Average Time Research Articles

On the structure of a viscous liquid flow under periodic influences which have no predominant direction in space

Purpose of the work is the revealing and the researching of peculiarities of the dynamics of a viscous liquid which is undergoing by periodic in time influences possessing no predominant direction in space underpossible simplest hydro-mechanical conditions (which are able to provide non-trivial behavior of the liquid). Methods. The analytic investigational methods for boundary problems for Navier–Stokes and continuity equations are used that are the method of perturbations, the method of Fourier. Results. A new problem on the flow of a viscous liquid is formulated and solved. The hydro-mechanical system consists of an incompressible viscous liquid and a moving absolutely solid wall which creates periodic influences to the liquid. A new peculiarity of the viscous liquid dynamics is revealed consisting in that in simplest hydro-mechanical conditions the liquid in the background of oscillatios (in average of time) performs a motion of a new type — a stationary fading with the distance from the wall motion which is characterized by the presence of a laminate structure. A physical interpretation of the formulation of the problem under consideration is given. Conclusion. The obtained results can be used in particular in a scientific search of ways to control hydro-mechanical systems, under a developing methods of a creation of prescribed flows of liquid media.

Surgeon ability to predict physical activity and sedentary time: Comparison of self-reported and measured activity

BackgroundPrior work evaluated clinician work-related physical activity and found it does not meet recommended requirements. We aimed to assess more fully daily surgeon physical activity and compare it to self-reported activity. MethodsThis multispecialty prospective cohort study included attending surgeons from 14 surgical departments within four French university hospitals. Over a 14-month period (11/01/2020-12/31/2021), surgeons were continuously monitored 24/7 for their daily physical activity by wearing an accelerometer on their ankle. For each surgeon, measured parameters included the daily average of step counts and sedentary time, as well as the total weekly time of physical activity within the 30 days preceding surgeries. Surgeons self-reported the validated Global Physical Activity Questionnaire from the World Health Organization (WHO). The self-reported and measured physical activity of surgeons were described, and their correlation was assessed using Spearman rank correlation. ResultsOverall, there were 38 surgeons in the cohort and 8810 surgeries performed. Surgeons were 78.9 % male, median age was 46.1, and median BMI was 24.5. Median measured daily step count was 9439 (IQR: 7238–9918). The measured weekly total time of physical activity was 918 min (95 % CI: 767–990), while the corresponding self-reported median time was 1940 min (95 % CI: 1120–3600) (Spearman coefficient = 0.14, p = 0.41). The measured median daily sedentary time was 353 min (95 % CI: 316–374), compared to a self-reported median of 240 min (95 % CI: 210–300) (Spearman coefficient = 0.20, p = 0.24). ConclusionsSurgeons may overestimate the sufficiency of their physical activity and underestimate their sedentary time. Increased awareness is needed to improve surgeon wellness.

Event-Triggered Adaptive Antidisturbance Switching Control for Switched Systems With Dynamic Neural Network Disturbance Modeling.

In this article, a dynamic event-triggered adaptive antidisturbance (ETAAD) switching control strategy is proposed for switched systems subject to multisource disturbances. The disturbances are divided into two categories: the available unmodeled disturbance and the unavailable dynamic neural network modeled disturbance. First, a dynamic ET criterion is set based on the system state. Then, a novel dynamic ETA disturbance estimator is introduced to observe the modeled disturbance. Furthermore, according to the ET rule and adaptive disturbance observer, a switched controller is designed. Next, under the controller and switching criterion with the average dwell time limitation, sufficient conditions are given to force the switched systems to realize multisource disturbance suppression (DS), trajectory tracking, and communication resource (CR) saving simultaneously. Meanwhile, the Zeno phenomenon may be caused by the ET rule being excluded. In addition, the presented ETAAD approach is also applicable to the nonswitched systems case. Finally, a simulation case is given to validate the effectiveness of the dynamic ETAAD switching control method.

Naringenin Nanoformulations for Neurodegenerative Diseases.

Glioblastoma (GBM) is a grade-IV astrocytoma, which is the most common and aggressive type of brain tumor, spreads rapidly and has a life-threatening catastrophic effect. GBM mostly occurs in adults with an average survival time of 15 to 18 months, and the overall mortality rate is 5%. Significant invasion and drug resistance activity cause the poor diagnosis of GBM. Naringenin (NRG) is a plant secondary metabolite byproduct of the flavanone subgroup. NRG can cross the blood-brain barrier and deliver drugs into the central nervous system when conjugated with appropriate nanocarriers to overcome the challenges associated with gliomas through naringenin-loaded nanoformulations. Here, we discuss several nanocarriers employed that are as delivery systems, such as polymeric nanoparticles, micelles, liposomes, solid lipid nanoparticles (SLNs), nanosuspensions, and nanoemulsions. These naringenin-loaded nanoformulations have been tested in various in vitro and in vivo models as a potential treatment for brain disorders. This review nanoformulations of NRG can a possible therapeutic alternative for the treatment of neurological diseases are discussed.

Low interobserver agreement among subspecialised breast pathologists in evaluating HER2-low breast cancer

AimsMetastatic HER2-low breast cancer (HLBC) can be treated by trastuzumab deruxtecan. Assessment of low levels of HER2 protein expression suffers from poor interobserver reproducibility. The aim of the study was...

Real-world analysis of two ischaemic stroke and TIA systolic blood pressure goals on 12-month mortality and recurrent vascular events

IntroductionWhether obtaining the more intensive goal systolic blood pressure (SBP) of <130 mm Hg, rather than a less intensive SBP goal of <140 mm Hg poststroke/transient ischaemic attack (TIA) is...

Association of screen exposure/sedentary behavior and precocious puberty/early puberty.

In recent years, with the development of society, children's daily exposure to screen time has gradually increased. Screen exposure and sedentary behavior have brought a host of harms to children's lives. The aim of this study was to explore the effects of screen exposure and sedentary behavior on precocious puberty and early development. This is a cross-sectional study in the school-based population. A total of 3,560 children were recruited from Qufu City, Shandong province using multistage stratified cluster random sampling. All study subjects had a physical examination by professional pediatricians in October 2019, and were investigated with health questionnaires. Precocious puberty is defined as development of secondary sexual signs in boys before 9 years or in girls before 8 years. Screen time was calculated as the average of screen time on weekdays and weekend days, and sedentary time was calculated as the average of sedentary time on weekdays and weekend days. After adjusting for potential confounders, logistic regression was used to examine the association between screen exposure and sedentary behavior and early puberty and precocious puberty. Sedentary time was a risk factor for precocious puberty and early development (OR = 1.428, 95% CI = 1.087-1.876) in girls without adjustment. No significant association was found between screen exposure and early puberty and early development both in girls and boys. Excessive sedentary behavior was associated with an increased risk of early puberty, especially in girls, while there was no significant association between screen exposure and early puberty and early development. In addition, further longitudinal investigations are needed to determine the causal relationship between screen exposure, sedentary behavior and precocious puberty.

Three-Dimensional Printing Technology Based on Digital Orthopedics: 5-Point Positioning Point-Contact Pedicle Navigation Template in the Case of Scoliosis and Complex Pedicle.

Imperfect fitting of the navigation template leads to prolonged surgery time and increased blood loss. These problems have not been effectively addressed in previous research. This study explores the efficacy of a novel 5-point positioning point-contact pedicle navigation template in complex pedicle situations in scoliosis. This study employed a retrospective controlled design. From November 2019 to November 2023, 28 patients with scoliosis and complex pedicle were selected and underwent scoliosis correction surgery. A 5-point positioning point-contact pedicle navigation template was used intraoperatively to guide pedicle screw placement. Matched with 56 historical cases as a control group. The analysis included screw placement time, screw placement bleeding volume, fluoroscopy frequency, manual repositioning frequency, screw placement accuracy and grade, screw placement complications, and main curve correction rate. Continuous variables were compared using the independent samples t-test. Categorical data were analyzed with the chi-square test. All 28 patients successfully underwent surgery, with a total of 268 pedicle screws placed. The surgery duration ranged from 220 to 410 min, with an average of (283.16 ± 51.26) min. Intraoperative blood loss ranged from 630 to 1900 mL, with an average of (902.17 ± 361.25) mL. Pedicle screw placement time ranged from 60 to 130 min, with an average of (85.24 ± 24.65) min. Pedicle screw placement bleeding volume ranged from 40 to 180 mL, with an average of (76.47 ± 42.65) mL. Fluoroscopy frequency ranged from 3 to 7 times, with an average of (4.31 ± 1.14) times. Manual repositioning frequency ranged from 0 to 2 times, with an average of (0.46 ± 0.58) times. Pedicle screw placement grades: Grade I: 237 screws; Grade II: 25 screws; Grade III: 6 screws; Grade IV: 0 screws. There were no screw-related complications. The correction rate ranged from 46% to 68%, with an average of (55.83 ± 9.22)%. Compared to the experienced screw group, the differences in screw placement time, screw placement bleeding volume, fluoroscopy procedures, and manual redirections were statistically significant (p < 0.05). The 5-point positioning point-contact pedicle navigation template features a claw-like structure that securely adapts to various deformed vertebral facet joints, avoiding drift phenomena and ensuring accurate screw placement. Its pointed contact structure with the lamina of the spine avoids extensive and complete detachment of posterior structures, reducing blood loss, surgery time, and trauma. Predesigned pedicle screw entry points and directions reduce fluoroscopy frequency and surgery time.

Correlation analysis of cofilin-1 with renal prognosis in primary IgA nephropathy

PurposeThe purpose of this study was to investigate the correlation between podocyte related biomarker cofilin-1 and renal function, and explore the value of cofilin-1 in predicting the risk of renal adverse prognosis in IgA nephropathy (IgAN).MethodsPatients with primary IgAN diagnosed by initial renal biopsy performed in our hospital from January 2019 to February 2022 were included. This study was a prospective cohort study. All IgAN patients were detected the expression of cofilin-1 and other related biomarkers (RhoA, NGAL) in urine by enzyme-linked immunosorbent assay (ELISA) and follow-up at least 6 months. We also collected baseline clinicopathologial data of IgAN. The decreased renal function group was defined as baseline eGFR < 60 ml/min/1.73m2. Logistic and Cox regression model were used to analyze the correlation among cofilin-1 and renal prognosis.Results133 IgAN patients were included, with a male-to-female ratio of 1.25:1 and an age of 37.67 ± 13.78 years, as well as an average of eGFR was 71.63 (40.42,109.33) ml/min/1.73m2. 56 patients (42.1%) had decreased renal function at baseline, with the average of eGFR was 34.07 (16.72, 49.21) ml/min/1.73 m2. 12 of which developed to renal adverse prognosis. The average of follow-up time was 22.035 ± 8.992 months. The multivariate regression analysis showed that increased urinary cofilin-1 was an independent risk factor associated with baseline renal function decline and renal adverse prognosis in IgAN patients (P < 0.05). ROC curves showed great efficacy of urinary cofilin-1 levels in diagnosing baseline renal function decline and predicting renal adverse prognosis (the area under the ROC curve was 0.708 and 0.803).ConclusionCofilin-1 as a novel biomarker of podocyte lesion is closely related to renal function decline in IgAN. Cofilin-1 has certain clinical value in predicting the risk of renal adverse prognosis. Podocyte fusion affects the renal prognosis of IgAN.

NEOROCKS color survey: Final results

Context. Near-Earth objects (NEOs) are the most accessible small Solar System bodies by both spacecrafts and ground-based telescopes. Close encounters of these objects with Earth represent opportunities to characterize their physical and mineralogical properties. They are also a constant threat to humanity due to possible impact events with Earth. In this context, the NEOROCKS project has been financed by the European Union’s Horizon 2020 research and innovation program. Aims. We present the final results on photometry of the NEOROCKS project, with the aim of extending the dataset of surface colors for small NEOs with unknown properties and, when possible, characterizing newly discovered NEOs. Methods. Photometric observations were performed using the 1.2 m telescope at the Haute-Provence observatory (in France) in the BVRI filters of the Johnson-Cousins photometric systems between May 2022 and June 2023. The stability and dynamics of objects from the NEOROCKS database was investigated by numerical integration. Results. We obtained new surface colors for 83 NEOs. Overall, the NEOROCKS color database contains 170 objects. The majority of the objects in the dataset with diameters D&lt;500 m belong to a group of silicate bodies. We estimated the unbalanced percentage between S- and C-type objects as an observational bias due to reflective proprieties of the surface of objects. The average of Lyapunov time of about 100 years is evidence of highly chaotic orbits of objects from the color database of NEOROCKS. Asteroid 2011 OL51 has a reasonable probability of being a parent body contributor to the October Capricornidis meteor shower. Asteroids 2004 HK33, 2022 VV (D-type), 2003 WR21, and 2017 SE1 (A-type) belong to end-member classes and have ΔV&lt;7 km/s; thus, they are possible candidates for in situ investigations.

Cauchy universality and random billiards

Motion in bounded domains represents a paradigm in several settings: from billiard dynamics, to random walks in a finite lattice, with applications to relevant physical, ecological, and biological problems. A remarkable universal property, involving the average of return times to the boundary, has been theoretically proposed and experimentally verified in quite different contexts. We discuss here mechanisms that lead to violations of universality, induced by boundary effects and we also emphasize the role played by replacing straight lines with random walks in this framework. We suggest that our analysis should be relevant where nonhomogeneity appears in the stationary probability distribution in bounded domain. Published by the American Physical Society 2024

Stabilization of Networked Switched Systems Under DoS Attacks.

This article studies the stability issue of networked switched systems (NSSs) under denial-of-service (DoS) attacks. To address this issue, the derived limitations imposed on both the frequency of DoS attacks on each subsystem and the upper limit of attack duration that each subsystem can tolerate are mode-dependent, which is more efficient and flexible than the current results for NSSs. Moreover, we reveal the relationship between the upper bound of the average maximum tolerable attack duration associated with the corresponding subsystem and the actual mode-dependent average dwell time. Furthermore, we identify that the total tolerable DoS attack duration as a percentage of the system runtime in this article can be higher than existing results. Finally, an example is given to demonstrate the effectiveness of our work.

Power-Doppler Ultrasonic Imaging of Peripheral Perfusion in Diabetic Mice.

We explored the capabilities of power-Doppler ultrasonic (PD-US) imaging without contrast enhancement for monitoring changes in muscle perfusion over time. Ischemic recovery was observed in healthy and type II diabetic male and female mice with and without exercise. In separate studies, perfusion was measured during and after 5-min ischemic periods and during four-week recovery periods following irreversible femoral ligation. A goal was to assess how well PD-US estimates tracked the diabetic-related changes in endothelial function that influenced perfusion. The average perfusion recovery time following femoral ligation increased 47% in diabetic males and 74% in diabetic females compared with non-diabetic mice. Flow-mediated dilation in conduit arteries and the reactive hyperemia index in resistive vessels each declined by one half in sedentary diabetic mice compared with sedentary non-diabetic mice. We found that exercise reduced the loss of endothelial function from diabetes in both sexes. The reproducibility of perfusion measurements was limited primarily by our ability to select the same region in muscle and to effectively filter tissue clutter. PD-US measurements can precisely follow site-specific changes in skeletal muscle perfusion related to diabetes over time, which fills the need for techniques capable of regularly monitoring atherosclerotic changes leading to ischemic vascular pathologies.

Does intramedullary K-wire buried under the skin justify the treatment for both-bone forearm fracture in children? : A descriptive analytical study

Introduction: Surgical treatment including intramedullary K wire fixation is desirable for unstable pediatric both bone fracture to avoid angulation, rotational deformity and refracture ensuring optimal functional outcomes. However, it is debatable to leave free end of K wire exposed or to bury underneath the skin. The aim of the study is to assess the functional outcomes and complications after intramedullary K wire buried under the skin for pediatric both bone fracture. Method: This is a prospective analytical study performed from 15 August 2021 to 15 February 2023. This study included unstable closed diaphyseal forearm facture in children aged between 5 and 13 years treated with intramedullary K wires which were buried inside the skin. Study variables included demographical profiles, fracture pattern, time for surgical intervention, Modified Flynn et al criteria, time to unite the fracture and any associated complications). Results: Mean age of the patient in our study was 8.70±2.17 years. Average time required to unite the fracture was 3.15±0.62 months. Thirty-Four (97.2%) patients had excellent outcomes; one (2.8%) patient had good functional outcomes based on Modified Flynn et al criteria. Nine (25.7%) patients had bursa formation at proximal aspect of ulnar K wire while one patient (2.8%) had superficial infection at olecranon site. Conclusion: Intramedullary K wire for pediatric diaphyseal both bone fractures is excellent surgical technique. Even though controversy exist between exposed K wires and those buried underneath the skin, buried K wires have reasonable advantages and less side effects in terms of infection and overall functional outcomes. Keywords: Both bone; Bury; Forearm fracture; Functional outcomes; Intramedullary K wire

Fault-Tolerant Control of Floating Wind Turbine With Switched Adaptive Sliding Mode Controller

The fast-growing development of floating wind turbines demands control systems capable of both reducing output power fluctuations and fault-tolerant function. In this paper, we propose an adaptive switched sliding mode controller to enhance the performance of floating wind turbine systems in the presence of environmental uncertainties and actuator faults. A control-oriented switched linear model for floating wind turbines is introduced, considering the average dwell time. Based on the proposed controller, a full-order state observer and an adaptive law compensate for the debilitated control outputs resulting from detecting errors, disturbances, and faults. The control parameters are derived by solving stability theorems, which are proved by the Lyapunov stability theory, linear matrix inequality technique, and average dwell time technique. The proposed model and controller are validated on the NREL 5MW wind turbine and spar-buoy platform using the high-fidelity fatigue, aerodynamics, structures, and turbulence (FAST) code. The performance of the proposed controller is compared with an optimal gain-scheduling proportional-integral controller under different wind-wave combined conditions. The results show that the proposed controller improves the power quality and attenuates mechanical loads of floating wind turbine under healthy and faulty conditions. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —Floating wind turbines have drawn significant interest in renewable energy. When operating in the ocean far from shore, it is of great importance for floating wind turbines to have fault-tolerance capabilities for achieving stable power quality when faults occur in one or more components. A challenging problem is how to mitigate the fault effects on the wind turbine system. This paper proposes an adaptive fault-tolerant control strategy in the case of actuator fault occurrence in floating wind turbines.

Accurate Vision-Based PCB Positioning Using Cosine-Convolutional Neural Networks

Object positioning is a fundamental task for assembly and inspection operations in the electronic industry. Traditional methods such as template matching and feature-point detection have been applied for object positioning. They are however computationally expensive and are generally affected by environmental changes. Deep learning models based on Convolutional Neural Network (CNN) have also been used for object positioning. They are computationally very efficient but can be sensible under environmental variations such as illumination and noise. In this article, a Cosine-Convolution operation is proposed with the objective of minimizing the effects of illumination variations. The proposed Cosine-Convolution can substitute any convolutional operation in a CNN-based regressor for positioning tasks. The proposed convolution is based on cosine-measure that normalizes the convolution between an image window and a filter at local scope. The proposed Cosine-Convolutional Neural Network (Cosine-CNN) performs more accurate than the traditional CNN under environment variations, including illumination changes, noise, defocusing and template occlusion. The experimental results reveal that the proposed model can reach mean prediction errors smaller than 1 pixel and <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$1^\circ$</tex-math> </inline-formula> for object shift and rotation, regardless of the environmental variations. The method is computationally very fast, with an average evaluation time of 1.2-ms for real-time PCB positioning. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —The training of deep learning models based on Convolutional Neural Network (CNN) can be tedious. Image samples with different illumination settings must be provided to have an efficient and robust model, which may not be easy to acquire or synthesize. This study proposes a solution to the challenge of illumination variations in images for the object positioning task in Printed Circuit Boards (PCB). A new Convolutional operation called Cosine-Convolutional that normalizes the traditional Convolution is introduced to overcome the illumination variations in the input images. Experimental results demonstrate that the proposed Cosine-Convolutional operation is less sensitive against lightning variations with respect to the training images.

EUS-guided Gastroenterostomy: A Multicenter International Study Comparing Benign and Malignant Diseases.

Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is a minimally invasive therapy for patients with gastric outlet obstruction without the risks of surgical bypass and the limited long-term efficacy of enteral self-expanding metal stent placement. However, due to its novelty, there is a lack of significant data comparing long-term outcomes of patients with EUS-GE, based on the underlying disease. In this study, we compare outcomes of EUS-GE on benign versus malignant indications. Consecutive patients from 12 international, tertiary care centers who underwent EUS-GE over 3 years were extracted in a retrospective registry. Demographic characteristics, procedure-related information and follow-up data was collected. Primary outcome was the rate of adverse events associated with EUS-GE and the comparison of the rate of adverse events in benign versus malignant diseases. Secondary outcomes included technical and clinical success as well as hospitalization admission. A total of 103 patients were included: 72 malignant and 31 benign. The characteristics of the patients undergoing EUS-GE is shown in Table 1. The mean age of the cohort was 68 years and 58 years for malignant and benign etiology. Gender distribution was 57% and 39% being females in malignant and benign etiology group, respectively. Clinical success, technical success, average procedure time, and hospital length of stay were similar in both groups. Patients with benign underlying etiology had significantly higher number of surgically altered midgut anatomy ( P =0.0379). EUS-GE is equally efficient regardless of the underlying etiology (malignant vs. benign), and the adverse events both groups were comparable.

ECGVEDNET: A Variational Encoder-Decoder Network for ECG Delineation in Morphology Variant ECGs.

Electrocardiogram (ECG) delineation to identify the fiducial points of ECG segments, plays an important role in cardiovascular diagnosis and care. Whilst deep delineation frameworks have been deployed within the literature, several factors still hinder their development: (a) data availability: the capacity of deep learning models to generalise is limited by the amount of available data; (b) morphology variations: ECG complexes vary, even within the same person, which degrades the performance of conventional deep learning models. To address these concerns, we present a large-scale 12-leads ECG dataset, ICDIRS, to train and evaluate a novel deep delineation model-ECGVEDNET. ICDIRS is a large-scale ECG dataset with 156,145 QRS onset annotations and 156,145 T peak annotations. ECGVEDNET is a novel variational encoder-decoder network designed to address morphology variations. In ECGVEDNET, we construct a well-regularized latent space, in which the latent features of ECG follow a regular distribution and present smaller morphology variations than in the raw data space. Finally, a transfer learning framework is proposed to transfer the knowledge learned on ICDIRS to smaller datasets. On ICDIRS, ECGVEDNET achieves accuracy of 86.28%/88.31% within 5/10 ms tolerance for QRS onset and accuracy of 89.94%/91.16% within 5/10 ms tolerance for T peak. On QTDB, the average time errors computed for QRS onset and T peak are -1.86 ± 8.02 ms and -0.50 ± 12.96 ms, respectively, achieving state-of-the-art performances on both large and small-scale datasets. We will release the source code and the pre-trained model on ICDIRS once accepted.

Quality Economic Growth: Is It Possible to Achieve by An Archipelago Area?

The purpose of this study, the researcher uses descriptive and verifiable analysis methods. Verifiable analysis through panel data regression analysis, by choosing the best approach from the Common Effect Model, Fixed Effect Model or Random Effect Model. The research variables consisted of natural resource factors (F_SDA) in the primary sector which were proxied from the contribution of the agriculture, forestry and fisheries sectors as well as the mining and quarrying sector to GDP, Foreign Investment (FDI), Government Expenditure (Blj_P), Average School Length (R_LS), Population Growth (Pert_Pduk) as free variables and Economic Growth (Pert_Ek) and Employment Opportunity Rate (TKK). Secondary data was obtained from BPS, the Ministry of Finance of the Republic of Indonesia, SatuData of the Ministry of Manpower. The type of data is panel data that was studied during the time period 2010 to 2019. The results of the study show that relatively high economic growth in areas with archipelagic characteristics does not have an impact on increasing employment opportunities. The F_SDA and FDI variables have no effect on economic growth in archipelagic areas, the Blj_P variables are influential and significant, while Pert_Pduk have an effect but not significantly on economic growth in archipelagic areas. The human resource factor variable that is proxied from the average of a long time (R_LS) has an effect but is negative and significant on economic growth in the archipelago. Overall, from this study, it was found that economic growth in the archipelago during the period from 2010 to 2019 was not of good quality.

Influential Signs of Dry Eye-Related Ocular Symptoms in Participants With Unstable Tear Film.

The aim of this study was to investigate the factors influencing dry eye disease (DED)-related ocular symptoms in participants with short fluorescein tear break-up time (FTBUT). This cross-sectional study included 82 participants with short FTBUT (<10 seconds). Examinations included Ocular Surface Disease Index (OSDI), FTBUT, average noninvasive tear break-up time (NIBUTave), lid wiper epitheliopathy, lipid layer thickness, blink rate, partial blink, tear meniscus height, and meibomian gland (MG) evaluation which included ratio of residual MG area (RMGA) and MG grade in tarsal plates. One-way analysis of variance was used to detect differences between symptomatic tear film instability group (FTBUT <5 s, OSDI ≥13), asymptomatic tear film instability group (FTBUT <5 s, OSDI <13), and control group (FTBUT ≥5 s, OSDI <13). A bivariate correlation, partial correlation, and multiple linear regression analyses were used to identify major factors. Only the right eye was included. Among the participants with FTBUT <5 seconds, symptomatic group showed less upper RMGA ( P < 0.001) and NIBUTave ( P = 0.010). OSDI was negatively associated with upper RMGA ( r = -0.450, P < 0.001) and NIBUTave ( r = -0.414, P = 0.001), and positively associated with upper MG grade ( r = 0.277, P = 0.027). Linear regression analysis showed that the upper RMGA significantly affected OSDI (B = -41.895, P = 0.001), while not significantly correlated with age, upper MG grade, and NIBUTave. The upper RMGA might be the main factor affecting DED-related discomfort in participants with unstable tear film, indicating an early ocular change in DED.