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Purpose: To use artificial intelligence to identify imaging biomarkers for anatomic and functional progression of lamellar macular hole (LMH) and elaborate a deep learning (DL) model based on OCT and OCT angiography (OCTA) for prediction of visual acuity (VA) loss in untreated LMHs. Design: Multicentric retrospective observational study. Participants: Patients aged >18 years diagnosed with idiopathic LMHs with availability of good quality OCT and OCTA acquisitions at baseline and a follow-up >2 years were recruited. Methods: A DL model based on soft voting of 2 separate models (OCT and OCTA-based respectively) was trained for identification of cases with VA loss >5 ETDRS letters (attributable to LMH progression only) during a 2-year follow-up. Biomarkers of anatomic and functional progression of LMH were evaluated with regression analysis, feature learning (support vector machine [SVM] model), and visualization maps. Main Outcome Measures: Ellipsoid zone (EZ) damage, volumetric tissue loss (TL), vitreopapillary adhesion (VPA), epiretinal proliferation, central macular thickness (CMT), parafoveal vessel density (VD) and vessel length density (VLD) of retinal capillary plexuses, choriocapillaris (CC), and flow deficit density (FDD). Results: Functionally progressing LMHs (VA-PROG group, 41/139 eyes [29.5%]) showed higher prevalence of EZ damage, higher volumetric TL, higher prevalence of VPA, lower superficial capillary plexus (SCP), VD and VLD, and higher CC FDD compared with functionally stable LMHs (VA-STABLE group, 98/139 eyes [70.5%]). The DL and SVM models showed 92.5% and 90.5% accuracy, respectively. The best-performing features in the SVM were EZ damage, TL, CC FDD, and parafoveal SCP VD. Epiretinal proliferation and lower CMT were risk factors for anatomic progression only. Conclusions: Deep learning can accurately predict functional progression of untreated LMHs over 2 years. The use of AI might improve our understanding of the natural course of retinal diseases. The integrity of CC and SCP might play an important role in the progression of LMHs. Financial Disclosures: The authors have no proprietary or commercial interest in any materials discussed in this article.

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Lamellar ichthyosis (LI) is a chronic disease, mostly caused by mutations in the TGM1 gene, marked by impaired skin barrier formation. No definitive therapies are available, and current treatments aim at symptomatic relief. LI mouse models often fail to faithfully replicate the clinical and histopathological features of human skin conditions. To develop advanced therapeutic approaches, such as combined ex vivo cell and gene therapy, we established a human cellular model of LI by efficient CRISPR-Cas9-mediated gene ablation of the TGM1 gene in human primary clonogenic keratinocytes. Gene-edited cells showed complete absence of transglutaminase 1 (TG1) expression and recapitulated a hyperkeratotic phenotype with most of the molecular hallmarks of LI in vitro. Using a self-inactivating γ-retroviral (SINγ-RV) vector expressing transgenic TGM1 under the control of its own promoter, we tested an ex vivo gene therapy approach and validate the model of LI as a platform for pre-clinical evaluation studies. Gene-corrected TGM1-null keratinocytes displayed proper TG1 expression, enzymatic activity, and cornified envelope formation and, hence, restored proper epidermal architecture. Single-cell multiomics analysis demonstrated proviral integrations in holoclone-forming epidermal stem cells, which are crucial for epidermal regeneration. This study serves as a proof of concept for assessing the potential of this therapeutic approach in treating TGM1-dependent LI.

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The stratum corneum (SC) presents certain limitations for topical administration of medication, which can be overcome using penetration enhancers (PEs) such as terpene (TP). The SC is also crucial for maintaining the skin barrier and consists of two lamellar structures: the short periodicity phase (SPP) and long periodicity phase (LPP). In this study, we monitored changes in the X-ray diffraction peaks of the human SC, 30 min after TP application (neroridol, 1,8-cineol, and d-limonene). With the application of nerolidol, no significant changes were observed in the small-angle diffraction peak positions for the lamellar structure of SPP, but the integrated intensity decreased. On the contrary, when applying 1,8-cineole and d-limonene, a lower angle peak shift with broadening of the peak width of SPP diffraction peaks was observed for d-limonene than for 1,8-cineole, and the degree of peak shift and width broadening was greater for d-limonene than for 1,8-cineole. The diffraction peaks of LPP disappeared when 1,8-cineole and d-limonene were applied. These results indicate that the degree of interaction between the SC and TP differs depending on the molecular species, and d-limonene and 1,8-cineole exhibit penetration-enhancing via lamellar structure disruption of both SPP and LPP, immediately after application.

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Background: The aim of this study was to evaluate the intraoperative complications and visual outcomes of manual deep anterior lamellar keratoplasty (mDALK) in patients who underwent previous radial keratotomy (RK) for myopia. Methods: The notes of patients who underwent mDALK after RK at three different hospitals-San Giovanni Addolorata Hospital (Rome, Italy), Mount Saint Joseph Hospital (Vancouver, Canada), and Tor Vergata University Hospital (Rome, Italy)-were retrospectively reviewed. We analyzed the manual dissection success rate and conversion to penetrating keratoplasty (PK), the residual recipient stromal thickness, the postoperative corrected distance visual acuity (CDVA), postoperative refraction, and topographic astigmatism. Results: Thirteen eyes of eleven patients were included in the analysis (male 7/11, 63.6%). Preoperatively, mean topographic astigmatism was 5.4 ± 3.5 D (range 1.6-14.8 D), and mean CDVA was 0.47 ± 0.2 logMAR (range 0.3-1.0 logMAR) [Snellen equivalent 20/50]. Manual dissection was performed in all cases. None of the examined eyes were converted to PK. An improvement in both topographic astigmatism (2.8 ± 0.9 D, p = 0.0135) and CDVA (0.23 ± 0.2 LogMAR, p = 0.0122) was recorded at 12-month follow-up. Conclusions: mDALK is a safe and effective surgical technique when applied to eyes previously treated with RK, with an observed improvement in CDVA and topographic astigmatism.

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Antibiotics are essential for treating infections and reducing risks during medical interventions. However, many commonly used antibiotics lack the physiochemical properties for an efficient oral administration when treating systemic infection. Instead, we are reliant on intravenous delivery, which presents complications outside of clinical settings. Developing novel formulations for oral administration is a potential solution to this problem. We engineered hexosome and cubosome liquid crystal nanoparticles (LCNPs) characterized by small-angle X-ray scattering and cryogenic transmission electron microscopy, and could encapsulate the antibiotics vancomycin (VAN) and clarithromycin (CLA) with high loading efficiencies. By rationally choosing stable lipid building blocks, the loaded LCNPs demonstrated excellent resilience against enzymatic degradation in an in vitro gut model LCNP stability is crucial as premature antibiotic leakage can negatively impact the gut microbiota. In screens against the representative gut bacteria Enterococcus faecalis and Escherichia coli, our LCNPs provided a protective effect. Furthermore, we explored co-administration and dual loading strategies of VAN and CLA, and demonstrated effective loading, stability and protection for E. faecalis and E. coli. This work represents a proof of concept for the early-stage development of antibiotic-loaded LCNPs to treat systemic infection via oral administration, opening opportunities for combination antibiotic therapies.

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Developing high-temperature-resistant adsorbents with superior porous properties is crucial for safely disposing of heavy metal-containing solid waste via pyrolysis. We synthesized aluminosilicates hydrothermally and observed that acidic conditions, especially HCl (pH=2.6), favored sponge-like mineral (NC2.6) formation with a specific surface area of 500.31 m²/g and pore volume of 0.986 cm³ /g, while alkaline conditions (pH=12.0) promoted spherical particle growth. NC2.6 exhibited higher adsorption capacity compared to kaolinite and halloysite in the PbCl2 vapor adsorption, reaching a maximum of 137.68 mg/g at 700 â„ƒ (75.91 % stable). We examined the effect of CO2 and H2O on adsorption efficiency and explored the mechanisms using DFT and GCMC simulations. From GCMC results, CO2 negatively impacted PbCl2 adsorption due to competitive adsorption, while H2O increased adsorption content (144.24 mg/g at 700 â„ƒ) by converting PbCl2 into oxides. DFT revealed the presence of CO2 enhanced the adsorption stability of PbCl2 via the formation of covalent bonds between O in CO2 and Pb, and active O on the aluminosilicate surface. H2O increased PbCl2 adsorption energy, as O in H2O occupied an active Al that originally formed a covalent bond with Cl, while the H formed a weak hydrogen bond with this Cl.

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INTRODUCTION: Patients with atopic dermatitis (AD) have impaired barrier function, which decreases skin hydration, weakens their defense against microorganisms, and culminates in increased inflammatory responses. Here, we conducted a clinical trial to evaluate the efficacy of a multi-lamellar emulsion (MLE) containing the pseudoceramide PC-9S and a synthetic sphingosine kinase 1 (SPHK1) activator, Defensamide™, in improving mild-to-moderate atopic dermatitis. METHODS: Forty patients aged ≥ 2 years were randomized into a combined-therapy group treated with the MLE containing PC-9S and Defensamide™ plus a topical corticosteroid and a topical-corticosteroid-only group. Assessments based on therapeutic methods included the Eczema Area and Severity Index (EASI), the Investigator Global Assessment (IGA), transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin dryness, a visual analogue scale (VAS) of itchiness, a VAS of sleep disturbance, patient satisfaction, and the Dermatology Life Quality Index (DLQI). RESULTS: Thirty-eight patients completed this study. In the combined-therapy group, significant improvements in clinical and instrumental measures such as EASI scores, skin hydration, and skin dryness were noted at 4 weeks compared to baseline, but such improvements were not noted in the topical corticosteroid-only group. Subjective assessments of itching and sleep disturbance and DLQI scores also showed significant improvements in the combined-therapy group. CONCLUSION: Combined therapy with the MLE containing Defensamide™ and PC-9S and with topical corticosteroid demonstrated superior clinical outcomes compared with topical corticosteroid monotherapy. Our findings underscore the potential of MLE-containing formulations as effective adjunctive therapies for AD, offering both objective and subjective symptomatic relief and enhancing patients' quality of life.

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AIM: The aim of the study was to analyze the techniques and outcomes of deep anterior lamellar keratoplasty (DALK) done in eyes with healed hydrops. METHODS: Thirty-one eyes with paracentral scars following acute hydrops underwent DALK and were included in the study. Manual layer-by-layer dissection with stromal air injection was done in all cases, keeping dissection of the site of preexisting perforation to the end. RESULTS: Out of the 31 eyes, in 28 eyes, DALK could be completed, and in 3 eyes, procedure had to be converted to penetrating keratoplasty. Visual outcomes in all cases were good, with 26 out of 28 eyes (92.8%) achieving a best-corrected visual acuity (BCVA) of 6/12 or better. Preoperative mean BCVA of LogMAR 1.19 ± 0.27 improved to a postoperative mean BCVA of LogMAR 0.23 ± 0.08 (P < 0.00001). Postoperative mean refractive astigmatism at the last follow-up was -2.69 ± 0.82 D with postoperative a spherical equivalent of -2.31 ± 0.7 D. Complications included double anterior chamber in one eye and secondary angle closure in two eyes. Stromal rejection in one eye was managed with steroids and one eye with suture infiltrate needed selective suture removal. CONCLUSION: Layer-by-layer dissection with limited air injection into the stroma has shown good visual outcomes in patients undergoing DALK following healed hydrops, and DALK can very well be the primary treatment option even in such cases with a paracentral posthydrops scar.

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BACKGROUND: Corneal dermoid is a congenital benign tumor and ocular malformation, often diagnosed at birth or in early childhood. Its treatment and long-term prognosis remain under-researched, necessitating further investigation. PURPOSE: This study aims to investigate the epidemiological and clinical characteristics of corneal dermoid, evaluate the efficacy of different surgical methods, and identify factors influencing treatment outcomes. METHODS: A retrospective analysis was conducted on the clinical data of 58 patients treated for corneal dermoid at our hospital from 2017 to 2021. Patients' demographic information, tumor characteristics, surgical methods, and postoperative outcomes were collected and analyzed. Descriptive statistics, independent sample t-test, chi-square (χ 2) test, and Spearman correlation analysis were used to evaluate the distribution characteristics and intergroup differences of corneal dermoid. RESULTS: The average age of the patients was 6.3 years, with 55.2% being male and 44.8% female. The right eye was affected in 63.8% of cases, with the temporal limbus being the most common site (75.9%). Pathological examination revealed tumors covered by squamous epithelium, containing hair follicles, sebaceous glands, adipose tissue, and fibrous tissue; some cases also had cartilage and glandular tissue. Surgical methods included corneal dermoid excision (100%), lamellar keratoplasty (37.9%), amniotic membrane grafting (31.0%), and autologous limbal stem cell transplantation (8.6%). None of the 50 followed up patients experienced tumor recurrence. Postoperative vision improved in 58.0% of patients, with more females (61.9%) experiencing visual impairment compared to males (38.1%) (χ²=4.711, p=0.030). CONCLUSIONS: This study analyzed 58 corneal dermoid patients treated from 2017 to 2021, focusing on epidemiological and clinical characteristics, surgical efficacy, and treatment outcomes. It identified common pathological features and effective surgical methods, with no tumor recurrence in followed up patients. The study highlights the need for further research with larger sample sizes and longer follow-up periods.

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Small-angle X-ray and neutron scattering (SAXS and SANS) patterns from certain semicrystalline polymers and liquid crystals contain discrete reflections from ordered assemblies and central diffuse scattering (CDS) from uncorrelated structures. Systems with imperfectly ordered lamellar structures aligned by stretching or by a magnetic field produce four distinct SAXS patterns: two-point 'banana', four-point pattern, four-point 'eyebrow' and four-point 'butterfly'. The peak intensities of the reflections lie not on a layer line, or the arc of a circle, but on an elliptical trajectory. Modeling shows that randomly placed lamellar stacks modified by chain slip and stack rotation or interlamellar shear can create these forms. On deformation, the isotropic CDS becomes an equatorial streak with an oval, diamond or two-bladed propeller shape, which can be analyzed by separation into isotropic and oriented components. The streak has elliptical intensity contours, a natural consequence of the imperfect alignment of the elongated scattering objects. Both equatorial streaks and two- and four-point reflections can be fitted in elliptical coordinates with relatively few parameters. Equatorial streaks can be analyzed to obtain the size and orientation of voids, fibrils or surfaces. Analyses of the lamellar reflection yield lamellar spacing, stack orientation (interlamellar shear) angle α and chain slip angle ϕ, as well as the size distribution of the lamellar stacks. Currently available computational tools allow these microstructural parameters to be rapidly refined.

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OBJECTIVE: Ex vivo skin has been used to study various skin conditions from atopic dermatitis to burn injury. The aim of this research is to identify a more effective barrier improvement strategy and to evaluate topical formulations in replenishing the skin. The skin can create new longer chain fatty acids and ceramides (CERs) from topically applied skin natural fatty acid to help renew the skin's barrier. METHODS: An ex vivo skin model damaged by sequential tape stripping of the stratum corneum (SC) was used to investigate the repair of the SC. Confocal laser scanning microscopy was used to assess the SC layers recovered. Ultrastructural analysis was performed using transmission electron microscopy to visualize the lamellar bodies and intercellular lipid lamellae. RESULTS: The data in this study provide the first direct ex vivo evidence comparing different marketed formulations containing three CERs with those containing fatty acids. Free fatty acid (FFA)-containing formulations, but not CER-containing formulations, directly applied to the damaged skin, showed an increased number of repaired SC layers and this was reflected at the ultrastructural level by an increased intercellular lipid lamellae length and an increased number of lamellar bodies. CONCLUSION: These findings demonstrate that FFA-containing formulations can repair damaged ex vivo skin and point to a repair mechanism in which topically applied palmitic and stearic acids, (which boost lipid levels and elongation) can increase the production and transport of lipids into a repaired SC and thus rebuild an effective skin barrier.

OBJECTIF: La peau ex vivo a été utilisée pour étudier diverses affections cutanées, allant de la dermatite atopique aux brûlures. L'objectif de cette étude est d'identifier une stratégie d'amélioration de la barrière cutanée plus efficace et d'évaluer les formulations topiques pour reconstituer la peau. La peau peut créer de nouveaux acides gras à chaîne plus longue et des céramides (CER) à partir d'acides gras naturels de la peau appliqués par voie topique pour aider à renouveler la barrière cutanée. MÉTHODES: Un modèle de peau ex vivo endommagé par un décapage séquentiel de la couche cornée a été utilisé pour étudier la réparation de la couche cornée. La microscopie confocale à balayage laser a été utilisée pour évaluer les couches de la couche cornée récupérées. Une analyse ultrastructurale a été réalisée par microscopie électronique à transmission pour visualiser les corps lamellaires et les lamelles lipidiques intercellulaires. RÉSULTATS: Les données de cette étude fournissent les premières preuves directes ex vivo comparant différentes formulations commercialisées contenant trois CER avec celles contenant des acides gras. Les formulations contenant des acides gras libres (AGL), mais pas celles contenant des CER, appliquées directement sur la peau endommagée, ont montré un nombre accru de couches de la couche cornée réparées, ce qui s'est traduit au niveau ultrastructural par une augmentation de la longueur des lamelles lipidiques intercellulaires et une augmentation du nombre de corps lamellaires. CONCLUSION: Ces résultats démontrent que les formulations contenant des AGL peuvent réparer la peau ex vivo endommagée et indiquent un mécanisme de réparation dans lequel les acides palmitique et stéarique appliqués par voie topique (qui stimulent les taux de lipides et leur allongement) peuvent augmenter la production et le transport de lipides dans une couche cornée réparée et ainsi reconstruire une barrière cutanée efficace.

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Nanoparticles have become versatile assets in the medical field, providing notable benefits across diverse medical arenas including controlled drug delivery, imaging, and immunological assays. Among these, non-lamellar lipid nanoparticles, notably cubosomes and hexosomes, showcase remarkable biocompatibility and stability, rendering them as optimal choices for theranostic applications. Particularly, incorporating edge activators like sodium taurocholate enhances the potential of these nanoparticles for dermal and transdermal drug delivery, overcoming the stratum corneum, a first line of defense in our skin. This study reports on the formulation of monoolein-based cubosomes and hexosomes incorporating taurocholate and stabilized by Span 80 and co-encapsulating Chlorin e6 and coenzyme QH for photodynamic therapy in skin metastatic melanoma. The formulations were optimized using small-angle X-ray scattering, and cryo-transmission electron microscopy confirmed the presence of cubosomes or hexosomes, depending on the ratio between taurocholate and Span 80. Furthermore, the co-loaded nanoparticles exhibited high encapsulation efficiencies for both Ce6 and the coenzyme QH. In vitro studies on human melanoma cells (Me45) demonstrated the biocompatibility and photodynamic activity of the loaded formulations. These findings show the possibility of formulating more biocompatible cubosomes and hexosomes for photodynamic therapy in skin cancer treatment.

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Despite its widespread use as a stabilizer across various industries over the past several decades, the health effects of chronic exposure to PFOA are still unclear. We administered PFOA by oral gavage (0, 12.5, 50, and 200 µg/day/mouse, eight groups) to male and female mice for six months. Body weight gain decreased with dose accompanied by increased liver weight, and PFOA altered liver damage-related-blood biochemical indicators and induced pathological lesions, including hepatocellular hypertrophy, cholangiofibrosis, and centrilobular hepatocellular vacuolation. Loss of the Golgi apparatus, formation of lamellar body-like structures, and lipid accumulation were observed in the liver of PFOA-treated mice. We also cohabited five pairs of male and female mice for the last ten days of administration, dosed PFOA to dam up to 28 days after birth, and investigated effects on reproduction and development. The survival rate of pups and the sex ratio of surviving mice decreased significantly at the highest dose. PFOA tissue concentration increased with the dose in the parent mice's liver and the pups' blood and brain. Taken together, we suggest that PFOA primarily affects the liver and reproduction system and that disturbance in lipid metabolism and Golgi's structural stability may be involved in PFOA-induced toxicity.

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Purpose: Atopic dermatitis is characterized by chronic inflammation and dryness accompanied by severe itching. The combined use of moisturizers and topical anti-inflammatory drugs is essential for alleviating atopic dermatitis. We have developed a topical anti-inflammatory drug with a steroid and a moisturizer with heparinoid, both in lamellar structure-based formulations containing synthetic pseudo-ceramides. Here, assessed the efficacy of this combination in the treatment of atopic dermatitis. Methods: We included 22 patients with mild to moderate atopic dermatitis and subjected them to a seven-week treatment with the test formulations, followed by a four-week post-treatment period. Results: Clinical findings and the quality of life of participants remarkably improved after one week of treatment. Furthermore, skin hydration and transepidermal water loss considerably improved at weeks one and three, respectively. The Cer [NP]/[NS] ratio, an indicator of epidermal turnover, substantially increased during the treatment period and remained elevated even thereafter. The improvement in stratum corneum function was distinctive in participants with lower barrier function. Conclusion: These findings indicated that the combined use of the anti-inflammatory drug and moisturizer, both in lamellar structure-based formulations, is effective in treating atopic dermatitis in patients with fragile barrier function.

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Research on the local hippocampal atrophy for early detection of dementia has gained considerable attention. However, accurately quantifying subtle atrophy remains challenging in existing morphological methods due to the lack of consistent biological correspondence with the complex curving regions like the hippocampal head. Thereby, this article presents an innovative axis-referenced morphometric model (ARMM) that follows the anatomical lamellar organization of the hippocampus, which capture its precise and consistent longitudinal curving trajectory. Specifically, we establish an "axis-referenced coordinate system" based on a 7 T ex vivo hippocampal atlas following its entire curving longitudinal axis and orthogonal distributed lamellae. We then align individual hippocampi by deforming this template coordinate system to target spaces using boundary-guided diffeomorphic transformation, while ensuring that the lamellar vectors adhere to the constraint of medial-axis geometry. Finally, we measure local thickness and curvatures based on the coordinate system and boundary surface reconstructed from vector tips. The morphometric accuracy is evaluated by comparing reconstructed surfaces with those directly extracted from 7 T and 3 T MRI hippocampi. The results demonstrate that ARMM achieves the best performance, particularly in the curving head, surpassing the state-of-the-art morphological models. Additionally, morphological measurements from ARMM exhibit higher discriminatory power in distinguishing early Alzheimer's disease from mild cognitive impairment compared to volume-based measurements. Overall, the ARMM offers a precise morphometric assessment of hippocampal morphology on MR images, and sheds light on discovering potential image markers for neurodegeneration associated with hippocampal impairment.

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Background: Keratoconus (KCN) is characterized by gradual thinning and steepening of the cornea, which can lead to significant vision problems owing to high astigmatism, corneal scarring, or even corneal perforation. The detection of KCN in its early stages is crucial for effective treatment. In this review, we describe current advances in the diagnosis and treatment of KCN. Methods: This narrative review focuses on recent advancements in the diagnosis and treatment of KCN, especially evolving approaches and strategies. To ensure the inclusion of the most recent literature, relevant publications discussing advanced imaging techniques and treatment options for KCN were extensively gathered from the PubMed/MEDLINE and Google Scholar databases. The following index terms and keywords were used for the online search: keratoconus, diagnosis of keratoconus, advances in the diagnosis of keratoconus, topography or tomography, anterior segment optical coherence tomography, treatment of keratoconus, advances in the treatment of keratoconus, collagen crosslinking, intrastromal ring, keratoplasty, and new techniques in keratoconus. Results: Various screening methods such as corneal topography, tomography, anterior segment optical coherence tomography, and assessment of corneal biomechanics have been developed to identify KCN in its early stages. After diagnosis, KCN management focuses on preventing disease progression. Corneal collagen crosslinking is a minimally invasive treatment that can slow or stop the progression of the condition. Recent research has also explored the use of copper sulfate eye drops (IVMED-80) as a noninvasive treatment to prevent the progression of KCN. Current treatment options for visual improvement include scleral lenses, intracorneal ring segments, corneal allogeneic intrastromal ring segments, and deep anterior lamellar keratoplasty. Recently, novel alternative procedures, such as isolated Bowman layer transplantation, either as a corneal stromal inlay or onlay, have demonstrated encouraging outcomes. Artificial intelligence has gained acceptance for providing best practices for the diagnosis and management of KCN, and the science of its application is contentiously debated; however, it may not have been sufficiently developed. Conclusions: Early detection and advancements in screening methods using current imaging modalities have improved diagnosis of KCN. Improvement in the accuracy of current screening or diagnostic tests and comparison of their validities are achievable by well-designed, large-scale, prospective studies. The safety and effectiveness of emerging treatments for KCN are currently being investigated. There is an ongoing need for studies to track progress and evaluate clinicians' knowledge and practices in treating patients with KCN. Artificial intelligence capabilities in management approach considering the currently available imaging modalities and treatment options would best benefit the patient.

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The aim of our study is to investigate the feasibility and outcomes of using a femtosecond laser (FSL) platform (Ziemer LDV Z8) for deep anterior lamellar keratoplasty (DALK), enabling the creation of mushroom-shaped graft-host junctions, lamellar cuts, and intrastromal tunnels, to facilitate the big bubble, in one step. We included wet lab experiments on nine porcine eyes to assess the laser accuracy and cuts depth using an anterior segment (AS) OCT. This was followed by an interventional prospective case series on 10 eyes with variant corneal pathologies. The Z8 system, with in-built intraoperative optical coherence tomography (iOCT), guided corneal scans and directed the cuts. ASOCT showed visible mushroom configurations, lamellar cuts, and tunnels. Deviations from the target were 1.6%, 2.6%, and 3.5%. Anterior lamellar removal was easy in all clinical cases, including corneal scarring. The intrastromal tunnel was found at the preset location and the mushroom configuration was acquired. A big bubble was achieved in all cases. Type 1, 2, and 3 bubbles were formed in eight, one, and one case, respectively. We describe a new approach to DALK in which the in-built iOCT-guided FSL enables safe, precise, controlled, and reproducible desired cuts in one step. The preliminary clinical outcomes were favorable.

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BACKGROUND: We investigate novel OCT parameters, based on the volumetric analysis of lamellar macular holes (LMHs), as prognostic indicators for visual outcomes after surgery. METHODS: LMHs were divided into degenerative LMHs (D-LMHs) and ERM-foveoschisis (ERM-FS). Pre-operative clinical, OCT linear and volumetric parameters were collected. Volumes were obtained using the OCT automatic segmentation, such as central retinal volume (CRV) and outer nuclear layer (ONL) volume, or using a novel method to calculate volumes of specific LMH entities like epiretinal proliferation (ERP), foveal cavity (FC) in D-LMH and schitic volume (SV) in ERM-FS. Univariate and multivariate linear regression analysis evaluated the factors predictive for post-operative best-corrected visual acuity (BCVA). RESULTS: We included 31 eyes of 31 patients (14 D-LMH,17 ERM-FS). A pre-operative BCVA ≤ 0.48 logMAR was a predictor for achieving ≤0.30 logMAR at final follow-up. A lower pre-operative BCVA (p = 0.008) and the presence of ERP (p = 0.002) were associated with worse visual outcomes post-surgery. Moreover, novel pre-operative OCT parameters significantly associated with worse post-operative BCVA, such as increased FC volume (p = 0.032) and lower CRV (p = 0.034) in the D-LMH subtype and lower CRV (p < 0.001) and ERP volume (p < 0.001), higher SV (p < 0.001) and foveal ONL volume (p < 0.001) in the ERM-FS subtype. CONCLUSIONS: Novel volumetric OCT parameters can be prognostic indicators of visual outcome following surgery in LMHs.

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A novel zwitterion composed of an imidazolium tethered to an anionic sulfonyl(trifluoromethane sulfonyl)imide group was prepared as an alternative dielectric material to traditional ionic liquids. The zwitterion not only melted below 100 °C but also proved to be nonhygroscopic. High-capacitance organic dielectric materials were obtained by blending this compound with poly(methyl methacrylate) over a range of concentrations and thicknesses. Above a specific temperature and concentration, films exhibit a capacitance nearly equivalent to that of an electrostatic double layer, approximately 10 µF/cm2, regardless of their thickness. Grazing-incidence wide-angle X-ray scattering experiments suggest that the zwitterions adopt a lamellar ordering at their surface above a critical concentration. The observed ordering is correlated with a 1000-fold increase in capacitance. The behavior suggests that the zwitterions exhibit strong electrostatic correlations throughout the film bulk, pointing the way toward a novel class of organic dielectric materials.

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This study focuses on the design, characterization, and optimization of nanostructured lipid carriers (NLCs) loaded with docetaxel for the treatment of skin cancer. Employing a systematic formulation development process guided by Design of Experiments (DoE) principles, key parameters such as particle size, polydispersity index (PDI), zeta potential, and entrapment efficiency were optimized to ensure the stability and drug-loading efficacy of the NLCs. Combined XRD and cryo-TEM analysis were employed for NLC nanostructure evaluation, confirming the formation of well-defined nanostructures. In vitro kinetics studies demonstrated controlled and sustained docetaxel release over 48 h, emphasizing the potential for prolonged therapeutic effects. Cytotoxicity assays on human umbilical vein endothelial cells (HUVEC) and SK-MEL-24 melanoma cell line revealed enhanced efficacy against cancer cells, with significant selective cytotoxicity and minimal impact on normal cells. This multidimensional approach, encompassing formulation optimization and comprehensive characterization, positions the docetaxel-loaded NLCs as promising candidates for advanced skin cancer therapy. The findings underscore the potential translational impact of these nanocarriers, paving the way for future preclinical investigations and clinical applications in skin cancer treatment.