Mirror View Research Articles

Improving walking via real-time visual feedback after stroke in treadmill training (RE-VISIT): a protocol for randomized controlled trial

BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating real-time visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.

Indirect laryngeal surgery of vocal fold polyps: a dying or evolving art?

Vocal fold polyps (VFPs) are the most common benign laryngeal lesions that require surgery and are routinely managed by microlaryngoscopy (MLS) under general anaesthesia. Prior to introduction of MLS, VFPs were removed using indirect laryngoscopic surgery (ILS) in local anaesthesia, a procedure that required substantial surgical skill to operate with an unmagnified mirror view of the larynx. With the adoption of wireless endoscopy equipment and personal computers, we tried to simplify this technique so that it can be easily performed in the office. This study aimed to assess the effectiveness of ILS by comparing voice outcomes with MLS. ILS and MLS were performed in six patients each. Treatment outcomes were measured using a voice self-assessment and objective acoustic analysis. The total cost of both procedures was calculated. Both techniques allowed successful removal of VFPs in all patients, without significant intergroup differences in voice outcomes. The cost of ILS was significantly lower. Despite the pilot nature of the study and the small sample size, our data indicate the potential value of this technique which, considering its simplicity and economic value could be used as an alternative to MLS in carefully selected patients.

360-degree video-based body-ownership illusion for inducing embodiment: development and feasibility results

Illusions that create a sense of ownership over a virtual body have been widely used to investigate the characteristics of our bodily experience. Despite the great potential of 360-degree videos to implement full-body ownership illusion, research is in its early stages, and no validated tools—neither commercial nor free—are available for the scientific and clinical community. In the current study, we present and discuss the development and feasibility results of a free 360-degree video-based body ownership illusion that researchers and scholars can experience using a cardboard headset with their smartphones. Forty-six participants underwent the 360-degree video-based full-body ownership illusion, visualizing in a first-person perspective (1PP) or in a mirror view the pre-recorded body of a young female performer. All participants were exposed to a congruent visuo-tactile condition (embodiment condition) and to an incongruent visuo-tactile condition (control condition). Participants completed the Embodiment Questionnaire and the Objectified Body Consciousness (OBC) scale. Results revealed that in the congruent visuo-tactile condition (compared to the control one), participants experienced a strong illusion in terms of body ownership, self-location, and agency. In terms of visual perspective, there was no difference in embodiment feelings between participants who experienced the illusion in 1PP and those who underwent a mirror perspective. Lastly, the control beliefs subscale (i.e., OBC scale) displayed a positive correlation with the self-location illusion susceptibility. Overall, these results point to the feasibility of this novel tool as immersive 360-degree video-based scenarios to deliver bodily illusions, and they open new avenues for future clinical interventions.

Endotracheal Intubation with Laryngeal Mirror in Simulated Difficult Direct Laryngoscopy: Comparison of Gum Elastic Bougie Versus Styleted Endotracheal Tube.

Laryngeal mirror (LM) is an inexpensive, portable, readily available device which can help visualize the vocal cords in difficult airway (DA) situations. We evaluated its use in improving glottic view prior to placing the airway adjuncts in simulated difficult airway.Eighty patients scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation were allocated- Bougie group (Group B) and Stylet group (Group S). Direct laryngoscopy was performed and CL grade III simulated. The glottic view was obtained using laryngeal mirror and Gum Elastic Bougie (GEB)/ Styleted Endotracheal Tube (ETT) inserted under mirror view. Time taken to obtain glottic view in LM and time for successful intubation were noted.Significant improvement in glottic view with LM was observed, with the view improving to Grade I in 76.25% and grade II in 23.75% of patients. Both groups were comparable with respect to number of attempts and success rate (p = 0.55).The success rate was 90% in group B and 95% in group S. Time taken for intubation was less in Group S (52.44 ± 14.23s vs. 62.805 ± 20.74s) [p = 0.01]. Hence, overall stylet proved to be a better adjunct with mirror guided intubation.We recommend stylet assisted rather than GEB assisted ET intubation under LM guidance in emergency scenarios. Also, further controlled trials are recommended to know the exact location of the mirror in relation to bulb of the laryngoscope as well as different angles at which it is placed to improve the view and stabilize the assembly.

Are you a mentor? A qualitative study: imago-graphic students’ mirror views

Objectives: Mentoring is widely acknowledged for providing support, fostering students’ learning and self-development. This study was conducted at the Faculty of Medicine, Suez Canal University with the following objectives, exploring students’ perception of their mentors, analysing expected roles and essential skills for mentors.
 Methodology: A qualitative study was conducted. A focus group was planned in the first mentorship session, a sample of 30 year 1 and 2 students divided into 2 focus groups (n=15 students per a focus group). Focus group started with an imaginary students’ drawing of the mentor followed by further analysis and discussion.
 Results: Data displayed in a graphical format, and then further discussed to have more details. Three main themes had emerged: perception of mentors, role of the mentor and expectations from mentors. Perception was then analysed into positive, where the ease of communication was mostly discussed, and negative perception where the fear of humiliation was one of the common students’ fears. For mentors’ roles, guidance for portfolio submission was the highest frequency (45%) then came the role of academic and personal support (30%).
 
 Conclusion: Mentorship experience is a rich process of interaction and communication between mentors and mentees. Mentors should receive appropriate training to be well prepared for their roles. This study provides practical insights into essential skills mentors should have for an effective mentorship experience.
 Keywords: mentorship, info-graphic, mentors, qualitative, focus group

Effects of Line of Vision on Posture, Muscle Activity and Sitting Balance During Tooth Preparation

ObjectivesMost dentists maintain awkward and restricted postures for prolonged periods that stress the body while providing direct patient care. Information about working posture must be analysed in a more systematic manner to provide a deeper understanding of the relationship between working posture and work-related musculoskeletal disorders (MSD). Therefore, the present study aimed to clarify the effects of different lines of vision during tooth preparation, such as the direct and the mirror view technique, on-body tilt (angle), muscle activity, and sitting balance, which may correlate with the reduction or prevention of MSD. MethodsA mannequin head with a maxillary right first molar embedded in a model was attached to the dental chair headrest. Two different techniques for tooth preparation were selected: direct view and mirror view. Muscle activity, body tilt (angle), and sitting balance were analysed as independent parameters. ResultsDifferent tooth preparation techniques had a distinct influence on body tilt (angle), muscle activity, and sitting balance. The direct view technique resulted in significantly larger values for all parameters, except for the activity of the spinal column erector muscles than the mirror view technique. ConclusionBased on these results, the direct view technique for tooth preparation, which is used by most dentists in practice, imposes a burden on the lower back, shoulders, and neck of the dentist.

Educating Nurses on Supported Mirror Viewing for Patients After Amputation and Other Physical Disfigurements.

Rehabilitation Nursing: 1/2 2021 - Volume 46 - Issue 1 - p E4-E5 doi: 10.1097/RNJ.0000000000000309

Educating Nurses on Supported Mirror Viewing for Patients After Amputation and Other Visible Disfigurements.

The aim of our study was to test an educational intervention to improve nurses' confidence in supporting and frequency of offering a mirror to patients who have recently suffered visible body disfigurement. Forty-eight registered nurses who worked in two acute care hospitals took part in a mixed-method one-group repeated-measures (pretest and posttest) research study. The educational intervention included a video, a presentation, and a recorded discussion. Study participants experienced a significant increase in confidence in supporting and frequency of offering mirrors to patients. An overarching theme from the qualitative analysis was that the nurse participants perceived assisting patients in viewing their changed bodies in mirrors as "an act of compassion." Four subthemes emerged: (a) seeing mirrors differently, (b) there is only one first time, (c) how can we do this better, and (d) "me too" stories of their own and patients' difficult mirror-viewing experiences. Education enhances nurses' frequency of offering mirrors and supporting patients in mirror viewing after visible disfigurement because of trauma or surgery. Education provides nurses with the necessary skills to assist patients in adapting to an altered body image.

Transforming the Experience of Mirror Viewing for Individuals Faced With Disfiguring Injuries.

This study explored the feasibility of educating nurses on an emotionally sensitive topic using video. The aim was to educate nurses on how to assist individuals who have had an amputation of a limb in viewing themselves in the mirror. One-group repeated-measures design with 2 time points (pretest and posttest at 1 month). Nurses viewed a video in which 8 amputee actors described how and why nurses should support individuals' viewing of self in the mirror following amputation. This video-based education was feasible, and recommendations were made for future research. Participants were engaged and shared insight into how this knowledge would change their nursing practice. A larger educational research study to test the effect of this education on improving nursing confidence and offering the mirror is recommended.

A facile and versatile route for preparation AgNp nanocomposite thin films via thiol-acrylate photopolymerization: Determination of antibacterial activity

Size, shape and distribution-controlled silver nanoparticles (AgNps) were produced by a rapid and efficient method either in solvent or in polymer matrix by which the silver ion is reduced and a polymer matrix is simultaneously generated in the presence of various photoinitiators by the means of UV light.2-Mercaptothioxanthone (TX-SH), Thioxanthone (TX) and TX + Thiophenol were used as photoinitiator systems for the polymerization of PEGMEA/PEGDA monomer mixture in the presence of AgNO3 salt. As a summary of results, it is important to note that the size and distribution of Nps depend on the photoreducing species. Therefore TX-SH, due to thiol functionality in its structure, helped production of he 7–40 nm size and distribution-controlled AgNps in polymer matrix. In-situ prepared AgNps/Polymer nanocoatings exhibited a reflected silver mirror view as a result of aggregation depending on the irradiation time. Antibacterial efficiency and susceptibility of AgNps containing nanocomposite films were examined for t E. coli, P. aeruginosa, S. aureus and B. cereus. Obtained antimicrobial results show that photochemically prepared nanocomposites considerably increase the antimicrobial activity on Gram negative bacteria compared to Gram positive bacteria.

CSP and governance in emerging and developing country firms: Of mirrors and substitutes

AbstractA recent debate in the international CSR literature has focused on the question whether CSR serves as a mirror or a substitute of country-level governance. Advocates of the mirror view highlight the role of country level institutions to drive corporate social performance (CSP) levels, whereas proponents of the substitute view find companies to become more active in light of governance gaps. We contribute to this debate by moving the focus to a sample of 264 emerging economy and developing country companies and by comparing the relationship between country-level governance and CSP based on three different CSP dimensions, namely, emissions, human rights, and community performance. Whilst we find corporate emissions performance and human rights performance to align more closely with the mirror view, there is some indication that corporate community performance—possibly traced back to the longstanding tradition of corporate philanthropy in non-Western contexts—instead acts as a substitute to fill institutional voids. We discuss implications of our findings for research and policymakers.

Nasopharyngeal Width and Its Association With Sleep-Disordered Breathing Symptoms in Children.

ObjectivesAlthough adenotonsillar hypertrophy is the main cause of sleep-disordered breathing in children, surrounding anatomic factors, such as the width of the nasopharynx, can affect upper airway patency. However, there have been no reports of the association of nasopharyngeal width with sleep-disordered breathing in children. This study was undertaken to measure nasopharyngeal width in children undergoing adenotonsillectomy for sleep-disordered breathing and to investigate the clinical implications of this factor.MethodsThis was a retrospective study with a follow-up period of 1 year, performed at a tertiary referral center. We reviewed the operative records of children who underwent adenotonsillectomy at our center for symptoms of sleep-disordered breathing, such as snoring, apnea, and mouth breathing. The nasopharyngeal width was measured immediately before adenotonsillectomy, which was performed under general anesthesia with a microscopy-assisted mirror view. Adenotonsillar hypertrophy was graded on a four-point scale, and symptoms of sleep-disordered breathing were evaluated by using the Korean version of the Obstructive Sleep Apnea-18 questionnaire before and after surgery. The relationships between the average nasopharyngeal width and patient age and sex, adenotonsillar hypertrophy, and the Korean version of the Obstructive Sleep Apnea-18 score were analyzed.ResultsThe study included 549 children (343 boys) with a mean age of 6.0 years (range, 2 to 11 years). The average nasopharyngeal width was 11.9 mm (range, 7.0 to 18.0 mm) and increased with age (range, 11.2 to 13.3; β=0.264; P<0.001). At 1 year after surgery, children with a greater nasopharyngeal width at the time of surgery exhibited additional improvements in symptoms of obstruction relative to those at 1 month after surgery.ConclusionThe average nasopharyngeal width in children is approximately 11.9 mm and exhibits a slight increase with age. The width of the nasopharynx may be a factor associated with the degree of improvement in symptoms of sleep-disordered breathing after adenotonsillectomy.

Developing Country Firms and the Challenge of Corruption

Corruption is an important topic for management scholars and practitioners. Given the rise to economic prominence of firms from developing countries, this paper investigates how developing country firms engage with this challenge. Based on a content analysis of 191 codes of conduct, issued by firms from 18 developing countries, we first investigate what anti-corruption commitments developing country firms make in their codes of conduct; we then determine contextual factors at national business system level that drive differences in firm engagement. We provide evidence for a ‘mirror view’ of corporate social responsibility, according to which companies match the quality of national-level institutions in their own anti-corruption commitments. This result stands in contrast to the basic expectation underlying the concept of corporate social responsibility that companies step in to close governance gaps and address wider societal-level challenges. Our findings thus highlight limitations to purely private governance mechanisms aimed at combatting corruption.

Developing country firms and the challenge of corruption: Do company commitments mirror the quality of national-level institutions?

Corruption is an important topic for management scholars and practitioners. Given the rise to economic prominence of firms from developing countries, this paper investigates how developing country firms engage with this challenge. Based on a content analysis of 191 codes of conduct, issued by firms from 18 developing countries, we first investigate what anti-corruption commitments developing country firms make in their codes of conduct; we then determine contextual factors at national business system level that drive differences in firm engagement. We provide evidence for a “mirror view” of corporate social responsibility, according to which companies match the quality of national-level institutions in their own anti-corruption commitments. This result stands in contrast to the basic expectation underlying the concept of corporate social responsibility that companies step in to close governance gaps and address wider societal-level challenges. Our findings thus highlight limitations to purely private governance mechanisms aimed at combatting corruption.

Rear Mirror View of some Biological Tools and Processes

Rear Mirror View of some Biological Tools and Processes

Assessment of posterior choanal obstruction caused by adenoidal hypertrophy: Intra-operative mirror versus rigid nasendoscopic examination

ObjectivesThe aim of the study is to compare the degree of posterior choanal obstruction caused by adenoidal hypertrophy intra-operatively, when assessed by mirror versus rigid nasendoscopic examination, in children undergoing adenoidectomy. MethodsThis is a prospective blinded study including all consecutive paediatric cases undergoing adenoidectomy under care of the senior author during the period from June 2015 to December 2016. All cases were performed under general anaesthesia. The degree of posterior choanal obstruction caused by adenoidal hypertrophy was assessed in each patient using both a rigid nasendoscope and a nasopharyngeal mirror. Photographs of the choanae and the adenoids were obtained for both methods. Two independent ENT specialists (a registrar and a consultant), who were blinded to the clinical history and identity of the patients, assessed these photographs. Assessors scored the degree of choanal obstruction on the right and left sides separately out of 100%. The scores were analysed using the Two-Sample equal variance T-test function. ResultsA total of 26 patients were included; all of them were children aged between 2 and 13 years. A total of 52 choanae were assessed and photographed, resulting in 52 photographs for the nasendoscopic views and 26 photographs for the mirror views.The trans-nasal nasendoscopic views consistently showed a significantly higher degree of posterior choanal obstruction compared to trans-oral mirror examination views (P-value < 0.001). There was no significant difference between the scores of both assessors (P-value > 0.05). In 8 of the 26 patients (30.7%), the registrar's decision would have changed from not proceeding with surgery had he only used the mirror view, to proceeding with surgery had he also used the nasoendoscopic view. This was the case for 6 of the 26 patients (23%) reviewed by the consultant. There were three patients in common in which both the registrar and the consultant would have similarly changed decisions. ConclusionIntra-operative nasendoscopy is more sensitive than mirror examination in assessing the degree of posterior choanal obstruction due to adenoidal hypertrophy. It is important to consider nasendoscopy in patients with symptoms of adenoidal hypertrophy where mirror examination of the posterior choanae is negative.

Breaking the Carnival Mirror

We present a reflexive paper assignment calling for students to report on their own family and/or personal experiences in order to answer the question, “From where does the greatest harm arise?” We find that, through the process of answering this question and sharing findings in class, students’ conception of criminality is broadened. Institutional forms of deviance and white-collar crime come to be understood as the real commonplace sources of harm while street crime is seen to be less common than typically imagined. The book The Rich Get Richer and the Poor Get Prison: Ideology, Class and Criminal Justice by Reiman and Leighton informs this assignment. The authors make the case that the criminal justice system presents to us a carnival mirror-like image of what causes the greatest harm to the society. The criminal justice system, through its policies and procedures, leads the public to conceive of only a narrow and distorted depiction of criminality. The typical crime is thought to be person to person, violent, and carried out by the typical criminal, who is assumed to be black, young, and urban. In opposition to this carnival mirror view, Reiman and Leighton explain that certain institutions cause immensely more harm than that caused by street criminality.

Photochemically Prepared Gold/Polymer Nanocoatings: Formation of Gold Mirror

In this study a rapid method is developed to obtain Au nanoparticles (AuNPs)/polymer composite materials by which HAuCl4 salt is reduced and a polymer matrix is simultaneously generated by the means of UV light. 2‐Mercaptothioxanthone (TX‐SH), thioxanthone (TX), and TX + thiophenol are used as photoinitiator system for the poly(ethylene glycol) methyl ether acrylate and poly(ethylene glycol) diacrylate mixtures in the presence of HAuCl4. Except for a few studies, in situ reduction of Au ions, in an attempt to make them near or at polymer surface, has hardly been investigated at all. As a result of this study, it is important to note that the change of shape of NPs depends on the photoreducing species. TX‐SH, due to thiol functionality in its structure, helps the production of the size, shape, and controlled distribution of AuNPs either in polymer matrix or in solution. Prepared AuNPs/polymer nanocoatings exhibit a reflected gold mirror view depending on the irradiation time. In addition to the foregoing approach in obtaining a thin film in the presence of AuNPs, it is expected that they are well ordered near the film surface with controlled shape and narrow range in size distribution. image

Corporate Social Responsibility in Developing Country Multinationals: Identifying Company and Country-Level Influences

ABSTRACT:The extant literature on cross-national differences in approaches to corporate social responsibility (CSR) has mostly focused on developed countries. Instead, we offer two inter-related studies into corporate codes of conduct issued by developing country multinational enterprises (DMNEs). First, we analyse code adoption rates and code content through a mixed methods design. Second, we use multilevel analyses to examine country-level drivers of differences in code content—specifically, elements of a country’s National Business System (NBS). We find that DMNEs are much more likely to adopt a code of conduct than their domestic counterparts; however, this does not translate into greater code comprehensiveness. We also find support for the ‘substitute view’ of CSR in developing countries, i.e. that MNEs from poorer countries and from countries with lower governance effectiveness tend to express more comprehensive commitments. However, this dynamic does not extend to a country’s labour system; instead, CSR appears here to match the efficiency of a country’s labour market, thus reflecting the ‘mirror view’ of CSR.

Perception of hand movement by mirror reflection evokes brain activation in the motor cortex contralateral to a non-moving hand

We investigated whether perception of hand movement via mirror reflection evokes activation in the motor cortex (M1) contralateral to the non-moving hand (the M1 ipsilateral to the moving hand). Continuous electroencephalography (EEG) was recorded from 14 participants while they performed unimanual extension–flexion hand movements in direct view and mirror view conditions. We measured the lateralized readiness potential (LRP) as a marker of M1 activation in both conditions. Both the direct and mirror view conditions produced LRPs, with the mirror view conditions revealing clear activation in M1 contralateral to the non-moving hand (ipsilateral to the moving hand) during both flexion and extension phases. This unambiguous demonstration of M1 activation in association with a non-moving hand (which is visually-perceived as moving), suggests that perception of movement can directly lead to M1 activation.