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Surgical Approaches in Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis Comparing Vitrectomy vs. Vitrectomy Combined with Scleral Buckling, Lens-Sparing vs. Phako Procedures

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Open Journal of Ophthalmology 2023年第4期13卷 371-397页

作者： miguel A. quiroz-Reyes Erick A. quiroz-gonzalez miguel A. quiroz-gonzalez Virgilio Lima-Gomez Retina Department of Oftalmologia Integral ABC Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Institute of Ophthalmology Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant differen

关键词： Lens-Sparing Phaco-Procedure Pars Plana Vitrectomy Rhegmatogenous Retinal Detachment Scleral Buckle

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Long-Term Postoperative Perfusion Indices in Surgically Resolved Myopic Traction Maculopathy

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Open Journal of Ophthalmology 2023年第1期13卷 143-171页

作者： miguel A. quiroz-Reyes Erick A. quiroz-gonzalez miguel A. quiroz-gonzalez Virgilio Lima-Gomez Oftalmologia Integral ABC Retina Specialists Unit Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Institute of Ophthalmology Fundacion Conde de Valenciana Private Assistance Institution (Nonprofit Organization) Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic traction maculopathy. Purpose: To report the structural, functional and perfusional outcomes in patients underwent surgery for different stages of myopic traction maculopathy (MTM). Methods: A retrospective, consecutive, comparative, interventional, one-surgeon, case-control study was conducted in 46 eyes of 34 individuals between April 2015 and May 2021. Participants included normal emmetropic eyes (Control emmetropia, n = 25), healthy myopic eyes (Control high myopia, n = 20), and operated and structurally fully resolved myopic eyes with different stages of MTM (Surgically treated group, n = 46). Long-term postoperative functional and perfusional follow-up evaluations were performed with spectral domain-optical coherence tomography (SD-OCT) and OCT angiography. The primary outcome measure included long-term functional, structural and perfusion macular status across groups. Results: Forty-six eyes in 34 patients were included in the study group, with both eyes affected in 12 (26.3%) patients. The mean axial length was 29.89 ± 1.67 mm. The preoperative logMAR was 1.29 ± 0.54 and the postoperative logMAR was 0.60 ± 0.52 (P Conclusion: Compared to emmetropic and healthy myopic eyes, surgically-resolved MTM eyes generally have larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area, thinner central subfoveal thickness, and more macular defects. Eyes with stage III or IV MTM had larger deviation compared to eyes at earlier stages. Visual function change after surgery was associated with superficial foveal avascular zone area. Better functional, structural and perfusion index outcomes were observed when highly myopic eyes underwent early surgery.

关键词： Choriocapillaris Flow Area Deep Vascular Plexus Foveoretinal Detachment Myopic Foveoschisis Foveal Avascular Zone Myopic Macular Hole

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Resolving Myopic Foveoretinal Detachment by Fovea-Saving Internal Limiting Membrane Peeling: A Case-Series Report

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Open Journal of Ophthalmology 2023年第1期13卷 106-121页

作者： miguel a.gel quiroz-Reyes Erick Andres quiroz-gonzalez miguel a.gel quiroz-gonzalez Virgilio Lima-Gomez Oftalmologia Integral ABC Retina Department Medical and Surgical Assistance Institution (Nonprofit Organization) Affiliated with the Postgraduate Studies Division at the National Autonomous University of Mexico Mexico City Mexico Juarez Hospital Public Assistance Institution (Nonprofit Organization) Mexico City Mexico

Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. Macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the

关键词： Automated Microperimetry Myopic Foveoretinal Detachment Myopic Foveoschisis Myopic Macular Hole Myopic Traction Maculopathy Posterior Staphyloma

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＂Takeaway＂ drug delivery： A new nanomedical paradigm

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Nano Research 2017年第7期10卷 2234-2243页

作者： Elena gonzalez-Domfnguez Benito Rodriguez-gonzalez Moises Perez-Lorenzo miguel A. Correa-Duarte Department of Physical Chemistry Biomedical Research Center (CINBIO) and Southern Galicia Institute of Health Research (IISGS)Universidade de Vigo 36310 Vigo Spain

An alternative model to the well-established paradigm of the externally switchable drug delivery systems is herein proposed. In contrast to the on--off archetype, here the amount of released drug is pre-set by the application of an external stimulus, and is gradually released after the withdrawal of the exogenous signal. These attributes are achieved through an innovative approach featuring the integration of plasmonic nanovehicles in a polymer-based film. Such a platform is provided with optically responsive capabilities together with multiple diffusional barriers, allowing for an ＂on-demand＂ time-limited release where light acts as a therapeutic ＂starting shot＂. These nanoarchitectured depots have great potential as implantable drug delivery systems in clinical scenarios where a recurrent, sustained, and yet, on--off administration of medication is required. The application of these hybrid materials may extend the implementation of nanomedicine strategies beyond the point-of-care setting.

关键词： release plasmonic nanocapsule hydrogel near infrared (NIR)

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Long-Term Postoperative Perfusion Status in Giant Retinal Tears: A Preliminary Case Report

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Open Journal of Ophthalmology 2022年第2期12卷 180-200页

作者： miguel A. quiroz-Reyes Erick A. quiroz-gonzalez miguel A. quiroz-gonzalez Margarita Montano Ahmad R. Alsaber Virgilio Lima-Gomez Retina Specialists Unit Oftalmologia Integral ABC Medical and Surgical Assistance Institution (Non-Profit Organization) Postgraduate Division National Autonomous University of Mexico Mexico CityMexico Department of Mathematics and Statistics University of Strathclyde Glasgow UK Juarez Hospital Public Assistance Institution (Non-Profit Organization) Mexico City Mexico

Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term structural, functional, and perfusion outcomes in normal control eyes and eyes treated for different degrees of GRT-associated extensions of RRD. Methods: One emmetropic normal eye (control), one healthy highly myopic eye (control myopic), and three eyes surgically treated for GRT (surgical), were included in the study for a long-term comparison of study outcomes. The surgical eyes were classified based on the degree of GRT-associated RRD extension as follows: one eye with GRT-associated RRD extension ˚one eye with GRT-associated RRD extension between 180˚- 270˚and one eye with GRT-associated RRD extension > 270˚. Structural, functional, and perfusion outcomes were compared with those of the control eyes. Results: All three eyes were phakic and the condition was monocular. The mean age of the patients was 48.67 ± 8.50 years (range, 39 - 55 years). All three eyes had GRT macula-off RRD. The mean preoperative time for GRT surgery was 1.2 weeks. The mean pre- and postoperative best corrected visual acuities (BCVA) were 1.87 logMAR and 0.46 logMAR, respectively. The mean postoperative follow-up period was 19.67 ± 5.69 months. Proliferative vitreoretinopathy resulted in multiple surgeries in one eye (31.5%). Long-term postoperative optical coherence tomography (OCT) showed abnormal retinal thickness, ellipsoid zone disruption, and external limiting membrane line discontinuities in one eye. OCT angiography yielded abnormal perfusion indices in the surgically treated eyes. Conclusions: Our data showed multiple structural alterations in spectral-domain OCT biomarkers. One eye that developed secondary epiretinal membrane (ERM) proliferation showed a significantly improved BCVA after proliferation and internal limiting membrane were removed. P

关键词： Choriocapillaris Subfoveal Plexus Deep Vascular Plexus Giant Retinal Tears Macular Perfusion Indices Rhegmatogenous Retinal Detachment

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Application of artificial intelligence in the diagnosis and treatment of hepatocellular carcinoma: A review

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World Journal of Gastroenterology 2020年第37期26卷 5617-5628页

作者： miguel Jimenez Perez Rocio gonzalez Grande UGC de Aparato Digestivo Unidad de Hepatologia-Trasplante HepaticoHospital Regional Universitario de MalagaMalaga 29010Spain

Although artificial intelligence(AI)was initially developed many years ago,it has experienced spectacular advances over the last 10 years for application in the field of medicine,and is now used for diagnostic,therapeutic and prognostic purposes in almost all *** application in the area of hepatology is especially relevant for the study of hepatocellular carcinoma(HCC),as this is a very common tumor,with particular radiological characteristics that allow its diagnosis without the need for a histological ***,the interpretation and analysis of the resulting images is not always easy,in addition to which the images vary during the course of the disease,and prognosis and treatment response can be conditioned by multiple *** vast amount of data available lend themselves to study and analysis by AI in its various branches,such as deeplearning(DL)and machine learning(ML),which play a fundamental role in decision-making as well as overcoming the constraints involved in human *** is a form of AI based on automated learning from a set of previously provided data and training in algorithms to organize and recognize *** is a more extensive form of learning that attempts to simulate the working of the human brain,using a lot more data and more complex *** review specifies the type of AI used by the various ***,welldesigned prospective studies are needed in order to avoid as far as possible any bias that may later affect the interpretability of the images and thereby limit the acceptance and application of these models in clinical *** addition,professionals now need to understand the true usefulness of these techniques,as well as their associated strengths and limitations.

关键词： Artificial intelligence Machine learning Hepatocellular carcinoma Diagnosis Treatment Prognosis

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Thermo-electro-mechanical microstructural interdependences in conductive thermoplastics

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npj Computational Materials 2023年第1期9卷 955-965页

作者： Javier Crespo-miguel Sergio Lucarini a.gel Arias Daniel Garcia-gonzalez Department of Continuum Mechanics and Structural Analysis Universidad Carlos III de MadridAvda.de la Universidad 3028911 LeganésMadridSpain Department of Civil and Environmental Engineering Imperial College of LondonSouth Kensington CampusLondon SW72AZUK

Additive manufacturing has enabled the design of thermoplastic components that provide structural support,electrical conductivity and heat generation modulated by mechanical *** mechanisms and interplays that govern the material response at the microstructural level remain,however,***,we develop an experimental method to characterise conductive filaments from a combined mechanical,electrical and thermal *** approach is used to unravel exciting material interplays of conductive polylactic *** overcome experimental limitations that prevent a complete microstructural analysis of the problem,we develop a full-field homogenisation framework and implement it for finite *** framework accounts for viscoplasticity,electrical and thermal conduction,convection and heat generation via Joule effect,as well as for the interdependences between *** experimental validation,the framework is applied to virtually optimise fabrication requirements to obtain desired properties in final products,i.e.,stiffer products,filaments with higher conductivities or with better sensing capabilities.

关键词： conductive electrical overcome

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Decoupled Photovoltaic Power Ramp-rate Calculation Method for Perturb and Observe Algorithms

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Journal of Modern Power Systems and Clean Energy 2022年第4期10卷 932-940页

作者： Jose miguel Riquelme-Dominguez Francisco M.gonzalez-Longatt Sergio Martinez Electrical Engineering Department Escuela Tecnica Superior de Ingenieros IndustrialesUniversidad Politecnica de Madrid28006 MadridSpain Department of Electrical Engineering Information Technology and CyberneticsUniversity of South-Eastern Norway3918 PorsgrunnNorway

As photovoltaic energy increasingly penetrates in power systems,transmission system operators have started to request its participation in providing ancillary *** of the demanded services is the power ramp-rate control(PRRC),which attempts to limit the power ramps produced by intermittent irradiance *** order to achieve the desired objective,solutions based on storage systems or modifying the maximum power point tracking(MPPT)in perturb and observe(P&O)algorithms are commonly *** starting point in PRRC is the determination of the instantaneous power ramprate,and different methods have been proposed in the literature for its ***,the accuracy and computational speed of existing procedures can be improved,which may be critical in situations with rapid irradiance *** this paper,a decoupled photovoltaic power ramp-rate calculation method is presented,in which the effect of variable irradiance and the P&O algorithm are computed *** proposed method has been theoretically demonstrated and tested through simulation and experimental *** results show that it can improve the previous methods in terms of accuracy and computation *** validation with hardware-inthe-loop demonstrates the suitability of the proposed method for real-time applications,even in presence of noisy measurements.

关键词： Hardware-in-the-loop maximum power point tracking perturb and observe photovoltaic power ramp-rate control ramp-rate calculation method

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Hybrid magnetorheological elastomers enable versatile soft actuators

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npj Computational Materials 2022年第1期8卷 1546-1559页

作者： miguel a.gel Moreno-Mateos Mokarram Hossain Paul Steinmann Daniel Garcia-gonzalez Department of Continuum Mechanics and Structural Analysis Universidad Carlos III de MadridAvda.de la Universidad 3028911LeganésMadridSpain Zienkiewicz Centre for Computational Engineering Faculty of Science and EngineeringSwansea UniversitySA18ENSwanseaUK Institute of Applied Mechanics University of Erlangen-NurembergEgerland Str.5ErlangenGermany Glasgow Computational Engineering Centre School of EngineeringUniversity of GlasgowG128QQGlasgowUK

Recent advances in magnetorheological elastomers(MREs)have posed the question on whether the combination of both soft-and hard-magnetic particles may open new routes to design versatile multifunctional ***,we conceptualise ultra-soft hybrid MREs(≈1–10 kPa stiffness)combining experimental and computational ***,a comprehensive experimental characterisation is *** results unravel that the magneto-mechanical performance of hybrid MREs can be optimised by selecting an adequate mixing ratio between ***,a multi-physics computational framework provides insights into the synergistic magneto-mechanical interactions at the *** particles amplify the magnetisation and hard particles contribute to torsional *** numerical results suggest that the effective response of hybrid MREs emerges from these intricate ***,we uncover exciting possibilities to push the frontiers of MRE *** are demonstrated by simulating a bimorph beam that provides actuation flexibility either enhancing mechanical bending or material stiffening,depending on the magnetic stimulation.

关键词： versatile magneto enable

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Task Offloading in Edge Computing Using GNNs and DQN

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Computer Modeling in Engineering & Sciences 2024年第6期139卷 2649-2671页

作者： Asier Garmendia-Orbegozo Jose David Nunez-gonzalez miguel a.gel Anton Department of Applied Mathematics University of the Basque Country UPV/EHUEibar20600Spain TECNALIA Basque Research and Technology Alliance(BRTA)San Sebastian20009Spain

In a network environment composed of different types of computing centers that can be divided into different layers(clod,edge layer,and others),the interconnection between them offers the possibility of peer-to-peer task *** many resource-constrained devices,the computation of many types of tasks is not feasible because they cannot support such computations as they do not have enough available memory and processing *** this scenario,it is worth considering transferring these tasks to resource-rich platforms,such as Edge Data Centers or remote cloud *** different reasons,it is more exciting and appropriate to download various tasks to specific download destinations depending on the properties and state of the environment and the nature of the *** the same time,establishing an optimal offloading policy,which ensures that all tasks are executed within the required latency and avoids excessive workload on specific computing centers is not *** study presents two alternatives to solve the offloading decision paradigm by introducing two well-known algorithms,Graph Neural Networks(GNN)and Deep Q-Network(DQN).It applies the alternatives on a well-known Edge Computing simulator called PureEdgeSimand compares them with the two defaultmethods,Trade-Off and Round *** showed that variants offer a slight improvement in task success rate and workload *** terms of energy efficiency,they provided similar ***,the success rates of different computing centers are tested,and the lack of capacity of remote cloud servers to respond to applications in real-time is *** novel ways of finding a download strategy in a local networking environment are unique as they emulate the state and structure of the environment innovatively,considering the quality of its connections and constant *** download score defined in this research is a crucial feature for determining the quality of a download path

关键词： Edge computing edge offloading fog computing task offloading

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