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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 -
Optics Express May 2024To achieve defect detection in bare polycrystalline silicon solar cells under electroluminescence (EL) conditions, we have proposed ASDD-Net, a deep learning algorithm...
To achieve defect detection in bare polycrystalline silicon solar cells under electroluminescence (EL) conditions, we have proposed ASDD-Net, a deep learning algorithm evaluated offline on EL images. The model integrates strategies such as downsampling adjustment, feature fusion optimization, and detection head improvement. The ASDD-Net utilizes the Space to Depth (SPD) module to effectively extract edge and fine-grained information. The proposed Enhanced Cross-Stage Partial Network Fusion (EC2f) and Hybrid Attention CSP Net (HAC3) modules are placed at different positions to enhance feature extraction capability and improve feature fusion effects, thereby enhancing the model's ability to perceive defects of different sizes and shapes. Furthermore, placing the MobileViT_CA module before the second detection head balances global and local information perception, further enhancing the performance of the detection heads. The experimental results show that the ASDD-Net model achieves a mAP value of 88.81% on the publicly available PVEL-AD dataset, and the detection performance is better than the current SOTA model. The experimental results on the ELPV and NEU-DET datasets verify that the model has some generalization ability. Moreover, the proposed model achieves a processing frame rate of 69 frames per second, meeting the real-time defect detection requirements for solar cell surface defects.
PubMed: 38858917
DOI: 10.1364/OE.517341 -
PeerJ. Computer Science 2024Numerous impediments beset contemporary art education, notably the unidimensional delivery of content and the absence of real-time interaction during instructional...
Numerous impediments beset contemporary art education, notably the unidimensional delivery of content and the absence of real-time interaction during instructional sessions. This study endeavors to surmount these challenges by devising a multimodal perception system entrenched in Internet of Things (IoT) technology. This system captures students' visual imagery, vocalizations, spatial orientation, movements, ambient luminosity, and contextual data by harnessing an array of interaction modalities encompassing visual, auditory, tactile, and olfactory sensors. The synthesis of this manifold information about learning scenarios entails strategically placing sensors within physical environments to facilitate intuitive and seamless interactions. Utilizing digital art flower cultivation as a quintessential illustration, this investigation formulates tasks imbued with multisensory channel interactions, pushing the boundaries of technological advancement. It pioneers advancements in critical domains such as visual feature extraction by utilizing DenseNet networks and voice feature extraction leveraging SoundNet convolutional neural networks. This innovative paradigm establishes a novel art pedagogical framework, accentuating the importance of visual stimuli while enlisting other senses as complementary contributors. Subsequent evaluation of the usability of the multimodal perceptual interaction system reveals a remarkable task recognition accuracy of 96.15% through the amalgamation of Mel-frequency cepstral coefficients (MFCC) speech features with a long-short-term memory (LSTM) classifier model, accompanied by an average response time of merely 6.453 seconds-significantly outperforming comparable models. The system notably enhances experiential fidelity, realism, interactivity, and content depth, ameliorating the limitations inherent in solitary sensory interactions. This augmentation markedly elevates the caliber of art pedagogy and augments learning efficacy, thereby effectuating an optimization of art education.
PubMed: 38855203
DOI: 10.7717/peerj-cs.2047 -
Age and Ageing Jun 2024Problematic polypharmacy is the prescribing of five or more medications potentially inappropriately. Unintentional prescribing cascades represent an under-researched...
INTRODUCTION
Problematic polypharmacy is the prescribing of five or more medications potentially inappropriately. Unintentional prescribing cascades represent an under-researched aspect of problematic polypharmacy and occur when an adverse drug reaction (ADR) is misinterpreted as a new symptom resulting in the initiation of a new medication. The aim of this study was to elicit key stakeholders' perceptions of and attitudes towards problematic polypharmacy, with a focus on prescribing cascades.
METHODS
qualitative one-to-one semi-structured interviews were conducted with predefined key stakeholder groups. Inductive thematic analysis was employed.
RESULTS
Thirty-one stakeholders were interviewed: six patients, two carers, seven general practitioners, eight pharmacists, four hospital doctors, two professional organisation representatives and two policymakers. Three main themes were identified: (i) ADRs and prescribing cascades-a necessary evil. Healthcare professionals (HCPs) expressed concern that experiencing an ADR would negatively impact patients' confidence in their doctor. However, patients viewed ADRs pragmatically as an unpredictable risk. (ii) Balancing the risk/benefit tipping point. The complexity of prescribing decisions in the context of polypharmacy made balancing this tipping point challenging. Consequently, HCPs avoided medication changes. (iii) The minefield of medication reconciliation. Stakeholders, including patients and carers, viewed medication reconciliation as a perilous activity due to systemic communication deficits.
CONCLUSION
Stakeholders believed that at a certain depth of polypharmacy, the risk that a new symptom is being caused by an existing medication becomes incalculable. Therefore, in the absence of harm, medication changes were avoided. However, medication reconciliation post hospital discharge compelled prescribing decisions and was seen as a high-risk activity by stakeholders.
Topics: Humans; Polypharmacy; Qualitative Research; Male; Attitude of Health Personnel; Female; Aged; Inappropriate Prescribing; Middle Aged; Stakeholder Participation; Drug-Related Side Effects and Adverse Reactions; Practice Patterns, Physicians'; Interviews as Topic; Health Knowledge, Attitudes, Practice; Medication Reconciliation; Aged, 80 and over; Caregivers; Risk Assessment; Perception; Pharmacists
PubMed: 38851215
DOI: 10.1093/ageing/afae116 -
PloS One 2024Stereopsis is a critical visual function, however clinical stereotests are time-consuming, coarse in resolution, suffer memorization artifacts, poor repeatability, and... (Comparative Study)
Comparative Study
PURPOSE
Stereopsis is a critical visual function, however clinical stereotests are time-consuming, coarse in resolution, suffer memorization artifacts, poor repeatability, and low agreement with other tests. Foraging Interactive D-prime (FInD) Stereo and Angular Indication Measurement (AIM) Stereo were designed to address these problems. Here, their performance was compared with 2-Alternative-Forced-Choice (2-AFC) paradigms (FInD Stereo only) and clinical tests (Titmus and Randot) in 40 normally-sighted and 5 binocularly impaired participants (FInD Stereo only).
METHODS
During FInD tasks, participants indicated which cells in three 4*4 charts of bandpass-filtered targets (1,2,4,8c/° conditions) contained depth, compared with 2-AFC and clinical tests. During the AIM task, participants reported the orientation of depth-defined bars in three 4*4 charts. Stereoscopic disparity was adaptively changed after each chart. Inter-test agreement, repeatability and duration were compared.
RESULTS
Test duration was significantly longer for 2-AFC (mean = 317s;79s per condition) than FInD (216s,18s per chart), AIM (179s, 60s per chart), Titmus (66s) or RanDot (97s). Estimates of stereoacuity differed across tests and were higher by a factor of 1.1 for AIM and 1.3 for FInD. No effect of stimulus spatial frequency was found. Agreement among tests was generally low (R2 = 0.001 to 0.24) and was highest between FInD and 2-AFC (R2 = 0.24;p<0.01). Stereoacuity deficits were detected by all tests in binocularly impaired participants.
CONCLUSIONS
Agreement among all tests was low. FInD and AIM inter-test agreement was comparable with other methods. FInD Stereo detected stereo deficits and may only require one condition to identify these deficits. AIM and FInD are response-adaptive, self-administrable methods that can estimate stereoacuity reliably within one minute.
Topics: Humans; Depth Perception; Adult; Male; Female; Young Adult; Vision, Binocular; Middle Aged; Vision Tests; Aged
PubMed: 38848392
DOI: 10.1371/journal.pone.0305036 -
Journal of Refractive Surgery... May 2024To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation. (Review)
Review
PURPOSE
To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation.
METHODS
PubMed and Scopus were the main resources used to search the medical literature. An extensive search was performed to identify relevant articles concerning factors influencing the level of corneal aberrations as of August 27, 2023. The following keywords were used in various combinations: corneal, aberrations, defocus, astigmatism, spherical aberration, coma, trefoil, quadrafoil, intraocular lens, and IOL.
RESULTS
Conclusive evidence is lacking regarding the correlation between age and changes in corneal aberrations. Patients with astigmatism have greater corneal higher-order aberrations than those with minimal astigmatism, particularly concerning trefoil and coma. Increased levels of corneal higher-order aberrations are noted following contact lens wear, in patients with dry eye disease, and with pterygium. Increased higher-order aberrations have been reported following corneal refractive surgery and for 3 months following trabeculectomy; regarding intraocular lens surgery, the results remain controversial.
CONCLUSIONS
Several factors influence the level of corneal higher-order aberrations. Multifocal and extended depth-of-focus IOLs can share similarities in their optical properties, and the main difference arises in their design and performance with respect to spherical aberration. Preoperative evaluation is critical for proper IOL choice, particularly in corneas with risk of high levels of aberrations. .
Topics: Humans; Corneal Wavefront Aberration; Risk Factors; Lens Implantation, Intraocular; Visual Acuity; Refraction, Ocular; Multifocal Intraocular Lenses; Depth Perception; Corneal Topography; Cornea
PubMed: 38848055
DOI: 10.3928/1081597X-20240416-01 -
Frontiers in Public Health 2024Healthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers' hesitancy...
Vaccine communication strategies among healthcare workers as a reflection of the Israeli Ministry of Health's communication strategies before and after the COVID-19 pandemic.
BACKGROUND
Healthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers' hesitancy and doubts about getting the flu vaccine themselves. However, few studies have dealt with how they perceive their role in communicating information regarding vaccines, especially following the COVID-19 pandemic.
OBJECTIVES
(1) To identify the communication strategies used by the Israeli Ministry of Health regarding vaccines during epidemic crises (before and after the COVID-19 pandemic); (2) To identify the communication strategies used by healthcare workers regarding vaccines before and after the COVID-19 pandemic.
METHODS
A qualitative study based on in-depth interviews was conducted among healthcare workers and used a semi-structured protocol as a research tool. A total of 18 healthcare workers were sampled using purposeful and snowball sampling.
RESULTS
Despite healthcare workers' perception that there has been a decrease in trust in the Israeli Ministry of Health among the public following the COVID-19 outbreak, they still rely on the Israeli Ministry of Health as their primary source of information and use the same communication strategies (such as fear appeals and correcting information) as of the Israeli Ministry of Health to communicate with the public, healthcare providers, and other relevant stakeholders.
CONCLUSION
Healthcare workers have been shaped by the professional socialization processes within the health system, leading to a predominant reliance on established communication strategies and informational channels. This reliance underscores the importance of evolving these methods to better engage with the public. To address this, there is a compelling need to innovate and adopt new communication techniques that emphasize effective dialogue and transparent interactions. By doing so, healthcare professionals can ensure that their outreach is not only informative but also responsive to the diverse needs and preferences of the community.
Topics: Humans; Israel; COVID-19; Health Personnel; Qualitative Research; Female; Male; Adult; COVID-19 Vaccines; Middle Aged; Communication; Trust; SARS-CoV-2; Pandemics; Health Communication; Interviews as Topic
PubMed: 38846621
DOI: 10.3389/fpubh.2024.1377393 -
Indian Journal of Palliative Care 2024For patients with diabetes and cancer at the end-of-life and their families, the safety sought in end-of-life care leads them to opt for home care. In developing...
OBJECTIVES
For patients with diabetes and cancer at the end-of-life and their families, the safety sought in end-of-life care leads them to opt for home care. In developing countries where palliative care is not yet effectively integrated into public health policies, factors such as long distances to hospital referrals, lack of adequate infrastructure and shortage of specialised health professionals create a sense of insecurity for people seeking end-of-life care. The present study explored the factors that reinforce the feeling of security and insecurity of family members who have opted to accompany their relatives with diabetes and/or advanced cancer at the end-of-life at home in Togo.
MATERIALS AND METHODS
This was an ethnographic approach based on observations and in-depth semi-structured interviews with people with the following characteristics: family members (bereaved or not) with experience of caring for a patient with diabetes and cancer at home at the end-of-life. The data were analysed using content and thematic analysis. This was done to identify categories and subcategories using the qualitative analysis software Nvivo12.
RESULTS
The results show that of the ten relatives interviewed, eight had lived with the patient. Factors contributing to the feeling of security in the accompaniment of end-of-life care at home by the family members were, among others: 'Informal support from health-care professionals,' 'social support' from relatives and finally, attitudes and predispositions of the family members (presence and availability to the patient, predisposition to respect the patient's wishes at the place of end-of-life care and predisposition to talk about death with the dying person).
CONCLUSION
The 'informal support of health-care professionals', the 'perception of the home as a safe space for end-of-life care' and the 'social support' of family members contributed most to the feeling of safety among family members accompanying their diabetic and cancer patient family members at the end-of-life at home in Togo. Therefore, palliative and end-of-life care must be rethought in public health policies in Togo to orientate this care toward the home while providing families/caregivers with the knowledge and tools necessary to strengthen care.
PubMed: 38846130
DOI: 10.25259/IJPC_66_2023 -
ENeuro Jun 2024In measurement, a reference frame is needed to compare the measured object to something already known. This raises the neuroscientific question of which reference frame...
In measurement, a reference frame is needed to compare the measured object to something already known. This raises the neuroscientific question of which reference frame is used by humans when exploring the environment. Previous studies suggested that, in touch, the body employed as measuring tool also serves as reference frame. Indeed, an artificial modification of the perceived dimensions of the body changes the tactile perception of external object dimensions. However, it is unknown if such a change in tactile perception would occur when the body schema is modified through the illusion of owning a limb altered in size. Therefore, employing a virtual hand illusion paradigm with an elongated forearm of different lengths, we systematically tested the subjective perception of distance between two points [tactile distance perception (TDP) task] on the corresponding real forearm following the illusion. Thus, the TDP task is used as a proxy to gauge changes in the body schema. Embodiment of the virtual arm was found significantly greater after the synchronous visuotactile stimulation condition compared with the asynchronous one, and the forearm elongation significantly increased the TDP. However, we did not find any link between the visuotactile-induced ownership over the elongated arm and TDP variation, suggesting that vision plays the main role in the modification of the body schema. Additionally, significant effect of elongation found on TDP but not on proprioception suggests that these are affected differently by body schema modifications. These findings confirm the body schema malleability and its role as a reference frame in touch.
Topics: Humans; Female; Male; Virtual Reality; Touch Perception; Young Adult; Adult; Illusions; Distance Perception; Proprioception; Body Image; Forearm
PubMed: 38844346
DOI: 10.1523/ENEURO.0244-23.2024