bluuebunny/crossref_metadata_2025 huggingface dataset:
COMMUNICATION STRATEGY IN DELIVERING DA'WAH MESSAGES AND INCREASING THE NUMBER OF FOLLOWERS
Authors: Nurjaman Dadi , Zebua Van Riswansyah
Published: January 2023

This study aims to describe how the communication strategy of an Instagram account @kajianislam is in conveying da'wah messages and in increasing its followers. This descriptive research was carried out in 2022 by selecting the object of study on the social media Instagram account @kajianislam using qualitative research methods. The results of this study indicate that the Instagram account @kajianislam is viewed from a communication strategy according to Onong Uchjana Effendy, namely identifying communication goals, selecting communication media, assessing communication objectives and source credibility. He also took steps to increase his followers so that he was successfully followed by 2.8 million followers.
COMMUNICATION TECHNIQUES OF KH NAJIH AHJAD IN THE COURT OF DA'I PONDOK MASKUMAMBANG ISLAMIC BOARDING SCHOOL
Authors: Handriyani Aan , Chandra Ahmad
Published: January 2023

Research Objectives: To find out the communication techniques of KH. Nadjih Ahjad in the cadre of preachers at the Maskumambang Islamic Boarding School. Methods, this research includes field research with qualitative methods with the aim of getting a complete picture of the object of this research. Research Results, KH. Nadjih Ahjad uses various communication techniques in conducting preacher cadres, namely informative techniques, perfesive techniques, instructive techniques and humanist techniques.
ISLAMIC ETHICS IN COMMUNICATION CROSS POLITICAL PARTIES
Authors: Rokhman Saeful
Published: January 2023

To find out Islamic ethics in communicating across political parties. Research method: Qualitative. Research Results: Every time we welcome the General Election and the Presidential Election, disputes occur so fiercely, both in the real world and in cyberspace. Swearing and swearing in order to defend the party and its lord became our daily food. Therefore, we need to apply three Islamic ethics in communicating across political parties, namely politics without hoaxes, politics without cheating, and politics without criticizing.
A Catalog of Habitable Zone Exoplanets
Authors: Hill Michelle L. , Bott Kimberly , Dalba Paul A. , Fetherolf Tara , Kane Stephen R. , Kopparapu Ravi , Li Zhexing , Ostberg Colby
Published: January 2023

The search for habitable planets has revealed many planets that can vary greatly from an Earth analog environment. These include highly eccentric orbits, giant planets, different bulk densities, relatively active stars, and evolved stars. This work catalogs all planets found to reside in the habitable zone (HZ) and provides HZ boundaries, orbit characterization, and the potential for spectroscopic follow-up observations. Demographics of the HZ planets are compared with a full catalog of exoplanets. Extreme planets within the HZ are highlighted, and how their unique properties may affect their potential habitability is discussed. Kepler-296 f is the most eccentric ≤2 R
⊕ planet that spends 100% of its orbit in the HZ. HD 106270 b and HD 38529 c are the most massive planets (≤13 M
J) that orbit within the HZ, and are ideal targets for determining the properties of potential hosts of HZ exomoons. These planets, along with the others highlighted, will serve as special edge cases to the Earth-based scenario, and observations of these targets will help test the resilience of habitability outside the standard model. The most promising observational HZ target that is known to transit is GJ 414 A b. Of the transiting, ≤2 R
⊕ HZ planets, LHS 1140 b, TRAPPIST-1 d, and K2-3 d are the most favorable. Of the nontransiting HZ planets, HD 102365 b and 55 Cnc f are the most promising, and the best nontransiting candidates that have ≤2 R
⊕ are GJ 667 C c, Wolf 1061 c, Ross 508 b, Teegarden’s Star b, and Proxima Cen b.
PROSPECTS FOR DEVELOPMENT OF THE GEOPOLITICAL POSITION OF THE REPUBLIC OF CROATIA
Authors: JOZIĆ Jugoslav , BARIĆ Robert
Published: January 2023

This article analyses to what extent the Republic of Croatia has so far been able to use its favourable geographical position and other geographical features of its territory to improve its own geopolitical position. The article uses the method of neoclassical geopolitics. The conducted analysis shows that the geopolitical agents are aware of the potential of the Croatian territory and that some geopolitical goals are defined in the National Security Strategy. Consequently, Croatian transport infrastructure is constantly being built, modernized, and partly connects to the network of pan-European corridors. Croatia has been able to use its favourable geographical position in defining and implementing its foreign policy goals.
Connectivité entre le reporting financier et extra-financier : une exploration à travers la comptabilité « climat »
Authors: David Bastien , Giordano-Spring Sophie
Published: January 2023

À partir d’informations relevant du reporting climat, cette recherche explore la notion de connectivité entre le reporting financier et extra-financier. À l’aide des propositions de l’EFRAG (2021), nous proposons une définition de la connectivité et élaborons un score de communication qui lui est associé. Une étude exploratoire des pratiques des firmes de l’indice CAC40ESG et CAC40 est ensuite conduite, à partir des scores mesurés et textes qui leurs sont associés. Les résultats mettent en évidence une faiblesse générale de la connectivité et une forte dispersion des profils de publication, y compris au sein de l’indice ESG. Cette hétérogénéité en matière d’indicateurs de performance (KPI) pose des questions sur les difficultés opérationnelles de construction de normes de reporting RSE pour les acteurs de marché.
Sulfated polysaccharide-rich extract from Navicula incerta: physicochemical characteristics, antioxidant activity, and anti-hemolytic property
Authors: González-Vega Ricardo I. , Del-Toro-Sánchez Carmen L. , Moreno-Corral Ramón A. , López-Elías José A. , Reyes-Díaz Aline , García-Lagunas Norma , Carvajal-Millán Elizabeth , Fimbres-Olivarría Diana
Published: January 2023

A sulfated polysaccharide from Navicula incerta (SPNi) was extracted, and its physicochemical characteristics, antioxidant activity, and anti-hemolytic property were investigated. The polysaccharide yield was 4.8% (SPNi weight/biomass dry weight). Glucose, galactose, mannose, and xylose were the primary sugars. The sulfate content and Mw values were 0.46% and 45 kDa, respectively. The FT-IR spectrum showed characteristic bands at 3276,1079,1255, and 820 cm−1, related to -OH, C-O-C, S=O, and C-O-S stretching vibration. The 1H-NMR analysis revealed signals of anomeric protons, indicating the presence of CH2-O and CH-O groups. SPNi registered ferric-reducing antioxidant power (up to 1.47 µmol TE/g) and 54% anti-radical activity on ABTS+. This polysaccharide registered 90% hemolysis inhibition achieving integrity of the erythrocyte membrane. The results indicate that SPNi could be a candidate for biotechnology applications where antioxidant activity and hemolysis inhibition are required.
Intuitionistic fuzzy credibility Dombi aggregation operators and their application of railway train selection in Pakistan
Authors: Qiyas Muhammad , Khan Neelam , Naeem Muhammad , Abdullah Saleem
Published: January 2023

The degree of credibility of the fuzzy assessment value demonstrates its significance and necessity in the fuzzy decision making problem. The fuzzy assessment values should be closely related to their credibility measures in order to increase the credibility levels and degrees of fuzzy assessment values. This will increase the abundance and the credibility of the assessment information. As a new extension of the intuitionistic fuzzy concept, this study suggests the idea of an intuitionistic fuzzy credibility number (IFCN). So, based on Dombi norms, we proposed some new operational laws for intuitionistic fuzzy credibility numbers. Different intuitionistic fuzzy credibility aggregation operators are defined using Dombi t-norm and t-conorm operations. i.e., intuitionistic fuzzy credibility Dombi weighted averaging (IFCDWA), intuitionistic fuzzy credibility Dombi ordered weighted averaging (IFCDOWA), intuitionistic fuzzy credibility Dombi hybrid weighted averaging (IFCDHWA) operators. Next, we defined multiple criteria group decisions (MCGDM) approach. To ensure that their results are reliable and applicable, we also gave an example of railway train selection and discussed comparative result analysis.
Multi-stage hybrid evolutionary algorithm for multiobjective distributed fuzzy flow-shop scheduling problem
Authors: Zhang Wenqiang , Zhang Xiaoxiao , Hao Xinchang , Gen Mitsuo , Zhang Guohui , Yang Weidong
Published: January 2023

In the current global cooperative production mode, the distributed fuzzy flow-shop scheduling problem (DFFSP) has attracted much attention because it takes the uncertain factors in the actual flow-shop scheduling problem into account. This paper investigates a multi-stage hybrid evolutionary algorithm with sequence difference-based differential evolution (MSHEA-SDDE) for the minimization of fuzzy completion time and fuzzy total flow time. MSHEA-SDDE balances the convergence and distribution performance of the algorithm at different stages. In the first stage, the hybrid sampling strategy makes the population rapidly converge toward the Pareto front (PF) in multiple directions. In the second stage, the sequence difference-based differential evolution (SDDE) is used to speed up the convergence speed to improve the convergence performance. In the last stage, the evolutional direction of SDDE is changed to guide individuals to search the local area of the PF, thereby further improving the convergence and distribution performance. The results of experiments show that the performance of MSHEA-SDDE is superior to the classical comparison algorithms in terms of solving the DFFSP.
3D human pose detection using nano sensor and multi-agent deep reinforcement learning
Authors: Sun Yangjie , Che Xiaoxi , Zhang Nan
Published: January 2023

Due to the complexity of three-dimensional (3D) human pose, it is difficult for ordinary sensors to capture subtle changes in pose, resulting in a decrease in the accuracy of 3D human pose detection. A novel 3D human motion pose detection method is designed by combining Nano sensors and multi-agent deep reinforcement learning technology. First, Nano sensors are placed in key parts of the human to collect human electromyogram (EMG) signals. Second, after de-noising the EMG signal by blind source separation technology, the time-domain and frequency-domain features of the surface EMG signal are extracted. Finally, in the multi-agent environment, the deep reinforcement learning network is introduced to build the multi-agent deep reinforcement learning pose detection model, and the 3D local pose of the human is output according to the features of the EMG signal. The fusion and pose calculation of the multi-sensor pose detection results are performed to obtain the 3D human pose detection results. The results show that the proposed method has high accuracy for detecting various human poses, and the accuracy, precision, recall and specificity of 3D human pose detection results are 0.97, 0.98, 0.95 and 0.98, respectively. Compared with other methods, the detection results in this paper are more accurate, and can be widely used in medicine, film, sports and other fields.
Group 2 Innate Lymphoid Cells Are Detrimental to the Control of Infection with Francisella tularensis
Authors: Dow Joshua , Cytlak Urszula M , Casulli Joshua , McEntee Craig P , Smedley Catherine , Hodge Suzanne H , D’Elia Riccardo V , Hepworth Matthew R , Travis Mark A
Published: January 2023

Innate lymphoid cells (ILCs) are capable of rapid response to a wide variety of immune challenges, including various respiratory pathogens. Despite this, their role in the immune response against the lethal intracellular bacterium Francisella tularensis is not yet known. In this study, we demonstrate that infection of the airways with F. tularensis results in a significant reduction in lung type 2 ILCs (ILC2s) in mice. Conversely, the expansion of ILC2s via treatment with the cytokine IL-33, or by adoptive transfer of ILC2s, resulted in significantly enhanced bacterial burdens in the lung, liver, and spleen, suggesting that ILC2s may favor severe infection. Indeed, specific reduction of ILC2s in a transgenic mouse model results in a reduction in lung bacterial burden. Using an in vitro culture system, we show that IFN-γ from the live vaccine strain–infected lung reduces ILC2 numbers, suggesting that this cytokine in the lung environment is mechanistically important in reducing ILC2 numbers during infection. Finally, we show Ab-mediated blockade of IL-5, of which ILC2s are a major innate source, reduces bacterial burden postinfection, suggesting that IL-5 production by ILC2s may play a role in limiting protective immunity. Thus, overall, we highlight a negative role for ILC2s in the control of infection with F. tularensis. Our work therefore highlights the role of ILC2s in determining the severity of potentially fatal airway infections and raises the possibility of interventions targeting innate immunity during infection with F. tularensis to benefit the host.
Apoptosis Inhibitor of Macrophages Contributes to the Chronicity of Mycobacterium avium Infection by Promoting Foamy Macrophage Formation
Authors: Kajiwara Chiaki , Shiozawa Ayako , Urabe Naohisa , Yamaguchi Tetsuo , Kimura Soichiro , Akasaka Yoshikiyo , Ishii Yoshikazu , Tateda Kazuhiro
Published: January 2023

In Mycobacterium avium infections, macrophages play a critical role in the host defense response. Apoptosis inhibitor of macrophage (AIM), also known as CD5L, may represent a novel supportive therapy against various diseases, including metabolic syndrome and infectious diseases. The mechanisms of AIM include modulating lipid metabolism in macrophages and other host cells. We investigated the role of AIM in M. avium infections in vitro and in vivo. In a mouse model of M. avium pneumonia, foamy macrophages were induced 6 wk after infection. The bacteria localized in these macrophages. Flow cytometric analysis also confirmed that the percentage of CD11chighMHCclassIIhigh interstitial and alveolar macrophages, a cell surface marker defined as foamy macrophages, increased significantly after infection. AIM in alveolar lavage fluid and serum gradually increased after infection. Administration of recombinant AIM significantly increased the number of bacteria in the lungs of mice, accompanied by the induction of inflammatory cytokine and iNOS expression. In mouse bone marrow–derived macrophages, the mRNA expression of AIM after M. avium infection and the amount of AIM in the supernatant increased prior to the increase in intracellular bacteria. Infected cells treated with anti-AIM Abs had fewer bacteria and a higher percentage of apoptosis-positive cells than infected cells treated with isotype control Abs. Finally, AIM in the sera of patients with M. avium-pulmonary disease was measured and was significantly higher than in healthy volunteers. This suggests that AIM production is enhanced in M. avium–infected macrophages, increasing macrophage resistance to apoptosis and providing a possible site for bacterial growth.
African Swine Fever Virus E184L Protein Interacts with Innate Immune Adaptor STING to Block IFN Production for Viral Replication and Pathogenesis
Authors: Zhu Zixiang , Li Shasha , Ma Caina , Yang Fan , Cao Weijun , Liu Huanan , Chen Xia , Feng Tao , Shi Zhengwang , Tian Hong , Zhang Keshan , Chen Hongjun , Liu Xiangtao , Zheng Haixue
Published: January 2023

African swine fever is one of the most serious viral diseases that affects domestic and wild pigs. The causative agent, African swine fever virus (ASFV), has evolved sophisticated immune evasion mechanisms that target both innate and adaptive immune responses. However, the underlying molecular mechanisms have not been fully understood. Here, we report that ASFV E184L protein inhibits host innate immune response via targeting the stimulator of IFN genes (STING)-mediated signaling pathway in both human embryonic kidney HEK-293T cells and porcine pulmonary alveolar macrophages. E184L interacts with STING, impairing dimerization and oligomerization of STING but not affecting its puncta formation at the perinuclear region. Furthermore, E184L disrupts STING-TBK1-IRF3 complex formation, leading to inhibition of STING phosphorylation, and IRF3 dimerization and nuclear translocation. The 1–20 aa region in E184L is essential for E184L-STING interaction and blocking IL-1β and type I IFN production. Deletion of E184L in ASFV considerably impairs antagonistic function of the virus in suppression of the STING-mediated antiviral response, an effect that is reversible by introduction of E184L. Importantly, the virulence of mutant ASFV lacking E184L is reduced in pigs compared with its parental virus due to induction of higher IFN production in vivo. Our findings indicate that ASFV E184L is an important antagonist of IFN signaling to evade host innate immune antiviral responses, which improves our understanding of immune evasion mechanisms of ASFV.
A Novel TrxR1 Inhibitor Regulates NK and CD8+ T Cell Infiltration and Cytotoxicity, Enhancing the Efficacy of Anti–PD-1 Immunotherapy against Hepatocarcinoma
Authors: Su Xiaoxia , Yin Hanwei , Bai Man , Liu Jiayi , Liu Runyu , Zeng Huihui , Wen Jinhua
Published: January 2023

Hepatocellular carcinoma (HCC) has the third highest cancer-related mortality rate globally. The immunosuppressive microenvironment of HCC limits effective treatment options. HCC cells and associated microenvironmental factors suppress NK and T cell infiltration and cytotoxic activities. The abnormal number or function of NK and T cells leads to a lack of immune surveillance. Recently, immunotherapy targeting PD-1 and PD-L1 has been shown to activate functionally exhausted cytotoxic immune cells in some solid tumors. However, the response rate and therapeutic efficacy against solid tumors with little lymphocyte infiltration are limited, especially for HCC. Therefore, new targets and therapeutics that induce tumor cell apoptosis and overcome the problem of depletion of immune cells, thereby inhibiting the immune escape of HCC cells, are urgently required. Butaselen (2-bis[2-(1,2-benzisothiazol-2(2H)-ketone)]butane), an organic molecule containing selenium, is a new type of thioredoxin reductase inhibitor. In this study, we found that butaselen promoted NK and T cell activity and infiltration in the tumor microenvironment in HCC-bearing mice by enhancing the expression of CXCR3, NKG2D, and their respective ligands. When used alone, it can significantly inhibit tumor growth and exert a synergistic effect in combination with PD-1 blockade. We suggested the role of the thioredoxin reductase system in the regulation of the tumor immunosuppressive microenvironment and developed a new effective therapeutic molecule for HCC, revealing the mechanism of butaselen in inhibiting tumor cell immune escape.
Complete Tolerogenic Adjuvant Stimulates Regulatory T Cell Response to Immunization
Authors: Zheng Guoxing , Geng Yajun , Yan Zhaoqi , Shin Soo Min , Joshi Kanak , Panicker Anjali , Shankar Archana , Elangovan Ramya , Koehler Jason , Gnanasekar Varun , Gilles Jessica Ann , Munirathinam Gnanasekar , Chen Aoshuang
Published: January 2023

We have determined in mice the minimum composition required for forming a vaccine adjuvant that stimulates a regulatory T (Treg) cell response to immunization, and we named the adjuvant “complete tolerogenic adjuvant.” This new kind of adjuvant may let us use the well-proven “Ag with adjuvant” form of immunization for inducing Treg cell–mediated Ag-specific immunosuppression. The minimum composition consists of dexamethasone, rapamycin, and monophosphoryl lipid A at a mass ratio of 8:20:3. By dissecting the respective role of each of these components during immunization, we have further shown why immunosuppressive and immunogenic agents are both needed for forming true adjuvants for Treg cells. This finding may guide the design of additional, and potentially more potent, complete tolerogenic adjuvants with which we may form numerous novel vaccines for treating immune diseases.
Seismic reflection interpretation of the Carboniferous Cumberland Basin, Northern Nova Scotia
Authors: Durling P W
Published: January 2023

An interpretation of approximately 1700 km of seismic data was completed in 1996. The seismic analysis, together with well information and geological map data, were used to map thirteen seismic horizons in the Cumberland Basin. Ten of the horizons were mapped
only in limited areas, whereas three horizons could be mapped regionally. These are: BW (base of the Windsor Group), BP (base of the Boss Point Formation), and PG (base of the Pictou Group). The BW horizon is the deepest regional horizon mapped. The horizon generally dips southerly toward the
Cobequid Highlands. It is affected by faults adjacent to the Scotsburn Anticline and the Hastings Uplift; the horizon was not recognized over part of the uplift. On the seismic reflection data, the horizon varies between 500 ms and 3200 ms two-way travel time (approximately 800-7600 metres) and
rocks corresponding to this horizon do not outcrop in the basin. The BP and PG horizons can be traced to outcrop on the flanks of the major anticlines. Time structure maps of these horizons mimic the distribution of synclines mapped from outcrop geology. The BP horizon is affected by more faults and
is more tightly folded than the PG horizon south of a major fault (Beckwith Fault). North of the Beckwith Fault, both horizons are essentially flat and not deformed. Several geological relationships were documented during this study. A thick (up to 1600 m) clastic unit was recognized in the central
portion of the southern margin of the Cumberland Basin. It is interpreted as Windsor Group equivalent. Seismic reflections from within the Falls and Millsville conglomerates were recognized and suggest that these rocks correlate with the Windsor Group. Seismic profiles that cross the southern margin
of the Cumberland Basin image parts of the asement complex to the south of the basin (Cobequid Highlands) and show reflection patterns consistent with mountain fronts. The seismic data image the folded and faulted Cobequid Highlands basement complex, which is interpreted as a thrusted structural
wedge.
Photoallergic reaction to cephalosporin
Authors: Kalathil Aishwarya Anilkumar , Phiske Meghana Madhukar , Someshwar Shylaja
Published: January 2023

Photoallergic reactions are Type IV hypersensitivity reactions localized to photo-exposed areas, with generalization in severe cases. Diagnosis is based on history, photo-patch testing and clinico-histopathological correlation. A 47-year-old man developed multiple, erythematous plaques over V-area of neck, retroauricular area, extensor aspect of both forearms after oral cefixime post-cholecystectomy. He had similar episode of lesser severity two months ago after oral Cefixime. Histopathology showed acanthotic epidermis, foci of spongiosis causing vesiculation with lymphocytes. Upper dermis showed infiltrate of lymphocytes and neutrophils along with perivascular infiltrate. Diagnosis was photoallergic reaction to Cefixime. Lesions completely subsided with oral steroids, hydroxychloroquine, antihistamines, sunscreen and emollients over two months. Cephalosporins have multiple side-effects including hypersensitivity, rash, Steven–Johnson syndrome and toxic epidermal necrolysis. Cephalosporin induced photoallergy is not reported. Hence, cephalosporins should be added to the existing list of systemic drugs causing photoallergic reactions.
Determination of the repeatability of corneal densitometry as measured with a Scheimpflug camera device in refractive surgery candidates
Authors: Balparda Kepa , Mesa-Mesa Sara , Maya-Naranjo Maria Isabel , Mora-Sánchez Carolina , Escobar-Giraldo Mariana
Published: January 2023

Purpose:

Corneal densitometry analysis provides an objective measurement of corneal transparency in patients undergoing photorefractive keratectomy (PRK). To date, no study that focuses on determining the reliability and smallest real difference (SRD), specifically in PRK candidates, has been published.

Methods:

The study was conducted at Clínica de Oftalmología Sandiego, Medellín, Colombia. This was a prospective and analytical study. Refractive surgery candidates underwent Pentacam measurements twice with five minutes of difference. Repeatability of measurements was evaluated for every area using Wilcoxon signed-rank test, Spearman’s rank-order correlation, and the intraclass correlation coefficient, followed by a within-subjects factor (Sw) finishing with a determination of the SRD for all areas. Bland–Altman plots were created and analyzed.

Results:

A total of 110 eyes were included. The mean total densitometry was 18.67 ± 1.56 grayscale units (GSU) and 18.65 ± 1.49 GSU for the first and second measurements, respectively. Wilcoxon was non-significant (P > 0.05) while the intraclass correlation coefficient demonstrated an excellent agreement. SRD ranged from 0.21 GSU (posterior × 6–10 mm) to 1.79 GSU (total × 10–12 mm). Anterior depths and 10–12 mm annulus had consistently more variability and greater (worse) SRD. The 10–12 mm annulus showed great dispersion on the Bland–Altman plots.

Conclusion:

Corneal densitometry has an excellent repeatability in refractive surgery candidates for areas below 10 mm. Any densitometry change ≥1.0 GSU in areas under 10 mm should be considered as well above measurement noise and corresponding to a real change in measured parameters. The 10–12 mm area does not seem to be reliable enough in refractive surgery candidates to warrant surveillance after corneal-based surgery.
Secondary glaucoma following vitreo-retinal surgeries
Authors: Kolipaka Gowri P , Rao Aparna
Published: January 2023

Vitreoretinal surgeries either in the form of external compression by buckles or by increasing the intraocular volume by tamponades can cause a significant rise in intraocular pressure (IOP), causing glaucoma to be one of the most common consequences of vitreoretinal surgeries despite improved surgical techniques. Identifying the mechanism that causes the raised IOP is crucial as the management of glaucoma can differ accordingly. Intravitreal (IVT) injections in the form of IVT steroids or anti-vascular endothelial growth factor (anti-VEGF) injections can also cause a significant rise in the IOP and effect, especially the glaucomatous eyes, which are already predisposed. Not just the overlapping clinical features make the diagnosis confusing but also associated scarring of the conjunctiva, and the presence of episcleral hardware in some cases due to scleral buckle make the surgical management of glaucoma in these eyes very challenging. In this review, we describe in detail the various mechanisms causing secondary glaucoma post vitreoretinal surgeries with a focus on how to distinguish between them. We also discuss the possible consequences of anti-VEGF agents on IOP, various surgical challenges, and modifications with newer surgical options in the management of this refractory glaucoma.
Short-term outcomes of micropulse transscleral cyclophotocoagulation as a primary versus additional therapy in eyes with uncontrolled glaucoma
Authors: Rajendrababu Sharmila , Senthilkumar Vijayalakshmi A , Tara Techi Dodum , Uduman Mohammed Sithiq , Aila Laxmi Ananya , Shukla Aakriti Garg
Published: January 2023

Purpose:

To study the safety and efficacy outcomes of Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) as a primary versus additional therapy in eyes with uncontrolled glaucoma.

Methods:

This was a prospective, interventional, comparative study. All patients with advanced and refractory glaucoma treated with MP-TSCPC from April 2020 to December 2020 were recruited in this study.

Results:

A total of 77 eyes of 77 patients were analyzed. Group A (n = 33), included patients with advanced glaucoma at high risk for invasive surgery, who underwent MP-TSCPC as the primary intervention, and group B (n = 44) included patients who had undergone previous surgical intervention and MP-TSCPC was used additionally to control the intraocular pressure (IOP). Mean IOP and mean number of antiglaucoma medications were 34.06 (13.9) mmHg and 3.64 (0.7), respectively, in group A and 35.61 (11.5) mmHg and 3.73 (0.9), respectively, in Group B. Postoperatively, the mean IOP and percentage of IOP reduction were significantly lower at 1, 3, and 6 months, that is, 20.78 (32%), 22.07 (30%), and 19.09 (37%), respectively, in group A and 23.68 (35%), 19.50 (44%), and 19.61 (42%), respectively, in group B, but there was no difference between the groups at all visits. Postoperative need for ocular hypotensive drugs did not differ in group A (P = 0.231); however, it was significantly lower in group B (P = 0.027). Group A had 87%, 77%, and 74% success rates at 1, 3, and 6 months, respectively, whereas group B had 91%, 86%, and 77% success rates at 1, 3, and 6 months, respectively. Postoperative complications and intervention did not reveal any statistical difference between the two groups.

Conclusion:

MP-TSCPC may be considered as a temporizing measure both as a primary or as an additional intervention to control the IOP in eyes with refractory and advanced glaucoma that have a high risk of vision-threatening complications with invasive surgery.
Macular vessel densities by optical coherence tomography angiography in patients with intermediate uveitis
Authors: Sarıgül Sezenöz Almila , Güngör Sirel Gür , Kurt Rengin Aslıhan , Gökgöz Gülşah , Adwan Noor , Toprak Uğur
Published: January 2023

Purpose:

To evaluate the macular microvascular changes in patients with intermediate uveitis (IU) using optical coherence tomography angiography (OCT-A) and to determine the relationship of OCT-A measurements with disease duration and activity.

Methods:

This cross-sectional study was performed at the uvea department of a tertiary hospital. Patients with IU (8 women, 8 men; mean age: 28.80 ± 12.80 years) were included in the study. The macular thickness measurements obtained by optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering, Heidelberg, Germany) and macular superficial and deep vessel density (VD) parameters obtained by OCT-A (Avanti RTVue-XR; Optovue, Fremont, CA, USA) were compared with healthy subjects (12 men, 22 women; mean age: 28.40 ± 8.32 years). Eyes with pathology including marked obvious edema in the macula were not included in the study.

Results:

The macular thickness was found to be higher in the patient group (p < 0.001). The deep and superficial VD measurements in almost all quadrants in both superficial and deep layers were significantly lower in the IU patient group (p < 0.05). Macular thickness was increased in the active state of IU (p = 0.03), however, none of the OCT-A parameters showed a significant difference between active and inactive IU patients (p > 0.05). No correlation was observed between OCT-A parameters and total IU disease duration.

Conclusion:

Quantitative analyses of macular vascular structures demonstrate significantly reduced VD in both superficial and deep retinal layers in IU patients. Considering the importance of the macula in visual prognosis, OCT-A can provide crucial data for the monitoring and follow-up of IU patients.
Factors affecting the epithelial integrity of human donor corneas
Authors: Kaur Amanjot , Mohamed Ashik , Priyadarshini Smruti R , Mohanty Amrita , Sahu Srikant K , Das Sujata
Published: January 2023

Purpose:

To evaluate various factors affecting the integrity of human donor corneal epithelium.

Methods:

Donor corneal buttons were evaluated for epithelial defect (ED) and exposure. The slit-lamp photographs were taken on day 01, and the data such as age and gender of the donor, cause of death, refrigeration of cadavers, death-to-preservation time (DPT), experience of technician, and distance from site of collection to eye bank were collected.

Results:

A total of 100 consecutive corneal buttons belonging to 56 donors were evaluated. The median age of donors was 50 years. Males constituted 45 (80.4%). The mean DPT was 9.7 ± 5.3 hours. After death, 34 donors (60.7%) were refrigerated before the collection/retrieval. Most of the corneas (80%) were recovered by technicians having an experience of 0–5 years. Thirty-one donors (55.3%) were located at 1–50 km from the eye bank. The mean area of exposure was 15 ± 4.3 mm2. The mean area of ED was 28.7 ± 5.9 mm2. ED was significantly associated with refrigeration of cadavers and longer DPT. On multivariate analysis, only DPT was found to be significantly associated (P = 0.006; odds ratio [OR] = 1.54 ± 0.24) with the presence of ED. After transplantation, only two corneas had persistent epithelial defects and were treated successfully using various interventions.

Conclusion:

Integrity of donor corneal epithelium is mainly influenced by the refrigeration of cadavers and DPT.
Bilateral radiation retinopathy 17 years following radiotherapy for nasopharyngeal carcinoma: A diagnostic and therapeutic challenge during COVID-19 lockdown
Authors: Chakraborty Koyel , Padhy Srikant K , Nayak Bhagabat , Verma Gargi
Published: January 2023

A 40-year-old male presented with reduced vision in the right eye for one week. He had a history of nasopharyngeal carcinoma for which 34-Gy radiation was administered. The best-corrected visual acuity (BCVA) was 20/40 in the right eye and 20/20 in the left eye. Anterior segment examination suggested a bilateral early posterior subcapsular cataract. Fundoscopy revealed bilateral localized telangiectasia and macular edema in the right eye. Diagnosis of bilateral extremely delayed onset radiation retinopathy with right eye macular edema was made. Three doses of intravitreal bevacizumab injection were administered in the right eye. The patient was lost to follow-up due to COVID-19 and presented with recurrence.
Comparison of topical steroids versus adjunctive intracameral triamcinolone versus posterior subtenon triamcinolone in pediatric cataract surgery
Authors: Raina Usha K , Ravinesh Kumar , Bhattacharya Shruti , Pavitra Banu , Thakar Meenakshi
Published: January 2023

Purpose:

Prolonged postoperative topical corticosteroids are commonly given after pediatric cataract surgery to control inflammation. This study was undertaken to compare the efficacy, safety, and compliance of postoperative topical steroids and adjunctive intracameral (I/C) triamcinolone acetonide (tricort) and posterior subtenon (PST) triamcinolone in modulating postoperative inflammation after surgery.

Methods:

Forty-eight eyes of children with pediatric cataract between the ages of 5 and 10 years were randomized into three equal groups (T, I, S) before surgery. Group T received postoperative topical 1% prednisolone tapered over 4 weeks; Group I received adjunctive intraoperative I/C 1.2 mg/0.03 ml tricort and topical 1% prednisolone for 2 weeks postoperatively, and Group S received a single 0.5 ml (40 mg/ml) PST tricort without topical steroids. Signs of inflammation, intraocular pressure (IOP), and central corneal thickness were assessed at day 1, week 1, week 3, week 6, and week 12 postoperatively with optical coherence tomography (OCT) macula to rule out cystoid macular edema at the sixth and 12th weeks postoperatively.

Results:

Posterior synechiae were present in two eyes out of 16 in groups T and I, which resolved. Severe anterior chamber cells were present in four eyes out of 16 in group T, in two eyes in group I, and in one eye in group S, which resolved. All groups had comparable pre- and postoperative IOP.

Conclusion:

In pediatric cataracts, outcomes were better with PST tricort and the adjunctive I/C tricort compared to postoperative topical prednisolone, for modulating postoperative inflammation.
Evaluation of retinal function and morphology in isoametropic amblyopia
Authors: Sharma Pradeep , Anand Mrinalini , Sharma Anu , Phuljhele Swati , Saxena Rohit
Published: January 2023

Purpose:

To observe the photoreceptor anomalies in cases of ametropic amblyopia.

Methods:

A prospective study with 25 isoametropic amblyopic children in the age group of 5–14 years and 25 age-matched controls was done. Examination included refraction, best-corrected visual acuity (BCVA), and color vision. Adaptive optics (AO) and multifocal electroretinogram (mf-ERG) were done to assess the anatomy and function of photoreceptors. The subgroup analysis of the improved and non-improved groups was done.

Results:

The mean cone density in cases and control in the superior, temporal, and nasal quadrants was respectively as follows (21640 ± 5713, 24040 ± 3386, P = 0.01) (19755 ± 6282, 21832 ± 2911, P = 0.03) (19897 ± 5418, 22171 ± 3660, P = 0.01) (20768 ± 4799, 22819 ± 3241, P = 0.01). The amplitude of N1 wave and P1 wave in cases was significantly low compared to the controls. Cases with subnormal color vision had reduced BCVA (0.55 ± 0.018) in comparison to the children with normal response (0.350 ± 0.014). Cone density was also significantly reduced in children with subnormal color vision. Sixteen out of 25 cases showed BCVA improvement with spectacles. Baseline cone density was found to be significantly higher in the improved group. There was no correlation between BCVA and AO parameters.

Conclusion:

Patients with ametropic amblyopia show subnormal photoreceptor properties than controls. Low cone density may be associated with defective color vision and poor prognosis in these cases.
Important signs to check posterior capsule integrity
Authors: Khadia Anjali , Gupta Isha , Thangaraju Dharmeswari , Assadi Fatima A , Ghosh Aditi , Veena K , Mouttapa Fredrick , Venkatesh Rengaraj
Published: January 2023

For beginner surgeons, it is difficult to recognize the posterior capsule during cataract surgery. In the case of brown cataracts with a thin posterior capsule and in cataracts with asteroid hyalosis, it is difficult to identify the capsule before intraocular lens (IOL) implantation even for expert surgeons. Here we illustrate five important signs, which can be practiced in routine cases to make sure the posterior capsule is intact, before IOL implantation.
A stitch in time saves my (ne) (vision)
Authors: Shivanna Yathish , Koul Ameeta , Sanjay Srinivasan
Published: January 2023

Background:

Corneal melt with iris prolapse is a rare complication of autoimmune diseases, especially rheumatoid arthritis.

Purpose:

To highlight a challenging case of a peripheral ulcerative keratitis (PUK) with corneal melt and iris prolapse in a patient’s only eye.

Synopsis:

A 56-year-old Asian Indian male presented with blurring of vision in the right eye and was diagnosed with cataract. He was a known type 2 diabetes mellitus and a rheumatoid arthritis patient and was not on treatment. He had been previously diagnosed with PUK in the left eye and was lost to follow-up due to coronavirus disease 2019 (COVID-19) after therapeutic penetrating keratoplasty and lost his vision in that eye. Cataract surgery in the right eye was done under cover of immunosuppression. Subsequently, he developed PUK and was treated with a glue and bandage contact lens. Again, he was lost to follow-up and then presented a few months later with corneal melt with iris prolapse in the right eye. We describe in the video the surgical and medical challenges and successful salvage of both the eyeball and the vision.

Highlights:

Highlights include the following: A rare case of corneal melt with iris prolapse. 2. Demonstration of surgical technique of patch graft. 3. Anterior segment optical coherence tomography before and after the procedure.

Video link:

https://youtu.be/HbgixlEAYKU

Key words: Corneal melt, iris prolapse, immunosuppression, patch graft, rheumatoid arthritis
Taming the polar bear: Ten tips to manage posterior polar cataract
Authors: Mohan Sashwanthi , Mohan Sujatha , Rajan Mohan
Published: January 2023

Background:

Posterior polar cataracts are challenging even for skilled cataract surgeons due to the high risk of posterior capsule rupture and vitreous loss during cataract surgery; hence, it is important to know how to manage such cases.

Purpose:

In this video, we describe the necessary precautions and steps to be taken to prevent and manage complications in phacoemulsification cataract surgery for posterior polar cataracts.

Synopsis:

The video contains ten tips to follow to avoid complications while performing phacoemulsification cataract surgery in patients with posterior polar cataracts and includes preoperative identification on slit-lamp examination, size of capsulorhexis, avoidance of hydrodissection, technique of nucleus management, viscoelastic injection to keep the anterior chamber formed, epinucleus and cortical matter removal, posterior capsular rupture management, anterior vitrectomy, and intraocular lens (IOL) implantation in eyes with posterior capsular rupture.

Highlights:

The video highlights ten different steps to be followed in the surgical management of patients with posterior polar cataract which, if followed meticulously, can give excellent outcomes in these patients.

Conclusion:

Posterior polar cataracts can be managed with phacoemulsification, with good visual outcomes if these precautions are followed.

Video link:

https://youtu.be/TeoLckE83xM. Additional information: Won Best Educational Video in a contest by phacotraining.org
Interdisciplinary care in orbital complications of acute rhinosinusitis in children
Authors: Trbojević Tena , Penezić Ana , Sitaš Ingrid , Grgić Marko Velimir , Ravlić Maja Malenica , Štefanović Iva Mihatov
Published: January 2023

Purpose:

Orbital cellulitis is a serious condition with potentially severe complications. Treatment requires interdisciplinary care and early introduction of antimicrobial therapy. In our tertiary center, a team of pediatricians, pediatric ophthalmologists, and otorhinolaryngologists successfully participated in the management of pediatric periorbital/orbital cellulitis. This study aimed to demonstrate our interdisciplinary approach and to investigate clinical profile and management of pediatric periorbital/orbital cellulitis.

Methods:

A retrospective chart review was performed of all pediatric patients hospitalized for periorbital and orbital cellulitis in a tertiary hospital center from September 15, 2016, to March 15, 2020.

Results:

A total of 26 children—median age 2.7 years (range 0.5–12)—were treated during the study period. Disease presentation was unilateral, mainly during winter (n = 12) and autumn (n = 12), without ophthalmoplegia/proptosis. Seven patients had orbital cellulitis (Chandler classification of ≥III) and were older (6.5 years, P = 0.011) with sinusitis (P < 0.001), required surgery (P = 0.004), underwent longer antimicrobial treatment (13 days, P < 0.001), and had a longer length of hospital stay (13.43 days, P = 0.001). Orbital cellulitis occurred in a median of three days (range 1–12) of acute rhinosinusitis. Radiological survey was performed in 11 patients, whereas six patients were treated surgically. All intraoperatively collected cultures (sinus swabs) were positive, whereas Streptococcus pyogenes and Peptostreptococcus were isolated in five cases. All patients fully recovered. No recurrence was documented.

Conclusion:

Sinusitis is associated with severe orbital cellulitis and surgical management. Orbital cellulitis occurred early in the course of acute rhinosinusitis, as a distinctive presentation of rhinosinusitis. Interdisciplinary care and early management are crucial in treatment of pediatric periorbital/orbital cellulitis.
Parallelism between hypovitaminosis D3 and recently detected myopia in children with amplified screen use in the COVID-19 era—A preliminary study
Authors: Pannu Anju , Vichare Nitin , Pushkar K , Kumar Anupam , Gupta Simple
Published: January 2023

Purpose:

This introductory study aims to analyze the association of serum vitamin D3 levels with recently detected myopia in Indian children following home confinement post-COVID-19 pandemic.

Methods:

Children aged 5–15 years who had not attended physical school in the past 1 year and visited the ophthalmology department with various ocular symptoms were divided into two groups: the myopic group with recently detected myopia and the non-myopic group with ocular ailments other than myopia. All children underwent basic ophthalmic evaluation and a general physical examination. Blood samples were collected for serum vitamin D3 levels. A pretested questionnaire inquiring about the duration of exposure to a digital screen, outdoor activities, and socioeconomic status was filled out for all children.

Results:

The mean serum vitamin D3 level in the myopic group was 28.17 ± 15.02 ng/dl in comparison to 45.36 ± 17.56 ng/dl in the non-myopic group (P value < 0.05). Linear regression of the data establishes that myopia is associated with hypovitaminosis D3 (OR- 13.12, 95% CI 2.90–50.32, a P value of 0.001). The correlation between spherical equivalent and vitamin D3 levels was significant (Pearson correlation value: 0.661). In the myopic group, 63.3% of children had screen use >6 hours against 43.3% of children in the non-myopic group. In the myopic group, 33.3% of the children had an outdoor activity duration of <2 hours against 6.6% of children in the non-myopic group.

Conclusion:

This study proposes hypovitaminosis D3 as a strong factor associated with the development of myopia in children. Although it is a preliminary study, it suggests that the trial for vitamin D3 supplementation in young children to delay or cease the development of myopia is warranted.
Apples to Oranges
Authors: Wlodarczyk Jordan R. , Yoon Dong Hum , Wickham Carey J , Mirza Kasim L. , Wang Johnny , Lee Sang W. , Ault Glenn T. , Cologne Kyle G.
Published: January 2023

Background:

Over- prescription of opioids after surgery contributes to the national opioid epidemic. Differences may exist with procedure type, but these are understudied.

Objective:

This study aims to evaluate opioid consumption patterns following hemorrhoidectomy vs. other anorectal operations, as hemorrhoidectomy recovery is reportedly more painful.

Design:

Retrospective cohort study with prospective telephone survey.

Setting:

Single safety net hospital.

Patients:

Group of 27 and 73 patients undergoing outpatient hemorrhoidectomy and anorectal surgery other than hemorrhoidectomy, respectively, between July 2019 and March 2020.

Main Outcome Measures:

We measured the prescription and consumption quantities of morphine milligram equivalents (MME) after surgery for hemorrhoids vs. other anorectal procedures.

Results:

MME prescribed at discharge was higher for the hemorrhoid cohort vs. for other anorectal surgery (86.1 ± 17.5 vs. 76.0 ± 6.3, P < 0.001). The hemorrhoid group utilized higher quantities of MME during recovery: 30 (IQR 75 MME) vs. 6.25 (IQR 30 MME), P = 0.017), and also expressed lower satisfaction with their post-operative pain control regimen (33.3% vs. 88.3%, P < 0.001). No differences were seen in patients continuing on opioids on postoperative day seven (p = 0.348), and patients with complete compliance with their non-opioid multimodal pain control regimen (p = 1.0). Return trips to the emergency department for pain and patients requiring additional opioid medication after discharge were higher in the hemorrhoidectomy group (33.3% vs. 1.3%, P < 0.001 and 14.8% vs. 1.3% P = 0.016, respectively). The 50th, 75th, and 90th percentile for total MME consumed by the hemorrhoidectomy (vs. other anorectal surgery) cohort were 75 (vs. 30), 75 (vs. 54), and 97.5 (vs. 75) MME, respectively.

Conclusions:

Hemorrhoidectomy surgery requires up to five times the amount of opioids for postoperative pain control compared to other anorectal surgeries. Prescribed opioids still exceed the amount used, although dissatisfaction with pain control remains high after hemorrhoid surgery. Further study is required to better understand this unique entity.

Limitations:

Retrospective single-center design, patient-reported outcomes, male majority in the non-hemorrhoidectomy group.

Conflict of Interest:

None.