Erratum: Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

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Inverted ILM Flap Technique in Optic Disc Pit Maculopathy

Purpose: To present the outcome of optic disc pit maculopathy (ODPM) managed successfullywith an inverted internal limiting membrane (ILM) flap over the optic disc. A narrative review ofODPM pathogenesis and surgical management techniques are also provided. Case Report: This prospective interventional case series included three eyes of three adultpatients (25–39 years old) with unilateral ODPM and a mean duration of unilaterally decreasedvisual acuity of 7.33 ± 2.40 months (4–12 months). The pars plana vitrectomy with posteriorvitreous detachment induction was performed on eyes, followed by an inverted ILM flap insertionover the optic disc and gas tamponade. Patients were followed for 7–16 weeks postoperatively;best-corrected visual acuity (BCVA) improved dramatically in one patient from 2/200 to 20/25.BCVA in other patients improved two and three lines – to 20/50 and 20/30, respectively. Asignificant anatomical improvement was achieved in all three eyes, and no complication wasdetected throughout the follow-up period. Conclusion: Vitrectomy with inverted ILM flap insertion over the optic disc is safe and can yieldfavorable anatomical improvement in patients with ODPM

A cost utility and cost effectiveness analysis of different oral antiviral medications in patients with HBeAg-Negative chronic hepatitis B in Iran: an economic microsimulation decision model

Background: Although hepatitis B infection is the major cause of chronic liver disease in Iran, no studies have employed economic evaluations of the medications used to treat Iranian patients with chronic hepatitis B (CHB). Therefore, the cost-effectiveness of the different treatment options for this disease in Iran is unknown. Objectives: The aim of this study was to compare the cost utility and cost-effectiveness of medication strategies tailored to local conditions in patients with HB e antigen (HBeAg)-negative CHB infection in Iran. Methods: An economic evaluation of the cost utility of the following five oral medication strategies was conducted: adefovir (ADV), lamivudine (LAM), ADV + LAM, entecavir (ETV), and tenofovir (TDF). A Markov microsimulation model was used to estimate the clinical and economic outcomes over the course of the patient’s lifetime and based on a societal perspective. Medical and nonmedical direct costs and indirect costs were included in the study and life-years gained (LYG) and quality-adjusted life-years (QALY) were determined as measures of effectiveness. The results are presented in terms of the incremental cost-effectiveness ratio (ICER) per QALY or LYG. The model consisted of nine stages of the disease. The transition probabilities for the movement between the different stages were based on clinical evidence and international expert opinion. A probabilistic sensitivity analysis (PSA) was used to measure the effects of uncertainty in the model parameters. Results: The results revealed that the TDF treatment strategy was more effective and less costly than the other options. In addition, TDF had the highest QALY and LYG in the HBeAg-negative CHB patients, with 13.58 and 21.26 (discounted) in all comparisons. The PSA proved the robustness of the model results. The cost-effectiveness acceptability curves showed that TDF was the most cost-effective treatment in 59% - 78% of the simulations of HBeAg-negative patients, with WTP thresholds less than $14010 (maximum WTP per QALY). Conclusions: The use of TDF in patients with HBeAg-negative CHB seemed to be a highly cost-effective strategy. Compared with the other available medication options, TDF was the most cost-saving strategy. Thus, TDF may be the best option as a first-line medication. Patients can also be switched from other medications to TDF

Genome-resolved analyses show an extensive diversification in key aerobic hydrocarbon-degrading enzymes across bacteria and archaea

Background Hydrocarbons (HCs) are organic compounds composed solely of carbon and hydrogen that are mainly accumulated in oil reservoirs. As the introduction of all classes of hydrocarbons including crude oil and oil products into the environment has increased significantly, oil pollution has become a global ecological problem. However, our perception of pathways for biotic degradation of major HCs and key enzymes in these bioconversion processes has mainly been based on cultured microbes and is biased by uneven taxonomic representation. Here we used Annotree to provide a gene-centric view of the aerobic degradation ability of aliphatic and aromatic HCs in 23,446 genomes from 123 bacterial and 14 archaeal phyla. Results Apart from the widespread genetic potential for HC degradation in Proteobacteria, Actinobacteriota, Bacteroidota, and Firmicutes, genomes from an additional 18 bacterial and 3 archaeal phyla also hosted key HC degrading enzymes. Among these, such degradation potential has not been previously reported for representatives in the phyla UBA8248, Tectomicrobia, SAR324, and Eremiobacterota. Genomes containing whole pathways for complete degradation of HCs were only detected in Proteobacteria and Actinobacteriota. Except for several members of Crenarchaeota, Halobacterota, and Nanoarchaeota that have tmoA, ladA, and alkB/M key genes, respectively, representatives of archaeal genomes made a small contribution to HC degradation. None of the screened archaeal genomes coded for complete HC degradation pathways studied here; however, they contribute significantly to peripheral routes of HC degradation with bacteria. Conclusion Phylogeny reconstruction showed that the reservoir of key aerobic hydrocarbon-degrading enzymes in Bacteria and Archaea undergoes extensive diversification via gene duplication and horizontal gene transfer. This diversification could potentially enable microbes to rapidly adapt to novel and manufactured HCs that reach the environment

A trend of Medical Negligence in Laser Therapy in the Capital City: A Nine-Year Survey

Background: the purpose of the present study is to investigate the common causes of injuries, claims, and decisions related to laser therapy medical malpractice during a nine-year survey. Study design: This study is a retrospective descriptive study. Methods: The legal documents in the coroner’s Office of Forensic Medicine were investigated in a national database from 2012 to 2020 in Tehran, Iran. The frequency and nature of the cases, including the year of litigation, the location and certificate of the provider, the injury sustained, the cause of legal action and judgment were collected. Results: Three hundred and eighty-three cases related to injury from laser therapy were registered in the coroner’s Office of Forensic Medicine during the study period. The incidence of litigation related to laser surgery showed an increasing trend, with a peak occurrence in 2020. Laser hair removal was the most common (51.2%) litigated procedure. General practice operators (48%) recorded the highest rate of laser-related medical complaints. lack of skill was the most common reason for failure. Among 383 cases with public decisions, 62.4% of them were fault liability in paid judgment. Conclusions: Medical claims related to laser application are increasing. However, as it is clear, the growth of laser technology and the increasing demand for lasers in medical science require more surveillance to avoid probable injuries and improve patient safety, especially surveillance of the physicians who work outside the scope of their specialty.&nbsp

Robust Adaptive Control of a Micro Telemanipulation System Using Sliding Mode-Based Force Estimation

Abstract-Piezoelectric actuators are widely used in micro manipulation applications. However, hysteresis nonlinearity limits the accuracy of these actuators. This paper presents a novel approach for utilizing a piezoelectric nano-stage as the slave manipulator of a teleoperation system based on a sliding mode controller. The Prandtl-Ishlinskii (PI) model is used to model actuator hysteresis in feedforward scheme to cancel out this nonlinearity. The presented approach requires full state and force measurements at both the master and slave sides. Such a system is costly and also difficult to implement. Therefore, sliding mode unknown input observer (UIO) is proposed for full state and force estimations. Furthermore, the effects of uncertainties in the constant parameters on the estimated external forces should be eliminated. So, a robust adaptive controller is proposed and its stability is guaranteed through the Lyapunov criterion. Performance of the proposed control architecture is verified through experiments

Predicting successful trading in the West Texas Intermediate crude oil cash market with machine learning nature-inspired swarm-based approaches

The subject of predicting global crude oil prices is well recognized in academic circles. The notion of hybrid modeling suggests that the integration of several methodologies has the potential to optimize advantages while reducing limitations. Consequently, hybrid techniques are extensively used in contemporary research. In this paper, a novel decompose-ensemble prediction approach is proposed by integrating various optimization algorithms, namely biography-based optimization (BBO), backtracking search algorithm (BSA), teaching-learning-based algorithm (TLBO), cuckoo optimization algorithm (COA), multi-verse optimization (MVO), and multilayer perceptron (MLP). Furthermore, the aforementioned approaches, namely BBO-MLP, BSA-MLP, and TLBO-MLP, include the de-compose-ensemble technique into the individual artificial intelligence model in order to enhance the accuracy of predictions. In order to validate the findings, the forecast is conducted using the authoritative data on oil prices. This study will use three primary indicators, including EMA 20, EMA 60, EMA 100, ROC, and AUC assessments, to assess and evaluate the efficacy of the five methodologies under investigation. The below findings are derived from the conducted research: Based on the achieved AUC values of 0.9567 and 0.9429, it can be concluded that using a multi-verse optimization technique is considered the most suitable strategy for effectively handling the dataset pertaining to crude oil revenue. The next four approaches likewise have a significant AUC value, surpassing 0.8. The AUC values for the BBO-MLP, BSA-MLP, TLBO-MLP, and COA-MLP approaches were obtained as follows: (0.874 and 0.792) for training and testing stages, (0.809 and 0.792) for training and testing stages, (0.9353 and 0.9237) for training and testing stages, and (0.9092 and 0.8927) for training and testing stages, respectively. This model has the potential to contribute to the resolution of default probability and is very valuable to the credit card industry. Broadly speaking, this novel forecasting approach serves as a notable predictor of crude oil prices

Individual Radiosensitivity Assessment of the Families of Ataxia-Telangiectasia Patients by G2-Checkpoint Abrogation

Objectives: Ataxia-telangiectasia (A-T) is an autosomal recessive multisystem disorder characterised by cerebellar degeneration, telangiectasia, radiation sensitivity, immunodeficiency, oxidative stress and cancer susceptibility. Epidemiological research has shown that carriers of the heterozygous ataxia-telangiectasia mutated (ATM) gene mutation are radiosensitive to ionising irradiation and have a higher risk of cancers, type 2 diabetes and atherosclerosis. However, there is currently no fast and reliable laboratory-based method to detect heterozygous ATM carriers for family screening and planning purposes. This study therefore aimed to evaluate the ability of a modified G2-assay to identify heterozygous ATM carriers in the families of A-T patients. Methods: This study took place at the Tehran University of Medical Sciences, Tehran, Iran, between February and December 2017 and included 16 A-T patients, their parents (obligate heterozygotes) and 30 healthy controls. All of the subjects underwent individual radiosensitivity (IRS) assessment using a modified caffeine-treated G2-assay with G2-checkpoint abrogation. Results: The mean IRS of the obligate ATM heterozygotes was significantly higher than the healthy controls (55.13% ± 5.84% versus 39.03% ± 6.95%; P <0.001), but significantly lower than the A-T patients (55.13% ± 5.84% versus 87.39% ± 8.29%; P = 0.001). A receiver operating characteristic (ROC) curve analysis of the G2-assay values indicated high sensitivity and specificity, with an area under the ROC curve of 0.97 (95% confidence interval: 0.95–1.00). Conclusion: The modified G2-assay demonstrated adequate precision and relatively high sensitivity and specificity in detecting heterozygous ATM carriers. Keywords: Ataxia-Telangiectasia; Chromosome Breakage; Genetic Carrier Screening; Heterozygote; Radiation Sensitivity; Sensitivity and Specificity