Challenges in the management of pediatric blepharokeratoconjunctivis / ocular rosacea

Introduction: Childhood blepharokeratoconjunctivitis is a common lid margin inflammation with secondary ocular surface disease. Its etiology is unclear and there are no randomized controlled trials to support the superiority of any treatment option. / Areas covered: We searched the following databases; Cochrane Central Register of Controlled Trials, Ovid MEDLINE and affiliated Ovid databases, EMBASE, the ISRCTN registry, Clinical- Trials.gov and the World Health Organization International Clinical Trials Registry Platform. Due to the paucity of pediatric data we also considered information from articles focused on adults. / Expert commentary: Treatment is based on the assumption that the mechanisms of BKC and rosacea keratitis are the same: meibomian gland dysfunction, bacterial colonisation of the lid margin, delayed type hypersensitivity, Demodex folliculorum, genetic predisposition and Toll-like receptors inducing release of pro-inflammatory cytokines. Generally accepted grading scales are needed. Randomized clinical trials are needed to evaluate treatment options. The effects of antibiotics, immunomodulators, osmoprotectants and essential fatty acids need further investigation

Experimental investigations into low concentrating line axis solar concentrators for CPV applications

Solar photovoltaic conversion systems with integrated, low concentration ratio, non-imaging reflective concentrators, could be on south facing building roofs used to generate power at a lower cost than currently available proprietary systems. The experimental investigation presented by this research provides information on the optical and energy conversion characteristics of two geometrically equivalent non-imaging concentrators; a compound parabolic concentrator and a V-trough reflector. The aim was to investigate the assumption of uniform cell illumination when PV cells located on the receiver surface with their central axes are aligned parallel with the focal line of the line-axis concentrator. Solar radiation incident was measured at the aperture and the PV cell surface using respectively a pyranometer and photodiodes at six different collector tilt angles of 0°, 10°, 20°, 30°, 40° and 52°. The analysis of the collected experimental data presented demonstrated that the V-trough system had a more even distribution of solar radiation than the CPC and a higher optical concentration ratio (ratio of solar radiation incident on the aperture cover to that incident on the receiver) though the geometrical concentration ratio of the two collectors was equal to 2.2×. Also, the V-trough concentrator had an electrical power output up to 17.2% higher than the CPC system at a specific tilt angle of 30°. The V-trough had a consistently higher receiver plate temperature as it was reflecting larger quantities of solar radiation than the CPC. Over 17 consecutive typical summer days’ similar performance was observed over the range of tilt angles studied. The development of V-trough concentrators should be preferred due to higher power production, reduced complexity, increased uniformity of illumination and lower manufacturing costs compared to CPCs

Diagnostic signature for heart failure with preserved ejection fraction (HFpEF):a machine learning approach using multi-modality electronic health record data

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is thought to be highly prevalent yet remains underdiagnosed. Evidence-based treatments are available that increase quality of life and decrease hospitalization. We sought to develop a data-driven diagnostic model to predict from electronic health records (EHR) the likelihood of HFpEF among patients with unexplained dyspnea and preserved left ventricular EF. METHODS AND RESULTS: The derivation cohort comprised patients with dyspnea and echocardiography results. Structured and unstructured data were extracted using an automated informatics pipeline. Patients were retrospectively diagnosed as HFpEF (cases), non-HF (control cohort I), or HF with reduced EF (HFrEF; control cohort II). The ability of clinical parameters and investigations to discriminate cases from controls was evaluated by extreme gradient boosting. A likelihood scoring system was developed and validated in a separate test cohort. The derivation cohort included 1585 consecutive patients: 133 cases of HFpEF (9%), 194 non-HF cases (Control cohort I) and 1258 HFrEF cases (Control cohort II). Two HFpEF diagnostic signatures were derived, comprising symptoms, diagnoses and investigation results. A final prediction model was generated based on the averaged likelihood scores from these two models. In a validation cohort consisting of 269 consecutive patients [with 66 HFpEF cases (24.5%)], the diagnostic power of detecting HFpEF had an AUROC of 90% (P < 0.001) and average precision of 74%. CONCLUSION: This diagnostic signature enables discrimination of HFpEF from non-cardiac dyspnea or HFrEF from EHR and can assist in the diagnostic evaluation in patients with unexplained dyspnea. This approach will enable identification of HFpEF patients who may then benefit from new evidence-based therapies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-022-03005-w