Utility of retinoscopy to examine peripheral refraction

Purpose: This study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open–field autorefractometry (AR) in myopic subjects.Methods: Peripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland – Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. Results: For MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. Conclusion: Our results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice. (AU)

A Comparative Analysis of Telerehabilitation and Telemedicine Utilization During the COVID-19 Pandemic in Poland: Trends, Patterns, and Implications.

The study aimed to examine the influence of COVID-19 on the adoption of teleservices in Poland, with a focus on contrasting patterns between rehabilitation and ambulatory care settings. We conducted a retrospective analysis of a national dataset to assess trends in telehealth use from 2020 to 2022. The use of teleservices peaked in April 2020 in both sectors. The share of the teleservices in the period of October 2020-December 2022 was much higher in the ambulatory (average 7,8%) than the rehabilitation sector (average 0,16%). Although, the analysis showed a moderate relationship between COVID-19 incidence and telehealth utilization (Spearman's rho from 0.39 and 0.52). Our findings demonstrate no statistically significant difference in Spearman's rho values between ambulatory care and rehabilitation, indicating a similar strength of response to the pandemic waves. Our findings underscore the importance of telehealth services in ensuring healthcare accessibility during times of crisis, emphasizing their role in facilitating continuity of care amidst pandemic-related disruptions. This study contributes to the understanding of telehealth utilization trends during the COVID-19 pandemic, offering insights into the adaptive responses of healthcare systems to unprecedented challenges. Further research is warranted to explore the long-term implications of telehealth use and to inform strategies for optimizing healthcare delivery in post-pandemic contexts.

Insect Protein as a Component of Meat Analogue Burger.

Researchers are exploring solutions to meet the growing demand for protein due to the expected increase in global population by 2050. Interest in alternative protein sources like insects has risen, driven by concerns about environmental impact and the need for sustainable food production. This study aimed to develop and evaluate the physicochemical properties of soy-protein-based burgers enriched with insect protein from Alphitobius diaperinus. Three formulations were developed: a control (B0) and burgers with 5% (B5) and 10% (B10) insect protein-Whole Buffalo Powder (WBP). The results showed that adding insect protein decreased the burger analogue's pH. A clear trend was observed of increasing total lipids and saturated fatty acids (SFA) and decreasing monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA) as the WBP concentration increased from 0% to 10%. No significant differences with increasing WBP concentration in the protein content of the burger analogue, as well as the cooking yield, were noted. The WBP addition had a notable effect on the color change, especially a decrease in brightness (L*). It was shown that as the WBP concentration increased, there were no significant differences in the texture profile of the burger analogues. The formulation with 5% WBP concentration was the most acceptable in sensory analysis.

Utility of retinoscopy to examine peripheral refraction.

PURPOSE: This study explored whether retinoscopy (RET) provides comparable results of relative peripheral refraction (RPR) to open-field autorefractometry (AR) in myopic subjects. METHODS: Peripheral refraction was measured in 20 myopic and 20 control adult subjects. Both central and peripheral refraction (20° nasal and temporal eccentricity) were measured using RET and open-field AR. Differences in the median central spherical equivalent (SE), median RPR, and median J45/J180 power vectors between the RET and AR techniques were analyzed. Moreover, Bland - Altman plots were used to assess the agreement between RET and AR methods for RPR measurements in MG. RESULTS: For MG, the median RPR values were positive (hyperopic shift), and no significant differences were observed between the RET and AR techniques with respect to RPR measurement. In addition, we did not observe any significant differences in the RPR values between the nasal and temporal eccentricities for either the RET or AR technique for myopic subjects. There was also a significant correlation and agreement between the RET and AR technique for RPR measurements. With respect to central refraction, the median SE was slightly more positive for the RET than for the AR technique. Inside the CG, we also found significant correlation between the RET and AR technique for RPR measurements, and we observed a myopic shift in peripheral eccentricities. CONCLUSION: Our results show that retinoscopy may be a useful tool for objective measurements of RPR in myopic subjects and may be used interchangeably with the open-field AR method in everyday clinical practice.

Role of Janus Kinase Inhibitors in Therapy of Psoriasis.

Janus kinases inhibitors are molecules that target Janus kinases-signal transducers and activators of transcription (JAK/STAT). They inhibit this intracellular signal pathway, blocking the gene transcription of crucial proinflammatory cytokines that play a central role in the pathogenesis of many inflammatory and autoimmune diseases, including psoriasis. This process reduces psoriatic inflammation. The JAK inhibitors are divided into two generations. The first generation of JAK inhibitors blocks two or more different Janus kinases. The second generation is more specified and blocks only one type of Janus kinase and has less side effects than the first generation. Tofacitinib, ruxolitinib and baricitinib belong to first generation JAK inhibitors and decernotinib and filgotinib belong to second group. This narrative review summarizes the role of Janus kinase inhibitors in the therapy of psoriasis. Oral JAK inhibitors show promise for efficacy and safety in the treatment of psoriasis. Studies to date do not indicate that JAK inhibitors are superior to recent biologic drugs in terms of efficacy. However, JAK inhibitors, due to their lack of increased incidence of side effects compared to other biologic drugs, can be included in the psoriasis treatment algorithm because they are orally taken. Nevertheless, further studies are needed to evaluate long-term treatment effects with these drugs.

The Combination of Neural Tracking and Alpha Power Lateralization for Auditory Attention Detection.

Purpose The acoustic source that is attended to by the listener in a mixture can be identified with a certain accuracy on the basis of their neural response recorded during listening, and various phenomena may be used to detect attention. For example, neural tracking (NT) and alpha power lateralization (APL) may be utilized in order to obtain information concerning attention. However, these methods of auditory attention detection (AAD) are typically tested in different experimental setups, which makes it impossible to compare their accuracy. The aim of this study is to compare the accuracy of AAD based on NT, APL, and their combination for a dichotic natural speech listening task. Method Thirteen adult listeners were presented with dichotic speech stimuli and instructed to attend to one of them. Electroencephalogram of the subjects was continuously recorded during the experiment using a set of 32 active electrodes. The accuracy of AAD was evaluated for trial lengths of 50, 25, and 12.5 s. AAD was tested for various parameters of NT- and APL-based modules. Results The obtained results suggest that NT of natural running speech provides similar accuracy to APL. The statistically significant improvement of the accuracy of AAD using a combined method has been observed not only for the longest duration of test samples (50 s, p = .005) but also for shorter ones (25 s, p = .011). Conclusions It seems that the combination of standard NT and APL significantly increases the effectiveness of accurate identification of the traced signal perceived by a listener under dichotic conditions. It has been demonstrated that, under certain conditions, the combination of NT and APL may provide a benefit for AAD in cocktail party scenarios.

Application of Blue Filters Increases the Usefulness of Moreland Test in Anomaloscopic Color Vision Assessment for Blue-Green Color Range.

The effect of blue light filters on the anomaloscopic examination was analyzed. Thirty subjects (18-43 y, 20 female, 10 male) without color vision disorders were examined in 4 filter conditions: no filter (F-0), Blue Control Hoya (F-BC), Med-1 JZO (F-Med1) and 450 Eschenbach (F-450). Both Rayleigh test (red-green axis) and Moreland test (blue-green axis) were performed. Application of F-BC filter shows negligible effect on color vision perception in both tests. Contrary to this, the application of strong F-450 filter causes significant shift in Moreland test towards tritanopy and the decrease in correlations of Moreland parameters with Rayleigh test parameters. The application of medium strong F-Med1 filter causes the slight shift in Moreland test towards the center of the Moreland scale and increases the Spearman correlations between Moreland and Rayleigh test parameters. This observation suggests that the about 15-40% reduction of blue diode intensity in the Moreland test may be beneficial in detecting mild changes in color vision perception in the blue-green axis and may improve its usefulness in evaluating the color vision perception disorders accompanying different illnesses, such as diabetes, glaucoma, neuritis optica, or cataract. The discussion concerning the modifications of Moreland test construction is also presented.

Computerised dynamic posturography for postural control assessment in subjects wearing multifocal contact lenses dedicated for myopia control.

PURPOSE: To measure body balance using computerised dynamic posturography in young adults wearing multifocal contact lenses (MFCL) with high addition powers designed for myopia control. METHODS: Twenty-four young adults (mean age: 24 years) wearing distance-centred soft MFCL (SwissLens Orbis Relax) with two different central zones (3 and 4.5 mm), two addition powers (+2 D, +4 D) and single vision control lenses. Body balance was measured on a moving platform under three viewing conditions: (1) eyes open when fixating on letters at 3 m or (2) at 40 cm, as well as (3) with the eyes closed. Parameters of body stabilisation were analysed: the rate of body stabilisation (τrelax ), the stabilisation time (Tmax ) and the number of oscillations (Nosc ). RESULTS: The MFCLs did not produce a significant difference in the mean values of the analysed parameters (p > 0.05 for τrelax, Tmax, Nosc ). However, a positive correlation was found between pupil size and Nosc and Tmax (p < 0.01), suggesting an effect of the +4 D add with the 3 mm central zone on the posturographic parameters. As was expected, dynamic body stabilisation was better with eyes open versus eyes closed (p < 0.005). CONCLUSIONS: Distance-centred MFCLs with a medium addition (+2 D) do not disturb body stabilisation in young adults. However, high additions (+4 D) with a small central zone may affect body balance control in subjects with large pupil size.

Variability of Rayleigh and Moreland test results using anomaloscope in young adults without color vision disorders.

AIM: To validate the reference ranges proposed by the manufacturer of the Oculus HMC Anomaloscope MR for Rayleigh and Moreland tests in healthy young adults. METHOD: The manual Rayleigh (red-green) and the Moreland (blue-green) anomaloscope tests were performed on 90 healthy subjects (54 female, 36 male, 178 eyes) residing in Poland, aged between 18-45 years, and without color vision disorders (assessed with HRR test). The analyzed parameters for both the Rayleigh and the Moreland tests were as follows: the lower (R1/M1) and the upper (R2/M2) limits; the center (RC/MC) and the width (RW/MW) of the matching ranges. RESULTS: The results of the Rayleigh test were similar to the values proposed in the anomaloscope user's manual, however, with a small shift of RC and R2 towards the red color. The double-peak distribution of R2 with a small second peak (approximately at R2 = 52) was mainly due to the measurements in male subjects (nmale = 8, nfemale = 2), which suggests that this group might be diagnosed with subtle protanomaly. The results of the Moreland test showed a high MW which did not correspond to the reference range described in the anomaloscope user's manual. The observed significant correlations between R1 and M1 suggest that the M1 parameter seems to be the best indicator of blue vision quality. CONCLUSIONS: Oculus HMC Anomaloscope MR is a sensitive tool for detection of prot-deuteranomalies but the reference ranges for young adults require a certain adjustment towards the red color. The parameters obtained for the Moreland test varied significantly between the subjects and therefore the test should not be used as is to diagnose color vision deficits in the green-blue area (tritanomaly).

Frontal brain areas are more involved during motor imagery than during motor execution/preparation of a response sequence.

Results of several neuroimaging studies support the functional equivalence model, which states that motor imagery (MI) and motor execution (ME) involve the same processes, except for the final execution component. In contrast, the motor-cognitive model implies that MI additionally involves frontal executive control processes. However, according to some authors MI may actually be more comparable to motor preparation (MP). In the current electroencephalographic study, a version of the discrete sequence production paradigm was employed in which human participants initially had to prepare a sequence of five finger movements that subsequently had to be executed, imagined, or withheld. MI, ME, and MP were compared by computing event-related (de)-synchronization in the theta, alpha/mu, and beta bands. Results revealed a major increase in frontal theta power during MI as compared to ME and MP. At the end of the examined intervals, a posterior reduction in alpha power was present during ME and MP, but not during MI. Finally, above sensorimotor areas a decrease in beta power was observed that was most pronounced in the case of ME. The increase of frontal theta activity during MI may reflect increased effort, while the absence of a reduction in posterior alpha power suggests no major involvement of visuospatial attention and/or visual imagery. The present findings favor the motor-cognitive model, as it predicts extra involvement of frontal executive processes during MI.

Contrast sensitivity and visual acuity in subjects wearing multifocal contact lenses with high additions designed for myopia progression control.

OBJECTIVES: To assess the visual performance of multifocal contact lenses (MFCLs) with high addition powers designed for myopia control. METHODS: Twenty-four non-presbyopic adults (mean age 24 years, range 18-36 years) were fitted with soft MFCLs with add powers of +2.0 D (Add2) and +4.0 D (Add4) (RELAX, SwissLens) and single vision lenses (SVCL; Add0) in a counterbalanced order. In this double-masked study, half of the participants were randomly fitted with 3 mm-distance central zone MFCLs while the other half received 4.5 mm-distance central zone MFCLs. Visual acuity was measured at distance (3.0 m) and at near (0.4 m). Central and peripheral contrast sensitivity was evaluated at distance using the Gabor patch test. The area under the logarithmic contrast sensitivity function curve (ALCSF) was calculated and compared between the groups (i.e. different additions powers used). RESULTS: Near and distance visual acuities were not affected by the lenses, neither Add2 nor Add4, when compared to Add0, however, CZ3 significantly reduced distance visual acuity with Add4 when compared to CZ4.5 (-0.08 logMAR vs. for CZ3 and -0.18 logMAR for CZ4.5, p = 0.013). MFCLs impaired central ALCSF only when Add2 was used (15.99 logCS for Add2 and 16.36 logCS for SVCLs, p = 0.021). Peripheral ALCSF was statistically lower for both addition powers of the MFCLs when compared to SVCLs (12.70 for Add2 and Add4, 13.73 for SVCLs, p = 0.009). The above effects were the same for both central zones used. CONCLUSIONS: MFCLs with CZ3 diameter and high add power (Add4) slightly reduced distance visual acuity when compared to CZ4.5 but no reduction in this parameter was found with medium add power (Add2). Central contrast sensitivity was impaired only by MFCLs with the lower add power (Add2). Both add powers in the MFCLs reduced peripheral contrast sensitivity to a similar extent.

Parameters of the crossing points between center of pressure and center of mass signals are potential markers of postural control efficiency.

Posturographic signals were recorded for 384 subjects of different ages and with old persons with gait disturbances. Four conditions were used: Eyes Open/Closed vs. Head Normal/Bent Back. 'Center of Pressure' (CoP) signals were decomposed into 'Center of Mass' (CoM) and the remaining difference between Center of Pressure and Center of Mass (CoPM). The Zero-Crossing points in which the Center of Mass and Center of Pressure paths cross each other have been extracted. Velocity of CoM, velocity of CoPM and acceleration of CoPM in Zero-Crossing points were analyzed to be potential markers of balance efficiency. Three factors causing the deterioration of balance quality were analyzed: closing eyes, bending the head back and patient age. The influence of the given factors was measured using the significance p of the t-Student test and Cohen's d effect size and applied to differences for the logarithms of three of the mentioned above variables measured without and with the given deteriorating factor. In the majority of comparisons, the proposed new parameters of balance quality possessed higher statistical power to detect deteriorated balance quality than the standard parameters: standard deviation of the signal and ellipse area covering 90% of the signal envelope. Most valuable are the velocity and acceleration of CoPM for the medio-lateral direction. Logarithms of the analyzed parameters are proposed to be used in analyses because they possess normal or close to normal distribution and they are less sensitive to single high values occurring often in measurements.

Deficient vergence prism adaptation in subjects with decompensated heterophoria.

Vergence prism adaptability was evaluated in subjects with high symptomatic and asymptomatic heterophoria and compared to individuals with a heterophoria within normal range (the control group). A computer haploscope was used to measure phoria values and changes in the eye position after introducing 6 prism diopters base out in front of the right eye. Phoria values were measured with a nonius paradigm every minute for a period of 10 minutes during adaptation. The results showed that subjects with symptomatic heterophoria are characterized by a lower rate of prism adaptation and adapted to a smaller extent with respect to the control group. The group with high but asymptomatic heterophoria showed prolonged adaptation time but after several minutes of binocular viewing the subjects were able to adapt to the prism to a level similar to the control group. These findings suggest that an impairment in the slow vergence control system may be responsible for the inability to fully reduce vergence effort, which results in poor vergence ranges and asthenopic symptoms during prolonged viewing.

The engagement of cortical areas preceding exogenous vergence eye movements.

Source analyses on event related potentials (ERPs) derived from the electroencephalogram (EEG) were performed to examine the respective roles of cortical areas preceding exogenously triggered saccades, combined convergences, and combined divergences. All eye movements were triggered by the offset of a central fixation light emitting diode (LED) and the onset of a lateral LED at various depths in an otherwise fully darkened room. Our analyses revealed that three source pairs, two located in the frontal lobe-the frontal eye fields (FEF) and an anterior frontal area-, and one located within the occipital cortex, can account for 99.2% of the observed ERPs. Overall, the comparison between source activities revealed the largest activity in the occipital cortex, while no difference in activity between FEF and the anterior frontal area was obtained. For all sources, increased activity was observed for combined vergences, especially combined convergences, relative to saccades. Behavioral results revealed that onset latencies were longest for combined convergences, intermediate for combined divergences, and the shortest for saccades. Together, these findings fit within a perspective in which both occipital and frontal areas play an important role in retinal disparity detection. In the case of saccades and combined divergences stimulus-locked activity was larger than response-locked activity, while no difference between stimulus- and response-locked activity was observed for combined convergences. These findings seem to imply that the electrophysiological activity preceding exogenous eye movements consists of a sensory-related part that is under cortical control, while subcortical structures may be held responsible for final execution.

On understanding creative language: The late positive complex and novel metaphor comprehension.

Novel metaphoric sentences have repeatedly evoked larger N400 amplitudes than literal sentences, while investigations of the late positive complex (LPC) have brought inconsistent results, with reports of both increased and reduced amplitudes. In two experiments, we examined novel metaphor comprehension in Polish, using the same set of literal, novel metaphoric, and anomalous sentences. The first aim of the study was to test whether novel metaphors would evoke larger or smaller late positivity complex (LPC) amplitudes compared to literal and anomalous sentences. Some earlier studies have shown that whether increased LPC amplitudes are observed or not may be related to the task participants are asked to perform, with explicit acceptability judgments being more likely to evoke the LPC effect. The second aim of the study was, thus, to test whether the observed LPC pattern would be the same across two tasks, the semantic decision task (Experiment 1) and the reading task (Experiment 2). Our results replicated the N400 effect observed in earlier studies on metaphor in both experiments. Most importantly, a reduction in late positivity to novel metaphors relative to anomalous sentences was found in both experiments. Additionally, this difference was broadly distributed over parietal sites in Experiment 1, and clearly left-lateralized in Experiment 2, which might imply differences in the involvement of recollection and semantic processes. Overall, these results seem to indicate that both conventionality and task demands modulate the LPC pattern.

Unstable Binocular Fixation Affects Reaction Times But Not Implicit Motor Learning in Dyslexia.

Purpose: Individuals with developmental dyslexia suffer not only from reading problems as more general motor deficits can also be observed in this patient group. Both psychometric clinical tests and objective eyetracking methods suggest that unstable binocular fixation may contribute to reading problems. Because binocular instability may cause poor eye-hand coordination and impair motor control, the primary aim of this study was to explore in dyslexic subjects the influence of unstable binocular fixation on reaction times (RTs) and implicit motor learning (IML), which is one of the fundamental cerebellar functions. Methods: Fixation disparity (FD) and instability of FD were assessed subjectively using the Wesson card and a modified Mallett test. A modified version of the Serial Reaction Time Task (SRTT) was used to measure the RTs and IML skills. The results for the dyslexic group (DG), which included 29 adult subjects (15 were tested binocularly, DGbin; 14 were tested monocularly, DGmono), were compared with data from the control group (CG), which consisted of 30 age-matched nondyslexic subjects (15 tested binocularly, CGbin; and the other 15 tested monocularly, CGmono). Results: The results indicated that the DG showed poorer binocular stability and longer RTs in the groups tested binocularly (RTs: 534 vs. 411 ms for DGbin and CGbin, respectively; P < 0.001) as compared with the groups examined monocularly (RTs: 431 vs. 424 ms for DGmono and CGmono, respectively; P = 0.996). The DG also exhibited impaired IML when compared with the CG (EFIML: 25 vs. 50 ms for DG and CG, respectively; P = 0.012). Conclusions: Unstable binocularity in dyslexia may affect RTs but was not related to poor IML skills. Impaired IML in dyslexia was independent of the viewing conditions (monocular versus binocular) and may be related to cerebellar deficits.

How effector-specific is the effect of sequence learning by motor execution and motor imagery?

The aim of the present study was twofold. First, we wanted to examine how effector specific the effect of sequence learning by motor execution is, and second, we wanted to compare this effect with learning by motor imagery. We employed a Go/NoGo discrete sequence production task in which in each trial a spatial sequence of five stimuli was presented. After a Go signal the corresponding spatial response sequence had to be executed, while after a NoGo signal, the response sequence had to be mentally imagined. For the training phase, participants were divided into two groups. In the index finger group, participants had to respond (physically or mentally) with the left or right index finger, while in the hand group they had to respond with four fingers of the left or right hand. In a final test phase both execution modes were compared and all trials had to be executed. Response times and the percentage of correct responses were determined to establish learning effects. Results showed that sequence learning effects as assessed in the test phase were independent of the effector used during the training phase. Results revealed the presence of aspecific learning effects in the case of learning a required motor task with an index finger, but sequence-specific learning effects, both due to motor execution and to motor imagery, were not effector specific.

The influence of motor imagery on the learning of a fine hand motor skill.

Motor imagery has been argued to affect the acquisition of motor skills. The present study examined the specificity of motor imagery on the learning of a fine hand motor skill by employing a modified discrete sequence production task: the Go/NoGo DSP task. After an informative cue, a response sequence had either to be executed, imagined, or withheld. To establish learning effects, the experiment was divided into a practice phase and a test phase. In the latter phase, we compared mean response times and accuracy during the execution of unfamiliar sequences, familiar imagined sequences, and familiar executed sequences. The electroencephalogram was measured in the practice phase to compare activity between motor imagery, motor execution, and a control condition in which responses should be withheld. Event-related potentials (ERPs) and event-related lateralizations (ERLs) showed strong similarities above cortical motor areas on trials requiring motor imagery and motor execution, while a major difference was found with trials on which the response sequence should be withheld. Behavioral results from the test phase showed that response times and accuracy improved after physical and mental practice relative to unfamiliar sequences (so-called sequence-specific learning effects), although the effect of motor learning by motor imagery was smaller than the effect of physical practice. These findings confirm that motor imagery also resembles motor execution in the case of a fine hand motor skill.