Ocular surface changes in moderate-to-severe acne vulgaris

AIM:To investigate ocular surface disorders and tear function changes in patients with acne vulgaris and explore the potential relationship between acne vulgaris and dry eye.METHODS:This cross-sectional study included right eyes of 53 patients with acne vulgaris and 54 healthy controls.The participants completed the Ocular Surface Disease Index(OSDI)questionnaire.The following ocular surface-related parameters were measured:tear meniscus height(TMH),noninvasive tear breakup time(NIBUT),Schirmer I test(SIT),lipid layer thickness(LLT)score of the tear film,meibum score,meibomian gland orifice obstruction score,the ratio of meibomian gland loss,conjunctival hyperemia score,and corneal fluorescein staining(CFS)score.RESULTS:The stability of the tear film decreased in acne vulgaris patients.In the acne group,the TMH and NIBUT were lower,whereas the OSDI,meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss,and conjunctival hyperemia score were higher compared with controls(P<0.05).There were no significant differences in the CFS score,SIT,or LLT score between the groups(P>0.05).In two dry eye groups,the TMH,NIBUT,and LLT score were lower in the acne with dry eye(acne-DE)group,and the meibum score,meibomian gland orifice obstruction score,ratio of meibomian gland loss and conjunctival hyperemia score in the acne-DE group were higher(P<0.05).There were no significant differences between OSDI,SIT,and CFS score(P>0.05).CONCLUSION:Patients with moderate-to-severe acne vulgaris are more likely to experience dry eye than those without acne vulgaris.Reduced tear film stability and meibomian gland structure dysfunction are more pronounced in patients with moderate-to-severe acne and dry eye.

Effects of diamagnetic drift on nonlinear interaction between multi-helicity neoclassical tearing modes

A numerical study of the diamagnetic drift effect on the nonlinear interaction between multi-helicity neoclassical tearing modes(NTMs) is carried out using a set of four-field equations including two-fluid effects.The results show that,in contrast to the single-fluid case,5/3 NTM cannot be completely suppressed by 3/2 NTM with diamagnetic drift flow.Both modes exhibit oscillation and coexist in the saturated phase.To better understand the effect of the diamagnetic drift flow on multiple-helicity NTMs,the influence of typical relevant parameters is investigated.It is found that the average saturated magnetic island width increases with increasing bootstrap current fraction f_(b) but decreases with the ion skin depth δ.In addition,as the ratio of parallel to perpendicular transport coefficients χ_(‖)/χ_(⊥) increases,the average saturated magnetic island widths of the 3/2 and 5/3 NTMs increase.The underlying mechanisms behind these observations are discussed in detail.

Assessment of tear film parameters post-treatment with commercial eyelid cleaning wipes:a pilot study

AIM:To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters.METHODS:This study enrolled 48 healthy participants aged 20-35y(both males and females).Clinical assessment included the Ocular Surface Disease Index(OSDI)questionnaire,non-invasive tear break-up time(NITBUT),tear meniscus height(TMH),and lipid layer pattern(LLP).Based on these initial results,participants were categorized as either non-dry eye or dry eye.Participants in each group were randomly allocated to either Blephaclean■or Systane■treatments.Changes in NITBUT,TMH,and LLP levels before and after lid wipe treatment were assessed.RESULTS:The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group(P<0.001).Following the application of eyelid wipes(Systane■wipes),dry eye subjects experienced a significant improvement in NITBUT levels(P=0.0014)compared to the non-dry eye individuals.Although the remaining participants showed a marginal increase in TMH and NITBUT levels,these changes did not achieve statistical significance(P>0.05).Similarly,the LLP levels were significantly improved with Systane■(P<0.001)post-treatment compared to individuals in the non-dry eye group.However,the dry eye subjects showed higher posttreatment LLP levels than the untreated group(P<0.02).CONCLUSION:The short-term effects of Systane®eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease.Nonetheless,further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.

Microstructure and Hot Tearing Sensitivity Simulation and Parameters Optimization for the Centrifugal Casting of Al-Cu Alloy

Four typical theories on the formation of thermal tears:strength,liquid film,intergranular bridging,and solidifica-tion shrinkage compensation theories.From these theories,a number of criteria have been derived for predicting the formation of thermal cracks,such as the stress-based Niyama,Clyne,and RDG(Rapaz-Dreiser-Grimaud)criteria.In this paper,a mathematical model of horizontal centrifugal casting was established,and numerical simulation analysis was conducted for the centrifugal casting process of cylindrical Al-Cu alloy castings to investigate the effect of the centrifugal casting process conditions on the microstructure and hot tearing sensitivity of alloy castings by using the modified RDG hot tearing criterion.Results show that increasing the centrifugal rotation and pouring speeds can refine the microstructure of the alloy but increasing the pouring and mold preheating temperatures can lead to an increase in grain size.The grain size gradually transitions from fine grain on the outer layer to coarse grain on the inner layer.Meanwhile,combined with the modified RDG hot tearing criterion,the overall distribution of the castings’hot tearing sensitivity was analyzed.The analysis results indicate that the porosity in the middle region of the casting was large,and hot tearing defects were prone to occur.The hot tearing tendency on the inner side of the casting was greater than that on the outer side.The effects of centrifugal rotation speed,pouring temperature,and preheating temperature on the thermal sensitivity of Al-Cu alloy castings are summarized in this paper.This study revealed that the tendency of alloy hot cracking decreases with the increase of the centrifugal speed,and the maximum porosity of castings decreases first and then increases with the pouring temperature.As the preheating temperature increases,the overall maximum porosity of castings shows a decreasing trend.

Suppression of the m/n=2/1 tearing mode by electron cyclotron resonance heating on J-TEXT

Stabilization of tearing modes and neoclassical tearing modes is of great importance for tokamak operation.Electron cyclotron waves(ECWs)have been extensively used to stabilize the tearing modes with the virtue of highly localized power deposition.Complete suppression of the m/n=2/1 tearing mode(TM)by electron cyclotron resonance heating(ECRH)has been achieved successfully on the J-TEXT tokamak.The effects of ECW deposition location and power amplitude on the 2/1 TM suppression have been investigated.It is found that the suppression is more effective when the ECW power is deposited closer to the rational surface.As the ECW power increases to approximately 230 k W,the 2/1 TM can be completely suppressed.The island rotation frequency is increased when the island width is reduced.The experimental results show that the local heating inside the magnetic island and the resulting temperature perturbation increase at the O-point of the island play dominant roles in TM suppression.As the ECW power increases,the 2/1 island is suppressed to smaller island width,and the flow shear also plays a stabilizing effect on small magnetic islands.With the stabilizing contribution of heating and flow shear,the 2/1 TM can be completely suppressed.

The impact of toroidal mode coupling on high-density discharges in J-TEXT

Density limit has long been a widely studied issue influencing the operating range of tokamaks.The rapid growth of the m/n=2/1(where m and n are poloidal and toroidal mode numbers,respectively)tearing mode is generally regarded as a primary precursor to the density limit disruption.In this experiment,the coupling of the m/n=1/1 mode and the m/n=2/1 mode in highdensity plasma was observed.During a sawtooth cycle,the frequencies of the two modes gradually converge until they become equal.After that,toroidal coupling occurs between the 1/1 and 2/1 modes,resulting in a mutually fixed phase relationship.With the occurrence of toroidal coupling,the 2/1 mode is stabilized.Prior to the disruption,the cessation of the 1/1 and 2/1 mode coupling,along with the rapid growth in the amplitude of the 2/1 mode,can be observed.Additionally,under the same parameters,comparing discharges with or without the 1/1 mode,it is found that the presence of the 1/1 mode leads to higher plasma density and temperature parameters.

Intra-and interobserver reliability of ocular surface analyzer LacryDiag

AIM:To invastigate intra-and interobserver reliability of interferometry,tear meniscus height(TMH)measurement and meibography(MBG)of an ocular surface analyzer,LacryDiag(Quantel Medical,France).METHODS:Five consecutive measurements and subsequent analysis of interferometry,TMH,and MBG were recorded by two examiners using the LacryDiag.To assess intra-and interobserver reliability,we used Cohen’s kappa for categorical variables(interferometry),or intraclass correlation coefficient for continuous variables(TMH,MBG).RESULTS:Thirty eyes of 30 examinees were included.For both observers,there was excellent intraobserver reliability for MBG(0.955 and 0.970 for observer 1 and 2,respectively).Intraobserver reliability for observer 1 was substantial for interferometry(0.799),and excellent for TMH(0.863).Reliability for observer 2 was moderate for interferometry(0.535)and fair to good for TMH(0.431).Interobserver reliability was poor for interferometry(0.074)and fair to good for TMH(0.680)and MBG(0.414).CONCLUSION:LacryDiag ocular surface analyzer in our study proves to be a reliable noninvasive tool for the evaluation of TMH and MBG.As for interferometry,poor interobserver reliability,fair to good intraobserver reliability for observer 1,and moderate for observer 2,leave room for improvement.

Effects of counter-current driven by electron cyclotron waves on neoclassical tearing mode suppression

Through theoretical analysis,we construct a physical model that includes the influence of counter-external driven current opposite to the plasma current direction in the neoclassical tearing mode(NTM).The equation is used with this model to obtain the modified Rutherford equation with co-current and counter-current contributions.Consistent with the reported experimental results,numerical simulations have shown that the localized counter external current can only partially suppress NTM when it is far from the resonant magnetic surface.Under some circumstances,the Ohkawa mechanism dominated current drive(OKCD)by electron cyclotron waves can concurrently create both co-current and counter-current.In this instance,the minimal electron cyclotron wave power that suppresses a particular NTM was calculated by the Rutherford equation.The result is marginally less than when taking co-current alone into consideration.As a result,to suppress NTM using OKCD,one only needs to align the co-current with a greater OKCD peak well with the resonant magnetic surface.The effect of its lower counter-current does not need to be considered because the location of the counter-current deviates greatly from the resonant magnetic surface.

Traumatic isolated bilateral gluteus minimus injuries misdiagnosed as lumbar radiculopathy:A case report

BACKGROUND The tear of the gluteus medius and minimus tendons can cause chronic buttock pain,especially in middle-aged individuals;these tears occur mostly in association with degenerative changes in the muscles and tendons.Chronic injuries are more common than acute injuries,and concurrent injuries to the gluteus medius and minimus tendons without chronic pain are rare,especially isolated injuries to both sides of the gluteus minimus;such a case has not yet been reported.CASE SUMMARY The authors present a case of bilateral acute traumatic injuries to the gluteus minimus during buttock strengthening exercises in a 75-year-old male patient.The patient completely returned to his pre-injury lifestyle after 8 weeks of injury,with no limitations,but the diagnosis was initially delayed due to misdiagnosis as lumbar radiculopathy,resulting in unnecessary socio-economic burden on the patient.CONCLUSION When treating patients who complain of hip pain,it is important to consider various causes to make a correct diagnosis.

Analyze interleukin-1β,interleukin-6,and tumor necrosis factor-αlevels in dry eye and the therapeutic effect of cyclosporine A

BACKGROUND Dry eye is a common eye disease.Artificial tears supplements are widely used for the treatment of dry eyes.However,multiple adverse effects have been observed in patients receiving long-term treatment with artificial tears,which may affect the therapeutic effect.AIM To analyze the characteristics of interleukin-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)levels in patients with dry eye and the therapeutic effect of artificial tears combined with cyclosporine A.METHODS A total of 124 dry eye patients treated at The First People’s Hospital of Xining from April 2020 to April 2022 were selected as the observation group,while 20 healthy individuals served as the control group during the same period.Levels of inflammatory markers,including IL-1β,IL-6,and TNF-α,were analyzed.The observation group was further divided into a study group and a control group,each consisting of 62 patients.The control group received artificial tears,whereas the study group received a combination of artificial tears and cyclosporine A.Inflammatory markers,Schirmer’s test(SIT),tear break-up time(TBUT),corneal fluorescein staining(CFS),National Eye Institute Visual Function Questionnaire-25(NEI-VFQ-25)scores,and adverse events(AEs)were compared between the two groups.RESULTS The observation group exhibited significantly elevated serum levels of IL-1β,IL-6,and TNF-αin comparison to the healthy group.Following treatment,the study group demonstrated substantial reductions in IL-1β,IL-6,and TNF-αlevels relative to the control group.Moreover,after treatment,the study group experienced a marked decrease in CFS scores and significant increases in both SIT and BUT levels when compared to the control group.Additionally,significant improvements were observed in the primary symptom of dry eye and secondary symptoms such as photophobia,foreign body sensation,fatigue,red eye,and burning sensation within the study group.Furthermore,post-treatment NEI-VFQ-25 scores across all dimensions exhibited significant enhancements in the study group compared to the control group(P<0.05).It is noteworthy that significant AEs were reported in both groups throughout the treatment period.CONCLUSION Cyclosporine A combined with artificial tears is effective in treating dry eye,yielding enhanced outcomes by improving SIT and TBUT levels,reducing CFS scores,and ameliorating vision-related quality of life.

Lateral femoral tunnel preparation and graft fixation for anterior cruciate ligament reconstruction–A discussion

This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research.

Red Envelopes: Opening a Legacy

University application season left many of my peers adrift or overwhelmed,but I had steadfastly been pointed in the right direction.This sense of direction was instilled in me by my grandfather,Low King Wing.Although he passed away when I was only three,my grandpa remains a towering figure of respect in my life.At that tender age,I couldn’t grasp the finality of his departure.All I knew was that Grandpa lay still in the coffin,unresponsive to my cries,no matter how hard I wailed.Exhausted from crying,I fell asleep.In a dream,Grandpa hugged me tightly,as he always did,urging me to eat well,grow up strong,and be happy every day.This embrace inexplicably brought more tears.

Autologous blood in the management of ocular surface disorders

Autologous blood therapy has emerged as a promising modality in managing ocular surface disorders.This review provides a comprehensive overview of the current literature regarding the use of autologous blood in ocular surface disorders,encompassing its physiological basis,clinical applications,techniques,challenges,and future perspectives.The ocular surface,comprising the cornea,conjunctiva,and tear film,plays a critical role in maintaining visual function,and its disruption can lead to various pathological conditions.With its rich composition of growth factors,cytokines,and other bioactive molecules,autologous blood offers therapeutic potential in promoting corneal wound healing,reducing inflammation,and improving tear film stability.Clinical studies have demonstrated the efficacy and safety of autologous blood therapy in diverse ocular surface disorders,including persistent epithelial defects,neurotrophic keratopathy,and dry eye disease.However,challenges such as variability in treatment response,adverse effects,and optimal patient selection remain areas of concern.Further research is needed to elucidate the underlying mechanisms of action,refine treatment protocols,and explore synergistic approaches with other therapeutic modalities.Despite these challenges,autologous blood therapy holds promise as a valuable adjunctive treatment option for ocular surface disorders,offering new avenues for improving patient outcomes and quality of life.This review examines the mechanisms underlying ocular surface disorders while discussing existing autologous blood-based therapies for managing these disorders.Current clinical trials are also summarized,and a comparison between autologous blood therapy and conventional eyedrops is attempted.Finally,safe techniques and protocols for autologous blood medicine are elucidated,and adverse effects and future perspectives of this novel therapy are reviewed.

Optimizing Recovery Following Mihata Superior Capsular Reconstruction Surgery with Tensor Fascia Lata Auto Graft: A Comprehensive Rehabilitation Protocol

Objective: Superior Capsular Reconstruction (SCR) using a Tensor Fascia Lata (TFL) autograft is an evolving technique for treating irreparable rotator cuff tears. The Mihata technique, initially developed in Japan, has shown promising long-term results. However, a standardized post-operative rehabilitation protocol for this procedure in the USA is lacking. Purpose: This study aims to evaluate the outcomes of a comprehensive rehabilitation protocol following SCR with TFL autograft in a cohort of nine patients. Participants and Methods: A prospective observational study was conducted at Concentra Urgent Care, San Francisco. Nine patients, aged 55 - 65 years, underwent SCR with TFL autograft performed by a specialized orthopedic surgeon. Post-operative rehabilitation was managed using a structured protocol, divided into three phases focusing on passive exercises, progressive range of motion, and strengthening. Outcomes were measured using the Visual Analogue Scale (VAS) for pain, forward flexion range of motion (FF-ROM), and Single Assessment Numeric Evaluation (SANE) scores over a six-month period. Results: Significant improvements were observed in pain reduction (mean VAS decrease of −3.67 points, p = 0.01), ROM (mean FF increase of 41.11 degrees, p = 0.014), and SANE scores (mean improvement of 42.11%, p = 0.009), indicating the efficacy of the rehabilitation protocol. Conclusion: The comprehensive rehabilitation protocol following SCR with TFL autograft significantly improved pain, range of motion, and shoulder function in patients, suggesting its potential utility in clinical practice.

The Incidence and Risk Factors of Third- and Fourth-Degree Perineal Tears in Ministry of Health in Bahrain over 5 Years

Background: Perineal trauma and vaginal laceration are considered a common complication associated with vaginal delivery. Well established risk factors, recognized by the Royal College of Obstetricians and Gynecologists, are ethnicity, birth weight over 4 kg persistent occipital posterior position, null parity, induction of labor, shoulder dystocia, instrumental delivery. There are other risk factors that were suggested in the literature, but data are conflicting, such as prolonged second stage of labor, episiotomy and obesity. Objective: To evaluate third- and fourth-degree perineal rears rates and the impact of related risk factors on perineal tears in Ministry of health in Bahrain over 5 years (which includes Salmanyia Medical complex (SMC) and Jidhafs maternity hospital (JMH)). Methods: This retrospective descriptive cross-sectional study analyzed all vaginal deliveries from January 2015 to December 2019 in Obstetrics and Gynecology department in Salmanyia Medical Complex (the main hospital in Kingdom of Bahrain which received all kinds of cases including low and high risks) and Jidhafs Maternity Hospital (tertiary hospital which received only low risk cases), Kingdom of Bahrain. During the period of interest 33,694 records were identified. Data were extracted from observational recording from SMC and JMH labour registry books. Results: There was no statistically significant difference between groups according to age (p = 0.199). On the other hand, there was statistically significant higher cases of >40 weeks at gestational age, obesity > 35 kg/mr, vacuum delivery, pushing stage > 90 min, birth weight > 4 kg, head circumference > 34 cm, fetal length at birth > 50 cm, episiotomy and lower cases of nulliparity in study group compared to control group 16 (66.7%) vs. 13,805 (41.0%), 3 (12.5%) vs. 1448 (4.3%), 3 (12.5%) vs. 1414 (4.2%), 4 (16.7%) vs. 1751 (5.2%), 3 (12.5%) vs. 1751 (5.2%), 12 (50.0%) vs. 15,926 (47.3%), 15 (62.5%) vs. 20,135 (59.8%) and 17 (70.8%) vs. 29,024 (86.2%);(p = 0.027, 0.009, Conclusion: Gestational age > 40 weeks, obesity > 35 kg/mr, pushing stage > 90 min, birth weight > 4 kg, head circumference > 34 cm, fetal length at birth > 50 cm and using of vacuum increase incidence of 3rd and 4th degree perineal tears with vaginal delivery however maternal age and nulliparity have no significant role. Finally, episiotomy did not represent as protective factor for perineal damage. .

Risk Factors Associated with Obstetric Perineal Tear in a Maternity Ward of the Communal Medical Center of Ratoma-Conakry-Guinea

Introduction: Obstetric perineal tears are a common complication during childbirth. The objectives of this study were to describe the sociodemographic characteristics, the different types of perineal tears and to identify the associated risk factors. Patients and Method: The maternity of the CMC of Ratoma served as a setting for carrying out this study. This was a prospective study of a descriptive and analytical type, which took place over a period of 6 months from July 1, 2021 to January 1, 2022. Results: The frequency of perineal tear was 9%. The average age of the patients concerned was 23.99 years ± 5.18 years, with extremes of 15 and 38 years. Housewives were the most numerous (30.88%). Most of our parturient had undergone excision (99.6%) and they were more frequently primiparous (40.44%) and pauciparous (47.79%). The multiplicity of risk factors was a remarkable fact (scarred perineum, edematous, short, and infected). The presentation was cephalic in 96.33%, posterior variety in 3.81% and the variety of positions could not be specified by the health worker who provided care to the parturient in 46.56%. The expulsion took place in OP (92.37%) and in OS (2.30%). In most cases, midwives carried out deliveries (93%). Perineal tears were 1st degree (54.41%), 2nd degree (39.70%), 3rd degree (5.15%) and 4th degree (0.74%). Conclusion: Prevention of perineal obstetric injuries is based on better knowledge of risk factors and delivery by qualified personnel. The main limitation of this study is the impossibility of highlighting occult perineal lesions due to the weakness of the technical platform.

The Prevalence Type of the Meniscus Tear in Patients with Anterior Cruciate Ligament (ACL) Injury, in Abu Arish General Hospital, Jazan, KSA

Background: The anterior cruciate ligament (ACL) is the main structure that prevents the forward movement of the tibia about the femur Meniscus tear which is a common finding in patients with anterior cruciate ligament (ACL) injury. Aim: To investigate the prevalence of types of meniscus tears in patients with Anterior Cruciate Ligament (ACL) Injury. Methods: A retrospective study was conducted among inpatients. Clinical evaluation included side-to-side difference in anterior tibial translation (ATT) as measured by a KT-1000 arthrometer (MEDmetric Corp) and a grade of pivot-shift test at final follow-up in all patients. Subsequent meniscal tear was defined by symptoms of joint line pain and/or locking or joint effusion requiring surgical treatment. Results: Most of patients were males (92.6%). The patients were categorized into 5 groups according to age with a mean of age 32.8 ± 10.6. The most common causes of ACL injury were falling down (43.2%), trauma (38.1%) or knee torsion (18.8%). Medial meniscal tear was found in 92 knees (55.7%), while lateral meniscal tear was found in 19 knees (10.8%) and the most common type was the longitudinal tear that was found in 31 knees (17.6%). Similarly, 66.7% of the meniscal flap tears and half of the meniscal bucket-handle tears were significantly associated with loose body (P Conclusion: The present study demonstrated that meniscus tears are more common in individuals with chronic ACL rupture. The main factors contributing to ACL injury were classified as falls, trauma, and knee torsion. Gender was identified as a critical determinant in the etiology of ACL injury. The occurrence of a ramp lesion was associated longitudinal meniscal tears, whereas chodoral injury was associated with the majority of meniscal flap tears and meniscal bucket-handle tears.

A Tearful Return

The majority of students from China’s quake-hit area have returned to school, either in temporary Sichuan classrooms or in other parts of the country "The students of Beichuan Middle School who survived the earthquake should be more strong-minded,"

Tearful Smile on Swollen Faces

I opened the album. A group photo reminded me of an event that I can never forget. It happened in my fi fth year of primary school.

Dynamic tear meniscus parameters in complete blinking:insights into dry eye assessment

AIM:To investigate the relationship between dynamic tear meniscus parameters and dry eye using an automated tear meniscus segmentation method.METHODS:The analysis of tear meniscus videos captured within 5s after a complete blink includes data from 38 participates.By processing video data,several key parameters including the average height of the tear meniscus at different lengths,the curvature of the tear meniscus’s upper boundary,and the total area of the tear meniscus in each frame were calculated.The effective values of these dynamic parameters were then linearly fitted to explore the relationship between their changing trends and dry eye disease.RESULTS:In 94.74%of the samples,the average height of central tear meniscus increased over time.Moreover,97.37%of the samples exhibited an increase in the overall tear meniscus height(TMH)and area from the nasal to temporal side.Notably,the central TMH increased at a faster rate compared to the nasal side with the temporal side showing the slowest ascent.Statistical analysis indicates that the upper boundary curvature of the whole tear meniscus as well as the tear meniscus of the nasal side(2,3,and 4 mm)aid in identifying the presence of dry eye and assessing its severity.CONCLUSION:This study contributes to the understanding of tear meniscus dynamics as potential markers for dry eye,utilizing an automated and non-invasive approach that has implications for clinical assessment.