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Introduction: The aim of this study is to determine the best cut-off value for the Standardized Patient Evaluation of Eye Dryness Portuguese version questionnaire and verify possible differences between the questionnaire score and different age groups. Methods: The clinical validation of the Standardized Patient Evaluation of Eye Dryness Portuguese version was performed by completing this and the Ocular Surface Disease Index in Portuguese version questionnaire, in 180 volunteers (68.9% female), with an age range of 19–96 years. Results: An excellent degree of reliability was found between the Standardized Patient Evaluation of Eye Dryness Portuguese version and the Ocular Surface Disease Index Portuguese version questionnaires (Cronbach's Alpha = 0.824). The Receiver Operating Characteristic curve analysis revealed a cut-off of 8 points (Sensitivity of 71.2% and Specificity of 71%). Furthermore, the area under the curve of the Receiver Operating Characteristic curve was 0.813, indicating that Standardized Patient Evaluation of Eye Dryness Portuguese version questionnaire is a good diagnostic tool and interchangeable with the Ocular Surface Disease Index questionnaire. Conclusion: The Standardized Patient Evaluation of Eye Dryness Portuguese version questionnaire is a reliable tool for the detection of dry eye symptoms in the Portuguese population with a broad age range. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of punctal plugs combined with cyclosporine eye drops on dry eye disease (DED) and ocular surface inflammation. Methods: In a clinical trial, 73 patients were randomly allocated into three groups: punctal plug group, combination therapy group, and cyclosporine group. At the baseline and four weeks after treatment, the Schirmer I test score, fluorescein tear film break-up time (FBUT), ocular surface staining score and dry eye symptoms were assessed. Tear samples were collected to detect the level of inflammatory factors (interleukins, matrix metalloproteinase 9 (MMP-9) and tumor necrosis factor alpha (TNF-α)). In an animal experiment, a New Zealand rabbit dry eye model was induced. The rabbits were randomly divided into control group, punctal plug group, and combination therapy group (n = 6). Conjunctival goblet cell density, protein level of MMP-9 in conjunctiva and mRNA levels of inflammatory factors in conjunctiva and cornea were measured before and after treatment. Results: In combination therapy group of the clinical trial, the following results were observed: significant improvement in Schirmer I test scores and FBUT compared to the cyclosporine group and punctal plug group, respectively; a decrease in the tear levels of IL-6, IL-1, and MMP-9 compared to the punctal plug group; and a decrease in the tear levels of IL-1α, IL-6, and IL-17 compared to the baseline (all p < 0.05). In the animal experiment, rabbits in combination therapy group had a higher goblet cell density (p < 0.01) and lower mRNA levels of IL-16 (p < 0.05), IL-17 (p < 0.05), and MMP-9 (p < 0.01) in conjunctiva and that of MMP-9 (p < 0.01) in cornea compared to punctal plug group. Conclusion: Cyclosporine eye drops combined with degradable punctal plugs is a more optimized clinical treatment strategy for DED compared with degradable punctal plugs or cyclosporine eye drops alone, considering the influence of comprehensive clinical efficacy and ocular surface inflammation. [ABSTRACT FROM AUTHOR]

AbstractHigh-strength martensitic precipitation-hardening stainless steel XM-25, characterised by its high strength, high hardness, and good workability, has been utilised in engineering as the low-pressure last stage blade of steam turbines. However, it is beset by the issue of water erosion. This paper focuses on the restoration of large blade workpieces made of XM-25 material, employing directed energy deposition (DED) laser cladding with parent material powder. The parameters for laser cladding include laser power of 1300 W, movement speed of 500 mm/min, and powder feed rate of 15 g/min. The performance of the XM-25 alloy after laser cladding restoration is evaluated through non-destructive testing (PT, RT), tensile testing, hardness testing, metallographic analysis, fracture morphology analysis, residual stress measurement, and high-cycle fatigue testing. Results indicate that the material after laser cladding exhibits an ultimate tensile strength exceeding 1200 MPa, a yield strength above 1050 MPa, microhardness above 415 HBW, residual stress at approximately 30% of the base material, and a fatigue limit of 586.25 MPa – 95% higher than the base material. These findings confirm the effectiveness of the proposed DED laser cladding method for restoring XM-25 turbine blades, offering a viable engineering solution for mitigating and repairing water erosion in steam turbine components. [ABSTRACT FROM AUTHOR]

Alloys developed by fusion-based additive manufacturing often suffer from the coarse columnar grain structure and their effect on properties. This work involves the practical application of pulsed laser in laser-based directed energy deposition (DED-LB) of super duplex stainless steel which led to engineering the microstructure, improving the mechanical properties, and changing the dominant texture. Pulsed laser DED-LB (here P-DED) with laser spot sizes of 1 and 2 mm and different frequencies were used. Refine-grained ferritic steels containing porosity were produced when using a small laser spot size. Ferrite-to-austenite (α → γ) transformation was constrained to the grain boundaries under the effect of small excitation overlaps. Using broader laser, higher energy input, and ultra-short pulse intervals encouraged γ nucleation, promoted the density, and decreased the content of undesirable oxides that are typically formed during the conventional DED-LB (here C-DED). The local ferritization under the fusion lines of C-DED was avoided by P-DED. Directionally solidified α, extending into several layers, was inhibited by P-DED with optimum overlap. Enhanced supercooling resulted in an in situ grain refinement and columnar-to-equiaxed morphological transition. Defect-free microstructure and effective distribution of interphase boundary surface by P-DED, with a laser spot size of 2 mm and ⁓99% excitation overlap, largely improved the toughness and elongation (with acceptable strength). Pulse-induced convection and isotropic heat flow during P-DED with smaller laser spot size subsided the trend of preferred orientation. However, an alignment of < 001 > α with deposition direction during P-DED with the broader laser preserved the typical {001} < 100 > solidification texture and, consequently, the transformation texture. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a highly prevalent condition, resulting in reduced quality of life, lower participation in social life and impaired work efficiency. Hydroxypropyl methylcellulose (HPMC) is a cellulose‐based viscosity‐enhancing agent and is one of the most popular therapeutic ingredients in artificial tears. This review aims to evaluate the literature on the efficacy and safety of HPMC used in the treatment of DED. Literature searches were conducted in PubMed and Cochrane CENTRAL. A total of 28 clinical trials from 26 publications are included in this review, including 21 clinical intervention studies evaluating the effect of HPMC treatment over time and seven single instillation studies evaluating the short‐term physical and symptomatic effects of HPMC after drop‐instillation. The duration of clinical intervention studies ranged from 2 weeks to 5.5 months. DED severity ranged from mild to severe. Drop frequency ranged from two to up to 16 drops per day. HPMC concentration in artificial tears ranged from 0.2% to 0.5%. No major complications or adverse events were reported. Artificial tears containing HPMC were effective at improving symptoms and some signs of DED. However, combination drops with HPMC plus other therapeutic ingredients seem more effective than HPMC alone. HPMC appears to be equally effective or inferior to hyaluronic acid (HA). There is no evidence of superiority or inferiority to either carboxymethylcellulose (CMC) or polyethylene glycol 400/propylene glycol (PEG/PG). No single study explained the choice of drop frequency or HPMC concentration. More well‐designed studies are needed to determine an evidence‐based standard for HPMC treatment, including drop frequency, concentration and molecular weight for different DED severity and subgroups. [ABSTRACT FROM AUTHOR]

In this paper, we present the characteristics of our Directed Energy Deposition 3D printing machine LAMDA, focusing on the local shield nozzle and monitoring feedback. We explain the effects of the local shield nozzle, which ensures a wide shielding area, and the monitoring feedback, which stabilizes the melt pool and improves the stability of the metal material and shape, with examples of the resulting structures. [ABSTRACT FROM AUTHOR]

Additive manufacturing of metallic components often results in the formation of columnar grain structures aligned along the build direction. These elongated grains can introduce anisotropy, negatively impacting the mechanical properties of the components. This study aimed to achieve controlled solidification with a fine-grained microstructure to enhance the mechanical performance of printed parts. Stainless steel 316L was used as the test material. High-intensity ultrasound was applied during the direct energy deposition (DED) process to inhibit the formation of columnar grains. The investigation emphasized the importance of amplitude changes of the ultrasound wave as the system's geometry continuously evolves with the addition of multiple layers and assessed how these changes influence the grain size and distribution. Initial tests revealed significant amplitude fluctuations during layer deposition, highlighting the impact of layer deposition on process uniformity. The mechanical results demonstrated that the application of ultrasound effectively refined the grain structure, leading to a 15% increase in tensile strength compared to conventionally additively manufactured samples. [ABSTRACT FROM AUTHOR]

Extreme high-speed directed energy deposition (German acronym—EHLA) is a modified variant of the laser based directed energy deposition (DED-LB) and is being applied as an efficient coating process for rotational symmetric components. Recent advancements regarding available machine kinematics enable the utilization of the originally 2D rotational symmetric process for a 3D process so that EHLA technology can be used for additive manufacturing, repair, and free-form coating applications. Compared to conventional DED-LB, an EHLA coating process results in a lower surface roughness; however, a subtractive postprocessing is still required for most industrial applications. To minimize the extent of the surface postprocessing and to improve the resulting surface properties, the principle of a laser based remelting process is investigated and characterized in this work. In contrast to the conventional, scanner type laser polishing, the remelt process is conducted with the same machine which was also used for probe deposition. For this study, additively manufactured probes as well as coatings were deposited by using EHLA technology with 316L stainless steel. After the probe deposition, a remelt parameter study was conducted in which the process feed rate, beam power, beam diameter, and hatching parameter were variated. The resulting surface properties, Sa and Wa, were analyzed and evaluated by white light interferometry and compared to the as-built reference surfaces. As a result, the developed remelt parameters can reduce the Sa values of an additively manufactured EHLA wall by 94% and coating surface by 76%. [ABSTRACT FROM AUTHOR]

Pure copper has antimicrobial effect, and the development of pure copper coating technology for product surfaces is needed to prevent the spread of infections. To achieve high antimicrobial performance in coatings, it is essential to form a coating with high copper purity and minimal defects. In this study, we attempted to form a pure copper coating layer on a SS304 substrate using multibeam directed energy deposition with blue diode lasers. In the coating layer formation process, multiple bead layers are overlapped to form a smooth surface and two different types of joining is conducted simultaneously: the similar material joining area with the remelted previous layer, and the dissimilar-material joining area with the substrate. However, it was challenging to conduct this process for SS304 and pure copper due to their significantly different thermal properties. Therefore, we varied the hatching distance to control the heat input to both joining areas and investigated the effect on the quality of the coating layer. The results showed that there is an optimal ratio of similar and dissimilar joining areas, at which a high-quality coating layer with few voids and low dilution is formed. Furthermore, antimicrobial tests showed that the pure copper coating layer formed in this study exhibited the antimicrobial performance equivalent to those of a pure copper plate. [ABSTRACT FROM AUTHOR]

PurposeThis study compares the corneal temperature in dry eyes with normal eyes via high-resolution infrared thermography.MethodsA total of 86 participants were enrolled, with 40 and 46 participants in the dry eye disease (DED) and control groups, respectively. All participants underwent non-invasive breakup time (NIBUT) measurement, an Ocular Surface Disease Index (OSDI) questionnaire and ocular thermography.ResultsIn the DED group, the mean initial central corneal temperature (initial CCT) is 33.25 ± 0.66°C, the tenth-second central corneal temperature (10s-CCT) is 32.47 ± 0.84°C, and the mean change in central corneal temperature measured within 10 s (change in CCT within 10 s) is 0.78 ± 0.30°C. For the controls, the initial CCT, 10s-CCT, and change in CCT within 10 s are 33.14 ± 1.02°C, 32.90 ± 0.99°C, and 0.23 ± 0.20°C, respectively. Except for the initial CCT (p = 0.549), significant differences are observed in the 10s-CCT (p = 0.034) and the change in CCT within 10 s (p

This review explores the critical role of powder quality in metal 3D printing and the importance of effective powder recycling strategies. It covers various metal 3D printing technologies, in particular Selective Laser Melting, Electron Beam Melting, Direct Energy Deposition, and Binder Jetting, and analyzes the impact of powder characteristics on the final part properties. This review highlights key challenges associated with powder recycling, including maintaining consistent particle size and shape, managing contamination, and mitigating degradation effects from repeated use, such as wear, fragmentation, and oxidation. Furthermore, it explores various recycling techniques, such as sieving, blending, plasma spheroidization, and powder conditioning, emphasizing their role in restoring powder quality and enabling reuse. [ABSTRACT FROM AUTHOR]

The state-of-the-art cleaner smart manufacturing process in the metal industry is the direct energy deposition-arc (DED-arc) process, which has emerged as an energy-efficient method for producing complex geometry metallic constructions. Process flexibility, material-consumption efficiency and high performance have drawn attention amongst both academics and industry, as DED-arc presents an ecologically viable alternative to traditional manufacturing techniques. Concurrently, the parallel emergence of extended reality (XR) technology has unveiled multiple novel possibilities for enhancing the sustainable development of DED-arc processing toward cleaner manufacturing. However, an evident knowledge gap exists concerning the integration of XR into the DED-arc process chain. This research aims to solve this problem by systematically exploring the potential of implementing XR technology within the DED-arc framework. Therefore, this study identifies through a literature review the technological difficulties and prospects associated with merging XR and DED-arc. Subsequently, a series of practical experiments are executed, presenting various applications of XR within the DED-arc process chain. The current research makes several noteworthy contributions to the practical understanding of how XR can be integrated into the DED-arc manufacturing process. Technological challenges are discussed, while the potential benefits of XR adoption in the DED-arc process chain are illuminated in practical applications. [ABSTRACT FROM AUTHOR]

Annual monitoring of wilt pathogens on elm trees in Alberta is part of a provincially-regulated prevention and control program for Dutch elm disease. Over the past eight years (2016–2023), twig samples with wilt symptoms from 200 elm trees across Alberta were tested for the presence of wilt pathogens. Plenodomus tracheiphilus, the causal agent of Mal secco disease of citrus trees, was isolated from 116 out of the 200 elm trees. The identification of this fungus was confirmed morphologically by comparison with the type culture, and sequencing the internal transcribed spacer region, the β-tubulin gene, the DNA-directed RNA polymerase II second largest subunit gene, the actin gene and eight protein-coding genes exclusively present in the P. tracheiphilus genome. The pathogenicity of P. tracheiphilus isolated from Alberta was tested by artificial inoculation on elm trees to fulfill Koch's postulates based on symptom observation and fungal re-isolation. Our data indicated that P. tracheiphilus is commonly present in Alberta's elm trees especially in the Edmonton area and that the previously described Dothiorella elm wilt is actually caused by P. tracheiphilus and not Dothiorella ulmi. [ABSTRACT FROM AUTHOR]

In this review, we aimed to investigate the literature on sex-specific prevalence of meibomian gland dysfunction (MGD) and to determine whether women or men are more at risk for MGD. A search was conducted on PubMed using the terms: (Sex OR Gender OR prevalence) AND (Meibomian gland). Twenty-four relevant studies on MGD prevalence were identified, including 10 population-based and 14 hospital-based studies. Among the population-based studies, five studies reported higher rates among men, three studies found no differences, and one study observed higher rates among women. In the hospital-based studies, 10 studies reported no difference, two found higher rates among men, and one found higher among women. In the reviewed literature, there was a considerable variation between studies in terms of quality, sample size, age ranges, diagnostic criteria. While most of the population-based studies suggest a higher prevalence among men, the majority of clinic-based studies show no significant difference. Further research with larger samples and standardized criteria is needed to determine whether men are indeed more susceptible to MGD. [ABSTRACT FROM AUTHOR]

The NiTi alloy has attracted significant interest owing to its notable wear and corrosion resistance, suggesting the significant promise of utilizing additively manufactured NiTi alloys in tribological applications. In this study, dry sliding wear tests with sliding velocity of 0.1 m/s for total distance of 250 m at room temperature, 50 °C, 100 °C, and 200 °C were carried out on samples of NiTi alloy samples fabricated using laser powder and laser wire directed energy deposition (LP-DED and LW-DED) processes. Enhanced friction and wear behavior of LP-DED samples were captured at lower temperatures due to higher hardness and the stable dominating NiTi B2 austenite phase in the sample microstructure as confirmed from x-ray diffraction (XRD) analysis. Accumulated transferred material at lower temperatures played a crucial role in modifying the wear mechanisms. However, at higher temperatures both LP-DED and LW-DED samples presented similar wear mechanisms. [ABSTRACT FROM AUTHOR]

Congenital aniridia is a rare bilateral ocular malformation characterized by the partial or complete absence of the iris and is frequently associated with various anomalies, including keratopathy, cataract, glaucoma, and foveal and optic nerve hypoplasia. Additionally, nearly 50% of individuals with congenital aniridia experience symptoms of ocular dryness. Traditional treatment encompasses artificial tears and autologous serum. This study aimed to assess the effectiveness and safety of using platelet rich in growth factors (PRGF) plasma in patients with congenital aniridia and ocular dryness symptoms. Methods: The included patients underwent two cycles of a 3-month PRGF treatment. At 6 months, symptomatology was evaluated using the OSDI and SANDE questionnaires, and ocular surface parameters were analyzed. Results: The OSDI and SANDE values for frequency and severity demonstrated statistically significant improvements (p < 0.05). Ocular redness, corneal damage (corneal staining), and tear volume (Schirmer test) also exhibited statistically significant improvements (p < 0.05). No significant changes were observed in visual acuity or in the grade of meibomian gland loss. Conclusion: The use of PRGF in patients with congenital aniridia and ocular dryness symptoms led to significant improvements in symptomatology, ocular redness, and ocular damage. No adverse effects were observed during the use of PRGF. [ABSTRACT FROM AUTHOR]

Multi-material Directed Energy Deposition of new high-performance components is limited by phase incompatibilities between metals and by the composition variations which complicate parameter optimization. In this work, a methodology of incorporation of a graded Multi-Material Compatibility Interface (MMCI) was employed to allow deposition of tungsten layers (melting at 3410 °C) on a much less refractory metal, copper (boiling at 2562 °C). The manufacturing of parts combining tungsten and copper is of interest for components designed to dissipate heat in extreme environments, such as the divertor for tokamak fusion reactors. A succession of miscible filler metals rationally selected from thermodynamics were printed by laser and powder injection, with optimization of energy and material inputs for each layer, supported by material characterization and physical numerical analysis of the process phenomenology. 90 %wt. tungsten layer deposition on a copper initial substrate is achieved using an MMCI with 6 intermediate layers and 1.6 mm total thickness. The results reveal the importance of controlling the dilution ratio to achieve stable depositions of multi-material with compositional gradients, with a progressive increase in melt pool temperatures. The numerical analysis highlighted the important role of the dissolution and mixing of partially melted refractory powders, and the selective vaporization of volatile elements.

Additive manufacturing of metallic components often results in the formation of columnar grain structures aligned along the build direction. These elongated grains can introduce anisotropy, negatively impacting the mechanical properties of the components. This study aimed to achieve controlled solidification with a fine-grained microstructure to enhance the mechanical performance of printed parts. Stainless steel 316L was used as the test material. High-intensity ultrasound was applied during the direct energy deposition (DED) process to inhibit the formation of columnar grains. The investigation emphasized the importance of amplitude changes of the ultrasound wave as the system’s geometry continuously evolves with the addition of multiple layers and assessed how these changes influence the grain size and distribution. Initial tests revealed significant amplitude fluctuations during layer deposition, highlighting the impact of layer deposition on process uniformity. The mechanical results demonstrated that the application of ultrasound effectively refined the grain structure, leading to a 15% increase in tensile strength compared to conventionally additively manufactured samples.

Abstract Introduction An innovative eye drops formulation containing 0.2% hyaluronic acid and a low concentration of hydrocortisone (0.001%; hereafter HALH) has been recently placed on the market (Idroflog®, Alfa Intes, Italy) to manage the dysregulated parainflammation in patients with dry eye disease (DED). In the present paper, the effectiveness of HALH on the signs and symptoms of DED was retrospectively evaluated and compared with that one obtained using standard tear substitutes (STS) by means of low- and high-tech (Keratograph®) assessments. Methods This was a multicenter retrospective study carried out between February and April 2023, involving adult patients with DED diagnosis owing to post-cataract surgery, meibomian gland dysfunction, allergy, or glaucoma medications. The primary aim was to compare the changes induced by different therapies on Keratograph® parameters (noninvasive Keratograph tear breakup time [NIKBUT], tear meniscus height [TMH], eyelid meibography, conjunctival hyperemia, and conjunctivochalasis) or collected by traditional low-tech measures (tear breakup time [TBUT], Schirmer test, Efron score, and epithelial alterations) and the Ocular Surface Disease Index score. Results Data from 155 patients were analyzed. The effectiveness of HALH and STS was reported by both high- and low-tech measures. NIKBUT-first showed a significant improvement in the HALH group versus the STS one at 15 days (6.4 ± 3.6 vs 5.4 ± 3.7 s, p = 0.02), whereas this difference was latent with low-tech TBUT until 45 days (6.8 ± 2.6 vs 5.6 ± 2.3 s, p = 0.03). Patients with DED occurring after cataract surgery reported an enhanced activity of HALH versus STS, particularly for NIKBUT-first, TMH, Schirmer test, and hyperemia stage. Conclusion These findings highlighted the effectiveness of HALH in all DED subtypes, especially in patients with post-cataract surgery, as well as its superiority versus STS in terms of tear film stability improvement. We recommend longer observation (i.e., 3–6 months) to fully ascertain whether the early improvement detected by high-tech measures will be confirmed in subsequent time points even using low-tech tests.

James Chelnis,1,2,&ast; Chantel N Garcia,3,&ast; Haya Hamza4 1New York Eye & Ear Infirmary of Mount Sinai, New York, NY, USA; 2Manhattan Face and Eye, New York, NY, USA; 3Carolina Eye Doctors, Harrisburg, NC, USA; 4Lumenis Be, Yokneam, Israel&ast;These authors contributed equally to this workCorrespondence: James Chelnis, Manhattan Face and Eye, 150 W 58th St &num;1C, New York, NY, 10019, USA, Tel +1 212-484-9707, Email info@manhattanfaceandeye.comPurpose: To evaluate the efficacy of multi-frequency RF and IPL + MGX combination for treatment of Meibomian Gland Dysfunction (MGD).Patients and Methods: Eligible subjects had signs and moderate-to-severe symptoms of DED (Dry Eye Disease) due to MGD. Subjects underwent 4 treatments at 2-week intervals. Each treatment consisted of intense pulsed light (IPL) followed by radiofrequency (RF) on the periocular skin, followed by meibomian gland expression (MGX). The main outcome measure was the quality of meibum in 15 meibomian glands along the lower eyelid, using the modified Meibomian Gland Score (mMGS). The main hypothesis was a reduction of mMGS between the baseline (BL) and the follow-up (FU). Other outcome measures, such as symptoms measured with the OSDI (Ocular Surface Disease Index) questionnaire, meibography, non-invasive tear break-up time (NIBUT), and matrix metallopeptidase 9 (MMP-9) levels in tear samples were evaluated as well.Results: 31 subjects completed the FU. Between BL and FU, mMGS decreased from 30.4 (8.5) to 9.3 (9.5) (− 69.3%, 95% CI: − 55.6% to − 82.9%, p< 0.0001); OSDI decreased from 63.6 (17.2) to 25.0 (20.6) (− 60.7%, 95% CI: − 47.8% to − 73.5%, p< 0.0001); NIBUT did not change (p=0.92). An adjusted model with a historical control was constructed to allow the comparison of these subjects with those treated similarly with IPL+MGX (but without RF) in a different study. This analysis identified that the change in mMGS was larger when RF was included (− 20.9 vs − 18.3, adjusted p-value (p_adjusted) < 0.05). The difference in OSDI change was not significant (− 38.1 vs − 25.5, p_adjusted = 0.196).Conclusion: Combination of multi-frequency RF and IPL+MGX improves signs and symptoms of MGD. In comparison to a historical control, improvements were generally larger. A randomized controlled study comparing the combination of RF and IPL+MGX with IPL+MGX alone is required to further elaborate the relative contribution of RF.Keywords: IPL, RF, MGD, DED

The state-of-the-art cleaner smart manufacturing process in the metal industry is the direct energy deposition-arc (DED-arc) process, which has emerged as an energy-efficient method for producing complex geometry metallic constructions. Process flexibility, material-consumption efficiency and high performance have drawn attention amongst both academics and industry, as DED-arc presents an ecologically viable alternative to traditional manufacturing techniques. Concurrently, the parallel emergence of extended reality (XR) technology has unveiled multiple novel possibilities for enhancing the sustainable development of DED-arc processing toward cleaner manufacturing. However, an evident knowledge gap exists concerning the integration of XR into the DED-arc process chain. This research aims to solve this problem by systematically exploring the potential of implementing XR technology within the DED-arc framework. Therefore, this study identifies through a literature review the technological difficulties and prospects associated with merging XR and DED-arc. Subsequently, a series of practical experiments are executed, presenting various applications of XR within the DED-arc process chain. The current research makes several noteworthy contributions to the practical understanding of how XR can be integrated into the DED-arc manufacturing process. Technological challenges are discussed, while the potential benefits of XR adoption in the DED-arc process chain are illuminated in practical applications.

Introduction: This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis. Materials and methods: Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available. Results: The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent. Conclusions: The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues. [ABSTRACT FROM AUTHOR]

The awareness of energy consumption is gaining much more attention in manufacturing due to its economic and sustainability benefits. Reducing energy consumption in advanced manufacturing processes, like directed energy deposition (DED) manufacturing, is critical for Industry 4.0 and the forthcoming Industry 5.0 since it allows for more economical, sustainable, and environmentally friendly manufacturing approaches. An energy consumption model is needed for quantifying the consumption and predicting the impact of various process parameters in manufacturing. This paper aims to develop an energy consumption model for DED-based hybrid additive manufacturing (HAM) for an Inconel 718 part. The specific energy consumption (SEC) is used while developing the energy consumption of the product manufacturing lifecycle. This study focuses on the analysis to investigate three significant factors (scanning speed, laser power, and feed rate), their interactions' effects, and whether they have a significant effect on energy consumption. The results suggest that all the factors have a strong influence, but their interaction effects have a weak influence on the energy consumption for HAM. Among the three process parameters, it is found that laser power has the most significant effect on energy consumption. Again, based on the regression analysis, this study also recommends high scanning speed while the laser power and feed rate should be low. Also, idle time has significant energy consumption during the whole HAM process. [ABSTRACT FROM AUTHOR]

The quality and performance of additively manufactured part is linked to the process parameters such as laser power, scanning speed, powder feed rate, and layer thickness. However, hatch spacing is one of the process parameters that affect the quality and performance of the part, but its effect has not been fully investigated. Therefore, this study seeks to investigate the effect of hatch spacing on the metallurgical characteristics, including microstructural evolution, microhardness, and corrosion behavior of 17–4 PH stainless produced through direct energy deposition. A LENS system was used to manufacture 17–4 PH SS cubes and the hatch overlap was varied from 20 to 80%. Subsequently, the printed cubes were subjected to heat treatment (H900) followed by material characterization which includes microstructural analysis, microhardness, and corrosion behavior. This study deduced that varying the percent overlap had an impact on the proportion of delta ferrite and the grain size. Furthermore, increasing the percent overlap from 20 to 80% was found to cause a reduction in hardness (340–331 HV). Meanwhile, it was found that traditionally manufactured 17–4 PH SS is more susceptible to corrosion than additively manufactured 17–4 PH SS. [ABSTRACT FROM AUTHOR]

Introduction: An innovative eye drops formulation containing 0.2% hyaluronic acid and a low concentration of hydrocortisone (0.001%; hereafter HALH) has been recently placed on the market (Idroflog®, Alfa Intes, Italy) to manage the dysregulated parainflammation in patients with dry eye disease (DED). In the present paper, the effectiveness of HALH on the signs and symptoms of DED was retrospectively evaluated and compared with that one obtained using standard tear substitutes (STS) by means of low- and high-tech (Keratograph®) assessments. Methods: This was a multicenter retrospective study carried out between February and April 2023, involving adult patients with DED diagnosis owing to post-cataract surgery, meibomian gland dysfunction, allergy, or glaucoma medications. The primary aim was to compare the changes induced by different therapies on Keratograph® parameters (noninvasive Keratograph tear breakup time [NIKBUT], tear meniscus height [TMH], eyelid meibography, conjunctival hyperemia, and conjunctivochalasis) or collected by traditional low-tech measures (tear breakup time [TBUT], Schirmer test, Efron score, and epithelial alterations) and the Ocular Surface Disease Index score. Results: Data from 155 patients were analyzed. The effectiveness of HALH and STS was reported by both high- and low-tech measures. NIKBUT-first showed a significant improvement in the HALH group versus the STS one at 15 days (6.4 ± 3.6 vs 5.4 ± 3.7 s, p = 0.02), whereas this difference was latent with low-tech TBUT until 45 days (6.8 ± 2.6 vs 5.6 ± 2.3 s, p = 0.03). Patients with DED occurring after cataract surgery reported an enhanced activity of HALH versus STS, particularly for NIKBUT-first, TMH, Schirmer test, and hyperemia stage. Conclusion: These findings highlighted the effectiveness of HALH in all DED subtypes, especially in patients with post-cataract surgery, as well as its superiority versus STS in terms of tear film stability improvement. We recommend longer observation (i.e., 3–6 months) to fully ascertain whether the early improvement detected by high-tech measures will be confirmed in subsequent time points even using low-tech tests. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of discontinuing chronic topical immune modulating (IM) treatment on Schirmer tear test (STT) values in dogs with dry eye disease (DED). Methods: Serial measurements of STTs from 14 dogs (16 eyes) previously diagnosed with DED were obtained before and after discontinuation of topical IM agents. Dogs with moderate to severe DED that had been well controlled with a topical IM treatment were included. After initial assessment topical IM treatment was discontinued, but topical lubricant was continued, and STT values were obtained sequentially. A mixed-effects regression model was used to evaluate the effects of age, gender, breed, clinical score, frequency of treatment, baseline STT value, and drug type on final STT values after IM withdrawal. P

Dry eye disease (DED) is a common ocular condition with a significant impact on patients' quality of life. Conventional treatments include behavioral changes, tear substitutes, and anti-inflammatory agents; however, recent advances in the understanding of DED pathogenesis have opened the way to the development of novel treatment strategies able to target several pathways involved in the onset and persistence of DED. Literature search was conducted on PubMed and Scopus around the term 'dry eye disease' and others involving its pathophysiology and therapeutic strategy. The primary focus was on recent drugs approved by FDA or under investigation in phase 3 clinical trials. Google and ClinicalTrials.gov were used for obtaining information about the status of FDA approval and ongoing clinical trials. Due to its multifaced pathogenesis, DED management is often challenging, and patients' needs are frequently unmet. Recently, several novel treatments have been either FDA-approved or studied in late-phase trials. These novel drugs target-specific biological components of the ocular surface and reduce inflammation and ocular pain. Additionally, new drug delivery systems allow for increased bioavailability, improve effective dosing, and minimize ocular side effects. These advances in drug therapies show real promise for better management of DED patients. [ABSTRACT FROM AUTHOR]

Metal additive manufacturing is a developing technique with numerous advantages and challenges to overcome. As with all manufacturing techniques, the specific raw materials and processing parameters used have a profound influence on microstructures and the resulting behavior of materials. It is important to understand the relationship between processing and microstructures of Ti to advance knowledge of Ti-alloys in the additive field. In this study, a face-centered cubic (FCC) phase was found in grade 2 commercially pure titanium specimens, additively manufactured with directed energy deposition in an argon atmosphere. Two scanning speeds (500 and 1000 mm/min) and three scanning patterns (cross-hatched and unidirectional patterns) were investigated. Electron backscatter diffraction and energy-dispersive X-ray spectroscopy were used for microstructural and compositional analysis. Inverse pole figure, phase, and kernel average misorientation (KAM) maps were analyzed in this work. Larger amounts of the FCC phase were found in the unidirectional scanning patterns for the slower scanning speed, while the cross-hatched pattern for both scanning speeds showed a lower amount of FCC. Higher KAM averages were present in the faster scanning speed specimens. According to EDS scans, small amounts of nitrogen were uniformly distributed throughout the specimens, leading to the possibility of interstitial content as a contributing factor for development of the observed FCC phase. However, there is no clear relationship between nitrogen and the FCC phase. The formation of this FCC phase could be connected to high densities of crystalline defects from processing, plastic deformation, or the distribution of interstitials in the AM structure. An unexpected Kurdjumow–Sachs-type orientation relationship between the parent beta phase and FCC phase was found, as 110 B C C ∥ 111 F C C , 111 B C C ∥ 110 F C C . [ABSTRACT FROM AUTHOR]

In this study, the potential of Fe3Al coating material as an environmentally friendly alternative to coatings containing critical elements for brake discs was investigated. A buffer layer of Cr–Mo steel (Ferro 55) that was about 500 µm thick was applied on a gray cast iron disc to enhance the coating quality and prevent the formation of hot cracks during solidification. The microstructural analysis of the cross-section of the coating showed that the buffer layer diffused into the Fe3Al coating, forming a combination of Fe3Al, Fe, and Fe3AlC0.5 phases. The tribological properties of the Fe3Al-coated disc were evaluated using pin-on-disc tests against two different copper-free friction materials extracted from commercial brake pads. The wear results show a coefficient of friction comparable to that of an uncoated disc (≈0.55), but with a reduction in particulate matter (PM) emissions, which decreased from 600 to 476 #/cm3. The last issue is an interesting aspect that is gaining increasing importance in view of the upcoming international standards. [ABSTRACT FROM AUTHOR]

Background/Aim: To evaluate the clinical efficacy of combination therapy with diquafosol sodium and sodium hyaluronate in dry eye patients after small incision lenticule extraction (SMILE). Patients and Methods: A prospective randomized controlled study was conducted on consecutive patients who were diagnosed with dry eye disease (DED) and ready to accept SMILE from January 2021 to December 2021. The participants were randomly allocated to either a combination with diquafosol sodium 3% and sodium hyaluronate 0.3% group (DQS group, n=40) or a sodium hyaluronate 0.3% group (HA group, n=41). Dry eye disease parameters included tear film break-up time (TBUT), Shirmer I test (SIT), corneal and conjunctival fluorescein staining score (FS score), and Ocular Surface Disease Index (OSDI); tests were conducted before surgery and at 1 week, 1 month, and 3 months after surgery. Results: At 1 week after surgery, there were no statistically significant overall differences in DED parameters between the 2 groups. At postoperative month 1, the FS score was significantly lower in the DQS group than in the HA group (1.20±1.06 vs. 1.83±1.41 respectively, p=0.026). At 3 months after the surgery, the DQS group was significantly superior to the HA group in OSDI (12.98±7.29 vs. 16.82±8.25, p=0.029), TBUT (5.83±2.02 vs. 4.24±0.94, p=0.0002), and SIT (7.75±3.92 vs. 5.24±3.42, p=0.003). Conclusion: Our study showed that combination therapy with diquafosol and hyaluronate was beneficial for improving both signs and symptoms of dry eye patients after small incision lenticule extraction. [ABSTRACT FROM AUTHOR]

This paper provides quantitative information about the paths taken by blown powder particles during laser cladding. A proportion of the powder is "wasted" by bouncing off the solid areas surrounding the melt pool. This wastage reduces the productivity and profitability of the process. In this paper, specially developed software was used to analyze high-speed imaging videos of the cladding process, to monitor the directions of powder particle flight toward and away from the melt pool area. This information has been correlated to the geometry and position of the melt pool zone for three different cladding techniques: single track cladding (A tracks), standard overlapping track cladding (AAA cladding), and a recently developed technique called ABA cladding. The results show that the melt pool geometry, and particularly the overlap between the melt pool and the incoming powder stream, has a strong influence on powder catchment efficiency. ABA cladding was found to have considerably better powder catchment efficiency than standard AAA cladding and this improvement can be explained by consideration of the geometries and positions of the melt pools and surrounding solid material in each case. As powder costs are an important factor in industrial laser cladding, the adaption of the ABA technique, and/or control of pool/powder stream overlap (e.g., by making the powder stream not coaxial with the laser beam), could improve the profitability of the process. [ABSTRACT FROM AUTHOR]

In this study, the application of the ABA cladding strategy in coaxial wire-based cladding processes is investigated. Individual weld seams (A) are first welded on the substrate and additional weld seams (B) are deposited into the intermediate spaces in the second step. Thereby, two different seam geometries are present in the cladding. Unidirectional AAA and ABA claddings are generated using laser hot-wire cladding and analyzed with respect to the quality criteria height, waviness, degree of dilution, and defects. Three different welding parameter sets are used to consider the effect of the contact angle on the applicability of the ABA cladding strategy. When the same process parameters and seam-to-seam offsets are used for the ABA cladding, as for the AAA cladding, the B weld seams are higher than the A weld seams and an uneven ridged cladding surface is present. Two approaches to solving this problem are considered. The cross-sectional area of the B weld seams is reduced by adjusting the welding speeds or an increase in the seam-to-seam offset. Both measures result in a significant reduction in waviness of 30%–58% compared to the AAA cladding. However, lack of fusion defects occurs more frequently at the deposition regime of the B weld seams. It was, therefore, necessary to adjust the process parameters for weld seam B. [ABSTRACT FROM AUTHOR]

The National Aeronautics and Space Administration (NASA) has been involved in the development and maturation of metal additive manufacturing (AM) for space applications since the late 2000's. Several efforts have focused on the understanding of AM processes through material characterization and testing, standards development, component fabrication, and infusion into propulsion development and flight applications. NASA matured commonly used aerospace alloys from various alloy families (Nickel, Copper, Stainless and Steel, Aluminum, and Titanium-based) through detailed AM process and heat treatment characterization, in addition to mechanical and thermophysical testing. While these alloys are actively used in many propulsion applications, there is a need for ongoing AM optimized alloys using integrated computational materials engineering (ICME) and process development for high performance applications. The applications targeted are liquid rocket engines; advanced propulsion systems; and in-space propulsion with high heat fluxes, high pressure, and/or that use propellants that can degrade alloys (e.g., hydrogen). This paper highlights the characterization and physical properties of the more common AM alloys using laser powder bed fusion (L-PBF) and laser powder directed energy deposition (LP-DED) processes. Additionally, this paper discusses some of the ongoing novel alloy development and maturation using AM for use in these harsh environments, such as GRCop-42, GRCop-84, NASA HR-1, GRX-810, and C-103. The results from these processes demonstrated that AM could enable rapid development, and that optimized alloys could be developed using ICME, yielding higher performances. These alloys have undergone modeling, fundamental metallurgical evaluations, heat treatment studies, detailed microstructure characterization, and mechanical testing campaigns. This, combined with direct application-specific component fabrication and hot-fire testing, enabled the increase of the Technology Readiness Level (TRL) through high duty-cycle testing. A background and overview of these novel AM-enabled alloys and AM processing developments including metallurgical and mechanical property studies is presented here. The latest advancement in the parallel component development and hot-fire testing and future developments for these alloys is also discussed. • Additive manufacturing (AM) has enabled development of novel alloys for extreme propulsion environments. • NASA has matured alloys including GRCop-42, GRCop-84, NASA HR-1, GRX-810, C-103. • Characterization, material properties, and hot-fire test application data has been made available. [ABSTRACT FROM AUTHOR]

Hanan M Aljammaz,1 Wijdan M Aleithan,1 Amal Mohammad Albalawi,2 Rabab T Aljayani,3 Rawabi T Aljayani,4 Manal M Aljammaz,5 Saad H Alenezi,6 Shaker Alreshidi,6 Faris Hashem,7 Naif M Alali,7 Hani B ALBalawi7 1Internal Medicine Department, King Fahad Specialist Hospital, Tabuk, Saudi Arabia; 2Psychiatry Department, Eradah Mental Health Complex, Tabuk, Saudi Arabia; 3Ophthalmology Department, Dammam Medical Complex, Dammam, Saudi Arabia; 4Internal Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia; 5Medical Laboratory Department, University of Tabuk, Tabuk, Saudi Arabia; 6Ophthalmology Department, Faculty of Medicine, Majmaah University, Majmaah, Saudi Arabia; 7Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi ArabiaCorrespondence: Faris Hashem, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia, Tel +966507001234, Fax +966144273022, Email fhashem@ut.edu.saPurpose: Dry eye disease (DED) is a common ocular problem that worsens patients’ quality of life. This study aimed to assess DED prevalence and risk factors among medical students at the University of Tabuk.Patients and Methods: This is an analytical, cross-sectional, survey-based study. An online questionnaire was distributed by email to all medical students at the University of Tabuk. A self-administered McMonnies questionnaire was used in the assessment.Results: We included 247 medical students who completed the questionnaire. Most participants were females (71.3%) and were < 25 years old (85.8%). DED prevalence rate was 18.2% (95% CI=13.61% to 23.61%). Furthermore, DED was found to be significantly associated with the presence of irritation of eyes when waking up from sleep (OR=19.315), sleeping with partially opened eyes (OR=19.105), redness and irritation of the eyes when swimming in chlorinated fresh water (OR=7.863), and having prescription eyedrops or other dry eye treatments (OR=3.083).Conclusion: Our study at the University of Tabuk found that 18.2% of medical students had dry eye disease and identified the associated risk factors. Early diagnosis and treatment are crucial to prevent complications due to the high prevalence of DED.Keywords: eye dryness, survey, DED, observational study

Aircraft manufacturing sector manufactures a huge number of preforms near to the final profile or accuracy molds to avoid waste and to be more sustainable in terms of environment. However, this near net shape (NNS) profiles need requirements to avoid expansions and contractions in the manufacturing process, restricted tolerances and high dimensional stability. Therefore, the aim of this paper is to propose a machinability characterization finished milling study of Invar 36 samples fabricated by Wire Arc Additive Manufacturing (WAAM) technology using Minimum Quantity Lubrication (MQL). The results state that the WAAM sample roughness values reach the smallest values for all the cutting conditions although the average WAAM sample force increment is 9% comparing the wrought one owing to the high hardness level of WAAM samples (20%). Moreover, not only the statistical analysis demonstrates that the cutting speed is irrelevant in this machinability investigation, but it also optimizes the best roughness value (0.8 mm) when milling at the cutting speed of 50 m/min and feed per tooth of 0.06 mm/z. Finally, the main wear mechanism when finished milling WAAM sample of Invar 36 is adhesion on the rake a clearance faces.