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Thomas M Aaberg Jr,1 Robert W Cook,2 Kristen Oelschlager,2 Derek Maetzold,2 P Kumar Rao,3 John O Mason III41Michigan State University Medical School and Retina Specialists of Michigan, Grand Rapids, MI, 2Castle Biosciences, Friendswood, TX, 3Washington University School of Medicine in St Louis, St Louis, MO, 4Retina Consultants of Alabama and University of Alabama Birmingham, Birmingham, AL, USA Objective: Assess current clinical practices for uveal melanoma (UM) and the impact of molecular prognostic testing on treatment decisions.Design: Cross-sectional survey and sequential medical records review.Participants: Ophthalmologists who treat UM.Methods: (A) Medical records review of all Medicare beneficiaries tested by UM gene expression profile in 2012, conducted under an institutional review board-approved protocol. (B) 109 ophthalmologists specializing in the treatment of UM were invited to participate in 24-question survey in 2012; 72 were invited to participate in a 23-question survey in 2014.Main outcome measures: Responses analyzed by descriptive statistics, frequency analyses (percentages, Tukey, histograms), and Fisher’s exact test. Descriptive presentation of essay answers.Results: The review of Medicare medical records included 191 evaluable patients, 88 (46%) with documented medical treatment actions or institutional policies related to surveillance plans. Of these 88, all gene expression profiling (GEP) Class 1 UM patients were treated with low-intensity surveillance. All GEP Class 2 UM patients were treated with high-intensity surveillance (P

Polymer and ceramic-based composites offer a unique blend of desirable traits for improving dielectric permittivity. This study employs an empirical approach to estimate the dielectric permittivity of composite materials and uses a finite element model to understand the effects of permittivity and filler concentration on mechanical and electrical properties. The empirical model combines the Maxwell-Wagner-Sillars (MWS) and Bruggeman models to estimate the effective permittivity using Barium Titanate (BT) and Calcium Copper Titanate Oxide (CCTO) as ceramic fillers dispersed in a Polydimethylsiloxane (PDMS) polymer matrix. Results indicate that the permittivity of the composite improves with increased filler content, with CCTO/PDMS emerging as the superior combination for capacitive applications. Capacitance and energy storage in the CCTO/PDMS composite material reached 900 nF and 450 nJ, respectively, with increased filler content. Additionally, increased pressure on the capacitive model with varied filler content showed promising effects on mechanical properties. The interaction between BT filler and the polymer matrix significantly altered the electrical properties of the model, primarily depending on the composite's permittivity. This study provides comprehensive insights into the effects of varied filler concentrations on estimating mechanical and electrical properties, aiding in the development of real-world pressure-based capacitive models.

BackgroundRetinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a rare, autosomal dominant, universally fatal disease without effective treatment options. This study explores the safety and preliminary efficacy of crizanlizumab, a humanized monoclonal antibody against P-selectin approved for the prevention of sickle cell crises, in slowing retinal nonperfusion and preserving vision in patients with RVCL-S.METHODSEleven patients with RVCL-S with confirmed exonuclease 3 prime repair exonuclease 1 (TREX1) mutations received monthly crizanlizumab infusions over 2 years. The study measured the nonperfusion index within 3 retinal zones and the total retina with fluorescein angiography, visual acuity, intraocular pressure (IOP), and optical coherence tomography central subfield thickness (CST) at baseline, 1 year, and 2 years. A mixed repeated-measures analysis was performed to assess the progression rates and changes from baseline.RESULTSEleven participants received crizanlizumab infusions. All of the participants tolerated crizanlizumab well, with 8 of 11 (72.7%) reporting mild adverse effects such as nausea, fatigue, and gastrointestinal symptoms. The change in total retinal nonperfusion was 7.22% [4.47, 9.97] in year 1 and -0.69% [-4.06, 2.68] in year 2 (P < 0.001). In the mid periphery, the change in nonperfusion was 10.6% [5.1, 16.1] in year 1 and -0.68% [-3.98, 5.35] in year 2 (P < 0.01), demonstrating a reduction in progression of nonperfusion in the second year of treatment. Visual acuity, IOP, and CST remained stable.CONCLUSIONCrizanlizumab has an acceptable safety profile. These results show promising potential for examining crizanlizumab in larger studies of RVCL-S and similar small-vessel diseases and for using the retina as a biomarker for systemic disease.Trial registrationClinicalTrials.gov NCT04611880.FUNDINGThe Clayco Foundation; DeNardo Education and Research Foundation Grant; Jeffrey T. Fort Innovation Fund; Siteman Retina Research Fund; unrestricted grant from Research to Prevent Blindness Inc.; National Heart,Lung, and Blood Institute (NHLBI), NIH (R01HL129241); National Institute of Neurological Disorders and Stroke (NINDS), NIH (RF1NS116565).

Background: The clinical profile varies in patients with Wilson's disease (WD). There is paucity of data regarding adult and pediatric patients with hepatic WD., Methods: As many as 140 consecutive patients diagnosed with hepatic WD between December 2006 and January 2021 were included in the study. Data was collected regarding the demographic parameters, clinical presentation, extrahepatic organ involvement, liver histology and laboratory investigations. Adult and children (0-14 years) with hepatic WD were compared regarding these features., Result: Eighty-eight adults and 52 children were included in the study. The median age of presentation was 17 years (range: 1.1-42 years). Male preponderance was seen (adult 68/88, 69%; children 40/52, 77%). Adults as compared to children presented more commonly as cirrhosis (52/88 vs. 15/52, p = 0.0005) and with hepatic decompensation (35/88 vs. 9/52, p = 0.005). Presentation with acute-on-chronic liver failure (ACLF) was more common in children (10/52 vs. 2/88, p = 0.0005). Twenty-eight-day mortality was 50% (5/10) in children and none in adults presenting with ACLF. Nazer's Prognostic Index (≥ 7) and New Wilson Index were more accurate in predicting mortality among children with ACLF with AUROC 1, while AARC (APASL ACLF Research Consortium) was less accurate with AUROC 0.45. Liver histology findings were similar in adults and children. Extrahepatic involvement was also similar. (8/88 in adults vs. 3/52 children, p value 0.48)., Conclusion: Most patients with WD present as cirrhosis in adulthood. ACLF is more common in children. Nazer's prognostic index and new Wilson Index score are accurate in predicting mortality in children with ACLF., (© 2024. Indian Society of Gastroenterology.)

Objective: To describe and quantify the structural and functional consequences of retinal vasculopathy with cerebral leukoencephalopathy (RVCL) on the neurosensory retina., Design: Cross sectional descriptive study from December 2021 to December 2022., Participants: Retinal vasculopathy with cerebral leukoencephalopathy patients (n = 9, 18 eyes) recruited from the RVCL Research Center at Washington University in St. Louis., Methods: Retinal vasculopathy with cerebral leukoencephalopathy patients underwent comprehensive ophthalmological evaluation including OCT, OCT angiography (OCTA), ultrawidefield fundus imaging, retinal autofluorescence, dark adaptation, electroretinography (ERG), Goldmann kinetic perimetry, and fluorescein angiography (FA)., Main Outcome Measures: Comprehensive characterization from various modalities including best-corrected visual acuity, central subfield thickness (μm) from OCT, foveal avascular zone (mm 2 ) from OCTA, dark adaptation rod intercept (seconds), cone response in ERG, and presence or absence of vascular abnormalities, leakage, neovascularization, and nonperfusion on FA., Results: A total of 18 eyes from 9 individuals were included in this study. The best-corrected visual acuity ranged from 20/15 to 20/70. The mean central subfield thickness from OCT was 275.8 μm (range, 217-488 μm). The mean foveal avascular zone (FAZ) from OCTA was 0.65 (range, 0.18-1.76) mm 2 . On dark adaptometry, the mean time was 5.02 (range, 2.9-6.5) minutes, and 1 individual had impaired dark adaptation. Electroretinography demonstrated mild cone response impairment in 4 eyes. On FA, there was evidence of macular and peripheral capillary nonperfusion in 16 of 18 eyes and notable areas of vascular leakage and retinal edema in 5 of the 18 eyes., Conclusions: This study illustrates the phenotypic spectrum of disease and may be clinically valuable for aiding diagnosis, monitoring disease progression, and further elucidating the pathophysiology of RVCL to aid in the development of therapies., Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (Copyright © 2023 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Kidney tumors represent a significant medical challenge, characterized by their often-asymptomatic nature and the need for early detection to facilitate timely and effective intervention. Although neural networks have shown great promise in disease prediction, their computational demands have limited their practicality in clinical settings. This study introduces a novel methodology, the UNet-PWP architecture, tailored explicitly for kidney tumor segmentation, designed to optimize resource utilization and overcome computational complexity constraints. A key novelty in our approach is the application of adaptive partitioning, which deconstructs the intricate UNet architecture into smaller submodels. This partitioning strategy reduces computational requirements and enhances the model's efficiency in processing kidney tumor images. Additionally, we augment the UNet's depth by incorporating pre-trained weights, therefore significantly boosting its capacity to handle intricate and detailed segmentation tasks. Furthermore, we employ weight-pruning techniques to eliminate redundant zero-weighted parameters, further streamlining the UNet-PWP model without compromising its performance. To rigorously assess the effectiveness of our proposed UNet-PWP model, we conducted a comparative evaluation alongside the DeepLab V3+ model, both trained on the "KiTs 19, 21, and 23" kidney tumor dataset. Our results are optimistic, with the UNet-PWP model achieving an exceptional accuracy rate of 97.01% on both the training and test datasets, surpassing the DeepLab V3+ model in performance. Furthermore, to ensure our model's results are easily understandable and explainable. We included a fusion of the attention and Grad-CAM XAI methods. This approach provides valuable insights into the decision-making process of our model and the regions of interest that affect its predictions. In the medical field, this interpretability aspect is crucial for healthcare professionals to trust and comprehend the model's reasoning.

Aim and Objective: Tobacco can alter the antioxidative capacity of saliva, and it is the first fluid that is exposed to tobacco. Superoxide dismutase (SOD) is the first line defense antioxidant that plays an important protective role against peroxidation of lipids, converts superoxide radicals into hydrogen peroxide, and decreases the toxic effects of free radicals. The aim of this study was to estimate and compare the levels and activity of SOD in the saliva of smokeless tobacco (SLT) consumers and non-consumers., Method and Methodology: Total of 64 individuals were divided into two groups (study and control) with 32 patients each. The patients were divided into two groups-Group I: 32 healthy individuals who do not consume SLT (control group) and Group II: 32 individuals who consume SLT for a period more than 1 year (study group). Saliva samples were collected for analysis from both the groups., Results: The results of this study showed that antioxidant salivary SOD enzyme activity in tobacco chewers is higher in comparison to non-chewers., Conclusion: The present study enlightens us to the possible relationship between SOD enzyme levels, oxidative stress, and tobacco habit. In initial or early stages, antioxidant levels increase, thereby showing an evidence of endogenous activity. But as the duration of the habit increases, there is decrease in the body's defense mechanism, and the level of SOD starts to fall resulting in oral lesions. This will help in establishing the reliability of SOD in saliva as a potential biomarker of oxidative stress in tobacco chewers. Further, it may also help in establishing the role of oxidative stress in the pathogenesis of premalignant lesions and oral cancer.

Chronic Kidney Disease (CKD) represents a considerable global health challenge, emphasizing the need for precise and prompt prediction of disease progression to enable early intervention and enhance patient outcomes. As per this study, we introduce an innovative fusion deep learning model that combines a Graph Neural Network (GNN) and a tabular data model for predicting CKD progression by capitalizing on the strengths of both graph-structured and tabular data representations. The GNN model processes graph-structured data, uncovering intricate relationships between patients and their medical conditions, while the tabular data model adeptly manages patient-specific features within a conventional data format. An extensive comparison of the fusion model, GNN model, tabular data model, and a baseline model was conducted utilizing various evaluation metrics, encompassing accuracy, precision, recall, and F1-score. The fusion model exhibited outstanding performance across all metrics, underlining its augmented capacity for predicting CKD progression. The GNN model's performance closely trailed the fusion model, accentuating the advantages of integrating graph-structured data into the prediction process. Hyperparameter optimization was performed using grid search, ensuring a fair comparison among the models. The fusion model displayed consistent performance across diverse data splits, demonstrating its adaptability to dataset variations and resilience against noise and outliers. In conclusion, the proposed fusion deep learning model, which amalgamates the capabilities of both the GNN model and the tabular data model, substantially surpasses the individual models and the baseline model in predicting CKD progression. This pioneering approach provides a more precise and dependable method for early detection and management of CKD, highlighting its potential to advance the domain of precision medicine and elevate patient care.

The ongoing Russia-Ukraine war is the most prominent conflict in Europe since the Second World War and has several geopolitical, economic, infrastructure, and health implications. The war has serious negative consequences on people and the planet. The damage to industrial and commercial infrastructure can contaminate water sources, which can be hazardous for human and ecosystem health. Water shortages and deteriorating sanitary conditions are already evident since water supply and sanitary infrastructure have been hit. Air quality is adversely affected due to troop movement and constant bombarding. Chances of radiation leakage from nuclear sites also remain. The physical, chemical and biological characteristics of soil have been impacted due to shelling and explosions, as a result of which, agriculture has been severely affected. Military actions have caused large-scale deforestation and even wildfires. There is also fear of biodiversity loss and species extinction in the long term. The war of such nature may directly hamper efforts to deal with aspects such as climate change, sustainable development goals (SDGs), conservation and protection of biodiversity, and pollution control at local and global levels. Besides this, the repercussions of this war on essential services such as healthcare, education, social security, and public amenities will be felt for a long. As a result of important interruptions in the supply of energy and raw materials throughout the world, prices for commodities, oil, and food have risen dramatically. To avert such damages in the future and make the offenders accountable, in the long term, reforms in the mandate of the International Criminal Court are required to include environmental crimes. New international norms to safeguard the environment during conflict are urgently needed. The environment should not be considered an unavoidable war casualty. Environmental and human security are inextricably linked. The international community's reaction to the crisis must include addressing this as a priority., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Almost all effective treatments for non-alcoholic fatty liver disease (NAFLD) involve reduction of adiposity, which suggests the metabolic axis between liver and adipose tissue is essential to NAFLD development. Since excessive dietary sugar intake may be an initiating factor for NAFLD, we have characterized the metabolic effects of liquid sucrose intake at concentrations relevant to typical human consumption in mice. We report that sucrose intake induces sexually dimorphic effects in liver, adipose tissue, and the microbiome; differences concordant with steatosis severity. We show that when steatosis is decoupled from impairments in insulin responsiveness, sex is a moderating factor that influences sucrose-driven lipid storage and the contribution of de novo fatty acid synthesis to the overall hepatic triglyceride pool. Our findings provide physiologic insight into how sex influences the regulation of adipose-liver crosstalk and highlight the importance of extrahepatic metabolism in the pathogenesis of diet-induced steatosis and NAFLD., (© 2022. The Author(s).)

Purpose: The treatment paradigm for patients with anorectal melanoma eligible for sphincter-sparing excision has evolved over time. This study examines outcomes across a 30-year era in this rare disease with poor prognosis., Methods and Materials: This retrospective cohort study included all patients with pelvis-confined anorectal melanoma undergoing sphincter-sparing local excision and adjuvant radiation therapy (RT) at our institution between 1989 and 2020. Patterns of care and predictors of outcome were evaluated., Results: Of the 108 patients included, 92 (85%) presented with clinically uninvolved nodes. For clinically node-negative patients, the sentinel lymph node biopsy rate increased from 18/43 (42%) before 2008 to 38/49 (78%) subsequently and the use of inguinal nodal RT decreased from 33/35 (94%) before 2003 to 1/57 (2%) subsequently. All clinically node-positive patients treated before 2003 received inguinal nodal RT, whereas no node-positive patient treated subsequently received this treatment. Patients treated before 2016 mostly received biochemotherapy, and those treated since 2017 mostly received immune checkpoint inhibitors. With median follow-up of 32 months, 77 patients (71%) recurred. Three-year actuarial outcomes were 84% local control, 64% nodal control, 38% distant metastasis-free survival, 30% disease-free survival, and 51% melanoma-specific survival. Ostomy-free survival at last follow-up was 95%. Factors contributing to outcome were identified. Outcomes for patients treated in the contemporary era (2017+) were not significantly better than those treated earlier., Conclusions: Sphincter-sparing surgery followed by adjuvant RT results in excellent local control and ostomy-free survival for locally resectable anorectal melanoma. Overall oncologic outcomes continue to be poor, reinforcing the need to identify more effective therapies., (Copyright © 2022 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)

Background: Accurate semantic segmentation of kidney tumors in computed tomography (CT) images is difficult because tumors feature varied forms and occasionally, look alike. The KiTs19 challenge sets the groundwork for future advances in kidney tumor segmentation., Methods: We present weight pruning (WP)-UNet, a deep network model that is lightweight with a small scale; it involves few parameters with a quick assumption time and a low floating-point computational complexity., Results: We trained and evaluated the model with CT images from 210 patients. The findings implied the dominance of our method on the training Dice score (0.98) for the kidney tumor region. The proposed model only uses 1,297,441 parameters and 7.2e floating-point operations, three times lower than those for other network models., Conclusions: The results confirm that the proposed architecture is smaller than that of UNet, involves less computational complexity, and yields good accuracy, indicating its potential applicability in kidney tumor imaging., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Medical Signals & Sensors.)

Purpose: To determine whether the addition of adjunctive tests, including immunohistochemistry (IHC), cytokine analysis, flow cytometry, and IgH gene rearrangement testing, achieves improved diagnostic parameters compared with cytologic smears alone in the detection of vitreoretinal lymphoma (VRL). To determine which of these tests or combination of tests provide the greatest diagnostic utility., Design: Retrospective review to assess diagnostic value., Methods: This single university-affiliated tertiary care center study included data from 237 vitreous biopsies performed between 1999 and 2017 in patients with suspected VRL. From 1999 to 2008-2009, cytologic smears were the sole test performed (84 cases). The protocol initiated in 2008-2009 added the 4 additional diagnostic tests (153 cases). The sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and diagnostic yield were calculated. Parameters were calculated for tests individually, for all 5 combined, and all possible 2-, 3-, and 4-test combinations. For cytologic smears, diagnostic parameters were calculated both before and after the addition of adjunctive tests to our protocol and for the entire cohort., Results: Of the 237 vitreous biopsies, 50 samples (21%) were from patients with confirmed central nervous system lymphoma and/or actively treated central nervous system, systemic, or intraocular lymphoma. Diagnostic yields (95% CI) were 90% (85%-93%) for smears, 82% (72%-89%) for IHC, 91% (85%-96%) for cytokine analysis, 76% (67%-84%) for IgH gene rearrangement, and 50% (40%-60%) for flow cytometry. For smears, the sensitivity pre-protocol was 73% (39%-94%), compared with 87% (69%-96%) post-protocol. IgH gene rearrangement was the only test exhibiting low sensitivity (40%). The combination of smears, IHC, and cytokine analysis exhibited the highest diagnostic parameters, with sensitivity 92%, specificity 98%, and diagnostic yield 100%., Conclusions: The combination of cytologic smears, IHC, and cytokine analysis seems to be a reasonable and sufficient protocol for the diagnosis of suspected VRL. IgH gene rearrangement and flow cytometry may be the most expendable tests from our protocol., (Copyright © 2021 Elsevier Inc. All rights reserved.)

BACKGROUND AND OBJECTIVE: There are limited data on the adverse events of D-penicillamine in Wilson's disease (WD) that can result in dose modification or treatment discontinuation. The objective of this study was to observe the adverse events related to D-penicillamine in patients with hepatic WD., Methods: A retrospective audit of prospectively registered hepatic WD patients at a tertiary care center between December 2006 and January 2020 was carried out. Demographic variables, laboratory parameters, and details of treatment were noted. Adverse events (AEs) related to D-penicillamine treatment, the timing and management of these AEs were analysed., Results: The study included 112 patients with hepatic WD on D-penicillamine. D-penicillamine intolerance was seen in 28/112 (25%) over 179 person-years. Of the 28 AEs, severe AEs leading to permanent D-penicillamine discontinuation occurred in 16 (57%) [never reintroduced 12 (43%), discontinued after intolerant to rechallenge, 4 (14%)], temporary cessation followed by reintroduction to initial dose 13 (46%) and continuation with reduced dose in 3 (11%) patients. Overall, most common AEs were hematological [16, 57% (pancytopenia n = 8, bicytopenia n = 5 and hemolytic anemia n = 3)] while renal adverse events (n = 7, 25%) constituted the most common indication for permanent discontinuation. Cytopenias developed beyond 12 months of D-penicillamine initiation whereas hemolytic anemia developed within first 3 months. Following D-penicillamine discontinuation in 25 patients, it was reintroduced to initial dose in 13/25 (52%), switched to trientine due to neurological worsening in 2/25 (8%) and switched to zinc in 10/25 (40%). In patients with reintroduction, gradual dose escalation was tolerated in 9/13 (69%) with a recurrence of AEs leading to permanent discontinuation in 4/13 (31%)., Conclusion: D-penicillamine treatment is associated with significant AEs mainly related to blood, kidney, and skin. Temporary cessation of drug with reintroduction at a lower dose is an effective and safe option., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Aim: To evaluate differences in microparticle profiles in vitreous samples between diabetic and non-diabetic eyes undergoing vitrectomy., Methods: Un-masked cross-sectional series of 34 eyes undergoing vitrectomy. Vitreous specimens were collected and processed to evaluate for membrane integrity (DAPI), apoptosis (Annexin-V), and endothelial-cell origin (V-Cadherin). A BD LSR II flow cytometer was used for analysis and standardized sub-micron-sized beads were used for size comparison., Results: Thirty-four specimens underwent analysis. Greater levels of Annexin-V were found on microparticles from specimens in which blood had entered the vitreous ( n =12) compared to those without blood ( n =22; 52.3%±30.7% vs 19.6%±27.2%, P =0.002). Patients with diabetes having surgery with hemorrhage ( n =7) had greater expression of Annexin-V than those without hemorrhage ( n =8; 62.1%±31.7% vs 18.9%±20.9%, P =0.009). However, in patients with non-diabetic vitreous hemorrhage, the level of Annexin-V expression was not significantly different compared to other disease processes (38.6%±25.7%, n =5 vs 20.0%±30.9%, n =14, P =0.087)., Conclusion: Increased expression of the apoptotic marker, Annexin-V is detected on vitreous microparticles in diabetes-related vitreous hemorrhage. When evaluating vitreous hemorrhage in patients without diabetes, the apoptotic signal is not significantly different. Vitrectomy in patients with diabetes, and improvement in visual outcomes, may be related to the removal of a serum-derived, pro-apoptotic vitreous. Further investigation is warranted in order to identify the molecular characteristics of microparticles that regulate disease., (International Journal of Ophthalmology Press.)

Background and Aim: The COVID pandemic and countrywide lockdown has had significant impact on patients with inflammatory bowel disease (IBD), with delay in diagnosis, difficulty in access to healthcare and unavailability of drugs. We conducted a telephonic survey to assess this impact., Methods: Out of 350, 302 participated in the survey. Demographic data, disease severity at the time of survey, extent of disease, details of therapy, and adherence were noted. A validated questionnaire addressing information source, perception of COVID-19 situation, contact with healthcare, and adherence to standard precautions was administered telephonically., Results: Out of 350 contacted patients, 302 (86.28%) patients participated in the survey. Median age of cohort was 39 years. Ulcerative colitis (UC) constituted 79%, 16% Crohn's disease (CD), and 5% IBD-unclassified. At the time of survey, 86.98% patients with UC were in clinical remission and 75.75% of CD patients were generally well. A total of 115 (38%) cases were nonadherent to therapy due to unavailability of medicines (66.38%), financial constraints (25.21%) and inability to reach healthcare facility (3.6%). Disease flare was seen in 14.2% and correlated well with nonadherence. Existing drug therapy was switched to alternative drug in 70 (23.17%) cases due to unavailability (74%). Social media (52.3%) and television (40.4%) were the common sources of information about the pandemic. Telemedicine platforms (WhatsApp and telephone) were used by 180 (59.6%) patients for consultation with good acceptance (81.6%). 87 (28.8%) patients failed to contact healthcare. Apprehension regarding severe COVID infection was noted in 80% while 29% thought that IBD therapy could increase infection risk. Adherence to wearing mask, hand washing, and social distancing was 100%., Conclusion: Pandemic resulted in disruption of healthcare visits and medication supply. Majority were concerned about increased risk of COVID-19 infection and adhered to standard precautions. Mobile phone-based formats for patient care may be an alternative due to patient acceptance and convenience., (© 2022 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Irreversible blindness resulting from retinal or optic nerve diseases continues to devastate patients. The use of stem cell technology to reverse blindness promises great individual and societal benefit. Stem cell therapies seek to replace or enhance the function of damaged tissues. Currently, there are no FDA approved and commercially available products in this arena. Numerous clinical trials are underway, but as of today, we are still awaiting rigorous study data. Meanwhile, physicians and patients are desperate to restore vision and are lured to clinics claiming success. It remains our duty to vet these claims and guide our patients with their best interests in mind., Competing Interests: Disclosure This work was supported by an unrestricted grant to the John F. Hardesty MD Department of Ophthalmology and Visual Sciences from Research to Prevent Blindness., (Copyright 2022 by the Missouri State Medical Association.)