Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety.

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.

Stabilization of refraction and timing of spectacle prescription following manual small-incision cataract surgery.

Purpose: To determine the stabilization of refraction at 2 weeks following MSICS by comparing the difference in spherical, cylindrical component and also spherical equivalent of refraction of 2 weeks follow-up with that of 6 weeks following surgery. Methods: The difference of spherical, cylindrical component and also spherical equivalent of refraction at 2 weeks and 6 weeks follow-up of 194 eyes that underwent uncomplicated MSICS with implantation of PMMA IOL conducted by a single experienced surgeon were compared to find out the amount of change and its significance was statistically tested by Wilcoxon-Signed Rank Test. Results: The difference in spherical power (0.04 ± 0.30), cylinder power (0.03 ± 0.40), and spherical equivalent (0.06 ± 0.34) were very small and not significant statistically (P-value ≤0.05). Conclusion: Necessary spectacle correction can safely be prescribed after 2 weeks following MSICS as subjective refraction stabilizes by that time without undergoing significant change. However, our observation was applicable in patients who had an uneventful cataract surgery without any risk factor, which can delay wound healing or cause poor visual outcome.

Metaheuristics with Deep Transfer Learning Enabled Detection and classification model for industrial waste management.

Rapid industrialization has led to the generation of a considerable amount of waste, both solid and liquid, in industrial fields like food processing, sugar, pulp, sago or starch, dairies, paper, fruit processing, poultry, distilleries, slaughterhouses, tanneries, and so forth. Despite the requirement for pollution control measures, the waste is discharged into water bodies or generally dumped on land without appropriate management, and thus becomes a significant source of environmental pollution and health hazards. The most essential step of waste management is the segregation of waste into the various elements, and normally this process is done automatically by hand-picking. A smart waste material classification technique is required to simplify the procedures. Therefore, the study presents a new Metaheuristics with Deep Transfer Learning Enabled Detection and Classification Methods for Industrial Waste Management (MDTLDC-IWM) method. The presented MDTLDC-IWM model facilitates the use of DL models for the identification and classification of waste materials in the IWM system. To accomplish this, the presented MDTLDC-IWM model follows two key phases, namely waste object recognition and waste object classification. At the initial stage, the YOLO-v5 object detector with the Harris Hawks Optimization (HHO) algorithm is used. Next, in the second stage, the stacked sparse auto encoder (SSAE) model is applied for the waste object classification method. The SSAE model is effectively optimized using the Aquila Optimization Algorithm (AOA), which helps to accomplish maximum classification of waste objects. The MDTLDC-IWM model has achieved a precision of 96.84 percent and an F score of 96.71 percent. A benchmark dataset is used to test the experimental validity of the presented MDTLDC-IWM model. Extensive comparative analysis reported the enhanced performance of the MDTLDC-IWM model over recent state-of-the-art approaches.

Deep Learning-Based Privacy-Preserving Data Transmission Scheme for Clustered IIoT Environment.

The Industrial Internet of Things (IIoT) has received significant attention from several leading industries like agriculture, mining, transport, energy, and healthcare. IIoT acts as a vital part of Industry 4.0 that mainly employs machine learning (ML) to investigate the interconnection and massive quantity of the IIoT data. As the data are generally saved at the cloud server, security and privacy of the collected data from numerous distributed and heterogeneous devices remain a challenging issue. This article develops a novel multi-agent system (MAS) with deep learning-based privacy preserving data transmission (BDL-PPDT) scheme for clustered IIoT environment. The goal of the BDL-PPDT technique is to accomplish secure data transmission in clustered IIoT environment. The BDL-PPDT technique involves a two-stage process. Initially, an enhanced moth swarm algorithm-based clustering (EMSA-C) technique is derived to choose a proper set of clusters in the IIoT system and construct clusters. Besides, multi-agent system is used to enable secure inter-cluster communication. Moreover, multi-head attention with bidirectional long short-term memory (MHA-BLSTM) model is applied for intrusion detection process. Furthermore, the hyperparameter tuning process of the MHA-BLSTM model can be carried out by the stochastic gradient descent with momentum (SGDM) model to improve the detection rate. For examining the promising performance of the BDL-PPDT technique, an extensive comparison study takes place and the results are assessed under varying measures. A significant amount of capital is required. It goes without saying that one of the most obvious industrial IoT concerns is the high cost of adoption. Secure data storage and management connectivity failures are common among IoT devices due to the massive amount of data they create. The simulation results demonstrate the enhanced outcomes of the BDL-PPDT technique over the recent methods. Despite the fact that the offered BDL-PPDT technique has an accuracy of just 98.15 percent, it produces the best feasible outcome. Because of the data analysis conducted as detailed above, it was determined that the BDL-PPDT technique outperformed the other current techniques on a range of different criteria and was thus recommended.

Effect of depth of the sclerocorneal incision on postoperative corneal astigmatism in manual small-incision cataract surgery.

Purpose: To determine the effect of depth of scleral tunnel incision measured by anterior segment OCT on postoperative corneal astigmatism by comparing the change of magnitude of corneal astigmatism between superficial and deep sclerocorneal tunnel incision in manual small-incision cataract surgery (SICS). Methods: Depths of sclerocorneal incision of 72 eyes of patients undergoing uncomplicated manual SICS and attending regular follow-up schedule were assessed with anterior segment OCT at 6-week post-op follow-up. Results: The overall mean ± standard deviation (SD) change of astigmatism for superficial incision, that is, ≤399 µm, was 0.44 ± 0.30 and that for deeper, that is, ≥400 µm, was 0.13 ± 0.48 and the change was significantly higher in ≤399 µm group than in ≥400 µm group (P = 0.003). In both superior and temporal incision locations, the mean ± SD change of astigmatism for ≤399 µm incision was 0.48 ± 0.29 and 0.40 ± 0.30, respectively, and that for ≥400 µm was 0.03 ± 0.34 and 0.23 ± 0.57, respectively. The change of astigmatism was significantly higher in ≤399 µm incision group overall (P = 0.003) and also higher in both superior and temporal incision location groups (P = 0.001 and P = 0.479, respectively). Conclusion: The depth of sclerocorneal incision had a statistically significant effect on the change of astigmatism following manual SICS, with superficial incision (≤399 µm) causing a higher change than deeper incision (≥ 400 µm).

Case reports on atypical presentation of Plasmodium falciparum malaria in pediatric patients.

Variable atypical symptoms are commonly observed in malaria caused by Plasmodium falciparum especially in endemic tropical nations such as India. Nystagmus is observed following involvement of the cerebellum especially during the postrecovery phase. While psychotic features such as severe agitation, hallucination, paranoia may be the early symptoms of falciparum malaria among pediatric patients, urticaria with or without fever can be the initial manifestation of the disease. As the morbidity and mortality of severe malaria are very high in India, these atypical presentations should be considered during diagnosis. We believe our report on atypical cases of falciparum malaria will sensitize doctors and health personnel about rare presentations in children and help in early diagnosis and management to reduce the severity and death toll due to the disease.