Eye Closure Research Articles

The Effect of Upright Stance and Vision on a Cognitive Task in Elderly Subjects and Patients with Parkinson's Disease.

Standing compared to sitting enhances cognitive performance in healthy subjects. The effect of stance on cognitive performance has been addressed here in patients with Parkinson's disease (PwPD). We hypothesized that a simple cognitive task would be less enhanced in PwPD by standing with respect to sitting, because of a larger cognitive effort for maintenance of standing posture than in healthy subjects. We recruited 40 subjects (20 PwPD and 20 age-matched healthy subjects, HE). Each participant performed an arithmetic task (backward counting aloud by 7) in two postural states, sitting and standing, with eyes open (EO) and with eyes closed (EC). All trials lasted 60 s and were randomized across subjects and conditions. The number of correct subtractions per trial was an index of counting efficiency and the ratio of correct subtractions to total subtractions was an index of accuracy. All conditions collapsed, the efficiency of the cognitive task was significantly lower in PwPD than HE, whilst accuracy was affected to a lower extent. Efficiency significantly improved from sitting to standing in HE under both visual conditions whilst only with EO in PwPD. Accuracy was not affected by posture or vision in either group. We suggest that standing, compared to sitting, increases arousal, thus improving the cognitive performance in HE. Conversely, in PwPD this improvement was present only with vision, possibly due to their greater balance impairment with EC consuming an excess of attentional resources. These findings have implications for balance control and the risk of falling in PwPD in the absence of visual cues.

High-speed data transmission over a microresonator frequency comb with dispersion compensation for augmented data rates and reach

Abstract Microresonator frequency comb-based high-speed data transmission provides a pathway towards augmented data capacity without increasing the number of laser sources. Their use with intensity-modulated direct detection modulation (IMDD) formats is especially pertinent in data center communications where minimizing cost, latency and complexity is paramount. This however implies that the same extent of digital signal processing techniques commonly used in coherent detection for the management of fiber impairments including chromatic dispersion are not available. With the proliferation of silicon photonics technologies in data center transceivers integrated dispersion compensation which can overcome fiber impairments would be of great merit. We demonstrate low power generation of the primary comb state in a silicon nitride microresonator and transmission of 25 Gb/s NRZ and 50 Gb/s PAM4 data over 20 km of single mode fiber. This represents the longest fiber reach demonstrated to date for the transmission of IMDD data using an integrated, microresonator frequency comb. An integrated, tunable grating device for dispersion compensation that reduces dispersion impairments after several fiber lengths generates significant improvements in the eye diagram, six orders of magnitude improvement in the bit-error rate and 14 dB improvement in the transmitter and dispersion eye closure quaternary values. Concurrently, doubling data transmission is demonstrated via polarization multiplexing a comb line and successful dispersion compensation of up to 20 km.

Linear shallow neural network to accelerate transmitter dispersion eye closure quaternary (TDECQ) assessment

Linear shallow neural network to accelerate transmitter dispersion eye closure quaternary (TDECQ) assessment

Risky alcohol use during youth: Impact on emotion, cognitive networks, and resting-state EEG activity

The identification of the risk factors of alcohol consumption in youths is crucial for early interventions focused on reducing harmful alcohol use. In our study, 82 college students (40 healthy control (CO group) and 42 with risky alcohol use (RAU group) determined by AUDIT questionnaire) between the ages of 18 and 25 years underwent a comprehensive neuropsychological assessment covering emotional and cognitive functioning. Their resting-state activity was also recorded with an EEG for 10 min with their eyes open (EO) and 10 min with their eyes closed (EC) and analyzed using the Fitting Oscillations & One-Over-F (FOOOF) paradigm. After adjusting for sex, those in the RAU group had higher emotional dysregulation and impulsivity traits. The RAU girls presented more emotional regulation problems, such as dysregulation and negative urgency compared with the RAU boys. The RAU youths had significantly worse functioning in several cognitive domains, such as sustained attention, verbal memory, and executive functions. Cognitive network analysis revealed a different pattern of connections in each group showing that in the RAU group, the verbal memory domain had the highest connection with other cognitive functions. The EEG analyses did not reveal any significant differences between the CO and the RAU groups. However, we observed only in the EO condition that boys the from the RAU group displayed a higher theta/beta ratio than the RAU girls, whereas these differences were not observed within the CO group. Our findings highlight the need to explore more deeply the emotional, cognitive and brain changes underlying the RAU in young people.

Photosensitivity and self-induction in patients aged 50 and older.

Photosensitivity is known to occur predominantly in children and adolescents and with a clear female predominance. Little is known on the prevalence of photosensitivity in older patients (50+) and its phenotypical appearance. A retrospective observational study was performed investigating the prevalence of a photoparoxysmal EEG response (PPR) on at least one EEG during the period 2015-2021. Data were gathered from patients aged 50 years and older by retrieving clinical and EEG characteristics from existing medical records. Data on photosensitivity-related symptoms in daily life were gathered with telephone interviewing. In 248 patients a PPR had been elicited, of whom 16 patients (6.5%) were 50 years or older. In older patients, photosensitivity was a persistent feature of childhood-onset epilepsy (n = 8), of adult-onset epilepsy (n = 7), or an incidental finding (n = 1). In the 50+ group, 56% of photosensitive patients was female, whereas 72% in the total PPR-group. In six of 16 older patients, eye closure sensitivity was observed; two of these patients reported self-induction. Symptoms of photosensitivity in daily life were present in eight out of nine patients who consented in a telephone interview. For seven of these patients, wearing sunglasses was helpful. Female preponderance for photosensitivity was not found in epilepsy patients of 50 years and older. In 44% of the older photosensitive patients in this series, the PPR was a feature of adult-onset epilepsy. Symptoms of photosensitivity in daily life in older patients with epilepsy seem comparable to those in younger patients, and thus worthwhile to diagnose and treat them equally.

The relationship between postural control and cognitive functioning following Zumba dancing in middle-aged women: A randomized clinical trial

This study aimed to investigate the effect of 12-week Zumba dancing on postural control and cognitive parameters and the correlations between these parameters in middle-aged women. Thirty-eight women, aged between 50 and 60 years, were randomly allocated to a Zumba group (ZG) or control group. Postural control and cognitive functions [working memory (WM) and reaction time (RT)] were assessed before and after 12 weeks of a Zumba dancing program using a stabilometric force platform, Corsi Block-Tapping Task and Simple RT tests, respectively. The results indicate that ZG showed significantly (p<.01) better balance performances when standing on a stable surface in both visual conditions [firm surface with eyes opened (EO) (20,9%) and eyes closed (EC) (12.3%)]. However, when standing on an unstable surface in both visual conditions (foam surface with EO/EC), the ZG showed no significant improvement in postural control. It seems that the benefits of Zumba on postural control depend on the sensory condition. Besides, 12-week Zumba dancing was not sufficient to significantly enhance cognitive performances (RT/WM) performances. These cognitive performances were related to postural control in challenging conditions and can be considered an effective tool for monitoring postural performances following an intervention program. Clinicians should, therefore, focus on interventions that boost cognitive functions in middle-aged women to achieve optimal postural control, mainly in challenging conditions, in order to prevent the risk and fear of falls as well as the incidence of falling.

Electroencephalogram-Based Metastability in Mild Cognitive Impairment Alzheimer's Disease.

Background: In this study, we analyze metastability, a feature of brain dynamics in subjects experiencing mild cognitive impairment Alzheimer's disease (MCI-AD) under eyes open (EO) and eyes closed (EC) conditions. Alzheimer's disease (AD) is a critically prolonged brain disorder that interrupts neural synchronization and desynchronization. Thus, studying metastability under EO and EC conditions would help in understanding the cortical dynamics and its impact in early-stage AD. Methods: Metastability is investigated using three methods namely frequency variance analysis, Kuramoto order parameter, and through meta-state activation patterns. Frequency variance estimated from 21 electroencephalogram (EEG) channels was clustered into three regions namely anterior, central, and posterior to study the regional metastability analysis. Global metastability was assessed from Kuramoto order parameter and meta-state activation patterns by collating the 21 EEG channels. Results: Reduction in metastability was observed in central regions of MCI-AD subjects through the study of frequency variance analysis. There was a marked reduction in global metastability in the patient group under the resting EO condition. Reduction in meta-state activation properties such as temporal activation sequence complexity, modularity, and leap size in MCI-AD condition under the EO condition indicates an overall reduction in brain flexibility. Conclusion: Taken together, the study infers an underlying structural change in neuronal dynamics influencing the reduction of metastability under the MCI-AD condition. The study further revealed that this reduction in metastability is more pronounced in the EO condition.

Developmental outcome of electroencephalographic findings in SYNGAP1 encephalopathy.

SYNGAP1 haploinsufficiency results in a developmental and epileptic encephalopathy (DEE) causing generalized epilepsies accompanied by a spectrum of neurodevelopmental symptoms. Concerning interictal epileptiform discharges (IEDs) in electroencephalograms (EEG), potential biomarkers have been postulated, including changes in background activity, fixation-off sensitivity (FOS) or eye closure sensitivity (ECS). In this study we clinically evaluate a new cohort of 36 SYNGAP1-DEE individuals. Standardized questionnaires were employed to collect clinical, electroencephalographic and genetic data. We investigated electroencephalographic findings, focusing on the cortical distribution of interictal abnormalities and their changes with age. Among the 36 SYNGAP1-DEE cases 18 presented variants in the SYNGAP1 gene that had never been previously reported. The mean age of diagnosis was 8 years and 8 months, ranging from 2 to 17years, with 55.9% being male. All subjects had global neurodevelopmental/language delay and behavioral abnormalities; 83.3% had moderate to profound intellectual disability (ID), 91.7% displayed autistic traits, 73% experienced sleep disorders and 86.1% suffered from epileptic seizures, mainly eyelid myoclonia with absences (55.3%). A total of 63 VEEGs were revised, observing a worsening of certain EEG findings with increasing age. A disorganized background was observed in all age ranges, yet this was more common among older cases. The main IEDs were bilateral synchronous and asynchronous posterior discharges, accounting for ≥50% in all age ranges. Generalized alterations with maximum amplitude in the anterior region showed as the second most frequent IED (≥15% in all age ranges) and were also more common with increasing age. Finally, diffuse fast activity was much more prevalent in cases with 6years or older. To the best of our knowledge, this is the first study to analyze EEG features across different age groups, revealing an increase in interictal abnormalities over infancy and adolescence. Our findings suggest that SYNGAP1 haploinsufficiency has complex effects in human brain development, some of which might unravel at different developmental stages. Furthermore, they highlight the potential of baseline EEG to identify candidate biomarkers and the importance of natural history studies to develop specialized therapies and clinical trials.

Impact of neuromuscular training including balance, strength and plyometric exercises on static and dynamic balance in high-level male runners with mild intellectual disability.

This study aims to investigate the impact of neuromuscular training (NMT) on static and dynamic postural balance (PB) among high-level male runners with intellectual disability. Twenty-seven runners were randomly assigned to a NMT group and a control group who maintained their conventional training. Static and dynamic PB were assessed using the centre of pressure (CoP) excursions (in bipedal and unipedal stances under open eyes (OE) and closed eyes (CE) conditions) and the star excursion balance test (SEBT), respectively, at pre-training and post-training. The NMT group showed significantly (p < 0.05) decreased CoP values and increased SEBT scores at post-training compared to pre-training. The switch from OE to CE did not affect static PB in the bipedal stance, only in the NMT group. The NMT was effective in improving static and dynamic PB in runners with intellectual disability. The NMT could reduce visual dependency.

Sponge Inspired Flexible, Antibacterial Aerogel Electrode with Long‐Term High‐Quality Electrophysiological Signal Recording for Human‐Machine Interface

AbstractFlexible bioelectronics have a large range of applications in the field of human health monitoring and human‐machine interfaces. Among various bioelectronics, flexible electrodes have been widely studied. However, it is still lack of investigation in the development of electrodes with high signal quality and long service life. Here, a sponge inspired flexible electrode based on cellulose aerogel is developed via thermally induced phase separation. Due to its flexibility, the electrode can easily conform to skin and achieve a higher signal‐to‐noise ratio (SNR) than the commercial rigid electrode. At the same time, the aerogel electrode with a sponge‐like structure can absorb solutions several times their own weight (≈800%). In addition, the dope of polypyrrole coated silver nanowires (AgNWs@PPy) improves its intrinsic bactericidal activity (antibacterial rate above 97.8%) and the cellulose‐based material itself offers good skin compatibility. Therefore, all these features contribute to a longer service life, while has been proven in electrophysiological signals recording. The SNR of electrocardiogram (ECG) signals recorded by aerogel electrode in 24 h is ≈15% higher than that of commercial electrode. Apart from that, when the commercial electrode is unavailable for eye‐open (EO) and eye‐closed (EC) paradigm in 12 h, the aerogel electrode can still record clear electroencephalogram (EEG) features.

Lower Eyelid Laceration in Children: A Case Report

Introduction : Eyelid lacerations may be associated with serious ocular injury and are often accompanied by other ocular injuries. Most injuries occur in children. Eyelids have an important role in protecting the globe. Effective management of eyelid lacerations requires an understanding of the basic anatomical features of the eyelids.&#x0D; Case Illustration : A two-year-old boy was brought to our emergency department after getting scratched in the eyelid by the family dog. The patient has received first aid and a tetanus shot at another hospital. Eye examination shows a lower eyelid laceration on the right eye, extending from the medial downwards around 3 cm. Visual examination was central+, steady+, maintenance+, and eye movement was within normal limits. The patient was admitted to undergo eyelid repair in the operating room.&#x0D; Discussion : The first step in eyelid repair is wound irrigation and removal of foreign particles to avoid infection and inflammation, and primary repair of eyelids should be performed within 12 to 24 hours of the injury to reduce subsequent complications. The recommended method for best wound closure and healing is gently handling tissue edges, slight eversion, and using the smallest diameter sutures. A proper pre-operative assessment and surgical planning include evaluation of the thickness of the defect, the size, the location, and the involvement of canthus and lacrimal drainage. The goals are to provide adequate eye closure, preservation of tear film, maintenance of visual field, and aesthetics.&#x0D; Conclusion : A thorough knowledge of the eyelid anatomy and suture technique is important to successfully repair the defect while maintaining eyelid function.

Eye Blink Detection- A New System for Driver Drowsiness and Distraction Detection

The advancement of technology has led to innovative solutions for ensuring road safety, particularly in the detection of driver drowsiness and distraction. This abstract presents a novel approach using eye blink detection as a fundamental component in a system designed to mitigate the risks associated with drowsy and distracted driving. The proposed system integrates cutting-edge computer vision techniques to accurately detect and analyze eye blinks in real-time. By utilizing high-resolution cameras installed within the vehicle, the system captures and processes images of the driver's face, focusing on the eyes to track blinking patterns and durations. Through sophisticated algorithms and machine learning models, it distinguishes between normal blinks and extended periods of eye closure, indicative of drowsiness or distraction. Furthermore, the system incorporates contextual awareness by considering various factors such as environmental conditions, driving behavior, and facial expressions to enhance the accuracy of detection. Machine learning algorithms trained on diverse datasets enable the system to adapt and improve its performance over time, making it more adept at recognizing subtle variations in blink patterns unique to each driver. The applications of this system are multifaceted. Firstly, it serves as an early warning system, alerting drivers when signs of drowsiness or distraction are detected. This proactive approach aims to prevent accidents by prompting drivers to take necessary breaks or refocus their attention on the road. Moreover, the system can integrate with existing driver assistance technologies, allowing for automated interventions, such as adjusting seat vibrations or emitting audible alerts to re-engage the driver. In conclusion, the proposed eye blink detection system represents a significant advancement in the realm of driver safety technologies. By leveraging sophisticated algorithms and real-time analysis of blink patterns, it offers a promising solution to mitigate the risks associated with driver drowsiness and distraction, ultimately contributing to safer roads and reducing the likelihood of accidents. KEYWORDS: Eye blinking, Detection, Driver, Drowsiness, Distraction, Detection, computer vision, machine learning, Deep learning, image processing.

Effects of Pilates Exercises on Core Stability After Recovery from COVID-19: A Randomized Controlled Trial.

The primary objective was to investigate the effects of Pilates exercises on CS, and the secondary objective was to assess static trunk balance after recovery from COVID-19. 145 recovered COVID-19 university students between the ages of 19 and 25 participated in this single-blinded, randomized controlled trial study. The participants were divided into a Pilates group and a control group, each of which received a home exercise program. Core muscle endurance was measured using the five basic endurance tests and static balance using the Prokin system with open eyes (OE) and closed eyes (CE) at baseline and after three months of treatment. All measured parameters showed improvement within the groups after treatment. Group comparison revealed a significant increase in the Pilates group in all core endurance tests (P<0.001). The Prokin system results showed improvement in the Pilates group after treatment, while perimeter with OE, CE, and ellipse area with EC decreased (P<0.001), but there was no significant difference in ellipse with OE between the groups. Pilates exercises positively improved core muscle endurance and trunk balance in people infected with COVID-19, which will be reflected in their quality of movement patterns and quality of life.

Blepharoclonus in Parkinsonism.

In clinical practice, we have observed that patients with Parkinson disease (PD) often have blepharoclonus, but its prevalence is not well described in the literature. Understanding the relative frequencies of blepharoclonus in PD and atypical parkinsonian syndromes may shed light on the diagnostic utility of this clinical sign. We aimed to assess (1) the frequency of blepharoclonus in patients with PD in a single-center cohort; (2) the association of blepharoclonus with disease stage, tremor severity, and non-motor symptoms; and (3) the frequency of blepharoclonus in synucleinopathy vs non-synucleinopathy-associated parkinsonism. We prospectively enrolled 85 patients, 75 with PD and 10 with atypical parkinsonism. Blepharoclonus was considered present if eyelid fluttering was sustained for >5 seconds after gentle eye closure. For each patient, demographics were collected, and we completed selected questions from the MDS-UPDRS (Unified Parkinson's Disease Rating Scale) part 2, REM Sleep Behavior Disorder Questionnaire, and MDS-UPDRS part 3 tremor assessments and recorded the presence/absence of dyskinesia. 63 of 75 patients with PD (84%) had blepharoclonus. Among the 10 patients with atypical parkinsonism, 5 had synucleinopathy syndromes. Blepharoclonus was present in 3 of 5 patients with synucleinopathy and 0 of 5 patients with non-synucleinopathy-associated parkinsonian syndromes. Blepharoclonus is prevalent in our PD cohort, suggesting possible utility as a clinical marker for PD. The absence of blepharoclonus in a patient with parkinsonism may suggest a non-synucleinopathy (e.g., tauopathy). Analysis of a larger cohort of both PD and atypical parkinsonism would be needed to establish whether blepharoclonus distinguishes PD from atypical parkinsonism, or synucleinopathy from non-synucleinopathy.

Time Series Data Analysis of Mindfulness Breathing Method Using Electroencephalogram.

Workers and students are often stressed and distressed by a variety of factors, including work and study. However, support for individual psychological stress is not yet well established. This study aimed to evaluate the effect of mindfulness breathing on the mental load of college students using an electroencephalogram (EEG). Twenty participants were randomly allocated into treatment or control groups, with 10 participants in each group. Mindfulness breathing was applied to participants in the treatment group, while those in the control group received no treatment. The regression equation was evaluated from the EEG, and time series analysis was performed based on autocorrelation and partial autocorrelation. In the After condition after mindfulness breathing exercises in the Mi group, the alpha wave content of the regression equation at eye closure after task performance showed an upward trend, and the autocorrelation coefficient showed repeated upward and downward fluctuations. It was suggested that alpha wave content may increase over time with mindfulness breathing exercises. The EEG after mindfulness breathing exercises was shown not to be constant and to have non-linear characteristics. This suggested that the effects of mindfulness breathing exercises could be evaluated using time series data.

Abducens palsy with facial nerve palsy: A rare clinical presentation

Abstract Multiple cranial nerve palsies are commonly due to brainstem lesions and the presence of abducens nerve palsy with peripheral facial nerve palsy is very rare and the exact etiologies are not defined. Very few reports of pontine infarct are associated with the condition. We report a young male presented with sudden onset diplopia with left-side abduction deficit and inadequate eyelid closure of the left eye. Upon evaluation, it was found to have high blood pressure recordings and imaging revealed the presence of an ipsilateral pontine infarct. The patient was managed with antihypertensives and antiplatelet agents and symptomatic resolution was found after 2 months of follow-up. This report describes a very rare association of abducens and facial nerve palsy in pontine infarct and to our best knowledge only a few reports are available on the same.

Tape Tarsorrhaphy in the Management of Lagophthalmos Caused by Severe Congenital Blepharoptosis Procedures.

Lagophthalmos, a common complication after blepharoptosis correction, has plagued oculoplastic surgeons. The goal of this study was to investigate the effect of tape eyelid closure on reducing the occurrence of lagophthalmos after blepharoptosis correction. From April 2020 to June 2021, a total of 112 patients with severe congenital ptosis received corrective surgery at the Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University. Of these, 48 underwent frontalis muscle advancement technique and 64 underwent conjoint fascial sheath suspension. Preoperative data collected included demographics, levator function, Bell's phenomenon, and marginal reflex distance 1 (MRD1). Postoperative data included surgery type, MRD1, eyelid closure function, aesthetic outcomes (including eyelid contour, eyelid symmetry, and eyelid crease), keratitis, and other complications. Frontalis muscle advancement technique group: the median of safe eye closure time was 7.3 months (positive Bell's phenomenon; interquartile range [IQR], 3.8-10.8 months) and 13.9 months (poor Bell's phenomenon; IQR, 11.6-16.1 months). There was a significant improvement between the preoperative and postoperative MRD1 (-1.52 ± 0.82 vs 3.85 ± 0.58 mm, P < 0.05). Conjoint fascial sheath suspension group: the median of safe eye closure time was 5.7 months (positive Bell's phenomenon; IQR, 2.9-8.5 months) and 12.4 months (poor Bell's phenomenon; IQR, 8.1-16.7 months). There was a significant improvement between the preoperative and postoperative MRD1 (-1.02 ± 0.91 vs 4.15 ± 1.03 mm, P < 0.05). All patients/guardians were satisfied with the aesthetic outcomes. Tape tarsorrhaphy is a safe, easy-to-learn method for treating lagophthalmos with a good aesthetic outcome.

Depression Identification Using Asymmetry Matrix and Machine Learning Algorithms

Purpose: Developing an efficient and reliable method for the identification of depression is highly important. This paper aims to propose an approach for depression diagnosis using an interhemispheric asymmetry matrix and machine learning algorithms.&#x0D; Materials and Methods: First, an EEG signal was acquired from 24 depressed patients and 24 healthy subjects. The EEG signal was acquired from participants for 5 minutes in Eyes-Closed (EC) and 5 minutes in Eyes-Open (EO) condition. After preprocessing data, interhemispheric asymmetry for absolute and relative powers of theta and beta frequency bands, theta-to-alpha power ratio, and Individual Alpha Frequency (IAF) features were computed. Then, the proposed asymmetry matrix is used as a feature for statistical and classification analysis. In this paper, the classification was performed using a Support Vector Machine (SVM), logistic regression, and Multi-Layer Perceptron (MLP).&#x0D; Results: The results demonstrated that central and temporal theta absolute power, central and temporal IAF asymmetries in the EC condition and occipital beta absolute power, temporal theta relative power, temporal theta-to-alpha power ratio, and temporal IAF asymmetries in the EO condition have significant differences between depressed and healthy groups. Findings show that beta absolute power asymmetry in the occipital region and EO condition is a good biomarker for depression identification with 77.1% accuracy using the Gaussian SVM classifier.&#x0D; Conclusion: The results of this study show performance of proposed asymmetry matrix features in depression detection. Findings show that beta absolute power asymmetry in the occipital region and EO condition is a good biomarker for depression identification.

In-vehicle fragrance administration as a countermeasure for driver fatigue

Driver fatigue is a contributing factor in about 10–30% of all fatal crashes. Prevention of fatigue-related crashes relies on robust detection of driver fatigue and application of effective countermeasures. A potential countermeasure is fragrance administration since odors can have alerting effects on humans. The aim here was to investigate if a fragrance incorporating trigeminal components could be used as an in-vehicle countermeasure for driver fatigue.The fragrance was tested in a driving simulator with 21 healthy but sleep-deprived participants. Each participant performed a monotonous driving task twice, once with active fragrance containing a trigeminal component and once with olfactory fragrance, in a cross-over single-blind design. The order of trigeminal/olfactory fragrance was randomized and blinded to the participants. Both fragrances (trigeminal/olfactory) were administered either when the participant fell asleep (defined as eye closure > 3 s) or after approximately 45 min if the participant did not fall asleep.Self-reported sleepiness was assessed using the Karolinska Sleepiness Scale (KSS) every 5 min during driving. Variability in speed and lateral position and line crossing frequency were logged for each drive to measure driving performance. Heart rate measurements (ECG) and eye blinks (EOG) were collected to investigate potential arousing effects of the fragrance and to track objective signs of sleepiness.Mean blink duration, which was used as an objective measure of sleepiness, decreased significantly, after fragrance exposure, as did the frequency of line crossings, but there were no statistically significant differences between the fragrance with trigeminal stimulus and the pure olfactory fragrance.The results are in line with the effects found for other commonly used fatigue countermeasures, like playing loud music. These countermeasures can restore alertness and driving performance for a short while. Whether this is sufficient to support driving performance until the driver can make a safe stop in real traffic remains a topic for future studies.

Sjogren's syndrome meets Meige's syndrome

This report details a rare case where a patient simultaneously suffered from Sjogren's syndrome (SS) and Meige's syndrome (MS). SS, an autoimmune disorder, and MS, a rare neurological condition characterized by involuntary eyelid closure, presented in a 73-year-old male. The patient had been experiencing dry eye symptoms for the past 5 years, with the onset of eyelid spasms and tetanic eye closure occurring 3 years ago. Traditional treatments, including subthalamic nucleus deep brain stimulation, provided only temporary relief. Diagnostic evaluations, including blood tests and imaging, confirmed SS and MS coexistence. Treatment involved a combination of steroids, immunosuppressants, and immunoglobulin, leading to significant symptom relief. This case suggests a potential association between SS and the development of MS, highlighting the importance of immunomodulatory therapy in managing neurological symptoms. Further research is needed to explore the relationship between these two conditions and to develop more effective treatment strategies.