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Byline: Madhu. Kumar, Simakurthy. Sriram, Tudymol. Devasia, Ashok. Kanakamedala, Jayamadhury. Gudimetla, K. Padma Progressive subretinal fibrosis and uveitis is a rare entity which usually affects young myopic females and causes [...]

Byline: Madhu. Kumar, Tudymol. Devasia, Simakurthy. Sriram, Ashok. Kanakamedala, Jayamadhury. Gudimetla, I. Sumanth Vitreous prolapse and intraocular lens decentration following neodymium-doped yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy is rare. [...]

Byline: Sudhakar. Potti, Ashok. Kanakamedala, Eswar. Sakare, Nivedita. Sodum A 65-year-old patient undergoing cataract surgery was given peribulbar anesthesia. For additional anesthesia, Van Lint technique was tried; patient moved his [...]

Across the U.S.A., steel girder bridges experience significant deterioration caused by corrosion, and the current repair methods for corroded steel girders require considerable time and cost. Corrosion is typically found at end-span locations above girder supports at abutments and piers caused by deicers and water leaking from the deck joints. Therefore, there is a need for effective, rapid, and robust repair strategies that can be implemented by bridge maintenance personnel. This paper presents five innovative repair methods for rehabilitating corroded steel girder bridges. The five innovative repair methods were evaluated to select two repair procedures that can be implemented by the local Department of Transportation (DOT) in Indiana. During the evaluation process, typical and critical requirements associated with repair methods for corrosion-damaged steel girders were considered, including robustness, reduction of implementation cost, and time. Furthermore, feedback from the local DOT in Indiana was collected to identify any additional requirements. The evaluation was completed by choosing two innovative repair methods through a selection process called the house of quality matrix, which is a commonly used tool in the consumer product industry. After completing the evaluation, two repair methods, “sandwich panel” and “web strengthening with diagonally oriented angles,” were selected.

Aim To report silicone oil tamponade induced vasculitis in the early post operative period - a rare manifestation of ‘Toxic Posterior Segment Syndrome’ after pars plana vitrectomy for rhegmatogenous retinal detachment.Case description A 50-year-old gentleman presented with vasculitis after a pars plana vitrectomy with silicone oil tamponade on the first post-operative day. He was started on oral steroids (1 mg/ kg) tapered sequentially every week. All signs of vasculitis resolved over a period of one month after which the silicone oil was removed. The patient maintained a visual acuity of 20/90 even after 3 months. There was no recurrence of vasculitis observed thereafter.Conclusion Silicone oil induced vasculitis is a rarely described entity, especially as a manifestation of toxic posterior segment syndrome. This differential must be kept in mind even on the first post-operative day in cases where silicone oil has been used for tamponade.

Introduction Tuberculosis can involve any organ in the body including ocular tissue of which the uveal tissue is most commonly infected. Choroidal involvement ranges from choroidal tubercles to granulomas. This is one of the few cases of a solitary choroidal granuloma with no other systemic symptoms in an immunocompetent child.Method A case report.Results A 12-year-old female, presented with diminution of vision in the left eye for a month. The anterior segment of her left eye was normal. A fundus examination revealed an isolated orangish-yellow choroidal mass, 4 DD in size, involving the posterior pole with overlying subretinal exudation. CT scan of the thorax showed large pulmonary, cervical and pancreatic lymph nodes, along with lytic lesions of the thoracic vertebrae. Excision biopsy of the cervical lymph nodes showed caseating granulomas with no e/o malignancies on histopathology. The patient was started on anti-tubercular therapy. Six months after the treatment, the lesion had reduced in size and her vision had improved.Conclusion Isolated choroidal tuberculomas can be present in eyes with little associated ocular inflammation and no other symptoms of systemic tuberculosis. High suspicion, early diagnosis and rapid initiation of medication are important for the treatment of ocular and systemic tuberculosis.

Remaining vigilant is the best approach when mitigating oil and gas pipeline leaks and ruptures, particularly with new legislation and other requirements that can lead to penalties and fines, not [...]

The current study aims to determine the expression of trefoil factor 2 (TFF2), trefoil factor 3 (TFF3), and adrenomedullin (ADM) in salivary samples of periodontitis patients with and without coronary heart disease (CHD). A total of 75 patients were selected based on the inclusion and exclusion criteria and divided into three groups of 25 patients each: generalized periodontitis (GP) only; GP+CHD; and CHD only. Demographic, periodontal, and cardiac parameters were recorded, and unstimulated saliva samples were collected and analyzed for the expression of TFF2, TFF3, and ADM. Among the demographic variables, the means for age, weight, and body mass index were significantly different between the groups on statistical analysis. Plaque index, bleeding on probing, probing pocket depth, clinical attachment level, and the expression of TFF2 were highest in the GP+CHD group, and ADM was highest in the CHD group, with Pvalues of < 0.01 as compared to the other groups. TFF2, TFF3, and ADM were also correlated with the demographic and periodontal parameters. The study demonstrates significantly elevated levels of TFF2 in CHD and GP patients, and a higher expression of ADM in CHD patients only, suggesting the possibility of an underlying inflammatory mechanism.

The value of purchasing software is discussed.

This article advises companies looking to cut expenses to retain the electronic data interchange (EDI) format rather than the Extensible Markup Language (XML) format, at least for now.

Developmental dysplasia of the hip (DDH) is the most common anatomical pathology present in newborns. DDH is the most common orthopaedic disorder in newborns, with incidences cited from 4.4% to 51.8% depending on risk factors, populations and method of reporting. Traditionally, the standard physical exam for newborns includes the Barlow and Ortolani maneuvers. If either is positive by the pediatrician, the baby is then sent for evaluation by a pediatric orthopaedic surgeon. At this stage, either the pediatrician or pediatric orthopaedic surgeon obtains an ultrasound—the gold standard for DDH diagnosis. When early identification and treatment are not in place, it can lead to significant consequences on an individual’s health and financial and public health implications for society at large. This is a detailed technique guide aimed to help physicians consistently perform thorough US evaluations of pediatric hips in order to successfully screen, diagnosis and manage treatment of DDH.

Pure and metal‐doped ZnO nanopowders with composition formula M0.04Zn0.96O (where M = Al, Mg, Sm, and Cu) are synthesized using the coprecipitation method. The structural characterization of synthesized powders is investigated using X‐ray diffraction and the results confirm the hexagonal wurtzite structure without any additional phases. The change in structural parameters of ZnO with dopants is estimated using X‐ray peak profile analysis. The structural characterization is further analyzed by Fourier‐transform infrared spectroscopy. The size and morphology of the synthesized powders are analyzed by a field‐emission scanning electron microscope, which also evidences the formation of uniform nanostructures with quasi‐spherical and hexagonal shapes. Moreover, the elemental composition of these metal‐doped nanotructures is determined by energy‐dispersive X‐ray measurements. UV–vis spectroscopy is used to determine the energy bandgap of ZnO nanopowders. A vibration sample magnetometer is employed to measure the samples' magnetic properties, and dopants are found to induce distinct magnetic behaviors in ZnO. The antimicrobial activity of the synthesized powders is measured using the well diffusion method. It is observed that the introduction of dopant metals leads to increased microbial activity. Among the doped ZnO variants, Al‐doped ZnO exhibits the highest level of microbial activity compared to pure ZnO and other samples. Zinc oxide (ZnO) nanostructures draw attention due to distinctive characteristics and potential uses in opto‐optoelectronics, spintronics, and nanotechnology. Bandgap, high electron mobility, conductive property, and biocompatibility nature highlight these materials. Herein, the primary objective is to study the structural, optical, magnetic, and antibacterial properties of transition‐metal and rare‐earth‐metal ions doped to ZnO nanopowders synthesized by coprecipitation a cost‐effective straightforward technique.

Developing software in foreign lands can save time and money--but only if companies do it right. More and more companies are going offshore to develop and maintain their software: GE, [...]

In recent years, electrophoretic deposition (EPD) has been adopted as a cost-effective and reliable single-step solution-based room temperature coating method for carbon nanotubes (CNTs), predominantly on conducting surfaces. Contrary to this general pre-requisite of conductive target substrates, in this work we have explored a fabrication strategy for the scalable deposition of CNTs on insulating glass surfaces by the sequential combination of electrospraying and the EPD technique. This combined process flow has been referred to as “electrospray-assisted EPD”, where an initial CNT coating on glass substrates is obtained by electrospraying which, in turn, further assists CNT film growth by EPD. The successful integration of the electrospray technique in the EPD process flow also eliminates the need for surface functionalization of the insulator substrates prior to the deposition step. Electrospray-assisted EPD has resulted in the successful fabrication of uniform, homogenous, and thick CNT deposits (∼4.5 - 5 μm) with precise thickness control. A detailed investigation of the effect of the initial electrosprayed coating on the final CNT film growth and thickness is also presented in this report. This research endeavor presents a significant opportunity for the integration of this deposition model into a wider platform of materials research and technology, chemical sensing, and applications based upon printable and flexible electronics.

Over the last decade in materials science, molecular electronics has emerged as one of the most rapidly developing interdisciplinary research areas with the prospects of ultimate miniaturization and integration of functional organic species with traditional silicon based semiconductor technology. To this end, fundamental studies to investigate the electrical and optical properties of organic nanomaterials deserve special attention. In this work, conductive probe atomic force microscopy (CP-AFM) and Raman spectroscopy have been performed on a new class of ionic materials, referred to as group of uniform materials based on organic salts (GUMBOS) and nanoparticles derived from these GUMBOS, termed as nanoGUMBOS. The GUMBOS investigated in this study are 1,1′-Diethyl-2,2′-cyanine bis (trifluoromethanesulfonyl) imide ([PIC][NTf2]) and 1,1′-Diethyl-2,2′-cyanine bis (pentafluoromethanesulfonyl) imide ([PIC][BETI]), which have been synthesized by use of a facile, template free anion exchange reaction between their respective parent compounds, followed by an ultrasonication assisted, additive free re-precipitation reaction to obtain the nanoscale particles (nanoGUMBOS). The ([PIC][NTf2] nanoGUMBOS were found to self-assemble into distinct diamond-like, trapezoid structures whereas [PIC][BETI] exhibited rod-like structures. [PIC][NTf2] nanoGUMBOS induced ~25 and ~38 times enhancement in the Raman signal intensity as compared to the parent compound [PIC][I] and [PIC][BETI] nanoGUMBOS respectively. In conjunction with the results of Raman spectra, the current-voltage (I-V) data obtained by CP-AFM are also presented as first-time evidence of electrical performance exhibited by these unique class of materials. The results reported in this study are indicative of their potential incorporation into next generation organic thin film applications in optoelectronics, dye-sensitized solar cells, and chemical sensors.

Molecular electronics, where nanoscale organic species are utilized as active electronic components, offers a promising approach towards ultimate miniaturization and integration of hybrid electronic materials (HEMs) with traditional silicon based complementary metal oxide semiconductors (CMOS) technology. Toward this end, fundamental research studies to understand the electronic and optical properties of these molecules are of paramount importance. In this work, conductive probe atomic force microscopy (CP-AFM) and Raman spectroscopy have been performed on ionic liquid based unique organic nanoparticles derived from a Group of Uniform Materials Based on Organic Salts (GUMBOS). Aptly named as nanoGUMBOS, the material investigated in this report is Rhodamine6G tetraphenylborate ([R6G][TPB]) as has been synthesized by a room temperature facile metathesis reaction between Rhodamine 6G chloride (R6GCl) and sodium tetraphenylborate (NaTPB) followed by an ultrasonication-assisted, additive-free, re-precipitation reaction. To the best of our knowledge, the results reported herein are first-time evidence of electrical performance exhibited by [R6G][TPB] nanoGUMBOS. In conjunction with the supportive results of Raman spectra, the current-voltage (I-V) characteristics obtained are indicative of the potential incorporation of this unique compound in hybrid electronics with respect to potential applications in optoelectronics and chemical sensing.

There have been several recent systematic reviews of quadriceps tendon autografts (QT), which have not shown any significant difference in outcomes between QT and hamstring tendon autograft (HS) for ACL reconstruction (ACLR). However, several recent comparative studies have been published comparing QT to HS for ACLR.

Inati: Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novonordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Research Funding; Global Blood Therapeutics: Research Funding. Kanakamedala:Novartis: Consultancy; Genesis Research: Employment. Pilipovic:Novartis Pharma AG: Employment, Equity Ownership. Sabah:Novartis: Employment.

Introduction: Doublet combinations including lenalidomide (len) and dexamethasone (dex; Ld) are increasingly used to treat frontline (FL) multiple myeloma (MM) patients (pts). Len has also been used as maintenance therapy where strategies increasing len dose with first relapse have been considered (Harousseau JL et al. Blood2017). Triplet combinations are emerging as standard of care for relapsed/refractory (RR) MM and the treatment paradigm is shifting, with new agents like carfilzomib, ixazomib, elotuzumab, and daratumumab being added to Ld. Although these new combinations have shown improved clinical outcomes in RRMM, most pts ultimately relapse. Thus, treatment decision with each relapse becomes increasingly important to improve survival; the most critical decision may come at first relapse. With earlier len use, better understanding of treatment sequencing patterns of len and its use in clinical practice settings may help optimize treatment strategies in RRMM pts in later lines. We present real-world clinical practice data on treatment sequencing at relapse from len-based FL therapy.

Introduction: Many new treatments and combinations have emerged over the last decade to treat relapsed or refractory multiple myeloma (RRMM). Treatment strategies include doublet and/or triplet combinations from the following classes of agents: immunomodulatory drugs, proteasome inhibitors, and recently approved immuno-oncology agents. Combinations with new agents like pomalidomide, carfilzomib, ixazomib, elotuzumab, and daratumumab have demonstrated improved survival in RRMM in clinical trials, specifically with continued treatment until disease progression, with an acceptable safety profile (Lonial S et al. N Engl J Med2015; Dimopoulos M et al. N Engl J Med2016; Palumbo A et al. N Engl J Med2016; Moreau P et al. N Engl J Med2016; Stewart AK et al. N Engl J Med2015; Dimopoulos M et al. Blood2012). Median duration of treatment (DoT) was described in the literature as 12.4 wk for pomalidomide plus low-dose dexamethasone, 68 wk for ixazomib plus lenalidomide/dexamethasone, 74 wk for elotuzumab plus lenalidomide/dexamethasone, and 88 wk for carfilzomib plus lenalidomide/dexamethasone (Lonial S et al. N Engl J Med2015; Moreau P et al. N Engl J Med2016; Stewart AK et al. N Engl J Med2015; Dimopoulos M et al. Blood2012). The actual DoT of these agents in clinical practice settings is not known and it is unclear if DoT is affected by safety concerns and/or might have an impact on patient (pt) outcomes. Here we provide real-world evidence of DoT and time to next therapy (TTNT) with each of these agents in an attempt to understand their potential for durability of response and tolerability.

This book is an upgraded edition of the one published in 1975. As stated in the foreword and in the introduction by the authors, the manual is based on repeated and "systematic anatomical study of cadaver material, normal subjects, patients and standard anatomy texts and manuals."The book is primarily intended for the electromyographer who performs needle EMG. The material is divided into nine sections on muscles of the shoulder, arm, forearm and hand, foot, leg, thigh, pelvis, and hip. Important muscles in each area are individually illustrated. Their innervation, origin, insertion, points of electrode insertion, and test maneuvers are briefly described. Pitfalls in electrode placement, relevant comments on innervation, and clinical significance of EMG results in pathological situations are also included.The strengths of the book are its brevity, clarity, and overall accuracy. It is a simple, practical anatomic guide to EMG of the limbs and deserves to be

This 672-page volume written by a single author contains 26 chapters in seven parts and three appendices. Part 1 deals with basic anatomy and physiology of the neuromuscular system and basics of electrodiagnosis, including recording apparatus. The next three parts contain nerve conduction studies, tests for neuromuscular transmission, and electromyography, including single-fiber electromyography. Part 5 contains reviews of blink reflex, F wave, H-reflex, and somatosensory evoked potentials. The disorders of the spinal cord, peripheral nervous system, neuromuscular junction, myopathies, and abnormal muscle activity are discussed in the last two parts. The appendices cover a historical review of electrodiagnosis, the fundamentals of electronics, instrumentation, and a glossary of terms approved by the American Association of Electrodiagnosis and Electromyography.The book is intended for practicing electromyographers and all those concerned with electrodiagnostic tests in clinical practice. The author's extensive experience in electrophysiological studies prompted him to write this book.The notable feature

Practical Electromyography is, "specifically directed to raising the level of everyday diagnostic electromyography... to establish an acceptable level of electrodiagnosis by those physicians who are 'into it,' " and the authors have unquestionably accomplished this goal. The volume is dedicated to the physiatrists who have trained at the Department of Physical Medicine and Rehabilitation at Ohio State University.The book's 17 chapters include one on the history of electrodiagnosis. Four chapters, "Electromyography Examination," "Radiculopathies," "EMG in Upper Motor Neuron Conditions," and "Interpretation and Reporting," were coauthored by the editor, Dr Johnson, professor and chairman of the aforementioned department.The book deals with the practical aspects of electrodiagnosis and electromyography in conditions seen in the day-to-day practices of busy physiatrists, neurologists, and other physicians. Descriptions of techniques are brief and adequate. The authors briefly review the anatomy and relevant theoretical aspects of each topic. Some techniques have been developed at Ohio

To the Editor.—Charles B. Clark, MD (241:801, 1979), describes symptoms and treatment of cubital tunnel syndrome. He mentions seven tests in diagnosing and localizing compression of the ulnar nerve. He states: "In my experience, these tests are more reliable than electrical studies, which include nerve conduction times and electromyography."The tests he briefly describes are useful in diagnosing cubital tunnel syndrome; however, they are not absolutely conclusive of the diagnosis. Nerve root compression and thoracic outlet syndrome involving C8-T1 segments can mimic some of the symptoms and signs he described in the article. These need to be excluded before submitting the patient for surgery. This can be done only by doing motor and sensory nerve conduction studies at various segments of the ulnar nerve (above, across, and below the elbow), F-wave latency and conduction velocity on both sides (if necessary), and electromyography. In addition, nerve conduction velocity studies and