Improved Demodex diagnosis in the clinical setting using a novel in situ technique

Purpose: To compare existing and novel diagnostic techniques for confirming ocular Demodex infestation and to recommend the most reliable method for routine use by eye care practitioners, based on yield and clinical applicability. Methods: Fifteen participants with a prior Demodex blepharitis diagnosis or featuring typical cylindrical dandruff (CD) collarettes, and seven healthy controls were enrolled. Demodex presence was assessed using five techniques, applied consecutively, on a minimum of two different eyelashes on each eyelid of every participant, for each test, in situ: 1. using fine-point forceps and 25-40x biomicroscopy magnification, by eyelash rotation as proposed by Mastrota (ROT); 2. by removing cylindrical dandruff and exposing the eyelash insertion point at the lid margin (CDR); and 3. by laterally tensioning the eyelash (LET) following CDR. The typical appearance of cigar-shaped mite tails protruding from each assessed eyelash follicle was observed, and mite tails counted and averaged per participant for each assessment technique. 4. Lash epilation, and mite presence evaluated using bright-field microscopy at 10-40x magnification (EPI). 5. Finally, eyelash follicles were imaged using in vivo confocal microscopy (IVCM) and the images visually inspected for mite presence. Results: In the Demodex group, the highest numbers of mites/eyelash were identified by LET (3.8 ± 1.4), versus CDR (2.4 ± 1.6) and ROT (1.1 ± 1.2), alone (all p < 0.002). An average of 1.0 ± 0.8 mites/lash was identified by EPI. IVCM failed to offer unequivocal evidence of Demodex presence even in confimed cases. Conclusions: A novel technique for the clinical diagnosis and grading of Demodex in situ is described. By removing cylindrical dandruff and applying static, lateral tension to the eyelash without epilation, large numbers of mites are visible at the exposed eyelash follicle. The proposed method is convenient and clinically applicable, requiring only forceps and 25-40x biomicroscope magnification, and allowing rapid, efficient evaluation of large numbers of eyelashes

An investigation into the fertilizer potential of slaughterhouse cattle paunch

In Australia, the red meat processing industry actively seeks approaches to improve the management of solid waste from processing operations and enhance the environmental performance. Recycling of paunch waste to farmland could be a cost-effective and practicable environmental option. However, little is known about the agronomic value of fresh and composted paunch, and the associated requirements for land application. Therefore, a short-term experimental work was undertaken to assess potential risks due to weed seed contamination and determine the agronomic response of ryegrass (Lolium perenne L.) to soil incorporation of paunch. The risk of weed contamination from soil application of paunch appeared to be low; however, methods that account for viability of seeds may be required to fully discard such a risk. Soil application of paunch at field equivalent rates of 150-300 kg ha-1 of N increased dry matter yield by ≈30% on average compared with untreated grass, but was approximately 35% lower than a mineral fertilizer treatment applied at the same rates. Dry matter yield of paunch-treated grass was between 2000 and 3000 kg per ha over four consecutive cuts at 25-day intervals. Nitrogen use-efficiency of paunch was approximately 10% (range: 3% to 20%, depending on paunch type), and total N in harvested plant material showed values, which were between 2% and 3%. Overall, there appears to be potential for paunch-derived products to be used as a source of carbon and nutrients in crop production. Areas that merit a research priority within this space are also outlined in this paper. Such work is required to inform soil-, climate- and crop-specific land application rates, optimize agronomic performance, and minimize environmental concerns. There is also a requirement for the value proposition to industry to be determined, including reduced cost of disposal of material via gate fees and fertilizer replacement value

Effect of a liposomal spray on the pre-ocular tear film

Purpose: With the potential to address evaporative dry eye, a novel spray has been developed in which phospholipid liposomes are delivered to the tear film via the surface of the closed eyelid. This study evaluated the short-term effects of liposomal spray application on the lipid and stability characteristics of the pre-ocular tear film in normal eyes. Methods: Twenty-two subjects (12M, 10F) aged 35.1 ± 7.1 years participated in this prospective, randomised, double-masked investigation in which the liposomal spray was applied to one eye, and an equal volume of saline spray (control) applied to the contralateral eye. Lipid layer grade (LLG), non-invasive tear film stability (NIBUT) and tear meniscus height (TMH) were evaluated at baseline, and at 30, 60, 90 and 135 minutes post-application. Subjective reports of comfort were also compared. Results: Treated and control eyes were not significantly different at baseline (p>0.05). Post-application, LLG increased significantly, at 30 and 60 minutes, only in the treated eyes (p=0.005). NIBUT also increased significantly in the treated eyes only (p0.05). Comfort improved relative to baseline in 46% of treated and 18% of control eyes, respectively, at 30 minutes post-application. Of those expressing a preference in comfort between the eyes, 68% preferred the liposomal spray. Conclusions: Consistent with subjective reports of improved comfort, statistically and clinically significant improvements in lipid layer thickness and tear film stability are observed in normal eyes for at least an hour after a single application of a phospholipid liposomal spray

Effect of water-in-oil microemulsions and lamellar liquid crystalline systems on the precorneal tear film of albino New Zealand rabbits

The aim of this study is to investigate the effect of phase transition water-in-oil (w/o) microemulsions (ME) and liquid crystalline systems (LC) on the precorneal tear film (PCTF). The study used six albino NZ rabbits and monitored the integrity and stability of the PCTF before and after instillation of test formulations. The effects were evaluated by assessment of the PCTF lipid layer using interferometry, tear evaporation rate measurements, and indirect estimation of tear volume. Ocular application of test formulations changed the appearance of the PCTF lipid layer, indicating lipid layer disruption. The recovery time was longer in case of ME compared with an aqueous solution (SOL). The tear evaporation rate was increased after application of both ME and LC systems compared with the SOL, with the LC system showing the greatest effect. Tear volume measurement results revealed minimal changes associated with the instillation of both ME systems. Whilst phase transition w/o ME systems can interact with the PCTF lipid layer in albino New Zealand rabbits, their effect on the volume of resident tears was found to be minimal

The Role of MAPK in Drug-Induced Kidney Injury

This paper focuses on the role that mitogen-activated protein kinases (MAPKs) play in drug-induced kidney injury. The MAPKs, of which there are four major classes (ERK, p38, JNK, and ERK5/BMK), are signalling cascades which have been found to be broadly conserved across a wide variety of organisms. MAPKs allow effective transmission of information from the cell surface to the cytosolic or nuclear compartments. Cross talk between the MAPKs themselves and with other signalling pathways allows the cell to modulate responses to a wide variety of external stimuli. The MAPKs have been shown to play key roles in both mediating and ameliorating cellular responses to stress including xenobiotic-induced toxicity. Therefore, this paper will discuss the specific role of the MAPKs in the kidney in response to injury by a variety of xenobiotics and the potential for therapeutic intervention at the level of MAPK signalling across different types of kidney disease

Using Electronic Health Record Data to Improve Community Health Assessment

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment. Purpose: To produce population health indicators using data from EHR systems that could be combined and visually displayed alongside social determinants data, and to provide data sets at geographic levels smaller than a county. Methods: Data from multiple EHR systems used by major health systems covering \u3e90% of the population in a metropolitan urban area were extracted and linked using a health information exchange (HIE) network for individuals who had at least two clinical encounters within the HIE network over a 3-year period. Population health indicators of highest interest to public health stakeholders were calculated and visualized at varying levels of geographic granularity. Results: Ten population health indicators were calculated, visualized, and shared with public health partners. Indicators ranged from the prevalence of a disease to the proportion of individuals with poor maintenance of their chronic condition. Calculating rates at the census-tract level or larger (e.g., average population size \u3e 4000 people) is preferable to smaller geographic units of analysis. Implications: Extraction and linking of EHR system data are feasible for public health via an HIE network. While indicators can be derived, biases exist in the data that require more study. Further, HIE networks do not yet possess data for all conditions and measures desired by local public health stakeholders. The data that can be extracted, however, can be combined with public datasets on social determinant

Omega-3 polyunsaturated fatty acid supplementation for improving peripheral nerve health: Protocol for a systematic review

Introduction Damage to peripheral nerves occurs in a variety of health conditions. Preserving nerve integrity, to prevent progressive nerve damage, remains a clinical challenge. Omega-3 polyunsaturated fatty acids (PUFAs) are implicated in the development and maintenance of healthy nerves and may be beneficial for promoting peripheral nerve health. The aim of this systematic review is to assess the effects of oral omega-3 PUFA supplementation on peripheral nerve integrity, including both subjective and objective measures of peripheral nerve structure and/or function. Methods and analysis A systematic review of randomised controlled trials that have evaluated the effects of omega-3 PUFA supplementation on peripheral nerve assessments will be conducted. Comprehensive electronic database searches will be performed in Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), US National Institutes of Health Clinical Trials Registry and the WHO International Clinical Trials Registry Platform. The title, abstract and keywords of identified articles will be assessed for eligibility by two reviewers. Full-text articles will be obtained for all studies judged as eligible or potentially eligible; these studies will be independently assessed by two reviewers to determine eligibility. Disagreements will be resolved by consensus. Risk of bias assessment will be performed using the Cochrane Collaboration risk of bias tool to appraise the quality of included studies. If clinically meaningful, and there are a sufficient number of eligible studies, a meta-analysis will be conducted and a summary of findings table will be provided. Ethics and dissemination This is a systematic review that will involve the analysis of previously published data, and therefore ethics approval is not required. A manuscript reporting the results of this systematic review will be published in a peer-reviewed journal and may also be presented at relevant scientific conferences

Hypersonic Boundary Layer Transition Measurements Using NO2 approaches NO Photo-dissociation Tagging Velocimetry

Measurements of instantaneous and mean streamwise velocity profiles in a hypersonic laminar boundary layer as well as a boundary layer undergoing laminar-to-turbulent transition were obtained over a 10-degree half-angle wedge model. A molecular tagging velocimetry technique consisting of a NO2 approaches?NO photo-dissociation reaction and two subsequent excitations of NO was used. The measurement of the transitional boundary layer velocity profiles was made downstream of a 1-mm tall, 4-mm diameter cylindrical trip along several lines lying within a streamwise measurement plane normal to the model surface and offset 6-mm from the model centerline. For laminar and transitional boundary layer measurements, the magnitudes of streamwise velocity fluctuations are compared. In the transitional boundary layer the fluctuations were, in general, 2-4 times larger than those in the laminar boundary layer. Of particular interest were fluctuations corresponding to a height of approximately 50% of the laminar boundary layer thickness having a magnitude of nearly 30% of the mean measured velocity. For comparison, the measured fluctuations in the laminar boundary layer were approximately 5% of the mean measured velocity at the same location. For the highest 10% signal-to-noise ratio data, average single-shot uncertainties using a 1 ?Es and 50 ?Es interframe delay were ~115 m/s and ~3 m/s, respectively. By averaging single-shot measurements of the transitional boundary layer, uncertainties in mean velocity as low as 39 m/s were obtained in the wind tunnel. The wall-normal and streamwise spatial resolutions were 0.14-mm (2 pixel) and 0.82-mm (~11 pixels), respectively. These measurements were performed in the 31-inch Mach 10 Air Wind Tunnel at the NASA Langley Research Center