Red and green defocus curves and duochrome test in different age groups / Curvas de desenfoque rojo y verde y prueba de duocromo en diferentes grupos de edad

Purpose: To compare the eye defocus curves (DCs) obtained with stimuli on red, green, and white backgrounds and to investigate the applicability of the duochrome test (DT) in different age groups. Methods: 12 elderly (ELD: 59.3 ± 3.9 years) and 8 young (YG: 22.1 ± 1.1 years) subjects were recruited. An optometric assessment with the DT was carried out to obtain the subjective refraction at distance. DCs at distance on green, white, and red backgrounds were measured and the following parameters were deduced: dioptric difference between red-green, green-white, red-white focal positions (minima of the DCs), best corrected visual acuity (BCVA), and widths of the DCs for red, green, and white. Results: The DC difference between the green-white focal positions (mean ± standard deviation) was -0.12±0.17 diopters (D) (ELD, p = 0.012) and -0.11±0.12 D (YG, p = 0.039), while the red-white difference was not statistically significant. The DC red-green difference was 0.20±0.16 D (ELD, p = 0.002) and 0.18±0.18 D (YG, p = 0.008). The ELD BCVA with green background was significantly worse than BCVA with red (p = 0.007) and white (p = 0.007). The mean value of the DC's width in ELD for green (1.01±0.36 D) was higher than for red (0.77±0.21 D) and for white (0.84±0.35 D), but with no statistical significance. Conclusion: Both age groups showed a slight focusing preference for red when using white light. Moreover, ELD showed a worse BCVA with a green compared to a red background. Despite these results deduced by DC analyses, these aspects do not compromise the possibility of using the DT in clinical practice both in the young and in the elderly. Furthermore, the difference of about 0.20 D between red-green DC in both groups confirms the clinical appropriateness of the widespread use of 0.25 D step as the standard minimum difference in power between correcting lenses.(AU)

Assessing the role of visual dysfunctions in the association between visual symptomatology and the use of digital devices / Evaluación del papel de las disfunciones visuales en la asociación entre la sintomatología visual y el uso de dispositivos digitales

Purpose: To evaluate the association between visual symptoms and use of digital devices considering the presence of visual dysfunctions. Methods: An optometric examination was conducted in a clinical sample of 346 patients to diagnose any type of visual anomaly. Visual symptoms were collected using the validated SQVD questionnaire. A threshold of 6 hours per day was used to quantify the effects of digital device usage and patients were divided into two groups: under and above of 35 years old. A multivariate logistic regression was employed to investigate the association between digital device use and symptoms, with visual dysfunctions considered as a confounding variable. Crude and the adjusted odds ratio (OR) were calculated for each variable. Results: 57.02 % of the subjects reported visual symptoms, and 65.02% exhibited some form of visual dysfunction. For patients under 35 years old, an association was found between having visual symptoms and digital device use (OR = 2.10, p = 0.01). However, after adjusting for visual dysfunctions, this association disappeared (OR = 1.44, p = 0.27) and the association was instead between symptoms and refractive dysfunction (OR = 6.52, p < 0.001), accommodative (OR = 10.47, p < 0.001), binocular (OR = 6.68, p < 0.001) and accommodative plus binocular dysfunctions (OR = 46.84, p < 0.001). Among patients over 35 years old, no association was found between symptoms and the use of digital devices (OR = 1.27, p = 0.49) but there was an association between symptoms and refractive dysfunction (OR = 3.54, p = 0.001). Conclusions: Visual symptoms are not dependent on the duration of digital device use but rather on the presence of any type of visual dysfunction: refractive, accommodative and/or binocular one, which should be diagnosed.(AU)

Asymmetry of the Subjective Visual Vertical in Patients With Unilateral Peripheral Vestibular Deficit.

BACKGROUND AND OBJECTIVES: Perception of verticality is clinically assessed using the subjective visual vertical (SVV), a test of the otolith system that consists of aligning a bar on the gravitational vertical in darkness. Patients with acute unilateral vestibulopathy (AUVP) show a systematic SVV bias toward the affected side, whichever the side of line orientation. Whether SVV estimates are symmetrical has not been investigated. SUBJECTS AND METHODS: This study included 10 patients with AUVP (vestibular neuritis) and 10 with BPPV (posterior semicircular canal). SVV measurements were made at two preset angles of line orientation (15° and 30°) toward the ipsilateral and contralateral sides, relative to the affected side. RESULTS: The results showed asymmetrical SVV estimates in the AUVP group, with significantly greater SVV errors for ipsilateral than contralateral line orientation, as well as for the preset angle of 30° compared to 15°. SVV estimates were significantly lower in patients with BPPV who also exhibited SVV asymmetry. SVV estimates remained unchanged just after the maneuver and were normalized some days later or after supplementary maneuvers. CONCLUSIONS: SVV asymmetry should be routinely considered in the clinic. We recommend individually assessing ipsilateral and contralateral SVV and using at least two preset angles. This allows for a better assessment and diagnosis of otolith organ imbalance that can trigger chronic instability and dizziness. The contribution of neck afferents related to head position in space seems to be the main source of SVV asymmetry.

The artistic image processing for visual healing in smart city.

This study investigates the processing methods of artistic images within the context of Smart city (SC) initiatives, focusing on the visual healing effects of artistic image processing to enhance urban residents' mental health and quality of life. Firstly, it examines the role of artistic image processing techniques in visual healing. Secondly, deep learning technology is introduced and improved, proposing the overlapping segmentation vision transformer (OSViT) for image blocks, and further integrating the bidirectional long short-term memory (BiLSTM) algorithm. An innovative artistic image processing and classification recognition model based on OSViT-BiLSTM is then constructed. Finally, the visual healing effect of the processed art images in different scenes is analyzed. The results demonstrate that the proposed model achieves a classification recognition accuracy of 92.9% for art images, which is at least 6.9% higher than that of other existing model algorithms. Additionally, over 90% of users report satisfaction with the visual healing effects of the artistic images. Therefore, it is found that the proposed model can accurately identify artistic images, enhance their beauty and artistry, and improve the visual healing effect. This study provides an experimental reference for incorporating visual healing into SC initiatives.

Optimal gamma-band entrainment of visual cortex.

Visual entrainment is a powerful and widely used research tool to study visual information processing in the brain. While many entrainment studies have focused on frequencies around 14-16 Hz, there is renewed interest in understanding visual entrainment at higher frequencies (e.g., gamma-band entrainment). Notably, recent groundbreaking studies have demonstrated that gamma-band visual entrainment at 40 Hz may have therapeutic effects in the context of Alzheimer's disease (AD) by stimulating specific neural ensembles, which utilize GABAergic signaling. Despite such promising findings, few studies have investigated the optimal parameters for gamma-band visual entrainment. Herein, we examined whether visual stimulation at 32, 40, or 48 Hz produces optimal visual entrainment responses using high-density magnetoencephalography (MEG). Our results indicated strong entrainment responses localizing to the primary visual cortex in each condition. Entrainment responses were stronger for 32 and 40 Hz relative to 48 Hz, indicating more robust synchronization of neural ensembles at these lower gamma-band frequencies. In addition, 32 and 40 Hz entrainment responses showed typical patterns of habituation across trials, but this effect was absent for 48 Hz. Finally, connectivity between visual cortex and parietal and prefrontal cortices tended to be strongest for 40 relative to 32 and 48 Hz entrainment. These results suggest that neural ensembles in the visual cortex may resonate at around 32 and 40 Hz and thus entrain more readily to photic stimulation at these frequencies. Emerging AD therapies, which have focused on 40 Hz entrainment to date, may be more effective at lower relative to higher gamma frequencies, although additional work in clinical populations is needed to confirm these findings. PRACTITIONER POINTS: Gamma-band visual entrainment has emerged as a therapeutic approach for eliminating amyloid in Alzheimer's disease, but its optimal parameters are unknown. We found stronger entrainment at 32 and 40 Hz compared to 48 Hz, suggesting neural ensembles prefer to resonate around these relatively lower gamma-band frequencies. These findings may inform the development and refinement of innovative AD therapies and the study of GABAergic visual cortical functions.

Icon Arrays for Medical Risk Communication: Do Icon Type and Color Influence Cardiovascular Risk Perception and Recall?

BACKGROUND: Icon arrays have been shown to be an effective method for communicating medical risk information. However, in practice, icon arrays used to visualize personal risks often differ in the type and color of the icons. The aim of this study was to examine the influence of icon type and color on the perception and recall of cardiovascular risk, as little is known about how color affects the perception of icon arrays. METHODS: A total of 866 participants aged 40 to 90 years representative of the German population in terms of gender and age completed an online experiment. Using a 2 × 2 between-subjects design, participants were randomly assigned to 1 of 4 experimental groups. They received their hypothetical 10-year cardiovascular risk using an icon array that varied by icon type (smiley v. person) and color (black/white v. red/yellow). We measured risk perception, emotional response, intentions of taking action to reduce the risk (e.g., increasing one's physical activity), risk recall, and graph evaluation/trustworthiness, as well as numeracy and graphical literacy. RESULTS: Icon arrays using person icons were evaluated more positively. There was no effect of icons or color on risk perception, emotional response, intentions of taking action to reduce the risk, or trustworthiness of the graph. While more numerate/graphical literate participants were more likely to correctly recall the presented risk estimate, icon type and color did not influence the probability of correct recall. CONCLUSIONS: Differences in the perception of the tested icon arrays were rather small, suggesting that they may be equally suitable for communicating medical risks. Further research on the robustness of these results across other colors, icons, and risk domains could add to guidelines on the design of visual aids. HIGHLIGHTS: The use of different icons and colors did not influence the perception and the probability of recalling the 10-year cardiovascular risk, the emotional response, or the intentions to reduce the presented risk.Icon arrays with person icons were evaluated more positively.There was no evidence to suggest that the effectiveness of the studied icon arrays varied based on individuals' levels of numerical or graphical literacy, nor did it differ between people with or without a history of CVD or on medication for an increased CVD risk.

The Impact of Cerebral Visual Impairment on Social Skills and Sensory Processing.

Limited evidence exists on the impact of cerebral visual impairment (CVI) on developmental domains in toddlers. This study investigated whether CVI influences social skills and sensory processing in toddlers with cerebral palsy (CP). The study included toddlers with CP, with or without CVI, and typically developing (TD) toddlers. All parents completed the demographic information form. Social skills were assessed by the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). Sensory processing was evaluated by the Infant/Toddler Sensory Profile (ITSP). Analysis of covariance was employed to assess the disparity in BITSEA and ITSP scores. Toddlers with CP and CVI group demonstrated lower social competence than the other groups (p < .05). Having CVI did not cause a statistically significant difference in sensory processing among toddlers with CP (p > .05). CVI significantly affects social competence in toddlers with CP but does not affect sensory processing.

Understanding How Vision Impacts Social Skills and Sensory Processing in Toddlers with Cerebral PalsyCerebral palsy (CP) is a lifelong condition that affects a child's ability to control their muscles and movements. It occurs due to damage or abnormalities in the brain that happen before, during, or shortly after birth. This condition can affect various aspects of daily life, including walking, feeding, and dressing. It often leads to challenges in physical skills and may be accompanied by difficulties in sensory, cognitive, and social functions. One of the accompanying difficulties is cerebral visual impairment (CVI), a common challenge for these children that affects their vision without apparent eye problems. As vision is crucial for social development, children with CVI may experience socio-visual deprivation, leading to cognitive deficits and behavioral difficulties. This study explores how vision influences the social and sensory abilities of toddlers with CP. We compared 66 toddlers: 22 with CP and CVI, 22 with CP without CVI, and 22 typically developing toddlers. The findings reveal that toddlers with CP and CVI group demonstrated lower social competence than the other groups. However, the presence of CVI did not cause difference in sensory processing among toddlers with CP. Understanding the impact of CVI on social and sensory skills is crucial for developing tailored therapy interventions for toddlers with CP. This research sheds light on the intricate relationship between vision and social competence, emphasizing the need for targeted support for these children. By recognizing and addressing these challenges early on, we can enhance the overall well-being and development of toddlers with CP.

Exploring the relationship between 24-2 visual field and widefield optical coherence tomography data across healthy, glaucoma suspect and glaucoma eyes.

PURPOSE: To utilise ganglion cell-inner plexiform layer (GCIPL) measurements acquired using widefield optical coherence tomography (OCT) scans spanning 55° × 45° to explore the link between co-localised structural parameters and clinical visual field (VF) data. METHODS: Widefield OCT scans acquired from 311 healthy, 268 glaucoma suspect and 269 glaucoma eyes were segmented to generate GCIPL thickness measurements. Estimated ganglion cell (GC) counts, calculated from GCIPL measurements, were plotted against 24-2 SITA Faster visual field (VF) thresholds, and regression models were computed with data categorised by diagnosis and VF status. Classification of locations as VF defective or non-defective using GCIPL parameters computed across eccentricity- and hemifield-dependent clusters was assessed by analysing areas under receiver operating characteristic curves (AUROCCs). Sensitivities and specificities were calculated per diagnostic category. RESULTS: Segmented linear regression models between GC counts and VF thresholds demonstrated higher variability in VF defective locations relative to non-defective locations (mean absolute error 6.10-9.93 dB and 1.43-1.91 dB, respectively). AUROCCs from cluster-wide GCIPL parameters were similar across methods centrally (p = 0.06-0.84) but significantly greater peripherally, especially when considering classification of more central locations (p < 0.0001). Across diagnoses, cluster-wide GCIPL parameters demonstrated variable sensitivities and specificities (0.36-0.93 and 0.65-0.98, respectively), with the highest specificities observed across healthy eyes (0.73-0.98). CONCLUSIONS: Quantitative prediction of VF thresholds from widefield OCT is affected by high variability at VF defective locations. Prediction of VF status based on cluster-wide GCIPL parameters from widefield OCT could become useful to aid clinical decision-making in appropriately targeting VF assessments.

Consequences of eye movements for spatial selectivity.

What determines spatial tuning in the visual system? Standard views rely on the assumption that spatial information is directly inherited from the relative position of photoreceptors and shaped by neuronal connectivity.1,2 However, human eyes are always in motion during fixation,3,4,5,6 so retinal neurons receive temporal modulations that depend on the interaction of the spatial structure of the stimulus with eye movements. It has long been hypothesized that these modulations might contribute to spatial encoding,7,8,9,10,11,12 a proposal supported by several recent observations.13,14,15,16 A fundamental, yet untested, consequence of this encoding strategy is that spatial tuning is not hard-wired in the visual system but critically depends on how the fixational motion of the eye shapes the temporal structure of the signals impinging onto the retina. Here we used high-resolution techniques for eye-tracking17 and gaze-contingent display control18 to quantitatively test this distinctive prediction. We examined how contrast sensitivity, a hallmark of spatial vision, is influenced by fixational motion, both during normal active fixation and when the spatiotemporal stimulus on the retina is altered to mimic changes in fixational control. We showed that visual sensitivity closely follows the strength of the luminance modulations delivered within a narrow temporal bandwidth, so changes in fixational motion have opposite visual effects at low and high spatial frequencies. By identifying a key role for oculomotor activity in spatial selectivity, these findings have important implications for the perceptual consequences of abnormal eye movements, the sources of perceptual variability, and the function of oculomotor control.

Long-term exposure to prometryn damages the visual system and changes color preference of female zebrafish (Danio rerio).

Color vision, initiated from the cone photoreceptors, is essential for fish to obtain environmental information. Although the visual impairment of triazine herbicide prometryn has been reported, data on the effect of herbicide such as prometryn on natural color sensitivity of fish is scarce. Here, zebrafish were exposed to prometryn (0, 1, 10, and 100 µg/L) from 2 h post-fertilization to 160 days post-fertilization, to explore the effect and underlying mechanism of prometryn on color perception. The results indicated that 10 and 100 µg/L prometryn shortened the height of red-green cone cells, and down-regulated expression of genes involved in light transduction pathways (arr3a, pde6h) and visual cycle (lrata, rpe65a); meanwhile, 1 µg/L prometryn increased all-trans-retinoic acid levels in zebrafish eyes, and up-regulated the expression of genes involved in retinoid metabolism (rdh10b, aldh1a2, cyp26a1), finally leading to weakened red and green color perception of female zebrafish. This study first clarified how herbicide such as prometryn affected color vision of a freshwater fish after a long-term exposure from both morphological and functional disruption, and its hazard on color vision mediated-ecologically relevant tasks should not be ignored.

An allocentric human odometer for perceiving distances on the ground plane.

We reliably judge locations of static objects when we walk despite the retinal images of these objects moving with every step we take. Here, we showed our brains solve this optical illusion by adopting an allocentric spatial reference frame. We measured perceived target location after the observer walked a short distance from the home base. Supporting the allocentric coding scheme, we found the intrinsic bias , which acts as a spatial reference frame for perceiving location of a dimly lit target in the dark, remained grounded at the home base rather than traveled along with the observer. The path-integration mechanism responsible for this can utilize both active and passive (vestibular) translational motion signals, but only along the horizontal direction. This asymmetric path-integration finding in human visual space perception is reminiscent of the asymmetric spatial memory finding in desert ants, pointing to nature's wondrous and logically simple design for terrestrial creatures.

Development of neural circuits for social motion perception in schooling fish.

The collective behavior of animal groups emerges from the interactions among individuals. These social interactions produce the coordinated movements of bird flocks and fish schools, but little is known about their developmental emergence and neurobiological foundations. By characterizing the visually based schooling behavior of the micro glassfish Danionella cerebrum, we found that social development progresses sequentially, with animals first acquiring the ability to aggregate, followed by postural alignment with social partners. This social maturation was accompanied by the development of neural populations in the midbrain that were preferentially driven by visual stimuli that resemble the shape and movements of schooling fish. Furthermore, social isolation over the course of development impaired both schooling behavior and the neural encoding of social motion in adults. This work demonstrates that neural populations selective for the form and motion of conspecifics emerge with the experience-dependent development of collective movement.

The effects of simulated monocular and binocular vision impairment on football penalty kick performance.

Sports performance is relatively robust under high levels of binocular blur. However, the limited research studies investigating monocular impairments has shown it has a larger impact on sport performance. This research study is relevant for classification in sports for athletes with vision impairment (VI), where visual acuity (VA) from the better eye is used during classification. Across two experiments, we aimed to establish the point at which binocular and monocular impairments affected performance in a football penalty kick (PK) through simulating varying severities of degraded VA and contrast sensitivity (CS) in active football players. In experiment one, 25 footballers performed PKs as VA and CS were systematically decreased in both eyes, and in one condition, visual field (VF) was reduced. The most severe VA/CS condition and reduced VF significantly impacted outcome, ball velocity and placement (ball kicked closer to the centre of the goal) (p < 0.05). In experiment two, 29 different footballers performed PKs as VA and CS of only the dominant eye were systematically decreased and in one condition the dominant eye was occluded, and participants viewed their environment through the non-dominant eye (monocular viewing). No differences were observed when assessing monocular impairments influence on outcome, velocity and ball placement. PKs have a high resilience to VI, but binocular impairment has a more immediate effect, suggesting binocular measures should be used in classification processes in football.

Effect of nystagmus on VEP-based objective visual acuity estimates.

In order to determine the effect of nystagmus on objective visual acuity (VA) estimates, we compared subjective (VApsych) and objective (VEP, VAVEP) VA estimates in participants with nystagmus. For this purpose, 20 participants with nystagmus (NY) caused by idiopathic infantile nystagmus, albinism, achiasma or acquired nystagmus were recruited in this study. Estimates of BCVA (best corrected visual acuity) were determined psychophysically (VApsych; FrACT, Freiburg visual acuity test) and electrophysiologically (VAVEP; EP2000) according to ISCEV (International Society of Clinical Electrophysiology of Vision) guidelines. For each participant the eye with the stronger fixation instability [Nidek microperimeter (MP-1), Nidek Instruments] was included for further analysis. VApsych vs VAVEP were compared via paired t-tests and the correlation of the difference between VApsych and VAVEP (∆VA) vs the degree of fixation instability was tested with Pearson correlation (r). We found VAVEP to be better than VApsych [by 0.12 Logarithm of the Minimum Angle of Resolution (logMAR); mean ± standard error (SE) of VAVEP vs VApsych: 0.176 ± 0.06 vs. 0.299 ± 0.06, P = 0.017] and ∆VA to be correlated linearly with the degree of fixation instability (r2 = 0.21,p = 0.048). In conclusion, on average we report a small VA overestimation, around 1 line, for VAVEP compared to VApsych in NY. This overestimation depended on the magnitude of the fixation instability. As a rule of thumb, a reduction of the fixation probability in the central 4° from 100 to 50% leads on average to a VAVEP overestimation of around 0.25 logMAR, i.e. 2.5 lines.

The potential role of robust face representations learned within families when searching for one's child in a crowd.

Own child's face is one of the most socially salient stimuli for parents, and a faster search for it than for other children's faces may help provide warmer and more sensitive care. However, it has not been experimentally examined whether parents find their child's face faster. In addition, although own child's face is specially processed, the search time for own child's face may be similar to that for other socially salient stimuli, such as own or spouse's faces. This study tested these possibilities using a visual search paradigm. Participants (parents) searched for their child's, own, spouse's, other child's, same-sex adult's, or opposite-sex adult's faces as search targets. Our findings indicate that both mothers and fathers identified their child's face more quickly than other children's faces. Similarly, parents found their own and spouse's faces more quickly than other adults' faces. Moreover, the search time for family members' faces increased with the number of faces on the search display, suggesting an attentional serial search. These results suggest that robust face representations learned within families and close relationships can support reduced search times for family members' faces.

Glaucoma Rehabilitation using ElectricAI Transcranial Stimulation (GREAT)-study protocol for randomized controlled trial using combined perceptual learning and transcranial electrical stimulation for vision enhancement.

BACKGROUND: Glaucoma patients with irreversible visual field loss often experience decreased quality of life, impaired mobility, and mental health challenges. Perceptual learning (PL) and transcranial electrical stimulation (tES) have emerged as promising interventions for vision rehabilitation, showing potential in restoring residual visual functions. The Glaucoma Rehabilitation using ElectricAI Transcranial stimulation (GREAT) project aims to investigate whether combining PL and tES is more effective than using either method alone in maximizing the visual function of glaucoma patients. Additionally, the study will assess the impact of these interventions on brain neural activity, blood biomarkers, mobility, mental health, quality of life, and fear of falling. METHODS: The study employs a three-arm, double-blind, randomized, superiority-controlled design. Participants are randomly allocated in a 1:1:1 ratio to one of three groups receiving: (1) real PL and real tES, (2) real PL and sham tES, and (3) placebo PL and sham tES. Each participant undergoes 10 sessions per block (~ 1 h each), with a total of three blocks. Assessments are conducted at six time points: baseline, interim 1, interim 2, post-intervention, 1-month post-intervention, and 2-month post-intervention. The primary outcome is the mean deviation of the 24-2 visual field measured by the Humphrey visual field analyzer. Secondary outcomes include detection rate in the suprathreshold visual field, balance and gait functions, and electrophysiological and biological responses. This study also investigates changes in neurotransmitter metabolism, biomarkers, self-perceived quality of life, and psychological status before and after the intervention. DISCUSSION: The GREAT project is the first study to assess the effectiveness of PL and tES in the rehabilitation of glaucoma. Our findings will offer comprehensive assessments of the impact of these treatments on a wide range of brain and vision-related metrics including visual field, neural activity, biomarkers, mobility, mental health, fear of falling, and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05874258 . Registered on May 15, 2023.

Multisensory integration of speech and gestures in a naturalistic paradigm.

Speech comprehension is crucial for human social interaction, relying on the integration of auditory and visual cues across various levels of representation. While research has extensively studied multisensory integration (MSI) using idealised, well-controlled stimuli, there is a need to understand this process in response to complex, naturalistic stimuli encountered in everyday life. This study investigated behavioural and neural MSI in neurotypical adults experiencing audio-visual speech within a naturalistic, social context. Our novel paradigm incorporated a broader social situational context, complete words, and speech-supporting iconic gestures, allowing for context-based pragmatics and semantic priors. We investigated MSI in the presence of unimodal (auditory or visual) or complementary, bimodal speech signals. During audio-visual speech trials, compared to unimodal trials, participants more accurately recognised spoken words and showed a more pronounced suppression of alpha power-an indicator of heightened integration load. Importantly, on the neural level, these effects surpassed mere summation of unimodal responses, suggesting non-linear MSI mechanisms. Overall, our findings demonstrate that typically developing adults integrate audio-visual speech and gesture information to facilitate speech comprehension in noisy environments, highlighting the importance of studying MSI in ecologically valid contexts.

Endoscopic Endonasal Approach Is Superior to Transcranial Approach for Small to Medium Tuberculum Sellae Meningiomas in Terms of Visual Outcome and Complications: A Retrospective Study in a Single Center.

OBJECTIVE: This study compared the effectiveness of the endoscopic endonasal approach (EEA) with the conventional transcranial approach (TCA) for treating tuberculum sellae meningiomas (TSMs), aiming to identify the superior surgical method and the risk factors affecting outcomes. METHODS: Patients treated for TSM from 1998 to 2023 at our institution were retrospectively analyzed, evaluating patient characteristics, tumor features, outcomes, and complications. A novel grading system for preoperative evaluation of TSMs was proposed. RESULTS: Among 49 patients, 26 underwent EEA and 23 underwent TCA. The maximum diameters were comparable between the groups (mean 22 mm vs. 23 mm). Gross total resection rates were 62% for EEA and 70% for TCA, showing no significant difference. However, postsurgical visual improvement was significantly higher in the EEA group compared with the TCA group (77% vs. 44%; P = 0.020), with fewer complications in the EEA group (8% vs. 35%; P = 0.032). CONCLUSIONS: EEA is a safe and effective treatment approach for small to medium TSMs, with outcomes comparable to TCA in terms of resection but superior in visual improvement and fewer complications. Selection of surgical approach should consider patient and tumor characteristics as well as surgeon experience.

Reading Reshapes Stimulus Selectivity in the Visual Word Form Area.

Reading depends on a brain region known as the "visual word form area" (VWFA) in the left ventral occipitotemporal cortex. This region's function is debated because its stimulus selectivity is not absolute, it is modulated by a variety of task demands, and it is inconsistently localized. We used fMRI to characterize the combination of sensory and cognitive factors that activate word-responsive regions that we precisely localized in 16 adult humans (4 male). We then presented three types of character strings: English words, pseudowords, and unfamiliar characters with matched visual features. Participants performed three different tasks while viewing those stimuli: detecting real words, detecting color in the characters, and detecting color in the fixation mark. There were three primary findings about the VWFA's response: (1) It preferred letter strings over unfamiliar characters even when the stimuli were ignored during the fixation task. (2) Compared with those baseline responses, engaging in the word reading task enhanced the response to words but suppressed the response to unfamiliar characters. (3) Attending to the stimuli to judge their color had little effect on the response magnitudes. Thus, the VWFA is uniquely modulated by a cognitive signal that is specific to voluntary linguistic processing and is not additive. Functional connectivity analyses revealed that communication between the VWFA and a left frontal language area increased when the participant engaged in the linguistic task. We conclude that the VWFA is inherently selective for familiar orthography, but it falls under control of the language network when the task demands it.

Towards an evidence-based integrative lighting score: a proposed multi-level approach.

Background: Human circadian clocks are synchronized daily with the external light-dark cycle and entrained to the 24-hour day. There is increasing evidence that a lack of synchronization and circadian entrainment can lead to adverse health effects. Beyond vision, light plays a critical role in modulating many so-called non-visual functions, including sleep-wake cycles, alertness, mood and endocrine functions. To assess (and potentially optimize) the impact of light on non-visual functions, it is necessary to know the exact 'dose' (i.e. spectral irradiance and exposure duration at eye level) of 24-hour light exposures, but also to include metadata about the lighting environment, individual needs and resources.Problem statement: To address this problem, a new assessment tool is needed that uses existing metrics to provide metadata and information about light quality and quantity from all sources. In this commentary, we discuss the need to develop an evidence-based integrative lighting score that is tailored to specific audiences and lighting environments. We will summarize the most compelling evidence from the literature and outline a future plan for developing such a lighting score using internationally accepted metrics, stakeholder and user feedback.Conclusion: We propose a weighting system that combines light qualities with physiological and behavioral effects, and the use of mathematical modelling for an output score. Such a scoring system will facilitate a holistic assessment of a lighting environment, integrating all available light sources.

To assess the impact of light on non-visual functions, it is essential to know the exact 'dose' of 24-hour light exposures and metadata about the lighting environment and the individual.There is to date no measurement method available that allows a holistic assessment of a lighting environment for visual and non-visual aspects in humans.We discuss the need for an evidence-based integrative lighting score and outline a plan for its development.An evidence-based integrative lighting score, which includes a weighting system to combine light qualities with physiological and behavioral effects, will only be possible by joining forces, knowledge, and methodologies from many disciplines.Such a score entails the potential to sustainably assess, improve and maintain optimized lighting environments that promote the health and productivity of any cohort over the long term.