Recurrent subacute visual loss presenting in a 52-year-old Caucasian woman with chronic relapsing inflammatory optic neuropathy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Chronic relapsing inflammatory optic neuropathy is a recently described form of recurrent isolated subacute optic neuropathy. The condition is highly responsive to systemic steroid treatment and prone to relapse on steroid withdrawal. A complete work up for demyelination, autoimmune disease and sarcoidosis must be made before considering chronic relapsing inflammatory optic neuropathy.</p> <p>Case presentation</p> <p>We describe the case of a 52-year-old Caucasian woman who presented with isolated subacute optic neuropathy. There was no evidence of demyelination, autoimmunity or sarcoidosis. There was an abrupt and prompt response to systemic corticosteroids and a relapse of the condition on steroid withdrawal.</p> <p>Conclusions</p> <p>Chronic relapsing inflammatory optic neuropathy requires careful consideration and differentiation from demyelinating optic neuritis and ischemic optic neuropathy since the treatment is different and the outcome without treatment is likely to be poor. The importance of identifying these patients has considerable clinical implications as the condition is highly responsive to steroids.</p

WASP-39b: exo-Saturn with patchy cloud composition, moderate metallicity, and underdepleted S/O

WASP-39b is one of the first extrasolar giant gas planets that has been observed within the JWST ERS program. Fundamental properties that may enable the link to exoplanet formation differ amongst retrieval methods, for example metallicity and mineral ratios. In this work, the formation of clouds in the atmosphere of WASP-39b is explored to investigate how inhomogeneous cloud properties (particle sizes, material composition, opacity) may be for this intermediately warm gaseous exoplanet. WASP-39b's atmosphere has a comparable day-night temperature median with sufficiently low temperatures that clouds may form globally. The presence of clouds on WASP-39b can explain observations without resorting to a high (> 100x solar) metallicity atmosphere for a reduced vertical mixing efficiency. The assessment of mineral ratios shows an under-depletion of S/O due to condensation compared to C/O, Mg/O, Si/O, Fe/O ratios. Vertical patchiness due to heterogeneous cloud composition challenges simple cloud models. An equal mixture of silicates and metal oxides is expected to characterise the cloud top. Further, optical properties of Fe and Mg silicates in the mid-infrared differ significantly which will impact the interpretation of JWST observations. We conclude that WASP-39b's atmosphere contains clouds and the underdepletion of S/O by atmospheric condensation processes suggest the use of sulphur gas species as a possible link to primordial element abundances. Over-simplified cloud models do not capture the complex nature of mixed-condensate clouds in exoplanet atmospheres. The clouds in the observable upper atmosphere of WASP-39b are a mixture of different silicates and metal oxides. The use of constant particles sizes and/or one-material cloud particles alone to interpret spectra may not be sufficient to capture the full complexity available through JWST observations.Comment: 21 pages, 18 figures, submitted to A&A on 22. November 2022, in review since 8. December 202

Drug utilization pattern in OPD of government dental college and hospital, Aurangabad

Background: To study drug prescription pattern in dental OPD of Government Dental College and Hospital.Methods: 100 prescriptions were screened & analyzed as per the study parameters from OPD of Government Dental College & Hospital, Aurangabad. Groups of drugs commonly prescribed, like antibiotic, analgesics & others prescription were recorded.Results: Most common groups of drugs prescribed by dental surgeons were NSAIDs, antimicrobials, antiseptics and multivitamins. NSAIDs- 86%; Antimicrobials- 85%; Antiseptics- 8.6%; Multivitamins- 12.3%. The average number of drugs prescribed per patient was 3 and the average number of antimicrobial prescribed per patient was 1.Conclusions: For rational prescribing of drugs there is a need of mass-awareness amongst dental surgeons about the good prescribing by following 6 steps of WHO program on rational use of drugs

Desperately seeking fixedness: practitioners accounts of 'becoming doctoral researchers

We draw upon the concept of liminality to explore the experiences of practitioners enrolled on a UK Doctor of Business Administration (DBA) programme. We analyse twenty practitioners’ reflective journals to detail how the DBA liminal space was negotiated. More specifically, we describe how practitioners deal with their struggles of identity incoherence or ‘monsters of doubt’ which are amplified in the DBA context owing to the complex nature of the separation phase of liminality. We identify three broad methods deployed in this endeavour: ‘scaffolding’; ‘putting the past to work’ and ‘bracketing’- which evidence practitioners ‘desperately seeking fixedness’. We make three contributions – first, we provide empirical insights into the experiences of the increasingly significant, but still under researched, DBA student. Second, we develop our understandings of monsters of doubt through illustrating how these are negotiated for learning to progress. Finally, we contribute to wider discussions of ‘becoming’ to demonstrate the simultaneous and paradoxical importance of movement and fixedness in order to learn and become

Trail cameras are a key monitoring tool for determining target and non-target bait-take during rodent removal operations: evidence from Desecheo Island rat eradication

Efforts to remove invasive rodents (e.g. Rattus spp. and Mus musculus) from islands often use toxicant-laced baits containing the anticoagulants brodifacoum or diphacinone. Rodenticide baits are generally delivered through aerialor hand-broadcast, or in bait stations. These baits are not rodent-specific and are subject to non-target consumption or secondary exposure (e.g. an individual preying upon another individual that has consumed bait). During rodenticide applications, it is generally unknown which animals are visiting and consuming bait; and to quantify this, we recommend using trail cameras (e.g. Reconyxtm motion-activated infra-red) positioned to monitor individual bait pellets. To demonstrate the importance and effectiveness of using trail cameras during such operations, we report results of target (Rattus rattus, black rat) and non-target (native land crab, lizard, insect) bait-interactions after an aerial-broadcast of (Rattus rattus, black rat) and non-target (native land crab, lizard, insect) bait-interactions after an aerial-broadcast of Brodifacoum-25D Conservation to eradicate rats from Desecheo Island, Puerto Rico. During the first five days following bait application, trail cameras (n = 15) revealed that there were 40 incidences of animals contacting bait pellets: 50% rat, 32% hermit crab, 13% Ameiva lizard, and 5% insect. Trail cameras provide temporal and spatial information regarding the eff ectiveness of rodent removal, and the last rat pictured by trail cameras on Desecheo was six days after bait application began. Trail cameras revealed 30 incidences of animals contacting bait pellets 6–20 days after bait application began: 47% hermit crab, 37% Ameiva lizard, 13% insect, and 3% black crab. Despite viewing ~69,000 images from trail cameras, lizards were never pictured consuming bait on Desecheo; therefore, any brodifacoum exposure to Desecheo lizards likely occurred via secondary pathways (e.g. consumption of contaminated insects). Scaling up, we estimate that \u3e 75% of the total bait distributed on Desecheo was not consumed by rats. Trail cameras help inform the hazards of rodenticide use and can be easily incorporated into rodent removal operations

On the shock behaviour and response of Ovis Aries vertebrae

When investigating a biological system during shock loading, it is best practice to isolate different components to fully comprehend each individual part [1,2] before building up the system as a whole. Due to the high acoustic impedance of bone in comparison to other biological tissues [3] the majority of the shock will be transmitted into this medium, and as such can cause large amounts of damage to other parts of the body potentially away from the impact area

Mineral cloud and hydrocarbon haze particles in the atmosphere of the hot Jupiter JWST target WASP-43b

Context: Having a short orbital period and being tidally locked makes WASP-43b an ideal candidate for the James Webb Space Telescope (JWST) phase curve measurements. Phase curve observations of an entire orbit will enable the mapping of the atmospheric structure across the planet, with different wavelengths of observation allowing different atmospheric depths to be seen. Aims: We provide insight into the details of the clouds that may form on WASP-43b and their impact on the remaining gas phase, in order to prepare the forthcoming interpretation of the JWST and follow-up data. Methods: We follow a hierarchical modelling strategy. We utilise 3D GCM results as input for a kinetic, non-equilibrium model for mineral cloud particles and for a kinetic model to study a photochemically-driven hydrocarbon haze component. Results: Mineral condensation seeds form throughout the atmosphere of WASP-43b. This is in stark contrast to the ultra-hot Jupiters, such as WASP-18b and HAT-P-7b. The dayside is not cloud free but it is loaded with few yet large mineral cloud particles in addition to hydrocarbon haze particles of a comparable abundance. Photochemically driven hydrocarbon haze appears on the dayside, but it does not contribute to the cloud formation on the nightside. The geometrical cloud extension differs across the globe due to the changing thermodynamic conditions. Day and night differ by 6000 km in pressure scale height. As reported for other planets, the C/O is not constant throughout the atmosphere and varies between 0.74 and 0.3. The mean molecular weight is approximately constant in a H2- dominated WASP-43b atmosphere because of the moderate day/night-temperature differences compared to the super-hot Jupiters. Conclusions: WASP-43b is expected to be fully covered in clouds which are not homogeneously distributed throughout the atmosphere. The dayside and the terminator clouds are a combination of mineral particles of locally varying size and composition as well as of hydrocarbon hazes. The optical depth of hydrocarbon hazes is considerably lower than that of mineral cloud particles such that a wavelength-dependent radius measurement of WASP-43b would be determined by the mineral cloud particles but not by hazes

Anatomy of the neural fibers at the superior mesenteric artery-a cadaver study

PURPOSE Most surgeons perform right-sided semicircular clearance of the superior mesenteric artery (SMA) nerve plexus for pancreatic head carcinoma, presuming a linear course of the SMA nerve fibers. The hypothesis was that the SMA nerve plexus fibers follow a non-linear course, and the goal of the present study was to assess the neural fibers distribution along the SMA. METHODS The course of neural fibers along the retropancreatic and suprapancreatic SMA was assessed in 7 cadavers. RESULTS In the retropancreatic course of the vessel, the main nerve cords branch and form a large number of finer nerve branches performing an anti-clockwise rotation of slightly less than 90° around the SMA. Finer nerve branches are located rather close to the vessel, while the main nerve cords are localized in the loose connective tissue of the peripheral parts of the vascular sheath. Nerve fibers around the suprapancreatic SMA run as two main nerve cords framing the artery on the right lateral-ventral and the left lateral to lateral-dorsal side. CONCLUSION The rotation of the nerve fiber around the SMA indicates that a more radical resection of at least 180° of neural tissue around the SMA might be required to achieve tumor clearance in pancreatic cancer with perineural invasion at the uncinate margin