SUBFOVEAL NODULE IN COATS' DISEASE: Toward an Updated Classification Predicting Visual Prognosis.

To determine the prevalence, clinical characteristics and nature of subfoveal nodules in Coats' disease and the associated impact on the long-term visual outcome. Consecutive cases of Coats' disease with foveal exudation were retrospectively reviewed. The presence of a subfoveal nodule or macular fibrosis was recorded. Clinical characteristics, retinal imaging, and outcome were analyzed by comparative analysis. The histopathological description of an enucleated eye with subfoveal nodule was performed. Among 40 patients presenting unilateral Stage 2B or 3A1 Coats' disease, a subfoveal nodule was detected in 21 patients (52.5%). The median follow-up was 4.7 years. Nineteen patients (47.5%) did not present a subfoveal nodule. Three patients (15.8%) without subfoveal nodule and 21 patients (100%) with subfoveal nodule progressed to a macular fibrotic scar (P < 0.0001), and the mean time of macular fibrosis onset was 11.0 ± 2.6 months. Final visual acuity was significantly worse in patients who presented a subfoveal nodule at diagnosis (P = 0.01). Of 18 cases with subfoveal nodule who underwent fluorescein angiography, retinal-retinal anastomosis and neovascularization were detected in 13 (72.2%) and 2 eyes (11.1%), respectively. Histopathological analysis of a subfoveal nodule revealed an aggregate of proteinaceous material including fibrin, spindle cells, macrophages, and pigmented cells. The presence of a subfoveal nodule at presentation is a predictive factor for macular fibrosis development and worse visual outcome in patients with Coats' disease. These observations suggest an updated classification introducing two subcategories within Stage 2B: without subfoveal nodule (Stage 2B1) and with subfoveal nodule (Stage 2B2)

Assessing optical earth observation systems for mapping and monitoring temporary ponds in arid areas

Remote sensing methods for locating and monitoring temporary ponds over large areas in arid lands were tested on a study site in Northern Senegal. Three main results are presented, validated with field data and intended to highlight different spectral, spatial and temporal characteristics of the methods: (1) Among several water indices tested, two Middle Infrared-based indices (MNDWIModified Normalized Difference Water Index and NDWI1Normalized Difference Water Index) are found to be most efficient; (2) an objective method is given prescribing the necessary sensor spatial resolution in terms of minimal detected pond area; and (3) the potential of multi-temporal MODIS imagery for tracking the filling phases of small ponds is illustrated. These results should assist in epidemiological studies of vector-borne diseases that develop around these ponds, but also more generally for land and water management and preservation of threatened ecosystems in arid areas

Sequential drain amylase to guide drain removal following pancreatectomy

BACKGROUND: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. METHODS: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. RESULTS: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. CONCLUSIONS: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful

Fresnel laws at curved dielectric interfaces of microresonators

We discuss curvature corrections to Fresnel's laws for the reflection and transmission of light at a non-planar refractive-index boundary. The reflection coefficients are obtained from the resonances of a dielectric disk within a sequential-reflection model. The Goos-H\"anchen effect for curved light fronts at a planar interface can be adapted to provide a qualitative and quantitative extension of the ray model which explains the observed deviations from Fresnel's laws.Comment: submitted to Phys. Rev.

Conductometric biosensor based on whole-cell microalgae for assessment of heavy metals in wastewater

Whole-cell Chlorella vulgaris conductometric biosensors consisting of gold planar interdigitated electrodes and sol-gel algal membranes have been used for assessment of heavy-metal ions in water. These analytes act as algal alkaline phosphatase inhibitors. Enzyme residual activity has been measured in Tris-nitrate buffer in the presence of Mg²⁺ ions as activator. Operating conditions of this biosensor have been optimized and its characteristics are discussed. Detection limits are about 1 ppb for Cd²⁺, Co²⁺, Ni²⁺, Pb²⁺ and 10 ppb for Zn²⁺. The storage stability of the biosensor in buffer solution at 4 oC is more than 40 days. The biosensor has been used to assess wastewater pollution.Описан биосенсор для оценки содержания тяжелых металлов в воде. Для его создания клетки Chlorella vulgaris иммобилизировали на золотых планарных гребенчатых электродах с помощью золь–гель технологии. Тяжелые металлы являются ингибиторами щелочной фосфатазы. Остаточную активность иммобилизованного фермента измеряли в трис-нитратном буферном растворе в присутствии активатора: ионов магния. Оптимизированы рабочие характеристики биосенсора. Нижняя граница определения составляла 1 млрд ⁻¹ для Cd²⁺, Co²⁺, Ni²⁺, Pb²⁺ и 10 млрд ⁻¹ для Zn²⁺. Срок хранения биосенсора в буферном растворе при температуре 4 оC составляет более 40 дней. Биосенсор использован для оценки загрязнения тяжелыми металлами сточных вод.Описано біосенсор для оцінки вмісту важких металів у воді. Для його створення клітини Chlorella vulgaris іммобілізували на золотих планарних гребінчастих електродах за допомогою золь–гель технології. Важкі метали є інгібіторами лужної фосфатази. Залишкову активність іммобілізованого ферменту вимірювали в трис-нітратному буферному розчині за присутності активатора – іонів магнію. Оптимізовано робочі характеристики біосенсора. Нижня межа визначення складала 1 млрд ⁻¹ для Cd²⁺, Co²⁺, Ni²⁺, Pb²⁺ та 10 млрд ⁻¹ для Zn²⁺. Термін зберігання біосенсора у буферному розчині за температури 4 оC був більшим, ніж 40 діб. Біосенсор використано для оцінки забруднення важкими металами стічних вод

A novel transflectance near infrared spectroscopy technique for monitoring hot melt extrusion

yesA transflectance near infra red (NIR) spectroscopy approach has been used to simultaneously measure drug and plasticiser content of polymer melts with varying opacity during hot melt extrusion. A high temperature reflectance NIR probe was mounted in the extruder die directly opposed to a highly reflective surface. Carbamazepine (CBZ) was used as a model drug, with polyvinyl pyrollidone-vinyl acetate co-polymer (PVP-VA) as a matrix and polyethylene glycol (PEG) as a plasticiser. The opacity of the molten extrudate varied from transparent at low CBZ loading to opaque at high CBZ loading. Particulate amorphous API and voids formed around these particles were found to cause the opacity. The extrusion process was monitored in real time using transflectance NIR; calibration and validation runs were performed using a wide range of drug and plasticiser loadings. Once calibrated, the technique was used to simultaneously track drug and plasticiser content during applied step changes in feedstock material. Rheological and thermal characterisations were used to help understand the morphology of extruded material. The study has shown that it is possible to use a single NIR spectroscopy technique to monitor opaque and transparent melts during HME, and to simultaneously monitor two distinct components within a formulation

Evidence Vs. Practice in Early Drain Removal Following Pancreatectomy

Background: Early drain removal when postoperative day (POD) 1 drain fluid amylase (DFA) was ≤ 5000 U/L reduced complications in a previous randomized controlled trial. We hypothesized that most surgeons continue to remove drains late and this is associated with inferior outcomes. Methods: We assessed the practice of surgeons in a prospectively maintained pancreas surgery registry to determine the association between timing of drain removal with demographics, co-morbidities, and complications. We selected patients with POD1 DFA ≤ 5000 U/L and excluded those without drains, and subjects without data on POD1 DFA or timing of drain removal. Early drain removal was defined as ≤ POD5. Results: 244 patients met inclusion criteria. Only 90 (37%) had drains removed early. Estimated blood loss was greater in the late removal group (190 mL vs 100 mL, p = 0.005) and pathological findings associated with soft gland texture were more frequent (97(63%) vs 35(39%), p < 0.0001). Patients in the late drain removal group had more complications (84(55%) vs 30(33%), p = 0.001) including pancreatic fistula (55(36%) vs 4(4%), p < 0.0001), delayed gastric emptying (27(18%) vs 3(3%), p = 0.002), and longer length of stay (7 days vs 5 days, p < 0.0001). In subset analysis for procedure type, complications and pancreatic fistula remained significant for both pancreatoduodenectomy and distal pancreatectomy. Conclusion: Despite level 1 data suggesting improved outcomes with early removal when POD1 DFA is ≤ 5000 U/L, experienced pancreas surgeons more frequently removed drains late. This practice was associated with known risk factors (EBL, soft pancreas) and may be associated with inferior outcomes suggesting potential for improvement

Libxc: a library of exchange and correlation functionals for density functional theory

The central quantity of density functional theory is the so-called exchange-correlation functional. This quantity encompasses all non-trivial many-body effects of the ground-state and has to be approximated in any practical application of the theory. For the past 50 years, hundreds of such approximations have appeared, with many successfully persisting in the electronic structure community and literature. Here, we present a library that contains routines to evaluate many of these functionals (around 180) and their derivatives.Comment: 15 page