Search Results (50)

Objective: To evaluate the efficacy of lid wipes and tear substitutes, in addition to standard postoperative treatment, in alleviating signs and symptoms of ocular surface disease (OSD) following cataract surgery. Methods: Retrospective study on patients who underwent cataract surgery and received either standard postoperative treatment (topical antibiotics, corticosteroids, and nonsteroidal anti-inflammatory drugs) or the same regimen supplemented with lid wipes and tear substitutes. Preoperatively and one month postoperatively, symptoms were evaluated using the 5-item Dry Eye Questionnaire (DEQ-5) and the Ocular Surface Disease Index (OSDI), while noninvasive keratograph break-up time (NIKBUT), tear meniscus height (TMH), conjunctival hyperemia, and infrared meibography were measured by the Oculus Keratograph. Results: A total of 63 patients (mean age 75.1 ± 6.3 years) were analyzed. Patients receiving standard treatment showed no significant changes in OSDI (+2 ± 32.7; p = 0.859) or DEQ-5 scores (+1.7 ± 5.4; p = 0.204). Conversely, those receiving the adjunct of lid wipes and tear substitutes demonstrated significant improvement in OSDI scores (−19.4 ± 15.9; p < 0.0001), a trend toward improvement in DEQ-5 scores (−1.9 ± 5.5; p = 0.059), and a reduction in the meibography score of the inferior eyelid (−0.24 ± 0.60; p = 0.023). Intergroup comparisons showed significantly greater improvements in both OSDI and DEQ-5 scores in patients receiving treatment for the ocular surface. Multivariate regression analysis confirmed the association between the use of wipes and tear substitutes and improvements in OSDI (p = 0.010) and DEQ-5 scores (p = 0.015). No significant postoperative changes in objective OSD parameters were observed in either group. Conclusions: The addition of lid wipes and tear substitutes to the standard postoperative regimen significantly improved patient-reported symptoms of ocular discomfort after cataract surgery, while no significant changes were observed in objective signs of ocular surface disease. These findings support the routine use of lid wipes and tear substitutes as an effective strategy for managing postoperative ocular surface discomfort. Full article

Home-compostable, biobased films were developed by blending poly(lactic acid) (PLA) with poly(butylene succinate-co-adipate) (PBSA). Among the formulations, the PLA/PBSA 60/40 blend demonstrated strong potential for industrial film production due to its enhanced flexibility and tear resistance. Thanks to their thermoplastic nature, these films can be applied to various substrates—such as paper or paperboard—and are easily recyclable within industrial processing environments. In this study, nanostructured clay and talc were incorporated into PLA/PBSA 60/40-based films to produce composites, which were evaluated for their effectiveness in limiting the diffusion of moisture from high-humidity soft cheeses. The materials’ melt fluidity and tensile properties were also characterized, and the composite morphology was examined using electron microscopy. The results revealed that the filler type significantly affected both the morphological structure and barrier performance, highlighting the critical role of material composition in the development of effective and environmentally sustainable packaging solutions. The biobased PLA/PBSA (60/40) films, particularly those filled with talc, exhibited high processability, flexibility, and effectiveness as a moisture barrier for dairy packaging. Although not yet feasible as a direct LDPE substitute without increasing their thickness, their low mass loss points to their strong potential for sustainable applications—especially when paired with paperboard in rigid packaging. Full article

This case report presents a unique constellation of symptoms—including dry eye disease, visual and general asthenia, sleep disturbances, and restless legs syndrome—in a patient with a recent history of coronavirus disease 2019 (COVID-19) infection. While these symptoms have individually been associated with either COVID-19 or long COVID, their concurrent presentation and the simultaneous, positive response across all manifestations to a combined therapeutic regimen have not been previously described in a single case. The patient demonstrated notable improvement in both ocular and systemic symptoms following a six-week treatment with topical tear substitutes and oral administration of melatonin, and a multivitamin supplement including B-complex vitamins, antioxidants, and neuroprotective agents (Colinplus Delta^®, Farmaplus Italia Srl, Via Giovanni Porzio 4, 80143 Napoli, Italy). This response suggests a possible shared pathophysiological mechanism underlying these manifestations, potentially involving post-viral neuroinflammation, immune dysregulation, oxidative stress, or autonomic dysfunction. This case report highlights the need for an increased awareness of the interconnected nature of ocular and neurological symptoms in long COVID and supports further research into non-invasive, multimodal treatment strategies for this emerging clinical spectrum. Full article

Biodegradable agricultural films manufactured with straw serve as a viable substitute for plastic films, effectively addressing the issue of white pollution. However, existing biodegradable straw fiber films exhibit insufficient mechanical properties, primarily characterized by their susceptibility to fracture damage. To address this issue, a novel method for the preparation of film raw materials was proposed, which employs the synergistic treatment of bioenzymes and a single screw extruder, with the aim of enhancing the mechanical properties of the film. The method begins with the application of microbial agents to pretreat the straw, for improving its fiber morphology and inducing beneficial physicochemical structural changes. Subsequently, single screw extrusion technology is employed to further enhance the quality of the straw fibers and the mechanical performance of the film. The bio-mechanical pulp produced with this method demonstrated an increase in the crystallinity index (CrI) from 50.33% to 60.78%, while the degree of polymerization (DP) decreased from 866.51 to 749.60. Furthermore, the tensile strength, tear strength, and burst strength of the fiber covering film increased by 35.74%, 16.22%, and 11.65%, respectively, which meet the mechanical durability requirements for farmland mulching. This research effectively mitigates agricultural white pollution by converting agricultural waste straw into biodegradable mulch film, which promotes the recycling of straw resources. This study presents a novel method with significant potential application value for the production of bio-pulping in the paper industry. Full article

Human space exploration presents an unparalleled opportunity to study life in extreme environments—but it also exposes astronauts to physiological stressors that jeopardize key systems like vision. Corneal health, essential for maintaining precise visual acuity, is threatened by microgravity-induced fluid shifts, cosmic radiation, and the confined nature of spacecraft living environments. These conditions elevate the risk of corneal abrasions, infections, and structural damage. In addition, Spaceflight-Associated Neuro-Ocular Syndrome (SANS)—while primarily affecting the posterior segment—has also been potentially linked to anterior segment alterations such as corneal edema and tear film instability. This review examines these ocular challenges and assesses current mitigation strategies. Traditional approaches, such as terrestrial eye banking and corneal transplantation, are impractical for spaceflight due to the limited viability of preserved tissues, surgical complexities, anesthetic risks, infection potential, and logistical constraints. The paper explores emerging technologies like 3D bioprinting and stem cell-based tissue engineering, which offer promising solutions by enabling the on-demand production of personalized corneal constructs. Complementary advancements, including adaptive protective eyewear, bioengineered tear substitutes, telemedicine, and AI-driven diagnostic tools, also show potential in autonomously managing ocular health during long-duration missions. By addressing the complex interplay of environmental stressors and biological vulnerabilities, these innovations not only safeguard astronaut vision and mission performance but also catalyze new pathways for regenerative medicine on Earth. The evolution of space-based ophthalmic care underscores the dual impact of space medicine investments across planetary exploration and terrestrial health systems. Full article

Fumed silica, a nanomaterial with a high specific surface area, excellent chemical stability, and electrical insulation, serves as an effective filler for rubber compounding. Compared to traditional carbon black, silica (SiO₂), the main component of fumed silica, improves the hardness and tear resistance of tread rubber, making it a viable substitute in some formulations. However, silica-filled compounds generally exhibit lower tensile properties and abrasion resistance than carbon black. Fumed silica, with its higher structural integrity, provides additional reinforcement points within natural rubber matrices, enhancing tensile strength and abrasion resistance. Studies demonstrate that replacing carbon black with an equivalent amount of fumed silica as the primary filler significantly improves tread rubber’s hardness (by 20%) and 300% tensile modulus (by 14%) while also reducing rolling resistance and enhancing wet skid performance. Fumed silica’s large specific surface area and low density (10–15% of conventional silica) make it challenging to use directly as a tread rubber filler due to dust formation and prolonged mixing times. This study developed a process combining fumed silica with deionized water, followed by drying and ball milling. This treatment reduces the material’s volume, forming a cohesive gel that, upon processing, minimizes dust and significantly decreases mixing time and difficulty. The interaction between the hydroxyl (–OH) groups on the surface of fumed silica and water molecules likely results in hydrated silica. This interaction enhances surface polarity and forms a hydration layer, improving the hydrophilicity and dispersion of fumed silica in rubber matrices. This reduces the shear modulus difference (ΔG′) between low and high strain, maintaining a consistent elastic modulus over a wide strain range. Such stability enables rubber to perform better under dynamic loads or in complex working conditions. The experimental results demonstrate that the hydration–ball milling process enhances the tensile strength of vulcanizates, improves the dispersion of fumed silica in rubber, strengthens the filler network, boosts dynamic performance, and enhances the wet skid resistance of tread rubber. Full article

This research examines the possibility of palm oil and oil palm trunk biochar (OPTB) from pyrolysis effectively serving as alternative processing oils and fillers, substituting petroleum-based counterparts in natural rubber (NR) composites. Chemical, elemental, surface and morphological analyses were used to characterize both carbon black (CB) and OPTB, by using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET) gas porosimetry, and scanning electron microscopy (SEM). The influences of OPTB contents from 0 to 100 parts per hundred rubber (phr) on thermal, dielectric, dynamic mechanical, and cure characteristics, and the key mechanical properties of particulate NR-composites were investigated. OPTB enhanced the characteristics of the composites, as demonstrated by a rise in dielectric constant, thermal stability, storage modulus, glass transition temperature (T_g), hardness and modulus at 300% elongation, along with a decrease in the loss tangent (tan δ). Tear strength exhibited an increase with OPTB content up to a specific threshold, whereas tensile strength and elongation at break declined. This implies a compromise between the various mechanical properties when incorporating OPTB as a filler. This work supports the potential application of OPTB as a renewable substitute for CB in the rubber industry, particularly in tire production and other industrial rubber applications, which would also bring environmental, sustainability, and economic benefits for the palm oil-related industry. Full article

The increasing concern for sustainability in the footwear industry has spurred the exploration of eco-friendly alternatives for materials commonly used in sole manufacturing. This study examined the effect of incorporating rice straw and cellulose as fillers into soles made from either styrene–butadiene rubber (SBR) or thermoplastic polyurethane (TPU). Both fillers were used as a substitute in mass percentages ranging from 5 to 20% in the original SBR and TPU formulas, and their impact on mechanical properties such as abrasion and tear resistance, as well as thermal properties, was thoroughly evaluated. The results demonstrated that the inclusion of fillers affects the overall performance of the soles, with the optimal balance of mechanical and thermal properties observed at a 10% filler content. At this level, improvements in durability were achieved without significantly compromising flexibility or abrasion resistance. Thermal analysis revealed increased thermal stability at moderate filler contents. This research not only offers a sustainable alternative to traditional materials but also enhances sole performance by improving the composition. Furthermore, this study paves the way for future research on the feasibility of incorporating eco-friendly materials into other consumer product applications, highlighting a commitment to innovation and sustainability in product design. Full article

The partial substitution of chemical fertilizer with organic fertilizer is a crucial practice for enhancing crop production and quality, although its impact on natural rubber has rarely been explored. In this study, a two-year field experiment was conducted to investigate the impact of different nitrogen application rates and varying proportions of organic nitrogen substitution on dry rubber yield, nitrogen nutrition, and natural rubber properties. Regarding nitrogen application, the control treatment received no nitrogen amendment, while the low-nitrogen treatment was amended with 138 g·tree⁻¹·year⁻¹ of nitrogen. The medium-nitrogen treatment received 276 g·tree⁻¹·year⁻¹ of nitrogen, and the high-nitrogen treatment received 552 g·tree⁻¹·year⁻¹ of nitrogen. In addition, the low-organic-nitrogen substitution treatment and medium-organic-nitrogen substitution treatment were amended with 276 g·tree⁻¹·year⁻¹ of nitrogen each. The results demonstrated that the 50% organic nitrogen substitution treatment resulted in the highest dry rubber yield across all sampling periods, ranging from 46.43 to 94.65 g·tree⁻¹. Additionally, this treatment exhibited superior soil total nitrogen (1067.69 mg·kg⁻¹), available nitrogen (84.06 mg·kg⁻¹), and nitrogen content in roots (1.08%), leaves (3.25%), fresh rubber latex (0.27%), and raw natural rubber (0.44%) compared with other treatments. In terms of the physical properties of natural rubber, the 50% organic nitrogen substitution treatment resulted in advantages in the weight-average molecular weight (1.57 × 10⁶ g·mol⁻¹), number-average molecular weight (0.36 × 10⁶ g·mol⁻¹), plasticity retention index (97.35%), Wallace plasticity (40.25), and Mooney viscosity (81.40). For mechanical properties, natural rubber from the substitution treatment exhibited higher tensile strength (19.84 MPa), greater elongation at break (834.75%), and increased tear strength (31.07 N·mm⁻¹). Overall, the substitution of 50% chemical nitrogen fertilizer with organic nitrogen fertilizer improved nitrogen nutrition in rubber trees by introducing organic nitrogen input, resulting in remarkable enhancements in natural rubber properties. Therefore, the incorporation of organic fertilizer as a substitution for 50% of chemical fertilizer is demonstrated as an effective strategy for improving both the yield and properties of natural rubber. Full article

Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley (“A” distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the “A” distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the “A” due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, −0.70 (−3.28–1.38), 0.98 (0.93 ± 1.04)), its validity for “A” distance is lower (LR, Y:O2, X:O3, −2.37 (−13.53–4.83), 1.02 (0.62–1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the “A” distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges. Full article

Purpose: An innovative eyedrop formulation based on a combination of 0.2% hyaluronic acid and 0.001% hydrocortisone sodium phosphate (Idroflog^®, Alfa Intes, Italy; HAC eyedrops) was granted a European Patent in 2016 and has been available on the market since 2019 in Europe and in other countries around the world. HAC eyedrops aim to synergize the moisturizing effects of hyaluronic acid with the mild anti-inflammatory properties of low-dose hydrocortisone, offering a more effective and safer alternative for treating dry eye disease (DED), targeting both tear film instability and dysfunctional para-inflammation. The activity of HAC eyedrops has been explored in different post-marketing clinical trials, in addition to preclinical studies. In this narrative review, we explored the available evidence on the use of HAC eyedrops for the management of para-inflammation in DED patients to provide a comprehensive overview of efficacy and safety data related to the use of this medical device in routine clinical practice. Methods: A literature search for preclinical and clinical data involving treatment with HAC eyedrops was conducted using PubMed/MEDLINE, considering only original research articles published in English, without time restrictions. Results: One preclinical and four clinical papers were retrieved. Preclinical evidence suggests that 0.001% hydrocortisone is able to control the expression of inflammatory markers, and this, together with the hydrating and lubricating properties of hyaluronic acid, leads to improvements in DED clinical signs, such as tear volume and the stability of the tear film. The results of clinical trials demonstrate that HAC eyedrops are able to improve the signs and symptoms of DED and that 0.001% low-dosage hydrocortisone can be helpful in preventing the progression to chronic stages of DED. Conclusions: HAC eyedrops represent a promising therapeutic strategy for the management of dysfunctional para-inflammation and offer a valuable addition to the armamentarium of treatments for DED. Full article

Anterior cruciate ligament (ACL) plays an important role in stabilising the knee joint, prevents excessive anterior translation of the tibia, and provides rotational stability. ACL injuries commonly occur as a result of rapid deceleration, sudden change in direction, or direct impact to the knee during sports activities. Although several deep learning techniques have recently been applied in the detection of ACL tears, challenges such as effective slice filtering and the nuanced relationship between varying tear grades still remain underexplored. This study used an advanced deep learning model that integrated a T-distribution-based slice attention filtering mechanism with a penalty weight loss function to improve the performance for detection of ACL tears. A T-distribution slice attention module was effectively utilised to develop a robust slice filtering system of the deep learning model. By incorporating class relationships and substituting the conventional cross-entropy loss with a penalty weight loss function, the classification accuracy of our model is markedly increased. The combination of slice filtering and penalty weight loss shows significant improvements in diagnostic performance across six different backbone networks. In particular, the VGG-Slice-Weight model provided an area score of 0.9590 under the receiver operating characteristic curve (AUC). The deep learning framework used in this study offers an effective diagnostic tool that supports better ACL injury detection in clinical diagnosis practice. Full article

Disturbance or insufficiency of the tear film challenges the regulatory systems of the ocular surfaces. The reaction of the surfaces includes temporary mechanisms engaged in the preservation of homeostasis. However, strong or persisting challenges can lead to the potential exhaustion of the coping capacity. This again activates the vicious circle with chronic inflammation and autocatalytic deterioration. Hence, the factors challenging the homeostasis should be addressed in time. Amongst them are a varying osmolarity, constant presence of small lesions at the epithelium, acidification, attrition with mechanical irritation, and onset of pain and discomfort. Each of them and, especially when occurring simultaneously, impose stress on the coping mechanisms and lead to a stress response. Many stressors can culminate, leading to an exhaustion of the coping capacity, outrunning normal resilience. Reaching the limits of stress tolerance leads to the manifestation of a lubrication deficiency as the disease we refer to as dry eye disease (DED). To postpone its manifestation, the avoidance or amelioration of stress factors is one key option. In DED, this is the target of lubrication therapy, substituting the missing tear film or its components. The latter options include the management of secondary sequelae such as the inflammation and activation of reparative cascades. Preventive measures include the enhancement in resilience, recovery velocity, and recovery potential. The capacity to handle the external load factors is the key issue. The aim is to guard homeostasis and to prevent intercellular stress responses from being launched, triggering and invigorating the vicious circle. Considering the dilemma of the surface to have to cope with increased time of exposure to stress, with simultaneously decreasing time for cellular recovery, it illustrates the importance of the vicious circle as a hub for ocular surface stress. The resulting imbalance triggers a continuous deterioration of the ocular surface condition. After an initial phase of the reaction and adaption of the ocular surface to the surrounding challenges, the normal coping capacity will be exhausted. This is the time when the integrated stress response (ISR), a protector for cellular survival, will inevitably be activated, and cellular changes such as altered translation and ribosome pausing are initiated. Once activated, this will slow down any recovery, in a phase where apoptosis is imminent. Premature senescence of cells may also occur. The process of prematurization due to permanent stress exposures contributes to the risk for constant deterioration. The illustrated flow of events in the development of DED outlines that the ability to cope, and to recover, has limited resources in the cells at the ocular surface. The reduction in and amelioration of stress hence should be one of the key targets of therapy and begin early. Here, lubrication optimization as well as causal treatment such as the correction of anatomical anomalies (leading to anatomical dry eye) should be a prime intent of any therapy. The features of cellular stress as a key hub for the vicious circle will be outlined and discussed. Full article

The authors performed an ex vivo and in vivo evaluation of the ultrastructural effects on the conjunctival epithelial cells of a new multiple-action tear substitute containing cross-linked hyaluronic acid, lipids and trehalose (Trimix^®), using scanning electron microscopy (SEM) with conjunctival impression cytology. The ex vivo study highlights the persistence and distribution of the product at 5 and 60 min on a monolayer of conjunctival epithelial cells and an increase in microvilli density at the 60 min evaluation. In vivo examination was conducted on three subjects with different grades of ocular surface inflammation, treated with one drop of the product twice daily for thirty days. At the baseline (T₀) and twelve hours after the last administration of the tear drop (T₃₀), impression cytology of the upper bulbar conjunctiva for SEM evaluation of conjunctival epithelial cells was carried out. Slit lamp examination (SLE), corneal and conjunctival Fluotest, tear film break-up time (TBUT), and ocular surface disease index (OSDI) questionnaires were also performed to correlate the ultrastructural results with the clinical findings. After 30 days of treatment, a significant improvement in all clinical and symptomatic parameters and in the condition of the ocular surface was detected, with microvillar regeneration and strengthening in all the patients, and a complete restoration in 2/3 of them. The persistence and distribution of the product on the epithelial cells was also noted 12 h after the last administration. The results, therefore, suggest a marked epitheliotropic effect along with a high residence time of the tear substitute. Full article

Although the eye can be subjected to therapeutic manipulation, some of its structures are highly inaccessible. Thus, conventional therapeutic administration pathways, such as topical or systemic routes, usually show significant limitations in the form of low ocular penetration or the appearance of side effects linked to physiology, among others. The critical feature of many xenobiotics is the drug gradient from the concentrated tear reservoir to the relatively barren corneal and conjunctival epithelia, which forces a passive route of absorption. The same is true in the opposite direction, towards the ocular surface (OS). With the premise that tears can be regarded as equivalent to or a substitute for plasma, researchers may determine drug concentrations in the OS fluid. Within this framework, a survey of scholarly sources on the topic was conducted. It provided an overview of current knowledge, allowing the identification of relevant theories, methods, and gaps in the existing research that can be employed in subsequent research. OS fluid (tears particularly) has enormous potential as a source of biological material for external drug screening and as a biomarker of various systemic diseases. Given the numerous alternate matrices, knowledge of their properties is very important in selecting the most appropriate specimens in toxicological analyses. Full article