Disruption Of Layer Research Articles

Thermal behavior and dynamics of flow boiling in a pin-fin microchannel

As the need for effective heat dissipation in specialized systems intensifies, the study of flow boiling in microchannels has gained prominence due to its high efficiency and cost benefits. Utilizing a three-dimensional computational model incorporating the Volume of Fluid (VOF) and Saturated Interfacial Volume (SIV) methodologies, this research scrutinizes the behavior of saturated flow boiling in a microchannel featuring a centrally positioned, heated square cylinder. The analysis focuses on variations in bubble morphology, fluidic behavior, and thermal profiles, revealing that the evaporation of a thin liquid film contributes significantly to heat transfer efficacy. A systematic assessment of temperature gradients, heat transfer coefficients, and liquid film metrics uncovers the critical drivers behind effective heat transfer across different surfaces. Additionally, the study elucidates the role of Reynolds number and initial bubble size, indicating that higher Reynolds numbers thicken the liquid film, reducing heat transfer efficiency, while larger initial bubble diameters thin the liquid film, thereby boosting efficiency. Factors such as thermal boundary layer disruption and superheated fluid absorption further contribute to heat transfer optimization. This investigation enriches the current understanding of phase-change heat transfer dynamics and bubble interactions in microchannel environments equipped with a heated square cylinder.

Mechanisms of carbon dioxide extracting oil at the boundary layer on shale nanopore surface: insights from molecular dynamics

Boundary layer formed by crude oil on the shale nanopores surface hinders fluidity of crude oil and leads to a decline in oil recovery. CO2 injection has been considered as an effective method to enhance shale oil recovery. However, the impact of CO2 on the disruption of boundary layers within shale nanopores and the extraction mechanisms of crude oil during the recovery process remains unclear. In this work, molecular dynamics simulation was employed to investigate the process of using scCO2 to extract crude oil from shale nanopore surface. During the process of scCO2 extraction, polar molecules have the capability to reduce the diffusion coefficient, prolong the residence time, and decrease flowability of decane, ultimately resulting in a deterioration of its kinetic properties. Phenol, with its hydrophilic hydroxyl group, closely adheres to the shale surface, while the oleophylic benzene ring covers the shale surface, causing a transition in the wettability of this segment from hydrophilic to oleophylic. As a result, a substantial adsorption of decane occurs on phenol. The research findings contribute to the comprehension of the scCO2 extraction mechanism and the advancement of unconventional oil and gas resources.

Filaggrin Mutation Status and Prevention of Atopic Dermatitis with Maternal Probiotic Supplementation.

The World Allergy Organization recommends probiotics in the prevention of atopic dermatitis in high-risk populations. Mutations in the filaggrin gene (FLG) result in an increased risk of atopic dermatitis through disruption of the skin keratin layer. This exploratory study investigated whether the preventive effect of maternal probiotics was evident in children with and without FLG mutations. DNA was collected from children (n = 228) from the Probiotic in the Prevention of Allergy among Children in Trondheim (ProPACT) study. Samples were analysed for 3 common FLG mutations (R501X, R2447X, and 2282del4). Overall, 7% of children had heterozygous FLG mutations; each child had only one of the 3 mutations. Mutation status had no association with atopic dermatitis (RR = 1.1; 95% CI 0.5 to 2.3). The risk ratio (RR) for having atopic dermatitis following maternal probiotics was 0.6 (95% CI 0.4 to 0.9) and RR was similar if the child expressed an FLG mutation (RR = 0.6; 95% CI 0.1 to 4.1) or wildtype FLG (RR = 0.6; 95% CI 0.4 to 0.9). The preventive effect of probiotics for atopic dermatitis was also evident in children without FLG mutation. Larger confirmatory studies are needed.

Mixed convection heat transfer in a partial porous layered split lid-driven wavy wall cavity with Cu–H2O nanofluid

This numerical study investigates mixed convection heat transfer in a two-dimensional irregularly-shaped enclosure with a nanofluid-saturated porous medium. The enclosure has wavy vertical walls, a centered triangular block, and a lid split into two regions moving in opposite directions. Transport equations are solved using the finite element method under varied Darcy (10−5 to 10−1), Reynolds (50 to 200), Richardson (0.1 to 10), amplitude (0 to 0.2), and nanoparticle volume fraction (0 to 0.1) numbers. Results demonstrate the combined effects of forced convection from lid motion and natural convection from temperature differences significantly enhance heat transfer. The wavy walls induce secondary flows and periodic disruption of thermal boundary layers. Increasing Darcy number enables deeper penetration into the porous block. Copper nanoparticles incrementally improve conductive heat transfer. Richardson number effects are more prominent at higher Reynolds numbers as buoyancy forces influence vertical convection. This study provides novel insights into synergistically utilizing wavy geometries, nanofluids, porous media, and active pumping for optimizing heat transfer in irregular enclosures for electronics cooling and thermal management.

A Clinically Explainable AI-Based Grading System for Age-Related Macular Degeneration Using Optical Coherence Tomography.

We propose an automated, explainable artificial intelligence (xAI) system for age-related macular degeneration (AMD) diagnosis. Mimicking the physician's perceptions, the proposed xAI system is capable of deriving clinically meaningful features from optical coherence tomography (OCT) B-scan images to differentiate between a normal retina, different grades of AMD (early, intermediate, geographic atrophy (GA), inactive wet or active neovascular disease [exudative or wet AMD]), and non-AMD diseases. Particularly, we extract retinal OCT-based clinical imaging markers that are correlated with the progression of AMD, which include: (i) subretinal tissue, sub-retinal pigment epithelial tissue, intraretinal fluid, subretinal fluid, and choroidal hypertransmission detection using a DeepLabV3+ network; (ii) detection of merged retina layers using a novel convolutional neural network model; (iii) drusen detection based on 2D curvature analysis; (iv) estimation of retinal layers' thickness, and first-order and higher-order reflectivity features. Those clinical features are used to grade a retinal OCT in a hierarchical decision tree process. The first step looks for severe disruption of retinal layers' indicative of advanced AMD. These cases are analyzed further to diagnose GA, inactive wet AMD, active wet AMD, and non-AMD diseases. Less severe cases are analyzed using a different pipeline to identify OCT with AMD-specific pathology, which is graded as intermediate-stage or early-stage AMD. The remainder is classified as either being a normal retina or having other non-AMD pathology. The proposed system in the multi-way classification task, evaluated on 1285 OCT images, achieved 90.82% accuracy. These promising results demonstrated the capability to automatically distinguish between normal eyes and all AMD grades in addition to non-AMD diseases.

Связь парацентральной острой срединной макулопатии и гипертонической болезни

Purpose. To study changes in retinal microcirculation and the prevalence of chronic paracentral acute middle maculopathy (PAMM) lesions in patients with mild hypertension. Participants. Twenty-seven patients (21 males and 6 females 50.3 ± 6.3 years) with mild hypertension without cardiovascular risk and 24 healthy subjects (15 males and 9 females, 46.3 ± 13.0 years) were included. Methods. The foveal avascular zone (FAZ) area, vessel density of superficial and deep capillary plexus were assessed using optical coherence tomography (OCT) angiography. The presence of chronic PAMM lesions was evaluated by the revision of cross-sectional OCT images of 6-mm volume scans. A chronic or resolved PAMM lesion was defined as inner nuclear layer thinning with outer plexiform layer disruption. Results. There was no difference between hypertensive and healthy group in baseline characteristics, vessel density of superficial capillary plexus, vessel density of deep capillary plexus and FAZ area. Chronic PAMM lesions were found in 88.9 % hypertensive patients and in 16.7 % healthy individuals. The odds ratio for the presence of chronic PAMM lesions in mild hypertension was 40.0 (p < 0.001). Conclusion. Chronic PAMM lesions are highly prevalent in hypertensive patients and may represent the earliest changes in retinal microcirculation in mild hypertension, before changes in OCT angiography parameters have become apparent. Keywords: paracentral acute middle maculopathy, hypertension, optical coherence tomography

Synthesis and Crystallization Mechanism for SAPO-34 Zeolite Derived from Magadiite.

In this work, we explored the hydrothermal synthesize and crystallization process of SAPO-34 zeolites from two-dimensional layered silicate magadiite by using tetraethylammonium hydroxide (TEAOH) as a templating agent. Comprehensive characterization was conducted by XRD, SEM, FTIR, Raman, and BET. Time-resolved PXRD analysis revealed that SAPO-34 zeolite exhibited a steep growth curve when the crystallization time was 30 h, and the crystallinity reached 98.65 % at 48 h. Specifically, the disruption of the magadiite layer exposed charged silanol groups on the surface, fostering an affinity for AlO4 and PO4 species, thereby initiating the nucleation process. Under the guidance of TEAOH, these nucleation sites transformed into SAPO-34 nuclei, gradually advancing towards crystallization. FTIR and Raman analyses affirmed the presence of 6Rs, followed by D6R and 4Rs SBUs, along with the characteristic CHA structure. Combined with 29Si NMR established that disaggregated silicate minerals served as zeolite synthesis "seeds", enhancing nucleation sites and overall crystallization efficiency.

Central Bouquet Hemorrhages in Pathologic Myopia: Clinical Characteristics and Prognostic Relevance

To compare the clinical implications of central bouquet hemorrhages (CBH) to primarily subretinal hemorrhages, both occurring in the setting of pathologic myopia with lacquer crack formation. Multi-center retrospective cohort study PARTICIPANTS: 25 eyes (11 primarily subretinal hemorrhages, 14 CBH) were monitored over a median of 35 months (interquartile range [IQR] 9.50-54). Comprehensive ophthalmological examinations and optical coherence tomography (OCT) were reviewed. The study employed linear mixed-effects models to compare the impact of CBH versus primarily subretinal hemorrhages on baseline visual acuity (VA), rate of VA improvement, and final VA, adjusting for the follow-up period. Times of hemorrhages reabsorbtion and rate of ellipsoid zone (EZ) layer disruption on OCT were recorded. Eyes with CBH exhibited significantly worse baseline VA (0.93±0.45[20/160 Snellen] vs. 0.36±0.26[20/50 Snellen] LogMAR, p<0.001), a slower rate of VA improvement (p=0.04), and a trend towards worse final VA (0.48±0.47[20/60 Snellen] vs. 0.16±0.16[20/30 Snellen] LogMAR, p=0.06) compared to eyes with primarily subretinal hemorrhages. The CBH group experienced prolonged reabsorption times (median 10 months [IQR 4.6-23.3] vs. 2.3 months [IQR 2-3.2]) and a high prevalence of EZ layer disruption (86% vs. 0%) than primarily subretinal hemorrhages. CBH reabsorption was followed by the appearance of vertical hyperreflective lines in the central fovea in 67% of eyes, persisting for up to 6 years of follow-up. CBH signifies a distinct condition in pathologic myopia, characterized by worse visual outcomes, prolonged structural impact, and possible irreversible damage, compared to primarily subretinal hemorrhages. CBH regression should be taken into account in the differential diagnosis of vertical hyperreflective lesions in the central fovea on OCT in eyes with pathologic myopia.

Characterization of intestinal O-glycome in reactive oxygen species deficiency.

Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation resulting from an inappropriate inflammatory response to intestinal microbes in a genetically susceptible host. Reactive oxygen species (ROS) generated by NADPH oxidases (NOX) provide antimicrobial defense, redox signaling and gut barrier maintenance. NADPH oxidase mutations have been identified in IBD patients, and mucus layer disruption, a critical aspect in IBD pathogenesis, was connected to NOX inactivation. To gain insight into ROS-dependent modification of epithelial glycosylation the colonic and ileal mucin O-glycome of mice with genetic NOX inactivation (Cyba mutant) was analyzed. O-glycans were released from purified murine mucins and analyzed by hydrophilic interaction ultra-performance liquid chromatography in combination with exoglycosidase digestion and mass spectrometry. We identified five novel glycans in ileum and found minor changes in O-glycans in the colon and ileum of Cyba mutant mice. Changes included an increase in glycans with terminal HexNAc and in core 2 glycans with Fuc-Gal- on C3 branch, and a decrease in core 3 glycans in the colon, while the ileum showed increased sialylation and a decrease in sulfated glycans. Our data suggest that NADPH oxidase activity alters the intestinal mucin O-glycans that may contribute to intestinal dysbiosis and chronic inflammation.

Optical coherence tomography biomarkers DROL, PROS, SND, hyperreflective walls of foveal cystoid spaces as predictors of central macular thickness and visual acuity in diabetic macular edema treated with intravitreal ranibizumab.

This study aims to establish DROL (disruption of retinal outer layers), PROS (photoreceptor outer segment length), SND (subfoveal neuroretinal detachment), and hyperreflective walls of foveal cystoid spaces (HRW) as optical coherence tomography (OCT) biomarkers and predictors of central macular thickness (CMT) and visual acuity in diabetic macular edema (DME) treated with intravitreal ranibizumab (IVR). In this prospective, interventional study performed at a tertiary care center over a span of 1 year from December 2021 to December 2022, 50 eyes of 46 patients of DME were included. Visual acuity and spectral domain OCT imaging were performed at baseline. Using inbuilt calipers on SD-OCT, the horizontal extent of DROL and the vertical extent of PROS were measured manually. SND and HRW were assessed qualitatively. IVR was administered and patients were followed up at 4, 8, and 12 weeks. The eyes without DROL had statistically significant (P < 0.05) lesser CMT and better BCVA (best-corrected visual acuity) (P < 0.05) after pro re nata injection of IVR. There was a positive correlation between the extent of baseline DROL with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05), whereas negative correlation with the extent of baseline PROS with final CMT (P < 0.05) and final logMAR BCVA (P > 0.05). The presence of HRW and SND predicted non-resolution of CMT and worse visual acuity after treatment with IVR in DME. DROL, PROS, SND, and hyperreflective walls of foveal cystoid spaces may be utilized as qualitative as well as quantitative biomarkers to predict the post-treatment CMT and visual acuity in DME.

Mass intraoperative endothelial glycocalyx shedding affects postoperative systemic inflammation response

BacgroundOff-pump coronary artery bypass graft (OPCABG) has a high incidence of postoperative systemic inflammation response syndrome (SIRS), and perioperative endothelial glycocalyx layer (EGL) disruption can be one of the predisposing factors. We hypothesized that EGL shedding happened earlier in OPCABG which can influence on postoperative SIRS, and sevoflurane might preserve EGL better than propofol.MethodsWe randomly allocated 50 patients undergoing OPCABG to receive either sevoflurane-sufentanil or propofol-sufentanil anesthesia. Plasma syndecan-1, heparan sulfate (HS), atrial natriuretic peptide (ANP), IL-6, and cardiac troponin I (cTnI) were measured. Blood samples were collected at 6 timepoints: induction (T1), before grafting (T2), after grafting(T3), surgery done (T4), postoperative day1 (POD1,T5) and POD2 (T6). SIRS criteria and sequential organ failure assessment (SOFA) score were examined.ResultsThere were neither differences of syndecan-1, HS, IL-6 nor of SIRS criteria or SOFA score between the sevoflurane and propofol groups. All patients were pooled as a single group for further statistical analyses, plasma syndecan-1 (P < 0.001) and IL-6 (P < 0.001) increased significantly as a function of time; syndecan-1 increasing correlated significantly with the duration of coronary graft anastomosis (r = 0.329, P = 0.026). Syndecan-1(T3) correlated significantly with ANP(T3) (r = 0.0.354, P = 0.016) and IL-6 (T5) (r = 0.570, P < 0.001). The maximum value of IL-6 correlated significantly with SIRS (r = 0.378, P = 0.010), the maximum value of SOFA score (r = 0.399, P = 0.006) and ICU days (r = 0.306, P = 0.039). The maximum value of SOFA score correlated significantly with the occurrence of SIRS (r = 0.568, P < 0.001) and ICU days (r = 0.338, P = 0.022).ConclusionsOPCABG intraoperative early EGL shedding caused of grafts anastomosis greatly affected postoperative SIRS and SOFA score, sevoflurane did not clinically preserve EGL better.Trial registrationChiCTR-IOR-17012535. Registered on 01/09/2017.

UV-Induced Spectral and Morphological Changes in Bacterial Spores for Inactivation Assessment.

The ability to detect and inactivate spore-forming bacteria is of significance within, for example, industrial, healthcare, and defense sectors. Not only are stringent protocols necessary for the inactivation of spores but robust procedures are also required to detect viable spores after an inactivation assay to evaluate the procedure's success. UV radiation is a standard procedure to inactivate spores. However, there is limited understanding regarding its impact on spores' spectral and morphological characteristics. A further insight into these UV-induced changes can significantly improve the design of spore decontamination procedures and verification assays. This work investigates the spectral and morphological changes to Bacillus thuringiensis spores after UV exposure. Using absorbance and fluorescence spectroscopy, we observe an exponential decay in the spectral intensity of amino acids and protein structures, as well as a logistic increase in dimerized DPA with increased UV exposure on bulk spore suspensions. Additionally, using micro-Raman spectroscopy, we observe DPA release and protein degradation with increased UV exposure. More specifically, the protein backbone's 1600-1700 cm-1 amide I band decays slower than other amino acid-based structures. Last, using electron microscopy and light scattering measurements, we observe shriveling of the spore bodies with increased UV radiation, alongside the leaking of core content and disruption of proteinaceous coat and exosporium layers. Overall, this work utilized spectroscopy and electron microscopy techniques to gain new understanding of UV-induced spore inactivation relating to spore degradation and CaDPA release. The study also identified spectroscopic indicators that can be used to determine spore viability after inactivation. These findings have practical applications in the development of new spore decontamination and inactivation validation methods.

A Light Microscopic Study Comparing Pulp Histological Alterations Following Tooth Preparation Using a High-speed Handpiece and an Er: YAG Laser.

Histological alterations were evaluated in this study after tooth preparation with carbide burs using a traditional handpiece and Er: YAG laser. Tooth preparation was done on 30 intact maxillary first premolars of healthy patients. Ten maxillary first premolars were used as control, wherein no tooth preparation was done. Box-shaped tooth preparation was done on the occlusal surface of maxillary first premolars using carbide bur in the handpiece and Er: YAG laser (n = 10). After performing the recommended procedure for different groups, each tooth was extracted and 4-5 μm thick sections were prepared and stained using H and E stains. A 4-40× microscope was used to examine the morphological alterations in the odontoblasts. The Chi-square test was used to compare the outcomes. The high-speed drill group and the control group had statistically significant differences (P = 0.05). High-speed drill and laser group differences were not statistically significant (P > 0.05). The histological findings as seen with laser tooth preparation were nearly identical to those of control or nonmanipulated teeth under light microscope, whereas disruption of odontoblastic layer was seen with high-speed drills.

P086 Identification of a Novel Immunometabolic Target and Agonist for PLXDC2 for Amelioration of DSS Colitis Model in Mice

Abstract Background PLXDC2 is expressed on the cell surface of macrophage, dendritic and specific mesenchymal and epithelial cells whose activation shifts cellular metabolism and reduces oxidative stress to rebalance the immune response and decrease inflammation. It’s role in IBD pathogenesis is unknown. PLXDC2 activation improves disease severity in rheumatoid arthritis models1, while loss of PLXDC2 exacerbates the severity of disease in DSS colitis2. PX-04 is a novel, first-in-class, orally active PLXDC2 agonist. Here, we report on the consequences of activating PLXDC2 using PX-04 in an acute DSS colitis model. Methods Mice were given DSS in drinking water for seven days to induce disruption of the epithelial layer. At project initiation, mice were 8 weeks of age and began once daily dosing with 20mg/kg of PX-04 24 hours after being placed on DSS. Mice were weighed and scored daily for 15 symptoms of disease (weight loss, diarrhea, rectal bleeding, rectal inflammation, pain, &amp; overall behavior). Colons were collected and digested, and the resultant cellular suspensions were filtered to produce single cell suspensions. Colonic Lamina Propria Immune cells were isolated by Percoll gradient centrifugation. Cells were labeled with mixtures of extracellular (CD45, CD3, CD4, CD8, CD19, NK1.1, CD25, F4/80, CD11b, Gr1, CX3CR1, CD64) and intracellular (Tbet, RORγT, FOXP3, IFNγ, IL17, IL10, TNFα) antibodies in a sequential live staining in 96-well plates. Data was acquired using a FACS Celesta flow cytometer with FACSDiva software. Results Oral PX-04 treatment decreased the cumulative disease activity of mice challenged with DSS (FIG 1A). Immunologically, PX-04 affected both the adaptive and innate immune responses. First, PX-04 greatly decreased Th17 cells in the colon, while providing a slight increase to regulatory CD4+ T cells (FIG. 1C). A lower proportion of Natural Killer (NK) cells (FIG. 7D) produced IFNγ. Meanwhile, the proportion of TNF producing dendritic cells was decreased by PX-04 treatment. Conclusion Conclusion: PLXDC2 is expressed in cells relevant to IBD pathogenesis. PX-04, which binds to and activates PLXDC2, effectively decreases levels of effector T cells and myeloid cells, as well as overall disease severity in acute DSS colitis, warranting further investigation. 1Tubau-Juni et al. J Immunol 206(Supp) 2Tubau-Juni et al. Sci Rep 10(1)

Inherited Stanford A DeBakey I Aortic Dissection: Unveiling Genetic Predispositions and Surgical Management

BACKGROUND: Aortic dissection refers to the disruption of the medial layer of the aorta caused by intramural hemorrhage. This leads to the separation of the layers of the aortic wall, resulting in the establishment of a true lumen and a false lumen, which may or may not be connected. The prevalence of aortic dissection ranges from 0.2% to 0.8%. Additionally, a notable percentage, surpassing 20%, of individuals exhibit a familial inclination towards thoracic aorta dissection. CASE PRESENTATION: A male patient in his middle age, 41 years old, with risk factors of uncontrolled hypertension, obesity, and a familial propensity to aortic dissection, presented to the emergency department exhibiting symptoms of chest pain. It characterized the sensation as having a tearing quality and indicated that it extended towards the abdomen region. The results of the test revealed several notable findings. A blood pressure reading of 235/133, a wider mediastinum and cardiomegaly on the chest X-ray, a slight increase in Hs-Troponin levels, and an electrocardiogram showed sinus rhythm with left ventricular hypertrophy. He underwent a computed tomography scan, which revealed the existence of an aortic dissection that extended from the ascending to the descending aorta without any aortic valve involvement. He was assessed with a Stanford A. DeBakey I aortic dissection, and underwent successful therapy for aortic arch replacement with the elephant trunk procedure, and plans to undertake an endovascular procedure for the descending aorta in the upcoming period. CONCLUSION: Aortic dissection is a pathological disorder that may exhibit hereditary inheritance, and the choice of surgical technique is dependent on the specific underlying disease.

An experimental and numerical investigation of thermofluidic properties on the novel curved microchannel heat sink with slotted section

The current work proposes the development of a novel curved microchannel heat sink by modifying the existing flat microchannel heat sink for enhancing the heat dissipation in the electronic device without significant pressure drop penalty. The inspiration for the curved channel is taken from a NACA airfoil. The microchannel comprises two sections: a curved section and a slotted straight section. Experimental and numerical investigations are performed on the proposed geometry to study the thermofluidic properties for Reynolds number (Re) ranging from 200 to 500 using DI water as working fluid. Fluid flow and heat transfer are analysed by carrying out a full domain numerical simulation in ANSYS Fluent 19.0. The thermofluidic properties of the curved microchannel heat sink (CMCHS) and straight microchannel heat sink (SMCHS) are compared numerically by keeping the geometrical parameters (hydraulic diameter, foot area and fin area) and inlet parameters (inlet velocity and heat flux) identical. The average heat transfer coefficient (havg) of CMCHS is enhanced over SMCHS due to the formation of vorticities in the slotted region owing to the fluid intermixing and boundary layer disruption. The presence of curved section leads to reducing pressure drop penalty pertaining to gravitational effects. Together, the curved section and slotted section enhance the performance factor of CMCHS over SMCHS. The vortices formed increase as the Reynolds number increases, enabling an increase in the heat transfer coefficient. Therefore, the performance factor also increases as the Reynolds number is increased. An enhancement of ≈ 67.6 % in havg is achieved for Re = 500 in CMCHS compared to SMCHS with DI water as the working fluid.

Macular dystrophy in Kabuki syndrome due to de novo KMT2D variants: refining the phenotype with multimodal imaging and follow-up over 10 years: insight into pathophysiology

BackgroundKabuki Syndrome is a rare and genetically heterogenous condition with both ophthalmic and systemic complications and typical facial features. We detail the macular phenotype in two unrelated patients with Kabuki syndrome due to de novo nonsense variants in KMT2D, one novel. A follow-up of 10 years is reported. Pathogenicity of both de novo nonsense variants is analyzed.MethodsFour eyes of two young patients were studied by full clinical examination, kinetic perimetry, short wavelength autofluorescence, full field (ff) ERGs, and spectral-domain optical coherence tomography (SD-OCT). One patient had adaptive optic (AO) imaging. Whole exome sequencing was performed in both patients.ResultsBoth patients had de novo nonsense variants in KMTD2. One patient had c.14843C>G; p. (Ser4948ter) novel variant and the second c.11119C>T; p. (Arg3707ter). Both had a stable Snellen visual acuity of 0.2–0.3. The retinal multimodal imaging demonstrated abnormalities at the fovea in both eyes: hyperreflectivity to blue light and a well-delimited gap—disruption of ellipsoid and interdigitation layer on OCT. The dark area on AO imaging is presumed to be absent for, or with structural change to photoreceptors. The ff ERGs and kinetic visual fields were normal. The foveal findings remained stable over several years.ConclusionKabuki syndrome–related maculopathy is a distinct loss of photoreceptors at the fovea as shown by multimodal imaging including, for the first time, AO imaging. This report adds to the literature of only one case with maculopathy with two additional macular dystrophies in patients with Kabuki syndrome. Although underestimated, these cases further raise awareness of the potential impact of retinal manifestations of Kabuki syndrome not only among ophthalmologists but also other healthcare professionals involved in the care of patients with this multisystem disorder.

The impact of the grinding angle of the soil dredging tool on its performance

This investigation explores the optimization of the backhoe blade's entry angle, addressing its crucial role in enhancing energy efficiency and operational effectiveness in subsoil manipulation - a fundamental aspect of agricultural tillage technologies. Utilizing an integrated approach that combines detailed field experiments with robust theoretical simulations, the study methodically quantifies the effects of angular variations on energy demands and mechanical performance during soil dredging. Our results reveal precise angular configurations that offer optimal reductions in energy use while significantly improving the disruption and aeration of the subsoil layer. This optimization contributes directly to the development of advanced, precision-engineered agricultural implements aimed at boosting sustainability and productivity in farming practices. Furthermore, the outcomes of this research provide pivotal insights into soil health management strategies, potentially influencing crop yield through improved root penetration and water absorption. These findings are expected to serve as a benchmark for future innovations in agricultural machinery design, aligning with global trends towards more sustainable agricultural practices and enhanced food security. This study sets a new standard for agricultural tool engineering, paving the way for transformative changes in the sector.

Study of OCT based biomarkers as a predictor of visual outcome in diabetic macular edema

To determine the association between optical coherence tomography (SD-OCT) based biomarkers and visual acuity (VA) in diabetic macular edema (DME). This cross-sectional study was conducted at a tertiary care teaching hospitalbetweenJanuary 2021 and July 2022.The study included 54 eyes (30 patients) with DME. Based on the early treatment diabetic retinopathy study (ETDRS) grading system, these were classified as mild (n=1), moderate (n=31), severe (n=14), and very severe (n=8) non-proliferative diabetic retinopathy (NPDR). The demographics, VA recorded using ETDRS chart and ETDRS scoring system, slit lamp biomicroscopy findings, colour fundus pictures and biomarkers determined using macular scans on SD-OCT were noted. Six eyes with proliferative diabetic retinopathy (n-4) and considerable media opacity (n-2) were excluded. The data was entered into Microsoft Excel spreadsheet 2021and IBM's SPSS 26 statistical program was used to calculate the results.VA and biomarkers, which included central macular thickness, disorganisation of retinal inner layers (DRIL), ellipsoid zone disruption (EZD), choroidal thickness were measured on SD-OCT.: The mean age was 59.4±9.4 years, and male to female ratio was 1.3:1. Mean uncorrected and best corrected VA were 46 and 61 letters, 55.12±1.76 and 67.25±10.05 letters for moderate NPDR, 43.07±3.95 and 52.14±17.83 letters for severe NPDR, and 26.50±16.53 and 36±16.38 letters for very severe NPDR, respectively. VA deteriorated with increasing disease severity. Poorer VA was associated with increased average foveal and macular thickness and increased mean horizontal disruption of the inner retinal layers (DRIL). Average choroidal thickness positively correlated with increasing DR severity. : Poorer VA was associated with increasing DR severity, increased central retinal thickness, increased mean horizontal DRIL and increased average foveal choroidal thickness. We found no statistically significant correlation between VA and ellipsoid zone disruption.

Disruption of Cerebellar Granular Layer as a Consequence of Germinal Matrix Intraventricular Hemorrhage in Extreme Prematurity: An Acute Direct Mechanism Too?

Cerebellum is an important brain structure for the future development of motor, cognitive, and behavioral abilities in children. This structure undergoes its most significant growth during the third trimester of pregnancy. Prematurity gathers several risk factors for cerebellar impairment and underdevelopment, and among them is ventricular dilatation following germinal matrix intraventricular hemorrhage (GMH-IVH). In this report, we illustrate how this prevalent complication associated with prematurity may induce secondary cerebellar cortical damage. A premature male born by an emergency Caesarean section displayed massive GMH-IVH at brain ultrasound performed after three hours of extrauterine life and died after 18 hours of life, despite maximized vital support. We report a postmortem histopathological specimen of the cerebellar cortex showing the disruption of the external granular layer (EGL) by hemorrhagic content flowing from the supratentorial ventricles into the fourth ventricle and cisterna magna. The expansion of the ventricular system and the presence of blood in the lateral ventricles can cause inflammation and damage to the cerebellar gyri. Experimental models have shown a thinning of the EGL, suggesting that blood surrounding the cerebellum has a harmful action. Additionally, a sudden influx of cerebrospinal fluid from the lateral ventricles may directly contribute to cerebellar damage, indicating that this may be another way in which the cerebellar gyri are impaired during acute severe GMH-IVH. This is the first histopathologically confirmed case of acute disruption in the cerebellar cortex during a GMH-IVH in a premature baby.