Late Middle Ages-Europe.

At the end of the late Middle Ages, there had been changes in indications for surgery, with prophylactic trepanation falling out of favor. The management of wounds and the methods for opening the cranium had become fairly standardized. Narrow non-plunging trepans were the preferred drills, and cranial openings were widened by the use of multiple drill holes connected with chisels of which the lenticular was preferred. Concerns about damaging the dura led Theodoric to delay trepanation until the clinical changes reflected separation of the dura from the cranium, at least in his view. Draining pus remained the main indication for trepanation. In no case was the level of consciousness considered in determining the need to open the cranium.

High-Density Polyethylene Custom Focusing Lenses for High-Resolution Transient Terahertz Biomedical Imaging Sensors.

Transient terahertz time-domain spectroscopy (THz-TDS) imaging has emerged as a novel non-ionizing and noninvasive biomedical imaging modality, designed for the detection and characterization of a variety of tissue malignancies due to their high signal-to-noise ratio and submillimeter resolution. We report our design of a pair of aspheric focusing lenses using a commercially available lens-design software that resulted in about 200 × 200-µm2 focal spot size corresponding to the 1-THz frequency. The lenses are made of high-density polyethylene (HDPE) obtained using a lathe fabrication and are integrated into a THz-TDS system that includes low-temperature GaAs photoconductive antennae as both a THz emitter and detector. The system is used to generate high-resolution, two-dimensional (2D) images of formalin-fixed, paraffin-embedded murine pancreas tissue blocks. The performance of these focusing lenses is compared to the older system based on a pair of short-focal-length, hemispherical polytetrafluoroethylene (TeflonTM) lenses and is characterized using THz-domain measurements, resulting in 2D maps of the tissue refractive index and absorption coefficient as imaging markers. For a quantitative evaluation of the lens effect on the image resolution, we formulated a lateral resolution parameter, R2080, defined as the distance required for a 20-80% transition of the imaging marker from the bare paraffin region to the tissue region in the same image frame. The R2080 parameter clearly demonstrates the advantage of the HDPE lenses over TeflonTM lenses. The lens-design approach presented here can be successfully implemented in other THz-TDS setups with known THz emitter and detector specifications.

Storylines of family medicine IV: perspectives on practice-lenses of appreciation.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IV: perspectives on practice-lenses of appreciation', authors address the following themes: 'Relational connections in the doctor-patient partnership', 'Feminism and family medicine', 'Positive family medicine', 'Mindful practice', 'The new, old ethics of family medicine', 'Public health, prevention and populations', 'Information mastery in family medicine' and 'Clinical courage.' May readers nurture their curiosity through these essays.

Full-aperture extended-depth oblique plane microscopy through dynamic remote focusing.

Significance: The reprojection setup typical of oblique plane microscopy (OPM) limits the effective aperture of the imaging system, and therefore its efficiency and resolution. Large aperture system is only possible through the use of custom specialized optics. A full-aperture OPM made with off the shelf components would both improve the performance of the method and encourage its widespread adoption. Aim: To prove the feasibility of an OPM without a conventional reprojection setup, retaining the full aperture of the primary objective employed. Approach: A deformable lens based remote focusing setup synchronized with the rolling shutter of a complementary metal-oxide semiconductor detector is used instead of a traditional reprojection system. Results: The system was tested on microbeads, prepared slides, and zebrafish embryos. Resolution and pixel throughput were superior to conventional OPM with cropped apertures, and comparable with OPM implementations with custom made optical components. Conclusions: An easily reproducible approach to OPM imaging is presented, eliminating the conventional reprojection setup and exploiting the full aperture of the employed objective.

Highly Resolved Genomes of Two Closely Related Lineages of the Rodent Louse Polyplax serrata with Different Host Specificities.

Sucking lice of the parvorder Anoplura are permanent ectoparasites with specific lifestyle and highly derived features. Currently, genomic data are only available for a single species, the human louse Pediculus humanus. Here, we present genomes of two distinct lineages, with different host spectra, of a rodent louse Polyplax serrata. Genomes of these ecologically different lineages are closely similar in gene content and display a conserved order of genes, with the exception of a single translocation. Compared with P. humanus, the P. serrata genomes are noticeably larger (139 vs. 111 Mbp) and encode a higher number of genes. Similar to P. humanus, they are reduced in sensory-related categories such as vision and olfaction. Utilizing genome-wide data, we perform phylogenetic reconstruction and evolutionary dating of the P. serrata lineages. Obtained estimates reveal their relatively deep divergence (∼6.5 Mya), comparable with the split between the human and chimpanzee lice P. humanus and Pediculus schaeffi. This supports the view that the P. serrata lineages are likely to represent two cryptic species with different host spectra. Historical demographies show glaciation-related population size (Ne) reduction, but recent restoration of Ne was seen only in the less host-specific lineage. Together with the louse genomes, we analyze genomes of their bacterial symbiont Legionella polyplacis and evaluate their potential complementarity in synthesis of amino acids and B vitamins. We show that both systems, Polyplax/Legionella and Pediculus/Riesia, display almost identical patterns, with symbionts involved in synthesis of B vitamins but not amino acids.

Investigation of Head Lice and Intestinal Parasites in Primary and Secondary School in Sivas.

Objective: The purpose of this study was to investigate the prevalence of intestinal parasites and head lice in primary school-aged children and to determine a possible relationship between the co-occurrence of ecto-endoparasites. Methods: The study were conducted in three schools in the center of Sivas: Sivas Karsiyaka Primary School, Kilavuz IMKB Primary School, and Karsiyaka 27 June Middle School. The presence of head lice and intestinal parasites was investigated in a total of 563 children aged 6 to 17, with 294 girls and 269 boys. Classroom teachers and students were provided with information about intestinal parasites, head lice, and methods of transmission and prevention, and a questionnaire was administered. During the head lice examination, students were inspected with a comb, and samples with nits were examined under a microscope in the laboratory. Cellophane tape and stool samples obtained from the participants were examined on the same day using the native-lugol, flotation, and trichrome staining methods under a light microscope (x10, x40, x100). Results: Five hundred sixty-three children were evaluated for head lice and 15 (2.6%) were found to be positive. During the examination, only nits were found in 11 students (1.9%), and both adult lice and nymphs were seen in 4 students (0.7%). Head lice were found positive in 2 out of 269 boys (0.7%), while 13 out of 294 girls (4.2%) positive (p<0.05). As a result of stool examination in children, Entamoeba coli was found in 11 (1.95%), Giardia intestinalis in 4 (0.71%), Blastocystis sp. in 14 (2.48%), Enterobius vermicularis in 8 (1.42%) and Taenia spp. in 2 (0.35%). Head lice infestation and Taenia spp. were found to coexist in 2 (0.35%) children. Conclusion: In conclusion, although there has been a noticeable decrease in head lice and intestinal parasites among primary school-aged children in Sivas province, these conditions are still present, as evidenced by previous studies conducted in our region.

[Structural and functional features of the eye in Marfan syndrome. Report 2. Changes in the anatomical complex of the lens]. / Strukturno-funktsional'nye osobennosti glaza pri sindrome Marfana. Soobshchenie 2. Izmeneniya anatomicheskogo kompleksa khrustalika.

Analysis of lens changes in Marfan syndrome (MS), in addition to assessing the position of the lens itself, should include the possibility of examining its supporting and accommodative components (ciliary zonule and ciliary body), or what can be called the entire anatomical complex of the lens. Optical methods of studying the structures of the anterior segment of the eye, due to iris opacity, allow only to analyze the state of the lens within the natural or medically enlarged pupil width. Visualization of the structures located behind the iris is possible with the use of radiation diagnostic methods, in particular ultrasound biomicroscopy (UBM). PURPOSE: This study assesses the state of the anatomical complex of the lens in MS using UBM. MATERIAL AND METHODS: The study was carried out on clinical material previously used by us to analyze changes in the fibrous membrane of the eye in MS. At the first stage, the main (19 patients with MS, 38 eyes) and the control (24 patients with myopia, 48 eyes) groups were formed for comparative evaluation. The formed groups were standardized according to the age of the patients and the axial length of the eye. At the second stage, patients with MS were divided into subgroups depending on the absence or presence of biomicroscopic signs of ectopia lentis (22 and 16 eyes, respectively). For UBM, an ultrasound linear sensor with a scanning frequency of 50 MHz was used (Aviso device, Quantel Medical, France). Various biometric UBM indicators were determined: lens thickness, diameter of the lens, lens-axial length factor, iris-lens angle, iris-lens contact distance, posterior chamber depth, length of the fibers of ciliary zonule, thickness of the ciliary body, sclera-ciliary process angle. RESULTS: There are changes in the anatomical complex of the lens as a whole in MS (in the lens itself, the ciliary zonule, and the ciliary body), which are characterized by an increase in lens thickness and a decrease in the diameter of the lens, an increase in the length of the fibers of the ciliary zonule and a decrease in the thickness of the ciliary body. At the same time, the displacement of the lens detected by optical biomicroscopy (ectopia lentis) can be considered as an advanced stage of changes in the anatomical complex of the lens. CONCLUSION: UBM provides the possibility of full-fledged visualization of all components of the anatomical complex of the lens in terms of both diagnostics, and monitoring of changes in MS. The question of the advisability of including this method in the algorithm for diagnosing ocular manifestations in order to verify the MS remains open. Possible obstacles may be, on the one hand, related to the need for special and expensive equipment, and on the other hand, the absence of a generally accepted «normal¼ values of UBM indicators of the anatomical complex of the lens.

Comparison of visual performance between diffractive bifocal and diffractive trifocal intraocular lenses.

To evaluate the visual performance of a diffractive bifocal intraocular lens (IOL) with + 4.0 D near addition (ZMB00) and a diffractive trifocal IOL with + 2.17 D and + 3.25 D near addition (AcrySof IQ PanOptix TFNT00), we investigated the 10-week postoperative parameters after cataract surgery in which ZMB00 or TFNT00 lenses were implanted bilaterally from 2011 to 2020 (with a 3-month interval between implantation of the right and left lenses). The study included 1448 eyes of 724 patients. The diffractive bifocal group comprised 1326 eyes of 663 patients (aged 67.0 ± 7.8 years; females/males, 518/145), and the diffractive trifocal group comprised 122 eyes of 61 patients (aged 66.6 ± 7.3 years; females/males, 35/26). A linear mixed-effects model using data for both eyes, with strict adjustments for sex, age, subjective refraction spherical equivalent, subjective refraction cylinder, corneal astigmatism, axial length, corneal higher-order aberrations, and pupil diameter, ensured statistical validity. Uncorrected near visual acuity and higher-order aberrations (ocular/internal, scaled to a pupil size of 4 mm) (Wavefront_4mm_postoperative_Ocular/Internal_Spherical) were significantly better in the bifocal group (p < 0.00068, Wald test). Uncorrected intermediate visual acuity, contrast sensitivity (6.3/4.0/2.5/1.6/1.0/0.7 degrees), and contrast sensitivity with glare (4.0/1.6/1.0/0.7 degrees) were significantly better in the trifocal group (p < 0.00068, Wald test).

Genomic Diversity in the Endosymbiotic Bacteria of Human Head Lice.

Insects have repeatedly forged symbioses with heritable microbes, gaining novel traits. For the microbe, the transition to symbioses can lead to the degeneration of the symbiont's genome through transmission bottlenecks, isolation, and the loss of DNA repair enzymes. However, some insect-microbial symbioses have persisted for millions of years, suggesting that natural selection slows genetic drift and maintains functional consistency between symbiont populations. By sampling in multiple countries, we examine genomic diversity within a symbiont species, a heritable symbiotic bacterium found only in human head lice. We find that human head louse symbionts contain genetic diversity that appears to have arisen contemporaneously with the appearance of anatomically modern humans within Africa and/or during the colonization of Eurasia by humans. We predict that the observed genetic diversity underlies functional differences in extant symbiont lineages, through the inactivation of genes involved in symbiont membrane construction. Furthermore, we find evidence of additional gene losses prior to the appearance of modern humans, also impacting the symbiont membrane. From this, we conclude that symbiont genome degeneration is proceeding, via gene inactivation and subsequent loss, in human head louse symbionts, while genomic diversity is maintained. Collectively, our results provide a look into the genomic diversity within a single symbiont species and highlight the shared evolutionary history of humans, lice, and bacteria.

Body lice: a vector for re-emerging disease outbreak in a rehabilitation camp in Northwestern Iran.

OBJECTIVE: The report of the outbreak of body louse in northwestern Iran after three decades reminds us again of the danger of the re-emerging of previous epidemics. RESULTS: The results of the study that nearly 70% of the patients in a rehabilitation Centre were infected with body louse. In this study, scientific measures were taken to prevent the spread of body lice to healthy people, including isolation of the patients, washing the clothes of those infected at high temperatures, and spraying the rest area, beddings, and blankets. This is a more recent report on an outbreak of body louse in Iran in 2023.

Geometric transformation adaptive optics (GTAO) for volumetric deep brain imaging through gradient-index lenses.

The advance of genetic function indicators has enabled the observation of neuronal activities at single-cell resolutions. A major challenge for the applications on mammalian brains is the limited optical access depth. Currently, the method of choice to access deep brain structures is to insert miniature optical components. Among these validated miniature optics, the gradient-index (GRIN) lens has been widely employed for its compactness and simplicity. However, due to strong fourth-order astigmatism, GRIN lenses suffer from a small imaging field of view, which severely limits the measurement throughput and success rate. To overcome these challenges, we developed geometric transformation adaptive optics (GTAO), which enables adaptable achromatic large-volume correction through GRIN lenses. We demonstrate its major advances through in vivo structural and functional imaging of mouse brains. The results suggest that GTAO can serve as a versatile solution to enable large-volume recording of deep brain structures and activities through GRIN lenses.

Functional subtypes of synaptic dynamics in mouse and human.

Synapses preferentially respond to particular temporal patterns of activity with a large degree of heterogeneity that is informally or tacitly separated into classes. Yet, the precise number and properties of such classes are unclear. Do they exist on a continuum and, if so, when is it appropriate to divide that continuum into functional regions? In a large dataset of glutamatergic cortical connections, we perform model-based characterization to infer the number and characteristics of functionally distinct subtypes of synaptic dynamics. In rodent data, we find five clusters that partially converge with transgenic-associated subtypes. Strikingly, the application of the same clustering method in human data infers a highly similar number of clusters, supportive of stable clustering. This nuanced dictionary of functional subtypes shapes the heterogeneity of cortical synaptic dynamics and provides a lens into the basic motifs of information transmission in the brain.

Intracapsular accommodation mechanism in terms of lens curvature gradient.

The intracapsular accommodation mechanism (IAM) may be understood as an increase in the lens equivalent refractive index as the eye accommodates. Our goal was to evaluate the existence of an IAM by analysing observed changes in the inner curvature gradient of the lens. To this end, we fitted a gradient index and curvature lens model to published experimental data on external and nucleus geometry changes during accommodation. For each case analysed, we computed the refractive power and equivalent index for each accommodative state using a ray transfer matrix. All data sets showed an increase in the effective refractive index, indicating a positive IAM, which was stronger for older lenses. These results suggest a strong dependence of the lens equivalent refractive index on the inner curvature gradient.

Comparison of proximal and minus lens autorefraction techniques to measure monocular accommodative amplitude.

SIGNIFICANCE: This study provides a faster method for objectively measuring accommodative amplitude with an open-field autorefractor in a research setting. PURPOSE: Objective measures of accommodative amplitude with an autorefractor take time because of the numerous stimulus demands tested. This study compares protocols using different amounts and types of demands to shorten the process. METHODS: One hundred participants were recruited for four age bins (5 to 9, 10 to 14, 15 to 19, and 20 to 24 years) and monocular amplitude measured with an autorefractor using three protocols: proximal, proximal-lens (letter), and proximal-lens (picture). For proximal, measurements were taken as participants viewed a 0.9 mm "E" placed at 13 demands (40 to 3.3 cm = 2.5 to 30 D). The other protocols used a target (either the "E" or a detailed picture) placed at 33 and 12.5 cm followed by 12.5 cm with a series of lenses (-2, -4, and -5.5 D). Adjustments were made for lens effectivity for the three lens conditions, which were thus 9.6, 11.1, and 12.0 D for individuals without additional spectacle lenses. Accommodative amplitude was defined as the greatest response measured with each technique. One-way analysis of variance was used to compare group mean amplitudes across protocols and differences between letter protocols by age bin. RESULTS: Amplitudes were significantly different between protocols (p < 0.001), with proximal having higher amplitudes (mean ± standard deviation, 8.04 ± 1.70 D) compared with both proximal-lens protocols (letter, 7.48 ± 1.42 D; picture, 7.43 ± 1.42 D) by post hoc Tukey analysis. Differences in amplitude between the proximal and proximal-lens (letter) protocol were different by age group (p = 0 .003), with the youngest group having larger differences (1.14 ± 1.58 D) than the oldest groups (0.17 ± 0.58 and 0.29 ± 0.48 D, respectively) by post hoc Tukey analysis. CONCLUSIONS: The proximal-lens protocols took less time and identified the maximum accommodative amplitude in participants aged 15 to 24 years; however, they may underestimate true amplitude in younger children.

Pediculicide regulations and usage trends in Türkiye in 2015-2022.

BACKGROUND: Over the years, the increasing prevalence of head lice infestation has led to an increase in treatment-related costs and the development of resistance to pediculicides. This study aimed to evaluate pediculicide sales over an 8-year period (2015-2022), including the COVID-19 pandemic. METHODS: Data on products registered in the Turkish Pharmaceutical Index Dataview, Intercontinental Medical Statistics (IMS) database, sold on prescription and approved by the Ministry of Health in Türkiye were formally requested from the research organization IQVIA for pharmacologically active pediculicides (PAP) such as permethrin, pyrethrin, and sumithrin. Data for physically active products containing dimethicone (DMT) were obtained from the relevant pharmaceutical companies. Sale revenues were determined based on sale prices in the aforementioned year. RESULTS: Total sales of pediculicides decreased from 2,452,846 units in 2015 to 2,028,840 units in 2022. While PAP consumption decreased over the years, from 1,832,006 to 518,460 units, DMT consumption increased from 620,840 to 1,510,380 units, from 2015 to 2022. The total price of pediculicides for the consumer increased more than threefold in Turkish currency. In terms of USD, an almost similar amount of money was spent over the years, with the exception of 2022 when the expenditure almost halved mainly due to the high inflation rate in the country. CONCLUSION: The decrease in PAP and the increase in DMT indicate that local lice have developed resistance to the former. Further studies are needed to determine the possible development of resistance in the country.

Moving between doing and being-Meanings of person-centredness as narrated by nursing home managers. A phenomenological hermeneutical study.

AIM: This study aimed to illuminate meanings of person-centredness as narrated by nursing home managers in nursing homes rated as highly person-centred. DESIGN: A phenomenological hermeneutical approach was used. METHODS: Twelve nursing home managers in 11 highly person-centred nursing homes in 7 municipalities in Sweden were included in this interview study. The findings were interpreted, reflected and discussed through the lens of Ricoeur. RESULTS: Meanings of person-centredness could be understand as moving between doing and being through knowing, sensing, sharing and giving for person-centredness. These aspects contributed via knowledge, understanding, interaction and action that involved doing for and being with older persons through these caring dimensions. By moving between doing for, being with and being part of the overall nursing home narrative, knowing, sensing, sharing and giving could support the persons' identity in different ways. This may also contribute to sense-making, preserving dignity and promoting self-esteem when aiming to provide a good life for older persons in nursing homes, within an ever-present ethical frame. NO PATIENT OR PUBLIC CONTRIBUTION: This study illuminated meanings of person-centredness as narrated by nursing home managers. No patient of public contribution was investigated.

The effect of Galilean magnification loupes on the visual acuity and working distance of dental students.

OBJECTIVE: This study aimed to evaluate the visual acuity and working distance of dental students using Galilean loupes at different magnification levels. METHODS: The participants included 50 undergraduate dentistry students selected from each class in the second to fifth years (N = 200) of São Paulo State University, School of Dentistry, Araraquara. The response variables were (i) the working distance between the operator's eyes and the mouth of the dental phantom head, and (ii) visual acuity. The independent variables were the five levels of the Galilean magnification system (naked eye, Galilean loupe simulator without magnification, and Galilean loupes with 2.5×, 3.0×, or 3.5× magnification) and academic year. Visual acuity was measured using a miniature Snellen eye chart inserted into the Class I cavities of the maxillary molars. After verifying the assumptions of normality and sphericity, a mixed repeated measures analysis was performed (α = 0.05). RESULTS: Statistical significance was found between the "magnification system" and "academic year" for visual acuity (p < 0.001). For the second-, fourth-, and fifth-year participants, there were no significant differences in visual acuity between the naked eye and different magnifications of the Galilean loupes, which were superior to and significantly different from that of the loupe simulator. For the working distance, statistical significance was observed in the interaction between "magnification system" and "academic year" (p = 0.008). For the third-, fourth-, and fifth-year participants, there was no significant difference in the working distance between the naked eye and different magnifications of the Galilean loupes, which were superior to and significantly different from that of the simulator. CONCLUSION: It was concluded that the different magnification levels of the Galilean loupes did not influence the visual acuity or distance between the eyes of the operator and the mouth of the dental phantom head in the evaluated students.

Development of a bio-inspired optical system that mimics accommodation and lighting regulation like the human eye.

Bio-inspired optical systems have recently been developed using polarizers and liquid or rigid lenses. In this work, we propose a bio-inspired opto-mechatronic system that imitates the accommodation and regulation of light intensity as the human eye does. The system uses a polymeric lens as a cornea, an adjustable diaphragm as an iris, a tunable solid elastic lens as a crystalline lens, and a commercial sensor as a retina. We also present the development of the electronic control system to accommodate and regulate the amount of light that enters the system, for which two stepper motors, an Arduino control system, and light and movement sensors are used. The characterization of the system is presented together with the results obtained, where it can be seen that the system works in an acceptable range as the human eye does.