same IOL model was implanted in all cases. The whole sample was divided into a training dataset, used to optimize the formula constants, and a testing dataset, used to investigate the spherical equivalent prediction error (SEQ-PE) of 8 IOL power formulas. Trueness, precision, and accuracy were evaluated by means of the robust 2-sample t test. Cochran Q test was performed to assess whether the percentage of eyes with an SEQ-PE within each threshold was significantly different; in such an event, the McNemar test was then applied., Results: Both the training and testing datasets included 317 eyes. No significant differences were detected for trueness because of constant optimization. Precision and accuracy were better when K was entered, although a statistically significant difference was observed only with the EVO (precision: P = .02 and accuracy: P = .03) and Haigis ( P < .01 for both precision and accuracy) formulas. No significant differences were observed for the percentage of eyes with an absolute SEQ-PE within any threshold., Conclusions: With most formulas, IOL power calculation is not more accurate when TCP is used instead of K., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: To compare 2 different datasets, using Eyetemis, an online analytical tool designed for assessing the spherical equivalent prediction errors (SEQ-PEs) of intraocular lens (IOL) power calculation formulas after cataract surgery., Setting: Institutional., Design: Retrospective case series., Methods: The study comprised 2 distinct datasets of patients who had undergone successful cataract surgery. Dataset 1 includes standard eyes, whereas Dataset 2 includes eyes with keratoconus. An online tool was used for SEQ-PE analysis across the 2 datasets, adhering to ISO standards for evaluating accuracy based on trueness and precision. The tool incorporates robust t tests for comparing the trimmed mean of the data, adjusting for heteroscedasticity. IOL constants in Dataset 1 were optimized for the comparison of Hoffer Q, Holladay 1, SRK/T, Haigis, and Barrett Universal II (BUII) formulas. In Dataset 2, IOL constants from the IOLCon website were used for the comparison of the BUII and its designated KCN version: Barrett TrueK Keratoconus (TrueK [KCN])., Results: For Dataset 1, the trimmed mean SEQ-PE values of all formulas were not significantly different from zero. BUII had superior precision and accuracy compared with all other formulas, except from Haigis ( P ≤ .04). For Dataset 2, BUII's trimmed-mean SEQ-PE was significantly different from zero (0.59 diopters [D], P < .01), unlike the TrueK (KCN) (0.12 D, P = .10). In addition, TrueK (KCN) exhibited enhanced precision and accuracy relative to BUII ( P < .01)., Conclusions: The online analysis tool provides a streamlined approach for assessing the prediction accuracy of SEQ refraction after cataract surgery, effectively evaluating trueness, precision, and overall accuracy through the use of advanced statistical methods., (Copyright © 2024 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Background: To analyze the difference and agreement between measurements obtained by a new fully automatic optical biometer, the SW-9000 μm Plus, based on optical low-coherence reflectometry (OLCR) and a commonly used optical biometer (Pentacam AXL) based on Scheimpflug imaging with partial coherence interferometry (PCI)., Methods: The central corneal thickness (CCT), anterior chamber depth (ACD, from epithelium to anterior lens surface), lens thickness (LT), mean keratometry (K m ), corneal astigmatism, corneal diameter (CD), pupil diameter (PD), and axial length (AL) of 74 eyes (from 74 healthy subjects) were measured using the SW-9000 μm Plus and the Pentacam AXL to determine the agreement. Double angle plots were used for astigmatism vector analysis. Bland-Altman and 95% limits of agreement (LoA) were calculated., Results: Statistically significant differences were detected for all parameters but J 0 vector. The Bland-Altman analysis of AL, CCT, ACD, K m , CD, J 0 and J 45 indicated a high level of agreement between the two devices. Among AL, CCT, ACD, K m , J 0 , J 45 , CD, and PD, the 95% LoA ranged from  -0.07 to 0.05 mm, -9.67 to 7.34 mm, -0.11 to 0.04 mm, -0.25 to 0.50 D, -0.22 to 0.20 D, -0.15 to 0.20 D, -0.23 to 0.35 mm and 1.55 to 3.77 mm, respectively., Conclusions: The measurements of AL, CCT, ACD, K m , corneal astigmatism, and CD showed a narrow LoA and may be used interchangeably in healthy subjects between the new OLCR optical biometer and the Scheimpflug/PCI biometer; however, a poor agreement was noted for PD values., (© 2024. The Author(s).)

Purpose: To evaluate and compare the repeatability of corneal densitometry (CD) measurements obtained using both an anterior-segment optical coherence tomography (AS-OCT) device and a Scheimpflug camera system, while also assessing the level of agreement. The study also sought to investigate the correlation of CD with age, gender, and central corneal thickness (CCT) in normal eyes., Methods: CD measurements were obtained using the Casia 2 and the Pentacam AXL Wave. Data were collected on Total Corneal Densitometry and 4 concentric corneal annular areas, these are referred to as zone 1, denoting the central area, through to zone 4, designating the outermost peripheral region. Repeatability was assessed using intra-session test-retest variability, coefficient of variation (CoV), and intraclass correlation coefficient (ICC). The agreement was evaluated using Bland-Altman plots. Correlation analysis was performed between CD, age, gender, and CCT., Results: The study included 96 healthy volunteers. The Casia 2 demonstrated high repeatability with ICC values exceeding 0.9 in all the corneal zones and lower CoV values compared to the Pentacam AXL Wave (ranging from 1.07% to 2.25% for Casia 2 and from 1.91% to 6.89% for Pentacam).95% LoA were within ± 2 standard deviation from the average mean except from zone 1 (± 2.42).However, the measurements showed a consistent bias among all the corneal zones. CD values were positively correlated with age, except for zone 1 with the Pentacam (p = 0.083)., Conclusions: The findings suggest that the Casia 2 can be a reliable tool for assessing corneal transparency in healthy individuals, however its measurements are not interchangeable with those provided by the Pentacam. The AS-OCT device may be more sensitive in detecting subtle age-related changes in CD within the central zone., (© 2024. The Author(s).)

Purpose: To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power., Design: Retrospective, interinstrument reliability study., Methods: Setting: Institutional., Participants: Two hundred twenty-five eyes of 225 cataract surgery patients., Measurements: Patients underwent measurements by both devices preoperatively., Main Outcome Measures: Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK)., Results: Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK, and IOLM700 M-PK were 0.03, 0.08, 0.02, and 0.09 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (P = 0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (P = 0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (P < 0.001, r = 0.848, mean bias: +0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (P < 0.001, r = 0.776, mean bias: -0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices., Conclusion: The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Epizootic haemorrhagic disease (EHD), caused by the EHD virus (EHDV), is a vector-borne viral disease transmitted through Culicoides biting midges. EHDV comprises seven serotypes (1, 2, and 4-8), with EHDV-8 having recently emerged and spread in Europe over the last two years. Such event has raised concerns about the significant threat posed by EHDV-8 to livestock industry. In this study, an inactivated vaccine against EHDV-8 (vEHDV8-IZSAM) was developed. Safety and efficacy of the vaccine were evaluated in calves through clinical, serological, and virological monitoring following experimental challenge. The vaccine was proven safe, with only transient fever and localized reactions observed in a few animals, consistent with adjuvanted vaccine side effects. vEHDV8-IZSAM elicited a robust humoral response, as evidenced by the presence of neutralizing antibodies. After challenge with a virulent isolate, viraemia and clinical signs were evidenced in control animals but in none of the vaccinated animals. This study highlights the potential of vEHDV8-IZSAM as a safe and highly effective vaccine against EHDV-8 in cattle. It offers protection from clinical disease and effectively prevents viraemia. With the recent spread of EHDV-8 in European livestock, the use of an inactivated vaccine could be key in protecting animals from clinical disease and thus to mitigate the economic impact of the disease. Further investigations are warranted to assess the duration of the induced immunity and the applicability of this vaccine in real-world settings. Accordingly, joint efforts between public veterinary institutions and pharmaceutical companies are recommended to scale up vaccine production., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Mention of trade names or commercial products in this article is solely for the purpose of providing specific information and does not imply recommendation or endorsement by the IZSAM., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Radiomics features (RFs) serve as quantitative metrics to characterize shape, density/intensity, and texture patterns in radiological images. Despite their promise, RFs exhibit reproducibility challenges across acquisition settings, thus limiting implementation into clinical practice. In this investigation, we evaluate the effects of different CT scanners and CT acquisition protocols (KV, mA, field-of-view, and reconstruction kernel settings) on RFs extracted from lumbar vertebrae of a cadaveric trunk. Employing univariate and multivariate Generalized Linear Models (GLM), we evaluated the impact of each acquisition parameter on RFs. Our findings indicate that variations in mA had negligible effects on RFs, while alterations in kV resulted in exponential changes in several RFs, notably First Order (94.4%), GLCM (87.5%), and NGTDM (100%). Moreover, we demonstrated that a tailored GLM model was superior to the ComBat algorithm in harmonizing CT images. GLM achieved R2 > 0.90 in 21 RFs (19.6%), contrasting ComBat's mean R2 above 0.90 in only 1 RF (0.9%). This pioneering study unveils the effects of CT acquisition parameters on bone RFs in cadaveric specimens, highlighting significant variations across parameters and scanner datasets. The proposed GLM model presents a robust solution for mitigating these differences, potentially advancing harmonization efforts in Radiomics-based studies across diverse CT protocols and vendors., (© 2024. The Author(s).)

Background: To compare results from different corneal astigmatism measurement instruments; to reconstruct corneal astigmatism from the postimplantation spectacle refraction and toric intraocular lens (IOL) power; and to derive models for mapping measured corneal astigmatism to reconstructed corneal astigmatism., Methods: Retrospective single centre study involving 150 eyes treated with a toric IOL (Alcon SN6AT, DFT or TFNT). Measurements included IOLMaster 700 keratometry (IOLMK) and total keratometry (IOLMTK), Pentacam keratometry (PK) and total corneal refractive power in 3 and 4 mm zones (PTCRP3 and PTCRP4), and Aladdin keratometry (AK). Regression-based models mapping the measured C0 and C45 components (Alpin's method) to reconstructed corneal astigmatism were derived., Results: Mean C0 components were 0.50/0.59/0.51 dioptres (D) for IOLMK/PK/AK; 0.2/0.26/0.31 D for IOLMTK/PTCRP3/PTCRP4; and 0.26 D for reconstructed corneal astigmatism. All corresponding C45 components ranged around 0. The prediction models had main diagonal elements lower than 1 with some crosstalk between C0 and C45 (nonzero off-diagonal elements). Root-mean-squared residuals were 0.44/0.45/0.48/0.51/0.50/0.47 D for IOLMK/IOLMTK/PK/PTCRP3/PTCRP4/AK., Conclusions: Results from the different modalities are not consistent. On average IOLMTK/PTCRP3/PTCRP4 match reconstructed corneal astigmatism, whereas IOLMK/PK/AK show systematic C0 offsets of around 0.25 D. IOLMTK/PTCRP3/PTCRP4. Prediction models can reduce but not fully eliminate residual astigmatism after toric IOL implantation., (© 2024 The Authors. Clinical & Experimental Ophthalmology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Ophthalmologists.)

Usutu virus (USUV), an arbovirus from the Flaviviridae family, genus Flavivirus, has recently gained increasing attention because of its potential for emergence. After his discovery in South Africa, USUV spread to other African countries, then emerged in Europe where it was responsible for epizootics. The virus has recently been found in Asia. USUV infection in humans is considered to be most often asymptomatic or to cause mild clinical signs. However, a few cases of neurological complications such as encephalitis or meningo-encephalitis have been reported in both immunocompromised and immunocompetent patients. USUV natural life cycle involves Culex mosquitoes as its main vector, and multiple bird species as natural viral reservoirs or amplifying hosts, humans and horses can be incidental hosts. Phylogenetic studies carried out showed eight lineages, showing an increasing genetic diversity for USUV. This work describes the development and validation of a novel whole-genome amplicon-based sequencing approach to Usutu virus. This study was carried out on different strains from Senegal and Italy. The new approach showed good coverage using samples derived from several vertebrate hosts and may be valuable for Usutu virus genomic surveillance to better understand the dynamics of evolution and transmission of the virus., (© 2024. The Author(s).)

Purpose: To evaluate the repeatability of automatic measurements of a new anterior segment optical coherence tomographer (ANTERION; Heidelberg Engineering) and their agreement with an anterior segment optical coherence tomography device combined with Placido disc corneal topography (MS-39; CSO) in patients affected by keratoconus., Methods: Fifty-four consecutive patients were included. Three measurements were performed with the ANTERION and one with the MS-39. Repeatability was assessed by means of within-subject standard deviation, coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Agreement was investigated with the 95% limits of agreement. The paired t -test and Wilcoxon matched-pairs test were performed to compare the measurements of the different devices., Results: Repeatability of ANTERION measurements was high, with an ICC greater than 0.98 for all parameters. Many parameters revealed a CoV of less than 1% and a CoV within 5% was obtained for astigmatism measurements. The ANTERION measured a significantly higher corneal power and the MS-39 more negative posterior keratometric values. These differences were mirrored by a moderate agreement for mean simulated keratometry and poor agreement for total corneal power and posterior keratometry., Conclusions: The ANTERION revealed high repeatability of automatic measurements and good agreement with the MS-39 for many parameters in patients affected by keratoconus, but for most parameters the two instruments cannot be considered interchangeable. [ J Refract Surg . 2024;40(7):e445-e452.] .

Objective: To quantify the distribution of cauda equina nerve roots in supine and upright positions using manual measurements and radiomics features both in normal subjects and in lumbar spinal canal stenosis (LSCS) patients., Methods: We retrospectively recruited patients who underwent weight-bearing MRI in supine and upright positions for back pain. 3D T2-weighted isotropic acquisition (3D-HYCE) sequences were used to develop a 3D convolutional neural network for identification and segmentation of lumbar vertebrae. Para-axial reformatted images perpendicular to the spinal canal and parallel to each vertebral endplate were automatically extracted. From each level, we computed the maximum antero-posterior (AP) and latero-lateral (LL) dispersion of nerve roots; further, radiomics features were extracted to quantify standardized metrics of nerve root distribution., Results: We included 16 patients with LSCS and 20 normal subjects. In normal subjects, nerve root AP dispersion significantly increased from supine to upright position (p < 0.001, L2-L5 levels), and radiomics features showed an increase in non-uniformity. In LSCS subjects, in the upright position AP dispersion of nerve roots and entropy-related features increased caudally to the stenosis level (p < 0.001) and decreased cranially (p < 0.001). Moreover, entropy-related radiomics features negatively correlated with pre-operative Pain Numerical Rating Scale. Comparison between normal subjects and LSCS patients showed a difference in AP dispersion and increase of variance cranially to the stenosis level (p < 0.001) in the upright position., Conclusions: Nerve root distribution inside the dural sac changed between supine and upright positions, and radiomics features were able to quantify the differences between normal and LSCS subjects., Clinical Relevance Statement: The distribution of cauda equina nerve roots and the redundant nerve root sign significantly varies between supine and upright positions in normal subjects and spinal canal stenosis patients, respectively. Radiomics features quantify nerve root dispersion and correlates with pain severity., Key Points: • Weight-bearing MRI depicts spatial distribution of the cauda equina in both supine and upright positions in normal subjects and spinal stenosis patients. • Radiomics features can quantify the effects of spinal stenosis on the dispersion of the cauda equina in the dural sac. • In the orthostatic position, dispersion of nerve roots is different in lumbar spinal stenosis patients compared to that in normal subjects; entropy-related features negatively correlated with pre-operative Pain Numerical Rating Scale., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Usutu virus (USUV) is a zoonotic arbovirus infecting mainly wild birds. It is transmitted by ornithophilic mosquitoes, mainly of the genus Culex from birds to birds and to several vertebrate dead-end hosts. Several USUV lineages, differing in their virulence have emerged in the last decades and now co-circulate in Europe, impacting human populations. However, their relative transmission and effects on their mosquito vectors is still not known. We thus compared the vector competence and survival of Culex pipiens mosquitoes experimentally infected with two distinct USUV lineages, EU2 and EU3, that are known to differ in their virulence and replication in vertebrate hosts. Infection rate was variable among blood feeding assays but variations between EU2 and EU3 lineages were consistent suggesting that Culex pipiens was equally susceptible to infection by both lineages. However, EU3 viral load increased with viral titer in the blood meal while EU2 viral load was high at all titers which suggest a greater replication of EU2 than EU3 in mosquito. While their relative transmission efficiencies are similar, at least at low blood meal titer, positive correlation between transmission and blood meal titer was observed for EU3 only. Contrary to published results in vertebrates, EU3 induced a higher mortality to mosquitoes (i.e. virulence) than EU2 whatever the blood meal titer. Therefore, we found evidence of lineage-specific differences in vectorial capacity and virulence to both the vector and vertebrate host which lead to balanced propagation of both viral lineages. These results highlight the need to decipher the interactions between vectors, vertebrate hosts, and the diversity of arbovirus lineages to fully understand transmission dynamics., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Prat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: To assess the repeatability and reproducibility of the ocular measurements obtained with the Suoer SW-9000 μm Plus, a new fully automatic biometer based on optical low coherence reflectometry (OLCR) biometer, and to compare them to those obtained by a swept-source optical coherence tomography (SS-OCT)-based biometer., Methods: This prospective study consisted of 115 eyes of 115 healthy subjects. The measurements were taken by the two optical biometers in random order. The measured parameters were axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), anterior chamber depth (ACD), mean keratometry (Km), lens thickness (LT) and corneal diameter (CD). To evaluate the intraobserver repeatability and interobserver reproducibility, the within-subject SD, test-retest variability, coefficient of variation (CoV) and intraclass correlation coefficient (ICC) were adopted. The Bland-Altman plot was drawn to assess the agreement., Results: The repeatability and reproducibility of all parameters for the new device were excellent (ICC>0.960 and CoV<0.71%). The Bland-Altman plots showed high agreement between the OLCR-based and SS-OCT-based devices for AL, CCT, AQD, ACD, Km and LT, with narrow 95% limit of agreements (LoAs) (-0.08 mm to 0.06 mm, -15.91 µm to -1.01 µm, -0.09 mm to 0.09 mm, -0.09 mm to 0.08 mm, -0.47 D to 0.35 D, -0.05 mm to 0.16 mm, respectively) and moderate agreement for CD (95% LoA: -0.67 mm to -0.01 mm)., Conclusions: The new Suoer SW-9000 μm Plus biometer showed excellent repeatability and reproducibility. All the parameters obtained by this biometer were similar to those measured by SS-OCT-based biometer., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Clinical research emphasizes the implementation of rigorous and reproducible study designs that rely on between-group matching or controlling for sources of biological variation such as subject's sex and age. However, corrections for body size (i.e. height and weight) are mostly lacking in clinical neuroimaging designs. This study investigates the importance of body size parameters in their relationship with spinal cord (SC) and brain magnetic resonance imaging (MRI) metrics. Data were derived from a cosmopolitan population of 267 healthy human adults (age 30.1±6.6 years old, 125 females). We show that body height correlated strongly or moderately with brain gray matter (GM) volume, cortical GM volume, total cerebellar volume, brainstem volume, and cross-sectional area (CSA) of cervical SC white matter (CSA-WM; 0.44≤r≤0.62). In comparison, age correlated weakly with cortical GM volume, precentral GM volume, and cortical thickness (-0.21≥r≥-0.27). Body weight correlated weakly with magnetization transfer ratio in the SC WM, dorsal columns, and lateral corticospinal tracts (-0.20≥r≥-0.23). Body weight further correlated weakly with the mean diffusivity derived from diffusion tensor imaging (DTI) in SC WM (r=-0.20) and dorsal columns (-0.21), but only in males. CSA-WM correlated strongly or moderately with brain volumes (0.39≤r≤0.64), and weakly with precentral gyrus thickness and DTI-based fractional anisotropy in SC dorsal columns and SC lateral corticospinal tracts (-0.22≥r≥-0.25). Linear mixture of sex and age explained 26±10% of data variance in brain volumetry and SC CSA. The amount of explained variance increased at 33±11% when body height was added into the mixture model. Age itself explained only 2±2% of such variance. In conclusion, body size is a significant biological variable. Along with sex and age, body size should therefore be included as a mandatory variable in the design of clinical neuroimaging studies examining SC and brain structure., Competing Interests: Declaration of interests Since June 2022, Dr. A.K. Smith has been employed by GE HealthCare. This article was co-authored by Dr. Smith in his personal capacity. The opinions expressed in the article are his in and do not necessarily reflect the views of GE HealthCare. Since August 2022, Dr. M. M. Laganà has been employed by Canon Medical Systems srl, Rome, Italy. This article was co-authored by Dr. M. M. Laganà in her personal capacity. The opinions expressed in the article are her own and do not necessarily reflect the views of Canon Medical Systems. Since September 2023, Dr. Papp has been an employee of Siemens Healthcare AB, Sweden. This article was co-authored by Dr. Papp in his personal capacity. The views and opinions expressed in this article are his own and do not necessarily reflect the views of Siemens Healthcare AB, or Siemens Healthineers AG. Since January 2024, Dr. Barry has been employed by the National Institute of Biomedical Imaging and Bioengineering at the NIH. This article was co-authored by Robert Barry in his personal capacity. The opinions expressed in the article are his own and do not necessarily reflect the views of the NIH, the Department of Health and Human Services, or the United States government. Guillaume Gilbert is an employee of Philips Healthcare. S Llufriu received compensation for consulting services and speaker honoraria from Biogen Idec, Novartis, Bristol Myer Squibb Genzyme, Sanofi Jansen and Merck. The Max Planck Institute for Human Cognitive and Brain Sciences and Wellcome Centre for Human Neuroimaging have institutional research agreements with Siemens Healthcare. NW holds a patent on acquisition of MRI data during spoiler gradients (US 10,401,453 B2). NW was a speaker at an event organized by Siemens Healthcare and was reimbursed for the travel expenses. The other authors declare no competing interests.

Purpose: To assess the clinical outcomes and safety profiles of patients who underwent immediate sequential bilateral phakic lens surgery., Methods: This retrospective multicenter study included 254 consecutive patients (508 eyes) who underwent bilateral same-day Implantable Collamer Lens (ICL) (STAAR Surgical) surgery. The authors focused on 1-year postoperative clinical outcomes and adverse events., Results: In the initial cohort, 176 patients (352 eyes) met inclusion criteria. Of these, 335 eyes underwent myopic ICL placement, and 17 eyes received a hyperopic ICL. Notably, 87% of eyes achieved ±0.50 diopters (D) and 95% achieved ±1.00 D of the intended refraction. One year postoperatively, 78% of eyes demonstrated optimal vaulting (250 to 750 µm), with a significant 19% reduction in vaulting observed over the 12 months ( P < .001). Only minor adverse events, including early cataract formation (1 case), secondary toric ICL rotation (3 cases), and ICL exchange due to inappropriate vaulting (6 cases), were noted., Conclusions: The findings corroborate the safety and efficacy of immediate sequential bilateral phakic lens surgery and indicate its potential as a treatment option. The low incidence of minor adverse events further reinforces its favorable safety profile. [ J Refract Surg . 2024;40(5):e313-e320.] .

Background: Achieving precise refractive outcomes in phakic posterior chamber intraocular lens (pIOL) implantation is crucial for patient satisfaction. This study investigates factors affecting pIOL power calculations, focusing on myopic eyes, and evaluates the potential benefits of advanced predictive models., Design: Retrospective, single-center, algorithm improvement study., Methods: Various variations with different effective lens position (ELP) algorithms were analyzed. The algorithms included a fixed constant model, and a multiple linear regression model and were tested with and without incorporation of the posterior corneal curvature (Rcp). Furthermore, the impact of inserting the postoperative vault, the space between the pIOL and the crystalline lens, into the ELP algorithm was examined, and a simple vault prediction model was assessed., Results: Integrating Rcp and the measured vault into pIOL calculations did not significantly improve accuracy. Transitioning from constant model approaches to ELP concepts based on linear regression models significantly improved pIOL power calculations. Linear regression models outperformed constant models, enhancing refractive outcomes for both ICL and IPCL pIOL platforms., Conclusions: This study underscores the utility of implementing ELP concepts based on linear regression models into pIOL power calculation. Linear regression based ELP models offered substantial advantages for achieving desired refractive outcomes, especially in lower to medium power pIOL models. For pIOL power calculations in both pIOL platforms we tested with preoperative measurements from a Scheimpflug device, we found improved results with the LION 1 ICL formula and LION 1 IPCL formula. Further research is needed to explore the applicability of these findings to a broader range of pIOL designs and measurement devices., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the magnitude of IOL transversal shift (ITS) after phacoemulsification and to analyse the factors contributing to IOL decentration and ITS., Methods: 94 consecutive patients who underwent cataract surgery and IOL implantation was enrolled. Each patient underwent anterior segment optical coherence tomography with CASIA 2 (Tomey, Nagoya, Japan) to assess crystalline lens decentration, thickness and diameter seven days preoperatively and at one and sixty days postoperatively. Univariate and multivariate linear regression analysis were performed to evaluate the determinants of ITS and final decentration., Results: The preoperative crystalline lens diameter was associated with the ITS and with the IOL final decentration. A positive association between the final IOL decentration and the first post-surgical day decentration was found (p < 0.0001)., Conclusion: Greater crystalline lens diameter was associated with greater decentration and with greater ITS. Day-one IOL decentration seems to be the main determinant of final IOL decentration., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

Radiomics features (RFs) studies have showed limitations in the reproducibility of RFs in different acquisition settings. To date, reproducibility studies using CT images mainly rely on phantoms, due to the harness of patient exposure to X-rays. The provided CadAIver dataset has the aims of evaluating how CT scanner parameters effect radiomics features on cadaveric donor. The dataset comprises 112 unique CT acquisitions of a cadaveric truck acquired on 3 different CT scanners varying KV, mA, field-of-view, and reconstruction kernel settings. Technical validation of the CadAIver dataset comprises a comprehensive univariate and multivariate GLM approach to assess stability of each RFs extracted from lumbar vertebrae. The complete dataset is publicly available to be applied for future research in the RFs field, and could foster the creation of a collaborative open CT image database to increase the sample size, the range of available scanners, and the available body districts., (© 2024. The Author(s).)

Purpose: To compare simulated keratometry (SimK) and total corneal power (TCP) in keratoconic eyes, to determine whether the differences are systematic and predictable and to evaluate an adjusted TCP-based formula for intraocular lens (IOL) power calculation., Methods: In a consecutive series of keratoconic eyes, measurements of SimK, TCP, posterior keratometry, and anterior and posterior corneal asphericities (Q-values) were retrospectively collected. The difference between SimK and TCP was linearly correlated to the biometric parameters. In a separate sample of keratoconic eyes that had undergone cataract surgery, IOL power was calculated with the Barrett Universal II, Hoffer QST, Holladay 1, Kane, and SRK/T formulas using the SimK and an adjusted TCP power. The respective prediction errors were calculated., Results: A total of 382 keratoconic eyes (271 patients) were enrolled. An increasing overestimation of SimK by TCP was detected from stage I to III, with a significant correlation between the SimK and TCP difference and SimK in the whole sample ( P < .0001, r 2 = 0.1322). Approximately 7% of cases presented an underestimation of SimK by TCP. IOL power calculation with the adjusted TCP improved outcomes, achieving a maximum of 80% of eyes with a prediction error within ±0.50 diopters with the Hoffer QST, Holladay 1, and Kane formulas., Conclusions: Overall, SimK overestimated TCP. Such a difference could not be predicted by any variable. The proposed TCP-adjustment formula (TCP adj = TCP + 0.56 diopters) in keratoconic eyes for IOL power calculation might be valuable for improving refractive outcomes. [ J Refract Surg . 2024;40(4):e253-e259.] .

Purpose: This study aimed to explore the concept of total keratometry (TK) by analyzing extensive international datasets representing diverse ethnic backgrounds. The primary objective was to quantify the disparities between traditional keratometry (K) and TK values in normal eyes and assess their impact on intraocular lens (IOL) power calculations using various formulas., Design: Retrospective multicenter intra-instrument reliability analysis., Methods: The study involved the analysis of biometry data collected from ten international centers across Europe, the United States, and Asia. Corneal power was expressed as equivalent power and astigmatic vector components for both K and TK values. The study assessed the influence of these differences on IOL power calculations using different formulas. The results were analyzed and plotted using Bland-Altman and double angle plots., Results: The study encompassed a total of 116,982 measurements from 57,862 right eyes and 59,120 left eyes. The analysis revealed a high level of agreement between K and TK values, with 93.98% of eyes exhibiting an absolute difference of 0.25 D or less. Astigmatism vector differences exceeding 0.25 D and 0.50 D were observed in 39.43% and 1.08% of eyes, respectively., Conclusions: This large-scale study underscores the similarity between mean K and TK values in healthy eyes, with rare clinical implications for IOL power calculation. Noteworthy differences were observed in astigmatism values between K and TK. Future investigations should delve into the practicality of TK values for astigmatism correction and their implications for surgical outcomes., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: To assess agreement between a new aberrometer (Osiris-T; CSO) employing pyramid wavefront sensor technique and Scheiner-Smirnov aberrometer (OPD-Scan III; Nidek) on measuring ocular, corneal, and internal aberrations in healthy participants., Methods: The measurements were conducted three times consecutively by an experienced examiner. The total root mean square (RMS) aberrations, higher order aberration RMS, coma Z 3 ±1 , trefoil Z 3 ±3 , spherical aberration Z 4 0 , and astigmatism II Z 4 ±2 up to 7th order were exported in both 4-and 6-mm pupil zones. The parameters between the two devices were statistically compared using the paired t -test, and the differences assessed with Bland-Altman plots and 95% limits of agreement., Results: This prospective study included 70 right eyes of 70 healthy participants with an average age of 25.94 ± 6.59 years (range: 18 to 47 years). The mean difference in the two devices ranged from 0.01 µm for astigmatism II Z 4 ±2 to 0.63 µm for total RMS in 4 mm and from 0.01 to 1.41 µm in 6-mm pupil size. The Bland-Altman analysis of ocular, corneal, and internal aberrations indicated high agreement between the two devices and the maximum absolute values for 95% limits of agreement ranged from 0.03 to 1.06 µm for 4-mm pupil diameters and 0.12 to 1.13 µm for 6-mm pupil diameters., Conclusions: The newly developed pyramid wavefront sensor technique aberrometer demonstrated a high agreement with a Scheiner-Smirnov aberrometer when measuring ocular, corneal, and internal aberrations in healthy participants. Thus, the two aberrometers may be considered interchangeable for clinical applications. [ J Refract Surg . 2024;40(4):e218-e228.] .

Background: To evaluate the intraobserver repeatability and interobserver reproducibility of a newly developed dynamic real-time visualization 25 kHz swept-source optical coherence tomography (SS-OCT) based biometer (ZW-30, TowardPi Medical Technology Ltd, China) and compare its agreement with another SS-OCT based biometer (IOLMaster 700, Carl Zeiss Meditec AG, Jena, Germany)., Methods: Eighty-two healthy right eyes were enrolled in this prospective observational study. Measurements were repeated for three times using the ZW-30 and IOLMaster 700 in a random order. Obtained parameters included axial length (AL), central corneal thickness (CCT), aqueous depth (AQD), anterior chamber depth (ACD), lens thickness (LT), mean keratometry (Km), astigmatism magnitude (AST), vector J 0 , vector J 45 , and corneal diameter (CD). The within-subject standard deviation (Sw), test-retest (TRT) variability, coefficient of variation (CoV), and intraclass correlation coefficient (ICC) were adopted to assess the intraobserver repeatability and interobserver reproducibility. The double-angle plot was also used to display the distribution of AST. To estimate agreement, Bland-Altman plots were used., Results: For the intraobserver repeatability and interobserver reproducibility, the Sw, TRT and CoV for all parameters were low. Meanwhile, the ICC values were all close to 1.000, except for the J 45 (ICC = 0.887 for the intraobserver repeatability). The double-angle plot showed that the distribution of AST measured by these two devices was similar. For agreement, the Bland-Altman plots showed narrow 95% limits of agreements (LoAs) for AL, CCT, AQD, ACD, LT, Km AST, J 0 , J 45 , and CD (- 0.02 mm to 0.02 mm, - 7.49 μm to 8.08 μm, - 0.07 mm to 0.04 mm, - 0.07 mm to 0.04 mm, - 0.07 mm to 0.08 mm, - 0.16 D to 0.30 D, - 0.30 D to 0.29 D, - 0.16 D to 0.16 D, - 0.23 D to 0.13 D, and - 0.39 mm to 0.10 mm, respectively)., Conclusions: The newly dynamic real-time visualization biometer exhibited excellent intraobserver repeatability and interobserver reproducibility. The two devices both based on the SS-OCT principle had similar ocular parameters measurement values and can be interchanged in clinical practice., (© 2024. The Author(s).)

Background: The dysregulation of the gut-brain axis in chronic inflammatory bowel diseases can cause neuro-psychological disturbances, but the underlying mechanisms are still not fully understood. The choroid plexus (CP) maintains brain homeostasis and nourishment through the secretion and clearance of cerebrospinal fluid. Recent research has demonstrated the existence of a CP vascular barrier in mice which is modulated during intestinal inflammation. This study investigates possible correlations between CP modifications and inflammatory activity in patients with Crohn's disease (CD)., Methods: In this prospective study, 17 patients with CD underwent concomitant abdominal and brain 3 T MRI. The volume and permeability of CP were compared with levels of C-reactive protein (CRP), fecal calprotectin (FC), sMARIA and SES-CD scores., Results: The CP volume was negatively correlated with CRP levels (R = -0.643, p-value = 0.024) and FC (R = -0.571, p-value = 0.050). DCE metrics normalized by CP volume were positively correlated with CRP (K-trans: R = 0.587, p-value = 0.045; Vp: R = 0.706, p-value = 0.010; T1: R = 0.699, p-value = 0.011), and FC (Vp: R = 0.606, p-value = 0.037)., Conclusions: Inflammatory activity in patients with CD is associated with changes in CP volume and permeability, thus supporting the hypothesis that intestinal inflammation could affect the brain through the modulation of CP vascular barrier also in humans., Competing Interests: Declaration of competing interest The following authors disclose conflicts of interest: Federica Furfaro received consulting fees from Amgen, AbbVie and lecture fees from Janssen and Pfizer; Mariangela Allocca received consulting fees from Nikkiso Europe, Mundipharma, Janssen, AbbVie and Pfizer; Gionata Fiorino received consultancy fees from Ferring, MSD, AbbVie, Takeda, Janssen, Amgen, Sandoz, Samsung Bioepis, Celltrion; Silvio Danese served as a speaker, consultant, and advisory board member for Schering-Plow, Abbott (AbbVie) Laboratories, Merck, UCB Pharma, Ferring, Cellerix, Millenium Takeda, Nycomed, Pharmacosmos, Actelion, Alfa Wasserman, Genentech, Grunenthal, Pfizer, AstraZeneca, Novo Nordisk, Cosmo Pharmaceuticals, Vifor, and Johnson and Johnson; Alessandro Armuzzi has received consulting and/or advisory board fees from AbbVie, Allergan, Amgen, Arena, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mylan, Pfizer, Protagonist Therapeutics, Roche, Samsung Bioepis, Sandoz, and Takeda; lecture and/or speaker bureau fees from AbbVie, Amgen, Arena, Biogen, Bristol-Myers Squibb, Celltrion, Eli-Lilly, Ferring, Galapagos, Gilead, Janssen, MSD, Mitsubishi Tanabe, Novartis, Pfizer, Roche, Samsung Bioepis, Sandoz, Takeda, and Tigenix; and research grants from MSD, Pfizer, Takeda and Biogen; Maria Rescigno reports payment or honoraria for speaking engagements from Fondazione Internazionale Menarini; Riccardo Levi has received funds from Esaote. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. All remaining authors declare no financial or non-financial competing interests. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: The increasing number of coronary computed tomography angiography (CCTA) requests raised concerns about dose exposure. New dose reduction strategies based on artificial intelligence have been proposed to overcome limitations of iterative reconstruction (IR) algorithms. Our prospective study sought to explore the added value of deep-learning image reconstruction (DLIR) in comparison with a hybrid IR algorithm (adaptive statistical iterative reconstruction-veo [ASiR-V]) in CCTA, even in clinical challenging scenarios, as obesity, heavily calcified vessels and coronary stents., Methods: We prospectively included 103 consecutive patients who underwent CCTA. Data sets were reconstructed with ASiR-V and DLIR. For each reconstruction signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) was calculated, and qualitative assessment was made with a four-point Likert scale by two independent and blinded radiologists with different expertise., Results: Both SNR and CNR were significantly higher in DLIR (SNR-DLIR median value [interquartile range] of 13.89 [11.06-16.35] and SNR-ASiR-V 25.42 [22.46-32.22], P < 0.001; CNR-DLIR 16.84 [9.83-27.08] vs CNR-ASiR-V 10.09 [5.69-13.5], P < 0.001).Median qualitative score was 4 for DLIR images versus 3 for ASiR-V ( P < 0.001), with a good interreader reliability [intraclass correlation coefficient(2,1)e intraclass correlation coefficient(3,1) 0.60 for DLIR and 0.62 and 0.73 for ASiR-V].In the obese and in the "calcifications and stents" groups, DLIR showed significantly higher values of SNR (24.23 vs 11.11, P < 0.001 and 24.55 vs 14.09, P < 0.001, respectively) and CNR (16.08 vs 8.04, P = 0.008 and 17.31 vs 10.14, P = 0.003) and image quality., Conclusions: Deep-learning image reconstruction in CCTA allows better SNR, CNR, and qualitative assessment than ASiR-V, with an added value in the most challenging clinical scenarios., Competing Interests: The authors declare that they have no conflict of interests., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Epizootic hemorrhagic disease (EHD) is a non-contagious arthropod-transmitted viral disease and a World Organization for Animal Health (WOAH)-listed disease of domestic and wild ruminants since 2008. EHDV is transmitted among susceptible animals by a few species of midges of genus Culicoides . During the fall of 2021, a large outbreak caused by the epizootic hemorrhagic disease virus (EHDV), identified as serotype 8, was reported in Tunisian dairy and beef farms with Bluetongue virus (BTV)-like clinical signs. The disease was detected later in the south of Italy, in Spain, in Portugal and, more recently, in France, where it caused severe infections in cattle. This was the first evidence of EHDV-8 circulation outside Australia since 1982. In this study, we analyzed the epidemiological situation of the 2021-2022 EHDV outbreaks reported in Tunisia, providing a detailed description of the spatiotemporal evolution of the disease. We attempted to identify the eco-climatic factors associated with infected areas using generalized linear models (GLMs). Our results demonstrated that environmental factors mostly associated with the presence of C. imicola , such as digital elevation model (DEM), slope, normalized difference vegetation index (NDVI), and night-time land surface temperature (NLST)) were by far the most explanatory variables for EHD repartition cases in Tunisia that may have consequences in neighboring countries, both in Africa and Europe through the spread of infected vectors. The risk maps elaborated could be useful for disease control and prevention strategies.