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This work presents an innovative optical chemical sensing approach, which considers a molecularly imprinted polymer (MIP) as the core of an optical waveguide. More specifically, a channel was achieved into an FR4 substrate through a CNC machine. As proof of concept, a MIP prepolymeric mixture for furfural (2-FAL) detection was poured into the channel and then polymerized to obtain the waveguide’s core. The optical-chemical platform was interrogated through two plastic optical fibers (POFs) integrated into the system itself. The idea was to create a core with a refractive index (RI) variable as a function of the analyte-receptor binding interaction. First, the optical chemical sensor response was numerically evaluated by finite element method (FEM) simulations. Then, the sensor platform was tested by using two different experimental setups, both including two channels: the sensor channel consisting of the MIP-core based waveguide and the reference channel, consisting of another waveguide having a core of not imprinted polymer (NIP). The introduction of a reference channel in the experimental setup allowed to eliminate several factors of irreproducibility and noise, due to external conditions (e.g., temperature) or light source fluctuations. Moreover, selectivity tests were carried out to confirm the good selectivity of the proposed optical-chemical sensor system. The results obtained by the two experimental setups are comparable in terms of the limit of detection (LOD), which is equal to around 0.003 mg L−1. The achieved results paved the way for this innovative, low-cost, and selective sensing methodology.

The article outlines principles that companies need to follow when deciding whether to purse an open or closed ecosystem, that include benefits and costs through centralized governance, strategic differentiation through different openness levels, and tradeoffs.

A versatile and low-cost plasmonic biosensor was designed, realized, and tested by combining a bioreceptor layer with a probe based on two plastic optical fibers (POFs) built-in with a sensing chip carried out via a multilayer on UV-curable optical adhesives. The proposed sensitive multilayer has been developed to excite the surface plasmon resonance (SPR) phenomenon on a gold surface in contact with the monitored bioreceptor layer. More specifically, a binding interaction between a bioreceptor layer and its analyte has been studied for the first time by exploiting SPR platforms based on UV-curable optical adhesives. First, a resin block with a V-shaped channel on its surface was designed and printed using a 3-D printer to locate the source and receiver on the same side. Then, the channel was covered by a silver layer to obtain the mirror effect. After this, it was filled with an UV-curable optical adhesive, with two POFs fixed at the end of the trench, in order to obtain the core of the sensor’s waveguide. Finally, an optical buffer layer and a gold nanofilm were deposited on the core to excite the SPR phenomenon efficiently. The obtained SPR probe was first tested as a refractometer to obtain the bulk sensitivity, and then, following a functionalization process, binding tests were carried out to detect immunoglobulin (IgG) in the buffer. The experimental results show an ultralow detection limit of 1.17 fM, a detection range from 1 to 250 fM, and a sensitivity at low concentrations of 3.42 nm/fM.

This work proposes an analysis relative to an optical-chemical sensor used to detect furanic compounds in aqueous solutions. The optical platform consists of a flexible substrate covered with inkjet-printed silver nanoparticle lines; on the latter, a molecularly imprinted polymer (MIP) layer specific for a furanic compound detection, i.e., furfural (2-FAL, or furan-2-carbaldehyde, or 2-furaldehyde), is then deposited. Two plastic optical fibers (POFs) are used to launch the light into the optical-chemical sensor and collect it at the platform’s output. For the first time, an oblique lines-based pattern has been tested for 2-FAL detection in water. The performances of the sensor based on this pattern have been compared to two other similar sensor configurations in which the inkjet-printed lines are located in different directions with respect to the input light respectively longitudinally and orthogonally. In this work, the characterization has been carried out by two different experimental setups. In such a way, it has been determined that the printed pattern has a noticeable influence on the chemical performance of the proposed 2-FAL sensor. Moreover, selectivity tests have been performed to confirm the good selectivity of the proposed optical-chemical platform. The obtained results have added more information relative to a simple, low-cost, highly sensitive, and selective sensing approach.

Purpose To identify audience and faculty preferences to optimize digital education sessions in ophthalmology.Methods We distributed an online survey to ophthalmology trainees and specialists worldwide. The survey investigated respondents’ preferences on various findings of hypothetical digital educational sessions. Data were analyzed using descriptive statistics, Fisher's exact probability and ANOVA tests.Results The survey was completed by 655 respondents, from 53 different countries. According to most respondents, the optimal duration and timeframe for a valuable digital education session would be 30–60 min, without a break (52%), in the evening time-slot (6-8 p.m.) (45%) of a weekday (Monday-Thursday) (46%), regardless of age (p-value = 0.84, 0.39, 0.89, respectively) and job position (p-value = 0.31, 0.29, 0.08, respectively). The availability of webinars and recorded surgical videos/clinical cases, associated with live discussion, represented the most important opportunity of digital educational channels for 46% and 42% of respondents, respectively.Conclusion Appropriate planning of timing and structure of digital educational ophthalmology sessions may optimize their effectiveness. Using multiple e-learning formats may be helpful to ensure the continuity of learning activities, also in view of a long-term replacement of traditional in-person education.

An increased demand for endoscopy facilities has stimulated studies on efficiency. This study used a time and motion method to evaluate the effective use of healthcare resources in the intraprocedural phase of endoscopy procedures in a GI department of a tertiary care referral hospital and to identify potential recruitable resources.

The paper investigates the territorial layout of the fortified system of Naples that developed during the Spanish Vice Kingdom in the 16th-17th centuries.

Purpose To describe the role of optical coherence tomography angiography (OCTA) to help in differential diagnosis between papilledema and a rare case of choroidal neovascularization (CNV) associated with Morning Glory Syndrome (MGS).Methods Observational case report.Results A 22-year old man was referred to Eye clinic from Neurological unit with a diagnosis of papilledema in right eye. OCTA scans on the optic disc revealed a dense radial peripapillary vascular network while two polypoidal choroidal vasculopathy (PCV) were present in peripapillary region at the edge of staphyloma in corrispondence of choriocapillary layer. Therefore, the patient underwent three-monthly intravitreal injections of anti-vascular endothelial growth factor. One and six months after loading phase, the PCVs showed no clinical activity at structural spectral domain-OCT and OCTA.Conclusion This case revealed the crucial role of OCTA as an efficace diagnostic technique in discriminating papilledema from MGS complicated by CNV, allowing to make differential diagnosis, useful in ophthalmological and neurological clinical practice.

Purpose To evaluate retinal and choriocapillary vessel density (VD) changes in patients with chronic central serous chorioretinopathy (CSC) treated with half-fluence verteporfin photodynamic therapy (vPDT) or eplerenone, using optical coherence tomography angiography (OCTA).Methods Patients affected by CSC and treated with vPDT and eplerenone were retrospectively studied. At baseline and 3 months after each treatment, all patients underwent a complete ophthalmological examination, including an evaluation of best-corrected visual acuity (BCVA), slit-lamp biomicroscopy, fundus examination, fluorescein angiography (FA), indocyanine green angiography (ICGA), spectral-domain optical coherence tomography (SD-OCT) and OCTA.Results Forty-eight eyes of patients with CSC were analysed. Twenty-four eyes were placed in the vPDT group, and 24 eyes formed the eplerenone group. In both groups, OCTA showed a significant improvement in the VD of deep capillary plexus (DCP) and choriocapillaris (CC) after treatments with respect to baseline (p < 0.001), whereas the VD of superficial capillary plexus (SCP) did not show significant differences (p > 0.05). The PDT group demonstrated a statistically significant increase in the VD of DCP and CC with respect to the eplerenone group (DCP p = 0.012; CC p = 0.004). A statistically significant reduction with respect to baseline in subfoveal choroidal thickness (SFCT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) and in central foveal thickness (CFT) (p = 0.001 for vPDT group; p = 0.001 for eplerenone group) was also found. The SFCT was significantly thinnest in the PDT group with respect to the eplerenone group (p = 0.021).Conclusion OCTA allowed us to study retinal and choriocapillary vascular changes in patients with CSC treated with vPDT and eplerenone.

In the last decade, the electric vehicle technology has been establishing and shows a great potential to become predominant in mobility sector. One of the critical problems of current technology is a limited vehicle range compared to extended charging times. Energy consumption of HVAC unit, especially in winter season, can remarkably affect the range. This work evaluates the benefits of introducing a thermal energy storage able to recover the regenerative braking energy excess, in terms of range extension of a light duty commercial vehicle. A detailed digital twin model of the vehicle has been implemented into the Matlab/Simulink platform to this aim. Results show potential benefits up to 10% of increase in vehicle range under winter conditions. Thermal Energy Storage has been then confirming a viable and effective mean to increase the EV range especially under cold ambient conditions.

In this work, two sensor configurations have been realized and tested to measure micro/nano-liquid volumes. Measurement of micro/nano volumes is of high interest for a variety of application domains, such as calibrating micropipettes for biochemical uses or examining volume variations to prevent liquid leakage. The proposed sensor chips are based on patches of polymeric light diffusing fibers (P-LDFs), opportunely modified in two different ways. More specifically, one configuration is based on a polishing process, whereas the other one foresees five micro-holes achieved along the patch. For both sensor configurations, the P-LDF patches have been employed between a white light source and a surface plasmon resonance (SPR) platform connected to a spectrometer. In such a way, once a micro/nano-liquid volume is deposited on the sensitive P-LDF patch, the mode profile of the light into the SPR platform based on multimode plastic optical fibers changes. Consequently, the resonance wavelength varies as a function of the micro/nano-liquid volume in contact with the sensitive area of the P-LDF patch. The volume sensor systems were tested by using water micro-volumes in the range from 1 to $5~\mu \text{L}$ with a step size of $1~\mu \text{L}$ . The experimental results have demonstrated that both the proposed sensor configurations present a volume resolution of about 80 nL. This value is about seven times more minor than the value obtained by a similar sensor configuration which includes the same P-LDF patch without modifications.

In this work, a novel surface plasmon resonance (SPR) sensor has been designed, realized, and investigated. The SPR platform was created by using a D-shaped plastic optical fiber shell (POFS), obtained by removing the graded index core region from the fiber’s protective jacket, to create a microchannel. The latter was then coated with a gold nanofilm to obtain the plasmonic-sensitive region. The sensor’s structure includes an integrated measuring cell, being the solution under test injected into the microchannel using a peristaltic pump. The microchannel dimension ( $160 \mu \text{m}$ ) allows for avoiding microfluidic systems, typically adopted in this kind of SPR configuration. As a proof of concept, the plasmonic sensor has been tested as a refractometer using different water–ethanol solutions, with a refractive index (RI) ranging from 1.332 to 1.352. The experimental results have highlighted a sensitivity and a resolution equal to about 1026 nm/RIU and $1.95\times 10^{-{4}}$ RIU, respectively. These values testify to the proposed sensor’s goodness and its suitability for biochemical sensing applications.

In this work, an optimized force sensor system was simulated, fabricated, and experimentally tested. It is based on a modified plastic optical fiber (POF) bonded on the back side of a spring-steel cantilever. The POF is opportunely modified with several notches in order to enhance the performance of the sensor system. In particular, an optimization analysis of the position and characteristics of these notches was presented. First, a numerical analysis based on finite element method (FEM) simulations was conducted to determine where the cantilever’s elastic stress is maximum, resulting in its constrained end. Subsequently, an experimental analysis was carried out to characterize the sensor by fixing one end of the cantilever and applying transversal forces on the unconstrained end, applying different weights. Several preliminary optimization tests were performed to establish the best working condition in terms of light source and notches parameters, i.e., depth and periodicity. From the experimental results, the optimized force sensor system denoted a very good linear behavior in the range from 50 to 300 mN, with a sensitivity and resolution equal to 110.34 mV/N and 5 mN, respectively.

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The widespread use of prostate specific antigen (PSA) caused high rate of overdiagnosis. Overdiagnosis leads to unnecessary definitive treatments of prostate cancer (PCa) with detrimental side effects, such as erectile dysfunction and incontinence. The aim of this study was to evaluate the feasibility of an artificial neural network-based approach to develop a combinatorial model including prostate health index (PHI) and multiparametric magnetic resonance (mpMRI) to recognize clinically significant PCa at initial diagnosis.

Background: Helicobacter pylori infection is associated with gastric cancer, but the effect of eradication treatment on gastric cancer risk is not well defined. Purpose: To determine whether H. pylori eradication treatment can reduce the risk for gastric cancer. Data Sources: PubMed, EMBASE, Cochrane Library, Google Scholar, and online clinical trial registers through 31 January 2009, without language restrictions. Study Selection: Randomized trials that compared eradication treatment with no treatment in H. pylori--positive patients and that assessed gastric cancer or progression of preneoplastic lesions during follow-up. Data Extraction: Two authors independently reviewed articles and extracted data. Data Synthesis: Seven studies met inclusion criteria, 1 of which was excluded from pooled analysis because of clinical and methodological heterogeneity. All studies were performed in areas with high incidence of gastric cancer, mostly in Asia. Overall, 37 of 3388 (1.1 %) treated patients developed gastric cancer compared with 56 of 3307 (1.7%) untreated (control) participants. In a pooled analysis of 6 studies with a total of 6695 participants followed from 4 to 10 years, the relative risk for gastric cancer was 0.65 (95% CI, 0.43 to 0.98). Limitations: All studies but 1 were performed in Asia. Only 2 assessed gastric cancer incidence, and only 2 were double-blinded. Conclusion: Helicobacter pylori eradication treatment seems to reduce gastric cancer risk.

Multisided platforms are new organizing forms that can boost innovation in the healthcare sector by empowering patients as innovators and facilitating the commercialization of innovations by and for patients. However, applying the playbook script for the platform model from other sectors may prove challenging given the distinctive nature of the healthcare services. Drawing on the case of a leading healthcare innovation platform in Europe, this article examines the platform’s role in identifying and enabling the development and diffusion of patient innovations. This involves three main roles (community organizer, market matchmaker, and innovation manager) and corresponding orchestration activities.

Purpose: To evaluate the radial peripapillary vascular plexus of a cavitary congenital optic disc anomaly in a young patient with recessive autosomal metaphyseal acroscyphodysplasia using optical coherence tomography angiography (OCTA).Methods: Observational case report.Results: A 17-year-old man, with diagnosis of metaphyseal acroscyphodysplasia was referred to Eye Clinic for fundus examination and multimodal imaging for retinal epithelium hypertrophy in the right eye. Clinical examination showed cup-shaped metaphyses, short stature, hyperthelorism, and telecanthus. An optic disc coloboma was detected in the right eye on fundus examination. Wide field en-face Optical Coherence Tomography (OCT) showed a hyporeflective area corresponding to the right optic disc coloboma. At OCTA examination, the whole papillary region revealed a rarefaction of the vascular network, while the ganglion cell complex’s and retinal fiber layers’ parameters were normal in both eyes.Conclusion: The presence of coloboma disc congenital defect linked to embryological abnormalities during the development process could pave the way for a wider understanding of the pathogenesis of metaphyseal acroscyphodysplasia by increasingly framing it as a systemic disease.

This study describes the optical coherence tomography and optical coherence tomography angiography features of three eyes of three patients affected by contractile morning glory syndrome. Optical coherence tomography angiography scans of the peripapillary retina revealed a dense microvascular network without any vascular difference between the superficial vascular plexus and the deep vascular plexus around the optic nerve. These optical coherence tomography angiography findings confirm that the contractile movement could be due to the presence of an autonomic cholinergic muscular mechanism in the posterior part of the globe. In fact in our cases, the contractile movement seemed to be induced by massage of the eyeball. Optical coherence tomography angiography is a valid, non-invasive, dyeless, and reliable method that could shed light on the pathogenesis of this rare disease of the optic disk.

Purpose To evaluate a case of macular retinoschisis associated with a TJP2 mutation in a young woman affected by a Progressive Familiar Intrahepatic Cholestasis (PFIC) using multimodal imaging.Methods Observational case report.Results A 35-year-old woman, undergone a liver transplant for PFIC, was referred to Eye Clinic for complete ophthalmological examination and multimodal imaging. Fundus examination showed no significant alterations in both eyes while multicolor image revealed the presence of several cystes in macular region. The autofluorescence image highlighted small areas of iperautofluorescence in macular region. En-face image showed a “coral shape pattern” and structural optical coherence tomography (OCT) revealed foveal hyporeflective cystic spaces in outer and inner nuclear layers, areas of splitting within the nerve fiber layer (schisis areas) and an initial preretinal fibrosis. Lastly, OCT-angiography (OCT-A) demonstrated small perifoveal teleangectasias and slight reduction of the foveal avascular zone area.Conclusion Multimodal imaging could help to highlight the presence of a rare retinal disorder associated with a gene related systemic disease.

Purpose: To evaluate choriocapillary vascular density changes in choroidal neovascularization (CNV) type 2 associated with choroidal nevus using optical coherence tomography angiography (OCT-A) before and after anti-VEGF treatment.Methods: Observational case report.Results: A 25-year-old woman, was referred to Eye Clinic and presented a decreased visual acuity in right eye. Fundus examination showed a pigmented lesion located in macular region associated with subretinal hemorrhages adjacent to the mass in right eye. The diagnosis of choroidal nevus-associated with CNV was made and confirmed by spectral domain (SD)-OCT, OCT-A, and ultrasound examination. Two monthly ranibizumab intravitreal injections (IVT) were performed and a regression of the activity of neovascular lesion was noted. OCT-A showed a reduction of choriocapillaris vessel density (VD) before the treatment and an increase of VD after IVT injections.Conclusion: OCT-A could be a non-invasive and diagnostic tool to evaluate choriocapillaris vascular changes after IVT injections in CNV associated with choroidal nevus.

AimsTo date, reverse transcriptase PCR (RT-PCR) on nasopharyngeal swabs is the ‘gold standard’ approach for the diagnosis of COVID-19. The need to develop easy to use, rapid, robust and with minimal hands-on time approaches are warranted. In this setting, the Idylla SARS-CoV-2 Test may be a valuable option. The aim of our study is to evaluate the analytical and clinical performance of this assay on previously tested SARS-CoV-2 people by conventional RT-PCR based approach in different settings, including initial diagnosis and clinical follow-up.MethodsTo evaluate the sensitivity and specificity of the Idylla SARS-CoV-2 Test, we retrieved 55 nasopharyngeal swabs, previously analysed by a fully validated assay, from symptomatic patients or from people who have been in close contact with COVID-19 positive cases. Discordant or high discrepant cases were further analysed by a third technique. In addition, a second subset of 14 nasopharyngeal swab samples with uncertain results (cycle threshold between 37 and 40), by using the fully validated assay, from patients with viral infection beyond day 21, were retrieved.ResultsOverall, Idylla showed a sensitivity of 93.9% and a specificity of 100.0%. In addition, in the additional 14 nasopharyngeal swab samples, only five (35.7%) featured a positive result by the Idylla SARS-CoV-2 Test.ConclusionsWe demonstrated that the Idylla SARS-CoV-2 Test may represent a valid, fast, highly sensitive and specific RT-PCR test for the identification of SARS-CoV-2 infection.

Objectives: To analyze the effect of the employment of polyvinylpyrrolidone-iodine (PVP-I) 0.6% eye drop on the clinical course of patients affected by Adenoviral Keratoconjunctivitis (AKC). Methods: Consecutive patients with clinical signs of AKC and positive results of AdenoPlus test were enrolled from four Italian Centres. Patients were randomized to receive: PVP-I 0.6% eye drops four times/daily for 20 days (Group A) or hyaluronate-based tear substitutes four times/daily for 20 days (Group B). Best-corrected visual acuity (BCVA), optical coherence tomography (OCT) Optovue iVue pachymetry map; corneal haze; conjunctival injection and chemosis; subepithelial corneal infiltrates (SEIs); corneal and conjunctival staining and corneal densitometry were recorded at diagnosis and at every follow-up visit. The primary outcome was the resolution time of AKC. Results: Overall, 59 AKC patients (34 for Group A and 25 for Group B) completed the study. Patients of Group A showed a significantly shorter resolution time and lower incidence of SEIs compared to patients of Group B. In particular, SEIs were present at the last visit in 3/34 (8.82%) patients of the Group A vs 11/25 (44%) of the Group B (p= 0.005). Patients of Group A showed a significantly lower incidence of corneal haze compared to patients of Group B (0/34 vs 3/25; p= 0.038). No side effects were reported for both groups. Conclusions: Although further clinical evaluations are needed, according to our data the use of PVP-I 0.6% eye drop in the setting of AKC reduces the risk of SEIs as well as the resolution time of the disease.

Purpose: To compare efficacy of treat and extend (T&E) versus fixed regimen treatment protocols in neovascular age-related macular degeneration (nAMD).Methods: Randomized clinical trials (RCTs) comparing T&E versus fixed regimen protocols for nAMD were systematically searched. Primary outcome was to compare the mean best corrected visual acuity (BCVA) change in T&E regimen versus fixed regimen. Secondary outcomes were change in the mean optical coherence tomography (OCT) central retinal thickness (CRT) and mean number of injections. Standardized mean difference (SMD) along with 95% confidence intervals (CIs) were calculated. Random-effect models were used for meta-analyses.Results: Four RCTs were included, with a total of 649 and 621 eyes in the T&E and fixed regimen cohort at 12 months, and 267 and 249 eyes at 24 months. Pooled analysis of mean BCVA change included all four RCTs at 12 months and two RCTs at 24 months, showing no difference between the two groups (12-month: SMD = 0.08, 95% CI: −0.20 to 0.35, p= 0.55; 24-month: SMD = 0.04, 95% CI: −0.13 to 0.21, p= 0.64). Pooled analysis of OCT CRT change at 12 months included three studies, showing no difference between the two groups (SMD = 0.03, 95% CI: −0.46 to 0.51, p= 0.91). Pooled analysis of mean injection number included all four RCTs at 12 months and two RCTs at 24 months, showing significant difference between the two groups (12-month: SMD = −1.11, 95% CI: −1.67 to −0.56, p< 0.001; 24-month: SMD = −1.34, 95% CI: −1.54 to −1.15, p< 0.001).Conclusion: A T&E regimen proved as effective as a fixed dosage regimen throughout a 24-month follow-up and with a lower number of injections.

Purpose: To report a case of quiescent choroidal neovascularization (CNV) associated with choroidal nevus using optical coherence tomography angiography (OCTA) during 5 years follow-up.Methods: Observational case report.Results: A 53-year old woman was referred our department with diagnosis of choroidal nevus. At 1 year follow-up, fundus autofluorescence revealed hyper/hypoautofluorescent area, infrared image showed hyperreflective area and enhanced depth imaging OCT presented a shallow pigment epithelium detachment without exudation or hemorrhage. Fluorescein angiography and indocyanine green angiography suspected the presence of CNV. Finally, OCTA confirmed a quiescent CNV with an increased flow area of the vascular lesion without any changes in best-corrected visual acuity. At 20 months and 5 years follow-up, the CNV remained quiescent showing no clinical activity on structural SD-OCT and no changes in CNV morphology on OCTA.Conclusion: This case shows the features of quiescent CNV secondary to choroidal nevus after long-term follow-up. OCTA represents a valid imaging technique that allows to identify the CNV and to monitor its progression over time.

Purpose: To detect the vessel density (VD) of the radial peripapillary capillary (RPC) in eyes affected by pathological myopia with or without a peripapillary intrachoroidal cavitation (PICC) and in eyes with PICC complicated by choroidal neovascularization (CNV), using optical coherence tomography angiography (OCTA).Methods: We prospectively enrolled highly myopic patients from January 2016 to December 2019 at the Eye Clinic of the University of Naples “Federico II.” We divided included patients into three groups: group 1 including patients with PICC complicated by CNV; group 2 including patients with PICC without complications; group 3 including patients with high myopia without PICC and CNV. One-way analysis of variance (ANOVA) followed by Bonferroni post hoc analysis was used to evaluate differences in VD of radial peripapillary capillary (RPC) in papillary whole, peripapillary regions and its sectors among the three groups.Results: We enrolled 12 highly myopic eyes with PICC complicated by CNV, 21 highly myopic eyes with PICC without CNV and 23 highly myopic eyes without PICC. The myopic eyes with PICC revealed a statistically significant reduction in VD of the RPC comparing to the other groups (p< 0.001), especially in eyes affected by myopic PICC complicated by CNV (p< 0.001). These results were similar analyzing the VD in different sectors of the peripapillary region among the three groups (p< 0.001).Conclusion: OCTA detects the changes in peripapillary vascular density of highly myopic eyes. We demonstrated that the RPC vasculature is significantly influenced by the presence of PICC, especially in myopic eyes developing a CNV.

In this paper, we demonstrate automatic vehicle detection and counting by processing data acquired using a phase-sensitive optical time-domain reflectometer (?-OTDR) distributed optical fiber sensor. The acquired data are processed using the Hough transform, which detects the lines in the images formed by representing the acquired data in the space–time domain. A rough classification of the vehicles (heavy versus light vehicles) is also proposed, based on the amplitude of the vibration data along the detected lines. The method has been experimentally tested by performing ?-OTDR measurements along a telecommunication fiber cable running in a buried conduit along the state road SS18 (province of Salerno, Italy), opened to normal traffic. Comparison with ground-truth data, manually generated by inspecting video recordings, allowed us to estimate a vehicle detection success rate up to 73%, while heavy vehicles were fully detected.

Purpose: Usher syndrome (USH) is an autosomal recessive disorder characterized by congenital sensorineural hearing impairment and retinitis pigmentosa. Classification distinguishes three clinical types of which type I (USH1) is the most severe, with vestibular dysfunction as an added feature. To date, 15 genes and 3 loci have been identified with the USH1Ggene being an uncommon cause of USH. We describe an atypical USH1G-related phenotype caused by a novel homozygous missense variation in a patient with profound hearing impairment and relatively mild retinitis pigmentosa, but no vestibular dysfunction.Methods: A 26-year-old female patient with profound congenital sensorineural hearing loss, nyctalopia and retinitis pigmentosa was studied. Audiometric, vestibular and ophthalmologic examination was performed. A panel of 13 genes was tested by next-generation sequencing (NGS).Results: While the hearing loss was confirmed to be profound, the vestibular function resulted normal. Although typical retinitis pigmentosa was present, the age at onset was unusually late for USH1 syndrome. A novel homozygous missense variation (c.1187T>A, p.Leu396Gln) in the USH1Ggene has been identified as causing the disease in our patient.Conclusions: Genetic and phenotypic heterogeneity are very common in both isolated and syndromic retinal dystrophies and sensorineural hearing loss. Our findings widen the spectrum of USH allelic disorders and strength the concept that variants in genes that are classically known as underlying one specific clinical USH subtype might result in unexpected phenotypes.

The EU's General Data Protection Regulation (GDPR) and the recently announced Digital Markets Act (DMA) are setting the standard for countries around the world - and in some cases offering a cautionary tale. Banning critical levers of the platform business model through an overly restrictive DMA would put a break on business model innovation for all firms; mandating specific design choices will constrain particular innovation opportunities. [Extracted from the article]

Objective: To compare outcomes of cataract surgery combined with either anti-Vascular Endothelial Growth Factor (anti-VEGF) therapy or dexamethasone implant (DEX) in patients with diabetic macular oedema (DMO). Methods: Pubmed and Embase databases were searched for studies reporting outcomes of diabetic cataract surgery combined with either anti-VEGF or DEX, with a follow-up ≥3 months. The primary outcome was the mean change in central macular thickness (CMT). Mean change in best corrected visual acuity (BCVA) was considered as a secondary outcome. The mean difference between baseline and post-treatment values (MD) with 95%-Confidence Interval (95%CI) was calculated and meta-analyses were performed. Results: Nine-teen studies were included, 8 in the DEX group and 11 in the anti-VEGF group. A significant reduction of macular thickness was shown in the DEX group at 3 months (MD = −98.35 µm; 95% CI, −147.15/−49.54), while mean CMT change was non-significant in the anti-VEGF group (MD = −21.61 µm; 95% CI, −59.46/16.24; test of group differences, P&lt; 0.001). At 3 months, no difference in visual gain was found between the two groups (P= 0.13). Conclusions: In DMO patients, cataract surgery combined with DEX seems to provide better anatomical outcomes compared with cataract surgery combined with anti-VEGF therapy. However, our evidence was limited by significant heterogeneity. Randomised trials comparing these two different combined approaches are warranted.

Background: To investigate the anatomical and functional results in eyes with peripapillary pachychoroid syndrome (PPS) undergoing photodynamic therapy (PDT). Methods: A total of 25 eyes from 23 patients with PPS treated with PDT were retrospectively evaluated in this multicentric study. Main outcome measure was the proportion of eyes that achieved treatment success, defined as a decrease in both subretinal fluid (SRF) height and central subfield thickness (CST), at 3 months after PDT compared to baseline. Secondary outcomes were the change in CST, SRF, and best-corrected visual acuity (BCVA) 3 months after treatment and predictive factors for treatment success. When available, data between 3 and 12 months were also reviewed. Results: Treatment success was achieved in 16 eyes (64%). In the total cohort, CST decreased significantly from 356 ± 118 µm at baseline to 282 ± 90 µm and 270 ± 91 µm at 1 and 3 months, respectively (p&lt; 0.001). Maximal SRF height decreased significantly from 102 ± 83 µm at baseline to 38 ± 46 µm and 32 ± 42 µm at 1 and 3 months, respectively (p&lt; 0.001), and remained stable at month 6 (29 ± 44 µm) and month 12 (23 ± 35 µm). BCVA improved significantly from baseline to month 3 (p= 0.021). Conclusions: PDT can be considered an efficacious treatment option in patients with PPS. Prospective data with longer follow-up in a bigger cohort are needed in order to determine the optimal treatment algorithm in this relatively novel disease.

Supplemental Digital Content is available in the text.In this study we analyzed the feasibility and safety of single-step multiple transluminal gateway drainage (MTGD) for complex walled-off necrosis (WON) using lumen-apposing metal stents (LAMSs). Six patients underwent endoscopic ultrasound (EUS)-guided MTGD using two LAMSs. Technical success was 100%. The mean procedure time was 29 min. The mean number of direct endoscopic necrosectomy sessions per patient was 2. Two of six patients developed adverse events, which was bleeding in both cases and treated endoscopically and surgically, respectively. The mean hospital stay was 52.5 days. No patients had residual necrosis or WON recurrence. Although the limited number of patients, the single-step MTGD using electrocautery-LAMSs can be considered a feasible and well-tolerated treatment option for patients with complex WON. Nevertheless, larger randomized controlled studies are needed in order to confirm our data and better define the advantages of this technique.

Objective: To investigate the effectiveness of a home-based preoperative rehabilitation program for improving preoperative lung function and surgical outcome of patients with chronic obstructive pulmonary disease (COPD) undergoing lobectomy for cancer.Methods: This was a prospective, observational, single-center study including 59 patients with mild COPD who underwent lobectomy for lung cancer. All patients attended a home-based preoperative rehabilitation program including a minimum of 3 sessions each week for 4 weeks. Each session included aerobic and anaerobic exercises. Participants recorded the frequency and the duration of exercise performed in a diary. The primary end point was to evaluate changes in lung function including predicted postoperative (PPO) forced expiratory volume in 1 second (FEV1), 6-minute walking distance test (6MWD), PPO diffusing capacity for carbon monoxide (DLCO) %, and blood gas analysis values before and after the rehabilitation program. Postoperative pulmonary complications were recorded and multivariable analysis was used to identify independent prognostic factors (secondary end point).Results: All patients completed the 4-week rehabilitation program. Thirteen of 59 (22%) patients (Group A) performed <3 sessions per week (mean sessions per week: 2.3±1.3); 46 of 59 (78%) patients (Group B) performed ⩾3 sessions per week (mean sessions per week: 3.5±1.6). The comparison of PPO FEV1% and 6MWD before and after rehabilitation showed a significant improvement only in Group B. No significant changes in PPO DLCO% or in blood gas analysis values were seen. Nine patients presented postoperative pulmonary complications, including atelectasis (n= 6), pneumonia (n= 1), respiratory failure (n= 1), and pulmonary embolism (n= 1). Group A presented higher number of postoperative pulmonary complications than Group B (6 vs 3; p= 0.0005). Multivariate analysis showed that the number of weekly rehabilitation sessions was the only independent predictive factor (p= 0.001).Conclusions: Our simple and low-cost rehabilitation program could improve preoperative clinical function in patients with mild to moderate COPD undergoing lobectomy and reduce postoperative pulmonary complications. All patients should be motivated to complete at least 3 rehabilitation sessions per week in order to obtain significant clinical benefits. Our preliminary results should be confirmed by larger prospective studies.

To describe the vascular changes of circumscribed choroidal hemangioma (CCH) after ruthenium-106 brachytherapy using optical coherence tomography angiography (angio-OCT). Seven eyes of 7 patients diagnosed with symptomatic CCH who underwent ruthenium-106 plaque radiotherapy were included in the study. Patients underwent complete ophthalmic examination, bulbar echography and angio-OCT. The same protocol was applied 1 year after ruthenium-106 brachytherapy. At baseline, the mean best-corrected visual acuity (BCVA) in affected eyes was 0.67 ± 0.14 logMAR, and the mean tumor thickness was 4.46 ± 0.91 mm measured by standardized A-scan echography. After ruthenium-106 plaque treatment, the mean BCVA increased to 0.17 ± 0.10 logMAR (p= 0.001) and the mean tumor thickness to 2.29 ± 0.71 mm (p= 0.003). Moreover, there was a significant reduction of the tumor basal diameter (p= 0.009). Intra-tumor angio-OCT measurements revealed a statistically significant reduction of the vessel and flow areas (p= 0.006 and p= 0.002, respectively) 1 year after brachytherapy. Angio-OCT is a non-invasive reliable method with which to evaluate the vascular features of CCH and consequently to monitor changes after conservative treatment.

To evaluate the use of a three-dimensional heads-up microscope (3DM) during 25-gauge pars plana vitrectomy (PPV) compared with a traditional ophthalmic microscope (TM) in terms of efficacy, safety, and teaching and learning satisfaction. Prospective comparative interventional study. Fifty eyes affected by one of the following diseases: rhegmatogenous or tractional retinal detachment, epiretinal membrane, full-thickness macular hole, vitreous hemorrhage, or dropped lens. The 50 eyes were randomly assigned to one of two groups: group A (25 eyes) underwent 25-gauge PPV with 3DM, and group B (25 eyes) underwent 25-gauge PPV with TM. The main outcome measures were the duration of the operation, intraoperative complications, and surgeon and observer satisfaction. A questionnaire was used to assess surgeon satisfaction according to the following parameters: comfort, visibility, image quality, depth perception, simplicity of use, maneuverability, and teaching. A questionnaire to assess observer satisfaction was completed by 20 observers (surgical residents or ophthalmic surgeons). The degree of satisfaction was higher using 3DM for both surgeons and observers (P< 0.001). The average duration of the operation did not differ significantly between the two methods. No major complications occurred for either method. PPV with 3DM is more comfortable for the surgeon and poses no substantially greater risk of complications for the patient. The high-definition screen delivers excellent depth perception and better screen parameter control, which results in high-quality surgical performance. 3DM surgery helps to significantly improve teaching and learning intra-operative surgical procedures.

This study describe the optical coherence tomography angiography (OCTA) features of a young patient with Tuberous sclerosis complicated with CNV unilateral macular choroidal neovascularization during the ranibizumab therapy. OCTA scans of macular region of right eye, revealed a dense microvascular network confirming the diagnosis of CNV. After four monthly intravitreal injections, OCTA revealed a decrease of size and activity of CNV. OCTA is a valid, non-invasive, dyeless, and reliable method that could improve the diagnosis and management of CNV in child with Tuberous sclerosis.

AimTo describe the vascular features of choroidal tumors using enhanced depth imaging (EDI), optical coherence tomography (OCT), and OCT-angiography.MethodsIn this prospective study, we evaluated 116 Caucasian patients with choroidal tumors (60 eyes with choroidal nevi, 40 with choroidal melanoma, 6 with choroidal hemangioma, 2 with optic disc melanocytoma, 6 with choroidal osteoma, and 2 with retinal metastases). Patients underwent a complete ophthalmic examination including bulbar echography, EDI-OCT, OCT-angiography, and multicolor imaging. Sixteen patients also underwent fluorescein and indocyanine angiography.ResultsThe left eye was more involved than the right eye. The mean tumor thickness was 1.23±0.17 mm in the 60 eyes with choroidal nevi; 2.75±0.83 mm in the 40 eyes with choroidal melanoma; 3.28±0.78 mm in the 6 eyes with retinal angioma; 2.02±0.001 mm in the 2 eyes with optic disc melanocytoma; 2.40±0.31 mm in the 6 eyes with choroidal osteoma; and last, 3.49±0.001 mm in the 2 eyes with retinal metastases. OCT-angiography showed: (i) a lack of blood flow in the outer retinal layer (ORL) and a normal choroid capillary layer in choroidal nevi and optic disc melanocytomas; (ii) a lack of blood flow in the ORL of choroidal metastases; and (iii) a dense irregular vascular network in the ORL and choroid capillary layers of choroidal melanomas, choroidal hemangiomas, and choroidal osteomas.ConclusionsOCT-angiography is a noninvasive reliable method with which to evaluate the vascularization of small choroidal tumors and may improve the diagnosis of these tumors.