A portable gas sensor based on In2O3@CuO P-N heterojunction connected via Wi-Fi to a smartphone for real-time carbon monoxide determination.

This research presents a compact portable electronic gas sensor that can be monitored through a smartphone application. The smart sensor utilizes three state-of-the-art sensors. The sensors integrate an ESP8266 microcontroller within the same device. This facilitates their integration with the electronics and enhances their performance. Herein, primarily focuses on utilizing the sensor to detect carbon monoxide. This article outlines the fabrication process of a gas sensor utilizing a P-N heterojunction, eliminating the need for a binder. The sensor consists of CuO/copper foam nanowires and hierarchical In2O3. In order to verify the system's functionality, it underwent testing with various levels of CO concentrations (10-900 ppm), including particular tests designed to examine the device's performance in different humidity and temperature circumstances. A mobile application for the provision of monitoring services has been developed at last. To process the information obtained from the gas sensor, an algorithm has been constructed, trained, and integrated into a smartphone for this purpose. This research demonstrated that a smartphone-coupled gas sensor is a viable system for real-time monitoring and the detection of CO gas.

Wireless wearable potentiometric sensor for simultaneous determination of pH, sodium and potassium in human sweat.

This paper reports on the development of a flexible-wearable potentiometric sensor for real-time monitoring of sodium ion (Na+), potassium ion (K+), and pH in human sweat. Na0.44MnO2, polyaniline, and K2Co[Fe(CN)6] were used as sensing materials for Na+, H+ and K+ monitoring, respectively. The simultaneous potentiometric Na+, K+, and pH sensing were carried out by the developed sensor, which enables signal collection and transmission in real-time to the smartphone via a Wi-Fi access point. Then, the potentiometric responses were evaluated by a designed android application. Na+, K+, and pH sensors illustrated high sensitivity (59.7 ± 0.8 mV/decade for Na+, 57.8 ± 0.9 mV/decade for K+, and 54.7 ± 0.6 mV/pH for pH), excellent stability, and good batch-to-batch reproducibility. The results of on-body experiments demonstrated that the proposed platform is capable of real-time monitoring of the investigated ions.

Nonsurgical Consecutive Exotropia Following Childhood Esotropia: A Multicentered Study.

PURPOSE: Nonsurgical consecutive exotropia (NCX) occurs when an esotropia (ET) spontaneously converts to exotropia (XT) without surgical intervention. Although NCX is considered to occur in early-onset accommodative ET with high hyperopia, consensus on causation is lacking. We report the clinical characteristics of NCX and assess the response to conservative management. DESIGN: Retrospective, multicenter, observational case series. METHODS: Patients aged 6 months and older with an initial diagnosis of ET who converted to XT without surgical intervention. Sensory strabismus was excluded. Age, visual acuity, cycloplegic refraction, glasses prescriptions, deviation, and binocular vision were collected. RESULTS: Forty-nine children were included with a mean age of 3.5 ± 1.6 years and 8.4 ± 3.6 years at the time of ET and NCX, respectively. Mean refractive error was +4.40 ± 2.13 diopters (D) and +4.05 ± 2.74 D at the time of ET and NCX, respectively. Accommodative ET occurred in 60% of cases, and only 35.7% were high hyperopes. All but 1 patient presented with XT at distance. In response to the XT, a mean decrease in hyperopic prescription of 1.55 ± 0.48 D was given (N = 17); only 1 case reverted to ET. Eventually, 43% underwent XT surgery, with similar rates between those who had refractive management and those who did not. CONCLUSIONS: NCX occurs in both accommodative and nonaccommodative ET; high hyperopia is present in only one-third of cases. On average, drift to XT occurs within 5 years. Refractive management has a modest result. No predictive risk factors were identified. Our findings challenge hyperopia-linked theories of causation. Nonrefractive explanations, such as the role of the vergence system, deserve further study.

Rise in the incidence of severe pediatric blepharokeratoconjunctivitis during the COVID-19 pandemic.

Severe blepharokeratoconjunctivitis (BKC) is associated with vision loss and ocular morbidity; hence, early diagnosis and treatment are crucial. Retrospective data collection using electronic patient and billing database records of all patients <18 years of age with severe BKC between March 2010 and March 2022 was performed at the Eye Clinic at the Hospital for Sick Children in Toronto, Canada. Severe BKC was defined as including corneal inflammation, new vessel formation, scarring, thinning and lipid deposits. We excluded patients with mild or no corneal involvement, and those with other corneal pathologies. Over the study period, 257 patients were diagnosed with severe BKC (161 females), with an average age of 8 years. There was a statistically significant threefold increase in the diagnosis of severe BKC since the beginning of the COVID-19 pandemic in 2020 compared to the previous years. We speculate that the increased use of facial masks during the pandemic contributed to this significant increase.

A paired emitter-detector diode-based photometer for the determination of sodium hypochlorite adulteration in milk.

This paper reports on developing a low cost but efficient paired emitter-detector diode (PEDD)-based photometer. The photometer consists of a white light-emitting diode (LED) as the emitter diode, an RGB LED as the detector diode, and a multimeter for recoding the signal. The developed PEDD-based photometer was utilized for the determination of liquid bleach adulteration in cow milk samples. N,N-Diethyl-p-phenylenediamine sulfate aqueous solution of pH 6 was used as a probe to monitor the presence of residual active chlorine in milk. The results showed that the developed method could be used to determine sodium hypochlorite in the concentration range of 0.5 to 20.0 ppm Cl2 with 0.14 and 0.46 ppm Cl2 limit of detection and limit of quantification, respectively. The intraday and interday precisions of the method at two concentration levels of 5.5 and 13.7 ppm Cl2 were 1.04% and 0.52%, and 1.81% and 1.02%, respectively. The recoveries of 114.2% and 106.9% were obtained for 5.5 and 13.7 ppm Cl2 concentrations levels, respectively. Real sample analyzes results showed that "maybe" liquid bleach adulteration in milk is the case for local distributors of raw milk.

Late surgery for unilateral persistent fetal vasculature: long-term visual and anatomic outcomes.

BACKGROUND: Persistent fetal vasculature (PFV) is a congenital anomaly caused by failure of the ocular vasculature to regress. We report the visual and anatomic outcomes in patients who underwent surgery for PFV between 7-48 months of age. METHODS: The medical records of patients who underwent lensectomy and anterior or core vitrectomy for unilateral PFV, with or without intraocular lens implantation, were reviewed retrospectively. Inclusion criteria were surgery between 7-48 months of age and at least 12 months of follow-up. Patients with severe posterior segment involvement were excluded. The primary outcome was the final visual acuity using age-appropriate tests converted to logMAR. Secondary outcomes included the rate of adverse events and number of subsequent intraocular procedures. RESULTS: A total of 20 patients with a mean age at surgery of 19.3 ± 10.5 months and mean follow-up of 73.7 ± 46.7 months were included. Sixteen patients had delayed surgery due to late presentation; the remaining 4 were managed initially with refractive correction and occlusion. Eight patients (40%) achieved a final visual acuity better than 1.0 logMAR. Four eyes had adverse events, including one retinal detachment. No patient developed glaucoma. Four eyes underwent subsequent procedures. CONCLUSIONS: In our study cohort, surgery for unilateral PFV between 7-48 months of age achieved functional visual acuity in over one-third of patients. This is comparable to results achieved with surgery before 7 months of age, but with fewer adverse events. Differences in disease severity could account for later PFV presentation and surgery as well as outcomes.

Evaluation of IOL power calculation with the Kane formula for pediatric cataract surgery.

PURPOSE: To assess the accuracy of the Kane formula for intraocular lens (IOL) power calculation in the pediatric population. METHODS: The charts of pediatric patients who underwent cataract surgery with in-the-bag IOL implantation with one of two IOL models (SA60AT or MA60AC) between 2012 and 2018 in The Hospital for Sick Children, Toronto, Ontario, CanFada, were retrospectively reviewed. The accuracy of IOL power calculation with the Kane formula was evaluated in comparison with the Barrett Universal II (BUII), Haigis, Hoffer Q, Holladay 1, and Sanders-Retzlaff-Kraff Theoretical (SRK/T) formulas. RESULTS: Sixty-two eyes of 62 patients aged 6.2 (IQR 3.2-9.2) years were included. The SD values of the prediction error obtained by Kane (1.38) were comparable with those by BUII (1.34), Hoffer Q (1.37), SRK/T (1.40), Holaday 1 (1.41), and Haigis (1.50), all p > 0.05. A significant difference was observed between the Hoffer Q and Haigis formulas (p = 0.039). No differences in the median and mean absolute errors were found between the Kane formula (0.54 D and 0.91 ± 1.04 D) and BUII (0.50 D and 0.88 ± 1.00 D), Hoffer Q (0.48 D and 0.88 ± 1.05 D), SRK/T (0.72 D and 0.97 ± 1.00 D), Holladay 1 (0.63 D and 0.94 ± 1.05 D), and Haigis (0.57 D and 0.98 ± 1.13 D), p = 0.099. CONCLUSION: This is the first study to investigate the Kane formula in pediatric cataract surgery. Our results place the Kane among the noteworthy IOL power calculation formulas in this age group, offering an additional means for improving IOL calculation in pediatric cataract surgery. The heteroscedastic statistical method was first implemented to evaluate formulas' predictability in children.

Immediate versus delayed sequential bilateral cataract surgery in children: a cost-effectiveness analysis.

BACKGROUND/AIMS: Children with bilateral cataracts may undergo immediate sequential bilateral cataract surgery (ISBCS), which involves surgery on both eyes during the same general anaesthesia, or delayed sequential bilateral cataract surgery (DSBCS), which involves operating on each eye on separate days and requires a second anaesthesia. ISBCS is viewed with caution because of the risk of bilateral endophthalmitis. Proponents of ISBCS emphasise that the incidence of serious complications is low and is outweighed by benefits such as avoidance of multiple anaesthesia, faster visual rehabilitation and potential for decreased costs. However, there is a paucity of literature regarding the cost-effectiveness of ISBCS in children. We conducted a cost-effectiveness analysis to determine whether ISBCS is more cost-effective than DSBCS from the societal and health system perspectives in Ontario, Canada, which has a universal, single-payer system. METHODS: A retrospective analysis of children who underwent ISBCS or DSBCS at a tertiary referral paediatric hospital was conducted. A decision tree was constructed using TreeAge Pro 2018 software. Clear visual axis was the measure of effectiveness. A time horizon of 8 weeks postoperatively was adopted. Both direct and indirect costs were included. RESULTS: Fifty-three children were included, 37 in the ISBCS group and 16 in the DSBCS group. ISBCS and DSBCS were equally effective. ISBCS resulted in cost-savings of $3,776 (95% CI:-$4,641 to $12,578) CAD, per patient, from the societal perspective and $2,200 (95% CI:-$5,615 to $10,373) CAD per patient from the health system perspective. CONCLUSION: ISBCS was less costly than DSBCS from both societal and health system perspectives while being equally effective.

Comparison of the Barrett Universal II formula to previous generation formulae for paediatric cataract surgery.

PURPOSE: To compare the accuracy of the Barrett Universal II (BUII) five-variable formula to previous generation formulae in calculating intraocular lens (IOL) power following paediatric cataract extraction. METHODS: Retrospective study of consecutive paediatric patients who underwent uneventful cataract extraction surgery along with in-the-bag IOL implantation between 2012 and 2018 in the Hospital for Sick Children, Toronto, Ontario, Canada. The accuracy of five different IOL formulae, including the BUII, Sanders-Retzlaff-Kraff Theoretical (SRK/T), Holladay I, Hoffer Q and Haigis, was evaluated. Constant optimization was performed for each IOL and for each formula separately. Mean prediction error (PE) and the mean and median absolute PE (APE) were calculated for the five different IOL formulae investigated. RESULTS: Sixty-six eyes of 66 children (59% males) with a median age at surgery of 6.2 years (IQR, 3.2-9.2 years) were included in the study. The mean IOL power that was implanted was 23.3 ± 5.1 D (range; 12.0-39.0 D). Overall, the BUII had a comparable median APE to the Hoffer Q, Holladay I, SRK/T and Haigis formulae (BUII: 0.49D versus 0.48D, 0.61D, 0.74D and 0.58D respectively; p = 0.205). The BUII, together with Hoffer Q, produced better predictability within 0.5D from target refraction compared with the SRK/T formula (BUII:51.5%, Hoffer Q:51.5% versus SRK/T:31.8%, p = 0.002 for both). CONCLUSION: The BUII formula had comparable accuracy to other tested formulae and outperformed the SRK/T formula, when calculating IOL power within the 0.5D range from target refraction in paediatric eyes undergoing cataract surgery with in-the-bag IOL implantation.

Outcomes and complications of immediate versus delayed sequential bilateral cataract surgery in children.

PURPOSE: To present the largest series to date comparing outcomes and complications of immediate versus delayed sequential bilateral cataract surgery (ISBCS vs DSBCS) in children at a single center over a 10-year period. METHODS: The medical records of children <2 years of age who underwent ISBCS and DSBCS were reviewed retrospectively. Data was collected on outcomes and complications (ophthalmological and anesthesia-related) up to 8 weeks postoperatively. RESULTS: A total of 53 children were included: 37 ISBCS and 16 DSBCS. There were no differences between groups with regard to sex, age at surgery, and type of surgery. The ISBCS group had significantly more patients with systemic or ocular comorbidities than the DSBCS group (35% vs 6%; P = 0.029). Mean operating room time was significantly lower for the ISBCS group (3.61 vs 4.09 hours; P = 0.037), whereas total surgical time was similar. No major intraoperative surgical complications or anesthesia-related adverse events occurred in either group. Postoperative complications (most commonly, raised intraocular pressure) occurred in 5 eyes (7%) in the ISBCS group and 8 eyes (25%) in the DSBCS group (P = 0.009). Patients in the ISBCS group required significantly fewer follow-up visits compared to the DSBCS group (4 vs 6; P = 0.0002). CONCLUSIONS: ISBCS avoids multiple anesthesia sessions and reduces follow-up visits, with intra- and postoperative ophthalmological or anesthesia-related complications comparable to DSBCS.

Safety of intracameral moxifloxacin in the pediatric population: an equivalence study.

PURPOSE: To investigate whether the safety of intracameral moxifloxacin (IC-Mox) was equivalent to subconjunctival antibiotics (SC-Abs) in pediatric lens surgery. SETTING: The Hospital for Sick Children, Toronto, Canada. DESIGN: Retrospective consecutive cohort study. METHODS: This equivalence study compared 95% CI in the difference between the preoperative and postoperative safety variables of best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT), endothelial cell density (ECD), corneal edema, and anterior chamber (AC) inflammation in IC-Mox with SC-Abs. The zone of clinical equivalence for BCVA was set at ±0.2 logarithm of the minimum angle of resolution, IOP at ±3 mm Hg, CCT at ±30 µm, and ECD at ±400 cells/mm. RESULTS: The charts of 358 patients undergoing lens-related surgeries were reviewed. Of 317 eyes (215 patients) included, 170 eyes received IC-Mox and 147 eyes had SC-Abs. The mean age was 4.9 and 5.1 years with a mean follow-up of 19 and 34.4 months (P < .001) in IC-Mox and SC-Ab groups, respectively. The 95% CIs for the change from preoperative to postoperative safety parameters between IC-Mox and SC-Abs were all in the zones of clinical equivalence (BCVA, P = 0.75; highest IOP in the first 6 weeks postoperatively, P = 0.27; IOP at the last visit, P = 0.74; CCT, P = 0.89; and ECD, P = 0.76). During the first 6 weeks postoperatively, there was no difference in corneal edema (P = .69) and AC flare (P = .4) between IC-Mox and SC-Ab groups, whereas AC cellular activity was significantly higher in the SC-Ab group (P = .028). CONCLUSIONS: IC-Mox prophylaxis in pediatric patients showed equivalent postoperative safety outcomes when compared with SC-Abs. The use of IC-Mox (250 µg) for endophthalmitis prophylaxis appears to be safe in the pediatric population.

Congenital Corneal Opacities Associated With Trisomy 8 Mosaicism Syndrome.

PURPOSE: To describe the clinical, anterior segment optical coherence tomography (OCT) and histopathological features of 2 infants with congenital corneal opacities (CCOs) and undiagnosed trisomy 8 mosaicism syndrome (T8mS). METHODS: This is a retrospective case report documenting ocular and systemic findings, imaging, pathology and management of 2 patients with T8mS. RESULTS: An 11-month-old white male infant and a 4-week-old Asian female were initially seen for unilateral and bilateral CCOs, respectively. Corneal examination revealed para-axial anterior stromal opacities with blood vessels. Superficial irregular opacities were seen on OCT, and specular microscopy revealed normal endothelial cell morphology. One eye required superficial keratectomy to clear the visual axis and developed steroid-induced glaucoma in the early postoperative period, successfully treated with goniotomy. Both patients had hyperopia, anisometropia, and amblyopia, which was managed with glasses and patching. Cytogenetic testing (through microarray and fluorescence in situ hybridization) later diagnosed T8mS in both cases. CONCLUSIONS: T8mS should be considered in the differential diagnosis for superficial CCOs with blood vessels. Anterior segment OCT can guide management and cytogenetics performed to confirm diagnosis. Systemic associations and, in particular, risk of acute myeloid leukemia and myelodysplastic syndromes warrant prompt diagnosis of this condition.

The effect of a single anti-Vascular Endothelial Growth Factor injection on neonatal growth and organ development: In-vivo study.

Retinopathy of prematurity (ROP) is one of the leading causes of blindness in preterm Infants. Anti-vascular endothelial growth factor (VEGF) is emerging as a promising treatment, but there is insufficient evidence on their safety. We investigate the effect of systemic anti-VEGF in rat pups with equivalent maturity to a 32 week neonate. A single dose of either anti-VEGF antibody (n = 7) or saline (control group; n = 6) was administered to newborn rats intra-peritoneally on the first day of life. 14 days' post treatment, the serum concentration of anti-VEGF was measured and the brain, lung, heart, kidney and liver were harvested and weighed. The heart was processed to measure the Fulton index (a surrogate for pulmonary hypertension). All other organs were processed for mRNA expression of VEGF and VEGF-receptors (R1&R2). No group differences in body and organ weights were noted. The anti-VEGF was still detected in serum 14 days post Injection and resulted in increase in lung (p < 0.002) and kidney (p < 0.01) VEGF mRNA expressions and the lung (p < 0.02) VEGF-R1 and kidney (P < 0.001) VEGF-R2 mRNA expressions. The treated pups exhibited increased total heart weight (p < 0.01) and Fulton Index (p < 0.05). No changes were seen in the liver and brain. Anti-VEGF antibody did not affect mortality, total body and organ weights, but was associated with pulmonary hypertension. Expression of lung and kidney VEGF and its receptors was increased, whilst the brain and liver did not show changes. Dosing experiments can now be targeted to assess safety threshold and at anti-VEGF dose used in human ROP treatment.