Demarcation Line Research Articles

ПЕРЕДУМОВИ ЗМІН ТЕРИТОРІАЛЬНО ПРОСТОРОВОЇ ОРГАНІЗАЦІЇ РЕГІОНІВ УКРАЇНИ

The parameters and structure of the territorial organization of Ukraine are undergoing changes caused by the war. New prerequisites for the territorial and spatial organization of the regions of Ukraine are being formed. The research aims to develop a methodological approach to the systematization of the type of region. The formation of regions is determined by a complex of physical - geographical, socio-economic, military - political, cultural and religious features and characteristics. There are well-known examples of a sharp and radical breakdown of the military-political situation and the slow civilizational and evolutionary formation of new regional entities. At this stage, the tasks of urban planning analysis of trends and tendencies of changes in the regional structure appear. The prerequisites for changes in the territorial spatial organization of the war-torn regions of Ukraine are analyzed.
 The main parameters of the formation of the region are determined in the process of systematization of typological features. The main factors and regularities of regional development, trends in changing the form and function of the object of study, the forecast of changes in the structure of the region are carried out using systemic analysis. An analysis of the main features/imperatives forming the "basis" of regionalism has been carried out. The features and properties of the territorial system of the corresponding typology are determined by the function, autonomy of the territorial system construction, and the stability of the system.
 It was determined that the extra-regional influence that forms the new region provides the task of state security, compliance with the function of the border, and the function of military-political limitation. The program strategy of its development should provide methodological prerequisites for the implementation of the main functions and tasks.
 The generalized systematization of the type of regions in modern conditions provides grounds for defining a region covering the territories of several regions, the borders of which determine the limits of a special regime. The defined border is the state border of Ukraine, the depth of the region is determined by the size of the special regime zone, the influence of the security factors of the demarcation line. Contours of the border region are determined at the level of decisions of central authorities.

Long-term outcomes of tailored stromal expansion with refractive lenticule for crosslinking thin corneas.

To assess the long-term safety and stability of visual outcomes following the modified technique of collagen crosslinking (CXL) using refractive lenticule in eyes with thin corneas (<400 µm) and progressive keratoconus. A tertiary eye care hospital in India. Prospective, interventional case series. Eyes with progressive keratoconus and thin corneas (<400 µm) underwent CXL with intraoperative stromal augmentation using a refractive lenticule obtained from small-incision lenticule extraction (SMILE). Preoperative and postoperative evaluation (3 months, and then yearly thereafter) included corneal tomography (Oculus Pentacam), uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), manifest refraction, and endothelial cell count (specular microscopy), and adverse events, if any, were noted. The patients were followed up for a period of 5 years. Seven eyes were included in the analysis. Mean corneal flattening of -4.29 D was noted from preoperative maximum keratometry (P = 0.018). An improvement in UDVA and CDVA of 0.38 logarithm of minimum angle of resolution (logMAR) and 0.36 logMAR, respectively, was noted at 5 years postoperative visit. Four eyes demonstrated a gain of two lines in CDVA. Mean spherical equivalent improved from -6.85 D preoperatively to -6.05 D at 5 years postoperatively. Clear demarcation line was noted between 230 to 270 µm on anterior segment optical coherence topography. No significant endothelial cell loss was noted postoperatively. Long-term outcomes demonstrated safety and disease stability following lenticule-assisted CXL.

Public Debate and Artistic Expression: A Jurisprudential Analysis of Freedom of Expression in Europe And Indonesia

Objective: This research aims to critically analyze various decisions of the European Court of Human Rights and the Supreme Court of the Republic of Indonesia regarding freedom of expression in the context of public and artistic debates, which, in practice, lack a clear demarcation line to decipher the abstract theme of freedom of expression. Methodology: The author conducted an in-depth review of the court decisions and critically analyzed them, supported by various international, European, and Indonesian legal instruments. Therefore, a qualitative approach predominates in this research. Results and Conclusions: This article concludes that the abstract theme of freedom of expression inherent in human rights is determined by the knowledge and preferences of the judges, leading to a lack of consistency in their decisions. On the other hand, various international, European, and Indonesian legal instruments have guaranteed freedom of expression for every individual, but these guarantees are not always adhered to by the European Court of Human Rights and the Supreme Court of the Republic of Indonesia. Originality/value: This research contributes by identifying the issues arising from various judicial decisions, providing guidance for judges adjudicating cases related to freedom of expression. This can enrich the discourse on freedom of expression and help prevent judges from falling into the scenarios created by their predecessors.

From Social Chronotope to Political Myth: Ukrainian Case

The author proposes to consider ideas, values, meanings and orientations regarding the identity of Ukraine that gained independence through the concept of a social chronotope. This implies a conceptual and mental space in which temporal and spatial characteristics are combined. The researcher uses a socio-constructivist approach to identity, a discourse analysis of publications by representatives of the political and intellectual elite, and secondary sociological data. The social chronotope was formed by the Ukrainian elite based on historical myths and new geopolitical realities that made Ukraine the largest country in Europe. The most important component of the chronotope was the idea that Ukraine needs an identity that distinguishes it from Russia. If the events of 2004 determined the vector of Ukrainian identity politics as European, the Euromaidan of 2014 drew a demarcation line not only between Ukraine and Russia, but also between Kyiv as a center of political power and a symbol of political community, on the one hand, and the pro-Russian regions of the eastern Ukraine, on the other hand. Their inhabitants were denied Ukrainian citizenship, their views and values were marginalized, which destroyed the social chronotope. It is, thus, replaced with an ideological confrontation in the form of a political myth about the Europeanness of Ukraine, which is hindered by Russia and the “separatists” under its influence.

Esotericism between Europe and East Asia: How the “Esoteric Distinction” Became a Structure in Cross-Cultural Interpretation

Abstract Different understandings of “esoteric” are the main subject and the demarcation line of several fields of study. However, the history of this term is either neglected or distorted by specific historiographical paradigms. Tracing European writings on China and Japan from the sixteenth to the eighteenth centuries, this article demonstrates that “esoteric” language was central to scholarship on Asia, shaping common terms that remain in use today. By showing how the emergence and development of an “esoteric distinction” between teachings and practices was linked to cross-cultural interpretation and translingual practices, the article argues that this distinction was not a mere projection of European concepts, but rather the result of cultural exchanges that need to be carefully studied on a case-by-case basis within their concrete historical contexts. To better understand the negotiations of what many today would call “esotericism,” a decentered historiography is needed that considers the global history of general terms.

Endoscopic criteria for early differential diagnosis of gastritis-like form of primary non-Hodgkin's lymphomas and gastric cancer: A prospective study

Aim. To reveal and study basic endoscopic differential-significant criteria characterizing gastric-like form of primary non-Hodgkin's lymphoma (NHL) from adenocarcinoma and signet-ring cell carcinoma (SRCC) of the stomach.&#x0D; Materials and methods. In the prospective study, based of Blokhin National Medical Research Center of Oncology in the period from 2019 to June 2023, 106 patients with gastritic-like forms of primary NHL, adenocarcinoma and SRCC of the stomach were analyzed. Complex endoscopic study included examination in the modes of white light, magnification, narrow-band imaging (NBI, BLI, LCI) was done.&#x0D; Results. All patients were divided into three groups: MALT gastric lymphoma (38 patients, 35.8%), gastric adenocarcinoma (33 patients, 31.1%), and SRCC (35 patients, 33.1%). At MALT-lymphoma the tumor was localized in the antrum of the stomach (52.6%),adenocarcinoma and SRCC – in the body (45.5 and 60%). In the tumor structure in MALT-lymphoma of the stomach in 100% of cases multiple point areas of microdepressions and multicenter character of the lesion were determined. At adenocarcinoma – depressed area in the central part of tumor (45.5%), at SRCC – extended areas of microdepressions (51.4%) and multicentric character of lesions. At MALT-lymphoma the pit pattern in 63.2% is of "balloon" type, vascular – of tree-like type (84.2%). In adenocarcinoma the vascular pattern was of the loop-type (42.4%), in SRCC – of the corkscrew-type (74.3%). Demarcation line was observed only in adenocarcinoma (100%). At endosonographic study at MALT-lymphoma the tumor was coming from deep layers of mucous coat (100%), changes of regional lymph nodes (LN) were absent, at adenocarcinoma – from mucous membrane (100%), LN were not changed, at SRCC – submucous spread of tumor (100%), changes in LN (40%).&#x0D; Conclusion. Complex endoscopic examination is necessary to improve the quality of endoscopic examination of malignant gastric-like tumors, to determine the depth of invasion and spread of the tumor process, to assess the regional lymph drainage.

Gastric adenocarcinoma of the fundic gland type: A review of the literature.

Gastric adenocarcinoma of the fundic gland type (GA-FG) is a newly described tumor entity but lacking consensus. This review summarizes the key features and controversies regarding this uncommon neoplasm. We reviewed studies on GA-FG published in English from 2007 to 2021. We found that 327 cases (340 lesions) have been reported. GA-FG lesions originate from deep layers of the gastric mucosa, with the following characteristics on conventional white-light endoscopy examination. These lesions, macroscopically identified as submucosal tumor-like 0-IIa, tend to have a whitish discoloration without inflammation, atrophy, or intestinal metaplasia in the background mucosa. Tumors located in the upper third of the stomach are usually solitary, with an average size <10 mm. Contrastingly, magnifying endoscopy with narrow-band imaging mostly shows the absence of any demarcation line, with a regular microvascular pattern and regular microsurface pattern. GA-FGs are covered with normal foveolar epithelium, forming a so-called endless glands pattern in the deeper region, which are mainly composed of chief cells or parietal cells. Most tumors exhibit submucosal invasion, but lymphovascular invasion and nodal metastasis are rare. Regarding the treatment of GA-FG, endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) are effective treatment methods. GA-FG is a rare tumor that typically follows a benign course. This neoplasm has distinct endoscopic and pathological features and could be treated by ESD or EMR.

Conservation policies and management in the Ukrainian Emerald Network have maintained reforestation rate despite the war

The Russian-Ukrainian War, ongoing since 2014, impacts an area containing Emerald Network environmental-protection sites created through the implementation of the Bern Convention on the Conservation of European Wildlife and Natural Habitats. Here we explore the impact of this conflict on institutional links supporting environmental sustainability and conservation efforts. Using satellite data, we analyzed tree cover changes in the Luhansk region’s Emerald Network protected areas from 1996 to 2020. The results reveal that the implementation of Bern Convention conservation policies led to a shift from deforestation (−4% each) to reforestation (+8% and +10%) on both sides of the Emerald Network divided by the demarcation line in 2014. It also shows that despite the war, territories under Ukraine control after 2014 continued reforestation (+9%), while sites under Russian control experienced dramatic forest loss (−25%). These findings emphasize the significant consequences of warfare-induced separation of local institutions on conservation areas and underscore the positive impact of the Emerald Network establishment, both before and after the conflict’s onset.

THE LANDSCAPE OF THE WAR IN UKRAINE IN VISUAL PROJECTS AND ARTISTIC PRACTICES OF 2022–2023 (case study of discourse)

Since February 24, 2022, the discourse of visual arts in Ukraine has been characterised by a significant focus on revising and rethinking the topic of the ongoing war in the country since 2014. The author analyses the forms of art representation of the war in Ukraine based on visual projects and art practices in the dimension of existential resistance to cruel reality, which contribute to the narrative of Ukraine’s resistance. The article discusses the correlations between the art discourse and the figurative topic of war, which has become an integral part of the art landscape. The article suggests analysing the events in Ukraine during 2022–2023 in the paradigm of cruel optimism, which is exemplified by the art projects by Alexander Krolikowski, Fedir Alexandrovich, Kateryna Yakovlenko, Anton Logov, and others. A crucial aspect of the research involves delineating the inherent characteristics of the new imagery and language in visual arts. This allows the author to posit the realisation of the concept of “zero” language, which lacks conventional forms of expressiveness but embodies an objectification of depicted signs and motifs associated with archetypal structures and linked to thanatological discourse. It has been demonstrated that the use of thanatological discourse in visual art practices was the impetus for finding new vitality in the pathological reality of military necrophilia. The art discourse takes on an objective ground, with a clear demarcation line between the living and the dead, one’s own and alien, cruel and optimistic, etc.

A novel imaging technology to assess tissue oxygen saturation and its correlation with indocyanine green in the gastric conduit during thoracic esophagectomy

BackgroundAnastomotic leakage in esophagectomy is a serious complication, and assessing blood perfusion in the conduit can help minimize this risk. Indocyanine green is the most widely used method to assess tissue blood flow; however, this technique has disadvantages. Evaluating tissue oxygen saturation in the gastric conduit during thoracic esophagectomy compared with indocyanine green blood perfusion assessment addresses these disadvantages and can be performed easily and repeatedly. MethodsThis was a prospective study of patients with esophageal cancer who underwent thoracic esophagectomy. Intraoperative tissue oxygen saturation and indocyanine green measurements were obtained to determine the anastomotic site and to compare the correlation between the 2 methods. Tissue oxygen saturation and indocyanine green values were obtained at the tip of the gastric conduit, the demarcation line indicating visible perfusion, and the end of the right gastroepiploic artery. ResultsFifty-seven patients were enrolled in this study; 3 developed anastomotic leakage, and all 3 underwent robotic thoracic surgery. The tissue oxygen saturation value decreased gradually toward the tip of the conduit, as did congestion, and was significantly decreased at the tip compared with the value at the demarcation line (P = .001). Mean tissue oxygen saturation differed significantly between the leakage and no-leakage groups at the anastomosis site (P = .04). We found a negative correlation between tissue oxygen saturation and indocyanine green values at the end of the right gastroepiploic artery (r = −0.361; P = .03). ConclusionTissue oxygen saturation imaging was useful in determining the anastomotic site and addressed the disadvantages associated with indocyanine green.

USE OF LOW-INTENSITY LASER RADIATION IN THE COMPLEX TREATMENT OF WOUNDS

Abstract. Increasing the eff ectiveness of treatment of infected wounds is an extremely urgent problem, which, despite signifi cant achievements, is far from a fi nal solution. The development of new methods of local impact on wounds, especially laser irradiation and evaluation of its eff ectiveness, are promising.The aim of the study. To evaluate the eff ectiveness of using low-intensity laser irradiation in the complex treatment of wounds.The object of the study was 10 patients with wounds of the lower extremities. Among the examined were 6 men and 4 women aged from 48 to 83 years. 6 patients had type 2 diabetes; in 4 – CHD, obliterating atherosclerosis of the vessels of the lower extremities. All patients involved in the study signed the appropriate informed consent.The complex treatment of all patients included irradiation of the wound with a low-intensity laser (B-Cure Laser); with a power of 250 mW; wavelength 808 nM; with a pulse frequency of 15 kHz; with a pulse duration of 17 μs with an energy of 3.75 Joule/min; with a spot of radiation 45Ч10 mm, lasting 3 minutes around the perimeter of the wound edges and 1 minute on the wound bed. The wound area was measured using the «IntimoMeasure» program. All patients underwent microbiological and cytological examination of smearsprints from the wound on days 1, 3, 5, 7 and 10.Research results. It has been established that the use of low-intensity laser irradiation of the wound has a positive eff ect on the wound healing process.As early as 2-3 days after the start of treatment, the amount of discharge from the wound signifi cantly decreased, the amount of necrotic tissue decreased, and the demarcation line was clearly defi ned. A decrease in the number of necrotic tissues and microorganisms, an increase in the number of leukocytes, monocytes, macrophages, and plasma cells was noted in the smears.After 4-6 days, signs of granulation formation appeared, the number of lymphocytes, macrophages, and plasma cells increased. The concentration of microorganisms did not exceed 10Ч2-3 CFU/ml. At 7-8 days, most of the wounds were without signs of necrotic tissue, granulation tissue increased intensively, signs of connective tissue formation, epithelization from the edges of the wound appeared.On 9-10 days, most of the wounds were represented by granulation tissue with pronounced proliferation of the epithelium at the edges of the wound. During the fi rst three days, the area of the wound decreased by almost 17 % compared to the initial size, and from the 7th day it did not exceed 60 % of the initial level.Conclusions. 1. Low-intensity laser irradiation of wounds against the background of complex drug therapy is an eff ective method of treatment, promotes rapid cleansing of wounds, intensive development of granulations, accelerates epithelization. 2. Availability, ease of use and absolute safety allow recommending this method for use in complex wound treatment.

Abundance and distribution of the Caspian seals on ice in the Russian part of the Northern Caspian in February — March 2023

The aim of this research was to assess the current abundance of the Caspian seal population on ice in the Russian part of the North Caspian using instrumental methods of aerial survey in the infrared and optical ranges using a manned aircraft and UAV.The main method of the research was a multispectral aerial survey, the essence of which is to survey seal haulouts synchronously in the infrared and optical ranges. In winter, 90% of all mature individuals gather on the ice substrate of the Northern Caspian for reproduction, lactation and mating and spend a significant part of their time outside the water, which greatly facilitates their detection and counting. The aerial survey was carried out in parallel from two types of aircraft — the La‑8 manned amphibious aircraft and unmanned aerial vehicles equipped with high-resolution cameras in optical and infrared modes, which ensure reliable registration of seals on ice.Novelty: the advantage of joint use of a manned aircraft and a UAV equipped with special photo and infrared equipment is noted.As a result of the research, the flights were carried out from February 20 to March 5, 2023 in the daytime in good visibility conditions at an altitude of 200 to 300 m. amounted to 19704 individuals, including 4062 puppies. The animals were located in the southeastern part of the ice cover near the air demarcation line between the Russian Federation and the Republic of Kazakhstan on the ice edge. An increase in the number of seals was recorded due to migrating individuals from Kazakhstan. Breeding of the Caspian seal in winter 2022/2023 proceeded in a satisfactory manner. During the flight, it was found that there were no fresh releases of seals on the coast of Dagestan. Separate old carcasses, partially torn to pieces, were registered only on the shores of the Agrakhan Peninsula.Practical value: the obtained data are needed to assess the current abundance of the Caspian seal population in the Caspian Sea.

Clinical and Morphological in Vivo Confocal Microscopy Findings following a Modified Biphasic Higher Fluence Transepithelial Corneal Crosslinking

Purpose: To compare the refractive efficacy and morphological changes in the cornea following a novel biphasic higher fluence transepithelial corneal crosslinking (BI-TE-CXL) and transepithelial corneal crosslinking (TE-CXL) in adults keratoconus. Methods: Patients with progressive keratoconus who required corneal crosslinking were assigned to the BI-TE-CXL group (32 eyes, phase 1: 7.2 J/cm2 for 5 min and 20 s of pulsed-light exposure, KXL, Glaukos-Avedro; phase 2: 3.6 J/cm2 for 6 min and 40 s of continuous light exposure at the front curvature apex with a 6 mm diameter light spot, UVX-2000, IROC) or the TE-CXL group (32 eyes, uniform 7.2 J/cm2 for 5 min and 20 s of pulsed-light exposure, KXL, Glaukos-Avedro). Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), corneal fluorescein staining (CFS), corneal topography, anterior segment optical coherence tomography (AS-OCT), and in vivo corneal confocal microscopy (IVCM) were performed 3, 6, 12 and 24 months after surgery. Results: The CFS scores in the BI-TE-CXL group were significantly higher than those in the TE-CXL group on the first two days after surgery (p < 0.001). The Kmax (at 12 and 24 months) and CDVA (logMAR) were significantly lower in the BI-TE-CXL group than those in the TE-CXL group (p < 0.05). The corneal demarcation line under AS-OCT was visible in 81.3% of patients in the BI-TE-CXL group and 15.6% in the TE-CXL group. The depth of the demarcation line under IVCM was significantly deeper in the BI-TE-CXL group (248.3 ± 25.0 μm) than that of the TE-CXL group (136.5 ± 15.6 μm) in the central cornea (p < 0.001). The cross-linked collagen structures in the central cornea were still present after 12 months in the BI-TE-CXL group. No significant difference in sub-basal nerve density between the two groups (p > 0.05). Conclusions: Following BI-TE-CXL, CDVA was significantly improved, accompanied by deeper demarcation line depth and persistent crosslinked structures in the central corneal stroma.

Statistical regulations of the occurrence of fires in cities during marital state

The process of the occurrence of fires in cities located near the demarcation line during martial law was studied. The subject of the study is statistical regularities that allow us to describe the process of fire occurrence in cities during martial law. Data on fires that occurred in seventeen urban settlements of Ukraine, which are in the immediate vicinity of the demarcation line for the period of 2022, were processed. Statistical hypotheses that allow describing the flow of fires that periodically occurred in cities during the studied period, as well as the time intervals between the moments of their occurrence, have been verified. It has been established that the number of fires that periodically occur on the territory of cities during martial law cannot be described by the Poisson distribution law. Instead, for 59 % of the studied cities, the hypothesis about the geometric law of distribution was confirmed. For some cities in which the number of fires was less than 50 during the period of 2022, it was not possible to obtain any results. It was established that for 35 % of the total number of analyzed cities, the statistical hypothesis about the possibility of describing the time intervals between the occurrence of fires by the exponential law of distribution was confirmed. A much worse result was obtained when testing the possibility of describing the time intervals between the occurrence of fires by other distribution laws. Therefore, if it is necessary to describe the process of the occurrence of fires in urban settlements during martial law, it is necessary to study each individual case by probabilistic laws. The research results can be used to build information systems to support decision-making by management involved in the elimination of the consequences of dangerous events and emergency situations related to fires.

Detecting the magical yellow-blue demarcation off the Yellow River Estuary from the space

River deltas rank among the most ecologically and socio-economically valuable environments on the planet. The Yellow River Delta in China is not only home to young wetland ecosystem, but also to world-renowned tourism resources. One of these was the unique yellow-blue demarcation line (YBDL), formed in the Yellow River Estuary (YRE) as a result of the meeting of terrestrial sediment-laden river water and clear sea water, which had developed into a famous attraction and generated significant tourism revenues. Moreover, its distribution was of vital ecological and geomorphological importance due to association with the dynamics of estuarine turbidity plume. However, little is yet known about the dynamics and influencing factors of YBDL. In this study, we proposed an integrated method for extracting YBDL from satellite imagery and investigated the spatiotemporal distributions of YBDL during the flood season (June-October) from 2016 to 2022 using multi-source satellite imageries. The average relative error of our algorithm reached 10.53%. The results indicated that the YBDL started to frequently occur after 2018, mainly distributed within 10 km off the YRE, with two types of short straight and long curved shapes. July was the period with the highest frequency and most widespread distribution of YBDL. The riverine water and sediment discharge controlled 45.9% of the variations in YBDL length, and the extreme flooding, as well as the implementation of Water-Sediment Regulation Scheme, significantly increased the distribution extent of the YBDL. The morphology of river distributary mouths dominated the changes in the YBDL distribution centres, and the north distributary mouth experienced dramatic evolution in the last three years, with an increased YBDL distribution. Tidal currents could promote the development of YBDL at the front of the river mouth plumes while inhibiting the YBDL on the other side. This study is the first systematic investigation of the spatiotemporal evolutions and driving mechanisms of YBDL in the YRE, which could provide a reference for tourism planning and YRE National Park construction.

Evolution of demarcation line after pneumatic retinopexy—a case report

BackgroundDemarcation line in a rhegmatogenous retinal detachment (RD) is a classic finding noted in chronic cases. In this case report, we describe a case of evolution of post-operative demarcation line after pneumatic retinopexy (PnR) in a subtotal rhegmatogenous RD.Case descriptionA 31-year-old male diagnosed with acute, subtotal, macula-off rhegmatogenous RD in the left eye of 15-day duration underwent PnR on the same day. His presenting visual acuity was 6/48 in the left eye. Transconjunctival cryopexy was performed to the retinal break at the same sitting and 0.5 cc of 100% perfluoroproprane (C3F8) gas was injected in the vitreous cavity and right lateral position was advised to the patient.ResultA pigmentary demarcation line was noted extending the nasal part of the macula along the most dependent part of the detachment on the immediate post-operative day and was more obviously visible on the 2nd and then on the 11th post-operative day. The visual acuity at the last follow-up visit improved to 6/18. Successful reattachment of the retina was noted on the last follow-up visit.ConclusionPost-operative demarcation lines after RD surgery could develop due to subretinal migration of pigments and along the most-dependent part depending upon post-operative positioning of the patient. Careful post-operative positioning, particularly in macula splitting RDs could be important to avoid pigment accumulation along the foveal area.

Coexistence of pigmentary demarcation line type B and congenital vitiligo: A unique case report and exploration of potential association

This case report describes a rare occurrence of coexisting Pigmentary Demarcation Line (PDL) type B and congenital vitiligo in a 4-year-old girl. The patient presented with linear band of hyperpigmentation along the blaschko line on the inner sides of bilateral thighs and lower abdomen, accompanied by depigmented patches on the knees, since birth. The clinical history, examination findings, and histopathological analysis supported the diagnosis. The case sheds light on a potential association between PDL and congenital vitiligo, which is not well-documented in the existing literature. Further research and long-term follow-up are recommended to investigate the underlying mechanisms and potential genetic predisposition, providing a deeper understanding of association between these conditions.

Preoperative H. pylori Eradication Therapy Facilitates Precise Delineation in Early Gastric Cancer with Current H. pylori Infection

Introduction: Early gastric cancer with current Helicobacter pylori infection (HpC-EGC) is common, but it is still unclear whether H. pylori eradication therapy (Hp-ET) or endoscopic submucosal dissection (ESD) should be performed first. We evaluated Hp-ETs short-term effects on horizontal boundary delineations of HpC-EGC in ESD. Methods: Prospectively enrolled HpC-EGC patients were randomly assigned to eradication or control groups. Operation scopes of HpC-EGC lesions were delineated with marking dots at 5 mm out of the endoscopic demarcation line by an independent endoscopist, unaware of eradication status, before formal circumferential incision. As representatives, precise delineation rate, the shortest distance of all marking dots to the pathological demarcation line in all slices of one intact resected specimen (D_min), and negative marking dot specimen rate were examined. Results: Twenty-three HpC-EGC patients (25 lesions) were allocated to eradication group and 26 patients (27 lesions) were allocated to the control group with similar eradication success rates and all were differentiated type. With improving background mucosa inflammation after Hp-ET and similar gastritis-like epithelium rates, 10 lesions (40.0%) in the eradication group were of precise delineation compared to control group with 2 lesions (7.4%) (relative risk = 5.40, 95% CI 1.31–22.28). D_min of eradication and control groups were 4.17 ± 2.52 mm and 2.67 ± 2.30 mm (p = 0.029), accompanied by 4 (14.8%) and none (0.0%) specimens that exhibited positive marking dots (p = 0.11), respectively. Conclusion: For HpC-EGC patients, administrating eradication medication before ESD is beneficial for the precise delineation of lesions and reducing the risk of positive horizontal resection margins.

Topography-guided transepithelial corneal collagen cross-linking by sequential ultraviolet A irradiation in different diameters for progressive keratoconus in adults

Objective: To compare the efficacy and safety of a novel customized topography-guided transepithelial corneal collagen cross-linking (TG-CXL) procedure by sequential ultraviolet A irradiation in different diameters and conventional transepithelial corneal collagen cross-linking (TE-CXL) in adult patients with progressive keratoconus. Methods: A prospective cohort study was conducted. Adult patients diagnosed with progressive keratoconus in the Affiliated Xiamen Eye Center of Xiamen University were continuously recruited and randomly assigned to receive the TG-CXL or TE-CXL procedure from March 2020 to March 2021. Patients in the TE-CXL group were irradiated in the central 9-mm zone of the cornea (total energy, 7.2 J/cm2; irradiance, 45 mW/cm2), while patients in the TG-CXL group were first irradiated with the protocol used in the TE-CXL group, and further irradiated in the central 6-mm zone (total energy, 3.6 J/cm2; irradiance, 9 mW/cm2). The subjective symptom of pain and corneal fluorescein sodium staining were scored within postoperative 3 days. Slit lamp examination, measurements of uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), corneal topography, anterior segment optical coherence tomography, in vivo corneal confocal microscopy, corneal endothelial cell count, and non-contact tonometry were performed before surgery and at 3, 6, and 12 months after surgery. Results: A total of 66 patients were enrolled (mean age, 23.0±3.3 years old), with 33 patients (33 eyes) in each group. No statistically significant differences were found in age, gender, and maximum keratometry (Kmax) between the two groups (P>0.05). On day 1 after surgery, the average pain score of the TG-CXL group (2.21±0.45) was significantly higher than that of the TE-CXL group (1.32±0.33) (P<0.05). The pain was rapidly alleviated in both groups on days 2 and 3. On days 1 and 2, the corneal fluorescein sodium staining scores in the TG-CXL group (4.15±0.83 and 2.21±0.60, respectively) were significantly higher than those in the TE-CXL group (1.76±0.56 and 0.85±0.51, respectively, P<0.001), while there was no significant difference between the two groups at day3 (P=0.184). The UCVA and BCVA of the TG-CXL group at 3, 6, and 12 months after surgery were significantly improved when compared with the baseline. At 3, 6, and 12 months, the BCVA (LogMAR) of the TG-CXL group (0.21±0.15, 0.22±0.16, and 0.22±0.16, respectively) were significantly improved when compared with those of the TE-CXL group(0.32±0.15, 0.34±0.15, and 0.36±0.16, respectively, P<0.01). However, there was no significant difference in UCVA between groups at any time point after surgery (P>0.05). The spherical and cylindrical power values of the TG-CXL group were improved when compared with the baseline (P<0.05). However, no significant difference in spherical power values was found between the two groups at any time point after surgery (P>0.05). Meanwhile, there were significant differences in cylindrical power values between the two groups at 6 and 12 months after surgery (P<0.05). The Kmax in the TG-CXL group was improved at all of the time points after surgery when compared with the baseline (P<0.001), while no significant difference in Kmax was found at any time point after surgery in the TE-CXL group when compared with the baseline (P>0.05). At 6 and 12 months after surgery, the Kmax values in the TG-CXL group were significantly lower than the TE-CXL group (P<0.05). No significant differences were found in flat keratomety, steep keratometry, the minimal thickness of the cornea, endothelial cell density, and intraocular pressure between the two groups at any time point after surgery (P>0.05). Within one month after surgery, optical coherence tomography revealed the increased density in the anterior stroma in both groups. In most patients in the TG-CXL group, a demarcation line was visible in the central and para-central corneal stroma, representing a clear and continuous, high-signal arc-shaped linear structure, which was deeper in the central cornea than the para-central cornea. In contrast, a demarcation line, fuzzy and focally discontinuous, was visible only in a few patients in the TE-CXL group, with an almost uniform depth in the central and the para-central cornea. Confocal microscopy demonstrated an apparent mesh-like cross-linked collagen structure in the superficial and intermediate corneal stroma at all time points after surgery in the TG-CXL group, with thickening stromal collagen fibers and an increased number of interconnections. In contrast, the mesh-like structure and number of interconnections in the superficial corneal stroma were significantly reduced at 12 months after surgery in the TE-CXL group, with no cross-linking structure in the intermediate corneal stroma at any time point after surgery. No serious complications such as corneal infection, sterile corneal ulcer, and persistent epithelial defect were observed in both groups during the follow-up of 12 months. Conclusions: The TG-CXL procedure by sequential irradiation in two different diameters with ultraviolet A light was effective and safe in the management of progressive keratoconus in adults, achieving significant refractive improvement. This might be a good technical alternative for refractive corneal cross-linking surgery.

City Sediments in Beirut: An Urban Ecology Perspective

Cities are products of urbanization processes, economic changes, technology and climate change. Adversely, in specific contexts, they are affected by wars’ enduring physical effect, long after armed conflicts are over. Hence cities are perceived as dynamic organisms, in continuous change of spatial abandonment, neglect and regeneration process, unfolding a continuum of space and time. In tandem between urban ecology and the urban history specificities, this paper addresses Beirut as a case study in its actual condition, and the different representations of the informal resurgence of green areas. It follows a methodology of identification and mapping of the different urban sediments which constituted over time potential reservoirs for urban ecology. These include previous war demarcation line, train tracks traces, cemeteries, destroyed wheat silos following the 2020 port explosion and other liminal spaces. This approach brings in a new perspective for approaching urban ecology differently according to the urban contexts historiography