Search Results (105)

Background: A novel titanium scleral buckle implant (TSBI) was developed for the treatment of posterior pole retinal detachments, analytically modeled and structurally tested as part of preclinical approval studies. The strength and stiffness requirements to apply pressure for retinal reattachment also suggested potential benefits for correcting high myopia greater than 8 diopters. Methods: Laboratory load testing and analytical calculations were complemented by nonlinear finite element modeling (FEM), applied for the first time to capture the interaction between the highly deformed myopic eye and the TSBI. Simulations were used to visualize posterior pole indentation and force distribution across anatomical regions. Seven TSBI units were tested in the transverse direction and six in the longitudinal direction. Results: The simulations confirmed that stable indentation is maintained even in areas distant from the sutures. The TSBI’s minimum midspan bending capacity was 40 N at yield and 60 N at ultimate. These values, together with FEM predictions, demonstrated a very large safety margin and showed that the implant deforms insignificantly under high intraocular pressure changes. Conclusions: The TSBI withstands ocular forces, cushions the sclera safely, and retains its geometry, a behavior that may differ from softer buckle materials, which can exhibit time-dependent deformation under sustained loading. Early controlled clinical applications outside the USA, followed for over three years, further validate its safety and potential effectiveness. Full article

Background/Objectives: Age-related macular degeneration, particularly geographic atrophy, is a major cause of irreversible vision loss and shares pathological features with myopic chorioretinal atrophy (CRA). This study was designed as an exploratory methodological analysis to evaluate the feasibility of using the fellow eye as an internal control in early-phase clinical trials for myopic CRA. Methods: This exploratory and methodological retrospective study included eight patients (16 eyes) with myopic CRA who visited the Department of Ophthalmology at Nagoya City University Hospital between January 2010 and August 2023. Atrophic areas in both eyes were measured, and the longitudinal changes were analyzed. Three mixed-effects models were compared to assess the impact of inter-individual and inter-ocular variability on atrophic area progression. Subsequently, fixed-effects and mixed-effects models were compared using the Akaike Information Criterion (AIC). Finally, the square root of the variance ratio was calculated to quantify the contribution of inter-ocular variability to atrophic area progression. Results: In all eyes, the square root of the atrophic area increased over time. The model including random intercepts and slopes for each eye nested within patients had the lowest AIC of 69.4, suggesting that accounting for both inter-individual and inter-ocular variability improved model accuracy. The mixed-effects model had a lower AIC than the fixed-effects model, indicating a better fit. The square root of the variance ratio was 0.34 in the mixed-effects model, indicating that the inter-ocular variability was lower than the inter-individual variability, though it remained appreciable. Conclusions: This study quantitatively supports the feasibility and methodological validity of inter-ocular comparison designs for early-phase clinical trials in myopic CRA. Full article

Childhood myopia progression remains a major global public health concern, and spectacle lenses designed to induce peripheral myopic defocus have emerged as a non-pharmacological strategy for myopia control; however, real-world evidence from European populations remains limited. This retrospective observational study evaluated the 12-month real-world effectiveness of cylindrical annular refractive element spectacle lenses in a Turkish pediatric cohort. Children aged 5–15 years who wore myopia-control spectacle lenses from the CARE platform or single-vision lenses were included. Cycloplegic spherical equivalent refraction (SER) and axial length (AL) were measured at baseline and at 12 months. The primary outcomes were 12-month changes in SER and AL. Multivariable generalized estimation equations were applied to account for inter-eye correlation and to adjust for age and gender. A total of 168 eyes were analyzed (85 with single-vision lenses; 83 with myopia-control lenses). After 12 months, the myopia-control group demonstrated significantly slower progression than the single-vision group, with mean SER changes of −0.40 ± 0.92 D versus −0.77 ± 0.74 D and axial elongation of 0.17 ± 0.25 mm versus 0.31 ± 0.30 mm, respectively. Treatment group remained a significant predictor of both refractive progression (p = 0.008) and axial elongation (p = 0.003). Age was independently associated with axial length change (p < 0.001), whereas gender was not. These findings provide real-world European evidence supporting the role of defocus-modulating spectacle lenses in pediatric myopia management. Full article

Background and Objectives: Intermittent exotropia (IXT) is a common childhood strabismus with variable natural history and no universally accepted first-line management. We aimed to characterize long-term real-world outcomes and identify factors associated with alignment stability across surgical and non-surgical strategies. Materials and Methods: This retrospective single-center cohort study reviewed consecutive patients with IXT managed between January 2008 and March 2024. Clinical data included IXT subtype, prism and alternate cover test measurements, binocular control (ECS), stereopsis, refractive error, and treatments (observation, over-minus lenses, and surgery). Postoperative success was defined as ≤10 prism diopters (PD) of eso/exophoria without diplopia. Longitudinal refractive change was analyzed using linear mixed-effects modeling, and time to alignment failure (≤±10 PD at near and distance) was evaluated using Kaplan–Meier and Cox regression analyses. Results: A total of 415 patients were included (mean follow-up 53.2 ± 47.8 months). Over-minus therapy was used in 252 (60.7%) patients for a median of 24 months, and 61 (14.7%) achieved spontaneous alignment. At the final visit, combined near-and-distance alignment success was 41.0% (170/415). Among surgically treated patients (n = 167), motor success was 65.3% (109/167), with reoperation required in 12.6% (21/167). Kaplan–Meier analysis showed cumulative alignment survival of 0.899 at 1 year, 0.563 at 5 years, and 0.302 at 10 years (median 70 ± 4.7 months). In Cox modeling, surgery was strongly protective (HR 0.174), while older age (HR 1.040 per year) and poor baseline distance control (HR 1.421) increased the risk of failure; over-minus therapy was not independently associated with survival. Both treatment groups showed a similar myopic shift over time (β = −0.25 D/year), with no between-group difference. Conclusions: In this longitudinal cohort, intermittent exotropia showed a variable course, with many patients ultimately requiring surgery despite initial non-surgical management. Long-term success was more closely tied to preoperative control quality than age. These findings support an individualized, control-based approach to treatment planning and timing of intervention. Full article

Background/Objectives: The perceived-time-based model posits that time perception is a critical factor in intertemporal decision-making; however, the mechanisms underlying this influence remain inadequately explored. Despite growing behavioral and neuroimaging findings, no study has directly compared the temporal neural dynamics of individuals who overestimate or underestimate time during intertemporal choices. Methods: This study screened participants with time overestimation or underestimation to examine differences in their electroencephalogram (EEG) activity during an intertemporal choice task. Results: Behavioral results revealed that the time overestimation group selected the smaller-sooner (SS) option at a higher rate than the time underestimation group, exhibiting a myopic decision-making tendency. EEG results revealed that, compared to the time overestimation group, the time underestimation group exhibited a more pronounced N2 amplitude, an enhanced P300 amplitude, and greater beta band oscillations. Within the time overestimation group, the larger-later (LL) option elicited a more negative N2 amplitude than the SS option. Conversely, in the time underestimation group, the LL option elicited a more positive P300 amplitude than the SS option. Conclusions: The results indicate that, during intertemporal decision-making, the time overestimation group experienced more conflict in the LL option, demonstrating lower cognitive control and fewer cognitive resources. This tendency may be driven by a hot system, resulting in more impulsive choices. Full article

This paper is a focused, standards-aligned survey of where autoregressive (AR) large language models (LLMs) tend to break down when deployed inside industrial informatics workflows that must satisfy long-horizon objectives, hard constraints, traceability, and functional-safety obligations (e.g., IEC 61508/ISO 26262/ISO 21448). Rather than claiming new algorithms or experiments, we synthesize and organize prior work into (i) a control-oriented taxonomy of four AR failure modes that recur in practice (compounding error, myopic objectives, data brittleness/hallucinations, and scaling/latency inefficiencies), (ii) a catalog of standards-compatible deployment patterns that mitigate these issues (human-gated LLM-in-the-loop, retrieval + verification pipelines, planner-of-record architectures, and runtime assurance envelopes), and (iii) an operational decision framework (criteria table with observable proxies, a stepwise decision procedure, and worked examples) for deciding when token-centric mitigations are sufficient versus when state/world-model components become warranted. Joint Embedding Predictive Architectures (JEPA) and Hierarchical JEPA (H-JEPA) JEPA are proposed as representative state-predictive architectures, with discussion explicitly bounded by currently available empirical evidence; we explicitly note that the published evidence base is currently concentrated on vision/multimodal benchmarks and that industrial control validation remains limited. To make evidence boundaries transparent, we introduce (a) a survey method (scope, inclusion/exclusion criteria, and data-extraction fields), (b) a comparison matrix across representative prior systems, and (c) an evidence map that links each deployment pattern to peer-reviewed empirical findings and system reports. Full article

With the deep integration of the modern automotive industry and artificial intelligence technologies, connected and automated vehicles (CAVs) have emerged as a key breakthrough for improving traffic safety and operational efficiency. This study proposes a distributed multi-vehicle cooperative trajectory planning and control framework for ramp merging and diverging scenarios, integrating Deep Neural Networks (DNNs) with Model Predictive Control (MPC). The methodology consists of three key components: First, a distributed cooperative architecture based on dynamic topology is constructed to effectively reduce communication loads; second, a feature point-based Cubic Bézier Curve trajectory generation method is proposed, enabling flexible path planning with reduced reliance on high-precision maps; finally, a DNN-accelerated MPC solving strategy (NN-MPC) is designed. This strategy employs an offline-trained deep neural network to approximate the online optimization process, supplemented by a terminal Safety Check mechanism and a dynamic surrounding vehicle selection algorithm. Experimental results demonstrate that the proposed method successfully reproduces the planning capability of offline high-precision MPC in ramp merging and diverging scenarios while reducing computation time to the millisecond level. It effectively overcomes the myopic decision-making problem of traditional real-time algorithms, achieving smoother conflict resolution and higher traffic efficiency. Notably, quantitative validation confirms that this cooperative framework achieves an approximate 30% reduction in average travel delay compared to the non-cooperative baseline. This study confirms the engineering advantages of the hybrid architecture under dynamic high-density traffic flows, significantly enhancing the system’s real-time response capability while balancing the safety and riding comfort of cooperative driving. Full article

Background/Objectives: Diagnosing glaucoma in myopic eyes remains challenging because myopia-related structural changes can mimic glaucomatous damage on optical coherence tomography (OCT). This study aimed to identify the optimal circular scan diameter for differentiating physiological myopic thinning from glaucomatous loss by analyzing retinal nerve fibre layer thickness (RNFLT) and colour-code distribution across three scan diameters. Methods: In this prospective cross-sectional study, 204 eyes (41 controls, 44 mild myopia, 66 moderate myopia, and 53 high myopia) were examined using spectral-domain OCT (Spectralis, Heidelberg). Three concentric circumpapillary scans centred on the Bruch’s membrane opening were obtained: C1 = 3.5 mm, C2 = 4.1 mm, and C3 = 4.7 mm. Global and sectoral RNFLT were evaluated in seven anatomical regions (TS, NS, N, NI, TI, T, and G). Statistical analyses included one-way ANOVA, repeated-measures ANOVA, and receiver operating characteristic (ROC) analysis. Results: RNFLT decreased significantly with increasing scan diameter (p< 0.001). Thinning was most pronounced in the nasal-superior (NS) and nasal-inferior (NI) quadrants. Across all diameters, C2 (4.1 mm) showed the highest and most consistent discriminatory performance between myopic and control eyes (NI: AUC = 0.674, p = 0.001; NS: AUC = 0.625, p = 0.014). A progressive shift in OCT colour-code distribution was observed from green to yellow/red with both increasing myopia and larger scan diameters, reflecting anatomical stretching in the nasal and inferior regions. This change was most prominent at the outer ring (C3), where the temporal-inferior (TI) quadrant showed a significant rise in yellow codes (p = 0.020). Repeated-measures ANOVA revealed significant between-group effects in NS and NI (p < 0.01) and notable group × diameter interactions in NS and TS (p< 0.05). Conclusions: RNFLT thinning in non-glaucomatous myopic eyes predominantly affects nasal quadrants, whereas temporal segments remain relatively preserved. The 4.1 mm (C2) scan provides the most balanced diagnostic performance and minimizes false-positive “red disease” results. Recognition of the ring-dependent colour-code shift and segment-specific thinning is crucial for accurate interpretation of OCT findings in myopic eyes. Full article

Myopia has emerged as a global public health crisis, with prevalence exceeding 80% in East Asian urban populations and rising rapidly worldwide. High myopia substantially increases the lifetime risk of sight-threatening complications, including myopic macular degeneration, retinal detachment, and glaucoma. Multiple interventions have been investigated to slow myopia progression in children. Behavioral strategies, particularly increased outdoor exposure, demonstrate protective effects against myopia onset and may modestly slow progression, whereas several historically used approaches show no clinically meaningful benefit. Spectacle lens interventions include simultaneous defocus designs (e.g., DIMS, HALT, CARE) and contrast-modulating diffusion optics (DOT) lenses; collectively, these technologies have demonstrated consistent and clinically meaningful reductions in axial elongation across randomized clinical trials. Contact lens modalities, including dual-focus soft lenses and orthokeratology, have also demonstrated substantial efficacy in slowing progression in controlled studies. Low-dose atropine remains a cornerstone pharmacological therapy, particularly at concentrations between 0.01% and 0.05%, offering significant efficacy with minimal side effects. Repeated low-level red-light therapy has shown promising short-term reductions in axial elongation, although long-term safety and rebound effects remain uncertain. Combination therapy targeting complementary optical and pharmacological pathways shows additive benefits, particularly in children inadequately controlled with monotherapy. Contemporary clinical management emphasizes risk stratification based on axial length, age-specific growth targets, and structured longitudinal monitoring. The goal of modern myopia management is not merely to slow progression, but to prevent high myopia and reduce the lifetime burden of vision-threatening complications through a proactive, individualized approach increasingly regarded as the standard of care. Full article

Heating, ventilation, and air-conditioning (HVAC) systems dominate energy consumption in hot-climate buildings, where maintaining occupant comfort under extreme outdoor conditions remains a critical challenge, particularly under emerging time-of-use (TOU) electricity pricing schemes. While deep reinforcement learning (DRL) has shown promise for adaptive HVAC control, existing approaches often suffer from comfort violations, myopic decision making, and limited robustness to uncertainty. This paper proposes a comfort-first hybrid control framework that integrates Soft Actor–Critic (SAC) with a Cross-Entropy Method (CEM) refinement layer, referred to as SACEM. The framework combines data-efficient off-policy learning with short-horizon predictive optimization and safety-aware action projection to explicitly prioritize thermal comfort while minimizing energy use, operating cost, and peak demand. The control problem is formulated as a Markov Decision Process using a simplified thermal model representative of commercial buildings in hot desert climates. The proposed approach is evaluated through extensive simulation using Saudi Arabian summer weather conditions, realistic occupancy patterns, and a three-tier TOU electricity tariff. Performance is assessed against state-of-the-art baselines, including PPO, TD3, and standard SAC, using comfort, energy, cost, and peak demand metrics, complemented by ablation and disturbance-based stress tests. Results show that SACEM achieves a comfort score of 95.8%, while reducing energy consumption and operating cost by approximately 21% relative to the strongest baseline. The findings demonstrate that integrating comfort-dominant reward design with decision-time look-ahead yields robust, economically viable HVAC control suitable for deployment in hot-climate smart buildings. Full article

Wood flooring manufacturers face complex challenges in dynamically allocating resources across multi-channel markets, characterized by channel conflicts, demand uncertainty, and long-term cumulative effects of decisions. Traditional static optimization or myopic approaches struggle to address these intertwined factors, particularly when critical market states like brand reputation and customer base cannot be precisely observed. This paper establishes a systematic and theoretically grounded online decision framework to tackle this problem. We first model the problem as a Partially Observable Stochastic Dynamic Game. The core innovation lies in introducing an unobservable market position vector as the central system state, whose evolution is jointly influenced by firm investments, inter-channel competition, and macroeconomic randomness. The model further captures production lead times, physical inventory dynamics, and saturation/cross-channel effects of marketing investments, constructing a high-fidelity dynamic system. To solve this complex model, we propose a hierarchical online learning and control algorithm named L-BAP (Lyapunov-based Bayesian Approximate Planning), which innovatively integrates three core modules. It employs particle filters for Bayesian inference to nonparametrically estimate latent market states online. Simultaneously, the algorithm constructs a Lyapunov optimization framework that transforms long-term discounted reward objectives into tractable single-period optimization problems through virtual debt queues, while ensuring stability of physical systems like inventory. Finally, the algorithm embeds a game-theoretic module to predict and respond to rational strategic reactions from each channel. We provide theoretical performance analysis, rigorously proving the mean-square boundedness of system queues and deriving the performance gap between long-term rewards and optimal policies under complete information. This bound clearly quantifies the trade-off between estimation accuracy (determined by particle count) and optimization parameters. Extensive simulations demonstrate that our L-BAP algorithm significantly outperforms several strong baselines—including myopic learning and decentralized reinforcement learning methods—across multiple dimensions: long-term profitability, inventory risk control, and customer service levels. Full article

Background/Objectives: Myopia progression is strongly associated with axial length (AL) elongation, and orthokeratology (Ortho-K) lens design may influence treatment outcomes. This study has the aim to evaluate the impact of lens customization as optical zone diameter between specific higher-order aberrations (HOA) and axial length (AL) changes in myopic children. Methods: This retrospective study evaluated 66 Caucasian myopic children (mean age, 13.3 ± 1.4 years, 60% male) fitted with Ortho-K lenses with varying back optic zone diameters (BOZD, 4.7–6.0 mm) in a Spanish optometric clinic. Baseline mean spherical equivalent (sphere + 1/2 cylinder) was −2.94 ± 1.24 D and AL = 24.52 ± 0.80 mm. Results: After 12 months, children fitted with smaller BOZDs showed significantly less axial elongation than those with larger BOZDs (0.08 ± 0.12 mm vs. 0.15 ± 0.10 mm, p < 0.001) and smaller plus power ring diameter (PPRD). Differences in AL change were observed between PPRD subgroups (larger and smaller than 4.5 mm). HOA revealed distinct patterns: vertical coma increased significantly only in the PPRD > 4.5 mm group (p = 0.003), horizontal coma increased significantly only in the PPRD < 4.5 mm group (p = 0.004), while total coma increased in both, without intergroup differences. Both PPRD subgroups demonstrated significant increases in spherical aberration (p < 0.001). Conclusions: These findings suggest that reducing BOZD, and consequently PPRD, can slow AL elongation more effectively than standard designs, although optical side effects require consideration. Further studies should clarify the interplay of BOZD, PPRD, and pupil size in myopia control. Full article

This paper develops a dynamic asset allocation strategy for defined contribution pension funds using a stochastic control framework under the Heston stochastic volatility model. By solving the associated Hamilton–Jacobi–Bellman partial differential equation, we derive optimal equity allocations that adapt to changing market volatility and investor risk aversion using a constant relative risk aversion utility function (parameter $\gamma$). The strategy increases equity exposure during stable periods and reduces it during volatile regimes, capturing both myopic and intertemporal hedging demands. We test the model using historical U.S. data from 2006 to 2025 and benchmark its performance against a traditional static 60/40 stock–bond portfolio, as well as rule-based strategies such as volatility targeting and constant proportion portfolio insurance. Our results show that with moderate risk aversion, the dynamic strategy achieves long-term wealth comparable to the 60/40 benchmark while substantially reducing drawdown risk. As risk aversion increases, drawdown risk is further reduced and risk-adjusted returns remain competitive. Although higher aversion yields lower final wealth, certainty-equivalent returns are highest at moderate aversion levels. These results demonstrate that volatility responsive dynamic policies grounded in realistic stochastic volatility modeling can substantially enhance downside protection and risk-adjusted utility, especially for long-horizon, risk-averse pension participants. Full article

Scleral remodeling plays a crucial role in myopia development. Although ultrastructural collagen changes have been described, quantitative assessment at the fiber bundle level remains limited. This study quantitatively evaluated scleral collagen remodeling in a lens-induced myopia (LIM) mouse model using polarized light microscopy (PLM) combined with picrosirius red (PSR) staining. LIM was induced in C57BL/6J male mice by applying a monocular −30 D lens from postnatal week 3 to 6. Eyes wearing −30 D lenses showed myopic shifts in refraction (−8.42 ± 3.87 D vs. 4.42 ± 4.45 D; p = 0.002) and axial elongation (0.21 ± 0.04 mm vs. 0.18 ± 0.05 mm; p = 0.020) compared with contralateral controls. PLM revealed looser, more disorganized collagen bundles in myopic sclera. Quantitative analysis showed reduced bundle proportion (40.91 ± 6.58% vs. 48.36 ± 6.47%; p = 0.040) and mean size (147.11 ± 59.38 µm² vs. 281.45 ± 101.00 µm²; p = 0.002). These results indicate that myopia development involves structural remodeling of the sclera and that PLM with PSR staining provides a practical approach for quantitative wide-field evaluation of collagen architecture in experimental myopia. Full article

Myopia prevalence has risen dramatically worldwide, underscoring the critical need for effective interventions to slow its progression. Recent advancements in spectacle lens technology offer promising solutions, demonstrating significant efficacy in controlling myopia. This review critically examines next-generation spectacle lenses for myopia management, emphasizing their optical principles, mechanisms of action, clinical effectiveness, visual performance, compliance, and safety. Spectacle lenses incorporating technologies such as Defocus Incorporated Multiple Segments (DIMS), Highly Aspherical Lenslet Target (HALT), Diffusion Optics Technology (DOT), and Cylindrical Annular Refractive Element (CARE) lenses show a 40–60% reduction in refractive progression and axial elongation compared to traditional single-vision lenses. These lenses utilize optical strategies like simultaneous myopic defocus, peripheral contrast modulation, and controlled aberrations without compromising visual acuity, contrast sensitivity, accommodation, or binocular vision. High wearer compliance is attributed to excellent visual comfort, minimal adaptation issues, and favorable cosmetic appearance. Long-term studies further confirm sustained efficacy and safety profile. Ongoing research aimed at direct comparative trials, extended follow-up, and individualized lens designs will further define the role of these interventions. Collectively, the evidence positions next-generation spectacle lenses as a promising, evidence-based approach that may become an important component of global myopia management. Full article