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The human eye is one of the special sensory organs. Eyes undergo a series of changes right from infancy to attainment of adulthood. Major changes occur in globe dimensions, orbital and neurological structures. In order to have a sharp focus of the image on the retina, the intraocular structures undergo developmental changes in the 1st year of life along with the neurological growth which enables processing of that retinal image. The extraocular growth of the bony orbit and adnexa accompanies intraocular growth. An ophthalmologist looking after the pediatric patient must be aware of these physiological changes so as to not diagnose them as any pathologic conditions. There are few diseases which can also interfere with these normal developmental changes. It is valuable to know the developmental process to diagnose children with eye disorders. This review article lays emphasis on the normal anatomical alterations in the globe, anterior segment, pupil, lens, retina, lacrimal apparatus, and external orbit of the human eye during infancy and early adulthood and also discussing its practical implications.

OpenAI’s ChatGPT (Generative Pre-trained Transformer) is a chatbot that answers questions and performs writing tasks in a conversational tone. Within months of release, multiple sectors are contemplating the varied applications of this chatbot, including medicine, education, and research, all of which are involved in medical communication and scientific publishing. Medical writers and academics use several artificial intelligence (AI) tools and software for research, literature survey, data analyses, referencing, and writing. There are benefits of using different AI tools in medical writing. However, using chatbots for medical communications pose some major concerns such as potential inaccuracies, data bias, security, and ethical issues. Perceived incorrect notions also limit their use. Moreover, ChatGPT can also be challenging if used incorrectly and for irrelevant tasks. If used appropriately, ChatGPT will not only upgrade the knowledge of the medical writer but also save time and energy that could be directed toward more creative and analytical areas requiring expert skill sets. This review introduces chatbots, outlines the progress in ChatGPT research, elaborates the potential uses of ChatGPT in medical communications along with its challenges and limitations, and proposes future research perspectives. It aims to provide guidance for doctors, researchers, and medical writers on the uses of ChatGPT in medical communications.

Acute necrotizing encephalopathy is a rare, severe neurological condition, characterized by symmetrical necrotic brain lesions affecting the thalamus, cerebral white matter, brain stem, and cerebellum. Diagnosis relies on characteristic clinical and radiological features. We describe a 10-month-old female infant presenting with multiple seizures following a brief febrile upper respiratory illness. MRI of the brain showed bilateral symmetrical abnormal signal intensities involving both thalami and caudate nucleus, consistent with ANE. Management of ANE is symptom-related but high-dose steroids and IVIG have been used. This case highlights the importance of recognizing ANE beyond its usual geographic distribution. Early recognition and prompt management help improve outcomes.

Background: Indistinct and analogous histopathological features of various fibro-osseous lesions make establishing a definitive diagnosis a challenge. There is a need for additional molecular and histochemical tools to support and differentiate these lesions in order to establish a concrete diagnosis. Materials and Methods: A retrospective analysis of biopsied lesions in formalin-fixed paraffin-embedded sections (10 cases each of fibrous dysplasia, ossifying fibroma, and cement-osseous dysplasia) retrieved from the archives was studied for immunoexpression of osteocalcin (quantitative analysis in osteocytes), collagen characterization using Azan, Picrosirus, and Toluidine blue stain for evaluating intensity and localization of collagen fibers, and morphometric analysis of vasculature (for evaluating mean vessel density as square microns). Results: Positive immunostaining of osteocalcin suggested mutations of the GNAS-1 gene found in fibrous dysplasia indirectly, as it is a negative regulator of bone formation. Osteocalcin immunopositivity was quantitatively measured in the fibro-osseous lesions, with fibrous dysplasia measuring 14.47 ± 3.628 as compared to ossifying fibroma measuring 5.23 ± 1.33, followed by cemento-osseous dysplasia measuring 2.30 ± 1.409. Toluidine blue suggests the presence of oxytalan fibers (resistant to acid hydrolysis) in ossifying fibroma and cemento-osseous dysplasia, pointing toward the pathogenesis of the lesion. Azan stain and Picrosirus (under a polarizing microscope) helped in distinguishing hard tissue characteristics (70% of cases of fibrous dysplasia showed only a magenta component followed by intermixed magenta with a blue component in 20% of cases and only 10% of cases showed magenta with blue borders whereas for ossifying fibroma, 40% of cases depicted magenta with blue borders along with the other 40% with intermixed magenta with blue component). The mean vessel density was also highest in fibrous dysplasia measuring 7.90 ± 1.079 (in Sq. micron area), followed by ossifying fibroma and cemento-osseous dysplasia. Conclusion: The diagnosis of fibro-osseous lesions by hematoxylin and eosin alone is confusing and thus should be supported by relatively simple histomorphometric analysis for better treatment outcomes. At the diagnostic stage of fibro-osseous lesions, evaluation of intralesional vessel size, reliable molecular marker, and histochemical nature can aid in differentiating fibrous dysplasia from central ossifying fibroma and cemento-osseous dysplasia alongside, other clinical, radiographic and pathological criteria. These parameters help in the diagnostic decision-making of fibro-osseous lesions.

The implementation of three-dimensional (3D) printing technology has culminated in a notable rise in productivity and operational effectiveness for manufacturers. Additive manufacturing (AM) is a manufacturing technology that implies an alteration from the conventional approach of material removal. The fundamental idea underlying the AM technique is the gradual buildup of layers (layer-on-layer accumulation). In conventional approaches, every component can have detrimental implications due to the direct interaction between the tool and the workpiece, leading to the loss of heat through friction. The utilisation of 3D printing as a way to surpass conventional processing methods signifies a novel development in several sectors. This method involves the utilisation of unconventional techniques for the fabrication of components. The primary objective of this research is to investigate the chemical vapour jet drilling technique specifically applied to acrylonitrile butadiene styrene (ABS) materials. The intent is to enhance the surface characteristics, or surface finish (SF), and the dimensional accuracy (DA) of ABS workpieces. An evaluation regarding the reliability, repeatability, as well as preciseness of the vapour jet drilling (VJD) process is conducted via the utilisation of experiment and data analysis. The study employed a Taguchi L9 design of experiments to carry out a series of tests aimed at analysing the implications of three independent variables: pressure, flow rate, and standoff distance. The researchers employed a multiresponse optimisation approach to attain an optimal combination of parameters that resulted in a superior SF with DA. Consequently, the overall appeal of the outcome was reached. The process’s capabilities and dependability were assessed by conducting tests on the substrates at their optimal settings. Surface roughness and circularity were measured at numerous locations on the substrates. The study determined that the process capability indices (C p and C pk) had values over 1.33 for each of the response parameters, with C pk values also exceeding 1. The analysis of histograms and capability indices demonstrates that the VJD method, when conducted under optimised conditions, may be categorised as statistically controlled for the processing of ABS materials.

Abstract Ketamine, a pharmacological agent that acts as an antagonist of the N-methyl-D-aspartate (NMDA) receptor, has garnered considerable interest because of its notable and expeditious antidepressant properties observed in individuals diagnosed with major depressive disorder (MDD) who exhibit resistance to conventional therapeutic interventions. A comprehensive and rigorous systematic review was undertaken to evaluate the prevalence of ketamine abuse undergoing ketamine treatment for depressive disorders. A comprehensive search was conducted across the electronic databases to identify pertinent studies published between 2021 and 2023. The present investigation incorporated a comprehensive range of studies encompassing the abuse or misuse of ketamine, including case reports, observational studies, and clinical trials. Data extraction and quality assessment were conducted in accordance with predetermined criteria. The findings of this systematic review demonstrate the importance of monitoring and addressing ketamine abuse in patients receiving ketamine treatment for depressive disorders like MDD. The wide range of reported prevalence rates highlights the need for standardized criteria and measures for defining and assessing ketamine abuse. This study presents a significant contribution to the field by introducing a novel screening questionnaire and assessment algorithm designed to identify and evaluate ketamine misuse among major depressive disorder (MDD) patients undergoing ketamine treatment. This innovative tool holds the potential to enhance clinical practice by providing healthcare professionals with a standardized approach to promptly detect and address ketamine misuse. The integration of this screening tool into routine care protocols can facilitate more effective monitoring and management of ketamine misuse in this population, ultimately leading to improved patient outcomes and safety.

Dental caries is the most common unmet dental need of children with special health-care needs (SHCNs), and their treatment is challenging in routine dental settings. Based on surplus evidence, silver diamine fluoride (SDF) is a simple, safe, cost-effective, and efficient topical solution for treating dental caries. It is a clear, colorless, odorless fluoride-containing solution, does not require an extensive armamentarium for its application, and can be used in any setting. However, even with worldwide acceptance, there occurs limited research regarding SDF use in children with special needs. This review aims to update the possibilities and acceptability of SDF usage in patients with special needs with dental caries as a promising option for managing dental caries and improving their quality of life.

Background: Dental radiography is an integral part of intraoral evaluation. Children are often uncomfortable during the placement of film or sensor due to the impingement of the soft tissues. Thus, the perception of pain with three intraoral radiographic methods in children was evaluated using three subjective pain rating scales. Aim: To evaluate the discomfort with three different techniques, that is, intraoral periapical (IOPA) radiograph, charge-coupled device (CCD), and photostimulable phosphor (PSP) luminescence (PSPL), using the Wong–Baker Faces Pain Rating Scale (WBFPRS), numerical rating scale, and visual analog scale (VAS). Materials and Methods: A sample of 35 children aged 6–12 years were divided into two groups: group 1 (6–8 years) and group 2 (9–12 years). For each child, simulations of the three radiological methods (IOPA, CCD, and PSPL) were performed. The meaning of each facial expression on the WBFPRS, VAS, and the numbers on the numerical rating scale was explained to each child before the procedure. Statistical Analysis Used: A one-way analysis of variance (ANOVA) test and paired-samples t-test are used. Results: The results revealed that the CCD sensors elicited higher pain scores than those obtained with IOPA and PSPL, whereas the IOPA film showed the least pain score. Higher score values were obtained in group 1 than in group 2, indicating that children aged 6–8 years felt higher discomfort than the 9- to 12-year age group for the same procedure. This difference was statistically significant (P < 0.001). Conclusion: It was concluded that conventional IOPA films were tolerated better by children when compared to PSP plates and CCD sensors.

Skin cancer is a widespread and perilous disease that necessitates prompt and precise detection for successful treatment. This research introduces a thorough method for identifying skin lesions by utilizing sophisticated deep learning (DL) techniques. The study utilizes three convolutional neural networks (CNNs)—CNN1, CNN2, and CNN3—each assigned to a distinct categorization job. Task 1 involves binary classification to determine whether skin lesions are present or absent. Task 2 involves distinguishing between benign and malignant lesions. Task 3 involves multiclass classification of skin lesion images to identify the precise type of skin lesion from a set of seven categories. The most optimal hyperparameters for the proposed CNN models were determined using the Grid Search Optimization technique. This approach determines optimal values for architectural and fine-tuning hyperparameters, which is essential for learning. Rigorous evaluations of loss, accuracy, and confusion matrix thoroughly assessed the performance of the CNN models. Three datasets from the International Skin Imaging Collaboration (ISIC) Archive were utilized for the classification tasks. The primary objective of this study is to create a robust CNN system that can accurately diagnose skin lesions. Three separate CNN models were developed using the labeled ISIC Archive datasets. These models were designed to accurately detect skin lesions, assess the malignancy of the lesions, and classify the different types of lesions. The results indicate that the proposed CNN models possess robust capabilities in identifying and categorizing skin lesions, aiding healthcare professionals in making prompt and precise diagnostic judgments. This strategy presents an optimistic avenue for enhancing the diagnosis of skin cancer, which could potentially decrease avoidable fatalities and extend the lifespan of people diagnosed with skin cancer. This research enhances the discipline of biomedical image processing for skin lesion identification by utilizing the capabilities of DL algorithms.

Background: Aging mainly affects human appetite, food intake, and body weight. Physiological and psychopharmacological pathways demonstrate variations in hunger. Bodily signs characterize Elderly Depression, altered eating and sleeping patterns, cognitive impairments, and low mood. Objectives: To study the prevalence of Depression and Malnutrition in the geriatric population in the rural community and to examine the association between them among the study population. Methods: A community-based cross-sectional study was conducted in the rural areas of district Gautam Budh Nagar among geriatric population using a pre-designed pretested semi-structured questionnaire. Results: In the study, the prevalence of Depression among the study participants was found to be 155(41.2%) and malnutrition was found to be in 67 (17.8 %). Among bio social characters Age (p-value-0.000), gender (p-value-0.012), marital status (p-value-0.026), physical activity (p-value-0.004), and Malnutrition (p-value-0.000) found to be significantly associated with Depression among elderly. On multiple logistic regression, physical activity [aOR 23.6; 95% CI: 11.4-48.8] and Malnutrition or its risk [aOR 0.272; 95% CI: 0.130-0.569] were significantly associated with Geriatric Depression. Conclusions: Depression is recognized to have a significant impact on nutritional health in the elderly and is a major factor in weight loss.

The main objective of this study was to evaluate the tolerance of stationary phase (STAT) and long-term survival phase (LTS) Salmonella Enteritidis ATCC 13076 to atmospheric cold plasma (ACP) in phosphate buffered saline (PBS, pH 7.0) and on shell eggs. Salmonella Enteritidis was cultured in tryptic soy broth supplemented with 0.6% (w/v) yeast extract (35°C) for 20 h (STAT) and 21 days (LTS). Cell morphology was determined by light microscopy. The PBS and shell eggs were inoculated with STAT or LTS cells to obtain ∼7.0 log10 CFU/mL or egg. The ACP was applied at 45 kV (PBS) and 60 kV (shell eggs) for 1–4 min and 1–5 min, respectively. Pathogen survivors were enumerated on thin agar layer (TAL) medium and on xylose lysine tergitol-4 (XLT-4) agar after 48 h of incubation (35°C). For survivors on shell eggs, R2 and mean square error values were obtained using Log-linear with Tail and Weibull models. The STAT cells were predominantly rod-shaped whereas LTS cells were coccoid. In PBS, reductions (log10 CFU/mL) of STAT cells were 1.0, 0.95, 1.45, and 1.44 after exposure to ACP for 1, 2, 3, and 4 min, respectively. In contrast, reductions in LTS cells were significantly lower (p< 0.05) at 0.04 (1 min), 0.06 (2 min) 0.01 (3 min), and 0.11 (4 min). A similar pattern was observed for shell eggs whereby LTS cells exhibited much higher tolerance to ACP than STAT cells (p < 0.05). The Log-linear with Tail model produced a better fit of the survival data for STAT cells; times to achieve a 4- and 5- log reduction were 5.29 and 5.78 min, respectively. Sub-lethal injury occurred in both STAT and LTS survivors; however, differences were not significant (P > 0.05). Additionally, there were no observed differences in shell strength and yolk color between ACP-treated and control eggs. Based on these results, LTS cells of S. Enteritidis are more tolerant to ACP than STAT cells and should be considered when developing process validation protocols involving application of ACP to inactivate Salmonella on shell eggs.

IntroductionIn this paper we propose that one of the core developmental aims of adolescence is to cultivate a capacity for active balancing as the primary process for creating a coherent, agentic self capable of contributing to the functioning and purposes of the communities which adolescents inhabit, including society as a broader community. While there many valuable initiatives and programs to promote positive development, learning, and wellbeing, these efforts typically take a siloed approach focusing on one dimension of development (e.g., social-emotional learning), leaving adolescents to create coherence from these disconnected approaches. As adolescence face an increasingly uncertain future (e.g., career instability), serious threats to human survival (e.g., environmental degradation), social divides (e.g., political and ideological polarization), etc., a siloed approach to adolescent development is not simply outmoded but it reinforces a fragmented self.Conceptual model and backgroundIn this paper we argue that a siloed approach to adolescent development and learning may contribute to a fragmented sense of self and agency, which can be associated with increased vulnerability to mental health challenges. We first link the proposed developmental aim of adolescence to neuroscience findings that identify three brain changes during adolescence that lay the groundwork for cultivating active balancing and provide an ontogenetic neurological push for adolescents to learn and manage how to engage their worlds. Leveraging this ontogenetic push, we propose adolescents can cultivate their capacity for active balancing within the cultural communities of practice they inhabit. These communities provide a ready and powerful fusion of action, affect, and thought into coherent and relevant understandings of the why, how, and utility of practices in a community, or what we label orientations. Active balancing is the process of actively seeking to establish or reestablish one's intended balance among these orientations.Conclusions and implicationsBuilding the capacity for active balancing, we suggest, engenders greater resilience and adaptability to a range of situations, a tolerance for and ability to resolve tensions, and an ability to transcend vast differences, including cultural and ideological. Implications for both the adolescent and society are discussed.

A study was carried out to investigate the effect of storage of testes-epididymis complex at 5oC for 24 h and supplementation of lyophilized heterologous seminal plasma (LHSP) at different concentrations on the sperm quality during cool storage. Six pairs of testicles were collected immediately after orchiectomy from six stallions. One testes-epididymis (F1) was immediately processed for sperm retrieval and second testes-epididymis (F2) complex of each stallion was stored at 5℃ for 24 h. Spermatozoa were harvested from the epididymis by flotation technique and evaluated. Highly significant difference was observed among mean values of progressive motility (%) of epididymal sperm after 0 and 24 h of testicular-epididymal complex storage at 5°C, while no significant difference was observed among mean values of live sperm, membrane integrity and acrosomal integrity (%). Both epididymal sperm suspensions were supplemented with skim milk glucose semen extender fortified with different concentrations (0, 2, 5 and 10 mg/ml) of LHSP and cooled for 24 h. Sperm suspension evaluation at 0, 12 and 24 h of cool storage revealed that addition of 2 mg/ml LHSP has beneficial effect as compared to control on progressive motility and HOST in both epididymal sperm suspension at 12 h and 24 h of cool storage at 5℃. From the current study, it was inferred that the sperm quality was not deteriorated even after the sperm retrieval after 24 h from the epididymis on storage at 5℃. Further, LHSP supplemented @2 mg/ml originated from good fertility stallion is the suitable concentration for cool-storage of equine epididymal sperm suspension.

Summary: Background: It is unknown if early COVID-19 monoclonal antibody (mAb) therapy can reduce risk of Long COVID. The mAbs amubarvimab/romlusevimab were previously demonstrated to reduce risk of hospitalization/death by 79%. This study assessed the impact of amubarvimab/romlusevimab on late outcomes, including Long COVID. Methods: Non-hospitalized high-risk adults within 10 days of COVID-19 symptom onset enrolled in a randomized, double-blind, placebo-controlled phase 2/3 trial of amubarvimab/romlusevimab for COVID-19 treatment. Late symptoms, assessed using a participant-completed symptom diary, were a pre-specified exploratory endpoint. The primary outcome for this analysis was the composite of Long COVID by participant self-report (presence of COVID-19 symptoms as recorded in the diary at week 36) or hospitalization or death by week 36. Inverse probability weighting (IPW) was used to address incomplete outcome ascertainment, giving weighted risk ratios (wRR) comparing amubarvimab/romlusevimab to placebo. Findings: Participants received amubarvimab/romlusevimab (n = 390) or placebo (n = 390) between January and July 2021. Median age was 49 years, 52% were female, 18% Black/African American, 49% Hispanic/Latino, and 9% COVID-19-vaccinated at entry. At week 36, 103 (13%) had incomplete outcome ascertainment, and 66 (17%) on amubarvimab/romlusevimab and 92 (24%) on placebo met the primary outcome (wRR = 0.70, 95% confidence interval (CI) 0.53–0.93). The difference was driven by fewer hospitalizations/deaths with amubarvimab/romlusevimab (4%) than placebo (13%). Among 652 participants with available diary responses, 53 (16%) on amubarvimab/romlusevimab and 44 (14%) on placebo reported presence of Long COVID. Interpretation: Amubarvimab/romlusevimab treatment, while highly effective in preventing hospitalizations/deaths, did not reduce risk of Long COVID. Additional interventions are needed to prevent Long COVID. Funding: National Institute of Allergy and Infectious Diseases of the National Institutes of Health. Amubarvimab and romlusevimab supplied by Brii Biosciences.