Vision Impairment and Blindness in New Brunswick Nursing Homes

A vision assessment program carried out in all nursing homes examined 89.3 percent of all residents. Results provide documentation of vision loss and blindness in the sample. The data show increasing levels of vision loss and blindness with age. This study documents the contribution of such impairment to increasing levels of supervision and nursing care. It is also evident that increasing vision loss reduces mobility, thus limiting the range of physical and intellectual activities of aged persons. The major contributory factors to vision impairment are ocular and systemic diseases. The prevalence of these conditions is established. A need is demon­strated for provision of vision care in nursing homes. The study suggests that the application of available technology for vision assessment and remediation could restore or improve the visual capability of a substantial number of persons suffering from vision impairment or blindness. The presence of age related increases in intraocular pressure and previously undetected glaucoma offers preventive opportunity

Noise sensing via stochastic quantum Zeno

The dynamics of any quantum system is unavoidably influenced by the external environment. Thus, the observation of a quantum system (probe) can allow the measure of the environmental features. Here, to spectrally resolve a noise field coupled to the quantum probe, we employ dissipative manipulations of the probe, leading to so-called Stochastic Quantum Zeno (SQZ) phenomena. A quantum system coupled to a stochastic noise field and subject to a sequence of protective Zeno measurements slowly decays from its initial state with a survival probability that depends both on the measurement frequency and the noise. We present a robust sensing method to reconstruct the unkonwn noise power spectral density by evaluating the survival probability that we obtain when we additionally apply a set of coherent control pulses to the probe. The joint effect of coherent control, protective measurements and noise field on the decay provides us the desired information on the noise field

Role of the filter functions in noise spectroscopy

The success of quantum noise sensing methods depends on the optimal interplay between properly designed control pulses and statistically informative measurement data on a specific quantum-probe observable. To enhance the information content of the data and reduce as much as possible the number of measurements on the probe, the filter orthogonalization method has been recently introduced. The latter is able to transform the control filter functions on an orthogonal basis allowing for the optimal reconstruction of the noise power spectral density. In this paper, we formalize this method within the standard formalism of minimum mean squared error estimation and we show the equivalence between the solutions of the two approaches. Then, we introduce a non-negative least squares formulation that ensures the non-negativeness of the estimated noise spectral density. Moreover, we also propose a novel protocol for the design in the frequency domain of the set of filter functions. The frequency-designed filter functions and the non-negative least squares reconstruction are numerically tested on noise spectra with multiple components and as a function of the estimation parameters

Medication safety incidents in paediatric oncology after electronic medication management system implementation

Objective: To explore medication safety issues related to use of an electronic medication management system (EMM) in paediatric oncology practice, through the analysis of patient safety incident reports. Methods: We analysed 827 voluntarily reported incidents relating to oncology patients that occurred over an 18‐month period immediately following implementation of an EMM in a paediatric hospital in Australia. We identified medication‐related and EMM‐related incidents and carried out a content analysis to identify patterns. Results: We found ~79% (n = 651) of incidents were medication‐related and, of these, ~45% (n = 294) were EMM‐related. Medication‐related incidents included issues with: prescribing; dispensing; administration; patient transfers; missing chemotherapy protocols and information on current stage of patient treatment; coordination of chemotherapy administration; handling or storing medications; children or families handling medications. EMM‐related incidents were classified into four groups: technical issues, issues with the user experience, unanticipated problems in EMM workflow, and missing safety features. Conclusions: Incidents reflected difficulties with managing therapies rich in interdependencies. EMM, and especially its ‘automaticity’, contributed to these incidents. As EMM impacts on safety in such high‐risk settings, it is essential that users are aware of and attend to EMM automatic behaviours and are equipped to troubleshoot them

A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours

OBJECTIVES: Up to 20 % of incidentally found testicular lesions are benign Leydig cell tumours (LCTs). This study evaluates the role of contrast-enhanced magnetic resonance imaging (MRI) in the identification of LCTs in a large prospective cohort study. MATERIALS AND METHODS: We enrolled 44 consecutive patients with at least one solid non-palpable testicular lesion who underwent scrotal MRI. Margins of the lesions, signal intensity and pattern of wash-in and wash-out were analysed by two radiologists. The frequency distribution of malignant and benign MRI features in the different groups was compared by using the chi-squared or Fisher's exact test. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were calculated. RESULTS: The sensitivity of scrotal MRI to diagnose LCTs was 89.47 % with 95.65 % specificity; sensitivity for malignant lesions was 95.65 % with 80.95 % specificity. A markedly hypointense signal on T2-WI, rapid and marked wash-in followed by a prolonged washout were distinctive features significantly associated with LCTs. Malignant lesions were significantly associated with blurred margins, weak hypointense signal on T2-WI ,and weak and progressive wash-in. The overall diagnostic accuracy was 93 %. CONCLUSIONS: LCTs have distinctive contrast-enhanced MRI features that allow the differential diagnosis of incidental testicular lesions. KEY POINTS: • MRI is able to characterize testicular lesions suggesting a specific diagnosis. • Rapid and marked wash-in is a common feature of Leydig cell tumours. • Markedly hypointense T2-WI signal is significantly correlated with benign lesions. • Blurred margins and weak hypointense T2-WI signal are correlated with malignant tumours. • Weak and progressive wash-in features are present in 85 % of seminomatous lesions

Comparison of organic and conventional Italian cheeses chemical composition from parallel production

ABSTRACT: Although there are several studies comparing organic and conventional milk characteristics, very few focused on dairy processed products such as cheese. Thus, this study aimed for a detailed controlled examination of gross composition, minerals, and the fatty acid profile of organic (ORG) and conventional (CON) Italian cheeses from parallel production. Four Italian cheese types were analyzed: Latteria (ORG, n = 9; CON, n = 10); Asiago Protected Designation of Origin (PDO) fresco (ORG, n = 9; CON, n = 9); Caciotta (ORG, n = 8; CON, n = 8); and Mozzarella Traditional Specialty Guaranteed (TSG; ORG, n = 14; CON, n = 14). Cheese samples were collected from September 2020 to August 2021. Gross composition, minerals, and fatty acids were determined using infrared spectroscopy. Within each cheese type, paired ORG and CON samples were compared using a nonparametric Wilcoxon signed-rank test. Latteria showed lower PUFA, n-3, and n-6 content, and greater Fe, K, C10:0, C12:0, and C16:0 content in ORG than in CON. Asiago PDO fresco showed lower protein and Zn content and greater salt, ash, and Na content in ORG than in CON. Caciotta showed lower ash, n-3, and n-6 content and greater K, C4:0, C8:0, C10:0, C14:0, and C16:0 content in ORG than in CON. Mozzarella TSG showed lower fat and, therefore, fatty acid content, and greater moisture, ash, and Mg content in ORG than in CON. In conclusion, few significant differences in chemical composition were observed between ORG and CON cheeses, regardless of the type considered. Moreover, Asiago PDO fresco showed fewer significant differences between ORG and CON compared with Latteria, Caciotta, and Mozzarella TSG

Clinical presentation, management and follow-up of 83 patients with Leydig cell tumors of the testis: a prospective case-cohort study

LCTs are more frequent than generally believed, are associated with male infertility, cryptorchidism and gynecomastia, and should be treated conservatively (in compliant patients) with active surveillance, which appears to be a safe alternative to surgical enucleation. WHAT IS KNOWN ALREADY Increasing referrals for testicular imaging have led to an increase in findings of LCTs. The features and natural history of these tumors remain largely unknown, as the available studies are small and heterogeneous. LCTs were previously treated aggressively and follow-up data are lacking. STUDY DESIGN, SIZE, DURATION A case-cohort study of consecutive patients diagnosed with LCTs over a 10-year period was prospectively enrolled from 2009 to 2018 and compared to matched cohorts of patients with seminomas or no testicular lesions screened in the same timeframe. PARTICIPANTS/MATERIALS, SETTING, METHODS Of the 9949 inpatients and outpatients referred for scrotal ultrasound, a total of 83 men with LCTs were included. Enrolled subjects underwent medical history and clinical examination and were asked to undergo routine blood tests, hormone investigations (FSH, LH, total testosterone, estradiol, inhibin B, sex hormone-binding globulin (SHBG), prolactin), and semen analysis. Patients who consented also underwent contrast-enhanced ultrasound, elastography, gadolinium-enhanced scrotal magnetic resonance imaging, and hCG stimulation test (5000 IU i.m.) with serum total testosterone and estradiol measured at 0, 24, 48, and 72 hours. MAIN RESULTS AND THE ROLE OF CHANCE In total, 83 patients diagnosed with LCTs were compared against 90 patients diagnosed with seminoma and 2683 patients without testicular lesions (NoL). LCTs were diagnosed by enucleation (48.2%), orchiectomy (13.3%), or clinical surveillance (38.5%). Testicular volume, sperm concentration, and morphology were lower (P = 0.001, P = 0.001, and P < 0.001, respectively) in patients with LCTs than in the NoL group. FSH, LH, and SHBG were higher and the testosterone/LH ratio was lower in LCTs than in the NoL group (P < 0.001). The LCT group showed higher SHBG (P = 0.018), lower sperm concentration (P = 0.029), and lower motility (P = 0.049) than the seminoma group. Risk factors for LCTs were cryptorchidism (χ2 = 28.27, P < 0.001), gynecomastia (χ2 = 54.22, P < 0.001), and low testicular volume (χ2 = 11.13, P = 0.001). Five cases were recurrences or bilateral lesions; none developed metastases during follow-up (median, 66 months). LIMITATIONS, REASONS FOR CAUTION This study has some limitations. First, hCG and second-line diagnostic investigations were not available for all tumor patients. Second, ours is a referral center for infertility, thus a selection bias may have altered the baseline features of the LCT population. However, given that the comparison cohorts were also from the same center and had been managed with a similar protocol, we do not expect a significant effect. WIDER IMPLICATIONS OF THE FINDINGS LCTs are strongly associated with male infertility, cryptorchidism, and gynecomastia, supporting the hypothesis that testicular dysgenesis syndrome plays a role in their development. Patients with LCTs are at a greater risk of endocrine and spermatogenesis abnormalities even when the tumor is resected, and thus require long-term follow-up and prompt efforts to preserve fertility after diagnosis. LCTs have a good oncological prognosis when recognized early, as tissue-sparing enucleation is curative and should replace orchiectomy. Conservative surgery and, in compliant patients, active surveillance through clinical and radiological follow-up are safe options, but require monitoring of testicular failure and recurrence