Search

SignificanceFuture work should develop and evaluate interventional strategies to help overcome visual and health-related barriers to travel in visually impaired seniors and mitigate adverse impacts of loneliness for those who do not leave town.PurposeLife space refers to the area in which a person travels within a given time period. We explored whether demographics, vision, and/or health characteristics were related to restrictions in self-reported life space for visually impaired seniors.MethodsVisually impaired (n = 114) clinical trial participants aged ≥55 years learned visual assistive iPhone apps and completed the following baseline questionnaires: Life Space, 36-Item Short-Form Health Survey, University of California, Los Angeles Loneliness Scale, and New-General Self-efficacy Scale. Multiple logistic regressions evaluated associations between life space and patient factors after accounting for their distance to the next county or state.ResultsDuring 2021 to 2023, 17%, 43%, and 70% of participants had not left their town, county, or state, respectively, in the past 3 months, or planned to in the next 3 months. Those with reduced distance best-corrected visual acuity had greater odds of not leaving the county in these time frames (odds ratio [OR] = 3.5; p=0.04). Minority race was associated with greater odds of not leaving town or the county in the past 2 weeks or future 3 months (OR = 4.3 to 6.4; p=0.009 to 0.049). Increased self-efficacy was associated with reduced odds of not leaving the state in the past 3 months, next 3 months, or past and/or future 3 months (OR = 0.54 to 0.55; p=0.02 to 0.03). Better physical function was associated with reduced odds of not leaving the state in the past 2 weeks or 3 months (OR = 0.96 to 0.98; p=0.01 to 0.04). Increased loneliness was related to greater odds of not leaving town in the past and/or future 3 months (OR = 1.8 to 2.0; p=0.007 to 0.009).ConclusionsMinority race, reduced vision, self-efficacy, and physical health were related to life space restrictions in this cohort of visually impaired seniors, whereas loneliness was greater among those who were not leaving town.

SignificanceA majority of visually impaired older adults were able to learn to proficiently use visual-assistive iPhone applications (apps) following a median 1 hour and/or multiple training sessions, which should be considered when planning vision rehabilitation service delivery, including the option for remote telerehabilitation for those who prefer that modality.PurposeOlder adults with low vision are increasingly using technology to improve their visual functioning. We examined whether age-related comorbidities were potential barriers to success in learning to use visual-assistive apps on a smartphone.MethodsA clinical trial assessed visual-assistive apps in 116 older adults aged 55+ years (mean [standard deviation], 72 [10] years). Subjects were randomized to use an app (SuperVision+, Seeing AI, or Aira) preloaded to a loaner iPhone and completed one-on-one training. App proficiency was measured by the participant's ability to use the iPhone/app without cueing at the end of training sessions. Training time was recorded for the initial session and totaled after subsequent sessions. Multiple regression models explored significant factors associated with training time and proficiency.ResultsMedian initial and total training times were 45 and 60 minutes, respectively. Increased initial and total training times were both significantly related to increased age (p

In order to test the performance of laser devices for attacking miniature UAVs, we studied the principle of laser devices on soft killing and hard killing. Then, the flight test conditions of miniature UAVs were constructed, and the laser devices were tested and evaluated with the two indexes of maximum jamming range and maximum intercepting range. The first step involves calculating the far-field beam power density corresponding to the unmanned aerial vehicle (UAV) detection equipment and laser device at different distances. Subsequently, the signal electron count received by the UAV detector from the incident laser source target within the integration time tint is computed and compared against the full well charge of the photodetector. This comparison analyzes the UAV detector's potential for dazzle/blind effects. When the laser device is positioned 600 m from the UAV, the ratio of signal electrons received by the detector to the full well charge was 13.53, indicating that the detector receives signal electrons exceeding the full well charge by over 10 times, thus causing UAV detector blindness. At a distance of 1.2 km from the UAV, this ratio reduces to 2.92, where the detector receives signal electrons around three times the full well charge, causing UAV detector dazzle. Experimental testing determines that the maximum interception distance of this laser device for small, slow-moving UAV equipment is 500 m. Finally, it is proved that the method can effectively test the attacking performance of laser devices, and provides a basis for improving the function and performance of laser devices. [ABSTRACT FROM AUTHOR]

PurposeAn evidence basis is lacking but needed to compare reading ability outcomes after magnification device training remotely via telerehabilitation versus in office.MethodsA multicenter randomized controlled trial at academic centers and vision rehabilitation private practices randomized 61 visually impaired adults to telerehabilitation or in-office training 1 to 4 months after dispensing new portable electronic, hand-held, or stand optical magnifiers. Telerehabilitation included loaner equipment for Zoom videoconferencing with remote control access software. Using a multilevel regression model, changes in Activity Inventory responses using Rasch analysis estimated reading ability in dimensionless log odds units (logits) (0.14-logit change corresponds with ability change expected from a one-line change in visual acuity).ResultsAcross 47 participants who completed the trial, reading ability with new magnifiers improved significantly by 0.61 logits on average (95% confidence interval [CI], 0.36-0.86; P < 0.001) from baseline to 1 month, and by an additional 0.44 logits on average (95% CI, 0.19-0.69; P < 0.001) from 1 to 4months (i.e., after magnifier training), with very similar significant findings for both telerehabilitation (n = 29; mean improvement = 0.44 logits; 95% CI, 0.08-0.80; P = 0.018) and in-office training (n = 18; mean improvement = 0.43 logits; 95% CI, 0.15-0.71; P = .003), and no significant difference between randomized groups across both follow-ups (95% CI, -0.43 to 0.61; P = .73). Vision, demographics, and health factors were nonsignificantly related to reading ability changes from 1 to 4 months.ConclusionsReading ability improved after the provision of newly dispensed magnifiers, with further improvements following additional magnifier training via either telerehabilitation or in-office usual care.Translational relevanceThese findings provide support for the use of telerehabilitation to enhance reading ability with newly prescribed magnifiers as an alternative modality of care delivery.

In order to test the performance of laser devices for attacking miniature UAVs, we studied the principle of laser devices on soft killing and hard killing. Then, the flight test conditions of miniature UAVs were constructed, and the laser devices were tested and evaluated with the two indexes of maximum jamming range and maximum intercepting range. The first step involves calculating the far-field beam power density corresponding to the unmanned aerial vehicle (UAV) detection equipment and laser device at different distances. Subsequently, the signal electron count received by the UAV detector from the incident laser source target within the integration time tint is computed and compared against the full well charge of the photodetector. This comparison analyzes the UAV detector’s potential for dazzle/blind effects. When the laser device is positioned 600 m from the UAV, the ratio of signal electrons received by the detector to the full well charge was 13.53, indicating that the detector receives signal electrons exceeding the full well charge by over 10 times, thus causing UAV detector blindness. At a distance of 1.2 km from the UAV, this ratio reduces to 2.92, where the detector receives signal electrons around three times the full well charge, causing UAV detector dazzle. Experimental testing determines that the maximum interception distance of this laser device for small, slow-moving UAV equipment is 500 m. Finally, it is proved that the method can effectively test the attacking performance of laser devices, and provides a basis for improving the function and performance of laser devices.

The purpose of this study was to investigate the effect of instructions that prioritize either speed or accuracy in experienced senior football players when taking penalty kicks at five different targets in a goal. Sixteen male experienced senior football players performed in total 80 penalty kicks with instructions that prioritized either precision or speed at five different targets in the goal. Ball velocity and hit accuracy were evaluated between the two instructions and the five targets. The main findings showed that aiming for velocity resulted in higher ball velocity and lower kicking accuracy than aiming for accuracy. However, kicking accuracy was only lower when kicking to the bottom corner targets. Furthermore, when shooting high at the middle, the percentage of balls on target was higher when aiming for speed rather than accuracy. Based upon the findings of the study, it is suggested that a player should try to kick as fast as possible and aim for the middle of the goal, as ball velocity is faster than when aiming for accuracy and hit percentage in the goal is also at its highest, thereby increasing the chances of outdoing the goalkeeper, who most often goes for one of the sides. [ABSTRACT FROM AUTHOR]

INTRODUCTION Participant recruitment is critical to the success of smoking cessation trials. However, recruitment feasibility studies for inclusion and exclusion criteria commonly used in smoking cessation research remain scarce. We assessed the feasibility of recruiting potential research volunteers (PRVs) under two sets of inclusion criteria to inform eligibility requirements for a smoking cessation mobile intervention trial. METHODS We invited PRVs nationwide to participate in qualitative evaluation of a smoking cessation mobile application. To be eligible under Criteria I, participants were aged 18-29 years, neither four-year college graduates nor enrollees, exclusive cigarette smokers, willing to quit within 30 days, and not using cessation aids. Criteria II expanded eligibility to those using cigarettes and non-combustible tobacco products (e.g. e-cigarettes) and willing to quit within 6 months. We calculated recruitment yields and associated costs. RESULTS Of 10533 PRVs screened for eligibility, 48 were enrolled. Only 54 (0.5%) participants qualified under Criteria I and 164 (1.6%) under Criteria II. Age ineligibility was the top reason for exclusion (66.7%), whereas lifetime smoking, quit timeframe, and other tobacco product use contributed to ineligibility rates ranging from 46.5% to 65.3%. Enrolled participants were equally split by sex and roughly reflected the racial/ethnic composition of the United States. American Indians, who have the highest smoking prevalence, were <5% of enrolled participants. Recruitment costs averaged $106 per PRV. CONCLUSIONS Eligibility requirements used in cessation trials were restrictive for recruitment efforts. Relaxing inclusion criteria will reflect current tobacco use patterns and facilitate the timely completion of trials within budgetary thresholds. [ABSTRACT FROM AUTHOR]

Wearable optics have a broad range of uses, for example, in refractive spectacles and augmented/virtual reality devices. Despite the long-standing and widespread use of wearable optics in vision care and technology, user discomfort remains an enduring mystery. Some of this discomfort is thought to derive from optical image minification and magnification. However, there is limited scientific data characterizing the full range of physical and perceptual symptoms caused by minification or magnification during daily life. In this study, we aimed to evaluate sensitivity to changes in retinal image size introduced by wearable optics. Forty participants wore 0%, 2%, and 4% radially symmetric optical minifying lenses binocularly (over both eyes) and monocularly (over just one eye). Physical and perceptual symptoms were measured during tasks that required head movement, visual search, and judgment of world motion. All lens pairs except the controls (0% binocular) were consistently associated with increased discomfort along some dimension. Greater minification tended to be associated with greater discomfort, and monocular minification was often-but not always-associated with greater symptoms than binocular minification. Furthermore, our results suggest that dizziness and visual motion were the most reported physical and perceptual symptoms during naturalistic tasks. This work establishes preliminary guidelines for tolerances to binocular and monocular image size distortion in wearable optics.

Abstract Background Vitamin D deficiency (VDD) is conventionally associated with inadequate sunlight exposure. Ironically, recent evidence suggests a rising prevalence in urban areas of tropical regions like Sri Lanka, where comprehensive data are unavailable. This study aimed to estimate the prevalence of low vitamin D status in urban adults and its impact on serum calcium. Methods A population-based cross-sectional study was conducted among 1260 adults aged 35–74 years, living in Colombo, the most urban district in Sri Lanka. They were recruited from 63 administrative divisions, using multi-stage, probability-proportionate-to-size, cluster sampling. Non-fasting venous blood was collected without tourniquet. Low vitamin D (

This study is motivated by the reality that currently students' high-level thinking skills have not been achieved and their learning motivation is low. Even though students are expected to be able to overcome their difficulties with the help of 4C skills. Low motivation to learn is undoubtedly an important problem in education, where educators must take a leading position. Teachers should incorporate more activities into the classroom. The approach or model used by the teacher clearly has an impact on student actions. If teachers involve students in lessons, they will study harder, and vice versa. The aim of this research is to increase student learning motivation with the PBL model assisted by PPT media. This type of research is classroom action research (PTK) with research subjects of 24 class 2D students at SDIT Nur Hidayah. This research shows that the PBL model assisted by PPT media can increase students' learning motivation. The first cycle has a percentage value of 60%. Meanwhile, cycle II has a percentage value of 74%. Therefore, there was an increase from cycle I to cycle II, namely 14%.

Abstract Background Early diagnosis of HIV infection decreases the time from HIV diagnosis to viral suppression and reduces further HIV transmission. The Chinese Guidelines for the Diagnosis and Treatment of HIV/AIDS (2021 edition) state that an HIV RNA level > 5,000 copies/mL is the threshold for diagnosing HIV infection. The impact of low viral load values on HIV diagnosis needs to be investigated. Methods There were 3455 human immunodeficiency virus (HIV1 + 2) antibody results (immunoblotting method) and 65,129 HIV viral load values at Beijing Youan Hospital from 2019 to 2022. A total of 2434 patients had both antibody confirmatory results and viral load results. The confirmatory antibody results and HIV viral load results of 2434 patients were analyzed to investigate the impact of low viral load values on HIV diagnosis. Results Of the 2434 patients who had both confirmatory antibody results and viral load results, the viral load values of 140 patients (5.8%) had viral loads ranging from 40 copies/mL to 5,000 copies/mL before positive confirmatory antibody result, and of these 140 patients, the sample receipt time for the viral load tests of 96 (66.7%) individuals was 1 to 6 days earlier than the corresponding sample receipt time for the confirmatory antibody test. In addition, 34 patients (1.4%) had low viral loads ranging from 40 copies/mL to 1,000 copies/mL before positive confirmatory antibody result. Conclusion This study revealed that there is a risk of missed diagnosis if a threshold of 5000 copies/mL is used for the diagnosis of HIV infection. These data provide valuable information for the early diagnosis of HIV infection, and our findings have potential benefits for decreasing HIV transmission.

SignificanceVision rehabilitation providers tend to recommend handheld, illuminated optical magnifiers for short-duration spot reading tasks, but this study indicates that they are also a viable option to improve sustained, continuous text reading (e.g., books or magazines), especially for visually impaired adults who read slowly with only spectacle-based near correction.PurposeThe utility of handheld optical magnifiers for sustained silent reading tasks involving normal-sized continuous text could be a valuable indication that is not recognized by vision rehabilitation providers and patients.MethodsHandheld, illuminated optical magnifiers were dispensed to 29 visually impaired adults who completed the sustained silent reading test by phone at baseline without the new magnifier and 1 month after using the magnifier. Reading speed in words per minute (wpm) was calculated from the time to read each page and then averaged across up to 10 pages or determined for the fastest read page (maximum).ResultsFrom baseline without the magnifier to 1 month with the magnifier, there was a significant improvement in mean reading speed by 14 wpm (95% confidence interval [CI], 2.6 to 24; P = .02) and for maximum reading speed by 18 wpm (95% CI, 5.4 to 30; P = .005) on average across participants. Participants who had slower baseline reading speeds without the magnifier demonstrated significantly greater improvements in mean and maximum reading speeds on average with the magnifier (95% CI, 8 to 32 [ P = .003]; 95% CI, 4 to 36 [ P = .02]). A significantly greater number of pages were read with the new magnifier than without it (Wilcoxon z = -2.5; P = .01). A significantly greater number of pages were read with the magnifier by participants who read fewer pages at baseline (95% CI, 0.57 to 5.6; P = .02) or had greater improvements in mean reading speed (95% CI, 0.57 to 5.6; P = .007).ConclusionsMany visually impaired adults read more quickly and/or read a greater number of pages after using a new magnifier for a month than compared to without it. The largest gains occurred among those with more difficulty at baseline, indicating the potential to improve reading rates with magnifiers for those with greater deficits.

Successful goal-directed actions require constant fine-tuning of the motor system. This fine-tuning is thought to rely on an implicit adaptation process that is driven by sensory prediction errors (e.g., where you see your hand after reaching vs. where you expected it to be). Individuals with low vision experience challenges with visuomotor control, but whether low vision disrupts motor adaptation is unknown. To explore this question, we assessed individuals with low vision and matched controls with normal vision on a visuomotor task designed to isolate implicit adaptation. We found that low vision was associated with attenuated implicit adaptation only for small visual errors, but not for large visual errors. This result highlights important constraints underlying how low-fidelity visual information is processed by the sensorimotor system to enable successful implicit adaptation.

Background: Vitamin D deficiency (VDD) is conventionally associated with inadequate sunlight exposure. Ironically, recent evidence suggests a rising prevalence in urban areas of tropical regions like Sri Lanka, where comprehensive data are unavailable. This study aimed to estimate the prevalence of low vitamin D status in urban adults and its impact on serum calcium. Methods: A population-based cross-sectional study was conducted among 1260 adults aged 35–74 years, living in Colombo, the most urban district in Sri Lanka. They were recruited from 63 administrative divisions, using multi-stage, probability-proportionate-to-size, cluster sampling. Non-fasting venous blood was collected without tourniquet. Low vitamin D (< 30.0 ng/mL), VDD (< 20 ng/mL) and vitamin D insufficiency (20.0–29.9 ng/mL) were determined using chemiluminescence assay method, and serum calcium using Calcium Gen2 reagent. Results: Among the population (53.3% females; mean age = 51.8 years), the prevalence of low vitamin D was 93.9% (95% CI: 92.5–95.2). This was primarily due to VDD (67.5%; 95% CI: 64.9.0–70.1%), with some insufficiency (26.4%; 95% CI: 24.0–28.9%). Most VDD cases (53.9.0%) were 'mild' (10.0- < 20.0 ng/mL) in severity, with fewer 'moderate' (12.8%) and 'severe' (0.8%) cases. Prevalence of VDD was highest in females, aged 35–44-years, living in 'highly urban' areas and of Tamil ethnicity. Further, VDD showed a decreasing trend with older age groups, while it was significantly more prevalent in females than males (72.6% vs. 61.7%; p < 0.01), across all age groups. Low serum calcium levels were observed in 9.8% of adults with low vitamin D, compared to 22.4% with normal vitamin D, implying that there could be factors other than vitamin D in maintaining serum calcium levels. Conclusions: Colombo District, representing urban settings in Sri Lanka faces a high prevalence of low vitamin D, primarily VDD, with higher rates in females, younger individuals and highly urban areas. These findings challenge assumptions about tropical regions being guaranteed of optimal vitamin D levels; and underscore the need for national vitamin D supplementation and food fortification programs, especially in high-risk urban settings in South Asian countries like Sri Lanka. [ABSTRACT FROM AUTHOR]

Copyright of Jurisprudence Faculty Journal / Magallaẗ Kulliyyaẗ Al-fiqh is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Exposure of the Hubble Space Telescope to space in low Earth orbit resulted in numerous hypervelocity impacts by cosmic dust (micrometeoroids) and anthropogenic particles (orbital debris) on the solar arrays and the radiator shield of the Wide Field and Planetary Camera 2, both subsequently returned to Earth. Solar cells preserve residues from smaller cosmic dust (and orbital debris) but give less reliable information from larger particles. Here, we present images and analyses from electron, ion and X-ray fluorescence microscopes for larger impact features (millimetre- to centimetre-scale) on the radiator shield. Validated by laboratory experiments, these allow interpretation of composition, probable origin and likely dimensions of the larger impactors. The majority (~90%) of impacts by grains greater than 50 μm in size were made by micrometeoroids, dominated by magnesium- and iron-rich silicates and iron sulfides, metallic iron-nickel and chromium-rich spinel similar to that in ordinary chondrite meteorites of asteroid origin. Our re-evaluation of the largest impact features shows substantially fewer large orbital debris impacts than reported by earlier authors. Mismatch to the NASA ORDEM and ESA MASTER models of particle populations in orbit may be partly due to model overestimation of orbital debris flux and underestimation of larger micrometeoroid numbers. This article is part of the theme issue 'Dust in the Solar System and beyond'. [ABSTRACT FROM AUTHOR]

IntroductionGlobally, nearly half of all deaths among children under the age of five are linked to undernutrition. These tragic outcomes are most prevalent in low- and middle-income countries. The far-reaching impact of malnutrition affects not only individuals but also their families, communities, and entire nations. By examining underweight, we gain valuable insights into the intricate network of factors influencing child health. Therefore, this study aims to assess underweight prevalence and its associated factors among under-five children in low and lower-middle-income African countries.MethodWe conducted a secondary analysis of standard demographic and health surveys in 30 low and lower-middle-income African countries spanning from 2012 to 2022. Our analysis included a total sample of 200,655 children under the age of 5 years. We employed a three-level hierarchical model to assess the determinants of underweight among children in this age group. Measures of association were evaluated using adjusted odds ratios with a 95% confidence interval. Explanatory variables with a p-value less than the level of significance (0.05) were considered statistically significant.ResultThe pooled prevalence of underweight among children under the age of five in low and lower-middle income African countries was estimated at 17.60%, with a 95% confidence interval (CI) ranging from 17.44 to 17.77%. The hierarchical analysis identified several factors significantly associated with underweight, including male gender, birth size, maternal body mass index, maternal educational level, household wealth index, antenatal care (ANC) visits, community poverty level, and income level of countries.ConclusionThe high prevalence of underweight among children under the age of five in low and lower-middle income African countries underscores the need for targeted interventions. By addressing individual, community, and country-level factors, we can work toward improving child nutrition and well-being.

Purpose: Professional football players experience both physical and mental fatigue (MF). The main aims of this randomized crossover study were to investigate the effect of MF on repeated-sprint ability (RSA) and the effects of both physical fatigue and MF on psychomotor vigilance. Methods: Seventeen male professional football players performed 10 maximal 20-m shuttle sprints interspaced by incomplete recovery (RSA test). Running speed, heart rate, brain oxygenation, and rating of perceived exertion were monitored during each sprint. The RSA test was preceded by either a 30-minute Stroop task to induce MF or by watching a documentary for 30 minutes (control [CON]) in a randomized counterbalanced order. Participants performed a psychomotor vigilance test at baseline, after the cognitive task (MF or CON), and after the RSA test. Results: Heart rate and rating of perceived exertion significantly increased, while running speed and brain oxygenation significantly decreased over the repeated sprints (P <.001) with no significant differences between conditions. Response speed during the psychomotor vigilance test significantly declined after the Stroop task but not after CON (P =.001). Response speed during the psychomotor vigilance test declined after the RSA test in both conditions (P <.001) and remained lower in the MF condition compared to CON (P =.012). Conclusions: MF does not reduce RSA. However, the results of this study suggest that physical fatigue and MF have negative and cumulative effects on psychomotor vigilance. Therefore, strategies to reduce both physical fatigue and MF should be implemented in professional football players. [ABSTRACT FROM AUTHOR]

Detecting and avoiding obstacles while navigating can pose a challenge for people with low vision, but augmented reality (AR) has the potential to assist by enhancing obstacle visibility. Perceptual and user experience research is needed to understand how to craft effective AR visuals for this purpose. We developed a prototype AR application capable of displaying multiple kinds of visual cues for obstacles on an optical see-through head-mounted display. We assessed the usability of these cues via a study in which participants with low vision navigated an obstacle course. The results suggest that 3D world-locked AR cues were superior to directional heads-up cues for most participants during this activity.

ObjectiveTo determine the relationship between socioeconomic status (SES) and visual impairment (VI) or blindness in the rural Peruvian Amazon, hypothesizing that higher SES would have a protective effect on the odds of VI or blindness.MethodsIn this cross-sectional study of 16 rural communities in the Peruvian Amazon, consenting adults aged ≥ 50 years were recruited from ~30 randomly selected households per village. Each household was administered a questionnaire and had a SES score constructed using principal components analysis. Blindness and VI were determined using a ministry of health 3-meter visual acuity card.ResultsOverall, 207 adults aged ≥ 50 were eligible; 146 (70.5%) completed visual acuity screening and answered the questionnaire. Of those 146 participants who completed presenting visual acuity screening, 57 (39.0%, 95% CI 30.2-47.1) were classified as visually impaired and 6 (4.1%, 95% CI 0.9-7.3) as blind. Belonging to the highest SES tercile had a protective effect on VI or blindness (OR 0.29, 95% CI 0.09 to 0.91, p = 0.034), with a linear trend across decreasing levels of SES (p = 0.019). This observed effect remained significant regardless of how SES groups were assigned.ConclusionBelonging to a higher SES group resulted in a lower odds of VI or blindness compared to those in the lowest SES group. The observation of a dose response provides confidence in the observed association, but causality remains unclear. Blindness prevention programs could maximize impact by designing activities that specifically target people with lower SES.

BACKGROUND: Low vision affects over 300 million people worldwide and can compromise both activities of daily living and quality of life. Rehabilitative training and vision assistive equipment (VAE) may help, but some visually impaired people have limited resources to attend in-person visits to rehabilitation clinics to be trained to learn to use VAE. These people may be able to overcome barriers to care through access to remote, internet-based consultation (telerehabilitation). OBJECTIVES: To compare the effects of telerehabilitation with face-to-face (e.g. in-office or inpatient) vision rehabilitation services for improving vision-related quality of life and near reading ability in people with visual function loss due to any ocular condition. Secondary objectives were to evaluate compliance with scheduled rehabilitation sessions, abandonment rates for VAE devices, and patient satisfaction ratings. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register) (2021, Issue 9); Ovid MEDLINE; Embase.com; PubMed; ClinicalTrials.gov; and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any language restriction or study design filter in the electronic searches; however, we restricted the searches from 1980 onwards because the internet was not introduced to the public until 1982. We last searched CENTRAL, MEDLINE Ovid, Embase, and PubMed on 14 September 2021, and the trial registries on 16 March 2022. SELECTION CRITERIA: We included randomized controlled trials (RCTs) or controlled clinical trials (CCTs) in which participants diagnosed with low vision had received vision rehabilitation services remotely from a human provider using internet, web-based technology compared with an approach involving in-person consultations. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts retrieved by the searches of the electronic databases and then full-text articles for eligible studies. Two review authors independently abstracted data from the included studies. Any discrepancies were resolved by discussion. MAIN RESULTS: We identified one RCT/CCT that indirectly met our inclusion criteria, and two ongoing trials that met our inclusion criteria. The included trial had an overall high risk of bias. We did not conduct a quantitative analysis since multiple controlled trials were not identified.  The single included trial of 57 participants utilized a parallel-group design. It compared 30 hours of either personalized low vision training through telerehabilitation with a low vision therapist (the experimental group) with the self-training standard provided by eSight using the eSkills User Guide that was self-administered by the participants at home for one hour per day for 30 days (the comparison group). The trial investigators found a similar direction of effects for both groups for vision-related quality of life and satisfaction at two weeks, three months, and six months. A greater proportion of participants in the comparison group had abandoned or discontinued use of the eSight Eyewear at two weeks than those in the telerehabilitation group, but discontinuance rates were similar between groups at one month and three months. We rated the certainty of the evidence for all outcomes as very low due to high risk of bias in randomization processes and missing outcome data and imprecision.   AUTHORS CONCLUSIONS: The included trial found similar efficacy between telerehabilitation with a therapist and an active control intervention of self-guided training in mostly younger to middle-aged adults with low vision who received a new wearable electronic aid. Given the disease burden and the growing interest in telemedicine, the two ongoing studies, when completed, may provide further evidence of the potential for telerehabilitation as a platform for providing services to people with low vision.

PURPOSE: Although abstinence is recommended in pregnancy, many pregnancies are exposed to alcohol. Observational studies of the effects of low to moderate prenatal alcohol exposure (PAE) and neurodevelopmental outcomes have yielded inconsistent results, with some studies finding an increased risk of adverse neurobehavioral and cognitive outcomes, and other studies finding no changes or reduced risk of the same outcomes. The purpose of this narrative review is to summarize these inconsistencies and apply a methodological framework to discuss how different parameters contribute to the findings. The authors also provide recommendations on how to advance future research in this area. SEARCH METHODS: The PubMed, Web of Science, and Embase databases were searched, along with reference lists of selected systematic reviews and meta-analyses. Search terms used were (infant or child or children or adolescent or offspring) AND (low or light or mild or moderate or low-to-moderate) AND (drinking or alcohol or drinks) AND (pregnancy or prenatal or fetal) AND (neurodevelopment or behavioral or psychological or cognitive or developmental) NOT (mice or rat or fish or animal) NOT (meta-analysis or review). Peer-reviewed original research studies were included if they analyzed associations between an exposure defined and characterized as low/light or moderate PAE with offspring neurodevelopmental outcomes. Animal studies, studies that did not provide clear cutoff points to classify PAE categories, studies lacking an abstinence control group, and studies that did not present a multivariable-adjusted measure of association were excluded. SEARCH RESULTS: The searches identified 2,422 papers, with 36 papers meeting eligibility criteria. These studies were carried out across nine countries and included samples ranging from approximately 500 to 40,000 participants. Cognitive, academic, socioemotional, and behavioral outcomes were assessed from infancy through age 19. DISCUSSION AND CONCLUSION: When the findings from the selected articles were summarized by geographic region, exposure definition, or neurodevelopmental outcome, no consistent observations or patterns emerged between low to moderate PAE and offspring outcomes. Although some studies found positive (i.e., beneficial) associations between low to moderate PAE and outcomes (primarily outcomes related to cognition) and others found negative (i.e., detrimental) associations (primarily for behavioral outcomes), most findings were null (i.e., showed no effect of PAE). The heterogeneity in study results is likely due to methodological issues, including residual confounding, effect measure modification, and exposure misclassification that make synthesis of studies difficult. Alternative study designs, including longitudinal trajectory analysis, sibling design, negative controls, and instrumental variable analyses, may reduce biases and are discussed. To date, the consequences of light to moderate levels of PAE on neurodevelopment remain unresolved; studies that advance methodological rigor will be important contributions to the field.

Abstract Background Underweight is a public health problem globally, and more severe in South Sudan with wide sub-regional differences. In Nimule border town, which represents other border towns in South Sudan, data on underweight among children below two years is unavailable. Thus, this study set out to assess predictors of underweight among children younger than 24 months in Nimule border town, Magwi County, Eastern Equatoria State, South Sudan. Methods An analytical cross-sectional study was conducted in Nimule boarder town targeting 390 children younger than two years. Systematic sampling and simple random sampling methods were used. Data were collected through a researcher-administered questionnaire with both open and closed ended questions. Data was entered in EpiData and then exported into Statistical Package for Social Sciences research (SPSS) version 20 for analysis. Descriptive data analysis was conducted and data were summarized into frequencies and percentages, means with standard deviations, and medians with interquartile ranges. Bivariate analysis was conducted with the Chi-squared and Fisher's exact tests for categorical independent variables, and the student’s t-test for numerical variables. Finally, multivariate analysis was done via logistic regression analysis and results were stated as odds ratios (OR) with corresponding 95% confidence interval (CI). The level of statistical significance was set at 5%. Results Out of the total 390 participants, 112 (28.7%) were under weight. The study showed primary (aOR, 0.38; 95% CI, 0.12–1.18; P = 0.095) and secondary (aOR, 0.37; 95% CI, 0.12–1.17; P = 0.091 levels of education were associated with underweight but not tertiary level of education (aOR, 0.76; 95% CI, 0.21–2.74; p = 0.671). Household income of 5000 to 10,000 (aOR, 0.26; 95% CI, 0.10–0.68; P = 0.006) and above 10,000 (aOR, 0.11; 95% CI, 0.04–0.28; P

SignificanceUnderstanding longitudinal changes in why individuals frequent low-vision clinics is crucial for ensuring that patient care keeps current with changing technology and changing lifestyles. Among other findings, our results suggest that reading remains a prevailing patient complaint, with shifting priorities toward technology-related topics.PurposeThis study aimed to understand changes in patient priorities and patient care in low vision over the past decade.MethodsWe conducted a retrospective study of examination records (2009 to 2019, 3470 examinations) from two U.S. low-vision clinics. Automated word searches summarized two properties of the records: topics discussed during the case history and types of rehabilitative devices assessed. Logistic regression was used to model the effects of examination year, patient age, patient sex, and level of visual impairment.ResultsCollapsing across all years, the most common topic discussed was reading (78%), followed by light-related topics (71%) and technology (59%). Whereas the odds of discussing reading trended downward over the decade (odds ratio, 0.57; P = .03), technology, social interaction, mobility, and driving trended upward (odds ratios, 4.53, 3.31, 2.71, and 1.95; all P 's < 0.001). The most frequently assessed devices were tinted lenses (95%). Over time, video magnifier and spectacle assessments trended downward (odds ratios, 0.64 and 0.72; P = .004, 0.04), whereas assessments of other optical aids increased. The data indicate several consistent differences among patient demographics.ConclusionsReading is likely to remain a prevailing patient complaint, but an increase in technology-related topics suggests shifting priorities, particularly in younger demographics. "Low-tech" optical aids have remained prominent in low-vision care even as "high-tech" assistive devices in the marketplace continue to advance.

SignificanceThis pilot study provides some insight about the potential benefits of telerehabilitation training to improve the reading ability of adults with low vision using magnifiers, to spur future work with larger groups. Telerehabilitation services can be implemented clinically to facilitate access to follow-up care for low vision.PurposeA recent Cochrane systematic review revealed that there are no published visual function outcomes for telerehabilitation with handheld magnification devices for low vision; thus, this study aimed to provide evidence for its preliminary efficacy.MethodsOne to 4 months after receiving a new magnification device (i.e., handheld or stand optical magnifier or portable electronic magnifier), 14 adult low vision patients (with any visual acuity level or ocular diagnosis) received two training sessions at home via telerehabilitation with their vision rehabilitation provider located remotely in-office. Telerehabilitation included a loaner smartphone for Zoom videoconferencing with remote control access software. The Minnesota Low-Vision Reading Test was administered during each of the telerehabilitation sessions to assess near reading (acuity and speed) with the new magnifier.ResultsMean reading acuity with the magnifier was 0.17 logMAR across subjects before training at telerehabilitation session 1, which significantly improved to 0.09 on average a few weeks later at telerehabilitation session 2 (95%confidence interval, -0.001 to -0.16; P = .047). Logarithm reading speed with the magnifier for the reading acuity level at session 1 improved significantly by 0.18 log words per minute on average for the same text size at session 2 (95% confidence interval, 0.06 to 0.29; P = .002). With the magnifier at session 2, 71% of participants gained at least 0.1 log unit in reading acuity, and half improved by >0.01 in log reading speed; all participants with increased reading speed also improved in reading acuity ( P = .02).ConclusionsThese preliminary data support that telerehabilitation can enhance reading ability and efficiency with newly prescribed magnifiers as an alternative option to in-office vision rehabilitation.

Background: Underweight is a public health problem globally, and more severe in South Sudan with wide sub-regional differences. In Nimule border town, which represents other border towns in South Sudan, data on underweight among children below two years is unavailable. Thus, this study set out to assess predictors of underweight among children younger than 24 months in Nimule border town, Magwi County, Eastern Equatoria State, South Sudan. Methods: An analytical cross-sectional study was conducted in Nimule boarder town targeting 390 children younger than two years. Systematic sampling and simple random sampling methods were used. Data were collected through a researcher-administered questionnaire with both open and closed ended questions. Data was entered in EpiData and then exported into Statistical Package for Social Sciences research (SPSS) version 20 for analysis. Descriptive data analysis was conducted and data were summarized into frequencies and percentages, means with standard deviations, and medians with interquartile ranges. Bivariate analysis was conducted with the Chi-squared and Fisher's exact tests for categorical independent variables, and the student's t-test for numerical variables. Finally, multivariate analysis was done via logistic regression analysis and results were stated as odds ratios (OR) with corresponding 95% confidence interval (CI). The level of statistical significance was set at 5%. Results: Out of the total 390 participants, 112 (28.7%) were under weight. The study showed primary (aOR, 0.38; 95% CI, 0.12–1.18; P = 0.095) and secondary (aOR, 0.37; 95% CI, 0.12–1.17; P = 0.091 levels of education were associated with underweight but not tertiary level of education (aOR, 0.76; 95% CI, 0.21–2.74; p = 0.671). Household income of 5000 to 10,000 (aOR, 0.26; 95% CI, 0.10–0.68; P = 0.006) and above 10,000 (aOR, 0.11; 95% CI, 0.04–0.28; P < 0.001) South Sudanese pounds, supplementary feeding before 6 months (aOR; 0.01; 95% CI, 0.02–0.05; P < 0.001) were associated with underweight and irregular hand washing (aOR; 2.17; 95% CI, 1.14–4.11; P = 0.018) was associated with increased odds of underweight. Conclusions: This study established a high prevalence of underweight. Maternal level of education particularly primary, secondary, higher household incomes in excess of 5,000 South Sudanese pounds reduced the risk of underweight. While irregular hand washing was a risk factor for underweight. [ABSTRACT FROM AUTHOR]

We report a new low-affinity hemoglobinopathy (Hemoglobin Oviedo) in a family with isolated low oxygen saturation (89–92%) caused by a previously undescribed variant (NM_000518.5: c.115A > G;p.Thr39Ala) in the hemoglobin subunit β encoding gene (HBB gene) located on chromosome 11. [ABSTRACT FROM AUTHOR]

PurposeWe examined different methods to reduce the burden of accessing technology for videoconferencing during telerehabilitation for magnification devices for the visually impaired.MethodsDuring telerehabilitation studies over the past 5 years, vision rehabilitation providers assessed and gave training to visually impaired participants with newly dispensed magnification devices at home who connected to Zoom videoconferencing via loaner tablets or smartphones with assistance from (phase 1; n = 10) investigators by phone, (phase 2; n = 11) local Lions Club volunteers in participants' homes, or (phase 3; n = 24) remote access control software in a randomized controlled trial with 13 usual care controls who received in-office training. All participants completed the same post-telerehabilitation phone survey.ResultsA significantly greater proportion of phase 3 subjects indicated they strongly or mostly agreed that the technology did not interfere with the session (96%) compared to phase 1 (60%; 95% confidence interval [CI], 1.2-12.5; P = 0.03) or phase 2 (55%; 95% CI, 1.8-188; P = 0.01). The majority indicated telerehabilitation was as accurate as in person (68%), they were comfortable with telerehabilitation (91%) and interested in a future session (83%), and their magnifier use improved (79%), with no significant differences in these responses between phases (all P > 0.10), including comparisons of participants randomized to telerehabilitation or in-office training in phase 3 who reported similar overall satisfaction levels (P = 0.84).ConclusionsParticipants across all phases reported high levels of acceptance for telerehabilitation, with least interference from technology using remote access control in phase 3.Translational relevanceWith accommodations for accessibility to videoconferencing technology, telerehabilitation for magnification devices can be a feasible, acceptable, and valuable option in countries with resources to support the technology.

ObjectiveTo determine the relationship between visual impairment and other disabilities in a developing country.MethodsIn this cross-sectional ancillary study, all individuals 50 years and older in 18 communities in the Chitwan region of Nepal were administered visual acuity screening and the Washington Group Short Set (WGSS) of questions on disability. The WGSS elicits a 4-level response for six disability domains: vision, hearing, walking/climbing, memory/concentration, washing/dressing, and communication. The association between visual impairment and disability was assessed with age- and sex-adjusted logistic regression models.ResultsOverall, 4719 of 4726 individuals successfully completed visual acuity and disability screening. Median age of participants was 61 years (interquartile range: 55-69 years), and 2449 (51.9%) were female. Participants with vision worse than 6/60 in the better-seeing eye were significantly more likely to be classified as having a disability in vision (OR 18.4, 95% CI 9.9-33.5), walking (OR 5.3, 95% CI 2.9-9.1), washing (OR 9.4, 95% CI 4.0-21.1), and communication (OR 5.0, 95% CI 1.7-13.0), but not in hearing (OR 0.6, 95% CI 0.006-2.2) or memory (OR 2.2, 95% CI 0.7-5.1).ConclusionsVisually impaired participants were more likely to self-report disabilities, though causality could not be ascertained. Public health programs designed to reduce visual impairment could use the WGSS to determine unintended benefits of their interventions.

The purpose of this study was to investigate the effect of instructions that prioritize either speed or accuracy in experienced senior football players when taking penalty kicks at five different targets in a goal. Sixteen male experienced senior football players performed in total 80 penalty kicks with instructions that prioritized either precision or speed at five different targets in the goal. Ball velocity and hit accuracy were evaluated between the two instructions and the five targets. The main findings showed that aiming for velocity resulted in higher ball velocity and lower kicking accuracy than aiming for accuracy. However, kicking accuracy was only lower when kicking to the bottom corner targets. Furthermore, when shooting high at the middle, the percentage of balls on target was higher when aiming for speed rather than accuracy. Based upon the findings of the study, it is suggested that a player should try to kick as fast as possible and aim for the middle of the goal, as ball velocity is faster than when aiming for accuracy and hit percentage in the goal is also at its highest, thereby increasing the chances of outdoing the goalkeeper, who most often goes for one of the sides.

The fundamental role of vision during development and the nurturing role of early intersubjectivity have enabled the Robert Hollman Foundation to develop an early intervention program providing holistic support to visually impaired children and their families, where fostering parent-infant interactions is at the heart of our care. The aim of this study is to understand how parents perceive this approach. It is an eleven-year retrospective study of children following the Robert Hollman Foundation's early intervention program, in which parents' (n = 1086) perceptions of quality of care were measured through the administration of a specifically designed 4-point scale questionnaire. Annual longitudinal trends of parents' perceptions were calculated for every single response. Parents reported a very high satisfaction value in 21/23 questions (Mean > 3.7 out of a maximum score of 4, with the highest scores in human and soft skills of professionals) with a statistically positive trend (p < 0.05), throughout the period considered. Our core approach, based on an individualized nurturing relational support, has been appreciated and confirmed by the high satisfaction reported in the questionnaires by parents of children with visual impairment. We therefore hypothesize that parent-infant relationship-based and individualized approaches may help parents achieve better health, well-being, and quality of daily life for their children. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Journal of Occupational Therapy / Cadernos Brasileiros de Terapia Ocupacional is the property of Cadernos de Terapia Ocupacional da UFSCar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Spinal anesthesia is widely used in various types of surgery. However, several complications can occur afterward. This study aimed to identify differences in the incidence of anesthesia-related complications according to the approach methods (midline versus paramedian) for landmark-based spinal anesthesia. Materials and Methods: We searched electronic databases, including PubMed, EMBASE, CENTRAL, Scopus, and Web of Science, for eligible randomized controlled trials. The primary outcome was post-dural puncture headache (PDPH) incidence, and secondary outcomes were low back pain (LBP) incidence and success rate in the first trial of spinal anesthesia. We estimated the odds ratio (OR) with 95% confidence intervals (CI) using a random-effects model. Results: In total, 2280 patients from 13 randomized controlled trials were included in the final analysis. The incidence rates of PDPH were 5.9% and 10.4% in the paramedian and midline approach groups, respectively. The pooled effect size revealed that the incidence of PDPH (OR: 0.43, 95% CI [0.22–0.83]; p = 0.01; I2 = 53%) and LBP (OR: 0.27, 95% CI [0.16–0.44]; p < 0.001; I2 = 16%) decreased, and the success rate in the first attempt was higher (OR: 2.30, 95% CI [1.36–3.87]; p = 0.002; I2 = 35%) with the paramedian than with the midline approach. Conclusions: Paramedian spinal anesthesia reduced PDPH and LBP and increased the success rate of the first attempt. [ABSTRACT FROM AUTHOR]

Aims: The aim of this paper is to provide a comprehensive review of using Low-Level Laser Therapy (LLLT) as a therapeutic method for recurrent aphthous stomatitis (RAS), including analizing its underlying mechanisms, clinical applications, and potential benefits. Methods: Database search was conducted to identify relevant papers investigating the use of LLLT for RAS treatment. Articles published in scientific journals were selected for the reveiw in Science Direct, Google Scholar and PubMed were categorized and analyzed. Findings: During the initial search, a total of 88 articles were found. Five phases were performed to select articles and eventually 8 papers which met the inclusion criteria, were chosen. Conclusion: This literature review supported the idea that LLLT is a non-invasive and potentially effective therapy for RAS symptoms by accelerating the healing process and have beneficial effects in reducing pain and inflammation. [ABSTRACT FROM AUTHOR]

The greatest architectural monument of Szeged's Jewish community is the New Synagogue (1900–1903), designed by Lipót Baumhorn (1860, Kisbér—1932, Budapest). He designed twenty-six synagogues in the former Hungarian Kingdom and was known as the most successful synagogue architect in Europe. In Szeged, his most special buildings are the synagogue, the community's headquarters, and the Jewish cemetery's ceremonial hall. During the synagogue's construction, Baumhorn worked closely together with Dr. Immánuel Löw (1854, Szeged – 1944, Budapest), rabbi and scholar, who applied his immense knowledge in the decoration of the synagogue. Löw belonged to the Neolog denomination of Hungarian Judaism and designed the synagogue garden as an organic part of the building, presenting the flora of both Israel and Hungary. The Neolog movement brought a transformation in the sacred spaces of the synagogue, moving of the bimah to the Eastern end of the synagogue, introducing the use of an organ and a choir, and defining towers on the outside. The synagogue and its garden stand alone on the global stage, thanks to its extraordinary botanical decoration system that is both distinctively designed and rich in symbolic meaning, drawing inspiration from motifs found in the Hebrew Bible, all due to the remarkable botanical expertise of the rabbi, representing a unique and materialized fusion of Neolog Jewish ideals, Hungarian heritage, and architectural excellence. In our study, we present Szeged's new synagogue and its synagogue garden from an architectural and cultural-historical point of view, summarizing the emergence of Jewish ideas in the turn-of-the-century architecture and the transformation of the use of spaces. [ABSTRACT FROM AUTHOR]

There is increasing evidence that demographic history and phylogeographic consequences of past climate changes unfolded locally and varied from region to region. Despite the high rodent species diversity and endemism in low latitude Asia, how they have responded to the past climatic fluctuations remains unexplored. In the present study, we trapped 253 murine individuals and sequenced their mitochondrial COI gene sequence. A total of ten species belonging to five genera were recognized through phylogenetic analyses. The results of divergence time estimation showed that the most common ancestors for all recognized species occurred in the Pleistocene. Signals of demographic expansion were detected in six species by at least one test and the events of sharp population size increase occurred asynchronously among species. The demographic expansion during the glaciation periods was corroborated by the expanded suitable distributional areas predicted by ecological niche modelling. The diversified demographic histories of rat communities in low-latitude Asia suggested that species might have responded to past regional environmental changes in an individualistic way. [ABSTRACT FROM AUTHOR]

Background: Growing evidence has suggested a link between poor sleep quality and increased risk of dementia. However, little is known about the association between sleep timing, an important behavior marker of circadian rhythms, and dementia risk in older adults, and whether this is independent of sleep duration or quality. Methods: We included data from 1,051 community-dwelling older men and women (aged≥ 60y) without dementia from the Shanghai Aging Study. At baseline, participants reported sleep timing, duration, and quality using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Dementia diagnosis over the following 7.3 years was determined by neurologists using DSM-IV criteria. We used Cox proportional hazards models to examine the association between bedtime (before 9 p.m., after 11 p.m. vs. 9-11 p.m.), rise time (before 6 a.m., after 8 a.m. vs. 6-8 a.m.), and risk of dementia. Results: A total of 238 (22.8%), 675 (64.5%), and 133 (12.7%) participants reported going to bed before 9 p.m., between 9 and 11 p.m., and after 11 p.m., respectively, while 272 (26%), 626 (59.9%), and 148 (14.2%) reported getting up before 6 a.m., between 6 and 8 a.m., and after 8 a.m., respectively. Participants who reported going to bed earlier had a lower education level, were less likely to be smokers, more likely to have hypertension or diabetes, and had longer sleep duration but poorer sleep quality compared to those who reported a later bedtime. We found 47 incidents of dementia among 584 participants followed up over an average of 7.3 years. After adjustment for demographics, education, income, body mass index, depressive symptoms, smoking, alcohol use, physical activity, comorbidities, APOE4 genotype, and baseline MMSE, those with a bedtime of before 9 p.m. were two times more likely to develop dementia [hazard ratio (HR)=2.16 (95%CI: 1.06-4.40)], compared to those going to bed between 9 and 11 p.m. Later bedtime (i.e., after 11 p.m.) showed the opposite but had a non-significant association with dementia risk (HR=0.15, 95%CI: 0.02-1.29). We did not find an association for rise time and risk of dementia. Conclusion: Earlier sleep timing in older adults without dementia was associated with an increased risk of dementia. Future studies should examine the underlying mechanisms of this association and explore the usefulness of sleep timing as a preclinical marker for dementia.

This study investigated the age at first calving in Holstein heifers and its impact on various production parameters. A sample of 737 Holstein heifers born between 2015 and 2018 and finishing their first lactations between 2018 and 2020 was included. Cluster analysis revealed three groups based on age at first calving: high precocity, medium precocity and low precocity. Medium-precocity group exhibited the highest 305-day milk yield and peak milk production. Additionally, the same group demonstrated superior mean production per lactation, 305-day milk protein content, and 305-day milk yield. The lowest somatic cell count was found in the low-precocity group. In conclusion, medium-precocity cows showed better results such as higher 305-day milk yield and peak milk production. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sepsis-induced cardiomyopathy is cardiac dysfunction in sepsis that sometimes results in reduced cardiac output. Inotropic agents are recommended in patients with sepsis and cardiac dysfunction. Here, we present a case of sepsis-induced cardiomyopathy that was resistant to inotropes and was successfully treated with intra-aortic balloon pumping (IABP). We also reviewed the literature on similar cases of sepsis-induced cardiomyopathy treated with IABP. CASE REPORT: A 40-year-old woman with fever and hypotension was admitted to a university hospital. Laboratory test results showed elevated inflammatory markers and cardiac markers, such as creatinine kinase-MB and troponin T. Echocardiography revealed severe left ventricular hypokinesis, and cardiac monitoring revealed a low cardiac output. The patient received antimicrobials, vasopressors, and dobutamine; however, her circulatory status did not respond to these treatments. IABP was introduced 7 h after admission and dramatically increased her blood pressure and cardiac output, resulting in the reduction of vasopressor and dobutamine doses. The patient survived without any IABP-related complications. The literature review of 11 cases of sepsis-induced cardiomyopathy treated with IABP shows consistent results with the presented case in terms of positive effects of IABP on circulatory status and cardiac function, resulting in a reduction of inotropes. CONCLUSIONS: Some sepsis-induced cardiomyopathy cases with reduced left ventricular function may not respond to inotropes. IABP would be a treatment option for these patients because of its positive effects on cardiac and circulatory functions. [ABSTRACT FROM AUTHOR]

Anxiety and depression commonly co-occur during pregnancy and may increase risk of poor birth outcomes including preterm birth and low birth weight. Our understanding of rates, patterns, and predictors of comorbid anxiety and depression is hindered given the dearth of literature, particularly in low- and middle-income (LMI) countries. The aim of this study is (1) to explore the prevalence and patterns of comorbid antenatal anxiety and depressive symptoms in the mild-to-severe and moderate-to-severe categories among women in a LMI country like Pakistan and (2) to understand the risk factors for comorbid anxiety and depressive symptoms. Using a prospective cohort design, a diverse sample of 300 pregnant women from four centers of Aga Khan Hospital for Women and Children in Pakistan were enrolled in the study. Comorbid anxiety and depression during pregnancy were high and numerous factors predicted increased likelihood of comorbidity, including: (1) High level of perceived stress at any time point, (2) having 3 or more previous children, and (3) having one or more adverse childhood experiences. These risks were increased if the husband was employed in the private sector. Early identification and treatment of mental health comorbidities may contribute to decreased adverse birth outcomes in LMI countries.

Macular degeneration (MD), a retinal disease affecting central vision, represents the leading cause of visual impairment in the Western world, and MD patients face severe limitations in daily activities like reading and face recognition. A common compensation strategy adopted by these patients involves the use of a region in the spared peripheral retina as a new fixation spot and oculomotor reference (preferred retinal locus, or PRL). Still, peripheral vision is characterized by poorer visual acuity, fixation stability, and larger crowding zones that further hinder processes like object recognition, visual search, and reading. Perceptual learning (PL) has been successfully used to improve visual acuity in mild visual conditions (e.g., presbyopia, amblyopia and myopia), but results in MD are less clear, often showing limited generalization of learning, unlike what is observed in a healthy population. A possible reason is the suboptimal fixation in the PRL that might prevent patients from processing the briefly presented training stimuli. Following this hypothesis, we trained five MD patients and four age- and eccentricity-matched controls with a protocol that combined contrast detection and a task previously used to train fixation stability. Results showed transfer of learning to crowding reduction, reading speed, and visual acuity in both MD patients and controls. These results suggest that in the case of central vision loss, PL training might benefit from the integration of oculomotor components to optimize the effect of training and promote transfer of learning to other visual functions.