Points to consider when developing drugs for dry eye syndrome

Changes in both the social environment (e.g., the increased use of electronic media) and the atmospheric environment (e.g., air pollution and dust) have contributed to an increasing incidence of eye disease and an increased need for eye care. Notably, the signs and symptoms of dry eye syndrome can impact the daily quality of life for various age groups, including the elderly, and usually requires active treatment. The symptoms of dry eye syndrome include tear film instability, hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities. As treatments for dry eye are being developed, a standardized guideline is needed to increase the efficiency of drug development and improve the quality of clinical trial data. In this paper, we present general considerations for the pharmaceutical industry and clinical trial investigators designing clinical trials focused on the development of drugs to treat dry eye syndrome

The Risk of Type 2 Diabetes Mellitus according to Changes in Obesity Status in Late Middle-Aged Adults: A Nationwide Cohort Study of Korea

Background Although obesity is a well-known risk factor of type 2 diabetes mellitus (T2DM), there is scant data on discriminating the contribution of previous obesity and recent weight gain on developing T2DM. Methods We analyzed the Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 where Korean residents underwent biennial health checkups. Participants were classified into four groups according to their obesity status (body mass index [BMI] ≥25 kg/m2) before and after turning 50 years old: maintaining normal (MN), becoming obese (BO), becoming normal (BN), and maintaining obese (MO). Cox proportional hazards regression model was used to estimate the risk of T2DM factoring in the covariates age, sex, BMI, presence of impaired fasting glucose or hypertension, family history of diabetes, and smoking status. Results A total of 118,438 participants (mean age, 52.5±1.1 years; men, 45.2%) were prospectively evaluated for incident T2DM. A total of 7,339 (6.2%) participants were diagnosed with T2DM during a follow-up period of 4.8±2.6 years. Incidence rates of T2DM per 1,000 person-year were 9.20 in MN, 14.81 in BO, 14.42 in BN, 21.38 in MO. After factoring in covariates, participants in the groups BN (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.04 to 1.27) and MO (aHR, 1.14; 95% CI, 1.06 to 1.24) were at increased risk of developing T2DM compared to MN, whereas BO (hazard ratio, 1.06; 95% CI, 0.96 to 1.17) was not. Conclusion Having been obese before 50 years old increased the risk of developing T2DM in the future, but becoming obese after 50 did not. Therefore, it is important to maintain normal weight from early adulthood to prevent future metabolic perturbations

Quality of life in intermittent exotropia for Korean children and their parents

Background Patients with strabismus are more likely to have mental health problems, including high rates of depressive symptoms and social phobia. Intermittent exotropia (IXT) typically occurs in early childhood and is more common in Asian populations. We aim to assess the health-related quality of life (HRQOL) concerns in children with intermittent exotropia (IXT) using the Intermittent Exotropia Questionaire (IXTQ), and their associations with the clinical severity of IXT and the parents HRQOL concerns. Methods IXT, defined as both distance and near exodeviation ≥ 10 prism diopters were eligible for inclusion. The final IXTQ score is calculated using the mean score for all items, and ranges from 0 (worst HRQOL) to 100 (best HRQOL). The correlations of child IXTQ scores with their deviation angle and stereoacuity were measured, as were those with their parents IXTQ scores. Results One hundred twenty-two children with IXT (aged 5–17 years) and one parent for each child completed the child and parent IXTQ, respectively. The greatest HRQOL concern for each child with IXT and their parent was Worry about eyes (frequency 88%, score 35.0 ± 27.8). Lower child IXTQ scores were associated with a larger distance (r = 0.24, p = 0.007) and near deviation angle (r = 0.2, p = 0.026). It bothers me because I have to wait for my eyes to clear up and Waiting for their eyes to clear up were more common in children with a larger deviation angle (both p < 0.05). The parent IXTQ scores (52.1 ± 25.3) were lower than the child ones (79.7 ± 15.8) and showed a positive correlation with child IXTQ scores (r = 0.26, p = 0.004). Lower parent IXTQ scores were associated with poor distance stereoacuity (r = 0.23, p = 0.01). Conclusion The HRQOL of IXT children was positively related to that of their parents. A larger deviation angle and worse distance stereoacuity function may predict more-negative impacts on children and their parents, respectively.This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2020R1C1C1010834)

Solar Cyclic Modulation of Diurnal Variation in Cosmic Ray Intensity

Cosmic rays are ions that move at relativistic speeds. They generate secondary cosmic rays by successive collisions with atmospheric particles, and then, the secondary particles reach the ground. The secondary particles are mainly neutrons and muons, and the neutrons are observed by the ground neutron monitor. This study compared the diurnal variation in cosmic ray intensity obtained via harmonic analysis and that obtained through the pile-up method, which was examined in a previous study. In addition, we analyzed the maximum phase of the diurnal variation using four neutron monitors with a cutoff rigidity below approximately 6 GV, located at similar longitudes to the Oulu and Rome neutron monitors. Expanding the data of solar cycles 20–24, we examined the time of the maximum cosmic ray intensity, that is, the maximum phase regarding the solar cyclic modulation. During solar cycles 20–24, the maximum phase derived by harmonic analysis showed no significant difference with that derived by the pile-up method. Thus, the pile-up method, a relatively straightforward process to analyze diurnal variation, could replace the complex harmonic analysis. In addition, the maximum phase at six neutron monitors shows the 22-year cyclic variation very clearly. The maximum phase tends to appear earlier and increase the width of the variation in solar cycles as the cutoff rigidity increases