Glaucoma, the second leading cause of irreversible blindness globally, encompasses a heterogeneous group of ocular disorders characterized by the progressive degeneration of retinal ganglion cells. Pharmacotherapy remains the cornerstone of treatment, primarily aimed at reducing intraocular pressure (IOP) by decreasing aqueous humor production or enhancing its outflow. The therapeutic classes employed include carbonic anhydrase inhibitors, β-blockers, α-adrenergic agonists, prostaglandin analogs, parasympathomimetics, Rho kinase inhibitors, and hyperosmotic agents. Despite their efficacy, these medications are associated with a range of ocular and systemic side effects, influenced by their mechanisms of action, formulation, and dosage. Ocular adverse effects, such as irritation, dry eye, allergic reactions, and infections, are common, while systemic absorption may lead to more severe outcomes, including organ dysfunction, exacerbation of comorbid conditions, or life-threatening cardiovascular events. Given these potential risks, it is critical for clinicians to understand and monitor these adverse effects, as they significantly affect patient adherence, quality of life, and treatment outcomes. Ongoing research is essential to develop novel therapeutic regimens, agents, or delivery methods that minimize side effects and improve compliance. Incorporating patient-reported outcomes in clinical practice may further enhance the assessment of treatment impact, facilitating more tailored and effective management of glaucoma.

Glaucoma poses a serious public health concern as it is the second leading cause of blindness after cataracts, while also being the leading cause of irreversible blindness worldwide. Glaucoma is more prevalent among Black, Latino, and Asian populations and it is essential to examine both racial and ethnic disparities that exist in treatment and prevention. As the number of people with glaucoma continues to grow, it is important to review aspects of this condition in order to better care for those affected. This article will review significant forms of glaucoma and what differentiates them in a diagnosis, treatment options, and recommendations on prevention and improving awareness

Purpose To investigate secondary glaucoma resulting from uveitis in a patient infected with Human T-cell Leukemia Virus Type 1 (HTLV-1) pathologically and discuss the management of glaucoma with recurrent uveitis. Clinical course An octogenarian woman diagnosed as a carrier of HTLV-1 experienced recurrent uveitis and a sudden rise in intraocular pressure (IOP) in both eyes. Due to the uncontrolled IOP and severely damaged visual field in her left eye, a combined procedure of trabeculectomy and DGIS (Glaucoma drainage implant surgery, Baerveldt 350) was performed. The presence of HTLV-1 provirus was detected in the aqueous humor. Her trabeculectomy sample was processed for light microscopic observation. Following an irregular follow-up, she presented with a sudden decrease in vision and pain in her fellow eye, four years after the glaucoma surgeries. Her right eye exhibited a significant accumulation of mutton-fat-like keratic precipitates. Results Clinical manifestations revealed the presence of granulomatous uveitis. The combined glaucoma surgery, along with continuous topical corticosteroid medication post-surgery in her left eye, effectively suppressed the high IOP spikes and the recurrence of uveitis for 4 years. The pathological examination of the outflow pathways showed a range of damages in Schlemm's canal (SC), including SC endothelial loss, narrowing, and occlusion, as well as loss of trabecular meshwork (TM) cells and fused TM beams. Conclusion Combined GDIS and trabeculectomy represents a promising approach for managing such refractory cases of secondary glaucoma. The continuous topical corticosteroid medication is strongly recommended to prevent irreversible changes in SC and TM associated with granulomatous uveitis.

A surgical technique aimed at rerouting aqueous humor (AH) outflow from the anterior chamber to the suprachoroidal space (SCS) without performing surgical cyclodialysis was developed to decrease intraocular pressure (IOP) in glaucoma patients. The surgical outcomes of the technique were retrospectively analyzed in fifty-eight patients. At 6, 12, and 24 months, the mean IOP decreased from 27.8±8.3 to 14.95.0 mmHg, median 15.0 (25th percentile (p25 )13.0; 75th percentile (p75) 18.0), and 15.23.3 mmHg; hypotensive medication use reduced from median (p25; p75) 3 (2; 3) to 0 (0; 2), 0 (0; 2), and 0 (0; 1.5), and complete success was achieved in 62.8%, 51.2%, and 32.5% cases, with partial success in 28.4%, 44.2%, and 62.5% cases, respectively. Eight cases (13.8%) presented unsatisfactory outcomes. Intra- and postoperative complications were few and manageable. No bleb formation was observed in any of the cases. In 50% of cases, conjunctival lymphatic vessels (CLVs) developed following surgery in superior quadrants. The technique is safe and effective in providing a long-term decrease in IOP and hypotensive medication use. It was hypothesized in this study that the IOP decrease occurred as a result of enhanced AH outflow from the SCS to CLVs through intrascleral microchannels connecting the SCS to CLVs.

Purpose: Glaucoma is the second leading cause of blindness, however, it remains incurable even with the appropriate treatment. Intraocular pressure (IOP) reduction is currently the only proven method to decline glaucoma progression. When medical therapy fails, surgical treatment usually arises as the solution to a better IOP control. Nevertheless, its success is compromised by frequent post-operative complications, most of them due to excessive fibrous tissue formation during wound healing process. Nanotechnology devices for glaucoma surgery can improve post-operative IOP control and reduce undesirable fibrosis. This systematic review aims to summarize some advances of nanotechnology application to ophthalmology, giving an overview about the state of the art of the nanotechnology based glaucoma drainage devices. Methods: A literature search in the PubMed/Medline database was performed using the keywords: “glaucoma surgery”, “glaucoma drainage device”, “nanotechnology”, “nanoparticles”, “nanomedicine” and “valve”. Were included articles published until March 1, 2023. A first identification of relevant articles was done through the title and abstract’s information, and a second selection was done by full-text articles assessment. Seven articles were included in this systematic review. Results: Nanotechnology-based glaucoma drainage devices included in this review promise to overcome the challenges of glaucoma surgical treatment by allowing a more effective control over post-operative scarring, a noninvasive and customized control of aqueous humour (AH) drainage while achieving optimal IOP reduction through all phases of the post-operative period. Conclusion: Despite the decreased post-operative complications and apparently enhanced biocompatibility of nano-based drainage devices, further in vivo tests and human studies are needed to evaluate cytotoxicity and corroborate the biocompatibility and efficacy showed in the initial testing results of these devices.

Purpose: To evaluate the efficacy and survival rates of same session ab interno trabeculectomy with the trabectome and Ahmed glaucoma valve implant (AT) in comparison to the Ahmed glaucoma valve alone (A). Method: A total of 107 eyes undergoing primary glaucoma surgery were enrolled in this retrospective comparative case series, including 48 eyes which underwent AT and 59 eyes which received A alone. Participants were identified using the procedural terminology codes, and their medical records were reviewed. The primary outcome measure was surgical success, defined as intraocular pressure (IOP) > 5 mmHg, ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline at two consecutive visits after three months, no reoperation for glaucoma. Secondary outcome measures were IOP, the number of glaucoma medications, incidence of a hypertensive phase, and best corrected visual acuity (BCVA). Results: The cumulative probability of success at one year was 70% in AT, and 65% in A (p=0.85). IOP decreased significantly from 26.6 ± 10.1 mmHg at baseline to 14.7 ± 3.3 mmHg at the final follow-up in AT (p= 0.001). The corresponding numbers for A were 28.8 ± 10.2 and 16.7 ± 4.9, respectively (p= 0.001). The final IOP was significantly lower in AT (p= 0.022). The number of medications at baseline was comparable in both groups (2.6 ± 1.2 in AT and 2.5 ± 1.3 in A, p=0.851). Corresponding number at 1 year visit was 1.2±2 in AT and 2.8±1.8 in A (p=0.001). The incidence of a hypertensive phase was 18.7% in AT and 35.5% in A (p=0.05). HP resolved in only 30% of eyes. The criteria for HP resolution were fulfilled in 9 eyes (30%). There was no difference in the rate of resolution of the hypertensive phase between AT and A (33.3% and 28.5%, respectively, p=0.67). Conclusion: Ahmed glaucoma valve implant with same session trabectome surgery significantly decreased the rate of the hypertensive phase and postoperative IOP as well as the number of glaucoma medications.

Glaucoma is one of the most common causes of irreversible vision loss worldwide. It is an insidious disease with a multifactorial pathogenesis. Despite progress in treatment methods, prevention and lifestyle modifications may be useful in slowing the progression of this disease. This systematic review aimed to evaluate the influence of diet, oxidative stress, and disturbances in blood serum levels of nutrients on the incidence and severity of glaucoma based on scientific reports on the role of nutrition in the pathogenesis and course of glaucoma. This paper presents an analysis of the above issues; however, further research is required to develop this topic. Future clinical trials are needed to assess the influence of nutrition and to develop nutritional management strategies for patients with glaucoma.

To investigate switching from brimonidine and ripasudil, and brimonidine or ripasudil to a fixed combination of brimonidine and ripasudil and evaluate the associated efficacy and safety in glaucoma patients. Glaucoma patients undergoing treatment with at least brimonidine and ripasudil (n = 25) or treatment with at least brimonidine or ripasudil (n = 45) were evaluated in this retrospective study. After switching patients taking brimonidine and ripasudil, or brimonidine or ripasudil to a ripasudil/brimonidine fixed-combination ophthalmic suspension (RBFC), intraocular pressure (IOP), superficial punctate keratopathy (SPK) and conjunctival hyperemia were evaluated at baseline and at 4, 12 and 24 weeks. No significant differences in the IOPs were observed at any of the time points after switching from brimonidine and ripasudil to RBFC. However, at 4, 12 and 24 weeks, a significant decrease was observed in the mean baseline IOP from 17.0 ± 4.4 mmHg to 15.7 ± 3.2 mmHg (P < 0.01), 14.3 ± 3.4 mmHg (P < 0.01) and 14.4 ± 4.1 mmHg (P < 0.01), respectively, after switching from brimonidine or ripasudil to RBFC. No significant changes were noted for the SPK score or conjunctival hyperemia at any time points after switching to RBFC. Throughout the 24-week evaluation period, the IOP was maintained after switching from brimonidine and ripasudil to RBFC. However, there was a significant IOP decrease after switching from brimonidine or ripasudil to RBFC. These results demonstrate that RBFC is safe for use in the treatment of glaucoma patients.

Glaucoma is undoubtedly a major worldwide disease and cause of blindness. The term glaucoma however encompasses a group of disorders with differing age of incidence, intraocular pressures and varying degrees of hereditability in which vision loss occurs through a characteristic mode of retinal ganglion cell death. There are also significant differences in frequencies of incidence and gene associations for this group of disorders amongst different groups of populations. The current literature often states definitive trends in incidence for ethnic groups that fail to take into account an overall genetic fine structure for these groups. The present review intends to present an overview of some of the background necessary to discuss the genetic basis of glaucoma before describing some of the literature concerning the illness in Gypsy, Japanese, Scandinavian, Latino (Mexican and Brazilian) and Sub-Saharan African populations. It is intended that this review will give the reader a clearer picture of the diversity of worldwide glaucoma presentation which perhaps prove to question the current Ethnic view.

Abstract: The glucocorticoid receptor (GR), including both alternative spliced isoforms (GRa and GRb), has been implicated in the development of primary open-angle glaucoma (POAG) and iatrogenic glucocorticoid-induced glaucoma (GIG). POAG is the most common form of glaucoma, which is the leading cause of irreversible vision loss and blindness in the world. Glucocorticoids (GCs) are commonly used therapeutically for ocular and numerous other diseases/conditions. One serious side effect of prolonged GC therapy is the development of iatrogenic secondary ocular hypertension (OHT) and OAG (i.e. GC-induced glaucoma (GIG)) that clinically and pathologically mimics POAG. GC-induced OHT is caused by pathogenic damage to the trabecular meshwork (TM), a tissue involved in regulating aqueous humor outflow and intraocular pressure. TM cells derived from POAG eyes (GTM cells) have lower expression of GRb, a dominant negative regulator of GC activity, compared to TM cells from age-matched control eyes. Therefore, GTM cells have a greater pathogenic response to GCs. Almost all POAG patients develop GC-OHT when treated with GCs, in contrast to a GC responder rate of 40% in the normal population. Increased expression of GRb can block GC-induced pathogenic changes in TM cells and reverse GC-OHT in mice. Endogenous expression of GRb in the TM may relate to differences in the development of GC-OHT among the normal population. A number of studies have suggested increased levels of endogenous cortisol in POAG patients as well as differences in cortisol metabolism, suggesting that GCs may be involved in the development of POAG. Additional studies are warranted to better understand the molecular mechanisms involved in POAG and GIG in order to develop new disease modifying therapies to better treat these two sight threatening forms of glaucoma.

Glaucoma is a leading cause of blindness. Surgical and pharmacological treatment of glaucoma aims to lower the intraocular pressure (IOP) and preserve visual function. The severe acute res-piratory syndrome coronavirus 2 pandemic has placed a strain on the healthcare system. We aimed to compare the quantity, type of anti-glaucoma surgeries, and the disease stage before and during the coronavirus disease pandemic. We analyzed 362 eyes of 306 patients and 172 eyes of 149 patients from the pre-pandemic and pandemic groups, respectively. The number of an-ti-glaucoma surgeries was halved during the pandemic compared to a similar pre-pandemic pe-riod, with a significant difference in the procedural structures between the two groups (p<0.001). The most common procedures in the pre-pandemic group were Ex-Press implantation (33.7%) and trabeculectomy (31.5%). Within the pandemic group, half of the eyes underwent tra-beculectomy (50.0%), followed by Preserflo microshunt (11.6%). A significant difference in the average IOPs was revealed among patients who qualified for surgery 22.21 ± 7.83 mmHg in the pre-pandemic group and 25.16 ± 9.48 mmHg in the pandemic group; p<0.001). There was no significant difference in the best corrected visual acuity between the groups (p=0.263). Glaucoma treatment remained relatively accessible during the pandemic.

High rates of phosphorus (P) currently being applied to soils for the production of vegetables in the Mekong Delta, Vietnam has led to the concern of its negative effect on the economics and the environment. This research presents a comprehensive study on the determination of P supplying capacity in this region of Vietnam to examine the possibility of reducing P fertilizer input. One hundred twenty (120) soil samples were collected to evaluate total P and Bray 1 available P in the soils. Phosphorus maximum sorption, degree of P saturation, P release, and the effect of P fertilizer on corn (Zea mays L.) yield in greenhouse and fields were also determined. Total P concentrations of 56.7% soil samples evaluated yielded high P concentrations (>560 mg P/kg), while 74.2% of the samples had high Bray 1 available P concentrations (>20 mg P/kg soil). Maximum P sorption ranged from 149 to 555 mg P/kg soil, respectively and has negative correlation to available P (r = - 0.63*), degrees of P saturation ranged from 0.63 to 5.46% correlated to available P (r = 0.98**) and maximum P release ranged from 1.2 to 61.9 mg P/kg soil, respectively correlated to available P (r = 0.96**). Corn grown in soils with available P concentrations >15 mg P/kg did not respond to P fertilizer in greenhouse or field experiments. We conclude that many farmers in this region can reduce P fertilizer input, thus increasing their profits and reducing negative environmental impacts associated with excess soil P for sustainable agriculture.

Orthostatic hypotension (OH) is a condition marked by a significant drop in blood pressure upon standing, resulting from impaired autonomic regulation of vascular tone and blood volume. This study investigates the prevalence, physiological mechanisms, and occupational risk factors for OH among high-risk professions in Nepal, such as traffic police, security guards, and shopkeepers. Using a cross-sectional design, participants were evaluated for blood pressure variability, autonomic function, and fluid balance. The findings reveal a high incidence of OH, linked to reduced baroreceptor sensitivity and impaired sympathetic activation due to prolonged standing and inadequate hydration. This study highlights the need for tailored clinical interventions and workplace modifications to mitigate OH in vulnerable occupational groups.

The aim of this study was to analyze surgical and refractive outcomes of XEN glaucoma implant (Allergan, an Abbvie company, Irvine, CA, USA), a minimally invasive surgical device for the treatment of refractory glaucoma. A retrospective chart review of eyes that received XEN Gel Stent placement from December 2014 to October 2019 was conducted. Intraocular pressure (IOP) change, best corrected visual acuity (BCVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. Seventy-two subjects were included in the study: 32 (44%) males and 40 (56%) females. The mean follow-up time was 26.87 ± 15.33 months. The mean IOP before surgery was 24.82 ± 8.03 mmHg and decreased to 17.45 ± 5.84 mmHg at the end of the study, MD = -7.48, CI95 [-10.04; -4.93], p < 0.001. The mean decrease from baseline was 23%. Before surgery BCVA was 0.38±0.30 and at the end of the follow-up period it had improved to 0.47±0.37, MD = 0.09, CI95 [0.04; 0.13], p < 0.001. Additional procedures (fluorouracil injection, Bleb needling) were performed in 11/72 patients (15%). Further glaucoma surgery was necessary for 23.9%% of the patients. Implantation of XEN Gel Stent is both safe and effective for lowering IOP in refractory glaucoma patients.

Purpose: To evaluate the efficacy and survival rates of trabectome-mediated ab interno trabeculectomy combined with non-fenestrated Baerveldt glaucoma implants (BT) in comparison to Baerveldt glaucoma implant alone (B).Method: A total of 175 eyes undergoing primary glaucoma surgery (60 eyes BT and 115 B) were enrolled in this retrospective comparative case series. Participants were identified using the procedural terminology codes. Groups were then matched using Coarsened Exact Matching (51 eyes in each group). The primary outcome measure was surgical success, defined as 5 mmHg < IOP ≤ 21 mmHg, and IOP reduction ≥ 20% from baseline, and no reoperation for glaucoma. Secondary outcome measures were intraocular pressure, the number of glaucoma medications, and best corrected visual acuity (BCVA).Results: The cumulative probability of success at one year was 61% in BT, and 50% in B. IOP decreased significantly from 23.5±2.4 mmHg at baseline to 14.1±2.7 mmHg at the final follow up in BT (P= 0.001). The corresponding numbers for B were 23.2± 2.0 and 13.9± 1.6, respectively (P= 0.001). There was no significant difference in IOP at the final follow-up (P=0.56). The number of medications at baseline was 2.3±0.3 in both groups. However, BT needed significantly fewer drops at all postoperative time intervals and used 1.1±0.3 (BT) and 2.0±0.4 eye drops (B) at the final follow-up visit (P= 0.004). No dangerous hypotony or hypertension occurred in BT.Conclusion: Similar rates of success and IOP reduction were observed in BT and B. BT needed significantly fewer glaucoma medications. Tube fenestration was not necessary in BT resulting in less postoperative hypotony and hypertension.

Sewage sludge is an organic waste generated in waste-water treatment plants with certain content of nutrients, what may potentially be used as a source of slow release fertilizer, especially as phosphorus (P) source, but it demands some pre-treatment and the content of P is much lower compared to soluble mineral fertilizers. For these reasons, composted sewage sludge was used to manufacture pelletized organomineral fertilizers, mixing it with the inorganic sources monoammonium phosphate (MAP) and AshDec® (ASD) (thermochemically incinerated sewage sludge). The fertilizers were physiochemically characterized and evaluated as to the dynamics of soil P solubilization, and the forms of P remaining according to its lability. The sources evaluated were: organic compost of sewage sludge powder (SSC), pelletized SSC (SCP), pelletized organominerals SSC+MAP (S+MAP) and SSC+ASD (S+ASD), ASD alone, all compared to a soluble mineral fertilizer (MAP), and a control without P fertilizer. A test was conducted in leaching columns with 50 g of soil (Oxisol), where the fertilizers were applied at a dose of 100 mg P/column, and 30 mL of water or 2% citric acid were added daily for 30 consecutive days. The collected leachates had pH measured and P content determined. Pelletizing process resulted in denser products and promoted more gradual P release. The organomineral S+MAP was the most water-soluble recycled source, solubilizing about 70% of the total P, while the others presented much lower solubilization (&lt;20%). In contrast, all fertilizers showed high solubility in 2% citric acid (except for S+ASD). After leaching, the greatest amount of P remaining in the soil as labile and moderately labile. Composting and the AshDec process produced materials with slow P solubilization, which would be favoured to solubilize in acidic soils and acidic rhizosphere conditions. In turn, the organomineral mixture of SSC with a highly soluble mineral fertilizer (MAP) resulted in a promising product with intermediate nutrient solubility, better synchronized with crop demand, thus increasing efficiency in P use.

Childhood glaucoma encompasses congenital and juvenile primary glaucoma, which are heterogeneous, uncommon, and irreversible optic neuropathies leading to visual impairment with poorly understood genetic basis. Our goal was to identify gene variants associated with these glaucoma types by assessing the mutational burden in 76 matrix metalloproteinase-related genes. We studied 101 childhood glaucoma patients with no identified monogenic alterations using next-generation sequencing. Gene expression was assessed through immunohistochemistry. Functional analysis of selected gene variants was conducted in cultured cells and in zebrafish. Patients presented a higher proportion of rare variants in four metalloproteinase-related genes, including CPAMD8 and ADAMTSL4, compared to controls. ADAMTSL4 protein expression was observed in the anterior segment of both the adult human and zebrafish larvae's eye, including tissues associated with glaucoma. In HEK-293T cells, expression of four ADAMTSL4 variants identified in this study showed that two variants (p.Arg774Trp and p.Arg98Trp) accumulated intracellularly, inducing endoplasmic reticulum stress. Additionally, overexpressing these ADAMTSL4 variants in zebrafish embryos confirmed partial loss-of-function effects for p.Ser719Leu and p.Arg1083His. Double heterozygous functional suppression of adamtsl4 and cpamd8 zebrafish orthologs resulted in reduced volume of both the anterior eye chamber and lens within the chamber, supporting a genetic interaction between these genes. Our findings suggest that accumulation of partial functional defects in matrix metalloproteinases-related genes may contribute to increased susceptibility to early-onset glaucoma and provide further evidence supporting the notion of a complex genetic inheritance pattern underlying the disease.

Biomechanics is a branch of biophysics that deals with mechanics applied to biology. The biomechanics of the cornea plays a significant role in managing patients with glaucoma. While evidence suggests a higher risk of glaucoma in patients with thin and stiffer corneas, it also affects the measurement of intraocular pressure (IOP). We reviewed the pertinent literature to help the understanding of corneal biomechanics and how it can help optimize clinical and surgical treatments and a better approach to diagnosing and managing patients with glaucoma.

Leaf senescence in plants is the last stage of leaf development that is characterized by a decline in photosynthetic activity, an active degeneration of cellular structures and the recycling of accumulated nutrients to areas of active growth such as buds, young leaves, flowers, fruits and seeds. This process holds economic significance as it can impact yield, influencing the plant´s ability to maintain an active photosynthetic system during prolonged periods, especially during the grain filling stage, which affects plant weight and oil content. It can be associated with different stresses or environmental conditions, manifesting itself widely in the context of climate change and limiting yield, especially in crops of agronomic relevance. In this work we study the stability of two widely described sunflower genotypes belonging to the INTA Breeding Program against differential N conditions, to verify their yield stability in control conditions and under N supply. Two inbred lines were utilized, namely R453 (early senescence) and B481–6 (late senescence), with contrasting nitrogen availability in the soil but sharing the same ontogeny cycle length. It was observed that, starting from R5.5, the B481-6 genotype not only delayed senescence but also exhibited a positive response to increased nitrogen availability in the soil. This response included an increase in intercepted radiation, resulting in a statistically significant enhancement in grain yield. Conversely, the R453 genotype did not show significant differences under varying nitrogen availability and exhibited a tendency to decrease grain yield when nitrogen availability was increased. The response to nitrogen can vary depending on the specific genotype.

MATERIAL AND METHOD: This is an observational analytical cohort study carried out on a total of 160 patients, divided into 4 groups: healthy, with myopia, with primary open-angle glaucoma (POAG), and with POAG and myopia together. The study variables were Bruch's membrane opening area (BMO), the thickness of the RNFL and the RGC layer using the Glaucoma Premium program of the OCT Spectralis of Heidelberg. RESULTS: Regarding the analysis between age and the thickness of the RNFL, significant results were found in the healthy and glaucoma groups with myopia, for the rest of the groups, although there are no significant results, the correlation is negative, the older the younger is the thickness. Regarding intraocular pressure (IOP), significant results have been found in the nasal sector in the glaucoma group. In the glaucoma with myopia group, statistically significant results have been obtained when analyzing the thickness of the RNFL with refraction. In the analysis between the thickness of the RNFL and the RGC layer, significant results were obtained in the myopia and glaucoma groups; in the group of glaucoma with myopia, it occurs in the superior temporal sector. CONCLUSION: In the case of myopic patients with glaucoma, damage at the functional, both the thickness of the RNFL, the RCG and the BMO-MRW are greater than other groups. All these alterations can be evaluated and monitored with the OCT Spectralis thanks to the programs it includes, making this instrument one of the best for an early diagnosis of glaucoma and the damage produced in myopic patients.

Purpose: To compare the efficacy and safety of graft-free short tunnel small flap (STSF) technique with that of scleral patch graft (SPG) in Ahmed glaucoma valve (AGV) implantation. Design: Randomized clinical trial. Participants: Eighty-eyes of eighty patients with medically uncontrolled glaucoma including 41 in STSF and 39 eyes in SPG. Methods: Patients were enrolled and assigned randomly to STSF or SPG. Main Outcome Measures: tube exposure, Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), surgical complications, and success rate ( defined as intraocular pressure (IOP) >5 mmHg, ≤21 mmHg, and IOP reduction ≥20% from baseline at two consecutive visits after three months, no reoperation for glaucoma). Results: only one case in SPG developed tube exposure at 1-year follow-up. The cumulative probability of success during the first year of follow-up was 70% in the STSF and 65% in SPG (P = 0.36). IOP decreased significantly from 29.6 ± 8.6 mmHg at baseline to 16.4 ± 3.6 mmHg at the final follow-up in STSF (p = 0.001). The corresponding numbers for SPG were 30.9 ± 11.2 and 15.8 ± 4.7, respectively (p = 0.001). The final IOP was comparable between both groups (p = 0.65). Mean ± standard deviation of the number of glaucoma medications was 1.8 ± 0.9 in STSF and 1.6 ± 0.9 in SPG at final follow-up (P = 0.32). Postoperative complications developed in 8 patients (19%) in STSF and 9 patients (23%) in SPG (P = 0.81). Conclusions: STSF and SPG techniques had comparable complication rate at one-year follow-up. Both techniques were comparable in terms of success rate, postoperative IOP, and glaucoma medications.

To evaluate the 2-year efficacy and safety of ab interno trabeculectomy with the Trabectome in Chinese primary open-angle glaucoma (POAG) patients. This was a multicenter, retrospective study and included POAG patients with or without visually-significant cataracts. The primary outcome was intraocular pressure (IOP) reduction. Secondary outcomes included reduction of glaucoma medications, surgical complications, and success at 2-years. Success was defined as: 1) IOP < 21 mmHg and at least 20% IOP reduction from baseline after 3 months at any two consecutive visits, and 2) no additional glaucoma surgery required. A total of 42 patients were enrolled; thirteen had a history of failed glaucoma surgery. Twelve patients underwent Trabectome surgery combined with phacoemulsification while the remainder underwent Trabectome surgery alone. Overall, the mean preoperative IOP was 21.4±1.23 mmHg. The Trabectome lowered IOP to 18.5± 0.94 mmHg at 2 years (P<0.05). The number of glaucoma medications also decreased from a baseline of 2.0±0.9 to 1.2± 0.21 at 2 years (P=0.04). The overall success was 78%, with patients undergoing combined surgery having a higher success than those with Trabectome surgery alone (100% vs. 76%). No major complications were seen. The Trabectome appears to be an efficient and safe procedure in Chinese POAG patients in the long-term.

In this paper, we introduce the (ρ,q)-analogue of the p-adic factorial function. By utilizing some properties of (ρ,q)-numbers, we obtain several new and interesting identities and formulas. We then construct the p-adic (ρ,q)-gamma function by means of the mentioned factorial function. We investigate several properties and relationships belonging to the foregoing gamma function, some of which are given for the case p = 2. We also derive more representations of the p-adic (ρ,q)-gamma function in general case. Moreover, we consider the p-adic (ρ,q)-Euler constant derived from the derivation of p-adic (ρ,q)-gamma function at x = 1. Furthermore, we provide a limit representation of aforementioned Euler constant based on (ρ,q)-numbers. Finally, we consider (ρ,q)-extension of the p-adic beta function via the p-adic (ρ,q)-gamma function and we then investigate various formulas and identities.

Background: Retinal vascular abnormalities may be associated with glaucomatous damage. Adaptive optics (AO) is a new technology that enables analysis of retinal vasculature at the cellular level in vivo. The purpose of this study is to evaluate retinal arteriolar parameters using the adaptive optics fundus camera (AO -FC) rtx1 in patients with primary open-angle glaucoma (POAG) at different stages and to investigate the relationship between these parameters and changes in optical coherence tomography (OCT) and perimetry. We wanted to assess whether vascular changes could be a cause or effect of glaucomatous damage. Methods: Parameters of retinal supratemporal and infratemporal arterioles (wall thickness (WT), lumen diameter (LD), total diameter (TD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall (WCSA)) were analysed with the rtx1 in 111 POAG eyes, divided into three groups according to the severity of disease and 70 healthy eyes in correlation of structural defects in retinal nerve fibre layer and visual fields defects. Results: Compared with the control group, the POAG groups showed significantly smaller TD and LD values (p<0,05) and significantly higher WLR and WT values (p<0,05) for supratemporal and infratemporal arterioles. Rtx1 parameters significantly correlated with OCT parameters (retinal nerve fibre layer, ganglion cell complex and rim area) and visual field parameters (mean deviation and pattern standard deviation) (p<0.05). Conclusion:  The results suggest that vascular dysfunction may be involved in POAG pathogenesis and neurodegenerative damage, even at the very early stage of glaucoma, without visual field defects.

Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: A retrospective analysis was done on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. CST parameters were compared between eyes with POAG and those with PACG using a linear mixed model (LMM). Results: No differences were observed in age, central corneal thickness, intraocular pressure, or use of antiglaucoma eye drops between the two groups. Patients with PACG had a significantly shorter axial length (AL), a higher proportion of females, CST parameters, longer applanation 2 (A2) time, deeper A2 deformation amplitude, shorter peak distance (PD), longer whole eye movement, and longer whole eye movement time than patients with POAG. Highest concavity (HC) length and PD showed a significant positive correlation with AL. However, A1 length, A1 deformation amplitude, A2 time, A2 velocity, A2 length, A2 deformation amplitude, HC time, whole eye movement, and whole eye movement time were negatively correlated with AL. Conclusions: Biomechanical properties of the cornea differed between PACG and POAG. In some parts, AL differences between the POAG and PACG groups might contribute to the variation in CST parameters.

Purpose: To compare the standard implantation technique of a new ab externo microshunt (PRESERFLO) to a posterior technique with a small incision. The standard anterior approach (A) requires a relatively large, 6-8 mm perilimbal peritomy. In contrast, the posterior approach (P) involves only a 2-3 mm snip incision 2 mm posterior to the limbus. Methods: Charts of 126 PRESERFLO patients (54 A and 72 P) were retrospectively analyzed. Follow-up was 270 days. We compared the surgical time, intraocular pressure (IOP), number of medications, and complications. Results: The preoperative IOP in A was 21.8±8.5 mmHg and 23.9±8.1 mmHg in P (p=0.08). The surgical time for A was 26±0.8 minutes and 10±0.4 minutes for B (p<0.001). Following a low-pressure phase during the first week, A and P had an IOP value of 10.8±5.9 mmHg and 10.6±4.5 mmHg at 30 days, respectively (p=0.62). IOPs remained at this level throughout the study (all intra-group p> 0.08). There were no inter-group differences in IOP at any visit (all p-values > 0.3). Patients in A and P took 3.2 ± 1.3 and 3.3 ± 1.0 pressure-lowering medications at baseline, respectively (p=0.4). These values declined to 0.2 ± 0.6 in A and 0.3 ± 0.7 in P at 270 days. Both groups had a similar number of revisions (13 (10.3%) versus 10 (7.9%, p=0.14)) and complications (26 (20.8%) versus 31 (24.6%, all p>0.25). Conclusion: The posterior PRESERFLO insertion technique was 2.6 times faster than the standard anterior technique and yielded similar results with a large reduction in IOP and medications and a safety profile favorable over traditional filtering surgery.

Primary open-angle glaucoma (POAG) is a progressive optic neuropathy with a complex, multifactorial aetiology. Raised intraocular pressure (IOP) is the most important clinically modifiable risk factor for POAG. All current pharmacological agents target aqueous hu-mour dynamics to lower IOP. Newer therapeutic agents are required as some patients with POAG show a limited therapeutic response or develop ocular and systemic side ef-fects to topical medication. Elevated IOP in POAG results from cellular and molecular changes in the trabecular meshwork driven by increased levels of transforming growth factor β (TGFβ) in the anterior segment of the eye. Understanding how TGF affects both the structural and functional changes in the outflow pathway and IOP is required to de-velop new glaucoma therapies that target the molecular pathology in the trabecular meshwork. In this study we evaluated the effects of TGF-1 and -2 treatment on miRNA expression in cultured human primary trabecular meshwork cells. Our findings are pre-sented in terms of specific miRNAs (miRNA-centric), but given miRNAs work in net-works to control cellular pathways and processes, a pathway-centric view of miRNA ac-tion is also reported. Evaluating TGF-responsive miRNA expression in trabecular meshwork cells will further our understanding of the important pathways and changes involved in the pathogenesis of glaucoma and could lead to the development of miRNAs as new therapeutic modalities in glaucoma.

Introduction: Early childhood caries is a significant public health problem among preschool children. The COVID-19 pandemic, which restricted dental services, altered family dynamics, affected child development, and created new demands on caregivers, may have exacerbated this issue. Objective: Analyze the occurrence and severity of caries and identify associated factors in preschool children attending public municipal daycare centers in Salvador, Bahia, Brazil, Methodology: A cross-sectional epidemiological study was conducted to investigate caries in children aged 2 to 5 years in 2022 and 2023. Caries was assessed using the decayed, extracted, filled, and missing teeth (DEFT) index, and prevalence was calculated. Sociodemographic, family dynamic, dietary, and healthcare utilization data were obtained through a questionnaire. After descriptive and exploratory analyses, robust Poisson multivariable regression was conducted at a 5% significance level, considering socioeconomic, psychosocial, and behavioral aspects. Results: A total of 440 preschoolers participated, with a mean age of 55 months. The majority were Black or mixed race (88.86%) and female (52.73%). The prevalence of caries was 30.91% and the mean DEFT score was 1.1. In the multivariable analysis, low family income (up to one minimum wage) and not playing outdoors during the pandemic were associated with a higher prevalence of caries. Conclusion: The prevalence and severity of caries remain high, and the pandemic has contributed to the maintenance of this epidemiological scenario. Public health measures and policies promoting social justice should be planned to improve oral health conditions in childhood.

In this study, we propose a conservative and compact finite difference scheme designed to preserve both the mass change rate and energy for solving the sixth-order Boussinesq equation with the surface tension. Theoretical analysis confirms that the proposed scheme achieves second-order accuracy in temporal discretization and fourth-order accuracy in spatial discretization. The solvability, convergence, and stability of the difference scheme are rigorously established through the application of the discrete energy method. Additionally, a series of numerical experiments are conducted to illustrate the effectiveness and reliability of the conservative scheme for long-time simulations.

In this paper, we introduce a new class of $(p,q)$-analogue type of Fubini numbers and polynomials and investigate some properties of these polynomials. We establish summation formulas of these polynomials by summation techniques series. Furthermore, we consider some relationships for $(p,q)$-Fubini polynomials associated with $(p,q)$-Bernoulli polynomials, $(p,q)$-Euler polynomials and $(p,q)$-Genocchi polynomials and $(p,q)$-Stirling numbers of the second kind.

Software Engineering education has grown during the past couple of decades as a specialized branch of computer science education to address employment demands. Software Engineering education is constantly evolving because of its dynamic nature. However, there are still some gaps between the skills being taught in the universities and skills required for employment. In this paper, we present our experience of designing and delivering a new module to enhance skills for employment. We have taken a structured approach to analyze the gap through literature review and our personal experiences of engaging with employers of our students. Based on the analysis, we arrived at a set of gaps between what we teach and what the employers of our students need. We prioritized the gaps and envisaged a new module ‘Contemporary Software Engineering’ to address the gaps and subsequently help our students for an easy transition to job. As part of our experience, we present the background, design and delivery of the module and reflect on our journey of delivering the module for a few years.

Polluting discharges are produced at a rate that is inexorably rising in tandem with human activity development. Eutrophication and other matters, such as offensive aquatic life, require wastewater to be treated before being discharged into the environment. Prior releasing into water bodies, the treated waters must to undertake laboratory analysis. For this purpose, an analysis using standard methods was carried out at the Laboratory Waterworks in Debrecen on various samples taken from various wastewater treatment plants (sewage treatment plants) in Hungary. The overall objective of this study was to assess the quality of the effluents from the fourteen (14) wastewater treatment plants and investigate their efficiency by measuring various physicochemical parameters and microbiological parameters as excellent indicators to evaluate the performance of the studied wastewater treatment plants. The microbiological indicator monitored was the heterotrophic count (HPC) by estimating its total number, which provides useful information for the assessment and monitoring of water samples. The determination of physicochemical parameters included biological oxygen demand (BOD5), chemical oxygen demand (COD) and nitrite -N (NO2), ammonia-N (NH3-N), nitrate-N (NO3) total phosphorus (TP), Kjeldahl- Nitrogen (organic N+ammonia-N) (TKN), total inorganic N (TI), total suspended solids (TSS) and total nitrogen (TN). The performance of the wastewater treatment plants examined was checked and the results were conclusive. In the future, solutions should be applied to these wastewater treatment plants and some recommendations are suggested.

Formaldehyde is generated via the biochemical and chemical pathways, and it widely exists in foods. Its chronic exposure causes carcinogenic, neurotoxic, reproductive, allergic, immunological, genetic and respiratory toxicities. However, food-sourced formaldehyde is usually neglected due to its rapid metabolism after intake. Compared with its residual level in processed foods, a large proportion of formaldehyde disappears because of its high reactivity. Nevertheless, its elimination reaction mechanism and the potential consequences remain unclear. In this review, the disappearing pathway of formaldehyde from two aspects, the formation of formaldehyde-derived toxins and aromas, was reviewed. This review article may help food scientists take appropriate strategies to use the beneficial reactions of formaldehyde or divert its harmful effects to beneficial ones.

Employee turnover is a significant issue for financial institutions, impacting productivity, increasing recruitment costs, and disrupting critical operations. In this project, this study aimed to predict employee turnover using a dataset containing attributes such as employee satisfaction, performance, and tenure. By framing the task as a binary classification problem, this study employed CatBoost and XGBoost, two advanced regression-based algorithms, to develop predictive models. This paper's analysis demonstrated that CatBoost outperformed XGBoost across all evaluation metrics, including MAE, MSE, RMSE, and R², making it the more effective model for predicting turnover in the financial sector. The study highlights key factors contributing to employee attrition, such as job satisfaction, tenure, and promotion opportunities, offering actionable insights for retention strategies. Additionally, by predicting probabilities rather than binary outcomes, this study aims to make more detailed decisions about employee retention. This research provides valuable tools for financial institutions to mitigate the risk of turnover, retain critical talent, and ensure operational continuity.

Granular material is one of the most common in nature. Recently, there has been a significant amount of interest in the granular materials, such as powders or sand. It is challenging to describe the motion of such kind of macroscopic size matter, because it behaves like solid, fluid or gas. Size division, pattern formation, avalanches, packing and convection - these are just a few examples from a wide range of observed phenomena that occur during the motion process of granular matter. Most of these processes are based by flow and no wonder that much effort has been devoted to obtain a hydrodynamic description in which granular materials are treated as a continuous medium. During the research of vertically shaken granular medium motion in an opened container it was found that experimental and numerical results are explained by hydrodynamic theory. This paper investigates the motion of a granular matter for a shallow, vertically shaken bed. We assume the Leidenfrost state as initial and the matter resembles a fluid heated up from below.A one-dimensional isothermal and a non-isothermal problem of granular material motion,simulatedby a hydrodynamic model are considered, and the material is assumed to be a continuous medium. The local temporal solvability of isothermal and non-isothermal initial boundary-value problem in Sobolev’s spaces is proved. This work presents a numerical study of the one-dimensional model of granular medium flow. The feature of this model is consideration of the Navier-Stokes equations accounting an interpolation form of VanderWaals constitutive equation for pressure. A finite-difference approximation for numerical solution is proposed.

This bibliometric study analysed breast cancer research trends and outputs from 2014 to 1 2023, utilising data from the Scopus database. The primary objectives include analysing publication 2 growth, citation metrics, document type distribution, leading countries, preferred journals and 3 authorship patterns. The study reveals a significant increase in breast cancer research publications, 4 with a total of 12,073 documents and 216,769 citations over the ten-year period. The United States 5 leads in publication output and citation impact, followed by China and Japan. Articles are the 6 predominant document type for total 73.4% of publications, while reviews and book chapters also 7 contribute notably. The most preferred journals for publishing breast cancer research include Breast 8 Cancer Research and Treatment, Clinical Breast Cancer, and Breast Cancer Research. Authorship 9 patterns show a trend towards multi-authored papers, with a substantial number of papers having 10 more than five authors. The study underscores the global collaborative effort in advancing breast 11 cancer research and highlights key areas for future exploration.

The macular pigment optical density (MPOD) signifies a vital component of macular well-being and high-resolution visual acuity. MPOD can serve as a reliable biomarker for assessing the retinal defense mechanisms against oxidative stress and the deleterious effects of excessive light exposure. Elevated MPOD levels offer robust protection against the onset and progression of age-related macular degeneration (AMD) a prevalent cause of vision impairment among the elderly population. MPOD's implications in diverse ocular conditions, including diabetic retinopathy and glaucoma, have been explored and indicate a real need for clinical measurement of MPOD. This review looks at the potential of MPOD as a modifiable biomarker influencing the progression and onset of these conditions, particularly in the context of oxidative stress and retinal ischemia. The integration of MPOD measurement into routine eye examinations presents an unparalleled opportunity for early disease detection, precise treatment planning, and longitudinal disease monitoring. Emerging technologies and longitudinal investigations promise to elucidate the dynamic nuances of MPOD in the context of age-related ocular diseases.

This review article explores the transformative impact of Artificial Intelligence (AI) on glaucoma care, focusing on advancements in diagnosis, monitoring, and treatment algorithms. AI technologies have revolutionized the field of ophthalmology by enhancing the accuracy and efficiency of diagnosing glaucoma. Furthermore, AI-powered monitoring systems enable continuous and personalized patient care, facilitating early detection of disease progression. Integrating AI algorithms in treatment protocols promises individualized and optimized therapeutic strategies for better management of glaucoma. This comprehensive review elucidates AI applications' current state and future directions in transforming glaucoma care, emphasizing the potential benefits of improving patient outcomes.

Purpose: To compare refractive prediction error (PE)s between phacotrabeculectomy and phacoemulsification. Methods: Refractive PE was defined as the difference of spherical equivalent between the predicted value using the Barrett Universal II formula and the actual value obtained at postoperative one month. Forty-eight eyes that had undergone phacotrabeculectomy (19 eyes, open-angle glaucoma; 29 eyes, angle-closure glaucoma) were matched with 48 eyes that had undergone phacoemulsification by age, average keratometry value and axial length (AL), and their PEs were compared. The factors associated with PE were analyzed by multivariable regression analyses. Results: Phacotrabeculectomy group showed a larger absolute PE compared to the phacoemulsification group (0.51 ± 0.37 Diopters vs. 0.38 ± 0.22, P=0.033). Larger absolute PE was associated with longer AL (P=0.010) and higher intraocular pressure (IOP) difference (P=0.012). Hyperopic shift (PE>0) was associated with shallower preoperative anterior chamber depth (ACD) (P=0.024) and larger IOP difference (P=0.031). In the phacotrabeculectomy group, the PE was inversely correlated with AL: long eyes showed myopic shift and short eyes hyperopic shift (P=0.002). Conclusions: Surgeons should be aware of the possibility of worse refractive outcomes when planning phacotrabeculectomy especially in eyes with high preoperative IOP, shallow ACD, and/or extreme AL.

Purpose: To investigate the molecular basis of congenital glaucoma in a family with GAPO (growth retardation, alopecia, pseudoanodontia, and progressive optic atrophy) syndrome. Methods: We report ocular features of 3 girls with GAPO syndrome born of consanguineous marriage in a multi- generation consanguineous family. The proband (4year old girl) and her younger sibling (1 year old girl) were operated for bilateral congenital glaucoma in both eyes. The elder sibling (10year old female) had features of GAPO syndrome but did not manifest features of glaucoma. Results: A genetic evaluation using whole exome sequencing revealed a homozygous ANTXR1 mutation in all 3 affected siblings with GAPO. No other mutations were detected in the genes associated with glaucoma. A rare missense mutation in TGFBI gene was shared in the two siblings with congenital glaucoma and GAPO syndrome.Conclusions: Mutations in TGFBI gene could have a role in the pathogenesis of congenital glaucoma.

The aim of this study is to investigate the effect of two antiglaucoma procedures, namely trabeculectomy and Ex-PRESS mini-shunt insertion on the biomechanical properties of the cornea. This is a prospective study. Thirty patients (30 eyes) were included in the study. Nineteen eyes had an Ex-PRESS shunt inserted (Group 1) and 11 had trabeculectomy (Group 2). The examination time points for both groups were 1 to 3 weeks preoperatively and at month 1, 6 and 12 postoperatively. Corneal biomechanical properties [corneal hysteresis (CH) corneal resistance factor (CRF)] were measured with the Ocular Response Analyzer. In group 1, CH was significantly increased at 6 and 12 months compared to baseline values. Corneal hysteresis was also higher at 1 month postoperatively but this increase did not reach statistical significance. In group 2, the CH was significantly increased at all time points compared to the preoperative values. CRF decreased at all time points postoperatively compared to the preoperative values in both groups. The difference (preoperative values to postoperative values at all time points) of the CH and CRF between the two groups was also compared and no significant differences were detected between the two surgical techniques. Trabeculectomy and the EX-PRESS mini-shunt insertion alter significantly the corneal biomechanical properties as a result of the surgical trauma and the presence of the shunt in the corneal periphery. When compared between them they affect the corneal biomechanical properties in a similar way.

Glaucoma is a blinding disease largely caused by increased resistance to drainage of fluid from the eye’s anterior chamber, resulting in elevated intraocular pressure (IOP). A major site of fluid outflow regulation and pathology is the trabecular meshwork (TM) at the entrance of the eye’s drainage system. We aimed to characterize the structural and functional properties of a newly developed tissue-engineered anterior segment eye culture model. We hypothesized that repopulation of a decellularized TM with non-native TM cells could restore aspects of normal TM. The decellularization protocol removed all cells and debris while preserving the ECM. Seeded cells localized to the TM region and progressively infiltrated the meshwork ECM. Cells reached a distribution comparable to control TM after four days of perfusion culture. After a perfusion rate increase challenge, tissue-engineered cultures reestablished normal IOPs (reseeded = 13.7±0.4 mmHg, decellularized = 35.2±2.2 mmHg, p < 0.0001). eGFP expressing CrFK control cells caused a high and unstable IOP (27.0±6.2 mmHg). In conclusion, we describe a readily available, storable, and biocompatible scaffold for anterior segment perfusion culture of non-native cells. Tissue-engineered organs demonstrated similarities to native tissues and may reduce the need for scarce donor globes in outflow research.

Objective: To evaluate the affective responses to running with imposed velocity or self-selected time trials in runners, as well as the effects on volume load (VL) and training impulse (TRIMP). Anxiety was also determined. We establish the level of association between the dependent variables. Methods: Three visits were carried out. 1st visit consisted of a maximum running effort test (VO₂Max). 2nd and 3rd visits, participants were divided between the time limit (T_Lim) or time trial 1000m running at self-selected intensity (T₁₀₀₀). Participant responded to felt arousal, feeling and anxiety SUDS scale, before, during and after T_Lim and T₁₀₀₀. Results: T_Lim vs. T₁₀₀₀ (p<0.001), V_Peak x V₁₀₀₀ (p=0.013), showed differences, but did not influence VL_TLim vs. VL₁₀₀₀ (3181.34 ± 872.22 vs. 3570.60 ± 323.3; p=0.062). TRIMP showed no differences (p=0.068). Arousal did not differ between the pre-exercise (p=0.772) and post-exercise (p=0.083) groups, but was different during (p=0.035). There were differences between groups in the pre-exercise (p=0.012), during (p<0.001) and post-exercise (p<0.001) for feeling and anxiety scores. The correlation between TRIMP and affective scores showed association for T_Lim (r=0.46; p=0.043). Conclusion: The self-selected exercise generated positive affective responses, but the same did not occur for the imposed T_Lim. VL and TRIMP presented equality. There was association TRIMP and T_Lim feeling scale. T_Lim significantly increased anxiety scores.

ChatGPT, a state-of-the-art AI model created by OpenAI, is renowned for its ability to produce text responses that closely mimic human communication. Recently, it has broadened its scope to encompass multimodal interactions, rendering it particularly advantageous for medical applications. In this paper, we explore into the potential of ChatGPT in the realm of Ultrasound (US) imaging, Our investigation encompasses a series of case studies and examples, each tailored to demonstrate ChatGPT’s application in various aspects of US imaging. These include emphasizing its capacity for intricate analyses, including grayscale texture examination and perfusion metrics in contrast-enhanced ultrasound (CEUS). Moreover, its involvement in real-time imaging guidance, its role in streamlining workflow efficiencies, and its utility in the simplification of medical report generation to facilitate better patient communication. The case studies, while successful, unveil certain limitations and challenges, prominently featuring concerns regarding privacy and technical constraints. Despite these challenges, the evidence gathered from our examples indicates that ChatGPT's innovative features and its ability to operate across multiple modes significantly enhance the efficiency of quantitative image analysis in US imaging. By improving diagnostic precision and potentially elevating patient care outcomes, ChatGPT marks a significant stride forward in healthcare technology, though it necessitates careful consideration of its associated ethical and technical challenges.

Introduction: Bladder pain syndrome (BPS)/interstitial cystitis (IC) is a chronic inflammatory condition characterized by bothersome symptoms as pain, urgency, urinary incontinence and in some cases urinary retention, impacting a patient’s quality of life. However, also recurrent cystitis could cause a chronic bladder inflammation which can explain discomfort of the bladder and similar symptoms, often referred by younger patients during clinical evaluation. The aetiology of IC/BPS is still unknown, and it may be multifactorial. Although a definitive treatment is not available, the challenge is finding new therapeutic strategies. Different intravesical treatments such as heparin, hyaluronic acid, chondroitin sulfate, pentosan polysulfate, dimethylsulfoxide, liposomes, and botulinum onabotulinumtoxinA (BoNT‐A) are commonly proposed for BPS/IC. The aim of study was to evaluate the anti‐inflammatory effects of intravesical Vessilen® (a new formulation of 2% adelmidrol (the diethanolamide derivative of azelaic acid) + 0.1% sodium hyaluronate) administration in patients affected by IC/BPS or other bladder disorders. Methods: This was a prospective observational study. At baseline and after the treatment, validated questionnaires were administered to the patients: the Visual Analogue Scale (VAS) and International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ‐FLUTS Long Form). The subjective perception of the severity of symptoms was investigated by the Patient global impression scale (PGIs). Results: Based on 25 patients who completed the cycle of weekly instillation for six weeks, we observed a significant decrease in the severity of bladder symptoms according to both ICIQ‐FLUTS scale (89.3 vs 61.3; p=0.021) and VAS score (4.4 vs 2.6; p<0.001). Moreover, according to PGI‐I, 80% of patients observed an improvement in symptoms (PGI‐I score ≤ 3). Conclusion: Intravesical administration of adelmidrol combined with sodium hyaluronate (Vessilen®) could be an innovative therapeutic approach for patient complaining interstitial cystitis/bladder pain syndrome (IC/BPS) or other chronic inflammatory bladder disorders, due to its well‐known anti‐inflammatory and antinociceptive properties.Introduction: Bladder pain syndrome (BPS)/interstitial cystitis (IC) is a chronic inflammatory condition characterized by bothersome symptoms as pain, urgency, urinary incontinence and in some cases urinary retention, impacting a patient’s quality of life. However, also recurrent cystitis could cause a chronic bladder inflammation which can explain discomfort of the bladder and similar symptoms, often referred by younger patients during clinical evaluation. The aetiology of IC/BPS is still unknown, and it may be multifactorial. Although a definitive treatment is not available, the challenge is finding new therapeutic strategies. Different intravesical treatments such as heparin, hyaluronic acid, chondroitin sulfate, pentosan polysulfate, dimethylsulfoxide, liposomes, and botulinum onabotulinumtoxinA (BoNT‐A) are commonly proposed for BPS/IC. The aim of study was to evaluate the anti‐inflammatory effects of intravesical Vessilen® (a new formulation of 2% adelmidrol (the diethanolamide derivative of azelaic acid) + 0.1% sodium hyaluronate) administration in patients affected by IC/BPS or other bladder disorders. Methods: This was a prospective observational study. At baseline and after the treatment, validated questionnaires were administered to the patients: the Visual Analogue Scale (VAS) and International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ‐FLUTS Long Form). The subjective perception of the severity of symptoms was investigated by the Patient global impression scale (PGIs). Results: Based on 25 patients who completed the cycle of weekly instillation for six weeks, we observed a significant decrease in the severity of bladder symptoms according to both ICIQ‐FLUTS scale (89.3 vs 61.3; p=0.021) and VAS score (4.4 vs 2.6; p<0.001). Moreover, according to PGI‐I, 80% of patients observed an improvement in symptoms (PGI‐I score ≤ 3). Conclusion: Intravesical administration of adelmidrol combined with sodium hyaluronate (Vessilen®) could be an innovative therapeutic approach for patient complaining interstitial cystitis/bladder pain syndrome (IC/BPS) or other chronic inflammatory bladder disorders, due to its well‐known anti‐inflammatory and antinociceptive properties.

Breast cancer is among the most prevalent cancers in Indonesia. One of the methods for early detection of breast cancer is utilizing ultrasound images to classify breast conditions into normal, benign tumors, or cancer. The advent of deep learning technology facilitates the image analysis process, such as the use of Transfer Learning Convolutional Neural Networks (CNNs). Generally, CNN models require large and balanced datasets to perform well in classification tasks. However, medical datasets like breast ultrasound images tend to be limited and imbalanced. The Wasserstein GAN (WGAN) is a generative data augmentation method capable of producing synthetic images by learning the pattern of the distribution of real image data. The implementation of the Wasserstein distance results in the training process of WGAN demonstrating stability from epochs 3000, 2500, and 3000 out of a total of 5000 epochs. The quality of the synthetic images improves with an increasing number of training iterations. By using WGAN, all of the evaluation metrics of each classifier are increasing, with the best accuracy score is achieved by VGG16 model with 83.33% accuracy.

Background: Nanotechnology has emerged as a promising field of study, aiming to revolutionize healthcare through the innovative development of drugs, diagnostic tools, and medical devices. As a result, healthcare professionals in training are constantly faced with the challenge of understanding and applying these emerging technologies. The objective of this study is to determine the factors to consider for including the teaching of nanotechnological tools in medical specialty postgraduate programs. Methods: A study based on the Nominal Group Technique (NGT) was conducted to identify the factors that promote and hinder the implementation of nanotechnology in certain postgraduate programs where nanotechnology is employed, such as Internal Medicine, Critical Care Medicine, Family Medicine, and Clinical Pharmacology at the School of Medicine of Universidad de La Sabana. A framework analysis was used to analyze the collected data. Results: Based on the two research questions, several aspects were identified for the inclusion of nanotechnology in the medical practice of specialties. Key challenges include lack of knowledge and resource availability, misinformation, and lack of knowledge, as well as paradigmatic analysis as the main obstacles to the use of nanotechnology. Conclusions: The findings provide a first-time study on nanotechnology curricula within medical specialty programs in Colombia, with potential extrapolation to similar situations in other medical schools.

The species and bio-availability of phosphorus (P) in primary, secondary and digested sludge were fractionated and further analyzed in this study. Results showed that inorganic P (IP) was the primary P fraction in the secondary sludge and digested sludge, in which non-apatite IP (NAIP) amounted to 91.6% and 69.3% of IP, respectively. Organic P (OP), accounting for about 71.7% of total P (TP), was the dominant P composition in primary sludge. The content of bio-available P was about 9.7, 43.4, 29.8 mg-P/g-TS in primary sludge, secondary sludge and digested sludge, respectively, suggesting secondary sludge is the optimal choice when land application of sewage sludge is taken into consideration, followed by digested sludge and primary sludge. Polyphosphate and orthophosphate, comprising approximately 54.3% and 89.2% of TP, was the dominant P species in the secondary sludge and digested sludge, respectively. Monoester-P (54.6% of TP in extract) and diester- P (24.1%) were identified as OP species in primary sludge by Phosphorus-31 nuclear magnetic resonance (31PNMR). The present results would be helpful for P recovery and recycle from sewage sludge in wastewater treatment plant.

We conducted a comparative study on the development of two synthetic methods. The solvent-free synthesis is a green chemistry method developed in a bid to ameliorate environmental adverse effects of the conventional solvent-based synthesis. The synthesis of novel dichloro and polymethoxy p-nitrophenylhydrazones through solvent free technique gave moderate to high yields which were however lower than those of the solvent-based method. The established solvent-free approach has several benefits, including universality and simplicity of the approach, catalyst-free conditions, non-use of an organic solvent, quick reaction time, fast and efficient workup, and un-solvated pure products in moderate to high yields.

There is growing interest in understanding the connection between concussions on physical and mental health acutely and, in retirement, on neurodegenerative diseases. In this study, we utilised a “high-impact trauma” (HIT) device to investigate the effects of multiple concussions on the motor activity, and lifespan of the adult female Drosophila melanogaster as well as reactive oxygen and nitrogen species (RONS) levels in the fly brain and body. We found that repetitive hits, while not having acute physical effects, significantly increased long-term mobility deficits, and shortened lifespan, and exacerbated oxidative stress in both the brain and body. Notably, the novel CONKA product (Withania somnifera, Curcuma longa, Melissa officinalis, Rhodiola rosea, Vaccinium myrtillus) demonstrated promising protective effects, including mitigation of motor deficits, extension of lifespan, and reduction of oxidative stress in both the brain and body of the flies. When evaluating the contributions of individual components within the CONKA formulation, Curcuma longa, despite extending lifespan, did not contribute to mobility improvement or oxidative stress amelioration. This suggests that the benefits of CONKA are largely driven by its other four components, which displayed all the positive effects evaluated. The exclusion of Curcuma longa may streamline the formulation without diminishing its brain and body effects following a history of repetitive concussions, although this would require further study to confirm. Oral bioavailability may be an issue with Curcuma longa. Taken together, the findings validate that Drosophila melanogaster is a suitable system to mimic and investigate the effects of repetitive concussions on bodies and brains and assess the effects of health products and drug therapies.

The lunar calendar is often overlooked in time series data modelling, despite its importance in understanding seasonal patterns as well as economic, natural phenomena, and consumer behavior. This study aims to investigate the effectiveness of the lunar calendar in modelling and forecasting rainfall levels using various machine learning methods. The methods employed included Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) models to test the accuracy of rainfall forecasts based on the lunar calendar compared to those based on the Gregorian calendar. The results indicated that machine learning models incorporating the lunar calendar generally pro-vided greater accuracy in forecasting for periods of 3, 4, 6, and 12 months compared to models using the Gregorian calendar. These findings contributed to the advancement of forecasting techniques, machine learning, and the adaptation to non-Gregorian calendar systems, while also opening new opportunities for further research into lunar calendar applications across various domains.

Reaction of the phosphonated hydrazone (2-hydrazineylidenepropyl) diphenylphosphine oxide 1 with p-fluorophenyl-isothiocyanate yields as major product the thiosemicarbazone Ph2P(=O)CH2{C=N-NH(C=S)-N(H)C6H4F}CH3 (2-(1-(diphenylphosphoryl)propan-2-ylidene)-N-(4-fluorophenyl)hydrazine-1-carbothioamide) 2 along with bis(N-p-fluorophenylthiourea) 3 as minor product. This latter product 3 was isolated as main product by direct treatment of p-FC6H4N=C=S with hydrazine in a 2:1 ratio. Both 2 and 3 were characterized by NMR. Furthermore, the molecular structure of 3 was elucidated by an X-ray diffraction study. A conformational DFT study, at the B3LYP/6311 G++ (d, p) level of theo-ry, confirmed a good match between the calculated structure and the experimental one.

The design and control of lower limb rehabilitation robots for patients after a stroke has gained significant attention. This paper presents the dynamic analysis and control of a 3-degree-of-freedom lower limb rehabilitation robot using combined position-force control based on the force feed-forward and compensate gravity proportional derivative method. In the lower limb rehabilitation robot, the interaction force between the patient with the joints and links of the robot is uncertain and nonlinear due to the disturbance effect of Coriolis force, centrifugal force, gravitational force, and friction force. During recovery stages, forces exerted by the patient's lower limb are considered disturbances. Therefore, to meet the quality requirements in using the rehabilitation robot with different recovery stages of patient training, combining position control and force control is essential. In this paper, we proposed a combinations of proportional-derivative gravity compensation motion control and force feed-forward control to form an advanced combined controller (Position-Force Feedforward Control - PFFC) for a 3 DOF lower limb functional rehabilitation robot. The forces can be sensed using a 3-axis force sensor. In addition, the robot's position parameters are also measured by encoders. The control algorithm is implemented on the STM32F4 Discovery board. Verified test of the proposed control method is shown in the experiments and shown good performance of the system.

This paper presents an approach to assess and improve the cybersecurity infras- tructure of developing countries. We have highlighted and addressed the critical gaps through a hybrid approach encompassing SWOT analysis, benchmarking using Data Envelopment Analysis (DEA) and, Root Cause Analysis (RCA). This approach has provided a strong basis for evaluating cybersecurity performance by combining qualitative insights with quantitative metrics. As a case study, we have compared an underdeveloped country’s (Pakistan) cybersecurity pos- ture to five highly developed countries (Lithuania, Estonia, Singapore, Spain,and Norway). Our analysis has identified cybersecurity shortcomings and pro- vided actionable recommendations within a flexible framework, applicable for all developing countries to identify and address vulnerabilities, and align their cybersecurity infrastructure with international standards.

The increasing energy consumption and industrial activities that release carbon dioxide (CO2) emissions into the atmosphere have become one of the most serious environmental issues of today. This article discusses the current status in Azerbaijan regarding the development of effective approaches to reduce carbon emissions and ensure sustainable development, and it proposes relevant strategies for managing the carbon footprint. By exploring the interrelationship between the economy and the environment, it aims to contribute to the formation of more effective policies for managing CO2 emissions in Azerbaijan. According to the results of the econometric model established within the research for the period of 1990-2023, as the Azerbaijan economy grows, per capita CO2 emissions tend to increase, which can be linked to rising industrial activity, energy consumption, and other factors driving economic growth. The presence of a positive long-term relationship between population growth and per capita CO2 emissions can be attributed to higher overall energy consumption, increased demand for goods and services, and rising transportation needs. The strong correlation between economic growth and CO2 emissions suggests that it may be too early to assert the validity of the Kuznets curve for Azerbaijan economy as a developing country.

Fluctuations in kynurenic acid (KYNA) and brain-derived neurotrophic factor (BDNF) levels in the brain reflect its neurological status. The aim of the study was to investigate the effect of transiently elevated KYNA concentration in the cerebroventricular circulation on the expression of BDNF and its high-affinity tropomyosin-related kinase receptor B (TrkB) in specific structures of the sheep brain. Intracerebroventricularly cannulated anestrous sheep were subjected to a series of four 30-min infusions of KYNA: 4×5 μg/60 μL/30 min (KYNA20, n=6) and 4×25 μg/60 μL/30 min (KYNA100, n=6) or a control infusion (n=6), at 30-min intervals. Sections of the hippocampal CA3 field, amygdala (AMG), prefrontal cortex (PCx), and the hypothalamic medial-basal (MBH) and preoptic (POA) areas were dissected from the brain immediately after the experiment. The highest concentration of BDNF protein was found in the CA3 field (P&lt;0.01), which was 8-fold higher than in the AMG and 12-fold higher than that in the PCx (MBH and POA were not analyzed). The most pronounced BDNF mRNA expression was observed in the MBH followed by the PCx, POA, AMG and CA3, while the highest abundance of TrkB mRNA was recorded in the AMG followed by the MBH, PCx, CA3 and POA. KYNA increased (P&lt;0.05-P&lt;0.01) BDNF protein levels and the expression of its gene in the brain structures examined, with the effect varying by dose and brain region. KYNA, particularly at the KYNA100 dose, also increased (P&lt;0.01) TrkB gene expression, except for the AMG, where the lower KYNA20 dose was more effective (P&lt;0.01). These findings suggest a positive relationships between KYNA levels in the cerebroventricular circulation and BDNF-TrkB expression in specific brain regions in a sheep model. This indicates that a transient increase in CSF KYNA concentration can potentially restore BDNF production, whose deficiency underlies numerous neurological disorders.

Diospyros kaki, the most widely cultivated species of persimmon, has been long used in traditional medicine since its leaves extracts contain high amounts of flavonoids and terpenoids, endowed with potential antioxidant, anti-inflammatory, anticancer, antidiabetic and antimicrobial effects. Re-cently, many in vitro and in vivo studies have assessed different potential health benefits of per-simmon leaves; however, its anticancer activity towards colorectal cancer (CRC), the second deadliest cancer in Western countries, has not been investigated in depth. Since CRC current therapies are associated with serious side effects and show no efficacy towards patients carrying RAS/BRAF mutations, the search for new and more effective therapies has turned to plant extracts, which could help reduce conventional drugs dosages and toxicity. The effect of Diospyros kaki al-coholic extract has been investigated on E705 CRC cell line, representative of most CRC patients, and on SW480 cells, carrying a KRAS activating mutation. This extract is effective in reducing tumor cells viability, without affecting the healthy mucosa cell line CCD 841, and it triggers apoptosis in CRC cells, by disrupting mitochondrial functionality and increasing oxidative stress.

Pre-transport management activities can cause stress, injuries, and mortality in poultry. This study aimed to gather information about the current pre-transport practices (selection of unfit chickens, catching preparations, catching, and crating) for spent hens and broilers by questioning Flemish poultry farmers. The results showed that catching preparations such as an extra selection of chickens unfit for transport was performed by a minority of the poultry farmers, and that layer farmers were less in line with the EU-legislation for water and feed withdrawal than broiler farmers. All birds were caught inverted except for one broiler farmer who used mechanical catching (not yet common in Flanders). Additionally, mechanical catching may involve extra costs, increased biosecurity risks, and specific recommendations for the stable (height and width). The broiler farmers preferred mechanical catching for broiler catchers' well-being, while upright catching was considered better for animal welfare than catching more than three chickens by one/two legs, mechanically, or by wings. Awareness of the need to perform an extra selection by the poultry farmers before catching is required. Preparations like closing areas under the aviary system and removing litter (layers) can further streamline the process and reduce animal suffering.

This stability analysis method is simply represented and understood on a Bode plot of two impedances without complex equations. The external impedance of the charging system is properly quantified and designed based on the stability criteria by analyzing.

Arbutus unedo (strawberry tree) is a small Mediterranean tree capable of vigorous regrowth after disturbances like fire. Traditionally used for biomass fuel, its bark and branches hold potential for higher-value products through ecovalorisation into liquid mixtures that could replace petro-leum-based materials. This study aimed to explore the chemical composition of various compo-nents of Arbutus unedo and to produce a liquefied material from its internal (IB) and external bark (EB). Chemical compositions of internal and external bark were determined using TAPPI standards including ash, extractive content, lignin, and cellulose. Metal cations were analyzed by ICP. Liquefaction of bark was optimized in a PARR reactor, evaluating factors such as particle size, temperature, and time and the best polyols were monitored by FTIR-ATR. Polyurethane foams were made with internal and external bark liquefied materials by polymerization with isocyanate, a catalyst and water as blowing agent. Results showed that EB has a higher extractive and lignin content, while IB contains more cellu-lose. Liquefaction yields were higher for IB (74%) than EB (68%), with IB yielding polyols that produced stronger and more resilient foams. Mechanical properties of the foams were influenced by the NCO/OH ratio and catalyst levels. Overall, the internal bark demonstrated superior performance for foam production, highlighting its potential as an eco-friendly alternative to petroleum-derived materials.

Introduction: Leptin and ghrelin are two hormones that play a role in weight homeostasis. Leptin, which is produced primarily by adipocytes and is dependent on body fat mass, suppresses appetite and increases energy expenditure. Conversely, ghrelin is the “hunger hormone”, it stimulates appetite and promotes fat storage. Bariatric surgery significantly alters the levels and activity of these hormones, contributing to weight loss and metabolic improvements. Clarifying the interplay between bariatric surgery, weight loss, physical exercise, leptin, and ghrelin is essential for developing comprehensive strategies for optimizing long-term outcomes for candidates for bariatric surgery, especially sarcopenic patients. Methods: This was a randomized controlled study with two groups (n=22). The patients in both groups have obesity and sarcopenia. A Roux-en-Ygastric bypass (RYGB) procedure was performed in all patients. The intervention group participated in a structured exercise program three times per week beginning one month after surgery and lasting 16 weeks. Patient assessment was performed before surgery (baseline) and after completion of the exercise program. The control group received the usual standard of care and was assessed similarly. Results: After surgery, weight, BMI and lean mass decreased significantly in both groups from baseline to the second assessment. Leptin was not significantly different from baseline to the second assessment in the physical exercise group but was significantly lower in the control group (p=0.05). Ghrelin increased over time in both groups, but the differences were not significant. When we associated leptin (the dependent variable) with weight (the independent variable), we found that lower weight was associated with lower leptin levels. A similar relationship was also observed between leptin and sarcopenia parameters (muscle strength and mass), as well as with bone health parameters (bone mineral density and t-score). Higher ghrelin levels were significantly associated with higher t-scores and z-score (p<0.05). Conclusion: Exercise has been shown to have a significant effect on leptin and ghrelin levels after bariatric surgery. By incorporating regular physical activity into their lifestyle, bariatric patients can optimize their weight loss outcomes and improve their overall health. After the physical exercise protocol, patients in the intervention group revealed more established leptin levels, which may indicate a protected pattern concerning decreased leptin levels. An unfavorable profile was evidenced, according to which greater weight loss, sarcopenia, and osteoporosis were associated with lower leptin levels.

Among the theoretical problems with the prevailing theory of cosmology, Lambda Cold Dark Matter (λCDM), the most serious appears to be the twofold problem with the cosmological constant lambda: Dark Energy and Hubble Tension. Despite a two-decade search for systematic errors in astrometry the problems have not been resolved. This paper posits a potential source of error that may have affected astrometry related to the current and past measurements of lambda.

Differential beamforming has attracted much research since it can utilize the array with small aperture size to form frequency-invariant beampatterns and achieve high directional gains. It has recently been applied to the linear loudspeaker array to produce a broadside frequency-invariant radiation pattern. However, designing steerable frequency-invariant beampatterns for the linear loudspeaker array has yet to be explored. This paper proposes a method to design the steerable differential beamformer with the linear loudspeaker array. We first determine the target differential beampatterns according to the desired direction, the main lobe width, and the beampattern order. Then, we transform the target beampattern into the modal domain for representation. The Jacobi-Anger expansion is subsequently used to design the beamformer so that the resulting beam pattern matches the target differential beam pattern. Furthermore, based on the criterion of minimizing the mean square error between the synthesized beam pattern and the ideal one, a multi-constraint optimization problem is formulated to calculate the optimal desired weighting vector. Simulations and experimental results show that the proposed method can achieve steerable frequency-invariant beamforming over 300 Hz – 4 kHz.

N-(diisopropylphosphanyl)benzamide, PhC(O)NHPiPr2, has been synthesized in good yield following two alternative procedures that employ benzamide as the starting material. The first one is a two-step preparation, in which N-(trimetilsilyl)benzamide is reacted with PiPr2Cl, to give the title compound in good yield, whereas the second one is a straightforward synthesis which converts benzamide into N-(diisopropylphosphanyl)benzamide by reaction with PiPr2Cl in the presence of N,N-dimethylpyridin-4-amine (DMAP) and triethylamine. NMR spectroscopy and X-ray diffraction analyses have been performed to characterize the new compound and elucidate its molecular structure in the solid state. N-(diisopropylphosphanyl)benzamide adds to the limited family of amido-substituted phosphines, RC(O)NHPR’2, which can be classified as bidentate hybrid P,O-ligands, both in their neutral and anionic forms, the latter achievable by deprotonation of the NH group.

Microneedle technology is a novel platform technology that revolutionizes ocular drug delivery and addresses critical challenges in the treatment of ocular diseases. Routine treatment methods, such as eye drops and intravitreal injections, suffer from low bioavailability and poor patient compliance. So, novel advanced platform technologies are required to overcome these challenges. Microneedle is a minimally invasive and promising alternative technique that helps precisely control drug delivery to targeted tissues and organs. This review investigates the potential impact of microneedle technology for eye care, underscoring recent advancements, underlying mechanisms, and emerging preclinical and clinical uses. Different types of microneedles, including solid, coated, dissolvable, and hollow, have demonstrated their potential and capability to bypass several barriers in the cornea and sclera. This ensures effective drug penetration and delivery. The current innovations in material science and fabrication methods have enhanced the safety and efficacy of microneedles, reducing discomfort and the chances of infections. These microneedle technologies offer sustained and controlled drug delivery, which could improve therapeutic outcomes for various disease conditions like age-related macular degeneration, glaucoma, diabetic neuropathy, etc. In the current review, recent preclinical and clinical studies emphasize microneedle-based ocular drug delivery's feasibility and potential benefits. These include improved pharmacokinetics, reduced dosing frequency, enhanced patient adherence, and, most importantly, microneedles offer versatile platforms for delivering a wide range of small and large molecules and gene therapies. Despite the exciting progress, obstacles such as regulatory barriers, scalability, and long-term biocompatibility persist. It will be essential to tackle these challenges through interdisciplinary research and partnerships to integrate microneedle technology into standard clinical use effectively. Ultimately, microneedle drug delivery offers a revolutionary method that has the potential to significantly enhance the treatment and results of ocular diseases, marking the dawn of a new era in eye care.

Glaucoma secondary to Peters' anomaly (PA) is an important factor affecting visual prognosis, but there are few reports on it. This study aimed to investigate the characteristics of glaucoma asso-ciated with PA and glaucoma surgery outcomes. This retrospective study included 31 eyes of 20 patients with PA. PA was classified into three stages: Stage 1, with a posterior corneal defect only; Stage 2, a corneal defect with iridocorneal adhesion; and Stage 3, a corneal defect with lens ab-normalities. The associations between glaucoma and anterior segment dysgenesis severity, visual prognosis, and glaucoma surgery outcomes were analyzed. Sixteen eyes of 10 patients developed glaucoma. Stage 1 PA had no glaucoma, 52% of Stage 2 had glaucoma, and 75% of Stage 3 had glaucoma. Of the 16 eyes with glaucoma, 11 underwent surgery. Eight of these 11 eyes achieved intraocular pressure (IOP) control. Five of the nine eyes that underwent trabeculotomy (TLO) succeeded, and none had corneal staphyloma. Three of the four eyes for which TLO was ineffective had corneal staphyloma (P=0.0331). Patients with PA are more likely to develop glaucoma as anterior segment dysgenesis progresses, and the effect of TLO is limited if corneal staphyloma is present.

The XEN® gel stent reduces intraocular pressure (IOP) in glaucoma. XEN®-45 is widely used while the newer XEN®-63 has a larger lumen that may lower IOP more. We retrospectively compared the first 15 XEN®-63 cases to 15 matched XEN®-45 controls. With a preoperative IOP of 18.1 ± 3.9 mmHg (mean ± SD) and a final IOP of 9.2 ± 4.2 mmHg, XEN®-63 implantation resulted in an IOP reduction of 48.0 ± 23.3%. Similarly, with a preoperative IOP of 18.3 ± 4.5 mmHg and a final IOP of 10.5 ± 2.3 mmHg, XEN®-45 implantation resulted in an IOP reduction of 39.5 ± 17.81%. The median follow-up period was 57 days for the XEN®-63 group and 183 days for the XEN®-45 group. 5/15 eyes of each group underwent open conjunctival bleb revision within the period of observation. Two eyes of the XEN®-63 group also had secondary glaucoma surgery. In both groups only one eye required restart of antiglaucomatous medication. XEN®-63 and XEN®-45 effectively lower IOP and medication. XEN-63 achieved lower IOP over a short follow-up. Com-plication and revision rates were similar.

To compare surgical and refractive outcomes between phacotrabeculectomy (P-Trab) and phaco with Ex-PRESS (P-Ex-PRESS) for glaucoma at 6-month follow-up. This prospective randomized controlled trial included 81 eyes; 43 (53%) and 38 (47%) were assigned to the P-Ex-PRESS and P-Trab groups, respectively. Refraction, intraocular pressure (IOP), and best-corrected visual acuity were measured. Refractive change was described by analyzing the magnitude of the cylinder, and polar analysis assessed the change in trend of astigmatism [with-the-rule, against-the-rule (ATR), oblique] evaluating mean astigmatism in centroid form. All patients showed statistically significant postsurgical decrease in IOP (P&lt;0.05). There were no differences neither between the groups for postoperative IOP or visual outcomes, nor in astigmatism before or after surgery (P=0.61, P=0.74). In both groups, the mean pre- and postoperative astigmatism was ATR and OBL, respectively. Pre- and postoperative centroids in the P-Ex-PRESS group were 0.44±1.32 D at 177˚ and 0.35±1 D at 8˚, respectively, (P=0.5) and in the P-Trab group, 0.16±1.5 D at 141˚ and 0.39±1.38 D at 29˚, respectively (P=0.38). Both P-Ex-PRESS and P-Trab showed comparable antihypertensive efficacy in treating open-angle glaucoma in a 6-month period. Pre- and postoperative astigmatism did not differ between groups. The groups showed comparable results for final visual acuity.

Purpose: To investigate the extent of anterior chamber angle circumference needed to maintain a physiological outflow facility (C). Methods: Twenty anterior segments of porcine eyes were assigned to 5 groups, each with a different degree of cyanoacrylate-mediated angle closure: 90° (n = 4), 180° (n = 4), 270° (n = 4), 360° (n = 4) and four unoccluded control eyes. The outflow facility was measured at baseline, 3, 12, 24, and 36 hours after angle closure. Outflow patterns were evaluated with canalograms and the histomorphology was compared. Results: Baseline outflow facilities of the five groups were similar (F = 0.922, P = 0.477). Complete, circumferential occlusion over 360° induced a significant decrease in facility from baseline at all time-points (P ≤ 0.023 at 3, 12, 24 and 36 hours). However, no difference from baseline was found in any of the partially-occluded (0–270°) groups (F ≥ 0.067, P ≥ 0.296 at 3, 12, 24 and 36 hours). The canalograms confirmed the extent of occlusion with flow through the unblocked regions. Histology revealed no adverse effects of blockage on the TM or aqueous plexus in the unoccluded angle portions. The unoccluded TM appeared normal. Conclusion: Cyanoacrylate-mediated angle occlusion created a reproducible angle closure model. 90° of unoccluded anterior chamber angle circumference was sufficient to maintain physiological outflow. This model may help understand how outflow can be regulated in healthy, nonglaucomatous TM.

Glucosamine is the most common nutrition supplement used in the United States. It is promoted not only as a pain reliever but also a therapy to slow osteoarthritis. Although studies with 3,800 patients with osteoarthritis of the knee or hip found that glucosamine was no better than placebo, it continues to be used for these two indications due to its perceived safety. However, reports of an increased intraocular pressure are alarming, especially in glaucoma. Glycosaminoglycans play a key role in the physiology of the cornea, conventional outflow of aqueous humor and the retina. In theory, long-term treatment with glucosamine could reach a concentration that impacts the morphology and function of ocular tissues. We recommend ophthalmologists counsel glaucoma patients about the potential risks of glucosamine and encourage cessation in uncontrolled intraocular pressure.

The positive relationship between species richness and area is a fundamental principle in ecology. However, this pattern deviates on small islands, where species richness either changes independently of area or increases at a slower rate—a phenomenon known as the Small-Island Effect (SIE). While the SIE has been well-documented in natural ecosystem, its presence in highly fragmented and disturbed urban ecosystem remains unexplored, posing challenges for urban vegetation conservation. Urban remnant vegetation, isolated by surrounding infrastructures, preserves intact zonal vegetation characteristics, serves as a benchmark for restoring near-natural habitats and offers ideal conditions to test the existence of SIE in human-altered landscapes. In this study, we surveyed 17 remnant vegetation patches in Qingdao City, China. In total of 331 plants attributed to 255 genus in 81 families been recorded. Firstly, by using six species-area relationship regression models tested SIE for remnant vegetation with different life form (i.e. annual herb, perennial herb, shrub and tree), we found SIE detected in only woody plants, with area threshold ranging from 6.38 ha (tree) to 11.91 ha (shrub). According to stepwise and generalized linear regression mode analysis we found SIE detected in only woody plants, with area threshold 6.38 ha for tree and 11.91 ha for shrub. Further analysis revealed that the SIE in shrub was driven by landscape shape index, perimeter-area ratio, and the proportion of sealed surface within patch. For trees, the SIE was influenced by the distance to the source of species, GDP, night light intensity and perimeter-area ratio. This finding justifies that conservation in urban planning, construction and development should focus not only on protecting large areas, but also on maintaining and promoting diverse habitats within these areas. At the same time, reducing anthropogenic disturbance and enhancing the connectivity of green spaces are important for the persistence of metacommunities and can contribute to the local species pool, thus potentially improving the ecological resilience of urban environments.

Chikungunya is mosquito born disease that is spread across continents. This research provides valuable insights into the potential functional significance of the hydrophobic tail and cysteine-rich regions in E2 proteins. These findings lay the groundwork for future investigations into the specific roles of the C-terminal domain and post-translational modifications, which could ultimately lead to a better understanding of viral mechanisms and potential therapeutic targets.

Fanconi syndrome is a disorder of renal proximal tubule transport characterized by metabolic acidosis, amino aciduria, glucosuria, and phosphaturia. There are acquired and hereditary forms of this disorder. Fanconi syndrome in Basenjis was first described in 1976 and is now recognized as an inherited disease in these dogs. Linkage analysis within a large family of Basenjis that included both affected and unaffected individuals was performed to localize the causative variant within the genome. Significant linkage was identified between chromosome 3 (CFA3) makers and the disease phenotype. Fine mapping restricted the region to a 2.7 Mb section of CFA3. A whole genome sequence of a Basenji affected with Fanconi syndrome was generated, and the sequence data were examined for the presence of potentially deleterious homozygous variants within the mapped region. A homozygous 317 bp deletion was identified in the last exon of FAN1 of the proband. 78 Basenjis of known disease status were genotyped for the deletion variant. Among these dogs, there was almost complete concordance between genotype and phenotype. The only exception was one dog that was homozygous for the deletion variant but did not exhibit signs of Fanconi syndrome. These data indicate that the disorder is very likely the result of FAN1 deficiency. The mechanism by which this deficiency causes the disease signs remains to be elucidated. FAN1 has endonuclease and exonuclease activity that catalyzes incisions in regions of double-stranded DNA containing interstrand crosslinks. FAN1 inactivation may cause Fanconi syndrome in Basenjis by sensitization of kidney proximal tubule cells to toxin-mediated DNA crosslinking resulting in accumulation of genomic and mitochondrial DNA damage in the kidney. Differential exposure to environmental toxins that promote DNA crosslink formation may explain the wide age-at-onset variability for the disorder in Basenjis.

Background: Patients undergoing brain tumor resection experience neurological and cognitive (i.e., neurocognitive) changes reflected in altered performance on neuropsychological tests. These changes can be difficult to explain or predict. Brain connectivity, measured with neuroimaging, offers one potential model for examining these changes. In this study, we evaluated whether longitudinal changes in brain connectivity correlated with changes in neurocognitive abilities in patients before and after brain tumor resection. Methods: Patients underwent functional and diffusion MR scanning and neuropsychological evaluation before tumor resection followed by repeat scanning and evaluation two weeks post-resection. Using this functional and diffusion imaging data, we measured changes in the topology of the functional and structural networks. From the neuropsychological testing scores, we derived a composite score that described a patient’s overall level of neurocognitive functioning. We then used a multiple linear regression model to test whether structural and functional connectivity measures were correlated with changes in composite scores. Results: Multiple linear regression on 21 subjects showed that connectivity changes were highly correlated with changes in neuropsychological evaluation scores (R² adjusted = 0.79, p<0.001). Changes in functional local efficiency (p<0.001) and global efficiency (p<0.05) were inversely correlated with changes in composite score, while changes in modularity (p<0.01) as well as the patient’s age (p<0.05) were directly correlated with changes in composite score. Conclusion: Short interval changes in brain connectivity markers were strongly correlated with changes in the composite neuropsychological test scores in brain tumor resection patients. Our findings support the need for further exploration of brain connectivity as a biomarker relevant to brain tumor patients.

The gut, often referred to as the "second brain," has significant contributions in the maintaining of the good bacteria contribute enormous role such as digestion, produce essential vitamins, support the immune system, and protect against harmful bacteria. The beneficial flora including Akkermansia muciniphila, Adlercreutzia equolifasciens, Barnesiella, Christensenella minuta, and Oxalobacter formigenes, along with their derived bioactive metabolites emerged as a key player in maintaining host metabolic and immune health. Dietary choices such as blending of prebiotic, fermented, symbiotic, anti-inflammatory foods, and secondary metabolites from a wide variety of plants and fruits promotes the diversity, composition, and stability of beneficial intestinal microbes. The colourful plant foods rich in phytochemicals bioactive compounds such as carotenoids, flavonoids, polyphenols, alkaloids, anthocyanins, and capsaicin offer a wide array of unique properties such as analgesics, antioxidants, anti-inflammatory, antimicrobials effect and promoting the abundance of beneficial gut bacteria and their bioactive metabolites confer numerous health-promoting effects. Here, we present knowledge about most beneficial gut bacteria and their derived metabolites in terms of their sources and health benefits. Finally, we discuss best foods that skew towards promoting healthy intestinal microbes.

This article presents a method for detecting P, QRS, T, and U waves in electrocardiogram (ECG) signals through advanced signal processing techniques, including a Butterworth bandpass filter and peak finding algo- rithms. The results are evaluated against the voltage ranges recommended in the literature, underscoring the importance of accurate wave detection for the diagnosis of various cardiac conditions.

Additive Manufacturing (AM) methods are increasingly beign abopted in the industry as an alternative for mass production. In particular, Fused Deposition Modeling (FDM) technology is leading the way in this field. However, the adhesion of layers in products produced using FDM technology is an important issue. These products are particularly vulnerable to forces acting parallel to the layers and specially to impact strength. This study aims to optimize the impact strength against loads acting parallel to the layers (ZX orientation) of PA6, one of the most widely used materials in the industry. This orientation is critical in term of mechanical properties, and the mechanical characteristics are significantly lower compared to other orientation. In this study, filaments containing pure PA6 with 15% short carbon fiber and 30% glass fiber were utilized. Additionally, printing temperature, layer thickness and heat treatment duration were used as independent variables. An L9 orthogonal array was employed in this study, and each experiment was repeated three times to conduct impact strength tests. Characterization, Taguchi optimization, a factor analyses were performed, followed by fracture surface characterization by SEM. As a result, the highest impact strength was achieved with pure PA6 at 8.9 kJ/m2, followed by PA6 GF30 at 8.1 kJ/m2 and the lowest impact strength was obtained with PA6 CF15 at 6.258 kJ/m2. When compared to the literature and manufacturer datasheets, it was concluded that the impact strength values have significantly increased, and the chosen experimental factors and their levels, particularly nozzle temperature, were effective.

For Sir Ronald Fisher, it is important to consistently obtain significant p-values to support an experimental hypothesis. So, replicating experiments to obtain independent p-values is a legitimate and desirable research practice. Several simple statistics have been proposed to meta-analyze p-values, all assuming that they are genuine, i.e. observations from independent standard Uniform random variables. But, as publication bias favors the studies that report "significant" p-values, when a p&gt;0.05 is obtained for the outcome of an experiment, some researchers will "fall into temptation" and decide to replicate the experiment in the hope of getting a smaller second p-value, ideally a significant one. Consequently, if the smallest of two p-values is reported, this is a Beta(1,2) distributed "fake" p-value, not a uniformly distributed genuine p-value. This is an unacceptable scientific research practice, and moreover the detection of fake p-values is unpractical. Even when it is possible, the analytic results to accommodate their existence in combined tests are cumbersome. For an informed decision, inclusive when the presence of fake p-values in a sample of p-values to be meta-analyzed is probable, tables with simulated critical values for the usual combined testing are supplied. This will also allow comparisons to be made between several combined tests.

The global malaria community has picked up the theme of malaria elimination in greater than 90 % of the world’s population in the next decade. The recent reports of P. vivax in all sub-Saharan Africa, including Duffy negative individuals, threaten the efforts to achieve elimination. This is not only in view of strategies that are tailored only to P. falciparum elimination, but also due to currently revealed biological characteristics of P. vivax concerning the relapse patterns of hypnozoites and conservation of a large biomass at cryptic sites in the bone marrow and spleen. A typical scenario has been observed in Botswana from the period between 2008 to 2018, which palpably projects how P. vivax could endanger efforts at malaria elimination where the two parasites co-exist. The need for the global malaria community, NMPs, funding agencies and relevant stakeholders to engage in a forum to discuss and recommend clear pathways for sub-Saharan Africa regarding malaria elimination including P. vivax, is warranted.

Academic and corporate research has been focusing on analyzing stock performances, financial markets, and investment strategies for decades. According to Lynch and Rothchild (1989), certain investments can be described as plays. In this work, the authors use the term for investments in value stocks, spin-offs, and turnarounds to analyze the long-term stock performance and risk-adjusted excess returns of up to five years for those stocks. Additionally, stocks with a supe-rior return performance are identified within an investment play based on low P/E and P/B mul-tiples. The study finds that value stocks, spin-offs, and turnarounds outperform the S&P 500 on average on a one-, three- and five-year investment horizon. The analysis of the three investment plays confirms earlier studies that investment plays constitute a profitable investment opportunity. Moreover, the research exemplifies that private investors could achieve an excess return (alpha) through a passive buy-and-hold investment strategy. Overall, the analysis provides a deeper in-sight into the long-term performance of value stocks, spin-offs, and turnarounds.

Background: Chronic diseases are major causes of morbidity, disability, and death worldwide. In many cases, they are potentially preventable and treatable. Glaucoma is one of the leading causes of morbidity and blindness, the early recognition of which can help reduce the adverse outcomes of the disease. Health illiteracy among these patients and the absence of self-management of these diseases are barriers to effective management worldwide. Therefore, the present study aimed to calculate the level of health literacy and activity level of patients’ activation in self-management and to explore the link between them among patients with glaucoma in outpatient clinics. Material and methods: Convenience sampling of patients with glaucoma attending the outpatient ophthalmology clinics of a university hospital in Heraklion-Greece was performed. Convenience sampling was used to recruit 312 participants. Data were collected between November 2023 and May 2024. The Patient Activation Measure-13 (PAM-13) questionnaire, in its Greek version, was used to evaluate patients’ activation level in self-management, whereas the Greek version of the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) was used to assess health literacy. Results: Participants were classified as level 1(disengaged & overwhelmed) level in self-management (= 40.7, SD: ±29.9) and a sufficient health literacy level (= 10.7, SD ±3.7). However, there was no statistically significant relationship between health literacy levels and patient activation in self-management (p=0.602). Conclusions: Glaucoma patients experience challenges with health literacy and self-management activation, though there is no significant relationship between these two parameters. Multifaceted interventions seem essential for enhancing patients’ activation. Further research involving larger sample sizes, multi-center studies, and interventional design is needed.

PURPOSE: To investigate the oxylipin profiles in aqueous humor of primary open angle glaucoma (POAG) patients. METHODS: Aqueous humor samples were collected from 17 POAG patients and 15 cataract subjects and subjected to the liquid chromatography-mass spectrometry (LC-MS) analysis to detect the oxylipins. The prediction potential of the differential abundant oxylipins was assessed by the receiver operating characteristic (ROC) curves. Pathway and correlation analyses on the oxylipins and clinical and biochemical parameters were also conducted. RESULTS: The LC-MS analysis detected a total of 76 oxylipins, of which 29 oxylipins reached the detection limit. The multivariate analysis identified 5 differential abundant oxylipins, 15-keto-prostaglandin F2 alpha (15-kPGF2α), Leukotriene B4 (LTB4), 12,13-Epoxyoctadecenoic acid (12,13-Epome), 15-Hydroxyeicosatetraenoic acid (15-HETE) and 11-Hydroxyeicosatetraenoic acid (11-HETE). The 5 oxylipins are enriched in the arachidonic acid metabolism and linoleic acid metabolism pathways. Pearson correlation analysis showed that 11-HETE was positively correlated with intraocular pressure and central corneal thickness and negatively with cup/disk ratio in the POAG patients. In addition, 15-kPGF2α was positively correlated with visual field defect, and LTB4 was negatively correlated with macular thickness.  CONCLUSIONS: This study revealed the oxylipin profile in the aqueous humor of POAG patients. Oxylipins involved in arachidonic acid metabolism pathway could play a role in POAG and anti-inflammatory therapies could be potential treatment strategies for POAG.

For the first time, mathematical models were obtained for evaluating biomedical images using fuzzy set methods on the basis of expert knowledge bases, which made it possible to carry out complex qualitative diagnostics and increase the reliability and efficiency of diagnosis, to form a methodology for analyzing biomedical images based on the fuzzy set apparatus, which allowed to more fully assess the level of the disease for glaucoma. Aspects of practical implementation of the optical-electronic system of biomedical information processing are considered. An algorithm and an optical-electronic system of biomedical image analysis are proposed, which are used to increase the informativeness and reliability of diagnosing eye pathologies, in particular, glaucoma.

Purpose: To examine the effectiveness of patterned laser trabeculoplasty (PSLT) as an additional treatment for patients of open-angle glaucoma (OAG) receiving maximized ocular hypotensive medications (OHM). Methods: Forty eyes of 33 patients (average age 72.7±10.7 years) who had not previously undergone open glaucoma surgery or laser trabeculoplasty and were treated with maximized OHM between June 2018 and March 2022 were included. A 360-degree PSLT was conducted and postoperative intraocular pressure (IOP) and survival curves at 1, 3, 6, 9, and 12 months were evaluated. Results: According to the Kaplan-Meier survival analysis, the average survival time was 8.1 months with death defined as postoperative IOP reduction of less than 10% or requiring additional treatment. The average survival time was 4.9 months with death defined as postoperative IOP reduction of less than 20% or requiring additional treatment. In the 31 eyes which received no additional treatment after PSLT, the mean preoperative IOP was 18.5±3.9 mmHg, which reduced to 15.3±4.1 mmHg (p=1.62 x 10-6)), 15.5±3.4 mmHg (p=1.51 x 10-5), 15.7±4.0 mmHg (p=1.75 x 10-5), 14.7±4.38 (p=2.89 x 10-6), and 15.0±4.0 mmHg (p=5.74 x 10-9) at 1, 3, 6, 9 and 12 months after PSLT, respectively. The IOP reduction rate one year after PSLT was 18.7%. Thirteen of the 31 eyes (42%) achieved a 20% reduction in IOP compared to the baseline. Conclusion: Adjunctive treatment with PSLT in OAG patients receiving maximized OHM may be effective over 12-months of follow-up.

Purpose: We hypothesized that a recently introduced epibulbar micro-shunt (PRESERFLO, P) produces nycthemeral (24h) intraocular pressure (IOP) profiles different from ab-interno trabeculectomy (Trabectome, T). P is a flow restrictor that drains fluid into the sub-tenon space. In contrast, T increases conventional outflow, which is limited by episcleral venous pressure. Methods: In this prospective cohort, we analyzed 68 patients (34 P and 34 T) who presented for 24-h IOP monitoring 6 to 12 months after surgery. IOP and tonographic outflow facility were measured in the habitual position using a pneumatonometer. The IOP variation was considered the primary outcome measure. Glaucoma medications were also compared. Results: P had a higher baseline IOP than T (24.8±10.0 vs. 17.3±7.9 mmHg, p=0.001). Postoperatively, P and T had similar nycthemeral IOP profiles, but IOP in P was significantly lower than in T, except at 4 pm. P had a lower absolute IOP variation than T (5.8±2.6 vs. 7.1±2.7 mmHg, p=0.049). The relative IOP variation was similar in both (34.8±13.2 vs. 37.2±13.1, p=0.45) as was the tonographic outflow facility (0.35±0.23 vs. 0.26±0.18 µl/min/mmHg, p=0.097). Conclusion: Nycthemeral IOP profiles of P and T were similar, but P had lower IOPs and less variation than T. This could reflect how T, unlike P, is more impacted by habitual, positional factors, especially at night.

Purpose: To investigate trabeculopuncture (TP) for predicting the outcome of ab interno trabeculectomy (AIT). AIT is an effective, low-risk procedure for open angle glaucoma. Despite widespread utilization, it fails in patients with an unidentified distal outflow resistance. Methods: We bisected 81 enucleated porcine eyes and perfused them for 72 hours. They were assigned to two groups: trial (n=42) and control (n=39). Intraocular pressure (IOP) was measured continuously. At 24 hours, four YAG-laser trabeculopunctures on the nasal trabecular meshwork were performed, followed by a 180° AIT at the same site at 48 hours. Eyes were divided into TP and AIT responders and non-responders; the proportion of TP responders between both AIT groups was compared. Results: Both post-TP and post-AIT IOPs were lower than baseline IOP (p=0.015 and p<0.01, respectively). The success rates of TP and AIT were 69% and 85.7%, respectively. The proportion of TP responders among AIT responders was greater than that of AIT non-responders (p<0.01). Sensitivity and specificity values of TP as predictive test for AIT success were 77.7% and 83.3%, respectively. The positive and negative predictive values were 96.6% and 38.5%, respectively. Conclusion: A 10% reduction in IOP after TP can be used as predictor for the success (>20% IOP decrease) of 180° AIT in porcine eyes.

Purpose: To compare ab interno trabeculectomy by trabecular meshwork excision to plasma-mediated ablation in primary open-angle glaucoma. Methods: Retrospectively collected data of TrabEx+ (TEx, n=56) and Trabectome (T, n=99) were compared by coarsened exact matching to reduce confounding and matched based on baseline IOP and age. Primary outcomes were IOP and number of glaucoma medications. Complications and need for additional glaucoma surgery were assessed. Patients were followed for up to one year. Results: 53 TEx could be matched to T. Baseline IOP was 16.5±4.6 mmHg in both; age was 73.7±8.8 and 71.5±9.9 years in TEx and T, respectively. TEx were taking more medications than T (p<0.001). IOP was reduced to 14.8±4.3 in TEx and to 13.4±3.4 in T at 6 months, and to 14.9±6.0 (p=0.13) in TEx and to 14.1±3.8 mmHg (all p<0.05) in T at 12 months. Medications were reduced at both 6 and 12 months (p< 0.05). No differences were seen between TEx and T at 6 and 12 months. In TEx, only one serious complication occurred, and two patients required further glaucoma surgery. Conclusion: Although both groups had a baseline IOP considered low for ab-interno trabeculectomy, IOP and medications were reduced further at 6 and 12 months. IOP reduction did not reach significance in TEx at 12 months. The inter-group comparison did not reveal any significant differences. Both had a low complication rate.

Purpose: To determine whether 24-hour IOP monitoring can be a predictor for glaucoma progression and to analyze the inter-eye relationship of IOP, perfusion and progression parameters. Methods: We extracted data from manually drawn IOP curves with HIOP-Reader, a software suite we developed. The relationship between measured IOPs and mean ocular perfusion pressures (MOPP) to retinal nerve fiber layer (RNFL) thickness was analyzed. We determined the ROC curves for peak IOP (Tmax), average IOP (Tavg), IOP variation (IOPvar) and historical IOP cut-off levels to detect glaucoma progression (rate of RNFL loss). Bivariate analysis was conducted to check for various inter-eye relationships. Results: 217 eyes were included. The average IOP was 14.8±3.5 mmHg, with a 24-hour variation of 5.2±2.9 mmHg. 52% of eyes with RNFL data showed disease progression. There was no significant difference in Tmax, Tavg and IOPvar between progressors and non-progressors (all p>0.05). Except for Tavg and the temporal RNFL, there was no correlation between disease progression in any quadrant, Tmax, Tavg and IOPvar. 24-hour and outpatient IOP variables had poor sensitivities and specificities in detecting disease progression. The correlation of inter-eye parameters was moderate; correlation with disease progression was weak. Conclusion: In line with our previous study, IOP data obtained during a single visit (outpatient or inpatient monitoring) make for a poor diagnostic tool, no matter the method deployed. Glaucoma progression and perfusion pressure in left and right eyes correlated weakly to moderately with each other.

Purpose: Nycthemeral (24-hour) glaucoma inpatient intraocular pressure (IOP) monitoring has been used in Europe for more than 100 years to detect peaks missed during regular office hours. Data supporting this practice is lacking, partially because it is difficult to correlate manually drawn IOP curves to objective glaucoma progression. To address this, we deployed automated IOP data extraction tools and tested for a correlation to a progressive retinal nerve fiber layer loss on spectral-domain optical coherence tomography (SDOCT). Methods: We created and deployed a machine-learning image analysis software to extract IOP data from hand-drawn, nycthemeral IOP curves of 225 retrospectively identified glaucoma patients. The relationship between demographic parameters, IOP and mean ocular perfusion pressure (MOPP) data to SDOCT data was analyzed. Sensitivities and specificities for the historical cut-off values of 15 mmHg and 22 mmHg in detecting glaucoma progression were calculated. Results: IOP data could be extracted efficiently. The IOP average was 15.2±4.0 mmHg, nycthemeral IOP variation was 6.9±4.2 mmHg, and MOPP was 59.1±8.9 mmHg. Peak IOP occurred at 10 AM and trough at 9 PM. Disease progression occurred mainly in the temporal-superior and -inferior SDOCT sectors. No correlation could be established between demographic, IOP, or MOPP parameters and SDOCT disease progression. The sensitivity and specificity of both cut-off points (15 and 22 mmHg) were insufficient to be clinically useful. Outpatient IOPs were non-inferior to nycthemeral IOPs. Conclusion: IOP data obtained during a single visit make for a poor diagnostic tool, no matter whether obtained using nycthemeral measurements or during outpatient hours.

CYP1B1 loss-of-function (LoF) is the main known genetic alteration present in recessive primary congenital glaucoma (PCG), an infrequent disease characterized by delayed embryonic development of the ocular iridocorneal angle and caused by poorly understood molecular mechanisms. To model CYP1B1 LoF underlying PCG, we developed a cyp1b1 knockout (KO) zebrafish line using CRISPR/Cas9 genome editing. This line carries the c.535_667del frameshift mutation that results in a 72% mRNA reduction with residual mRNA predicted to produce an inactive truncated protein (p.(His179Glyfs*6)). Craniofacial defects and jaw maldevelopment were observed in 23% of somatic mosaic F0 crispant larvae (144 hpf). These early phenotypes were not detected in KO F3 larvae (144 hpf) but 27% of adult fishes (4 months) showed uni or bilateral craniofacial alterations, indicating the existence of incomplete penetrance and variable expressivity. These phenotypes increased to 86% in the adult offspring of inbred progenitors with craniofacial defects. No glaucoma-related phenotypes were observed in the cyp1b1 mutants. Transcriptomic analyses of the offspring (7dpf) of KO cyp1b1 progenitors with adult-onset craniofacial defects revealed that differentially expressed genes were functionally enriched in groups related with extracellular matrix and cell adhesion, cell growth and proliferation, lipid metabolism (retinoids, steroids, and fatty acids, and oxidation-reduction processes which included several cytochrome P450 genes) and inflammation. In summary, this study shows the complexity of phenotypes and molecular pathways associated with cyp1b1 LoF, with species-dependency, and provides evidence for dysregulation of extracellular matrix gene expression as one of the mechanisms underlaying pathogenicity associated with cyp1b1 disruption.

As in glaucoma and other optic neuropathies cellular dysfunction often precedes cell death, sensitive assessment of retinal ganglion cell (RGC) function represents a key outcome measure for neuroprotective strategies aimed at targeting distressed but still viable cells. Here we offer a conceptual framework to identify progressive stages of RGC dysfunction leading to cell death in mouse models of glaucoma and other optic neuropathies based on non-invasive pattern electroretinogram (PERG), to differentiate phenotypic and altered RGC response dynamics, to assess susceptibility to stressors and to assess reversible dysfunction.

Purpose: To create a highly balanced comparison of ab interno trabeculectomy (Trabectome, AIT) and trabecular bypass stenting (iStent, TBS).Setting: Eye and Ear Institute, Pittsburgh, Ross Eye Institute, Buffalo, and Glaucoma Associates of Texas, Dallas, USA.Design: Retrospective Exact Matching analysis.Methods: AIT and TBS patients were included from three large glaucoma practices. The primary outcome measure was the unmedicated IOP ≤ 21 mmHg at 2-year follow-up visit. A secondary measure was unmedicated IOP reduction ≥ 20% at 2 years. Patients were matched by baseline IOP, the number of glaucoma medications and glaucoma type using Exact Matching and by age using Nearest Neighbor matching. Patients without a close match were excluded. All surgeries were combined with phacoemulsification. Results: 154 AIT and 110 TBS eyes were analyzed. 48 AIT patients were exactly matched to 48 TBS patients. Both groups had a baseline IOP of 15.3±3.1 mmHg. At 24 months, the mean IOP was 13.9±3.3 for AIT versus 16.8±2.8 mmHg for TBS (p=0.04), while the number of medications was 0.7±1.0 for AIT versus 1.7±1.2 for TBS (p=0.04). The proportion of subjects achieving IOP ≤ 21 mmHg without medications at 24 months was 53% in AIT versus 16.6% in TBS (P < 0.05). At 24-month follow up 17.6% of patients in AIT had ≥ 20% IOP reduction without medication versus no patient in TBS. Conclusions: An Exact Matching comparison of AIT and TBS demonstrated greater IOP reduction with fewer medications in AIT.

Purpose: To investigate whether microsurgical excision of trabecular meshwork (TM) in an ex vivo pigmentary glaucoma model can normalize the hypertensive phenotype. Methods: Eight eyes of a porcine pigmentary glaucoma model underwent 90° of microsurgical TM excision with an aspirating dual-blade (Goniotome (G)). 24 hours later, an additional 90° of TM were removed. Anterior segments with sham surgeries served as the control (C). Outflow facility and intraocular pressure (IOP) were analyzed. Histology with hematoxylin and eosin (H&E) was obtained. Results: After the first 90° TM excision, IOP was significantly lower in G (10.23±2.39 mmHg, n=7) than C (20.04±1.97mmHg, n=8, P<0.01). Outflow facility in G (0.38±0.07 µl/min/mmHg) was higher than C (0.16±0.02 µl/min/mmHg, P<0.01). After the second 90° TM excision, IOP in G (6.46±0.81 mmHg, n=7) was significantly lower than C (20.25±1.66 mmHg, n=8, P<0.001), while the outflow facility in G (0.50±0.05 µl/min/mmHg, n=7) was higher than C (0.16±0.01 µl/min/mmHg, n=8, P<0.001). Compared to the first excision, excision of an additional 90° did not change of IOP (P=0.20) or outflow facility (P=0.17) further. Conclusion: Excision of 90° of TM in a pigmentary glaucoma model using an aspirating dual-blade decreased IOP and increased outflow facility. Translational Relevance: Microsurgical TM excision over 90° can effectively restore outflow in pigmentary glaucoma.

Carbonic Anhydrases (CAs) are a superfamily of metalloenzymes widespread in all life kingdoms, classified into seven genetically different families (α-θ). These enzymes catalyse the reversible hydration of carbonic anhydride (CO2), generating bicarbonate (HCO3-) and protons (H+). Fifteen isoforms of human CA (hCA I-XV) have been isolated, their presence being fundamental for the regulation of many physiological processes. In addition, overexpression of some isoforms has been associated with the outbreak or the progression of several diseases. For this reason, for a long time CA inhibitors (CAIs) are used in the control of glaucoma and as diuretics. Furthermore, the search for new potential CAIs for other pharmacological applications is a very active field. Amino acids constitute the smallest fundamental monomers of protein and, due to their useful bivalent chemical properties, are widely used in organic chemistry. Both proteinogenic and non-proteinogenic amino acids have been extensively used to synthesize CAIs. This article provides an overview of the different strategies that have been used to design new CAIs containing amino acids, and how these bivalent molecules influence the properties of the inhibitors.

This randomized controlled prospective trial evaluated the impact of neuro‐athletic training (NAT) on flexibility, serve speed, and upper extremity performance in elite volleyball players. Thirty professional players aged 18‐35 were initially recruited and randomly assigned to either the NAT intervention or control group. However, the study was completed with a final sample of 26 participants. Performance assessments, including the Sit and Reach Test, Pocket Radar Ball Coach for serve speed, and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), were conducted pre‐ and post‐intervention. The NAT group showed significant improvements in flexibility (p=0.005, d=2.32), serve speed (p<0.001, d=2.54), and upper limb performance (p<0.001, d=2.61), while the control group displayed no significant changes. These findings highlight NATʹs effectiveness in enhancing neuromuscular function and coordination, emphasizing its potential as a training approach in competitive volleyball.This randomized controlled prospective trial evaluated the impact of neuro‐athletic training (NAT) on flexibility, serve speed, and upper extremity performance in elite volleyball players. Thirty professional players aged 18‐35 were initially recruited and randomly assigned to either the NAT intervention or control group. However, the study was completed with a final sample of 26 participants. Performance assessments, including the Sit and Reach Test, Pocket Radar Ball Coach for serve speed, and Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), were conducted pre‐ and post‐intervention. The NAT group showed significant improvements in flexibility (p=0.005, d=2.32), serve speed (p<0.001, d=2.54), and upper limb performance (p<0.001, d=2.61), while the control group displayed no significant changes. These findings highlight NATʹs effectiveness in enhancing neuromuscular function and coordination, emphasizing its potential as a training approach in competitive volleyball.

Antisense oligonucleotides (ASOs) have emerged as a promising therapeutic approach for a wide variety of diseases, offering the potential to modulate gene expression with a high degree of specificity. These small, synthetic nucleic acid-like molecules provide unique advantages over traditional pharmacological treatments, including the ability to target previously "undruggable" genes. Despite this promise, several biological barriers severely limit their clinical efficacy Upon administration, ASOs primarily enter cells through endocytosis, becoming trapped inside membrane-bound vesicles known as endosomes. Studies estimate that only 1-2% of ASOs successfully escape endosomal compartments to reach the cytosol, and ultimately the nucleus, where they bind target mRNA and exert their therapeutic effect. Endosomal entrapment and inefficient nuclear localization are therefore critical bottlenecks in the therapeutic application of ASOs. This review explores the current understanding of endosomal escape, and nuclear transport of ASOs. Furthermore, we examine strategies aimed at overcoming these challenges, including the use of endosomal escape agents, peptide-ASO conjugates, non-viral delivery vehicles, and nuclear localization signals. By improving both endosomal escape and nuclear localization, significant advances in ASO-based therapeutics can be realized, ultimately enhancing their potency and expanding their clinical utility

Rhynchocypris kumgangensis, endemic to Korea, is limited to the upper Hangang River and Gucheondongcheon Stream. As a key and climate-sensitive biological indicator species in Deogyusan National Park, it has a southern range limit in the Gucheondong Valley. Due to climate change, notable shifts in the activity, vertical distribution, and population of R. kumgangensis in the Gucheondongcheon Stream are expected. Owing to the rapidly changing climate, significant changes in the activity, vertical distribution, and population size of R. kumgangensis in the Gucheondongcheon Stream are anticipated, and continuous surveys of the distribution of R. kumgangensis in this river area have been conducted. This study assessed the habitat of R. kumgangensis at 13 sites, including five in the Gucheondongcheon Stream, from July to October 2020 and compared the results with historical data to evaluate the impacts of climate change. At the five Gucheondongcheon Stream sites, 102 individuals were recorded from April to October 2020, and 378 were recorded between June 2018 and July 2019. Additionally, the subdominant species shifted from R. kumgangensis (2014–2018) to Zacco koreanus (2020). In the two southernmost Gucheondongcheon Stream sites, only 18 R. kumgangensis were observed in 2020 compared to 82 in 2019, indicating a significant population decline.

This study presents the experimental and analytical evaluations on an innovative connection class under cyclic loading. The connection was an H- or I-shaped section as a short stub column (SSC) between the end-plate and the column. The stub section was bolted to the column flange on the one side and bolted to the beam along with the welded end-plate on the other side. Stiffeners were installed on the webs and flanges of the beam and stub to ensure the necessary stiffness of the connection. The variables included thickness of stub flange/web and height of stub web. The cyclic loading was applied on a sample of the proposed connection according to AISC ANSI/AISC 341-16 loading protocol. Experimental observations displayed that the proposed connection, one can either employ hot rolling sections or create the connection as a plate girder, in which case the flange thickness and stub web, as well as the distance between two flanges and their height, was obtained according to the demand and performance of the structure. The optimum cross-section of the stub was then obtained. Also, the analytical model was calibrated using the finite element method (FEM), and its performance was confirmed. The effective parameters of the proposed connection were determined by modeling in the FEM software, and the design method was presented.

Objective: In recent years, the field of Essential Thrombocythemia (ET) research has seen a significant accumulation of scientific findings, but comprehensive bibliometric analyses remain lacking. This study aims to fill that gap by performing a thorough bibliometric analysis of ET research, identifying key contributors and collaboration networks, and mapping the development trends to provide insights for future research directions. Methods: A bibliometric analysis of ET-related publications from 2001 to 2024 was conducted using CiteSpace, VOSviewer, and R packages. Data were retrieved from the Web of Science Core Collection, with a focus on publication volume, citation analysis, co-authorship networks, co-citation relationships, and citation bursts. Results: A total of 4,297 studies published in 778 journals were included in the analysis. ET research has seen rapid growth, with researcher clusters in the United States and Europe driving progress through extensive regional and international collaborations. Leading researchers, such as Ayalew Tefferi from the Mayo Clinic and Alessandro M. Vannucchi from the University of Florence, have made significant advances in ET classification, molecular mechanisms, targeted therapies, and disease management. The discovery of driver mutations, such as JAK2, has revolutionized the diagnostic and therapeutic approaches to ET. Research focus has shifted from clinical morphological diagnosis to molecular diagnostics, with the field now entering the era of targeted therapies. However, the inherent heterogeneity of ET continues to present challenges for the widespread implementation of personalized precision treatment. Conclusion: Bibliometric analysis demonstrates significant advances in ET research, particularly in molecular pathology and targeted therapies. However, the heterogeneity of ET remains a major obstacle to personalized treatment. Future research should focus on further elucidating the pathogenesis of ET and improving stratified management approaches to achieve individualized precision therapy.

Phosphorus (P) is an essential element in food production, but it is often largely unavailable for plants as it persists in soils in immobilized forms. Farmers have been using P fertilizers extensively to overcome this unavailability, leading to the exhaustion of non-renewable deposits of phosphorite, rising fertilizers prices and causing several environmental impacts such as eutrophication. Its large-scale utilization is also inefficient since most of the added P becomes quickly unavailable for the plants. Therefore, farming solutions that improve P uptake, P use efficiency of plants and P mobilization in soils are highly important. In this narrative review, we summarized and explored the link between the Silicon (Si) and P cycles in soils. Silicon is quasi-essential for plants, and it has been established that its presence in soil and uptake by plants has several benefits, especially in toxic and nutrient-deficient conditions. Here, we established that Si in soils can affect crop production in P-deficient conditions through: 1) the pH effect – Si improves organic matter decomposition and decreases Al3+ availability; the Si uptake effect – the deposited Si in the plant improves its photosynthetic performance, improves the root ability to uptake P, improves organic matter decomposition and increases P/Mn ration in plant, improving P use; and 3) the Si soil effect – Si stimulates phosphorite rocks weathering and competes with P for the binding places at the surface of Ak and Fe hydroxides, releasing P into soil solution. This positive effect of Si on P mobilization in soils and consequent use by crops should be further disseminated to farmers and other relevant stakeholders.