Defining Dry Eye from a Clinical Perspective

Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.     

氨汽提尿素装置高压系统降压操作控制

通过对氨汽提尿素装置高压系统合成操作压力的理论分析,结合实际工况降低高压系统操作压力,使装置的设备运转状况得到有效改善。     

Sensitivity analysis of Johnson-Cook material parameters on adiabatic shear in different directions

ABSTRACT

This study investigates the effects of strain, strain rates, and forming directions (RD-rolling direction, TD-transverse direction, and ND-normal direction) on adiabatic shear, via dynamic impact compression tests using the Split Hopkinson Pressure Bar (SHPB) apparatus. A modified Johnson-Cook (J-C) constitutive model is proposed, which used to analyse the influence of the constitutive parameters on the sensitivity of adiabatic shear, employing a finite element software. The different sensitivities of adiabatic shear under different directions are explained by combining microscopic analysis and results from mechanical responses. The results show that the sensitivity of adiabatic shear can be related to the time of stress collapse in the following trend: ND?>?TD?>?RD; the sensitivities of these constitutive parameters on adiabatic shear are calculated and compared.     

Household endotoxin reduction in the Louisa Environmental Intervention Project for rural childhood asthma

Endotoxin exacerbates asthma. We designed the Louisa Environmental Intervention Project (LEIP) and assessed its effectiveness in reducing household endotoxin and improving asthma symptoms in rural Iowa children. Asthmatic school children (N = 104 from 89 homes) of Louisa and Keokuk counties in Iowa (aged 5-14 years) were recruited and block-randomized to receive extensive (education + professional cleaning) or educational interventions. Environmental sampling collection and respiratory survey administration were done at baseline and during three follow-up visits. Mixed-model analyses were used to assess the effect of the intervention on endotoxin levels and asthma symptoms in the main analysis and of endotoxin reduction on asthma symptoms in exploratory analysis. In the extensive intervention group, dust endotoxin load was significantly reduced in post-intervention visits. The extensive compared with the educational intervention was associated with significantly decreased dust endotoxin load in farm homes and less frequent nighttime asthma symptoms. In exploratory analysis, dust endotoxin load reduction from baseline was associated with lower total asthma symptoms score (Odds ratio: 0.52, 95% confidence interval: 0.29-0.92). In conclusion, the LEIP intervention reduced household dust endotoxin and improved asthma symptoms. However, endotoxin reductions were not sustained post-intervention by residents.     

Dietary advanced glycation end‐products: Perspectives linking food processing with health implications

Dietary advanced glycation end products (dAGEs) are complex and heterogeneous compounds derived from nonenzymatic glycation reactions during industrial processing and home cooking. There is mounting evidence showing that dAGEs are closely associated with various chronic diseases, where the absorbed dAGEs fuel the biological AGEs pool to exhibit noxious effects on human health. Currently, due to the uncertain bioavailability and rapid renal clearance of dAGEs, the relationship between dAGEs and biological AGEs remains debatable. In this review, we provide the most updated information on dAGEs including their generation in processed foods, analytical and characterization techniques, metabolic fates, interaction with AGE receptors, implications on human health and reducing strategies. Available evidence demonstrating a relevance between dAGEs and food allergy is also included. AGEs are ubiquitous in foods and their contents largely depend on the reactivity of carbonyl and amino groups, along with surrounding condition mainly pH and heating procedures. Once being digested and absorbed into the circulation, two separate pathways can be involved in the deleterious effects of dAGEs: an AGE receptor‐dependent way to stimulate cell signals, and an AGE receptor‐independent way to dysregulate proteins via forming complexes. Inhibition of AGEs formation during food processing and reduction in the diet are two potent approaches to restrict health‐hazardous dAGEs. To elucidate the biological role of dAGEs toward human health, the following significant perspectives are raised: molecular size and complexity of dAGEs; interactions between unabsorbed dAGEs and gut microbiota; and roles played by concomitant compounds in the heat‐processed foods.     

Isolated hepatic tuberculosis mimicking liver tumors in a dialysis patient

Cases of isolated hepatic tuberculosis (TB) are rare. The diagnosis is often delayed or missed because of nonspecific symptoms and laboratory findings. Besides, the disease is extremely rare even in a country where TB is an alarming public health problem. This report demonstrates the difficulty in correctly diagnosing local hepatic TB. We report the case of a 62‐year‐old male patient with end‐stage renal disease treated with hemodialysis, who developed 2 months of abdominal distension and general anorexia, with hyperechoic hepatic lesions on ultrasound. Computed tomography suspected multiple liver tumors. The liver biopsy finally led to the diagnosis of TB of the liver without other involvements. We conclude that isolated hepatic TB is one of the rare forms of extrapulmonary TB in dialysis patients. A greater awareness of this rare clinical entity may prevent needless surgical interventions.     

Iterative equalization combining algorithm in intersymbol interference channel

To realize joint optimization of spatial diversity and equalization combining in the intersymbol interference (ISI) channel, an iterative equalization combining algorithm is proposed. The proposed algorithm uses the coefficients of Turbo equalization to calculate the combination weights without estimating the signal to noise ratio in each diversity branch. The equalized symbols from different diversity branches are combined, and the extrinsic information output from the decoder is fed back to the equalizers, so as to exchange soft information between the equalizers and the decoder. The performance of the proposed algorithm is analyzed using the extrinsic information transfer (EXIT) chart and verified by simulations. Results show that our approach fully exploits time domain information from the multipath channel and spatial domain information from multi receiving antennas, which efficiently improve the performance of the receiver in the severe ISI channel.