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Abstract Despite advances in systemic care, diabetic disease of the eye (DDE) remains the leading cause of blindness worldwide. There is a critical gap of up-to-date, evidence-based guidance for ophthalmologists in Canada that includes evidence from recent randomized controlled trials. Previous guidance has not always given special consideration to applying treatments and managing DDE in the context of the healthcare system. This consensus statement aims to assist practitioners in the field by providing a spectrum of acceptable opinions on DDE treatment and management from recognized experts in the field. In compiling evidence and generating consensus, a working group of retinal specialists in Canada addressed clinical questions surrounding the four themes of disease, patient, management, and collaboration. The working group reviewed literature representing the highest level of evidence on DDE and shared their opinions on topics surrounding the epidemiology and pathophysiology of diabetic retinopathy and diabetic macular edema; diagnosis and monitoring; considerations around diabetes medication use; strategic considerations for management given systemic comorbidities, ocular comorbidities, and pregnancy; treatment goals and modalities for diabetic macular edema, non-proliferative and proliferative diabetic retinopathy, and retinal detachment; and interdisciplinary collaboration. Ultimately, this work highlighted that the retinal examination in DDE not only informs the treating ophthalmologist but can serve as a global index for disease progression across many tissues of the body. It highlighted further that DDE can be treated regardless of diabetic control, that a systemic approach to patient care will result in the best health outcomes, and prevention of visual complications requires a multidisciplinary management approach. Ophthalmologists must tailor their clinical approach to the needs and circumstances of individual patients and work within the realities of their healthcare setting.

The present research's main objective was to apply thorough exploration approaches that combine remote sensing data with geochemical sampling and analysis to predict and identify potential chromitite locations in a complex geological site, particularly in rugged mountainous terrain, and differentiate the ultramafic massif containing chromitite orebodies from other lithologies. The ultramafic massif forming the mantle section of the Kırdağ ophiolite, located within the Erzurum–Kars Ophiolite Zone and emerging in the east of Oltu district (Erzurum, NE Turkey), was selected as the study area. Optimum index factor (OIF), false-color composite (FCC), decorrelation stretch (DS), band rationing (BR), minimum noise fraction (MNF), and principal and independent component analyses (PCA-ICA) were performed to differentiate the lithological features and identify the chromitite host formations. The petrography, mineral chemistry, and whole-rock geochemical properties of the harzburgites, which are the host rocks of chromitites in the research area, were evaluated to verify and confirm the remote sensing results. In addition, detailed petrographic properties of the pyroxenite and chromitite samples are presented. The results support the existence of potential chromitite formations in the mantle section of the Kırdağ ophiolite. Our remote sensing results also demonstrate the successful detection of the spectral anomalies of this ultramafic massif. The mineral and whole-rock geochemical features provide clear evidence of petrological processes, such as partial melting and melt–peridotite interactions during the harzburgite formation. The chromian spinels' Cr#, Mg#, Fe3+, Al2O3, and TiO2 concentrations indicate that the harzburgite formed in a fore-arc environment. The Al2O3 content and Mg# of the pyroxenes and the whole-rock Al2O3/MgO ratio and V contents of the harzburgite are also compatible with these processes. Consequently, the combined approaches demonstrated clear advantages over conventional chromitite exploration techniques, decreasing the overall costs and supporting the occurrence of chromite production at the site. [ABSTRACT FROM AUTHOR]

Abstract Background Non-dystrophic myotonias (NDMs) comprise muscle chloride and sodium channelopathies due to genetic defects of the CLCN1- and SCN4A-channels. No licensed antimyotonic treatment has been available until approval of mexiletine (NaMuscla®) for adult patients by the EMA in December 2018. This Delphi panel aimed to understand how outcomes of the pivotal phase III Mexiletine study (MYOMEX) translate to real world practice and investigate health resource use, quality of life and the natural history of NDM to support economic modelling and facilitate patient access. Methods Nine clinical experts in treating NDM took part in a two-round Delphi panel. Their knowledge of NDM and previous use of mexiletine as an off-label treatment prior to NaMuscla’s approval ensured they could provide both qualitative context and quantitative estimates to support economic modelling comparing mexiletine (NaMuscla) to best supportive care. Consensus in four key areas was sought: healthcare resource utilization (HRU), treatment with mexiletine (NaMuscla), patient quality of life (QoL), and the natural history of disease. Concept questions were also asked, considering perceptions on the feasibility of mapping the validated Individualized Neuromuscular Quality of Life (INQoL) instrument to the generic EQ-5D™, and the potential impact on caregiver QoL. Results Consensus was achieved for key questions including the average long-term dosage of mexiletine (NaMuscla) in practice, the criteria for eligibility of myotonia treatment, the clinical importance of QoL outcomes in MYOMEX, the higher proportion of patients with increased QoL, and the reduction in the need for mental health resources for patients receiving mexiletine (NaMuscla). While consensus was not achieved for other questions, the results demonstrated that most experts felt mexiletine (NaMuscla) reduced the need for HRU and was expected to improve QoL. The QoL mapping exercise suggested that it is feasible to map domains of INQoL to EQ-5D. Points of interest for future research were identified, including that mexiletine (NaMuscla) may slow the annual decrease in QoL of patients over their lifetime, and a significant negative impact on QoL for some caregivers. Conclusions This project successfully provided data from an informed group of clinical experts, complementing the currently available clinical trial data for mexiletine (NaMuscla) to support patient access decisions.

This study aims to predict the long-term behavior of fiber-reinforced plastic (FRP) or steel plates externally strengthening RC two-way slabs using ANSYS software non-linear finite element (FE) modeling and making a comparison between the FE analysis with the experimental test results, in addition, calculated the effect of parameters on the strengthened slab behavior: compressive strength, the magnitude of sustained load, slab length to slab thickness, and the external strengthening type. The Prony series were used in the model of non-linear viscoelastic in this paper to study the deflection of time-dependent adopted. The modeling was done to solve the problems of the creep by the FEs by ANSYS software, the results showed an acceptable agreement level with the results of the experiment. The parametric study’s numerical results indicate that as sustained load increases for 20–60% Pu kN, the time-dependent deflection increases by around 2.5 times, as well as a decrease in the long-term efficiency of the slabs that external strengthening where the deflection is increased due to increased creep, and the effect creep has on the deflection. [ABSTRACT FROM AUTHOR]

Marine fish is an important source of high-quality, yet relatively cheap animal protein in the Egyptian's diet. Although most parasitic diseases might not cause direct losses of fish, it has deleterious effects on their weight gain and marketability and weaken the fish's immune system paving the way for more serious secondary infections. In this study, we recorded the most common parasitic infestations in marine fish in Egypt in the period between winter 2019 to summer 2021 and described their associated pathologic effects. Four hundred fish from seven different fish species (Mugil cephalus, Pomadasys incisus, Gilthead sea bream, Pagrus Pagrus, Morone labrax (sea bass), thunnus thynnus and Caranx crysos) were randomly collected from the Mediterranean and the Red Sea. Out of the 400 examined fish, 197 (49.25%) infestations were recorded. The isolated parasites were a crustacean, two cestodes, and a nematode and were morphologically identified as follows: Ceratothoa oestroides, Callitetrarhynchus gracilis, Tetraphyllidean larvae and Hysterothylacium deardorffoverstreetorum). Among the infested fish, the highest prevalence of infestation was recorded by Ceratothoa oestroides (43.65%) followed by Hysterothylacium deardorffoverstreetorum (31.98%) and Callitetrarhynchus gracilis (24.37%), and the lowest prevalence rate was recorded by the Tetraphyllidean larvae (15.74%). The pathologic macroscopic and microscopic lesions associated with each type of infestation are described underscoring the importance of continuous search for and application of possible safe control measures for marine fish parasites to spare the fish industry the detrimental effects of these infestations. [ABSTRACT FROM AUTHOR]

This laboratory study investigates the feasibility of using geopolymer-based stabilization of base soil and reclaimed asphalt pavements (RAP) to fully replace cement in road rehabilitation projects. Geopolymer is an environment-friendly material that is based on the alkaline activation of aluminosilicate precursors. The performance of Portland cement as a chemical stabilizer for the full depth reclamation (FDR) of asphalt pavements is well established. However, Portland cement manufacturing has a high carbon footprint and other significant environmental impacts. Furthermore, there is a shortage of cement available for FDR projects across many country regions. Simultaneously, there is a strong motivation to explore various industrial wastes such as ponded ash, slag, ground glass fibers, etc., as replacements for Portland cement in construction. Therefore, a geopolymer based on ground glass fibers (GGF), either separately or combined with ponded fly ash (PFA) or slag (S), was studied to replace cement in FDR. All mixtures were tested for unconfined compressive strength (UCS), flexural strength, and drying shrinkage, wetting/drying, freezing/thawing, and tube suction tests. The results showed promising performance of geopolymer-based stabilized mixtures as compared to control. However, some test methods related to FDR with cement need to be modified to suit the mixtures of FDR with geopolymer. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the antiparasitic activity of the wasp venom (WV), Vespa orientalis, against the adult Fasciola gigantica (F. gigantica) worm, as WV has known pharmacological properties. We assessed its anthelmintic efficacy using 40 adult F. gigantica flukes collected from slaughtered cattle divided into four groups (10 each). Worms in three groups were treated with 50, 100, and 200 µg/ml of WV, while a fourth untreated one was used as control. After WV treatment, the tegument area of the fluke's body was assessed using a scanning electron microscope. This revealed several tegumental alterations all over the fluke's body, including sunken spines due to local swelling, complete disappearance of spines from their sockets, furrowing and sloughing of the basal lamina, splitting off some spines to resemble an "open jaw," broken oral and ventral sucker teguments, increased swelling of the ventral sucker with loss of its ridges, severe swelling and smoothening of the ventral sucker due to loss of normal transverse ridges, deformed cirrus, and swollen sensory papillae with blebs. The sensory papillae were completely disrupted and dislodged, leaving pits and a series of holes throughout the basal lamina and severely eroded, turning into lesions exposing the basement membrane. These findings indicate that WV destructs the tegument surface of the adult flukes. However, further in vivo studies on the activity of WV treatment are recommended. [ABSTRACT FROM AUTHOR]