Rowerosenberg4112

High myopic patients may develop strabismus due to globe dislocation out of the normal extraocular muscle cone. Surgical correction of this strabismus type is possible by joining the superior and lateral rectus muscles without the need for a scleral suture called the Yokoyama procedure. Data from large patient samples and the evaluation of a potential effect of an additional medial rectus recession (MRR) have been lacking so far.

We pooled retrospective patient data of 14 departments of ophthalmology in Germany and Switzerland and analysed determinants of postoperative results using multivariable regression models.

We included 133 patients (mean age 59.7 ± 13.4 years, surgery between 2008 and 2017) with a mean preoperative esotropia (both Yokoyama with and without MRR) of 23.8°±4.6°. The angle of preoperative esotropia increased with age. The postoperative esotropia was 8.7° ± 9.9°, and six patients were overcorrected. While preoperative esotropia was highly associated with postoperative results, we fouect size of the Yokoyama procedure appears to be mainly driven by preoperative esotropia.Tyrosine kinase domain (TKD) mutation and particularly exon 20 insertion mutations of erb-b2 receptor tyrosine kinase 2 (ERBB2/HER2) have been extensively reported in non-small cell lung cancer (NSCLC). Nevertheless, the clinical significance of non-TKD mutations remains unknown. To date, no clinical trials have revealed that tyrosine kinase inhibitors are effective in NSCLC patients with non-TKD ERBB2 mutations. mTOR inhibition Here we report a patient with advanced lung adenocarcinoma harboring non-TKD mutation of ERBB2, S335C, without other actionable alterations benefited from pyrotinib. After first-line treatment of pyrotinib monotherapy, a pan-HER inhibitor, the patient achieved a durable partial response with good tolerance. This case powerfully illustrates that pyrotinib might be a promising first-line treatment strategy for NSCLC patients with non-TKD mutation of ERBB2.Lithium (Li) metal anodes hold great promise for next-generation high-energy-density batteries, while the insufficient fundamental understanding of the complex solid electrolyte interphase (SEI) is the major obstacle for the full demonstration of their potential in working batteries. The characteristics of SEI highly depend on the inner solvation structure of lithium ions (Li+ ). Herein, we clarify the critical significance of cosolvent properties on both Li+ solvation structure and the SEI formation on working Li metal anodes. Non-solvating and low-dielectricity (NL) cosolvents intrinsically enhance the interaction between anion and Li+ by affording a low dielectric environment. The abundant positively charged anion-cation aggregates generated as the introduction of NL cosolvents are preferentially brought to the negatively charged Li anode surface, inducing an anion-derived inorganic-rich SEI. A solvent diagram is further built to illustrate that a solvent with both proper relative binding energy toward Li+ and dielectric constant is suitable as NL cosolvent.

Acne is a common disorder in adolescents. The prevalence of acne in adults is also increasing. There are only a few Indian studies on the prevalence and clinical features of adult acne.

To evaluate the prevalence and possible etiological and aggravating factors of acne in adult population.

Adult patients more than 25years with acne were enrolled, and detailed history and examination were recorded. Type of acne, age, gender, area of involvement, and associated factors were noted.

Out of 24,056 adult patients, 180 had acne, with the prevalence of 0.74%. Mean age of patients with acne was 30.1years. A total of 81.7% patients with acne were female and 68.3% had persistent type of acne. Inflammatory papular acne (72.8%) was the most common type of acne in our study population. Cheek (85%) was the predominant site of involvement; 62.8% patients developed scarring. Underlying chronic stress was present in 23.9% and family history of acne in 60.6%. A total of 43.5% patients reported aggravation with cosmetics and 42.8% provided history of oily and high glycemic food conduction. Premenstrual flare and hirsutism were seen in 61.9% and 16.3% female patients, respectively.

Acne is more common in people with 25-35years of age with female preponderance and a gradual decline in the prevalence is seen thereafter. Inflammatory nature is more common with cheeks being commonest site of affection. Facial scarring is more common that emphasizes the importance of early and adequate intervention.

Acne is more common in people with 25-35 years of age with female preponderance and a gradual decline in the prevalence is seen thereafter. Inflammatory nature is more common with cheeks being commonest site of affection. Facial scarring is more common that emphasizes the importance of early and adequate intervention.Ammonia is a key inorganic contaminant in wastewater and an important nutrient element for agriculture. Herein, a two-stage direct contact membrane distillation (DCMD) system was developed and investigated for ammonia recovery from a synthetic anaerobic digestate. In the 1st stage DCMD (DCMD-1), both ammonia and water moved across MD membrane to realize ammonia separation, while in the 2nd stage (DCMD-2), only water migrated and as a result ammonia was concentrated. It was found that increasing the initial feed solution pH could enhance ammonia removal in the DCMD-1 from 16.0 ± 2.0% (no pH adjustment) to 84.2 ± 1.9% (pH 12). A higher feed solution temperature increased both ammonia flux and water flux. The optimal condition was determined as an initial feed pH of 12, a feed temperature of 60°C, and the 0.6 M H2 SO4 adsorption solution. With the addition of the DCMD-2, the ammonia concentration was improved from 3 g L-1 to 7.8 ± 0.2 g L-1 , which was further enhanced to 26.3 ± 3.0 g L-1 after five batches of operation. These results have demonstrated the feasibility of a two-stage DCMD system for ammonia recovery from anaerobic digestate and warrant further investigation of several key issues that may advance this technology. PRACTITIONER POINTS A two-stage membrane distillation system is developed to remove and recover ammonia from anaerobic digester effluents. The system uses ammonia/ammonium equilibrium to separate ammonia in the 1st stage and then concentrate it in the 2nd stage. A high initial pH of the feed solution plays a key role in achieving high ammonia removal. Minimizing the volume of permeate solution can increase the ammonia concentration.

The aim of this study was to assess the real-life effectiveness and safety of direct acting antivirals (DAAs) in patients with cirrhosis and history of hepatic decompensation compared to those with compensated cirrhosis.

Data of patients treated with DAAs and included in the EpiTer-2 database (N=10152) were collected retrospectively. The primary endpoint was sustained viral response (SVR) at 12weeks posttreatment. Patients were also evaluated in terms of liver-related adverse events and treatment modification/discontinuation.

The overall SVR rate was 91.4% in the intent to treat (ITT) analysis and 95.2% in the per-protocol (PP) analysis (P<.001). Patients with decompensated cirrhosis had lower SVR rates compared to those with compensated cirrhosis in ITT analysis (86.4% vs 92.0%, P<.001), while not in PP analysis (92.9% vs 95.5%, P>.05). Adverse events (AE) occurred 45.6% and 29.3% of patients with decompensated and compensated cirrhosis (P<.001). Patients with decompensated cirrhosis were a itself.The intensive application of pesticides to increase crop production has resulted in contamination of the agricultural products. Due to their occurrence at trace levels and the complexity of food samples, analysis of pesticide residues requires selective and efficient sample preparation methods. For this purpose, an extraction method based on supercritical carbon dioxide and acetonitrile as entrainer solvent was developed for trace analysis of atrazine, diazinon, chlorothalonil, and deltamethrin pesticides in honey samples. A Box-Behnken experimental design was applied to optimize extraction variables including static extraction time (5-15 min), pressure (200-700 bar), and temperature (45-70°C). The optimum extraction conditions were found to be 11.5 min static extraction time, 252 bar, and 70°C. The proposed analytical method showed a good linearity (≥0.998), low limit of detection (0.005-0.009 mg/kg), and good extraction recovery (74-111%). The precision study of the proposed method at two concentration levels of each pesticides, 0.25 and 1.0 mg/kg was found to be in the ranges of 2.3-4.21% for intraday (n = 3) and 3.93-8.02% for interday precisions (n = 3). The developed method is promising for use in trace analysis of pesticides in complex food samples including honey.

Adverse events are often encountered in surgical intensive care units (ICUs), and most of them occur due to preventable errors. Establishment of a patient safety culture is recommended for preventing and reducing these errors.

This study was performed to investigate the relationship between surgical ICU nurses' patient safety culture and adverse events.

This was a cross-sectional descriptive study.

The study was performed in the surgical ICUs of four university hospitals in Izmir province, Turkey and was conducted in accordance with the Declaration of Helsinki and approved by an Ethics Committee. The sample comprised 113 nurses working in the surgical ICUs of the hospitals between November 2018 and February 2019. Data were collected using a questionnaire that comprised a demographic form, adverse events form, and patient safety culture hospital questionnaire. Student's t test, one-way analysis of variance, and logistic regression analyses were used to evaluate the data. P values <.05 were considered significant.

At the end of the study, nurses' level of patient safety culture was found to be intermediate (65.5%), with the highest average positive response rate (PRR) obtained for teamwork within the units (65.5%) and the lowest average PRR obtained for the frequency of adverse event reporting (25.3%). There was a significant correlation between patient safety culture and adverse events (r = 0.027, P < .05).

Surgical ICUs nurses' level of patient safety culture was average, and there was a significant correlation between patient safety culture and adverse events.

Managers should establish a reliable system for reporting adverse events and encourage ICU nurses to report them. It is very important to adopt a non-punitive approach at instances when an adverse event is reported.

Managers should establish a reliable system for reporting adverse events and encourage ICU nurses to report them. It is very important to adopt a non-punitive approach at instances when an adverse event is reported.Atopic dermatitis (AD) is affected by both internal factors as psychological stress (1) and external factors as climatec (2) and lifestyle (3). With the widespread adoption of smartphones, this offers a novel vehicle to collect data in real-time from a real-world setting. The aim of this study was to leverage mobile technology to conduct a fully remote longitudinal 12-weeks study in which a high-frequent sampling of both actively and passively collected data was used to explore disease and trigger associations within AD.