Virtual Reality With Eye Tracking for Pediatric Ophthalmology: A Systematic Review.

Virtual reality presents an efficient and engaging approach to ophthalmological diagnosis and treatment in children. This systematic review investigates the current state of eye tracking technology integrated into virtual reality for the spectrum of pediatric ophthalmology. The search encompassed the MEDLINE database via PubMed, without imposing any time restrictions. A total of 20 relevant studies that met our inclusion criteria were incorporated and categorized into the following domains: diagnosis, examination, treatment, and rehabilitation use of virtual reality devices within the realm of pediatric ophthalmology. Strabismus examinations and postoperative monitoring, inherited retinal degeneration examination and visual function testing, therapy of amblyopia, glaucoma visual field testing, cerebral visual impairment rehabilitation, and neuro-ophthalmic disease examination were included in the final analysis. Pediatric ophthalmology offers a promising landscape for the integration of eye tracking technology within virtual reality, with accelerated, quantifiable, and objective examination and diagnosis, and precise, real-time measurements that are crucial in children. Virtual reality is an engaging experience, easily applied in a pediatric setting and facilitating compliance during examination and adherence to therapy. Although our systematic review provides insights into the current state of research, it is anticipated that further exploration is required for the widespread utilization of eye tracking in virtual reality within pediatric ophthalmology. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Electroactive composite biofilms integrating Kombucha, Chlorella and synthetic proteinoid Proto-Brains.

In this study, we present electroactive biofilms made from a combination of Kombucha zoogleal mats and thermal proteinoids. These biofilms have potential applications in unconventional computing and robotic skin. Proteinoids are synthesized by thermally polymerizing amino acids, resulting in the formation of synthetic protocells that display electrical signalling similar to neurons. By incorporating proteinoids into Kombucha zoogleal cellulose mats, hydrogel biofilms can be created that have the ability to efficiently transfer charges, perform sensory transduction and undergo processing. We conducted a study on the memfractance and memristance behaviours of composite biofilms, showcasing their capacity to carry out unconventional computing operations. The porous nanostructure and electroactivity of the biofilm create a biocompatible interface that can be used to record and stimulate neuronal networks. In addition to in vitro neuronal interfaces, these soft electroactive biofilms show potential as components for bioinspired robotics, smart wearables, unconventional computing devices and adaptive biorobotic systems. Kombucha-proteinoids composite films are a highly customizable material that can be synthesized to suit specific needs. These films belong to a unique category of 'living' materials, as they have the ability to support cellular systems and improve bioelectronic functionality. This makes them an exciting prospect in various applications. Ongoing efforts are currently being directed towards enhancing the compositional tuning of conductivity, signal processing and integration within hybrid bioelectronic circuits.

Functionalizing the Electrical Properties of Kombucha Zoogleal Mats for Biosensing Applications.

Kombucha is a type of tea that is fermented using yeast and bacteria. During this process, a film made of cellulose is produced. This film has unique properties such as biodegradability, flexibility, shape conformability, and ability to self-grow as well as be produced across customized scales. In our previous studies, we demonstrated that Kombucha mats exhibit electrical activity represented by spikes of the electrical potential. We propose using microbial fermentation as a method for in situ functionalization to modulate the electroactive nature of Kombucha cellulose mats, where graphene and zeolite were used for the functionalization. We subjected the pure and functionalized Kombucha mats to mechanical stimulation by applying different weights and geometries. Our experiments demonstrated that Kombucha mats functionalized with graphene and zeolite exhibit memfractive properties and respond to load by producing distinctive spiking patterns. Our findings present incredible opportunities for the in situ development of functionalized hybrid materials with sensing, computing, and memory capabilities. These materials can self-assemble and self-grow after they fuse their living and synthetic components. This study contributes to an emergent area of research on bioelectronic sensing and hybrid living materials, opening up exciting opportunities for use in smart wearables, diagnostics, health monitoring, and energy harvesting applications.

On Transducing Properties of Kombucha-Proteinoid Complexes.

We investigate the information processing capacities of kombucha-proteinoid proto-brains, focusing on the transducing properties through accommodation spiking, tonic bursting spiking, and optical and acoustic stimulation. We explore self-organization, adaptability, and emergent phenomena in this unconventional proto-architecture. By constructing kombucha-proteinoid networks exposed to diverse audio stimuli, we analyze nonlinear dynamics using time series analysis. Assessing information representation in the presence of extreme noise, we examine the system's resilience. Our results illustrate intricate pathways resulting from the interplay between the synthetic biological substrate and bio-inspired stimulation. The kombucha-proteinoid proto-brains consistently map complex stimuli to distinct activation levels, showcasing their adaptability and potential for information processing without the need for external shaping circuits.

The Effect of Phacoemulsification on the Intraocular Pressure of Patients With Open Angle Glaucoma: A Systematic Review and Meta-Analysis.

PRCIS: There is evidence that cataract surgery can reduce intraocular pressure in patients with primary open angle, normal tension, or exfoliative glaucoma. The complete effect of phacoemulsification is masked by topical intraocular pressure-lowering medications. PURPOSE: To assess the impact of phacoemulsification and intraocular lens implantation on intraocular pressure (IOP) level in individuals with primary open angle glaucoma (POAG), exfoliative glaucoma (XFG), exfoliation syndrome (XFS), normal tension glaucoma (NTG), ocular hypertension (OH), or healthy controls 12 months after the surgery. METHODS: In July 2023, a comprehensive literature review was conducted across six databases. The analysis focused on the phacoemulsification arms of randomized controlled trials (RCTs). The primary outcome of interest was the mean IOP change observed 12 months after phacoemulsification. RESULTS: This meta-analysis included 9 arms from 9 RCTs, comprising a total of 502 participants. Overall, the average IOP was reduced by 3.77 mm Hg (95% CI: -5.55 to -1.99, I2 =67.9%) 12 months after surgery. The subgroup analysis, focused on whether a washout period was used before measuring IOP, revealed that studies with a washout period exhibited a more pronounced IOP reduction of 5.25 mm Hg (95% CI: -7.35 to -3.15, I2 =0%), while studies without a washout period exhibited a reduction of 3.13 mm Hg (95% CI: -5.46 to -0.81, I2 =75.8%). The sensitivity analysis for the latter group, excluding an outlier study, showed a reduction of 1.81 mm Hg (95% CI: -2.95 to -0.67, I2 =0%). CONCLUSIONS: The findings of this systematic review and meta-analysis indicate that cataract surgery meaningfully lowers IOP in POAG, XFG/XFS, or OH 12 months after surgery. However, the use of topical medications masks the precise impact of phacoemulsification upon postoperative IOP. Further research using appropriate washout periods is warranted.

Correlation between color vision, visual acuity, contrast sensitivity and photostress recovery in the visually impaired: a cross-sectional study.

Background: To investigate the correlation of colour vision, visual acuity, contrast sensitivity, and photostress recovery time test scores in visually impaired patients. Materials and methods: A total of 133 subjects were enroled and 133 eyes were examined. The pathological group consisted of 76 (57.1%) males with an average age of 68.0 (SD=13.2) and 57 (42.9%) females, with an average age of 68.1 (SD=15.2), Mann-Whitney U test was used to evaluate the differences in K-colour tests, HRR, visual acuity, Contrast Sensitivity test and photostress recovery time test between two different groups of severity. Results: Correlations were found among colour vision tests, visual acuity, contrast sensitivity, and photostress recovery time scores in eyes with age-related macular degeneration, with diabetic retinopathy, with optic nerve diseases, and various other retinal diseases (P<0.05). In patients with moderate-visual impairments. Conclusions: The colour vision test scores correlate with the scores of visual acuity, contrast sensitivity, and photostess recovery time test. It may be a useful clinical surrogate for functional vision.

Neuropsychiatric manifestations associated with Juvenile Systemic Lupus Erythematosus: An overview focusing on early diagnosis.

Juvenile systemic lupus erythematosus (jSLE) is a chronic multisystem inflammatory disease that manifests before the age of 16 years, following a remitting - relapsing course. The clinical presentation in children is multifaceted, most commonly including constitutional, hematological, cutaneous, renal, and neuropsychiatric symptoms. Neuropsychiatric manifestations range widely, affecting approximately 14-95 % of jSLE patients. They are associated with high morbidity and mortality, particularly at a younger age. Headaches, seizures, cognitive dysfunction, and mood disorders are the most frequent neuropsychiatric manifestations. The pathophysiological mechanism is quite complex and has not yet been fully investigated, with autoantibodies being the focus of research. The diagnosis of neuropsychiatric jSLE remains challenging and exclusionary. In this article we review the clinical neuropsychiatric manifestations associated with jSLE with the aim that early diagnosis and prompt treatment is achieved in children and adolescents with the disease.

No ultrasounds detected from fungi when dehydrated.

Many organisms (including certain plant species) can be observed to emit sounds, potentially signifying threat alerts. Sensitivity to such sounds and vibrations may also play an important role in the lives of fungi. In this work, we explore the potential of ultrasound activity in dehydrating fungi, and discover that several species of fungi do not emit sounds (detectable with conventional instrumentation) in the frequency range of 10kHz to 210kHz upon dehydration. Over 5 terabytes of ultrasound recordings were collected and analysed. We conjecture that fungi interact via non-sound means, such as electrical or chemical.

Investigation of Sleep Quality and Mental Health of Greek Physicians During the COVID-19 Pandemic.

The global outbreak of COVID-19 has had an impact on physicians, not only as a time of great concern and responsibility, but also as a human performance factor influencing their sleep quality and mental health. However, studies have not yet defined the frequency and the interplay of sleep and mental issues. The purpose of this study was to explore the anxiety and sleep disturbances prevalence in Greek physicians, as well as their relationship with sociodemographic and profession-related traits, aiming to raise awareness for changes in healthcare management and policy making.

Kombucha electronics: electronic circuits on kombucha mats.

A kombucha is a tea and sugar fermented by over sixty kinds of yeasts and bacteria. This symbiotic community produces kombucha mats, which are cellulose-based hydrogels. The kombucha mats can be used as an alternative to animal leather in industry and fashion once they have been dried and cured. Prior to this study, we demonstrated that living kombucha mats display dynamic electrical activity and distinct stimulating responses. For use in organic textiles, cured mats of kombucha are inert. To make kombucha wearables functional, it is necessary to incorporate electrical circuits. We demonstrate that creating electrical conductors on kombucha mats is possible. After repeated bending and stretching, the circuits maintain their functionality. In addition, the abilities and electronic properties of the proposed kombucha, such as being lighter, less expensive, and more flexible than conventional electronic systems, pave the way for their use in a diverse range of applications.

Responsive fungal insoles for pressure detection.

Mycelium bound composites are promising materials for a diverse range of applications including wearables and building elements. Their functionality surpasses some of the capabilities of traditionally passive materials, such as synthetic fibres, reconstituted cellulose fibres and natural fibres. Thereby, creating novel propositions including augmented functionality (sensory) and aesthetic (personal fashion). Biomaterials can offer multiple modal sensing capability such as mechanical loading (compressive and tensile) and moisture content. To assess the sensing potential of fungal insoles we undertook laboratory experiments on electrical response of bespoke insoles made from capillary matting colonised with oyster fungi Pleurotus ostreatus to compressive stress which mimics human loading when standing and walking. We have shown changes in electrical activity with compressive loading. The results advance the development of intelligent sensing insoles which are a building block towards more generic reactive fungal wearables. Using FitzHugh-Nagumo model we numerically illustrated how excitation wave-fronts behave in a mycelium network colonising an insole and shown that it may be possible to discern pressure points from the mycelium electrical activity.

Fungal electronics.

Fungal electronics is a family of living electronic devices made of mycelium bound composites or pure mycelium. Fungal electronic devices are capable of changing their impedance and generating spikes of electrical potential in response to external control parameters. Fungal electronics can be embedded into fungal materials and wearables or used as stand alone sensing and computing devices.

Teleophthalmology and Artificial Intelligence As Game Changers in Ophthalmic Care After the COVID-19 Pandemic.

The current COVID-19 pandemic has boosted a sudden demand for telemedicine due to quarantine and travel restrictions. The exponential increase in the use of telemedicine is expected to affect ophthalmology drastically. The aim of this review is to discuss the utility, effectiveness and challenges of teleophthalmological new tools for eyecare delivery as well as its implementation and possible facilitation with artificial intelligence. We used the terms: "teleophthalmology," "telemedicine and COVID-19," "retinal diseases and telemedicine," "virtual ophthalmology," "cost effectiveness of teleophthalmology," "pediatric teleophthalmology," "Artificial intelligence and ophthalmology," "Glaucoma and teleophthalmology" and "teleophthalmology limitations" in the database of PubMed and selected the articles being published in the course of 2015-2020. After the initial search, 321 articles returned as relevant. A meticulous screening followed and eventually 103 published manuscripts were included and used as our references. Emerging in the market, teleophthalmology is showing great potential for the future of ophthalmological care, benefiting both patients and ophthalmologists in times of pandemics. The spectrum of eye diseases that could benefit from teleophthalmology is wide, including mostly retinal diseases such as diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration but also glaucoma and anterior segment conditions. Simultaneously, artificial intelligence provides ways of implementing teleophthalmology easier and with better outcomes, contributing as significant changing factors for ophthalmology practice after the COVID-19 pandemic.

Stimulating Fungi Pleurotus ostreatus with Hydrocortisone.

Fungi cells can sense extracellular signals via reception, transduction, and response mechanisms, allowing them to communicate with their host and adapt to their environment. They feature effective regulatory protein expressions that enhance and regulate their response and adaptation to various triggers such as stress, hormones, physical stimuli such as light, and host factors. In our recent studies, we have shown that Pleurotus oyster fungi generate electrical potential impulses in the form of spike events in response to their exposure to environmental, mechanical, and chemical triggers, suggesting that the nature of stimuli may be deduced from the fungal electrical responses. In this study, we explored the communication protocols of fungi as reporters of human chemical secretions such as hormones, addressing whether fungi can sense human signals. We exposed Pleurotus oyster fungi to hydrocortisone, which was directly applied to the surface of a fungal-colonized hemp shavings substrate, and recorded the electrical activity of the fungi. Hydrocortisone is a medicinal hormone replacement that is similar to the natural stress hormone cortisol. Changes in cortisol levels released by the body indicate the presence of disease and can have a detrimental effect on physiological process regulation. The response of fungi to hydrocortisone was also explored further using X-rays to reveal changes in the fungi tissue, where receiving hydrocortisone by the substrate can inhibit the flow of calcium and, as a result, reduce its physiological changes. This research could open the way for future studies on adaptive fungal wearables capable of detecting human physiological states and biosensors built of living fungi.

Reactive fungal wearable.

Smart wearables sense and process information from the user's body and environment and report results of their analysis as electrical signals. Conventional electronic sensors and controllers are commonly, sometimes augmented by recent advances in soft electronics. Organic electronics and bioelectronics, especially with living substrates, offer a great opportunity to incorporate parallel sensing and information processing capabilities of natural systems into future and emerging wearables. Nowadays fungi are emerging as a promising candidate to produce sustainable textiles to be used as ecofriendly biowearables. To assess the sensing potential of fungal wearables we undertook laboratory experiments on electrical response of a hemp fabric colonised by oyster fungi Pleurotus ostreatus to mechanical stretching and stimulation with attractants and repellents. We have shown that it is possible to discern a nature of stimuli from the fungi electrical responses. The results paved a way towards future design of intelligent sensing patches to be used in reactive fungal wearables.

Association between serum 25-hydroxyvitamin D levels and body composition in postmenopausal women: the postmenopausal Health Study.

OBJECTIVE: The present study examined the association between body composition measurements, using dual-energy x-ray absorptiometry and anthropometry, with serum 25-hydroxyvitamin D levels in nonosteoporotic, postmenopausal women. METHODS: Serum 25-hydroxyvitamin D, intact parathyroid hormone, insulin-like growth factor I levels, dual-energy x-ray absorptiometry measurements of fat and fat-free mass, anthropometric and handgrip strength measurements, dietary intake estimations, ultraviolet B radiation exposure, and physical activity levels were collected from 112 nonosteoporotic, postmenopausal women (age, 60.3 +/- 5.0 y; body mass index, 29.5 +/- 4.8 kg/m). RESULTS: At a bivariate level, serum 25-hydroxyvitamin D levels were inversely associated with regional and total body fat mass (P < 0.05), whereas positive associations were observed with regional and total body fat-free mass (P < 0.05). After controlling for age, serum intact parathyroid hormone, insulin-like growth factor I levels, ultraviolet B radiation exposure, and physical activity levels, most of the associations observed at a bivariate level between serum 25-hydroxyvitamin D levels and body composition indices (as obtained by dual-energy x-ray absorptiometry) remained significant. No significant associations were observed between anthropometric indices of body mass and serum 25-hydroxyvitamin D levels. CONCLUSIONS: An independent inverse association between serum 25-hydroxyvitamin D levels and dual-energy x-ray absorptiometry measurements of total body and regional fat mass was observed in nonosteoporotic, overweight, postmenopausal women. Further clinical trials are required to come to safe conclusions on whether it is the fat mass that affects serum 25-hydroxyvitamin D levels or vice versa and whether there is a need to also take into account body composition when providing recommendations for vitamin D intake in postmenopausal women.