Cultural bias: a comparison of semantic responses by 126 students from Pakistan and the United Kingdom to a wheelchair when viewed against a congruent and incongruent background.

PURPOSE: Converging visual behavioural and attentional allocation studies within neuroscience have shown culture influences the processing of visual information obtained from the visual field. While attending (reviewing) a visual scene, individuals from a collectivist culture attend more to the context (background) compared to those from an individualist culture who view more the focal object. This highlights the effect of cultural conditioning in terms of holistic and analytical processing of visual information. This study aimed to demonstrate these principles in the context of an assistive product, a wheelchair, highlighting the key visual elements of the form; and, how a congruent background (hospital room) or incongruent (athletics track) influenced cultural bias during visual processing and assigned meaning. MATERIAL AND METHODS: A combination of research methods (Semantic Differential Scale and eye-tracking) was used to triangulate the results. A total of 126 adult student participants, (Pakistani/collectivist, n = 57) and the (UK/individualist, n = 69), viewed a visual presentation of a wheelchair with semantically congruent and then an incongruent background and responded via an online questionnaire. A sub-sample completed the survey whilst monitored via eye-tracking. RESULTS: Pakistani respondents used shorter and less frequent fixations on the foreground compared to the responses of their counterparts (UK respondents). The wheel of the wheelchair was highlighted as the prominent form by both groups. CONCLUSION: Results demonstrate a culture-influenced pattern of visual processing even when the product was displayed against a semantically incongruent background. The findings from this study also validate and extend the outcomes of similar studies revealing a more specific, yet consistent, cultural effect on individuals' visual perception. Finally, the efficacy of triangulated research methods in their relationship to exploring the AT product's semantics was discussed.IMPLICATIONS FOR REHABILITATIONThe knowledge of AT products' semantics will be significant to investigate, for their improved social acceptance, particularly when considered from a diverse cultural standpoint.A model of best practice, focussing on semantics manipulation, will provide AT product designers, practitioners, and those involved in their marketing, Internationally, with a suitable process/tool to positively reframe the perception of these devices.Finally, this research will help product and industrial designers to consider cultural cognitive styles in the design of products for the better adoption of products within the global marketplace.

20 years of the Loughborough user centered assistive technology design process: has it made a difference?

An estimated 518 students were taught the Loughborough User Centered Assistive Technology design process, LUCAT, since 2000. Graduates were contacted via a professional networking website to take part in a survey with four being interviewed. The purpose of the survey was to find out if: 1) Did they still use any parts of the process; and 2) Where they had applied them. The respondents ranged from returning placement undergraduates to senior managers in research and development within major companies. From the 105 respondents 23% stated they used parts of the LUCAT process every working day, a further 25% once a week and 27% once a month. The elements of the process used were predominantly semi-structured interviews, concept generation, codesign, design presentation and feedback. Respondents highlighted the benefits of using this process including gaining insights from users, being time efficient, saving money, developing a relationship with end users and making a difference to the lives of people with disability. It was suggested some industries had still not incorporated a User Centered Design approach within New Product Development. The use of the process was shown to be useful beyond AT product design into most areas of design activity.

Contribution of Various Types of Transfusion to Acute and Delayed Intracerebral Hemorrhage Injury.

Intracerebral hemorrhage (ICH) is the second most prevalent type of stroke, after ischemic stroke, and has exceptionally high morbidity and mortality rates. After spontaneous ICH, one primary goal is to restrict hematoma expansion, and the second is to limit brain edema and secondary injury. Various types of transfusion therapies have been studied as treatment options to alleviate the adverse effects of ICH etiopathology. The objective of this work is to review transfusions with platelets, fresh frozen plasma (FFP), prothrombin complex concentrate (PCC), and red blood cells (RBCs) in patients with ICH. Furthermore, tranexamic acid infusion studies have been included due to its connection to ICH and hematoma expansion. As stated, the first line of therapy is limiting bleeding in the brain and hematoma expansion. Platelet transfusion is used to promote recovery and mitigate brain damage, notably in patients with severe thrombocytopenia. Additionally, tranexamic acid infusion, FFP, and PCC transfusion have been shown to affect hematoma expansion rate and volume. Although there is limited available research, RBC transfusions have been shown to cause higher tissue oxygenation and lower mortality, notably after brain edema, increases in intracranial pressure, and hypoxia. However, these types of transfusion have varied results depending on the patient, hemostasis status/blood thinner, hemolysis, anemia, and complications, among other variables. Inconsistencies in published results on various transfusion therapies led us to review the data and discuss issues that need to be considered when establishing future guidelines for patients with ICH.

A Systematic Review of Biosynthesized Metallic Nanoparticles as a Promising Anti-Cancer-Strategy.

Cancer is one of the foremost causes of death worldwide. Cancer develops because of mutation in genes that regulate normal cell cycle and cell division, thereby resulting in uncontrolled division and proliferation of cells. Various drugs have been used to treat cancer thus far; however, conventional chemotherapeutic drugs have lower bioavailability, rapid renal clearance, unequal delivery, and severe side effects. In the recent years, nanotechnology has flourished rapidly and has a multitude of applications in the biomedical field. Bio-mediated nanoparticles (NPs) are cost effective, safe, and biocompatible and have got substantial attention from researchers around the globe. Due to their safe profile and fewer side effects, these nanoscale materials offer a promising cure for cancer. Currently, various metallic NPs have been designed to cure or diagnose cancer; among these, silver (Ag), gold (Au), zinc (Zn) and copper (Cu) are the leading anti-cancer NPs. The anticancer potential of these NPs is attributed to the production of reactive oxygen species (ROS) in cellular compartments that eventually leads to activation of autophagic, apoptotic and necrotic death pathways. In this review, we summarized the recent advancements in the biosynthesis of Ag, Au, Zn and Cu NPs with emphasis on their mechanism of action. Moreover, nanotoxicity, as well as the future prospects and opportunities of nano-therapeutics, are also highlighted.

Arsenic exposure through drinking groundwater and consuming wastewater-irrigated vegetables in Multan, Pakistan.

Arsenic (As) is one of the most toxic metalloids for humans. Above permissible levels of As cause severe health implications. Contaminated drinking water and food items may be the leading sources of As exposure to people all around the world. The current study assessed the levels of As in drinking water, vegetables, irrigation water, agricultural soils, and the human population (adult women and men) of rural and peri-urban areas of Multan (Pakistan). For a comparison between peri-urban (exposed site) and rural areas (control site), we sampled irrigation water, vegetables and vegetable-grown soils, drinking water, and human blood. In all sample types, As concentration was significantly higher at exposed site than at control site. Alarmingly, As concentration in drinking groundwater (34 µg As L-1) of exposed site was 3.4-folds higher than the permissible limit (set by WHO). Among the studied vegetables, the cumulative daily dietary intake of As was recorded maximum by the consumption of okra (474 ng d-1 on exposed site) and minimum by long melon (1 ng d-1 on control site). However, As intake via drinking water was estimated to contribute ≥ 98% of total As intake at both sites. Hence, the health risks associated with drinking As-contaminated groundwater were recorded much higher than the health risks associated with the consumption of As-contaminated vegetables. Blood As levels in most of the subjects at exposed site exceeded the safe limit of 12 µg L-1. Conclusively, the findings of the current study indicated that drinking contaminated groundwater may be the major cause of As-associated health risks in the region.

The influence of social context on the perception of assistive technology: using a semantic differential scale to compare young adults' views from the United Kingdom and Pakistan.

Background and aim: A Society's view of disability may influence the perception and use of Assistive Technology (AT) products. Semantic cues or cultural coding provide the viewer with a series of visual stimuli to be given or ascribed meaning. Previous research has shown cognitive approaches to visual perception and assignment of meaning vary between diverse cultures. This study reviews the influence of contextual settings on perception, to provide the basis for a debate on the societal perception of communicative content (semantic/meaning) of an AT product; and, the relevance of different cultural cognitive styles. The paper explores, from a cultural viewpoint, the overall understanding of disability internationally.Method: A Semantic Differential (SD) scale was used to obtain views on the image of an attendant wheelchair from nine hundred and ninety-one (991) young adults from the United Kingdom (UK) and Pakistan (PAK), reflecting the individualist and collectivist societies, respectively. This survey follows a previous paper-based study using the same image and protocol. Comparing the two surveys, a consensus of views from the two groups was achieved.Results and conclusion: The responses from the UK group were skewed towards a negative view of disability compared to the Pakistan group. This inferred greater social stigma associated with this AT product in the UK. The combined findings from both surveys provide insights into societal perception of AT products and disability. Areas for future research are suggested, including what visual components of an AT product (graphemes) appear to be associated with positive or negative responses for collectivist and individual societal groups.Implications for rehabilitationAssistive Technology (AT) product designers, academics, professionals and stakeholders need to be aware of challenges which are originated from one's socio-cultural environment. AT products convey certain meanings, semantics, which are interpreted by the society and are subjective to a specific cultural setting.•For the effective communication of meanings and values an AT product relies on the visual clues and design features embedded within the design. However, there have been a limited number of studies reviewing this aspect of product semantics.•The survey and associated testing has highlighted the differences in cultural perception towards AT products and demonstrated the importance of effectively designing the semantic attributes of an AT product as well as its function.•The demonstration of the efficacy of methods within the study for exploring the interpretation of semantic attributes of AT products will help designers and developers better understand the perceptions of individual cultures and societal groups.•A better understanding of different cultures and societies will enable designers and clinicians who specify AT products to reduce AT product abandonment; and, the associated stigma around disability.

Cultural influences on perception of disability and disabled people: a comparison of opinions from students in the United Kingdom (UK) Pakistan (PAK) about a generic wheelchair using a semantic differential scale.

Assistive Technology (AT) product use occurs within a socio-cultural setting. The growth internationally in the AT product market suggests that designers need to be aware of the influences that diverse cultures may have on the societal perception of an AT product through its semantic attributes. The study aimed to evaluate the visual interaction with an AT product by young adults from Pakistan, a collectivist society, and the United Kingdom (UK), an individualist society. A paper-based questionnaire survey was carried out with 281 first-year undergraduate students from the UK and Pakistan to evaluate their perception towards the visual representation of a generic conventional wheelchair image. A semantics differential (SD) scale method was used involving a seven-point bipolar SD scale incorporating sixteen pairs of adjectives defining functional, meaning, and usability attributes of the product. The mean (M) and standard deviation (sd) values were obtained for each pair of adjectives and compared between both groups by employing appropriate parametric tests. The results show that having a diverse cultural background did not appear to have overtly influenced the meanings ascribed to the generic manual wheelchair, which was unexpected. The University 'Internationalist' environment may have influenced the results. Some minor but critical differences were found for some pairs of adjectives (bulky-compact, heavy-light), having p-value less than .05 (p < .05) that related to previous experience of wheelchairs and/or their use. Further studies are planned to investigate and validate outcomes with other student and non-student groups.Implications for RehabilitationThe semantic attributes of assistive technologies highlight a number of aspects that have implications for those involved in Assistive Technology (AT) product development, manufacturing and marketing.• For online sales, the AT products rely on the web page image to communicate the purpose and attributes of the product. There are limited explorations related to the semantic/communicative attributes of AT product presented in images, as perceived by individuals from diverse cultural backgrounds.• The knowledge towards semantic meaning ascribed to the AT product is important to investigate to provide a perspective that goes beyond practical functions of the AT product towards the communicative function.• Information of comprehending semantics and significance of the AT product from a social (non-users) viewpoint may benefits manufacturers in the development of AT products that best meet the societal needs, preferences and expectations.• A model of best practice, with a focus on semantic manipulation will offer Industrial Designers (ID) internationally with the suitable process and tools to reframe perceptions of disability and enhance acceptance of AT products not only for users, but also for the society around them.

Use of 'Trocar Site Closure Device' for Frontalis Brow Suspension.

Ptosis correction by Fox Pentagon technique of frontalis brow suspension, using 'trocar site closure device' for placement of banked fascia lata is presented. The use of this device was found to be safe, secure, smooth, and stable. It has a gently tapered cutting upper edge and a blunt front, and is less traumatic as compared to the conventional Wright's fascia needle or the 18 gauge needle which are sharper and could cause an inadvertent and relatively more damage to the eyelids' delicate tissues. The surgery can be performed quickly with this single-use device and it provides a good grasp for holding the fascia lata during the manoeuvres, forming the desired pentagon.

Peripheral ulcerative keratitis: Our challenging experience.

A 52 year old male presented with peripheral ulcerative keratitis in the right eye. Patient's history included retinitis pigmentosa, pseudophakia (right eye), cataract (left eye), bilateral partial deafness, ischemic heart disease, hypertension, type 1 diabetes mellitus, depression, hyperparathyroidism, hypertriglycemia and renal failure. The patient was on weekly hemodialysis. The peripheral corneal ulceration remained stable until he developed sudden and rapid thinning after eight months of regular follow up and management. Laboratory investigations including immunological studies were negative and we had to rely on treatment based on clinical signs, including the visual acuity, size, depth and staining of the ulcer and perilimbal, episcleral, scleral, corneal and anterior chamber reactions. The patient was treated with medical and conservative approaches and the eye was protected with a plastic shield to avoid injury. Despite our efforts, the patient perforated his eye due to a trivial trauma during sleep. He was managed successfully with cyanoacrylate glue and a bandage contact lens. The anterior chamber reformed after the perforation was sealed and the patient is on a regular follow up with a multidisciplinary approach.

Nocardia canaliculitis presenting as pouted punctum.

A rare case of culture-positive Nocardia canaliculitis is reported that presented with a history of chronic conjunctivitis and epiphora for the last 1.4 years, refractory to multiple treatment courses. Chronic conjunctivitis and a pouted punctum were observed in the right lower eyelid. Probing and sac syringing was performed. The "Sulfur granules" were expressed and subjected to various microbiological analyses. Nocardia sp was grown on culture. The patient was successfully managed with surgical removal of concretions and topical/systemic antibiotics.