Changes In Appearance Research Articles

The Impact of a Breast Cancer Diagnosis on the Social Interaction Patterns of Young Omani Women: A Qualitative Study Approach

Background and Aim: Young women diagnosed with breast cancer (BC) face considerable psychological and emotional distress, impacting their interactions with themselves, their families, and the wider community. This study sought to explore the interaction patterns of young Omani BC survivors following their diagnosis and during treatment. Materials and Methods: Semi-structured individual interviews were conducted with 11 Omani women diagnosed with BC, recruited from the Sultan Qaboos Comprehensive Cancer Care and Research Centre in Muscat, Oman. Participants were selected using purposive sampling to target Omani BC survivors aged under 45 years, with one to five years of survivorship post-diagnosis. Framework analysis was employed to analyse the qualitative data. Results: Six key types of interactions with various groups were identified: self, children, spouses, family, friends, and society. While many BC survivors demonstrated resilience through their strong faith, viewing the illness as part of a divine plan, others experienced diminished confidence and social withdrawal due to body image issues. Interactions with children centred on maintaining normalcy, while spouses typically provided emotional support despite challenges with intimacy. Family and friends offered crucial support, although concerns regarding societal stigma led some women to conceal their diagnosis. Conclusions: Participants in this study demonstrated a strong sense of acceptance of their cancer diagnosis as a result of their faith, viewing it as part of a divine plan. Their belief in divine guidance, paired with optimism about the available treatments, fostered resilience, allowing them to maintain a calm and hopeful outlook during their journey of treatment and recovery. However, some participants experienced a decline in self-confidence, particularly after treatment. This affected their willingness to socialise and interact with others, leading to introversion and a marked withdrawal from social interactions, often related to changed self-perception or fear of judgment following changes in appearance.

Spatially resolved gene expression profiling of tumor microenvironment reveals key steps of lung adenocarcinoma development

The interaction of tumor cells and their microenvironment is thought to be a key factor in tumor development. We present spatial RNA profiles obtained from 30 lung adenocarcinoma patients at the non-invasive and later invasive stages. We use spatial transcriptome sequencing data in conjunction with in situ RNA profiling to conduct higher resolution analyses. The detailed examination of each case, as well as the subsequent computational analyses based on the observed diverse profiles, reveals that significant changes in the phenotypic appearances of tumor cells are frequently associated with changes in immune cell features. The phenomenon coincides with the induction of a series of cellular expression programs that enable tumor cells to transform and break through the immune cell barrier, allowing them to progress further. The study shows how lung tumors develop through interaction in their microenvironments.

An Earth Mover's Distance-Based Self-Supervised Framework for Cellular Dynamic Grading in Live-Cell Imaging.

Cellular appearance and its dynamics frequently serve as a proxy measurement of live-cell physiological properties. The computational analysis of cell properties is considered to be a significant endeavor in biological and biomedical research. Deep learning has garnered considerable success across various fields. In light of this, various neural networks have been developed to analyze live-cell microscopic videos and capture cellular dynamics with biological significance. Specifically, cellular dynamic grading (CDG) is the task that provides a predefined dynamic grade for a live-cell according to the speed of cellular deformation and intracellular movement. This task involves recording the morphological and cytoplasmic dynamics in live-cell microscopic videos. Similar to other medical image processing tasks, CDG faces challenges in collecting and annotating cellular videos. These deficiencies in medical data limit the performance of deep learning models. In this article, we propose a novel self-supervised framework to overcome these limitations for the CDG task. Our framework relies on the assumption that increasing or decreasing cell dynamic grades is consistent with accelerating or decelerating cell appearance change in videos, respectively. This consistency is subsequently incorporated as a constraint in the loss function for the self-supervised training strategy. Our framework is implemented by formulating a probability transition matrix based on the Earth Mover's Distance and imposing a loss constraint on the elements of this matrix. Experimental results demonstrate that our proposed framework enhances the model's ability to learn spatiotemporal dynamics. Furthermore, our framework outperforms the existing methods on our cell video database.

Online Multi-object Tracking with YOLOv9 and DeepSORT Optimized by Optical Flow

To ensure reliable environmental perception in the realm of autonomous driving, precise and robust multi-object tracking proves imperative. This study proposes an innovative approach to multi-object tracking by combining YOLOv9's sophisticated detection capabilities with an enhanced DeepSORT tracking algorithm, enriched through the integration of optical flow. In the proposed method, the YOLOv9 detector acutely identifies objects in input images, and these detected entities are subsequently transmitted to the optimized DeepSORT tracking algorithm. The principal contribution of this study lies in improving the Kalman filter measurement model within DeepSORT by incorporating robust local optical flow, thus adding a velocity dimension to the filter's update vector. This novel approach significantly improves tracking resilience in the face of occlusions, rapid movements, and appearance changes. Evaluations on MOT17 and KITTI show substantial improvement gains of 2.42%, 2.85%, and 1.84% for HOTA, MOTA, and IDF1, respectively, on MOT17, and 1.94% in MOTA and 2.09% in HOTA on KITTI. The proposed method particularly excels in managing scenarios involving dense traffic and light variations, which are recurrent problems in dynamic urban environments. This enhanced performance positions the proposed solution as an essential component of future perception architectures for autonomous vehicles, promising safer and more efficient navigation in the complex real world.

146 Predicting the change in appearance of psoriasis during treatment using deep learning

146 Predicting the change in appearance of psoriasis during treatment using deep learning

A Parkinson's disease-related nuclei segmentation network based on CNN-Transformer interleaved encoder with feature fusion.

Automatic segmentation of Parkinson's disease (PD) related deep gray matter (DGM) nuclei based on brain magnetic resonance imaging (MRI) is significant in assisting the diagnosis of PD. However, due to the degenerative-induced changes in appearance, low tissue contrast, and tiny DGM nuclei size in elders' brain MRI images, many existing segmentation models are limited in the application. To address these challenges, this paper proposes a PD-related DGM nuclei segmentation network to provide precise prior knowledge for aiding diagnosis PD. The encoder of network is designed as an alternating encoding structure where the convolutional neural network (CNN) captures spatial and depth texture features, while the Transformer complements global position information between DGM nuclei. Moreover, we propose a cascaded channel-spatial-wise block to fuse features extracted by the CNN and Transformer, thereby achieving more precise DGM nuclei segmentation. The decoder incorporates a symmetrical boundary attention module, leveraging the symmetrical structures of bilateral nuclei regions by constructing signed distance maps for symmetric differences, which optimizes segmentation boundaries. Furthermore, we employ a dynamic adaptive region of interests weighted Dice loss to enhance sensitivity towards smaller structures, thereby improving segmentation accuracy. In qualitative analysis, our method achieved optimal average values for PD-related DGM nuclei (DSC: 0.854, IOU: 0.750, HD95: 1.691 mm, ASD: 0.195 mm). Experiments conducted on multi-center clinical datasets and public datasets demonstrate the good generalizability of the proposed method. Furthermore, a volumetric analysis of segmentation results reveals significant differences between HCs and PDs. Our method holds promise for assisting clinicians in the rapid and accurate diagnosis of PD, offering a practical method for the imaging analysis of neurodegenerative diseases.

Night-time ultraviolet B treatment can prevent edible rose flowers from plant disease without changes in appearance and polyphenol content

Night-time ultraviolet B treatment can prevent edible rose flowers from plant disease without changes in appearance and polyphenol content

Experimental investigation on freeze–thaw resistance of thermally activated recycled fine powder concrete

Recycled fine powder (RFP) is a new auxiliary cementitious material with potential activation. However, prior to its applications in concrete, its durability should be examined. This study focuses on RFP as the study subject. Through the freeze–thaw test of concrete, indexes such as the appearance change, mass and relative dynamic elastic modulus loss, microstructure, and pore and bubble structures are analyzed. The freeze–thaw model is used to predicate the service life of concrete under freeze–thaw cycles. The effect of a high RFP dosage on the freeze–thaw resistance of concrete before and after thermal activation is comprehensively examined. Results show that the appearance damage increases gradually when the RFP content is more than 15 %. For RFP dosages of 45 % and 60 %, thermally activated RFP concrete exhibits better freeze–thaw resistance than inactivated RFP concrete, and the maximum number of freeze–thaw cycles that thermally activated RFP can withstand is greater than that for inactivated RFP concrete. The mass loss and relative dynamic elastic modulus loss of thermally activated RFP concrete at 60 % dosage are lower than those of inactivated RFP concrete. Microscopic analysis shows that the most probable pore size, the proportion of harmful pores and more-harmful harmful pores of the thermally activation of RFP concrete is smaller than that of the inactivated RFP concrete when the dosages are 45 % and 60 %. Under the SEM image of dosage 60 %, the gels of the thermally activation of RFP concrete are more dense. These results indicate that the thermally activation of RFP tends to refine the pore structure and improve the pore distribution. Furthermore, the average radius and spacing of bubbles are smaller when the dosage of activated RFP is 60 %, thereby improving the freeze–thaw resistance of concrete. In this study, the freeze–thaw model used in this paper that can effectively describe the freeze-thaw change and predict the service life of RFP concrete. When the RFP dosage is 60 %, the lifespan of thermally activated RFP concrete is 2.4–3 times longer than that of inactivated RFP concrete, meeting the needs for structural designs in the central and southern regions of China for 50 years. The research results provide a theoretical basis for RFP resource utilization and the determination of the actual service life of RFP concrete.

Freeze-thaw resistance and deterioration mechanism of alkali-activated filling grouts prepared from full industrial solid wastes for tunnels

To promote the application of the proposed alkali-activated grout (AAG) prepared from full solid wastes in cold-zone tunnel projects located at high altitudes and latitudes, it is imperative to fully recognise its endurance to the repeated freezing and thawing in specific service scenarios. For this purpose, two groups of representative AAG were selected as subjects for this study, and a typical OPC-based grout was chosen as the control group. Freeze-thaw cycle tests were carried out on grout samples after 28 days of standard curing using the slow-freeze method to simulate the harsh service environment in cold regions. The deterioration impact of freeze-thaw cycling on the grout samples were evaluated by monitoring the changes in visual appearance, mass loss, mechanical strength, and damage coefficient after 20, 40, 60 and 80 freeze-thaw cycles. Furthermore, the deterioration mechanism of various grout samples under the action of freeze-thaw cycling was revealed by multi-technique characterization methods including X-ray diffraction (XRD), scanning electron microscope (SEM), and mercury intrusion porosimetry (MIP). The results show that at the same number of freeze-thaw cycles, the surface deterioration, mass loss and strength damage of AAG were obviously better than that of the OPC-based grout, suggesting that AAG exhibited greater resistance to freezing and thawing than the OPC-based grout. The mass loss ratio increased with the increase of the number of freeze-thaw cycles, following a roughly power function pattern. The deterioration in the flexural strength of grout samples caused by freeze-thaw cycles was more severe than the deterioration in their compressive strength. The gel products of AAG were mainly C-A-S-H and N-A-S-H, which showed stronger resistance to freeze-thaw damage than the gel products of the OPC-based grout, C-S-H and portlandite. Compared with the OPC-based grout, AAG samples possessed a denser microstructure with lower porosity and a smaller proportion of large-sized harmful pores, which was not favourable for the pore water holding and migration of during freeze-thaw cycling and the development of osmotic and frost heave stresses, thus providing better resistance to freezing and thawing. A variety of macroscopic characterisations and microstructural tests have demonstrated the good durability of AAG against the freeze-thaw cycles, which can serve as a scientific foundation for its future engineering uses.

Hierarchical structure design of MoS2/PDA/Ag-hybrid hydrogel system enhances all-environment solar water purification

As a promising and sustainable way for freshwater production, interfacial solar vapor generation technology often encounters harsh conditions such as fluctuating illumination, high salinity, bacterial growth, and acid/alkali corrosion, which can reduce its conversion efficiency and lifespan. Here, to address these challenges, an environmentally adaptive hierarchical structure incorporating plasmonic Ag nanoparticles, MoS2 nanoflowers, and polydopamine (PDA) (MoS2@PDA/Ag) within a hybrid hydrogel matrix was designed as the functional solar evaporator. By systematically adjusting the volume ratio of cellulose nanofibers (CNF) and polyvinyl alcohol (PVA) skeletons, high evaporation efficiencies can be achieved in hypersaline conditions. Further, the cooperation of multi-photothermal materials endows the evaporator with a broad light absorption spectrum, superior photothermal conversion efficiency, and strong antimicrobial capabilities. The evaporator demonstrates a high evaporation rate of 2.79 kg m-2 h−1 under 1 sun irradiation and maintains sustainable evaporation for 8 h without salt deposition in 20 % NaCl solution. After being immersed in an acidic and alkaline seawater environment for 30 days, the evaporator shows no change in appearance, with only a slight decrease in performance. This work presents a promising platform for the development of solar evaporators with practical applications in various environmental conditions.

Translation and validation of the Swedish version of the Appearance Schemas Inventory-Revised and investigation of the modified three subscale structure in patients undergoing breast reconstruction.

Breast cancer can lead to changes in appearance and subsequent concerns about body image. This study aimed to translate the body investment instrument, Appearance Schemas Inventory-Revised (ASI-R), to Swedish, and perform a validation in women who underwent mastectomy and were awaiting breast reconstruction. The instrument was translated, and its psychometric properties were investigated according to current guidelines. Three hundred and ninety-seven women were eligible for the study, and 215 (54%) participants responded. An exploratory factor analysis (EFA) revealed that a three-factor structure was the most adequate solution. Three new subscales were suggested: body image investment cognition; breast and body image investment emotions; breast reflecting dysfunctional cognitive and emotional patterns of appearance investment and body image investment behaviors; breast reflecting positive ways of investing in body image. Consistent with previous findings, control over appearance is a central theme in women with breast cancer undergoing mastectomy and reconstruction. The obtained factor structure was considered similar to the original structure and three-factor solutions obtained from an American cohort of patients with breast cancer. The ASI-R has shown good psychometric properties in Swedish women undergoing mastectomy and reconstruction. Further studies on convergent validity and confirmatory factor analysis are required.

UUVDNet: An efficient unmanned underwater vehicle target detection network for multibeam forward-looking sonar

Precise localization of unmanned underwater vehicle (UUV) on multi-beam forward-looking sonar (MFLS) is a key technology in underwater robotic exploration. However, large appearance change and weak features of targets in MFLS image, pose a serious challenge on target detection. This paper proposes an efficient UUV detection model with an enhanced training scheme and convolutional block attention mechanism. The proposed training scheme is composed of dual-path gradient information optimization and adaptive loss adjustment, which improves the network’s detection capabilities and the underwater environment adaptability. The convolutional block attention module (CBAM) is developed for extracting channel and spatially weighted feature maps, and providing a mechanism to adaptive feature refinement. We construct a comprehensive sonar detection dataset from field experiments. By comparing existing state-of-the-art detection algorithms, our proposed UUVDNet outperforms Faster R-CNN, Cascade R-CNN, CenterNet, SSD, YOLOv8n, DPFIN, and MBSNN in terms of mAP50–95 by 39.5%, 35.7%, 8.4%, 14.0%, 2.5%, 13.6%, and 21.8%, respectively. Furthermore, our inference model size is the most compact among all detection models, with a size of 5.1M. Final ablation experiments effectively showcase the proposed components’ efficiency.

Identification and characterization of alopecia areata subgroups regarding quality of life impairment based on demographic, clinical, psychological, and social factors

ABSTRACT The benign dermatological hair condition Alopecia Areata (AA) is known to impair Quality of Life (QoL), especially mental and social health, due to the accompanying visible appearance changes. Previous studies have identified demographic, clinical, social, and psychological variables related to QoL. Yet, the novelty of this study lies in examining how QoL differences in AA relate to (combinations of) these variables. The aim of the current study is to identify and characterize subgroups of AA persons with less or more QoL impairment by means of (combinations of) demographic, clinical, psychological, and social factors, including both potential risk (perceived stigmatization, avoidant coping, physical identity definition) and protective factors (disclosure, social support, emotion-focused coping and non-physical identity definition). An online questionnaire was filled out by 322 persons with AA, including the Dermatology Life Quality Index (DLQI) as QoL measure, Perceived Stigmatization Questionnaire (FSQ), brief COPE, Social Support Survey, a newly developed identity-definition measure, clinical characteristics, and demographics. Classification and Regression Tree (CART) analysis identified subgroups based on QoL outcome. Lowest QoL impairment was found in persons with low feelings of being flawed combined with low secretiveness. Low QoL impairment was also found in persons feeling flawed combined with low avoidant coping, low sensitivity to others’ opinions and older age. QoL impairment was intermediate in persons perceiving more social support in those with a younger age, and defining identity less on physical appearance in those sensitive to others’ opinions. Highest QoL impairment was characterized by feeling flawed combined with an avoidant coping style. Current findings provide indications for the identification of risk and protective profiles for QoL impairment and which factors to address in interventions to improve QoL in AA.

Uptake of lead, cadmium and copper by heavy metal-resistant Pseudomonas aeruginosa strain DR7 isolated from soil.

This study highlights the biosorption capacity for Cd (II), Cu (II) and Pb (II) by a locally isolated Pseudomonas aeruginosa DR7. At initial concentrations of 150mg L-1 and 240min of contact time, P. aeruginosa DR7 showed a 62.56mg/g removal capacity for Cd (II) at an optimum pH of 6.0, 72.49mg/g for Cu (II) at an optimum pH of 6.0, and 94.2mg/g for Pb (II) at an optimum pH of 7.0. The experimental data of Cd (II), Cu (II), and Pb (II) adsorbed by the pseudo-second-order kinetic model correlates well with P. aeruginosa DR7, with R2 all above 0.99, showing that the fitting effect was satisfactory. The isothermal adsorption processes of Cd (II) (0.980) and Cu (II) (0.986) were more consistent with the Freundlich model, whereas Pb (II) was more consistent with the Langmuir model (0.978). FTIR analysis suggested the involvement of hydroxyl, carbonyl, carboxyl, and amine groups present in the inner regions of P. aeruginosa cells during the biosorption process. SEM-EDS analysis revealed that after contact with metals, there were slight changes in the surface appearance of the cells, which confirmed the deposition of metals on the bacterial surface. There was also the possibility of the metals being translocated into the bacterial inner regions by the appearance of electron-dense particles, as observed using TEM. As a conclusion, the removal of metals from solutions using P. aeruginosa DR7 was a plausible alternative as a safe, cheap, and easily used biosorbent.

American Foregut Society White Paper on the Endoscopic Assessment of the Gastroesophageal Valve after Anti-Reflux Surgery

Background: Pathologic reflux is a common debilitating digestive condition and anti-reflux surgery is an effective treatment option. Depending on the specifics of the procedure, anti-reflux surgery leads to distinct changes in the endoscopic appearance of the esophagogastric junction (EGJ). This American Foregut Society (AFS) white paper develops nomenclature for describing the endoscopic characteristics of the EGJ after commonly performed laparoscopic antireflux operations. Methods: The AFS Anti-Reflux Barrier Collaborative analyzed the anatomic manipulation and corresponding endoscopic appearance of the EGJ after commonly performed anti-reflux surgery including: (1) 360° anterior/posterior (AP) fundoplication (Nissen); (2) posterior partial fundoplication (Toupet); (3) anterior partial fundoplication (Watson, Dor); (4) magnetic sphincter augmentation; and (5) concomitant hiatal hernia repair with transoral fundoplication (cTIF). Results: Characteristics common to the anti-reflux surgery procedures include restoration of intra-abdominal esophageal length and crural diaphragm repair such that the hiatal aperture is no longer visible in the retroflexed endoscopic view. With regard to the geometry of anti-reflux procedures, the Collaborative established that when evaluated endoscopically in retroflection, the surgically constructed valve should be described in reference to the angle of His and the extent of anatomic change described in terms of (1) the depth of the anterior and posterior grooves, (2) the apposition of the valve collar to the endoscope, (3) the length of the valve, and (4) the position of the squamocolumnar junction relative to the lip of the valve. Conclusions: Current anti-reflux operations share much in common but employ varying degrees of valvular reconstruction leading to distinct endoscopic characteristics. Developing a consistent nomenclature for describing the appearance of the post-surgical valve is essential to develop a better understanding of how variables such as the tightness of the hiatal repair, tightness of the valve collar, and length of the valve can impact the outcome of anti-reflux surgery and predict reflux recurrence.

Prodromal symptoms of a first manic episode: a qualitative study to the perspectives of patients with bipolar disorder and their caregivers’

BackgroundDiagnosing bipolar disorder (BD) is challenging, and adequate treatment is of major importance to minimalize the consequences of the illness. Early recognition is one way to address this. Although in clinical research the prodromal phase of BD is gaining interest, the perspective of patients with BD and their caregivers on prodromal symptoms is still lacking. The aim of this study is to gain insights in prodromal symptoms of patients with BD and their caregivers before the onset of a first manic episode.MethodsA qualitative research method was used to investigate prodromal symptoms one year prior to a first manic episode. In-depth interviews were conducted with patients with BD type I and their caregivers. Only patients with a first manic episode in the previous five years were included.ResultsThe prodromal symptoms from patients’ and caregivers’ perspectives could be clustered into seven themes, with underlying subthemes: behavior (increased activity, destructive behavior, disinhibited behavior, inadequate behavior, changes in appearance), physical changes (changes in sleep, physical signals, differences in facial expression), communication (reciprocity, process, changes in use of social media), thought (process and content), cognition (changes in attention and concentration, forgetfulness), emotions (positive emotions, more intense emotions, mood swings), and personality (more pronounced manifestation of existing personality traits).ConclusionPatients with bipolar I disorder and their caregivers described subsyndromal manic features one year prior to a first manic episode. In addition, they recognized mood lability, physical changes and more pronounced manifestation of existing personality traits. The results of this study confirm the presence of a prodromal phase. In clinical practice, monitoring of prodromal symptoms of BD can be useful in patients with depression, especially those with a familial risk of BD.

Exploring Edible Insects: From Sustainable Nutrition to Pasta and Noodle Applications-A Critical Review.

Edible insects provide an alternative source of high-quality proteins, essential lipids, minerals, and vitamins. However, they lack the acceptability and consumption rates of more common staple foods. In contrast, pasta and noodles are globally appreciated foods that are consumed across various cultures. These products contribute greatly to the population's energy intake but generally lack essential nutrients. Recently, edible insects have gained in popularity due to their numerous benefits, both environmental and nutritional. Current research indicates that incorporating edible insect ingredients into pasta and noodle formulations enhances their nutritional quality by increasing protein and fiber content and reducing carbohydrates. However, adding new ingredients to enrich common foods often carries technological and sensory challenges, such as changes in processing parameters, texture, flavor, and appearance. Technology assessment, scientific research, information campaigns, and public policies can help overcome these issues. This review aims to summarize the benefits of entomophagy (the consumption of insects as food) for sustainability, nutrition, and health; highlight the potential of pasta and noodles as carriers of nutritious and bioactive ingredients, including insects; and critically address the advancements in insect-enriched pasta and noodle technology, identifying current challenges, knowledge gaps, and opportunities.

Programmable Robotic Shape Shifting and Color Morphing Dynamics Through Magneto-Mechano-Chromic Coupling.

Recreating natural organisms' dynamic shape-morphing and adaptive color-changing capabilities in a compact structure poses significant challenges but unlocks unprecedented hybridized robotic-visual applications. Overcoming programmability and predictability obstacles is key to achieving real-time, responsive changes in appearance and functionality, enhancing robot-environment-user interactions in ways previously unattainable. Herein, a Soft Magneto-Mechano-Chromic (SoMMeC) structure comprising a magnetic actuating and a synthetic photonic film, mirroring the intricate color-tuning mechanism of chameleons is devised. A model combining numerical simulation and a strain-dependent color evolution map enables precise predictions and controllable shape-color alterations across various geometrical and magnetization profiles. The SoMMeC exhibits rapid (0.1s), broad (full-visible spectrum), tether-free (remote magnetic manipulation), and programmable (model-guided control) color transformations, surpassing traditional limitations with its real-time response, broad and omnidirectional coloration for enhanced visibility, and robustness against external disturbances. The SoMMeC translates into dynamic advertising iridescence, adaptive camouflage, self-sensing, and multi-level encryption, and transcends traditional robotics by seamlessly blending dynamic movement with nuanced visual changes. It opens up a spectrum of applications that redefine robotic functionality through dynamic appearance modulation, making robotic systems more versatile, adaptive, and suitable for unexplored integrative functions.

Sub-RPE Optically empty structures in Polypoidal Choroidal Vasculopathy: a novel optical coherence tomography finding

Purpose: To describe the appearance of a novel OCT feature in PCV and report its prevalence in a clinical cohort Methods: We retrospectively analysed the OCT and ICGA images of eyes with PCV. Main outcome measures included the appearance, prevalence and longitudinal changes of ‘optically empty sub-RPE structures’ on OCT and correlate them with ICGA and OCTA. Results: We evaluated OCT of 55 patients. Each patient had monthly OCT from baseline to month 12. Presence of sub-RPE optically empty structures at any visit was detected in 10 eyes (7 at baseline, 3 during follow-up). These lesions are located under the RPE and are characterized by homogenously hyporeflective content similar to the vitreous cavity, which appear optically empty. Additional features include hypertransmission tail into choroid, round/ polygonal in shape surrounded by thin wall and fuzzy overlying RPE. When compared with ICGA, these structures can be colocalized to area of pooling associated with polypoidal lesions but can persist after polyp regression. No flow signal was detected within the center of these optically empty structures. Conclusion: Sub-RPE optically empty structures likely represent spaces not filled with blood and are distinct from the lumen of a polypoidal lesion.

Heterogeneity in Reported Side Effects Following Initiation of Elexacaftor-Tezacaftor-Ivacaftor: Experiences at a Quaternary CF Care Center.

The benefits of Elexecaftor-Tezacaftor-Ivacaftor (ETI) therapy on the health and wellbeing of people with CF (pwCF) are well documented. Since approval, however, a growing number of potential side effects have emerged in reports from clinical practice. With current understanding of ETI tolerability limited to data from clinical trials, the prevalence of side effects and their impact on care decision making remains poorly categorized. A 10-question survey was developed and distributed to patients 18 years or older who were treated at the Massachusetts General Hospital CF centers. Reports of side effects were measured across 12 distinct categories, and dose adjustments and discontinuation due to side effects were collected. If a patient reported no side effects, they did not have to complete the entire survey. Among 92 respondents initiated on ETI, 51 respondents (55.4%) reported potential side effects and 41 (44.5%) respondents reported no adverse events. The most commonly reported side effects were mental health, changes in appearance, and gastrointestinal complaints, which were reported by 22.8%, 30.4%, and 21.7% of patients, respectively. Eighteen (19.6%) respondents modified their dosing in response to side effects, and six discontinued treatment permanently (6.52%) due to persistent side effects. Responses demonstrated marked heterogeneity, with most respondents reporting at least one side effect following initiation. Dose modification was commonly utilized to mitigate adverse effects, however few respondents had to discontinue treatment. These findings demonstrate the importance of monitoring for potential drug-related side effects of ETI in clinical settings.