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Open Mind : Discoveries in Cognitive... 2024The comparison between conscious and unconscious perception is a cornerstone of consciousness science. However, most studies reporting above-chance discrimination of...
The comparison between conscious and unconscious perception is a cornerstone of consciousness science. However, most studies reporting above-chance discrimination of unseen stimuli do not control for criterion biases when assessing awareness. We tested whether observers can discriminate subjectively invisible offsets of Vernier stimuli when visibility is probed using a bias-free task. To reduce visibility, stimuli were either backward masked or presented for very brief durations (1-3 milliseconds) using a modern-day Tachistoscope. We found some behavioral indicators of perception without awareness, and yet, no conclusive evidence thereof. To seek more decisive proof, we simulated a series of Bayesian observer models, including some that produce visibility judgements alongside type-1 judgements. Our data are best accounted for by observers with slightly suboptimal conscious access to sensory evidence. Overall, the stimuli and visibility manipulations employed here induced mild instances of blindsight-like behavior, making them attractive candidates for future investigation of this phenomenon.
PubMed: 38895041
DOI: 10.1162/opmi_a_00145 -
Frontiers in Neuroscience 2024Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual...
BACKGROUND
Single-pulse transcranial magnetic stimulation (spTMS) applied to the Early Visual Cortex (EVC) has demonstrated the ability to suppress the perception on visual targets, akin to the effect of visual masking. However, the reported spTMS suppression effects across various studies have displayed inconsistency.
OBJECTIVE
We aim to test if the heterogeneity of the spTMS effects can be attributable to variations in experimental factors.
METHODS
We conducted a meta-analysis using data collected from the PubMed and Web of Science databases spanning from 1995 to March 2024. The meta-analysis encompassed a total of 40 independent experiments drawn from 33 original articles.
RESULTS
The findings unveiled an overall significant spTMS suppression effect on visual perception. Nevertheless, there existed substantial heterogeneity among the experiments. Univariate analysis elucidated that the spTMS effects could be significantly influenced by TMS intensity, visual angle of the stimulus, coil type, and TMS stimulators from different manufacturers. Reliable spTMS suppression effects were observed within the time windows of -80 to 0 ms and 50 to 150 ms. Multivariate linear regression analyses, which included SOA, TMS intensity, visual angle of the stimulus, and coil type, identified SOA as the key factor influencing the spTMS effects. Within the 50 to 150 ms time window, optimal SOAs were identified as 112 ms and 98 ms for objective and subjective performance, respectively. Collectively, multiple experimental factors accounted for 22.9% ( = 0.3353) and 39.9% ( = 0.3724) of the variance in objective and subjective performance, respectively. Comparing univariate and multivariate analyses, it was evident that experimental factors had different impacts on objective performance and subjective performance.
CONCLUSION
The present study provided quantitative recommendations for future experiments involving the spTMS effects on visual targets, offering guidance on how to configure experimental factors to achieve the optimal masking effect.
PubMed: 38894939
DOI: 10.3389/fnins.2024.1351399 -
Antimicrobial Resistance and Infection... Jun 2024In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection.... (Observational Study)
Observational Study
Association of institutional masking policies with healthcare-associated SARS-CoV-2 infections in Swiss acute care hospitals during the BA.4/5 wave (CH-SUR study): a retrospective observational study.
BACKGROUND
In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave.
METHODS
SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the "Hospital-based surveillance of COVID-19 in Switzerland"-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model.
RESULTS
We included 2'980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30-0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies.
CONCLUSIONS
Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Topics: Humans; COVID-19; Switzerland; Masks; Retrospective Studies; Cross Infection; SARS-CoV-2; Female; Male; Middle Aged; Adult; Hospitals; Aged; Health Personnel; Infection Control; Organizational Policy; Aged, 80 and over
PubMed: 38886813
DOI: 10.1186/s13756-024-01422-4 -
PloS One 2024Organ segmentation has become a preliminary task for computer-aided intervention, diagnosis, radiation therapy, and critical robotic surgery. Automatic organ...
Organ segmentation has become a preliminary task for computer-aided intervention, diagnosis, radiation therapy, and critical robotic surgery. Automatic organ segmentation from medical images is a challenging task due to the inconsistent shape and size of different organs. Besides this, low contrast at the edges of organs due to similar types of tissue confuses the network's ability to segment the contour of organs properly. In this paper, we propose a novel convolution neural network based uncertainty-driven boundary-refined segmentation network (UDBRNet) that segments the organs from CT images. The CT images are segmented first and produce multiple segmentation masks from multi-line segmentation decoder. Uncertain regions are identified from multiple masks and the boundaries of the organs are refined based on uncertainty data. Our method achieves remarkable performance, boasting dice accuracies of 0.80, 0.95, 0.92, and 0.94 for Esophagus, Heart, Trachea, and Aorta respectively on the SegThor dataset, and 0.71, 0.89, 0.85, 0.97, and 0.97 for Esophagus, Spinal Cord, Heart, Left-Lung, and Right-Lung respectively on the LCTSC dataset. These results demonstrate the superiority of our uncertainty-driven boundary refinement technique over state-of-the-art segmentation networks such as UNet, Attention UNet, FC-denseNet, BASNet, UNet++, R2UNet, TransUNet, and DS-TransUNet. UDBRNet presents a promising network for more precise organ segmentation, particularly in challenging, uncertain conditions. The source code of our proposed method will be available at https://github.com/riadhassan/UDBRNet.
Topics: Humans; Neural Networks, Computer; Tomography, X-Ray Computed; Uncertainty; Organs at Risk; Image Processing, Computer-Assisted; Algorithms; Lung
PubMed: 38885241
DOI: 10.1371/journal.pone.0304771 -
Journal of Pharmacy & Bioallied Sciences Apr 2024The aim of this study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color...
AIM OF THE STUDY
The aim of this study was to evaluate the effect of the resin infiltration technique and remineralization of induced enamel caries with fluoride solution on the color masking of white spot lesions and surface roughness.
MATERIALS AND METHODS
A total of 45 sound teeth were used in this study. All the teeth were sectioned along the long axes into two halves, lingual and buccal to get 90 specimens. All specimens were immersed in a demineralized solution for 7 days. The specimens were divided randomly into three equal groups ( = 30) according to the type of treatment; Group 1 ( = 30) was treated with fluoride varnish (Clinpro); Group 2 ( = 30) was treated by resin infiltration (Icon); and Group 3 ( = 30) was used as a control group with no treatment. The color and surface roughness were measured three times at baseline (T1), directly after induction of artificial white spot lesions (WSLs) (T2), and directly after application of the treatment options (T3). The colors were measured using a portable reflective spectrophotometer and the 3D surface roughness was measured using a Light Sectioning Vision System. Data were collected and statistically analyzed using T test and Mann-Whitney U test.
THE RESULTS
Surface roughness was almost equal in the study groups with no statistically significant differences reported. Icon showed slightly higher color scores than that of ClinPro.
CONCLUSIONS
The Icon produced favorable esthetic results compared to the fluoride therapy while no significant differences were reported regarding the surface roughness.
PubMed: 38882736
DOI: 10.4103/jpbs.jpbs_973_23 -
PNAS Nexus Jun 2024Amid the COVID-19 pandemic, education systems globally implemented protective measures, notably mandatory mask wearing. As the pandemic's dynamics changed, many...
Amid the COVID-19 pandemic, education systems globally implemented protective measures, notably mandatory mask wearing. As the pandemic's dynamics changed, many municipalities lifted these mandates, warranting a critical examination of these policy changes' implications. This study examines the effects of lifting mask mandates on COVID-19 transmission within Massachusetts school districts. We first replicated previous research that utilized a difference-in-difference (DID) model for COVID-19 incidence. We then repeated the DID analysis by replacing the outcome measurement with the reproductive number ( ), reflecting the transmissibility. Due to the data availability, the we estimated only measures the within school transmission. We found a similar result in the replication using incidence with an average treatment effect on treated (ATT) of 39.1 (95% CI: 20.4 to 57.4) COVID-19 cases per 1,000 students associated with lifting masking mandates. However, when replacing the outcome measurement to , our findings suggest that no significant association between lifting mask mandates and reduced (ATT: 0.04, 95% CI: -0.09 to 0.18), except for the first 2 weeks postintervention. Moreover, we estimated below 1 at 4 weeks before lifting mask mandates across all school types, suggesting nonsustainable transmission before the implementation. Our reanalysis suggested no evidence of lifting mask mandates in schools impacted the COVID-19 transmission in the long term. Our study highlights the importance of examining the transmissibility outcome when evaluating interventions against transmission.
PubMed: 38881839
DOI: 10.1093/pnasnexus/pgae212 -
Lancet (London, England) Jun 2024Neovascular age-related macular degeneration (nAMD) is a leading cause of blindness. The first-line therapy is anti-vascular endothelial growth factor (anti-VEGF) agents...
BACKGROUND
Neovascular age-related macular degeneration (nAMD) is a leading cause of blindness. The first-line therapy is anti-vascular endothelial growth factor (anti-VEGF) agents delivered by intravitreal injection. Ionising radiation mitigates key pathogenic processes underlying nAMD, and therefore has therapeutic potential. STAR aimed to assess whether stereotactic radiotherapy (SRT) reduces the number of anti-VEGF injections required, without sacrificing visual acuity.
METHODS
This pivotal, randomised, double-masked, sham-controlled trial enrolled participants with pretreated chronic active nAMD from 30 UK hospitals. Participants were randomly allocated in a 2:1 ratio to 16-Gray (Gy) SRT delivered using a robotically controlled device or sham SRT, stratified by treatment centre. Eligible participants were aged 50 years or older and had chronic active nAMD, with at least three previous anti-VEGF injections, including at least one in the last 4 months. Participants and all trial and image reading centre staff were masked to treatment allocation, except one unmasked statistician. The primary outcome was the number of intravitreal ranibizumab injections required over 2 years, tested for superiority (fewer injections). The main secondary outcome was Early Treatment Diabetic Retinopathy Study visual acuity at two years, tested for non-inferiority (five-letter margin). The primary analysis used the intention-to-treat principle, and safety was analysed per-protocol on participants with available data. The study is registered with ClinicalTrials.gov (NCT02243878) and is closed for recruitment.
FINDINGS
411 participants enrolled between Jan 1, 2015, and Dec 27, 2019, and 274 were randomly allocated to the 16-Gy SRT group and 137 to the sham SRT group. 240 (58%) of all participants were female, and 171 (42%) of all participants were male. 241 participants in the 16-Gy SRT group and 118 participants in the sham group were included in the final analysis, and 409 patients were treated and formed the safety population, of whom two patients allocated to sham treatment erroneously received 16-Gy SRT. The SRT group received a mean of 10·7 injections (SD 6·3) over 2 years versus 13·3 injections (5·8) with sham, a reduction of 2·9 injections after adjusting for treatment centre (95% CI -4·2 to -1·6, p<0·0001). The SRT group best-corrected visual acuity change was non-inferior to sham (adjusted mean letter loss difference between groups, -1·7 letters [95% CI -4·2 to 0·8]). Adverse event rates were similar across groups, but reading centre-detected microvascular abnormalities occurred in 77 SRT-treated eyes (35%) and 13 (12%) sham-treated eyes. Overall, eyes with microvascular abnormalities tended to have better best-corrected visual acuity than those without. Fewer ranibizumab injections offset the cost of SRT, saving a mean of £565 per participant (95% CI -332 to 1483).
INTERPRETATION
SRT can reduce ranibizumab treatment burden without compromising vision.
FUNDING
Medical Research Council and National Institute for Health and Care Research Efficacy and Mechanism Evaluation Programme.
PubMed: 38876132
DOI: 10.1016/S0140-6736(24)00687-1 -
Medicine Jun 2024In the fight against the COVID-19 pandemic, the importance of health literacy in individuals' attitudes has increased. This study aimed to show whether there is a...
In the fight against the COVID-19 pandemic, the importance of health literacy in individuals' attitudes has increased. This study aimed to show whether there is a relationship between health literacy and adherence to personal protective anti-COVID-19 health behaviors in health workers and their relatives and to evaluate the barriers to adherence to personal protective anti-COVID-19 health behaviors. Designed as a cross-sectional mixed-methods study. Participants were asked to fill in an online survey form containing questions designed to determine their sociodemographic data, health literacy, adherence to protective anti-COVID-19 health behaviors, and barriers to adherence. The research results were evaluated with a confidence interval of 95% and margin of error of 0.05. Thematic content analysis was used to evaluate participants' answers to the open-ended questions. In this study, data collected from 393 participants were analyzed. In the Disease Prevention and Health Promotion Subscale, the group of participants who adhered to wearing masks "at all times" obtained a higher average score from the Turkey Health Literacy Scale than other participant groups, while the participant group that "always" complied with hand washing and social distancing obtained higher average scores from the Turkey Health Literacy Scale and its two subscales compared to other participant groups. As a result of the thematic content analysis carried out in order to determine the situations that prevent the participants from complying with personal protective anti-COVID-19 health behaviors, the main themes were determined as "forgetting/not wearing the habit of wearing a mask," "mask ergonomics" and "noncompliance with social distance." This study shows that there is a positive relationship between health literacy and adherence to protective anti-COVID-19 health behaviors among health workers and their relatives and revealed major barriers to adherence to protective anti-COVID-19 health behaviors among health workers and their relatives.
Topics: Humans; Health Literacy; COVID-19; Male; Female; Cross-Sectional Studies; Adult; Health Personnel; Health Behavior; Turkey; Middle Aged; SARS-CoV-2; Family; Masks; Surveys and Questionnaires; Young Adult
PubMed: 38875376
DOI: 10.1097/MD.0000000000038505 -
Annals of Thoracic Surgery Short Reports Jun 2024Aspiration and vocal fold mobility impairment (VFMI) are frequently reported in adults after cardiac surgery (CS) and impede recovery. Preoperative and postoperative...
BACKGROUND
Aspiration and vocal fold mobility impairment (VFMI) are frequently reported in adults after cardiac surgery (CS) and impede recovery. Preoperative and postoperative laryngoscopic evaluations have not been undertaken, masking the incidence and evolution of dysphagia and VFMI in CS patients. We therefore sought to determine frequency of unsafe swallowing and VFMI before and after CS.
METHODS
Thirty-five adults undergoing elective CS enrolled. Participants underwent fiberoptic endoscopic evaluations of swallowing and VFMI before and after surgical procedure. Trained raters performed duplicate, blinded ratings with the validated Penetration-Aspiration Scale, and a laryngologist performed blinded ratings of VFMI. Descriptive, Wilcoxon signed rank, and McNemar tests were performed.
RESULTS
Preoperative swallowing safety profiles were 60% safe, 34% penetration, and 6% aspiration. Postoperative swallowing safety profiles were 14% safe, 63% penetration, and 23% aspiration. Significant differences in preoperative to postoperative swallowing outcomes were noted for Penetration-Aspiration Scale scores ( < .0001), unsafe swallowing (40% vs 86%; χ = 12.8; = .0003), and aspiration (6% vs 23%; χ =6; = .01). No differences in VFMI were noted preoperatively to postoperatively (partial VFMI, 9% vs 23%; > .05).
CONCLUSIONS
A 4-fold increase in aspiration was observed in CS patients. No cases of vocal fold paralysis were observed across time points. These data highlight the utility of instrumental laryngoscopic evaluations during the acute postoperative phase.
PubMed: 38872831
DOI: 10.1016/j.atssr.2023.11.030 -
Mathematical Biosciences and... Apr 2024Precise segmentation of liver tumors from computed tomography (CT) scans is a prerequisite step in various clinical applications. Multi-phase CT imaging enhances tumor...
Precise segmentation of liver tumors from computed tomography (CT) scans is a prerequisite step in various clinical applications. Multi-phase CT imaging enhances tumor characterization, thereby assisting radiologists in accurate identification. However, existing automatic liver tumor segmentation models did not fully exploit multi-phase information and lacked the capability to capture global information. In this study, we developed a pioneering multi-phase feature interaction Transformer network (MI-TransSeg) for accurate liver tumor segmentation and a subsequent microvascular invasion (MVI) assessment in contrast-enhanced CT images. In the proposed network, an efficient multi-phase features interaction module was introduced to enable bi-directional feature interaction among multiple phases, thus maximally exploiting the available multi-phase information. To enhance the model's capability to extract global information, a hierarchical transformer-based encoder and decoder architecture was designed. Importantly, we devised a multi-resolution scales feature aggregation strategy (MSFA) to optimize the parameters and performance of the proposed model. Subsequent to segmentation, the liver tumor masks generated by MI-TransSeg were applied to extract radiomic features for the clinical applications of the MVI assessment. With Institutional Review Board (IRB) approval, a clinical multi-phase contrast-enhanced CT abdominal dataset was collected that included 164 patients with liver tumors. The experimental results demonstrated that the proposed MI-TransSeg was superior to various state-of-the-art methods. Additionally, we found that the tumor mask predicted by our method showed promising potential in the assessment of microvascular invasion. In conclusion, MI-TransSeg presents an innovative paradigm for the segmentation of complex liver tumors, thus underscoring the significance of multi-phase CT data exploitation. The proposed MI-TransSeg network has the potential to assist radiologists in diagnosing liver tumors and assessing microvascular invasion.
Topics: Humans; Liver Neoplasms; Contrast Media; Tomography, X-Ray Computed; Microvessels; Algorithms; Neoplasm Invasiveness; Image Processing, Computer-Assisted; Liver; Radiographic Image Interpretation, Computer-Assisted; Male; Female
PubMed: 38872556
DOI: 10.3934/mbe.2024253