Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab

Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD), treated by vitrectomy, submacular tissue plasminogen activator (tPA) injection and pneumatic displacement of SMH with air followed by postoperative intravitreal ranibizumab (RZB).Methods: Patients with SMH and nAMD had 25-guage vitrectomy and subretinal tPA (12.5 micrograms/0.1 mL) with fluid/air exchange. Intravitreal RZB was administered postoperatively to patients eligible for National Health Service (NHS) funded treatment.Results: Of the total of 16 patients, 11 (68.7%) had complete displacement of SMH. The remaining five had residual SMH, mainly subretinal pigment epithelium in location. Three of the four patients who previously had a failed expansile gas pneumatic displacement were successfully displaced with vitrectomy surgery. At presentation 5/16 (31.3%) patients were eligible for NHS funded intravitreal RZB. This increased to 12 patients after the vitrectomy procedure (75.0%). At 6 months postoperatively all improved by $1 line. Ten of the 16 patients (63%) improved by ≥2 lines, with 10 of the 12 patients (83%) treated with RZB improving by ≥2 lines.Conclusion: Vitrectomy/subretinal tPA/air to displace SMH followed by intravitreal RZB injection can stabilize/improve vision in patients with nAMD. This technique displaces hemorrhage not displaced by attempted expansile gas techniques.Keywords: submacular hemorrhage, neovascular age-related macular degeneration, vitrectomy, tissue plasminogen activator, ranibizuma

Iron binding properties of whey protein, casein, soya protein and egg albumen : a thesis presented in partial fulfilment of the requirements for the degree of Master of Technology in Food Technology at Massey University

Iron binding properties of whey protein, casein, soya protein and egg albumen were investigated in aqueous dispersions using centrifugation and ultrafiltration techniques. Protein-iron mixtures were centrifuged at 10,800 g for 20 min and iron that co-sedimented with protein was considered to be bound to the insoluble protein fraction. The supernatants were ultrafiltered to obtain iron bound to the soluble protein fraction. Both the soluble and insoluble fractions of each protein were shown to bind substantial quantities of iron from ferrous sulphate. The amount of iron bound/g to the insoluble fraction of the protein was highest for casein (87 mg) followed by albumen (80 mg), soya protein (66 mg) and whey protein (63 mg). A similar trend was observed for the soluble fraction; casein bound 74 mg iron/g protein followed by albumen (68 mg), soya protein (54 mg) and whey protein (12 mg). This binding was markedly influenced by pH of the protein-iron mixtures in the range 2 – 7. The binding data was analyzed using the Scatchard equation to obtain binding constants (k) and the number of binding sites (n). The n values obtained were ~ 2 (whey protein), 13 (casein), 200 (soya protein) and 42 (albumen). The values obtained for the binding constants were ~ 11 (whey protein), 5 (casein), 3 (soya protein) and 1 (albumen). Thus soys protein had the highest number of binding sites and whey protein had the greatest affinity for iron. Solubility of each protein was dependent on pH and it generally decreased with increase in iron concentration. The effects of chelating agents (citric acid and ascorbic acid) on the iron binding properties of the four proteins were also examined. Addition of citric acid and ascorbic acid increased the solubilities of both protein and iron. The solubilizing effect of these two acids was dependent on the protein source, pH and acid concentration. Iron binding by both the insoluble and soluble fractions decreased in the presence of citric acid and ascorbic acid, with no significant differences between the effects of the two acids. The effects of proteins and protein digestion products on in vitro iron availability were studied. Ferrous iron complexes with protein were prepared and subjected to simulated gastrointestinal digestion followed by measurement of soluble iron. The in vitro availability of iron was in the order of 26% (soya protein), 16% (casein), 14% (albumen) and 10% (whey protein). When citric acid and ascorbic acid were added prior to enzymatic digestion the availability of iron increased to 63% (soya protein), 36% (albumen), 31% (casein) and 22% (whey protein)

ENGG 390: Optimizing Ball Seat Production Process

IDEX IH&S is a global leader in life science fluidics, microfluidics, and optics. Ball seats, a legacy product, support $4.85M revenue for their Middleboro, MA site. Over the past couple of years, the Ball Seats department has been facing a challenge with an On-Time Delivery rate of 59%. My project examines ways to improve inefficiencies and optimize the production process. I accomplished these goals by leading a Value Stream Mapping rapid improvement event, collecting and analyzing data through Standard Work studies, and introducing a new flow on the production floor that resulted in a 40% increase in throughput

Animations in medical education: You can do it!

Introduction: Animations are the best suited to convey and create an impact of an idea or concept in media business. Animations are sequential frames of pictures shown across this fourth dimension, namely "time." Cartoons are the best examples of animations; needless to say, animations grab the attentions of every one. Animations can also be effectively used in medical education especially in teaching human embryology. It communicates of a concept of three-dimensional structures against one more dimension, namely time. However, to create a module of animation, knowledge, and operative skills of animation software like Flash® , Author ware® , Macromedia® or other high-ended software is necessary. Aim: To design simple, user-friendly and easy to make an effective animation using one of the office tools of Windows® , Power Point® . Materials and Methods: A personal computer with following configuration was used. Pentium III processor with 1.3 Gz speed, 40 GB HDD, 128 MB RAM, with multimedia kit, key pad, and scroll mouse was used. Programs used were Power Point® and MS Paint® . A screen play of sequences of diagrams was written. Frames consisting of diagrams of stages of development were drawn in MS Paint® , and were pasted in PowerPoint slides and animation tool was applied. Previewing was done at every stage. Results: Stages of development of storyboard have been shown as print screen images, 1-6. Conclusion: Emphasis is that such simple animations can be easily made. It is cheap and does not require any sophisticated software. However, it is time consuming but can be taken up as phased assignments or can be given as undergraduate student projects. This will certainly help to build teaching material in the department

Dataset of groundnut plant leaf images for classification and detection

Data for publication in Data in Brief.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV

Accuracy of Intraocular Lens Power Estimation in Eyes Having Phacovitrectomy for Rhegmatogenous Retinal Detachment

Purpose: To evaluate the accuracy of intraocular lens power estimation in eyes having phacovitrectomy for rhegmatogenous retinal detachment. Methods: Retrospective case review of 100 consecutive eyes that underwent phacovitrectomy for rhegmatogenous retinal detachment. Axial lengths were measured using optical biometry and/or ultrasound A-scan. Achieved and predicted refraction were compared to calculate the mean postoperative refractive prediction error and the mean absolute prediction error. Factorial analysis of variance models were developed to assess outcome on the whole and that between the subgroups. Results: Ninety-five eyes had postoperative refraction: 41 macula-on (43%) and 54 macula-off (57%). The mean postoperative prediction error was -0.34 +/- 0.89 diopters. There was no statistical significant difference in the refractive outcomes between macula-on and macula-off groups (P > 0.05). Overall, using mean absolute prediction error as the outcome measure, optical biometry was more accurate than ultrasound (P = 0.040). However, significantly more ultrasound-measured axial lengths were selected for intraocular lens power estimation in macula-off group compared with the macula-on group (P = 0.016). Conclusion: Combined phacovitrectomy in rhegmatogenous retinal detachment included a small biometric error that was within the tolerable range in most cases. Both optical biometry and ultrasound should be used to estimate axial lengths, for macula-off rhegmatogenous retinal detachment cases, to improve the accuracy of intraocular lens power calculation