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Cortex; a Journal Devoted To the Study... Jun 2024Understanding the neural substrate of altered conscious states is an important cultural, scientific, and clinical endeavour. Although hypnosis causes strong shifts in...
Understanding the neural substrate of altered conscious states is an important cultural, scientific, and clinical endeavour. Although hypnosis causes strong shifts in conscious perception and cognition, it remains largely unclear how hypnosis affects information processing in cortical networks. Here we manipulated the depth of hypnotic states to study information processing between cortical regions involved in attention and awareness. We used high-density Electroencephalography (EEG) to record resting-state cortical activity from 30 hypnosis experts during two hypnotic states with different depth. Each participant entered a light and a deep hypnotic state as well as two well-matched control states. Bridging top-down and lateralisation models of hypnosis, we found that interhemispheric frontoparietal connectivity distinguished hypnosis and control conditions, while no difference was found between the two hypnotic states. Using a graph-theoretic measure, we revealed that the amount of information passing through individual nodes (measured via betweenness centrality) is reduced during hypnosis relative to control states. Finally, we found that theta power was enhanced during hypnosis. Our result contributes to the current discussion around a role for theta power in bringing about hypnotic states, as well as other altered conscious states. Overall, our findings support the notion that altered top-down control in frontoparietal regions facilitates hypnosis by integrating information between cortical hemispheres.
PubMed: 38865762
DOI: 10.1016/j.cortex.2024.05.008 -
IEEE Transactions on Visualization and... Jun 2024Through a human-subject experiment, we investigated the effects of focal distance on depth perception and accommodative response in an optical see-through augmented...
Through a human-subject experiment, we investigated the effects of focal distance on depth perception and accommodative response in an optical see-through augmented reality (AR) display. The display was able to provide focus cues and was rigorously calibrated. The near-field distances ranging between 3 diopters and 1 diopter were considered as target distance. In the experiment, it was found that the perceived depth of a virtual object was significantly biased along with the focal distance of virtual image plane of the display. In addition, the experimental results implied that the perceived depth of a virtual object would be potentially more accurate in the condition where the focal distance of virtual image plane was consistent with the target distance than in the conditions where it could deviate from the target distance. Regarding accommodative response, it was found that the response to a virtual object changed along with the focal distance of virtual image plane as well as the target distance. However, the changing rate depending on target distance was less steep in the conditions where the focal distance could be mismatched with the target distance than in the condition where it was consistent with the target distance. In the consistent condition, the changing rate of accommodative responses to virtual objects were similar to that for their physical counterparts.
PubMed: 38865223
DOI: 10.1109/TVCG.2024.3413594 -
Circulation. Cardiovascular Quality and... Jun 2024The VIVID (Videos for Addressing Racial Disparities in Implantable Cardioverter Defibrillator Therapy via Innovative Designs) study was a multicenter, randomized...
Assisting Black Patients With Decision-Making for Implantable Cardioverter Defibrillator Therapy: Qualitative Findings From the Videos to Reduce Racial Disparities in ICD Therapy via Innovative Designs (VIVID) Trial.
BACKGROUND
The VIVID (Videos for Addressing Racial Disparities in Implantable Cardioverter Defibrillator Therapy via Innovative Designs) study was a multicenter, randomized controlled trial aimed at evaluating the effectiveness of a video-based decision support tool in enhancing informed consent for implantable cardioverter defibrillator (ICD) implantation among Black patients who met guideline criteria for primary prevention ICDs. Within the broader VIVID randomized trial, a qualitative investigation was conducted to elucidate the decisional factors among Black individuals considering ICD implantation for the primary prevention of sudden cardiac arrest.
METHODS
Between October 2016 and July 2019, in-depth interviews were conducted at 2 time points from randomization, ≈7 days (time interval for the decision) and at 90 days; the time interval for determining ICD implantation. Interview findings were categorized by randomized groups, those assigned to 1 of the 2 encounter-based video decision support tools or standard care (without video). Interview participants were purposefully selected to ensure diversity across gender, age, educational background, research site, and randomization group; participants were sampled from 14 academic and community-based electrophysiology clinics in the United States. Data analysis employed applied thematic analysis techniques.
RESULTS
A diverse sample of Black individuals were interviewed at 1 week (n=59; female, 37.3%) and 90 days (n=48; female, 39.6%). The primary factors influencing the decisions of Black individuals considering a primary prevention ICD implantation were (1) their clinicians' recommendations for ICD implantation; (2) their perception of their cardiac health status; and (3) a desire to prolong their lives for the sake of their families.
CONCLUSIONS
These findings offer valuable insights that may guide clinicians in their communication with Black patients during shared decision-making encounters related to ICD implantation.
PubMed: 38864226
DOI: 10.1161/CIRCOUTCOMES.123.010550 -
Journal of Imaging Informatics in... Jun 20243D data from high-resolution volumetric imaging is a central resource for diagnosis and treatment in modern medicine. While the fast development of AI enhances imaging...
3D data from high-resolution volumetric imaging is a central resource for diagnosis and treatment in modern medicine. While the fast development of AI enhances imaging and analysis, commonly used visualization methods lag far behind. Recent research used extended reality (XR) for perceiving 3D images with visual depth perception and touch but used restrictive haptic devices. While unrestricted touch benefits volumetric data examination, implementing natural haptic interaction with XR is challenging. The research question is whether a multisensory XR application with intuitive haptic interaction adds value and should be pursued. In a study, 24 experts for biomedical images in research and medicine explored 3D medical shapes with 3 applications: a multisensory virtual reality (VR) prototype using haptic gloves, a simple VR prototype using controllers, and a standard PC application. Results of standardized questionnaires showed no significant differences between all application types regarding usability and no significant difference between both VR applications regarding presence. Participants agreed to statements that VR visualizations provide better depth information, using the hands instead of controllers simplifies data exploration, the multisensory VR prototype allows intuitive data exploration, and it is beneficial over traditional data examination methods. While most participants mentioned manual interaction as the best aspect, they also found it the most improvable. We conclude that a multisensory XR application with improved manual interaction adds value for volumetric biomedical data examination. We will proceed with our open-source research project ISH3DE (Intuitive Stereoptic Haptic 3D Data Exploration) to serve medical education, therapeutic decisions, surgery preparations, or research data analysis.
PubMed: 38862851
DOI: 10.1007/s10278-024-01094-x -
Journal of Gerontological Social Work Jun 2024Dementia caregiving involves a challenging and complex process, especially for immigrant families. Using a qualitative method, this study provides an in-depth...
Dementia caregiving involves a challenging and complex process, especially for immigrant families. Using a qualitative method, this study provides an in-depth exploration of caregiving experiences among Korean American caregivers of people living with dementia. Based on various sampling strategies, 16 Korean American caregivers of family members/relatives with dementia were recruited in the greater Los Angeles area. Guided by the stress process model and the constant comparative method, themes and subthemes were derived and categorized into four domains: (1) background/context; (2) perception/appraisal; (3) resources/coping, and (4) caregiver burden/reward. Findings suggest that intervention efforts should focus on educating and training dementia caregivers.
PubMed: 38861569
DOI: 10.1080/01634372.2024.2366259 -
The British Journal of Dermatology Jun 2024Epidermolysis bullosa (EB) concerns a heterogeneous group of rare genetic skin fragility disorders that result in chronic blistering and wounding. EB significantly...
BACKGROUND
Epidermolysis bullosa (EB) concerns a heterogeneous group of rare genetic skin fragility disorders that result in chronic blistering and wounding. EB significantly impacts the daily lives of patients with EB, as well as their families. While advances in diagnostics are improving the speed and accuracy of EB diagnosis, little is known about the experiences and needs of parents and patients throughout their diagnostic journey.
OBJECTIVES
In this qualitative study, we explore the parent and patient perspective on the EB diagnostic trajectory to gain an in-depth understanding of their lived experiences and needs.
METHODS
Participants were parents of paediatric patients (n=18), and adult patients (n=8) recruited from the Dutch EB Registry. After purposive sampling, they participated in semi-structured interviews via video-calls to discuss their personal diagnostic trajectory and the subsequent impact of EB diagnosis on their (family) life. Applying a constructivist approach, a reflexive thematic analysis was executed to facilitate a dynamic and iterative process, involving inductive open coding of transcripts and constant comparison of data.
RESULTS
Ten major themes were developed, representing three distinct groups: (i) parents of children with JEB and RDEB, (ii) parents of children with EBS and DDEB, and (iii) adult patients with localized EB. The EB diagnostic process appeared to have a diversity of emotional consequences, varying from desperation and uncertainty about the future, to clarification and confirmation. The urgent need for a timely diagnosis and accurate prognosis was emphasized, particularly by parents of children with extensive presentation. Both parents and patients expressed shortcomings in clinical practice, with severity ratings in current EB disease terminology in particular seeming to have an adverse impact on illness perception, healthcare-seeking behaviour, research participation, and engagement in peer support.
CONCLUSIONS
This study describes the lived experience and needs of parents of children and adult patients during the diagnostic process of EB. We show an urgent need to accelerate diagnostics and imply that the EB community should continue working towards ever faster diagnosis, public awareness, and education. While guiding patients along the diagnostic journey, clinicians should focus their support strategies on tailored medical communication, while refraining from value-connoted wording.
PubMed: 38860499
DOI: 10.1093/bjd/ljae242 -
Journal of Women's Health (2002) Jun 2024The postpartum period is a window to engage birthing people in their long-term health and facilitate connections to comprehensive care. However, postpartum systems...
The postpartum period is a window to engage birthing people in their long-term health and facilitate connections to comprehensive care. However, postpartum systems often fail to transition high-risk patients from obstetric to primary care. Exploring patient experiences can be helpful for optimizing systems of postpartum care. This is a qualitative study of high-risk pregnant and postpartum individuals. We conducted in-depth interviews with 20 high-risk pregnant or postpartum people. Interviews explored personal experiences of postpartum care planning, coordination of care between providers, and patients' perception of ideal care transitions. We performed thematic analysis using the (COM-B) model of behavior change as a framework. COM-B allowed for a formal structure to assess participants' ability to access postpartum care and primary care reengagement after delivery. Participants universally identified difficulty accessing primary care in the postpartum period, with the most frequently reported barriers being lack of knowledge and supportive environments. Insufficient preparation, inadequate prenatal counseling, and lack of standardized care transitions were the most significant barriers to primary care reengagement. Participants who most successfully engaged in primary care had postpartum care plans, coordination between obstetric and primary care, and access to material resources. High-risk postpartum individuals do not receive effective counseling on the importance of primary care engagement after delivery. System-level challenges and lack of care coordination also hinder access to primary care. Future interventions should include prenatal education on the benefits of primary care follow-up, structured postpartum planning, and system-level improvements in obstetric and primary care provider communication.
PubMed: 38860345
DOI: 10.1089/jwh.2024.0108 -
The Cleft Palate-craniofacial Journal :... Jun 2024To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to...
OBJECTIVES
To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems.
DESIGN
A retrospective study.
SETTING
Dental college and hospital.
PARTICIPANTS
Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected.
MAIN OUTCOME
The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done.
RESULTS
The study found significant differences in nasal length ( = .003) and depth ( < .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length ( = .01).
CONCLUSION
The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.
PubMed: 38860313
DOI: 10.1177/10556656241261908 -
Neurology Perspectives 2024Myeloneuropathy is a diagnosis ascribed to disorders that concomitantly affect the spinal cord and peripheral nerves. Recognizing this syndrome may sometimes be arduous,...
INTRODUCTION
Myeloneuropathy is a diagnosis ascribed to disorders that concomitantly affect the spinal cord and peripheral nerves. Recognizing this syndrome may sometimes be arduous, even for the most consummate clinicians, because symptomatology can mimic either spinal cord or peripheral nerve disease. Besides, examination findings suggest a predominantly myelopathic or neuropathic picture. This article reports a rendezvous of rare cases of clinically diagnosed myeloneuropathy with different etiological backgrounds and therapeutic responses.
METHODS
Eleven cases of non-compressive myeloneuropathy were admitted to the Department of General Medicine of Burdwan Medical College and Hospital, Burdwan, West Bengal, India, between May 2018 and May 2022.
RESULTS
We report the cases of 11 patients (6 men and 5 women) who presented with myeloneuropathy of different etiologies (vitamin B12, copper, and vitamin E deficiencies, organophosphate poisoning, chronic alcohol abuse, illicit substances abuse, anti-thyroid peroxidase/anti-thyroglobulin antibody-related neurologic disorder responsive to steroids, Sjögren syndrome, chikungunya infection, paraneoplastic, and hereditary).
CONCLUSION
Meticulous historical analysis, careful clinical examination, and apposite utilization and interpretation of biochemical, electrophysiological, and neuroimaging findings are sine-qua-non for an accurate and consistent approach to evaluating a suspected case of myeloneuropathy, facilitating early treatment and recovery. Differential identification of these disorders needs an in-depth perception of the mode of onset of symptoms, the course of progression of the disease, the pattern of myelopathic/neuropathic findings, and recognition of other neurological or systemic manifestations. For untroubled understanding, etiologies of myeloneuropathies should be subdivided into a few broad categories, e.g., metabolic (nutritional), toxic (toxin-induced), infectious, inflammatory (immune-mediated), paraneoplastic, and hereditary disorders.
PubMed: 38859960
DOI: 10.1016/j.neurop.2023.100138 -
Optics Express May 2024A tomographic waveguide-based augmented reality display technique is proposed for near-eye three-dimensional (3D) display with accurate depth reconstructions. A pair of...
A tomographic waveguide-based augmented reality display technique is proposed for near-eye three-dimensional (3D) display with accurate depth reconstructions. A pair of tunable lenses with complementary focuses is utilized to project tomographic virtual 3D images while maintaining the correct perception of the real scene. This approach reconstructs virtual 3D images with physical depth cues, thereby addressing the vergence-accommodation conflict inherent in waveguide augmented reality systems. A prototype has been constructed and optical experiments have been conducted, demonstrating the system's capability in delivering high-quality 3D scenes for waveguide-based augmented reality display.
PubMed: 38859019
DOI: 10.1364/OE.524983