Does the type of suturing technique used affect astigmatism after deep anterior lamellar keratoplasty in keratoconus patients?

Banu Torun Acar, Ece Turan Vural, Suphi AcarHaydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, TurkeyPurpose: To compare the effect of three different suturing techniques on astigmatism after deep anterior lamellar keratoplasty (DALK) in patients with keratoconus.Methods: In this retrospective study, 54 eyes of 54 patients with advanced keratoconus underwent DALK with three suturing techniques: single running, interrupted running, and combined interrupted and running. Postkeratoplasty astigmatism was evaluated during examinations 1, 3, and 6 months postoperatively and 2 months after completing suture removal.Results: Twenty-four eyes had single running sutures, 16 eyes had interrupted sutures, and in 14 eyes the suturing technique used was combined interrupted and running sutures. Mean age was 25.6 ± 5.9 years, 27.3 ± 6.8 years, and 26.5 ± 5.7 years (P = 0.422), and postoperative astigmatism 1 month after surgery was 3.79 ± 1.19 D, 5.56 ± 1.78 D, and 4.21 ± 1.55 D in the three groups, respectively (P = 0.012). However, 2 months after completing the suture removal, final postoperative astigmatism was 3.43 ± 1.44 D, 3.87 ± 1.38 D, and 3.71 ± 1.46 D (P = 0.846). Final astigmatism less than 4 D was seen in 18 cases (75%) in the single running group, nine cases (56.2%) in the interrupted running group, and nine cases (64.2%) in the combined interrupted and running group (P = 0.08).Conclusion: Postkeratoplasty astigmatism is comparable with three different suturing techniques used in patients with keratoconus after completing suture removal in DALK. Due to earlier suture removal in DALK, the type of suturing technique used is not considerably important.Keywords: astigmatism, deep anterior lamellar keratoplasty, suturing techniqu

Does ownership type affect environmental disclosure?

PurposeIn recent years, firms tend to direct their attention in communicating their environmental actions with their stakeholders. However, the level of environmental disclosers varies significantly among firms. This paper aims to explain the variation in environmental disclosure of firms based on their ownership type, namely – state ownership and institutional ownership. The study further aims to understand whether and how the relationship between ownership structure and environmental disclosure changes regarding countries’ development levels.Design/methodology/approachThis paper uses a sample of 27,847 firm-year observations from 72 countries/economic districts between the years 2002 and 2017 and regression analysis to test how the relationship between different ownership structures and environmental disclosure and whether this relation is conditional on countries’ development levels.FindingsThis study finds that firms with higher state ownership have higher environmental disclosures and higher institutional ownership has a negative effect on environmental disclosures. Furthermore, this paper also documents that firms with higher state ownership and operating in developed countries have incrementally higher environmental disclosure, relative to firms operating in developing countries.Research limitations/implicationsThe study has limitations that would provide possible starting points for further research. The first limitation is related to the environmental disclosure measure, which reflects the level of environmental disclosure of firms based on their disclosure information given in the Thomson Reuters, Asset4 database. A more refined measure can be constructed using hand-collected data based on linguistic analysis, which may reflect not only the level of the disclosure but also the quality of the environmental disclosure. The second limitation is the limited focus of the study toward state and institutional shareholding. Therefore, future research may consider examining the different types of ownership such as family ownership.Practical implicationsThe findings of the study may help policymakers and regulators to consider the potential impact of various ownership types on environmental disclosures. Also, given the impact of countries’ development levels, regulators should consider that a one-size-fits-all is not applicable in environmental disclosures. Therefore, each country should consider the institutional dynamics of their operating environment to set appropriate regulations to enhance environmental disclosures.Social implicationsFrom a social perspective, the findings indicate that firms’ stakeholder engagement via environmental disclosures depends on the type of the controlling shareholders.Originality/valueThis study contributes to the literature by developing a new construct for environmental disclosure based on Biodiversity, Climate Change, Environmental Investments and Spill Impact Reduction performance measures. Further, grounding on legitimacy and stakeholder theories, this study shows the influence of ownership type on environmental disclosures and how this effect changes in accordance with the countries’ development

Substituted Co(II) and Cu(II) metallophthalocyanines from new Schif base containing pyrrole units: Synthesis, characterization and investigation of photocatalytic activity on 2,3‑dichlorophenol oxidation

In this article, novel Schif base compound 1 bearing pyrrole moiety has been synthesized from the reaction of 1-hydroxybenzaldehyde with 1,2-aminophenylpyrrole for the frst time. The cobalt phthalocyanine and copper phthalocyanine (3–4) were prepared by the cyclotetramerization of the novel phthalonitrile compound 2 and the corresponding metal salts. The new phthalonitrile compound 2 was synthesized by the reaction between 4-((E)-{[2-(1H-pyrro-1-yl)phenyl]imino}methyl) phenol 1 and 4-nitrophthalonitrile in DMF. The all new compounds (1–4) have been characterized by FT-IR spectroscopy, 1 H-NMR/13C-NMR, mass, UV–Vis spectroscopy techniques and elemental analysis (for metallophthalocyanines). Chlorinebearing phenols are of a class of pollutants. They have been regarded as a potential risk to environment and human health. It is important to advanced efective techniques to remove chlorinated phenols in wastewater. For this purpose, we investigated that diferent parameters infuenced the photooxidation process were determined and 2,3-dichlorophenol oxidize to the less harmfull products with high conversion and yield in the presence of Cu(II) and Co(II) phthalocyanine catalysts

Sağlıklı Bireylerde Ağırlık Kaldırmanın Omuz Kas Aktivasyonlarına Etkisi

Giriş: Günlük yaşam sırasında ağırlık kaldırmak sıklıkla kullanılmakta olup, omuz eklemi de üst ekstremitenin hareket serbestliğinin çoğundan sorumludur. Amaç: Bu çalışmada, sağlıklı bireylerde omuz ekleminin fleksiyon ve abdüksiyon hareketleri sırasında ağırlık kaldırmanın kas aktivasyonlarına farklı açı değerlerindeki etkisinin belirlenmesi amaçlanmıştır. Yöntem: Çalışma, yaş ortalaması 22.60 ± 0.44 olan 28 sağlıklı erkek bireyin katılımı ile gerçekleştirilmiştir. Bireyler ağırlıksız ve 3 kilogramlık bir ağırlık ile omuz fleksiyon ve abdüksiyon hareketi yaptığı sırada kas aktivasyonları trapezius kası üst orta ve alt parçaları ile deltoid kasının ön ve orta parçalarından yüzeyel elektromiyografi cihazı ile kaydedilmiştir. Hareketler 0-30, 0-60, 0-90, 0-120, 0-150 ve 0-180 dereceler arasında ve metronom eşliğinde yapılmıştır. Bulgular: Ağırlıksız olarak gerçekleştirilen fleksiyon ölçümlerinde tüm hareket açıklıklarında aktivitesi en fazla olan kas ön deltoid kası iken ağırlık ile gerçekleştirilen fleksiyon ölçümlerinde ise hareketin erken açılarında en aktif kasın üst trapezius, diğer açılarda ise ön deltoid kası olduğu görülmüştür. Ağırlıksız olarak gerçekleştirilen abdüksiyon ölçümlerinde ise yine erken derecelerde en aktif kas ön deltoid iken ağırlık ile gerçekleştirilen ölçümlerde ise üst trapezius kasının aktif olduğu belirlenmiştir. Sonuç ve Öneriler: Ağırlık ile veya ağırlıksız yapılan fleksiyon ve abdüksiyon hareketlerinde çalışma grubumuzda yer alan bireylerde en fazla aktivasyon gösteren kaslar, üst trapezius ve ön deltoid kasları olmaktadır. Bu kasların aktivasyonunu düzenlemeyi hedefleyen tedavilerde omuzun dirençli fleksiyon veya abdüksiyon hareketlerinin kullanımı göz önünde bulundurulabilir

Ownership and Corporate Social Responsibility:"The power of the female touch"

Using a sample of 26,029 firm-year observations over the period 2002–2017 from 4,479 firms and 44 countries, we examine the relationship between ownership concentration and corporate social responsibility by focusing on the mediating role of board gender diversity and the moderating role of family shareholding. We find that ownership concentration negatively affects corporate social responsibility, and the board gender diversity partially mediates this negative effect. Our results indicate that the mediating effect of board gender diversity leads to a 10.65 percent decrease in the impact of ownership concentration on corporate social responsibility. Furthermore, moderated path analysis indicates that family shareholding weakens the direct effect of ownership concentration on board gender diversity and its indirect effect on corporate social responsibility. In post hoc analysis, we also document that the effect of gender diversity on the board is more prevalent in high gender-egalitarian societies where women are more involved in decision-making. Our study addresses the strategic role of female board members in increasing firms' respect for corporate social responsibility, especially in family-controlled firms. Thus, our results may provide insights to regulators and policymakers to enhance firms’ corporate social practices by encouraging women’s participation on corporate boards

Usher syndrome associated with Fuchs’ heterochromic uveitis: a case report

We report a case of Usher syndrome in association with unilateral Fuchs’ heterochromic uveitis

A Novel De Novo Missense Mutation in HNF4A Resulting in Sulfonylurea-Responsive Maturity-onset Diabetes of the Young

Maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes, with autosomal-dominant inheritance, which usually develops before 25 years of age. MODY is classically caused by a heterozygous mutation of genes known to affect insulin production or secretion. Heterozygous inactivating hepatocyte nuclear factor 4A (HNF4A) mutations, one of the rare subtypes of MODY, cause impaired insulin secretion and subsequent glucose intolerance especially in adolescence. Conversely, HNF4A mutations are also known to be associated with macrosomia and hyperinsulinemic hypoglycemia in newborns. Herein, we report a rare cause of diabetes resulting from a novel heterozygous mutation in the HNF4A gene. In conclusion, genetic testing should be considered in order to establish an accurate diagnosis and provide an opinion in determining the appropriate type of treatment