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AIM: To report the incidence, risk factors and visual outcomes for postoperative endophthalmitis (POE) based on 7-year data from the Malaysian Ministry of Health Cataract Surgery Registry (MOH CSR). METHODS: Data was collected from the web-based MOH CSR. All consecutive cataract surgery patients from 1st June 2008 to 31st December 2014 were identified. Exclusion criteria were traumatic cataract or previous ocular surgery. Demographic data, ocular co-morbidities, intraoperative details and postoperative visual acuity (VA) at final ophthalmological follow-up were noted. All eyes were taken for analysis. Subjects with POE were compared against subjects with no POE for risk factor assessment using multiple logistic regressions. RESULTS: A total of 163 503 subjects were screened. The incidence of POE was 0.08% (131/163 503). Demographic POE risk factors included male gender (OR: 2.121, 95%CI: 1.464-3.015) and renal disease (OR: 2.867, 95%CI: 1.503-5.467). POE risk increased with secondary causes of cataract (OR: 3.562, 95%CI: 1.740-7.288), uveitis (OR: 11.663, 95%CI: 4.292-31.693) and diabetic retinopathy (OR: 1.720, 95%CI: 1.078-2.744). Intraoperative factors reducing POE were shorter surgical time (OR: 2.114, 95%CI: 1.473-3.032), topical or intracameral anaesthesia (OR: 1.823, 95%CI: 1.278-2.602), posterior chamber intraocular lens (PCIOL; OR: 4.992, 95%CI: 2.689-9.266) and foldable IOL (OR: 2.276, 95%CI: 1.498-3.457). POE risk increased with posterior capsule rupture (OR: 3.773, 95%CI: 1.915-7.432) and vitreous loss (OR: 3.907, 95%CI: 1.720-8.873). Postoperative VA of 6/12 or better was achieved in 15.27% (20/131) subjects with POE. CONCLUSION: This study concurs with other studies regarding POE risk factors. Further strengthening of MOH CSR data collection process will enable deeper analysis and optimization of POE treatment.

This book is both an excellent introduction to and in-depth analysis of the world of film festivals. Based on ethnographic research, interviews, archival work and film analysis, Cindy Hing-Yuk Wong’s book offers both a big picture view of the role of festivals within the global film industry and a close-up scrutiny of specific events, films and people to give a sense of the culture-making activity that happens in these spaces. Whereas Marijke de Valck’s Film Festivals: From European Geopolitics to Global Cinephilia (2007) narrates a history of film festivals that is Euro-American centric, Wong’s analysis engages with how films and filmmakers from less wealthy film industries around the world gain wider recognition via major European festivals, as well as examining the development of important festivals in East Asia.

Background/Aims Acanthamoeba keratitis (AK) is a rare but sightthreatening infection. Molecular diagnosis of corneal scraping has improved the diagnosis of AK. Different molecular targets and conditions have been used in diagnosis thus far. In this study, we prospectively compared the performance of five PCR assays on corneal samples for the diagnosis of AK. Methods 1217 corneal scraping samples were obtained from patients, for whom an AK was suspected. Sample processing involved both molecular diagnostics and culture. Acanthamoeba PCR assays detected different regions of the Acanthamoeba nuclear small-subunit rRNA gene: three final point PCR assays using Nelson, ACARNA and JDP1-JDP2 pairs of primers, and two real-time PCR assays using Acant primer-probe. Human DNA and internal control were co-amplified in the real-time PCR assay to ensure scraping quality and the absence of inhibitors. In the absence of a gold standard, the performance of each test was evaluated using latent class analysis. Genotypes of Acanthamoeba isolates were also characterised. Results Estimated prevalence of AK was 1.32%. The sensitivity of Acanthamoeba diagnostic PCRs (73.3% to 86.7%) did not differ significantly from that of culture (66.7%), or according to the target sequence or the technology. Sensitivity could be increased to 93.8% or 100% by combining two or three assays, respectively. PCR specificity (99.3% to 100%) differed between the assays. T4 was the predominant Acanthamoeba genotype (84.6%). Conclusions Culture and a single PCR assay could lead to misdiagnosing AK. A combination of different PCR assays and improved sample quality could increase diagnosis sensitivity. [ABSTRACT FROM AUTHOR]

Recent Australian inquiries have highlighted the ongoing problem of abuse within institutions for people with disabilities. Historical attention to this issue, however, is relatively scant. This article begins addressing this gap by exploring the ways in which attitudes towards gender, class and disability intersected in the late nineteenth century to increase the vulnerability of girls and young women with disabilities to abuse. It does so through the exploration of the transcripts and report from an 1890s inquiry into abuse and mismanagement within an Australian institution for blind girls and women. It uncovers the attempts of the accused perpetrator—a male teacher who was also blind—to present himself as a fatherly protector to women who, due to their gender, class and disability, were susceptible to malicious outside influences. His attempts, the article finds, were ultimately unsuccessful as a result of the women's responses, his own strange behaviour and the institution's incompatibility with the political priorities of the time. More generally, the article highlights how socially advantaged men have been able to exploit ideas about gender, class and disability in order to hide the abuse of women in disability institutions. [ABSTRACT FROM AUTHOR]

We present five cases of choroidal neovascularization secondary to pediatric Best disease which were treated with two different doses of intravitreal ranibizumab. Optical coherence tomography was used for monitoring of the cases. Three cases had subretinal fibrosis at presentation and two out of these 3 cases required repeat intravitreal ranibizumab at one year follow-up due to recurrence of subfoveal subretinal fluid. [ABSTRACT FROM AUTHOR]

Background Web-based learning is increasingly used as an adjunct to, and a replacement for, traditional learning methods. We investigated the impact of web-based learning modules in improving the delivery of undergraduate medical education in general surgery and urology. Objectives To determine if online learning modules improve student performance in general surgery and urology. To determine if previous use of online learning modules promote future utilization of such modules among students. Materials and Methods Four general surgical and urologic web-based learning modules were delivered as an adjunct to traditional teaching via an online learning management system to fourth year medical students in 2009 and 2010. Each module contained 40 identical pre-module and post-module questions which allow analysis of change in student performance after delivery of these modules. The student t-test and Fisher’s exact test were used for statistical analysis. Results In urology, the mean pre-module score was 22.4 (SD 4.3) and the mean post-module score was 33.0 (SD 2.1) (P < 0.001). Students who completed all the pre-module and post-module questions had a mean increase of 12.8 score points (SD 3.9). In general surgery, significantly more students completed all of the pre-module (42.7% vs. 27.5%) and post-module (23.2% vs. 7.3%) questions for the general surgical modules in 2010 compared to the urology modules in 2009 (P ≤ 0.001). Conclusions The introduction of web-based general surgery and urologic learning modules as an adjunct to traditional teaching improved student knowledge, and their usage improved over time.

BackgroundInfestations of the parasitic copepod Lepeophtheirus salmonis, commonly referred to as sea lice, represent a major challenge to commercial salmon aquaculture. Dependence on a limited number of theraputants to control such infestations has led to concerns of reduced sensitivity in some sea lice populations. This study investigates trends in the efficacy of the in-feed treatment emamectin benzoate in Scotland, the active ingredient most widely used across all salmon producing regions.Methodology/principal findingsStudy data were drawn from over 50 commercial Atlantic salmon farms on the west coast of Scotland between 2002 and 2006. An epi-informatics approach was adopted whereby available farm records, descriptive epidemiological summaries and statistical linear modelling methods were used to identify factors that significantly affect sea lice abundance following treatment with emamectin benzoate (SLICE(R), Schering Plough Animal Health). The results show that although sea lice infestations are reduced following the application of emamectin benzoate, not all treatments are effective. Specifically there is evidence of variation across geographical regions and a reduction in efficacy over time.Conclusions/significanceReduced sensitivity and potential resistance to currently available medicines are constant threats to maintaining control of sea lice populations on Atlantic salmon farms. There is a need for on-going monitoring of emamectin benzoate treatment efficacy together with reasons for any apparent reduction in performance. In addition, strategic rotation of medicines should be encouraged and empirical evidence for the benefit of such strategies more fully evaluated.

The article presents a study on the linguistic and nonlinguistic aspects of politeness, in the Korean and American cultures. Politeness theory suggests that speakers will be more polite when the relative power of the target over the speaker increases, the social distance between the target and the speaker increases, and the degree of imposition on the target increases the size of a request. The study attempted to explore the linguistic as well as nonlinguistic cues and strategies used to communicate politeness. Strategies used were other--orientation, affiliation, and circumspection. Americans and Koreans were more affiliative toward peers and more circumspect toward superiors whereas reverse while delivering good news. Both Americans and Koreans, circumspection was more apparent from the purely nonverbal channel of behavior. Koreans pay more attention to interpersonal and relational cues. Americans are affected more by the content of the message than by their relationship with the target of the message.

The extracellular environment consists of a plethora of molecules, including extracellular miRNA that can be secreted in association with extracellular vesicles (EVs) or soluble protein complexes (non-EVs). Yet, interest in therapeutic short RNA carriers lies mainly in EVs, the vehicles conveying the great majority of the biological activity. Here, by overexpressing miRNA and shRNA sequences in parent cells and using size exclusion liquid chromatography (SEC) to separate the secretome into EV and non-EV fractions, we saw that >98% of overexpressed miRNA was secreted within the non-EV fraction. Furthermore, small RNA sequencing studies of native miRNA transcripts revealed that although the abundance of miRNAs in EVs, non-EVs and parent cells correlated well (R2 = 0.69–0.87), quantitatively an outstanding 96.2–99.9% of total miRNA was secreted in the non-EV fraction. Nevertheless, though EVs contained only a fraction of secreted miRNAs, these molecules were stable at 37 °C in a serum-containing environment, indicating that if sufficient miRNA loading is achieved, EVs can remain delivery-competent for a prolonged period of time. This study suggests that the passive endogenous EV loading strategy might be a relatively wasteful way of loading miRNA to EVs, and active miRNA loading approaches are needed for developing advanced EV miRNA therapies in the future.

Extracellular vesicles (EVs) are nano-sized particles constitutively released from cells into all biological fluids. Interestingly, these vesicles contain genetic cargoes including proteins, RNA and bioactive lipids that can be functionally delivered and affect recipient cells. As a result, there is growing interest in studying EVs in pathological conditions, including central nervous system (CNS)-related diseases, as EVs may be used for diagnostic purposes or as therapeutic agents. However, one major bottleneck is the need for better EV purification strategies when considering complex biological sources such as serum/protein-rich media or plasma. In this study, we have performed a systematic comparison study between the current gold-standard method: ultracentrifugation, to an alternative: size-exclusion chromatography (LC), using induced pluripotent stem cell (iPSC) derived complex media as a model system. We demonstrate that LC allows for derivation of purer EVs from iPSCs, which was previously impossible with the original UC method. Importantly, our study further highlights the various drawbacks when using the conventional UC approach that lead to misinterpretation of EV data. Lastly, we describe novel data on our iPSC-EVs; how they could relate to stem cell biology and discuss their potential use as EV therapeutics for CNS diseases.

The last decade has seen a sharp increase in the number of scientific publications describing physiological and pathological functions of extracellular vesicles (EVs), a collective term covering various subtypes of cell-released, membranous structures, called exosomes, microvesicles, microparticles, ectosomes, oncosomes, apoptotic bodies, and many other names. However, specific issues arise when working with these entities, whose size and amount often make them difficult to obtain as relatively pure preparations, and to characterize properly. The International Society for Extracellular Vesicles (ISEV) proposed Minimal Information for Studies of Extracellular Vesicles (“MISEV”) guidelines for the field in 2014. We now update these “MISEV2014” guidelines based on evolution of the collective knowledge in the last four years. An important point to consider is that ascribing a specific function to EVs in general, or to subtypes of EVs, requires reporting of specific information beyond mere description of function in a crude, potentially contaminated, and heterogeneous preparation. For example, claims that exosomes are endowed with exquisite and specific activities remain difficult to support experimentally, given our still limited knowledge of their specific molecular machineries of biogenesis and release, as compared with other biophysically similar EVs. The MISEV2018 guidelines include tables and outlines of suggested protocols and steps to follow to document specific EV-associated functional activities. Finally, a checklist is provided with summaries of key points.

Purpose: This study aimed to evaluate the treatment efficacy, anatomical outcomes, and refractive outcomes of laser photocoagulation (LPC) and intravitreal ranibizumab (IVR) in the treatment of type I retinopathy of prematurity (ROP) at one-year follow-up., Methods: This is a retrospective study on the treatment of type I ROP and aggressive ROP (A-ROP) using LPC or IVR in three Malaysian hospitals providing pediatric ophthalmology services from January 2019 to December 2021. Information on gestational age, birth weight, ROP zone and stage, and underlying comorbidities was collected. Parameters for evaluating treatment efficacy include the time taken to achieve complete regression, the regression rate, and the reactivation rate. The anatomical and refractive outcomes were evaluated at one year of adjusted age., Results: This study included 92 eyes from 46 infants. Of these, 42 eyes received LPC as the initial treatment, while 50 eyes underwent IVR. A higher percentage of infants with cardiovascular disease were treated with IVR (66.7%) compared to LPC (40%) (p<0.05). However, there were no significant differences in gestational age, birth weight, respiratory distress syndrome, sepsis, or intraventricular hemorrhage between the two treatment groups (p>0.05). Infants treated with LPC had a higher regression rate than those treated with IVR, but they were also significantly more myopic and had worse best-corrected visual acuity (BCVA). Conversely, infants treated with IVR experienced a significantly higher reactivation rate compared to those treated with LPC. Logistic regression analysis showed no significant associations between gestational age, birth weight, plus disease, zone 1 ROP, and the choice of initial treatment with the reactivation of ROP., Conclusions: Both LPC and IVR effectively treat type I ROP in infants, with IVR yielding superior anatomical and refractive outcomes and LPC offering a lower reactivation rate. Understanding individual patient characteristics is crucial for treatment selection., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. National Medical Research Register (NMRR) issued approval NMRR ID-23-01753-OWD (IIR). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Wardati H et al.)

Aim: To assess strabismus control and motor ocular alignment for basic exotropia surgery at 5y follow-up., Methods: The medical records of 80 consecutive patients aged less than 17 years of age, who underwent surgery for basic exotropia by a single surgeon between years 2000 to 2009 and completed a minimum of 5y follow-up post-operatively were reviewed. Pre- and post-operative characteristics were documented at 1wk, 6mo, 1, 3 and 5y follow-up. Subjects at 5-year follow-up were assigned to the success group if they had a post-operative angle of deviation within 10 prism diopters of exotropia or within 5 prism diopters of esotropia for distance on prism cover test, and had moderate to good strabismus control. The remaining subjects were assigned to the failure group., Results: Post-operative surgical success at one week was 75%, which decreased to 41% at 5y follow-up. The success group was noted to have more patching pre-operatively (P=0.003). The duration of patching a day (P=0.020) and total duration of patching pre-operatively (P=0.030) was higher in the success group. Surgical success at 1y (P=0.004) and 3y (P=0.002) were associated with higher surgical success at 5y follow-up., Conclusion: Post-operative motor alignment and strabismus control for basic exotropia surgery at 1y and beyond is associated with higher exotropia surgery success at 5-year follow-up. There is an association between pre-operative patching and 5-year surgical success of basic intermittent exotropia surgery.