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.     

Tunneling Conductance Dependence of the Tunneling Spectra in Bi2Sr2CaCu2O8

We have measured the tunneling spectra in Bi₂Sr₂CaCu₂O₈ with a scanning tunneling microscope(STM) at various tip-sample distances by changing the tunneling conductance in a controlled manner. When the tunneling conductance is increased from 1×10^–9 to 1×10^–5 S, the spectra do not show changes in particular. However, the gap value decreases steeply and the asymmetric back ground density of states turns inverted V-shaped one above 6×10^–4 S. The changes in the tunneling spectra at the high tunneling conductances are explained by the enhancement of the local carrier density induced by the pressure that the STM tip applied to the sample.     

Effective lightning protection schemes for distribution line

The causes of lightning outage are subdivided into direct lightning strokes and induced lightning strokes, which are identified by the characteristics of the lightning overvoltage. In the past, lightning protection devices were directed mainly toward the latter, and attention has been focused on the installation of lightning protection devices, ground wires, and reinforcement of insulators. However, lightning outages continue to occur. Thus it is extremely important to clarify the fault characteristics of lightning surges and to study the effectiveness of various lightning protection devices by considering both direct lightning stroke and induced lightning stroke in order to prevent lightning outage in the future. In this research, the electromagnetic transients program (EMTP) has been applied to the direct lightning stroke, and the induced lightning outage analysis program for multiple conductor systems has been applied to the induced lightning stroke to study the effectiveness of lightning protection devices provided by combination of various lightning protection devices. The most effective lightning protection schemes are analyzed and evaluated based on verification tests on the full scale models as well as economic considerations.     

A case of inflammatory pseudotumor of the liver causing elevated serum CA19-9 levels

Inflammatory pseudotumor of the liver is a rare lesion characterized by proliferating fibrovascular tissue admixed with inflammatory cells. A 50-yr-old Japanese man was hospitalized because of upper abdominal pain and high fever. Computed tomography revealed a poorly demarcated, low density mass in the left lobe of the liver, and abnormal laboratory findings included WBC 9340/mm3, CRP 10.5 mg/dl, and marked elevation of CA19-9 to 1167.9 U/ml. Endoscopic retrograde cholangiography showed irregularity of the intrahepatic bile duct of the left lateral segment, and the lateral segmental branches of the portal vein were not visualized on the venous phase of abdominal angiography. Ultrasound-guided liver biopsy was performed, but malignant disease, including intrahepatic cholangiocarcinoma, could not be completely ruled out. The patient underwent left hepatic lobectomy with lymph node dissection. Histopathological examination yielded a definitive diagnosis of inflammatory pseudotumor. The lesion was immunohistochemically stained for CA19-9 by the ABC method, and the biliary epithelium in severely inflamed portal canals was found to be positive. The markedly elevated preoperative level of CA 19-9 decreased to almost within the normal range and the patient remains well 2 yr 9 months after surgery, without any complications.     

Improvement of a neural network-based motion generator with bimanual coordination for upper limb prosthesis

We propose to redesign a neural network used as a motion generator with bimanual coordination for upper limb prosthesis in order to improve its learning capability. We assumed that the wearer of the prosthesis was a unilateral amputee. In our previous work, we proposed a prosthesis control system using a neural network that learned bimanual coordination in order to implement smooth motion with both hands. However, the previously proposed system has the problem that a neural network cannot generate the desired motion of the prosthesis in special cases. The reason is that the motion generator calculates the desired posture of the prosthesis from the current posture of the healthy arm only, regardless of the current posture of the prosthesis. We propose to use the current posture of both the healthy arm and the prosthesis as neural network inputs in order to solve this problem. In this article, we show that a single neural network whose input was the current posture of both arms could learn the relationships of the coordinated motions of holding boxes of different sizes, and the newly proposed system can calculate the desired motion of the prosthesis in special cases through computer simulations.     

A variational approach to multi-phase motion of gas, liquid and solid based on the level set method

We propose a simple and robust numerical algorithm to deal with multi-phase motion of gas, liquid and solid based on the level set method [S. Osher, J.A. Sethian, Front propagating with curvature-dependent speed: Algorithms based on Hamilton-Jacobi formulation, J. Comput. Phys. 79 (1988) 12; M. Sussman, P. Smereka, S. Osher, A level set approach for capturing solution to incompressible two-phase flow, J. Comput. Phys. 114 (1994) 146; J.A. Sethian, Level Set Methods and Fast Marching Methods, Cambridge University Press, 1999; S. Osher, R. Fedkiw, Level Set Methods and Dynamics Implicit Surface, Applied Mathematical Sciences, vol. 153, Springer, 2003]. In Eulerian framework, to simulate interaction between a moving solid object and an interfacial flow, we need to define at least two functions (level set functions) to distinguish three materials. In such simulations, in general two functions overlap and/or disagree due to numerical errors such as numerical diffusion. In this paper, we resolved the problem using the idea of the active contour model [M. Kass, A. Witkin, D. Terzopoulos, Snakes: active contour models, International Journal of Computer Vision 1 (1988) 321; V. Caselles, R. Kimmel, G. Sapiro, Geodesic active contours, International Journal of Computer Vision 22 (1997) 61; G. Sapiro, Geometric Partial Differential Equations and Image Analysis, Cambridge University Press, 2001; R. Kimmel, Numerical Geometry of Images: Theory, Algorithms, and Applications, Springer-Verlag, 2003] introduced in the field of image processing.     

Basic constructs of the SIM operating system

The basic constructs of SIMPOS (Sequential Inference Machine Programming and Operating System) are explained. SIMPOS is an operating system for a super-personal computer (SIM), based on logic programming language (a modified Prolog, called KL0). Our design principle is simplicity both in concept and structure. The entire system will be constructed using these basic constructs.     

Grain Boundary Segregation Behavior of Boron in Low-Alloy Steel

The boron concentration profiles around prior austenite grain boundaries in Fe-0.05C-0.5Mo-0.001B (mass pct) are examined using aberration-corrected STEM-EELS. In order to obtain the precise distribution of boron around the boundaries, tilt series measurements with thin specimens (<30 nm) are performed and the EEL spectra are analyzed by principal component analysis (PCA) and multivariate curve resolution (MCR). The boron concentration profile changes with the cooling rate from the solid solution temperature. The concentration at grain boundaries is maximized at a medium rate (30 °C/s), where the concentration reaches 8 at. pct, and it decreases at a larger (250 °C/s) or smaller (5 °C/s) rate. On the other hand, the boron distribution becomes wider as the cooling rate becomes smaller. The current results suggest that the boron segregation in the alloy is formed by the “non-equilibrium segregation mechanism.”