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Over the past two decades, the advancement of analytical examinations like proteomics for investigating neuronal-related biomarkers has emerged as one of the most important and effective tools for clinical evaluation and prognosis. However, there remains an unmet need in this area. With advances in quantifying methods and detection in omics research, including proteomics and metabolomics, the close association of the salivary glands and tears with the nervous system has become increasingly evident. As noninvasive specimens, saliva and tears serve as attractive substitutes for neuronal biomarkers, containing numerous proteins and metabolites that represent various ailments in neurodegenerative illnesses like multiple sclerosis (MS). These noninvasive biomarkers might potentially correlate with susceptibility, severity, and pathogenesis of neurological disorders and could be utilized in early diagnosis and prognosis. Therefore, tear and salivary proteomics present novel insights into understanding disease progression and offer personalized treatment options with greater sensitivity. This approach helps highlight the most relevant experimental outcomes related to tear and salivary biomarkers for multiple sclerosis. [ABSTRACT FROM AUTHOR]

Background/Objectives: In this study, we aimed to analyze the changes in the expression profiles of selected messenger RNAs (mRNAs) and their encoded proteins in the tears of patients undergoing photorefractive keratectomy (PRK), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) procedures. Methods: A total of 120 patients were divided into three groups based on the laser vision correction (LVC) procedure: PRK, FS-LASIK, or SMILE. Tear samples were collected preoperatively and at 1, 7, 30, and 180 days postoperatively. The expression levels of selected messenger RNAs (mRNAs) and proteins were analyzed by using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Results: PRK and FS-LASIK elicited significantly stronger biological responses than SMILE. Interleukin-15 (IL-15) expression increased notably in the PRK and FS-LASIK groups, with mRNA levels reaching fold changes of 4.65 ± 0.65 and 4.99 ± 0.28, respectively, on day 1, compared with only 2.09 ± 0.23 in the SMILE group. Vascular endothelial growth factor A (VEGFA) levels were also elevated in the PRK (2.98 ± 0.23 fold change) and FS-LASIK groups (3.45 ± 1.09 fold change) on day 1, while the SMILE group showed minimal fluctuations. The protein concentration analysis based on the ELISA confirmed these trends, with IL-15 levels peaking at 54.2 ± 2.5 pg/mL in the PRK group and 52.8 ± 3.1 pg/mL in the FS-LASIK group, compared with 32.4 ± 1.9 pg/mL in the SMILE group on day 1. Similarly, VEGFA protein concentrations were the highest in the PRK (72.4 ± 4.1 pg/mL) and FS-LASIK patients (69.5 ± 3.8 pg/mL) on day 1 but remained low in the SMILE patients (45.6 ± 2.3 pg/mL). By day 180, gene expression and protein levels in all groups had stabilized, returning to near-preoperative values. Conclusions: PRK and FS-LASIK induced more pronounced molecular and protein-level changes during corneal wound healing than the less invasive SMILE procedure, indicating stronger biological responses. These findings suggest that tailored postoperative care based on the specific procedure could optimize healing and patient outcomes. However, further research with larger sample sizes and longer follow-ups is needed to confirm these observations and develop personalized treatment strategies. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusionsTo extend cross-sectional data on cytokine ratios (CRs) in dry eye disease (DED) signs by investigating longitudinal change in pro- to anti-inflammatory CRs and associations with change in DED signs and symptoms.Secondary analysis of fifty-four subjects [mean age 57.3 (SD 13.2) years, 85.2% female; 68.5% white] with ≥ 4 uL pooled tear volumes at months 0, 6, and 12. Pro-inflammatory (IL-1b, IL-6, IL-8, IL-17A, IFN-g, and TNF-a) to anti-inflammatory (IL-6, IL-10) cytokine ratios (CR) were calculated. DED signs (corneal and conjunctival staining scores, tear break-up time, Schirmer test, Meibomian gland plugging, tear osmolarity, composite sign severity score) and symptoms [Ocular Surface Disease Index (OSDI)] were measured. Changes over time in DED signs, symptoms, and CRs were evaluated using longitudinal models. Correlations between changes in CR and changes in DED signs and symptoms were evaluated using Spearman correlation coefficients (rho).DED signs which improved over time (p < 0.001) included corneal and conjunctival staining score, tear break-up time, tear osmolarity, and composite sign severity score. Using IL-10 as anti-inflammatory, changes in corneal and conjunctival staining and composite severity score significantly correlated with changes in pro- to anti-inflammatory CRs from month 0 to 6 (|rho|: 0.29-0.45, p: 0.003-0.04) but not between month 0 to 12 (|rho|: 0.01 to 0.24, all p > 0.08). DED symptoms decreased across one year (p < = 0.001) for all OSDI measures; these changes did not correlate with changes in CRs (|rho|: 0.00 to 0.29, all p > 0.04).Improvement in some DED signs across one year correlated weakly with decreases in pro- to anti-inflammatory CRs, in alignment with the understanding of DED as inflammatory. CRs may provide greater insight than absolute tear cytokine concentrations as possible DED biomarkers. Additional studies that provide standardized clinical information and tear collection and analysis are needed to validate CRs in DED. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the potential of microRNAs (miRNAs) in tears, blood, and aqueous humor as biomarkers for predicting treatment response in wet age-related macular degeneration (AMD) patients undergoing anti-vascular endothelial growth factor (anti-VEGF) therapy. Methods: In a single-center prospective cohort study, treatment-naïve wet AMD patients and age-matched controls were enrolled. Clinical data and miRNA levels (miR-199a-3p, miR-365-3p, miR-200b-3p, miR-195-5p, miR-335-5p, and miR-185-5p) in tears, blood, and aqueous humor were collected. Treatment response was categorized into responders and non-responders based on visual acuity and central subfield thickness. MiRNA levels were quantified using reverse-transcription PCR. Statistical analyses were performed, including ROC analysis, to evaluate predictive accuracy. Results: Dysregulated miRNA profiles were observed in wet AMD tears and blood compared to controls. Specifically, miR-199a-3p, miR-195-5p, and miR-185-5p were upregulated, while miR-200b-3p was downregulated in tears. All six miRNAs were elevated in wet AMD blood samples. Notably, responders showed higher tear expression of miR-195-5p and miR-185-5p. Combining these miRNAs yielded the highest predictive power (AUC = 0.878, p = 0.006) for anti-VEGF responders. Conclusions: Dysregulated miRNA profiles in tears and blood suggest their potential as biomarkers for wet AMD. MiR-195-5p and miR-185-5p in tears demonstrate predictive value for anti-VEGF treatment responders. This study underscores the non-invasive prediction potential of miRNA tear analysis in wet AMD treatment responses. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study is to comprehensively evaluate the effect of smartphone use on the eye. Twenty-two children, aged 8-16 years, participated in this study. A self-administered questionnaire about smartphone usage time, outdoor activities, and sleep time to obtain dry eye was applied to the child and parents. An ocular surface disease index (OSDI), tear break-up time (TBUT), blink time, autorefractometer, optical biometry, accommodation, contrast sensitivity, and optical coherence tomography tests were applied before a 5-min video watching, and during the video session we counted the complete -incomplete blinks. After video watching, we did the tests. After the tests, we again applied a 5-min video watching and after the video we tested all the parameters again, and finally, following a 5-min resting period, we tested the parameters again. We found no difference between the groups in terms of OSDI scores. Children with punctate epithelial erosions and time spent on the phone have a statistical relation. TBUT also differs statistically before and after test periods (p =.014), since complete blinks did not differ but incomplete blinks differed before and after video watching. The nearpoint of convergence also differs after video watching (p =.008) and anterior chamber depth (ACD) decreases even after the short-time video watching period. On the contrary, we did not find any effect of short-time smartphone watching on auto-keratometer values and retinal-choroidal thickness. This is the first comprehensive study on the short-term effects of smartphone on the paediatric age group. Even 10 min of smartphone can have an effect on TBUT, incomplete blinks, nearpoint of convergence break-recovery, and ACD. During this coronavirus disease 2019 pandemic, we must be mindful of the time our children spend on the phone and keep in mind that even 10 min can have ocular effects. [ABSTRACT FROM AUTHOR]

The examinations of tear quality and volume are important indicators for the diagnosis of dry eye disease. Tests commonly used in clinical practice to diagnose dry eye disease include testing of tear volume and tear film stability to assess the severity of the condition, and analyzing and labeling of tear components under laboratory conditions to diagnose clinical staging and also to guide clinical supplementation of relevant components to target treatment. Accurate assessment of tear production and compositional changes enables clinicians to effectively monitor the severity of dry eye disease and evaluate the effectiveness of therapeutic measures. With the development of optical imaging technology and artificial intelligence in recent years, the combination of clinical tear indicators and examination techniques has enabled the application of new testing methods that provide more convenient, rapid and accurate testing, greatly improving the diagnosis and treatment of dry eye disease in the clinic.

AIM: To investigate the expression levels and clinical significance of hypoxia-inducible factor-1α(HIF-1α)and interleukin-17(IL-17)in conjunctival epithelial cells and tear fluid of patients with dry eyes.METHODS: Retrospective study. A total of 183 dry eye patients admitted to our hospital from February 2021 to March 2023 were selected, and 181 people who were physically healthy in our hospital during the same period were chosen as the control group. HIF-1α and IL-17 expression levels in conjunctival epithelial cells and tear fluid of the two groups of subjects were tested, and the diagnostic value of HIF-1α and IL-17 in conjunctival epithelial cells and tear fluid of the subjects in testing dry eyes was analyzed through receiver operating characteristics(ROC)curves.RESULTS: Compared with the control group, patients in the dry eye group had elevated levels of HIF-1α and IL-17 expression in conjunctival epithelial cells(all P

Abstract Background Protein biomarkers have been broadly investigated in cerebrospinal fluid and blood for the detection of neurodegenerative diseases, yet a clinically useful diagnostic test to detect early, pre-symptomatic Alzheimer’s disease (AD) remains elusive. We conducted this study to quantify Aβ40, Aβ42, total Tau (t-Tau), hyperphosphorylated Tau (ptau181), glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) in eye fluids relative to blood. Methods In this cross-sectional study we collected vitreous humor, aqueous humor, tear fluid and plasma in patients undergoing surgery for eye disease. All six biomarkers were quantitatively measured by digital immunoassay. Spearman and Bland–Altman correlation analyses were performed to assess the agreement of levels between ocular fluids and plasma. Results Seventy-nine adults underwent pars-plana vitrectomy in at least one eye. Of the 79, there were 77 vitreous, 67 blood, 56 tear fluid, and 51 aqueous samples. All six biomarkers were quantified in each bio-sample, except GFAP and NfL in tear fluid due to low sample volume. All six biomarkers were elevated in vitreous humor compared to plasma samples. T-Tau, ptau181, GFAP and NfL were higher in aqueous than in plasma, and t-Tau and ptau181 concentrations were higher in tear fluid than in plasma. Significant correlations were found between Aβ40 in plasma and tears (r = 0.5; p = 0.019), t-Tau in plasma and vitreous (r = 0.4; p = 0.004), NfL in plasma and vitreous (r = 0.3; p = 0.006) and plasma and aqueous (r = 0.5; p = 0.004). No significant associations were found for Aβ42, ptau181 and GFAP among ocular fluids relative to plasma. Bland–Altman analysis showed aqueous humor had the closest agreement to plasma across all biomarkers. Biomarker levels in ocular fluids revealed statistically significant associations between vitreous and aqueous for t-Tau (r = 0.5; p = 0.001), GFAP (r = 0.6; p

Background: Protein biomarkers have been broadly investigated in cerebrospinal fluid and blood for the detection of neurodegenerative diseases, yet a clinically useful diagnostic test to detect early, pre-symptomatic Alzheimer's disease (AD) remains elusive. We conducted this study to quantify Aβ40, Aβ42, total Tau (t-Tau), hyperphosphorylated Tau (ptau181), glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) in eye fluids relative to blood. Methods: In this cross-sectional study we collected vitreous humor, aqueous humor, tear fluid and plasma in patients undergoing surgery for eye disease. All six biomarkers were quantitatively measured by digital immunoassay. Spearman and Bland–Altman correlation analyses were performed to assess the agreement of levels between ocular fluids and plasma. Results: Seventy-nine adults underwent pars-plana vitrectomy in at least one eye. Of the 79, there were 77 vitreous, 67 blood, 56 tear fluid, and 51 aqueous samples. All six biomarkers were quantified in each bio-sample, except GFAP and NfL in tear fluid due to low sample volume. All six biomarkers were elevated in vitreous humor compared to plasma samples. T-Tau, ptau181, GFAP and NfL were higher in aqueous than in plasma, and t-Tau and ptau181 concentrations were higher in tear fluid than in plasma. Significant correlations were found between Aβ40 in plasma and tears (r = 0.5; p = 0.019), t-Tau in plasma and vitreous (r = 0.4; p = 0.004), NfL in plasma and vitreous (r = 0.3; p = 0.006) and plasma and aqueous (r = 0.5; p = 0.004). No significant associations were found for Aβ42, ptau181 and GFAP among ocular fluids relative to plasma. Bland–Altman analysis showed aqueous humor had the closest agreement to plasma across all biomarkers. Biomarker levels in ocular fluids revealed statistically significant associations between vitreous and aqueous for t-Tau (r = 0.5; p = 0.001), GFAP (r = 0.6; p < 0.001) and NfL (r = 0.7; p < 0.001). Conclusion: AD biomarkers are detectable in greater quantities in eye fluids than in plasma and show correlations with levels in plasma. Future studies are needed to assess the utility of ocular fluid biomarkers as diagnostic and prognostic markers for AD, especially in those at risk with eye disease. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the factors associated with anterior location of Marx's line in ocular surface and living habits, especially in tear film. This cross-sectional study enlisted 483 participants with meibomian gland dysfunction, who were divided into two groups: 160 participants with mild anterior location of Marx's line and 323 participants with moderate-to-severe anterior location. Participants completed a survey of demographic characteristics (sex, age, length of visual terminal use, sleep duration, skin property), and the Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires. They also underwent slit-lamp examinations of the lids, and measurements of non-invasive tear break up time, tear meniscus height, fluorescein tear break up time, lipid layer thickness, partial blink rate, lid wiper epitheliopathy, and meibomian gland dropout. The tear meniscus height (mild:0.21(0.18–0.25), moderate-to-severe:0.19(0.16–0.23), p = 0.004), fluorescein tear break up time(mild:3(2–4),moderate to severe:2(1–3), p = 0.000), max LLT(mild:87(62–100), moderate-to-severe:99(69–100), p = 0.04), average LLT(mild:64.5(47.5–96.75), moderate-to-severe:74(53–100), p = 0.012), min LLT(mild:52(38–75), moderate-to-severe:59(41–85), p = 0.029) differed significantly between mild and moderate-to-severe anterior location of Marx's line, and associated to the anterior location of Marx's line(r=-0.134, p = 0.03; r=-0.194, p = 0.000; r = 0.093, p = 0.041; r = 0.119, p = 0.009; r = 0.105, p = 0.022) However, no statistical significance was observed in the OSDI, SPEED, partial blink rate, non-invasive tear breakup time, lipid layer thickness, meibomian gland dropout and lid wiper epitheliopathy(p > 0.05). Meanwhile, in the demographic characteristics, statistically significant correlations were associated with skin property(r = 0.154, p = 0.001) and sleep duration(r=-0.124, p = 0.006), but not with age, sex, and the length of visual terminal use (p > 0.05). Lower TMH and shorter TBUT positively correlated with anterior location of the Marx's line, and were risk factors. Meanwhile, participants with oily skin and shorter sleep duration were more likely to exhibit anterior location of Marx's line. [ABSTRACT FROM AUTHOR]

Purpose: The management of blepharitis continues to challenge clinicians due to the poorly understood aetiology of the condition. We recently identified the family of intracellular plakin proteins as essential driving forces underlying anterior blepharitis. A large‐scale protein analysis was used to study if a topical dexamethasone/tobramycin solution could be used to reverse the expression of plakin proteins. Methods: Tear film samples from treatment naïve patients with anterior blepharitis (n = 15) were collected with Schirmer filtration paper. A subgroup of the patients (n = 10) received treatment with a dexamethasone/tobramycin 1 + 3 mg/mL ophthalmic suspension (Tobradex®) for 3 weeks and collection of tear film samples was repeated. The samples were analysed with label‐free quantification nano liquid chromatography–tandem mass spectrometry requiring quantification in at least 70% of the samples in each group. Proteins were considered differentially expressed if p < 0.05. Results: Following Tobradex® intervention, 27 proteins were upregulated while 61 proteins were downregulated. Regulated proteins after Tobradex® treatment were involved in intermediate filament cytoskeleton organization including downregulation of the plakin proteins envoplakin, epiplakin and periplakin. Plectin, a protein of the plakin family, remained unchanged after Tobradex® therapy. Tobradex® treatment resulted in the regulation of proteins involved in translation including a cluster of downregulated ribosomal proteins. Tobradex® intervention was associated with the regulation of proteins involved in fructose metabolism and glycolytic processes including fructose‐1.6‐bisphosphatase 1, fructose‐bisphosphate aldolases A and B, pyruvate kinase PKM and transketolase. Ig lambda chain V‐I region, prominin‐1, and protein Niban were upregulated after Tobradex® treatment. Conclusions: Tobradex treatment reversed the expression of plakin proteins in anterior blepharitis. Topical solutions which inhibit the expression of plakin proteins may have the potential to restore the ocular surface integrity in anterior blepharitis and should be explored further. [ABSTRACT FROM AUTHOR]

A novel research objective is to identify new molecules in more readily accessible biological fluids that could be used in the diagnosis of multiple sclerosis (MS) and other demyelinating disorders. To compare the level of selected cytokines in tears between patients with MS or other demyelinating disorder and healthy controls. 84 patients with diagnosed MS during remission or with other demyelinating disease of the CNS and 70 healthy controls were enrolled in the study. Tears were collected without any stimulation and stored till the day of assessment. The concentration of selected cytokines was measured by the Bio-Plex Pro Human cytokine screening panel 27 cytokines assay according to the manufacturer's instructions. Statistical analysis was performed with Statistica 13. IL-1b level was significantly lower in the study group compared to the control group [3,6 vs 8.71, p < 0.001]. The same pattern was observed for IL-6 [3,1 vs 5.26, p = 0.027] and IL-10 [1,7 vs 10.92, p < 0.001] (Table 1). In the study group, IL-1RA (p = 0.015), IL-5 (p = 0.04), IL-9 (p = 0.014), and IL-15 (p = 0.037) showed significant correlations with age. In the total sample, IL-1Ra (p = 0.016) and IFN-g (p = 0.041) were significantly correlated with age, while in the control group, IL-8 (p = 0.09), MIP-1a (p = 0.009), and RANTES (p = 0.031) showed significant correlations. Our results show that MS and other demyelination diseases lead to decrease in the overall level of cytokines in tears. Further research is needed to determine the role of tear fluid in the assessment of demyelinating disorders like MS. [ABSTRACT FROM AUTHOR]

Background: Dry eye disease (DED) stands out as one of the most common eye conditions encountered in clinical settings. This study aimed to determine the diagnostic ability and feasibility of post-blink blur time (PBBT) in detecting patients with DED symptoms. Methods: The study included 200 subjects, 100 with and 100 without DED symptoms defined by the Schein questionnaire, who underwent assessment of DED signs [visual acuity, PBBT, conjunctival hyperemia, lid-parallel conjunctival folds—LIPCOF, tear film break-up time—TBUT, fluorescein corneal staining, and meibum score]. Results: DED subjects had a lower PBBT than controls (p < 0.001), with subjective (6 (1–45) s vs. 8 (1–70) s) and objective (6 (2–33) s vs. 8 (2–50) s) PBBT measurements being similar between repeats. The correlations between subjective and objective PBBT measurements were significantly positive (R = 0.873, p < 0.001). Subjective PBBT was negatively related to the Schein questionnaire (R = −0.217, p = 0.002), conjunctival hyperemia (R = −0.105, p = 0.035), and corneal staining (R = −0.153, p = 0.031), while positively related to the TBUT (R = 0.382, p < 0.001) and meibum score (R = 0.106, p = 0.033). Logistic regression analysis showed DED symptoms were significantly associated with subjective PBBT (AOR 0.91, p = 0.001), TBUT (AOR 0.79, p < 0.001), meibum score (AOR 0.65, p = 0.008), LIPCOF (AOR 1.18, p = 0.002) and corneal staining (AOR 1.14, p = 0.028). Conclusions: Subjective self-reported PBBT is a reliable and non-invasive screening test for evaluating time-wise changes in visual acuity and detecting a tear film dysfunction. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The lacrimal gland is crucial for maintaining ocular health by producing the aqueous component of the tear film, which hydrates and nourishes the ocular surface. Decreased production of this component results in dry eye disease, a condition affecting over 250 million people worldwide. However, the scarcity of primary human material for studying its underlying mechanisms and the absence of a cell model for human lacrimal gland epithelial cells present significant challenges. Here, we describe the generation of immortalized human lacrimal gland cell lines through the introduction of an SV40 antigen. We successfully isolated and characterized three cell clones from a female lacrimal gland donor, confirming their epithelial identity through genomic and protein analyses, including PCR, RNAseq, immunofluorescence and cultivation in a 3D spheroid model. Our findings represent a significant advancement, providing improved accessibility to investigate the molecular pathogenesis mechanisms of dry eye disease and potential therapeutic interventions. We identified the expression of typical epithelial cell marker genes and demonstrated the cells' capability to form 2D cell sheets and 3D spheroids. This establishment of immortalized human lacrimal gland cells with epithelial characteristics holds promise for future comprehensive studies, contributing to a deeper understanding of dry eye disease and its cellular mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the role of vitamin D3 supplementation in treating non-Sjogren dry eye (NSDE) patients compared to the conventional treatment with artificial tears. Study Design: Non-randomized controlled Trial. Place and duration of study: Rural Health Centre (RHC) Buchaal Kalan from September 2021 to July 2022 Methods: This study allocated 108 patients with NSDE and hypovitaminosis D via two-arm parallel assignment. The sample was divided into two groups by non-probability purposive sampling. Group 1 received conventional treatment as artificial tears 4 times/day and group 2 was given oral vitamin D3 supplementation of 6000 IU daily along with artificial tears for a period of 90 days. The impact of oral vitamin D3 supplementation on NSDE was assessed by comparing means of ocular parameters of both groups over time. Tear break-up time (TBUT) in seconds and Schirmer's test (ST) score in millimeters were primary outcome measures. The ocular surface disease index (OSDI) score and numerical pain rating scale (NPRS) were secondary outcome measures. Results: The mean age of patients in group 1 and group 2 was 34.98±8.64 and 34.87±8.79 respectively. Similarly, the mean serum 25 (OH) D level was 15.03±3.27 in group 1 and 14.93±3.26 in group 2. Results showed that OSDI and NPRS scores were decreased in both groups, however, TBUT and ST scores were improved in group 2. Conclusion: Oral vitamin D3 supplementation may serve as a new treatment option for NSDE patients having hypovitaminosis D. [ABSTRACT FROM AUTHOR]

The ocular surface system interacts with, reacts with, and adapts to the daily continuous insults, trauma, and stimuli caused by direct exposure to the atmosphere and environment. Several tissue and para-inflammatory mechanisms interact to guarantee such an ultimate function, hence maintaining its healthy homeostatic equilibrium. Evaporation seriously affects the homeostasis of the system, thereby becoming a critical trigger in the pathogenesis of the vicious cycle of dry eye disease (DED). Tear film lipid composition, distribution, spreading, and efficiency are crucial factors in controlling water evaporation, and are involved in the onset of the hyperosmolar and inflammatory cascades of DED. The structure of tear film lipids, and subsequently the tear film, have a considerable impact on tears' properties and main functions, leading to a peculiar clinical picture and specific management. [ABSTRACT FROM AUTHOR]

The aim of this study was to see whether well-regulated Type-2 diabetes mellitus (DM) under than 10 years impacted meibography and tear film break-up time. DM (n=45) and normal subjects (n=45) were recruited. Two years' mean glycated hemoglobin data were calculated as the regulation indicator. Eye examination followed by noninvasive tear break-up time (NTBUT) measurement and then meibography were conducted. Regression analyses corrected for age and gender were used for comparisons between groups. Pearson correlation analysis was used to examine the linear relationship between NTBUT and meibomian gland loss to mean glycated hemoglobin. A value of p<0.05 was considered statistically significant. The meiboscale comparisons within groups did not show any statistical difference. The mean meibomian gland loss comparisons between groups for the right lower eyelid (r=0.017, p=0.69), right upper eyelid (r=0.04 p=0.24), left lower eyelid (r=0.009, p=0.68) and left upper eyelid (r=0.027, p=0.13) were all similar. NTBUT for right and left eye were similar between groups (p=0.69 and p=0.36 respectively). Pearson's correlation did not show any significant correlation between glycated hemoglobin, NTBUT and gland loss. In conclusion, it was found that patients with less than 10-year disease duration under DM regulation had similar ocular surfaces to normal subjects. [ABSTRACT FROM AUTHOR]

Margery Kempe is an intriguing figure in medieval England. Following a dramatic conversion experience, Kempe feels called to conform her life to that of Christ. This illiterate wife and mother of fourteen senses God's desire for her to (pay scribes to) put her extraordinary religious encounters on paper. The Book of Margery Kempe becomes the first autobiography written in the English language. While Kempe's Book has received scholarly interest for its record of a middle-class woman's lived experience, it has been largely neglected from theological investigation—due, in part, to Kempe's unseemly devotional style. Known for her copious tears and bouts of loud sobbing, Kempe did not conform to the devotio moderna of her day. The present article will introduce The Book and address the heightened emotion so particular to this author. It will, finally, point to anointed aspects of Kempe's experience meriting a pentecostal designation. [ABSTRACT FROM AUTHOR]

The article explores cross-modal iconic relations in nine diverse Western-music songs ranging from 1600 to 2015, all of them thematizing dysphoric weeping. Initial input comes from five recurrent features observed in ancient Greek texts associated with performative events, including the prominence of sound, interjections and strong self-referentiality, repetitions and refrains, the motif of endlessness, and tears associated with streams of water, dew, and libation liquids. The analysis adopts Peirce's conceptual distinction between image, diagram, and metaphor iconicity, although the continuum reading proposed by several scholars is ultimately favored. The sample turns out to offer plenty of evidence of iconic relations. Interjections, falsetto, verbal repetitions, musical repetitions, musical rendering of sighs and endlessness, ostinato patterns, downward notes, and water images (rain and rivers), all of this is shown to substantiate cross-modal iconicity encompassing weeping, lyrics, music (including musical notation), and images, in different combinations. Quantitative investigations confirming/disconfirming and adding iconicity patterns, and comparative analyses linking Western and non-Western lament traditions constitute desiderata for future work. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the related research progress of ocular complications (OCs) caused by type 2 diabetes mellitus (T2DM), tear and tarsal function, and the application of deep learning (DL) in the diagnosis of diabetes and OCs caused by it, to provide reference for the prevention and control of OCs in T2DM patients. This study reviewed the pathogenesis and treatment of diabetes retinopathy, keratopathy, dry eye disease, glaucoma, and cataract, analyzed the relationship between OCs and tear function and tarsal function, and discussed the application value of DL in the diagnosis of diabetes and OCs. Diabetes retinopathy is related to hyperglycemia, angiogenic factors, oxidative stress, hypertension, hyperlipidemia, and other factors. The increase in water content in the corneal stroma leads to corneal relaxation, loss of transparency, and elasticity, and can lead to the occurrence of corneal lesions. Dry eye syndrome is related to abnormal stability of the tear film and imbalance in neural and immune regulation. Elevated intraocular pressure, inflammatory reactions, atrophy of the optic nerve head, and damage to optic nerve fibers are the causes of glaucoma. Cataract is a common eye disease in the elderly, which is a visual disorder caused by lens opacity. Oxidative stress is an important factor in the occurrence of cataracts. In clinical practice, blood sugar control, laser therapy, and drug therapy are used to control the above eye complications. The function of tear and tarsal plate will be affected by eye diseases. Retinopathy and dry eye disease caused by diabetes will cause dysfunction of tear and tarsal plate, which will affect the eye function of patients. Furthermore, DL can automatically diagnose and classify eye diseases, automatically analyze fundus images, and accurately diagnose diabetes retinopathy, macular degeneration, and other diseases by analyzing and processing eye images and data. The treatment of T2DM is difficult and prone to OCs, which seriously threatens the normal life of patients. The occurrence of OCs is closely related to abnormal tear and tarsal function. Based on DL, clinical diagnosis and treatment of diabetes and its OCs can be carried out, which has positive application value.

The article aims to study the tears within Horace’s Satires, or in other words, in a genre that has its identity gesture in the opposite laughter. Such an investigation, supported by the tools of the pragmatics of human communication and linguistic and stylistic analysis, shows how the poet integrated tears into his satirical work. The analysis concerns the presence, contexts, functions, effects, and linguistic expressions used in describing the crying gesture with considerations also on their register.

Background/Objectives: In this study, we aimed to analyze the changes in the expression profiles of selected messenger RNAs (mRNAs) and their encoded proteins in the tears of patients undergoing photorefractive keratectomy (PRK), femtosecond-assisted laser in situ keratomileusis (FS-LASIK), and small-incision lenticule extraction (SMILE) procedures. Methods: A total of 120 patients were divided into three groups based on the laser vision correction (LVC) procedure: PRK, FS-LASIK, or SMILE. Tear samples were collected preoperatively and at 1, 7, 30, and 180 days postoperatively. The expression levels of selected messenger RNAs (mRNAs) and proteins were analyzed by using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA), respectively. Results: PRK and FS-LASIK elicited significantly stronger biological responses than SMILE. Interleukin-15 (IL-15) expression increased notably in the PRK and FS-LASIK groups, with mRNA levels reaching fold changes of 4.65 ± 0.65 and 4.99 ± 0.28, respectively, on day 1, compared with only 2.09 ± 0.23 in the SMILE group. Vascular endothelial growth factor A (VEGFA) levels were also elevated in the PRK (2.98 ± 0.23 fold change) and FS-LASIK groups (3.45 ± 1.09 fold change) on day 1, while the SMILE group showed minimal fluctuations. The protein concentration analysis based on the ELISA confirmed these trends, with IL-15 levels peaking at 54.2 ± 2.5 pg/mL in the PRK group and 52.8 ± 3.1 pg/mL in the FS-LASIK group, compared with 32.4 ± 1.9 pg/mL in the SMILE group on day 1. Similarly, VEGFA protein concentrations were the highest in the PRK (72.4 ± 4.1 pg/mL) and FS-LASIK patients (69.5 ± 3.8 pg/mL) on day 1 but remained low in the SMILE patients (45.6 ± 2.3 pg/mL). By day 180, gene expression and protein levels in all groups had stabilized, returning to near-preoperative values. Conclusions: PRK and FS-LASIK induced more pronounced molecular and protein-level changes during corneal wound healing than the less invasive SMILE procedure, indicating stronger biological responses. These findings suggest that tailored postoperative care based on the specific procedure could optimize healing and patient outcomes. However, further research with larger sample sizes and longer follow-ups is needed to confirm these observations and develop personalized treatment strategies.

Purpose: To estimate the roles of extracellular vesicles (EVs) in tears and to determine whether their profiles are associated with the type of ocular disease. Study design: Cross-sectional study. Methods: Tear EVs were extracted from 14 healthy participants and from 21 patients with retinal diseases (age-related macular degeneration [AMD] or diabetic macular edema [DME]). The surface marker expression of tear EVs was examined, and microRNAs (miRNAs) were extracted and profiled by use of real-time PCR array. The stability of the expression of the miRNAs was determined, and their functions were assessed by network analyses. Classification accuracy was evaluated by use of a random forest classifier and k-fold cross-validation. Results: The miRNAs that were highly expressed in tear EVs were miR-323-3p, miR-548a-3p, and miR-516a-5p. The most stably expressed miRNAs independent of diseases were miR-520h and miR-146b-3p. The primary networks of the highly stably expressed endogenous miRNAs were annotated as regulation of organismal injury and abnormalities. The highly expressed miRNAs for severe retinal disease were miR-151-5p for AMD and miR-422a for DME, suggesting potential roles of tear EVs in liquid biopsy. Nine miRNAs (miR-25, miR-30d, miR-125b, miR-132, miR-150, miR-184, miR-342-3p, miR-378, and miR-518b) were identified as distinguishing individuals with AMD from healthy individuals with a classification accuracy of 91.9%. Conclusions: The finding that tear EVs contain characteristic miRNA species indicates that they may help in maintaining homeostasis and serve as a potential tool for disease diagnosis. [ABSTRACT FROM AUTHOR]

To assess the relationship between tear inflammatory cytokine ratios (CRs) and signs and symptoms of dry eye disease (DED) to investigate the possible use of tear CRs, which may better address the complexity of cytokine interactions than absolute cytokine levels, as a DED biomarker. Tear concentrations of IL-1b, IL-6, IL-8, IL-10, IL-17A, IFN-g, and TNF-a were measured using standardized procedures, as were DED signs (corneal and conjunctival staining scores, tear break-up time, Schirmer test, Meibomian gland plugging, tear osmolarity, composite sign severity score) and symptoms [Ocular Surface Disease Index (OSDI)]. Ratios between pro-inflammatory (IL-1b, IL-8, IL-17A, IFN-g, and TNF-a) and anti-inflammatory (IL-10) cytokines were calculated. Given its opposing roles in inflammation, IL-6 was tested as both a pro- and anti-inflammatory cytokine. Correlations between CR and DED symptoms and signs were calculated using Spearman correlation coefficients (rho). At baseline, 131 patients, 80.2% female and mean age 54.2 years (SD 14.1, range 20–82), from 10 sites of the Dry Eye Assessment and Management study had sufficient tear volumes ≥4 μL for analysis. IL-6:IL-10, IL-8:IL-10, and TNF-a:IL-10 had some significant correlations, mostly with conjunctival or corneal staining or the composite sign severity score (IL-8:IL-10 and conjunctival staining: rho = 0.19, p = 0.03; IL-6:IL-10 and corneal staining: rho = 0.31, p < 0.001; IL-8:IL-10 and corneal staining: rho = 0.21, p = 0.01; IL-6:IL-10 and composite sign severity score: rho = 0.26, p = 0.003; IL-8:IL-10 and composite sign severity score: rho = 0.26, p = 0.003; TNF-a:IL-10 and corneal staining: rho = 0.29, p < 0.001; TNF-a:IL-10 and Schirmer test: rho = −0.23, p = 0.009). CRs had no significant correlation with DED symptoms. All significant correlations using IL-6 in the denominator (anti-inflammatory) produced counterintuitive results based on clinical understanding of the disease. Pro- to anti-inflammatory CR was weakly correlated with some DED signs and not with symptoms, as measured by OSDI. Future studies in different dry eye populations are needed and should address sampling biases and tear collection techniques. [ABSTRACT FROM AUTHOR]

Purpose: To detect the viral RNA load of SARS-CoV-2 in conjunctival swabs of COVID-19 patients, and compare with nasopharyngeal swabs. Methods: Conjunctival swabs of COVID-19 patients (with PCR positive nasopharyngeal swabs) were subjected to quantitative reverse transcription–polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2 RNA. The cycle threshold (Ct) values of Open Reading Frame 1 (ORF 1 Ab gene) and nucleoprotein (N gene) PCRs were used to assess the viral RNA load, and compare them with the baseline values of nasopharyngeal swabs. Results: Of 93 patients, 17 (18.27%) demonstrated SARS-CoV-2 RNA in conjunctival swabs. Baseline nasopharyngeal swabs were collected at a median of 2 days; while, the conjunctival swabs were collected at median 7 days, from onset of illness (p < 0.001). Despite a significant delay in conjunctival swab collection than nasopharyngeal swabs, the Ct values (ORF or N gene PCRs) were comparable between nasopharyngeal swab and conjunctival swab samples. Subsequently, during the recovery period, in four of these 17 patients (with conjunctival swab positivity), when the second nasopharyngeal swab was ‘negative’, the conjunctival swab was ‘positive’. Conclusion: The conjunctival swabs demonstrated SARS-CoV-2 RNA in 17 (18.27%) of 93 COVID-19 patients. Our results may suggest a delayed or a prolonged shedding of the virus/viral RNA on the ocular surface than in nasopharyngeal mucosa. [ABSTRACT FROM AUTHOR]

In this article, I explore the rhetorical deployment of White tears, tears that are circulated within narratives of interracial conflict as evidence for the rightness of White supremacist norms. More specifically, White tears are those that are framed as deictic indicators of a White victim versus a Black, Indigenous, people of color (BIPOC) threat. These presumed relations of cause and effect are made possible within an emotional context that assumes a baseline White rationality as the norm; distress signals the threat of non-White aggression. Analysis of several prominent cases of crying demonstrates how tears can be marshaled as evidence for the legitimacy of White bodies at the expense of those of color. Although considering the rhetorical force of affect and emotion is important for critical rhetorical analyses, such work needs to contend with how scripts for emotional engagement are already inclined toward or against certain bodies. It then becomes possible to develop alternative, subversive framings. [ABSTRACT FROM AUTHOR]

Sjögren's Disease (SjD) is an autoimmune disorder associated with decreased saliva and/or tear secretions, resulting in patients reporting dryness in the mouth and eyes. Serum autoantibodies directed against the Ro60/SS-A and La/SS-B autoantigens are a distinctive feature of the disease. Analysis of the saliva and tear proteomes represents one promising alternative method of both classifying and monitoring the condition, and research into salivary and tear proteomics in patients with SjD, with and without sicca, has shown its efficacy and practicality in both clinical and research settings. Studies analyzing the saliva proteomics of SjD patients have generally shown an overexpression of proteins involved in T-cell activation, the immune response, β-2 microglobulin, and the recruitment of pro-inflammatory agents. These studies also show a decrease in or downregulation of proteins involved in salivary secretion. Studies analyzing the tear proteomics of patients with SjD have generally indicated an upregulation of proteins involved with TNF-α signaling, B-cell survival, and the recruitment of pro-inflammatory agents. Studies also note the differential expression of tear protein folding as a hallmark of ocular involvement in this condition. These findings help to elucidate the biochemical relationship between the proteomes of saliva/tear fluids and the general pathophysiology of the gland involved with the pathogenesis of this condition, giving further credence to the potential role of salivary and tear proteomics in the future of diagnosis and treatment for patients with SjD. [ABSTRACT FROM AUTHOR]

Abstract Background To evaluate the efficacy of 1% and 2% rebamipide clear solution in the treatment of dry eye disease (DED). Methods Two hundred twenty patients with DED were randomly assigned to one of three groups: the 1% rebamipide, 2% rebamipide, or placebo (eye drops containing the same ingredients, except for the active components). Each eye drop was instilled four times daily for 12 weeks. Changes in tear film break-up time (TBUT), corneal and conjunctival staining score, Schirmer 1 test, and the Ocular Surface Disease Index (OSDI) from baseline to 12-week visit between the study groups were compared for efficacy assessment. Results The mean age of study patients was 43.8±14.2 years. The 1% and 2% rebamipide groups showed greater improvement in TBUT (1.99±1.87 and 2.02±2.21 s) at 12 weeks from baseline than the placebo group (1.25±2.93 s). The 2% rebamipide group showed greater improvement in the corneal staining score (− 3.15±2.00) at 12 weeks from baseline than the placebo group (− 2.85±1.80). The 1% and 2% rebamipide groups showed improvement in Schirmer 1 test (1.27±3.86 and 1.50±4.14 mm) at 12 weeks of treatment, but not the placebo group (0.55±2.99 mm). Both the rebamipide groups and the placebo group showed significantly improved OSDI after treatment for 12 weeks; however, there was no significant difference among the three groups. Conclusions 1% and 2% rebamipide clear solutions are an effective therapeutic option for improving TBUT and tear volume, and stabilizing the corneal staining score in DED.

Abstract Purpose Due to technological advancements, surgical invasiveness has been reduced. However, cataract surgery has been implicated in causing postoperative inflammation, including dry eye syndrome. The innate immune system may be involved in postoperative inflammation, and complement activation could potentially play a crucial role in defense against pathogens, homeostasis, and wound healing. To investigate changes in the tear film complement activation products (CAPs) and ocular surface after vitrectomy combined with cataract surgery. Methods Forty-three patients (23 women; median age, 69 years) were enrolled in this prospective study and underwent phacoemulsification and vitrectomy. We measured Schirmer's test (ST) and CAPs in the tears at baseline (the day before surgery), 4 days and 1 month after the surgery. Tears were collected in microtubes. The CAPs in the tear fluid were analyzed by cytometric bead array. Results The median ST (8.5 mm) at baseline increased to 16 mm at 4 days ( P 10 mm, n = 21) based on the preoperative ST values. At 1 month postoperatively, the C3a levels were 2194 pg/ml in the preoperative short ST group and 1391 pg/ml in the long ST group, with significantly higher C3a concentrations in the short ST group (P

This observational study aimed to evaluate the use of a single portable device to assess the non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer patterns (LLP) in young females with refractive errors (REs). The study was conducted at the College of Applied Medical Science (Female campus), Riyadh, Saudi Arabia between January 5, 2021 to May 15, 2021. Forty young females, with mean age of 23.0± 4.3 years with REs (2.53 ± 2.05 D) and 40 females, mean age 23.8± 4.5 years with healthy eyes were recruited. The tests were administered in the following order: Ocular Surface Disease Index (OSDI), followed by NITBUT, TMH, and LLP. Significant differences (via Mann–Whitney U test) were noted in the median ocular surface disease index (OSDI; p

Mucosal antibodies play a key role in protection against breakthrough COVID‐19 infections and emerging viral variants. Intramuscular adenovirus‐based vaccination (Vaxzevria) only weakly induces nasal IgG and IgA responses, unless vaccinees have been previously infected. However, little is known about how Vaxzevria vaccination impacts the ability of mucosal antibodies to induce Fc responses, particularly against SARS‐CoV‐2 variants of concern (VoCs). Here, we profiled paired mucosal (saliva, tears) and plasma antibodies from COVID‐19 vaccinated only vaccinees (uninfected, vaccinated) and COVID‐19 recovered vaccinees (COVID‐19 recovered, vaccinated) who both received Vaxzevria vaccines. SARS‐CoV‐2 ancestral‐specific IgG antibodies capable of engaging FcγR3a were significantly higher in the mucosal samples of COVID‐19 recovered Vaxzevria vaccinees in comparison with vaccinated only vaccinees. However, when IgG and FcγR3a engaging antibodies were tested against a panel of SARS‐CoV‐2 VoCs, the responses were ancestral‐centric with weaker recognition of Omicron strains observed. In contrast, salivary IgA, but not plasma IgA, from Vaxzevria vaccinees displayed broad cross‐reactivity across all SARS‐CoV‐2 VoCs tested. Our data highlight that while intramuscular Vaxzevria vaccination can enhance mucosal antibodies responses in COVID‐19 recovered vaccinees, restrictions by ancestral‐centric bias may have implications for COVID‐19 protection. However, highly cross‐reactive mucosal IgA could be key in addressing these gaps in mucosal immunity and may be an important focus of future SARS‐CoV‐2 vaccine development. [ABSTRACT FROM AUTHOR]

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Diabetes mellitus (DM) is a chronic metabolic condition characterized by high blood glucose levels owing to decreased insulin production or sensitivity. Current diagnostic approaches for gestational diabetes entail intrusive blood tests, which are painful and impractical for regular monitoring. Additionally, typical blood glucose monitoring systems are restricted in their measurement frequency and need finger pricks for blood samples. This research study focuses on the development of a non-invasive, real-time glucose monitoring method based on the detection of glucose in human tears and finger blood using mid-infrared (IR) spectroscopy. The proposed solution combines a fuzzy logic-based calibration mechanism with an IR sensor and Arduino controller. This calibration technique increases the accuracy of non-invasive glucose testing based on MID absorbance in fingertips and human tears. The data demonstrate that our device has high accuracy and reliability, with an error rate of less than 3%, according to the EGA. Out of 360 measurements, 97.5% fell into zone A, 2.2% into zone B, and 0.3% into zone C of the Clarke Error Grid. This suggests that our device can give clinically precise and acceptable estimates of blood glucose levels without inflicting any harm or discomfort on the user. [ABSTRACT FROM AUTHOR]

Introduction: Although uncommon, incomplete capsulotomy, anterior capsule tags and anterior capsule tears are still encountered during femtosecond laser-assisted cataract surgery (FLACS), resulting in surgical complications. This highlights the need to improve femtosecond laser-assisted capsulotomy technique to reduce capsulotomy-related complications. Therefore, the purpose of this study was to investigate the efficacy of a newly developed, modified technique of setting capsulotomy irradiation thickness in lowering the incidence of capsulotomy-related complications in FLACS. Methods: This open-label prospective, comparative cohort study included 440 eyes (220 patients) treated with FLACS using the LenSx laser system (Alcon Laboratories, Inc. Fort Worth, TX, USA). Varying capsulotomy irradiation thicknesses were applied in each eye of the same patient. In Group 1, capsulotomy irradiation thickness was set between the upper edge of the highest point of the anterior capsule and the lower edge of the lowest point of the anterior capsule (modified technique). In Group 2, this was set between the center of the highest point of the anterior capsule and the center of the lowest part of the anterior capsule (conventional technique). Incidence rates of incomplete capsulotomy, anterior capsule tags and tears, and posterior capsule tears were compared. Results: Preoperative baseline characteristics showed no significant differences. Mean total of the irradiation thicknesses was 877.1 ± 81.9 µm in Group 1 and 808.9 ± 80.0 in Group 2, with a statistically significant difference (P < 0.001). Incidences of incomplete capsulotomy were 1.8% and 7.7%, anterior capsule tags were 2.3% and 8.6%, and anterior capsule tears were 0% and 3.2% in Groups 1 and 2, respectively. These differences were statistically significant (P = 0.006, 0.005, and 0.015, respectively). No posterior capsule tears were reported in either group. Conclusion: The modified technique for capsulotomy in FLACS may significantly reduce the occurrence of capsulotomy-related complications, maximizing the benefits of FLACS. [ABSTRACT FROM AUTHOR]

The book of Jeremiah contains metaphors depicting Israel and Zion as a woman. These include the city as a mourning woman (4:19–21; 10:20). Real mourning women are addressed in Jer 9:17–22, following laments variously attributed to Jeremiah and/or Yahweh (8:18–9:2, 10). Working with the (MT) canonical form and engaging the insights of trauma studies, this article traces linguistic and thematic connections between the two passages before tracing similar connections to Rachel's lament (Jer 31). The mourning women in Jer 9 serve a societal role by giving voice to lament; this effective power is affirmed by trauma studies. When read alongside the lament by Jeremiah and/or Yahweh, this article notes the women also take up a prophetic role as with Jeremiah they embody and express Yahweh's own pathos. In ch. 31, the mourning women are metaphorically instantiated in the eponymous mother who also voices Yahweh's pathos yet remains uncomforted. This study points to the hope that arises from Yahweh's identification with his people in the pathos expressed by prophet, mourning women, and Rachel. Ultimately, Yahweh's identification with his people, and his words of hope offer comfort to unrequited lament. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the ocular surface inflammation in patients with primary open angle glaucoma and ocular hypertension by analyzing tears and to compare findings with healthy controls. Methods: Observational case–control study. Tear samples were collected by 5 µl microcapillary tube from 24 patients with glaucoma treated by antiglaucoma drops, 9 non-treated patients with ocular hypertension and 45 healthy controls. Tears were analyzed from right eye by multiplex Bio-Plex system for the presence of 6 cytokines: IL1β, IL10, IL4, IFNγ, MIF and VEGF. Results: Significantly higher concentrations of IL1β and IL10 (glaucoma or ocular hypertension vs. healthy controls, p < 0.0001), VEGF (glaucoma vs. ocular hypertension, p < 0.05; ocular hypertension vs. healthy controls, p < 0.02) and MIF (glaucoma vs. healthy controls, p < 0.03) were detected in patients' tears. Both patient groups have activated to a significantly lower extent the Th1 pathway represented by IFNγ than Th2 pathway represented by IL10 (p < 0.001) and, at the same time, the IFNγ/IL4 ratio was significantly increased in healthy controls (p < 0.001) and patients with ocular hypertension (p < 0.02) compared to glaucoma individuals. Conclusion: This study shows that secretion of inflammation-related cytokines by conjunctival cells is increased in both, glaucoma and ocular hypertension patients and can be detected in their tears. Nevertheless, data indicates stronger ocular surface inflammation in non-treated follow-up patients diagnosed with ocular hypertension than in glaucoma subjects treated by antiglaucoma drops. [ABSTRACT FROM AUTHOR]

Dryness symptoms in soft contact lens (SCL) wearers are common, especially at the end of the day, and are the most common reason for discontinuing wear. With reference to mechanisms for dry eye syndromes in non-SCL wearers, this review examines mechanisms whereby dryness symptoms are generated during SCL wear, including the significance of endogenous tear dysfunctions, pre-lens tear film instability, post-lens tear film volumes and stagnation, tear hyperosmolarity, blink inefficiency, SCL material dehydration, and front surface biocompatibility and wetness. Numerous efforts have been made to reduce dryness symptoms by improving SCL materials and surfaces, but the prevalence of dryness symptoms remains stubbornly high. It is possible that symptoms might be due to neuropathy and associated increases in corneal and/or lid wiper sensitivity that develops during SCL wear. For example, over time, sensory thresholds for SCL awareness may be lowered and/or conditions that increase their perception sharpened. There are several mechanisms contributing to thinner pre-lens tear films and reduced SCL biocompatibility. Dryness symptoms may occur with bandage SCL, especially in a previous wearer of SCL. [ABSTRACT FROM AUTHOR]

Human emotional tears are a powerful socio-emotional signal. Yet, they have received relatively little attention in empirical research compared to facial expressions or body posture. While humans are highly sensitive to others’ tears, to date, no automatic means exist for detecting spontaneous weeping. This article employed facial and postural features extracted using four pre-trained classifiers (FACET, Affdex, OpenFace, OpenPose) to train a Support Vector Machine (SVM) to distinguish spontaneous weepers from non-weepers. Results showed that weeping can be accurately inferred from nonverbal behavior. Importantly, this distinction can be made before the appearance of visible tears on the face. However, features from at least two classifiers need to be combined, with the best models blending three or four classifiers to achieve near-perfect performance (97% accuracy). We discuss how direct and indirect tear detection methods may help to yield important new insights into the antecedents and consequences of emotional tears and how affective computing could benefit from the ability to recognize and respond to this uniquely human signal. [ABSTRACT FROM AUTHOR]

Pioneering Pakistani female journalist Zeb-un-Nissa Hamidullah in her 'Between ourselves: a weekly feature for women' columns, which appeared in Karachi's English-language daily newspaper Dawn during the late 1940s and early 1950s, encouraged her readers to stretch rather than breach the boundaries in how (educated) Pakistani women—as 'good wives and wise mothers'—should fulfil their familial (and wider social) responsibilities. Her advice—which often took the form of 'homespun' homilies—consistently flagged up the crucial role of women, whose duties included not simply overseeing their children's behaviour but teaching their offspring, through their own emotional responses, how to feel. In their capacity as mothers, women needed to exercise sabr (patience and perseverance) when providing all-important emotional training for future Pakistani citizens who—like the state—were still in the process of being made. Accordingly, this article discusses the spatially defined context in which 'Between ourselves' appeared—that is, Dawn itself and the fast-expanding city of Karachi which was rife with uncertainties—before turning to the emotional 'good practice' that Hamidullah promoted. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is an age-related progressive neurodegenerative brain disorder that represents the most common type of dementia. It poses a significant diagnostic challenge that requires timely recognition and treatment. Currently, there is no effective therapy for AD; however, certain medications may slow down its progression. The discovery of AD biomarkers, namely, magnetic resonance imaging, positron emission tomography and cerebrospinal fluid molecules (amyloid-β and tau) has advanced our understanding of this disease and has been crucial for identifying early neuropathologic changes prior to clinical changes and cognitive decline. The close interrelationship between the eye and the brain suggests that tears could be an interesting source of biomarkers for AD; however, studies in this area are limited. The identification of biomarkers in tears will enable the development of cost-effective, non-invasive methods of screening, diagnosis and disease monitoring. In order to use tears as a standard method for early and non-invasive diagnosis of AD, future studies need to be conducted on a larger scale. [ABSTRACT FROM AUTHOR]

Abstract Background Surgical glue has been used in several body tissues, including perineal repair, and can benefit women. Objectives To evaluate the effectiveness of n-butyl-2-cyanoacrylate surgical glue compared to the polyglactin 910 suture in repairing first- and second-degree perineal tears and episiotomy in vaginal births. Design A parallel randomised controlled open trial. Setting Birth centre in Itapecerica da Serra, São Paulo, Brazil. Participants and methods The participants were 140 postpartum women allocated into four groups: two experimental groups repaired with surgical glue (n = 35 women with a first-degree tear; n = 35 women with a second-degree tear or episiotomy); two control groups sutured with thread (n = 35 women with a first-degree tear; n = 35 women with a second-degree tear or episiotomy). The outcomes were perineal pain and the healing process. Data collection was conducted in six stages: (1) up to 2 h after perineal repair; (2) from 12 to 24 h postpartum; (3) from 36 to 48 h; (4) from 10 to 20 days; (5) from 50 to 70 days; and (6) from 6 to 8 months. ANOVA, Student's t, Monte Carlo, x-square and Wald tests were used for the statistical analysis. Results One hundred forty women participated in the first three stages, 110 in stage 4, 122 in stage 5, and 54 in stage 6. The women treated with surgical glue had less perineal pain (p ≤ 0.001). There was no difference in the healing process, but the CG obtained a better result in the coaptation item (p ≤ 0.001). Conclusions Perineal repair with surgical glue has low pain intensity and results in a healing process similar to suture threads. Trial registration Brazilian Registry of Clinical Trials (UTN code: U1111-1184-2507; RBR-2q5wy8o); date of registration 01/25/2018; www.ensaiosclinicos.gov.br/rg/RBR-2q5wy8/

The lacrimal gland is crucial for maintaining ocular health by producing the aqueous component of the tear film, which hydrates and nourishes the ocular surface. Decreased production of this component results in dry eye disease, a condition affecting over 250 million people worldwide. However, the scarcity of primary human material for studying its underlying mechanisms and the absence of a cell model for human lacrimal gland epithelial cells present significant challenges. Here, we describe the generation of immortalized human lacrimal gland cell lines through the introduction of an SV40 antigen. We successfully isolated and characterized three cell clones from a female lacrimal gland donor, confirming their epithelial identity through genomic and protein analyses, including PCR, RNAseq, immunofluorescence and cultivation in a 3D spheroid model. Our findings represent a significant advancement, providing improved accessibility to investigate the molecular pathogenesis mechanisms of dry eye disease and potential therapeutic interventions. We identified the expression of typical epithelial cell marker genes and demonstrated the cells’ capability to form 2D cell sheets and 3D spheroids. This establishment of immortalized human lacrimal gland cells with epithelial characteristics holds promise for future comprehensive studies, contributing to a deeper understanding of dry eye disease and its cellular mechanisms.

Key Clinical Message Hemolacria can occur on the basis of a psychiatric disorder without an organic cause. However, this should be a diagnosis of exclusion. Treatment of the underlying psychiatric illness may relieve this condition. Abstract A 24‐year‐old man presented with the chief complaint of bloody tears, which began 4 months earlier after commencing mandatory military service. He had no underlying diseases, and all work‐ups returned normal, though a microscopic examination confirmed red blood cells. He was diagnosed with hemolacria secondary to generalized anxiety disorder and major depressive disorder, responding to propranolol and sertraline. Hemolacria was totally cured after 6 months of treating the underlying psychiatric illness.

Background: To evaluate the efficacy of 1% and 2% rebamipide clear solution in the treatment of dry eye disease (DED). Methods: Two hundred twenty patients with DED were randomly assigned to one of three groups: the 1% rebamipide, 2% rebamipide, or placebo (eye drops containing the same ingredients, except for the active components). Each eye drop was instilled four times daily for 12 weeks. Changes in tear film break-up time (TBUT), corneal and conjunctival staining score, Schirmer 1 test, and the Ocular Surface Disease Index (OSDI) from baseline to 12-week visit between the study groups were compared for efficacy assessment. Results: The mean age of study patients was 43.8±14.2 years. The 1% and 2% rebamipide groups showed greater improvement in TBUT (1.99±1.87 and 2.02±2.21 s) at 12 weeks from baseline than the placebo group (1.25±2.93 s). The 2% rebamipide group showed greater improvement in the corneal staining score (− 3.15±2.00) at 12 weeks from baseline than the placebo group (− 2.85±1.80). The 1% and 2% rebamipide groups showed improvement in Schirmer 1 test (1.27±3.86 and 1.50±4.14 mm) at 12 weeks of treatment, but not the placebo group (0.55±2.99 mm). Both the rebamipide groups and the placebo group showed significantly improved OSDI after treatment for 12 weeks; however, there was no significant difference among the three groups. Conclusions: 1% and 2% rebamipide clear solutions are an effective therapeutic option for improving TBUT and tear volume, and stabilizing the corneal staining score in DED. [ABSTRACT FROM AUTHOR]

Eyecare practitioners' management of ocular surface disease is essential in managing increasing dry eye disease (DED) presentations including ocular neuropathic pain (ONP). Topical Proxymetacaine offers a simple, readily available and practical method of detecting ONP in practice and can be used to differentiate ONP from DED by eyecare practitioners, when accompanied with an anterior segment examination. Differentiating DED from ONP presents a significant opportunity to eyecare providers, allowing appropriate treatment choices for more adequate symptom control, greater patient satisfaction, and reduced emergent re-presentations. This study aims to differentiate patients presenting with DED symptoms into DED or ONP using a simple diagnostic tool, which can be used in practice to allocate appropriate treatment options for the patient's respective condition. A comparison of the prevalence of presentations of ONP presenting with DED symptoms in hospital ophthalmology settings and in optometric primary care settings will also be made. Patients with symptoms of DED were opportunistically recruited as they presented to ophthalmology outpatient clinics and primary care optometric services. Patients were then categorised as DED, ONP, or mixed DED/ONP based on their subjective response 30 seconds post-Proxymetacaine Hydrochloride 2% instillation. Twenty-one patients were recruited, including 12 patients from ophthalmologic outpatient clinics and nine patients from primary care optometric services. Twelve patients were identified to have primary DED, while nine patients were identified to have ONP. 43% of patients presenting with DED symptoms had features of neuropathic pain in ophthalmologic outpatient presentations compared to 44% of patients in primary care optometric services. Categorising DED and ONP patients by their response to Proxymetacaine can be used as a simple diagnostic tool in guiding future patient management and can be indicative of their potential response to topical therapies. The use of topical Proxymetacaine and the resultant change in ocular pain score can facilitate selection of patients who may benefit from centrally acting neuropathic pain agents over topical ocular therapy. [ABSTRACT FROM AUTHOR]