Urticaria After Lidocaine Use for Pecto-Intercostal Nerve Block.

Urticaria within one hour of lidocaine injection is a sign of type I (immediate) hypersensitivity to lidocaine, yet most patients suspected of having a lidocaine allergy do not exhibit urticaria. Aside from being a sign of a rare lidocaine allergy, urticaria can also be a symptom of COVID-19. COVID-19 patients who experience urticaria after receiving lidocaine require careful evaluation to determine the cause. Here, we present a case of a patient exhibiting urticaria one hour after a lidocaine injection for the Pecto-intercostal nerve block to treat COVID-19-induced costochondritis.

A review of web-based application of online learning in pathology and laboratory medicine.

Web-based learning applications can support health sciences education, including knowledge acquisition in pathology and laboratory medicine. Websites can be developed to provide learning content, assessments, and products supporting pathology education. In this paper, we review informatics principles, practices, and procedures involved with educational website development in the context of existing websites and published studies of educational website usage outcomes, including that of the authors. We provide an overview with analysis of potential results of usage to inform how such websites may be used, and to guide further development. We discuss the value of educational websites for individual users, educational institutions, and professional organizations. Educational websites may offer assessments that are formative, for learning itself, as practice, preparation, and self-assessment. Open access websites have the advantage of worldwide availability 24/7, particularly aiding persons in low resource settings. Commercial offerings for educational support in formal curricula are beyond the scope of this review. This review is intended to guide those interested in website development to support non-commercial educational purposes for users seeking to improve their knowledge and diagnostic skills supporting careers in pathology.

Flexible constraint hierarchy during the visual encoding of tool-object interactions.

Tools and objects are associated with numerous action possibilities that are reduced depending on the task-related internal and external constraints presented to the observer. Action hierarchies propose that goals represent higher levels of the hierarchy while kinematic patterns represent lower levels of the hierarchy. Prior work suggests that tool-object perception is heavily influenced by grasp and action context. The current study sought to evaluate whether the presence of action hierarchy can be perceptually identified using eye tracking during tool-object observation. We hypothesize that gaze patterns will reveal a perceptual hierarchy based on the observed task context and grasp constraints. Participants viewed tool-objects scenes with two types of constraints: task-context and grasp constraints. Task-context constraints consisted of correct (e.g., frying pan-spatula) and incorrect tool-object pairings (e.g., stapler-spatula). Grasp constraints involved modified tool orientations, which requires participants to understand how initially awkward grasp postures can help achieve the task. The visual scene contained three areas of interests (AOIs): the object, the functional tool-end (e.g., spoon handle) and the manipulative tool-end (e.g., spoon bowl). Results revealed two distinct processes based on stimuli constraints. Goal-oriented encoding, the attentional bias towards the object and manipulative tool-end, was demonstrated when grasp did not lead to meaningful tool-use. In images where grasp postures were critical to action performance, attentional bias was primarily between the object and functional tool-end, which suggests means-related encoding of the graspable properties of the object. This study expands from previous work and demonstrates a flexible constraint hierarchy depending on the observed task constraints.

Implicit development of gaze strategies support motor improvements during action encoding training of prosthesis use.

BACKGROUND: Action observation training has been suggested to facilitate motor improvements in the lives of persons with neural injury. Previous studies have shown that for persons with upper limb amputation, matched limb training, where prosthesis users emulate each other, has shown promise above mismatched training where a prosthesis user emulates actions of a person with sound limbs (most commonly that of a therapist). OBJECTIVE: The mechanism underlying the matched limb training benefit is unclear. Gaze strategies may reveal unique patterns between matched and mismatched training which could explain improvements in motor function in matched limb training. METHODS: Twenty persons with sound limbs were trained on how to use a prosthesis simulator using matched or mismatched limb training in a single session. Eye movements were recorded during the training phase. Kinematics were recorded as persons performed the task. RESULTS: Gaze patterns showed differences between the training groups. The mismatched group demonstrated a higher probability of gaze on the path between the start and end of the action, while the matched group demonstrated a significantly higher probability of focusing on the elements of the path of the action and a trend of focusing on the shoulders. Kinematics also revealed overall improvements in motor control for the matched group. CONCLUSIONS: This study proposes a putative mechanism that may explain improvements in matched limb training through shifting gaze strategies. Further work is needed to understand whether implicit visual strategies seen during matched limb training might encourage motor learning during functional training with prostheses.