Management of inflammation in dry eye disease: Recommendations from a European panel of experts

Introduction: Early initiation of anti-inflammatory therapies is recommended for dry eye disease (DED) to break the vicious cycle of pathophysiology. However, there is limited guidance on how to implement topical ciclosporin (CsA) and corticosteroid treatment into clinical practice. This expert-led consensus provides practical guidance on the management of DED, including when and how to use topical CsA. Methods: A steering committee (SC) of seven European DED experts developed a questionnaire to gain information on the unmet needs and management of DED in clinical practice. Consensus statements on four key areas (disease severity and progression; patient management; efficacy, safety and tolerability of CsA; and patient education) were generated based on the responses. The SC and an expanded expert panel of 22 members used a nine-point scale (1 = strongly disagree; 9 = strongly agree) to rate statements; a consensus was reached if ≥75% of experts scored a statement ≥7. Results: A stepwise approach to DED management is required in patients presenting with moderate corneal staining. Early topical CsA initiation, alone or with corticosteroids, should be considered in patients with clinical risk factors for severe DED. Patient education is required before and during treatment to manage expectations regarding efficacy and tolerability in order to optimise adherence. Follow-up visits are required, ideally at Month 1 and every 3 months thereafter. Topical CsA may be continued indefinitely, especially when surgery is required. Conclusion: This consensus fills some of the knowledge gaps in previous recommendations regarding the use of topical corticosteroids and CsA in patients with DED

Periodontitis and Systemic Markers of Neurodegeneration. A case-control study

Aim: To investigate whether periodontitis is associated with amyloid beta (Aβ) peptides and whether systemic inflammation could act as a potential mediator of this link. Materials and Methods: A case–control study was designed including 75 patients with periodontitis (cases) and 75 age‐balanced and gender‐matched participants without periodontitis (controls). Full‐mouth periodontal evaluation was performed in all participants. Demographic, clinical and behaviour data were also recorded. Fasting blood samples were collected, and serum levels of interleukin 6 (IL‐6), high‐sensitivity C‐reactive protein (hs‐CRP), Aβ1‐40 and Aβ1‐42 were determined. Results: Cases showed higher levels of IL‐6 (8.7 ± 3.2 vs. 4.8 ± 0.5 pg/ml), hs‐CRP (3.3 ± 1.2 vs. 0.9 ± 0.7 mg/L), Aβ1‐40 (37.3 ± 6.0 vs. 30.3 ± 1.8 pg/ml) and Aβ1‐42 (54.5 ± 10.6 vs. 36.5 ± 10.0 pg/ml) when compared to controls (all p < .001). Diagnosis of periodontitis was statistically significantly associated with circulating Aβ1‐40 (urn:x-wiley:03036979:media:jcpe13267:jcpe13267-math-0001 = 6.9, 95% CI: 5.4–8.3; p < .001) and Aβ1‐42 (urn:x-wiley:03036979:media:jcpe13267:jcpe13267-math-0002 = 17.8, 95% CI: 14.4–21.3; p < .001). Mediation analysis confirmed hs‐CRP and IL‐6 as mediators of this association. Conclusions: Periodontitis is associated with increased peripheral levels of Aβ. This finding could be explained by enhanced systemic inflammation that can be seen in patients with periodontitis

Slicing Strategies for the Generalised Type-2 Mamdani Fuzzy Inferencing System

The final publication is available at Springer via http://dx.doi.org/[insert DOI]".As a three-dimensional object, there are a number of ways of slicing a generalised type-2 fuzzy set. In the context of the Mamdani Fuzzy Inferencing System, this paper concerns three accepted slicing strategies, the vertical slice, the wavy slice, and the horizontal slice or alpha -plane. Two ways of de ning the generalised type-2 fuzzy set, vertical slices and wavy slices, are presented. Fuzzi cation and inferencing is presented in terms of vertical slices. After that, the application of all three slicing strategies to defuzzi cation is described, and their strengths and weaknesses assessed

Modelling of the radiative properties of an opaque porous ceramic layer

Solid Oxide Fuel Cells (SOFCs) operate at temperatures above 1,100 K where radiation effects can be significant. Therefore, an accurate thermal model of an SOFC requires the inclusion of the contribution of thermal radiation. This implies that the thermal radiative properties of the oxide ceramics used in the design of SOFCs must be known. However, little information can be found in the literature concerning their operating temperatures. On the other hand, several types of ceramics with different chemical compositions and microstructures for designing efficient cells are now being tested. This is a situation where the use of a numerical tool making possible the prediction of the thermal radiative properties of SOFC materials, whatever their chemical composition and microstructure are, may be a decisive help. Using this method, first attempts to predict the radiative properties of a lanthanum nickelate porous layer deposited onto an yttria stabilized zirconium substrate can be reported

Recent Progress in Fabrication of High-Strength Glow Discharge Polymer Shells by Optimization of Coating Parameters

OAK A271 RECENT PROGRESS IN FABRICATION OF HIGH-STRENGTH GLOW DISCHARGE POLYMER SHELLS BY OPTIMIZATION OF COATING PARAMETERS. In this paper, the authors report the progress they have made in fabrication of high-strength thin-walled glow discharge polymer (GDP) shells for cryogenic experiments at OMEGA. They have investigated a number of different parameters involved in making such shells. Optimization of hydrogen to hydrocarbon precursor flow has been observed to be critical in obtaining strong shells. They can routinely make high-strength shells of OMEGA size (900 {micro}m in diameter) with thicknesses in the range of 1.0 to 1.5 {micro}m. The permeabilities of these shells to various gases have been found to be as much as three times higher than those of lower strength shells. Run to run variability and other batch statistics are discussed

Diabetes mellitus remission in three cats with hypersomatotropism after cabergoline treatment

Three diabetic cats presented with polyuria, polydipsia, polyphagia and poor glycemic control. Cat 1 displayed prognathia inferior and had a body condition score (BCS) of 4/5; cat 2 had a BCS of 5/5; and cat 3 had broad facial features. Serum insulin-like growth factor 1 concentrations were compatible with hypersomatotropism in cat 1 and cat 2 (>1500 ng/ml and 1200 ng/ml, respectively) and just below the cut-off of 1000 ng/ml (947 ng/ml) in cat 3; in this last cat diagnosis was further supported by the presence of pituitary enlargement on MRI. Oral cabergoline (10 μg/kg q48h) was initiated. Insulin requirements progressively reduced, as evidenced by daily blood glucose monitoring and weekly blood glucose curves. Diabetic remission occurred in all three cats between the second and third months of cabergoline treatment. At the time of writing, remission has persisted thus far (cat 1: 23 months; cat 2: 14 months; cat 3: 38 months). Relevance and novel information: To our knowledge, these are the first reported cases of diabetic remission in cats with hypersomatotropism after cabergoline treatment, despite previous reports of this being an ineffective treatment. Further work is indicated to determine why some cats do, and others do not, respond to this treatment.Fil: Miceli, Diego Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; Argentina. Universidad de Buenos Aires; ArgentinaFil: Vidal, Patricia Noemi. Universidad de Buenos Aires; ArgentinaFil: Pompili, Gustavo A. Universidad de Buenos Aires; ArgentinaFil: Castillo, Víctor A. Universidad de Buenos Aires; ArgentinaFil: Soler Arias, Elber A. Universidad de Buenos Aires; ArgentinaFil: Niessen, Stijn JM. Royal Veterinary College University ; Reino Unid

Evaluating the impact of atmospheric forcing and air–sea coupling on near-coastal regional ocean prediction

Atmospheric forcing applied as ocean model boundary conditions can have a critical impact on the quality of ocean forecasts. This paper assesses the sensitivity of an eddy-resolving (1.5 km resolution) regional ocean model of the north-west European Shelf (NWS) to the choice of atmospheric forcing and atmosphere–ocean coupling. The analysis is focused on a month-long simulation experiment for July 2014 and evaluation of simulated sea surface temperature (SST) in a shallow near-coastal region to the south-west of the UK (Celtic Sea and western English Channel). Observations of the ocean and atmosphere are used to evaluate model results, with a particular focus on the L4 ocean buoy from the Western Channel Observatory as a rare example of co-located data above and below the sea surface. The impacts of differences in the atmospheric forcing are illustrated by comparing results from an ocean model run in forcing mode using operational global-scale numerical weather prediction (NWP) data with an ocean model run forced by a convective-scale regional atmosphere model. The value of dynamically representing feedbacks between the atmosphere and ocean state is assessed via the use of these model components within a fully coupled ocean–wave–atmosphere system. Simulated SSTs show considerable sensitivity to atmospheric forcing and to the impact of model coupling in near-coastal areas. A warm ocean bias relative to in situ observations in the simulation forced by global-scale NWP (0.7 K in the model domain) is shown to be reduced (to 0.4 K) via the use of the 1.5 km resolution regional atmospheric forcing. When simulated in coupled mode, this bias is further reduced (by 0.2 K). Results demonstrate much greater variability of both the surface heat budget terms and the near-surface winds in the convective-scale atmosphere model data, as might be expected. Assessment of the surface heat budget and wind forcing over the ocean is challenging due to a scarcity of observations. However, it can be demonstrated that the wind speed over the ocean simulated by the convective-scale atmosphere did not agree as well with the limited number of observations as the global-scale NWP data did. Further partially coupled experiments are discussed to better understand why the degraded wind forcing does not detrimentally impact on SST results