Visual Reading Research Articles

Enhancing the diagnostic capacity of [18F]PSMA-1007 PET/MRI in primary prostate cancer staging with artificial intelligence and semi-quantitative DCE: an exploratory study

BackgroundTo investigate the ability of artificial intelligence (AI)-based and semi-quantitative dynamic contrast enhanced (DCE) multiparametric MRI (mpMRI), performed within [18F]-PSMA-1007 PET/MRI, in differentiating benign from malignant prostate tissues in patients with primary prostate cancer (PC).ResultsA total of seven patients underwent whole-body [18F]-PSMA-1007 PET/MRI examinations including a pelvic mpMRI protocol with T2w, diffusion weighted imaging (DWI) and DCE image series. Conventional analysis included visual reading of PET/MRI images and Prostate Imaging Reporting & Data System (PI-RADS) scoring of the prostate. On the prostate level, we performed manual segmentations for time-intensity curve parameter formation and semi-quantitative analysis based on DCE segmentation data of PC-suspicious lesions. Moreover, we applied a recently introduced deep learning (DL) pipeline previously trained on 1010 independent MRI examinations with systematic biopsy-enhanced histopathological targeted biopsy lesion ground truth in order to perform AI-based lesion detection, prostate segmentation and derivation of a deep learning PI-RADS score. DICE coefficients between manual and automatic DL-acquired segmentations were compared. On patient-based analysis, PET/MRI revealed PC-suspicious lesions in the prostate gland in 6/7 patients (Gleason Score-GS ≥ 7b) that were histologically confirmed. Four of these patients also showed lymph node metastases, while two of them had bone metastases. One patient with GS 6 showed no PC-suspicious lesions. Based on DCE segmentations, a distinction between PC-suspicious and normal appearing tissue was feasible with the parameters fitted maximum contrast ratio (FMCR) and wash-in-slope. DICE coefficients (manual vs. deep learning) were comparable with literature values at a mean of 0.44. Further, the DL pipeline could identify the intraprostatic PC-suspicious lesions in all six patients with clinically significant PC.ConclusionFirstly, semi-quantitative DCE analysis based on manual segmentations of time-intensity curves was able to distinguish benign from malignant tissues. Moreover, DL analysis of the MRI data could detect clinically significant PC in all cases, demonstrating the feasibility of AI-supported approaches in increasing diagnostic certainty of PSMA-radioligand PET/MRI.

Ethical mediarhetoric in videogame cybertexts: procedural explication of moral topics in an educational context

Introduction. Education in the field of ethics and practical philosophy is important both within the framework of educational and disciplinary discourse and in terms of personal and social formation of a person, his/her value-behavioral system of coordinates. Video game cybertexts containing moral themes in their narrative and procedural structure can increase interest in the study of theoretical issues of ethics and create a special virtual-simulative space of moral experimentation. Materials and Methods. The theoretical part of the paper is based on the conceptual framework of understanding video games as a procedural cybertext formulated by E. Aarseth and I. Bogost. The operation of the multimodal-semiotic structure of video games is based on the ideas of J. Havreljak and W. Toch. The experimental cluster of work is realized on the principles of Digital Game-Based Learning developed by M. Prensky and a set of pedagogical practices on the use of ICT-based learning. Results. Based on the interpretation of the features of multimodal semiotics of ethically engaged video games, two modes of their distinction are revealed – narrative and gameplay. Narrative represents moral themes through narrative storytelling, and gameplay through gameplay. It has two forms of manifestation and certainty - external-iconic (based on visual reading and ethically binary interpretation of videogame cybertext) and procedural, where at the level of program architectonics the possibilities of choice and realization of simulations of ethical activities are created. The experiment allowed a radical change for the better (from 20% to 73%) in most students' expectations about the educational possibilities of video games in this disciplinary area. The DGBL methodology helped the learners (80%) to experience (80%) the practical dimension of important ethical issues and to conduct a series of moral experiments within the virtual simulations. Most of the students (75%) were able to correctly relate theoretical knowledge from philosophy and ethics to specific video game situations and successfully interpreted them. Conclusion. Given the time-consuming nature of these cybertexts, it is recommended that they be used only as supplementary media to the main course texts. It seems most appropriate to study them as part of an elective to a basic course in ethics or philosophy. This material could also be the basis for the creation of an educational laboratory on practical ethics in a social and humanitarian quantorium.

The no-retina-touch technique: vitrectomy and platelet-rich plasma in the treatment of lamellar macular hole. New insights into pathogenesis.

To explore the use of autologous platelet-rich plasma (PRP) as a potential therapeutic adjuvant strategy for treating degenerative lamellar macular holes (LMHs). A prospective interventional case series. Seven consecutive patients (8 eyes) with a diagnosis of LMH underwent a pars-plana vitrectomy with PRP injection under air tamponade. Anatomical results based on spectral domain optical coherence tomography (SD-OCT) and functional results, in terms of best corrected visual acuity (BCVA) and reading performance, were analyzed. At 12 months postoperatively, 7 out of 8 eyes (88%) presented a complete closure of the LMH. The ellipsoid zone (EZ) was restored in 3 eyes (37.5%). The mean (±SD) postoperative BCVA was 0.39 (±0.56) LogMAR, resulting in a statistically significant visual acuity improvement (p = 0.007). The mean (±SD) maximum reading speed (MaxRS) improved to 133.48 (±41.47) wpm, with a significant increase compared to the baseline (p = 0.029). The mean (±SD) reading acuity score (RA score) resulted in 0.44 (±0.04) LogRAD, with an improvement in reading acuity that did not reach statistical significance (p = 0.129). The utilization of the PRP technique with a no-retina-touch approach safeguards the delicate retinal tissues, minimizing the possibility of iatrogenic trauma or post-operative complications, while maintaining a high rate of efficacy in enabling the improvement of the foveal defect in lamellar macular holes.

Visual reading for [18F]Florzolotau Tau PET scans in progressive supranuclear palsy.

The identification of tau accumulation within living brains holds significant potential in facilitating accurate diagnosis of progressive supranuclear palsy (PSP). While visual assessment is frequently employed, standardized methods for tau positron emission tomography (PET) specifically in PSP are absent. We aimed to develop a visual reading algorithm dedicated to the evaluation of [18F]Florzolotau PET in PSP. 148 PSP and 30 healthy volunteers were divided into a development set (for the establishment of the reading rules; n = 89) and a testing set (for the validation of the reading rules; n = 89). For differential diagnosis, 55 α-synucleinopathies were additionally included into the testing set. The visual reading method was established by an experienced assessor (Reader 0) and was then validated by Reader 0 and two additional readers on regional and overall binary manners. A positive binding in both midbrain and globus pallidus/putamen regions was characterized as a PSP-like pattern, whereas any other pattern was classified as non-PSP-like. Reader 1 (94.4%) and Reader 2 (93.8%) showed excellent agreement for the overall binary determination against Reader 0. The regional binary determinations of midbrain and globus pallidus/putamen showed excellent agreement among readers (kappa > 0.80). The overall binary evaluation demonstrated reproducibility of 86.1%, 94.4% and 77.8% for three readers. The visual reading algorithm showed high agreement with regional standardized uptake value ratios and clinical diagnoses. Through the application of the suggested visual reading algorithm, [18F]Florzorotau PET imaging demonstrated a robust performance for the imaging diagnosis of PSP.

Interrater agreement and variability in visual reading of [18F] flutemetamol PET images.

The purpose of this study was to validate the concordance of visual ratings of [18F] flutemetamol amyloid positron emission tomography (PET) images and to investigate the correlation between the agreement of each rater and the Centiloid (CL) scale. A total of 192 participants, clinically classified as cognitively normal (CN) (n = 59), mild cognitive impairment (MCI) (n = 65), Alzheimer's disease (AD) (n = 55), or non-AD dementia (n = 13), participated in this study. Three experts conducted visual ratings of the amyloid PET images for all 192 patients, assigning a confidence level to each rating on a three-point scale (certain, probable, or neither). The positive or negative determination of amyloid PET results was made by majority vote. The CL value was calculated using the CapAIBL pipeline. Overall, 101 images were determined to be positive, and 91 images were negative. Of the 101 positive images, the three raters were in complete agreement for 92 images and in disagreement for 9 images. Of the 91 negative images, the three raters were in complete agreement for 75 images and in disagreement for 16 images. Interrater reliability among the three experts was particularly high, with both Fleiss' kappa and Conger's kappa measuring 0.83 (0.76-0.89). The CL values of the unanimous positive group were significantly greater than those of the other groups, whereas the CL values of the unanimous negative group were significantly lower than those of the other groups. Images with rater disagreement had intermediate CLs. In cases with a high confidence level, the positive or negative visual ratings were in almost complete agreement. However, as confidence levels decreased, experts' visual ratings became more variable. The lower the confidence level was, the greater the number of cases with disagreement in the visual ratings. Three experts independently rated 192 amyloid PET images, achieving a high level of interrater agreement. However, in patients with intermediate amyloid accumulation, visual ratings varied. Therefore, determining positive and negative decisions in these patients should be performed with caution.

The effect of inter-letter spacing on the N170 during visual word recognition: An event-related potentials experiment

Previous behavioral studies have shown that inter-letter spacing affects visual word recognition and reading. While condensed spacing may hinder the early stages of letter encoding because of increased crowding effects, the impact of expanded inter-letter spacing is still unclear. To examine the electrophysiological signature of inter-letter spacing on visual word recognition, we presented words in three different inter-letter spacing conditions (default, condensed [−1.5 points] or expanded [+1.5 points]) in an event-related potentials go/no-go semantic categorization task. Our focus was on the N170, an event-related potentials component associated with the early encoding of orthographic information, which also is sensitive to crowding effects. Results revealed that the N170 amplitude reached the largest values for the condensed condition than for the default and expanded spacing conditions, which did not differ. While increased crowding impacted the early encoding of orthographic information, extra letter spacing (compared with default spacing) did not. This outcome is consistent with the Modified Receptive Field hypothesis, in which letter receptors adapt their size to cope with letter crowding. These findings reveal that reducing the space between letters more than the default spacing impairs the ability to process written words, whereas slightly expanding the space between letters does not provide any additional benefit.

Does the optimal level of illumination improve both visual functions and visual comfort in schoolchildren with low vision?

Lighting modification is commonly performed by optometrists and occupational therapists to enhance visibility and visual comfort among schoolchildren with low vision. The purpose of this study is to determine the optimal illumination level for visual function and visual comfort of schoolchildren with low vision and the relationship between them. A cross-sectional study was conducted to assess five levels of illumination ranging from 125 lux to 2000 lux to determine the optimal illumination for visual functions and visual comfort in schoolchildren with low vision from a special education school for blind in Malaysia. Purposive sampling was done to recruit forty-two schoolchildren with low vision for this study. Visual functions assessed were visual acuity, measured using the Early Treatment Diabetic Retinopathy Study LogMAR chart at distance and near, contrast sensitivity (CS) measured using the Pelli-Robson chart at distance and the Mars CS chart at near. Reading speed was determined using the Universiti Kebangsaan Malaysia Malay Language Related Word Reading Text test chart. Subjects were asked to rate their visual comfort using a validated questionnaire at the end of each measurement of visual functions and reading speed for the different illumination levels. Visual acuity and contrast sensitivity at distance and near, visual comfort and reading speed improved significantly with increase in illumination levels (p<0.05). However, the interaction between illumination level and level of low vision was not significant (p>0.05). Visual comfort was significantly associated with visual function (p<0.05), while direct association between visual comfort and illumination level was not significant (p>0.05). Optimal illumination for improvement of visual function, reading speed and visual comfort range from 276.67 lux to 701.59 lux. Majority of the schoolchildren with low vision had improved visual function, reading speed and visual comfort with increased illumination. Illumination of at least 600 lux is recommended for maximum visual functioning and visual comfort of schoolchildren with low vision.

Research on the health lighting scheme of university library reading room

The quality of the indoor lighting environment in the reading space of the university library is essential for students' visual perception, emotional evaluation, and cognitive efficiency. The design of the lighting environment considering the change of natural light is one of the important development directions to improve the light environment quality of the reading room and meet the health requirements of students. This paper from the perspective of reading vision, emotion, and cognitive probes into the natural light environment lighting design, builds a reading lighting environment laboratory, using subjective evaluation, task performance, and physiological indicators of the measurement method, first analyses the weight of different indicators under different time, establish lighting environment comprehensive evaluation index I and artificial illumination and desktop illumination prediction model. The experimental results show that experimental results show that visual discomfort and clarity are the key factors in the early and later stages. In the transition phase, emotional indicators become particularly important. The model of dynamic lighting design scheme during 17:30–20:30 is: y = 227753.1746–900120.63492x+ 1179428.57142x2-512000x3, R2 = 0.99702; the fitting formula of desktop illumination in 17:30–20:30 period is: y = 566.666667–197.08995x + 158.73016x2-37.03704x3, R2 = 0.95238. The results aim to provide a theoretical basis for the design and optimization of dynamic lighting under natural light in the library reading room.

Training in a crowding task and possible transfer effects to eccentric visual acuity, contrast sensitivity, word recognition and reading

Training in a crowding task and possible transfer effects to eccentric visual acuity, contrast sensitivity, word recognition and reading

Visual impact of diffusion optic technology lenses for myopia control.

To assess the visual impact of Diffusion Optics Technology™ 0.2 DOT lenses (SightGlass Vision Inc.) designed for myopia control on primary gaze. DOT spectacle lenses contain light scattering elements that scatter light as it passes through the lens which, in turn, reduces retinal image contrast. Fifty-one children (12.2 ± 1.3, range 10-14 years; 51% females) were randomly assigned to wear DOT spectacle (n = 27) or single vision lenses (n = 24) across six investigational sites in North America. Binocular high- and low-contrast distant visual acuities, near visual acuity, reading speed, contrast sensitivity, stereoacuity and glare were assessed in primary gaze after at least 3 years of wear, with the study 95% powered in all metrics to detect significant differences between the groups. Mean binocular distance high-contrast (-0.09 ± 0.02 vs. -0.08 ± 0.02 logMAR, p = 0.81), low-contrast (0.05 ± 0.02 vs. 0.07 ± 0.02 logMAR, p = 0.52) and near visual acuity with glare sources (-0.06 ± 0.03 vs. -0.09 ± 0.03 logMAR, p = 0.32) were similar for DOT and single vision lens wearers, respectively. Contrast sensitivity was similar between children wearing DOT or single vision lenses across 11 of the 16 spatial frequencies (p > 0.05). Mean stereopsis was similar (p = 0.30) with the DOT lenses (33.2 ± 12.5″) and single vision lenses (38.1 ± 14.2″). Functional reading speed metrics were similar in both study groups, as was the objectively measured head tilt during reading (p > 0.05). The mean halo radius was 0.56° ± 0.17° with the DOT lenses compared with 0.50° ± 0.12° with single vision lenses (p = 0.02), but the statistically significant difference was smaller than the non-inferiority bound of 0.4°. Diffusion optics technology lenses provide a clinically equivalent visual experience to a standard single vision lens.

Development of a rapid test to determine endometritis of cows after calving.

Postpartum uterine disease, such as endometritis, is widespread in highly productive dairy cows, leading to fertility problems and economic losses. Despite existing diagnostic methods, early and effective detection of uterine infections remains problematic due to the subclinical nature of some conditions. This study aimed to develop and evaluate a rapid diagnostic test for endometritis in cows on different days postpartum (PP). The study was carried out on dairy Holstein-Friesian cows (n = 121) kept on farms in northern Kazakhstan. The study included both clinically normal cows and those diagnosed with endometritis, ensuring a comprehensive evaluation of the diagnostic methods across different stages of uterine health. The following laboratory tests were performed to diagnose and evaluate the presence and severity of endometritis in the cows: Nagorny-Kalinovsky test, Whiteside test, Katerinov test, Gavrish silver nitrate test, peroxide test, and clinical tests (rectal and vaginal examination). These tests were specifically chosen to identify inflammatory processes in the uterus, particularly focusing on detecting endometritis. From day 21 to 30 PP, rectal and vaginal examinations were 32% and 28% more effective than the Nagorny-Kalinovsky test and the Whiteside test. From day 61 postpartum, the Whiteside test was 37.5% more effective than the Nagorny-Kalinovsky test. Comparatively, among laboratory diagnostic methods from days 10 to 110 PP, the peroxide test showed the greatest effectiveness in identifying 80.9% of sick animals. In sick animals from day 10 to 20 PP, during the interaction of the cervicovaginal mucus with 10%, 20%, and 30% hydrogen peroxide (H2O2), an 8.1 ± 1.9-8.8 ± 1.6 cm foam column was formed within 4-5 min. The experiment showed that a 10% H2O2 solution yielded better results. Using H2O2 as a diagnostic agent for endometritis in cows has several advantages, including ease of use, it does not require special laboratory conditions and provides a visual reading of the reaction within 4-5 min. A limitation of this study is the focus on H2O2 without exploring other potential reagents that may enhance diagnostic accuracy. Future research could explore the long-term stability of cervicovaginal mucus samples and investigate the integration of additional substances that may expedite the detection of subclinical endometritis and improve the clarity of diagnostic results.

Artificial intelligence-driven mobile interpretation of a semi-quantitative cryptococcal antigen lateral flow assay

ObjectivesCryptococcosis remains a severe global health concern, underscoring the urgent need for rapid and reliable diagnostic solutions. Point-of-care tests (POCTs), such as the cryptococcal antigen semi-quantitative (CrAgSQ) lateral flow assay (LFA), offer promise in addressing this challenge. However, their subjective interpretation poses a limitation. Our objectives encompass the development and validation of a digital platform based on Artificial Intelligence (AI), assessing its semi-quantitative LFA interpretation performance, and exploring its potential to quantify CrAg concentrations directly from LFA images.MethodsWe tested 53 cryptococcal antigen (CrAg) concentrations spanning from 0 to 5000 ng/ml. A total of 318 CrAgSQ LFAs were inoculated and systematically photographed twice, employing two distinct smartphones, resulting in a dataset of 1272 images. We developed an AI algorithm designed for the automated interpretation of CrAgSQ LFAs. Concurrently, we explored the relationship between quantified test line intensities and CrAg concentrations.ResultsOur algorithm surpasses visual reading in sensitivity, and shows fewer discrepancies (p < 0.0001). The system exhibited capability of predicting CrAg concentrations exclusively based on a photograph of the LFA (Pearson correlation coefficient of 0.85).ConclusionsThis technology's adaptability for various LFAs suggests broader applications. AI-driven interpretations have transformative potential, revolutionizing cryptococcosis diagnosis, offering standardized, reliable, and efficient POCT results.

Reconnecting Anisometropic Amblyopic Eyes to the Cortex: VEP-Based Auditory Biofeedback.

This study aimed to evaluate the effectiveness of a visual rehabilitation method for anisometropic amblyopia that uses visual evoked potential (VEP) parameters and sound biofeedback to increase objectiveness. an observational, case-controlled trial. Ophthalmology Clinic, Emergency County Hospital, Cluj-Napoca, Romania. Sixteen subjects with amblyopic anisometropia, aged 15-57, and sixteen controls, aged 24-33, were included. Subjects were divided into two groups. The control group, composed of normal-vision subjects, and the amblyopic group received 10 training sessions. The rehabilitation program lasted 10 min, took place twice a week, and ran over five consecutive weeks. During each session, the subjects were asked to fixate on a target on the computer screen and were instructed to keep the fixation and maintain the sound of the biofeedback at high frequency. The study assessed the main visual parameters at baseline, after 10 sessions, and 1, 3, 6, and 12 months after treatment. Performance was evaluated by measuring visual acuity, contrast sensitivity, and reading velocity (words/minute). In the experimental group, mean BCVA improved with two rows, which means an improvement in the LogMARLogMAR scale with an average of nine letters. These values tended to be maintained over time. Both groups showed better reading velocities after training, but this parameter has undergone large variability during follow-ups. Contrast sensitivity was also improved and stable. Visual rehabilitation with the Retimax Vision Trainer can improve visual performance in patients with amblyopia after the critical period, an improvement that is maintained in most cases for at least one year after treatment.

The Impact of COVID-19 on Neuropsychological and Emotional-Behavioural Development in a Group of 8- and 9-Year-Old Children.

Introduction: The rapid spread of the COVID-19 pandemic has had a significant impact on the psychological well-being of millions of people around the world, and even more so among children. Contracting SARS-CoV-2, resulting in home confinement and restrictions on daily and school activities, led to negative effects on the mental health of the paediatric population. Although children suffering from COVID-19 had milder general symptoms compared to adults, impairments in cognitive, neuropsychological, and emotional-behavioural development were noted. Objective: The main aim of the present study was to detect possible changes in the neuropsychological and emotional-behavioural development of children after infection with the SARS-CoV-2 virus. The second aim was to investigate possible relationships between cognitive abilities and psychosocial characteristics. Methods: A total of 40 patients aged 8-9 years were recruited and divided into two groups: children who contracted (CG) and did not contract (NCG) SARS-CoV-2. The BVN 5-11 (Neuropsychological evaluation battery for developmental age from 5 to 11 years) instrument was administered to assess attention, memory, verbal recall, planning, phonemics, and categorical fluency domains in the paediatric population. Data on changes in emotional-behavioural profile and daily activities were collected through a questionnaire to parents. Results: The Wilcoxon signed-rank test revealed a significant change in mood after the COVID-19 period only in the CG participants (p = 0.019). However, the neuropsychological performance of the two identified groups on BVN 5-11 sub-items was below the cutoff of clinical significance. Correlations were found between sub-items of the BVN 5-11 battery, extracurricular activities, and children's psycho-motor development. Significant positive correlations were observed between Naming on visual presentation and Reading time (p = 0.006), backward digit span and time of motor activity (p = 0.009), Visual attention and Reading time (p = 0.048), and Phonemic fluency and time observed using devices (p = 0.030). Positive statistically significant correlations were also found between Mood and Free behaviour (p = 0.000), between Mood and Structured behaviour (p = 0.005), and between Mood and peer Interaction (p = 0.013). Conclusions: SARS-CoV-2 infection negatively affected the emotional development of children contracting the virus. The neuropsychological functioning of the paediatric population was influenced by psychosocial variables and time spent on daily activities, which played a protective role in children's cognitive development.

Validation of the interdisciplinary Norwegian vision assessment tool KROSS in stroke patients admitted to hospital or rehabilitation services

IntroductionIdentifying vision problems after stroke is important for providing appropriate referral and vision rehabilitation in healthcare services. In Norway, vision assessment is not a standard routine or integrated in stroke care, due to lack of knowledge, guidelines and validated Norwegian assessment tools for healthcare professionals (HCPs) without formal vision competence. This study aimed to validate and assess the reliability of the KROSS (Competence, Rehabilitation of Sight after Stroke) tool for identifying vision problems in stroke patients.MethodsThe KROSS tool has 21 items, including symptoms, observations, and assessment of visual acuity, visual field, eye movements and visual inattention. The primary outcome is to identify if a vision problem is present. Sixty-seven stroke survivors (69.8 years, 28 females) were assessed twice. The first KROSS assessment was by an HCP without formal vision competence and compared to a reference assessment by an optometrist/KROSS specialist within 2 days. Sensitivity, specificity, positive and negative predictive values (PPV/NPV) and inter-rater reliability (Gwet’s AC1/Cohen’s Kappa) were calculated with 95% confidence intervals.ResultsThe KROSS tool demonstrated high sensitivity (98%) and specificity (83%), with excellent reliability (AC1 > 0.86/Kappa > 0.83) and observer agreement (93%) for the primary outcome. A vision problem was identified in 64% of patients, where 44% reported a vision symptom. The PPV and NPV for identifying a vision problem were 0.91 and 0.95 respectively. Sensitivity scores for visual acuity, reading, and visual inattention assessments were all excellent (> 80%) and specificity scores were high for all items (> 70%). Most items showed excellent or substantial agreement (AC1 > 0.7/kappa > 0.6). The lowest agreements were for motility (AC1 > 0.8/kappa > 0.4) and peripheral visual fields (AC1 > 0.8/kappa > 0.5).ConclusionsThis study shows that the KROSS tool shows promise as a valuable tool for integrating vision assessment into stroke health services. It has high sensitivity and specificity, and excellent reliability, indicating high accuracy for identifying a vision problem. This indicates that the KROSS tool can reliably be used by HCPs without formal vision competence to identify a vision problem. The fact that many stroke survivors were identified with vision problems using the KROSS tool, even if they did not complain of visual symptoms, supports the significance of including structured vision assessment in stroke care.

Redesigning Municipality Logos in the Context of Visual Reading Using Artificial Intelligence

Redesigning Municipality Logos in the Context of Visual Reading Using Artificial Intelligence

CRISPR/Cas13a-Responsive and RNA-Bridged DNA Hydrogel Capillary Sensor for Point-of-Care Detection of RNA.

Disease diagnostics and surveillance increasingly highlight the importance of portable, cost-effective, and sensitive point-of-care (POC) detection of nucleic acids. Here, we report a CRISPR/Cas13a-responsive and RNA-bridged DNA hydrogel capillary sensor for the direct and visual detection of specific RNA with high sensitivity. The capillary sensor was simply prepared by loading RNA-cross-linking DNA hydrogel film (∼0.2 mm ± 0.02 mm) at the end of a capillary. When CRISPR/Cas13a specifically recognizes the target RNA, the RNA bridge in the hydrogel film is cleaved by the trans-cleavage activity of CRISPR/Cas13a, increasing the permeability of the hydrogel film. Different concentrations of target RNA activate different amounts of Cas13a, cleaving different amounts of the RNA bridge in the hydrogel and causing corresponding changes in the permeability of the hydrogel. Therefore, samples containing different amounts of the target RNA travel to different distances in the capillary. Visual reading of the distance provides quantitative detection of the RNA target without the need for any nucleic acid amplification or auxiliary equipment. The technique was successfully used for the determination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in clinical nasopharyngeal (NP) swab and saliva samples. Easily quantifiable distance using a ruler eliminates the need for any optical or electrochemical detection equipment, making this assay potentially useful for POC and on-site applications.

Investigating the impact of asymmetric macular sensitivity on visual acuity chart reading in choroideremia.

Degeneration in choroideremia, unlike typical centripetal photoreceptor degenerations, is centred temporal to the fovea. Once the fovea is affected, the nasal visual field (temporal retina) is relatively spared, and the preferred retinal locus shifts temporally. Therefore, when reading left to right, only the right eye reads into a scotoma. We investigate how this unique property affects the ability to read an eye chart. Standard- and low-luminance visual acuity (VA) for right and left eyes were measured with the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Letters in each line were labelled by column position. The numbers of letter errors for each position across the whole chart were summed to produce total column error scores for each participant. Macular sensitivity was assessed using microperimetry. Central sensitivity asymmetry was determined by the temporal-versus-nasal central macular difference and subsequently correlated to a weighted ETDRS column error score. Healthy volunteers and participants with X-linked retinitis pigmentosa GTPase regulator associated retinitis pigmentosa (RPGR-RP) were used as controls. Thirty-nine choroideremia participants (median age 44.9 years [IQR 35.7-53.5]), 23 RPGR-RP participants (median age 30.8 years [IQR 26.5-40.5]) and 35 healthy controls (median age 23.8 years [IQR 20.3-29.0]) were examined. In choroideremia, standard VA in the right eye showed significantly greater ETDRS column errors on the temporal side compared with the nasal side (p = 0.002). This significantly correlated with greater asymmetry in temporal-versus-nasal central macular sensitivity (p = 0.04). No significant patterns in ETDRS column errors or central macular sensitivity were seen in the choroideremia left eyes, nor in RPGR-RP and control eyes. Difficulty in tracking across lines during ETDRS VA testing may cause excess errors independent of true VA. VA assessment with single-letter optotype systems may be more suitable, particularly for patients with choroideremia, and potentially other retinal diseases with asymmetric central macular sensitivity or large central scotomas including geographic atrophy.

QOL-46. EFFECTIVENESS OF A TELEREHABILITATION PROGRAM TO IMPROVE VISUAL PERCEPTION IN CHILDREN AND ADOLESCENTS WITH HEMIANOPIA CONSECUTIVE TO A BRAIN TUMOUR

Abstract BACKGROUND Brain tumours in children often lead to visual impairment, which presents as a significant morbidity for long-term survivors. A recent Children Cancer Survivor Study showed that 22.5% of the patients with astroglial tumours had visual impairment five years after the diagnosis. In the pediatric population with hemianopia, there are no standardized protocols for managing vision loss. This study evaluated a 6-week home-based telerehabilitation program (home-based 3D-MOT-IVR) on visual perception in children with hemianopia consecutive to a brain tumour. METHODS This phase 2a, open-labelled, non-randomized, single-arm study included ten patients aged 12-18 years old with hemianopia consecutive to a pediatric brain tumour. Patients followed a 6-week home-based 3D-MOT-IVR with remote control of the device from the UHN laboratory. Visual assessments were performed at baseline, 2, 4, and 6 weeks, with follow-ups at 1 and 6 months to check the visual field, contrast sensitivity and reading speed. RESULTS The home-based 3D-MOT-IVR intervention proved feasible and safe, with no reported adverse events. All participants completed the prescribed stimulations, pre- and post-intervention assessment points, and 90% completed the follow-ups. Remarkably, the outcomes revealed significant improvements post-intervention: 50% of participants showed enhanced visual perception in their blind field, while 70% exhibited increased reading speed. Importantly, these positive effects were sustained at the 6-month follow-up. A robust correlation emerged between 3D-MOT-IVR performance and improved visual perception in the blind field, emphasizing the intervention’s effectiveness. CONCLUSION These promising results lay a strong foundation for a larger randomized controlled trial, offering hope for a meaningful breakthrough in visual rehabilitation for this vulnerable population. Further studies are being developed to confirm these results and identify the most appropriate schedules to optimize visual outcomes (such as duration and repetition of these programs).

Thinking and learning through images: a review of research related to visual literacy, children’s reading and children’s literature

ABSTRACT This article offers an update on key developments in research related visual literacy, children’s reading and children’s literature. Beginning with an overview of the field, we chart several distinctive ‘turns’ or research trajectories: the aesthetic, the intercultural or empathic, and the ethical. We then consider how questions of power, authenticity and representation are visible in three important areas of the field: research with marginalised groups; research that focuses on mediation within the visual reading process; advances in the types of visual texts being used in research. Key emergent ideas include the challenges of adult mediators’ expectations on children’s visual reading, the potential of texts’ material affordances, and new directions in open, more inclusive opportunities to respond to, and with, visual texts. We conclude with a hopeful look forward at emerging directions in policy and research.