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BackgroundTo compare the diagnostic performance of microbiological culture and 16S/18S rRNA gene polymerase chain reaction (PCR)-Sanger sequencing for infectious keratitis (IK) and to analyse the effect of clinical disease severity on test performance and inter-test concordance.MethodsThis was a three-arm, diagnostic cross-sectional study. We included all eligible patients who presented with presumed bacterial/fungal keratitis to the Queen's Medical Centre, Nottingham, UK, between June 2021 and September 2022. All patients underwent simultaneous culture (either direct or indirect culture, or both) and 16S (pan-bacterial)/18S (pan-fungal) ribosomal RNA (rRNA) PCR-Sanger sequencing. The bacterial/fungal genus and species identified on culture were confirmed using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry. Relevant clinical data were also collected to analyze for any potential clinico-microbiological correlation. Main outcome measures included the diagnostic yield, test accuracy (including sensitivity and specificity), and inter-test agreement [including percent agreement and Cohen's kappa (k)].ResultsA total of 81 patients (86 episodes of IK) were included in this study. All organisms identified were of bacterial origin. Diagnostic yields were similar among direct culture (52.3%), indirect culture (50.8%), and PCR (43.1%; p = 0.13). The addition of PCR enabled a positive diagnostic yield in 3 (9.7%) direct culture-negative cases. Based on composite reference standard, direct culture had the highest sensitivity (87.5%; 95% CI, 72.4–95.3%), followed by indirect culture (85.4%; 95% CI, 71.6–93.5%) and PCR (73.5%; 95% CI, 59.0–84.6%), with 100% specificity noted in all tests. Pairwise comparisons showed substantial agreement among the three tests (percent agreement = 81.8–86.2%, Cohen's k = 0.67–0.72). Clinico-microbiological correlation demonstrated higher culture-PCR concordance in cases with greater infection severity.ConclusionsThis study highlights a similar diagnostic performance of direct culture, indirect culture and 16S rRNA PCR for bacterial keratitis, with substantial inter-test concordance. PCR serves as a useful diagnostic adjuvant to culture, particularly in culture-negative cases or those with lesser disease severity (where culture-PCR concordance is lower).

Purpose: We aimed to determine whether Descemet's membrane (DM) scrolling occurs primarily along the vertical or horizontal axis and establish whether oval trephination along the axis of least scrolling can reduce the grade of the scroll. Methods: The longest limbus-to-limbus axis on 28 sclerocorneal discs was taken as the horizontal axis. The horizontal (n = 7) or (right angles to it) vertical (n = 6) axis was marked on DM before peeling it off. The direction and grade of scrolling was observed. Narrow strips (3–4 mm wide) were then cut along the two axes (n = 4 each) and the scrolling pattern was observed. Ellipses (7 × 9 mm) of DM were punched along the two axes (n = 6 each) and the scrolls graded. Immunofluorescent staining for elastin on horizontal and vertical tissue sections from three DM samples was performed. The intensity and thickness of elastin staining were measured. Results: Twenty-four (85.72%) DM samples showed scrolling along the horizontal axis, none showed scrolling along the vertical axis, and four (14.28%) samples showed a spiral scroll, regardless of which axis was marked (grade 3.7 and 3.6). Vertically oval discs showed significantly reduced scrolling (grade 1.2) compared to horizontally oval discs (grade 3.5). Narrow strips of DM showed a similar scrolling pattern. Immunohistology showed no difference in any of the parameters examined along the two axes or from the center to the periphery. Conclusion: DM scrolls primarily along the horizontal axis. Vertically oval DM samples show minimal scrolling, which can be an advantage in DMEK. Differential scrolling is not determined by the distribution of elastin.

This paper presents a new approach to estimate the probability of line-of-sight (LoS) for unmanned aerial vehicle (UAV) communications. We provide lower and upper bounds on the probability of LoS in terms of what we call the first-building-LoS probability. We provide a statistical model for the ground distance to the first building along the line from the user to the UAV. Based on this we provide a general formula for the first-building-LoS probability for urban environments where the building heights follow a Rayleigh distribution. We show that the first-building-LoS probability is a good estimate for the probability of LoS. Our closed-form formulas estimate the probability of LoS significantly more accurately than the existing approaches. We also obtain closed-form estimates of Area Line-of-Sight Probabilities for a scenario in which the UAV provides coverage to a circular region on the ground.

Sight is arguably the most important sense in human. Being constantly exposed to the environmental stress, irritants and pathogens, the ocular surface – a specialized functional and anatomical unit composed of tear film, conjunctival and corneal epithelium, lacrimal glands, meibomian glands, and nasolacrimal drainage apparatus – serves as a crucial front-line defense of the eye. Host defense peptides (HDPs), also known as antimicrobial peptides, are evolutionarily conserved molecular components of innate immunity that are found in all classes of life. Since the first discovery of lysozyme in 1922, a wide range of HDPs have been identified at the ocular surface. In addition to their antimicrobial activity, HDPs are increasingly recognized for their wide array of biological functions, including anti-biofilm, immunomodulation, wound healing, and anti-cancer properties. In this review, we provide an updated review on: (1) spectrum and expression of HDPs at the ocular surface; (2) participation of HDPs in ocular surface diseases/conditions such as infectious keratitis, conjunctivitis, dry eye disease, keratoconus, allergic eye disease, rosacea keratitis, and post-ocular surgery; (3) HDPs that are currently in the development pipeline for treatment of ocular diseases and infections; and (4) future potential of HDP-based clinical pharmacotherapy for ocular diseases.

One of the greatest challenges facing the medical community today is the ever-increasing trajectory of antimicrobial resistance (AMR), which is being compounded by the decrease in our antimicrobial armamentarium. From their initial discovery to the current day, antibiotics have seen an exponential increase in their usage, from medical to agricultural use. Benefits aside, this has led to an exponential increase in AMR, with the fear that over 10 million lives are predicted to be lost by 2050, according to the World Health Organisation (WHO). As such, medical researchers are turning their focus to discovering novel alternatives to antimicrobials, one being Host Defence Peptides (HDPs). These small cationic peptides have shown great efficacy in being used as an antimicrobial therapy for currently resistant microbial variants. With the sudden emergence of the SARS-CoV-2 variant and the subsequent global pandemic, the great versatility and potential use of HDPs as an alternative to conventional antibiotics in treating as well as preventing the spread of COVID-19 has been reviewed. Thus, to allow the reader to have a full understanding of the multifaceted therapeutic use of HDPs, this literature review shall cover the association between COVID-19 and AMR whilst discussing and evaluating the use of HDPs as an answer to antimicrobial resistance (AMR).

Background: Overprescribing of potentially harmful medication in UK general practice has a complex association with socioeconomic deprivation. Aim: To assess trends in general practice prescribing of five high-risk medications and their relationship with deprivation. Design & setting: An observational study was conducted using general practice data from three English regions with varied sociodemographic factors: West Yorkshire and Harrogate (WY), Black Country and West Birmingham (BC), and Surrey and East Sussex (SE). Method: Practice-level prescribing data were obtained from 2016–2021 for five drug classes: opioids, hypnotics, gabapentinoids, non-steroidal anti-inflammatory drugs (NSAIDs), and antibacterials. Prescribing trends were demonstrated using a linear model. Results: Reduction in NSAID, opioid, hypnotic and antibacterial prescriptions, and the increase in gabapentinoid prescriptions, were significant at each financial year time period. Index of Multiple Deprivation (IMD) was positively associated with all drug classes except antibacterials, which showed a positive association when incorporating the interaction term between IMD and age. When adjusting for IMD and population, region was independently associated with prescribing rate. Compared with WY, IMD had a smaller association with prescribing in BC for NSAIDs (coefficient = −0.01578, P = 0.004) and antibacterials (coefficient = −0.02769, P = 0.007), whereas IMD had a greater association with prescribing in SE for NSAIDs (coefficient = 0.02443, P<0.001), opioids (coefficient = 0.08919, P<0.001), hypnotics (coefficient = 0.09038, P<0.001), gabapentinoids (coefficient = 0.1095, P<0.001), and antibacterials (coefficient = 0.01601, P = 0.19). Conclusion: The association of socioeconomic deprivation with overprescribing of high-risk medication in general practice varies by region and drug type. Geographical location is associated with overprescribing, independent of socioeconomic status. [ABSTRACT FROM AUTHOR]

Background: COVID 19 resurgence in multiple waves and the highly infectious variant of SARS-CoV-2 (B.1.617) has wreaked havoc across healthcare systems in India. We conducted a study to delineate the clinico-epidemiological profile of COVID-19 patients in this second wave of the pandemic. Methods: This was a retrospective, single centre, observational study at the Emergency Department(ED) of a teaching institute in North India. The ED health records were screened for patient files with the diagnosis of COVID -19, age > 14 years, presenting from 10th April to 30th of May. ED clinical notes, disposition, and mortality data were retrieved and analysed. Results: 1647 files were screened and 253 eligible patients of COVID-19 were included in the study. 60% patients were male, mean age (+ SD) was 54 (+ 14.8 years). Shortness of breath (74.7%), fever (71.9%), cough (57.7%) were the common presenting symptoms. 20% of patients were nil comorbid; Diabetes (44.7%) and Hypertension (41.5%) were the common comorbid illnesses. 73.1% patients had severe COVID illness, 39.9% had oxygen saturation <90% on arrival and 33.2% had <70%. More than 90% patients required respiratory support on arrival. 25% of people presented to hospital after home isolation, of which 81% had severe COVID at presentation. 39 % patients of mild illness had received corticosteroids. Conclusion: The second wave of COVID-19 with rapid upsurge of cases overwhelmed the healthcare system with a higher proportion of severe COVID-19 cases and higher mortality, thus stressing the need for prior planning, preparation and strengthening healthcare systems across tiers. [ABSTRACT FROM AUTHOR]

Type1 diabetes mellitus, also known as juvenile diabetes is an autoimmune disorder. It is a chronic condition in which there is a destruction of pancreatic beta cells by autoimmune response. Here, a case of a 13-year-old girl, weighing 32 kg and with a Body Mass index (BMI) of 13.9 kg/m² was reported to the family medicine clinic with complaints of weakness, increased appetite and thirst, and increased frequency of micturition for the past two months. Personal history revealed a consistent weight loss over the past six months with the problem of lice in the hair from the past two months. A family history of diabetes, hypertension, and allergies was present. General physical examination reveals no abnormality and vitals were within normal limits. Blood investigations revealed increased levels of random blood sugar levels, glycated Haemoglobin (HbA1c) and Immunoglobulin (Ig)E. Hormonal assay was within normal limits, and skin prick test result revealed strong positive reactions to some allergens. The treatment included subcutaneous insulin, regular physical exercise and immunologic desensitisation of food allergens through Sublingual Immunotherapy (SLIT). The treatment resulted in controlled blood glucose levels with a reduction in insulin dose, a decrease in HbA1c levels, increased body weight and an improved BMI. [ABSTRACT FROM AUTHOR]

The efficient monitoring of the environment is currently gaining a continuous growing interest in view of finding solutions for the global pollution issues and their associated climate change. In this sense, two-dimensional (2D) materials appear as one of highly attractive routes for the development of efficient sensing devices due, in particular, to the interesting blend of their superlative properties. For instance, graphene (Gr) and graphitic carbon nitride g-C3N4 (g-CN) have specifically attracted great attention in several domains of sensing applications owing to their excellent electronic and physical-chemical properties. Despite the high potential they offer in the development and fabrication of high-performance gas-sensing devices, an exhaustive comparison between Gr and g-CN is not well established yet regarding their electronic properties and their sensing performances such as sensitivity and selectivity. Hence, this work aims at providing a state-of-the-art overview of the latest experimental advances in the fabrication, characterization, development, and implementation of these 2D materials in gas-sensing applications. Then, the reported results are compared to our numerical simulations using density functional theory carried out on the interactions of Gr and g-CN with some selected hazardous gases' molecules such as NO2, CO2, and HF. Our findings conform with the superior performances of the g-CN regarding HF detection, while both g-CN and Gr show comparable detection performances for the remaining considered gases. This allows suggesting an outlook regarding the future use of these 2D materials as high-performance gas sensors. [ABSTRACT FROM AUTHOR]

Retraction Note to: Development of high-performance flexible and stretchable sensor based on secondary doped PEDOT-PSS:TiO2 nanocomposite for room-temperature detection of nitric oxide 2(c) "PEDOT-PSS: PVA doped TiO SB 2 sb (8wt.%) thin" in another article by the same author group [[1]]. Mohammed Imran, Syed Khasim and Apsar Pasha disagree to this retraction. [Extracted from the article]