Taxonomy of hybridly polarized Stokes vortex beams.

Structured beams carrying topological defects, namely phase and Stokes singularities, have gained extensive interest in numerous areas of optics. The non-separable spin and orbital angular momentum states of hybridly polarized Stokes singular beams provide additional freedom for manipulating optical fields. However, the characterization of hybridly polarized Stokes vortex beams remains challenging owing to the degeneracy associated with the complex polarization structures of these beams. In addition, experimental noise factors such as relative phase, amplitude, and polarization difference together with beam fluctuations add to the perplexity in the identification process. Here, we present a generalized diffraction-based Stokes polarimetry approach assisted with deep learning for efficient identification of Stokes singular beams. A total of 15 classes of beams are considered based on the type of Stokes singularity and their associated mode indices. The resultant total and polarization component intensities of Stokes singular beams after diffraction through a triangular aperture are exploited by the deep neural network to recognize these beams. Our approach presents a classification accuracy of 98.67% for 15 types of Stokes singular beams that comprise several degenerate cases. The present study illustrates the potential of diffraction of the Stokes singular beam with polarization transformation, modeling of experimental noise factors, and a deep learning framework for characterizing hybridly polarized beams.

Analysis of choroidal thickness on optical coherence tomography in a patient with sudden-onset bilateral myopia, macular striae, and shallow anterior chamber after topiramate use.

This patient presented with sudden onset myopia, shallow anterior chamber, and radial macular folds in both eyes after using topiramate. Ocular parameters including increased choroidal thickness normalized after cessation of topiramate.

A wideband hybrid combiner design for ITER ion cyclotron radio frequency source.

The high-power radio frequency source for ion cyclotron heating and current drive of ITER tokamak consists of two identical 1.5 MW amplifier chains. These two chains will be combined using a wideband hybrid combiner with adequate coupling flatness, phase balance, return loss, and isolation response to generate 2.5 MW radio frequency (RF) power in the frequency range of 36 to 60 MHz. As part of the in-house development program at ITER-India, a wideband hybrid combiner with coupling flatness and return loss/isolation better than 0.4 and -25 dB, respectively, has been simulated. A detailed analysis for matched load performance of the hybrid combiner for the output power level of 3 MW as well as mismatched load performance for load power of 2.5 MW with voltage standing wave ratio 2.0 and 3.0 MW with voltage standing wave ratio 1.5 has been performed. Based on the simulation, a prototype model was in-house fabricated, and the simulated results have been validated experimentally in splitter and combiner mode. To evaluate performance as a combiner, two solid-state power amplifiers were combined through the prototype combiner for input power levels up to 2.5 kW on matched and mismatched load conditions. In the power splitter experiment, the RF power level up to 1.5 MW from a single amplifier chain was split through the prototype combiner to be dumped in the high power loads in the frequency range of 36 to 60 MHz.

Abernethy Malformation Masquerading as Congenital Heart Disease: A Boy With Cyanosis, Clubbing, and Hypoxia.

Abernethy malformation is an extrahepatic congenital portosystemic shunt characterized by the diversion of the portal blood away from the liver through a shunt that drains directly into the inferior vena cava. We present a case of a male child with Abernethy malformation, which was initially diagnosed as cyanotic heart disease due to pulmonary arteriovenous malformation. However, after proper clinical evaluation and investigations, the diagnosis of Abernethy malformation was established. Thereafter, the patient was successfully treated with endovascular embolization. At one year follow-up, marked relief in exertional dyspnea and improvement in physical growth was achieved with no observable complications.

Endovascular embolisation of a complex mandibular AVM: a hybrid transarterial and transvenous approach.

Mandibular arteriovenous malformations (AVMs) are rare lesions which can present with life-threatening haemorrhage. Endovascular embolisation can be life saving for these patients. We discuss a patient of mandibular AVM, who initially presented with reports of massive oral bleeding. The lesion was only partially embolised via transarterial route, as the nidus could not be penetrated completely. In view of rebleeding within 72 hours from the same site, a second embolisation procedure was done via combined, transarterial and transvenous approaches. Coils and onyx were used as embolising agents. Complete embolisation was achieved via combined approach. No further bleeding episodes were seen at 1-year follow-up. Endovascular embolisation of mandibular AVMs can be technically challenging and, hence, a sound knowledge of the anatomy as well as the possible modification of technique is essential to achieve complete obliteration of the lesion and to maximise the benefit of embolisation and to avoid major radical surgery.

SegPC-2021: A challenge & dataset on segmentation of Multiple Myeloma plasma cells from microscopic images.

Multiple Myeloma (MM) is an emerging ailment of global concern. Its diagnosis at the early stages is critical for recovery. Therefore, efforts are underway to produce digital pathology tools with human-level intelligence that are efficient, scalable, accessible, and cost-effective. Following the trend, a medical imaging challenge on "Segmentation of Multiple Myeloma Plasma Cells in Microscopic Images (SegPC-2021)" was organized at the IEEE International Symposium on Biomedical Imaging (ISBI), 2021, France. The challenge addressed the problem of cell segmentation in microscopic images captured from the slides prepared from the bone marrow aspirate of patients diagnosed with Multiple Myeloma. The challenge released a total of 775 images with 690 and 85 images of sizes 2040×1536 and 1920×2560 pixels, respectively, captured from two different (microscope and camera) setups. The participants had to segment the plasma cells with a separate label on each cell's nucleus and cytoplasm. This problem comprises many challenges, including a reduced color contrast between the cytoplasm and the background, and the clustering of cells with a feeble boundary separation of individual cells. To our knowledge, the SegPC-2021 challenge dataset is the largest publicly available annotated data on plasma cell segmentation in MM so far. The challenge targets a semi-automated tool to ensure the supervision of medical experts. It was conducted for a span of five months, from November 2020 to April 2021. Initially, the data was shared with 696 people from 52 teams, of which 41 teams submitted the results of their models on the evaluation portal in the validation phase. Similarly, 20 teams qualified for the last round, of which 16 teams submitted the results in the final test phase. All the top-5 teams employed DL-based approaches, and the best mIoU obtained on the final test set of 277 microscopic images was 0.9389. All these five models have been analyzed and discussed in detail. This challenge task is a step towards the target of creating an automated MM diagnostic tool.

Mars, a molecule archive suite for reproducible analysis and reporting of single-molecule properties from bioimages.

The rapid development of new imaging approaches is generating larger and more complex datasets, revealing the time evolution of individual cells and biomolecules. Single-molecule techniques, in particular, provide access to rare intermediates in complex, multistage molecular pathways. However, few standards exist for processing these information-rich datasets, posing challenges for wider dissemination. Here, we present Mars, an open-source platform for storing and processing image-derived properties of biomolecules. Mars provides Fiji/ImageJ2 commands written in Java for common single-molecule analysis tasks using a Molecule Archive architecture that is easily adapted to complex, multistep analysis workflows. Three diverse workflows involving molecule tracking, multichannel fluorescence imaging, and force spectroscopy, demonstrate the range of analysis applications. A comprehensive graphical user interface written in JavaFX enhances biomolecule feature exploration by providing charting, tagging, region highlighting, scriptable dashboards, and interactive image views. The interoperability of ImageJ2 ensures Molecule Archives can easily be opened in multiple environments, including those written in Python using PyImageJ, for interactive scripting and visualization. Mars provides a flexible solution for reproducible analysis of image-derived properties, facilitating the discovery and quantitative classification of new biological phenomena with an open data format accessible to everyone.

Resuscitative Effect of Centhaquine (Lyfaquin®) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial.

INTRODUCTION: Centhaquine (Lyfaquin®) showed significant efficacy as a resuscitative agent in animal models of haemorrhagic shock. Its safety and tolerability were confirmed in healthy human volunteers. In this study, our primary objective was to determine the safety, and the secondary objective was to assess the efficacy of centhaquine in patients with hypovolemic shock. METHODS: A prospective, multicentre, randomized phase II study was conducted in male and female patients aged 18-70 years with hypovolemic shock having systolic BP ≤ 90 mmHg. Patients were randomized in a 1:1 ratio to either the control or centhaquine group. The control group received 100 ml of normal saline infusion over 1 h, while the centhaquine group received 0.01 mg/kg of centhaquine in 100 ml normal saline infusion over 1 h. Every patient received standard of care (SOC) and was followed for 28 days. RESULTS: Fifty patients were included, and 45 completed the trial: 22 in the control group and 23 in the centhaquine group. The demographics of patients in both groups were comparable. No adverse event related to centhaquine was recorded in the 28-day observation period. The baseline, Injury Scoring System score, haemoglobin, and haematocrit were similar in both groups. However, 91% of the patients in the centhaquine group needed major surgery, whereas only 68% in the control group (p = 0.0526). Twenty-eight-day all-cause mortality was 0/23 in the centhaquine group and 2/22 in the control group. The percent time in ICU and ventilator support was less in the centhaquine group than in the control group. The total amount of vasopressors needed in the first 48 h of resuscitation was lower in the centhaquine group than in the control group (3.12 ± 2.18 vs. 9.39 ± 4.28 mg). An increase in systolic and diastolic BP from baseline through 48 h was more marked in the centhaquine group than in the control group. Compared with the control group, blood lactate level was lower by 1.75 ± 1.07 mmol/l in the centhaquine group on day 3 of resuscitation. Improvements in base deficit, multiple organ dysfunction syndrome (MODS) score and adult respiratory distress syndrome (ARDS) were greater in the centhaquine group than in the control group. CONCLUSION: When added to SOC, centhaquine is a well-tolerated and effective resuscitative agent. It improves the clinical outcome of patients with hypovolemic shock. TRIAL REGISTRATION: ClinicalTrials.gov identifier number: NCT04056065.

Multiplex flow magnetic tweezers reveal rare enzymatic events with single molecule precision.

The application of forces and torques on the single molecule level has transformed our understanding of the dynamic properties of biomolecules, but rare intermediates have remained difficult to characterize due to limited throughput. Here, we describe a method that provides a 100-fold improvement in the throughput of force spectroscopy measurements with topological control, which enables routine imaging of 50,000 single molecules and a 100 million reaction cycles in parallel. This improvement enables detection of rare events in the life cycle of the cell. As a demonstration, we characterize the supercoiling dynamics and drug-induced DNA break intermediates of topoisomerases. To rapidly quantify distinct classes of dynamic behaviors and rare events, we developed a software platform with an automated feature classification pipeline. The method and software can be readily adapted for studies of a broad range of complex, multistep enzymatic pathways in which rare intermediates have escaped classification due to limited throughput.

Enhanced Binary Hexagonal Extrema Pattern (EBHXEP) Descriptor for Iris Liveness Detection.

Biometric traits are frequently used by security agencies for automatic recognition of a person. There are numerous biometric traits used for person identification. In recent years, iris biometric trait becomes very popular and efficient in many security applications. However, biometric systems are prone to presentation attack. This attack is carried out by using spoofing of any biometric modality and present as a genuine trait. The effect of an artificial artifact of a humanoid iris could be in the form of contact lens attack and print attack make difficult the expected policy of a biometric liveness system. In this paper, the different and enhanced feature descriptor has been proposed i.e. Enhanced Binary Hexagonal Extrema Pattern (EBHXEP) for forged iris detection. The relationship between the center pixel and its hexa neighbor has been explored by the suggested descriptor. The Proposed approach is tested on ATVS-FIr DB and IIIT-D CLI database for iris liveness detection and the results show better results for liveness detection in term of accuracy and average error rate.

Mizuo-Nakamura phenomenon in an Indian male.

The authors present a 20-year-old myopic male who showed golden color of fundus (Mizuo-Nakamura phenomenon) in light and normal color after long dark adaptation. This phenomenon is associated with an abnormally slow dark adaptation and is typically noted in Oguchi disease, a variant of congenital stationary night blindness.

Identification and treatment of the visual processing asymmetry in MS patients with optic neuritis: The Pulfrich phenomenon.

BACKGROUND: The Pulfrich phenomenon (PF) is the illusory perception that an object moving linearly along a 2-D plane appears to instead follow an elliptical 3-D trajectory, a consequence of inter-eye asymmetry in the timing of visual object identification in the visual cortex; with optic neuritis as a common etiology. OBJECTIVE: We have designed an objective method to identify the presence and magnitude of the PF, in conjunction with a cooresponding strategy by which to abolish the effect; with monocular application of neutral density filters to the less affected fellow eye, in patients with MS and a history of optic neuropathy (e.g. related to acute optic neuritis or subclinical optic neuropathy). METHODS: Twenty-three MS patients with a history of acute unilateral or bilateral optic neuritis, and ten healthy control subjects (HC) were recruited to participate in a pilot study to assess our strategy. Subjects were asked to indicate whether a linearly moving pendulum ball followed a linear 2-D path versus an illusory 3-D elliptical object-motion trajectory, by reporting the ball's approximation to one of nine horizontally-oriented colored wires that were positioned parallel to one another and horizontal to the linear pendulum path. Perceived motion of the bob that moved along wires behind or in front (along the 'Z' plane) of the middle reference wire indicated an illusory elliptical trajectory of ball motion consistent with the PF. RESULTS: When the neutral density filter titration was applied to the fellow eye the severity of the PF decreased, eventually being fully abolished in all but one patient. The magnitude of neutral density filtering required correlated to the severity of the patient's initial PF magnitude (p < 0.001). CONCLUSIONS: We ascertained the magnitude of the visual illusion associated with the PF, and the corresponding magnitude of neutral density filtering necessary to abolish it.

Surgical outcome of superior rectus transposition in esotropic Duane syndrome and abducens nerve palsy.

PURPOSE: To evaluate surgical outcome of superior rectus transposition (SRT) in esotropic Duane syndrome (DS) and abducens nerve palsy. METHODS: Retrospective medical record analysis of all patients with esotropic DS and abducens nerve palsy treated with SRT at our center with minimum follow-up of 6 months. Primary outcome measures were esotropia in primary position and abduction limitation. Secondary outcome measures included head turn, stereopsis, and cyclovertical deviations. RESULTS: A total of 20 eyes of 19 patients were included: 9 with DS and 10 with traumatic abducens nerve palsy. One patient had bilateral esotropic DS. Mean age of DS patients was 12.5 ± 10.1 years; of abducens nerve palsy patients, 25.4 ± 11.3 years. Medial rectus recession (MRc) of 3.5 mm was additionally performed in 5 DS eyes. An adjustable MRc 5.6 ± 2.2 mm with or without augmentation suture was performed in all abducens nerve palsy patients. In DS patients, esotropia improved from 27.5Δ ± 5.4Δ to 3.6Δ ± 6.4Δ (P < 0.001), abduction limitation reduced from -3.8 to -1.8 (P < 0.001), and head posture improved from 20° to 4° (P < 0.001) at 6 months. In abducens nerve palsy patients, esotropia improved from 51.5Δ ± 18.8Δ to 6.1Δ ± 10.7Δ (P < 0.001), abduction limitation reduced from -3.8 to -2, and head posture improved from 25° to 8° (P < 0.001). Stereopsis improved in 4 patients (P = 0.12). No patient had vertical deviation or torsional diplopia. CONCLUSIONS: In our patient cohort with esotropic DS or abducens nerve palsy, SRT reduced esotropia and improved abduction. Because of a long-term exotropic drift, initial undercorrection in the immediate postoperative period may prevent eventual overcorrection.

Bilateral ocular surface squamous neoplasia with bilateral periocular basal cell carcinoma in a case of xeroderma pigmentosum.

Xeroderma pigmentosum (XP) is an autosomal recessive disorder associated with multiple oculocutaneous manifestations.We discuss a unique case of XP having bilateral ocular surface squamous neoplasia (OSSN) and periocular basal cell carcinoma. In the right eye, a large OSSN mass involving the ocular surface extensively along with intraocular invasion was noted, whereas in the left eye, the tumour mass was involving the limbus, and extending up to three clock hours. Because of extensive disease in the right eye, orbital exenteration was performed, and for the left eye, a wide excision of the mass with triple freeze thaw cryo application to the margins followed by amniotic membrane grafting was done. Basal cell carcinoma was noted around the medial canthus on both sides. The right-sided basal cell carcinoma was treated by wide excision followed by a forehead rotation flap and the left-sided lesion was managed with topical 5% imiquimod cream.

Impact of various extra-oral factors on caries experience among mentally disabled children residing in Bhopal city, central India: A cross-sectional study.

BACKGROUND: Dental caries is the most common dental problem among the mentally challenged children. There are various extra-oral factors responsible for high caries experience among such children. AIM: The aim of the present investigation was to study the impact of various extra-oral factors on dental caries experience among mentally challenged children residing in Bhopal city, Central India. MATERIALS AND METHODS: One hundred and fifty-two children between the age group 5 and 15 years were included in this descriptive cross-sectional study. A pretested pro forma was used to record information about socioeconomic status, demographic data, mental retardation (MR) type, and intelligent quotient. The clinical examination was performed to evaluate dental caries and treatment needs using the World Health Organization dentition status and treatment needs index. RESULTS: The mean decayed, missing, and filled teeth (DMFT and dmft) were 2.32 and 2.21, respectively. Age, parent occupation, income, and intelligent quotient were significant predictors of both DMFT and dmft. In addition, socio-economic status and type of MR were significant predictors of only DMFT. CONCLUSION: Dental health professionals should, therefore, be aware of the various extra-oral factors responsible for high caries experience of mentally challenged children. They should understand and provide basic treatment needs to such children.

A Unique Case of JOAG With Lamellar Ichthyosis With Rickets: A Case Report and Review of the Literature.

PURPOSE: Ichthyosis is known to have ocular associations such as blepharitis, hypertrophic conjunctivitis, corneal vascularization, ectropion, lagophthalmos, etc. However, no reports of its association with glaucoma are there, to the best of our knowledge. We report a unique case of juvenile open-angle glaucoma (JOAG) with lamellar ichthyosis. METHOD: A 16-year-old male child presented with a gradual, painless progressive diminution of vision in both eyes over a period of 3 years. Systemic examination revealed stunted body growth with knock-knees, suggestive of late-onset rickets. Generalized dry scaly lesions with erythema, along with hyperkeratosis of the palms and the soles, suggestive of lamellar ichthyosis were present. On ocular examination, the intraocular pressure was 36 mm Hg; optic nerve head examination revealed a horizontally oval disc with near total cupping in the right eye and total cupping in the left eye, with extensive neuroretinal rim thinning and pallor. Gonioscopy showed wide open angles with prominent iris processes. Screening of JOAG-associated genes (MYOC, NTF4, WDR36, and CYP1B1) and ichthyosis-associated gene (TGM1) was performed by the direct PCR-sequencing method. RESULTS: A diagnosis of JOAG with advanced glaucomatous optic neuropathy with lamellar ichthyosis and rickets was made. The patient underwent right followed by left eye trabeculectomy with 0.2 mg/dL MMC (for 1 min). Postoperatively, the intraocular pressure was 8 mm Hg at 1 week, and 12 to 14 mm Hg at the 6-week, the 3-month, and the 6-month follow-up, and the visual acuity was maintained in the right eye. No mutations in MYOC, NTF4, WDR36, CYP1B1, and TGM1 were observed in the patient and his family. CONCLUSIONS: An association of glaucoma with ichthyosis should be kept in mind. Therefore, a detailed baseline ocular examination in children with ichthyosis is required, as early detection of glaucoma could prevent irreversible blindness.

IAP Position Paper on Burden of Mumps in India and Vaccination Strategies.

JUSTIFICATION: Mumps, despite being a widely prevalent disease in the country, is considered as an insignificant public health problem mainly because of poor documentation of clinical cases and lack of published studies. In the absence of adequate published data on disease burden, Government of India has recently decided to introduce measles-rubella (MR) vaccine in its National Immunization Program and neglected mumps component. PROCESS: Following an IAP ACVIP meeting on December 6 and 7, 2014, a detailed review of burden of mumps in India along with vaccination strategies to control the disease was prepared. The draft was circulated amongst the members of the committee for review and approval. Revised final draft was later approved by IAP executive board in January 2015. OBJECTIVES: To provide a review of community burden of mumps in India; and to discuss the vaccination strategies to impress upon policymakers to include mumps vaccination in National immunization program. RECOMMENDATIONS: A total of 14 studies and two media reports on mumps outbreak were retrieved. The outbreaks were reported from all the regions of the country. Mumps meningoencephalitis was responsible for 2.3% to 14.6% of all investigated hospitalized acute encephalitis syndrome or viral encephalitis cases in different studies. Data from Infectious Disease Surveillance (ID Surv) portal of IAP and Integrated Disease Surveillance Program (IDSP) of Government of India (GoI) were also reviewed. While a total of 1052 cases were reported by the IDSurv, IDSP had investigated 72 outbreaks with 1564 cases in 14 states during different time periods. Genotypes G (subtype G2) and C were found to be main genotypes of the mumps virus circulating in the country. Three studies studied serological status of young children and adolescents against mumps, and found susceptibility rates ranging from 32% to 80% in different age groups. CONCLUSIONS: Mumps poses a significant disease burden in India. This calls for inclusion of mumps vaccine in the National immunization program.

Different storage conditions influence biocompatibility and physicochemical properties of iron oxide nanoparticles.

Superparamagnetic iron oxide nanoparticles (SPIONs) have attracted increasing attention in many biomedical fields. In magnetic drug targeting SPIONs are injected into a tumour supplying artery and accumulated inside the tumour with a magnet. The effectiveness of this therapy is thus dependent on magnetic properties, stability and biocompatibility of the particles. A good knowledge of the effect of storage conditions on those parameters is of utmost importance for the translation of the therapy concept into the clinic and for reproducibility in preclinical studies. Here, core shell SPIONs with a hybrid coating consisting of lauric acid and albumin were stored at different temperatures from 4 to 45 °C over twelve weeks and periodically tested for their physicochemical properties over time. Surprisingly, even at the highest storage temperature we did not observe denaturation of the protein or colloidal instability. However, the saturation magnetisation decreased by maximally 28.8% with clear correlation to time and storage temperature. Furthermore, the biocompatibility was clearly affected, as cellular uptake of the SPIONs into human T-lymphoma cells was crucially dependent on the storage conditions. Taken together, the results show that the particle properties undergo significant changes over time depending on the way they are stored.