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Aim Syphilis is a widely spread, sexually transmitted disease that is often considered archaic, but it has been on the rise in recent years. The oropharyngeal region is an uncommon location for treponema pallidum to present itself. It is even more uncommon when, on a radiological evaluation, it is diagnosed as a neoplasm or squamous cell carcinoma. This case report discusses a rare case of syphilis that mimics an oropharyngeal carcinoma. Summary The patient presented himself initially with cervical lymphadenopathies and an oropharyngeal lesion. On the MRI scan, the lesion was suspicious for an oropharyngeal squamous cell carcinoma. Multiple negative biopsies (2X) urged the search for an alternative diagnosis. After serologic testing, it became clear the patient was suffering from syphilis. Syphilis is known as the "great pretender" and can present in a non-specific manner. Key learning points i) Syphilis is known as the "great pretender". ii) Treponema pallidum infections need to be taken into account as a differential diagnosis in patients with an oropharyngeal lesion. iii) Syphilis is on the rise. iv) Syphilis has the ability to mimic a malignancy upon clinical presentation. v) Syphilis has the ability to mimic a malignancy on CT and MRI-imaging. [ABSTRACT FROM AUTHOR]

Introduction Crisis admissions of persons with dementia are more prevalent due to the rising number of people with dementia living longer at home. Moreover, societal dependency on informal care grows, which negatively impacts caregivers' wellbeing. This is often a direct reason for crisis admission of the person with dementia. Therefore, we developed REMIND, a digital tool for frequent monitoring of wellbeing and resilience of caregivers, which enables case managers to provide timely support, thereby preventing deterioration in caregiver wellbeing and eventually crisis admissions. The aim of this pilot study is to explore the usability and acceptability of REMIND. Theory/Methods During a 3-month period case manager-caregiver duo's used REMIND. The monitor was developed in co-creation with end-users during focus groups. The pilot version of REMIND consisted of a weekly set of questions on social support, reciprocity, burden, wellbeing, own activities and small crises, filled in via a chat on a smartphone or computer. Caregiver wellbeing was displayed in graphs on a dashboard for case managers to act upon. Usability and acceptability of the tool were explored in semi-structured interviews with the caregivers and case managers. Two independent researchers applied content analysis on the transcripts. Results Eight case managers and fourteen caregivers participating considered the tool easy to use. Caregivers appreciated REMIND, because it stimulated self-reflection regarding the burden of their caregiving processes. Case managers valued the tool's ability to gain better insight in the actual wellbeing of caregivers, because some caregivers find it hard to acknowledge themselves being burdened during a face-to-face conversation. The fact that REMIND provided insight in wellbeing patterns over time instead of a single assessment during a monthly home visit, was highly appreciated by case managers. The monitor outcomes were therefore considered a suitable starting point for conversations with caregivers. Suggestions for improvements included, more diverse set of questions and additional functions including peers support. Discussions In this pilot, REMIND was found highly usable and acceptable for both caregivers and casemanagers. The use a co-design approach in the development likely contributed to these findings. Conclusions Pilot evaluation of digital monitor for caregivers and case managers showed that the tool was easy to use and stimulated self-reflection in caregivers. For case managers it provided a starting point for conversations. The tool is able to monitor wellbeing of caregivers and thereby has the potential to prevent crisis. Lessons learned Developing a monitoring tool for caregivers of persons with dementia in a co-creation design process with end-users led to a well-accepted and easy-to-use device. Limitations Casemanagers in this pilot study were early adopters. Further research should include a more diverse group of case managers. Suggestions for future research A future randomized controlled study with longer follow-up may determine whether its use prevents (small) crises. [ABSTRACT FROM AUTHOR]

Background and Aim: If a person does not become ambulant after an amputation, a knee disarticulation (KD) shouldbe considered and the person may then benefit from a cosmetic KD prosthesis. The features of a cosmetic KD prosthesis are, however, seldom described. The aim of this clinical note is to describe the development of a cosmeticKD prosthesis.Technique: A non-ambulant person with bilateral KD formulated, together with her physiatrist, the criteria for a cosmetic KD prosthesis. On the basis of these, a lightweight, natural-looking, well-fitting, easy-to-put-on and take-off KD prosthesis, with no thigh lengthening during sitting, was made. This prosthesis was fixed on a wheelchair and does not impede transfer.Discussion: A newly constructed cosmetic prosthesis for non-ambulant persons with a KD is described in detail. We hope that this will encourage physiatrists and prosthetists to offer non-ambulant persons with a KD a cosmetic prosthesis.Clinical Relevance: A cosmetic leg prosthesis with good cosmetic properties, good sitting comfort, and no restrictions in making transfers is described in detail for non-ambulant persons with a knee disarticulation. [ABSTRACT FROM AUTHOR]

The author focuses on the case S versus Hena, a case wherein the court was called upon to exclude certain evidence against one of the accused in terms of section 35(5) of the 1996 Constitution of the Republic of South Africa. He notes that this section places a responsibility upon the court to exclude evidence obtained in a manner that violates any constitutional right. He also claims that the judge's interpretation of the elements of the section with regards to this case is wrong.

Abstract: Atomised and milled Ferrosilicon with average particle diameters of 38 and 50 µm respectively were fluidised with air at ambient conditions. The entrainment rate of the more spherical atomised particles was on average six times that of the irregularly shaped milled particles over the range of superficial velocities investigated. In an attempt to decouple the effect of particle size from shape, the bed was divided into theoretically isolated bins based on the distributions of particle sizes. This indicated that the atomised particles had a higher entrainment rate for particles smaller than approximately 25 µm whereas the opposite was true for particles greater than this size. None of the entrainment correlations investigated was able to predict the switch in entrainment behaviour as a function of particle sphericity and diameter. Furthermore, the traditional critical particle diameter associated with cohesive Geldart A particles was not observed for either of the two particle shapes. It is therefore concluded that neither the hydrodynamic nor Van der Waals forces acting on the particles can adequately explain the entrainment rate behaviour of differently shaped high-density Geldart A particles. [Copyright &y& Elsevier]

Focuses on the significance of information technology during the study of the author about judicial processes in Europe. Sources of information; Emphasis on civil procedural law and constitutional law; Assessment on the socio-political characteristics of the society.

Vibrotactile feedback can be built into clothing such as vests. This means that often vibrotactile information is presented to the back. It is known that the back has a relatively low spatial acuity. Spatial acuity varies across different limbs and sometimes with different locations on a limb. These known anisotropies suggest that there might be systematic variations in vibrotactile spatial acuity for different areas of the back and also for different orientations (i.e. horizontal vs. vertical). Here we systematically measured spatial acuity in four areas of the back for both horizontal and vertical orientations. The results show no significant differences in spatial acuity for the back areas that were tested. Spatial acuity was, however, higher in the horizontal direction than in the vertical direction by roughly a factor of two. This means that when designing vibrotactile displays for the back the tactor density can be lower in the vertical direction than in the horizontal direction and density should be constant for different areas of the back. [ABSTRACT FROM AUTHOR]

Background: Unilateral condylar hyperplasia (UCH) of the mandible is a rare condition characterized by asymmetric growth of the mandibular condyles. Bone scintigraphy with SPECT(/CT) is commonly used to diagnose UCH and guide treatment. Still, varying results have been reported using the traditional threshold of 55%:45% in relative tracer uptake. While absolute quantification of uptake on SPECT/CT could improve results, optimal correction and reconstruction settings are currently unknown., Methods: Three anthropomorphic phantoms representing UCH were developed from patient CT volumes and produced using 3D printing technology. Fillable spherical inserts of different sizes (Ø: 8-15 mm) were placed in the condylar positions representing symmetrical and asymmetrical distributions. Recovery coefficients were determined for SPECT/CT using various reconstruction corrections, including attenuation and scatter correction (ACSC), resolution modeling (RM), and partial volume correction (PVC) using phantom measurements. Uptake ratios between condyles and condyle to clivus were evaluated. Finally, the impact of these correction techniques on absolute activity and diagnostic accuracy was assessed in a retrospective patient cohort for the diagnostic threshold of 55%:45%., Results: The activity was only partially recovered in all spherical inserts (range: 22.5-64.9%). However, RM improved relative recovery by 20.2-62.3% compared to ACSC. In the symmetric phantoms, the 95% confidence interval (CI) of condyle ratios included the diagnostic threshold (57.6%:42.4%) for UCH when using ACSC potentially leading to false positives, but not for ACSCRM datasets. Partial volume corrections coefficients from the NEMA IQ phantom was positionally dependent, with improvements seen performing PVC using coefficients derived from anthropomorphic phantoms. Retrospective application in a patient cohort showed only a weak linear correlation (R²: 0.25-0.67) and large limits of agreement (9.6-12.5%) between different reconstructions. Up to 44% of patients were reclassified using the 55%:45% threshold. Using clinical outcome data, ACSCRM had highest sensitivity (91%; 95% CI 59-100%) and specificity (66%; 95% CI 47-81%), significantly improving specificity (P = 0.038)., Conclusions: Anthropomorphic phantoms were shown to be essential in determining optimal settings for acquisition, reconstruction, and analysis. SPECT/CT reconstructions with attenuation and scatter correction and resolution modeling are recommended and could improve specificity when using the 55%:45% threshold to assess condylar growth., (© 2024. The Author(s).)

In this study, we were interested in the question whether vibrotactile thresholds on the back, in terms of the Just Noticeable Difference (JND), scale with back length. Although there exists only indirect physiological evidence, it could be assumed that the density of mechanoreceptors is lower if back size is larger. As a consequence, the JND would increase with back length. We measured psychophysical curves for 40 male participants with back lengths in the range of 36 to 55 cm. Nine equally spaced vibration motors were placed in vertical direction on their back, 2 cm left of the spine. For each stimulus pair, participants had to decide whether the second vibration was above or below the first vibration. It was found that the slope of the fit of the JND as a function of back length was not significantly different from zero, so contrary to our expectation, we did not find an influence of back length on JND. This means that when customizing a wearable haptic device for the back, measuring back length is not the way to go.

Objectives: Informal caregiving is becoming increasingly important in dementia care, but causes a considerable burden on caregivers which impacts their wellbeing. We aimed to develop and pilot test a digital monitoring tool (REsilience Monitor for INformal caregivers in Dementia [REMIND]) for wellbeing and resilience of informal caregivers to provide timely support and thereby prevent their overburden and eventually crises admissions of persons with dementia., Methods: A human-centered design method based on co-creation with informal caregivers and professionals was used to design REMIND. During co-creation meetings and in-between sprint sessions, a point of focus was formulated, and a prototype was created. Case manager-caregiver duos pilot-tested REMIND for 3 months. Semi-structured interviews were conducted to determine usability and acceptability. Thematic analysis was applied to the transcripts., Results: Informal caregivers and professionals with varying backgrounds participated in three co-creation meetings. Defined point of focus was to develop a tool that is able to provide insight into the experienced burden of informal caregivers. The REMIND prototype consisted of weekly questions about wellbeing and resilience for informal caregivers and a dashboard with answers for case managers. Eight case managers and 13 informal caregivers considered REMIND easy-to-use. Informal caregivers mentioned that REMIND stimulated self-reflection. Case managers appreciated the tool's ability to gain insight in the actual wellbeing of informal caregivers., Conclusions: The REMIND tool developed in co-creation with end-users potentially increases insight in actual wellbeing of informal caregivers for both caregivers and case managers. A long-term (controlled) follow-up study is needed to evaluate REMIND's impact on caregiver burden and crisis admissions., (© 2023 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.)

Introduction: Recent evidence indicates that vibrotactile displays can potentially reduce the risk of sensory and cognitive overload. Before these displays can be introduced in super agile aircraft, it must be ascertained that vibratory stimuli can be sensed and interpreted by pilots subjected to high G loads., Methods: Each of 9 pilots intercepted 32 targets in the Swedish Dynamic Flight Simulator. Targets were indicated on simulated standard Gripen visual displays. In addition, in half of the trials target direction was also displayed on a 60-element tactile torso display. Performance measures and subjective ratings were recorded., Results: Each pilot pulled G peaks above +8 Gz. With tactile cueing present, mean reaction time was reduced from 1458 ms (SE = 54) to 1245 ms (SE = 88). Mean total chase time for targets that popped up behind the pilot's aircraft was reduced from 13 s (SE = 0.45) to 12 s (SE = 0.41). Pilots rated the tactile display favorably over the visual displays at target pop-up on the easiness of detecting a threat presence and on the clarity of initial position of the threats., Discussion: This study is the first to show that tactile display information is perceivable and useful in hypergravity (up to +9 Gz). The results show that the tactile display can capture attention at threat pop-up and improve threat awareness for threats in the back, even in the presence of high-end visual displays. It is expected that the added value of tactile displays may further increase after formal training and in situations of unexpected target pop-up.