Rapid retinal functional testing

The most prominent causes of loss of vision in individuals over 50 years include age-related macular degeneration(AMD),glaucoma,and diabetic retinopathy(DR).While it is important to screen for these diseases effectively,current eye care is not properly doing so for much of the population,resulting in unfortunate visual disability and high costs for patients.Innovative functional testing can be unified with other screening methods for a more robust and safer screening and prediction of disease.The goal in the creation of functional testing modalities is to develop highly sensitive screening tests that are easy to use,accessible to all users,and inexpensive.The tests herein are deployed on an iPad with easily understood and intuitive instructions for rapid,streamlined,and automatic administration.These testing modalities could become highly sensitive screenings for early detection of potentially blinding diseases.The applications from our collaborators at AMA Optics include a cone photostress recovery test for detection of AMD and diabetic macular edema(DME),brightness balance perception for optic nerve dysfunction and especially glaucoma,color vision testing which is a broad screening tool,and visual acuity test.Machine learning with the combined structural and functional data will optimize identification of disease and prediction of outcomes.Here,we review and assess various tests of visual function that are easily administered on a tablet for screening in primary care.These user-friendly and simple screening tests allow patients to be identified in the early stages of disease for referral to specialists,proper assessment and treatment.

Outcomes of anatomical versus functional testing for coronary artery disease

Background Many patients have symptoms suggestive of coronary artery disease （CAD） and are often eval- uated with the use of diagnostic testing, although there are limited data from randomized trials to guide care.

Research on Evacuation Path Planning Based on Improved Sparrow Search Algorithm

Reducing casualties and property losses through effective evacuation route planning has been a key focus for researchers in recent years.As part of this effort,an enhanced sparrow search algorithm(MSSA)was proposed.Firstly,the Golden Sine algorithm and a nonlinear weight factor optimization strategy were added in the discoverer position update stage of the SSA algorithm.Secondly,the Cauchy-Gaussian perturbation was applied to the optimal position of the SSA algorithm to improve its ability to jump out of local optima.Finally,the local search mechanism based on the mountain climbing method was incorporated into the local search stage of the SSA algorithm,improving its local search ability.To evaluate the effectiveness of the proposed algorithm,the Whale Algorithm,Gray Wolf Algorithm,Improved Gray Wolf Algorithm,Sparrow Search Algorithm,and MSSA Algorithm were employed to solve various test functions.The accuracy and convergence speed of each algorithm were then compared and analyzed.The results indicate that the MSSA algorithm has superior solving ability and stability compared to other algorithms.To further validate the enhanced algorithm’s capabilities for path planning,evacuation experiments were conducted using different maps featuring various obstacle types.Additionally,a multi-exit evacuation scenario was constructed according to the actual building environment of a teaching building.Both the sparrow search algorithm and MSSA algorithm were employed in the simulation experiment for multiexit evacuation path planning.The findings demonstrate that the MSSA algorithm outperforms the comparison algorithm,showcasing its greater advantages and higher application potential.

Information-motivation-behavioral guided nursing for stroke patients with pulmonary dysfunction:A randomized controlled trial

BACKGROUND Patients with stroke frequently experience pulmonary dysfunction.AIM To explore the effects of information-motivation-behavioral(IMB)skills modelbased nursing care on pulmonary function,blood gas indices,complication rates,and quality of life(QoL)in stroke patients with pulmonary dysfunction.METHODS We conducted a controlled study involving 120 stroke patients with pulmonary dysfunction.The control group received routine care,whereas the intervention group received IMB-model-based nursing care.Various parameters including pulmonary function,blood gas indices,complication rates,and QoL were assessed before and after the intervention.RESULTS Baseline data of the control and intervention groups were comparable.Post-intervention,the IMB model-based care group showed significant improvements in pulmonary function indicators,forced expiratory volume in 1 sec,forced vital capacity,and peak expiratory flow compared with the control group.Blood gas indices,such as arterial oxygen pressure and arterial oxygen saturation,increased significantly,and arterial carbon dioxide partial.pressure decreased significantly in the IMB model-based care group compared with the control group.The intervention group also had a lower complication rate(6.67%vs 23.33%)and higher QoL scores across all domains than the control group.CONCLUSION IMB model-based nursing care significantly enhanced pulmonary function,improved blood gas indices,reduced complication rates,and improved the QoL of stroke patients with pulmonary dysfunction.Further research is needed to validate these results and to assess the long-term efficacy and broader applicability of the model.

On the Weyl’s Lemma for Triharmonic Functions

In this paper,by choosing some appropriate test functions,we prove the Weyl’s lemma for triharmonic functions based on the new type of mean value formulas.

Study on the Application Value of Liver Function and Serological Index Levels in the Diagnosis of Fatty Liver

Objective:To explore the application value of liver function and serological index detection in diagnosing fatty liver.Methods:Ninety patients with fatty liver disease(disease group)and ninety healthy subjects(healthy group)were selected as the subjects of this study.They all underwent liver function index testing and serological index testing.Test results were compared,and the diagnostic accuracy of single and combined tests was evaluated.Results:Liver function indicators of patients in the disease group were higher than those in the healthy group,with severe patients exhibiting higher levels than moderate patients and mild patients(P<0.05).Serological indicators in patients in the disease group were higher than those in the healthy group,with severe patients showing higher levels than moderate patients and mild patients(P<0.05).The diagnostic accuracy of liver function index testing was higher than that of serological index testing,and the accuracy of combined testing was higher than that of single testing(P<0.05).Conclusion:In diagnosing fatty liver,combining liver function testing and serological testing enables the initial diagnosis of the disease and facilitates the accurate assessment of its severity.

Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.

Semen analysis in 21st century medicine： the need for sperm function testing

Sperm function testing, once commonly performed for the infertile couple before employing assisted reproductive technology （ART）, has fallen out of favour in many reproductive medicine centers throughout the world. Indeed, the most recent addition of the ＇World Health Organisation （WHO） Laboratory Manual for the Examination and Processing of Hu- man Semen＇ now groups many of these procedures into a section termed Research Procedures. In large part, this reflects the current clinical practice of bypassing the in-depth evaluation of the male partner, while assuming that if a spermatozoon can be found for intracytoplasmic sperm injection （ICSI）, it must be a healthy cell capable of achieving fertilization. Never- theless, sperm function testing can provide valuable clinical insights into defects causing male infertility. Admittedly, in some cases, functional sperm deficiencies can be overcome using an ART. In other cases, couples will be empowered by the knowledge of the cause of their infertility, and for some couples, perhaps even the likelihood of ICSI success （relative to the spermatozoa）. The knowledge allows them to make truly informed reproductive decisions, including （perhaps） the de- cision to seek donor insemination, to adopt or to remain childless. Knowledge of the cause of their infertility may provide closure for couples and a sense of confidence regarding their choice of reproductive treatment.

Pancreatic function testing: Here to stay for the 21st century

The diagnosis of Chronic Pancreatitis （CP） is based on the detection of abnormal structure or function of the diseased pancreas. The pancreatic function tests more accurately determine the presence of CP than tests of structure, especially for early stage disease. The function tests can be divided into two categories： non- invasive and invasive. The invasive ＂tube＂ tests can reliably detect mild, early CP, but are only available at a few referral centers and tend to be poorly tolerated by patients. The non-invasive tests are easy to obtain, but tend to perform poorly in patients with early, mild disease. Therefore, no one test is useful in all clinical situations, and a detailed understanding of the rational, pathophysiologic basis, strengths, and limitations of various tests is needed. This review highlights the role of various pancreatic function tests in the diagnosis of CP including fecal fat analysis, fecal elastase, fecal chymotrypsin, serum trypsin, the secretin stimulation test, the cholecystokinin （CCK） stimulation test, the combined secretin-CCK stimulation test, the intraductal and endoscopic secretin stimulation tests, and the functional magnetic resonance imaging of the pancreas after secretin stimulation.

Update on endoscopic pancreatic function testing

Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditional fluid analysis.

Technological insights:combined impedance manometry for esophageal motility testing-current results and further implications

This review focuses on current aspects of the novel technology of combined impedance manometry for esophageal motility testing. It presents methodological features, summarizes current results and discusses implications for further research. The combined technique assesses simultaneously bolus transport and associated peristalsis, thus allowing detailed analysis of the relationships between bolus transit and esophageal motility. Recent studies demonstrate that combined impedance manometry provides important additional information about esophageal motility as compared to conventional manometry: (1) monitoring of bolus transport patterns, (2) calculation of bolus transit parameters, (3) evaluation of bolus clearance, (4) monitoring of swallow associated events such as air movement and reflux, and (5) investigation of the relationships between bolus transit and LES relaxation. Studies with healthy subjects have identified several useful parameters for comprehensive assessment of eosphageal function. These parameters were found to be pathological in patients with classical achalasia, mild GERD, and ineffective esophageal motility. The technology of combined impedance manometry provides an important new tool for esophageal function testing, advancing both clinical and basic research. However, several important issues remain to be standardized to make the technique suitable for widely clinical use.

THE SIGNIFICANCE OF TESTING PREOPERATIVE VISUAL FUNCTION IN CATARACT USING LASER INTERFEROMETRIC VISUAL ACUITY AND ERG

Tests of preoperative visual function and prediction of postoperative E chart visual acuity(ECVA) using laser interferometric visual acuity(LIVA) and electroretinogram(ERG) were performed in 16 cases(19 eyes) of cataract. The results showed that the coincident rate between preoperative LIVA and postoperative ECVA was 63.2%, and there was a parallel correlation between preoperative amplitude of photopic ERG b-wave and postoperative ECVA in 79.0% of the eyes. Comparing these two methods, the test of LIVA ...

Implementation of a Subjective Visual Vertical and Horizontal Testing System Using Virtual Reality

Subjective visual vertical(SVV)and subjective visual horizontal(SVH)tests can be used to evaluate the perception of verticality and horizontality,respectively,and can aid the diagnosis of otolith dysfunction in clinical practice.In this study,SVV and SVH screen version tests are implemented using virtual reality(VR)equipment;the proposed test method promotes a more immersive feeling for the subject while using a simple equipment configuration and possessing excellent mobility.To verify the performance of the proposed VR-based SVV and SVH tests,a reliable comparison was made between the traditional screen-based SVV and SVH tests and the proposed method,based on 30 healthy subjects.The average results of our experimental tests on the VR-based binocular SVV and SVH equipment were−0.15◦±1.74 and 0.60◦±1.18,respectively.The proposed VR-based method satisfies the normal tolerance for horizontal or vertical lines,i.e.,a±3◦error,as defined in previous studies,and it can be used to replace existing test methods.

Functional Cardiological Changes Resulting from Thoracoscopic Thoracic Sympathectomy: Systematic Review

Hyperhidrosis is a condition resulting from a systemic sympathetic hyperactivity. The gold standard treatment is the resection or surgical ablation of the paravertebral sympathetic chain: the endoscopic thoracoscopic sympathectomy (ETS). Non-cardiac thoracic surgeries carry a considerable incidence of pathological postoperative cardiac events, raising attention to possible worsen cardiac functional capacity after the resection of a pair of thoracic sympathetic ganglia. The aim of this study is to investigate literature evidences of postoperative cardiovascular functional changes on patients submitted to ETS as treatment for hyperidrosis. This is a systematic review of the literature. Clinical studies published between January 1999 and April 2019 were analyzed. The PICO strategy was used to construct the question of systematic reviews research. The process of selecting articles was organized according to PRISMA Diagram. The search in electronic databases resulted in seven articles, of which one was excluded for being out of scope of the research, leaving six articles. All studies showed a pattern of heart rate (HR) reduction after endoscopic thoracic sympathectomy. It was suggested a relation between the extension of the procedure and the presence of cardiac functional alterations. There was an improvement in myocardial physical conditioning and maintenance of functional capacity. To elucidate the real mechanisms involved in the maintenance of myocardial function, and even its improvement, it is necessary to develop further studies that directly evaluate them.

Unit 1 of Ling’ao Nuclear Power Plant phase II underwent hot functional test successfully

On February 25, the Unit 1 of Ling’ao Nuclear Power Plant phase II underwent a 41-day-long hot functional test successfully with its major systems satisfying the requirements for

Architecture and Methodology of Unit Testing Embedding Pair-Wise Mode for Small Team

In this paper, the new organization for unit testing embedding pair-wise mode is proposed with the core thought focused on the cooperation of programmer and tester by “cross-testing”. The typical content of unit testing for the new organizing mode should have three aspects, including self-checking, cross-testing and independent-testing. For cross-testing, executing “pair-wise” mode, mainly tackles data testing, function testing and state testing, which function testing must be done by details and state testing must be considered for completeness. With the specializing of independent-testing, it should be taken as more rigid testing without arbitrariness. Consequently, strategy and measure are addressed for data testing focusing on boundary testing and function/state testing. And organizing method of procedure and key points of tackling unit testing are investigated for the new organizing mode. In order to assess the validity of our study and approach, a series of actual examples are demonstrated for GUI software. The result indicates that the execution of unit testing for the new organizing mode is effective and applicable.

Detecting the nerve function of fibril in patients with cervicalspondylotic radiculopathy using quantitative sensory testing

BACKGROUND: Pain and sensory disability are greatly affected by subjective factors, there are no quantitative indexes to evaluate cervical spondylotic radiculopathy(CSR). The judgment on clinical body examination and chief complaint always causes nonobjective results with great individual differences. Quantitative sensory testing (QST) can be used to judge the nerve function of fibril. The application of QST for the quantitative evaluation of peripheral nervous system disease needs to be further studied. OBJECTIVE: The cold-thermal sensation and pain of patients with CSR are quantitatively analyzed by using QST technology in order to evaluate the nerve function of fibril in patients with CSR. DESIGN: Case-control observation. SETTING: Pain Center of Beijing Hospital of Ministry of Health. PARTICIPANTS: Twenty patients with CSR, including 8 males and 12 females, aged from 33 to 70 years, who received treatment between January and April 2005 in Pain Center of Beijing Hospital of Ministry of Health were involved in CSR group. All the involved patients presented symptoms in unilateral upper extremity (left side 10 patients, right side 10 patients). They did not undergo physical therapy or nerve block therapy in 1 week before examination. Eight non-CSR patients who received treatment in Pain Center concurrently were involved in the control group (2 patients with trigeminal neuralgia, 4 with osteoarthrosis of knee joint and 2 with lumbar intervertebral disc protrusion), and another 12 healthy volunteers were involved. Four non-CSR patients and 12 healthy volunteers, 8 male and 12 female, were aged from 23 to 75 years. The informed consents were obtained from all the involved subjects. METHODS: The volar thresholds of cold sensation, thermal sensation, cryalgesia of thenar eminence of both upper extremities of all the subjects were examined separately by limit method with type TSA-Ⅱ temperature sensation analysator made by Medco Company (Israel). The subjects were pre-examined to be familiar with the method for sensory discrimination and affirmation. Thenar eminence vola of bilateral upper extremities were detected. The infrared detector of a semiconductor was contacted with skin. The infrared detector could be used to heat and cool skin. A group of cold-heat water circulation device was given electric current to produce temperature gradient, which was higher or lower than skin temperature. The initial temperature of infrared detector was 32 ℃, stimulation temperature was increased or decreased progressively at 1 ℃/s, and temperature change range was 0 to 50 ℃. In the first step, subjects pressed down the button to stop the stimulation when the temperature of infrared detector was decreased progressively until the subjects felt, and the threshold of cold sensation was obtained; In the second step, the threshold of thermal sensation was obtained when the temperature of infrared detector was increased progressively until the subjects felt; In the third step, the threshold of cryalgesia was obtained when the temperature of infrared detector was decreased progressively until subjects felt; and in the fourth step, the threshold of thermalgesia was obtained when the temperature of infrared detector was increased progressively until subjects felt. Each step was conducted 4 times and the mean threshold was obtained. Before each measurement, the temperature was made to rebound to the initial temperature and kept for 10 s. MAIN OUTCOME MEASURES: The thresholds of cold sensation, thermal sensation and cryalgesia, thermalgesia of thenar eminence vola of bilateral upper extremities of all the subjects. RESULTS: Twenty patients with CSR and 20 healthy subjects participated in the final results. ① In the CSR group, the threshold of cold sensation of affected side was lower than that of intact side [(29.00±1.26) ℃ vs.(30.00±1.06) ℃, P < 0.05], and the threshold of thermal sensation of affected side was higher than that of intact side [(35.04±0.87) ℃ vs. (34.14±0.99) ℃, P < 0.05]. There were no significant differences in the thresholds of cold and thermal sensation between affected side and intact side (P > 0.05). ②In the CSR group, the difference of threshold of cold sensation, thermal sensation, cryalgesia and thermalgesia between affected side and intact side was (-1.01±0.57), (0.89±0.39), (2.49±1.10) and (-1.62±0.86) ℃, respectively , the absolute value of which was higher than that of control group, respectively [(0.04±0.28),(0.05±0.26),(0.28±1.79),(0.17±1.10) ℃,P < 0.01]. In the CSR group, the threshold of cold sensation and thermalgesia of affected side was lower than that of intact side, respectively; and the threshold of thermal sensation and cryalgesia of affected side was higher than that of intact side, respectively. CONCLUSION: The superficial sensation of affected extremity of patients with CSR is lessened as compared with that of intact extremity. There are dysfunctions of small myelinated fiber (Aδ fiber) and demyelinated fiber (C fiber) in the affected-side extremity. QST, as a mean for quantitatively evaluating the function of Aδ fiber and C fiber, plays an objective evaluative role in the diagnosis and therapeutic effect observation of CSR.

Health Evaluation for Hypertensive Population Using Exercise Testing and Health-related Quality of Life Questionnaire

Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument. Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.

Gait analysis in swine,sheep,and goats after neurologic injury:a literature review

Medical research on neurologic ailments requires representative animal models to validate treatments before they are translated to human clinical trials.Rodents are the predominant animal model used in neurological research despite limited anatomic and physiologic similarities to humans.As a result,functional testing designed to assess locomotor recovery after neurologic impairment is well established in rodent models.Comparatively,large r,more clinically relevant models have not been as well studied.To achieve similar locomotor testing standardization in larger animals,the models must be accessible to a wide array of researchers.Non-human primates are the most relevant animal model fo r translational research,however ethical and financial barriers limit their accessibility.This review focuses on swine,sheep,and goats as large animal alternatives for transitional studies between rodents and non-human primates.The objective of this review is to compare motor testing and data collection methods used in swine,sheep,and goats to encourage testing standardization in these larger animal models.The PubMed database was analyzed by searching combinations of swine,sheep,and goats,neurologic injuries,and functional assessments.Findings were categorized by animal model,data collection method,and assessment design.Swine and sheep were used in the majority of the studies,while only two studies were found using goats.The functional assessments included open pen analysis,treadmill walking,and guided free walking.Data collection methods included subjective behavioral rating scales and objective tools such as pressure-sensitive mats and image-based analysis software.Overall,swine and sheep were well-suited for a variety of assessment designs,with treadmill walking and guided free walking offering the most consistency across multiple trials.Data collection methods varied,but image-based gait analysis software provided the most robust analysis.Future studies should be conducted to standardize functional testing methods after neurologic impairment in large animals.

Liver dysfunction-related COVID-19:A narrative review

The coronavirus 2019 disease(COVID-19)is caused by a novel coronavirus,severe acute respiratory syndrome coronavirus 2.This disease was designated by the World Health Organization as a pandemic on March 11,2020,which is not seen before.There are no classical features among the cases of the disease owing to the involvement of nearly all body tissues by the virus.Hepatic involvement is one of the characteristics of the COVID-19 course.There are six possible mechanisms of such involvement:Direct virus injury,drug-induced effect,inflammatory cytokine storm,hypoxia-ischemic destruction,abnormalities in liver function tests,and pre-existing chronic liver diseases.Liver abnormalities are seen commonly in the severe or critical stage of COVID-19.Therefore,these abnormalities determine the COVID-19 severity and carry a high rate of morbidity and mortality.The elderly and patients with comorbidities like diabetes mellitus and hypertension are more vulnerable to liver involvement.Another issue that needs to be disclosed is the liver manifestations following the COVID-19 vaccination,such as autoimmune hepatitis.Of note,complete vaccination with third and fourth booster doses is necessary for patients with previous chronic liver diseases or those who have been subjected to liver transplantation.This review aims to explore the various aspects of liver dysfunction during the COVID-19 course regarding the epidemiological features,predisposing factors,pathophysiological mechanisms,hepatic manifestations due to COVID-19 or following vaccination,role of liver function tests in the assessment of COVID-19 severity,adverse effects of the therapeutic agents for the disease,and prognosis.