Search

Introduction: Vegetarianism dates back to a time before recorded history. The present study was undertaken to compare individuals (vegetarians and non-vegetarians) lipid profile which is used to determine the risk of obesity, myocardial infarction and helps in determining the treatment has border line or high-risk cases. Aims & objectives: The present study was designed to investigate comparative study of serum lipid profile in vegetarians and non-vegetarians’ young adults, so that the effects produced by the type of dietary intake can be evaluated. Materials and methods: A total of 100 (50 vegetarians and 50 non-vegetarians) were selected from Kurnool medical college, Kurnool with exclusion criteria (Subjects with history of hypercholesterolemia, hereditary dyslipidemias, Subjects on drugs that affect the lipid profile, hypertensive’s, diabetics, heart diseases and thyroid diseases and subjects with Smoking and Alcohol). All parameters (lipid profile) were done on a Semi automated analyser (Erba chem-5x). Results: The mean values of TC (Total cholesterol), LDL, VLDL, TG (Triglycerides) are high in non-vegetarians when compared to vegetarians and HDL is high in vegetarians. The p value is <0.0001 and is considered highly significant and food good relation with vegetarian diet. Conclusion: It concludes that healthy dietary pattern maintains a favorable lipid profile. [ABSTRACT FROM AUTHOR]

Introduction: Emerging and re-emerging viral diseases are a major threat to public health. Odisha, being one of the coastal states in the country, reports many viral illnesses due to its typical geographical location. This study focuses on the prevalence of different viral diseases in the state of Odisha, India, from 2010-2017. Material and Methods: A total of 43,397 patients with clinical suspicion of viral diseases were screened for different viral etiologies during 2010-2017. The laboratory diagnosis was conducted by serology (ELISA) and RT-PCR for 24 different viruses, i.e., dengue, chikungunya, Japanese encephalitis, hepatitis A virus, hepatitis E virus, hepatitis B virus, hepatitis C virus, rotavirus, herpes simplex virus-1 and herpes simplex virus-2, Epstein- Barr virus, cytomegalovirus, and respiratory viruses. Patients were enrolled from sporadic hospital admissions and outbreaks under different categories as per clinical diagnoses like fever with rash, diarrhoea, encephalitis, jaundice, respiratory illness, and fever of unknown etiology. Results: The majority of patients belonged to exanthematous group, i.e., fever with rash (32.24%). The number of males was more in all categories except fever with rash, where females (53.34%) were more. Children <16 years of age were found to be the predominant age group for suspected viral diarrhoea (85.26%), encephalitis (76.96%), fever of unknown origin (40.16%), and respiratory infections (27.23%). Conclusion: Not only vector-borne diseases pose a threat to the Odisha state, but other viral illnesses have also emerged. This detailed report of different viral diseases in the state of Odisha will support public health management. [ABSTRACT FROM AUTHOR]

Background: The Norwood operation (NO) for infants with univentricular physiology has high interstage mortality. This study evaluated outcomes and risk factors for mortality following NO. Methods: Retrospective single-center study of patients undergoing NO from 2010 to 2020. Analysis used appropriate statistics. Results: Of 269 patients undergoing NO, 213 (79.2 %) survived to discharge. Non-survivors had longer bypass times, delayed sternal closure, required nitric oxide, higher vasoactive scores, required post-operative catheterization, Extracorporeal Life Support (ECLS), and longer ventilation (p

In the context of a growing global population, an automated framework for disease detection can greatly assist medical professionals in diagnosing ocular diseases. This framework offers advantages such as accurate, stable, and rapid outcomes, thereby enhancing the success rate of early disease detection. The primary objective of this study was to enhance the quality of fundus images using an adaptive contrast enhancement algorithm (CLAHE) and Gamma correction as preprocessing techniques. CLAHE is employed to heighten the local contrast of fundus images, while Gamma correction enhances the intensity of relevant features. This research adopts a deep learning approach that integrates convolutional neural networks (CNNs) and both short-term and long-term memory (LSTM) mechanisms. The purpose of this combination is to automatically detect aged macular degeneration (AMD) in fundus ophthalmology. In this mechanism, CNNs are utilized to extract pertinent features from the images, and LSTM is subsequently employed to discern these extracted features. To validate the effectiveness of the proposed method, a diverse dataset of 2000 experimental fundus images is collected from various sources. These images are categorized into four distinct classes in an equitable manner. Quality assessment techniques are then applied to this dataset. The hybrid deep AMDNet23 model proposed in this study achieves successful detection of AMD ocular disease with an achieved accuracy of 96.50 %. Moreover, the system's prowess is benchmarked against 13 other pre-trained CNN models, effectively illuminating its supremacy in AMD ocular disease diagnosis within the realm of fundus imagery datasets. This exhaustive comparison underscores the method's immense potential and reaffirms its position at the forefront of cutting-edge ocular health diagnostics.

Objective: Surgery for heart defects in children with trisomy 13 or 18 is controversial. We analyzed our 20-year experience. Methods: Since 2002, we performed 21 operations in 19 children with trisomy 13 (n = 8) or trisomy 18 (n = 11). Age at operation was 4 days to 12 years (median, 154 days). Principal diagnosis was ventricular septal defect in 10 patients, tetralogy of Fallot in 7 patients, arch hypoplasia in 1 patient, and patent ductus arteriosus in 1 patient. Results: The initial operation was ventricular septal defect closure in 9 patients, tetralogy of Fallot repair in 7 patients, pulmonary artery banding in 1 patient, patent ductus arteriosus ligation in 1 patient, and aortic arch/coarctation repair in 1 patient. There were no operative or hospital deaths. Median postoperative intensive care and hospital stays were 189 hours (interquartile range, 70-548) and 14 days (interquartile range, 8.0-37.0), respectively, compared with median hospital stays in our center for ventricular septal defect repair of 4.0 days and tetralogy of Fallot repair of 5.0 days. On median follow-up of 17.4 months (interquartile range, 6.0-68), 1 patient was lost to follow-up after 5 months. Two patients had reoperation without mortality. There have been 5 late deaths (4 with trisomy 18, 1 with trisomy 13) predominately due to respiratory failure from 4 months to 9.4 years postoperatively. Five-year survival was 66.6% compared with 24% in a group of unoperated patients with trisomy 13 or 18. Conclusions: Cardiac operation with an emphasis on complete repair can be performed safely in carefully selected children with trisomy 13 or trisomy 18. Hospital resource use measured by postoperative intensive care and hospital stays is considerably greater compared with nontrisomy 13 and 18.

We present an adolescent male with a single intracardiac mass and pulmonary emboli, complicated by peripheral venous thrombosis and subsequent development of pulmonary pseudoaneurysms, leading to diagnosis of Hughes-Stovin syndrome. Remission was achieved with cyclophosphamide, corticosteroids, and pseudoaneurysm resection and maintained with infliximab and methotrexate.

Energy storage devices are imperative to damp out the oscillations caused by sudden magnified disturbances occurring in a power system. The presence of a small rating of storage device in each area can alleviate the system oscillations effectively. Therefore, in this work, redox flow batteries (RFBs) have been integrated in each area of a five-area interconnected system for effective load frequency control (LFC). The RFB pumps up the active power into the system quickly to meet the short-time overload; in turn, the efficacy of the LFC in the system is boosted. Despite the presence of the RFB in the power system, a secondary controller is necessary to quench the deviation of frequency and tie-line power caused by the power mismatch between demand and generation. In this perspective, a cascade controller incorporated with a fractional operator (FO) has been endorsed and designed through a nascent selfish herd optimizer technique to evaluate the transient response of the system. Besides this, the unprecedented performance of fractional-order cascade controllers has been compared with one-stage classical controllers with and without a fractional operator. Further, the robustness of the proposed controller has been inspected through subjecting it to a random load in the presence/absence of an RFB and parametric variation. Finally, the proposed model has been simulated in the OPAL-RT-4510 platform to validate the performance of the proposed controller that has produced in the MATLAB environment.

In recent power system, the quality of power is highly influenced by the imbalance between generation and load demand. Automatic Generation Control (AGC) is an imperative control strategy to minimize the frequency or power deviation by regulating the generation. In this work, a centralized Sliding Mode Control (SMC) is employed as AGC to achieve reliable performance of a Microgrid (MG). Due to existence of some poor inertia sources in MG, a knowledgeable and reliable controller is very indispensable. Wind turbine, photovoltaic unit, fuel cell, aqua-electrolyser, fly-wheel, ultra capacitor, battery energy storage units reside in MG with nonlinearities such as Generation Rate Constraint (GRC), communication delay and anomalous load. Further, a Small Hydro Power Plant (SHPP) is integrated with MG to enhance the performance response. The performance of the controller is enhanced by Selfish Herd Optimization (SHO) and a novel fuzzy adaptive SHO (FASHO). The decisive parameters of SHO are decided by fuzzy logic control by which the efficacy of algorithm is improved. The proposed FASHO based SMC controller is substantiated over SHO/FASHO based PID, FOPID and FOPID-(1 + PI) controllers. The proposed FASHO-SMC controller and integration of SHPP are wrapped up as superior approaches to enhance the performance of MG.

Background: The study was aimed to evaluate the safe time and safe protocol for postoperative resumption of oral hydration in pediatric patients undergoing elective nonabdominal surgery under general anesthesia. Methodology: One hundred and sixty patients (of age 6 months to 12 years) were assigned into two groups. The assessment of level of consciousness, protection of the airway (coughing and swallowing), absence of nausea and vomiting, and normal saturation were used as the safety criteria for start of postoperative oral hydration in both groups. Clear fluids in dose of 0.5–1 ml/kg were offered to them after completing 4th and 1st h of recovery in standard and experimental group, respectively. Next hour onward clear fluids was given as per the need of patients. Safety profile, safety protocol, and parental/patient satisfaction with early and delayed oral hydration were recorded. Data analysis was done using SPSS (Statistical package for social sciences) version 20:0 and P < 0.05 was considered statistically significant. Results: Statistical insignificant difference was found with age, sex, weight, and the American Society of Anesthesiologists status, duration of surgery, type of surgery, type of anesthesia, fasting time, time from last intake of liquid and solid preoperatively in both the groups. None of the patients enrolled in the study experienced desaturation, moderate sedation, regurgitation, or pulmonary aspiration of gastric content. The incidence of postoperative nausea and vomiting was 7.5% and 3.75% in the standard and experimental group, respectively. Mean total volume of oral hydrating solution was 140.82 ml and 123.56 ml in standard and experimental group, respectively. Statistically significant difference (P < 0.001) was observed in parental/pediatric patient satisfaction score among two groups. Significantly shorter time to oral hydration in experimental group (71.44 min) than standard group (244.44 min) was as expected. Conclusion: Early postoperative oral hydration with clear liquid is safe and highly satisfying for parents and patients following elective nonabdominal surgery.

Objectives: This study was conducted to determine the prevalence and to understand the maternal characteristics and risk factors of small for gestational age (SGA) fetuses among booked antenatal mothers in the third trimester in a tertiary care hospital. Methods: 250 consecutive booked and singleton mothers at or above 28 weeks gestation were screened for SGA. Those who were diagnosed so, were matched 1:2 ratio with age matched controls and compared. Results: The prevalence of SGA was 13.6% (95% CI 9.4-17.8). Fifty-three percent were in the age group of 20-24 years, 68% were primigravida and 75% of multigravida women had previous history of SGA child. Mothers of SGA fetuses had median BMI of 22.4 kg/m2 and gained 8 kg in pregnancy. Each kilogram gain in pre-pregnancy weight reduces the risk of having SGA fetus by 0.8%. Each earlier week of delivery increased the risk of LBW by 20%. Each gram of low hemoglobin increased the risk of having SGA fetus by 7.6%. Mothers with previous history of SGA had odds of 36 times to have SGA fetus in the current pregnancy. Conclusions: Apart from knowing the prevalence, this study also sheds light into fact that several social, educational and nutritional factors play a role in causation of a SGA fetus. Health policies aimed in improving adolescent health and education could be one of the primary preventive strategies.

In 1960, Dr Nina Starr Braunwald became the first woman to perform open heart surgery. Sixty years later, despite the fact that women outnumbered men in American medical school in 2017, men still dominate the field of cardiac surgery. Women surgeons remain underrepresented in cardiac surgery; 11% of practicing cardiac surgeons in Canada were women in 2015, and 6% of practicing adult cardiac surgeons in the US were women in 2019. Although women remain a minority in other surgical specialties also, cardiothoracic surgery remains one of the most unevenly–gender distributed specialties. Why are there so few women cardiac surgeons, and why does it matter? Evidence is emerging regarding the benefits of diversity for a variety of industries, including healthcare. In order to attract and retain the best talent, we must make the cardiac surgery environment more diverse, equitable, and inclusive. Some causes of perpetuation of the gender gap have been documented in the literature—these include uneven compensation and career advancement opportunities, outdated views on family dynamics, and disproportionate scrutiny of women surgeons, causing additional workplace frictions for women. Diversity is an organizational strength, and gender-diverse institutions are more likely to outperform their non-gender-diverse counterparts. Modifiable issues perpetuate the gender gap, and mentorship is key in helping attract, develop, and retain the best and brightest within cardiac surgery. Facilitating mentorship opportunities is key to reducing barriers and bridging the gap. Résumé: En 1960, la Dre Nina Starr Braunwald est devenue la première femme à pratiquer une chirurgie à cœur ouvert. Soixante ans plus tard, malgré le fait que les femmes étaient plus nombreuses que les hommes dans les facultés de médecine américaines en 2017, les hommes dominent toujours le domaine de la chirurgie cardiaque. Les chirurgiennes restent sous-représentées en chirurgie cardiaque; 11 % des chirurgiens praticiens en cardiologie au Canada étaient des femmes en 2015, et 6% des chirurgiens praticiens en cardiologie pour adultes aux États-Unis étaient des femmes en 2019. Bien que les femmes restent également minoritaires dans d’autres spécialités chirurgicales, la chirurgie cardiothoracique reste l’une des spécialités où la répartition des sexes est la plus inégale. Pourquoi y a-t-il si peu de chirurgiennes en cardiologie, et pourquoi est-ce important? Des données émergent au sujet des avantages de la diversité pour une variété de secteurs, y compris les soins de santé. Afin d’attirer et de retenir les meilleurs talents, nous devons rendre le milieu de la chirurgie cardiaque plus diversifié, équitable et inclusif. Certaines causes expliquant la persistance de l’écart entre les sexes ont été documentées dans la littérature : il s’agit notamment de l’inégalité de la rémunération et des possibilités d’avancement, de points de vue dépassés sur la dynamique familiale et de l’attention disproportionnée portée aux chirurgiennes, ce qui entraîne des frictions supplémentaires pour les femmes en milieu de travail. La diversité est une force au sein d’une organisation, et les établissements où la diversité des genres est présente sont plus susceptibles d’obtenir de bons résultats que les autres. Des problèmes modifiables perpétuent l’écart entre les sexes, et le mentorat est essentiel pour attirer, perfectionner et retenir les meilleurs éléments dans le domaine de la chirurgie cardiaque. Il est essentiel de faciliter les possibilités de mentorat pour réduire les obstacles et combler le fossé.

Objectives: To note the value of serum Vitamin B12, folic acid, and ferritin in normal and high-risk pregnancies (HRPs) in patients attending antenatal clinic at All India Institute of Medical Sciences (AIIMS). Materials and Methods: This is a cross-sectional study where a total of 282 patients attending Gynaecology Outpatient Department at AIIMS, New Delhi, India were recruited. Among the 282 subjects, 251 were pregnant, and 31 were controls. The serum was tested for serum Vitamin B12, serum folic acid, and serum ferritin levels using Beckman Coulter Access 2 immunoassay. Results: The median value of serum folic acid level in pregnant women was 12 pg/ml with range being 2–20 pg/ml in contrast to 8 pg/ml with range being 3–20 pg/ml in nonpregnant female. This difference was statistically significant. (P = 0.05). There was no significant difference in the median level of serum Vitamin B12 and serum ferritin in pregnant and nonpregnant group. Serum Vitamin B12 level was lower in the third trimester (127 pg/ml) than in first trimester (171 pg/ml) and the difference is statistically significant (P = 0.03). Serum ferritin levels were also significantly lower in the second trimester (16.4 pg/ml) than third trimester (24.55 pg/ml). Although the median serum folic acid level was lower in the first trimester (9.84 pg/ml) than in second trimester (10.8 pg/ml) and in the third trimester (13.18 pg/ml) but the difference was not statistically significant. There was no significant difference in Vitamin B12 level in HRPs (median value 134 pg/ml) as compared to low-risk pregnancies (149.5 pg/ml). Conclusion: Serum folic acid levels are significantly higher during pregnancy as compared to nonpregnant state. However, there was no significant difference in the median level of serum Vitamin B12 and serum ferritin in pregnant and nonpregnant group. Serum folic acid level and ferritin level were significantly higher in HRPs compared to low-risk pregnancies.

Objectives: To note the value of serum parathyroid hormone (PTH) levels in normal and high-risk pregnancies (HRP) in patients attending antenatal visits at All India Institute of Medical Sciences (AIIMS). Materials and Methods: This is a cross-sectional study where a total of 282 patients attending Gynecology Outpatient Department at AIIMS, New Delhi were recruited. Among the 282 subjects, 251 were pregnant, and 31 were controls. The serum was tested for serum PTH levels using Beckman coulter access 2 immunoassay. Results: The median value of PTH level in pregnant women was 31.6 pg/ml with range being 0.8–505.5 pg/ml in contrast to 45.9 pg/ml with range being 19–102.7 pg/ml in nonpregnant female. This difference was statistically significant ( P = 0.0012). There was no significant difference in median level of PTH in different age group. Although the median PTH levels were lower in second trimester (25.25 pg/ml) than in first trimester (35.5 pg/ml) and in third trimester (32.4 pg/ml), the difference was not statistically significant. There was no significant difference in PTH level in HRP (median value – 31.6 pg/ml) as compared to low-risk pregnancies (31.5 pg/ml). Conclusion: Serum PTH levels are significantly lower during pregnancy as compared to nonpregnant state. However, age, parity, and HRP did not alter PTH level during pregnancy.

b>Introduction and Materials and Methods: Early diagnosis of sepsis is extremely important to reduce high mortality and morbidity. In this study, clinical usefulness of the volume, conductivity and scatter parameters (mean channels of cell volume, conductivity, and light scatter) in neutrophils was analyzed for predicting acute bacterial infection, which are obtained by the Coulter LH 750 Hematology Analyzer (Beckman Coulter, Fullerton, CA, USA) during automated differential counts. Results: Peripheral blood samples from 162 patients with positive blood cultures for bacteria and 40 healthy controls were studied. We observed a significant increase in the mean channel of neutrophil volume (MNV) from septic patients compared with control subjects (156 ± 13.5 vs. 143 ± 4.8; P < 001). Discussion and Conclusion: An elevation of the MNV was associated with a higher white blood cell count and percentage of neutrophils and was present even in patients who did not have leukocytosis or neutrophilia. With a cut-off of 149 for the MNV, a specificity of 91.4% and sensitivity of 88.7% were achieved. As a quantitative, objective, and more sensitive parameter, we propose that the MNV has a potential to be an additional indicator for acute bacterial infection.

Malaria, a febrile illness mostly confined to the tropical countries is transmitted by bite of infected female Anopheles mosquito. In 2015 alone, 88% of the malaria burden and 90% deaths due to malaria were confined to the African and Asian countries. Although number of tests are available for rapid diagnosis and screening for malaria, peripheral blood smear examination remains the gold standard. Leishman stain is recommended by WHO however herein we evaluate one of the alternative methods of staining which is simple and rapid. Fifty patients attending the various outpatient departments of the tertiary care hospital with fever and suspected to have malaria were selected. Two thin air dried smears prepared from the peripheral venous blood from these subjects were stained by Leishman and Toluidine blue method. The findings of the slides by two independent qualified professionals were noted and the results were analyzed. A total of 14% (7/50) cases were diagnosed to have malaria. All the malaria cases which were positive in Leishman stain were also detected in Toluidine blue stain. Malarial parasites were clearly visible against the homogenously light green background in Toluidine blue. The detection of malarial parasite by Toluidine blue was quick, easy and confirmative. Toluidine blue stained peripheral blood smear allows for easy identification and speciation of malarial parasite at low magnification and in shorter period of time.

Context: Coagulopathy frequently occurs following traumatic brain injury (TBI) and usually occurs 6-72 hour post-trauma. The incidence and the probable risk factors for development of coagulopathy and poor outcome following TBI are largely unknown and vary considerably. Aims: To assess the incidence and probable risk factors for development of coagulopathy and to identify the risk factors for poor outcome in terms of median survival time following TBI. Materials and Methods: In this prospective study over two years, patients of isolated moderate and severe traumatic brain injury (GCS≤12) admitted to trauma center had coagulation profile (PT, APTT, thrombin time, fibrinogen and D-dimer), arterial lactate and ABG analysis done on day of admission and on day three. Coagulopathy was defined as prothrombin time (PT) or/and activated partial thromboplastin time (APTT) more than 1.5 times the normal control. Incidence of in-hospital mortality was assessed in all cases. Statistical Analysis: A stepwise logistic regression analysis was performed to identify risk factors for coagulopathy and mortality in these patients. Results: A total of 208 patients were enrolled in the study. The mean age was 32 ± 12 years and mean GCS was 7.1 ± 2.8. Coagulopathy was present in 46% ( n = 96) of patients. Risk factors for development of coagulopathy were found out to be severity of head injury (OR: 2.81), elevated D-dimer (OR: 3.43), low hemoglobin (OR: 3.13), and effaced cisterns in the CT scan (OR: 2.72). Presence of coagulopathy (OR: 2.97) and severity of head injury (OR: 5.70) strongly predicted poor outcome, and were associated with a decreased median survival time. Conclusions: There is a high incidence of coagulopathy following TBI. The presence of coagulopathy as well as of severity of TBI are strong predictors of in-hospital mortality in these patients.

INTRODUCTION AND METHODS : Early diagnosis of sepsis is extremely important to reduce high mortality and morbidity. In the present study, clinical usefulness of the VCS parameters (mean channels of cell volume, conductivity, and light scatter) in neutrophils was analysed for predicting acute bacterial infection, which are obtained by the Coulter LH 750 hematology analyzer (Beckman Coulter, Fullerton, CA) during automated differential counts. RESULTS: Peripheral blood samples from 162 patients with positive blood cultures for bacteria and 40 healthy controls were studied. We observed a significant increase in the mean channel of neutrophil volume (MNV) from septic patients compared with control subjects (156 ± 13.5 vs 143 ± 4.8; P < .001). DISCUSSION AND CONCLUSION: An elevation of the MNV was associated with a higher WBC count and percentage of neutrophils and was present even in patients who did not have leucocytosis or neutrophilia. With a cutoff of 150 for the MNV, a specificity of 91% and sensitivity of 70% were achieved. As a quantitative, objective, and more sensitive parameter, we propose that the MNV has a potential to be an additional indicator for acute bacterial infection.

Importance and Objective: Menopause is a reproductive transition affecting half the world's population. Stigma and limited availability of evidence-based treatments that support biopsychosocial well-being mean that this life stage is often associated with challenging symptoms and reduced quality of life (QoL). The aim of this review was to examine the extent literature on psychological and mind-body interventions to manage perimenopausal and postmenopausal symptoms, and apply an interdisciplinary clinical, research, and cultural knowledge framework to guide recommendations for improving QoL and healthy aging in this population. We also aimed to understand the ideal delivery mode for such interventions., Methods: Using Scopus, Medline, and PubMed, a review of systematic reviews, guidelines, and randomized controlled trials was undertaken to examine the use of psychological and mind-body interventions to improve menopause-related QoL and symptoms, including hot flushes, depression, anxiety, fatigue, pain, and sleep; conclusions were based on an analysis of this available evidence and linked to clinical and cultural considerations., Discussion and Conclusion: Empirical support exists for a number of psychological and mind-body approaches to support QoL and symptoms during the menopause transition. The literature also identifies the need for menopause care that is culturally responsive.An online multimodal model of menopause care is thus recommended, incorporating evidence-based treatments (eg, cognitive behavioral therapy, yoga, hypnosis) and treatment techniques (eg, mindfulness, and education including nutrition support), as well as First Nations wisdom. We also recommend financial well-being approaches to support people undergoing menopause. Integrated, multimodal approaches should be available online to remove time, location, and healthcare access barriers, and be designed with diverse consumers to ensure equity for those underserved due to region, LGBTIQ+ assigned female at birth status, and for multicultural and First Nations people., Competing Interests: Financial disclosures/conflicts of interest: R.B. received funds from Besins P/L, Astellas P/L, and Theramex P/L for lectures given at sponsored meetings, and served on a medical advisory board for Astellas P/L in January 2024. The other authors have nothing to disclose., (Copyright © 2024 by The Menopause Society.)

Introduction: Bardet-Biedl Syndrome (BBS) is a ciliopathy causing developmental defects and progressive retinal dystrophy, whereas choroidal coloboma is a developmental defect causing structural deficiency in the posterior retina. Both are rarely reported together., Methods: Here, we describe the phenotype and genotype of three unrelated patients with co-occurrence of Bardet-Biedl Syndrome and chorioretinal coloboma and review the pertinent literature., Results: We describe three unrelated patients, with variable clinical features of Bardet Biedl syndrome. None had family history of BBS or coloboma. Each carried biallelic variants in BBS1 , BBS9 and TTC8 gene, respectively. Two had unilateral chorioretinal coloboma, while one had bilateral chorioretinal coloboma., Discussion: Although there may be other explanatory factors yet to be revealed, our data suggests that chorioretinal coloboma may be associated with BBS. The Hedgehog (Hh) signaling pathway, an intercellular communicator for development of the eye, is dependent on the primary cilia and plays a crucial role in the closure of the optic fissure. Both disorders therefore involve disruption of primary cilia function which may explain their association.

Background: Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common disorders of gut-brain interaction (DGBI). The Rome IV criteria are the gold standard for research when diagnosing DGBI. However, bothersomeness, or the degree to which symptoms are distressing or disruptive to a person's daily life, is a potential treatment-seeking motivator that is not assessed by the Rome criteria. The Rome Foundation developed and published diagnostic criteria for clinical practice that include bothersomeness. We aimed to evaluate these constructs via patient focus groups to determine what prompts healthcare-seeking as a means to assess its value in the Rome clinical criteria., Methods: Adults meeting Rome IV criteria for IBS, FD, or both participated in focus groups in Australia and the United States. Semi-structured interview transcripts were analyzed using Template Thematic Analysis, with three a priori and other a posteriori themes refined iteratively through team discussion and consensus., Key Results: Participants confirmed the frequency and duration of symptoms was not sufficient to reflect illness experience. Four major themes emerged: (1) Bothersomeness should be included in assessments of IBS and FD; (2) Patients find many DGBI symptoms bothersome; (3) Bothersomeness traverses multiple domains of quality of life; (4) Patients may hesitate to seek medical advice due to past negative experiences., Conclusions and Inferences: These findings support the value of the Rome Clinical Criteria. They emphasize the importance of expanding assessments of patients with DGBI to include how bothersome they perceive symptoms to be, how much symptoms interfere with their daily life, and what may moderate their decisions to seek treatment., (© 2024 John Wiley & Sons Ltd.)

Background: The outcomes of single-ventricle palliation in unbalanced atrioventricular canal defect with coarctation of aorta (uAVC+CoA) have not been well studied. Systemic ventricle outflow tract obstruction has a propensity to develop in these patients after aortic arch repair with pulmonary artery banding (arch-PAB), which may adversely affect survival and Fontan candidacy., Methods: A retrospective review was performed of patients who underwent single-ventricle palliation for uAVC+CoA from 2000 to 2022. Patients were divided into 2 groups based on initial palliation: (1) arch-PAB and (2) Norwood procedure. Demographic and clinical characteristics were analyzed and compared along with survival data., Results: Stage 1 palliation for uAVC+CoA was performed in 41 patients. Arch-PAB was performed in 14 infants and Norwood in 27 infants. Arch-PAB patients had more chromosomal abnormalities (28.6 vs 7.4%, P < .009) and less severe systemic ventricle outflow tract obstruction on baseline echocardiogram (0.0 vs 70.4%, P < .001). Survival to stage 3 palliation was lower for the arch-PAB group (28.6% vs 66.6%, P = .02). Arch-PAB remained a significant risk factor for mortality (hazard ratio, 2.93; 95% CI, 1.05-8.53; P = .04) after adjusting for chromosomal abnormalities and atrioventricular valve regurgitation. After arch-PAB, systemic ventricle outflow tract obstruction was diagnosed in 13 of 14 patients. Echocardiography underestimated the degree of outflow tract obstruction in 10 of 13 arch-PAB patients., Conclusions: Arch-PAB has worse outcomes than Norwood for uAVC+CoA. Systemic ventricle outflow tract obstruction develops in almost all patients after arch-PAB. Outflow tract obstruction is underestimated by the echocardiogram and requires a high index of suspicion, along with advanced imaging, to ensure timely diagnosis and management., Competing Interests: Disclosures Fawwaz R. Shaw is a member of The Annals of Thoracic Surgery Editorial Board. The other authors have no conflicts of interest to disclose., (Copyright © 2024 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: The effect of COVID-19 pandemic on the rates and trends of Needlestick and sharp injuries (NSSIs) and splash injuries (SIs) among healthcare providers (HCPs) is not well defined., Methods: A retrospective study analyzed the rates of injuries among HCPs during the pre-pandemic (38 months) and pandemic (37 months) periods. Single interrupted time-series analysis (SITSA) was employed to assess the impact of the pandemic on injury rates., Results: During the pre-pandemic and pandemic periods, 608 and 637 NSSIs and 137 and 120 SIs were reported, respectively. No statistically significant difference was identified in the median monthly rates of NSSIs (0.34 vs. 0.37; p=0.622) and SIs (0.075 vs. 0.047; p=0.094) per 1000 inpatient days, nor their combined risk (0.439 vs. 0.434; p=0.449). The SITSA indicated a marginally significant trend during the pandemic, with a monthly 0.0028% decrease in NSSI/SI rates (p = 0.059). Subsequent SITSA revealed significant changes in rates of NSSI during the pandemic, with rates rising early (p = 0.016) and falling marginally later (p = 0.051)., Conclusions: We report no statistically significant difference in the rates of NSSIs/SIs between the pre-pandemic and pandemic periods. HCPs remain at risk for occupational injuries, emphasizing targeted training and well-designed infection control policies., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To report incidence of procedure related complications in preterm infants with ROP treated with intravitreal anti vascular endothelial growth factors (anti VEGF) injection in both eyes on same day DESIGN: Retrospective, multicenter case series SUBJECTS: Preterm infants with ROP treated with anti VEGF bilaterally on same day METHODS: Intervention: All included infants underwent intravitreal anti VEGF injection in both eyes under aseptic precautions in ophthalmic operation theatre (OT) or neonatal intensive care unit (NICU). Postoperative examination was performed to look for procedure related complications MAIN OUTCOME MEASURES: Incidence of procedure related complication (Presumed endophthalmitis, intraocular inflammation, lens injury, vitreous hemorrhage, retinal tear) in the study cohort. To study association of indication, type of anti VEGF, type of needle used, setting of procedure, site of injection (distance from limbus) and experience of the treating ophthalmologist with the complications., Results: 9984 eyes of 4992 infants were analysed. The procedure was most commonly performed in ophthalmic OT (8258, 82.7%) using 29G (4514, 45.2%) needle between 1-1.5 mm (9984, 100%) from limbus. Aggressive retinopathy of prematurity was the most common indication for anti VEGF use (4866, 48.7%) while Bevacizumab was the most commonly used anti VEGF agent (8642, 86.6%). Overall, 26 eyes (0.3%) had procedure related complications. Lens injury (15, 0.15%) and presumed endophthalmitis (7, 0.07%) were most common complications. One eye had culture proven endophthalmitis with Pseudomonas aeruginosa. No case of bilateral endophthalmitis was noted. Endophthalmitis was not associated with setting of procedure or type of anti VEGF used, while risk of lens injury was seven times higher when performed in NICU and 30 times higher when performed by an ophthalmologist with < 1year of experience in injecting anti VEGF in preterm infants., Conclusions: The incidence of presumed endophthalmitis after bilateral same day anti VEGF in infants with ROP is 0.07%. These infants can be treated in both eyes on same day with the anti VEGFs and needles (29-32G) evaluated in this study, with emphasis on the direction of needle parallel to visual axis. Extra precaution is advocated if the procedure is planned in NICU or by an ophthalmologist with limited experience., (Copyright © 2024. Published by Elsevier Inc.)

The brain is an incredibly complex structure that consists of millions of neural networks. In developmental and cellular neuroscience, probing the highly complex dynamics of the brain remains a challenge. Furthermore, deciphering how several cues can influence neuronal growth and its interactions with different brain cell types (such as astrocytes and microglia) is also a formidable task. Traditional in vitro macroscopic cell culture techniques offer simple and straightforward methods. However, they often fall short of providing insights into the complex phenomena of neuronal network formation and the relevant microenvironments. To circumvent the drawbacks of conventional cell culture methods, recent advancements in the development of microfluidic device-based microplatforms have emerged as promising alternatives. Microfluidic devices enable precise spatiotemporal control over compartmentalized cell cultures. This feature facilitates researchers in reconstituting the intricacies of the neuronal cytoarchitecture within a regulated environment. Therefore, in this review, we focus primarily on modeling neuronal development in a microfluidic device and the various strategies that researchers have adopted to mimic neurogenesis on a chip. Additionally, we have presented an overview of the application of brain-on-chip models for the recapitulation of the blood-brain barrier and neurodegenerative diseases, followed by subsequent high-throughput drug screening. These lab-on-a-chip technologies have tremendous potential to mimic the brain on a chip, providing valuable insights into fundamental brain processes. The brain-on-chip models will also serve as innovative platforms for developing novel neurotherapeutics to address several neurological disorders.

Objective: To profile a cohort of gyrate atrophy patients classified by widefield retinal imaging and correlate the structural, biochemical, and functional characteristics., Design: Retrospective observational cohort study., Participants: Sixty-five patients (129 eyes) with gyrate atrophy., Methods: Data of participants with a diagnosis of gyrate atrophy were retrieved from their electronic medical records (January 2015 to December 2023). Retinal involvement was classified into 3 zones using widefield retinal images. Zone 3 had atrophic patches in the area anterior to the equator; zone 2 had involvement limited to the arcades but posterior to the equator; zone 1 had involvement within the vascular arcades and/or peripapillary region, with or without any other zone involvement. Macular assessment was performed using swept-source OCT (n = 104). Flash electroretinogram (ERG) was performed in 40 eyes. Serum ornithine levels (n = 35) were measured, and genetic analysis was conducted (n = 18)., Main Outcome Measures: Demography, patient profile, zone of retina involved, macular features, and serum ornithine levels., Results: The average age at presentation was 26.4 (range, 5-67) years; the majority were male. Nyctalopia (n = 35, 53.8%) and blurred vision (n = 29, 44.6%) were the most common symptoms. Positive family history was reported in 32.3% of patients. Most eyes were myopic (69.8% <-3 diopters). Posterior subcapsular cataracts were documented in 36.4% of eyes. The highest frequency of retinal area affected was zone 1 (57.14%), followed by zone 2 (33.33%) and zone 3 (9.52%), correlating with the age at presentation. Foveoschisis was observed in 57.7% of eyes, with a higher prevalence in eyes with zone 1 disease. Elevated serum ornithine levels (>163 μmol/L) were found in 77.14% of patients. The ERG showed nonrecordable (n = 32) or severely reduced (n = 8) responses in scotopic and photopic phases. Genetic analysis of 18 patients identified mutations in the OAT gene, including a novel missense variant (c.290T>C)., Conclusions: This large cohort of patients with gyrate atrophy revealed symmetrical involvement, predominantly in zone 1. Most patients presented between the first and third decades, experienced nyctalopia, vision reduction, early posterior subcapsular cataracts, and varying degrees of myopia. Zone 1 involvement was strongly associated with foveoschisis and visual compromise., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2024 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Outbreaks of the foot-and-mouth disease (FMD) have major economic impact on the global livestock industry by affecting the animal health and product safety. L-protease, a non-structural protein of FMDV, is a papain-like cysteine proteinase involved in viral protein processing as well as cleavage of host proteins for promoting the virus growth. FMDV synthesizes two forms of leader proteinase, L pro (Lab pro and Lb pro ), where the deletion of Lab pro is lethal and Lb pro deletion is reported to be attenuated. Defective replicons have been used by trans-complementing the deleted gene to produce one time replicating virus; thus, the bio-safety procedure can be compromised in the production units. Attempts are made to rescue of ΔLb pro FMDV Asia1 virus by co-expressing the Lb pro protein carried in pcDNA plasmid. Mutant FMDV cDNA, pAsia-ΔLb pro , was constructed by PCR mediated mutagenesis using inverse primers. Transfection of BHK-21 cells with in-vitro transcribed RNA from the constructs failed to produce an infective mutant FMDV. Genetic trans-complementation of the Lb pro , which was done by co-transfecting the pcDNALb pro plasmid DNA along with the pAsia-ΔLb pro RNA in BHK-21 cells also failed to produce viable virus. Expression experiments of reporter genes and indirect immune-fluorescence confirmed the production of the viral proteins in wild type FMDV pAsia WT ; however, it was absent in the pAsia-ΔLb pro indicating that the leaderless virus was unable to produce infectious progeny and infect the cells. Failure to produce virus either by Lb pro deleted mutant clone or by genetic complementation suggests little chance of reversion of the disabled virus with large deletions of FMDV genome., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Introduction: Glioma is a brain tumour occurring in all age groups but common in adults. Despite advances in the understanding of tumours, we cannot improve the survival of the patients and do not have an appropriate biomarker for progression and prognosis prediction. The base excision repair mechanism maintains the integrity of the genome, preventing tumour formation. However, continuous chemical damage to the cells results in mutations that escape the repair mechanism and support tumour growth. The tumour microenvironment in cancer is crucial in determining the tumour growth, development, and response to treatments. The present study explored the significance of Base Excision Repair genes (BER) in modulating the tumour microenvironment., Methods: We used the publically available data sets from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) to explore the role of the base excision repair gene in the modulating tumour microenvironment. The data was analysed for the expression of base excision repair genes, their correlation with the immune markers, their prognostic potential, and enrichment analysis to understand the pathways they modulate in low-grade glioma (LGG) progression., Results: The analysis showed BER genes contribute an integral role in the overall and disease-free survival of LGG. Genes like MUTYH, PNKP, UNG and XRCC1 showed a correlation with the immune infiltration levels and a significant correlation with various immune markers associated with different immune cells, including tumour-associated macrophages. MUTYH, UNG and XRCC1 correlated with IDH1 mutation status, and functional enrichment analysis showed that these genes are enriched in several pathways like Wnt, PD-1 and Integrin signalling., Conclusion: Our findings suggest that the BER genes MUTYH, PNKP, UNG and XRCC1 can potentially be prognostic biomarkers and highly correlate with the immune cells of the tumour microenvironment., Competing Interests: Declaration of Competing Interest The authors have no relevant financial or nonfinancial interests to disclose., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Purpose: To study the clinical profile, treatment, and outcomes of patients 35 years or older diagnosed with Coats disease. Methods: A cross-sectional observational hospital-based study was performed. Results: The study included 74 eyes diagnosed with adult-onset Coats disease. The mean age at presentation was 50 years (range, 35-75). Most patients were men (72.5%) and had a unilateral presentation (92.8%). The most common stage at presentation was 2A (extrafoveal exudation) (39.2%) followed by 2B (foveal exudation (33.7%). Optical coherence tomography was performed in 40 eyes; 32 eyes (80.0%) had intraretinal fluid (IRF), 31 eyes (77.5%) had hard exudates, and 22 eyes (55.0%) had a disorganized retinal inner layer. Fluorescein angiography was performed in 35 eyes and showed an irregular foveal avascular zone in 28 eyes (80.0%). Multiple leaking microaneurysms were seen in 32 eyes (91.4%), with extensive vascular abnormalities involving the macula (86%) and extramacular zones (91%). Treatment modalities comprised laser photoablation (43.4%), cryotherapy with or without laser application (5.7%), and intravitreal injections (49%), alone or in combination. At a mean follow-up of 28 months (range, 3-293), 23 eyes (39.6%) had anatomic resolution of subretinal fluid and/or IRF. No statistical improvement was found in the mean best-corrected visual acuity (VA) between preoperatively and postoperatively ( P  > .05). Conclusions: Patients with adult-onset Coats disease have a unilateral presentation with a less severe stage than patients with childhood-onset disease. Despite the good anatomic responses after treatment, the final VA remained unchanged., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of the article., (© The Author(s) 2024.)

Purpose: FLVCR1 encodes a solute carrier protein implicated in heme, choline, and ethanolamine transport. Although Flvcr1 -/- mice exhibit skeletal malformations and defective erythropoiesis reminiscent of Diamond-Blackfan anemia (DBA), biallelic FLVCR1 variants in humans have previously only been linked to childhood or adult-onset ataxia, sensory neuropathy, and retinitis pigmentosa., Methods: We identified individuals with undiagnosed neurodevelopmental disorders and biallelic FLVCR1 variants through international data sharing and characterized the functional consequences of their FLVCR1 variants., Results: We ascertained 30 patients from 23 unrelated families with biallelic FLVCR1 variants and characterized a novel FLVCR1-related phenotype: severe developmental disorders with profound developmental delay, microcephaly (z-score -2.5 to -10.5), brain malformations, epilepsy, spasticity, and premature death. Brain malformations ranged from mild brain volume reduction to hydranencephaly. Severely affected patients share traits, including macrocytic anemia and skeletal malformations, with Flvcr1 -/- mice and DBA. FLVCR1 variants significantly reduce choline and ethanolamine transport and/or disrupt mRNA splicing., Conclusion: These data demonstrate a broad FLVCR1-related phenotypic spectrum ranging from severe multiorgan developmental disorders resembling DBA to adult-onset neurodegeneration. Our study expands our understanding of Mendelian choline and ethanolamine disorders and illustrates the importance of anticipating a wide phenotypic spectrum for known disease genes and incorporating model organism data into genome analysis to maximize genetic testing yield., Competing Interests: Conflict of Interest James R. Lupski has stock ownership in 23andMe, is a paid consultant for Genome International, and is a coinventor on multiple US and European patents related to molecular diagnostics for inherited neuropathies, eye diseases, genomic disorders, and bacterial genomic fingerprinting. The Department of Molecular and Human Genetics at Baylor College of Medicine receives revenue from clinical genetic testing conducted at Baylor Genetics Laboratories. Amber Begtrup and Houda Elloumi are employees of GeneDx, LLC. All other authors declare no conflicts of interest., (Copyright © 2024 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the outcome and ocular adverse events of bedside bilateral sequential intravitreal anti-vascular endothelial growth factor injections for retinopathy of prematurity (ROP) (BBSIR)., Methods: This retrospective interventional study included infants who received BBSIR with a follow-up of at least 1 month. Clinical history, intravitreal injection details, indications, intraoperative and postoperative ocular adverse events, and outcomes were analyzed., Results: The study cohort included 192 babies (384 eyes) spread over 9 years. The mean gestational age was 30.2 ± 2.6 weeks (28.8-34.1), and the birth weight was 1098.11 ± 271.65 g (650-2000). The indications for BBSIR were as follows: 73.4% (n = 141 infants) were too sick to transfer to an ophthalmic unit, 10.9% (n = 21 infants) due to the parents' inconvenience of traveling to the ophthalmic center, and 15. 6% (n = 30 infants) due to both reasons. The injections were given by an ROP specialist/ROP-trained ophthalmologist after due parental consent, considering each eye as a fresh eye with separate scrubbing and draping. Light from the head-worn indirect ophthalmoscope served as the source of illumination. The retinopathy was regressing/regressed in 92.4% of babies until the last follow-up. The major ocular complication was cataract in 2 eyes (0.5%). There was no incidence of endophthalmitis till last follow-up (median 5.7 months)., Conclusions: As per this study, BBSIR was observed to be effective and safe if given by those fully trained in the management of ROP. Though the rate of complications like cataract is small, they can pose management challenges and impact vision in a growing child., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Objectives: Despite the need and uptake of mental health support by women with endometriosis, no research to date has explored their experience of psychological therapy. We aimed to understand the factors that predict engagement in psychological therapy by Australian women with endometriosis and to qualitative explore their experience of psychological support., Design: Mixed-methods design., Methods: A total of 200 women with self-reported endometriosis were recruited from the community. We explored; (1) the demographic and clinical predictors of engagement in psychological therapy, (2) the psychological approaches that seem most valuable to women in the management of endometriosis and (3) their experience engaging in psychological therapy for endometriosis., Results: Nearly half of women reported to have seen a psychologist within the past year, particularly for pain. Younger age (OR, .94; 95% CI, .886-.993), depressive symptoms (OR, 1.05; 95% CI, 1.002-1.099), and working part time compared to full time (OR, 2.17, 95% CI, 1.012-4.668), increased the likelihood of engaging in psychological therapy. Template thematic analysis identified three themes; (1) endometriosis and pain have multi-faceted psychological effects, (2) psychological support is sought to adjust and live with endometriosis and (3) there are helpful and unhelpful psychological tools for women with endometriosis., Conclusions: Our findings support the use of psychological therapy in the management of endometriosis, and the need for psychological therapy to acknowledge the chronicity and impact of symptoms, to enlist multidisciplinary support and to consider alternative options. Further advocacy is required to educate women on the benefits of psychological therapy for endometriosis., (© 2024 The Authors. British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Extremely preterm infants are at risk of developing retinopathy of prematurity (ROP), characterized by neovascularization and neuroinflammation leading to blindness. Polyunsaturated fatty acid (PUFA) supplementation is recommended in preterm infants to lower the risk of ROP, however, with no significant improvement in visual acuity. Reasonably, this could be as a result of the non-consideration of PUFA metabolizing enzymes. We hypothesize that abnormal metabolism of the arachidonic acid (AA) pathway may contribute to severe stages of ROP. The present study investigated the AA-metabolizing enzymes in ROP pathogenesis by a targeted gene expression analysis of blood (severe ROP = 70, No/Mild = 56), placenta (preterm placenta = 6, full term placenta = 3), and human primary retinal cell cultures and further confirmed at the protein level by performing IHC in sections of ROP retina. The lipid metabolites were identified by LC-MS in the vitreous humor (VH; severe ROP = 15, control = 15). Prostaglandins D2 (p = 0.02), leukotrienes B5 (p = 0.0001), 11,12-epoxyeicosatrienoic acid (p = 0.01), and lipid-metabolizing enzymes of the AA pathway such as CYP1B1, CYP2C8, COX2, and ALOX15 were significantly upregulated while EPHX2 was significantly (0.04) downregulated in ROP cases. Genes involved in hypoxic stress, angiogenesis, and apoptosis showed increased expression in ROP. An increase in the metabolic intermediates generated from the AA metabolism pathway further confirmed the role of these enzymes in ROP, while metabolites for EPHX2 activity were low in abundance. Inflammatory lipid intermediates were higher compared to anti-inflammatory lipids in VH and showed an association with enzyme activity. Both the placenta of preterm infants who developed ROP and hypoxic retinal cultures showed a reduced expression of EPHX2. These findings suggested a strong involvement of EPHX2 in regulating retinal neovascularization and inflammation. The study results underscore the role of arachidonic acid metabolism in the development of ROP and as a potential target for preventing vision loss among preterm-born infants., (© 2024 International Society for Neurochemistry.)

Purpose: To report the clinical profile and donor characteristics of post-optical keratoplasty adverse events notified at an eye bank., Methods: Between January 2013 and December 2022, 37,041 donor corneas were utilized for keratoplasty, of which 16,531 were used for penetrating keratoplasty (PK), 12,171 for endothelial keratoplasty (EK), and 1356 for anterior lamellar keratoplasty (ALK). EK included 10,956 Descemet stripping automated endothelial keratoplasty (DSAEK) and 1215 Descemet membrane endothelial keratoplasty (DMEK). The adverse events reported within the first 6 weeks of optical keratoplasty were analyzed for donor-related parameters., Results: A total of 41 (0.11%) recipients had post-keratoplasty infections. Of these, 33 occurred after EK (29 after DSAEK, and four after DMEK), two after ALK, and six after PK. The clinical presentation was keratitis alone in 16 eyes and associated with endophthalmitis in 25 eyes. The organisms isolated were gram-negative bacteria in 26 eyes, fungus in eight eyes, gram-positive bacteria in four eyes, mixed infection in five eyes, and microbiology inconclusive in seven eyes. The majority (78%) of the gram-negative infections were due to multidrug-resistant organisms. Most (88%) donor corneas were harvested from hospital premises. The most common cause of donor mortality was trauma. The median duration of presentation from surgery was 4.46 (range: 1-30) days. The death to preservation time was 4.18 (1.5-7.65) hours. The death to utilization time was 3 (2-4.7) days., Conclusion: The overall risk of infectious adverse events after keratoplasty was 0.11%, ranging from 0.08% to 0.36%. Most (80.4%) of the adverse events occurred after EK. The majority (78.9%) of the adverse events were of bacterial etiology, of which gram-negative infections (68.4%) were the most common. The trends and microbiological spectrum of organisms associated with infections should be thoroughly documented in eye banks to gain insights and formulate guidelines on the management of adverse events., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Caregivers play an integral role in supporting children's development, not only through their individual parenting practices but also how they work together as coparents. The literature on coparenting is extensive; however, most of the research has relied on global measures to assess the quality and functioning of the coparenting relationship. Examining the coparenting relationship with domain-specific measures enables a deeper understanding of this complex family process. One domain of particular interest is emotion socialization given the vast and long-term consequences emotion socialization has on children's emotional, social, behavioral, and psychological functioning. Emotion socialization literature would benefit from a domain-specific coparenting measure, as researchers have rarely explored how coparents work together when responding to their children's emotions (i.e., coparenting children's emotions). As such, an emotion-focused coparenting measure could address gaps in both coparenting and emotion socialization literature. This study outlines the development and psychometric evaluation of a domain-specific measure of coparenting, the Coparenting Children's Emotion Scale (CCES), which assesses how parents work together when responding to their children's emotions. In the current study, the factor structure, reliability, and validity of the CCES were examined in an Australian sample. Findings from exploratory and confirmatory factor analyses showed that the CCES comprises two subscales that capture coparents' levels of support/cooperation and undermining. In the current sample, both CCES subscales demonstrated good to excellent internal consistency, and good convergent and concurrent validity. The CCES will provide researchers and practitioners with a domain-specific measure to use in exploratory and intervention research., (© 2024 The Author(s). Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

Introduction: The bidirectional relationship between disease activity and mental health in inflammatory bowel disease (IBD) has prompted investigations into the efficacy of psychotherapeutic interventions such as acceptance and commitment therapy (ACT) on biopsychosocial outcomes. We aimed to examine the efficacy of an ACT program (intervention) in comparison with a cognitive behavioral therapy-informed psychoeducation program (active control) for individuals with IBD and coexistent psychological distress. Both programs were delivered online through a hybrid format (i.e., therapist-led and participant-led sessions)., Methods: A total of 120 adults with IBD were randomized to either the intervention (N = 61) or active control groups (N = 59). Efficacy was determined using linear mixed models for group differences, in rate of changes in study outcomes, between baseline, postintervention, and 3-month follow-up., Results: The primary outcome health-related quality of life significantly improved in the intervention group when compared with the active control group, with a significantly different rate of change observed from baseline to postintervention ( t [190] = 2.15, P = 0.033) in favor of the intervention group with a medium effect size (β = 0.41, mean difference = 0.07, 95% confidence interval 0.01-0.12, P = 0.014). Similarly, the secondary outcome Crohn's disease activity significantly reduced in the intervention group when compared with the active control group, with a significantly different rate of change observed from baseline to 3-month follow-up ( t [90] = -2.40, P = 0.018) in favor of the intervention group with a large effect size (β = -0.77, mean difference = -9.43, 95% confidence interval -13.72 to -5.13, P < 0.001) ( P = 0.014). Furthermore, when observing the rate of change in outcomes over time for the groups separately, anxiety symptoms and pain significantly improved in the intervention group only, and conversely, ulcerative colitis activity and stress symptoms significantly improved in the active control group only. All other outcomes (N = 14) significantly improved over time in both groups including IBD activity, gastrointestinal unhelpful thinking patterns, visceral anxiety, fatigue interference, fatigue severity, fatigue frequency, psychological inflexibility, self-efficacy, resilience, current health status, depression symptoms, IBD control, and pain catastrophizing; however, these changes were not significantly different between the groups., Discussion: Both programs were of benefit to people with IBD and distress. However, ACT offers a significant added benefit for health-related quality of life and self-reported Crohn's disease activity and may be a useful adjuvant therapy in integrated IBD care., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

DNA supercoiling is a biophysical feature of the double helix with a pivotal role in biological processes. However, understanding of DNA supercoiling in the chromatin remains limited. Here, we developed azide-trimethylpsoralen sequencing (ATMP-seq), a DNA supercoiling assay offering quantitative accuracy while minimizing genomic bias and background noise. Using ATMP-seq, we directly visualized transcription-dependent negative and positive twin-supercoiled domains around genes and mapped kilobase-resolution DNA supercoiling throughout the human genome. Remarkably, we discovered megabase-scale supercoiling domains (SDs) across all chromosomes that are modulated mainly by topoisomerases I and IIβ. Transcription activities, but not the consequent supercoiling accumulation in the local region, contribute to SD formation, indicating the long-range propagation of transcription-generated supercoiling. Genome-wide SDs colocalize with A/B compartments in both human and Drosophila cells but are distinct from topologically associating domains (TADs), with negative supercoiling accumulation at TAD boundaries. Furthermore, genome-wide DNA supercoiling varies between cell states and types and regulates human gene expression, underscoring the importance of supercoiling dynamics in chromatin regulation and function., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Purpose: To investigate the refractive error profile and progression in infants with different stages of ROP, without ROP, and those who received laser treatment for ROP., Methods: This retrospective study included the data from 838 infants (baseline mean age 3.7 ± 5.4 months) who had premature birth. Among these, 433 infants had one of the stages of ROP and 405 had no ROP. Infants with ROP were sub-divided into stage 1 (n = 76), stage 2 (n = 142), and stage 3 (n = 136) and aggressive posterior ROP, (APROP, n = 79). They were further categorized into those who received treatment (n = 213) and with no treatment for ROP (n = 220). Data from a subset of 117 infants was used to assess the 1-year change in the refractive error. Myopia was defined as spherical equivalent refraction (SER) <-0.50 diopters (D). Eyes with retinal detachment were excluded., Results: Higher percentage of myopia was found in infants with ROP (39.7%) than no-ROP (19.8%), and it increased with severity of ROP: stage 1: 19.7%, stage 2: 33.8%, stage 3: 45.6%, and 59.5% in APROP. Percentage of myopia doubled in those who underwent treatment for ROP (54.5%) compared to no-treatment group (25.5%). Mean (± SEM) change in SER after 1 year was significantly greater in infants with APROP -4.55 ± 1.38 D and stage 3 ROP -2.28 ± 0.57 D compared to other stages and no-ROP., Conclusion: Myopia was found to be more prevalent in preterm infants in general, and more in the presence of ROP. Preterm infants without or with any form of ROP, particularly those with severe form of ROP and those who received treatment require meticulous periodic refractive error assessment., (© 2024 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Introduction: Childhood experiences of pain associated with dental treatment can induce dental anxiety. Inferior alveolar nerve blocks are eight times more likely to fail in patients with irreversible pulpitis., Purpose: The objective was to compare the effectiveness of lignocaine and lignocaine with pre-operative oral ibuprofen for pulpectomy in 5 to 9-year-old children., Methods: One hundred and twenty-two children requiring pulpectomy in mandibular posterior teeth were included. The children were assigned to one of the two groups, Treatment group A: Pre-operative with oral ibuprofen and local anaesthesia with 2% lignocaine (with adrenaline 1: 80000); Treatment group B: Pre-operative with oral placebo and local anaesthesia with 2% lignocaine (with 1: 80000 adrenaline). Pain and pulse rate were recorded at baseline, one hour after administration of oral medication, fifteen minutes following administration of Inferior Alveolar Nerve Block (IANB), and also during the course pulpectomy. The results were statistically analysed using chi square test and repeated measures analysis of variance (ANOVA) Results: In treatment group A, 90.16% children had IANB success. In treatment group B, 9.83% had IANB success. The difference in the success rate between two groups was statistically significant (p<0.001) with an odds ratio of 84., Conclusion: Oral medication with ibuprofen is effective in increasing the success rate of IANB with lignocaine for the treatment of irreversible pulpitis of 5 to 9-year-old children. (EEJ-2023-09-122).

Background: Heart transplantation in the neonatal period is associated with excellent survival. However, outcomes data are scant and have been obtained primarily from two single-center reports within the United States. We sought to analyze the outcomes of all neonatal heart transplants performed in the United States using the United Network for Organ Sharing (UNOS) dataset., Methods: The UNOS dataset was queried for patients who underwent infant heart transplantation from 1987 to 2021. Patients were divided into two groups based on age - neonates (<=31 days), and older infants (32 days-365 days). Demographic and clinical characteristics were analyzed and compared, along with follow up survival data., Results: Overall, 474 newborns have undergone heart transplantation in the United States since 1987. Freedom from death or re-transplantation for neonates was 63.5%, 58.8% and 51.6% at 5, 10, and 20 years, respectively. Patients in the newborn group had lower unadjusted survival compared to older infants (p < .001), but conditional 1-year survival was higher in neonates (p = .03). On multivariable analysis, there was no significant difference in survival between the two age groups (p = .43). Black race, congenital heart disease diagnosis, earlier surgical era, and preoperative mechanical circulatory support use were associated with lower survival among infant transplants (p < .05)., Conclusions: Neonatal heart transplantation is associated with favorable long-term clinical outcomes. Neonates do not have a significant survival advantage over older infants. Widespread applicability is limited by the small number of available donors. Efforts to expand the donor pool to include non-standard donor populations ought to be considered., (© 2024 Wiley Periodicals LLC.)