Case of infiltrative optic neuropathy with hypertrophic pachymeningitis as a manifestation of en plaque meningioma.

We describe a case of infiltrative optic neuropathy with hypertrophic pachymeningitis noted on MRI of the brain, presenting a diagnostic dilemma with a wide variety of differential diagnoses to consider. Our patient is a middle-aged woman with a 20-year history of migranous-sounding headaches who was incidentally found to have worsening vision in her left eye during a routine driving test visual acuity check. Neurological examination revealed a left grade III relative afferent pupillary defect and a central scotoma with red desaturation. Subsequent MRI of her brain and anterior visual pathway revealed features suggestive of an infiltrative left optic neuropathy with hypertrophic pachymeningitis. An extended workup including diagnostic lumbar puncture and blood tests for possible autoimmune, infective and neoplastic causes proved unyielding. Eventually, an endoscopic transsphenoidal biopsy helped to clinch the diagnosis of a (meningothelial subtype) WHO grade 1 meningioma as the cause of her clinical and radiological presentation.

Lewis Acid Probe for Basicity of Sulfide Electrolytes Investigated by 11B Solid-State NMR.

Sulfide-based solid-state lithium-ion batteries (SSLIB) have attracted a lot of interest globally in the past few years for their high safety and high energy density over the traditional lithium-ion batteries. However, sulfide electrolytes (SEs) are moisture-sensitive which pose significant challenges in the material preparation and cell manufacturing. To the best of our knowledge, there is no tool available to probe the types and the strength of the basic sites in sulfide electrolytes, which is crucial for understanding the moisture stability of sulfide electrolytes. Herein, we propose a new spectral probe with the Lewis base indicator BBr3 to probe the strength of Lewis basic sites on various sulfide electrolytes by 11B solid-state NMR spectroscopy (11B-NMR). The active sulfur sites and the corresponding strength of the sulfide electrolytes are successfully evaluated by the proposed Lewis base probe. The probed strength of the active sulfur sites of a sulfide electrolyte is consistent with the results of DFT (density functional theory) calculation and correlated with the H2S generation rate when the electrolyte was exposed in moisture atmosphere. This work paves a new way to investigate the basicity and moisture stability of the sulfide electrolytes.

Dopant-driven recombination delay and ROS enhancement in nanoporous Cd1-xCuxS heterogeneous photocatalyst for the degradation of DR-23 dye under visible light irradiation.

Developing an efficient heterogeneous photocatalyst for environmental remediation and treatment strategies using visible light harvesting processes is promising but challenging. Herein, Cd1-xCuxS materials have been synthesized and characterized by precise analytical tools. Cd1-xCuxS materials exhibited excellent photocatalytic activity for direct Red 23 (DR-23) dye degradation in visible light irradiation. The operational parameters, like dopant concentration, photocatalyst dose, pH, and initial concentration of dye were investigated during the process. The photocatalytic degradation process follows pseudo-first-order kinetics. As compared to other tested materials, 5% Cu doped CdS material revealed superior photocatalytic performance for the degradation of DR-23 (k = 13.96 × 10-3 min-1). Transient absorption spectroscopy, EIS, PL, and transient photocurrent indicated that adding copper to the CdS matrix improved the separation of photo-generated charge carriers by lowering the recombination rate. Spin-trapping experiments recognized the photodegradation primarily based on secondary redox products, i.e., hydroxyl and superoxide radicals. According to by Mott-Schottky curves, photocatalytic mechanism and photo-generated charge carrier density were elucidated regarding dopant-induced valence and conduction bands shifting. Thermodynamic probability of radical formation in line with the altered redox potentials by Cu doping has been discussed in the mechanism. The identification of intermediates by mass spectrometry study also showed a plausible breakdown mechanism for DR-23. Moreover, samples treated with nanophotocatalyst displayed excellent results when tested for water quality metrics such as DO, TDS, BOD, and COD. Developed nanophotocatalyst shows high recyclability with superior heterogeneous nature. 5% Cu-doped CdS also exhibit strong photocatalytic activity for the degradation of colourless pollutant bisphenol A (BPA) under visible light (k = 8.45 × 10-3 min-1). The results of this study offer exciting opportunities to alter semiconductors' electronic band structures for visible-light-induced photocatalytic activity for wastewater treatment.

Rare case of anti-CV2 paraneoplastic polyneuropathy associated with lung adenocarcinoma.

We describe the first case of anti-CV2 paraneoplastic polyneuropathy associated with lung adenocarcinoma. Our patient presented with progressive unsteadiness and numbness involving bilateral upper and lower limbs. He had symmetrical length-dependent lower motor neuron pattern of weakness and numbness involving both small and large fibres with prominent sensory ataxia. An extended workup for the polyneuropathy involving a serum paraneoplastic antineuronal antibody panel showed a positive reaction for anti-CV2 antibody. CT scan of the thorax, abdomen and pelvis revealed a right upper lung nodule and histopathological examination of the nodule revealed lung adenocarcinoma. He was scheduled for chemotherapy following his discharge and there was improvement of his sensorimotor polyneuropathy following his chemotherapy.

Photosensitized Radical-Anion-Driven Metal-Free Selective Reduction of Aldehydes Using Graphene Oxide as an Electron Relay Mediator under Visible Light.

Despite the modern boost, developing a new photocatalytic system for the reduction of aldehydes is still challenging due to their high negative reduction potential. Herein, we have used a metal-free photoinduced electron-transfer system based on a cheap and readily available organic dye eosin Y (EY), graphene oxide (GO), and ammonium oxalate (AO) for photocatalytic reduction of structurally diverse aldehydes under sustainable conditions. The protocol shows remarkable selectivity for the photocatalytic reduction of aldehydes over ketones. The decisive interaction of GO and AO with the various states of EY (ground, singlet, triplet, and radical anions), which are responsible for the commencement of the reaction, was examined by various theoretical, optical, electrochemical, and photo-electrochemical studies. The synergetic system of GO, EY, and AO is appropriate for enhancing the separation efficiency of visible-light-induced charge carriers. GO nanosheets act as an electron reservoir to accept and transport photogenerated electrons from the photocatalytic system to the reactant. The reduction of the GO during the process ruled out the back transfer of photoexcited charges. Control experiments explained that the reaction involves two stages: electron transfer and protonation. This process eliminates the necessity of precious-metal-based photocatalysts or detrimental sacrificial agents and overcomes the redox potential limitations for the photoreduction of aldehydes.

Global metrics on ocular biometry: representative averages and standard deviations across ten countries from four continents.

BACKGROUND/OBJECTIVES: We provide global averages and standard deviations for ocular biometry-axial length (AL), corneal radius of curvature (CR), anterior chamber depth (ACD), lens thickness (LT), white to white (WTW), and central corneal thickness (CT). We hope a better understanding of normal and abnormal values will help clinicians gain further insight into their surgical outcomes, especially for off-target eyes. SUBJECTS/METHODS: We searched the MEDLINE database using keywords "axial length, corneal power, anterior chamber depth, lens thickness, white to white, and corneal thickness." We included studies that reported averages and standard deviations on eye biometry for at least 1300 eyes. Global weighted averages and standard deviations were calculated using the Cochrane method. RESULTS: Fourteen studies were included, originating from Asia (Japan, Singapore, Myanmar, Iran, South Korea, China), Europe (Germany, United Kingdom, Portugal), Australia, and North America (United States). Global ocular biometry metrics were: AL-23.49 mm ± 1.35 mm, CR-7.69 mm ± 0.28 mm, ACD-3.10 mm ± 0.47 mm, WTW-11.80 mm ± 0.42 mm, LT-4.37 mm ± 0.43 mm, and CT-544 µm ± 38 µm. Total eyes per value ranged from 19,538 to 90,814. CONCLUSIONS: We report global ocular biometry averages and standard deviations. No eyes were from studies in Africa or South America, highlighting the need to publish eye biometry data from these continents. We hope that promoting a deeper understanding of biometry values will help clinicians gain insight into surgical outcomes and drive innovations in lens calculations.

Understanding the intermediates and carbon dioxide adsorption of potassium chloride-incorporated graphitic carbon nitride with tailoring melamine and urea as precursors.

In this study, we demonstrated the synthesis of potassium chloride (KCl)-incorporated graphitic carbon nitride, (g-C3N4, CN) with varying amounts of N-vacancies and pyridinic-N as well as enhanced Lewis basicity, via a single-step thermal polymerization by tailoring the precursors of melamine and urea for carbon oxide (CO2) capture. Melamine, as a precursor, undergoes a phase transformation into melam and triazine-rich g-C3N4, whereas the addition of urea polymerizes the mixture to form melem and heptazine-rich g-C3N4 (CN11). Owing to the abundance of pyridinic-N and the high surface area, CN11 adsorbed higher amounts of CO2 (44.52 µmol m-2 at 25 °C and 1 bar of CO2) than those reported for other template-free carbon materials. Spectroscopic analysis revealed that the enhanced CO2 adsorption is due to the presence of pyridinic-N and Lewis basic sites on the surface. The intermediates of CO2adsorption, including carbonate and bicarbonate species, attached to the CN samples were identified using in-situ Fourier-transform infrared spectroscopy (FTIR). This work provides insights into the mechanism of CO2 adsorption by comparing the structural features of the synthesized KCl-incorporated g-C3N4 samples. CN11, with an excellent CO2 uptake capacity, is viewed as a promising candidate for CO2 capture and storage.

Integration Host Factor Binds DNA Holliday Junctions.

Integration host factor (IHF) is a nucleoid-associated protein involved in DNA packaging, integration of viral DNA and recombination. IHF binds with nanomolar affinity to duplex DNA containing a 13 bp consensus sequence, inducing a bend of ~160° upon binding. We determined that IHF binds to DNA Four-way or Holliday junctions (HJ) with high affinity regardless of the presence of the consensus sequence, signifying a structure-based mechanism of recognition. Junctions, important intermediates in DNA repair and homologous recombination, are dynamic and can adopt either an open or stacked conformation, where the open conformation facilitates branch migration and strand exchange. Using ensemble and single molecule Förster resonance energy transfer (FRET) methods, we investigated IHF-induced changes in the population distribution of junction conformations and determined that IHF binding shifts the population to the open conformation. Further analysis of smFRET dynamics revealed that even in the presence of protein, the junctions remain dynamic as fast transitions are observed for the protein-bound open state. Protein binding alters junction conformational dynamics, as cross correlation analyses reveal the protein slows the transition rate at 1 mM Mg2+ but accelerates the transition rate at 10 mM Mg2+. Stopped flow kinetic experiments provide evidence for two binding steps, a rapid, initial binding step followed by a slower step potentially associated with a conformational change. These measurements also confirm that the protein remains bound to the junction during the conformer transitions and further suggest that the protein forms a partially dissociated state that allows junction arms to be dynamic. These findings, which demonstrate that IHF binds HJs with high affinity and stabilizes junctions in the open conformation, suggest that IHF may play multiple roles in the processes of integration and recombination in addition to stabilizing bacterial biofilms.

Propionibacterium acnes endophthalmitis following transplantation of contaminated Descemet's membrane endothelial keratoplasty graft.

PURPOSE: To report the clinical outcomes of a case of Propionibacterium acnes (P. acnes) endophthalmitis following Descemet's membrane endothelial keratoplasty (DMEK) surgery. OBSERVATIONS: Transplantation of non-sterile DMEK tissue led to development of a retrolenticular white plaque confirmed through PCR testing to be the result of P. acnes endophthalmitis. Intraocular antimicrobial therapy, surgical scraping of the white plaque, and repeat DMEK tissue transplantation resulted in an excellent visual outcome (20/20). CONCLUSION: This is the first reported case of P. acnes endophthalmitis following DMEK surgery. Re-transplantation may be a viable option for DMEK patients who experience post-operative endophthalmitis.

Experimental realization of a Fresnel hologram as a super spectral resolution optical element.

A highly dispersive, diffractive optical element is designed and realized for an extremely high spectral resolution spectroscopy for exoplanet telescope application. Our design uses an annular Fresnel hologram to transform incident starlight directly into a spectrogram. The recording of the hologram is accomplished using two spherical waves of different radius of curvature. The resultant hologram consists of an annular grating structure with a gradually shrinking period as a function of increasing radius. The variable period not only could bring the incoming star-light into focus, but also exhibits a large on-axis chromatic behavior. We demonstrate a dispersion of wavelength 430-700 nm over 190 mm on-axis distance, leading to a super fine spectral resolution 0.0266 nm at wavelength 515 nm for a detector size of 20 µm.

Effect of over-the-counter brimonidine tartrate 0.025% ophthalmic solution on pupil size in healthy adults.

PURPOSE: To evaluate the effect of brimonidine tartrate 0.025% ophthalmic solution on pupil size under scotopic conditions in healthy adults METHODS: Pupil size was measured in 56 eyes of 28 volunteer participants using a pupillometer under scotopic conditions. Age, gender, and iris color were recorded. Subjects using any ophthalmic medications other than artificial tears were excluded. The pupil size was subsequently measured again under scotopic conditions 60 min after instillation of brimonidine tartrate 0.025% ophthalmic solution. RESULTS: Statistically significant miosis was seen after instillation of brimonidine tartrate 0.025% (p = 0.04). Average pupil size prior to brimonidine 0.025% instillation was 7.28 ± 1.05 mm, and average pupil size after instillation of brimonidine 0.025% was 6.36 ± 1.68 mm, a reduction of - 23.7% in pupil area. Subjects with light irides demonstrated a greater miotic effect than subjects with dark irides (1.55 mm vs. 0.67 mm, p < 0.0001), with a pupil area reduction of - 37.6% and - 17.4%, respectively. The amount of miosis was independent of initial pupil size. CONCLUSIONS: Brimonidine tartrate 0.025% causes significant miosis in scotopic settings, although the effect is not as great in darker colored eyes. Further studies are needed to determine the latency and duration of the effect and whether the amount of miosis is clinically significant.

Improvement of Multiple Generations of Intraocular Lens Calculation Formulae with a Novel Approach Using Artificial Intelligence.

Purpose: Cataract surgery is the most common eye surgery. Appropriate optimization of intraocular lens (IOL) calculation formulae can result in improved patient outcomes. The purpose of this article is to describe a methodology of optimizing existing IOL formulae and develop hybrid formulae based on artificial intelligence (AI). Methods: Preoperative biometric and postoperative outcomes data were obtained from medical records at a single institution. A numeric computing environment was used to analyze these data and refine IOL formulae using supervised learning AI. The mean absolute error of each IOL formulae with and without AI enhancement was determined, as well as the number of eyes within 0.5 diopter of the predicted refraction. Results: AI algorithms improved the mean absolute error as well as number of eyes within 0.5 diopters of predicted refraction for each of the formulae tested (P < 0.05). Conclusions: A novel methodology is described that uses AI to improve existing IOL formulae. This methodology has the potential to improve clinical outcomes for cataract surgery patients. Translational Relevance: Artificial intelligence can be used to improve existing IOL formulae.

The era of artificial intelligence and virtual reality: transforming surgical education in ophthalmology.

Training the modern ophthalmic surgeon is a challenging process. Microsurgical education can benefit from innovative methods to practice surgery in low-risk simulations, assess and refine skills in the operating room through video content analytics, and learn at a distance from experienced surgeons. Developments in emerging technologies may allow us to pursue novel forms of instruction and build on current educational models. Artificial intelligence, which has already seen numerous applications in ophthalmology, may be used to facilitate surgical tracking and evaluation. Within immersive technology, growth in the space of virtual reality head-mounted displays has created intriguing possibilities for operating room simulation and observation. Here, we explore the applications of these technologies and comment on their future in ophthalmic surgical education.

Method for IOL Power Calculation in the Second Eye of Patients With Previous Keratorefractive Surgery.

PURPOSE: To describe and evaluate a method for calculating intraocular lens (IOL) power in the second operative eye of patients with a history of keratorefractive surgery. METHODS: All eyes had undergone cataract surgery by a single surgeon from 2015 to 2018. Postoperative outcomes on the first eye (eg, IOL power implanted and postoperative refractive error) were used to back calculate a "Real K" for the first eye. The difference (delta) between the second and first eye topographic simulated keratometry values was then added to the first eye Real K to calculate the second eye Real K. This Real K value was inputted into the Holladay IOL Consultant software as an "alternate K" to derive an accurate IOL power for the second eye. Mean absolute error, mean error, and percentage of eyes on target using the Delta K method were compared with results obtained with intraoperative abserrometry and the Haigis-L and Barrett True-K No History formulas. RESULTS: The mean error for the Delta K method was significantly better than the Haigis-L (P = .00001) and Barrett True-K No History (P = .027) formulas, and on par with intra-operative aberrometry (P = .25). The mean absolute error of the Delta K method was significantly better than the Haigis-L formula (P = .03). The Delta K mean absolute error was on par with intraoperative aberrometry (P = .81) and the Barrett True-K No History formula (P = .56). CONCLUSIONS: The Delta K mean absolute error is comparable to the Barrett True-K No History formula. The mean error is lower than that calculated with the Barrett True-K No History formula and comparable to intraoperative aberrometry. [J Refract Surg. 2020;36(12):826-831.].

A corneal ring ulcer.

PURPOSE: The aim of this report is to present the case of a corneal ring ulcer that presented with diagnostic and therapeutic challenges. OBSERVATIONS: A 52-year-old woman was referred by her retina doctors for ulceration of the left cornea and pain 8 days after intravitreal ranibizumab injection for diabetic macular edema. She had been treated with erythromycin ointment, topical moxifloxacin, and therapeutic soft contact lens, which she tolerated for less than 24 hours prior to referral. Visual acuity of the left eye was counting fingers. Slit lamp examination revealed a ring-shaped corneal ulcer. CONCLUSIONS: Neurotrophic corneal ulceration can mimic acanthamoeba keratitis. Neurotrophic disease should be considered in patients with underlying risk factors in whom infectious etiology cannot be confirmed and/or who don't respond to anti-microbial therapy.

Experimental demonstration of broadband solar absorption beyond the lambertian limit in certain thin silicon photonic crystals.

The tantalizing possibility of 31% solar-to-electric power conversion efficiency in thin film crystalline silicon solar cell architectures relies essentially on solar absorption well beyond the Lambertian light trapping limit (Bhattacharya and John in Nat Sci Rep 9:12482, 2019). Up to now, no solar cell architecture has exhibited above-Lambertian solar absorption, integrated over the broad solar spectrum. In this work, we experimentally demonstrate two types of photonic crystal (PhC) solar cells architectures that exceed Lambertian light absorption, integrated over the entire 300-1,200 nm wavelength band. These measurements confirm theoretically predicted wave-interference-based optical resonances associated with long lifetime, slow-light modes and parallel-to-interface refraction. These phenomena are beyond the realm of ray optics. Using two types of 10-µm thick PhC's, first an Inverted Pyramid PhC with lattice constant a = 2,500 nm and second a Teepee PhC with a = 1,200 nm, we observe solar absorption well beyond the Lambertian limit over λ = 950-1,200 nm. Our absorption measurements correspond to the maximum-achievable-photocurrent-density (MAPD), under AM1.5G illumination at 4-degree incident angle, 41.29 and 41.52 mA/cm2 for the Inverted Pyramid and Teepee PhC, respectively, in agreement with wave-optics, numerical simulations. Both of these values exceed the MAPD (= 39.63 mA/cm2) corresponding to the Lambertian limit for a 10-µm thick silicon for solar absorption over the 300-1,200 nm band.

An In-situ and Direct Confirmation of Super-Planckian Thermal Radiation Emitted From a Metallic Photonic-Crystal at Optical Wavelengths.

Planck's law predicts the distribution of radiation energy, color and intensity, emitted from a hot object at thermal equilibrium. The Law also sets the upper limit of radiation intensity, the blackbody limit. Recent experiments reveal that micro-structured tungsten can exhibit significant deviation from the blackbody spectrum. However, whether thermal radiation with weak non-equilibrium pumping can exceed the blackbody limit in the far field remains un-answered experimentally. Here, we compare thermal radiation from a micro-cavity/tungsten photonic crystal (W-PC) and a blackbody, which are both measured from the same sample and also in-situ. We show that thermal radiation can exceed the blackbody limit by >8 times at λ = 1.7 µm resonant wavelength in the far-field. Our observation is consistent with a recent calculation by Wang and John performed for a 2D W-PC filament. This finding is attributed to non-equilibrium excitation of localized surface plasmon resonances coupled to nonlinear oscillators and the propagation of the electromagnetic waves through non-linear Bloch waves of the W-PC structure. This discovery could help create super-intense narrow band thermal light sources and even an infrared emitter with a laser-like input-output characteristic.

Safety and Efficacy of Colored Iris Reconstruction Lens Implantation.

PURPOSE: We sought to evaluate the 1- to 9-year safety and efficacy of colored iris reconstruction lens implantation in eyes with visual disturbances caused by partial or complete aniridia. DESIGN: Prospective, interventional case series. METHODS: Thirty-eight patients were implanted with Ophtec 311 colored iris reconstruction lenses at the University of California, Los Angeles as part of a larger U.S. Food and Drug Administration clinical trial. Patients in group 1 lacked corneal pathology. Patients in group 2 patients had corneal pathology, such as endothelial failure, previous transplants, or scarring. Safety measures included loss of corrected distance visual acuity (CDVA), surgical complications, adverse events, secondary interventions, and corneal endothelial cell loss. Efficacy measures included improvement in uncorrected distance visual acuity (UDVA) and subjective visual disturbances. RESULTS: Groups 1 (n = 8) and 2 (n = 30) showed improvements in CDVA (P = .155 and .038), UDVA (P = .002 and P < .001), and subjective visual disturbance scores at year 3. Median CDVA and UDVA declined slightly for both groups after 1-2 years. Group 2 experienced more adverse events, surgical complications, and secondary interventions. Endothelial cell loss was greater for group 2 (19.7%) than group 1 (8.05%), although this difference was not statistically significant (P = .067). CONCLUSIONS: Colored iris reconstruction lens implantation improved CDVA, UDVA, and subjective visual disturbances 3 years postoperatively and beyond. Adverse events, complications, and subsequent declines in visual acuity were common, however, in these eyes with complex medical and surgical histories.

A Review of Machine Learning Techniques for Keratoconus Detection and Refractive Surgery Screening.

Various machine learning techniques have been developed for keratoconus detection and refractive surgery screening. These techniques utilize inputs from a range of corneal imaging devices and are built with automated decision trees, support vector machines, and various types of neural networks. In general, these techniques demonstrate very good differentiation of normal and keratoconic eyes, as well as good differentiation of normal and form fruste keratoconus. However, it is difficult to directly compare these studies, as keratoconus represents a wide spectrum of disease. More importantly, no public dataset exists for research purposes. Despite these challenges, machine learning in keratoconus detection and refractive surgery screening is a burgeoning field of study, with significant potential for continued advancement as imaging devices and techniques become more sophisticated.