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We reevaluate acute retinal pigment epitheliitis (ARPE) first described by Krill and Deutman in 1972, integrating a meticulous literature review with advanced multimodal imaging analyses. Our review included 98 eyes from 86 published cases diagnosed with ARPE. We scrutinized ARPE's clinical presentations, variability, and imaging characteristics, revealing that a large majority (90 %) of cases previously diagnosed as ARPE align more closely with other retinal disorders based on modern diagnostic criteria and imaging techniques. Only a small fraction (5 eyes) did not fit into any known categories, casting doubt on ARPE's distinct existence. This underscores the critical role of multimodal imaging in redefining our understanding of macular diseases and challenges the historical classification of ARPE as a unique clinical entity., 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 Elsevier Inc. All rights reserved.)

Purpose: To report the clinical course of two cases of acute retinal necrosis (ARN) caused by varicella zoster virus (VZV) and cytomegalovirus (CMV) co-infection detected by polymerase chain reaction (PCR) on aqueous tap., Methods: Observational case reports., Results: Two patients presented to our services with unilateral panuveitis suggestive of ARN complicated by hemorrhagic vasculitis and started empirical therapy. Aqueous PCR was performed on the same day and showed double positivity for VZV and CMV, which guided treatment. At follow-up, wide-field color fundus imaging and high-resolution optical coherence tomography showed resolution of active retinitis., Conclusion: Our cases suggest that ARN complicated by hemorrhagic vasculitis may be secondary to CMV and VZV co-infection, both in patients with an unremarkable clinical history and in those with immunodeficiency. In our cases, aqueous PCR testing was of paramount importance to determine the aetiology of ARN and to adjust the antiviral therapy accordingly.

Objectives: This independent prospective study evaluated the short-term effects and safety of photobiomodulation (PBM) in early and intermediate age-related macular degeneration., Methods: patients were treated with PBM in one eye. Functional parameters and drusen volume were measured at one (W4), three- (W12) and six-months (W24) after PBM., Results: The study included 38 subjects who completed the PBM protocol. Two patients developed macular neovascularization during the study period. Best corrected visual acuity improved from 77.82 ± 5.83 ETDRS letters at baseline to 82.44 ± 5.67 at W12 (p < 0.01), then declined to 80.05 ± 5.79 at W24 (p < 0.01 vs. baseline). Low luminance visual acuity showed a similar pattern, improving from 61.18 ± 8.58 ETDRS letters at baseline to 66.33 ± 8.55 at W12 (p < 0.01), and decreasing to 62.05 ± 9.71 at W24 (p = 0.02). Contrast sensitivity improved at W12 (20.11 ± 9.23 ETDRS letters, p < 0.01), but returned to baseline by W24 (16.45 ± 9.12, p = 0.5). Scotopic microperimetry showed a decrease in mean absolute retinal sensitivity from 9.24 ± 3.44 dB to 7.47 ± 4.41 dB at W24 (p < 0.01), while relative sensitivity decreased only at W24 (p = 0.04). Drusen volume decreased at W4 (0.018 ± 0.009 mm3, p < 0.01) and W12 (0.017 ± 0.009 mm3, p < 0.01), with a slight increase at W24 (0.019 ± 0.012 mm3, p = 0.154)., Conclusions: PBM resulted in temporary improvements in visual function and a reduction in drusen volume, but these effects were not sustained at six months. The long-term efficacy and impact on disease progression are uncertain, necessitating further research to confirm these findings and determine optimal patient selection., (© 2024. The Author(s).)

In Italy, the use of autogenous inactivated vaccines prepared with the bacterial strains isolated from affected animals is authorized by the Ministry of Health in farms where bacterial diseases occur frequently. The autogenous vaccine performed using Pasteurella multocida is frequently used in rabbit farms, but the feedback of its application is not available. Therefore, the aim of this study is to give information about the impact on the clinical signs of a bivalent autogenous vaccine in rabbits of a genetic centre. The vaccine was prepared using two P. multocida strains belonging to serogroups A and F, equipped with virulence genes and responsible for cyclical outbreak of pasteurellosis in the farm. The vaccine was administered with a first injection, followed by another one after 15 days, then another one four months after the first injection, and then continuing with a further injection every six months to all rabbits. Clinical conditions and mortality rates were monitored for two years after the first vaccination. The improvement in clinical condition and the decrease of the mortality rate were significant especially in the first year post-vaccine. In addition, the number of animals removed due to the disease decreased greatly. Based on the finding of P. multocida strains belonging to serogroup D and serogroup A equipped with different virulence-gene patterns from those previously found, we suggest that the vaccine was unable to prevent the introduction and spreading of new strains among the rabbits., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Purpose: To report the clinical course and the retinal imaging features of a case of cytology-proven primary vitreoretinal lymphoma (PVRL) presenting with a transient bacillary layer detachment (BALAD) during the disease course., Methods: Observational case report., Results: A 50 year-old woman was referred to us with a 2-month history of vitritis in both eyes, poorly responding to oral prednisolone. After discontinuation of oral prednisolone, worsening of vitritis and the appearance of multiple creamy-like subretinal infiltrates in the mid-peripheral retina of both eyes, along with the exclusion of common causes of intermediate/posterior uveitis, made us consider PVRL. Aqueous humor sampling detected MYD88 L265P mutation, and subsequent diagnostic pars plana vitrectomy in the left eye yielded a positive cytology for large B cell lymphoma consistent with PVRL. During the disease course, optical coherence tomography of the macula showed a BALAD in the right eye, which resolved during follow-up., Conclusion: Our case indicates that BALAD is a possible rare manifestation of PVRL, and this should be considered in the differential diagnosis process in order to avoid diagnostic delays.

Purpose: To evaluate the influence of immunomodulatory therapy (IMT) on visual and treatment outcomes of inflammatory choroidal neovascularization (iCNV) in patients affected by multifocal choroiditis (MFC), and to compare them to patients treated with steroids as needed., Design: Multicenter retrospective matched cohort study., Methods: Patients affected by MFC with iCNV were divided into a IMT group and a "steroids as needed" group and matched according to the time between diagnosis and beginning of systemic treatment. Visual acuity (VA), number of anti-vascular endothelial growth factor (VEGF) intravitreal injections, and number of iCNV reactivations during 2 years of follow-up after treatment initiation were compared between the 2 groups., Results: A total of 66 eyes of 58 patients were included, equally divided into the 2 groups. Patients in the IMT group had a lower relative risk (RR) of iCNV reactivation (0.64, P = .04) and of anti-VEGF intravitreal injection retreatment (0.59, P = .02). Relapses of MFC-related inflammation were independently associated with a higher RRs of iCNV reactivation (1.22, P = .003). Final VA was higher in the IMT compared to the steroids as needed group (mean [SD], 69.1 [15.1] vs 77.1 [8.9] letters, P = .01), and IMT was associated with greater VA gains over time (+2.5 letters per year, P = .04)., Conclusions: IMT was associated with better visual and treatment outcomes in MFC complicated by iCNV compared to steroids as needed. The better outcomes of the IMT group and the association between MFC-related inflammation and iCNV reactivations highlight the need for tighter control of inflammation to prevent iCNV relapses and visual loss., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Pasteurellosis, a disease caused by Pasteurella multocida , is responsible for economic losses in rabbit industrial farms due to rhinitis, conjunctivitis, pneumonia, metritis, mastitis, orchitis, subcutaneous abscesses, otitis, encephalitis, and septicaemic forms. Although the occurrence of the disease is conditioned by predisposing factors that affect the rabbit immune response, the strains of P. multocida involved in the infection may have a different pathogenic ability. Therefore, typing of strains spread among the rabbits is important to assess their pathogenic potential. The aim of this study is to investigate the P. multocida strains responsible for disease in rabbit industrial farms. A total of 114 strains identified from different lesions were serotyped. Additionally, the presence of virulence-associated genes was investigated using three PCR (polymerase chain reaction) protocols. Capsular type A was prevalently found in strains from respiratory lesions while types D and F in those from metritis, mastitis, and other lesions. Different associations between some virulence-associated genes and both capsular type and lesions found in rabbits were detected. The presence of 8 virulence-associated genes seems to increase the occurrence of metritis. In addition, strains belonging to capsular type A and responsible for respiratory disorders especially, were found equipped with 10 and 11 virulence-associated genes. Nevertheless, the presence of strains responsible only for rhinitis was also detected among the latter, suggesting that the pathogenic ability of the bacteria depends on the expression rather than the presence of a gene.

The low carbon footprint, biodegradability, interesting mechanical properties, and relatively low price are considered some of the reasons for the increased interest in polylactic acid-based (PLA-based) filaments supplied with natural fillers. However, it is essential to recognize that incorporating natural fillers into virgin PLA significantly impacts the printability of the resulting blends. The complex inter-relationship between process, structure, and properties in the context of fused deposition modeling (FDM)-manufactured biocomposites is still not fully understood, which thus often results in decreased reliability of this technology in the context of biocomposites, decreased accuracy, and the increased presence of defects in the manufactured biocomposite samples. In light of these considerations, this study aims to identify the optimal processing parameters for the FDM manufacturing process involving wood-filled PLA biocomposites. This study presents an optimization approach consisting of Grey Relational Analysis in conjunction with the Taguchi orthogonal array. The optimization process has identified the combination of a scanning speed of 70 mm/s, a layer height of 0.1 mm, and a printing temperature of 220 °C as the most optimal, resulting in the highly satisfactory combination of good dimensional accuracy (Dx = 20.115 mm, Dy = 20.556 mm, and Dz = 20.220 mm) and low presence of voids (1.673%). The experimentally determined Grey Relational Grade of the specimen manufactured with the optimized set of process parameters (0.782) was in good agreement with the predicted value (0. 754), substantiating the validity of the optimization process. Additionally, the research compared the efficacy of optimization between the integrated multiparametric method and the conventional monoparametric strategy. The multiparametric method, which combines Grey Relational Analysis with the Taguchi orthogonal array, exhibited superior performance. Although the monoparametric optimization strategy yielded specimens with favorable values for the targeted properties, the analysis of the remaining characteristics uncovered unsatisfactory results. This highlights the potential drawbacks of relying on a singular optimization approach.

Purpose: To report a case of presumed sympathetic ophthalmia (SO) following scleral buckling (SB) surgery and to discuss the possible pathogenesis of this condition by reviewing the current evidence on this subject., Methods: Case report and narrative review of the literature; our case was imaged with spectral-domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA), fundus autofluorescence (FAF), fluorescein angiography (FFA) and indocyanine green angiography (ICGA)., Results: A 55-year-old man presented with a macula on rhegmatogenous retinal detachment which was treated with 360° SB surgery, subretinal fluid drain (SRFD), cryopexy and pneumoretinopexy. Due to failure of the primary surgery, a second procedure was performed the day after with the explant of the prior buckle and the implant of a wider circumferential element. At three months from surgery, the patient complained of severe bilateral vision loss. Multimodal imaging revealed bilateral, multi-focal exudative retinal detachments and choroidal swelling. A diagnosis of presumed SO was made and the patient was treated with a combination of steroid and immunosuppressive drugs. The clinical picture completely resolved at postoperative month 12., Conclusion: SO may be a rare complication of SB surgery. In our case, early recognition and prompt immunosuppressive treatment achieved good long-term clinical results., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To report imaging findings, including optical coherence tomography (OCT), of a case of endogenous Aspergillus endophthalmitis in a patient with newly diagnosed acquired immunodeficiency syndrome., Methods: Observational case report., Results: A 38-year-old patient presented with acute painful vision loss in his right eye (RE). Examination of the RE revealed anterior inflammation, vitritis and a fluffy macular infiltrate; OCT showed preretinal hyperreflective aggregates extending into the vitreous cavity with no evidence of subretinal and/or choroidal involvement. Lab tests showed leukopenia with lymphocyte T CD4+ count of 13 cells/μL and positive HIV serology. Vitreous biopsy was positive for Aspergillus niger and diagnosis of endogenous Aspergillus endophthalmitis secondary to HIV infection was made., Conclusions: OCT findings of this case show that ocular aspergillosis may present with disruption of the inner retinal layers and sparing of the outer retina and choroid, suggesting that Aspergillus may reach the eye through the retinal circulation.

Purpose: To investigate the presence and type of ocular abnormalities in patients with hemophagocytic lymphohistiocytosis (HLH)., Design: A retrospective cross-sectional study., Methods: Observational report of ocular findings and their associations with age, sex, underlying disease, and hematologic parameters. HLH was defined according to the 2004 criteria, and the patients were enrolled from March 2013 to December 2021. Analysis began in July 2022 and ended in January 2023. The main outcome measures were ocular abnormalities associated with HLH and their potential risk factors., Results: Of 1525 HLH patients, 341 had ocular examinations, and 133 (133 of 341, 39.00%) had ocular abnormalities. Mean age at presentation was 30.21 ± 14.42 years. The multivariate analysis indicated that old age, autoimmune disorders, decreasing red blood cell count, decreasing platelet count, and increasing fibrinogen level were independent risk factors of ocular involvement in HLH patients. The most common presenting ocular findings were posterior segment abnormalities (66 patients, 49.62%), including retinal and vitreous hemorrhage, serous retinal detachment, cytomegalovirus retinitis, and optic disc swelling. Other HLH-associated ocular abnormalities included ocular surface infection (conjunctivitis, 34 patients, 25.56%; keratitis, 16 patients, 12.03%), subconjunctival hemorrhage (11 patients, 8.27%), chemosis (5 patients, 3.76%), anterior uveitis (11 patients, 8.27%), glucocorticoid-induced glaucoma (5 patients, 3.76%), radiation cataract (1 patient, 0.75%), dacryoadenitis (2 patients, 1.50%), dacryocystitis (1 patients, 0.75%), orbital cellulitis (2 patients, 1.50%), orbital pseudotumor (2 patients, 1.50%), and strabismus (2 patients, 1.50%)., Conclusions: Eye involvement is not uncommon in HLH. Better awareness among both ophthalmologists and hematologists is necessary for prompt diagnosis and institution of appropriate management strategies with potential to save sight and life., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Acute optic neuritis (AON) is a common cause of sudden visual loss in young patients. Because of the risk of demyelinating disease, patients affected by unilateral or bilateral optic neuritis should be evaluated and treated accordingly. Despite advancements in imaging of the brain and retina, misdiagnosis of AON is not uncommon. Indeed, some acute disorders of the retina have the potential to mimic AON and their prompt diagnosis may avoid unnecessary neurologic investigation, psychological stress to the patient, and delays in treatment. This review describes uncommon retinal disorders presenting with sudden-onset visual loss and absent or subtle funduscopic manifestation that can mimic AON. Multimodal retinal imaging is essential in detecting these conditions and in their differential diagnosis. It behooves neurologists and general ophthalmologists to be aware of these entities and be familiar with multimodal imaging of the retina.

Colibacillosis, caused by E. coli , is responsible for economic losses in the poultry industry due to mortality, decreased production, and the cost of antibiotic treatments. Prevention of colibacillosis is based on improved biosecurity measures and the use of the vaccine performed with O78 E. coli strains, which is responsible for most cases of colibacillosis. Recently, there has been increased interest in other infection control methods, such as the use of natural compounds. The aim of this study was to evaluate the antimicrobial efficacy of cinnamon essential oil (CEO) against E. coli strains isolated from poultry. The MIC 50 and MIC 90 of CEO were determined by testing 117 strains belonging to serogroups O78, O2, O128, O139, isolated from laying hens (91 strains), broilers (10 strains), and turkeys (16 strains). The bacterial strains were tested at cell densities of 10 8 and 10 6 CFU/mL. At the cell density of 10 8 CFU/mL, MIC 50 and MIC 90 were 0.4 and 0.5 µL/mL for most of the tested strains, while they corresponded to 0.5 µL/mL for all strains isolated from broilers and for strains belonging to serogroup O139. At the cell density of 10 6 CFU/mL, MIC 50 and MIC 90 were 0.3 and 0.4 µL/mL, regardless of bird species of origin and for strains belonging to serogroups O78 and O2. In addition, a concentration of 0.04 µL/mL of CEO corresponded both to MIC 50 and MIC 90 for strains belonging to serogroups O139 and O128. Based on these results, cinnamon essential oil showed an effective antibacterial activity against E. coli strains from poultry and could find field application for the prevention of colibacillosis.

Colibacillosis, caused by enteropathogenic Escherichia coli (EPEC), is one of the most common diseases in rabbit farms, resulting in economic losses due to mortality and decrease in production. Until recently, antimicrobials were used to both treat and prevent disease on livestock farms, leading to the possible risk of antimicrobial resistance (AMR) and the selection of multidrug-resistant (MDR) bacteria. Therefore, interest in alternative control methods, such as the use of natural substances, has increased in the scientific community. The aim of this study was to evaluate the antimicrobial efficacy of Phyto-L (Pro Tech s.r.l.), a product containing organosulfur compounds (OSCs) such as propyl propane thiosulfonate (PTSO) from Allium spp., against 108 strains of E. coli isolated from rabbits with colibacillosis from 19 farms. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Phyto-L were assessed. Bacterial suspensions with a charge of 10 8 CFU/mL, corresponding to those found in the rabbit gut under pathologic conditions, were tested with different concentrations from 20 to 0.15 μL/mL of Phyto-L. For each strain, the MIC and concentrations above the MIC were plated on Tryptic Soy agar (TSA) without Phyto-L to assess the MBCs. MIC and MBC values ranged from 1.25 to 5 μL/mL and 1.25 to 20 μL/mL, respectively, depending on the strain tested. The data showed an interesting antibacterial activity of Phyto-L against EPEC strains. Therefore, this product could be effective in preventing colibacillosis in field application, especially considering that 10 4 -10 5 CFU/g of feces is the amount of E. coli usually found in the gut contents of rabbits under physiological condition.

The overwhelming popularity of technology-based solutions and innovations to address day-to-day processes has significantly contributed to the emergence of smart cities. where millions of interconnected devices and sensors generate and share huge volumes of data. The easy and high availability of rich personal and public data generated in these digitalized and automated ecosystems renders smart cities vulnerable to intrinsic and extrinsic security breaches. Today, with fast-developing technologies, the classical username and password approaches are no longer adequate to secure valuable data and information from cyberattacks. Multi-factor authentication (MFA) can provide an effective solution to minimize the security challenges associated with legacy single-factor authentication systems (both online and offline). This paper identifies and discusses the role and need of MFA for securing the smart city ecosystem. The paper begins by describing the notion of smart cities and the associated security threats and privacy issues. The paper further provides a detailed description of how MFA can be used for securing various smart city entities and services. A new concept of blockchain-based multi-factor authentication named "BAuth-ZKP" for securing smart city transactions is presented in the paper. The concept focuses on developing smart contracts between the participating entities within the smart city and performing the transactions with zero knowledge proof (ZKP)-based authentication in a secure and privacy-preserved manner. Finally, the future prospects, developments, and scope of using MFA in smart city ecosystem are discussed.

Purpose: To quantify the structural changes in choroidal vessels and to observe choroid microstructural changes in different age and sex groups in a healthy Chinese population., Methods: Enhanced depth imaging optical coherence tomography (EDI-OCT) was employed to analyze the luminal area, stromal area, total choroidal area, subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), large choroidal vessel layer (LCVL), choriocapillaris-medium choroidal vessel layer, and LCVL/SFCT of the choroid in the subfoveal macular area within 1500 μm of the macula. We analyzed the age- and sex-related changes in the subfoveal choroidal structure., Results: A total of 1566 eyes from 1566 healthy individuals were included. The mean age of the participants was 43.62 ± 23.29 years, the mean SFCT of healthy individuals was 269.30 ± 66.43 μm, LCVL/SFCT percentage was 77.21 ± 5.84%, and the mean macular CVI was 68.39 ± 3.15%. CVI was maximum in the 0-10 years group, decreasing with age, and the lowest values occurred in the >80 years group; LCVL/SFCT was the lowest in the 0-10 years group, increasing with age and reaching a maximum in the >80 years group. CVI showed a significant negative correlation with age, and LCVL/SFCT showed a significant positive correlation with age. There was no statistically significant difference between males and females. Interrater and intrarater reliability was less variable with CVI than with SFCT., Conclusions: The choroidal vascular area and CVI decreased with age in the healthy Chinese population, of which the age-related decrease in vascular components maybe dominated by the decrease in choriocapillaris and medium choroidal vessels. Sex had no effect on CVI. The CVI of healthy populations showed better consistency and reproducibility when compared with SFCT.

Kyrieleis plaques (KP) represent a peculiar type of vasculitis affecting retinal arterial branches in a beaded segmental pattern that can be found in several posterior inflammatory ocular conditions. The nature and precise location of KP is unclear. Adaptive Optics (AO) provides an in vivo visualization of retinal vasculature on a microscopic level, thus permitting a more detailed characterization of KP as compared to traditional imaging techniques. This study aims to report AO imaging of KP in Varicella Zoster virus (VZV)-associated posterior uveitis and to correlate the findings with traditional imaging techniques. Three patients diagnosed with VZV posterior uveitis underwent adaptive optics (AO) imaging and traditional multimodal imaging techniques, including fundus photography, fluorescein angiography, indocyanine green angiography and optical coherence tomography. In all subjects, AO imaging revealed segmental hyporeflectivity confined to the vessel wall, with no evidence of arterial wall disruption or extravascular involvement. In our series, AO findings support the view that KP are localized within the inner arterial wall, possibly at the endothelial level.

Background: To report a rare case of nasal natural killer/T (NK/T) cell lymphoma with bilateral intraocular and lung metastasis and to further describe the clinical features of intraocular manifestations., Case Presentation: A 54-year-old man presented with a 3-month history of left nasal congestion, and bilateral vision impairment of one week duration. Subsequent maxillary computed tomography (CT) and multiple biopsies confirmed the diagnosis of nasal NK/T-cell lymphoma. EBV-encoded small RNA (EBER) in situ hybridization revealed EBV infection. A comprehensive ophthalmic examination found lymphoma-associated retinopathy and choroidopathy, which presented as bilateral diverse patterns and retinal detachment. In addition, the chest CT showed multiple scattered nodules in both lungs, and soft-tissue mass in the left hilum with mediastinal and axillary lymphadenopathy. The condition of this patient deteriorated rapidly and he died shortly after diagnosis., Conclusions: The rarity of secondary ocular NK/T-cell lymphoma makes it challenging to identify these tumors early. Both otolaryngologist and ophthalmologists should be aware of ocular involvement and other secondary manifestations of NK/T-cell lymphoma.

MHealth technologies play a fundamental role in epidemiological situations such as the ongoing outbreak of COVID-19 because they allow people to self-monitor their health status (e.g. vital parameters) at any time and place, without necessarily having to physically go to a medical clinic. Among vital parameters, special care should be given to monitor blood oxygen saturation (SpO 2 ), whose abnormal values are a warning sign for potential COVID-19 infection. SpO 2 is commonly measured through the pulse oximeter that requires skin contact and hence could be a potential way of spreading contagious infections. To overcome this problem, we have recently developed a contact-less mHealth solution that can measure blood oxygen saturation without any contact device but simply processing short facial videos acquired by any common mobile device equipped with a camera. Facial video frames are processed in real-time to extract the remote photoplethysmographic signal useful to estimate the SpO 2 value. Such a solution promises to be an easy-to-use tool for both personal and remote monitoring of SpO 2 . However, the use of mobile devices in daily situations holds some challenges in comparison to the controlled laboratory scenarios. One main issue is the frequent change of perspective viewpoint due to head movements, which makes it more difficult to identify the face and measure SpO 2 . The focus of this work is to assess the robustness of our mHealth solution to head movements. To this aim, we carry out a pilot study on the benchmark PURE dataset that takes into account different head movements during the measurement. Experimental results show that the SpO 2 values obtained by our solution are not only reliable, since they are comparable with those obtained with a pulse oximeter, but are also insensitive to head motion, thus allowing a natural interaction with the mobile acquisition device., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.)

During the last decades, metal-based biomaterials have been extensively explored to be used as biocompatible metals for biomedical applications, owing to their superior mechanical properties and corrosion resistance. Consequently, for long-term implanted medical devices, to assure the biomaterials' reliability, functionality, and biocompatibility, studying the various bio-tribological damage mechanisms to obtain the optimum properties is one of the most important goals. In this review, we consider the most important metal-based biomaterials such as stainless steel, alloys of titanium (Ti), cobalt-chromium (Co-Cr), and Nichel-Titatium (Ni-Ti), as well Magnesium (Mg) alloys and with Tantalum (Ta), emphasizing their characteristics, clinical applications, and deterioration over time. The influence of metal elements on biological safety, including significant effects of metal-based biomaterials in dentistry were discussed, considering the perspectives of surface, mechanical properties, corrosion behaviors, including interactions, bio-mechanisms with tissues, and oral environments. In addition, the role of the oral microbiota was explored due to its role in this erosion condition, in order to further understand the mechanism of metal-based biomaterials implanted on the microflora balance of aerobic and anaerobic bacteria in an oral environment.

In the present study, AA2024 aluminum alloy and AISI304 stainless steel were welded in a lap joint configuration by Probeless Friction Stir Spot Welding (P-FSSW) with a flat surface tool. A full factorial DOE plan was performed. The effect of the tool force (4900, 7350 N) and rotational speed (500, 1000, 1500, 2000 RPM) was analyzed regarding the microstructure and microhardness study. A two-dimensional arbitrary Eulerian-Lagrangian FEM model was used to clarify the temperature distribution and material flow within the welds. The experimental results for the weld microstructures were used to validate the temperature field of the numerical model. The results showed that the tool rotation speed had an extensive influence on the heat generation, whereas the load force mainly acted on the material flow.

Campylobacter (C.) jejuni and C. coli are responsible for food poisoning in humans. Laying hens may host the bacteria usually without developing symptoms. The aims of this paper were to evaluate the incidence of C. jejuni and C. coli infection in laying hen flocks housed in different rearing systems, the plasma levels of two welfare indicators (corticosterone and interleukin 6, IL-6) and the antimicrobial resistance of the detected Campylobacter strains. Two different flocks (1 and 2) from cage (A), barn (B) and aviary (C) farms were investigated. The highest (p < 0.05) levels of IL-6 were detected in laying hens housed in aviaries. A similar trend emerged in corticosterone level, although differences were found between C1 and C2. C. jejuni and C. coli were identified in 43.5% and 38.9% of birds, respectively. In total, 14 out of 177 (7.9%) hens simultaneously hosted C. jejuni and C. coli.C. jejuni was prevalently detected in hens housed in barns (B1: 53.3%; B2: 46.7%) and aviaries (C1: 34.6%; C2: 86.7%). Conversely, laying hens housed in cages were significantly exposed to infection of C. coli (A1: 41.9%; A2: 80%) while, regarding barns and aviaries, a significant prevalence emerged only in flocks B2 (40%) and C1 (54.8%). Simultaneous infection was statistically significant in barn B1 (36.7%). Antibiotic resistance was mainly detected among C. coli strains, and it was most frequent for fluoroquinolones and tetracycline. Multidrug resistance was also found in C. jejuni (19.7%) and C. coli (17.5%) strains. Based on the results of this study, we recommend increasing biosecurity and hygienic measures to manage hen flocks.

In recent years, there has been a more prudent use of drugs on livestock farms and alternative products have been considered, with a view of reducing the risk of the onset of antibiotic resistance. Salmonella enterica subsp. enterica serovar Enteritidis ( S. Enteritidis) may cause disease in poultry, and it is also responsible for human food poisoning. The aim of this study was to evaluate the efficacy of garlic against S. Enteritidis and to define its Minimal Inhibitory Concentration (MIC) 90 and MIC 50 values. The study was carried out in vitro, testing 26 S. Enteritidis strains identified in laying hens from various farms in Southern Italy. A preliminary efficacy trial was carried out on two strains, S. Enteritidis and Escherichia coli , using a garlic concentration of 10 mg/mL (1%). Later, 26 strains of S. Enteritidis at 10 6 Colony Forming Unit (CFU) and 10 4 CFU were tested with different concentrations of garlic, ranging from 10 mg/mL to 1 mg/mL. Based on the results, intermediate concentrations of garlic, from 5 mg/mL to 4 mg/mL and 4 mg/mL to 3 mg/mL, were used to test 10 6 CFU and 10 4 CFU, respectively. The data were statistically analyzed. The MIC 90 was 4.75 mg/mL for strains tested at 10 6 CFU and 4 mg/mL for strains tested at 10 4 CFU. The results highlight garlic's potential to inhibit the growth of Salmonella enterica ser. Enteritidis in vitro. Efficacy was dependent on the microbial concentration used. In vivo efficacy trials will be crucial to confirm the efficacy of garlic against S. Enteritidis and to assess whether garlic can be used in poultry flocks to prevent the spread of the bacterium in the field.

Climate change, excessive exploitation of agricultural land which reduces natural habitats, wildlife shooting, and the use of pesticides all cause difficulties for wildlife, with considerable numbers of animals being brought to wildlife rescue centres. Although the efforts of staff involved in wildlife management at these centres usually focus on therapeutic treatments to reintroduce them into the wild, the monitoring of pathogens that may be transmitted to humans is of relevance. Campylobacter ( C. ) jejuni and C. coli are frequently carried by animals without inducing clinical signs and are responsible for enteric disorders and more rarely extra-intestinal disease in humans. Farm species and poultry, in particular, are the main reservoirs of C. jejuni and C. coli , but wild animals may also be carriers. The aim of this paper was to investigate the presence of C. jejuni and C. coli in wild birds housed at a wildlife rescue centre and to evaluate the sensitivity of the detected strains to antibiotics. Campylobacter was found in 52 out of 209 (24.88%) birds from 33 different species. C. jejuni was more prevalent, while C. coli was only detected in three Long-eared Owls ( Asio otus ). The incidence of the infection was particularly high (72.22%) among omnivorous species. Infection rates were higher in birds housed indoors (57.14%) than outdoors (31.74%). Moreover, Campylobacter was not detected in species whose mean temperature body is below 40 °C or higher than 42.2 °C. The most common antibiotic resistance in the tested strains was against trimethoprim/sulfamethoxazole, ciprofloxacin and enrofloxacin. In addition, multi-drug resistance was also found. The results highlight the need to increase biosecurity measures at rescue centres so as to reduce health-related risks to workers involved in wildlife management., Competing Interests: The authors declare no conflict of interest

Purpose: To assess the effectiveness and safety of intravenous (IV) dexmedetomidine for sedation in ophthalmic surgery., Methods: Prospective, observational, uncontrolled, single-center study. Patients were sedated with a continuous dexmedetomidine IV infusion started 15 min before regional anesthesia administration and maintained up to the end of surgery. Effectiveness of dexmedetomidine was assessed by the Modified Observer's Assessment of Alertness and Sedation (MOAA/S) targeted at 5. Safety was assessed by the incidence of patients' movements/snoring and by the incidence of respiratory and haemodynamic complications. An eleven-point numerical rating scale (NRS) was used to assess the level of satisfaction of both the surgeon and the patient., Results: 123 patients (73 males, mean age: 63 ± 13) were included; 81 (81/123; 65.8%) patients reached the requested MOAA/S score of 5. Any intraoperative movement - mostly voluntary - occurred in 34 (34/123; 27.6%) cases with no need for a switch to general anaesthesia; no ocular complications related to the intraoperative movements occurred. Intraoperative snoring occurred in 30 (30/123; 24.4%) patients and it did not affect the surgical manoeuvres. Respiratory drive depression requiring manual or mechanical ventilation never occurred. Bradycardia occurred in 14 (14/123; 11.3%), cases but only 4 (4/123; 3.2%) patients required atropine administration, which was always effective. Intraoperative analgesia was consistently obtained and both the surgeons and the patients reported a high NRS satisfaction score., Conclusion: Dexmedetomidine provided adequate sedation in patients undergoing ocular surgery under local anaesthesia and showed a good effectiveness and safety profile. Upper airway obstruction, apnoea and snoring can occur.

Protothecosis is a potential zoonosis related to bovine mastitis. In several countries, a higher incidence of protothecal bovine mastitis that is being recorded and the resistance of Prototheca species to various factors (chlorine, high temperatures, antimicrobial and antiseptic treatments, pH variations), make it difficult to control its spread among farms. The authors aim to describe the infection caused by microalgae, focusing on the problems within cattle farms and proposing new approaches to farm management, based on Regulation (EU) No 2016/429 on transmissible animal diseases. This new flexible approach, based on risk analysis, is a further tool in protecting against Prototheca species. The list of transmissible animal diseases under Regulation (EU) No 2016/429 includes those caused by microorganisms resistant to antimicrobials, which can have important implications for human and animal health, feed and food safety. This approach would involve a series of changes to the rules used for Official Controls (Regulation (EU) No 2017/625) moving from the concept of the food chain to that of the agri-food chain., Competing Interests: 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., (© 2022 The Author(s).)

With the rapid development of deep learning techniques, new innovative license plate recognition systems have gained considerable attention from researchers all over the world. These systems have numerous applications, such as law enforcement, parking lot management, toll terminals, traffic regulation, etc. At present, most of these systems rely heavily on high-end computing resources. This paper proposes a novel memory and time-efficient automatic license plate recognition (ALPR) system developed using YOLOv5. This approach is ideal for IoT devices that usually have less memory and processing power. Our approach incorporates two stages, i.e., using a custom transfer learned model for license plate detection and an LSTM-based OCR engine for recognition. The dataset that we used for this research was our dataset consisting of images from the Google open images dataset and the Indian License plate dataset. Along with training YOLOv5 models, we also trained YOLOv4 models on the same dataset to illustrate the size and performance-wise comparison. Our proposed ALPR system results in a 14 megabytes model with a mean average precision of 87.2% and 4.8 ms testing time on still images using Nvidia T4 GPU. The complete system with detection and recognition on the other hand takes about 85 milliseconds.

Purpose: To describe posterior ocular involvement features of Whipple's disease (WD) in a patient with no gastrointestinal symptoms., Methods: Retrospective case report., Observation: A 53-year-old man with a 2-year history of seronegative arthritis presented with bilateral intraocular inflammation, optic disc edema, and cystoid macular edema (CME) in the left eye. A diagnosis of noninfectious uveitis was made and oral prednisolone was started. Despite initial improvement, after 6 weeks, CME was found in both eyes. Because of the initial response, the anti-tumor necrosis factor agent Adalimumab was started. Twelve weeks after initiation of adalimumab, fundus examination revealed widespread dot-blot retinal hemorrhages and multifocal chorioretinal lesions at the posterior pole and mid-periphery. The chorioretinal lesions appeared as hyperreflective drusen-like deposits located in the sub-retinal pigment epithelium (RPE) space on the tomographic scan. WD was considered and confirmed by polymerase chain reaction test and duodenal biopsy., Conclusion: Posterior ocular involvement in WD may present with a wide clinical spectrum including intraocular inflammation and unique features of sub-RPE deposits, widespread retinal hemorrhages, and optic disc edema.

Bacteria belonging to the genus Pseudomonas are ubiquitous and characterized by a high adaptation capability to different environmental conditions and wide range of temperatures. They may colonize food, sometimes causing alteration. Quite recently, a blue pigmentation due to Pseudomonas fluorescens has been widely reported in mozzarella cheese. In this report, we describe a blue coloration occurred on rabbit meat stored in the refrigeration cell of a slaughterhouse. The alteration was observed after about 72 hours of storage at 4-6°C. Bacteriological analyses were performed, and a microorganism included in the Pseudomonas fluorescens group was identified. The experimental contamination was planned, using a bacterial suspension with 1×10 8 UFC/ml load to spread on rabbit carcasses. The blue pigmentation appeared after 24 hours of storage in a cell with the same conditions of temperature. The bacterium was reisolated and identified as responsible for the alteration on meat. These findings highlight the importance of considering the members of the genus Pseudomonas and, more specifically, of the P. fluorescens group when the microbiological quality of food is to be ascertained. In fact, even if these bacteria are not considered a public health problem, their presence should be monitored by food industry operators in self-control plans because they may cause alteration in food. In fact, any altered product should be withdrawn from the market in agreement with Regulation (EC) No 178/2002 of the European Parliament and of the Council., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).)

The number of pets such as dogs, cats, rabbits, and parrots has increased in European families. Social benefits to owners such as decreasing feelings of loneliness and anxiety are provided by pets which are also used in Animal-assisted Therapy (AAT). Nevertheless, human-animal interactions are also associated with health problems including allergies, asthma, and zoonosis. Rabbits may carry potential pathogens for humans. One of the most common bacteria that colonizes the oro-pharynx and the upper respiratory tract of rabbits is Pasteurella (P.) multocida . Transmission of the infection to humans results from scratches, licks, and bites but it also can occur from the inhalation of air particles containing the microorganism. Immunocompromised people or persons with pulmonary disorders are particularly susceptible to the infection. Infected rabbits may carry P. multocida with or without clinical signs. In this paper, the sensitivity to antibiotics and the invasiveness ability of P. multocida identified in a farm of pet rabbits affected by severe pasteurellosis were investigated. The strain was P. multocida belonging to capsular type A which is the type most often detected in humans. The identified strain was susceptible to the tested antibiotics, but it appeared equipped with several virulence genes which are responsible for fimbriae production, adhesion processes to host cells, enzyme production, and are involved in iron acquisition processes. These findings are of particular interest because rabbits recovered from pasteurellosis very often become carriers of the bacteria. Therefore, we suggest considering P. multocida screening in the routine medical checks of rabbits, especially if they are meant to be companion animals for children and elder people, given that the transmission of the pathogen cannot be excluded.

The main objective of this study was to investigate the influence of different types of slaughtering on the variations of pH and temperature. Ninety entire male beef cattle, belonging to the Charolais breed, were distributed in three groups based on method of slaughtering. A total of 30 subjects (group K) were slaughtered without stunning, according to the Koscher rite; thirty bovines (group T) were stunned with a captive bolt gun, following the common slaughtering reported by Council Regulation (EC) 1099/2009; other thirty animals (group H) were slaughtered without stunning, based on Halal procedures. The temperature and pH values of carcasses were determined at 3, 6 and 24 h post-mortem, respectively. At 24 h post-mortem of the 30 carcasses evaluated for each group, muscle temperature decreased in all three types of slaughtering. In particular, the average temperature was 4.0, 4.9 and 3.0 °C for traditional, Halal and Koscher slaughtering, respectively. Moreover, at the same time step (24 h post-mortem), muscle pH decreased showing values equal to 5.72, 5.83, 5.81 for traditional, Halal and Koscher slaughtering, respectively. The findings of the present study may be useful to highlight the influence of slaughtering method on pH and, more generally, on meat quality. Additionally, our results show that, in slaughtering carried out without prior stunning, the carcass could be more susceptible to alterations because of the high pH values., Competing Interests: 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., (© 2021 The Author(s).)

Marek's disease is an infectious disease in poultry that usually appears in neural and visceral tumors. This disease is caused by Gallid alphaherpesvirus 2 infection in lymphocytes, and its meq gene is commonly used in virulent studies for coding the key protein functional in oncogenic transformation of the lymphocytes. Although vaccines have been introduced in many countries to control its spread and are proven to be efficient, recent records show a decline of such efficiency due to viral evolution. In this study, we reviewed the outbreak of Marek's disease in Asia for the last 10 years, together with associated meq sequences, finding a total of 36 studies recording outbreaks with 132 viral strains in 12 countries. The visceral type is the most common (13 in 16 studies) form of Marek's disease, but additional unobserved neural changes may exist. MD induces liver lymphoma most frequently (11 in 14 studies), and tumors were also found in spleen, kidney, heart, gizzard, skin, intestine, lung, and sciatic nerve. Twelve viral strains distributed in China have been reported to escape the CVI988 vaccine, reaching a mortality rate of more than 30%. Phylogenetic analyses show the internal connection between the Middle East (Turkey, Iraq, Iran, Saudi Arabia), South Asia (India, Indonesia), and East Asia (China and Japan), while external viral communications might occasionally occur. In 18 strains with both sequential and mortality data, amino acid alignment showed several point substitutions that may be related to its virulence. We suggest more behavioral monitoring in Marek's disease-endemic regions and further studies on strain virulence, together with its Meq protein structural changes.

Objective: To report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery., Methods: This is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up., Results: A total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X 2 =8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery., Conclusions: Although the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Placoid lesions of the retina may be secondary to a wide spectrum of acquired inflammatory conditions that have been reported as single entities with different presentation and clinical course. These conditions include acute posterior multifocal placoid pigment epitheliopathy, persistent placoid maculopathy, serpiginous choroiditis, serpiginous-like choroiditis, relentless placoid chorioretinitis and acute syphilitic posterior placoid chorioretinitis. In this article, we will group these conditions under the name of 'placoids'. The recognition of the specific condition may be challenging in clinical practice, often resulting in diagnostic and therapeutic delay. Given the complex nature of placoids and their similarities, a systematic approach including differentiating between infectious and non-infectious aetiologies increases the chance of reaching the correct diagnosis. Detailed history and comprehensive clinical examination are the first steps to formulate a diagnostic hypothesis that should be corroborated by multimodal imaging and appropriate investigations. The advent of multimodal imaging has made it possible to extensively study placoids and revealed a constellation of specific findings that may help clinicians in the diagnostic process. The treatment of the conditions other than syphilis is complex and sometimes challenging. Our article is aimed at giving an overview of the individual entities associated with placoids and discussing the differential diagnosis. A practical and systematic approach is then proposed., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To describe the clinical course of a case of bilateral Salzmann nodular degeneration (SND) treated with superficial keratectomy (SK) followed by intense pulsed light (IPL) for the treatment of coexisting meibomian gland dysfunction (MGD)., Case Description: A 54-year-old man who presented to us complaining of progressive blurred vision associated with foreign body sensation in both eyes because of SND and coexisting MGD. In view of symptoms and visual acuity (VA) deterioration, bilateral SK was performed. Two months after SK, IPL treatment to the face and meibomian gland expression (MGX) using the E-eye device (E-SWIN, Paris) on days 0, 15, and 45, were performed in both eyes with the aim to avoid recurrence and/or progression of MGD. One year after SK, the patient was asymptomatic and VA was 20/20 in both eyes; however because of worsening of non-invasive tear film break-up time measured on Sirius ® Scheimpflug tomograph , IPL and MGX were promptly repeated and scheduled every 6 months., Conclusion: In our case, IPL was a safe and effective option to control MGD in a patient with SND requiring SK with no observed recurrence of SND 2 years after surgery.

Purpose: To describe the clinical course and the multimodal imaging of acute idiopathic maculopathy., Methods: Medical records and multimodal imaging including color fundus photography, optical coherence tomography, and fundus autofluorescence were retrospectively reviewed. Recognition of the fundus autofluorescence patterns and their relationship with the disease duration, best-corrected visual acuity, and optical coherence tomography features represented the main outcome measures., Results: Seventeen eyes of 16 patients (7 women; mean age 29.9 years) with a mean follow-up of 23.9 months were included. The mean best-corrected visual acuity at presentation was 0.63 ± 0.54 logarithm of the minimum angle of resolution (Snellen equivalent, 20/85). All but one patient had the best-corrected visual acuity recovery to 20/20. Four sequential patterns of fundus autofluorescence corresponding to 4 proposed stages of disease were observed. Patterns 1 (central hypoautofluorescence with surrounding hyperautofluorescence) and 2 (stippled hyperautofluorescence and hypoautofluorescence) were found at presentation. Patterns 3 (central hyperautofluorescence surrounded by hypoautofluorescence) and 4 (hypoautofluorescence) were observed during the disease course and/or at the last follow-up visit. Duration of the disease was significantly different between patterns at baseline and last visit. Pattern 1 significantly related to the presence of subretinal detachment (Fisher's exact test; P =0.003) on optical coherence tomography in comparison with Pattern 2. Pattern 4 showed unique homogeneously decreased autofluorescence with corresponding attenuation of retinal pigment epithelium and restored outer retinal layers on optical coherence tomography., Conclusion: A sequential disease staging based on multimodal imaging for acute idiopathic maculopathy is proposed. The recognition of the observed imaging patterns may help clinicians in the correct diagnosis and patient counseling.

A large section of the population around the globe is migrating towards urban settlements. Nations are working toward smart city projects to provide a better wellbeing for the inhabitants. Cyber-physical systems are at the core of the smart city setups. They are used in almost every system component within a smart city ecosystem. This paper attempts to discuss the key components and issues involved in transforming conventional cities into smart cities with a special focus on cyber-physical systems in the Indian context. The paper primarily focuses on the infrastructural facilities and technical knowhow to smartly convert classical cities that were built haphazardly due to overpopulation and ill planning into smart cities. It further discusses cyber-physical systems as a core component of smart city setups, highlighting the related security issues. The opportunities for businesses, governments, inhabitants, and other stakeholders in a smart city ecosystem in the Indian context are also discussed. Finally, it highlights the issues and challenges concerning technical, financial, and other social and infrastructural bottlenecks in the way of realizing smart city concepts along with future research directions.

Purpose : To report the clinical course of choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (VEGF) treatment in eyes with pre-existing geographic atrophy (GA). Material and Methods : Multicenter retrospective series. Electronic medical records, clinical notes, and multimodal retinal imaging of patients attending four tertiary referring centers with a diagnosis of unilateral CNV in the context of a pre-existing diagnosis of GA were included. GA was assessed on multimodal retinal imaging including spectral-domain optical coherence tomography (SD-OCT) scan with simultaneous near-infrared (NIR) reflectance imaging (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) which was acquired at baseline and every follow-up visit. GA area was measured in treated eyes and fellow eyes using NIR. Results : Fifty-four eyes from 27 patients (23 females, mean age 80.89 ± 7.5) were included. The mean number of injections in the treated eyes was 5.52 ± 1.9 by month 12. From baseline to month 12, stabilization of best-corrected visual acuity (BCVA) and a significant decrease ( P = .002) of central macular thickness (CMT) in the treated eyes were observed; there was a slight worsening of BCVA (-2 ETDRS letters) and a non-significant change ( P = .4) of CMT in the fellow eyes. GA significantly increased in both treated and untreated eyes ( P < .001 and P < .001, respectively) with a similar absolute increase (+2.68 mm 2 and +2.59 mm 2 , respectively) and growth rate (0.4 and 0.34, respectively). Conclusions : In our study anti-VEGF treatment for CNV in eyes with pre-existing GA was effective in terms of decrease of exudative changes and stabilization of VA by month 12. A similar growth rate of GA between treated and untreated eyes does not support a causal relationship between anti-VEGF treatment and GA progression in this subset of patients. Further studies with a longer follow-up are mandatory to confirm these results.

Monitoring of infections that may be transmitted to humans by animals in wildlife rescue centres is very important in order to protect the staff engaged in rehabilitation practices. Salmonella may be a natural inhabitant of the intestinal tract of turtles, rarely causing disease. This may represent a potential risk for humans, increasing the sanitary risk for operators in wildlife rescue centres. In this paper, the occurrence of non-typhoidal Salmonella among terrestrial turtles housed in a wildlife rescue centre in Southern Italy was investigated, in order to assess the serovars more frequently carried by turtles and identify those that may represent a risk for operators involved in wildlife management. Sixty-nine adult turtles ( Testudo hermanni hermanni , T. h. boettgeri , T. graeca , and T. marginata ) were tested. Detection and serotyping of Salmonella strains were performed according to ISO 6579-1 and ISO/TR 6579-3:2013, respectively. The distribution of Salmonella spp. was significantly higher in T. hermanni hermanni than in other species, independent of the age and gender of the animals. Two different Salmonella species, S. enterica and S. bongori , three S. enterica subspecies ( enterica , diarizonae , salamae ), and five different serovars (Hermannswerder, Abony, Ferruch, Richmond, Vancouver) within the group S. enterica subspecies enterica were identified. Different combinations of Salmonella types were simultaneously found in specimens of T. h. hermanni . Most of detected Salmonella types may represent a potential risk for public health. Adopting correct animal husbandry procedures and informing on potential sanitary risks may be useful for minimising the risk of transmission of Salmonella to workers involved in wildlife management.

Purpose : To report acute macular neuroretinopathy (AMN) in two young women two days after receiving Vaxzevria Coronavirus disease (COVID-19) vaccination. Methods: Observational case reports. Observation: The first patient was an Italian 22-year-old female with acute onset of paracentral scotoma two days post vaccination. The second patient was an Austrian 28-year-old female who presented with sudden onset paracentral scotoma two days after vaccination. Multimodal retinal imaging was consistent with AMN in both cases. Both patients were on long-term oral contraceptives, had no history of COVID-19 and experienced one-day duration fever the day after the vaccination. Conclusions : Vaccination may represent a possible risk factor for AMN onset in women on oral contraceptives. We encourage ophthalmologists to investigate recent vaccination status when dealing with new onset AMN. Further studies are needed to assess the link between vaccinations and AMN.

Purpose: To investigate the clinical course, genetic findings, and phenotypic spectrum of autosomal recessive bestrophinopathy (ARB) in a large cohort of children and adults., Design: Retrospective case series., Participants: Patients with a detailed clinical phenotype consistent with ARB, biallelic likely disease-causing sequence variants in the BEST1 gene, or both identified at a single tertiary referral center., Methods: Review of case notes, retinal imaging (color fundus photography, fundus autofluorescence, OCT), electrophysiologic assessment, and molecular genetic testing., Main Outcome Measures: Visual acuity (VA), retinal imaging, and electrophysiologic changes over time., Results: Fifty-six eyes of 28 unrelated patients were included. Compound heterozygous variants were detected in most patients (19/27), with 6 alleles recurring in apparently unrelated individuals, the most common of which was c.422G→A, p.(Arg141His; n = 4 patients). Mean presenting VA was 0.52 ± 0.36 logarithm of the minimum angle of resolution (logMAR), and final VA was 0.81 ± 0.75 logMAR (P = 0.06). The mean rate of change in VA was 0.05 ± 0.13 logMAR/year. A significant change in VA was detected in patients with a follow-up of 5 years or more (n = 18) compared with patients with a follow-up of 5 years or less (n = 10; P = 0.001). Presence of subretinal fluid and vitelliform material were early findings in most patients, and this did not change substantially over time. A reduction in central retinal thickness was detected in most eyes (80.4%) over the course of follow-up. Many patients (10/26) showed evidence of generalized rod and cone system dysfunction. These patients were older (P < 0.001) and had worse VA (P = 0.02) than those with normal full-field electroretinography results., Conclusions: Although patients with ARB are presumed to have no functioning bestrophin channels, significant phenotypic heterogeneity is evident. The clinical course is characterized by a progressive loss of vision with a slow rate of decline, providing a wide therapeutic window for anticipated future treatment strategies., (Copyright © 2020 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)