Ab-Externo XEN Gel stent implantation effectively treated refractory glaucoma with prior failed shunt tube.

PURPOSE: To assess the efficacy of a gelatin stent (XEN 45 Gel Stent; Allergan) implant in advanced glaucoma eyes that have failed prior aqueous shunt implantation. METHODS: We retrospectively reviewed 6 patients with refractory glaucoma, defined as persistently high IOP (> 21 mmHg) despite taking at least 3 IOP-lowering medications subsequent to undergoing a glaucoma drainage device (GDD) with or without a second GDD or cilioablative procedure. Eyes with previous failed GDD underwent subconjunctival 0.3 cc (0.4 mg/ml) mitomycin C, tenonectomy, and placement of an ab- externo XEN stent. The outcome measures included change in IOP and the number of glaucoma medications. Success was defined as patients achieving an IOP ≤ 18 mmHg with a percentage reduction of 25% or 15 mmHg and 40% mean IOP reduction from baseline while taking the same number or fewer medications. RESULTS: All six eyes with age of 77.6 ± 7.82 years who underwent XEN implantation following previous GDD surgery had primary open-angle glaucoma. The IOP decreased significantly from 32.33 ± 5.99 to 12.67 ± 3.27 mmHg (p < 0.001) with a follow-up of 13.9 ± 2 (11.7-16.7) months. Visual acuity and visual field remained stable after XEN placement. Compared to the baseline number of medications of 4.2 ± 0.8, all medication was discontinued except in one eye on two drops at the end of the follow-up. The overall surgical success rate was 100%. No complications, needling, or additional procedures were required. CONCLUSION: This study described successful implantation of the XEN stent following failed GDD. XEN Gel stent implantation associated with mitomycin C and tenonectomy can be considered a viable surgical option for patients with a history of previously failed tube shunt requiring further IOP lowering.

A field-based quantitative analysis of sublethal effects of air pollution on pollinators.

While the impact of air pollution on human health is well studied, mechanistic impacts of air pollution on wild systems, including those providing essential ecosystem services, are largely unknown, but directly impact our health and well-being. India is the world's largest fruit producer, second most populous country, and contains 9 of the world's 10 most polluted cities. Here, we sampled Giant Asian honey bees, Apis dorsata, at locations with varying air pollution levels in Bangalore, India. We observed significant correlations between increased respirable suspended particulate matter (RSPM) deposition and changes in bee survival, flower visitation, heart rate, hemocyte levels, and expression of genes related to lipid metabolism, stress, and immunity. Lab-reared Drosophila melanogaster exposed to these same sites also exhibited similar molecular and physiological differences. Our study offers a quantitative analysis on the current impacts of air pollution on insects, and indicates the urgency for more nonhuman studies to accurately assess the effects of pollution on our natural world.

Toxicity, behavioural and biochemical effect of Piper betle L. essential oil and its constituents against housefly, Musca domestica L.

Housefly, Musca domestica L. is a pest of public health importance and is responsible for spreading diseases like typhoid, diarrhoea, plague etc. Indiscriminate reliance on synthetic insecticides has led to development of insecticide resistance and ill effect to humans and nontarget animals. This demands an alternative and safer pest control option. This study evaluates the biological effect of Piper betle L essential oil and its constituent eugenol, eugenol acetate, and ß - caryophyllene on the housefly. The major components present in P. betel EO were safrole (44.25%), eugenol (5.16%), ß -caryophyllene (5.98%), ß -selinene (5.93%), α-selinene (5.27%) and eugenol acetate (9.77%). Eugenol caused 4.5fold higher ovicidal activity (EC50 86.99 µg/ml) than P. betle EO (EC50 390.37 µg/ml). Eugenol caused fumigant toxicity to adults (LC50 88.38 mg/dm3). On contact toxicity by topical application, eugenol acetate, eugenol and ß-caryophyllene caused higher mortality to larval and adult stages than EO. FESEM (Field Emission Scanning Electron Microscope) images reveal that exposure to P. betle EO causes the shrinkage of the larval cuticle. Both EO and eugenol induced the detoxifying enzymes Carboxyl esterase (Car E) and Glutathione S - transferases (GST) in larvae and adults. EO and eugenol at 0.2% caused effective repellence and oviposition deterrence to M. domestica adults and this merits their use as alternative strategy to manage M. domestica.

Effect of gelation on the Frank elastic constants in a liquid crystalline mixture exhibiting a twist bend nematic phase.

We report studies on the Frank elastic constant behaviour of a liquid crystal gel system exhibiting the twist bend nematic (Ntb) phase. Physical gelation is observed to ease the splay and stabilize the twist deformations in the nematic phase preceding the Ntb. More importantly, the ultra-low bend elastic constant (K33) of the system is enhanced by an order of magnitude on gelation. The magnitude of K33 remains high even in the vicinity of the Ntb phase, which otherwise is susceptible to bend deformations. This phenomenon is explained from the point of view of polar interactions in the Ntb system. XRD and dynamic rheology along with the elastic constant data validate this argument. Another salient feature of the system is that gel fibers grown in the direction orthogonal to the helical axis vanish in the Ntb phase as observed from polarizing optical microscopy. A possible reason for this is discussed on the basis of ordering developed in the surrounding medium. This feature gives the possibility of using the Ntb phase as a tool to imprint directional microstructures with a gel network.

Inhibitory activity of bio-active compounds isolated from Anadara granosa in shrimp health management.

The crude extract isolated from the visceral mass of Anadara granosa, an intertidal bivalve mollusc was tested for inhibitory activity against pathogenic bacteria of the shrimp and fish viz. Vibrio harveyi and Staphylococcus aureus respectively by agar well diffusion and contact bioautography methods. Maximum inhibitory activity was shown against V. harveyi by methanol and chloroform (9:1) extract. Twelve fractions (1-12) could be separated from the crude extract through column chromatography. Five out of twelve fractions (7, 8, 9, 10, and 11) showed antibacterial activity and they were further run on column chromatography for purity. The fraction no. 9 showed highest antibacterial activity among the five and was subjected to NMR for the proton, C13 and H1-H1 correlation, IR and mass spectral analysis for structural elucidation. Structure of the compound isolated from fraction no: 9 was determined as 1-(((2Z, 4Z)-dodeca-2,4-dienoyl)oxy)-3-hydroxypropan-2-yl tetradecanoate.

Effect of Atomic-Scale Differences on the Self-Assembly of Thiophene-based Polycatenars in Liquid Crystalline and Organogel States.

Two series of polycatenars are reported that contain a central thiophene moiety connected to two substituted oxadiazole or thiadiazole units. The number, position, and length of the peripheral chains connected to these molecules were varied. The oxadiazole-based polycatenars exhibited columnar phases with rectangular and hexagonal or oblique symmetry, whereas the thiadiazole-based polycatenars exhibited columnar phases with rectangular and/or hexagonal symmetry. All of the compounds exhibited bright emission in the solution and thin-film states. Two oxadiazole-based molecules and one thiadiazole-based molecule exhibited supergelation ability in hydrocarbon solvents, which is mainly supported by attractive π-π interactions. These gels showed aggregation-induced enhanced emission, which is of high technological importance for applications in solid-state emissive displays. X-ray diffraction studies of the xerogel fibers of oxadiazole-based polycatenars revealed a columnar rectangular organization, whereas a hexagonal columnar arrangement was observed for thiadiazole-based polycatenars. Rheological measurements carried out on the samples quantitatively confirmed the formation of gels and showed that these gels are mechanically robust. The impact of an atomic-scale difference (oxygen to sulfur, <2 % of the molecular weight) on the self-assembly and the macroscopic properties of those self-assembled structures are clearly visualized.

Swarm Intelligence Integrated Graph-Cut for Liver Segmentation from 3D-CT Volumes.

The segmentation of organs in CT volumes is a prerequisite for diagnosis and treatment planning. In this paper, we focus on liver segmentation from contrast-enhanced abdominal CT volumes, a challenging task due to intensity overlapping, blurred edges, large variability in liver shape, and complex background with cluttered features. The algorithm integrates multidiscriminative cues (i.e., prior domain information, intensity model, and regional characteristics of liver in a graph-cut image segmentation framework). The paper proposes a swarm intelligence inspired edge-adaptive weight function for regulating the energy minimization of the traditional graph-cut model. The model is validated both qualitatively (by clinicians and radiologists) and quantitatively on publically available computed tomography (CT) datasets (MICCAI 2007 liver segmentation challenge, 3D-IRCAD). Quantitative evaluation of segmentation results is performed using liver volume calculations and a mean score of 80.8% and 82.5% on MICCAI and IRCAD dataset, respectively, is obtained. The experimental result illustrates the efficiency and effectiveness of the proposed method.

Influence of polarization-tilt coupling on the ferroelectric properties of smectic gels.

We have studied composites of a ferroelectric liquid crystal mixture with a simple organic gelating agent, employing structural, thermal, electrical and mechanical probes, investigating the influence of the coupling between the polarization and the tilt angle on the ferroelectric properties of smectic gels. The calorimetric data, presenting clear signatures of the gelation occurring in the smectic A (SmA) phase or the isotropic phase, depending on the concentration of the gelator, help in constructing a rich diagram in the temperature-gelator concentration phase space. The atomic force microscopy imaging brings out the interesting feature of the transfer of chirality from the ferroelectric liquid crystal (FLC) to the gel strands, as exemplified by the creation of nanorope structures which have attracted much attention in recent times. The influence of gelation on the magnitude of the tilt angle appears to be dependent on the probe employed: there is no change in the values obtained by X-ray diffraction, which looks at the projection of the entire molecular length onto the layer normal. In contrast, the value from the electro-optic method, wherein the molecular-core is responsible for the results, diminishes with gelator concentration. The latter feature is copied by the magnitude of the polarization also. Dielectric spectroscopy shows that gelation weakly influences the soft mode in the SmA phase. However, the Goldstone mode behaviour is strongly dependent on the gelator concentration, with the appearance of two modes in the smectic C* (SmC*) phase of higher gel concentrations. With information obtained upon application of DC bias, the origin of the two relaxations is discussed. These data are analyzed in terms of the predictions of the Landau model proposed for the ordinary (non-gel) SmA-SmC* transition showing that the gel network enhances the linear polarization-tilt coupling over the biquadratic one. Upon gelation the system becomes mechanically strong with a large increase in the elastic moduli.

Flow capsulorhexis: A novel technique in white and hypermature cataracts.

We described a novel "flow capsulorhexis" technique in white and hypermature cataracts and compared it with the standard "needle decompression capsulorhexis" technique. Six hundred and eight eyes of 420 patients with intumescent or non-intumescent mature white cataracts who had undergone phacoemulsification or manual small incision cataract surgery with "flow capsulorhexis" (Group 1) or "needle decompression capsulorhexis" (Group 2) were assessed. The mean continuous curvilinear capsulorhexis (CCC) completion time was 6.6 ± 3.4 seconds in Group 1 and 10.4 ± 4.2 seconds in Group 2 (P < 0.001). The mean number of times for an ophthalmic viscosurgical device (OVD) supplement was 0.4 ± 0.2 and 1.8 ± 0.8 in Group 1 and Group 2, respectively (P < 0.001). CCC success rate was 95.8% in Group 1 and 87.2% in Group 2 (P = 0.001). The new technique was observed to have better outcomes in terms of surgical time, OVD supplement times, and success rate than the standard needle decompression technique.

Urrets-Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification.

Aim and background: Combined endocyclophotocoagulation and phacoemulsification (ECP/Phaco) are uncommonly associated with complications. We present the first case of a rare complication following ECP/Phaco. Case description: A 72-year-old patient with dense nuclear sclerotic cataracts and primary open-angle glaucoma (POAG) underwent bilateral surgery uneventfully. He experienced a brief episode of postoperative elevated intraocular pressure (IOP), but only one eye with a lower baseline IOP developed a dilated pupil. No pupillary response was observed after applying 4% pilocarpine. The fixed mydriasis persisted without reaction to light or near stimulus, and the best-corrected vision (BCVA) was 20/30 in the affected eye. Conclusion: This case reports a possible rare complication when undergoing ECP/Phaco therapy. The pathogenesis of Urrets-Zavalia syndrome is unknown, but we hypothesized that eyes with more pronounced increases in IOP from baseline may be more susceptible to ischemic injury to the pupillary sphincter, resulting in a chronically dilated pupil. Clinical significance: Even a modest transient rise in postoperative IOP in a glaucomatous eye with normal baseline IOP could result in a chronically dilated pupil. How to cite this article: Cheng AMS, Vedula GG, Kubal AA, et al. Urrets-Zavalia Syndrome of Unresolving Mydriasis Following Endocyclophotocoagulation Combined with Phacoemulsification. J Curr Glaucoma Pract 2024;18(1):28-30.

Anchoring transition induced by gelation in a liquid crystal system.

We report a novel type of anchoring transition (ANT) in a liquid crystal driven by the physical gelation of the system. The ANT manifests as anomaly in the thermal behaviour of the dielectric permittivity. Data from X-ray studies suggest that ANT is caused by the ability of the gel fibres to compete with the substrate-driven orientation conditions. It is further found that the molecular reorientation is possible only in cases where the gel is weak, the difference between weak and strong gels being established by rheological measurements.

Bacillus thuringiensis isolates from Great Nicobar Islands.

Bacillus thuringiensis (Bt) strains were isolated from soil samples of Great Nicobar Islands, one of the "hottest biodiversity hotspots," where no collection has been characterized previously. The 36 new Bt isolates were obtained from 153 samples analyzed by crystal protein production with light/phase-contrast microscopy, determination of cry gene profile by SDS-PAGE, evaluation of toxicity against Coleopteran, and Lepidopteran insect pests, finally cloning and sequencing. Majority of the isolates showed the presence of 66-35 kDa protein bands on SDS-PAGE while the rest showed >130, 130, 73, and 18 kDa bands. The variations in crystal morphology and mass of crystal protein(s) purified from the isolates of Bt revealed genetic and molecular diversity. Based on the toxicity test, 50 % of isolates were toxic to Ash weevils, 16 % isolates were toxic to cotton bollworm, 38 % isolates were toxic both to ash weevil as well as cotton bollworm, while 11 % of the isolates did not exhibit any toxicity. PCR analysis unveiled prepotency of cry1B- and cry8b-like genes in these isolates. This study appoints the first isolation and characterization of local B. thuringiensis isolates in Great Nicobar Islands. Some of these isolates display toxic potential and, therefore, could be adopted for future applications to control some agriculturally important insect pests in the area of integrated pest management for sustainable agriculture.

Expression of cry3A gene and its toxicity against Asian Gray Weevil Myllocerus undecimpustulatus undatus Marshall (Coleoptera: Curculionidae).

Coleopterans are the most damaging pests of many agricultural and forestry crops; there is an urgent need to develop effective biopesticides against these insects. Enhancers of Bt toxicity typify an opportunity to improve currently available commercial products into more effective control agents against diverse pests. A 1.9 kb DNA fragment, PCR amplified from native isolates of Bt using cry3A gene specific primers was cloned in expression vector pQE-80L and then used for transformation of Escherichia coli M15 cells. The sequence of the cloned crystal protein gene showed almost complete homology with a Coleopteran active Cry3A toxin gene with 117 mutations scattered in different domain regions encoding a protein of 645 amino acid residues in length, with a predicted molecular mass of 77.4 kDa. Phylogenetic analysis could be compulsive for new/novel Bacillus thuringiensis strains, allowing them to be grouped with related Cry proteins. The toxicity of Bt protein was determined against Myllocerus undecimpustulatus undatus Marshall (Coleoptera: Curculionidae) LC50 152 ng cm(-2). Genes coding for Coleopteran active Cry3A proteins have been isolated and their efficient expression will provide the tools necessary to increase the efficacy of Cry-based biopesticide against economically important beetles.

Towards complete photonic band gap in a high refractive index nanoparticle-doped blue phase liquid crystal.

Three-dimensional (3D) photonic crystals with complete photonic band gap (PBG) are fascinating due to the possibility of controlling light in all directions. Realizing such photonic crystals is nontrivial due to symmetry requirements and associated fabrication challenges. Liquid crystalline cubic blue phases (BPs) are soft 3D photonic crystals with an incomplete PBG due to the low refractive index contrast (<0.1). The present work attempts to drive a cubic BP towards a complete PBG via a simple approach of high refractive index nanoparticle-doping. The photonic band diagrams and reflection spectra of the nanoparticle-doped BP simulated using the finite element method show an increased PBG width, a parameter that quantifies the complete PBG. The reflection spectra obtained from UV-Vis-NIR spectroscopy show an increase (by a factor of >2) in PBG width for the nanoparticle-doped BP, validating the simulations. The findings are explained based on increased refractive index contrast (∼1.4) due to the nanoparticles getting trapped in the cores of disclination lines that make up the BP lattice. The simulations also indicate effective confinement of electric field eigenmodes in the nanoparticle-doped BP leading to high attenuation of the incident light. Further, the iso-frequency contours extracted from the band diagrams exhibit self-collimation and negative refraction of light.

Implementation of Client-Centered Care Coordination for HIV Prevention with Black Men Who Have Sex with Men: Activities, Personnel Costs, and Outcomes-HPTN 073.

BACKGROUND: Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related care outcomes among people living with HIV. METHODS: Client-centered care coordination (C4) is a multi-level intervention designed to address clinical, psychosocial, and structural barriers to HIV prevention services for Black MSM within HPTN 073, a PrEP demonstration project among Black MSM in three cities in the USA. The current study examined the implementation process of C4, specifically investigating the activities, cost, time, and outcomes associated with the C4 intervention. RESULTS: On average, participants engaged in five care coordination encounters. The vast majority of care coordination activities were conducted by counselors, averaging 30 min per encounter. The cost of care coordination was relatively low with a mean cost of $8.70 per client encounter. CONCLUSION: Although client-centered care coordination was initially implemented in well-resourced communities with robust HIV research and service infrastructure, our findings suggest that C4 can be successfully implemented in resource constrained communities.

Morphology of flexor digitorum accessorius muscle.

PURPOSE: Muscle flexor digitorum accessorius is the muscle of the second layer of the sole. It arises by two heads and gets inserted into the tendon of flexor digitorum longus muscle. A variant of this muscle has often been incriminated in causation of tarsal tunnel syndrome. The action and phylogenetic importance of this muscle remains a matter of disagreement among different researchers. The present study was planned to study the morphology of this muscle in human. METHOD: The second layer of the sole was dissected in forty-seven cadavers. Origin, insertion and any variations of this muscle were observed. Extension of origin of medial head of this muscle into the tarsal tunnel was also observed. RESULTS: The muscle was found to be very variable. The medial head was more variable, ranging from the complete absence to the bulky fleshy origin. It had fleshy origin from medial surface of calcaneus that extended deep to medio-malleolo calcaneal axis, i.e. into the tarsal tunnel in 80% of the cases. The lateral head was relatively constant and its origin was aponeurotic in all the cases. Insertion of this muscle was very variable, the commonest being insertion on the deep surface of flexor digitorum longus tendon. An accessory muscle-flexor digitorum accessorius longus-was observed in two cases. CONCLUSION: The bulky medial head appears to be assuming the function of primary toe flexor in the plantigrade man. The origin of medial head extends into the tarsal tunnel in majority. A bulky medial head should be considered as a possible cause of tarsal tunnel syndrome.

Photo-tunable epsilon-near-zero behavior in a self-assembled liquid crystal - nanoparticle hybrid material.

Dynamic tuning of electromagnetic response is an important parameter to realize exotic applications of optical metamaterials. Self-assembly achieved via the incorporation of soft materials is an attractive approach to achieve tunable optical properties. Among the soft materials, liquid crystals are highly sought after due to the inherent soft-stimuli responsiveness. This article reports experimental evidence of tunable epsilon-near-zero (ENZ) behavior brought about by an optical field in a self-assembled liquid crystal - nanoparticle system. The material consists of Au nanoparticles capped with a photo-active chiral liquid crystal ligand. In the liquid crystalline state, the system self-assembles into a helical lamellar superstructure, confirmed by polarizing optical microscopy, HRTEM, XRD, and circular dichroism studies. Upon irradiation with UV light, the localized surface plasmon resonance peak of Au red-shifts by ∼10 nm and gets restored with white light illumination. The effective permittivity of the system obtained from ellipsometry indicates ENZ behavior in the visible spectrum with a bandwidth of ∼45 nm which gets enhanced by a factor of 1.6 on UV illumination. Theoretical calculations, carried out using the effective medium approach, support the experimental findings, making the system an efficient ENZ metamaterial in the optical regime.

Effect of Photonic Band Gap on Photoluminescence in a Dye-Doped Blue Phase Liquid Crystal.

Tunability of fluorescence intensity is an essential parameter for enhancing the versatility of devices like emissive displays and solar cells. Soft photonic crystals, with their tunable photonic band gap (PBG), are highly sought-after systems for such purposes. Here, we report modulation of photoluminescence (PL) intensity in a fluorescent dye-doped blue phase liquid crystal, a 3D soft photonic crystal. On cooling, from the isotropic fluid phase, the PL intensity gets enhanced due to the overlapping of the emission wavelength of the dye with the photonic band edge. However, the PL intensity decreases on the application of an electric field, despite both thermal and electric fields having a similar effect (red shift) on the PBG. The contrasting behavior of PL intensity, also observed in composites obtained by varying the dye and the chiral dopant (handedness), is discussed in terms of scattering pathways for the emitted photons. The time-resolved PL studies show a reduction in the lifetime of the excited species upon cooling, validating the thermal dependence of PL intensity modulation due to Purcell effect. The facile modulation of PL intensity in the dye-doped blue phase system makes it appealing from the point of view of high-performance photonic applications.