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Introduction Preterm birth complications are the most common cause of death in children under 5 years. The presence of multiple microorganisms and genital tract inflammation could be the common mechanism driving early onset of labour. South Africa has high levels of preterm birth, genital tract infections and HIV infection among pregnant women. We plan to investigate associations between the presence of multiple lower genital tract microorganisms in pregnancy and gestational age at birth.Methods and analysis This cohort study enrols around 600 pregnant women at one public healthcare facility in East London, South Africa. Eligible women are ≥18 years and at

Abstract Background Vulvovaginal yeast infections in pregnancy are common and can cause extensive inflammation, which could contribute to adverse pregnancy outcomes. Symptomatic yeast infections are likely to cause more inflammation than asymptomatic. The objective of this study was to investigate associations between symptomatic and asymptomatic vulvovaginal yeast infections in pregnancy and perinatal outcomes. Methods We did a systematic review and searched eight databases until 01 July 2022. We included studies reporting on pregnant women with and without laboratory confirmed vulvovaginal yeast infection and preterm birth or eight other perinatal outcomes. We used random effects meta-analysis to calculate summary odds ratios (OR), 95% confidence intervals (CI) and prediction intervals for the association between yeast infection and outcomes. We described findings from studies with multivariable analyses. We assessed the risk of bias using published tools. Results We screened 3909 references and included 57 studies. Only 22/57 studies reported information about participant vulvovaginal symptoms. Preterm birth was an outcome in 35/57 studies (49,161 women). In 32/35 studies with available data, the summary OR from univariable analyses was 1.01 (95% CI 0.84–1.21, I 2 60%, prediction interval 0.45–2.23). In analyses stratified by symptom status, we found ORs of 1.44 (95% CI 0.92–2.26) in two studies with ≥ 50% symptomatic participants, 0.84 (95% CI 0.45–1.58) in seven studies with

With the advent of cloud computing, secured data deduplication has gained a lot of popularity. Many techniques have been pro-posed in the literature of this ongoing research area. Among these techniques, the Message Locked Encryption (MLE) scheme is often mentioned. Researchers have introduced MLE based protocols which provide secured deduplication of data, where the data is generally in text form. As a result, multimedia data such as images and video, which are larger in size compared to text files, have not been given much attention. Applying secured data deduplication to such data files could significantly reduce the cost and space required for their storage. In this paper we present a secure deduplication scheme for near identical (NI) images using the Dual Integrity Convergent Encryption (DICE) protocol, which is a variant of the MLE based scheme. In the proposed scheme, an image is decomposed into blocks and the DICE protocol is applied on each block separately rather than on the entire image. As a result, the blocks that are common between two or more NI images are stored only once at the cloud. We provide detailed analyses on the theoretical, experimental and security aspects of the proposed scheme. [ABSTRACT FROM AUTHOR]

Background: Hemoglobin (Hb) SD-Punjab is a rare Hb disorder which may present at any age ranging from infancy to adulthood with variable clinical severity. There are very few reports of HbSD-Punjab with stroke, leading to moyamoya syndrome. We report two siblings with HbSD-Punjab, their diagnosis, genotype–phenotype correlation, and management. Clinical Description: Two siblings, ages 6 and 4 years, presented together to the emergency for the first time with different manifestations. The elder child had fever and acute onset right-sided weakness with anemia and splenomegaly, whereas the younger sister presented with fever and decreased appetite with anemia and splenomegaly. Management and Outcome: Both siblings showed severe anemia with the second sibling showing low platelet counts also. Magnetic resonance imaging of the brain of the elder sister showed chronic infarcts in the left frontal region in addition to acute infarction in the left cerebral hemisphere with angiography suggestive of moyamoya disease. Both siblings had blood pictures suggestive of hemolytic anemia and Hb electrophoresis showed co-inheritance of HbSD-Punjab. Both siblings responded to supportive treatment and blood transfusions and were started on oral hydroxyurea. At the genotype level, a combination of factors was noted with normal α-gene copies known to increase severity and heterozygosity for Xmn1 polymorphism explaining the higher HbF levels which decrease severity. Conclusion: Knowledge of the varied clinical presentation of hemolytic disorders and early detection is key to prevent more severe sequelae in such disorders.

Colpocephaly is the disproportionate enlargement of the occipital horns of the lateral ventricles. It is usually diagnosed in the neonatal period or early childhood due to symptom severity. Adult cases of colpocephaly are rarely reported and often incidentally diagnosed. We report a case of colpocephaly with partial agenesis of the corpus callosum in a 30-year-old female with no past medical history. The patient presented after a syncopal episode with associated complaints of dizziness, vomiting, and chronic intermittent headaches. This case highlights the clinical and radiological features of colpocephaly in adults.

Introduction: A collection of diverse conditions together referred to as diabetes mellitus frequently manifest as periods of hyperglycemia and glucose intolerance, which can be caused by insufficient insulin, improper insulin action, or both. A medical condition known as obesity is the accumulation of excess body fat to the point that it may be harmful to one’s health. It has been determined that the adipokine vaspin (visceral adipose tissue-derived serpin A12) belongs to the family of serine protease inhibitors. Insulin, a polypeptide hormone, is released by the pancreatic beta cells. This hormone is both anti-catabolic and anabolic. Insulin decreases blood glucose levels by preventing its synthesis and encouraging its storage and use. Methodology: In total, 125 male and female participants of various ages participated in the current study. They included 25 healthy controls, 50 non-obese and 50 obese non–insulin-dependent diabetes mellitus patients, who visited the MDM Hospital’s outpatient clinic in Jodhpur, Rajasthan. Commercially available reagents and kits were utilized for the analysis of serum insulin and vaspin samples. Standard statistical tools were utilized to evaluate the parameters. Results and Discussion: When results were compared with healthy participants and non-obese NIDDM subjects, obese NIDDM subjects showed statistically significant higher fasting serum insulin and serum vaspin levels (P < 0.0001). Conclusion: Our study’s conclusions demonstrated a strong correlation between blood insulin and vaspin levels and diabetes and obesity. Vaspin has a positive impact on insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. It also enhances glucose tolerance and insulin sensitivity, reducing diabetes complications. This novel biomarker has the potential to enhance diabetes mellitus outcomes by facilitating prompt diagnosis, improved management, and reduction of complications.

Abstract Background South Africa maintains an integrated health system where syndromic management of sexually transmitted infections (STI) is the standard of care. An estimated 2 million cases of Neisseria gonorrhoeae (N. gonorrhoeae) occur in South Africa every year. Point-of-care diagnostic tests (POCT) may address existing STI control limitations such as overtreatment and missed cases. Subsequently, a rapid lateral flow assay with fluorescence-based detection (NG-LFA) with a prototype reader was developed for N. gonorrhoeae detection showing excellent performance and high usability; however, a better understanding is needed for device implementation and integration into clinics. Methods A qualitative, time-series assessment using 66 in-depth interviews was conducted among 25 trained healthcare workers involved in the implementation of the NG-LFA. Findings were informed by the Normalization Process Theory (NPT) as per relevant contextual (strategic intentions, adaptive execution, and negotiation capacity) and procedural constructs (coherence, cognitive participation, collective action, reflexive monitoring) to examine device implementation within primary healthcare levels. Interviews were audio-recorded, transcribed, and then analyzed using a thematic approach guided by NPT to interpret results. Results Overall, healthcare workers agreed that STI POCT could guide better STI clinical decision-making, with consideration for clinic integration such as space constraints, patient flow, and workload. Perceived NG-LFA benefits included enhanced patient receptivity and STI knowledge. Further, healthcare workers reflected on the suitability of the NG-LFA given current limitations with integrated primary care. Recommendations included sufficient STI education, and appropriate departments for first points of entry for STI screening. Conclusions The collective action and participation by healthcare workers in the implementation of the NG-LFA revealed adaptive execution within the current facility environment including team compositions, facility-staff receptivity, and STI management experiences. User experiences support future clinic service integration, highlighting the importance of further assessing patient-provider communication for STI care, organizational readiness, and identification of relevant departments for STI screening.

Hydrogen sulfide (H2S) is a colorless, foul smelling, toxic substance that can be found in water bodies and waste waters, especially in occupational susceptible environments, and can lead to harmful effects in humans at higher concentrations. An H2S monitoring probe NNAP is synthesized, which displays pH-dependent electrochemical, colorimetric, and fluorescence responses. NNAP functions as a fluorometric sensor at pH 7.4, with a limit of detection (LOD) of 0.70 mM, and as a colorimetric sensor at pH 12, where visible color changes are discernible to the naked eye, with an LOD of 4.28 mM. Additionally, it demonstrates utility in electrochemical sensing at pH 2, with a LOD of 2.5 mM. Furthermore, NNAP-coated paper strips have been successfully utilized for real-time H2S monitoring applications.Graphical Abstract: Hydrogen sulfide (H2S) is a colorless, foul smelling, toxic substance that can be found in water bodies and waste waters, especially in occupational susceptible environments, and can lead to harmful effects in humans at higher concentrations. An H2S monitoring probe NNAP is synthesized, which displays pH-dependent electrochemical, colorimetric, and fluorescence responses. NNAP functions as a fluorometric sensor at pH 7.4, with a limit of detection (LOD) of 0.70 mM, and as a colorimetric sensor at pH 12, where visible color changes are discernible to the naked eye, with an LOD of 4.28 mM. Additionally, it demonstrates utility in electrochemical sensing at pH 2, with a LOD of 2.5 mM. Furthermore, NNAP-coated paper strips have been successfully utilized for real-time H2S monitoring applications. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) are common curable sexually transmitted infections (STIs). Syndromic management of vaginal discharge syndrome (VDS), the current standard-of-care in resource-constrained settings, results in substantial antibiotic overtreatment. In view of increasing antimicrobial resistance, novel strategies to reduce antibiotic use are urgently needed. Methods: Data were obtained from pregnant women with VDS (observed and/or reported abnormal vaginal discharge with or without other urogenital symptoms) in an ongoing randomized controlled trial of STI screening strategies in South Africa, wherein women were tested for abnormal vaginal pH (pH > 4.5 - rapid test strips, multiple manufacturers), and STIs (GeneXpert CT/NG and TV; Cepheid, Sunnydale, California). We determined (1) the sensitivity and specificity of abnormal pH for CT or NG, and TV, and (2) hypothetical over or undertreatment with pH-guided therapy (treating those with abnormal pH) versus syndromic management (treating everyone). Results: Among 118 pregnant women with VDS, 74 (62.7%) had abnormal vaginal pH. Of those 118, 42 (35.6%) tested positive for any STI. By STI, positivity was CT, 26 (22.0%), NG, 8 (6.8%), CT/NG, 32 (27.2%), and TV, 15 (12.7%). Abnormal vaginal pH (Table) had a sensitivity of 71.4% (95% CI 55.4%--84.3%) and specificity of 42.0% (95% CI 31.0%--54.0%) for any STI. The sensitivity was 68.8% (95% CI 50.1%--83.9%) and specificity 40.0% (95%CI 29.2%--50.7%) for CT or NG, and the sensitivity was 80.0% (95% CI 51.9%-- 95.7%) and specificity 39.8% (95%CI 30.3%--49.9%) for TV. Based on STI positivity (Table), pH-guided therapy would reduce overtreatment from 76 (64.4%) to 44 (37.3%) women with no STI; 86 (72.9%) to 52 (44.1%) women without CT or NG, and 103 (87.3%) to 62 (52.5%) women without TV. Conversely, pH-guided therapy would undertreat 12 (10.2%) women with any STI; 10 (8.5%) with CT or NG, and 3 (2.5%) with TV. Conclusion: Abnormal pH showed moderate sensitivity for CT or NG, high sensitivity for TV, but low specificity for any STI. Although pH-guided therapy would considerably reduce antibiotic overtreatment in pregnant women with VDS, there is potential for missed treatment. Further research into benefit versus harm, including strategies to complement vaginal pH-guided therapy, is necessary. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) among pregnant women in South Africa have been reported to be more common among women living with HIV (WLHIV) than among HIV-negative women. The objectives of this study were to investigate the prevalence and incidence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) and their associations with HIV infection in pregnancy. Methods: CT/NG testing was implemented in an ongoing cohort study about STIs in pregnancy in a primary healthcare clinic in East London, South Africa. At the baseline antenatal care visit before 27 weeks of gestation and between 30-34 weeks, an HIV rapid test was done, and a nurse-collected vaginal swab was tested using the GeneXpert CT/NG assay. Women with positive results were offered treatment. We calculated percentages, relative risks (RR) and incidence rates per 100 woman-years (with 95% confidence intervals, CI). Results: From March 2021 to November 2022, we tested 215 women at baseline and at 30-34 weeks gestation. At baseline, 43 women were CT and/or NG-positive; CT 40/215 (19%, CI 14-25), NG 9/215 (4%, CI 2-8) (6 CT and NG), and 57 were WLHIV (27%, CI 21-33). The risk of CT/NG was 12% (7/57) in WLHIV and 23% (36/158) in HIV-negative women (RR 0.5, CI 0.3-1.1). CT/NG appeared to be less common in women reporting condom use at last intercourse (RR 0.38, CI 0.1-1.5) and more common among women reporting >1 partner in the last 6 months (1.4, CI 0.7-3.0). Most women with positive results (41/43) returned for treatment. At the 30-34 week visit, 16 (7%) women were CT-positive and 1 (0.5%) was NG-positive. CT/NG incidence among HIVnegative women (9 CT and 1 NG) was 0.1 (CI0.07-0.3) per 100 woman-years. There were no incident infections in WLHIV. Of 7 women with repeat positive CT results, 2/7 (29%) were WLHIV and 5/36 (14%) HIV-negative. Conclusion: CT and NG were highly prevalent in this cohort. Compared with HIV-negative women, WLHIV appeared less likely to have CT/NG at baseline and at follow-up. Over half of the positive results at 30-34 weeks (10/17) were new infections, highlighting the need for monitoring of incident CT/NG in late pregnancy. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) are associated with adverse pregnancy outcomes. Sexually transmitted infection (STI) testing followed by pathogen-directed treatment would optimize treatment compared with syndromic management. We aimed to determine STI treatment outcomes among pregnant women in South Africa. Methods: Pregnant women at 4 healthcare clinics in East London, South Africa were included in an implementation-effectiveness study. Eligibility criteria included <27 gestational weeks and attendance at their first antenatal care visit. Nursecollected vaginal specimens were tested on-site using the GeneXpert CT/NG and TV molecular assays. In one study arm, women with positive STI result(s) received pathogen-directed treatment, partner notification slips, and a test-of-cure (TOC) visit was scheduled at 21days post-treatment; visits were allowed up to 35 days. At TOC, sexual behaviour and partner treatment data were collected, and CT, NG, and TV STI testing were repeated; cure was defined as a negative result on repeat testing. Results: We tested 361 eligible women in one study arm between March 2021 and November 2022. Of these, 93 (26%) tested positive for any STI and 86 (93%) received treatment within study arm timeline (51 for CT, 15 for NG, and 34 for TV); 70/93 (75%) were asymptomatic and 28/93 (30%) were HIVpositive. TOC visit was attended by 55/86 (64%, 95% confidence interval, CI 53-74) women within the appropriate window of time; 9/55 (16%, CI 8-29) had a positive repeat STI test (4/32 (13%) for CT, 5/22 (23%) for TV, and 0/11 (0%) for NG) (Table 1). Most women (98%; 54/55) reported disclosure of their STI to their partner however only 45% (25/55) reported that their partner received treatment. Of the 9 women with repeat positive testing at TOC, only 1/9 (11%, CI 0.6-49) reported that her partner received treatment compared with 24/46 (52%, CI 37-67) of cured participants (Fisher Exact p=0.03). Conclusion: Primarily asymptomatic STIs were common among this cohort of pregnant women in South Africa. However, the potential benefits of STI testing and treatment in pregnancy may be limited by re-infection from untreated partners. Improving partner treatment should be prioritised. [ABSTRACT FROM AUTHOR]

Background: We are conducting studies about sexually transmitted infections (STIs) in pregnancy in 5 primary healthcare clinics in East London, South Africa. At antenatal visits, research nurses collect a vaginal swab for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis testing on the GeneXpert platform Women with any positive result are offered same-day treatment. Women who do not wait are telephonically requested to return for treatment. A subset was asked about their preparedness to wait for their results. Methods: Ensuring treatment for STIs in resourcelimited settings is challenging. Introduction of diagnostic testing for STIs is imperative. The GeneXpert system provides the opportunity for same-day treatment as STI test results are available within 90 minutes. However, it is not clear whether same-day treatment is feasible in clinics. In our study clinics, 2 have a designated waiting area and 3 do not. Results: We tested 1194 pregnant women for STIs from March 2021 to December 2022, of whom 282 (24%, 95% confidence interval, CI 21-26) had positive results for any STI. Of these, 116/282 (41%) received same-day treatment, 92/282 (33%) returned within 1 week, 53/282 (19%) within 2-11 weeks, and 21 (7%) did not return. The concordance of the intention to wait/not to wait and if participants effectively waited, was 70% (99/141) among 141 women who answered additional questions. The most common reasons not to wait were (1) need to get back to family (42/121, 35%), (2) need to get to work (33/121, 27%), and (3) hunger (18/121, 15%). Combining data from all participants in random effects meta-analysis stratified by clinic (Figure 1), 91% (CI 75-97%, I² 79%) waited in clinics with a waiting room compared with 18% (CI 13-25%, I² 60%) in clinics without. Conclusion: Same-day treatment for pregnant women with STIs was possible and more likely at clinics with a designated waiting area. The intention of women to wait is not a reliable indicator of actual waiting, suggesting that the intention can be modified. We have since built waiting rooms in 2 of the 3 clinics that did not have them and are studying the outcomes of this intervention on same-day STI treatment. [ABSTRACT FROM AUTHOR]

PurposeTo describe the early experiences of patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV) whose treatment was switched to faricimab from other anti-vascular endothelial growth factor (VEGF) agents.MethodsThis is a prospective cohort of eyes with nAMD and PCV that were previously treated with anti-VEGF agents other than faricimab. We evaluated visual acuity (VA), central subfield thickness (CST), macular volume (MV), pigment epithelial detachment (PED) height, and choroidal thickness (CT) after one administration of faricimab. Where present, fluid was further evaluated according to intraretinal fluid (IRF), subretinal fluid (SRF), or within PED.ResultsSeventy-one eyes from 71 patients were included (45.07% PCV and 54.93% typical nAMD). The mean [standard deviation (± SD)] VA, CST, and MV improved from 0.50 logMAR (± 0.27 logMAR) to 0.46 logMAR (± 0.27 logMAR) (p = 0.20), 383.35 µm (± 111.24 µm) to 322.46 µm (± 103.89 µm (p < 0.01), and 9.40 mm3 (± 1.52 mm3) to 8.75 mm3 (± 1.17 mm3) (p < 0.01) from switch to post switch visit, respectively. The CT reduced from 167 µm (± 151 µm) to 149 µm (± 113 µm) (p < 0.01). There was also a significant reduction in the maximum PED height between visits [302.66 µm (± 217.97 µm)] and the post switch visit [236.66 µm (± 189.05 µm); p < 0.01]. This difference was greater in PEDs that were predominantly serous in nature. In the eyes with typical nAMD (n = 39), improvements were significant for CST, MV, CT, and PED. In the eyes with PCV (n = 32), only reductions in CT were statistically significant, while VA, CST, MV, and PED only showed numerically smaller improvements. One patient developed mild vitritis without vasculitis, which resolved with topical steroids with no sequelae.ConclusionsIn our case series of Asian nAMD patients, switching to faricimab was associated with a stable VA and meaningful anatomical improvements, particularly with typical nAMD subtypes.

No abstract available.

Background With 425 million individuals globally living with diabetes, it is critical to support the self-management of this life-threatening condition. However, adherence and engagement with existing technologies are inadequate and need further research. Objective The objective of our study was to develop an integrated belief model that helps identify the significant constructs in predicting intention to use a diabetes self-management device for the detection of hypoglycemia. Methods Adults with type 1 diabetes living in the United States were recruited through Qualtrics to take a web-based questionnaire that assessed their preferences for a device that monitors their tremors and alerts them of the onset of hypoglycemia. As part of this questionnaire, a section focused on eliciting their response to behavioral constructs from the Health Belief Model, Technology Acceptance Model, and others. Results A total of 212 eligible participants responded to the Qualtrics survey. Intention to use a device for the self-management of diabetes was well predicted (R2=0.65; F12,199=27.19; P

BackgroundDiabetes affects millions of people worldwide and is steadily increasing. A serious condition associated with diabetes is low glucose levels (hypoglycemia). Monitoring blood glucose is usually performed by invasive methods or intrusive devices, and these devices are currently not available to all patients with diabetes. Hand tremor is a significant symptom of hypoglycemia, as nerves and muscles are powered by blood sugar. However, to our knowledge, no validated tools or algorithms exist to monitor and detect hypoglycemic events via hand tremors. ObjectiveIn this paper, we propose a noninvasive method to detect hypoglycemic events based on hand tremors using accelerometer data. MethodsWe analyzed triaxial accelerometer data from a smart watch recorded from 33 patients with type 1 diabetes for 1 month. Time and frequency domain features were extracted from acceleration signals to explore different machine learning models to classify and differentiate between hypoglycemic and nonhypoglycemic states. ResultsThe mean duration of the hypoglycemic state was 27.31 (SD 5.15) minutes per day for each patient. On average, patients had 1.06 (SD 0.77) hypoglycemic events per day. The ensemble learning model based on random forest, support vector machines, and k-nearest neighbors had the best performance, with a precision of 81.5% and a recall of 78.6%. The results were validated using continuous glucose monitor readings as ground truth. ConclusionsOur results indicate that the proposed approach can be a potential tool to detect hypoglycemia and can serve as a proactive, nonintrusive alert mechanism for hypoglycemic events.

Background: Biotin is the coenzyme of multiple carboxylases involved in gluconeogenesis, fatty acid synthesis, and amino acid catabolism. Biotinidase (BTD) deficiency is an autosomal recessive disorder affecting the biotin cycle. It disrupts endogenous biotin recycling and results in multiple carboxylase deficiency depending upon the level of enzyme activity. Children with profound deficiency often present in infancy with neurocutaneous manifestations. Management of symptomatic children or screen-positive newborns is lifelong oral supplementation with biotin. There may be partial or complete resolution of symptoms in the former. Clinical Description: We describe two unrelated families diagnosed as profound BTD deficiency, with three affected children in each family. The first family had two symptomatic surviving children, a 2-year-old boy with seizures, developmental delay, and hearing loss, and a 1.5-month-old boy with seizures. Diagnosis was established while ascertaining etiology for seizures refractory to multiple anticonvulsant therapy. The second family was referred for postconceptional counseling following two infantile deaths with similar phenotype, early-onset seizures, encephalopathy, and acute metabolic decompensation. Management: The affected children in the first family showed a dramatic response in seizure controls with oral biotin though the other symptoms such as developmental delay and hearing loss remained unaffected. Mother was advised regarding prenatal diagnosis in the next pregnancy but was unwilling. In the second family, stored genetic material from the earlier affected infant revealed a pathogenic homozygous indel in the BTD gene, which was confirmed in utero in the subsequent pregnancy. Both women were started on oral biotin on the lines of antenatal management of holocarboxylase synthetase deficiency. After birth, therapy was continued on the confirmation of profound BTD deficiency in both babies. They have remained asymptomatic on follow-up; the first baby till a year and the second till 3 months. Conclusion: There is a considerable phenotypic variability in profound BTD deficiency. Early detection and prompt treatment with biotin may result in complete resolution of some symptoms and ameliorate others. Antenatal biotin supplementation in families at high risk or with prenatal diagnosis of BTD deficiency may have a favorable outcome in affected progeny.

Primary membranous nephropathy (PMN) is a common cause of adult-onset nephrotic syndrome. Anti-M-type phospholipase A2 receptor (PLA2R) antibodies are pathogenic and correlate with clinical outcomes. The role of anti-PLA2R in recurrent PMN is unclear. In the present manuscript, we report five cases of PMN who underwent kidney transplantation (KT) with varying titers of anti-PLA2R pre-kidney transplantation (KT). Two patients with anti-PLA2R in the second and third tertiles had a recurrence of PMN, whereas patients with a negative or anti-PLA2R in the first tertile had no recurrence. The report signals a heightened risk of PMN recurrence in patients with elevated anti-PLA2R antibody titer at KT.

Abstract Background College students are leading an evolution of device use both in the type of device and the frequency of use. They have transitioned from desktop stations to laptops, tablets, and especially smartphones and use them throughout the day and into the night. Methods Using a 35-min online survey, we sought to understand how technology daily usage patterns, device types, and postures affect pain and discomfort to understand how knowledge of that pain might help students avoid it. Data were analyzed from 515 students (69.5% male) who completed an internet-delivered survey (81.3% response rate). Results Participants ranked smartphones as their most frequently used technology (64.0%), followed by laptops and tablets (both 53.2%), and desktop computers (46.4%). Time spent using smartphones averaged over 4.4 h per day. When using their devices, students were more likely to adopt non-traditional workplace postures as they used these devices primarily on the couch or at a chair with no desk. Conclusion Recent trends in wireless academic access points along with the portability of small handheld devices, have made smartphones the most common link to educational materials despite having the least favorable control and display scenario from an ergonomic perspective. Further, the potential impact of transitions in work environments due to COVID-19 may further exacerbate ergonomic issues among millions highlighting the need for such work to be carried out.

This review provides an overview of conventional and novel retinal imaging modalities for hydroxychloroquine (HCQ) retinopathy. HCQ retinopathy is a form of toxic retinopathy resulting from HCQ use for a variety of autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Each imaging modality detects a different aspect of HCQ retinopathy and shows a unique complement of structural changes. Conventionally, spectral-domain optical coherence tomography (SD-OCT), which shows loss or attenuation of the outer retina and/or retinal pigment epithelium–Bruch’s membrane complex, and fundus autofluorescence (FAF), which shows parafoveal or pericentral abnormalities, are used to assess HCQ retinopathy. Additionally, several variations of OCT (retinal and choroidal thickness measurements, choroidal vascularity index, widefield OCT, en face imaging, minimum intensity analysis, and artificial intelligence techniques) and FAF techniques (quantitative FAF, near-infrared FAF, fluorescence lifetime imaging ophthalmoscopy, and widefield FAF) have been applied to assess HCQ retinopathy. Other novel retinal imaging techniques that are being studied for early detection of HCQ retinopathy include OCT angiography, multicolour imaging, adaptive optics, and retromode imaging, although further testing is required for validation.

Objectives: To evaluate and compare the accuracy of Direct Digital Radiography (DDR) and cone-beam computed tomography (CBCT) in determination and diagnosis of periodontal osseous defects. Methods: A nonrandomized in vivo study was conducted to compare the two imaging modalities, DDR and CBCT, for the diagnosis of periodontal osseous defects. Comparison was made between the linear measurements of DDR and CBCT images with the actual measurements of various osseous defects during surgical exposure (Gold standard). Results: The results of the present study demonstrated the difference in the mean values of the DDR and surgical exposure measurements of periodontal osseous defects, whereas comparable mean values were found between the CBCT and surgical exposure measurements, with no statistically significant difference (P > 0.05) being found between each modality. Conclusion: CBCT proved to be an indispensable imaging tool in detecting and quantifying periodontal defects and furcation involvement more precisely and could provide additional benefits over the traditional radiography for clinical and postsurgical evaluation.