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light sense [keywords]
- The Prevalence of Air Regurgitation and Its Consequences After Conjunctivodacryocystorhinostomy and Dacryocystorhinostomy in Continuous Positive Airway Pressure Patients. [JOURNAL ARTICLE]
- Ophthal Plast Reconstr Surg 2014 Sep 17.
To describe the prevalence of air regurgitation into the periocular region in continuous positive airway pressure (CPAP) patients with a history of conjunctivodacryocystorhinostomy with a Lester Jones tube and a dacryocystorhinostomy with silicone intubation, as well as problems caused by this regurgitation and methods to cope.A retrospective chart review of patients who either underwent a conjunctivodacryocystorhinostomy or dacryocystorhinostomy was performed. Patients were contacted via phone interview. Demographic information, history of sleep apnea, use of CPAP, and presence of air regurgitation and associated complications were recorded. Institutional review board/ethics committee approval was obtained.Two patients who underwent a conjunctivodacryocystorhinostomy with Lester Jones tube and were on CPAP were identified. Both complained of air regurgitation, sensation of Lester Jones tube moving due to regurgitation, and periodic eye pain. Twenty-two patients who underwent a dacryocystorhinostomy with silicone stent and used CPAP were identified. Of these, 16 (72.7%) complained of air regurgitation. Difficulty sleeping (56.2%), dry eye symptoms upon waking (68.8%), eye pain upon waking (31.3%), and blurry vision upon waking (12.5%) were the commonest complaints due to air regurgitation. A total of 7 (43.7%) patients had to discontinue their CPAP at some point due to symptoms.This study brings to light the prevalence of air regurgitation in dacryocystorhinostomy procedures, and its associated symptoms. Given that this procedure is much more common than conjunctivodacryocystorhinostomy, surgeons should consider asking patients before performing surgery whether they use CPAP. Patients should be consented regarding the risk of air regurgitation and associated dry eye, foreign body sensation, and eye pain.
- A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others. [JOURNAL ARTICLE]
- Theor Med Bioeth 2014 Sep 17.
Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty's philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors' relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine.
- Negative optical torque. [Journal Article]
- Sci Rep 2014.:6386.
Light carries angular momentum, and as such it can exert torques on material objects. Applications of these opto-mechanical effects were limited initially due to their smallness in magnitude, but later becomes powerful and versatile after the invention of laser. Novel and practical approaches for harvesting light for particle rotation have since been demonstrated, where the structure is always subjected to a positive optical torque along a certain axis if the incident angular momentum has a positive projection on the same axis. We report here an interesting phenomenon of "negative optical torque", meaning that incoming photons carrying angular momentum rotate an object in the opposite sense. Surprisingly this can be realized quite straightforwardly in simple planar structures. Field retardation is a necessary condition and discrete rotational symmetry of material object plays an important role. The optimal conditions are explored and explained.
- A new comparator account of auditory verbal hallucinations: how motor prediction can plausibly contribute to the sense of agency for inner speech. [Journal Article]
- Front Hum Neurosci 2014.:675.
The comparator account holds that processes of motor prediction contribute to the sense of agency by attenuating incoming sensory information and that disruptions to this process contribute to misattributions of agency in schizophrenia. Over the last 25 years this simple and powerful model has gained widespread support not only as it relates to bodily actions but also as an account of misattributions of agency for inner speech, potentially explaining the etiology of auditory verbal hallucination (AVH). In this paper we provide a detailed analysis of the traditional comparator account for inner speech, pointing out serious problems with the specification of inner speech on which it is based and highlighting inconsistencies in the interpretation of the electrophysiological evidence commonly cited in its favor. In light of these analyses we propose a new comparator account of misattributed inner speech. The new account follows leading models of motor imagery in proposing that inner speech is not attenuated by motor prediction, but rather derived directly from it. We describe how failures of motor prediction would therefore directly affect the phenomenology of inner speech and trigger a mismatch in the comparison between motor prediction and motor intention, contributing to abnormal feelings of agency. We argue that the new account fits with the emerging phenomenological evidence that AVHs are both distinct from ordinary inner speech and heterogeneous. Finally, we explore the possibility that the new comparator account may extend to explain disruptions across a range of imagistic modalities, and outline avenues for future research.
- Intentional binding effect in children: insights from a new paradigm. [Journal Article]
- Front Hum Neurosci 2014.:651.
Intentional binding (IB) refers to the temporal attraction between a voluntary action and its sensory consequence. Since its discovery in 2002, it has been considered to be a valid implicit measure of sense of agency (SoA), since it only occurs in the context of voluntary actions. The vast majority of studies considering IB have recruited young adults as participants, while neglecting possible age-related differences. The aim of the present work is to study the development of IB in 10-year-old children. In place of Libet's classical clock method, we decided to implement a new and more suitable paradigm in order to study IB, since children could have some difficulties in dealing with reading clocks. A stream of unpredictable letters was therefore used: participants had to remember which letter was on the screen when they made a voluntary action, heard a sound, or felt their right index finger moved down passively. In Experiment I, a group of young adults was tested in order to replicate the IB effect with this new paradigm. In Experiment II, the same paradigm was then administered to children in order to investigate whether such an effect has already emerged at this age. The data from Experiment I showed the presence of the IB effect in adults. However, Experiment II demonstrated a clear reduction of IB. The comparison of the two groups revealed that the young adult group differed from the children, showing a significantly stronger linkage between actions and their consequences. The results indicate a developmental trend in the IB effect. This finding is discussed in light of the maturation process of the frontal cortical network.
- [Community cooperation initiatives pertaining to concomitant physical illnesses]. [English Abstract, Journal Article]
- Seishin Shinkeigaku Zasshi 2014; 116(7):570-5.
In the field of psychiatric care, while there is increasing demand related to concomitant physical illnesses (particularly during the emergency stage of such illnesses), this area is associated with several issues. As injuries resulting from attempted suicide among elderly patients with mood disorders increase, there has been a coordinated effort to improve mental healthy policies through government intervention (i. e., improving general practitioners' ability to deal with depression, and the establishment of psychiatric beds in concomitant illness wards). However, in addition to infrastructure issues, such as the location of, and access to, medical resources, communication loss and mutual unease are occurring between emergency medical services and psychiatric care providers. There is also a sense of distance between mental health professionals and the general medical community; timely and functional cooperation is not the norm. Fujita Health University Hospital has an emergency medical care center and psychiatric beds. For quite some time, the hospital has been dealing with over 100 cases a year, necessitating the emergency admission of patients with mental and concomitant physical illnesses from neighboring areas. The hospital provides continuous medical care in collaboration with psychiatrists and other mental health professionals. In light of this, within the Aichi prefectural regional health-care revitalization plan from 2011, this hospital has been commissioned to provide emergency psychiatric services for concomitant physical illness. Furthermore, Fujita has been upgrading its facilities with the aim of improving its response capabilities. However, it is impossible for this hospital to accept all emergent cases with concomitant illnesses within the whole of Aichi Prefecture, which has a population of over 7 million people. Thus, this does not reflect true medical collaboration with the community. In the debate over the formulation of a health-care plan commencing in the 2013 fiscal year, the issue of concomitant illnesses was highlighted when the subject of psychiatric emergency services was raised. There is some debate regarding the level of collaboration between emergency medical services, psychiatric hospitals, and general practices, with emergency medical care centers within the prefecture as the catchment area. A specific policy measure was then developed that included the creation of model pairs to facilitate concrete and effective collaboration between emergency units and psychiatric hospitals, the building of a support system for clinical management, and putting in place mechanisms to operate the system. Such efforts will hopefully promote the collaboration between psychiatric care centers and general medical treatment geared toward local circumstances.
- Advice on Degradation Products in Pharmaceuticals: A Toxicological Evaluation. [REVIEW]
- PDA J Pharm Sci Technol 2014 5/6; 68(3):221-238.
Degradation products are unwanted chemicals that can develop during the manufacturing, transportation, and storage of drug products and can affect the efficacy of pharmaceutical products. Moreover, even small amounts of degradation products can affect pharmaceutical safety because of the potential to cause adverse effects in patients. Consequently, it is crucial to focus on mechanistic understanding, formulation, storage conditions, and packaging to prevent the formation of degradation products that can negatively affect the quality and safety of the drug product. In this sense, databases and software that help predict the reactions involving the pharmaceutically active substance in the presence of degradation conditions can be used to obtain information on major degradation routes and the main degradation products formed during pharmaceutical product storage. In some cases, when the presence of a genotoxic degradation product is verified, it is necessary to conduct more thorough assessments. It is important to consider the chemical structure to distinguish between compounds with toxicologically alerting structures with associated toxic/genotoxic risks and compounds without active structures that can be treated as ordinary impurities. Evaluating the levels of degradation products based on a risk/benefit analysis is mandatory. Controlling critical variables during early development of drug products and conducting a follow-up study of these impurities can prevent degradation impurities present at concentrations greater than threshold values to ensure product quality. The definition of the impurity profile has become essential per various regulatory requirements. Therefore, this review includes the international regulatory perspective on impurity documents and the toxicological evaluation of degradation products. Additionally, some techniquesused in the investigation of degradation products and stability-indicating assay methods are highlighted.Degradation products are impurities resulting from chemical changes that occur during drug manufacturing. They can also form during storage and transportation in response to changes in light, temperature, pH, and humidity, or due to inherent characteristics of the active pharmaceutical substance, such as their reaction with excipients or on contact with the packaging. The presence of these chemicals can affect product safety and quality. Therefore, it is necessary to know and follow the guidelines and standards regarding degradation products and existing regulatory environments to assess the toxicity and risk related to their presence in pharmaceutical products.
- Music enrichment programs improve the neural encoding of speech in at-risk children. [Journal Article]
- J Neurosci 2014 Sep 3; 34(36):11913-8.
Musicians are often reported to have enhanced neurophysiological functions, especially in the auditory system. Musical training is thought to improve nervous system function by focusing attention on meaningful acoustic cues, and these improvements in auditory processing cascade to language and cognitive skills. Correlational studies have reported musician enhancements in a variety of populations across the life span. In light of these reports, educators are considering the potential for co-curricular music programs to provide auditory-cognitive enrichment to children during critical developmental years. To date, however, no studies have evaluated biological changes following participation in existing, successful music education programs. We used a randomized control design to investigate whether community music participation induces a tangible change in auditory processing. The community music training was a longstanding and successful program that provides free music instruction to children from underserved backgrounds who stand at high risk for learning and social problems. Children who completed 2 years of music training had a stronger neurophysiological distinction of stop consonants, a neural mechanism linked to reading and language skills. One year of training was insufficient to elicit changes in nervous system function; beyond 1 year, however, greater amounts of instrumental music training were associated with larger gains in neural processing. We therefore provide the first direct evidence that community music programs enhance the neural processing of speech in at-risk children, suggesting that active and repeated engagement with sound changes neural function.
- Electronic Circular Dichroism of the Chiral Rigid Tricyclic Dilactam with Nonplanar Tertiary Amide Groups. [JOURNAL ARTICLE]
- J Phys Chem B 2014 Sep 2.
Electronic circular dichroism (ECD) of the spirocyclic dilactam 5,8-diazatricyclo[6,3,0,0(1,5)]undecane-4,9-dione has been measured in the extended wavelength range (170-260 nm) utilizing far-UV CD instrumentation including synchrotron radiation light source. The data of this model of two non-planar tertiary amide groups interacting within the rigid chiral environment provided new infor-mation particularly about the shorter wavelength π-π* transition region below 190 nm. The interpretation using TD DFT calculations confirmed that effects of amide nonplanarity follow our previous observations on monolactams as far as amide n-π* transitions are concerned. ECD band in the n-π* transition region of the nonplanar diamide exhibits an identical bathochromic shift and its sign remains tied to the sense of nonplanar deformation in the same way. As far as n-π* transitions are concerned amide nonplanarity acts as a local phenomenon independently reflecting sum properties of single amide groups. On the other hand, CD bands associated with π-π* transitions (found between ~170 to 210 nm) form an exciton-like couplet with the sign pattern determined by mutual orientation of the associated electric transition moments. This sign pattern follows predictions pertaining to a coupled oscillator. The influence of amide nonplanarity on π-π* transitions is only minor and concentrates into the shorter wavelength lobe of the π-π* couplet. The detailed analysis of experimental ECD with the aid of TD DFT calculations shows that there is only little interaction between effects of inherent chirality caused by nonplanarity of amide groups and amide-amide coupling. Consequently these two effects can be studied nearly independently using ECD. In addition, the calculations indicate that participation of other type of transitions (n-σ*, π-σ* or Rydberg type transitions) is only minor and concentrated below 180 nm.
- Corneal Sensation and Dry Eye Symptoms after Conventional versus Inverted Side-Cut Femtosecond LASIK: A Prospective Randomized Study. [JOURNAL ARTICLE]
- Ophthalmology 2014 Aug 29.
To compare corneal sensation and self-reported dry eye symptoms after femtosecond-assisted LASIK with conventional versus inverted side cuts.Prospective, randomized, eye-to-eye study.A total of 120 eyes in 60 participants with myopia.Fellow eyes were randomized to receive femtosecond-assisted LASIK with a conventional 70-degree side cut made with the 60 kHz IntraLase FS (Abbott Medical Optics, Santa Ana, CA) or an inverted 130-degree side cut made with the 150 kHz IntraLase iFS (Abbott Medical Optics). Cochet-Bonnet aesthesiometry (Luneau Ophthalmologia, Chartes, France) measured corneal sensation (60 mm = normal sensation; <60 mm = depressed sensation) preoperatively and at postoperative months 1, 3, 6, and 12. Participants also completed serial dry eye surveys using the same subscales (frequency, severity, bothersome) as the validated, Rasch-tested, linear-scaled Quality of Vision questionnaire.Objective corneal sensation and self-reported light sensitivity, dryness, foreign body sensation, and pain/discomfort.Preoperative corneal sensation as measured by mean Cochet-Bonnet aethesiometry was equal between the inverted and conventional side cut groups but was better in eyes with an inverted side cut compared with a conventional side cut at all postoperative months (inverted vs. conventional: 1 month, 14.5 vs. 13.2 mm; 3 months, 24.9 vs. 18.4 mm; 6 months, 51.2 vs. 42.6 mm; 12 months, 59.8 vs. 58.3 mm; all P ≤ 0.02). None of the subjective dry eye parameters demonstrated statistically significant differences between the groups at any time point.The LASIK flaps with an inverted side cut are associated with superior recovery of corneal sensation compared with flaps with a conventional side cut during the first postoperative year; however, this may not translate to significant improvements in subjective dry eye symptoms.