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Purpose: To compare the visual outcomes of implantable Collamer lens (ICL) with small incision lenticule extraction (SMILE) in cases of moderate-high myopia. Methods: A prospective comparative study was conducted on 60 eyes of 30 patients with moderate-high myopia (−3D to −8D with astigmatism ≤1 D) at a tertiary eye care center. Patients underwent either SMILE or ICL in both eyes and had a postoperative follow-up of 1 year. Results: The manifest refractive spherical equivalent was −5.22 ± 1.05 D and −5.4 ± 1.17 D in the SMILE and ICL groups, respectively (P = 0.53). The mean sphere and cylinder were comparable between the groups. The mean uncorrected visual acuity improved from 1.18 ± 0.19 logMAR to 0.03 ± 0.07 logMAR in SMILE and 1.14 ± 0.25 logMAR to 0.011 ± 0.04 logMAR in the ICL group. The efficacy for SMILE was 83.3% and that for ICL was 93.3%. Safety and predictability (±0.5D) for both was 100%. A significant increase was observed in ocular aberration with a decrease in modular transfer function in the eyes that underwent SMILE, whereas no significant change in the eyes that underwent ICL. A significant difference was observed in all parameters of ocular aberration except corneal trefoil, corneal astigmatism, and PSF between the two groups at the final follow-up. The contrast sensitivity at final follow-up was higher in ICL cases when compared to SMILE. The quality of vision (QoV) score suggested a better QoV with ICL; however, the difference was not statistically significant. Conclusion: Both SMILE and ICL are safe in patients with moderate-high myopia. The efficacy, contrast sensitivity, and postoperative ocular aberration profile are better in cases undergoing ICL.

Effective planning, management, and control of industrial plants and processes have exploded in popularity to enhance global sustainability in recent decades. In this arena, computational predictive models have significantly contributed to plant performance optimization. In this regard, this research proposes an Improvised Grey Wolf Optimizer (IGWO) aided Artificial Neural Network (ANN) predictive model (IGWO-ANN Model-1 to 4) to predict the performance (permeate flux) of desalination plants accurately. For this, the proposed models investigated experimental inputs four: salt concentration & feed flow rate, condenser & evaporator inlet temperatures of the plant. Besides, mean squared error (MSE) and the regression coefficients (R2) have been used to assess the models' accuracy. The proposed IGWO-ANN Model-4 shows strong optimization abilities and provides better R2 = 99.3 % with minimum errors (0.004) compared to existing Response Surface Methodology (RSM) (R2 = 98.5 %, error = 0.100), ANN (R2 = 98.8 %, error = 0.060), GWO-ANN (R2 = 98.8 % error = 0.008), models. The proposed models are multitasking, multilayers, and multivariable, capable of accurately analyzing the desalination plant's performance, and suitable for other industrial applications. This study yielded a promising outcome and revealed the significant pathways for the researchers to analyze the desalination plant's performance to save time, money, and energy.

This research presents a new approach for identifying instances of copy-move forgeries in digital images by utilizing the Multiscale Detector a Neural Network-based method, which serves as an image key-point detector and descriptor. The act of copy-move manipulation involves the replication and subsequent insertion of a specific segment of an image, intending to modify the overall content of the image. The approach we utilize leverages the sophisticated functionalities of Multiscale Detector, a framework that combines key-point detection with descriptor extraction, to accurately detect and localize instances of copy-move manipulation. The effectiveness of our approach is assessed on a range of copy-move forgeries, encompassing instances that have undergone post-processing and geometric transformations. The experimental findings illustrate the resilience of our approach in identifying instances of manipulations over a diverse range of textured images and various alteration approaches. Furthermore, our approach demonstrates strong performance even when subjected to supplementary processing procedures such as brightness modification, color reduction, contrast adjustment, and blurring. Our suggested method has greater performance when compared to the existing manipulation detection approach, as demonstrated through a comparative analysis. In addition, the algorithm we have developed has high computing efficiency, allowing for real-time detection of forgeries. The methodology employed in this study, which builds upon the Multiscale Detector framework, offers a highly effective approach to the detection of copy-move manipulations in digital images.

Water is a natural and essential resource for humans, animals, and plants to persist. However, only ⁓2.5 % of the freshwater resources are available, while the remaining ⁓97.5 % is saline water, which is unsuitable for humanity. According to the WHO, water scarcity will worsen by 2050. As a result, numerous researchers, scientists, and engineers are working in this field to improve water resources with advanced treatment technologies. Aside from the multiple water resources, desalination is critical in converting saline water to fresh water. In line with a recent update from the International Desalination Association (IDA, Reuse Handbook 2022–23), approximately ⁓22,757 desalination plants are operating worldwide, providing ⁓107.95 million cubic meters of freshwater per day (m3/day). Furthermore, in this digital age, artificial intelligence (AI) techniques, such as gray wolf optimization (GWO), sine cosine algorithm (SCA), artificial neural networks (ANN), multi-verse optimizer (MVO), fuzzy logic systems (FLS), moth flame optimizer (MFO), particle swarm optimization (PSO), artificial hummingbird algorithm (AHA) and genetic algorithms (GA), are playing a vital role and capable of deep analysis of real-time desalination plant for saving time, energy, human efforts, and money. This study focuses on the critical review and various aspects of current-age PSO-ANN techniques for desalination plants. In this regard, recent datasets of the Web of Science (WoS), provided by Clarivate Analytics, state that about >54,856 records (1965–2023) of desalination and around > 180 records (2008–2023) of PSO-ANN techniques are available globally. These records involve research articles, reviews, proceedings, letters, books, chapters, and editorial materials. Finally, this review article is specific and analyzes the various perspectives of PSO-ANN techniques in the water desalination process, promoting plant engineers and researchers to improve plant performance with minimum effort and time.

Abstract Background Keratoconjunctivitis sicca or dry eye disease (DED) is a multifactorial disorder underpinned by a complex inflammatory cycle. Introduction of topical cyclosporine has been a significant advance in the management of DED. In recent years advancements in formulation technology have led to development of micellar nano-particulate (MNP) cyclosporine formulations that promise better penetration into ocular target tissues and potential for reduced ocular surface irritation. Methods We compared two dosing regimes of a proprietary MNP cyclosporine emulsion with the widely marketed topical cyclosporine formulation Restasis™ in a multicenter parallel-group randomised trial in patients with DED. Patients were randomised to one of 3 treatment groups with 90 patients eligible for the per protocol analysis: 30 in the higher dose test arm A; 32 in the lower dose test arm B; and 28 in the Restasis™ control arm C. All scored efficacy endpoints were tested for significance by comparing the mean change in scores from baseline in the test groups with that in the control group at 12 weeks, using the Student’s t test. Wilcoxon’s rank sum test was used to test individual symptom scores and clinician’s global evaluation of treatment grades. Results Corneal fluorescein staining score, the primary efficacy endpoint, decreased by 6.8 ± 4.0, 5.7 ± 3.9, and 4.6 ± 3.6 points in the 3 groups respectively, indicating superior efficacy in test arm A in comparison to control arm C (p = 0.0026). Schirmer’s tear test, conjunctival lissamine staining score, ocular surface disease index, and individual dry eye symptom scores also favoured higher dose MNP cyclosporine over Restasis™. The study failed to differentiate the treatment arms in terms of clinician’s global evaluation of treatment, use of tear substitutes, best corrected visual acuity or safety and toleration. Conclusion The results indicate that the dose of 1 drop of a 0.05% w/v ophthalmic emulsion of MNP cyclosporine administered topically twice daily yields better outcomes at 12 weeks than the lower dose tested in the study, and is more efficacious than an equivalent dose of Restasis™, the active control used in the study. Trial registration This trial was registered in the Clinical Trials Registry of India on 29/03/2019, and was assigned registration number CTRI/2019/03/018319.

Abstract Introduction For pregnant women, vaccination with inactivated influenza vaccine (IIV) and tetanus, diphtheria, acellular pertussis vaccine (Tdap) is recommended. In Peru, uptake is nonetheless low. A study was conducted to identify factors affecting maternal vaccination coverage. The study’s primary objectives were to describe the knowledge, attitudes, and practices regarding maternal immunization among pregnant/postpartum women and health care professionals (HCPs). The secondary objective was to determine the vaccination coverage and the impact of Ministry of Health (MOH) recommendations. Methods An observational multicenter, cross-sectional survey study was conducted from February 1, 2021 to June 30, 2021 in five cities in Peru. Two surveys were conducted to assess knowledge, attitudes, and practices concerning maternal immunization: one among pregnant/postpartum women and one among HCPs. Results Participants were 668 pregnant/postpartum women with a mean age of 29.6 years and 219 HCPs—mostly midwives (46.6%) and obstetricians/gynecologists (44.7%). Of the pregnant/postpartum women, 66.9% knew that, in general, vaccinations are given for prevention, and 98.5% believed vaccines are important. Nonetheless, 69.6% of pregnant/postpartum women had poor or moderate knowledge of maternal vaccination. Disease knowledge of influenza (89.1%) and tetanus (87.0%) was high, while knowledge of pertussis (37.7%) was low. Women agreed/strongly agreed that they would get vaccinated with Tdap if a doctor (96.3%), midwife (88.9%), or nurse (72.0%) recommended it. Of the HCPs, 81.3% routinely recommended Tdap vaccination for pregnant women. Conclusions To enhance vaccine acceptance in pregnant women in Peru, we must improve knowledge of the diseases, MOH recommendations, and benefits of the offered vaccinations. HCPs could provide this vaccination knowledge and information along with their vaccination recommendation as the pregnant/postpartum women indicated they would take the vaccines if recommended by their HCPs. Our findings are important for the successful implementation of maternal immunization programs in Peru.

Abstract In recent decades, nature-inspired optimization methods have played a critical role in helping industrial plant designers to find superior solutions for process parameters. According to the literature, such methods are simple, quick, and indispensable for saving time, money, and energy. In this regard, the Modified Whale Optimization Algorithm (MWOA) hybridized with Artificial Neural Networks (ANN) has been employed in the Reverse Osmosis (RO) desalination plant performance to estimate the permeate flux (0.118‒2.656 L/h m2). The plant’s datasets have been collected from the literature and include four input parameters: feed flow rate (400‒600 L/h), evaporator inlet temperature (60‒80 °C), feed salt concentration (35‒140 g/L) and condenser inlet temperature (20‒30 °C). For this purpose, ten predictive models (MWOA-ANN Model-1 to Model-10) have been proposed, which are capable of predicting more accurate permeate flux (L/h m2) than the existing models (Response Surface Methodology (RSM), ANN and hybrid WOA-ANN models) with minimum errors. Simulation results suggest that the MWOA algorithm demonstrates a stronger optimization capability of finding the correct weights and biases so as to enable superior ANN based modeling without limitation of overfitting. Ten MWOA-ANN models (Model-1 to Model-10) have been proposed to investigate the plant’s performance. Model-6 with a single hidden layer (H = 1), eleven hidden layer nodes (n = 11) and the thirteen search agents (SA = 13) produced most outstanding regression results (R2 = 99.1%) with minimal errors (MSE = 0.005). The residual errors for Model-6 are also found to be within limits (span of − 0.1 to 0.2). Finally, the findings show that the screened MWOA-ANN models are promising for identifying the best process parameters in order to assist industrial plant designers.

The paper manufacturing process is a large-scale process in which the control performance is required to be optimal in the machine direction (MD) and cross direction (CD). This work focuses on CD control, which is more complicated than MD control. Uncertainties in the process arise from different sources, so there is a requirement for better modeling techniques. The control of paper profile properties, namely basis weight, moisture, and caliper, is done with the help of actuators that are distributed spatially. Basis weight is taken as the profile parameter in this work. The work aims to improve robust performance and simplify the control design problem. Here, $\mu $ synthesis methods are used for controller design, as this method provides guaranteed robust performance. To simplify the design problem two-dimensional modeling is explained explicitly. The conventional methods of $\mu $ analysis are extended to spatial coordinates. The performance of the $\mu $ synthesis designed method is compared with the open loop shaping method. Control performance is judged in terms of sensitivity, stability margin, $\sigma $ performance, and robust performance. The effectiveness of the developed $\mu $ synthesis designed method is demonstrated using the industrial example from the pulp and paper industry.

Myopia is a major public health problem worldwide, including India, with the global prevalence of myopia increasing rapidly over decades. The clinical and socioeconomic impact of myopia is also expected to rise with rising prevalence. Therefore, the focus has now been shifted to prevent the incidence and progression of myopia. However, there is lack of any standardized guidelines for myopia management. This document aims to generate a national-level expert consensus statement on the management of childhood myopia in the Indian scenario. The expert panel of pediatric ophthalmologists consisted of 63 members who met in a hybrid meeting. A list of topics deliberating discussion in the meeting was provided to the experts in advance and they were instructed to provide their opinions on the matter during the meet. The panel of experts then gave their views on each of the items presented, deliberated on different aspects of childhood myopia, and reached a consensus regarding the practice patterns in the Indian scenario. In case of opposing views or lack of a clear consensus, we undertook further discussion and evaluated literature to help arrive at a consensus. A written document is prepared based on recommendations explaining definition of myopia, refraction techniques, components and methods of workup, initiation of anti-myopia treatment, type and timing of interventions, follow-up schedule, and indications for revised or combination treatment. This article formulates evidence-based guidelines for progressing myopes and pre-myopes and also establishes uniformity in the management of childhood myopia in the country.

Wearable sensing technology has quickly transformed from a science-fiction vision to a real-life technology in various fields such as defense, medical sciences, aerospace technology, food tech, etc. Wearable devices are drawing attention in the medical field as they provide relevant information about people’s health in real-time. These sensors are flexible, cost-effective, and highly sensitive, which makes them a favorable candidate for future sensing technology. Despite being relatively small, they frequently sense, collect, and upload a variety of physiological data to enhance quality of life. This could lead to a major change in the daily life of people, but for this change to happen, sustainable energy technology that can power flexible wearable devices is needed. Wearable sensors come in a variety of shapes and sizes and require energy for their proper functioning. As a result, it is critical to develop and choose dependable energy supply systems. This review paper discusses different energy sources that are used to power wearable devices along with various challenges that are in the realm of this technology. The future holds great possibilities for wearable sensing technology, which can be explored only if the power sourcing to these devices is more sustainable, eco-friendly, and efficient.

Abstract Zinc–air batteries proffer high energy density and cyclic stability at low costs but lack disadvantages like sluggish reactions at the cathode and the formation of by-products at the cathode. To resolve these issues, a new perovskite material, CaCu3Ti4O12 (CCTO), is proposed as an efficacious electrocatalyst for oxygen evolution/reduction reactions to develop zinc–air batteries (ZAB). Synthesis of this material adopted an effective oxalate route, which led to the purity in the electrocatalyst composition. The CCTO material is a proven potential candidate for energy applications because of its high dielectric permittivity (ε) and occupies an improved ORR-OER activity with better onset potential, current density, and stability. The Tafel value for CCTO was obtained out to be 80 mV dec−1. The CCTO perovskite was also evaluated for the zinc–air battery as an air electrode, corresponding to the high specific capacitance of 801 mAh g−1 with the greater cyclic efficiency and minimum variations in both charge/discharge processes. The highest power density (Pmax) measured was 127 mW cm−2. Also, the CCTO based paper battery shows an excellent performance achieving a specific capacity of 614 mAh g−1. The obtained results promise CCTO as a potential and cheap electrocatalyst for energy applications.

Myopia or short-sightedness is an emerging pandemic affecting more than 50% population in South-Asian countries. It is associated with several sight-threatening complications, such as retinal detachment and choroidal neovascularization, leading to an increased burden of visual impairment and blindness. The pathophysiology of myopia involves a complex interplay of numerous environmental and genetic factors leading to progressive axial elongation. Environmental factors such as decreased outdoor activity, reduced exposure to ambient light, strenuous near work, and role of family history of myopia have been implicated with increased prevalence of this refractive error. While multiple clinical trials have been undertaken to devise appropriate treatment strategies and target the modifiable risk factors, there is no single treatment modality with ideal results; therefore, formulating a comprehensive approach is required to control the myopia epidemic. This review article summarizes the epidemiology, dynamic concepts of pathophysiology, and evolution of the treatment modalities for myopia such as pharmacological (atropine and other agents) and optical methods (spectacles, contact lenses, and orthokeratology).

In this paper, five storey RC (Reinforced Concrete) building is retrofitted using friction damper and steel bracing methods to achieve a target seismic performance level in terms of inter-storey drift and plastic hinge rotations. Firstly, a static pushover analysis is performed to get the required damping value for the target performance limit. Then a friction damper is designed for this required damping value. To study the effectiveness of friction damper, a time history analysis of building is performed using scaled time history compatible with IS 1893 response spectrum (zone V, soil type 1) in SAP2000 v20. To bring inter-storey drift to the permissible limit, steel bracing along with friction dampers are used. Further response spectrum analysis is carried out to compare the results of storey displacement, drift with that of time history results. So, the combination of friction damper and steel bracing is found to be effective in retrofitting five storey RC buildings.

Background: The COVID-19 pandemic necessitated an unprecedented implementation of remote consultations in UK primary care services. Specifically, older adults in care homes had a high need for infection prevention owing to their existing health conditions. GP practices in the East Midlands incorporated augmented video consultations (AVC) with the potential to support remote healthcare assessments for older adults at care homes. Aim: To explore GPs' and care home staff's experiences of the use of AVC as a mechanism to perform remote examinations of older adults in care homes. Design & setting: Qualitative interviews were conducted with GPs and care home staff in the East Midlands, UK, during May–August 2020. Method: A convenience sample of GPs (n = 5), nurses (n = 12), and senior healthcare assistants (n = 3) were recruited using a purposive approach. Data were collected through semi-structured telephone interviews and analysed using framework analysis. Results: Findings from participants indicated that AVC enabled real-time patient examinations to aid diagnosis and promoted person-centred care in meeting the needs of older adults. The participants also discussed the challenges of video consultations for patients with cognitive impairment and those receiving end-of-life care. Conclusion: AVCs show great potential in terms of GPs providing primary care services for care homes. However, healthcare staff must be involved in the development of the technology, and consideration should be given to the needs of older adults with cognitive impairment and those receiving end-of-life care. It is also vital that training is available to encourage confidence and competency in implementing the technology.

The increasing environmental problems as well as demand of energy encourage the research for safe as well as efficient energy sources. As most of the energy sources are not consistent; thus, there is a requirement for highly efficient energy storing systems. Supercapacitors emerge with great researcher interest because of their very high capacity of storing energy. The performance and efficiency of supercapacitor depends directly on the electrode materials. The oxides of transition metals are highly explored as pseudo capacitors material. Nickel based electrode materials, characterized by ultrahigh theoretical capacitance has gained significant attention. These days nickel oxide-based electrodes owing to their high chemical stability, good theoretical specific capacitance, less cost, easy availability as well as non-toxic nature makes it very popular. This review deals with the recent development in the field of nickel-based supercapacitor electrodes by grouping them on the basis different morphologies such as nanoparticles, nanowires, thin films, nanofibers, etc along with challenges as well as future research.

Abstract Organic solar cells (OSCs) in terms of power conversion efficiency (PCE) and operational lifetime have made remarkable progress during the last decade by improving the active layer materials and introducing new interlayers. The newly developed wide bandgap organic donor and low bandgap acceptor molecules covered the absorption from the visible to the near‐infrared region. Whereas the incident high energy region (UV) is not in favor of OSCs. Its absorption causes thermalization losses and photoinduced degradation, which hinders the PCE and lifetime of OSCs. Recently, lanthanide and non‐lanthanide‐based down‐conversion (DC) materials have been introduced, which can effectively convert the high‐energy photons (UV) to low‐energy photons (visible) and resolve the spectral mismatch losses that limit the absorption of OSCs in high energy incident spectrum. Furthermore, the DC materials also protect the OSCs from UV‐induced degradation. The DC materials were also proposed to cross the Shockley‐Queisser efficiency limit of the solar cell. In this review, the need for DC materials and their processing method for OSCs have been thoroughly discussed. However, the main emphasis has been given to developing lanthanides and non‐lanthanides‐based DC materials for OSCs, their applications, and their impact on photovoltaic device performance, stability, and future perspectives.

The present study aims to see the enhancement in thermoelectric properties of bismuth telluride (Bi2Te3) annealed at different temperatures (573 and 773 K) through silver (Ag) nano-inclusions (0, 2, 5, 10, 15 and 20 wt %). Transmission electron microscopy (TEM) images of Ag incorporated in Bi2Te3 annealed at 573 K shows tubular, pentagonal, trigonal, circular and hexagonal nanoparticles with sizes of 6–25 nm (for 5 wt % Ag ) and 7–30 nm (for 20 wt % Ag). Ag incorporated in Bi2Te3 annealed at 773 K shows mainly hexagonally shaped structures with particle sizes of 2–20 nm and 40–80 nm (for 5 wt % Ag) and 10–60 nm (for 20 wt % Ag). Interestingly, the samples annealed at 573 K show the highest Seebeck coefficient (S, also called thermopower) at room temperature (p-type behavior) for 5% Ag which is increased ca. five-fold in comparison to Ag-free Bi2Te3, whereas for samples with the same content (5% Ag) annealed at 773 K the increment in thermopower is only about three-fold with a 6.9-fold enhancement of the power factor (S2σ). The effect of size and shape of the nanoparticles on thermoelectric properties can be understood on the basis of a carrier-filtering effect that results in an increase in thermopower along with a control over the reduction in electrical conductivity to maintain a high power factor yielding a high figure of merit.

Objectives To determine the risk of obstructive sleep apnea (OSA) for male permanent driving license (DL) applicants of Lucknow, India. Material and Methods In this cross-sectional community based, study body mass index, waist–hip ratio, blood pressure of each subject were determined as an anthropometric parameter along with the history of habit of smoking, tobacco chewing, alcohol consumption. STOP-Bang (Snoring, Tired or sleepy, Observed apnea, high blood Pressure, Body mass index, Age, Neck, Gender) Questionnaire – a scoring risk assessment tool – was applied for assessment of OSA risk (high OSA risk defined by score ≥ 3) for 542 male DL recipients at 2 Regional Transport Office (RTO) centers in Lucknow, India. The statistical software SPSS 17.0 was applied to the testing. Results In total 23% (N = 125) of participants were found with the risk of OSA. High blood pressure (≥ 140/90 mm Hg) was found for the maximum number of participants (40.5%) followed by neck circumference > 40 cm (17.1%), age (> 50 years old) (15.3%), snoring (12.3%) and tired/sleepy (10.5%). Mean values of age, anthropometric measurements and blood pressure were observed significantly higher (p < 0.001) for participants with the OSA risk. In this population the risk of OSA risk (STOP-Bang score ≥ 3) was observed for 6.7% of young ( 45 years old). Conclusions In view of findings of this study a high number of male driving license applicants were observed with the risk of OSA. Therefore efforts should be made to develop a national screening guideline/protocol for the OSA risk assessment for driving license applicants in India. This may reduce the possibility of road traffic accidents due to the OSA-associated fatigue and drowsiness behind the wheels. Int J Occup Med Environ Health 2018;31(1):25–36

Background: Although tension-band wiring is the most widely used technique to treat patellar fractures, metal implant-related complications such as implant failure, palpable hardware are very common and additional procedures are often necessary to treat the complications. We are presenting a new technique of fixing transverse patellar fractures with endobuttons which has minimal hardware-related complications. Materials and Methods: A total of 25 patients with

The metastasis to the eye in a patient of carcinoma of the cervix is rare. A case of carcinoma cervix in a 56-year-old female is described who presented with full chamber pseudohypopyon and deep vascularization in inferior quadrant of the cornea in the left eye. Magnetic resonance imaging revealed features suggestive of ocular metastasis in the anterior part of the uveal tract. Diagnosis was confirmed on cytology which showed features of squamous cell carcinoma. A high level of clinical suspicion in advanced cases of malignancies will help in early detection of ocular metastasis with unusual presentations.

Abstract Lead halide perovskites have displayed the highest solar power conversion efficiencies of 23% but the toxicity issues of these materials need to be addressed. Lead‐free perovskites have emerged as viable candidates for potential use as light harvesters to ensure clean and green photovoltaic technology. The substitution of lead by Sn, Ge, Bi, Sb, Cu and other potential candidates have reported efficiencies of up to 9%, but there is still a dire need to enhance their efficiencies and stability within the air. A comprehensive review is given on potential substitutes for lead‐free perovskites and their characteristic features like energy bandgaps and optical absorption as well as photovoltaic parameters like open‐circuit voltage (VOC), fill factor, short‐circuit current density (J SC), and the device architecture for their efficient use. Lead‐free perovskites do possess a suitable bandgap but have low efficiency. The use of additives has a significant effect on their efficiency and stability. The incorporation of cations like diethylammonium, phenylethyl ammonium, phenylethyl ammonium iodide, etc., or mixed cations at different compositions at the A‐site is reported with engineered bandgaps having significant efficiency and stability. Recent work on the advancement of lead‐free perovskites is also reviewed.

Objective: To study photoreceptor changes after a successful macular hole surgery using adaptive optics. Materials and Methods: Three patients who underwent a successful macular hole surgery were studied. Cone density, spacing, and number of nearest neighbors were analyzed at 2° and 4° of eccentricity in all four quadrants using adaptive optics. Results: All three patients gained a visual acuity better than logMAR 0.477 (Snellen equivalent 6/18) at 6 months following successful macular hole surgery. Following successful closure of the macular hole, photoreceptors were appreciated at 2° and 4° of eccentricity from the center. However, as compared with the fellow normal eye, cell density was reduced significantly in the inferior (12,929.33 ± 2047.50 versus 23,839.67 ± 3711.16 cells/mm 2 at 2°) and temporal quadrant (13,890 ± 3424.26 versus 22,578.67 ± 5651.34 cells/mm 2 at 2°), and intercell spacing was increased significantly in inferior (9.6 ± 0.92 versus 7.14 ± 0.545 µm) and nasal quadrant (8.83 ± 0.39 versus 7.49 ± 0.42 µm). Number of nearest neighbors was unaffected after the hole closure. Conclusion: Postoperative recovery of vision after successful closure of the hole occurs because of the migration or shifting of cells from parafoveal retina toward the center. Cells nearest to the hole margin (at 2° eccentricity) appear to shift more as compared with cells which are further away.

Study DesignProspective cohort study.PurposeEvaluation of the clinico-radiological outcome and complications of limited laminectomy and restorative spinoplasty in spinal canal stenosis.Overview of LiteratureIt is critical to achieve adequate spinal decompression, while maintaining spinal stability.MethodsForty-four patients with degenerative lumbar canal stenosis underwent limited laminectomy and restorative spinoplasty at our centre from July 2008 to December 2010. Four patients were lost to follow-up leaving a total of 40 patients at an average final follow-up of 32 months (range, 24-41 months). There were 26 females and 14 males. The mean±standard deviation (SD) of the age was 64.7±7.6 years (range, 55-88 years). The final outcome was assessed using the Japanese Orthopaedic Association (JOA) score.ResultsAt the time of the final follow-up, all patients recorded marked improvement in their symptoms, with only 2 patients complaining of occasional mild back pain and 1 patient complaining of occasional mild leg pain. The mean±SD for the preoperative claudication distance was 95.2±62.5 m, which improved to 582±147.7 m after the operation, and the preoperative anterio-posterior canal diameter as measured on the computed tomography scan was 8.3±2.1 mm, which improved to 13.2±1.8 mm postoperatively. The JOA score improved from a mean±SD of 13.3±4.1 to 22.9±4.1 at the time of the final follow-up. As for complications, dural tears occurred in 2 patients, for which repair was performed with no additional treatment needed.ConclusionsLimited laminectomy and restorative spinoplasty is an efficient surgical procedure which relieves neurogenic claudication by achieving sufficient decompression of the cord with maintenance of spinal stability.

【Abstract】Simultaneous isolated bilateral patellar fractures are very rare injuries and most often associated with systemic disorders such as hyperparathyroidism, osteoporosis, stress fracture and kidney failure. Isolated bilateral traumatic fracture of patella following an unusual mode of injury is seldomly reported in the literature. We reported such a case following a road traffic accident with-out any associated injuries or co-morbid condition. The patella on the right side had transverse open fracture which was fixed with two Kirschner wires following tension band principle, and that on the left side sustained upper pole comminution which was treated by partial patellectomy. The patient achieved good outcome: at 6 months he was able to squat and sit cross legged; at one year he obtained nearly normal muscle strength and full range of motion. We dis-cussed the injury mechanism, management and rehabilita-tion in such a case and reviewed the available literature regarding such a presentation. Key words: Fractures, bone; Patella; Wounds and injuries

Background: It is over the last decade that research in this field of domestic violence has led to greater recognition of the issue as public health problem. The paper aims to study the prevalence of physical, psychological, and sexual violence and potential risk factors of the women confronting violence within the home in India. Materials and Methods: A multicentric study with analytical cross-sectional design was applied. It covers 18 states in India with 14,507 women respondents. Multistage sampling and probability proportion to size were done. Results: The result shows that overall 39 per cent of women were abused. Women who have a lower household income, illiterate, belonging to lower caste, and have a partner who drinks/bets, etc. found to be important risk factors and place women in India at a greater risk of experiencing domestic violence. Conclusion: As India has already passed a bill against domestic violence, the present results on robustness of the problem will be useful to sensitize the concerned agencies to strictly implement the law. This may lead to more constructive and sustainable response to domestic violence in India for improvement of women health and wellbeing.

Present work reports the fabrication of a multilayer (5-layer) structure of BiFeO3(BFO)/BaTiO3(BTO) using spin-coating technique. The crystallographic structure, surface morphology and ferroelectric behavior of multilayer structure in metal-ferroelectric-metal capacitor have been studied. Le-Bail refinement of X-ray diffraction data revealed the formation of polycrystalline pure perovskite phase with induced stress. The values of remnant (Pr) and saturation polarization (Ps) for BFO/BTO multilayer structure are found to be 38.14 μC/cm2 and 71.54 μC/cm2 respectively, which are much higher than the corresponding values reported for bare BFO thin film. A large value of dielectric constant of 187 has been obtained for multilayer structure with a low leakage current density of 1.09 × 10−7 A/cm2 at applied bias of 10 V. The BFO/BTO multilayer structure favors the enhanced energy storage capacity as compared to bare BFO thin film with improved values of energy-density and charge-discharge efficiency as 121 mJ/cm3 and 59% respectively, suggesting futuristic energy storage applications.

Transition from room temperature diamagnetic to ferromagnetic state in N doped ZnO (ZnO:N) films grown by pulsed laser deposition with tunable energy density has been identified. ZnO:N films deposited with moderate laser energy density of 2.5 J/cm2 are single phase and nearly defect free having N dopant substitution at O sites in ZnO lattice, exhibiting intrinsic ferromagnetism. When energy density reduces (

Hemophagocytic syndrome (HPS) is an extremely rare condition arising from the overactivation of one’s own immune system. It results in excessive inflammation and tissue destruction. Prompt initiation of treatment is warranted in either scenario in order to decrease mortality. Most cases are triggered by infectious agents, malignancy, or drugs. We describe the first case of a CLL patient presenting with HPS due to acquisition of EBV-related large cell lymphoma in the setting of profound immunodeficiency.

We describe a case of anaplastic meningioma presenting in an extracranial osseous location, initially diagnosed as cancer of unknown primary. Although anaplastic meningioma comprise 3% of all meningiomas, this subtype is more likely to be associated with metastases. The increased degree of dedifferentiation in anaplastic meningioma makes diagnosis difficult, especially if characteristic imaging findings of meningioma are not identified. Adequate tissue for diagnostic purposes and appropriate imaging studies may help in establishing a definitive diagnosis.

BACKGROUND: Body mass index (BMI) and waist circumference (WC) are used in risk assessment for the development of non-communicable diseases (NCDs) worldwide. Within a Cambodian population, this study aimed to identify an appropriate BMI and WC cutoff to capture those individuals that are overweight and have an elevated risk of vascular disease. METHODOLOGY/PRINCIPAL FINDINGS: We used nationally representative cross-sectional data from the STEP survey conducted by the Department of Preventive Medicine, Ministry of Health, Cambodia in 2010. In total, 5,015 subjects between age 25 and 64 years were included in the analyses. Chi-square, Fisher's Exact test and Student t-test, and multiple logistic regression were performed. Of total, 35.6% (n = 1,786) were men, and 64.4% (n = 3,229) were women. Mean age was 43.0 years (SD = 11.2 years) and 43.6 years (SD = 10.9 years) for men and women, respectively. Significant association of subjects with hypertension and hypercholesterolemia was found in those with BMI ≥ 23.0 kg/m(2) and with WC >80.0 cm in both sexes. The Area Under the Curve (AUC) from Receiver Operating Characteristic curves was significantly greater in both sexes (all p-values

Clonal eosinophilic disorders are rare among hematological malignancies. Most eosinophilia tends to be due to secondary causes such as infections, hypersensitivity conditions, drug reactions, and connective tissue disorders. The presence of a primary clonal eosinophilic disorder such as chronic eosinophilic leukemia—not otherwise specified (NOS) in the presence of a synchronous large cell lymphoma—is rare making the diagnosis challenging. We present a case of a 51-year-old female with the aforementioned presentation and demonstrate the extensive workup performed to identify the diagnosis.

Shapiro syndrome and periodic hypothermia have been reported approximately fifty times in the literature. Shapiro syndrome is defined as the constellation of periodic hypothermia and hyperhidrosis along with agenesis of the corpus callosum by Shapiro et al. in 1969. Periodic hypothermia is a more broad diagnosis with a number of proposed mechanisms; it occurs in patients without structural brain abnormalities. Hematologic abnormalities beyond iron-deficiency anemia have not been documented in any of the reported cases of Shapiro syndrome or periodic hypothermia. Though accidental and therapeutic hypothermia have been associated with thrombocytopenia, this is, to our knowledge, the first reported case of periodic intrinsic hypothermia causing bicytopenia. In this report, we present the case of a patient with Shapiro syndrome who experienced cyclic bicytopenia mirroring hypothermic episodes. We address the differential diagnosis of bicytopenia, review the mechanisms proposed for cytopenias related to hypothermia, and propose possible mechanisms for the finding in this case.

BACKGROUND: Southeast Asia is a region with great potential for the emergence of a pandemic influenza virus. Global efforts to improve influenza surveillance in this region have documented the burden and seasonality of influenza viruses and have informed influenza prevention strategies, but little information exists about influenza vaccination guidelines and vaccine sales. METHODS: To ascertain the existence of influenza vaccine guidelines and define the scope of vaccine sales, we sent a standard three-page questionnaire to the ten member nations of the Association of Southeast Asian Nations. We also surveyed three multinational manufacturers who supply influenza vaccines in the region. RESULTS: Vaccine sales in the private sector were

Highly c-axis oriented Al and Fe co-doped ZnO (ZAF) thin film is prepared by pulsed laser deposition. Fe introduces redox centre along with shallow donor level while Al doping enhances conductivity of ZnO, thus removing the requirement of both mediator and bottom conducting layer in bioelectrode. Model enzyme (glucose oxidase), was immobilized on surface of ZAF matrix. Cyclic voltammetry and photometric assay show that prepared bio-electrode is sensitive to glucose concentration with enhanced response of 0.18 μAmM-1cm-2 and low Km ∼ 2.01 mM. The results illustrate that ZAF is an attractive matrix for realization of miniaturized mediator-less solid state biosensor.

A novel hybrid matrix of zinc oxide-methylene blue (ZnO-MB) has been successfully developed for biosensing application. The introduction of methylene blue into the ZnO thin film leads to reduction in the charge transfer resistance and suggests an increase in the electron transfer capacity of the composite. Glucose oxidase (GOx) was chosen as the model enzyme and effectively immobilized on the surface of hybrid ZnO-MB nanocomposite matrix. Electrochemical measurements were employed to study biosensing response of the GOx/ZnO-MB/ITO bioelectrode as a function of glucose concentration. The low oxidation potential (−0.23 V) of the hybrid bioelectrode, in a mediatorless electrolyte, makes it resistant against interference from other bio-molecules. The low value of Michaelis-Menten constant (2.65 mM) indicates that immobilized GOx retains its enzymatic activity significantly on the surface of nanocomposite hybrid matrix that results in an enhanced affinity towards its substrate (glucose). The ZnO-MB nanocomposite hybrid matrix, exhibiting enhanced sensing response (0.2 μAmM−1cm−2) with long shelf-life (>10 weeks), has potential for the realization of an integrated biosensing device.