Improvement of visual acuity based on optical coherence tomography patterns following intravitreal bevacizumab treatment in patients with diabetic macular edema

<b>AIM:</b>To report the visual outcome based on various patterns of optical coherence tomography (OCT) morphology in diabetic macular edema (DME), following treatment with anti-VEGF intravitreal bevacizumab (IVB) injection.<b>METHODS:</b>Sixty-seven consecutive subjects with centre involving DME underwent intravitreal injection of Bevacizumab (1.25 mg/0.05 mL) in this retrospective, comparative, non randomized study. The DME was classified into one of four categories:focal, diffuse, focal cystoid and neurosensory detachment based on OCT. Best corrected visual acuity (BCVA), macular appearance, and OCT findings were used to decide whether the subject should have a repeat injection of intravitreal bevacizumab. Outcome measures were a change in mean BCVA (Snellen converted to logMAR) and central macular thickness (CMT) in each group during the six month follow-up period.<b>RESULTS:</b>The mean BCVA improved to logMAR 0.23 at final follow-up from a baseline of 0.32 logMAR (<i>P=</i>0.040) in the focal group, logMAR 0.80 at final follow-up from a baseline of 0.82 logMAR (<i>P=</i>0.838) in the diffuse group, worsened to logMAR 0.53 at final follow-up from a baseline of 0.43 logMAR (<i>P=</i>0.276) in the focal cystoid group, and improved to logMAR 0.79 at final follow-up from a baseline of 0.93 logMAR (<i>P=</i>0.490) in the neurosensory detachment group. The mean CMT before treatment were 298.8±25.03 μm in the focal group, 310.8±40.6 μm in the diffuse group, 397.15±31.05 μm in the focal cystoid group and 401.03±75.1 μm in the neurosensory detachment group. A mean of 2.05 (range:1-5) injections in the focal group, 1.32 (range:1-2) in the diffuse group, 2.6 (range:1-6) in the focal cystoid group and 2.6 (range:1-6) in the neurosensory detachment group were performed during the six month follow-up period. Following intravitreal bevacizumab treatment, vision improved, remained unchanged or worsened in 11, 7 and 2 subjects in focal group; 11, 9 and 8 in diffuse group; 0, 2 and 4 in focal cystoid group and 5, 5 and 3 subjects respectively in neurosensory detachment group.<b>CONCLUSION:</b>OCT morpholgy patterns in DME may predict the effects of intravitreal bevacizumab treatment, and patients with focal DME are most likely to benefit from the improvent of visual acuity from this treatment

Surgical treatment of zygomatic bone fracture using two points fixation versus three point fixation-a randomised prospective clinical trial

<p>Abstract</p> <p>Background</p> <p>The zygoma plays an important role in the facial contour for both cosmetic and functional reasons; therefore zygomatic bone injuries should be properly diagnosed and adequately treated. Comparison of various surgical approaches and their complications can only be done objectively using outcome measurements which in turn require protocol management and long-term follow up. The preference for open reduction and internal fixation of zygomatic fractures at three points has continued to grow in response to observations of inadequate results from two point and one point fixation techniques.</p> <p>The objectives of this study were to compare the efficacy of zygomatic bone after treatment with ORIF using 2 point fixation and ORIF using 3 point fixation and compare the outcome of two procedures.</p> <p>Methods</p> <p>100 patients were randomly divided equally into two groups. In group A, 50 patients were treated by ORIF using two point fixation by miniplates and in group B, 50 patients were treated by ORIF using three point fixation by miniplates. They were evaluated for their complications during and after surgery with their advantages and disadvantages and the difference between the two groups was observed.</p> <p>Results</p> <p>A total of 100 fractures were sustained. We found that postoperative complication like decreased malar height and vertical dystopia was more common in those patients who were treated by two point fixation than those who were treated with three point fixation.</p> <p>Conclusions</p> <p>Based on this study open reduction and internal fixation using three point fixation by miniplates is the best available method for the treatment zygomatic bone fractures.</p

Determination of the Structural Characteristics of Microalgal Cells Walls under the Influence of Turbulent Mixing Energy in Open Raceway Ponds

Turbulent flow mixing is essential in optimizing microalgal cultivation in raceway ponds. Microalgal cells are however highly sensitive to hydrodynamic stresses produced by turbulent mixing because of their small size. The mechanical properties (wall deformation and von Misses stress) of the microalgal cell wall structure under the influence of turbulent mixing are yet to be explored. High turbulence magnitudes damage microalgal cell walls by adversely affecting their mechanical properties which consequently destroy the microalgal cells and reduce the biofuel production. Therefore, such a study is required to improve the biofuel productivity of microalgal cells before their cell wall damage in raceway pond. This study developed a novel fluid–structure interaction (FSI)-based numerical model to investigate the effects of turbulent mixing on the cell wall damage of microalgal cells in raceway ponds. The study investigated microalgal cell wall damage at four different locations in a raceway pond in consideration of the effects of pond’s hydrodynamic and geometric properties. An experiment was conducted with a laboratory-scale raceway pond to compare and validate the numerical results by using time-dependent water velocities. Microalgal cell wall shear stress, cell wall deformation, and von Misses stress in the raceway pond were investigated by considering the effects of aspect ratios, water depths, and paddle wheel rotational speeds. Results showed that the proposed numerical model can be used as a prerequisite method for the selection of appropriate turbulent mixing. Microalgal cell wall damage is high in shallow and narrow raceway ponds with high paddle rotational speeds

Numerical Investigation of the Pressure Drop Characteristics of Isothermal Ice Slurry Flow under Variable Ice Particle Diameter

Ice slurry is an advanced secondary refrigerant that has been attracting considerable attention for the past decade due to the growing concerns regarding energy shortage and environmental protection. To stimulate the potential applications of ice slurry, the corresponding pressure drop of this refrigerant must be comprehensively investigated. The flow of ice slurry is a complex phenomenon that is affected by various parameters, including flow velocity, ice particle size, and ice mass fraction. To predict the pressure drop of ice slurry flow in pipes, a mixture computational fluid dynamic model was adopted to simulate a two-phase flow without considering ice melting. The numerical calculations were performed on a wide range of six ice particle sizes (0.1, 0.3, 0.5, 0.75, 1, and 1.2 mm) and ice mass fraction ranging within 5%–20% in the laminar range of ice slurry flow. The numerical model was validated using experimental data. Results showed that the ice volumetric loading and flow velocity have a direct effect on pressure drop; it increases with the increase in volumetric concentration and flow velocity. The findings also confirmed that for constant ice mass fraction and flow velocity, the pressure drop is directly and inversely related to the particle and pipe diameters, respectively. Moreover, the rise in pressure drop is more significant for large ice particle diameter in comparison to smaller size ice particles at high values of ice concentration and flow velocity

Numerical Investigation of the Pressure Drop Characteristics of Isothermal Ice Slurry Flow under Variable Ice Particle Diameter

Ice slurry is an advanced secondary refrigerant that has been attracting considerable attention for the past decade due to the growing concerns regarding energy shortage and environmental protection. To stimulate the potential applications of ice slurry, the corresponding pressure drop of this refrigerant must be comprehensively investigated. The flow of ice slurry is a complex phenomenon that is affected by various parameters, including flow velocity, ice particle size, and ice mass fraction. To predict the pressure drop of ice slurry flow in pipes, a mixture computational fluid dynamic model was adopted to simulate a two-phase flow without considering ice melting. The numerical calculations were performed on a wide range of six ice particle sizes (0.1, 0.3, 0.5, 0.75, 1, and 1.2 mm) and ice mass fraction ranging within 5%–20% in the laminar range of ice slurry flow. The numerical model was validated using experimental data. Results showed that the ice volumetric loading and flow velocity have a direct effect on pressure drop; it increases with the increase in volumetric concentration and flow velocity. The findings also confirmed that for constant ice mass fraction and flow velocity, the pressure drop is directly and inversely related to the particle and pipe diameters, respectively. Moreover, the rise in pressure drop is more significant for large ice particle diameter in comparison to smaller size ice particles at high values of ice concentration and flow velocity

Perceived corporate social responsibility and pro-environmental behaviors: The role of organizational identification and coworker pro-environmental advocacy

Despite research suggesting that pro-environmental behaviors offer a range of positive benefits for organizations and that corporate social responsibility (CSR) positively affects employee behaviors and attitudes, very few studies have investigated how CSR affects pro-environmental behaviours. As such, this study investigates the impact of perceived CSR on employees' pro-environmental behaviours through organizational identification and coworkers' pro-environmental advocacy. Using a multistage sampling technique, a survey of line managers was conducted across 32 hotels in the understudied context of Malaysia's hotel industry. Based on 331 completed questionnaires, the results suggest that perceived CSR activities drive organizational identification and trigger coworkers’ pro-environmental advocacy, which in turn generate employees’ pro-environmental behaviours. The study offers valuable insights into the complex relationship between perceived CSR and pro-environmental behaviors and discusses the theoretical and research contributions and managerial implications.</p

Sensitivity and specificity of wearables for atrial fibrillation in elderly populations: A systematic review

Purpose of review: This study aims to evaluate the sensitivity and specificity of wearable devices for AF detection in older adults, as well as examine the incidence of AF across various studies, contextual factors impacting AF detection, and safety and adverse events associated with wearable use. Recent findings: A systematic search of three databases identified 30 studies on wearables for AF detection in older adults, encompassing 111,798 participants. Both PPG-based and single-lead electrocardiography-based wearables show scalable potential for screening and managing AF. The results of this systematic review demonstrate that wearable devices, such as smartwatches, can effectively identify arrhythmias like AF in older adults, with scalable potential in PPG-based and single-lead electrocardiography-based wearables. As wearable technologies continue to gain prominence in healthcare, it is crucial to understand their challenges and incorporate them as preventative and monitoring tools for AF detection in elderly populations to improve patient care and prevention technique