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5 mm Hg (median, 15.0; range, 9.0-28.0 mm Hg). In multiple regression analyses, the mean IOP was significantly lower among asthmatic children compared to normal participants (P = 0.007). The measured IOP was significantly higher in myopic participants than hyperopic patients (P = 0.003). Conclusions This study provides a useful normative IOP database using the noncontact tonometer for healthy Iranian school children.Purpose To describe one of the largest case series of children whose ocular surface disease was strongly suspicious for nonaccidental injury (NAI). Methods This multicenter retrospective case series includes 4 patients whose presentations were concerning for anterior segment NAI. The history, examination, treatment, and outcomes of these patients is presented, along with a brief review of case reports in the literature. Results A broad spectrum of anterior segment findings was noted in our case series and in cases previously reported in the literature. NAI appears to be associated with bilateral and recurrent disease as well as improvement during hospitalization that is better than initially expected. Conclusions Ocular surface NAI is a diagnosis of exclusion and necessitates a thorough history and examination. Clinician concern for ocular NAI should prompt examination or referral for signs of other bodily injuries, especially in young children. DBZ inhibitor datasheet Siblings of patients who have received the diagnosis of NAI may also be at risk.Adams-Oliver syndrome (AOS) is a congenital condition characterized by aplasia cutis congenita of the scalp and transverse limb defects. Other clinical features reported in association with AOS include cardiac malformations, cutis marmorata telangiectatica congenita, prenatal complications, and ophthalmic abnormalities. Reported ophthalmic manifestations range from Peters anomaly-like findings and cataract formation to incomplete or abnormal retinal vasculature, optic nerve hypoplasia, and rod dystrophy. We report the novel case of a 3-month-old boy with AOS type 2 who was found to have bilateral progressive macular ischemia.The American Heart Association (AHA) recommends first defibrillation energy dose of 2 Joules/kilogram (J/kg) for pediatric cardiac arrest with ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT). However, optimal first energy dose remains unclear. Methods Using AHA Get With the Guidelines-Resuscitation® (GWTG-R) database, we identified children ≤12 years with IHCA due to VF/pVT. Primary exposure was energy dose in J/kg. We categorized energy doses 1.7-2.5 J/kg as reference (reflecting 2 J/kg intended dose), 2.5 J/kg had lower survival rates in all patients ≤18 years old with initial VF. These results support current AHA guidelines for first pediatric defibrillation energy dose of 2 J/kg.Background Rapid emergency medical service (EMS) response after out-of-hospital cardiac arrest (OHCA) is a major determinant of survival, however this is typically measured until EMS vehicle arrival. We sought to investigate whether the interval from EMS vehicle arrival to patient attendance (curb-to-care interval [CTC]) was associated with patient outcomes. Methods We performed a secondary analysis of the "CCC Trial" dataset, which includes EMS-treated adult non-traumatic OHCA. We fit an adjusted logistic regression model to estimate the association between CTC interval (divided into quartiles) and the primary outcome (survival with favourable neurologic status at hospital discharge; mRS ≤ 3). We described the CTC interval distribution among enrolling clusters. Results We included 24,685 patients median age was 68 (IQR 56-81), 23% had initial shockable rhythms, and 7.6% survived with favourable neurological status. Compared to the first quartile (≤62 s), longer CTC quartiles (63-115, 116-180, and ≥181 s) demonstrated the following associations with survival with favourable neurological status adjusted odds ratios 0.95, 95% CI 0.83-1.09; 0.77, 95% CI 0.66-0.89; 0.66, 95% CI 0.56-0.77, respectively. Of the 49 study clusters, median CTC intervals ranged from 86 (IQR 58-130) to 179 s (IQR 112-256). Conclusion A lower CTC interval was associated with improved patient outcomes. These results demonstrate a wide range of access metrics within North America, and provide a rationale to create protocols to mitigate access obstacles. A 2-min CTC threshold may represent an appropriate target for quality improvement.Aim Current guidelines suggest the use of epinephrine in patients with cardiac arrest (CA). However, evidence for increased survival in good neurological condition is lacking. In experimental settings, epinephrine-induced impairment of microvascular flow was shown. The aim of our study was to analyse the association between epinephrine treatment and intestinal injury in patients after CA. Methods We have included 52 patients with return of spontaneous circulation (ROSC) after CA admitted to our medical intensive care unit (ICU). Blood was taken on admission and levels of circulating intestinal fatty acid binding protein (iFABP) were analysed. Results Patients were 64 (49.8-73.8) years old and predominantly male (76.9%). After six months, 50% of patients died and 38.5% of patients had a cerebral performance category (CPC)-score of 1-2. iFABP levels were lower in survivors (234 IQR 90-399pg/mL) as compared to non-survivors (283, IQR 86-11500pg/mL; p1500pg/mL, which was associated with dramatically increased mortality (HR4.87, 95%CI 1.95-12.1; p less then 0.001). iFABP levels predicted mortality independent from time to ROSC and the disease severity score SAPS II. In contrast to mortality, iFABP plasma levels were not associated with neurological outcome. Conclusions In this small, single centre study, cumulative dose of epinephrine used in cardiac arrest patients was associated with an increase in biomarker indicative of intestinal injury and 6-month mortality.The TGF-beta superfamily is widely involved in cell events such as cell division and differentiation, while bone morphogenetic proteins (BMPs) belong to one of the subgroups. Their functions in crustacean spermatogenesis are still unknown. In this study, we first identified the bone morphogenetic protein 2 (bmp2) from Eriocheir sinensis (E. sinensis) testis. The es-BMP2 shows high expression in E. sinensis testis. We found that es-BMP2 is expressed in spermatids. The successfully knockdown of es-BMP2 through in vivo RNAi are used for functional analysis. Compared with the control group, the proportion of abnormal nuclear cup morphology in mature spermatozoa increased significantly after es-bmp2 RNAi, suggesting that es-BMP2 plays an important role in mature sperm morphogenesis. Immunofluorescence results confirm this finding. In order to study the specific mechanism of es-BMP2 involved in spermiogenesis, we tested kinesin-14 KIFC1, which functions in the nucleus formation of spermatozoa in E. sinensis. The results showed that knockdown of es-BMP2 caused a significant decrease of es-KIFC1 expression.