Search

Rosacea is a common cause of ocular surface disease. Specific immunologic features have been implicated in its pathogenesis, including toll-like receptors, mitogen-associated kinase, and nuclear factor kappa-B. Myeolid differentiation factor 88 (MYD88) has been associated with these elements, suggesting a role for this protein in rosacea. This study was designed to compare the expression of MYD88 in the eyelids of patients with and without this disease.Western blotting for MYD88 was performed in 14 control patients and 15 patients with rosacea. Bands were quantified and normalized to actin. Immunohistochemical staining for MYD88 was performed in a different cohort of 12 patients with rosacea and 12 controls, and positively-staining cells were counted across five consecutive 40x fields. Statistical analyses compared the differences between the two groups via a dedicated software package.On western blotting, the mean ratios of MYD88 to actin were 13.8 (standard deviation = 14.1) and 44.3 (standard deviation = 39.6) in control and rosacea patients, respectively (MYD88 is enriched in eyelid specimens of rosacea. This finding further implicates the innate immune system in the pathogenesis of rosacea, and is consistent with previous reports regarding the role of this protein in ocular surface disease and the previously-implicated cellular features of the disease. Inhibition of MYD88 may be a successful treatment strategy to manage rosacea.

There is a growing demand for understanding sources of predictability on subseasonal to seasonal (S2S) time scales. Predictability at subseasonal time scales is believed to come from processes varying slower than the atmosphere such as soil moisture, snowpack, sea ice, and ocean heat content. The stratosphere as well as tropospheric modes of variability can also provide predictability at subseasonal time scales. However, the contributions of the above sources to S2S predictability are not well quantified. Here we evaluate the subseasonal prediction skill of the Community Earth System Model, version 1 (CESM1), in the default version of the model as well as a version with the improved representation of stratospheric variability to assess the role of an improved stratosphere on prediction skill. We demonstrate that the subseasonal skill of CESM1 for surface temperature and precipitation is comparable to that of operational models. We find that a better-resolved stratosphere improves stratospheric but not surface prediction skill for weeks 3–4.

Purpose To compare the expression of cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) and lymphocyte activation gene-3 (LAG-3) in nodular and orbitally-invasive forms of basal cell carcinoma (BCC). Methods Immunohistochemical staining for CTLA-4 and LAG-3 was performed on the pathology specimens of BCC from orbital exenteration and nodular forms. The numbers of positively-staining cells/×40 field were counted across 5 consecutive fields of each specimen and statistical analysis was performed to calculate the difference in expression between the 2 groups. Results Nine cases of orbitally-invasive BCC and 6 cases of nodular BCC were studied. The mean numbers of CTLA-4-positively staining cells were 11.51 cells/×40 field (median = 6.60 cells/×40 field, range = 0.4-31.8 cells/×40 field) in invasive BCC and 0.90 cells/×40 field (median = 0.60 cells/×40 field, range = 0.0-2.8 cells/×40 field) in nodular specimens. The difference between the 2 groups was statistically significant (p = 0.0030). The mean number of LAG-3-positively staining cells was 0.58 cells/×40 field (median = 0.0, range = 0.0-2.8 cells/×40 field) in invasive BCC and 3.13 cells/×40 field (median = 0.0, range = 0.0-18.18 cells/×40 field). There was no significant difference in LAG-3 positivity between tumor groups (p = 0.5564). Conclusions CTLA-4 expression was enriched in orbitally invasive BCC compared with nodular forms of BCC, whereas LAG-3 expression did not differ between these entities. CTLA-4 mediated immune suppression may facilitate the development of orbitally invasive BCC. Treatment strategies that use existing medications to target CTLA-4 may decrease the requirement for orbital exenteration and provide enhanced survival outcomes.

To compare characteristics of laser treatment for high-risk type 1 retinopathy of prematurity (ROP) in eyes treated with primary laser versus laser after an initial treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF).The medical records of consecutive patients at a single academic institution treated for type 1 ROP before 36 weeks' postmenstrual age with primary laser versus laser after initial treatment with anti-VEGF were reviewed retrospectively. Outcome measures were laser spot number, mean laser power, total laser energy (Joules), and retinal vascularization to the nasal ora at time of laser treatment.Compared with the 46 eyes treated with primary laser, the 46 eyes treated with laser after anti-VEGF required fewer spots (mean, 775 vs 1418 [P0.01]), less power (182 vs 223 mW [P0.01]), and less total energy (27 vs 61 Joules [P0.01]), and showed greater vascularization to the nasal ora at the time of laser treatment (47.8% vs 6.5% [P0.01]).In our study cohort, laser after initial anti-VEGF treatment may have allowed for greater retinal vascularization and been less destructive than primary laser for high-risk type 1 ROP.

Subseasonal weather prediction can reduce economic disruption and loss of life, especially during "windows of opportunity" when noteworthy events in the Earth system are followed by characteristic weather patterns. Sudden stratospheric warmings (SSWs), breakdowns of the winter stratospheric polar vortex, are one such event. They often precede warm temperatures in Northern Canada and cold, stormy weather throughout Europe and the United States - including the most recent SSW on January 5th, 2021. Here we assess the drivers of surface weather in the weeks following the SSW through initial condition "scrambling" experiments using the real-time CESM2(WACCM6) Earth system prediction framework. We find that the SSW itself had a limited impact, and that stratospheric polar vortex stretching and wave reflection had no discernible contribution to the record cold in North America in February. Instead, the tropospheric circulation and bidirectional coupling between the troposphere and stratosphere were dominant contributors to variability.

To compare rates of short-term retinal detachment (RD) of infants treated for type 1 retinopathy of prematurity (ROP) with intravitreal anti-vascular endothelial growth factor (VEGF) therapy with infants treated with laser therapy. The choice between these 2 treatments remains controversial. Comparative data are limited and describe re-treatment rates rather than retinal structural outcomes predictive of long-term vision. Anti-vascular endothelial growth factor acts faster than laser therapy, which may be beneficial for more aggressive ROP.Nonrandomized, comparative cohort study.The study included 1167 eyes of 640 infants treated for type 1 ROP. Among these, 164 eyes received anti-VEGF therapy and 1003 eyes received laser therapy.Pretreatment and posttreatment examinations and treatments were completed by ophthalmologists with expertise in ROP. The study was a secondary analysis of data from the retrospective Postnatal Growth and Retinopathy of Prematurity Study (G-ROP) 1 study (2006-2012) and the prospective G-ROP 2 study (2015-2017).Rate of RD (ROP stages 4A, 4B, or 5) within 8 weeks of initial treatment, an end point predictive of poor long-term vision. The results were stratified by postmenstrual age (PMA) at treatment as occurring before versus at or after 36 weeks and 0 days, because earlier disease may be considered more aggressive.Among 458 eyes treated before PMA 36 weeks and 0 days, the short-term RD rate was higher after laser therapy (29/368 eyes [7.9%]) than after anti-VEGF therapy (0/90 eyes [0%]; P0.001). Of 709 eyes treated at or after PMA 36 weeks and 0 days, short-term RD risk did not differ between groups (laser [20/635 eyes], 3.1%; anti-VEGF [1/74 eyes], 1.4%; P = 0.27).Anti-vascular endothelial growth factor therapy results in better short-term structural outcomes than laser therapy when type 1 ROP is treated before 36 weeks' PMA. After this age, both treatments have very low rates of short-term RD. The faster action of anti-VEGF agents likely is responsible for these findings.

Purpose To compare respiratory outcomes after treatment of retinopathy of prematurity (ROP) between infants treated with laser therapy under general anesthesia and infants treated with intravitreal bevacizumab under bedside sedation. Design Retrospective cohort study. Participants One hundred thirty-eight consecutive infants treated for ROP from September 2010 through September 2018 at 1 institution. Methods Retrospective medical, procedural, and ophthalmologic data were collected, including preprocedure (baseline) and postprocedure (24 hours, 48 hours, 7 days, and 28 days) respiratory status, birth weight, gestational age, gender, ROP treatment method, postmenstrual age at treatment, and coincident nonocular procedures during anesthesia. Respiratory outcomes at 48 hours were compared between infants treated with laser therapy under general anesthesia and infants treated with intravitreal bevacizumab under local sedation using multivariate logistic regression analysis to control for potentially confounding factors. Main Outcome Measures Proportion of infants who had returned to their respiratory baseline by 48 hours after ROP treatment. Results Return to respiratory baseline was significantly less common among 119 infants initially treated with laser therapy compared with 19 infants initially treated with bevacizumab at 24 hours (40% vs. 74%; P = 0.0115), 48 hours (53% vs. 79%; P = 0.0453), and 7 days (79% vs. 100%; P = 0.0242). In a multivariate logistic regression analysis, infants treated with laser therapy were less likely to return to respiratory baseline at 48 hours (odds ratio, 0.14; 95% confidence interval, 0.04–0.54). At 28 days, no difference was found between groups (laser, 97%; bevacizumab, 100%; P > 0.99). Conclusions Infants treated with intravitreal bevacizumab using bedside sedation returned to their preprocedure respiratory baseline faster than infants treated with laser under general anesthesia, with the differences persisting at least to 7 days or more after the procedure.

Changes in internal variability of seasonal and annual mean 2-m temperature in response to anthropogenic forcing are quantified for a global domain using climate models driven by a twenty-first-century high-emissions scenario. While changes in variance have been quantified previously in a univariate sense, the field significance of such changes has remained unclear. This paper proposes a new field significance test for changes in variance that accounts for spatial and temporal relationships within the domain. The test proposed here uses an optimization technique based on discriminant analysis, yielding results that are invariant to linear transformations of the data and therefore independent of normalization procedures. Multiple significance tests are employed because spatial fields can differ in many ways in a multivariate space. All climate models investigated here predict significant changes in internal variability of temperature in response to anthropogenic forcing. The models consistently predict decreases to temperature variance in regions of seasonal sea ice formation and across the Southern Ocean by the end of the twenty-first century. While more than half the models also predict significant changes in variance over ENSO regions and the North Atlantic Ocean, the direction of this change is model dependent. Seasonal mean changes are remarkably similar to annual mean changes, but there are model-dependent exceptions. Some models predict future variability that is more than double their preindustrial control variability, raising questions about the adequacy of doubling uncertainty estimates to test robustness in detection and attribution studies.

35th European Photovoltaic Solar Energy Conference and Exhibition; 1290-1293, The outdoor exposure of PV modules to different climatic variables and physical stresses reduces the power delivery capacity of a PV module over time. The degradation of the PV performance over lifetime is usually determined within the variation of Power at maximum power point (PMPP) and Fill Factor (FF) where the same magnitude of losses of the PMPP can have different causes with different evolution over time. The physic based understanding and modeling of the performance, using the IV curve measurements, can be used to estimate important device parameters and evaluate the health state of the system. In this context the physical model of PV could provide more granulated information about degradation and underlying mechanisms to make better predictions about service life. Single diode model parameter evolution was estimated from 8 years of outdoor IV curve measurements under a range of operating conditions without translating to STC. The results show that the main ageing factors are closely related to the decrease in short-circuit current due to the optical degradation and increase in series resistance regardless of outdoor operating conditions.

Recent developments in power electronics technology have led to a significant market penetration of adjustable speed drives (ASDs), which are economical, reliable and highly flexible in their use. However, ASDs are particularly sensitive to short supply interruptions from the distribution network. These events may result in the total disconnection of the specific ASD load, thereby causing loss of revenue for the user. It may cause a loss of production capacity and may also incur significant restart costs depending on the specific industrial process in which the ASD is used. This paper presents a mitigation strategy which aims to maintain the inverter synchronized on the induction machine during short supply interruptions. This mitigation strategy allows an automatic soft restart right after the power system recovery. This technique has been validated using numerical simulations. >