Short-Term Effects of Adding Topical Ketorolac to Intravitreal Bevacizumab in Diabetic Macular Edema: A Crossover Randomized Clinical Trial.

Purpose: To evaluate the short-term additive effects of topical ketorolac to intravitreal bevacizumab (IVB) in the management of center-involved diabetic macular edema (CI-DME). Methods: In a randomized double-masked placebo-controlled crossover clinical trial, eyes with CI-DME and the best-corrected visual acuity (BCVA) between (20/40) and (20/400) were included. These eyes should have had at least one intravitreal anti-VEGF injection in the preceding two months. They were randomized into two groups; while both groups received two IVB injections with a six-week interval, one group received topical ketorolac every 6 hr in the first interval and artificial tears every 6 hr as a placebo in the second interval and the other group received the same medications using a crossover method. The main outcome measures were changes in BCVA and central macular thickness (CMT). Results: Fifty-seven eyes of 35 patients with CI-DME were included in the study. The mean BCVA improvement was -0.09 ± 0.47 logMAR in the periods of receiving ketorolac and -0.03 ± 0.12 logMAR in the periods of placebo treatment, respectively (P = 0.99). Corresponding changes in CMT were -13.1 ± 170.1 and +11.7 ± 157.7 µm in the ketorolac and placebo periods, respectively (P = 0.322). The treatment effect was not statistically significant regarding both BCVA and CMT changes. Statistical analysis also disclosed that the carryover effect was insignificant for BCVA and CMT. Although the period effect was not significant for BCVA, it was at a meaningful level for CMT changes (P = 0.012). Conclusion: This crossover clinical trial demonstrated that in the course of DME treatment with IVB injections, topical ketorolac did not have any additive beneficial effect at least during a six-week period.

Rac1 promotes kidney collecting duct repair by mechanically coupling cell morphology to mitotic entry.

Prolonged obstruction of the ureter, which leads to injury of the kidney collecting ducts, results in permanent structural damage, while early reversal allows for repair. Cell structure is defined by the actin cytoskeleton, which is dynamically organized by small Rho guanosine triphosphatases (GTPases). In this study, we identified the Rho GTPase, Rac1, as a driver of postobstructive kidney collecting duct repair. After the relief of ureteric obstruction, Rac1 promoted actin cytoskeletal reconstitution, which was required to maintain normal mitotic morphology allowing for successful cell division. Mechanistically, Rac1 restricted excessive actomyosin activity that stabilized the negative mitotic entry kinase Wee1. This mechanism ensured mechanical G2-M checkpoint stability and prevented premature mitotic entry. The repair defects following injury could be rescued by direct myosin inhibition. Thus, Rac1-dependent control of the actin cytoskeleton integrates with the cell cycle to mediate kidney tubular repair by preventing dysmorphic cells from entering cell division.

Prevalence of depression among Iranian children and adolescents: An updated systematic review and meta-analysis.

Background and Aims: One of the most common mental disorders among children and adolescent is depression. Some of the conducted studies indicate a too-high prevalence of depression, which cannot be generalized to the entire country. So the pooled estimation of the results of different studies is very important to reach valid results. So the current study aimed to determine the prevalence of depression among Iranian children and adolescents using an updated systematic review and meta-analysis. Methods: A random-effects model was used to estimate the pooled prevalence of depression (I 2 = 99.7% and Cochran's Q, p < 0.001). To assess the effect of different factors on heterogeneity, the univariate meta-regression model was used. Publication bias was evaluated by Beggs and Eggers tests as well as funnel plots. Data were analyzed by STATA v 11 (StataCorp.). The significance level of the tests was considered less than 0.05. Results: The prevalence of depression was 33.3% (95% CI: 27.3-39.2). The most prevalence estimated using the Beak questionnaire (57.1% [95% CI: 50.2-64.0]) and the lowest was estimated using the K-SADS-PL (9.0% [95% CI: 4.0-13.6]). This estimate among females was more than among males (47.2% [95% CI: 35.4-58.9] vs. 30.5 [95% CI: 7.4-53.6]). Regarding the geographical region, the most and the lowest amount of depression was seen in the central with 41.7% (95% CI: 19.2-64.3) and southern region with 21.9% (95% CI: 14.2-29.6), respectively. Conclusion: The high prevalence of depressive disorders in Iranian children emphasizes the importance of prevention measures for these disorders.

Intravitreal Injections and Face Masks: Endophthalmitis Risk Before and During the COVID-19 Pandemic.

Purpose: To assess the added risk of acute endophthalmitis after intravitreal injections associated with the widespread use of face masks during the COVID-19 pandemic. Methods: In this retrospective, single-center study, records of patients with acute endophthalmitis following intravitreal bevacizumab (IVB) injections during the pre-COVID era-that is, March 1st, 2013 to October 31st, 2019 -and the COVID-19 era-that is, March 1st, 2020 to April 1st, 2021 -were reviewed and compared. Results: A total of 28,085 IVB injections were performed during the pre-COVID era; nine eyes of nine patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.032% (3.2 in 10,000 injections). In the COVID era, 10,717 IVB injections were performed; four eyes of four patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.037% (3.7 in 10,000 injections). The incidences of post-IVB endophthalmitis during these two eras were not statistically significantly different (P = 0.779). Conclusion: Face masking protocols seem unlikely to impose any additional risk of post-IVB endophthalmitis.

The effect of topical ketorolac tromethamine on macular thickening after phacoemulsification in diabetic patients.

BACKGROUND: To determine the effect of ketorolac tromethamine 0.5% in preventing post-phacoemulsification macular thickening. This randomized clinical trial. patients randomized 1:1 to receive either topical ketorolac three times a day or a placebo. METHODS: A total of 101 eyes of 101 diabetic patients who were scheduled for phacoemulsification and had normal macular contour and thickness enrolled consecutively. The topical ketorolac and placebo were prescribed on the day before surgery and continued up to 4 weeks after surgery. Patients with proliferative diabetic retinopathy, a history of intravitreal injection in less than three months, a history of macular photocoagulation in less than 6 months, and any other concomitant ocular pathologies were excluded. Central macular thickness (CMT) and best corrected visual acuity (BCVA) was recorded in the follow-ups of 6, 12, and 24 weeks after the surgery and compared with the controls. RESULTS: 49 eyes in the case group and 52 eyes in the control group were analyzed. Mean BCVA was significantly improved in both groups at all follow-ups (P < 0.001 for all). There was no statistically significant difference regarding the BCVA in different time points except week 12 (P = 0.028) among the study group. In the case and control groups, CMT was increased at all follow-ups (P < 0.05). There was no statistically significant difference when comparing the two groups regarding the mean of CMT at any time point postoperatively (P > 0.05 for all). CONCLUSION: Based on our findings, topical ketorolac tromethamine 0.5% is not effective in the prevention of post-phacoemulsification macular thickening in diabetic patients. TRAIL REGISTRATION: The study protocol was registered into www. CLINICALTRIAL: gov with the RCT registration number NCT03551808. (2018/06/11 ) CLINICAL TRIAL REGISTRATION NUMBER: NCT03551808.

Multi-Modal Mobility Morphobot (M4) with appendage repurposing for locomotion plasticity enhancement.

Robot designs can take many inspirations from nature, where there are many examples of highly resilient and fault-tolerant locomotion strategies to navigate complex terrains by recruiting multi-functional appendages. For example, birds such as Chukars and Hoatzins can repurpose wings for quadrupedal walking and wing-assisted incline running. These animals showcase impressive dexterity in employing the same appendages in different ways and generating multiple modes of locomotion, resulting in highly plastic locomotion traits which enable them to interact and navigate various environments and expand their habitat range. The robotic biomimicry of animals' appendage repurposing can yield mobile robots with unparalleled capabilities. Taking inspiration from animals, we have designed a robot capable of negotiating unstructured, multi-substrate environments, including land and air, by employing its components in different ways as wheels, thrusters, and legs. This robot is called the Multi-Modal Mobility Morphobot, or M4 in short. M4 can employ its multi-functional components composed of several actuator types to (1) fly, (2) roll, (3) crawl, (4) crouch, (5) balance, (6) tumble, (7) scout, and (8) loco-manipulate. M4 can traverse steep slopes of up to 45 deg. and rough terrains with large obstacles when in balancing mode. M4 possesses onboard computers and sensors and can autonomously employ its modes to negotiate an unstructured environment. We present the design of M4 and several experiments showcasing its multi-modal capabilities.

A multiscale chemical-mechanical model predicts impact of morphogen spreading on tissue growth.

The exact mechanism controlling cell growth remains a grand challenge in developmental biology and regenerative medicine. The Drosophila wing disc tissue serves as an ideal biological model to study mechanisms involved in growth regulation. Most existing computational models for studying tissue growth focus specifically on either chemical signals or mechanical forces. Here we developed a multiscale chemical-mechanical model to investigate the growth regulation mechanism based on the dynamics of a morphogen gradient. By comparing the spatial distribution of dividing cells and the overall tissue shape obtained in model simulations with experimental data of the wing disc, it is shown that the size of the domain of the Dpp morphogen is critical in determining tissue size and shape. A larger tissue size with a faster growth rate and more symmetric shape can be achieved if the Dpp gradient spreads in a larger domain. Together with Dpp absorbance at the peripheral zone, the feedback regulation that downregulates Dpp receptors on the cell membrane allows for further spreading of the morphogen away from its source region, resulting in prolonged tissue growth at a more spatially homogeneous growth rate.

Mini vitrectomy as an alternative technique for intraocular pressure adjustment in non-drainage scleral buckling.

Purpose: In non-drainage scleral buckling, anterior chamber paracentesis is usually carried out to decrease intraocular pressure. When the buckling is extensive however, this technique may be inefficient and time consuming. In this study, we tried to determine if a mini 25-gauge pars plana vitrectomy could be used as an efficient and safe alternative procedure to anterior chamber paracentesis for adjusting intraocular pressure during a non-drainage scleral buckling. Methods: In this case series, 44 patients with rhegmatogenous retinal detachment (proliferative vitreoretinopathy stage < C) were included. In all cases, a mini 25-gauge pars plana vitrectomy was performed before buckle fixation and repeated if necessary. Complete retinal attachment was defined as the anatomical success. Results: Forty-four eyes of 44 patients with mean age of 48.1 ± 18.2 years were included. Silicon buckle nº 276, sponge 505, and sponge 507 were utilized for 7, 34, and 3 eyes, respectively. Intravitreal injection of SF6 gas was performed for 54.5% of the eyes. Mean total time of the operation was 61 ± 16 min and the mean time for vitrectomy was 87 ± 31 s. Complete retinal attachment in 37 and incomplete attachment in 4 eyes were achieved after single operation that was a success rate of 93.2%. One had more than usual vitreous leak at the site of scleretomy and one developed a tiny vitreous hemorrhage at the sclerotomy site. Three sclerotomy sites needed suturing. Conclusion: The anatomical outcome and the safety observed in this study were comparable to the current methods reported in the literature. Therefore, if anterior chamber paracentesis fails to adjust intraocular pressure during a non-drainage scleral buckling, performing a small gauge mini vitrectomy is safe and helpful.

Superficial Retinal Microvasculature and Choriocapillaris Alterations after Photodynamic Therapy in Chronic Central Serous Chorioretinopathy.

Purpose: To compare superficial retinal vascular, choriocapillaris (CC), and choroidal thickness changes in chronic central serous chorioretinopathy (CSCR) patients after half-dose photodynamic therapy (PDT). Method: In this prospective interventional case series study, fifteen eyes of 14 patients with chronic CSCR undergoing half-dose PDT treatment were enrolled. All patients underwent enhanced depth imaging optical coherence tomography angiography (EDI-OCT) and optical coherence tomography angiography (OCTA) at baseline and 3 months after treatment. Best-corrected visual acuity (BCVA), superficial retinal vascular density, CC vessel density, foveal avascular zone (FAZ), central macular thickness (CMT), and choroidal thickness were compared. Results: Mean BCVA before and after PDT was 0.34 ± 0.26 and 0.19 ± 0.25 logMAR, respectively (p=0.011). Mean FAZ before treatment was 410.21 ± 117.00 µm2, which increased to 433.50 ± 116.76 µm2 (P=0.253). Mean vessel density at superficial capillary plexus (SCP) was 38.93 ± 11.12 at baseline, which increased to 39.04 ± 11.43 (P=0.886). Mean CC vessel density was 53.21 ± 4.14 at baseline, which significantly decreased to 51.85 ± 4.21 (P=<0.001). BCVA has no significant correlation with FAZ (P=0.282) and vessel density (P=0.0.241) at SCP. CMT significantly decreased from 380.87 ± 41.66 µ at baseline to 268.20 ± 28.07 µ at 3 months (P=0.132). We did not find any correlation between CMT and FAZ (P=0.040) and vessel density (P=0.686) at SCP. Mean subfoveal choroidal thickness reduced from 411 ± 171 µm before treatment to 372 ± 117 µm (P=0.106). Conclusion: PDT treatment can affect retinal and choroidal structural parameters, but we could not find any significant influence on retinal vascular parameters, including FAZ area and vessel densityonly mean CC vessel density and subfoveal choroidal thickness decreased.

Mini vitrectomy as an alternative technique for intraocular pressure adjustment in non-drainage scleral buckling / La minivitrectomía como técnica alternativa para el ajuste de la presión intraocular en el cerclaje escleral sin drenaje

Purpose In non-drainage scleral buckling, anterior chamber paracentesis is usually carried out to decrease intraocular pressure. When the buckling is extensive however, this technique may be inefficient and time consuming. In this study, we tried to determine if a mini 25-gauge pars plana vitrectomy could be used as an efficient and safe alternative procedure to anterior chamber paracentesis for adjusting intraocular pressure during a non-drainage scleral buckling. Methods In this case series, 44 patients with rhegmatogenous retinal detachment (proliferative vitreoretinopathy stage < C) were included. In all cases, a mini 25-gauge pars plana vitrectomy was performed before buckle fixation and repeated if necessary. Complete retinal attachment was defined as the anatomical success. Results Forty-four eyes of 44 patients with mean age of 48.1 ± 18.2 years were included. Silicon buckle nº 276, sponge 505, and sponge 507 were utilized for 7, 34, and 3 eyes, respectively. Intravitreal injection of SF6 gas was performed for 54.5% of the eyes. Mean total time of the operation was 61 ± 16 min and the mean time for vitrectomy was 87 ± 31 s. Complete retinal attachment in 37 and incomplete attachment in 4 eyes were achieved after single operation that was a success rate of 93.2%. One had more than usual vitreous leak at the site of scleretomy and one developed a tiny vitreous hemorrhage at the sclerotomy site. Three sclerotomy sites needed suturing. Conclusion The anatomical outcome and the safety observed in this study were comparable to the current methods reported in the literature. Therefore, if anterior chamber paracentesis fails to adjust intraocular pressure during a non-drainage scleral buckling, performing a small gauge mini vitrectomy is safe and helpful.

The Dynamics of Viruslike Capsid Assembly and Disassembly.

Cowpea chlorotic mottle virus (CCMV) is a widely used model for virus replication studies. A major challenge lies in distinguishing between the roles of the interaction between coat proteins and that between the coat proteins and the viral RNA in assembly and disassembly processes. Here, we report on the spontaneous and reversible size conversion of the empty capsids of a CCMV capsid protein functionalized with a hydrophobic elastin-like polypeptide which occurs following a pH jump. We monitor the concentrations of T = 3 and T = 1 capsids as a function of time and show that the time evolution of the conversion from one T number to another is not symmetric: The conversion from T = 1 to T = 3 is a factor of 10 slower than that of T = 3 to T = 1. We explain our experimental findings using a simple model based on classical nucleation theory applied to virus capsids, in which we account for the change in the free protein concentration, as the different types of shells assemble and disassemble by shedding or absorbing single protein subunits. As far as we are aware, this is the first study confirming that both the assembly and disassembly of viruslike shells can be explained through classical nucleation theory, reproducing quantitatively results from time-resolved experiments.

PANRETINAL PHOTOCOAGULATION VERSUS INTRAVITREAL BEVACIZUMAB VERSUS A PROPOSED MODIFIED COMBINATION THERAPY FOR TREATMENT OF PROLIFERATIVE DIABETIC RETINOPATHY: A Randomized Three-Arm Clinical Trial (CTPDR Study).

PURPOSE: To compare safety and therapeutic effect of three treatment protocols on patients with naive proliferative diabetic retinopathy. METHODS: A total of 207 eyes with proliferative diabetic retinopathy were randomly divided into three groups: full panretinal photocoagulation group; intravitreal bevacizumab (IVB) group with four monthly IVB injections; and modified combination group with two bimonthly IVB injections and a modified laser therapy. The best-corrected visual acuity and area of neovascularization leakage were compared at 1-year follow-up. RESULTS: The difference in final best-corrected visual acuity was not significant between the groups (P = 0.77). The modified combination group had the lowest final leakage area (P = 0.006). The difference in final mean deviation of visual field was not significant between IVB and modified combination groups (mean difference = 0.25, P = 0.23, 95% confidence interval, 0.12-1.38). There was no difference in rate of new-onset diabetic macular edema between IVB and modified combination groups (mean difference = 1.5%, P = 0.31, 95% confidence interval, 1.1-1.88). Mean of total IVB injections were 3.5, 7.4, and 6.2 for panretinal photocoagulation, IVB, and modified combination groups, respectively (P = 0.002). Patients in the IVB group underwent more visits (P = 0.001). In subgroup analysis, the difference in the final leakage area was significant for the eyes with diabetic macular edema (P = 0.005). CONCLUSION: A combination protocol of photocoagulation and IVB can be recommended for proliferative diabetic retinopathy, especially with baseline diabetic macular edema.

Therapeutic effects of human adipose mesenchymal stem cells and their paracrine agents on sodium iodate induced retinal degeneration in rats.

AIMS: The degeneration of retinal neurons which occurs in many neurodegenerative diseases of retina such as retinitis pigmentosa and aged-related macular degeneration, is a progressive phenomenon and leads to permanent visual disability. Aside from their economic and social impact, those who suffer from these diseases have a poor quality of life due to the lack of cures. Researchers have turned to stem cell therapies as a potential solution to this global health crisis. Mesenchymal stem cells (MSCs) and their paracrine agents such as conditioned medium (CM) and exosomes (Exo) have been applied to treat different retinal disorders. This study compared the therapeutic effects of human adipose mesenchymal stem cells (hADSCs) and their secretome on an in vivo model of sodium iodate retinal neurodegeneration. MAIN METHODS: We analyzed the expression of retinal cells' specific mRNAs by RT-PCR and proteins by immunostaining as well as performing visual cliff avoidance test as a functional evaluation technique. There were four therapeutic groups in this study: hADSC, hADSC-CM, hADSC-Exo and hADSC-Exo + CM. KEY FINDINGS: Although all groups showed different therapeutic effects on various retinal cells, the results of hADSC-CM were most striking, especially in terms of photoreceptor regeneration and retinal function. SIGNIFICANCE: The findings of present study demonstrated the different effects of MSC-based therapies on various retinal cells which could be helpful in designing more precise treatments that suit to each neurodegenerative disease mechanism and the cells involved. It also suggests that CM might be a better choice due to its multifactorial characteristic.

SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY BIOMARKERS OF RETINAL HYPERPERMEABILITY AND CHOROIDAL INFLAMMATION AS PREDICTORS OF SHORT-TERM FUNCTIONAL AND ANATOMICAL OUTCOMES IN EYES WITH DIABETIC MACULAR EDEMA TREATED WITH INTRAVITREAL BEVACIZUMAB.

PURPOSE: To assess spectral domain optical coherence tomography biomarkers of short-term outcomes in eyes with diabetic macular edema treated with intravitreal bevacizumab. METHODS: In a prospective interventional case series, 66 eyes with diabetic macular edema underwent 3 monthly intravitreal bevacizumab injections. Best-corrected visual acuity measurement and spectral domain optical coherence tomography were performed at baseline and at 3 months. Multivariate regression analysis was performed to investigate the baseline spectral domain optical coherence tomography parameters as predictors of functional and anatomical outcomes. RESULTS: Patients with diabetic nephropathy had greater subfoveal choroidal thickness (300.8 ± 35.54 vs. 253.0 ± 50.07 µm, P < 0.01) and were more likely to have subretinal fluid (r = 0.26, P = 0.03) at baseline. Multivariate analysis showed that the extent of external limiting membrane disruption (P = 0.03) and the extent of disorganization of retinal inner layers (P = 0.03) at baseline were predictors of best-corrected visual acuity at 3 months, whereas the extent of disorganization of retinal inner layers (P = 0.04) and duration of diabetes mellitus (P = 0.03) were predictors of central subfield thickness at 3 months. CONCLUSION: External limiting membrane disruption and disorganization of retinal inner layers, as the spectral domain optical coherence tomography biomarkers of retinal hyperpermeability, can predict short-term outcomes in diabetic macular edema eyes treated with intravitreal bevacizumab.

A Comparative Study on the Biodiversity and Species Richness of Phlebotomine Sand Flies (Diptera: Psychodidae) in Kermanshah and Khuzestan Provinces of Iran.

Background: Leishmaniasis is one of the most important vector-borne and neglected tropical diseases in many parts of the world. The main objective of this study was to determine the biodiversity of phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae) in Khuzestan and Kermanshah Provinces of Iran. Methods: Sampling was conducted in Khuzestan and Kermanshah Provinces using sticky paper traps and CDC light traps. The samples were then stored in 96% alcohol-containing vials, mounted, and identified. Afterward, the alpha diversity (using Simpson's, Shannon-Weiner's diversity, evenness, Maghalef's, Menhinick's, Hill N 1 and N 2 indices) and beta diversity indices (using Sorensen's and Jaccard's coefficients) were calculated. Results: A total of 4302 sand flies were caught and identified which comprised mostly of Phlebotomus papatasi, Ph. alexandri and Ph. sergenti. It was found that among the four counties of Ahvaz, Shush, Shushtar and Dezful in Khuzestan Province, Shush had the lowest, and Shushtar, the highest amount of species diversity and evenness. In the four studied counties of Kermanshah Province, species diversity in Kermanshah County had the lowest amount and Sarpol-e-Zahab, the highest. The species richness in Kermanshah County was the lowest, while Qasr-e-Shirin County had the highest amount. Conclusion: An overview of the biodiversity of phlebotomine sand flies in Kermanshah County in Kermanshah Province, and Shush County in Khuzestan Province, showed less stability in community structure of these vectors, which can be counted as an alarm for emerging dominant vectors among the studied counties and have the potential to increase the prevalence of leishmaniasis.

A bipedal walking robot that can fly, slackline, and skateboard.

Numerous mobile robots in various forms specialize in either ground or aerial locomotion, whereas very few robots can perform complex locomotion tasks beyond simple walking and flying. We present the design and control of a multimodal locomotion robotic platform called LEONARDO, which bridges the gap between two different locomotion regimes of flying and walking using synchronized control of distributed electric thrusters and a pair of multijoint legs. By combining two distinct locomotion mechanisms, LEONARDO achieves complex maneuvers that require delicate balancing, such as walking on a slackline and skateboarding, which are challenging for existing bipedal robots. LEONARDO also demonstrates agile walking motions, interlaced with flying maneuvers to overcome obstacles using synchronized control of propellers and leg joints. The mechanical design and synchronized control strategy achieve a unique multimodal locomotion capability that could potentially enable robotic missions and operations that would be difficult for single-modal locomotion robots.

Topical ketorolac as an adjunctive treatment with intravitreal bevacizumab in the management of diabetic macular edema: A double-masked placebo-controlled randomized clinical trial.

PURPOSE: To evaluate the additional effect of ketorolac eye drops on therapeutic effects of intravitreal Bevacizumab in patients with diabetic macular edema (DME) METHODS: In a randomized clinical trial, 50 patients with center involved DME (macular thickness ≥ 300 microns accompanied by decreased VA (24 < BCVA ≤ 70 ETDRS letters) were enrolled consecutively and randomized 1:1 to receive either bevacizumab plus topical ketorolac (25 patients) or bevacizumab plus artificial tears (25 patients). Patients with proliferative diabetic retinopathy, history of intraocular surgery, intravitreal injection in less than three months, macular photocoagulation less than 6 months and any other concomitant ocular pathologies were excluded from the study. All the patients received three consecutive monthly injections of intravitreal bevacizumab (IVB). After that, patients were examined every 6 weeks and reinjection was administered based on the "as needed" protocol if macular thickness was 300 microns or more and VA was 70 ETDRS letters or less.. Patients also received either topical ketorolac or artificial tears three times a day over the study period (6 months). Changes in central subfield thickness (CST), best-corrected visual acuity (BCVA, ETDRS letters), and number of IVB injections were compared between the study groups. RESULTS: Fifty eyes of 50 patients were included (25 eyes in each group). Mean CST was significantly decreased in both study groups at 14th week (-87 ± 98 µm, P = 0.012 and -100 ± 147 µm, P = 0.006 in bevacizumab plus ketorolac and bevacizumab plus artificial tears groups, respectively). Nevertheless, the changes of mean CST remained significant only in bevacizumab plus ketorolac group up to 26th week (-147 ± 124 µm, P < 0.001 and -51 ± 145 µm, P = 0.245, respectively). Comparing two groups, reduction of mean CST from baseline was significantly greater in bevacizumab plus ketorolac group compared with the control group at 26th week. (difference = -97 µm, 95%CI = -182 to -11, P = 0.017). In the study group, mean BCVA significantly increased at both 20th week (6.2 ± 10.1, P = 0.04) and 26th week (8.2 ± 10.9, P = 0.03). In contrast, visual acuity did not significantly improve at any time points in bevacizumab plus artificial tears group, While insignificant, the 26-week mean change of visual acuity from baseline was greater in bevacizumab plus ketorolac group (difference = 6.5 ETDRS letter; 95%CI = -14.4 to 1.4) Two groups were comparable regarding number of IVB injections (P = 0.99). CONCLUSION: Topical ketorolac 0.5% three times a day could enhance and sustain the efficacy of intravitreal bevacizumab in the treatment of DME.

Control of Thruster-Assisted, Bipedal Legged Locomotion of the Harpy Robot.

Fast constraint satisfaction, frontal dynamics stabilization, and avoiding fallovers in dynamic, bipedal walkers can be pretty challenging. The challenges include underactuation, vulnerability to external perturbations, and high computational complexity that arise when accounting for the system full-dynamics and environmental interactions. In this work, we study the potential roles of thrusters in addressing some of these locomotion challenges in bipedal robotics. We will introduce a thruster-assisted bipedal robot called Harpy. We will capitalize on Harpy's unique design to propose an optimization-free approach to satisfy gait feasibility conditions. In this thruster-assisted legged locomotion, the reference trajectories can be manipulated to fulfill constraints brought on by ground contact and those prescribed for states and inputs. Unintended changes to the trajectories, especially those optimized to produce periodic orbits, can adversely affect gait stability and hybrid invariance. We will show our approach can still guarantee stability and hybrid invariance of the gaits by employing the thrusters in Harpy. We will also show that the thrusters can be leveraged to robustify the gaits by dodging fallovers or jumping over large obstacles.

Time-Frequency Analysis of Photopic Negative Response in CRVO Patients.

PURPOSE: The PhNR is driven by retinal ganglion cells (RGCs). Therefore, the function of RGCs could be objectively evaluated by analyzing the PhNR. The aim of this article is to determine the effect of central retinal vein occlusion (CRVO) on PhNR and RGCs performances. METHODS: Seventeen patients with CRVO were included. Full-field photopic ERGs, including PhNR, were recorded and compared with the fellow normal eyes. ERG signals were analyzed based on the standard time-domain analyses of the PhNR as well as a continuous wavelet transform (CWT) to extract time-frequency components that correspond to the PhNR using MATLAB. We obtained the main frequencies and their occurrence time from CWT. RESULTS: All a-wave, b-wave, and PhNR amplitudes of CRVO eyes showed a significant reduction compared to those of the fellow eyes (P < .01, P < .001, and P < .001, respectively). The peak times of a-wave, b-wave, and PhNR were increased significantly in the CRVO eyes (P = .04, P = .04, and P = .003, respectively). The dominant f3 frequency, which corresponds to the PhNR in CRVO patients, showed a more significant decrease (P < .001) compared to other dominant frequencies (f0, f1, and f2). The occurrence time of f3 (t3) was significantly higher in the CRVO eyes (P < .001). Time-domain of the PhNR was also affected in CRVO patients (P < .001). CONCLUSION: CWT allows quantifications of ERG responses, especially for PhNR. The PhNR was severely affected in CRVO eyes implicating loss of RGCs. CWT might demonstrate the severity of CRVO more precisely and identify diagnostically significant changes of ERG waveforms that are not resolved when the analysis is only limited to the time-domain measurements.