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.     

A Student's t-based density peaks clustering with superpixel segmentation (tDPCSS) method for image color clustering

Image color clustering is a basic technique in image processing and computer vision, which is often applied in image segmentation, color transfer, contrast enhancement, object detection, skin color capture, and so forth. Various clustering algorithms have been employed for image color clustering in recent years. However, most of the algorithms require a large amount of memory or a predetermined number of clusters. In addition, some of the existing algorithms are sensitive to the parameter configurations. In order to tackle the above problems, we propose an image color clustering method named Student's t-based density peaks clustering with superpixel segmentation (tDPCSS), which can automatically obtain clustering results, without requiring a large amount of memory, and is not dependent on the parameters of the algorithm or the number of clusters. In tDPCSS, superpixels are obtained based on automatic and constrained simple non-iterative clustering, to automatically decrease the image data volume. A Student's t kernel function and a cluster center selection method are adopted to eliminate the dependence of the density peak clustering on parameters and the number of clusters, respectively. The experiments undertaken in this study confirmed that the proposed approach outperforms k-means, fuzzy c-means, mean-shift clustering, and density peak clustering with superpixel segmentation in the accuracy of the cluster centers and the validity of the clustering results.     

In vivo Kinetic Biodistribution of Nano‐Sized Outer Membrane Vesicles Derived from Bacteria

Evaluation of kinetic distribution and behaviors of nanoparticles in vivo provides crucial clues into their roles in living organisms. Extracellular vesicles are evolutionary conserved nanoparticles, known to play important biological functions in intercellular, inter‐species, and inter‐kingdom communication. In this study, the first kinetic analysis of the biodistribution of outer membrane vesicles (OMVs)—bacterial extracellular vesicles—with immune‐modulatory functions is performed. OMVs, injected intraperitoneally, spread to the whole mouse body and accumulate in the liver, lung, spleen, and kidney within 3 h of administration. As an early systemic inflammation response, increased levels of TNF‐α and IL‐6 are observed in serum and bronchoalveolar lavage fluid. In addition, the number of leukocytes and platelets in the blood is decreased. OMVs and cytokine concentrations, as well as body temperature are gradually decreased 6 h after OMV injection, in concomitance with the formation of eye exudates, and of an increase in ICAM‐1 levels in the lung. Following OMV elimination, most of the inflammatory signs are reverted, 12 h post‐injection. However, leukocytes in bronchoalveolar lavage fluid are increased as a late reaction. Taken together, these results suggest that OMVs are effective mediators of long distance communication in vivo.