A technique for determining pump injector settings for an on-table CT or 3D DSA in interventional radiology

Introduction On-Table computed tomography (CT) or 3D digital subtraction angiography (DSA) in interventional radiology (IR) has become a valuable diagnostic tool. Methods A review of the literature found a poor evidential base supporting the technical parameters for iodinated contrast delivery during these acquisition sequences. Results and conclusion This technical note presents an easy method of estimating the parameters needed to reliably obtain diagnostic on-table CT or 3D DSA images, whilst attempting minimising contrast dose. Implications for practice A systematic approach to estimating contrast delivery regimes during on-table CT and 3D DSA can help ensure diagnostic quality images are obtained. Further clinical studies are now required to rigorously evaluate this protocol

Initial single centre experiences of a radiographer advanced practitioner led nephrostomy exchange programme

PURPOSE: To evaluate the technical success, radiation dose, complications and costs from the introduction of a radiographer-led nephrostomy exchange service. METHODS: Post-graduate qualified interventional radiographers with several years’ experience in performing other interventional procedures began performing nephrostomy exchanges. Training was provided by an interventional radiologist. Each radiographer performed ten procedures under direct supervision followed by independent practice with remote supervision. Each radiographer was then responsible for the radiological report, discharge, re-referral for further exchange and, where indicated, sending urine samples for culture and sensitivity. Data extraction included the time interval between exchanges, radiation dose/screening time and complications. RESULTS: Thirty-eight long-term nephrostomy patients had their histories interrogated back to the time of the initial insertion. The mean (range) age at nephrostomy insertion was 67 (35-93) years and 65% were male. Indications for nephrostomy were prostatic or gynaecological malignancy, ureteric injury, bulky lymphoma and post-transplant ureteric stricture. A total of 170 nephrostomy exchanges were performed with no statistically differences in the radiation dose, fluoroscopy time nor complication rates between consultants and radiographers. There was, however, a statistical reduction in the time interval between nephrostomy exchanges for the radiographer group (P=0.022). CONCLUSION: Interventional radiographers can provide a safe, technically successful nephrostomy exchange program with radiation doses equivalent to radiologists. This is a cost-effective solution to the capacity issues faced in many departments, whilst providing career progression, job satisfaction and possibly improved care. IMPLICATIONS FOR PRACTICE: Radiographer-led interventional services should be considered by other institutions as a means of providing effective nephrostomy exchanges

The effect of chewing gum on physiological and self-rated measures of alertness and daytime sleepiness

The proposition that chewing gum can improve alertness was investigated via both physiological and self-rated measures. The Pupillographic Sleepiness Test (PST) provided a measure of pupillary unrest (PUI); a physiological index of daytime sleepiness. Chewing gum reduced the extent of sleepiness as measured by both PUI and self-rated sleepiness. Specifically, in comparison with sham chewing and no chewing controls, the chewing gum condition significantly limited the increase in pupillary unrest following the 11-minute PST within a darkened laboratory: a finding indicating moderation of the daytime sleepiness increase for the chewing gum condition. In addition, there was some evidence that chewing gum (relative to the no-chewing condition only) moderated the increase in a self-rated measure of sleepiness (Stanford Sleepiness Scale). However, there was no evidence that chewing gum moderated the decrease in self-rated alertness (Bond-Lader Visual Analogue Mood Scale). Although the precise mechanism underpinning the effect of chewing gum is unclear, the reduction in daytime sleepiness may be underpinned via heightened cerebral activity following the chewing of gum or the arousing effects of mint flavour

Sleep-dependent memory consolidation is related to perceived value of learned material

Although many types of newly encoded information can be consolidated during sleep, an enhanced effect has been found for memories tagged as relevant to the future, such as through knowledge of future testing or payment for successful recall. In the current study, participants (n = 80) learned Welsh and Breton translations of English words, and intrinsic relevance of learned material was operationalized as perceived value of the Welsh and Breton languages. Participants were non-Welsh native English speakers who had recently arrived in Wales. Memory for the words was tested immediately and 12 h later, after either a period of wake or a period of sleep. An increase in recall for both languages was found after sleep, but not after wake. Importantly, for the sleep condition, overnight improvement in Welsh word recall was associated with participants’ level of valuing the Welsh language. This association was not found for the wake period condition. These findings support previous indications of an active role of sleep in the consolidation of memories relevant for the future, and demonstrate that this effect may be modulated by individual differences in perceived value of the learned material. It remains to be established whether this association is mediated by an emotional attachment to the language or a cognitive facility with it, or both

Practice Makes Imperfect: Restorative Effects of Sleep on Motor Learning

Emerging evidence suggests that sleep plays a key role in procedural learning, particularly in the continued development of motor skill learning following initial acquisition. We argue that a detailed examination of the time course of performance across sleep on the finger-tapping task, established as the paradigm for studying the effect of sleep on motor learning, will help distinguish a restorative role of sleep in motor skill learning from a proactive one. Healthy subjects rehearsed for 12 trials and, following a night of sleep, were tested. Early training rapidly improved speed as well as accuracy on pre-sleep training. Additional rehearsal caused a marked slow-down in further improvement or partial reversal in performance to observed levels below theoretical upper limits derived on the basis of early pre-sleep rehearsal. This decrement in learning efficacy does not occur always, but if and only if it does, overnight sleep has an effect in fully or partly restoring the efficacy and actual performance to the optimal theoretically achieveable level. Our findings re-interpret the sleep-dependent memory enhancement in motor learning reported in the literature as a restoration of fatigued circuitry specialized for the skill. In providing restitution to the fatigued brain, sleep eliminates the rehearsal-induced synaptic fatigue of the circuitry specialized for the task and restores the benefit of early pre-sleep rehearsal. The present findings lend support to the notion that latent sleep-dependent enhancement of performance is a behavioral expression of the brain's restitution in sleep

Spatial attention: differential shifts in pseudoneglect direction with time-on-task and initial bias support the idea of observer subtypes

<p>Asymmetry in human spatial attention has long been documented. In the general population the majority of individuals tend to misbisect horizontal lines to the left of veridical centre. Nonetheless in virtually all previously reported studies on healthy participants, there have been subsets of people displaying rightward biases.</p> <p>In this study, we report differential time-on task effects depending on participants' initial pseudoneglect bias: participants with an initial left bias in a landmark task (in which they had to judge whether a transection mark appeared closer to the right or left end of a line) showed a significant rightward shift over the course of the experimental session, whereas participants with an initial right bias shifted leftwards.</p> <p>We argue that these differences in initial biases as well as the differential shifts with time-on task reflect genuine observer subtypes displaying diverging behavioural patterns. These observer subtypes could be driven by differences in brain organisation and/or lateralisation such as varying anatomical pathway asymmetries. </p&gt

Wake Up and Talk with Me! In-the-Field Study of an Autonomous Interactive Wake Up Robot

12th International Conference, ICSR 2020, Golden, CO, USA, November 14–18, 2020In this paper, we present a robot that is designed to smoothly wake up a user in the morning. We created an autonomous interactive wake up robot that implements a wake up behavior that was selected through preliminary experiments. We conducted a user study to test the interactive robot and compared it to a baseline robot that behaves like a conventional alarm clock. We recruited 22 participants that agreed to bring the robot to their home and test it for two consecutive nights. The participants felt significantly less sleepy after waking up with the interactive robot, and reported significantly more intention to use the interactive robot

Does Sleep Really Influence Face Recognition Memory?

Mounting evidence implicates sleep in the consolidation of various kinds of memories. We investigated the effect of sleep on memory for face identity, a declarative form of memory that is indispensable for nearly all social interaction. In the acquisition phase, observers viewed faces that they were required to remember over a variable retention period (0–36 hours). In the test phase, observers viewed intermixed old and new faces and judged seeing each before. Participants were classified according to acquisition and test times into seven groups. Memory strength (d′) and response bias (c) were evaluated. Substantial time spent awake (12 hours or more) during the retention period impaired face recognition memory evaluated at test, whereas sleep per se during the retention period did little to enhance the memory. Wakefulness during retention also led to a tightening of the decision criterion. Our findings suggest that sleep passively and transiently shelters face recognition memory from waking interference (exposure) but does not actively aid in its long-term consolidation

Sleep patterns and school performance of Korean adolescents assessed using a Korean version of the pediatric daytime sleepiness scale

PurposeKorean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS.MethodsWe distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12.ResultsThe amount of nighttime sleep decreased significantly with increasing age. During weekday nights, 5-6th graders slept for 7.95±1.05 h, 7-9th graders for 7.57±1.05 h, and 10-12th graders for 5.78±1.13 h. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, 8.15±1.12 h for 5-6th graders, 8.17±1.20 h for 7-9th graders, and 6.87±1.40 h for 10-12th graders. PDSS scores increased with age, 11.89±5.56 for 5-6th graders, 16.57±5.57 for 7-9th graders, and 17.71±5.24 for 10-12th graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability.ConclusionKorean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers

Preferential attention towards the eye-region amongst individuals with insomnia

People with insomnia often perceive their own facial appearance as more tired compared with the appearance of others. Evidence also highlights the eye-region in projecting tiredness cues to perceivers, and tiredness judgements often rely on preferential attention towards this region. Using a novel eye-tracking paradigm, this study examined: (i) whether individuals with insomnia display preferential attention towards the eye-region, relative to nose and mouth regions, whilst observing faces compared with normal-sleepers; and (ii) whether an attentional bias towards the eye-region amongst individuals with insomnia is self-specific or general in nature. Twenty individuals with DSM-5 Insomnia Disorder and 20 normal-sleepers viewed 48 neutral facial photographs (24 of themselves, 24 of other people) for periods of 4000 ms. Eye movements were recorded using eye-tracking, and first fixation onset, first fixation duration and total gaze duration were examined for three interest-regions (eyes, nose, mouth). Significant group × interest-region interactions indicated that, regardless of the face presented, participants with insomnia were quicker to attend to, and spent more time observing, the eye-region relative to the nose and mouth regions compared with normal-sleepers. However, no group × face × interest-region interactions were established. Thus, whilst individuals with insomnia displayed preferential attention towards the eye-region in general, this effect was not accentuated during self-perception. Insomnia appears to be characterized by a general, rather than self-specific, attentional bias towards the eye-region. These findings contribute to our understanding of face perception in insomnia, and provide tentative support for cognitive models of insomnia demonstrating that individuals with insomnia monitor faces in general, with a specific focus around the eye-region, for cues associated with tiredness