Conjunctival Melanoma: Features Based on the Fitzpatrick Skin Type (FST) in 540 Patients at a Single Ocular Oncology Center

Background: The Fitzpatrick skin type (FST) is a classification system for skin pigmentation that has been used to stratify risk for cutaneous melanoma; however, it has not yet been explored in the context of conjunctival melanoma. Herein, we examine FST and its association with the clinical features of conjunctival melanoma. Methods: A retrospective review was conducted on 540 medical records of patients with pathologic diagnosis of conjunctival melanoma. The patients were categorized according to the FST classification based on their external facial photographs at presentation. This includes: Type I (white skin color), Type II (fair skin color), Type III (average skin color), Type IV (light-brown skin color), Type V (brown skin color), and Type VI (black skin color). Other clinical features (namely tumor characteristics, tumor location, and tumor color) were also noted. Results: The FST included Types I (n=126, 23%), II (n=337, 62%), III (n=56, 10%), IV (n=8, 2%), V (n=12, 2%), and VI (n=1, \u3c1%). Statistical analysis (FST I vs. FST II vs. FST III, IV, V, and VI) revealed FST I and II tumors had smaller tumor thickness (2.1 vs. 2.8 vs. 3.6 mm, p=0.01) and less eyelid involvement (13% vs. 13% vs. 28%, p=0.02). Discussion: In this analysis, we found that the majority of patients with conjunctival melanoma are FST I or II; they also had smaller tumor thickness and less eyelid involvement than FST III, IV, V, and VI. Thus, patients with FST I and II should be considered a phenotype at risk for conjunctival melanoma and be observed accordingly

Photodynamic Therapy in Ocular Oncology

Over the past two decades, we have witnessed the increasing use of photodynamic therapy (PDT) in the field of ocular oncology. Based on a review of the literature and our own experience, we herein review the role of PDT for the management of intraocular tumors. The discussion includes two main topics. First, we discuss the application of PDT for benign tumors, including circumscribed choroidal hemangioma, choroidal osteoma, retinal astrocytoma, retinal capillary hemangioma (retinal hemangioblastoma), and retinal vasoproliferative tumor. Second, we assess the role of PDT for malignant tumors, including choroidal melanoma and choroidal metastasis

The Contrasting Behavior of Strongly and Weakly Interfacially Active Asphaltenes on the Rheology of Model Waxy Oils

Asphaltenes and waxes are two components of crude oil that cause flow assurance issues. Although the components coexist, few studies have considered the effect of asphaltenes on wax crystallization and gel-forming properties. Furthermore, the current understanding remains contradictory with both wax-alleviating and wax-aggravating behaviors observed. In this study, asphaltenes extracted from a heavy crude oil were fractionated into strongly and weakly interfacially active asphaltenes by partitioning at a water–oil interface. The two asphaltene fractions exhibited contrasting physicochemical properties, with the strongly interfacially active asphaltenes (IAA) being more polar due to their higher heteroatom content (particularly S and O) and forming larger aggregates in the solution compared to the weakly interfacially active asphaltenes (referred to as remaining asphaltenes, RA). The two asphaltene fractions lowered both the wax gelation temperature and wax appearance temperature; however, the effect was comparable. The unit cell lattice structure of the wax particle remained unchanged in the presence of asphaltenes, but the wax particles were found to be smaller with RA compared to IAA. However, the key finding of the study is how the two asphaltene fractions affected the yield strength of the gelled wax. For RA, the yield strength was lowered with an increasing asphaltene concentration, whereas for IAA, the overall effect was to increase the gel yield strength. Because the properties of the wax particles were largely unchanged by the two asphaltene fractions, the result suggests that the asphaltene–asphaltene interaction contributes to the overall yield strength. It was shown that the interaction between RA and RA is repulsive with negligible adhesion, whereas that between IAA and IAA is attractive with strong adhesion. These structure-breaker and structure-maker properties of the two asphaltenes confirm that the asphaltene–asphaltene interaction significantly contributes to modifying the yield strength of a waxy gel

Opportunities for process intensification technologies in nuclear effluent treatment: A review of precipitators, adsorbers and separators

This paper reviews the technologies and opportunities for process intensification (PI) in nuclear effluent treatment. PI is an area that has already created many innovations within the chemicals industry, and offers a growing field of research and development potential for nuclear operations. Technologies are considered here to be those ultimately resulting in step-change improvements to a number of operational aspects; such as smaller unit footprints, enhanced heat and mass transfer, reduction in secondary wastes, improved process safety and synergy, or direct integration with other downstream processes. Herein, we conduct a rigorous evaluation and scoping assessment of unit designs for the treatment of nuclear liquid effluents and solid-liquid waste management. Specific focus is given to precipitation, adsorption and separation operations, where over 250 articles are detailed, and prospects for technology transfer are discussed. In general, there is a trade-off in PI designs between operational simplicity (which may be more easily adopted in nuclear treatments) and more mechanically complex strategies that may, however, attain suitable scale-up requirements. Analysed options vary from those that would be radically different for industry, to those where applications are increasingly common in other process areas, with the advantages and limitations of all being discussed

Likelihood of Germline Mutation with Solitary Unilateral Retinoblastoma Based on Patient Age at Presentation. A Real-World Analysis of 482 Consecutive Patients.

Introduction: Retinoblastoma due to germline mutation has a greater risk of bilateral presentation, and multifocal or extraocular involvement. In solitary unilateral retinoblastoma, the inheritance pattern is less understood and assumed to be somatic. We assessed the likelihood of germline inheritance in children with unilateral retinoblastoma and whether it varies based on age at presentation. Methods: This was a retrospective case study assessing 482 consecutive patients with solitary unilateral retinoblastoma at Wills Eye Hospital between 1972 and 2020 for the likelihood of germline inheritance based on age at presentation (≤1 year vs. \u3e1 year). Germline inheritance was deemed likely if there was a family history of retinoblastoma, positive genetic testing, and/or progression to bilateral retinoblastoma. Only patients with \u3e1-month follow-up were included. Chi-square test and Odds Ratio analyses were performed. Results: 465 of the 482 patients had sufficient follow-up data. 16% (n=72) of all patients, and 29% (n=37) of patients ≤1 year of age with unilateral retinoblastoma were likely to have germline disease (p=0.001). When compared to patients \u3e1 year of age (n=339), patients ≤1 year (n=126) demonstrated a greater likelihood of germline inheritance with a 2.96 odds ratio ([1.55 – 5.65]). Discussion: The inheritance of unilateral retinoblastoma is poorly understood. We found that 16% of children with unilateral retinoblastoma likely have germline inheritance, with a greater likelihood in children ≤1 year of age. Therefore, early assessment of inheritance and genetic testing of unilateral retinoblastoma may uncover germline disease and potential bilateral progression, for which a more conservative management approach to preserve vision should be considered

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

Cold rotating finger: Apparatus to study wax deposition under shear

A bench-top Cold Rotating Finger (CRF) is developed to study the effect of fluid shear on wax deposition. An inner rotating cylinder provides opportunity to study wax deposition on surfaces in the region of high fluid shear stress (and laminar/turbulent flows). A model system of linear n-alkane (C20 to C40) dissolved in dodecane to 9 wt% was used for the deposition tests. The bulk fluid temperature was set to 45°C and the temperature of the inner rotating cylinder to 5°C, with wax deposits showing a mass variation less than ~5% at constant rotational speed. The kinetic of wax deposition is non-linear, with an initial rapid deposition (approximately linear) followed by a slower rate as deposit mass tends to steady-state within 30 min. The wax deposit mass is limited by thermal insulation of the cold surface and not wax depletion. As a function of rotational speed, the wax deposit mass is shown to be maximum under static condition and gradually decrease with increasing rotational speed (25 to 500 rpm). The wax deposit morphology is studied by cryo-scanning electron microscopy with the static deposit showing a layered structure (ridges) which diminished at 200 rpm, confirming a denser, less porous deposit. With its simple design and small sample volume, the CRF provides a route to easily study wax deposition under conditions more relevant to the industry scenario

The potential use of non-fungible tokens (NFTs) in healthcare and medical research.

Non-fungible tokens (NFTs) are cryptographic assets recorded on the blockchain that can certify authenticity and ownership, and they can be used to monetize health data, optimize the process of receiving a hematopoietic stem cell transplant, and improve the distribution of solid organs for transplantation. Blockchain technology, including NFTs, provides equitable access to wealth, increases transparency, eliminates personal or institutional biases of intermediaries, reduces inefficiencies, and ensures accountability. Blockchain architecture is ideal for ensuring security and privacy while granting individuals jurisdiction over their own information, making it a unique solution to the current limitations of existing health information systems. NFTs can be used to give patients the option to monetize their health data and provide valuable data to researchers. Wearable technology companies can also give their customers the option to monetize their data while providing data necessary to improve their products. Additionally, the process of receiving a hematopoietic stem cell transplant and the distribution of solid organs for transplantation could benefit from the integration of NFTs into the allocation process. However, there are limitations to the technology, including high energy consumption and the need for regulatory guidance. Further research is necessary to fully understand the potential of NFTs in healthcare and how it can be integrated with existing health information technology. Overall, NFTs have the potential to revolutionize the healthcare sector, providing benefits such as improved access to health information and increased efficiency in the distribution of organs for transplantation

Wax deposition using a cold rotating finger: An empirical and theoretical assessment in thermally driven and sloughing regimes

Time-dependent wax deposition was studied using a newly-built Cold Rotating Finger (CRF). Wax deposition rates and pseudo-steady state deposit mass values were shown to depend on the CRF rotational speed. Relative to 0 rpm, the wax deposit mass decreased with increasing rotational speed, reducing by 54% at 100 rpm and 82% at 700 rpm. At low rotational speeds, the reduced wax deposit correlated with changes in the bulk oil (To) and wax interface (Ti) temperatures as a function of increasing CRF rotational speed, with the behavior described by a diffusive model which accounted for the CRF fluid motion. The model described the temperature profile in the boundary layer by considering the heat transfer coefficient as a function of the CRF rotational speed, with heat transfer governing wax deposition. Mass transfer was described by Fick's law assuming a linear solubility with temperature and constant diffusivity determined from experimental data at CRF = 100 rpm. The change in heat transfer governed the mass deposited, with deposition at low rotational speeds described by a thermally-driven process. At higher rotational speeds, To was independent of CRF rpm, although the wax deposit mass continued to decrease. Visual assessment of the CRF revealed sloughing at rotational speeds 400 rpm. For high CRF rotational speeds, the molecular diffusion model could not accurately describe the wax deposit mass and was modified to include a sloughing term, , accounting for the wall shear stress, deposit radius and , which was taken to be an adjustable parameter to describe the sloughing intensity

Conditional Analysis on New Tumor Formation with Solitary Unilateral Retinoblastoma in 482 Consecutive Patients

PURPOSE: The objective of the study was to understand dynamic risk (conditional analysis based on patient age) for new tumor development in patients with solitary unilateral retinoblastoma. METHODS: This was a retrospective analysis. RESULTS: Of 482 patients with solitary unilateral retinoblastoma, 55 new tumors developed in 20 patients (4%). Comparison (new tumor vs. no new tumor development) revealed those with new tumor demonstrated younger mean age at presentation (10 vs. 36 months, CONCLUSION: Children (≤24 months) with solitary unilateral retinoblastoma showed decreasing risk for new tumors up to 24 months of life. Later onset of new tumor was more likely located in preequatorial region