Zhuwilkins5510

To review evidence on the utility of spectral domain optical coherence tomography (SD-OCT) in evaluating retinal structure prior cataract surgery and highlight new technologies that can assess retinal function perioperatively.

SD-OCT detected clinically unsuspected macular pathology in 4.6-25% of individuals in the pre-operative cataract evaluation. The most common findings were epiretinal membrane and macular degeneration with frequencies that varied by population studied. These conditions have been associated with complication after surgery (e.g. macular edema, visual dissatisfaction). As such, findings on SD-OCT may impact the informed consent process, alter IOL selection, and provide realistic postoperative vision expectations. Other technologies that assess retinal function, such as microperimetry and multifocal ERG are beginning to be studied but their utility in the pre-operative cataract evaluation is not yet known.

SD-OCT should be incorporated as a routine test prior to surgery to manage patient expectations and assist with optimal IOL selection, as even individuals with a seemingly normal clinical exam may have macular pathology. SD-OCT is the most established method for evaluating retinal anatomy and offers the benefits of a reduction in cases with missed macular pathology and fewer postoperative visual surprises.

SD-OCT should be incorporated as a routine test prior to surgery to manage patient expectations and assist with optimal IOL selection, as even individuals with a seemingly normal clinical exam may have macular pathology. SD-OCT is the most established method for evaluating retinal anatomy and offers the benefits of a reduction in cases with missed macular pathology and fewer postoperative visual surprises.

We discuss recent advancements in structural biology methods for investigating sites of protein-protein interactions. We will inform readers outside the field of structural biology about techniques beyond crystallography, and how these different technologies can be utilized for drug development.

Advancements in cryo-electron microscopy (cryoEM) and micro-electron diffraction (microED) may change how we view atomic resolution structural biology, such that well-ordered macrocrystals of protein complexes are not required for interface identification. However, some drug discovery applications, such as lead peptide compound generation, may not require atomic resolution; mass spectrometry techniques can provide an expedited path to generation of lead compounds. New crosslinking compounds, more user-friendly data analysis, and novel protocols such as protein painting can advance drug discovery programs, even in the absence of atomic resolution structural data. Finally, artificial intelligence and machine learninniques supported by advancements in computational methods will likely prove sufficient to support drug discovery efforts. In addition, these methods can be significantly faster than any crystallographic or cryoEM methods for identification of interacting regions.The unique activation signal of phase-change contrast agents (PCCAs or droplets) can be separated from the tissue signal and localized to generate super-resolution (SR) ultrasound (US) images. Lipid-shelled, perfluorocarbon PCCAs can be stochastically vaporized (activated) by a plane wave US transmission thereby enabling them to be used as separable targets for ultrasound localization microscopy. The unique signature of droplet vaporization imaging and the transient inherent nature of this signature increases signal contrast and therefore localization confidence, while the poor resolution of the low-frequency vaporization signal is overcome by the super-resolution result. Furthermore, our proposed PCCA SR technique does not require the use of user-dependent and flow-dependent spatio-temporal filtering via singular-value decomposition. Rather, matched filters selected by Fourier-domain analysis are able to identify and localize PCCA activations. Droplet SR was demonstrated in a crossed-microtube water phantom by localizing the activation signals of octafluoropropane nanodroplets (OFP, C3F8, -37 °C boiling point) to resolve 100 µm diameter fluorinated ethylene propylene tubes, which are ordinarily 35% smaller than the native diffraction-limited resolution of the imaging system utilized.Objective  Our primary objective was to determine whether biophysical profiles (BPP) performed on the antepartum unit result in changes in clinical decision making. Study Design  A retrospective cohort chart review was performed among women who had a BPP during hospital admission. BPP status was categorized as normal (8/8 points) and abnormal (6/8 or less points). The primary outcome, clinical decision making, was the need for prolonged external fetal monitoring (defined as > 2 hours) or decision to proceed with delivery. Secondary outcomes included mode of delivery, indicated preterm delivery, birth weight, 5-minute Apgar's score less then 7, and neonatal intensive care unit (NICU) admission. Results  Among our cohort ( n  = 186), 85.5% ( n  = 159) had a normal BPP. Delivery management was altered in one case (0.54%) by the BPP findings, and there were no BPPs that resulted in need for prolonged monitoring. Compared with women with normal BPP, women with abnormal BPPs were more likely to deliver at less then 37 weeks, to be admitted to the NICU, or have a 5-minute Apgar's score less then 7. Conclusion  In-hospital BPPs alter clinical decision making in less than 1% of cases.Objective  Outside pregnancy, nitrofurantoin, ciprofloxacin and sulfamethoxazole-trimethoprim (SMZ-TMP) are first-line therapy (FLT) for lower urinary tract infections (LUTIs). Optimal antibiotics for LUTI have been extrapolated based on expert opinion. Progression to pyelonephritis and adverse obstetric outcomes were compared between women who received FLT and those given alternative antibiotics. selleck compound Methods  This study includes a retrospective cohort of women with LUTI, including asymptomatic bacteriuria and acute cystitis at single health care system from July 2013 to May 2019. Women receiving FLT, defined as nitrofurantoin or SMZ-TMP, were compared with those receiving nonfirst-line therapy (nFLT). Primary outcome was progression to pyelonephritis. Secondary outcomes included pyelonephritis-related anemia, sepsis, length of stay, preterm birth (PTB), and low birth weight (LBW). Logistic regression was used to calculate odds of outcomes. Results  Of 476 women, 336 (70.6%) received FLT and 140 (29.4%) received nFLT.