Measuring attention of ADHD patients by means of a computer game featuring biometrical data gathering.

ADHD is a neurodevelopmental disorder diagnosed mainly in children, marked by inattention and hyperactivity-impulsivity. The symptoms are highly variable, such as different ages of onset and potential comorbidities, contributing to frequent misdiagnoses. Professionals note a gap in modern diagnostic tools, making accurate identification challenging. To address this, recent studies recommend gamification for better ADHD diagnosis and treatment, though further research is essential to confirm its efficacy. This work aims to create a serious game, namely "Attention Slackline", to assess attention levels. The game, designed with expert input, requires players to concentrate on a specific point to recognize specific patterns while managing distractions. A controlled experiment tested its precision, and results were compared with established attention tests by a correlation analysis. Statistical analysis confirmed the game's validity, especially in tracking attention through correct responses and errors. Preliminary evidence suggests that "Attention Slackline" may serve as a credible instrument for the assessment of attentional capacities in individuals with ADHD, given that its outcomes have been empirically shown to correlate with those derived from a well-established attention assessment methodology.

A novel approach to identify the brain regions that best classify ADHD by means of EEG and deep learning.

Objective: Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most widespread neurodevelopmental disorders diagnosed in childhood. ADHD is diagnosed by following the guidelines of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). According to DSM-5, ADHD has not yet identified a specific cause, and thus researchers continue to investigate this field. Therefore, the primary objective of this work is to present a study to find the subset of channels or brain regions that best classify ADHD vs Typically Developing children by means of Electroencephalograms (EEG). Methods: To achieve this goal, we present a novel approach to identify the brain regions that best classify ADHD using EEG and Deep Learning (DL). First, we perform a filtering and artefact removal process on the EEG signal. Then we generate different subsets of EEG channels depending on their location on the scalp (hemispheres, lobes, sets of lobes and single channels) and using backward and forward stepwise feature selection methods. Finally, we feed the DL neural network with each set, and compute the f1-score. Results and conclusions: Based on the obtained results, the Frontal Lobe (FL) (0.8081 f1-score) and the Left Hemisphere (LH) (0.8056 f1-score) provide more significant information detecting individuals with ADHD, than using the entire set of EEG Channels (0.8067 f1-score). However, when combining the Temporal, Parietal and Occipital Lobes (TL, PL, OL), better results (0.8097 f1-score) were obtained compared with using only the FL and LH subsets. The best performance was obtained using Feature Selection Methods. In the case of the Backward Stepwise Feature Selection method, a combination of 14 EEG channels yielded a 0.8281 f1-score. Similarly, using the Forward Stepwise Feature Selection method, a combination of 11 EEG channels yielded a 0.8271 f1-score. These findings hold significant value for physicians in the quest to better understand the underlying causes of ADHD.

Mobile robotics in smart farming: current trends and applications.

In recent years, precision agriculture and smart farming have been deployed by leaps and bounds as arable land has become increasingly scarce. According to the Food and Agriculture Organization (FAO), by the year 2050, farming in the world should grow by about one-third above current levels. Therefore, farmers have intensively used fertilizers to promote crop growth and yields, which has adversely affected the nutritional improvement of foodstuffs. To address challenges related to productivity, environmental impact, food safety, crop losses, and sustainability, mobile robots in agriculture have proliferated, integrating mainly path planning and crop information gathering processes. Current agricultural robotic systems are large in size and cost because they use a computer as a server and mobile robots as clients. This article reviews the use of mobile robotics in farming to reduce costs, reduce environmental impact, and optimize harvests. The current status of mobile robotics, the technologies employed, the algorithms applied, and the relevant results obtained in smart farming are established. Finally, challenges to be faced in new smart farming techniques are also presented: environmental conditions, implementation costs, technical requirements, process automation, connectivity, and processing potential. As part of the contributions of this article, it was possible to conclude that the leading technologies for the implementation of smart farming are as follows: the Internet of Things (IoT), mobile robotics, artificial intelligence, artificial vision, multi-objective control, and big data. One technological solution that could be implemented is developing a fully autonomous, low-cost agricultural mobile robotic system that does not depend on a server.

Intravitreal bevacizumab in cystoid macular edema associated to maternally inherited diabetes and deafness's macular dystrophy.

INTRODUCTION: Maternally inherited diabetes and deafness (MIDD) is a rare and infradiagnosed cause of diabetes which can, in a high number of cases, associate a macular dystrophy. CASE PRESENTATION: We report the case of a 49- year-old man affected of this syndrome, with proven m3243G>A mitochondrial mutation, who developed macular cysts 20 years after the initial presentation of his macular dystrophy. The fluorescein angiography showed no leakage, ruling out a diabetic macular edema. A treatment with intravitreal bevacizumab led to cystic changes resolution and visual acuity recovery. CONCLUSION: Intravitreal bevacizumab can be successfully employed for this complication of MIDD's macular dystrophy.

[Assumption of sincerity in medicine]. / Postulat de sincérité en médecine.

Medical practice is always embedded in time and space, whatever its scientific and technical progress could claim as universal truths. The postulate of sincerity is one those contextual elements but it has become so pervasive that a gloss of evidence surrounds it. This situation is at risk of loosing its depth, as much as its limits. By bringing closer together sincerity with more usual notions (transparency, confidence, uncertainty), one could get more insight into these matters of concern in medical practice.

La pratique médicale est toujours ancrée dans un temps et un lieu, quelles que soient les avancées scientifiques et techniques auxquelles elle a contribué et qui peuvent prétendre à une reconnaissance universelle. Le postulat de sincérité fait partie de ces déterminants contextuels, mais son statut contemporain « d'évidence ¼ risque de faire oublier sa profondeur, tout comme ses limites. En rapprochant la sincérité d'autres notions plus couramment évoquées (transparence, confiance, incertitude), nous verrons dans quelle mesure elle permet de les questionner à nouveaux frais.

Persistent Diplopia in Primary Position after Pars Plana Vitrectomy with Encircling Band in Rhegmatogenous Retinal Detachment.

PURPOSE: To evaluate the incidence of persistent diplopia in primary position after encircling band procedures with pars plana vitrectomy (PPV) and to report the outcomes. DESIGN: Observational, retrospective study. PARTICIPANTS: One hundred sixteen patients who underwent successful rhegmatogenous retinal detachment (RRD) at our center from 2009 through 2014. METHODS: We studied all patients with RRD who underwent successful PPV with an encircling band. Patients reporting diplopia more than 2 months after retinal surgery were identified and evaluated by our strabismus colleagues. MAIN OUTCOME MEASURES: Outcome measures included near and far deviation in prism diopters, degree of anisometropia, and visual acuity. RESULTS: Six of 116 patients reported persistent diplopia in primary position (5.2%). The diplopia most often was related to vertical microdeviations from 3 to 5 prism diopters, and it was managed adequately with prisms. The deviation remained unchanged during the follow-up, except in 1 patient. CONCLUSIONS: Persistent diplopia associated to PPV with an encircling band has a low incidence and a small angle of deviation, and in our cases, it could be corrected successfully with prisms.

Aflibercept in the management of acute retinal necrosis syndrome-related macular edema.

PURPOSE: Acute retinal necrosis (ARN) is a panuveitis syndrome that may lead to severe complications such as cystoid macular edema (CME). There is no consensus about the best treatment. We report one case of CME secondary to ARN managed with intravitreal aflibercept. CASE REPORT: A 41-year-old woman with a history of successfully treated varicella-zoster virus-associated ARN developed an epiretinal membrane (ERM) and underwent pars plana vitrectomy, ERM removal, inner limiting membrane peel, and lensectomy. After surgery, the retinal architecture improved and the visual acuity returned to 20/20. Six months later, she developed nontractional CME, which was treated monthly with triple-dose intravitreal aflibercept (2 mg). She gained 3 lines of vision and CME resolution was achieved. DISCUSSION: Cystoid macular edema is a late complication of ARN that may affect vision. Some off-label therapies have been reported to be useful in CME secondary to ARN, including pegaptanib and interferon-α-2. Since interferon-α-2a is not currently available for ophthalmic use in Spain, aflibercept was the first choice. This soluble protein blocks the placental growth factor and all isoforms of vascular endothelial growth factor (VEGF); its half-life is prolonged and its affinity to VEGF-A is more than 100-fold greater than bevacizumab, pegaptanib, or ranibizumab. After each injection, macular thickness decreased consistently and visual acuity improved 3 lines after the treatment. CONCLUSIONS: Intravitreal aflibercept is effective in the management of acute nontractional CME secondary to ARN.

Aproximación a la integración de la huella de carbono y aspectos nutricionales para un consumo sostenible de alimentos / An approach to integrate carbon footprint and nutritional aspects for sustainable food consumption

Fundamentos: El consumo de alimentos influye sobre el calentamiento global. Pero no hay que olvidar que los alimentos son una fuente de nutrientes. Para apoyar un consumo sostenible, se ha desarrollado un indicador que integra la huella de carbono (HC) y el valor nutricional de los alimentos. Métodos: Con el fin de proporcionar una ponderación objetiva, se utilizó la técnica no paramétrica 'Análisis Envolvente de Datos' (DEA) para definir la eficiencia-eco-nutricional (ENE). La ENE, definida como 'rendimiento nutricional/impacto ambiental', varía entre 0 y 1, significando 1 que el menú es eficiente. Se presentan dos modelos DEA: el primero basado en el contenido en macronutrientes, mientras que el segundo considera la ingesta diaria recomendada. Los modelos se probaron en un caso de estudio de 256 menús diarios. Resultados: Ambos modelos mostraron valores de ENE entre 0.42 y 1, lo que supone un potencial de reducción de la HC de hasta un 58%. El modelo 2 es preferible porque se basa en recomendaciones nutricionales. Conclusiones: La ENE permite agregar la HC y los aspectos nutricionales en un valor único para apoyar la toma de decisiones. Se proponen mejoras como la introducción de micronutrientes y otros impactos ambientales (AU)

Background: Food consumption has a large influence on global warming. Although we must not forget that the main role of food is nutrient provision. This study develops an indicator to integrate the carbon footprint (CFP) and nutritional values of diets to facilitate sustainable food consumption. Methods: To provide a non-subjective weighting, the nonparametric technique 'Data Envelopment Analysis' (DEA) was used to define the eco-nutritional-efficiency (ENE). The ENE, defined as the ratio 'nutritional performance/environmental impact', ranges between 0 and 1, with 1 being efficient. Two DEA models are presented: model 1 focuses on the macronutrient content, whereas model 2 takes the recommended daily intake into account. They were tested through a case study consisting of 256 daily menus. Results: The case study showed that the vegetarian lunch was in all efficient menus. Western menus performed the worst due to a high CFP from meat. Both models led to ENEs between 0.42 and 1, therefore showing a potential CFP reduction of up to 58%. Model 2 is preferred because it focuses on nutritional recommendations. Conclusions: The ENE succeeds in aggregating the CFP and nutritional aspects to create a unique value that can support decision-making. Further investigation is needed to include micronutrients and other environmental impacts (AU)

Spontaneous globe luxation in iatrogenic Cushing syndrome.

PURPOSE: We report a rare case of spontaneous eyeball luxation associated with exophthalmos due to iatrogenic Cushing syndrome (CS). The normalization of serum hormones led to the regression of the picture. CASE: A 64-year-old man presented with spontaneous globe luxation of the left eye after a 6-month history of bilateral, painless, and slowly progressive exophthalmos. The patient had been receiving weekly infusions of methylprednisone over the previous 6 months. His best-corrected visual acuity (BCVA) at presentation was 20/40 in the right eye and 20/20 in the left eye. The patient demonstrated full extraocular motility. The intraocular pressure (IOP) was elevated in the right eye (24 mHg) and normal in the left eye (18 mmHg). Exophthalmometry demonstrated bilateral proptosis with measurements of 27 mm in the right eye and 28 mm in the left eye. Computed tomography scan of the brain and orbits revealed increased orbital and cervical fat. Clinical, radiographic and serologic findings ruled out potential diagnoses including orbital metastasis, thyroid orbitopathy, carotid-cavernous fistula, and idiopathic orbital pseudotumor. Clinical suspicion of iatrogenic CS was high, and additional serologic testing confirmed the diagnosis. CONCLUSION: Exophthalmos is an uncommon sign of CS, but to our knowledge, this is the first reported case of spontaneous globe luxation secondary to CS. In our case, normalization of cortisol was sufficient to resolve the clinical symptoms and eliminated the need for surgical intervention such as orbital decompression surgery.

Long-term effectiveness of vitrectomy in diabetic cystoid macular edema.

BACKGROUND: The aim of this study is to assess whether the outcome of pars plana vitrectomy for the treatment of cystoid non-tractional diabetic macular edema is stable and durable. METHODS: A prospective longitudinal analysis of central macular thickness and visual acuity was performed, using repeated-measures ANOVA, in 22 subjects with cystoid diabetic macular edema. RESULTS: Of the patients, 45.5 % met the criteria for surgical success at 6 months (achieving a reduction of central macular thickness of over 20 %, without associated loss of vision and central macular thickness less than 300 µm), of which 70 % remained stable at 1 year. A significant outcome of the intervention was found on central macular thickness (p < 0.01), but not on visual acuity (p = 0.159). This change occurred in the immediate postoperative period to remain stable thereafter. CONCLUSIONS: Vitreoretinal surgery can be an alternative treatment option in cases that do not respond to other types of treatment provided. Its expected benefit is observed in most cases in the immediate postoperative period, and is usually stable and sustained over 1-year follow-up.