The greater prevalence of dry eye in women compared to men suggests that sex hormones may have a role in this condition. This review aims to present evidence for how sex hormones may affect the ocular structures involved in the production, regulation and maintenance of the normal tear film. It is hypothesised that hormone changes alter the homeostasis of the ocular surface and contribute to dry eye. Androgens impact on the structure and function of the meibomian and lacrimal glands and therefore androgen deficiency is, at least in part, associated with the aetiology of dry eye. In contrast, reports of the effects of oestrogen and progesterone on these ocular structures and on the conjunctiva are contradictory and the mechanisms of action of these female-specific sex hormones in the eye are not well understood. The uncertainty of the effects of oestrogen and progesterone on dry eye symptoms is reflected in the controversial relationship between hormone replacement therapy and the signs and symptoms of dry eye. Current understanding of sex hormone influences on the immune system suggests that oestrogen may modulate a cascade of inflammatory events, which underlie dry eye.

Composing adaptive and self-managing Web services needs plug-and-play architecture so that the deployment of control components does not require changes made to the Web services and the host middleware platforms. This is especially challenging for Web services running on COTS middleware platforms, such as Microsoft .Net. In this paper, we propose an architectural solution that introduces a management proxy between adaptive control components and Web services. The management proxy can be customized and seamlessly integrated with a COTS middleware platform by leveraging the existing middleware mechanisms. This solution enables dynamically composing adaptive Web services on COTS middleware without stopping its services. We demonstrate this architecture by a realistic Web service application built on .Net Windows Communication Foundation (WCF). The performance overhead incurred by this architecture is measured, and the results validate that our solution is efficient in terms of performance and flexibility.