Purpose: Charles Bonnet Syndrome (CBS) is a condition involving visual hallucinations as a result of vision loss, but it is not well characterized nor routinely assessed for. Some patients with ...Leber's Hereditary Optic Neuropathy (LHON) experience CBS, but there is limited published data. This is the first study screening for and characterizing CBS in a large cohort of the LHON patient population.
Methods: A recently validated French‐Canadian CBS screening questionnaire was adapted to an online bilingual (English‐French) format, tailored to LHON patients (Cantin et al. CJO, 2019;54:323‐7). The 59‐item questionnaire was distributed to numerous mailing lists, online communities and social media platforms consisting of LHON patients. Quantitative and qualitative response data was used for cross‐sectional analysis.
Results: A total of 169 affected LHON patients completed the questionnaire with 70% screening positive for CBS. Of the participants who screened positive for CBS, 58% were male and 85% were less than 65 years old. 55.1% were affected by the 11778G > A mutation, 13.6% by 14484 T > C, 14.4% by 3460G > A, 7.6% by other mutations and 9.3% by an unknown mutation. In addition, 41.5% of these participants have been diagnosed with LHON for more than 10 years while 38% have been diagnosed for <5 years.
Conclusions: Our results yielded a high proportion of LHON patients screening positive for CBS (70%), indicating the condition may be a lot more common than previously suspected, and only a minority of LHON patients are being adequately assessed and managed for the condition. There is also an indication that their CBS tends to be long‐lasting and can be associated with various negative health outcomes. Overall, this study provides a better understanding of the prevalence of CBS in LHON and the need for proactive discussions by health care providers.
References
1. Cantin S, Duquette J, Dutrisac F, Ponton L, Courchesne M, de Abreu Cybis W, et al. Charles Bonnet syndrome: development and validation of a screening and multidimensional descriptive questionnaire. Canadian Journal of Ophthalmology 2019;54:323–7. https://doi.org/10.1016/j.jcjo.2018.05.008.
The impact of cannabis consumption on visual processing Lalonde, Melanie; Nguyen, Hong‐An; Mostofian, Fargol ...
Acta ophthalmologica (Oxford, England),
December 2022, 2022-12-00, 20221201, Volume:
100, Issue:
S275
Journal Article
Peer reviewed
Purpose: Cannabis is one of the most widely used recreational drug in Canada. The purpose of this study is to evaluate the effect of cannabis consumption on the visual pathway via non‐invasive, ...objective electrophysiological testing.
Methods: Full field electroretinograms (ffERGs) including photopic negative responses (PhNRs), and visual evoked potentials (VEPs) were recorded in non‐users (control group) and in cannabis users. International Society for Clinical Electrophysiology of Vision (ISCEV) standard clinical protocols were used for all exams. Cannabis users were tested twice: at least 12 h after their last cannabis consumption (chronic group) and 2.5 h following their last consumption (acute group).
Results: When comparing the chronic and acute groups via paired t‐tests (n = 15), there was a statistically significant decrease in (1) the scotopic a‐wave amplitude (chronic −139.8 ± 7.4 μV and acute −114.8 ± 6.8 μV; p = 0.03; stimulus 10.0), (2) PhNR amplitude (chronic −32.2 ± 4.8 μV and acute −26.6 ± 3.1 μV; P = 0.01; stimulus 7 cd•s/m2), and the amplitude of the following two VEP parameters (3) N75 (chronic −2.6 ± 0.9 μV and acute −2.0 ± 1.1 μV; p = 0.04; stimulus 30 min), and (4) N135 (chronic −15.0 ± 1.4 μV and acute −12.3 ± 1.2 μV; p = 0.03; stimulus 15 min). PhNR implicit time was statistically significantly increased when comparing the control (63.4 ± 1.5 ms; n = 18) and the acute (69.1 ± 1.9 ms; n = 15) group (p = 0.03; stimulus 7 cd•s/m2). There were no statistically significant changes in ffERGs and VEPs between the control and chronic groups.
Conclusions: The results of this pilot study suggest that acute use of cannabis temporarily causes a reduction in photoreceptor activity with a downstream decrease in cortical activity. These changes appear to be reversible as there was no difference between the chronic exposure and the control groups.
A number of studies have indicated that short food supply chains could create economic, social, and environmental benefits, but most of those chains were implemented in developed countries. This ...research aims to find out the characteristics of short food supply chains and their benefits to small farmers in Vietnam, which is a developing country, based on the survey results from 338 small farmers in the third quarter of 2020, with the support of Stata 14 software. The results showed that the short food supply chains in the survey sample in Vietnam were characterized by two main actors: small farmers and distributors. Farmers could sell products flexibly at the local market. There was some initial evidence to prove that these chains helped to stabilize the input, output price, and revenue; formulated sustainable income; and increased the satisfaction and confidence of farmers. They eliminated gender discrimination in rural areas and improved livelihood for ethnic minorities. These chains also enhanced the mindset on green, organic, and clean production of farmers, which in turn created environmental benefits. COVID-19 has posed a negative impact on the income of farmers and made them change their production and sales method. Therefore, the research could suggest some policies to sustainably develop the short food supply chains in Vietnam in the future.
Data from a national Australian survey provide little evidence of a significant effect for the taste for soft news on news attachment among the general public as well as the six common sex-by-age ...targeted market segments of the news industry. This contradicts recent arguments that soft news is necessary to democratic life because, in an age of media proliferation and audience fragmentation, it keeps attention-scarce people with the news.
The Drosophila melanogaster embryo has been widely utilized as a model for genetics and developmental biology due to its small size, short generation time, and large brood size. Information on ...embryonic metabolism during developmental progression is important for further understanding the mechanisms of Drosophila embryogenesis. Therefore, the aim of this study is to assess the changes in embryos' metabolome that occur at different stages of the Drosophila embryonic development. Time course samples of Drosophila embryos were subjected to GC/MS-based metabolome analysis for profiling of low molecular weight hydrophilic metabolites, including sugars, amino acids, and organic acids. The results showed that the metabolic profiles of Drosophila embryo varied during the course of development and there was a strong correlation between the metabolome and different embryonic stages. Using the metabolome information, we were able to establish a prediction model for developmental stages of embryos starting from their high-resolution quantitative metabolite composition. Among the important metabolites revealed from our model, we suggest that different amino acids appear to play distinct roles in different developmental stages and an appropriate balance in trehalose-glucose ratio is crucial to supply the carbohydrate source for the development of Drosophila embryo.
The population health inpatient Medicare Advantage pharmacist (PHIMAP) intervention is a pharmacist-led, transitions-of-care intervention that aims to reduce hospital readmissions among Medicare ...Advantage beneficiaries. PHIMAP includes inpatient pharmacist participation in interdisciplinary rounds, admission and discharge medication reconciliation, pharmacy staff delivery of discharge medications to the bedside, personalized discharge medication lists and counseling, and communication with outpatient pharmacists through an electronic health record.
To evaluate the effect of the PHIMAP intervention on unplanned 30-day same-hospital readmissions among Medicare Advantage patients.
Those included were patients admitted to a large urban academic medical center between May 2018 and March 2020 who had a Medicare Advantage plan and were aged at least 18 years. A 2-group, quasi-experimental design was utilized. Control patients received the usual care, which included a best possible medication history and a postdischarge phone call. A multivariable logistic regression model was estimated to predict unplanned 30-day same-hospital readmissions. This study was a Hypothesis Evaluating Treatment Effectiveness study.
In total, 884 patients were included. The majority were White (59.0%), non-Hispanic (87.7%), English speaking (90.5%), and older adults (median age, 75 years; interquartile range, 70-83 years). We detected no statistically significant association between the PHIMAP intervention and unplanned 30-day same-hospital readmissions (odds ratio OR = 0.91, 95% CI = 0.56-1.52). After adjusting for patient demographics and clinical covariates, significant predictors of 30-day readmissions included the number of emergency department/inpatient visits within 180 days prior to index admission (OR = 1.40, 95% CI = 1.11-1.77); discharge to a post-acute care facility, such as an inpatient rehabilitation facility, long-term acute care facility, or skilled nursing facility (OR = 1.69, 95% CI = 1.06-2.66); hospital length of stay in days (OR = 1.04, 95% CI=1.01-1.07); and the Agency for Healthcare Research and Quality Elixhauser Comorbidity Index score (OR = 1.01, 95% CI = 1.01-1.02).
Significant predictors of readmissions among Medicare Advantage beneficiaries were consistent with greater illness severity, including a recent history of prior hospital utilization, a discharge to post-acute care facility (vs home), a longer length of hospital stay, and a higher comorbidity burden. Although we detected no statistically significant association between PHIMAP and unplanned 30-day same-hospital readmissions, differences in study group assignment based on the day of hospital discharge (weekend vs weekday) was a noted limitation of this study. Future studies of inpatient pharmacist-led interventions should plan to minimize the risk of selection bias due to differences in the time of patient discharge.
This study was supported in part by the National Institute on Aging under award number R01AG058911 (to Pevnick) and the UCLA Clinical Translational Science Institute (UL1 TR001881). The sponsor had no role in the design and conduct of the study, nor the writing of this report.
Graphene sheets decorated with nickel or copper oxides that were anchored on polyaniline (denoted as PANI-graphene/NiO and PANI-graphene/CuO) were prepared by a simple, easy to-control ...electrochemical method and applied as novel materials for sensitive and selective methanol sensing. The fabricated sensors exhibited good electrocatalytic activity, appropriate dynamic linear range (20-1300 mM), sensitivity (0.2-1.5 μA mM
−1
cm
−2
) and excellent selectivity towards methanol. It should be highlighted from the selectivity tests that no significant interference was observed from ethanol and other alcohols. To our best knowledge, using inexpensive but efficient transition metals like Ni, Cu instead of Pt, Pd and their composites with PANI, graphene would be scientifically novel and practically feasible approach for sensor fabrication that could be potentially used to identify methanol adulteration in counterfeit alcoholic beverages.
PANI/graphene/NiO or PANI/graphene/CuO were prepared by a simple, easy to-control electrochemical method and applied as novel materials for sensitive and selective methanol sensing.
Purpose:
Radio frequency catheter ablation (RFCA) is a well‐established clinical procedure for the treatment of atrial fibrillation (AF) but suffers from a low single‐procedure success rate. ...Recurrence of AF is most likely attributable to discontinuous or nontransmural ablation lesions. Yet, despite this urgent clinical need, there is no clinically available imaging modality that can reliably map the lesion transmural extent in real time. In this study, the authors demonstrated the feasibility of shear‐wave elastography (SWE) to map quantitatively the stiffness of RFCA‐induced thermal lesions in cardiac tissues in vitro and in vivo using an intracardiac transducer array.
Methods:
SWE was first validated in ex vivo porcine ventricular samples (N = 5). Both B‐mode imaging and SWE were performed on normal cardiac tissue before and after RFCA. Areas of the lesions were determined by tissue color change with gross pathology and compared against the SWE stiffness maps. SWE was then performed in vivo in three sheep (N = 3). First, the stiffness of normal atrial tissues was assessed quantitatively as well as its variation during the cardiac cycle. SWE was then performed in atrial tissue after RFCA.
Results:
A large increase in stiffness was observed in ablated ex vivo regions (average shear modulus across samples in normal tissue: 22 ± 5 kPa, average shear‐wave speed (ct): 4.5 ± 0.4 m s−1 and in determined ablated zones: 99 ± 17 kPa, average ct: 9.0 ± 0.5 m s−1 for a mean shear modulus increase ratio of 4.5 ± 0.9). In vivo, a threefold increase of the shear modulus was measured in the ablated regions, and the lesion extension was clearly visible on the stiffness maps.
Conclusions:
By its quantitative and real‐time capabilities, Intracardiac SWE is a promising intraoperative imaging technique for the evaluation of thermal ablation during RFCA.
Gait symptoms and balance impairment are characteristic indicators for the progression in Parkinson's disease (PD). Current gait assessments mostly focus on straight strides with assumed constant ...velocity, while acceleration/deceleration and turning strides are often ignored. This is either due to the set up of typical clinical assessments or technical limitations in capture volume. Wearable inertial measurement units are a promising and unobtrusive technology to overcome these limitations. Other gait phases such as initiation, termination, transitioning (between straight walking and turning) and turning might be relevant as well for the evaluation of gait and balance impairments in PD.
In a cohort of 119 PD patients, we applied unsupervised algorithms to find different gait clusters which potentially include the clinically relevant information from distinct gait phases in the standardized 4x10 m gait test. To clinically validate our approach, we determined the discriminative power in each gait cluster to classify between impaired and unimpaired PD patients and compared it to baseline (analyzing all straight strides).
As a main result, analyzing only one of the gait clusters constant, non-constant or turning led in each case to a better classification performance in comparison to the baseline (increase of area under the curve (AUC) up to 19% relative to baseline). Furthermore, gait parameters (for turning, constant and non-constant gait) that best predict motor impairment in PD were identified.
We conclude that a more detailed analysis in terms of different gait clusters of standardized gait tests such as the 4x10 m walk may give more insights about the clinically relevant motor impairment in PD patients.
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