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Sarah C Miller,1 Prajna Meeralakshmi,2 Michael J Fliotsos,3 Grant A Justin,4 Yoshihiro Yonekawa,5 Ariel Chen,1 Annette K Hoskin,6,7 Richard J Blanch,8– 10 Kara M Cavuoto,11 Rebecca Low,12 Ximin Li,1,13 Matthew Gardiner,14 TY Alvin Liu,1 Ankoor S Shah,14 James D Auran,15 Rupesh Agrawal,12,16– 18 Fasika A Woreta1 On behalf of The International Globe and Adnexal Trauma Epidemiology Study (IGATES)1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA; 2Aravind Eye Hospital, Madurai, India; 3Department of Ophthalmology, Yale New Haven Hospital, New Haven, CT, USA; 4Vitreoretinal Surgery Service, Duke Eye Center, Durham, NC, USA; 5Wills Eye Hospital, Mid Atlantic Retina, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA; 6Save Sight Institute, University of Sydney, Sydney, Australia; 7Lions Eye Institute, University of Western Australia, Perth, Australia; 8Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, England; 9University Hospitals Birmingham, NHS Foundation Trust, Birmingham, England; 10Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, England; 11Bascom Palmer Eye Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA; 12Department of Ophthalmology, Tan Tock Seng Hospital, Singapore, Singapore; 13Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; 14Massachusetts Eye and Ear Infirmary, Boston, MA, USA; 15Columbia University Irving Medical Center, New York City, NY, USA; 16Singapore Eye Research Institute, Singapore; 17Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; 18Duke NUS Medical School, SingaporeCorrespondence: Fasika A Woreta, The Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21205, USA, Tel +410-961-2868, Fax +410-614-9632, Email fworeta1@jhmi.edu Rupesh Agrawal, Department of Ophthalmology, Tan Tock Seng Hospital, Singapore Eye Research Institute, Lee Kong Chian School of Medicine, Nanyang Technological University, Duke NUS Medical School, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore, Tel +6563571000, Email Rupesh_agrawal@ttsh.com.sgPurpose: Hyphema is a sequela of ocular trauma and can be associated with significant morbidity. Management of this condition is variable and can depend on individual institutional guidelines. We aimed to summarize current practices in hyphema management across ophthalmological institutions worldwide.Methods: A cross-sectional online survey was conducted across North America, Asia, South America, Africa, Europe, and Australia from August 2020 to January 2021. The survey assessed the existing practices in the management of hyphema at each institution.Results: For layered hyphema, topical steroids were routinely administered by 34 (of 36 respondents, 94.4%) institutions, of which prednisolone was the preferred choice (n = 32, 88.9%). Topical cycloplegics were used at 34 (94.4%) institutions. No institution reported routine use of antifibrinolytics. Head elevation was the most deployed procedure to promote hyphema reabsorption (n = 31, 86.3%), followed by partial bed rest (n = 21, 58.3%). The majority of institutions (n = 25, 69.4%) did not routinely pursue admission for hyphema patients, although 75.0% of institutions (n = 27) scheduled follow-up visits within 48 hours of presentation. Additionally, few institutions performed routine sickle cell trait testing for patients presenting with hyphema (n = 6, 16.7%). The decision to perform anterior chamber washout varied and was often based on intraocular pressure and the speed of hyphema resolution.Conclusion: Unanimity of international institutions on hyphema management is lacking. As it stands, many current interventions have unconvincing evidence supporting their use. Evidence-based guidelines would be beneficial in guiding decision-making on hyphema management. Additionally, areas of consensus can be used as foundations for future standard of care investigations.Keywords: current practices, hyphema, trauma, sickle cell, anterior segment

In many collaborative systems it is useful to automatically estimate the quality of new contributions; the estimates can be used for instance to flag contributions for review. To predict the quality of a contribution by a user, it is useful to take into account both the characteristics of the revision itself, and the past history of contributions by that user. In several approaches, the user's history is first summarized into a number of features, such as number of contributions, user reputation, time from previous revision, and so forth. These features are then passed along with features of the current revision to a machine-learning classifier, which outputs a prediction for the user contribution. The summarization step is used because the usual machine learning models, such as neural nets, SVMs, etc. rely on a fixed number of input features.We show in this paper that this manual selection of summarization features can be avoided by adopting machine-learning approaches that are able to cope with temporal sequences of input. In particular, we show that Long-Short Term Memory (LSTM) neural nets are able to process directly the variable-length history of a user's activity in the system, and produce an output that is highly predictive of the quality of the next contribution by the user. Our approach does not eliminate the process of feature selection, which is present in all machine learning. Rather, it eliminates the need for deciding which features from a user's past are most useful for predicting the future: we can simply pass to the machine-learning apparatus all the past, and let it come up with an estimate for the quality of the next contribution.We present models combining LSTM and NN for predicting revision quality and show that the prediction accuracy attained is far superior to the one obtained using the NN alone. More interestingly, we also show that the prediction attained is superior to the one obtained using user reputation as a feature summarizing the quality of a user's past work. This can be explained by noting that the primary function of user reputation is to provide an incentive towards performing useful contributions, rather than to be a feature optimized for prediction of future contribution quality. We also show that the LSTM output changes in a natural way in response to user behavior, increasing when the user performs a sequence of good quality contributions, and decreasing when the user performs a sequence of low-quality work. The LSTM output for a user could thus be usefully shown to other users, alongside the user's reputation and other information.

Hui Yi Tan,1 Aniruddha Agarwal,2 Cecilia S Lee,3 Jay Chhablani,4 Vishali Gupta,5 Manoj Khatri,6 Jayabalan Nirmal,7 Carlos Pavesio,8 Rupesh Agrawal1,7–9 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Department of Vitreoretina, Stanley M Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, 3Department of Ophthalmology, University of Washington, Seattle, WA, USA; 4Department of Vitreoretina, L V Prasad Eye Institute, Hyderabad, Telangana, 5Department of Retina and Uvea, Post Graduate Institute of Medical Education and Research, Chandigarh, 6Department of Retina, Rajan Eye Care Hospital, Chennai, Tamil Nadu, India; 7School of Material Science and Engineering, Nanyang Technological University, Singapore; 8Department of Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, UK; 9Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore Abstract: Uveitis is an important cause of vision loss worldwide due to its sight-threatening complications, especially cystoid macular edema, as well as choroidal neovascularization, macular ischemia, cataract, and glaucoma. Systemic corticosteroids are the mainstay of therapy for noninfectious posterior uveitis; however, various systemic side effects can occur. Intravitreal medication achieves a therapeutic level in the vitreous while minimizing systemic complications and is thus used as an exciting alternative. Corticosteroids, antivascular endothelial growth factors, immunomodulators such as methotrexate and sirolimus, and nonsteroidal anti-inflammatory drugs are currently available for intravitreal therapy. This article reviews the existing literature for efficacy and safety of these various options for intravitreal drug therapy for the management of noninfectious uveitis (mainly intermediate, posterior, and panuveitis). Keywords: intravitreal therapy, noninfectious uveitis, posterior uveitis, intravitreal steroids, intravitreal methotrexate

Pearse A Keane,1 Gabriella de Salvo,2 Dawn A Sim,1 Srini Goverdhan,2 Rupesh Agrawal,1 Adnan Tufail1 1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, 2Department of Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, UK Abstract: Treatment of the neovascular form of age-related macular degeneration (AMD) has been revolutionized by the introduction of such agents as ranibizumab, bevacizumab, and aflibercept. As a result, the incidence of legal blindness occurring secondary to AMD has fallen dramatically in recent years in many countries. While these agents have undoubtedly been successful in reducing visual impairment and blindness, patients with neovascular AMD typically lose some vision over time, and often lose the ability to read, drive, or perform other important activities of daily living. Efforts are therefore under way to develop strategies that allow for earlier detection and treatment of this disease. In this review, we begin by providing an overview of the rationale for, and the benefits of, early detection and treatment of neovascular AMD. To achieve this, we begin by providing an overview of the pathophysiology and natural history of choroidal neovascularization, before reviewing the evidence from both clinical trials and “real-world” outcome studies. We continue by highlighting an area that is often overlooked: the importance of patient education and awareness for early AMD detection. We conclude the review by reviewing an array of both established and emerging technologies for early detection of choroidal neovascularization, ranging from Amsler chart testing, to hyperacuity testing, to advanced imaging techniques, such as optical coherence tomography. Keywords: Amsler, detection, choroidal neovascularization, hyperacuity, optical coherence tomography

Background: Carbapenem resistance due to the production of metallo-β -lactamase (MBL) in Gram-negative organism is an increasing public health problem. Aim: The purpose of this study is to detectMBL in Gram Negative bacterial isolates among Ventilator Associated Pneumonia patients. Materials and Methods: Phenotypic detection of MBL was done by three methods: 1.Modified Hodge Test (MHT) 2.Combined disc test (CDT) 3.Double Disc Synergy Test (DDST). Results: Out of 126 gram negative bacterial isolates, 80 (63.49%) showed resistance to carbapenem group of drugs. Among them maximum resistance was shown by Acinetobacter baumanii (90.32%), followed by Klebseilla pneumoniae (45.7%), Pseudomonas aeruginosa (26%). Out of 80 isolates, 66 were positive for MBL by MHT, 64 by CDT and 61 were detected positive for MBL by DDST. Conclusion: MHT and CDT were found equally efficient method to detect MBL. Maximum MBL production was detected in Acinetobacter baumanii. Simple and accurate screening test is required to prevent the spread of nosocomial strain in hospitals.

A retrospective, cross sectional, series of cases were currently studied in the department of ENT-Head &Neck Surgery of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal to find out the distribution of different malignancies in head and neck regions and to identify their treatment modalities during the period of one year from January 2003 to December 2003. Altogether 159 new cases of histopathologically/cytopathologically confirmedmalignancies of head and neck regions and their treatment modalities were analyzed. Out of 159 cases, malignancies of larynx (41), pharynx (31) and oral cavity (30) were found to be the commonest head and neck malignancies where as malignancies of ear (1), and salivary glands (4) were found to be the least common. Likewise surgery with or without radiotherapy and/or chemotherapy was found to be the commonest treatment modality. Of the 159 cases seven were occult primary. As the laryngo-pharyngo-oral malignancies are the commonest malignancies and surgery with or without radiotherapy and/or chemotherapy the commonest treatment modalities for these head and neckmalignancies. Awell equipped head and neck unit is needed at TUTH along with proposed radiotherapy and medical oncology support for better management of these malignancies.

In many collaborative systems it is useful to automatically estimate the quality of new contributions; the estimates can be used for instance to flag contributions for review. To predict the quality of a contribution by a user, it is useful to take into account both the characteristics of the revision itself, and the past history of contributions by that user. In several approaches, the user's history is first summarized into a number of features, such as number of contributions, user reputation, time from previous revision, and so forth. These features are then passed along with features of the current revision to a machine-learning classifier, which outputs a prediction for the user contribution. The summarization step is used because the usual machine learning models, such as neural nets, SVMs, etc. rely on a fixed number of input features.We show in this paper that this manual selection of summarization features can be avoided by adopting machine-learning approaches that are able to cope with temporal sequences of input. In particular, we show that Long-Short Term Memory (LSTM) neural nets are able to process directly the variable-length history of a user's activity in the system, and produce an output that is highly predictive of the quality of the next contribution by the user. Our approach does not eliminate the process of feature selection, which is present in all machine learning. Rather, it eliminates the need for deciding which features from a user's past are most useful for predicting the future: we can simply pass to the machine-learning apparatus all the past, and let it come up with an estimate for the quality of the next contribution.We present models combining LSTM and NN for predicting revision quality and show that the prediction accuracy attained is far superior to the one obtained using the NN alone. More interestingly, we also show that the prediction attained is superior to the one obtained using user reputation as a feature summarizing the quality of a user's past work. This can be explained by noting that the primary function of user reputation is to provide an incentive towards performing useful contributions, rather than to be a feature optimized for prediction of future contribution quality. We also show that the LSTM output changes in a natural way in response to user behavior, increasing when the user performs a sequence of good quality contributions, and decreasing when the user performs a sequence of low-quality work. The LSTM output for a user could thus be usefully shown to other users, alongside the user's reputation and other information.

One dimensional nanostructures, like nanowires and nanotubes, are increasingly being researched for the development of next generation devices like logic gates, transistors, and solar cells. In particular, semiconducting nanowires with a nonsymmetric wurtzitic crystal structure, such as zinc oxide (ZnO) and gallium nitride (GaN), have drawn immense research interests due to their electromechanical coupling. The designing of the future nanowire-based devices requires component-level characterization of individual nanowires. In this paper, we present a unique experimental set-up to characterize the mechanical and electromechanical behaviour of individual nanowires. Using this set-up and complementary atomistic simulations, mechanical properties of ZnO nanowires and electromechanical properties of GaN nanowires were investigated. In ZnO nanowires, elastic modulus was found to depend on nanowire diameter decreasing from 190 GPa to 140 GPa as the wire diameter increased from 5 nm to 80 nm. Inconsistent failure mechanisms were observed in ZnO nanowires. Experiments revealed a brittle fracture, whereas simulations using a pairwise potential predicted a phase transformation prior to failure. This inconsistency is addressed in detail from an experimental as well as computational perspective. Lastly, in addition to mechanical properties, preliminary results on the electromechanical properties of gallium nitride nanowires are also reported. Initial investigations reveal that the piezoresistive and piezoelectric behaviour of nanowires is different from bulk gallium nitride.

Detection and separation of the subtle post-seismic deformation signals associated with moderate magnitude earthquakes from interferometric synthetic aperture radar (InSAR) time-series is often challenging. Singular spectrum analysis (SSA) is a statistical non‐parametric technique used to decompose and reconstruct signals from complex time-series data. We show that the SSA analysis effectively distinguished the post-seismic signal associated with the 2019 M w 6 Mirpur earthquake from periodic and noise components. The SSA-derived post-seismic deformation signal is smoother and fits better to an exponential model with a decay time of 34 d. The post-seismic deformation is confined to the southeast of the rupture area and lasted for ∼90 d following the main shock. Inversion of the post-seismic deformation suggests an afterslip mechanism with a maximum slip of ∼0.07 m on the shallow, updip portions of the Main Himalayan Thrust. The 2019 Mirpur earthquake and afterslip together released less than 12 per cent of the accumulated strain energy since the 1555 Kashmir earthquake and implies continued seismic hazard in the future. [ABSTRACT FROM AUTHOR]