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.     

Characteristics of tiger nut milk: effects of milling

A standard method for the extraction of tiger nut milk has been introduced. It has been shown that, although milling duration improves the yield of tiger nut milk solids and its nutrient composition, there is a quantifiable loss of nutrient in the pressing residue during milk extraction. Milling duration improved the colloidal stability of the milk against creaming during 16 h of storage. A higher milling intensity resulted in the aggregation of biological polymers which resulted in colloidal destabilisation. Milling improved the lightness and stability and reduced browning rate of the tiger nut milk during storage. This report is important for the production of tiger nut milk of consistent and comparable characteristics. Milling has been introduced as a processing method for the qualitative and quantitative modulation of the properties of tiger nut milk. It is recommended to develop further strategies to improve the colloidal stability of tiger nut milk as a beverage.     

Behavior of 316L stainless steel containing corrosion pits under cyclic loading

The environmental performance of 316L grade stainless steel, in the form of tensile specimens containing a single corrosion pit with various aspect ratios, under cyclic loading in aerated chloride solutions is investigated in this study. Results from environmental tests were compared and contrasted with those obtained using finite element analysis (FEA). Fractography of the failed specimens obtained from experiments revealed that fatigue crack initiation took place at the base of the shallow pit. The crack initiation shifted towards the shoulder and the mouth of the pit for pits of increasing depth. This process is well predicted by FEA, as the strain contour maps show that strain is the highest around the centric strip of the pit. However, for shallow pits, local strain is uniformly distributed around that strip but begins to concentrate more towards the shoulder and the mouth region for increasingly deep pits.     

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.     

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.