VESTIBULAR DYSFUNCTIONS IN CHRONIC BRAIN ISCHEMIA IN THE POST COVID PERIOD.

OBJECTIVE: The aim: The aim of the study is the clinical-pathogenetic reasoning of vestibular dysfunctions (VD) development against the background of chronic brain ischemia in the presence of degenerative changes in the cervical spine (CS) in the post COVID period. PATIENTS AND METHODS: Materials and methods: 82 patients, in the conditions of the clinical base of the Odessa National Medical University in 2019-2021 were examined. Group I with VD against the background of chronic brain ischemia (CBI) at the compensated phase; Group II with VD against the background of CBI at the subcom¬pensated phase (33 men; 49 women), aged from 18 to 55 years. The control group (CG) consisted of 20 patients of the corresponding gender and age. The condition of the state of the autonomic nervous system, vestibular functions, cervical spine, cerebral arteries and emotional condition were examined. RESULTS: Results: Vestibulo-ataxic disorders were higher compared to CG and increased along with the degree of brain damage. An important aspect of the development of VD is autonomic dysfunction against the background of pathological autonomic characteristics with predominant parasympathetic orientation of autonomic tone, especially in the case of insufficiency of autonomic recativity (AR) and pathological autonomic support of activity. Such changes significantly increased in the presence of subcompensation of CBI. The correlation between psychoemotional disorders and changes in autonomic characteristics with VD against the background of CBI with initial regularities depending on the degree of brain damage was defined. The progression of CBI is facilitated by coronavirus infection and manifested in autonomic and psychoemotional dysfunctions. A characteristic hemodynamic feature in groups with compensated and subcompensated CBI is the presence of reduced perfusion in basilar (BA) and vertebral (VA) arteries. Changes in cerebral vascular reactivity with a decrease in cerebrovascular reactivity indicators were characteristic of the subcompensated phase of CBI. Hyperactivity to rotational functional loads in both clinical groups has a high correlation with the presence of stair descent and, to a lesser extent, isolated instability in CS. CONCLUSION: Conclusions: 1. The occurrence of VD is facilitated by the presence of autonomic dysfunction and degenerative-dystrophic changes in the CS, especially in case of subcompensation of CBI. 2. Psychoemotional changes were a characteristic feature of patients with VD against the background of CBI and had certain regularities depending on the phase of CBI. 3. Suffered coronavirus infection contributes to the progression of VD and further decompensation of CBI due to direct damage to the autonomic and vascular systems of the brain. 4. Changes in cerebral hemodynamics in the form of reduced perfusion in BA and VA, a decrease in cerebrovascular reactivity, and an increase in reactivity to rotational functional load were determined in patients with VD against the background of subcompensated CBI.

Impact of the COVID pandemic on emergency department CT utilization: where do we go from here?

PURPOSE: To analyze the impact of the coronavirus disease (COVID) pandemic on emergency department (ED) computed tomography (CT) utilization. METHODS: A retrospective observational study was conducted assessing seven hospitals' ED imaging volumes between Jan. 6, 2019, and Feb. 27, 2021. Weekly CT utilization is reported as CTs ordered per 100 ED visits. Utilization was ascertained in aggregate and by body area. Interrupted time series analysis was performed to assess significance of utilization change. Prespecified sensitivity analysis was performed for influenza-like or COVID-like illness (ILI/CLI). RESULTS: Weekly ED CT utilization increased from 35.9 CTs per 100 visits (95% confidence interval [95% CI] 35.8-36.1) to 41.8 per 100 visits (95% CI 41.7-42.0) in pre- and post-pandemic periods. Weekly ED CT chest utilization increased immediately following the pandemic declaration (+ 0.52 chest CTs per 100 ED visits, 95% CI 0.01-1.03, p < 0.05) and compared to pre-pandemic period (+ 0.02 per 100 ED visits, 95% CI 0.02-0.05, p < 0.02). For both CT abdomen/pelvis and CT head, there was neither an immediate effect (+ 0.34 CT-AP per 100 ED visits, 95% CI - 0.74 to 1.44, p = 0.89; - 0.42 CT-H per 100 ED visits, 95% CI - 1.53 to 0.70, p = 0.46) nor a change in weekly CT utilization (+ 0.03 CT-AP per 100 ED visits, 95% CI - 0.01 to 0.05, p = 0.09; + 0.03 CT-H per 100 ED visits, 95% CI - 0.01 to 0.06, p = 0.10).  CONCLUSION: These data may help formulate future strategies for resource utilization and imaging operations as we envision a future with COVID and other federal mandates affecting imaging utilization and appropriateness.

Developing a voluntary initiative for homeless populations in general dental practice.

The number of people experiencing homelessness is increasing in the UK and their access to general dental services is particularly challenging. This is often due to the numerous barriers that homeless populations face in accessing dental services. In this article, we provide information about a voluntary dental initiative that was set up in 2020 to cater to the needs of homeless populations. We give details of how this initiative started, reasons for attendance and services provided, collaborations, financial considerations and ways in which additional support is provided to patients. We end this article by outlining our key learning points, positive impacts of the initiative and a conclusion/summary of future plans.

That person is now with or without a mask: how encoding context modulates identity recognition.

Previous research has mostly approached face recognition and target identification by focusing on face perception mechanisms, but memory mechanisms also appear to play a role. Here, we examined how the presence of a mask interferes with the memory mechanisms involved in face recognition, focusing on the dynamic interplay between encoding and recognition processes. We approach two known memory effects: (a) matching study and test conditions effects (i.e., by presenting masked and/or unmasked faces) and (b) testing expectation effects (i.e., knowing in advance that a mask could be put on or taken off). Across three experiments using a yes/no recognition paradigm, the presence of a mask was orthogonally manipulated at the study and the test phases. All data showed no evidence of matching effects. In Experiment 1, the presence of masks either at study or test impaired the correct identification of a target. But in Experiments 2 and 3, in which the presence of masks at study or test was manipulated within participants, only masks presented at test-only impaired face identification. In these conditions, test expectations led participants to use similar encoding strategies to process masked and unmasked faces. Across all studies, participants were more liberal (i.e., used a more lenient criterion) when identifying masked faces presented at the test. We discuss these results and propose that to better understand how people may identify a face wearing a mask, researchers should take into account that memory is an active process of discrimination, in which expectations regarding test conditions may induce an encoding strategy that enables overcoming perceptual deficits.

Masked face identification is improved by diagnostic feature training.

To slow the spread of COVID-19, many people now wear face masks in public. Face masks impair our ability to identify faces, which can cause problems for professional staff who identify offenders or members of the public. Here, we investigate whether performance on a masked face matching task can be improved by training participants to compare diagnostic facial features (the ears and facial marks)-a validated training method that improves matching performance for unmasked faces. We show this brief diagnostic feature training, which takes less than two minutes to complete, improves matching performance for masked faces by approximately 5%. A control training course, which was unrelated to face identification, had no effect on matching performance. Our findings demonstrate that comparing the ears and facial marks is an effective means of improving face matching performance for masked faces. These findings have implications for professions that regularly perform face identification.

A retrospective analysis comparing set up errors from standard versus customised headrests for head and neck radiotherapy.

INTRODUCTION: In response to advice from The National Institute for Health and Care Excellence (1) to reduce hospital visits during COVID-19, standard headrests were introduced for head and neck radiotherapy within Northern Centre for Cancer Care (NCCC). The standard headrest requires one mould room appointment compared to 3 appointments with customised headrests. METHODS: Two groups of 10 patients treated between December 2019 and June 2020 were retrospectively analysed by 1 observer. Groups were stratified according to age, sex and tumour site. One group had customised headrest and the other had standard headrest. Five hundred and forty seven cone beam computed tomography images were reviewed. A 6 Degree of Freedom match was performed then chin, shoulder and spine position were assessed using dosimetrist drawn structures. Structures out of the tolerance were recorded. A chi-squared test was used for statistical analysis. RESULTS: The out of tolerance chin position count recorded was 21 for customised headrest and 36 for standard headrest, p-value 0.046. The shoulder position count was 13 for customised headrest and 77 for standard headrest p-value <0.001. The spine position count was 3 for CHR and 21 for standard headrest, p-value <0.001. This means the headrests compared are not equivalent in terms of set up reproducibility. Overall the standard headrest group had 10 set-up re-scans and no set up re-scans were recorded in the customised headrest group. CONCLUSION: Fewer hospital visits with SHR reduce patient exposure to COVID-19. However, CHR provided a more reliable level of immobilisation in this study. IMPLICATIONS FOR PRACTICE: The radiotherapy service will be reviewed in line with these findings.

Real-Time Gender Recognition for Juvenile and Adult Faces.

Facial gender recognition is a crucial research topic due to its comprehensive use cases, including a demographic gender survey, visitor profile identification, targeted advertisement, access control, security, and surveillance from CCTV. For these real-time applications, the face of a person can be oriented to any angle from the camera axis, and the person can be of any age group, including juveniles. A child's face consists of immature craniofacial feature points in texture and edge compared to an adult face, making it very hard to recognize gender using the child's face. Real-word faces captured in an unconstrained environment make the gender prediction system more complex to identify correctly due to orientation. These factors reduce the accuracy of the existing state-of-the-art models developed so far for real-time facial gender prediction. This paper presents the novelty of facial gender recognition for juveniles, adults, and unconstrained-oriented faces. The progressive calibration network (PCN) detects rotation-invariant faces in the proposed model. Then, a Gabor filter is applied to extract unique edge and texture features from the detected face. The Gabor filter is invariant to illumination and produces texture and edge features with redundant feature coefficients in large dimensions. Gabor has drawbacks such as redundancy and a large dimension resolved by the proposed meanDWT feature optimization method, which optimizes the system's accuracy, the size of the model, and computational timing. The proposed feature engineering model is classified with different classifiers such as Naïve Bayes, Logistic Regression, SVM with linear, and RBF kernel. Its results are compared with the state-of-the-art techniques; detailed experimental analysis is presented and concluded to support the argument. We also present a review of approaches based on conventional and deep learning methods with their pros and cons for facial gender recognition on different datasets available for facial gender recognition.

Properties and Characteristics of Three-Dimensional Printed Head Models Used in Simulation of Neurosurgical Procedures: A Scoping Review.

BACKGROUND: Intracranial surgery can be complex and high risk. Safety, ethical and financial factors make training in the area challenging. Head model 3-dimensional (3D) printing is a realistic training alternative to patient and traditional means of cadaver and animal model simulation. OBJECTIVE: To describe important factors relating to the 3D printing of human head models and how such models perform as simulators. METHODS: Searches were performed in PubMed, the Cochrane Library, Scopus, and Web of Science. Articles were screened independently by 3 reviewers using Covidence software. Data items were collected under 5 categories: study information; printers and processes; head model specifics; simulation and evaluations; and costs and production times. RESULTS: Forty articles published over the last 10 years were included in the review. A range of printers, printing methods, and substrates were used to create head models and tissue types. Complexity of the models ranged from sections of single tissue type (e.g., bone) to high-fidelity integration of multiple tissue types. Some models incorporated disease (e.g., tumors and aneurysms) and artificial physiology (e.g., pulsatile circulation). Aneurysm clipping, bone drilling, craniotomy, endonasal surgery, and tumor resection were the most commonly practiced procedures. Evaluations completed by those using the models were generally favorable. CONCLUSIONS: The findings of this review indicate that those who practice surgery and surgical techniques on 3D-printed head models deem them to be valuable assets in cranial surgery training. Understanding how surgical simulation on such models affects surgical performance and patient outcomes, and considering cost-effectiveness, are important future research endeavors.

Head and neck lymphoedema-research challenges during the COVID-19 pandemic.

Management of secondary head and neck lymphoedema has undergone little research investigation. Its treatment is time and labour intensive and involves multiple therapeutic modalities without a clear understanding of which is most effective. This study aimed to determine the feasibility of a randomised controlled trial comparing two therapeutic modalities to manage head and neck lymphoedema. The secondary objective was to evaluate the clinical effects of these treatments. Participants were randomised to receive treatment with manual lymphatic drainage or compression over 6 weeks, with the primary outcome-percentage tissue water-measured 12 weeks after treatment. Six participants were recruited until the study was ceased due to restrictions imposed by the COVID-19 pandemic. Some 86% of required attendances were completed. Percentage tissue water increased in all participants at 12 weeks. No consistent trends were identified between internal and external lymphoedema. The small number of people recruited to this study informs its feasibility outcomes but limits any conclusions about clinical implications.