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Simple Summary: Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. Genetic alterations promote cancer development and its spread to distant sites. Medications that counteract the effects of these alterations/mutations, called targeted therapies, are used to treat CRC. Immunotherapy, another class of medications that promotes immune system mediated recognition and destruction of cancer cells, is used for treatment of a small subset of CRC patients. Here we review the current state of knowledge and ongoing research into biomarkers, targeted therapy, and immunotherapy for CRC treatment. Colorectal cancer (CRC) is the second leading cause of cancer deaths worldwide. Although the overall incidence of CRC is decreasing, the incidence of young-onset CRC, characterized by a diagnosis of CRC before age 50, is increasing. Outcomes for CRC patients are improving, partly due to comprehensive molecular characterization of tumors and novel therapeutic strategies. Advances in genomic and transcriptomic analyses using blood- and tumor-tissue-based sequencing have facilitated identification of distinct tumor subtypes harboring unique biological characteristics and therapeutic vulnerabilities. These insights have led to the development and incorporation of targeted therapies and immunotherapy in CRC treatment. In this review, we discuss the molecular landscape and key oncogenes/tumor suppressors contributing to CRC tumorigenesis, metastasis, and therapeutic resistance. We also discuss personalized therapeutic strategies for subsets of CRC patients and provide an overview of evolving novel treatments being evaluated in clinical trials. [ABSTRACT FROM AUTHOR]

Background Facet-mediated pain is a major cause of low back pain and as a result, is a significant cause of morbidity, including disability and reduced functionality. Setting The present investigation involved a PubMed literature review between June 1, and 2021-January 1, 2022. Methods We systematically reviewed was carried Pubmed using the search terms "platelet-rich plasma", "inflammatory mediators", "facet arthropathy", "axial back pain", and "leukoreduction". Data extraction and quality assessment were performed by 3 independent reviewers. Out of the studies analyzed 2 were retrospective, while 1 was a prospective study. Results PRP injections for facet mediated or modulated pain are an alternative to conventional pharmacotherapies and interventional injections/radiofrequency. There are limited numbers of studies in world literature at present. Limitations Small number of articles in the world literature and small numbers of patients in those published studies. Conclusions At present, there are limited studies in the literature; however, larger well-designed studies are warranted to precisely understand efficacy, potential side effects and best practice techniques for PRP injections for facet mediated or modulated pain. [ABSTRACT FROM AUTHOR]

Background: The use of ≥30 mL/Kg fluid bolus in congestive heart failure (CHF) patients presenting with severe sepsis or septic shock remained controversial due to the paucity of data. Methods: The retrospective case-control study included 671 adult patients who presented to the emergency department of a tertiary care hospital from January 01, 2017 to December 31, 2019 with severe sepsis or septic shock. Patients were categorized into the CHF group and the non-CHF group. The primary outcome was to evaluate the compliance with ≥30 mL/Kg fluid bolus within 6 hours of presentation. The comparison of baseline characteristics and secondary outcomes were done between the groups who received ≥30 mL/Kg fluid bolus. For the subgroup analysis of the CHF group, it was divided based on if they received ≥30 mL/Kg fluid bolus or not, and comparison was done for baseline characteristics and secondary outcomes. Univariate and multivariable analyses were performed to explore the differences between the groups for in-hospital mortality and mechanical ventilation. Results: The use of ≥30 mL/Kg fluid bolus was low in both the CHF and non-CHF groups [39% vs. 66% (p<0.05)]. Mortality was higher in the CHF group [33% vs 18% (p<0.05)]. Multivariable analysis revealed that the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 12% [OR 0.88, 95% CI 0.82–0.95 (p<0.05)]. The use of ≥30 mL/Kg fluid bolus did not increase the odds of mechanical ventilation [OR 0.99, 95% CI 0.93–1.05 (p = 0.78)]. In subgroup analysis, the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 5% [OR 0.95, 95% CI 0.90–0.99, (p<0.05)] and did not increase the odds of mechanical ventilation. The presence of the low ejection fraction did not influence the chance of getting fluid bolus. Conclusion: The use of ≥30 mL/Kg fluid bolus seems to confer protection against in-hospital mortality and is not associated with increased chances of mechanical ventilation in heart failure patients presenting with severe sepsis or septic shock. [ABSTRACT FROM AUTHOR]

Alopecia areata (AA) is a highly prevalent autoimmune disease that attacks the hair follicle and leads to hair loss that can range from small patches to complete loss of scalp and body hair. Our previous linkage and genome‐wide association studies (GWAS) generated strong evidence for aetiological contributions from inherited genetic variants at different population frequencies, including both rare mutations and common polymorphisms. Additionally, we conducted gene expression (GE) studies on scalp biopsies of 96 patients and controls to establish signatures of active disease. In this study, we performed an integrative analysis on these two datasets to test the hypothesis that rare CNVs in patients with AA could be leveraged to identify drivers of disease in our AA GE signatures. We analysed copy number variants (CNVs) in a case‐control cohort of 673 patients with AA and 16 311 controls independent of the case‐control cohort of 96 research participants used in our GE study. Using an integrative computational analysis, we identified 14 genes whose expression levels were altered by CNVs in a consistent direction of effect, corresponding to gene expression changes in lesional skin of patients. Four of these genes were affected by CNVs in three or more unrelated patients with AA, including ATG4B and SMARCA2, which are involved in autophagy and chromatin remodelling, respectively. Our findings identified new classes of genes with potential contributions to AA pathogenesis. [ABSTRACT FROM AUTHOR]

Background Serum hemagglutination inhibition (HAI) and microneutralization (MN) antibodies are often used as a correlate of protection for influenza. However, these manual assays are labor-intensive and difficult to standardize due to variability in biologic reagents used and subjective interpretation of the results. Methods Sera with known HAI and MN titers were used to assess a novel test based on the inhibition of fluorescence ‘dequenching’. Whole influenza virions (A/California/07/2009 (H1N1), A/Hong Kong/4801/2014 (H3N2) and B/Brisbane/60/2008) labelled with 1,1′-dioctadecyl-3,3,3′,3′-tetramethylindodicarbocyanine perchlorate (DiD) were exposed to serial dilutions of serum and mixed with turkey red blood cells followed by acidification of the media (pH 5.0–5.5). The H1N1 and B/Brisbane strains were high hemagglutinating while the H3N2 strain had low hemagglutinating activity. In some experiments, labelled virions were subjected to repetitive freeze-thaw cycles prior to use in the assay. Results In the absence of detectable HAI/MN antibodies, there were consistent and substantial increases from baseline DiD fluorescence upon acidification. Sera with known high titer HAI/MN antibodies reduced or completely prevented DiD dequenching at low dilutions with progressive increases in fluorescence at higher dilutions, which permitted a reproducible assignment of an antibody ‘titer’ based on baseline and acidified DiD fluorescence values. The ‘titers’ measured by the DiD dequenching assay were highly correlated with HAI/MN results for the H1N1 and B strains (Spearman’s correlation coefficients (r s ) 0.874 to 0.946, p < 10 −7 to 10 −35 ). Correlations with HAI/MN titres for the low-hemagglutinating H3N2 strain tested were lower but remained statistically significant (r s 0.547–0.551, p < 0.004). Freeze-thawing of the DiD pre-stained virus stocks had no significant impact on the results of the assay. Conclusions The DiD dequenching assay may be a labour-saving and more objective alternative to the classic serologies. This novel assay could theoretically be standardized across laboratories using pre-stained virions and has the potential to be fully automated. [ABSTRACT FROM AUTHOR]

Liquid nanoemulsions are shown to transform into viscoelastic gels by reducing droplet size, increasing interfacial repulsive barrier between the nanodroplets and therefore increasing the effective oil volume fraction. The repulsive gelation in nanoemulsions can be achieved at a significantly lower oil volume fraction compared to conventional emulsion gels, making the nanoemulsion gel an attractive material for various low-fat food applications. Gelation in nanoemulsions stabilized by anionic small molecule emulsifier and polymeric protein are compared in terms of gel strength, average droplet size, effective oil volume fraction, and long-term gel stability. It is expected that higher stability and large surface area of nanoscale droplet size can further extend the application of nanoemulsion gels in the field of functional foods, cosmetics and pharmaceuticals. [ABSTRACT FROM AUTHOR]

Background: With the variability in health insurance coverage for psoriasis systemic therapies, recent changes in coverage for biologics have yet to be evaluated. Purpose: To determine changes in insurance coverage of biologics for moderate-to-severe psoriasis between 2009 and 2014, with a focus on insurance policies as stated in prior authorization (PA) forms, coverage denials, and time course of approval process. Methods: A retrospective chart review was performed on patients with a diagnosis of psoriasis ( International Classification of Diseases [ICD], Ninth Edition, code ICD 696.1) seen at the Department of Dermatology, Medical Faculty Associates, George Washington University between January 1, 2009 and December 31, 2014. Exclusion criteria included <9 % body surface area, loss to follow-up, lack of biologic treatment, biologic treatment via a clinical trial, and lack of health insurance. For all other patients, metrics collected included age, sex, body surface area, health insurance plan, prior therapies, prescribed biologic, PA necessity, time in days between PA submission and coverage decision, and denial justifications. Results: Eight hundred and sixty-four patients with a diagnosis of psoriasis within the time period were identified, 114 of who met the inclusion criteria. PA requirement increased from 16 % of patients prescribed a biologic in 2009 to 75 % of patients prescribed a biologic in 2014. The mean duration in days between PA submission and coverage decision from the insurance company increased from 3.7 days in 2009 to 6.7 days in 2014. PA denial rates increased from 0 % in 2009 to 19 % in 2014. The most common reason for coverage denial was failure to attempt alternative therapies prior to requesting biologics. Conclusion: Insurance coverage of biologics for moderate-to-severe plaque psoriasis has become increasingly regulated between 2009 and 2014. Given both the cost burden and potential benefits of these therapies, further examination of healthcare coverage and treatment accessibility is warranted for optimal patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The primary aim was to develop convolutional neural network (CNN)‐based artificial intelligence (AI) models for pneumothorax classification and segmentation for automated chest X‐ray (CXR) triaging. A secondary aim was to perform interpretability analysis on the best‐performing candidate model to determine whether the model's predictions were susceptible to bias or confounding. Method: A CANDID‐PTX dataset, that included 19,237 anonymized and manually labelled CXRs, was used for training and testing candidate models for pneumothorax classification and segmentation. Evaluation metrics for classification performance included Area under the receiver operating characteristic curve (AUC‐ROC), sensitivity and specificity, whilst segmentation performance was measured using mean Dice and true‐positive (TP)‐Dice coefficients. Interpretability analysis was performed using Grad‐CAM heatmaps. Finally, the best‐performing model was implemented for a triage simulation. Results: The best‐performing model demonstrated a sensitivity of 0.93, specificity of 0.95 and AUC‐ROC of 0.94 in identifying the presence of pneumothorax. A TP‐Dice coefficient of 0.69 is given for segmentation performance. In triage simulation, mean reporting delay for pneumothorax‐containing CXRs is reduced from 9.8 ± 2 days to 1.0 ± 0.5 days (P‐value < 0.001 at 5% significance level), with sensitivity 0.95 and specificity of 0.95 given for the classification performance. Finally, interpretability analysis demonstrated models employed logic understandable to radiologists, with negligible bias or confounding in predictions. Conclusion: AI models can automate pneumothorax detection with clinically acceptable accuracy, and potentially reduce reporting delays for urgent findings when implemented as triaging tools. [ABSTRACT FROM AUTHOR]

• SOM applied to classify 1188 cluster datasets to identify dominant influences. • Two data assemblies found, traced to monodisperse and non-monodisperse systems. • Variables like particle properties and operating conditions had lesser influence. • Non-monodisperse systems gave distinctly smaller clusters than monodisperse ones. The clustering phenomenon is an important characteristic of fluidized bed systems, so much attention has been given to understanding such unstable, transient features through both experiments and simulations. A review has pointed out that, because of the interplay of multiple factors, relationships are at times unclear even within the same study. For such non-linear and multi-dimensional problems, machine learning tools are proficient. In this study, self-organizing map (SOM) analysis was harnessed to classify 1188 circulating fluidized bed (CFB) riser cluster datasets of Geldart Group B particles into potential smaller data assemblies, in order to determine the key influence(s) responsible for the demarcation. Two distinct data assemblies were identified, with one constituted by the monodisperse particle systems (i.e., three narrow particle size distributions (PSDs)), while the other by the non-monodisperse particle systems (i.e., two binary mixtures and one broad PSD). Specifically, the clusters formed by the non-monodisperse systems were distinctively smaller than those of monodisperse ones. This suggests that multiple particle types hindered the growth of clusters, which has been tied to hydrodynamic screening, unequal charging and unequal damping effects that are unique to particle mixtures. More studies are needed to unveil the underlying mechanisms of such different clusters between the monodisperse versus non-monodisperse particle systems. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand how masculinity and race impact mental health among Black male graduate students. A qualitative study using in-depth interviews recruited Black male graduate students enrolled at a private university in the southern United States. Data were collected over zoom and recorded. Interviews were transcribed and the data were analyzed for similar themes. Twenty-nine Black male graduate students 23 to 51 were recruited. Participants reported the three main elements that impacted their mental health were (1) expectations, (2) pressure, and (3) being strong. These findings suggest that colleges need to develop programming to help Black men learn how to handle racial discrimination in positive ways. Additionally, findings also highlight the need for culturally relevant mental health services that let Black men know seeking help is ok and is what men do. [ABSTRACT FROM AUTHOR]

Background: The data on the COVID-19 patients who were discharged to self-quarantine is lacking. Aim: The aim of the study was to investigate the percentage of COVID-19 positive patients that were hospitalized within a three-week period after discharge from ED to self-quarantine. Methods: The patients who had confirmed SARS-CoV-2 on RT-PCR of the nasopharyngeal swab and were discharged from ED of a tertiary care hospital in the USA to self-quarantine from March 01- July 31, 2020, were included. Patients were divided into two groups based on serum albumin levels and were followed up for three weeks to see if low level of albumin increased the risk of hospitalization. Univariate and multivariate logistic regression analyses were performed to study the effect of albumin level and outcomes. Results: A total of 112 patients were included in the study out of which 65 had low serum albumin (<3.5 g/dL) and 47 had normal serum albumin (≥3.5 g/dL). More than 10% of patients discharged to self-quarantine needed hospitalization within three weeks. The Low albumin group had more co-morbidities at baseline. The low serum albumin group had 10 (15.38%) vs 2 (4.26%), p = 0.06 hospitalizations as compared to the normal serum albumin group. The multivariate logistic regression analysis did not reveal lower odds of hospitalization in the group with normal albumin, (OR 0.26, 95% CI 0.03–1.92, p = 0.19) after controlling for age, sex, and various co-morbidities. Conclusion: The low serum albumin was not associated with the risk of hospitalization in COVID-19 patients who were initially discharged to self-quarantine. [ABSTRACT FROM AUTHOR]

This document is a correction notice for a study titled "Low serum albumin and the risk of hospitalization in COVID-19 infection: A retrospective case-control study." The correction states that the eighth author's name was spelled incorrectly and provides the correct spelling as Macelyn Batten. The correct citation for the study is also provided. The document is published in PLoS ONE and is open access. [Extracted from the article]

[Display omitted] The scarcity of drinking water is a worldwide major issue in the current scenario. Using the solar still, an abundantly available saline water can be desalinated to obtain drinking water. However, solar still faces the issue of low productivity. The area of contact between the absorber plate of the solar still and the saline/impure water plays a crucial role in the evaporation of saline/impure water to obtain distilled water. The modifications in the geometry of the absorber plate is one of the enhancement techniques to improve the productivity of solar still. In the article, the impact of the fins integrated absorber plate, use of baffles, use of corrugated and stepped absorber plate was reviewed on the productivity of solar still. The effect of geometrical parameters of fins, baffles, steps and corrugations has also been reviewed. The use of fins on absorber plate reduces the thermal resistant to heat flow and distributes the heat along the water depth. The use of fins and baffles reduces the preheating time of saline water. The use of corrugated and stepped absorber plates increases the exposure area for the absorption of solar energy and the contact area among the absorber plate and saline water. For the same mass of saline water, the use of fins was observed better than the use of corrugation. Whereas for the same depth of water, the use of corrugation was observed better than the use of fins. The summary of results of the latest state-of-art-of literature on modification in the geometry of absorber plates is presented in tabular form. The discussion on comparative study among the various configuration of geometrical modification, key findings, and the scope of future scope is presented at the end of the article. [ABSTRACT FROM AUTHOR]

B Introduction/Hypothesis: b Activated partial thromboplastin times and heparin-calibrated anti-Xa levels are used to monitor unfractionated heparin infusions. B Results: b Fifty-nine patients were included in each study group with similar baseline characteristics, except for the higher utilization of an increased bleeding risk heparin infusion protocol in the evaluation group (23.7% vs 6.8%; p=0.01). [Extracted from the article]

For conjugated HIV-1 fusion peptide vaccine development, recombinant Tetanus toxoid heavy chain fragment C (rTTHC) was applied as a carrier protein to boost peptide immunogenicity. Understanding the characteristics of rTTHC is the first step prior to the peptide conjugation. A comprehensive mass spectrometry (MS) characterization was performed on E. coli expressed rTTHC during its purification process. Intact mass along with peptide mapping analysis discovered the existence of three cysteine modification forms: glutathionylation, trisulfide bond modification, and disulfide bond shuffling, in correlation to a three-peak profile during a hydrophobic interaction chromatography (HIC) purification step. Coexistence of these multiple oxidative forms indicated that the active thiols underwent redox reaction in the rTTHC material. Identity confirmation of the rTTHC carrier protein by MS analysis provided pivotal guidance to assess the purification step and helped ensure that vaccine development could proceed. [ABSTRACT FROM AUTHOR]

Objective. The performance of a novel unobtrusive system based on capacitively-coupled electrocardiography (ccECG) combined with different respiratory measurements is evaluated for the detection of sleep apnea. Approach. A sleep apnea detection algorithm is proposed, which can be applied to electrocardiography (ECG) and ccECG, combined with different unobtrusive respiratory measurements, including ECG derived respiration (EDR), respiratory effort measured using the thoracic belt (TB) and capacitively-coupled bioimpedance (ccBioz). Several ECG, respiratory and cardiorespiratory features were defined, of which the most relevant ones were identified using a random forest based backwards wrapper. Using this relevant feature set, a least-squares support vector machine classifier was trained to decide if a one minute segment is apneic or not, based on the annotated polysomnography (PSG) data of 218 patients suspected of having sleep apnea. The obtained classifier was then tested on the PSG and capacitively-coupled data of 28 different patients. Main results. On the PSG data, an AUC of 76.3% was obtained when the ECG was combined with the EDR. Replacing the EDR with the TB led to an AUC of 80.0%. Using the ccECG and ccBioz or the ccECG and TB resulted in similar performances as on the PSG data, while using the ccECG and ccECG-based EDR resulted in a drop in AUC to 67.4%. Significance. This is the first study which tests an apnea detection algorithm on capacitively-coupled ECG and bioimpedance signals and shows promising results on the capacitively-coupled data set. However, it was shown that the EDR could not be accurately estimated from the ccECG signals. Further research into the effect that respiration has on the ccECG is needed to propose alternative EDR estimates. [ABSTRACT FROM AUTHOR]

Abstract Background Needle-free vaccine delivery systems have many potential advantages including increased vaccine compliance and decreased risk of needlestick injuries and syringe reuse. The Med-Jet® H4 is a gas-powered, auto-disabling disposable syringe jet injector. The Med-Jet family of products are currently being used in dermatology, podiatry, pain management and veterinary practices. The objectives of this study were to assess patient attitudes, time-efficiency, safety and immunogenicity of the seasonal influenza vaccine delivered by Med-Jet compared to the traditional needle-and-syringe. Methods A total of 80 patients were randomized 2:1:1 to receive a commercial trivalent vaccine by Med-Jet or needle injection from a single-dose or multi-dose vial. Patient attitudes were assessed pre-randomization and post-immunization. Safety data were collected for 21 days post-immunization. Efficiency of vaccine administration was measured through a time-and-motion study. Humoral and cellular responses were assessed on Days 0 and 21. Results Overall, the participants readily accepted Med-Jet vaccination despite greater frequency of transient local reactions (eg: redness, swelling) immediately following immunization. Vaccine administration took slightly longer with the Med-Jet, but this difference decreased over time. Geometric mean hemagglutination inhibition titers, seroconversion and seroprotection rates in the Med-Jet and needle groups were equivalent for all influenza strains in the vaccine. Microneutralization responses were also essentially identical. There were no significant differences between the groups in the frequency of functional CD4 + T cells, memory subset distribution or poly-functionality. Conclusions These data suggest that the Med-Jet is an acceptable means of delivering seasonal influenza vaccine. The system was attractive to subjects, rapidly learned by skilled vaccine nurses and elicited both humoral and cellular responses that were indistinguishable from those elicited with needle injection. While other studies have assessed the humoral response to jet injection of influenza vaccine, to our knowledge, this study is the first to assess the cellular aspect of this response. (ClinTrials.gov -NCT03150537). [ABSTRACT FROM AUTHOR]

Purpose: Current release assays have inadequate temporal resolution ( ∼ 10 s) to characterise temperature sensitive liposomes (TSL) designed for intravascular triggered drug release, where release within the first few seconds is relevant for drug delivery. Materials and methods: We developed a novel release assay based on a millifluidic device. A 500 µm capillary tube was heated by a temperature-controlled Peltier element. A TSL solution encapsulating a fluorescent compound was pumped through the tube, producing a fluorescence gradient along the tube due to TSL release. Release kinetics were measured by analysing fluorescence images of the tube. We measured three TSL formulations: traditional TSL (DPPC:DSPC:DSPE-PEF2000,80:15:5), MSPC-LTSL (DPPC:MSPC:DSPE-PEG2000,85:10:5) and MPPC-LTSL (DPPC:MMPC:PEF2000,86:10:4). TSL were loaded with either carboxyfluorescein (CF), Calcein, tetramethylrhodamine (TMR) or doxorubicin (Dox). TSL were diluted in one of the four buffers: phosphate buffered saline (PBS), 10% bovine serum albumin (BSA) solution, foetal bovine serum (FBS) or human plasma. Release was measured between 37-45 °C. Results: The millifluidic device allowed measurement of release kinetics within the first few seconds at ∼5 ms temporal resolution. Dox had the fastest release and highest release %, followed by CF, Calcein and TMR. Of the four buffers, release was fastest in human plasma, followed by FBS, BSA and PBS. Conclusions: The millifluidic device allows measurement of TSL release at unprecedented temporal resolution, thus allowing adequate characterisation of TSL release at time scales relevant for intravascular triggered drug release. The type of buffer and encapsulated compound significantly affect release kinetics and need to be considered when designing and evaluating novel TSL-drug combinations. [ABSTRACT FROM AUTHOR]

Objective: Healthcare-related frustrations (HRFs) are common occurrences in patient-provider interactions. Little is known about HRFs experienced by individuals with chronic conditions. The purposes of this study were to: 1) identify the frequency of six HRFs among adults with chronic conditions; 2) assess factors associated with these HRFs; and 3) examine factors associated with multiple HRFs.Methods: Data were analyzed from 589 middle-aged and older adults with 1+ chronic conditions. A series of logistic regression models were fitted to identify factors associated with each frustration, and an ordinal regression model was fitted to identify factors associated with increasing frustrations.Results: Participants reported at least two of the six HRFs. The most commonly reported HRFs included feeling tired of describing the same condition (46%) and wishing their doctor had more time to speak with them during visits (44%). Having functional limitations (Beta=0.58, P=0.004), reporting more self-care barriers (Beta=0.41, P<0.001), visiting a physician more frequently (P<0.05), and having less support (Beta=-0.64, P=0.013) were associated with increasing HRFs.Conclusion: Reducing HRFs may improve patient-provider interactions, chronic disease management, and patients' overall quality of life.Practice Implications: Care coordination, communication and cultural competency training, and a review of materials may help address these frustrations. [ABSTRACT FROM AUTHOR]

Background: Ocular disorders are often neglected in children. At the school going age. They find difficulties in their day to day activities. Refractive Error affects a large proportion of school going children. This can be easily diagnosed and corrected with spectacles. If not corrected, they become a major cause of low vision or even blindness. In India, children younger than 15 years constitute about 42% of the population and out of it 30% lose their eyesight partially due to amblyopia before the age of 20 years. So we have selected this study. Methodology: This was a cross sectional study. The study was conducted in Dhiraj Hospital & Eye camps for school children during November 2014 to October 2015. We have examined 350 children. We have used snellen's distant vision chart, torch light, direct ophthalmoscope and ishihara's colour vision chart in the camps. We referred children who needed detailed examination to Dhiraj hospital where we did cycloplegic refraction. They were examined with auto refractometer, direct and indirect ophthalmoscopy and they were called for Post mydriatic test and also for follow up of other ocular disorders. Results: Our study was conducted in schools of Vadodra district and in Eye Opd of Dhiraj Genral hospital attached with SBKS MIRC pipariya , dist. Vadodara in Gujarat state. We have examined 350 children and done their complete follow up. We found refractive error in 130 (37.14%) in children. Amongst them Refractive error -130 and other disorders like Lacrimal sac disorder - 6, Meibomian gland dysfunction (MGD) - 9, Conjunctivitis- 12 , amblyopia -3 ,squint -1, Others (Normal)- 189. P value was significant in case of refractive error. Conclusion: Ocular disorders in school going children vary from place to place, mal nutrition, lack of attendance from parents & teachers on their complains of eye disorders, in some areas where treatment facility in private or government set up is not available so their problems are neglected. Climate condition also play significant role. The present study indicates that the school age is a high risk group for developing refractive errors. Most of the children were unaware of their problem. Thus prevalence of undetected refractive error was more. Allergic conjunctivitis was another issue of concern. More studies, resources and manpower are needed to detect uncorrected refractive error and achieve the goal of vision 2020. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) patients would strongly benefit from comfortable home diagnosis, during which detection of wakefulness is essential. Therefore, capacitively-coupled electrocardiogram (ccECG) and bioimpedance (ccBioZ) sensors were used to record the sleep of suspected OSA patients, in parallel with polysomnography (PSG). The three objectives were quality assessment of the unobtrusive signals during sleep, prediction of sleep–wake using ccECG and ccBioZ, and detection of high-risk OSA patients. First, signal quality indicators (SQIs) determined the data coverage of ccECG and ccBioZ. Then, a multimodal convolutional neural network (CNN) for sleep–wake prediction was tested on these preprocessed ccECG and ccBioZ data. Finally, two indices derived from this prediction detected patients at risk. The data included 187 PSG recordings of suspected OSA patients, 36 (dataset "Test") of which were recorded simultaneously with PSG, ccECG, and ccBioZ. As a result, two improvements were made compared to prior studies. First, the ccBioZ signal coverage increased significantly due to adaptation of the acquisition system. Secondly, the utility of the sleep–wake classifier increased as it became a unimodal network only requiring respiratory input. This was achieved by using data augmentation during training. Sleep–wake prediction on "Test" using PSG respiration resulted in a Cohen's kappa (κ) of 0.39 and using ccBioZ in κ = 0.23. The OSA risk model identified severe OSA patients with a κ of 0.61 for PSG respiration and κ of 0.39 using ccBioZ (accuracy of 80.6% and 69.4%, respectively). This study is one of the first to perform sleep–wake staging on capacitively-coupled respiratory signals in suspected OSA patients and to detect high risk OSA patients based on ccBioZ. The technology and the proposed framework could be applied in multi-night follow-up of OSA patients. [ABSTRACT FROM AUTHOR]

Summary Systemic Lupus Erythematosus (SLE) is characterized by B cells lacking IgD and CD27 (double negative; DN). We show that DN cell expansions reflected a subset of CXCR5- CD11c+ cells (DN2) representing pre-plasma cells (PC). DN2 cells predominated in African-American patients with active disease and nephritis, anti-Smith and anti-RNA autoantibodies. They expressed a T-bet transcriptional network; increased Toll-like receptor-7 (TLR7); lacked the negative TLR regulator TRAF5; and were hyper-responsive to TLR7. DN2 cells shared with activated naive cells (aNAV), phenotypic and functional features, and similar transcriptomes. Their PC differentiation and autoantibody production was driven by TLR7 in an interleukin-21 (IL-21)-mediated fashion. An in vivo developmental link between aNAV, DN2 cells, and PC was demonstrated by clonal sharing. This study defines a distinct differentiation fate of autoreactive naive B cells into PC precursors with hyper-responsiveness to innate stimuli, as well as establishes prominence of extra-follicular B cell activation in SLE, and identifies therapeutic targets. Graphical Abstract Highlights • Autoreactive CD27- IgD- CXCR5- CD11c+ (DN2) B cells expand in lupus patients • DN2 cells derive from naive cells and are poised to generate plasmablasts • DN2 B cells are hyper-responsive to Toll-like receptor-7 signaling • The properties of SLE DN2 B cells stem from distinct transcriptional networks The role of extrafollicular B cells in human systemic lupus is unknown. Jenks et al. define the main components of this pathway and its prominence in severe disease. Its activation is mediated by hyper-responsiveness to Toll-like receptor-7 and leads to the generation of autoreactive antibody-secreting plasmablasts. [ABSTRACT FROM AUTHOR]