Correlate climate, weather parameters, and environmental exposures with the severity of symptoms and signs of dry eye disease (DED) in Dry Eye Assessment and Management (DREAM) study participants. Methods: Participants from five distinct climates completed the Ocular Surface Disease Index (OSDI) and were examined for corneal and conjunctival staining, tear breakup time (TBUT), and Schirmer's testing at baseline, 3, 6, and 12 months. Climate, weather parameters, and pollutants including ozone (O 3), carbon monoxide (CO), nitrous oxides (NO 2 , NO x , NO y), sulfur dioxide (SO 2), particulate matter, and optical depth were obtained from governmental databases. Multivariate analysis and partial correlation coefficients (ρ) were used to assess associations, adjusted for age, sex, and the presence of Sjögren disease. Results: Among 535 participants, 81% were female and mean age was 58 years. Participants from the Mediterranean climate demonstrated better corneal fluorescein staining, better TBUT, and higher Schirmer's test scores throughout the calendar year (each P < 0.0001). Greater corneal fluorescein staining was associated with lower humidity (P < 0.0038). TBUT measurements positively correlated with temperature, humidity, and dewpoint and inversely correlated with NO 2 levels (P < 0.0038). Paradoxically, some airborne pollutants were associated with less severe signs of dry eye (P < 0.0038). Windspeed was not correlated with signs of DED, and OSDI scores did not correlate with individual environmental exposures. Conclusions: Dry eye signs differed between climates and local humidity levels. With the exception of NO 2 , airborne pollutants were not associated with detrimental dry eye features. Translational Relevance: These results support limiting dry air exposure for patients with DED.

Introduction: The National Institutes of Health (NIH) is the world’s largest funding source for research, and the R01 grant is seen as a stepping stone to future granting opportunities for the physician-scientist. Recently, both a gender and degree disparity in scholarly activity has been highlighted in the medical literature. Objective: To assess NIH R01 funding trends in general surgery over the last decade. Methods: A retrospective review of general surgery funding was extracted from the NIH’s Research Portfolio Online Reporting Tools Expenditures and Results database from 2008 through 2017. All principal investigators (PIs) were categorized by gender and academic degree(s). Linear regression analysis assessed NIH grant funding trends over time and comparisons of groups were completed with the t-test. Results: From 2008 to 2017, the NIH awarded 600 R01 grants and $272,669,397 to PIs in general surgery. The majority of R01 grants were awarded to males (76.33%; p < 0.01) and those holding a Doctorate of Medicine (MD) degree (58.33%; p < 0.01). No Doctorate of Osteopathic Medicine (DO) had received an NIH R01 grant during the time studied. No statistically significant trend could be established for the number of R01 grants awarded over time (p = 0.33), grants awarded to males or females over time (p = 0.73 and p = 0.18), or for those holding an MD or other type of degree over time (p = 0.30 and p = 0.39). Also, no statistically significant trend was established for increased grant funding over time (P = 0.88) but females and those holding an other type of degree (Doctorate in Philosophy (PhD), Doctorate in Science (DSc), Master of Public Health (MPH), etc.) experienced an increase in the total dollar amount of funding over the time studied (p < 0.01 and p < 0.01). Conclusion: For the years studied, a gender and degree disparity exists for those receiving an NIH R01 grant in general surgery. However, an increase in total grant funding has been seen for both females and non-physician scientists over from 2008 through 2017.

IntroductionDespite a call for increased research by family-medicine physicians, there is no data on the demographics of those awarded a National Institutes of Health (NIH) R01 grant. ObjectiveThe purpose of the study was to assess recent NIH R01 funding trends over the last decade in family medicine.Methods A retrospective analysis of NIH R01 grant funding in family medicine was conducted by extracting demographic data from the NIH’s Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database from 2008 through 2017. Demographics were reported as percentages, and comparisons of the groups were performed by the t-test. Results From 2008 to 2017, the NIH awarded 139 R01 grants to principal investigators (PI) in family medicine. Males comprised 51.80% of all awardees, and those holding a doctorate of medicine (MD) made up 43.88% of the awardees. No one holding a Doctorate of Osteopathic Medicine (DO) degree received an NIH R01 grant during the timeframe studied. A total of 81.97% of all MDs held a dual degree. When gender and degree were considered, no statistical difference was observed for the total amount of dollars awarded. ConclusionFor the years studied, a disparity related to medical degrees was noted for those family-medicine physicians who received an NIH R01 grant. However, no gender disparity was observed.

PurposeTo raise awareness of a possible association between continuous positive airway pressure (CPAP) devices and postoperative bleb-related infection.ObservationsA 57-year old patient on CPAP presented with unilateral bleb-associated endophthalmitis 32 months after routine ExPress Trabeculectomy with mitomycin C. The offending organism, Streptococcus mitis, is a nonmotile and generally non-virulent pathogen which predominates in the normal human respiratory flora.Conclusions and importanceThis conceptual report underscores a potential relationship between CPAP use and bleb-associated endophthalmitis. Streptococcal species are the most commonly reported causative organisms in bleb-associated endophthalmitis, and S. mitis is of particular concern as the most abundant microbe among all human oral flora. A logical risk factor for infection, the CPAP device may inadvertently deliver such organisms to the vulnerable conjunctival filtering bleb.

Berg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.