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Falls
Published in Henry J. Woodford, Essential Geriatrics, 2022
Around 75% of visual problems in older people are thought to be correctable.11 For example, through cataracts surgery and appropriate glasses. Presbyopia (see page 12) leads to many older people requiring glasses. These can be separate glasses for near and far vision or multifocal glasses (e.g. bifocal or varifocal) for convenience. However, bifocal and varifocal glasses are associated with an increased risk of falls.37 Single-lens glasses may be beneficial for people who regularly exercise outdoors.38 The other common causes of visual loss are age-related macular degeneration, glaucoma and diabetic retinopathy. Treatment of these conditions is aimed at preventing deterioration in vision.
Infamy: On Judgement and Punishment
Published in Philip Berry, Necessary Scars, 2021
I am sitting in a meeting room on the second floor of a grand but fusty Manchester hotel. They use a cleaning compound or air freshener that smells like a combination of talcum powder and nursing home. My team is assembling. Our leader is already present. She is likeable, realistic, experienced. We are here to judge a colleague. He was referred to the GMC on account of multiple concerns. We have interviewed him, his peers (both detractors and supporters), we have analysed 50 sets of clinical notes and recorded examples of satisfactory and unsatisfactory decisions or actions. I think I need glasses, because for the first time during one of these performance reviews, my head is killing me.
Making a success of the three-part consultation
Published in Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard, Consulting in a Nutshell, 2020
Roger Neighbour, Jamie Hynes, Helen Stokes-Lampard
If your computer screen is too easily visible to you, you will find the temptation to keep looking at it almost irresistible. You may well justify this by claiming that you need to refresh your memory about the patient's details, past history and medication record, or to see any clinical or Quality and Outcomes Framework (QOF) reminders. My advice (and it is only my advice; other views are possible) my advice is that you should check the patient's computer record beforehand, but, once the patient is in the room, concentrate on them, not the computer, especially at the beginning of the consultation. The conventional wisdom is that, in the name of openness and information-sharing, you should turn the screen so that both you and the patient can see what is on it. I'm not sure I accept this. Most of your patients will be elderly; they would need to use their reading glasses to read the computer screen. But most people don't wear their glasses for consulting the doctor. To them, the screen is just a blur, which they know displays information about them, but they can't see what it is. If you have ever found yourself in a similar situation, for instance when consulting a local government official or a financial adviser, you will know how unsettling this is.
Overcoming the resistance of hepatocellular carcinoma to PD-1/PD-L1 inhibitor and the resultant immunosuppression by CD38 siRNA-loaded extracellular vesicles
Published in OncoImmunology, 2023
Initially, EVs or EVs/siCD38 was added with 5 μM Dil dye (C1991S, Beyotime) for 15-min incubation at ambient temperature, and centrifuged at 1000 × g for 5 min, with the supernatant removed. Next, EVs culture medium was added for resuspension, followed by centrifugation at 1000 × g for 5 min and supernatant removal. These procedures were repeated twice and the obtained precipitate was the Dli-labeled EVs. Cover glasses were put on the top of the petri dish, where HCCLM3 cells were cultured. Upon reaching 50% confluence, the cells were co-cultured with Dli-labeled EVs or EVs/siCD38 at 37°C. After 24 h, the glasses were taken out, washed thrice with PBS, and soaked in 4% paraformaldehyde for 30 min at ambient temperature. Thereafter, the cells were permeabilized with 2% Triton X-100 for 15 min and stained with DAPI (2 μg/mL, C1005, Beyotime) for 10 min. Finally, the expression of fluorescence was detected with an upright fluorescence microscope.
Trends in Sports-Related Ocular Trauma in United States Emergency Departments from 2010 to 2019: Multi-Center Cross-Sectional Study
Published in Seminars in Ophthalmology, 2023
Veshesh Patel, Parastou Pakravan, Divy Mehra, Arjun Watane, Nicolas A. Yannuzzi, Jayanth Sridhar
There are various prevention efforts that may reduce ocular injuries caused by sports. Inadequate or underutilization of eye protection for ball-related sports, such as baseball, tennis, and basketball has been reported, and without eye protection, individuals are more likely to sustain an ocular injury.12 More than 70% of US children participate in sports, and accordingly, there are efforts to reduce sports-related ocular trauma.13 Examples of implementing safety include wearing helmets and encouraging the use of proper eye wear protection, such as glasses or goggles. Helmets are mandatory in sports, such as baseball and football, but improper wear can lead to an increased risk for ocular injuries. It is important to position and properly fit the helmet to protect the eye. Eye protection is not mandatory in most ball-related sports, such as basketball and soccer; however, wearing protective glasses can significantly reduce ocular injuries such as corneal/scleral abrasions and lacerations (penetrating injury).14,15 Another way to prevent ocular injuries is to educate coaches, players, referees, and parents the importance of eye safety and protection when participating in sports. As adolescents appear to be at high risk, this type of education should be introduced early in development.
Visual gaze patterns in trainee endoscopists – a novel assessment tool
Published in Scandinavian Journal of Gastroenterology, 2022
Urvi Karamchandani, Simon Erridge, Keane Evans-Harvey, Ara Darzi, Jonathan Hoare, Mikael Hans Sodergren
Compared with other validated skills assessment methods such as global rating scales and motion analysis, eye-tracking is still very much in the early stages of research. However, it has the advantages of being able to measure real-time performance through visualisation of the trainees’ eye movements on a screen utilising machine learning techniques and can also be used in re-validation of consultants. Moreover, given the advancements in eye-tracking technology, glasses are now very lightweight and portable, and can produce quantitative data with minimal set-up requirements or involvement of technicians. As a result, eye-tracking may be used in the future as an adjunctive assessment method during colonoscopy training. However, additional evaluation of other components of validity will be required before this is possible. Specific training in VGPs may also be worth incorporating into future training programmes.