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Hip replacement surgery can be painful; postoperative analgesia is crucial for comfort and to facilitate recovery. Regional anaesthesia can reduce pain and postoperative opioid requirements. The role of ultrasound-guided suprainguinal fascia iliaca block for analgesia after elective total hip arthroplasty is not well defined. This randomised trial evaluated its analgesic efficacy. Consenting participants (134) scheduled for elective primary total hip arthroplasty under spinal anaesthesia were randomly allocated to receive ultrasound-guided fascia iliaca block with ropivacaine 0.5% or sham block with saline. The primary outcome was opioid consumption in the first 24 h after surgery. Additional outcomes included pain scores at 4, 8, 12, and 16 h, opioid-related side-effects (nausea, vomiting, pruritis), ability to perform physiotherapy on the first postoperative day, and physiotherapist-assessed quadriceps weakness. There were no significant differences in 24-h opioid consumption (block vs sham block, mean difference −3.2 mg oral morphine equivalent, 95% confidence interval −15.3 to 8.1 mg oral morphine equivalent, P =0.55) or any other prespecified outcomes. In patients undergoing primary total hip arthroplasty, ultrasound-guided suprainguinal fascia iliaca block with ropivacaine did not confer a significant opioid-sparing effect compared with sham block. There were no differences in other secondary outcomes including pain scores, opioid-related side-effects, or ability to perform physiotherapy on the first postoperative day. www.clinicaltrials.gov (NCT03069183). [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine predictive factors for low final visual acuity in patients with inactive Vogt-Koyanagi-Harada (VKH) disease using Swept-source OCT and OCT-angiography (OCT-A). Methods: We conducted a prospective longitudinal study, including 21 patients (42 eyes), who were followed up for the first 24 months after disease onset. Patients were included at the acute phase and subsequently treated. Sequential qualitative and quantitative changes in OCT and OCT-A were assessed. Analytical statistical methods were employed to determine predictive factors for final visual acuity. Results: Structural alterations including focal parafoveal outer nuclear layer atrophy, ellipsoid zone disruption, interdigitation zone disruption, and irregular and thickened retinal pigment epithelium line were observed in 57.1% of eyes at month 3, with no significant improvement over time. The presence of flow voids at months 6, 12, and 24 was significantly associated with low final visual acuity. Serous retnal detachment at presentation emerged as an independent risk factor for structural changes detected by SS-OCT during the first 2 years of the disease. Optic disc edema was predictive factor for both structural SS-OCT and OCT-A changes. Conclusion: This study underscores the importance of monitoring flow voids to predict final visual acuity and highlights the impact of serous retinal detachment at presentation on structural changes in patients with inactive VKH disease. [ABSTRACT FROM AUTHOR]

New GeV-scale dark forces coupling predominantly to quarks offer novel signatures that can be produced directly and searched for at high-luminosity colliders. We compute the photon-proton and electron-proton cross sections for producing a GeV-scale gauge boson arising from a U(1)B gauge symmetry. Our calculation relies on vector meson dominance and a phenomenological model for diffractive scattering used for vector-meson photoproduction. The parameters of our phenomenological model are fixed by performing a Markov Chain Monte Carlo fit to existing exclusive photoproduction data for ω and ϕ mesons. Our approach can be generalized to other GeV-scale dark gauge forces. [ABSTRACT FROM AUTHOR]

The Internet of Things (IoT) is prone to malware assaults due to its simple installation and autonomous operating qualities. IoT devices have become the most tempting targets of malware due to well-known vulnerabilities such as weak, guessable, or hard-coded passwords, a lack of secure update procedures, and unsecured network connections. Traditional static IoT malware detection and analysis methods have been shown to be unsatisfactory solutions to understanding IoT malware behavior for mitigation and prevention. Deep learning models have made huge strides in the realm of cybersecurity in recent years, thanks to their tremendous data mining, learning, and expression capabilities, thus easing the burden on malware analysts. In this context, a novel detection and multi-classification vision-based approach for IoT-malware is proposed. This approach makes use of the benefits of deep transfer learning methodology and incorporates the fine-tuning method and various ensembling strategies to increase detection and classification performance without having to develop the training models from scratch. It adopts the fusion of 3 CNNs, ResNet18, MobileNetV2, and DenseNet161, by using the random forest voting strategy. Experiments are carried out using a publicly available dataset, MaleVis, to assess and validate the suggested approach. MaleVis contains 14,226 RGB converted images representing 25 malware classes and one benign class. The obtained findings show that our suggested approach outperforms the existing state-of-the-art solutions in terms of detection and classification performance; it achieves a precision of 98.74%, recall of 98.67%, a specificity of 98.79%, F1-score of 98.70%, MCC of 98.65%, an accuracy of 98.68%, and an average processing time per malware classification of 672 ms. [ABSTRACT FROM AUTHOR]

We investigate the rich stereochemistry of cocaine and its diastereoisomers from a theoretical perspective using density functional theory. The relative stability of the eight considered isomers is discussed, and a comparison of the corresponding internal coordinates is given. Our results reveal that the S-pseudococaine isomer is the most stable conformation, whereas the natural occurring isomer (R-cocaine) lies higher in energy. The different isomers' chemical reactivity is discussed based on the calculation of the hardness, softness, electrophilicity and dipole moment. It was found that the dipole moment varies over a broad range from 0.65 to 4.60 D, whereas the other properties are slightly modified. The solvent effect on the energy stability of the cocaine isomers was studied by considering chloroform, dimethyl-sulfoxide (DMSO) and water as implicit solvents. Our calculations show that the different isomers' energy order and their energy gaps are slightly modified due to solvent effects. However, in all cases, the S-pseudococaine remains the most stable isomer. However, the dipole moment and the chemical reactivity of the cocaine isomers increase with the solvent polarity. [ABSTRACT FROM AUTHOR]

To assess the effects of exposure to Cd and Zn on rat testicular development, offspring, from mothers receiving either tap water, Cd, Zn or Cd + Zn during gestation and lactation periods, were observed on gestational day (GD) 20 and on postnatal days (PND) 12, 21 and 35. During gestation, Cd induced maternal hypozincemia and less transfer of Zn to the fetus. During lactation, progressive Cd accumulation and Zn depletion in testis at PND12 and PND21 were noted. An increase of abnormal seminiferous tubules and a decrease in testis weight and plasmatic testosterone concentration were also observed at PND21 and PND35 respectively. Interestingly, Zn supply induced a significant protection against Cd toxicity. These results suggest that the toxic effects of Cd observed during development are mediated by the disruption of Zn metabolism, which is established in mothers during pregnancy causing Zn deficiency in fetuses and continues to become more pronounced during lactation. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence of lipid profile on foveal avascular central zone (ACZ) using Swept Source Optical Coherence Tomography Angiography (SS‐OCT A). Methods: A cross‐sectional, comparative study including 30 eyes of 15 volunteers with no history of ocular disease or surgery was conducted in the department of ophthalmology of Habib Thameur University Hospital, Tunis. SS‐OCT A imaging was performed using the DRI‐OCT Triton (Topcon, Japan). The macula was imaged using 3 × 3 mm scans, and superficial retinal OCT angiograms were extracted and analysed. Foveal ACZ was characterized by its perimeter, its area, its circularity, the aspect ratio (AR), the roundness index (Round), the solidity and the Feret's diameter (Feret). Patients with dyslipemia were compared to a control group using the Mann–Whitney U‐test and the degree of correlation between two variables was expressed as the Spearman's correlation coefficient. Results: Eleven males and four females were included in the study. Sixteen eyes of eight patients (53.3%) with dyslipemia were compared to fourteen eyes of 7 healthy controls (46.7%). Mean age was 53.33 ± 9.73 years. Mean total ACZ measurements were: Perimeter (2.63 ± 0.53), Area (3.98 ± 1.49), Circularity (7.07 ± 0.97), AR (1.23 ± 0.23), Round (8.32 ± 1.18), Solidity (8.86 ± 0.41) and Feret (6.53 ± 3.24). Comparative study revealed that ACZ area was higher in the dyslipemia group than in the control group (4.64 vs. 3.31, p = 0.02). There was no significant difference between the two groups in the other measurements of ACZ. Conclusions: Dyslipemia causes enlargement of the foveal avascular central zone without affecting its form. These results suggest that dyslipemia may affect foveal vascular structure potentially through chronic ischemia mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: To study the variation of retinal and choroidal density in patients with essential hypertension using Swept Source Optical Coherence Tomography Angiography (SS‐OCT A). Methods: Prospective cross‐sectional study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis between June, 1st 2021 and March, 30th 2022. Fifteen volunteer healthy patients (30 eyes) were included. All patients underwent complete ophthalmic examination, measurements of resting systolic and diastolic blood pressure and 3 × 3 and 4.5 × 4.5 SS‐OCT A angiograms in both eyes. Perimeter of avascular central zone (ACZ), superficial retinal plexus density (SRPD), deep retinal plexus density (DRPC) and choriocapillaris capillary vessel density (CVD) were calculated on exported jpg format images using the Fiji Software. Comparative Mann Whitney and Spearman tests were performed using 21.0 SPSS. Results: Eleven males and four females were eligible for the study. Mean age was 53.33 ± 9.73 years. Eight patients (53.3%) with chronic essential hypertension were compared to seven healthy volunteers (46.7%). Mean ACZ, SRPD, DRPD and CVD were respectively 2.62 ± 0.52 mm, 13.20 ± 2.10%, 17.14 ± 1.17% and 51.05 ± 0.85%. Mean systolic blood pressure was 13 ± 5 mmHg and mean diastolic blood pressure was 7.67 ± 5.16 mmHg. CVD was lower in patients with chronic hypertension than in the control group (50.59 vs 51.41, p = 0.047). There were no significant differences between hypertension group and normal group in ACZ, SRPD and DRPC measurements (p = 0.089, p = 0.90 and p = 0.70, respectively). No correlations were found between resting blood pressure values and ACZ measurements. Conclusions: Chronic hypertension does not affect retinal vessels and capillaries quantitative parameters. However, it may alter choroidal vascular structures by decreasing choriocapillaris vessel density. Larger studies are needed to strengthen these results. [ABSTRACT FROM AUTHOR]

Purpose: To describe restoration of outer retinal layers on Swept‐Source OCT (SS OCT) in Vogt Koyanagi Harada (VKH) disease over a year after the disease onset. Methods: Prospective longitudinal study carried out at the department of Ophthalmology of Fattouma Bourguiba University Hospital of Monastir. Twenty‐one patients (42 eyes) were followed‐up for 12 months after the disease onset. The patients were included at the acute phase and subsequently treated. Sequential SS OCT changes were assessed. Results: Structural SS OCT changes occurred in 24 eyes (57.1%) on month 3 (M3), in 23 eyes (54.8%) on month 6 (M6), and in 19 eyes (45.2%) on month 12 (M12). They included external nuclear layer atrophy (14.3% on M3; 11.9% on M6; and 9.5% on M12); ellipsoid zone disruption (40.5% on M3; 38.1% on M6; and 33.3% on M12); interdigitation zone disruption (42.9% on M3; 40.5% on M6; and 33.3% on M12); and multifocal retinal pigment epithelium thickening (50% on M3; 45.2% on M6; and 31% on M12). No significant association between final visual acuity and external retinal layers alterations at any stage of the study was found. Stepwise analysis showed that the presence of serous retinal detachment at presentation was an independent factor for structural SS OCT changes on M3. Conclusions: After initial onset, SS OCT shows thinning of the outer nuclear layer, disruption of the ellipsoid and interdigitation zones, and multifocal retinal pigment epithelium thickening. Serous retinal detachment at presentation is an independent factor for structural SS OCT changes during the first year of the disease. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of active cigarette smoking on retinal and choroidal micro‐vascularization using Swept Source Optical Coherence Tomography Angiography (SS‐OCT A). Methods: This is a cross‐sectional, observational, comparative study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis. Twelve eyes of "healthy" smokers, 10 eyes of former smokers (less than 3 years after quitting smoking) and 6 eyes of healthy non‐smokers controls were included. SS‐OCT A 3 × 3 mm angiograms were exported and analysed with image J, Fiji Software. Perimeter of avascular central zone (ACZ), superficial retinal plexus density (SRPD), deep retinal plexus density (DRPC) and choriocapillaris capillary vessel density (CVD) were calculated and analysed. Comparative Kruskal Wallis and Spearman tests were performed using 21.0 SPSS. Results: Volunteers with a smoking history had an average of 13.75 ± 10.26 pack‐years. The mean smoking period was 3.2 ± 5.13 years and mean smoking cessation period was 1.28 ± 0.85 years. Mean ACZ, SRPD, DRPD and CVD were respectively 2.62 ± 0.52 mm, 13.20 ± 2.10%, 17.14 ± 1.17% and 51.05 ± 0.85%. There was no significant difference between the three groups for the measurements of ACZ, SRPD, DRPD and CVD (p = 0.57, p = 0.97, p = 0.53 and p = 0.07; respectively). However, there was a significant positive correlation between the smoking cessation period and the DRPD (p = 0.003, r = 0.865). Conclusions: Despite the known effects of nicotine and other chemical substances in cigarettes on peripheral vascular structures, no significant difference in quantitative analysis of retinal and choroidal networks could be found. Deep retinal plexus density seems to increase after long smoking cessation periods. [ABSTRACT FROM AUTHOR]

Purpose: To monitor macular edema in Irvine‐Gass (IG) syndrome using Swept source optical coherence tomography (SS OCT) and describe different features. Methods: A prospective longitudinal study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis between January 1st 2020 and December 30th 2021. Patients with pseudophakic macular edema were included. Patients with ocular or systemic diseases that may interfere with ocular imaging (Age‐related macular degeneration, diabetes and central venous occlusion) were excluded. All patients underwent complete ophthalmic examination and SS OCT at first presentation (M1) and 2 months (M2) after treatment with topical nonsteroidal anti‐inflammatory drugs. Central retinal thickness (CRT), central choroidal thickness (CCT), serous retinal detachment thickness (SRDT) and diameter of the largest cystic intraretinal space (DCS) were measured and compared. Paired samples T‐test and McNemar test were performed using 21.0 SPSS. Results: Fourteen eyes of 14 patients (5 males and 9 females) were eligible for the study. The median age was 69 years ±8 years. Pseudophakic macular edema interested the right eye in 12 eyes. Qualitative analysis of SS OCT revealed serous retinal detachment in 11 eyes (73%) on M1 and 9 eyes (60%) on M2. Cystic intraretinal spaces were present in 14 eyes (100%) on M1 and 10 eyes (66%) on M2. CRT decreased significantly from 505.73 μm on M1 to 342.93 μm on M2 (p = 0.000), it affected the four macular quadrants significatively (p = 0.004). SRDT decreased from 134.80 μm on M1 to 56.33 μm on M2 (p = 0.03) and DCS from 287.93 μm on M1 to 104.93 μm on M2 (p = 0.000). Mean CCT was 205.60 μm on M1 and 210.20 μm on M2 with no significant difference (p = 0.90). Conclusions: SS OCT provides qualitative and quantitative analysis for the monitoring of the IG syndrome. It demonstrated improvement of the retinal measurements during the first 2 months with significant regression of the CRT, the SRDT and the DCS. Therefore, the choroid seems to be spared in the regeneration process. [ABSTRACT FROM AUTHOR]

Purpose: To describe clinical, etiological and tomographic features of anterior scleritis. Methods: Retrospective case series study carried out at the Ophthalmology department of Habib Thameur University Hospital of Tunis between the 1st January 2021 and the 1st January 2022. Nine patients (12 eyes) with anterior scleritis were included. All patients underwent complete ophthalmic examination including anterior segment and fundus slit lamp examination. The cases were documented with multimodal imaging including anterior segment optical coherence tomography (AS‐OCT). All patients were referred to the internal medicine department for general examination. Results: The median age of the patients was 37 years. 44% were male and 56% were female. Ophthalmic examination revealed diffuse conjunctival hyperemia and scleral vessel dilation with negative neosynephrine test in all eyes. The scleritis was bilateral in 3 patients, diffuse in 6 eyes, nodular in 5 eyes and necrotizing in 1 eye. One eye was complicated with angle closure glaucoma, 2 eyes had anterior uveitis, 1 eye had retinal vasculitis and 2 eyes were associated with posterior scleritis. AS‐OCT revealed a narrow anterior chamber and a closed angle in 1 eye, dilated scleral vessels in all eyes, thickening of the sclera in 11 eyes, dome‐shaped hyperreflective lesions corresponding to the nodules in 5 eyes and thinning of the sclera in the eye with necrotizing scleritis. Systemic disease was found in 7 patients. Main etiologies were tuberculosis in 3 patients and Behçet disease in 2 patients. The other two diagnosis were granulomatosis with polyangiitis and MacDuffie syndrome. Conclusion: In our case series Behcet disease and tuberculosis were the main diagnosis of anterior scleritis. AS‐OCT could show different features of anterior scleritis depending on the clinical presentation and could consequently help to monitor the inflammation. [ABSTRACT FROM AUTHOR]

• Computations show that nimetazepam exhibits two conformers. • With a barrier of 16.7 kcal/mol, room temperature crossover is fast. • Isomerization can be tracked by a kinetic NMR effect. • Circular dichroism effects can be predicted in a controllable way. We investigate the potential energy landscape and the spectroscopic properties of the nimetazepam molecule using a density functional theory approach. Our calculations show that despite the lack of a chiral carbon atom or a stereochemically active bond, this molecule exhibits two conformational enantiomers, M and P. For the isomerization process we find an activation energy of 16.7 kcal/mol. The conformers are inseparable at room temperature, and consequently, the nimetazepam drug exists as a racemic mixture. The theoretical spectroscopic analysis of these enantiomers including IR, VCD, NMR, UV-Vis, and ECD has been performed, to identify suitable experimental techniques to detect the individual stereoisomers. The infrared spectrum of nimetazepam agrees well with the experimentally observed one, and vibrational bands have been assigned. Moreover, the 1H and 13C NMR experimental chemical shifts have been well reproduced using the gauge independent atomic orbital method. The calculations suggest a dynamic 1H NMR effect that can be used to follow the isomerization process. The TD-DFT approach enables us to simulate the UV-Vis spectra, and the obtained results coincide satisfactorily with the observed spectrum. The M and P conformers show a complementary behavior in their predicted VCD and ECD spectra. [ABSTRACT FROM AUTHOR]

Purpose: To compare clinical and multimodal imaging findings in patients with PHOMS and correlate them with the etiology. Methods: A prospective descriptive comparative study carried out at the Ophthalmology Department of Habib Thameur University Hospital of Tunis between March 1st 2020 and March 30th 2021. Inclusion criteria were presence of blurred optic disc margins. Patients with optic disc drusen were excluded. All patients underwent complete ophthalmic examination, 24.2 Humphrey visual field (VF), fluorescein angiography (FA) and Swept‐Source Optical Coherence Tomography (SS‐OCT). Comparative Mann Whitney and chi‐squared tests were performed. Results: Sixteen eyes of 8 patients were eligible for the study. Mean age was 41.63 years +/‐ 10.49 years. Mean Best Corrected Visual Acuity was 0.23+‐0.27 log MAR. Main etiologies were sequelae of idiopathic intracranial hypertension (IIH) in 8 eyes (50%) and tilted disc syndrome (TDS) in 6 eyes (37.5%). VF defects were found in 12 eyes (75%). They included non‐specific scotomas (35.7%), blind spot enlargement (21.4%) and peripheral arcuate defect (12.5%). Peripapillary Retinal Nerve Fiber Layer (pRNFL) were thickened in 62.5% of eyes, altered in 31.3% and preserved in 6.3%. Inferior and nasal pRNFL showed no alterations in all eyes. SS‐OCT revealed hyperreflective lesions in all eyes, associated to posterior shadowing in 12 eyes (75%), hyperreflective dots in 10 eyes (62.5%) and peripapillary pigment epithelium detachment in 9 eyes (56.3%). There were no statistically significant differences in VF alterations between TDS and IIH group. Patients with IIH presented thicker pRNFL (p = 0.023) and were more likely to present annular leakage in FA (p = 0.012). Conclusions: PHOMS is a recently described entity that can be related to several etiologies such as IIH, TDS or ischemic optic nerve neuropathy. Both TDS and IIH can lead to visual field defects. IIH is more likely to give annular retention in FA and thickening of pRNFL. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinical experience of intravitreal injections of anti‐VEGF at a tertiary center of ophthalmology department in Tunisia during the COVID‐19 pandemic. Methods: Retrospective comparative cross‐sectional study describing the clinical experience of the ophthalmology department in Habib Thameur Hospital in Tunis, Tunisia from the 1st of March 2019 to the 1st of March 2021. Diagnosis, intravitreal injection history, medical history, ophthalmic examinations data were collected and analyzed. Results: From the1st of March 2019 to the 1st of March 2021, 2463 intravitreal injections of anti‐VEGF were made. The main etiologies were diabetic macular edema in 2003 eyes (82%), age‐related macular degeneration in 284 eyes (12%), retinal vein occlusion in 127 eyes (5%), and other macular diseases in 49 Eyes (1%). Before the Covid‐19 pandemic, from Mars 2019 till February 2020, we made 78 injections per month with only three cases of neovascular glaucoma (NVG) and two cases of vitreous hemorrhage. During the two months of national Covid lockdown, the total number of injections decreased to 39 injections per month. After the lockdown, the number of injections monthly had increased to 138 injections per month. There were no changes in the prevalence of responsible diseases (p = 0.29). Therefore, despite the increase of the number of injections, from May 2020 till March 2021, the number of NVG had risen to 16 and the vitreous hemorrhage to 27 (p = 0.03). Conclusions: COVID‐19 pandemic has dramatically affected the management and the treatment of eye diseases, and has resulted in a significantly worse short‐term outcomes and more severe ocular impairment. [ABSTRACT FROM AUTHOR]

Purpose: To describe a case of an early postoperative angle‐closure related to high vault after phakic implantable collamer lens (ICL) implantation managed by smaller size lens exchange. Methods: A case report if a 38‐year‐old woman with high myopia underwent refractive surgery correction with posterior phakic Implantable Collamer Lens (ICL) (STAAR Surgical, V4c) in the right eye. White‐to‐white measurement was 12.28 mm. Preoperative anterior chamber depth was 3.04 mm. ICL implantation with a 13.2 mm lens was performed Results: Postoperative examination showed a shallow anterior chamber with a raised intraocular pressure (IOP) of 28 mmHg. Anterior segment OCT (AS‐OCT) revealed a lens vault of 954 µm raising to 1154 µm after 4 days with iridocorneal angle closure. The diagnosis of acute angle‐closure secondary to non‐pupillary block due to the volume of the ICL was made. Explantation of the ICL and re‐implantation of a smaller sized lens (12.6 mm) was performed 7 days after the first surgery. Postoperative uncorrected visual acuity was 20/20, IOP was 14 mmHg and no crystalline lens opacities or anisocoria were noticed. The patient achieved a reduction in the vault from 1154 to 596 μm, with an open iridocorneal angle. Specular microscopy showed no significant endothelial cell loss. Conclusions: Extreme lens vault in our patient was related to poor correlation between pre‐operative measurements and postoperative lens vaulting. AS‐OCT was a helpful tool in diagnosing and managing high vaults with acute angle‐closure. Early ICL extraction in these cases is necessary to avoid angle‐closure glaucoma, severe endothelial loss, and pupillary defect. Ref‐erence Arjun Srirampur, Tarannum Mansoori, Pasyanthi Balijepalli, Aruna Kumari Gadde. Management of anisocoria and high vault in an eye with implantable collamer lens. Indian J Ophthalmol. 2020 Dec;68(12):3070–3072. [ABSTRACT FROM AUTHOR]

Research on new ingredients that can prevent excessive melanin production in the skin while considering efficacy, safety but also environmental impact is of great importance to significantly improve the profile of existing actives on the market and avoid undesirable side effects. Here, the discovery of an innovative technology for the management of hyperpigmentation is described. High‐throughput screening tests on a wide chemical diversity of molecules and in silico predictive methodologies were essential to design an original thiopyridinone backbone and select 2‐mercaptonicotinoyl glycine (2‐MNG) as exhibiting the most favorable balance between the impact on water footprint, skin penetration potential and performance. The effectiveness of 2‐MNG was confirmed by topical application on pigmented reconstructed epidermis and human skin explants. In addition, experiments have shown that unlike most melanogenesis inhibitors on the market, this molecule is not a tyrosinase inhibitor. 2‐MNG binds to certain melanin precursors, preventing their integration into growing melanin and leading to inhibition of eumelanin and pheomelanin synthesis, without compromising the integrity of melanocytes. [ABSTRACT FROM AUTHOR]

Myeloproliferative neoplasms (MPNs) comprise polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). The relationship between JAK2 p.(V617F) mutation and MPNs was first described in 2005. The purpose of this study was to determine the prevalence of JAK2 p.(V617F) mutation in Tunisian patients assessed for MPNs and try to set a genotype-phenotype correlation. A retrospective study was conducted between January 2015 and April 2019. We collected the clinical data of all patients with MPNs suspicion or atypical splanchnic vein thrombosis (SVT). JAK2 p.(V617F) mutation was detected by allele specific real-time quantitative fluorescence PCR (AS-qPCR). We gathered 974 patients who underwent molecular analysis, 55.5% of them were male and 44.5% were female. The median age of all studied patients was 56 years. JAK2 p.(V617F) was found in 349 (35.8%) of total enrolled cases. It was reported in 44%, 37%, 29% and 25% of all patients diagnosed as having respectively ET, PV, PMF and atypical SVT. JAK2 p.(V617F) was negative in 62.2% of patients addressed for suspicion of PV. There was a significant positive correlation between the JAK2 p.(V617F) mutation status, age, gender, white blood cell counts and platelet counts. To our best knowledge, this is the first vast investigation of JAK2 p.(V617F) variant in Tunisia and North Africa with the lowest mutation rate in entire cohort and MPNs subgroups, underlying a specific presentation of this mutation. It is considered as an essential marker of MPNs' diagnosis and prognosis and is associated with differences in the phenotype of these disorders, helpful for the follow-up of these patients. [ABSTRACT FROM AUTHOR]

Sarcopenia is a muscle disease with adverse changes that increase throughout the lifetime but with different chronological scales between individuals. Addressing "early muscle aging" is becoming a critical issue for prevention. Through the CHRONOS study, we demonstrated the ability of the high-density surface electromyography (HD-sEMG), a noninvasive, wireless, portable technology, to detect both healthy muscle aging and accelerated muscle aging related to a sedentary lifestyle, one of the risk factors of sarcopenia. The HD-sEMG signals were analyzed in 91 healthy young, middle-aged, and old subjects (25–75 years) distributed according to their physical activity status (82 active and 9 sedentary; International Physical Activity Questionnaire) and compared with current methods for muscle evaluation, including muscle mass (dual-energy X-ray absorptiometry [DXA], ultrasonography), handgrip strength, and physical performance. The HD-sEMG signals were recorded from the rectus femoris during sit-to-stand trials, and 2 indexes were analyzed: muscular contraction intensity and muscle contraction dynamics. The clinical parameters did not differ significantly across the aging and physical activity levels. Inversely, the HD-sEMG indexes were correlated to age and were different significantly through the age categories of the 82 active subjects. They were significantly different between sedentary subjects aged 45–54 years and active ones at the same age. The HD-sEMG indexes of sedentary subjects were not significantly different from those of older active subjects (≥55 years). The muscle thicknesses evaluated using ultrasonography were significantly different between the 5 age decades but did not show a significant difference with physical activity. The HD-sEMG technique can assess muscle aging and physical inactivity-related "early aging," outperforming clinical and DXA parameters. [ABSTRACT FROM AUTHOR]

Background: Efforts to prolong interscalene block (ISB) analgesia include the use of local anaesthetic adjuvants such as dexamethasone. Previous work showing prolonged block duration suggests that both perineural and intravenous (i.v.) routes can both prolong analgesia. The superiority of either route is controversial given the design of previous studies. As perineural dexamethasone is an off-label use, anaesthesiologists should be fully informed of the clinical differences, if any, on block duration. This study was designed to test whether perineural vs i.v. dexamethasone administration are equivalent.Methods: We randomised 182 eligible patients scheduled for arthroscopic shoulder surgery to receive low-dose ISB (0.5% ropivacaine 5 ml) with perineural or i.v. dexamethasone 4 mg. Subjects, anaesthesiologists, and research personnel were blinded. All subjects also received a standardised general anaesthetic and multimodal analgesia. The primary outcome was duration of analgesia analysed as an equivalence outcome (2 h equivalency margin) using the two one-sided test (TOST) method.Results: For the primary outcome, duration of analgesia, and perineural and i.v. administration of dexamethasone were not equivalent. The upper and lower bounds of the 90% confidence interval were 1 h (P=0.12) and -2.5 h (P=0.01), respectively. The observed difference in mean block duration was not clinically relevant (0.75 h longer for i.v. dexamethasone). There were no other clinically significant differences between groups.Conclusion: In the context of low-volume ISB with ropivacaine, perineural and i.v. dexamethasone were not equivalent in terms of their effects on block duration. However, there were no clinically significant differences in outcomes, and there is no advantage of perineural over intravenous dexamethasone. WWW.CLINICALTRIALS.Gov Registration: NCT02322242. [ABSTRACT FROM AUTHOR]

Background: Interscalene brachial plexus (ISB) block is routinely used to provide anesthesia and analgesia for shoulder surgery. Traditional local anesthetic volumes for ISB result in near universal ipsilateral phrenic nerve paresis potentially including oxygenation and ventilation. Aims: The purpose of this study was to determine the lowest minimal effective anesthetic volume in 95% of patients (MEAV 95) of ropivacaine 0.75% for ISB that provides surgical anesthesia for arthroscopic shoulder surgery. Methods: Prospective observational cohort study in patients undergoing arthroscopic shoulder surgery under ISB (C6 level) with sedation. The dose finding protocol used the Narayana rule for up/down sequential allocation to estimate the MEAV 95 of ropivacaine 0.75%. Successful ISB was defined as complete absence of pinprick sensation in the C5 and C6 dermatomes 30 min postblock. Secondary outcomes assessed included ability to complete surgery with propofol sedation, change in slow vital capacity, room air oxygen saturation postblock, block duration, ISB complications, and numeric rating scale for pain immediately after surgery. Results: The study was stopped early due to futility. Among 225 participants approached, 54 consented to participate. The MEAV 95 for ultrasound-guided ISB of ropivacaine 0.75% for shoulder surgery was unable to be accurately estimated. Local anesthetic volumes between 5 and 20 ml did not influence any of the predefined secondary outcomes. Conclusions: The MEAV 95 (at 30 min) of ropivacaine 0.75% for ultrasound-guided ISB exceeds the local anesthetic volumes that consistently produces hemidiaphragmatic impairment. ISB cannot be guaranteed to provide surgical anesthesia at 30 min without the potential for concomitant phrenic nerve block. [ABSTRACT FROM AUTHOR]

Purpose: To report the contribution of swept source optical coherence tomography (SS‐OCT) and OCT‐angiography (OCTA) imaging findings in the diagnosis and the follow‐up of type 2 macular telangiectasia (MacTel 2). Methods: A retrospective study of eight eyes (five patients) with various stages of MacTel2. Clinical staging of MacTel 2 was performed based on SS‐OCT and OCTA. Results: The average age was 63 years old. The mean follow up was 33.6 months. A very early non‐proliferative stage was found in three eyes, an early non‐proliferative stage in three eyes and a late proliferative stage in two eyes. The most common findings on SS‐OCT were disruption of the inner segment‐outer segment (IS/OS) layer in all eyes, parafoveal hyporeflective retinal cavities in four eyes and superficial retinal crystals in three eyes. Two eyes showed irregularity of foveal contour and internal limiting membrane draping associated with retinal vascular channels connecting the superficial and deep retinal layers and forming retinal‐choroidal anastomosis. OCTA findings included capillary telangiectatic changes and enlargement of intercapillary spaces predominantly in deep capillary plexus (DCP) in comparison with superficial capillary plexus (SCP) in all eyes. Irregularity of capillary size in the perifoveal region of the DCP and SCP, predominantly temporal to the fovea, was found in five eyes. Circumferential capillary distortions and subretinal neovascularization at the level of the outer retina and choriocapillaris were detectable in two eyes. At the mean period of follow‐up, lesions were stable in two eyes, an extension of IS/OS disruption was noted in four eyes, parafoveal cavities' appearance and/or extension was found in two eyes and neovascular proliferation appeared in one eye. Conclusions: SS‐OCT and OCTA imaging features facilitate the diagnosis, staging and long‐term follow‐ up of MacTel 2. Further prospective studies are need to characterize the progressive and sequential nature of structural changes in this disease. [ABSTRACT FROM AUTHOR]

Due to the sharp increase in global industrial production, as well as the over-exploitation of land and sea resources, the quality of drinking water has deteriorated considerably. Furthermore, nowadays, many water supply systems serving growing human populations suffer from shortages since many rivers, lakes, and aquifers are drying up because of global climate change. To cope with these serious threats, smart water management systems are in great demand to ensure vigorous control of the quality and quantity of drinking water. Indeed, water monitoring is essential today since it allows to ensure the real-time control of water quality indicators and the appropriate management of resources in cities to provide an adequate water supply to citizens. In this context, a novel IoT-based framework is proposed to support smart water monitoring and management. The proposed framework, named SmartWater, combines cutting-edge technologies in the field of sensor clouds, deep learning, knowledge reasoning, and data processing and analytics. First, knowledge graphs are exploited to model the water network in a semantic and multi-relational manner. Then, incremental network embedding is performed to learn rich representations of water entities, in particular the affected water zones. Finally, a decision mechanism is defined to generate a water management plan depending on the water zones' current states. A real-world dataset has been used in this study to experimentally validate the major features of the proposed smart water monitoring framework. [ABSTRACT FROM AUTHOR]

Quantitative resistance is considered more durable than qualitative resistance as it does not involve major resistance genes that can be easily overcome by pathogen populations, but rather a combination of genes with a lower individual effect. This durability means that quantitative resistance could be an interesting tool for breeding crops that would not systematically require phytosanitary products. Quantitative resistance has yet to reveal all of its intricacies. Here, we delve into the case of the wheat/Septoria tritici blotch (STB) pathosystem. Using a population resulting from a cross between French cultivar Renan, generally resistant to STB, and Chinese Spring, a cultivar susceptible to the disease, we built an ultra-dense genetic map that carries 148,820 single nucleotide polymorphism (SNP) markers. Phenotyping the interaction was done with two different Zymoseptoria tritici strains with contrasted pathogenicities on Renan. A linkage analysis led to the detection of three quantitative trait loci (QTL) related to resistance in Renan. These QTL, on chromosomes 7B, 1D, and 5D, present with an interesting diversity as that on 7B was detected with both fungal strains, while those on 1D and 5D were strain-specific. The resistance on 7B was located in the region of Stb8 and the resistance on 1D colocalized with Stb19. However, the resistance on 5D was new, so further designated Stb20q. Several wall-associated kinases (WAK), nucleotide-binding and leucine-rich repeats (NB-LRR) type, and kinase domain carrying genes were present in the QTL regions, and some of them were expressed during the infection. These results advocate for a role of Stb genes in quantitative resistance and for resistance in the wheat/STB pathosystem being as a whole quantitative and polygenic. [ABSTRACT FROM AUTHOR]