ベッターマンドラムおよび実用試験による繊維製床敷物の外観変化と厚さ減少

Ocular causes of reading impairment following stroke include visual field loss, eye movement impairment and poor central vision. Non ocular causes may include cognitive errors or language impairment. The purpose of this study was to identify all patients referred with suspected visual impairment who had reported reading difficulty to establish the prevalence of ocular and non ocular causes. Prospective, multicentre, observation study with standardised referral and assessment forms across 21 sites. Visual assessment included visual acuity measurement, visual field assessment, ocular alignment, and movement and visual inattention assessment. Multicentre ethical approval and informed patient consent were obtained. A total of 915 patients were recruited, with a mean age of 69·18 years (standard deviation 14·19). Reading difficulties were reported by 177 patients (19·3%), with reading difficulty as the only symptom in 39 patients. Fifteen patients had normal visual assessment but with a diagnosis of expressive or receptive aphasia. Eight patients had alexia. One hundred and nine patients had visual field loss, 85 with eye movement abnormality, 27 with low vision and 39 patients with visual perceptual impairment. Eighty-seven patients had multiple ocular diagnoses with combined visual field, eye movement, low vision or inattention problems. All patients with visual impairment were given targeted treatment and/or advice including prisms, occlusion, refraction, low vision aids and scanning exercises. Patients complaining of reading difficulty were mostly found to have visual impairment relating to low vision, eye movement or visual field loss. A small number were found to have non ocular causes of reading difficulty. Treatment or advice was possible for all patients with visual impairment.

Evidence-based classification of recommendations on use of genomic tests in clinical practice: Dealing with insufficient evidence

Introduction: FDG Brain PET is a valuable paraclinical tool for presurgical assessments of patients suffering from refractory epilepsy. By the widespread accessibility of PET, recognizing the functional lesions has become a current practical method especially in preoperative evaluations of the partial epilepsy disorders. The aim of our study was to assess the impact of quantitative software-aided method in localizing epileptic zones in human brain using 18F-FDG Brain PET scan beside the physician qualitative interpretations. Materials and Methods: The subjects have been selected among patients referred to brain PET imaging who were suffering from refractory epilepsy. Seventeen patients (9 men, 8 women ; 25±11 YO) underwent PET scan. Quantitative analysis of brain functional images were applied by the Scenium software which provided statistical color-coded images of Z-scores and standard deviations (1). We considered Z-scores<-2 as an abnormal range of brain metabolism. It is worth mentioning that, we categorized the patients based on their MRI investigations to lesional and non-lesional groups. Two physicians presented visual assessments in order to localizing epileptic spots. Also, the kappa index had been calculated as an agreement coefficient via SPSS (V.19.0) software. Results: In the case of assessing the accordance of lesions’ localization among MRI, EEG, and PET/CT evaluations, the agreement level of EEG versus quantitative and qualitative method were reported 0.67 and 0.12, respectively, which were related to non-lesional group. Also, in the lesional category, the kappa indices for quantitative and qualitative analysis against the suspicious lesions on MRI were 0.56 and 0.27, respectively Conclusion: Epilepsy disorder has destructive effects on quality of life. Thereby, accurate diagnosis of lesion locations could have a vital impact in order to patients’ treatment, exclusively in refractory epilepsy which might treat through doing the brain’s operation (2). The foregoing discussion is a confirmation of the supplementary role of quantitative software alongside visual assessments, in order to do pre-surgical evaluations of epileptic positions in human brain via 18F-FDG Brain PET images. Hence, utilizing of quantitative software could be a complementary method together with MRI and EEG procedures to improve the confidence of surgeon about the epileptic spots(3).

Many of the excavated pottery artifacts are suffering from different deterioration aspects. The pressure of burial environment is considered the most deteriorative agent for pottery in soil, which leads to damage of the artifact. Therefore, it is necessary to join these damaged parts to be suitable for museum display. The adhesive materials play a significant role in the joining processes of these artifacts. In this study, Paraloid B-72 in its traditional and nano form was prepared (50% in acetone) as adhesive for pottery artifacts. Twelve pottery tiles (14 ×4×1 cm) were prepared and then were adhered together with the adhesive in traditional and nano forms. The pottery samples were exposed to artificial aging as follows; accelerated heat-humid aging (temperature 100°C and 60% relative humidity) and light aging by U.V lamp for 100 hours. Visual assessment and several analytical techniques were used for the evaluation of the selected adhesive. The analytical techniques are transmission electron microscope (TEM), scanning electron microscope (SEM), color change and tensile strength. The results obtained from transmission electron microscope showed that grain size of nano paraloid was ranging from 33 to 51 nm where the particle size of the traditional paraloid was in the range between 103 to 150 nm. Visual assessment proved that nano paraloid had some simple changes in appearance. Scanning electron microscope revealed that the nano paraloid was more resistance for aging than traditional form. Color change revealed that nano paraloid gave the lowest level of total color differences (ΔE) after light, heat-humid and light-heat aging with 2.31, 3.26 and 4.60 respectively. The tensile strength revealed that nano paraloid gave highest tensile strength (81.3 N/mm2). According to these results, we recommend the use of nano paraloid in joining of archaeological pottery artifacts.

This paper discusses the issues of training machine learning models for people authentication by the face image in longwave infrared radiation. The analysis of public available and freely distributed datasets of other researchers in the field, which contain images of people’s faces in infrared range, are discussed. It was concluded, that it is necessary to form a dataset for training and testing machine learning models on one’s own. To obtain the highest results using trained methods in practical purposes a list of requirements for the collected dataset was developed. In conclusion, an experiment was conducted, where the machine learning method (logistic regression) was trained on each dataset and tested on a sample of 15 images combining each dataset (75 images totally). During the experiment it was discovered, that the algorithm trained on the collected dataset successfully copes with both: the task of authenticating user by his thermal imaging on theoretical datasets and in the practical one. The results obtained can be used in access control and management systems to increase the fault tolerance characteristics for person authentication. The use of this dataset allows the model training aimed at theoretical and practical use in the tasks of processing thermograms, for the person authentication by the pattern of veins and vascular networks on the face in cases of changes in appearance and environmental conditions.

To acquire the better object tracking performance in this paper, the object of interest is modeled by its RGB-color histogram feature together with deep convolutional neural network feature (deep CNN feature) and sparse representation. Because the information of the objects of interest cannot be obtained ahead in practical use, the deep CNN features should be abstracted through the pre-trained VGG network. Then the deep feature and RGB-color histogram are combined to model the object in adaptive mode. And then sparse representation is used to express the model. Above all, an adaptive particle filter algorithm based on deep CNN feature together with RGB-color feature and sparse representation is proposed to track the object of interest. Extensive experiment results demonstrate the effectiveness of our proposed method under the serious object occlusions and appearance changes.

The diagnostic performance of diffusion-weighted imaging magnetic resonance enterography [DWI-MRE] has not been clearly established in a paediatric population. We systematically evaluated the diagnostic performance of DWI-MRE for the detection of bowel inflammation in paediatric patients with suspected or known inflammatory bowel disease [IBD]. MEDLINE/PubMed, EMBASE, Web of science and the Cochrane library were searched for articles investigating the diagnostic performance of DWI-MRE for the detection of bowel inflammation in paediatric patients with suspected or known IBD up to December 31, 2020. Pooled sensitivity and specificity were calculated using a bivariate random-effects model. Pooled inter-reader agreement for the interpretation of DWI-MRE was also calculated. This study was registered as PROSPERO CRD42021228754. Nine studies covering 400 paediatric patients were included. The pooled sensitivity and specificity of DWI-MRE for the detection of bowel inflammation were 0.93 (95% confidence interval [CI], 0.88-0.96) and 0.96 [95% CI, 0.87-0.99], respectively. Substantial heterogeneity was noted in both sensitivity [I2 = 66%; p < 0.01] and specificity [I2 = 94%; p < 0.01]. Meta-regression analysis identified that the use of spasmolytics contributed to higher specificity [0.89-0.99] and that quantitative assessment with an apparent diffusion coefficient cut-off value contributed to lower sensitivity [0.93-0.85] and specificity [0.98-0.72]. The pooled coefficient of inter-reader agreement, including four studies using visual assessment, was 0.97 [95% CI, 0.78-1.00]. DWI-MRE, especially when used with spasmolytics, is accurate for the detection of bowel inflammation in paediatric patients with suspected or known IBD. Quantitative measurement of ADC is not practical for this purpose.

PurposeThere are no nationally representative data on oncologists’ use ofnext-generation sequencing (NGS) testing in practice. The purpose of thisstudy was to investigate how oncologists in the United States use NGS teststo evaluate patients with cancer and to inform treatmentrecommendations.MethodsThe study used data from the National Survey of Precision Medicine in CancerTreatment, which was mailed to a nationally representative sample ofoncologists in 2017 (N = 1,281; cooperation rate = 38%). Weightedpercentages were calculated to describe NGS test use. Multivariable modelingwas conducted to assess the association of test use with oncologist practicecharacteristics.ResultsOverall, 75.6% of oncologists reported using NGS tests to guide treatmentdecisions. Of these oncologists, 34.0% used them often to guide treatmentdecisions for patients with advanced refractory disease, 29.1% to determineeligibility for clinical trials, and 17.5% to decide on off-label use ofFood and Drug Administration–approved drugs. NGS test resultsinformed treatment recommendations often for 26.8%, sometimes for 52.4%, andnever or rarely for 20.8% of oncologists. Oncologists younger than 50 yearsof age, holding a faculty appointment, having genomics training, seeing morethan 50 unique patients per month, and having access to a molecular tumorboard were more likely to use NGS tests.ConclusionIn 2017, most oncologists in the United States were using NGS tests to guidetreatment decisions for their patients. More research is needed to establishthe clinical usefulness of these tests, to develop evidence-based clinicalguidelines for their use in practice, and to ensure that patients who canbenefit from these new technologies receive appropriate testing andtreatment.

The Bates-Jensen Wound Assessment Tool (BWAT) is used to assess wound healing in clinical practice. The purpose of this study was to evaluate BWAT use among nursing home residents with pressure injury. Findings and reliability estimates from the BWAT related to pressure injury characteristics (stage, anatomic location) and natural history (resolved, persisted) among 142 ethnically and racially diverse residents are reported. In this prospective 16-week study, 305 pressure injuries among 142 participants (34% prevalence) are described by stage, anatomic location, and BWAT scores. Visual and subepidermal moisture assessments were obtained from sacrum, buttock, ischial, and heel ulcers weekly. Participants were 14% Asian, 28% Black, 18% Hispanic, 40% White with a mean age of 78 ± 14 years, and were 62% female; 80% functionally dependent (bed mobility extensive/total assistance) and at risk (Braden Scale score 14 ± 2.7). The reliability coefficient for BWAT score (all participants, all anatomic locations) was high (r = 0.90; p < 0.0001; n = 1,161 observations). Weighted Kappas for characteristics ranging from 0.46 (skin color surrounding wound) to 0.79 (undermining) were consistent for all participants. BWAT scores showed strongest agreement coefficients for stage 4 pressure injury (r = 0.69), pressure injuries among Asian and White ethnicity/racial groups (r = 0.89, and r = 0.91, respectively), and sacrum anatomic location (r = 0.92) indicating scores are better correlated to fair skin tones. Lower agreement coefficients were demonstrated for stage 2 pressure injury (r = 0.38) and pressure injuries among African American and Hispanic ethnicity/racial groups (r = 0.88 and 0.87, respectively). BWAT scores were significantly different by pressure injury stage (F = 496.7, df = 6, p < 0.001) and anatomic location (F = 33.76, df = 8, p < 0.001). BWAT score correlated with pressure injury natural history (ulcer resolved 18.4 ± 7.4, ulcer persisted 24.9 ± 10.0; F = 70.11, df = 2, p < 0.001), but not with comorbidities. The BWAT provides reliable, objective data for assessing pressure injury healing progress.

Textile floor coverings. Determination of the mass per unit area of the use surface of needled floor coverings

To determine if measures of macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness can discriminate between children with and without vision loss (visual acuity or field) from their optic pathway glioma (OPG) using spectral-domain optical coherence tomography (SD-OCT). Children with OPGs (sporadic or secondary to neurofibromatosis type 1) enrolled in a prospective study of SD-OCT were included if they were cooperative for vision testing and macular SD-OCT images were acquired. Manual segmentation of the macular GCL-IPL and macular retinal nerve fiber layer (RNFL) was performed using elliptical annuli with diameters of 1.5, 3.0, and 4.5 mm. Logistic regression assessed the ability of GCL-IPL and RNFL thickness measures (micrometers) to differentiate between the normal and abnormal vision groups. Forty-seven study eyes (normal vision = 31, abnormal vision = 16) from 26 children with OPGs were included. Median age was 5.3 years (range, 2.5-12.8). Thickness of all GCL-IPL and RNFL quadrants differed between the normal and abnormal vision groups (P < 0.01). All GCL-IPL measures demonstrated excellent discrimination between groups (area under the curve [AUC] > 0.90 for all diameters). Using the lower fifth percentile threshold, the number of abnormal GCL-IPL inner macula (3.0 mm) quadrants achieved the highest AUC (0.989) and was greater than the macula RNFL AUCs (P < 0.05). Decreased GCL-IPL thickness (<fifth percentile) can discriminate between children with and without vision loss from their OPG. Ganglion cell layer-inner plexiform layer thickness could be used as a surrogate marker of vision in children with OPGs.

To analyze the axonal architecture of the optic nerve in patients with normal-pressure glaucoma and determine whether these parameters correlate with the disease severity. Using magnetic resonance (MRI) imaging (1.5-Tesla unit) and diffusion tensor (DT) MRI, we measured the optic nerve diameter, optic chiasm height and lateral geniculate nucleus (LGN) volume in patients with normal-pressure glaucoma and an age-matched control group. The retinal nerve fibre layer thickness (RNFL) was determined by optical coherence tomography (OCT). The study included 30 patients with normal-pressure glaucoma and 30 age-matched control subjects. Optic nerve diameter (p < 0.001), optic chiasm height (p < 0.001) and LGN volume (p = 0.02) were significantly smaller in the glaucoma group than in the control group and were significantly correlated with RNFL thickness and perimetric loss. In the control group, the parameters significantly (p < 0.05) decreased with age. The DT-MRI-derived fractional anisotropy for the optic nerve was significantly lower (p < 0.001), and the DT-MRI-derived mean diffusivity (p < 0.001), radial diffusivity (λ(⊥) ; p < 0.001) and axial diffusivity (λ(||) ; p = 0.009) for the optic nerve were significantly higher in the glaucoma group and significantly correlated with RNFL thickness and mean perimetric defect. Patients with normal-pressure glaucoma show an age-adjusted reduced optic nerve diameter, optic chiasm height and LGN volume as measured by MRI, correlating with a reduced RNFL thickness and increased perimetric loss. MRI may be applied to examine the optic nerve in patients with glaucoma with opaque optic media.

Introduction to dual sensory loss issue.

Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.

Learning in Stereochemistry still tends to lack contextualization and the integration of technology and ethnosciences. This study aims to develop and evaluate Smart Ethno-STEM (System of Mobile Augmented Reality Technology) as an innovative learning medium in organic chemistry, particularly on stereochemistry topics, to enhance students’ metacognitive skills and scientific literacy. The research employed a Research and Development (R&amp;D) design using the ADDIE model, involving validation, practicality, and effectiveness testing. The data were analyzed using descriptive validation and practicality scores, N-Gain, and MANOVA analysis. Validation results from one media expert and two material experts indicated that the media was categorized as highly valid (average score 4.46). Practicality tests conducted with 16 students showed a very practical use (average score of 4.75). The effectiveness test showed significant improvements in both metacognitive skills and scientific literacy, with N-Gain scores in the high category in the experimental group (metacognition 0.75; literacy 0.72) and in the medium category in the control group (metacognition 0.59; literacy 0.57). MANOVA results confirmed a significant influence of the class factor on both variables simultaneously (Sig. Hotelling’s Trace = 0.013). These findings demonstrate that Smart Ethno-STEM effectively enhances students’ higher-order thinking skills and connects scientific concepts with socio-cultural contexts, offering a contextual and technology-based solution for organic chemistry learning