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Artificial learning (AI) is one of the areas of computer science which develops the system in a way that our system starts learning and gives the reaction as a human brain does. This paper discussed one of the branches of AI i.e. Machine learning as the name suggests it focuses on the development of the computers especially their programs that access the data that can be used for self-development. The main objective of the paper is to compare the best machine learning model by using the performance parameter R squared and Mean square Error (MSE). The data set was taken from the promise repository for the analysis. Feature selection technique Boruta was applied to find the important/confirmed variables from the dataset which are having information regarding the JAVA projects. This paper finds out that among different algorithms which one outperforms when the comparative analysis was done to find the best model.

Background: Cytokines are major immune regulators, which play a critical role in the pathophysiology of unexplained recurrent pregnancy loss. Th1 class of cytokines has been shown to exert deleterious effects on pregnancy causing early loss.Methods: The changeover in the levels of Th1 cytokines was studied in two major groups; Gp I (N=30) comprised of RPL subjects with two or more consecutive spontaneous miscarriages history and Gp II (N=30) comprised of normal pregnancy controls .The efficacy of oral micronized progesterone was assessed in regulation of cytokine levels ,with Gp Ia (N=15) treated with 200 mg oral micronized progesterone and Gp Ib (N=15) comprised of untreated RPL subjects and its role in improving pregnancy outcome was also determined. The present study determined the levels of cytokine TNF-α, IL-6 and PTX-3 in serum samples for all the subjects at three time points at the time of enrolment, with (GpIa) or without (Gp Ib) progesterone administration at 20 weeks or abortion if earlier and at the time of delivery. Results: The results indicated that the levels of Th1 cytokines (TNF-α [37.80 versus 78.09], IL-6 [16.93 versus 81.12] and PTX-3 [17.42 versus 73.53]) was found to be reduced at every time point in the treated cases with an RPL history as compared to untreated ones. Further, the cases treated with with oral micronized progesterone were found to have better pregnancy outcomes (p

Introduction: The shift from the physical to virtual communication has been emerged as a vital platform to interact through technology. Apart from the positive influences, it is also affecting the adolescents in negative manner which leads to various health hazards. All governments are committed to the ambitious sustainable development agenda and its goals, in particular SDG target 16.2 to end abuse, exploitation, trafficking and all forms of violence against and torture of children. Despite the alarming situation and commitment, there is apathy towards coining the specific laws against cybercrime amongst adolescents. Methodology: A questionnaire based cross-sectional survey method was used for data collection from the adolescents who are using mobile phones since last one year and presented in outdoor pediatric department. The study was also conducted in two schools from urban and rural locations at Lucknow district during study period. Results: In the studied population of 900 students, the maximum students 606(67.3%) were from 16-18 years of age and simple mobile users were more 505(56.1%) in number when compared. the prevalence of bullied students were females 269(29.8%) and males 381(42.3%). Maximum bullied students were of age 16-18 years. As per the mode of assault sending inappropriate SMS 378 (58.1%) on mobile was outrageous than any other method. The assault was shared mainly with friends. Conclusion: Our results reflect that the prevalence of violence amongst adolescents have reached up to a point of saturation where it is mandatory to correct their attitude to avoid any unwanted happening. Apart from the surveillance of the mobile use this is our prime duty to monitor the activities of teens on internet and develop safe cyber space.

IMPORTANCE Studies evaluating combined penetrating keratoplasty and pars plana vitrectomy for infectious aetiologies are limited. BACKGROUND To evaluate the outcomes of combined penetrating keratoplasty and pars plana vitrectomy in patients with endophthalmitis and poor corneal clarity. DESIGN Retrospective interventional case series conducted at a tertiary care eye hospital in North India. PARTICIPANTS Review of records of 43 eyes of 43 patients. Mean age of patients was 53.39 ± 12.94 years (26 males). Patients with age > 14 years with minimum follow-up of 6 months were included. METHODS Combined penetrating keratoplasty and pars plana vitrectomy was performed in all eyes. MAIN OUTCOME MEASURES We analysed the preoperative, intraoperative and microbiological characteristics of patients undergoing combined surgeries. Anatomic and functional success and failure were pre-defined. RESULTS Aetiology for corneal opacification was corneal ulcer in 30(69.7%) eyes, corneal graft infection in eight(18.6%) eyes, bullous keratopathy in four (9.3%) eyes and corneal scar in one eye. Postoperative visual acuity improved in 20(46.5%) eyes, did not change in 14 (32.5%) eyes and deteriorated in nine eyes (20.9%). Anatomical failure (uncontrolled infection leading to phthisis bulbi or evisceration) was seen in 15 (34.8%) eyes. Microbiological analysis revealed bacterial growth in 26, fungal in 14 and no growth in three eyes. Fungal infection had a poorer outcome (P = 0.03). Six out of 11 monoocular patients regained ambulatory vision. CONCLUSIONS AND RELEVANCE Combined penetrating keratoplasty and pars plana vitrectomy is a complex but globe salvaging procedure for poor prognosis eyes which otherwise may need evisceration. Fungal infection carries a poorer prognosis.

Purpose The purpose of this paper is to examine the potential impact of organisational talent management practices on perceived employer branding. Talented employees are the lifeline of any organisation who contribute effectively to the organisation’s success. Talented workforce and their organisational attraction to remain productive act as a primary competitive enabler for the organizational performance. Employer branding now becomes a key factor to achieve success in business which engenders cognitive and emotional association along with positive involvement at workplace among organizational members. In the context of economic competitiveness and globalisation, employers are experiencing challenge in attracting and retaining talented workers. Design/methodology/approach This paper uses quantitative design; questionnaire survey method was used for assessing the organisational talent management and employer branding. Data have been collected through a sample of 232 executives’ class employees from various coal and iron mining industries located in Indian subcontinents. Finally, 197 responses were found to be acceptable for analysis. Hypotheses were tested using a comparison of means, correlations and multiple regression analysis. Findings Findings of the paper show that organisational talent management is strongly and positively with the perceived employer branding. Regression analysis showed that among the eight dimensions of organisational talent management, the predictors that are most effective in predicting the employer branding are, namely, rewards and remunerates fairly, manages work–life balance and attracts and recruits talent. Research limitations/implications This paper was limited by a small sample size and the use of a cross-sectional design is not done. On the ground of analysis, more specific approach is required to apply the findings to the general population. Originality/value Much of the work on employer branding is conceptual based on marketing principle and limited to deal with potential employees. This paper provides empirical evidence from the internal/current employees’ perspective, by investigating the relationship between organisational talent management practices and organisational attraction internally, that is, perceived employer branding. Present paper contributes significantly to the implication and understanding of social exchange theory, internal branding theory and social identity theory in organisational setting (Eisenberger et al., 1986; Liden et al., 1997; Masterson et al., 2000; Settoon et al., 1996; Wayne et al., 1997).

Background Epidemiological studies have shown Per- and polyfluoroalkyl substances (PFAS) to be associated with diseases of dysregulated lipid and sterol homeostasis such as steatosis and cardiometabolic disorders. However, the majority of mechanistic studies rely on single chemical exposures instead of identifying mechanisms related to the toxicity of PFAS mixtures. Objectives The goal of the current study is to investigate mechanisms linking exposure to a PFAS mixture with alterations in lipid metabolism, including increased circulating cholesterol and bile acids. Methods Male and female wild-type C57BL/6J mice were fed an atherogenic diet used in previous studies of pollutant-accelerated atherosclerosis and exposed to water containing a mixture of 5 PFAS representing legacy, replacement, and alternative subtypes (i.e., PFOA, PFOS, PFNA, PFHxS, and GenX), each at a concentration of 2 mg/L, for 12 weeks. Changes at the transcriptome and metabolome level were determined by RNA-seq and high-resolution mass spectrometry, respectively. Results We observed increased circulating cholesterol, sterol metabolites, and bile acids due to PFAS exposure, with some sexual dimorphic effects. PFAS exposure increased hepatic injury, demonstrated by increased liver weight, hepatic inflammation, and plasma alanine aminotransferase levels. Females displayed increased lobular and portal inflammation compared to the male PFAS-exposed mice. Hepatic transcriptomics analysis revealed PFAS exposure modulated multiple metabolic pathways, including those related to sterols, bile acids, and acyl carnitines, with multiple sex-specific differences observed. Finally, we show that hepatic and circulating levels of PFOA were increased in exposed females compared to males, but this sexual dimorphism was not the same for other PFAS examined. Discussion Exposure of mice to a mixture of PFAS results in PFAS-mediated modulation of cholesterol levels, possibly through disruption of enterohepatic circulation.

In Artificial Intelligence, the machine modeling technique means to behave in the manner of human reflects indistinguishable. To automatizes the development of rational model for data evaluation, machine learning mechanism of artificial intelligence, is used. Deep learning is the machine learning discipline, having objective to imbide the system and to discover pattern from input. In pattern recognition, deep learning has paramount importance and different advance powerful model’s architecture. The most effective, vital, and influential innovation in computer vision discipline is one of the architectures of deep learning called convolutional neural network. In this neural network various optimizers can be used for model molding into its appropriate form by weights futzing. Aiming to overcome the problem in getting the optimized result, the research used various algorithms of weight optimization. The article elaborates convolutional network concept as well as the idea behind the use of optimizers. Furthermore, the detailed study of optimizers is also presented in this paper. Along with it, experimental comparison and result of different learning paradigm optimizers is shown in the document. Considering the different image datasets, including MNIST, and CIFAR 10 dataset, the accuracies of convolutional model with different optimizers are verified.

PURPOSE: To analyze the role of polymerase chain reaction (PCR) of ocular fluids in management of tubercular (TB) anterior, intermediate, posterior, and panuveitis. METHODS: In Collaborative Ocular Tuberculosis Study (COTS)-1 (25 centers, n = 962), patients with TB-related uveitis were included. 59 patients undergoing PCR of intraocular fluids (18 females; 53 Asian Indians) were included. RESULTS: 59 (6.13%) of COTS-1 underwent PCR analysis. PCR was positive for Mycobacterium TB in 33 patients (23 males; all Asian Indians). 26 patients were PCR negative (18 males). Eight patients with negative PCR had systemic TB. Anti-TB therapy was given in 18 negative and 31 PCR cases. At 1-year follow-up, five patients with positive PCR (15.15%) and three with negative PCR (11.54%) had persistence/worsening of inflammation. CONCLUSIONS: Data from COTS-1 suggest that PCR is not commonly done for diagnosing intraocular TB and positive/negative results may not influence management or treatment outcomes in the real world scenario.

Indonesia and Malaysia have a combined population of ~225 million Muslims. Little academic work has been conducted on their motives for nonpilgrimage, leisure-based travel. Building on the travel career pattern approach for assessing tourist motivation, the this study sought to uncover the motivational patterns of Muslim tourists in this part of Southeast Asia. A combined total of 356 respondents from the two countries were sampled and the patterns of tourist motives between these Muslim tourists and data from previous studies of Western tourists were compared. Comparisons between the Malaysian data and the Indonesian data were also undertaken. The special importance of relationships, nature appreciation, and safety in the Muslim data compared to responses from Western respondents was identified. Close parallels between the Malaysian and Indonesian Muslim motivation patterns were found. The results were interpreted as highly consistent with Islamic teaching and the collectivist culture of the two communities.

PURPOSE To evaluate changes in foveal and parafoveal thickness measured using optical coherence tomography across five stages of macular telangiectasia 2 (MacTel 2) and to correlate the foveal slope angle with best-corrected visual acuity (BCVA). METHODS A multicentered, cross-sectional study of 90 patients with bilateral MacTel 2 was carried out. We reviewed medical records of patients who had undergone optical coherence tomography. Mean retinal thickness foveal and subfoveal were noted from ETDRS (Early Treatment Diabetic Retinopathy Study) mapping and later used for calculating foveal slope angle. The change in retinal thickness and foveal angle across five stages of MacTel 2 was assessed. Central foveal thickness and foveal slope angle were correlated with BCVA. RESULTS The foveal slope angles were calculated quadrantwise and stagewise. The mean slope angle was minimum in temporal quadrant (6.29°) followed by inferior (7.13°), superior (7.54°), and nasal (7.93°). The slope angles were 9.27°, 7.95°, 6.70°, 6.10°, and 6.31° in Stages 1, 2, 3, 4, and 5, respectively. Statistically significant correlation noted between the temporal, superior, inferior slope angles and BCVA (in logarithm of the minimum angle of resolution) with r = -0.18, -0.19, and -0.25, respectively (P < 0.05). No statistically significant correlation was noted between central retinal thickness and BCVA. CONCLUSION The BCVA correlates better with slope angles than central retinal thickness. This implies that, change in both foveal and parafoveal regions accounts for vision change. Greater the foveal slope angle, the better the vision.

Purpose: To report the morphological and vascular characteristics using funduscopic and angiographic features in different cohort as stratified by stages of macular telangiectasia type 2 (MacTel 2). Methods: A cross-sectional, multicentered study of 149 eyes (75 patients) with MacTel 2 was done. The eyes were divided into 2 groups: early group which includes eyes with stages 1 (40 eyes), 2 (41 eyes), and 3 (32 eyes) of MacTel 2 and late group which includes eyes with stages 4 (13 eyes) and 5 (23 eyes) of MacTel 2. The morphological and vascular characteristics on fundus examination and fluorescein angiography (FA) were studied in both groups and their association was found. Results: The gender (female: odds ratio [OR] = 4.98, P = .040), presence of dilated parafoveal capillaries (OR = 2.668, P = .026), retinal pigment plaques (OR = 27.067, P = .0001), patchy choroidal filling in FA (OR = 3.536, P = .004), and presence of prominent arteriole (OR = 3.434, P = .002) were associated with late stages of MacTel 2. Conclusion: Presence of retinal pigment plaques, dilated parafoveal capillaries, patchy choroidal filling, and female gender are more likely to be associated with late-stage disease.

Introduction: Approximately three-quarters of adolescents experience some type of victimization, either in school or as a whole in society. Their mental acumen is not strong enough due to various reasons to resolve this age-related crisis and pushing them in a web of stress. The attitude of victim is influenced by his self-social image, personality and behavior which provide the space to the perpetrator of the offence. Materials and Methods: A cross-sectional survey, using a pretested self-report questionnaire was conducted on 960 students aged 10–18 years of urban schools regarding the indulgence in violence as victims during the last one year. Observations: The prevalence of victimization was 18.33% while in male and female it was 59.09% and 40.90% in their respective groups. Parents possessing education less than high school produce the highest numbers of victims. 65.34% victims were staying with both parents and 19.88%, 63.63%, 55.11% and 35.79% were in habit of smoking, alcohol and tobacco use respectively. Discussion and Conclusion: Research studies have shown that the behavior can be modified and the proneness factors can be reduced or eliminated. Every child’s individuality should be appreciated for the value, rather than suppressed to reduce the risk of victimization. Not all children are able to alter their personal characteristics that may place them at increased risk. To benefit the society, the segregation and counselling of such students at school level is the only answer of this problem.

Progressive pulmonary fibrosis is a devastating consequence of many acute and chronic insults to the lung. Lung injury leads to alveolar epithelial cell (AEC) death, destruction of the basement membrane, and activation of transforming growth factor-β (TGF-β). There is subsequent resolution of the injury and a coordinated and concurrent initiation of fibrosis. Both of these processes may involve activation of similar intracellular signaling pathways regulated in part by dynamic changes to the extracellular matrix. Matrix signaling can augment the profibrotic fibroblast response to TGF-β. However, similar matrix/integrin signaling pathways may also be involved in the inhibition of ongoing TGF-β-induced AEC apoptosis. Focal adhesion kinase (FAK) is an integrin-associated signaling molecule expressed by many cell types. We used mice with AEC-specific FAK deletion to isolate the epithelial aspect of integrin signaling in the bleomycin model of lung injury and fibrosis. Mice with AEC-specific deletion of FAK did not exhibit spontaneous lung injury but did have significantly greater terminal deoxynucleotidyl transferase dUTP-mediated nick-end labeling-positive cells (18.6 vs. 7.1) per ×200 field, greater bronchoalveolar lavage protein (3.2 vs. 1.8 mg/ml), and significantly greater death (77 vs. 19%) after bleomycin injury compared with littermate control mice. Within primary AECs, activated FAK directly associates with caspase-8 and inhibits activation of the caspase cascade resulting in less apoptosis in response to TGF-β. Our studies support a model in which dynamic changes to the extracellular matrix after injury promote fibroblast activation and inhibition of epithelial cell apoptosis in response to TGF-β through FAK activation potentially complicating attempts to nonspecifically target this pathway for antifibrotic therapy.

The purpose of the study was to examine the differences in perceptions of motivation to lead, mental health, and job satisfaction of male and female police constables. Police constables (N = 203, male = 144, female = 59) were surveyed at four districts (Varanasi, Mirzapur, Allahabad and Lucknow) in the state of Uttar Pradesh, Republic of India. Participants’ responses were obtained on questionnaires which measured demographic characteristics, motivation to lead (Dubrin, 1998), psychological well-being, psychological distress (Heubeck & Neill Psychological Reports, 87:431–440, 2000), and job satisfaction (Dantzker’s Journal of Crime and Justice 16:171–181, 1993). Results of t test analysis indicated that job experience, salary, education, motivation to lead, and psychological well-being were significantly different among the male and female police constables. Motivation to lead was a significantly positive correlate of job satisfaction among male participants only while psychological well-being was significantly, positively correlated with job satisfaction of both male and female participants. Psychological well-being also exercised partial mediator effects on the positive relationship between “motivation to lead” and job satisfaction in male police constables only. However, psychological distress was negatively correlated with job satisfaction of male police constables. The findings have significant implications for increasing job satisfaction in the police department. Findings indicate that the government should concentrate on removing anomalies in the job conditions of the female police constables so as to promote psychological well-being. Simultaneously, the police department should also pay attention to conditions which can increase motivation to lead among its female police constables.

Introduction: Nocardia is a common cause of corneal infections but is a rare cause of choroidal abscess. We report a rare case of choroidal abscess, secondary to Nocardia and its management.Case: We report a case of choroidal abscess secondary to Nocardia asteroides species in an immunocompetent young male diagnosed by culture positivity of vitreous biopsy. He was managed by oral trimethoprimsulfamethoxazole and intravitreal Amikacin injections.Conclusion: All the previous reported cases were found to be immunocompromised patients. However, our patient was immunocompetent and the confirmation of diagnosis was done by culture of vitreous biopsy in comparison to a retinochoroidal biopsy, in all other previous cases.

Background Scleral buckling is an established modality of treating retinal detachment. Being an external implant the buckle may be prone to infections. We report such a case with a delayed presentation and a rare etiology. Case presentation A 45 year old male presented with redness, foreign body sensation and discharge for one month in his right eye. The patient had undergone a retinal detachment surgery elsewhere 14 years back without any visual gain. Right eye demonstrated no perception of light and the best corrected visual acuity in the left eye was 6/6, N6. On downgaze an exposed and anteriorly displaced scleral buckle was identified with black deposits and mucopurulent material overlying the buckle. Scleral buckle removal was done. On microbiological examination Curvularia species was identified. Successful treatment with antifungals was done. Conclusions Scleral buckle infection with dematiaceous fungi is a rare occurrence. To the best of our knowledge this is the first case report describing a buckle infection caused by the curvularia species.

Purpose: To standardize a nomenclature system for defining clinical phenotypes, and outcome measures for reporting clinical and research data in patients with ocular tuberculosis (OTB).Methods: Uveitis experts initially administered and further deliberated the survey in an open meeting to determine and propose the preferred nomenclature for terms related to the OTB, terms describing the clinical phenotypes and treatment and reporting outcomes.Results: The group of experts reached a consensus on terming uveitis attributable to tuberculosis (TB) as tubercular uveitis. The working group introduced a SUN-compatible nomenclature that also defines disease "remission" and "cure", both of which are relevant for reporting treatment outcomes.Conclusion: A consensus nomenclature system has been adopted by a large group of international uveitis experts for OTB. The working group recommends the use of standardized nomenclature to prevent ambiguity in communication and to achieve the goal of spreading awareness of this blinding uveitis entity.

A 43-year-old male with chronic Vogt–Koyanagi–Harada syndrome (VKH) presented with subfoveal choroidal neovascular membrane (CNVM) in the right eye with no evidence of active inflammation. He underwent intravitreal bevacizumab and dexamethasone injections. Postinjection he developed fresh keratic precipitates and exudative retinal detachment (RD). He received two more bevacizumab injections with oral corticosteroids and immunosuppressants causing resolution of exudative RD with scarred CNVM. We report this case to highlight that intravitreal injection may act as a trigger for rebound inflammation in VKH patients and may require anti-inflammatory drugs to be started even in the absence of an active inflammation.

Background: Tuberculosis (TB) is a major infection that can affect the eye as first and sole presentation without features of systemic disease. Controversy exists regarding diagnosis and management of tubercular uveitis (TBU), further compounded by regional variations in disease expression. Purpose: Collaborative Ocular Tuberculosis Study (COTS)-1 aims to address knowledge deficits through collaboration amongst uveitis specialists across the globe by sharing the data of patients with TBU presented at participating centers from January 2004 to December 2014. Methods: Data collection was facilitated by a novel method of real-time encrypted web-based data entry allowing regular updates as new data and recommendations become available. Results: Information on clinical features, investigation findings, management, and treatment outcomes were reviewed to get an idea about real world scenario. Conclusion: The current review aims to focus on methodology and briefing of published reports from COTS group in COTS-1 study to highlight key messages from this large data.

The choroid is one of the most vascularized structures of the human body and plays an irreplaceable role in nourishing photoreceptors. As such, choroidal dysfunction is implicated in a multitude of ocular diseases. Studying the choroid can lead to a better understanding of disease pathogenesis, progression and discovery of novel management strategies. However, current research has produced inconsistent findings, partly due to the physical inaccessibility of the choroid and the lack of reliable biomarkers. With the advancements in optical coherence tomography technology, our group has developed a novel quantitative imaging biomarker known as the choroidal vascularity index (CVI), defined as the ratio of vascular area to the total choroidal area. CVI is a potential tool in establishing early diagnoses, monitoring disease progression and prognosticating patients. CVI has been reported in existing literature as a robust marker in numerous retinal and choroidal diseases. In this review, we will discuss the current role of CVI with reference to existing literature, and make postulations about its potential and future applications.

Background: To study and analyse the factors affecting the proportion of retinopathy of prematurity (ROP) distribution between the urban and semi-urban regions in North India. Methods: Retrospective, observational, cross-sectional study. All babies referred for ROP examination by paediatricians or other general ophthalmologists between 2013 – 2016 were included in the study. Demographic, clinical and treatment related findings were recorded. Results: Five hundred and fifty-eight (467: urban & 91: semi urban) babies were examined for ROP. The mean birth weight in the urban and semi-urban setting was 1348.6 ± 395.21 gm and 1703.77 ± 401.76 gm respectively. The mean gestational age was 30.99 ± 2.93 weeks and 30.73 ± 2.08 weeks in the urban and semi-urban cohorts respectively. The average time for first ophthalmic examination following birth was 23.82 ± 13.69 (range: 3-77) days in the urban and 101.16 ± 238.26 (range: 13- 330) days in the semi-urban setting. 94% of the babies completed all screening examination visits. Any ROP was identified in 11.6% and 33.0% of the urban and semi-urban cohorts respectively; Type 1 was detected in 7.5% of urban babies and 23.1% of semi-urban babies Conclusion: Differences in the proportion of babies developing any ROP and Type 1 ROP between the semi-urban and urban groups is likely due to selection bias, as a high proportion of semi-urban babies did not attend for examination or failed to complete all the examinations necessary. This was particularly true for females. More needs to be done to increase access to regular, systematic screening of preterm babies within neonatal units.

Background Acute lymphoblastic leukemia (ALL) is a heterogeneous disorder with coexistence of multiple clones. The mortality rate in children with ALL has reduced to 15% to 20% in developed countries. However, it continues to be high in India (25%-35%), which may be attributed to ethnic variation and differences in disease biology. The treatment and outcome in ALL are dependent on risk stratification, which is derived from prognostic factors like leukocyte count, age at diagnosis, immunophenotypic subtypes and, most importantly, cytogenetic alterations. Chromosomal rearrangements are important initiating events in leukemogenesis. Approximately, 75% of children with ALL harbor a recurring chromosomal alteration detectable by karyotyping, fluorescence in situ hybridization, or other molecular techniques. The present study was planned to compare the prevalence of various cytogenetic alterations with western. literature and to see the association of these cytogenetic alterations with other prognostic factors as well as survival outcome. Methods We enrolled, 117 children of 1 to 14 years of age with newly diagnosed B-cell ALL from August 2014 to Mar 2016 prospectively. Patients were monitored for response to prednisolone, postinduction complete morphological remission minimal residual disease assessment, and were followed for a minimum 2 years. Results and Discussion We observed that poor-risk cytogenetic alterations were more prevalent, whereas good-risk cytogenetic alterations were less frequent in our patient cohort as compared with western studies. Conclusions We observed that event-free survival is significantly less in those with poor-risk cytogenetics. We have also highlighted nonrecurrent alterations observed in our study group.

Purpose Subtenon triamcinolone acetonide injection (STAI) is a safe drug delivery method for various ocular conditions. We report two cases of necrotic scleral melt, a rare complication of STAI. Methods The first patient received STAI for post-operative inflammation control and developed necrotic scleral melt at the site of STAI with superadded fungal keratitis. The second patient received three STAI for non-necrotizing, non-infectious anterior scleritis and developed scleral necrosis at the site of her last STAI. Noncompliance with medications resulted in the progression of scleral necrosis to a new area. Results In the first patient, surgical removal of triamcinolone deposit resulted in healing of the scleral melt while the second patient was managed conservatively with corticosteroids and immunosuppressants. Conclusion Scleral melt is a rare complication of STAI; however, an early diagnosis and management of any predisposing factor along with surgical debridement should be considered as a potential critical treatment option to salvage the eye.

The process of gaining knowledge from enormous amount of data is called data mining. This paper uses the Weka tool to compare different types of classification methods. Decision tree, Multilayer perceptron, Naive Bayes, J48 algorithms are used for classification analysis in terms of correctly and incorrectly classified instances and Area of ROC curve. Test option selected is cross validation with 10 folds. Datasets used breast cancer, diabetes from health care industry. In health care industry huge data is available but not so much knowledge extracted.

Purpose To evaluate the anatomical and functional outcome of patients with traumatic submacular hemorrhage (SMH). Methods A retrospective, interventional case series of patients presenting between January 2016 and April 2018 was carried out at 4 tertiary eye care centers of India. Medical records of the patients with a history of blunt trauma and SMH were retrospectively reviewed. The intervention done was any one of the following: pneumatic displacement with 0.3 ml of intravitreal gas [100% perfluoropropane (C3F8) gas], pneumatic displacement with intravitreal 0.3 ml of 100% C3F8 gas combined with 100 μg/0.1 ml of recombinant tissue plasminogen activator (r-tpa), pars plana vitrectomy (PPV) with subretinal r-tpa and gas tamponade. The primary outcome measures included change in visual and anatomical status. Results Twenty eyes of 20 patients with blunt trauma were analyzed. Thirteen patients had small size SMH, 5 patients had medium size SMH, and 2 patients had massive size SMH. Sixteen patients had a favorable functional outcome, and eighteen patients had favorable anatomical outcome. The size and duration of post-traumatic SMH did not significantly affect the anatomical (P = 0.123) or functional (P = 0.293) outcome in our study. The patients who presented with initial visual acuity of 6/60 or better showed better functional outcome, which was statistically significant (P = 0.007). Conclusion Minimally non-invasive procedure including intravitreal r-tpa and gas appear to be effective in the displacement of post-traumatic SMH.

Background Tinea corporis, a superficial dermatophyte, is a fungal infection of the body. Ocular involvement due to dermatophytes can present as eyelid infestation. Various cases of retinochoroiditis have been reported secondary to infective etiology such as Toxoplasma gondii, Candida albicans, Trichosporon beigelii, and Sporotrichum schenkii. However, retinochoroiditis secondary to fungal infection of the skin caused by T. corporis has not been reported in the past. Findings A 45-year-old female presented with blurring of vision in the left eye for the last 20 days with a history of very severe itching on the abdomen and back. She had been diagnosed to have T. corporis infection by a dermatologist in the past, however, was non-compliant with the treatment. Anterior segment was within normal limits. Fundus examination of the right eye was normal and left eye showed a diffuse yellowish retinochoroiditis patch with irregular margins at the inferotemporal arcade. Optical coherence tomography (OCT) of the left eye through the macula showed shallow subretinal fluid with hyperreflective dots and passing through the retinochoroitidis patch showed increased retinal thickening with a pigment epithelial detachment and subretinal fluid. Left eye fundus fluorescein angiography (FFA) showed three hyperfluorescent areas along the inferotemporal arcade increasing in size and intensity with blurring of margins in the late phases. She had extensive reddish color erythematous plaque-like skin lesions over the abdomen and back. Treatment with oral itraconazole resulted in complete resolution of retinochoroiditis. Itraconazole is an orally active, triazole anti-fungal agent found to be effective in the management of dermatomycosis. Conclusion We report this case to highlight that one must rule out an infective etiology of retinochoroiditis before starting oral corticosteroids as it may worsen the infection especially fungal as in our patient. A detailed medical history and thorough examination helped us in diagnosing a systemic infective pathology and the possible cause of retinochoroiditis. To the best of our knowledge, this is the first case of infective retinochoroiditis secondary to T. corporis to be reported.

Background To study and analyse the factors affecting the prevalence of prevalence of retinopathy of prematurity (ROP) between the urban and semi-urban regions in North India. Methods Retrospective, observational, cross-sectional study. All babies referred for ROP screening by paediatricians or other general ophthalmologists between 2013 – 2016 were included in the study. Demographic, clinical and treatment related findings were recorded. Results Five hundred and fifty-eight (467: urban & 91: semi urban) babies were screened for ROP. The mean birth weight in the urban and semi-urban setting was 1348.6 ± 395.21 gm and 1703.77 ± 401.76 gm respectively. The mean gestational age was 30.99 ± 2.93 weeks and 30.73 ± 2.08 weeks in the urban and semi-urban cohorts respectively. The average time for first ophthalmic examination following birth was 23.82 ± 13.69 days in the urban and 101.16 ± 238.26 days in the semi-urban setting. Prevalence of ROP in the urban cohort was 11.7% and in the semi-urban cohort was 31.9%. Statistically significance between the two groups was noted with birth weight, day of screening and prevalence but not with gender or gestational age. Conclusion The prevalence of ROP is found to be higher in the semi-urban setting due to delayed screening, higher drop-out rate and lack of basic treatment facilities like laser.

Protein phosphatase 2A (PP2A), a ubiquitously expressed Ser/Thr phosphatase is an important regulator of cytokine signaling and cell function. We previously showed that myeloid-specific deletion of PP2A (LysMcrePP2A−/−) increased mortality in a murine peritoneal sepsis model. In the current study, we assessed the role of myeloid PP2A in regulation of lung injury induced by lipopolysaccharide (LPS) or bleomycin delivered intratracheally. LysMcrePP2A−/− mice experienced increased lung injury in response to both LPS and bleomycin. LysMcrePP2A−/− mice developed more exuberant fibrosis in response to bleomycin, elevated cytokine responses, and chronic myeloid inflammation. Bone marrow-derived macrophages (BMDMs) from LysMcrePP2A−/− mice showed exaggerated inflammatory cytokine release under conditions of both M1 and M2 activation. Notably, secretion of IL-10 was elevated under all stimulation conditions, including activation of BMDMs by multiple Toll-like receptor ligands. Supernatants collected from LPS-stimulated LysMcrePP2A−/− BMDMs induced epithelial cell apoptosis in vitro but this effect was mitigated when IL-10 was also depleted from the BMDMs by crossing LysMcrePP2A−/− mice with systemic IL-10−/− mice (LysMcrePP2A−/− × IL-10−/−) or when IL-10 was neutralized. Despite these findings, IL-10 did not directly induce epithelial cell apoptosis but sensitized epithelial cells to other mediators from the BMDMs. Taken together our results demonstrate that myeloid PP2A regulates production of multiple cytokines but that its effect is most pronounced on IL-10 production. Furthermore, IL-10 sensitizes epithelial cells to apoptosis in response to myeloid-derived mediators, which likely contributes to the pathogenesis of lung injury and fibrosis in this model.

Pulmonary alveolar microlithiasis (PAM) is a rare entity, presenting mostly as an incidental finding. This disease has an autosomal recessive inheritance with inactivating mutations in the gene “solute carrier family 34 member 2”. The present study was conducted to bring attention to this rare though preventable disease. The study was a cross-sectional descriptive study, conducted at the Department of Pathology, of a tertiary care hospital in New Dehli-India. PAMs were incidentally seen in two patients diagnosed with micronodular hepatic cirrhosis leading to reanalysis of 212 autopsies, retrospectively. Statistical analysis was done using Stata 14.0. We observed three forms (Type A, B and C) of round hyaline bodies measuring in 200-800µm diameter with thin delicate, radiating fibrils. These bodies were PAS positive, showed black discolouration of the pigment with von Kossa stain and birefringence on polarized microscopy using Congo red stain, however the refringence was light green as compared to apple green birefringence seen with amyloid deposition. PAM has a slow progressive course leading to a high rate of incidental detection. Drugs known to inhibit the micro-crystal growth of hydroxyapatite may slow the disease progression. The family members of patients with PAM may also be kept on follow up with regular imaging. Key messages: It is important to bring out the incidental finding as, seemingly innocuous observations may provide valuable insight into incurable diseases, especially rare diseases.

A male patient underwent an uneventful cataract surgery. He developed fungal postoperative endophthalmitis by Scedosporium apiospermum species. This fungus is a common cause of endogenous endophthalmitis in immunocompromised patients with poor visual outcomes. We report this case to share our experience of managing fulminant postoperative endophthalmitis with an iris fungal ball in an immunocompetent patient caused by S. apiospermum.

Purpose: The aim of this study was to report visual and anatomical outcomes following treatment for diabetic macular edema (DME) in clinical practice in India. Methods: Retrospective chart review of patients with DME who were initiated on treatment and followed up for at least 1 year at 9 tertiary eye care centers during 2016–2017 was performed. Data on demographics, systemic illnesses, visual acuity and anatomical characteristics of DME, treatment history were collated and analyzed for change in visual acuity level and central macular thickness at 1 year. Results: A total 1853 patients were diagnosed with treatable DME during study period, 1315 patients were treated and 556 patients (1019 eyes) followed up at one year. Although patients achieved significantly better anatomical outcome (central macular thickness of

Transforming growth factor-β (TGF-β) is a critical driver of acute lung injury and fibrosis. Injury leads to activation of TGF-β, which regulates changes in the cellular and matrix makeup of the lung during the repair and fibrosis phase. TGF-β can also initiate alveolar epithelial cell (AEC) apoptosis. Injury leads to destruction of the laminin-rich basement membrane, which is replaced by a provisional matrix composed of arginine-glycine-aspartate (RGD) motif-containing plasma matrix proteins, including vitronectin and fibronectin. To determine the role of specific matrix proteins on TGF-β-induced apoptosis, we studied primary AECs cultured on different matrix conditions and utilized mice with deletion of vitronectin (Vtn−/−) or mice in which the vitronectin RGD motif is mutated to nonintegrin-binding arginine-glycine-glutamate (RGE) (VtnRGE/RGE). We found that AECs cultured on fibronectin and vitronectin or in wild-type mouse serum are resistant to TGF-β-induced apoptosis. In contrast, AECs cultured on laminin or in serum from Vtn−/−or VtnRGE/RGEmice undergo robust TGF-β-induced apoptosis. Plasminogen activator inhibitor-1 (PAI-1) sensitizes AECs to greater apoptosis by disrupting AEC engagement to vitronectin. Inhibition of integrin-associated signaling proteins augments AEC apoptosis. Mice with transgenic deletion of PAI-1 have less apoptosis after bleomycin, but deletion of vitronectin or disruption of the vitronectin RGD motif reverses this protection, suggesting that the proapoptotic function of PAI-1 is mediated through vitronectin inhibition. Collectively, these data suggest that integrin-matrix signaling is an important regulator of TGF-β-mediated AEC apoptosis and that PAI-1 functions as a natural regulator of this interaction.

Volatile organic compounds (VOCs) are a group of aromatic or chlorinated organic chemicals commonly found in manufactured products that have high vapor pressure, and thus vaporize readily at room temperature. While airshed VOCs are well studied and have provided insights into public health issues, we suggest that belowground VOCs and the related vapor intrusion process could be equally or even more relevant to public health. The persistence, movement, remediation, and human health implications of subsurface VOCs in urban landscapes remain relatively understudied despite evidence of widespread contamination. This review explores the state of the science of subsurface movement and remediation of VOCs through groundwater and soils, the linkages between these poorly understood contaminant exposure pathways and health outcomes based on research in various animal models, and describes the role of these contaminants in human health, focusing on birth outcomes, notably low birth weight and preterm birth. Finally, this review provides recommendations for future research to address knowledge gaps that are essential for not only tackling health disparities and environmental injustice in post-industrial cities, but also protecting and preserving critical freshwater resources.

This paper proposes MD5 and Multiplicative Inverse based Data Encryption Model for security of data during data transmission. It discusses about Cloud computing mechanism which is used to deliver information technology services. In cloud computing, Data security is biggest issue and significant aspect of Internet for enterprises of each size and type. However there are several existing researches that proposed different security mechanisms but they have certain limitations. Therefore this proposed model is developed to enhance the security of data at multiple layers. User defined port and IP address is used to make this proposed model more secure data transmission model. Moreover, the early session timeout is also controlled by reducing packet size. Proposed work would be capable to increase the efficiency of data communication along with security. In addition, unauthentic access of data is restricted using IP validation process.

The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.

Background Syphilitic uveitis is an infective uveitis and a great mimicker. Misdiagnosis can lead to delay in the specific treatment resulting in deterioration of uveitis and loss of vision. Findings A 38-year-old unmarried female presented with pain, redness, and blurring of vision in the left eye for the last 5 days. She denied history of any sexual exposure in the past. Anterior segment examination of the right eye was normal and the left eye showed keratic precipitates with anterior chamber cells and iris pigments on anterior lens capsule. Fundus examination of the right eye showed a hyperemic disc with posterior placoid retinochoroiditis and the left eye showed dense vitritis, hyperemic disc, and superficial retinal precipitates. She was misdiagnosed as viral retinitis elsewhere and started on antivirals with oral corticosteroids which resulted in deterioration of uveitis and progression to bilateral involvement. Further systemic investigations confirmed the diagnosis of syphilis and human immunodeficiency virus infection. She was then started on anti-syphilitic and anti-retroviral therapy which resulted in restoration of the vision in one eye. Conclusion Syphilitic uveitis does not occur in primary disease and is common in secondary and early latent phase of syphilis. History given by the patient is often contributory however at times can be misleading. A high clinical suspicion and thorough investigation is necessary for the correct diagnosis and timely intervention in preventing loss of vision.

A multiprocessor which shares the memory among processors and uses multiples translation lookaside buffers (TLBs) can face various problems. One such problem is the problem of inconsistency which may occur when the page table entry (PTE) is updated because of the multiple copies of same page table entry in various TLBs. Commonly, the inconsistency problem exists in virtually tagged caches, which keep page table entry information, like reference bit, dirty bit and protection bit, in every cache line (Agarwal et al Inconsistency in translation lookaside buffer, 2016 [1]). This paper presents concurrency control algorithms for translation lookaside buffer. We focus on algorithms that reduce the access rights to a page without causing the TLB inconsistency problem.

Purpose: To contribute a global description of the spectrum of choroidal involvement in tubercular uveitis (TBU).Methods: Retrospective cohort study of TBU patients with choroidal involvement from ...