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Purpose: Optic neuritis, defined as inflammation of the optic nerve, is the most common optic neuropathy affecting adults. Various studies in Southeast Asia have shown that the clinical profile of optic neuritis might differ in these regions from that reported in the western literature. Through this study, we evaluate the clinical profile of pediatric optic neuritis (PON) in the Indian population. Methods: This was a hospital-based prospective observational study. Patients with optic neuritis younger than 16 years who attended the neuro-ophthalmology clinic from May 2016 to April 2017 were included in the study. Results: This study included 54 eyes of 38 patients. The mean age of presentation was 10.6 years. Unilateral disease (58%) was found to be more common, and a slight female preponderance (58%) was noted. The most common feature was visual loss (96.3%). Pupillary light reflex abnormality was seen in most patients. Fundus examination revealed disk edema (77.7%) to be the most common feature. Neuroimaging was performed in 34 patients, and multiple sclerosis was diagnosed in four patients. At 3 months follow-up after treatment, 89% of eyes had best correct visual acuity of 6/9 or better (P < 0.001). Conclusion: In our study, we found the clinical profile of PON to be similar to that seen in western studies as well as those done previously in the Indian population, although with a few differences. [ABSTRACT FROM AUTHOR]

The bulk carrier excitation influences the phonon dynamics, which can alter and modulate the surface charge density of topological insulators such as bismuth selenide (Bi2Se3). This work investigates the charge carrier and phonon dynamics in Bi2Se3 grown on various substrates. The orientation of the substrate, the size of the crystallites, and the misfit of the lattice affect the carrier and phonon dynamics. Bi2Se3 thin films are grown under the same growth conditions on SiO2, Si(111), and SiN. Bi2Se3 overlayers exhibit substrate- dependent charge carrier relaxation channels and phonon dynamics. It is evident from Raman spectroscopy and ultrafast transient absorption spectroscopy that the heterointerface interactions of all three samples affect the vibration modes of Bi2Se3 and coherent acoustic phonon oscillations in the NIR range. At 13.6, 41.2, and 34.4 GHz, the vibration modes of SiO2, Si(111), and SiN are equivalent. The propagation depth of phonon waves is shown by measuring the speed of sound in Bi2Se3 overlayers on SiO2, Si(111), and SiN. This study demonstrates that the surface and bulk-bound charge carriers of a topological insulator determine the frequency and velocity of the generated sound. [ABSTRACT FROM AUTHOR]

Purpose: Our study aims to evaluate the effectiveness of intravenous erythropoietin (EPO) in patients with indirect traumatic optic neuropathy (TON), assess the side effects, and compare the visual function results among three groups of patients who had received different treatment options – EPO, steroids, and observation. Methods: Patients with indirect TON presenting to the neuro-ophthalmology clinic from August 2019 to March 2020, were assigned to three groups, with six patients in each group. In group 1, patients were recruited prospectively and received recombinant human erythropoietin, whereas, in groups 2 and 3, patients were recruited retrospectively and received intravenous methylprednisolone followed by oral steroids and multivitamins, respectively. Groups 1 and 2 included patients presenting within 2 weeks of trauma, whereas group 3 included those presenting beyond that. Best-corrected visual acuity, pupillary reaction, color vision, and visual fields following treatment were measured. Results: Initial visual acuity in the EPO group ranged from 20/80 to no perception of light (No PL). The mean initial BCVA (1.82 logMAR, standard deviation [SD] = 0.847) improved to 1.32, SD = 0.93 logMAR after treatment recorded at the third month (P = 0.0375), with no significant adverse effects. The initial BCVA of group 2 ranged from 20/120 to No PL. The mean initial BCVA (1.95, SD = 0.77 logMAR) improved to 1.45 logMAR, SD = 0.97 after treatment (P = 0.0435) but three patients had side effects of steroids. Initial visual acuity in Group 3 ranged from 20/40 to no PL. The mean initial BCVA (1.09 logMAR, SD = 1.10) worsened to 1.19 logMAR, SD = 1.06 after treatment after treatment (P = 0.0193). The improvement in BCVA when compared between the three groups was not significant. Conclusion: Both erythropoietin and steroids are effective in the management of traumatic optic neuropathy. However, erythropoietin shows lesser or no side effects when compared to steroids. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the current study was to determine the frequency of anxiety and depression among patients diagnosed with acute coronary syndrome (ACS) at a tertiary care cardiac center in Pakistan. Methodology: This cross-sectional study was conducted at a tertiary care cardiac center in Pakistan from May to November 2019. We included patients of either gender, between 30 and 70 years of age, diagnosed with ACS, and presented within 72 hours of onset of symptoms. After the standard treatment of the condition, the Beck Depression Inventory Scale (BDI) and Beck Anxiety Inventory (BAI) were used to assess post-AMI depression and anxiety. The BDI =17 was categorized as depression and BAI =11 was taken as anxiety. Results: In the selected sample of 122 patients, the mean age was 58.7 ± 10.2 years and 88 (72.1%) patients were male. Diabetes mellitus was detected in 76 (62.3%) patients and 64 (52.5%) patients were smokers. The mean BDI score was 28.6 ± 6.5 and mean BAI score was 19.5 ± 5.1. Anxiety and depression were observed in 36 (29.5%) and 51 (41.8%) patients, respectively. Conclusion: Depression and anxiety are a common remnants of ACS, hence, in our day to day clinical practice, appropriate consideration should be given to the psychological wellbeing of patients in addition to the management of ACS. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of pre-hospital aspirin use in patients presenting with ST- segment elevation myocardial infarction and to assess the demographic and clinical characteristics of the patients taken pre-hospital aspirin. Methodology: It was a prospective study conducted at tertiary care hospital for the duration of six months. About 657 patients aged between 18-80 years, of either gender and diagnosed with ST-elevation myocardial infraction were included in the study. Use of pre-hospital aspirin after symptoms was assessed in all patients, then followed and outcomes such as discharge status and length of hospital in days were evaluated. Results: Overall mean age was 54.60±12.06 years and most of them were males (79.1%). About 254 patients (38.7%) received aspirin before transfer to hospital and 403 patients (61.3%) received aspirin after arrival in hospital. Frequency of pre-hospital use of aspirin was significantly associated with gender (p=0.001), educational status (p=0.006), and monthly income (p=0.003). The mean rank of length of hospital stay was similar significantly lower in STEMI patients who received pre-hospital aspirin as compared to those who did not receive pre-hospital aspirin (p=0.001). Moreover, the death rate was lower in patients with pre-hospital aspirin administration as compared to those who did not receive pre-hospital aspirin (1.2%vs2%). However, the difference between pre-hospital aspirin use and discharge status was not statistically significant (p=0.434). Conclusion: Frequency of pre-hospital aspirin use was lower in patients with STEMI. Gender, educational status, and socio-economic status were the significant factors for pre-hospital aspirin use. [ABSTRACT FROM AUTHOR]

Background: In recent decades, though India has experienced progress in ensuring the survival of its youngest members of society, the newborns; today, deaths within the first month of life represent three-quarters of all infant deaths. Objective: to study the newborn care practices among pregnant of periurban area of Aligarh. Material and Methods: This community based study was conducted in the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh. Results: 83% pregnant women were in the age group of 15-30 years 17% in the age group of 31-45 years. There was a poor newborn care practices i.e majority (91.5%) of pregnant women delivered at home by untrained dais, unhygienic delivery practices, low level of breastfeeding practices and practices to prevent hypothermia and knowledge of danger signs in newborns requiring medical consultation, among pregnant women in periurban area of Aligarh, Utter Pradesh India. Conclusion: Neonatal survival is influenced much by care provided by the family before, during and after delivery, which in turn is influenced not only by mother's beliefs, but also perceptions of her immediate family. [ABSTRACT FROM AUTHOR]

This paper reviews the optimization strategies for the optimal simultaneous allocation of distributed generation (DG) and shunts capacitor banks (SCBs) in electrical distribution networks. These optimization strategies aim to determine the optimal size, location, and combination of DGs and SCBs to constitute a techno-economic system while satisfying the constraints and energy demand of the load. The optimization strategies explicitly reviewed include the problem formulations, optimization techniques, restrictions posed for optimization problems, decision variables, and network operating modes typically assumed while allocating the DGs and SCBs. In addition, there is an attempt to highlight the limitations of the existing literature and future research directions. This study undertakes a comprehensive review of the literature that systematically considers the simultaneous application of DGs and SCBs to advance the existing literature, which lacks such a review. Expectedly, this review will serve as a principle platform for researchers intending to explore the subject area for further improvement. [ABSTRACT FROM AUTHOR]

For over a decade, distributed generations (DGs) have sufficiently convinced the researchers that they are the economic and environment-friendly solution that can be integrated with the centralized generations. The optimal planning of distributed generations requires the appropriate location and sizing and their corresponding control with various power network types to obtain the best of the technical, economical, commercial, and regulatory objectives. Most of these objectives are conflicting in nature and require multi-objective solutions. Therefore, this paper brings a comprehensive literature review and a critical analysis of the state of the art of the optimal multi-objective planning of DG installation in the power network with different objective functions and their constraints. The paper considers the adoption of optimization techniques for distributed generation planning in radial distribution systems from different power system performance viewpoints; it considers the use of different DG types, distribution models, DG variables, and mathematical formulations; and it considers the participation of different countries in the stated DG placement and sizing problem. Moreover, the summary of the literature review and critical analysis of this article helps the researchers and engineers to explore the research gap and to find the future recommendations for the robust optimal planning of the DGs working with various objectives and algorithms. The paper considers the adoption of uncertainties on the load and generation side, the introduction of DGs with energy storage backups, and the testing of DG placement and sizing on large and complex distribution networks. [ABSTRACT FROM AUTHOR]

Rhizoctonia solani is a soil-borne fungus causing sheath blight disease in cereal crops including rice. Genetic resistance to sheath blight disease in cereal crops is not well understood in most of the host(s). Aside from this, a comparative study on the different hosts at the biochemical and proteomic level upon R. solani infection was not reported earlier. Here, we performed proteomic based analysis and studied defense pathways among cultivated rice (cv. Pusa Basmati-1), wild rice accession (Oryza grandiglumis), and barley (cv. NDB-1445) after inoculation with R. solani. Increased levels of phenol, peroxidase, and β-1, 3-glucanase were observed in infected tissue as compared to the control in all of the hosts. Wild rice accession O. grandiglumis showed a higher level of biochemical signals than barley cv. NDB 1445 and cultivated rice cv. Pusa Basmati-1. Using two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) and mass spectrometry (MS), differently expressed proteins were also studied in control and after inoculation with R. solani. Wild rice accession O. grandiglumis induced a cysteine protease inhibitor and zinc finger proteins, which have defense functions and resistance against fungal pathogens. On the other hand, barley cv. NDB-1445 and cultivated rice cv. Pusa Basmati-1 mainly induce energy metabolism-related proteins/signals after inoculation with R. solani in comparison to wild rice accession O. grandiglumis. The present comprehensive study of R. solani interaction using three hosts, namely, Pusa Basmati-1 (cultivated rice), O. grandiglumis (wild rice), and NDB-1445 (barley) would interpret wider possibilities in the dissection of the protein(s) induced during the infection process. These proteins may further be correlated to the gene(s) and other related molecular tools that will help for the marker-assisted breeding and/or gene editing for this distressing disease among the major cereal crops. [ABSTRACT FROM AUTHOR]

Appropriate packaging, low temperature and sanitization have immense potential in maintaining postharvest quality of whole green pea pods throughout the supply chain. Untreated green pea pods packed in perforated 38 µm LDPE, 25 µm PP and 25 µm HDPE films were stored at 5, 10, 15°C with 80% ± 5% RH for 12 days. Regular assessment of respiration rates, weight loss, firmness, color change, and biochemical attributes indicated significantly better quality in LDPE bags at 5 ± 1°C with 80% ± 5% RH. The synergistic effect of sanitization using sodium hypochlorite solution (100 ppm/2 min) and aqueous ozone (2 mg L−1/2 min) modified atmosphere packaging (O2:3%–5%, CO2:5%–10%) and low temperature (5°C) on microbial load, weight loss, respiration rate, and total color change was significant at 5% level with a slight change in biochemical attributes along with extended shelf‐life of 16 days as compared to 12 days for tap‐water washed samples. Novelty impact statement: Green pea pods are prone to substantial losses during postharvest handling operations. Sanitization treatments and packaging materials have potential to slow down metabolic activity, reduce rates of respiration and transpiration, prevent induction of spoilage causing bacteria/microorganisms, stimulate the Phenylalanine Ammonia Lyase (PAL) activity, and effectively delay the decay and senescence of vegetables. The present study suggests ozone sanitization, packaging in polymeric pouches and storage under recommended low temperature conditions as promising interventions for retention of the postharvest quality of green pea pods with extended shelf life. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the effect of application of developed electromagnetic field system on freezing characteristics and quality of whole frozen tomato fruit. The system was developed with an electromagnetic field generating apparatus for applying magnetic field in the range of 2.5 mT (0.025 kGauss) and 3.0 mT (0.030 kGauss) in the existing deep freezing system. Freezing experiments were conducted to analyze the freezing curve so as to determine the effect of electromagnetic field on effective freezing time and rate in comparison with ordinary freezing process. Sensory characteristics were evaluated on the basis of visual appearance, texture, and thawing loss after thawing of samples at room temperature. Results indicated that magnetic field resulted in complete freezing of tomato samples in much shorter period of time (220–260 min) as compared to ordinary freezing (1460 min) with prominent lowering of freezing point and extending degree of supercooling. Thawing loss was significantly (p < 0.05) lower for electromagnetically frozen samples. It was 0.02% for the tomato samples frozen under the effect of magnetic field as compared to control (1.73%). Electromagnetically frozen tomato samples exhibited freshness and textural characteristics in terms of hardness of cell structure as close to the fresh samples even upon thawing and thus may represent a veritable means to retain the quality of perishables for longer period of time. Novelty Impact Statement: The application of magnetic field along with the existing freezing method results positively in enhancing the degree of supercooling and helped in reducing the damage to the food products caused by the formation of non‐uniform and larger ice crystals while speeding up the freezing process. The samples frozen with applied magnetic field differed significantly from the samples frozen conventionally in terms of appearance, freshness, and thawing loss. The fast freezing controlled the ice nucleation, decreased the freezing period, and maintained the stability of size, shape, and distribution of ice crystals in the food product. Drip loss was observed to be 1.73% after thawing when tomatoes were frozen without the influence of magnetic field. By the application of magnetic field, it was reduced to 0.02% for the same samples under similar thawing conditions just after the completion of the freezing process. [ABSTRACT FROM AUTHOR]

Depression is associated with hyperactivity of the hypothalamo pituitary adrenal axis. Cortisol is a steroid hormone, released from the adrenal gland and is considered to be a biological marker of stress and anxiety. Serum or plasma cortisol levels have been previously studied in depressive patients but reported contradictory results. The present meta analysis aims to assess the serum or plasma concentration of cortisol in depressive patients compared with controls. We have conducted a systematic review with sequential meta analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Web of Science, PubMed, Scopus, and PsycINFO databases, and published reference lists were searched up to January 2021. We have conducted a systematic review on PubMed for the following search (MeSH) terms ("Hydrocortisone"[Mesh]) AND "Depressive Disorder"[Mesh]). The RevMan 5.3 and Open Meta Analyst software was used with the standard mean difference (SMD) and 95% confidence intervals (CIs). The Jamovi and Open Meta Analyst Software were used to evaluate the publication bias, sensitivity analysis, and meta regression as possible sources of heterogeneity. Seventeen studies having a combined population (n) of 1400 (743 depressive patients and 657 controls) had satisfied the inclusion criteria for serum or plasma cortisol. The pooled SMD of the serum or plasma cortisol levels in depressive patients compared with controls was 1.18, (95% CI: 0.84, 1.52; P < 0.00001) with I2 = 85% (Ph < 0.00001). This meta analysis indicates a statistically significant mean difference in serum or plasma cortisol between depressed patients and controls. Meta analysis concluded that serum or plasma cortisol can differentiate depressed patients from nondepressed controls. [ABSTRACT FROM AUTHOR]

Byline: Dayanand. Hota, Mahesh. Kumar, M. Kavitha, Jaya. Kaushik Atlantoaxial dislocation (AAD) occurs secondary to joint laxity between C1 and C2 vertebrae, resulting in loss of normal articulation and movement. [...]

This paper proposes an advanced Pareto-front non-dominated sorting multi-objective particle swarm optimization (Advanced-PFNDMOPSO) method for optimal configuration (placement and sizing) of distributed generation (DG) in the radial distribution system. The distributed generation consists of single and multiple numbers of active power DG, reactive power DG and simultaneous placement of active-reactive power DG. The optimization problem considers two multi-objective functions, i.e., power loss reduction and voltage stability improvements with voltage profile and power balance as constraints. First, the numerical output results of objective functions are obtained in the Pareto-optimal set. Later, fuzzy decision model is engendered for final selection of the compromised solution. The proposed method is employed and tested on standard IEEE 33 bus systems. Moreover, the results of proposed method are validated with other optimization algorithms as reported by others in the literature. The overall outcome shows that the proposed method for optimal placement and sizing gives higher capability and effectiveness to the final solution. The study also reveals that simultaneous placement of active-reactive power DG reduces more power losses, increases voltage stability and voltage profile of the system.

Retrospective descriptive study reporting the rate of occurrence of cerebral venous sinus thrombosis (CVST), highlighting the role of magnetic resonance imaging (MRI) and magnetic resonance venography (MRV) in patients with presumed idiopathic intracranial hypertension (IIH). Study was conducted in the department of neuro-ophthalmology at a tertiary eye care center in South India. Data from 331 patients diagnosed with IIH from June 2005 to September 2007 was included. Inclusion criteria were: Elevated opening cerebrospinal fluid (CSF) pressure of more than 200 mm of water on lumbar puncture, normal CSF biochemistry and microbiology,and normal neuroimaging as depicted by computed tomography(CT) scan. Exclusion criteria were: Space-occupying lesions, hydrocephalus, meningitis, intracranial pressure within normal range, abnormal CSF biochemistry and microbiology. The remaining patients were evaluated with MRI and MRV. CVST was present in 11.4% of patients who were presumed to have IIH (35/308). MRI alone identified 24 cases (68%) of CVST, while MRI used in combination with MRV revealed an additional 11 cases (32%). Risk factors associated with CVST were identified in nine out of 35 patients (26%). CVST may be misdiagnosed as IIH if prompt neuroimaging by MRI and MRV is not undertaken. Risk factors of CVST may not be apparent in all the cases and these patients are liable to be missed if CT scan alone is used for neuroimaging, hence MRI, combined with MRV should be undertaken to rule out CVST.

Due to their simple synthesis method and excellent properties, such as superior adsorption and regeneration capabilities, with a large surface area and tunable pores, metal-organic frameworks (MOFs) have emerged as a suitable option for wastewater treatment. Although an exponential growth in MOF literature has been observed in recent years, conducting a quantitative literature analysis of MOF application in wastewater treatment is a novelty. To fill this gap, a total of 1187 relevant publications were extracted from the Web of Science, published during the last 50 years, and analyzed using bibliometric and content analysis techniques. A bibliometric analysis was conducted to reveal growing publication trends, leading journals, prolific countries, and organizations; whereas, a content analysis was used to highlight key research themes and hot topics in this field. The analyses revealed that there is a strong international collaboration among authors, countries, and organizations. Chemical Engineering Journal, Journal of Hazardous Materials, and Journal of Environmental Chemical Engineering are the most prolific journals in this field. Furthermore, the use of MOFs for removing antibiotics from wastewater was identified as a recent hot topic. In addition, performance enhancements of MOFs, in terms of a higher adsorption capacity and water stability, were identified as topics of great interest. To cater to these issues, the application of graphene, graphene oxides, nanoparticles, and quantum dots was also observed in the research fronts in this field. [ABSTRACT FROM AUTHOR]

This work explores the effect of latent heat storage on the performance of a passive‐type mixed‐mode greenhouse dryer for groundnuts drying. Experiments were conducted for mixed‐mode greenhouse groundnuts drying (MMGGD), modified mixed‐mode greenhouse groundnuts drying (MMMGGD), and open sun groundnuts drying (OSGD) under the climate of Hisar (India). Average convective heat transfer coefficients for MMGGD, MMMGGD, and OSGD were 0.738, 0.607, and 0.555 W/m2 °C, respectively, and the respective average evaporative heat transfer coefficients were 113.304, 41.483, and 14.266 W/m2 °C. Energy and exergy efficiencies were found higher for MMMGGD, whereas the specific energy consumption was found lower as compared to MMGGD. Statistical analysis has shown the appropriateness of the page model for predicting the thin‐layer drying behavior of groundnuts for MMGGD, MMMGGD, and OSGD. The lower value of energy payback time (4.47 years) and the higher value of CO2 mitigation (953.299 tons) for MMMGGD show the environmental suitability as compared to MMGGD. Practical applications: The present study focuses on the development of drying systems to prevent post‐harvest losses in groundnuts due to moisture and uncontrolled weather conditions. The temperature range of the proposed modified mixed‐mode greenhouse dryer is suitable for drying for most of the agricultural commodities. This drying system can be used for a range of food crops in different small and medium industries. Due to electrical independence, the proposed system seems best suited for small farms and farmers in remote and rural areas. The modified mixed‐mode greenhouse may also be used as a field‐based storage house for grains and freshly harvested crops. [ABSTRACT FROM AUTHOR]

Introduction: Skin disorders are common in paediatric age group and are associated with significant morbidity and stress. These differ from adults in clinical presentation, treatment and prognosis. Data on pattern of paediatric dermatoses can be used in planning healthcare programs. Aim: To study the clinical pattern and prevalence of various skin conditions in paediatric age group in tertiary care centre of rural Haryana, India. Materials and Methods: The present cross-sectional observational study was conducted in Bhagat Phool Singh Government Medical College (W) Khanpur Kalan, Sonepat, Haryana, India. A total of 1,003 consecutive Outpatient Department (OPD) patients upto age of 14 years presenting with skin conditions were included in study from a period May 2021 to January 2022. Various parameters like age, gender, pattern of distribution and type of skin lesions were assessed. Results were entered in excel sheet and frequency, percentages were calculated. Results: Out of 1,003 patients 56.53% were males and 43.47% were females. Maximum number (33.20%) of patients were in the age group of 1-5 years. Scabies (24.12%) was the most reported dermatological condition. Majority of dermatoses belonged to infections (32.40%) and infestations (24.83%) followed by eczemas (17.34%). Bacterial infections (15.25%) were most common infections followed by fungal (10.37%) and viral (6.78%) infections. Conclusion: In the present study, infections and infestations were most common dermatological conditions. This study provides insight about the pattern of various dermatoses among children in rural setting. [ABSTRACT FROM AUTHOR]

Summary: This experimental work discusses the thermo‐enviro‐economic analyses for effect of mass of paraffin wax as phase change material (PCM) on solar distillation in inclined stepped solar still (SSS). Three identically designed SSS units, namely, S1, S2, and S3 respectively, laden with 0.45, 0.90, and 1.35 kg of PCM filled in copper tubes are fabricated and tested at 25 mL/min flow rate. The findings of the experimental study manifested that the performance of SSS unit is significantly improved as the mass of the PCM is increased. The amount of distillate produced by units S1, S2, and S3 are respectively, 1.99, 2.12, and 2.18 kg. The distillate obtained from S3 unit is 8.4% and 2.6% more than S1 and S2 units, respectively. The average values of energy and exergy efficiencies of this unit are evaluated as 31.53% and 2.15%, respectively. This unit is capable to mitigate 8.28 t of CO2 per year which is 7.6% and 2.1% higher than that of units S1 and S2, respectively. Carbon credit earned by units S1, S2 and S3 are respectively, $114.78, $121.58, and $124.23. The carbon credit earned from S3 unit is the highest among tested units which inferred that unit S3 is environmentally friendlier. The total productive cost of environmentally and thermally supreme unit S3 is evaluated as $0.30 which is 6.67% and 3.34% higher than that of S1 and S2 units, respectively. The study shows that the use of PCM in solar distillation has the potential to improve its productivity which helps to eradicate the scarcity of potable water. Highlights: The effect of mass of paraffin wax loading on the performance of stepped solar still is presented.Thermo‐enviro‐economic performance of system is observed to improve with increase in mass of paraffin wax loading.The system loaded with 1.35 kg paraffin wax is found best in environmental conservation and can mitigate 8.28 t CO2 per year.The total productive cost per day of the unit having maximum mass of paraffin wax is $0.30. [ABSTRACT FROM AUTHOR]

We report a rare case of low-grade systemic B-cell non-Hodgkin′s lymphoma (NHL) causing central retinal artery and vein occlusion, which was the only manifestation of disease recurrence. A young man with resolved systemic NHL underwent fluorescein angiography, magnetic resonance imaging and computed tomography to investigate a severe unilateral visual loss. A combined vascular occlusion was observed in the right eye. Neuroimaging detected optic nerve infiltration; but no systemic/ central nervous system involvement was observed. The patient was treated with high-doses of corticosteroids and optic nerve irradiation. The optic neuropathy and vascular occlusion were resistant to treatment. The subsequent neovascular glaucoma was treated by panretinal photocoagulation, which relieved the pain, but vision was not recovered. No further recurrence was observed over the following year.

Purpose: To assess the diagnostic accuracy of forced eyelid closure test (FECT), ice pack test (IPT), repetitive nerve stimulation test (RNS), and acetylcholine receptor (AchR) antibody test in patients with suspected ocular myasthenia. To assess the clinical utility of AchR antibody test in predicting disease progression.Methods: Retrospective cohort study of patients diagnosed with ocular myasthenia at a South-Indian neuro-ophthalmology tertiary eye clinic. Baseline characteristics; ocular myasthenia symptoms; results of FECT, IPT, RNS, and AchR antibody test; and progression time to generalized myasthenia (GM) over 36 months from the time of diagnosis were recorded and analyzed using receiver operator curve analysis, multiple logistic regression, and Kaplan-Meier survival analysis.Results: FECT had a sensitivity of 96.7% (95% CI: 88.5-99.6) and a specificity of 75% (95% CI: 34.9-96.8). Combination of FECT and IPT, using the positivity of at least one test, increased the sensitivity to 98.3% (95% CI: 91-100), reducing the specificity to 50% (95% CI: 15.7-84.3), whereas using the positivity of both tests, we obtained a sensitivity of 71.7% (95% CI: 58.6-82.5) and a specificity of 100% (95% CI: 63.1-100). In the subset of patients with double negative RNS and AchR antibodies, the positive predictive value of combined FECT and IPT (double positive) was 100%. Patients who developed GM were more likely to have a positive AchR antibody test result (P = 0.001).Conclusion: Combined FECT and IPT (double positive) has high diagnostic accuracy even among patients with normal RNS and negative AchR antibodies. Despite low sensitivity, AchR-antibody test has a significant predictive value in disease progression. [ABSTRACT FROM AUTHOR]

Purpose: Previous work on Magnetic Resonance Imaging (MRI) only planning has been applied to limited treatment regions with a focus on male anatomy. This research aimed to validate the use of a hybrid multi-atlas synthetic computed tomography (sCT) generation technique from a MRI, using a female and male atlas, for MRI only radiation therapy treatment planning of rectum, anal canal, cervix and endometrial malignancies. Patients and methods: Forty patients receiving radiation treatment for a range of pelvic malignancies, were separated into male (n = 20) and female (n = 20) cohorts for the creation of gender specific atlases. A multi-atlas local weighted voting method was used to generate a sCT from a T1-weighted VIBE DIXON MRI sequence. The original treatment plans were copied from the CT scan to the corresponding sCT for dosimetric validation. Results: The median percentage dose difference between the treatment plan on the CT and sCT at the ICRU reference point for the male cohort was − 0.4% (IQR of 0 to − 0.6), and − 0.3% (IQR of 0 to − 0.6) for the female cohort. The mean gamma agreement for both cohorts was > 99% for criteria of 3%/2 mm and 2%/2 mm. With dose criteria of 1%/1 mm, the pass rate was higher for the male cohort at 96.3% than the female cohort at 93.4%. MRI to sCT anatomical agreement for bone and body delineated contours was assessed, with a resulting Dice score of 0.91 ± 0.2 (mean ± 1 SD) and 0.97 ± 0.0 for the male cohort respectively; and 0.96 ± 0.0 and 0.98 ± 0.0 for the female cohort respectively. The mean absolute error in Hounsfield units (HUs) within the entire body for the male and female cohorts was 59.1 HU ± 7.2 HU and 53.3 HU ± 8.9 HU respectively. Conclusions: A multi-atlas based method for sCT generation can be applied to a standard T1-weighted MRI sequence for male and female pelvic patients. The implications of this study support MRI only planning being applied more broadly for both male and female pelvic sites. Trial registration This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (www.anzctr.org.au) on 04/10/2017. Trial identifier ACTRN12617001406392. [ABSTRACT FROM AUTHOR]