Abstract: This article reviews the history of the femtosecond laser in ophthalmology and its subsequent introduction into the field of cataract surgery. It discusses the innovations that this technology has brought to the field. The article also describes the current system of teaching cataract surgery to ophthalmology residents in the United States and then examines how femtosecond laser-assisted cataract surgery (FLACS) can be a beneficial part of residency education.
Abstract: Myopia in children remains a major public health problem worldwide, especially in some Asian countries such as China, Singapore and Japan. Although many interventions have been attempted, few has been proven to be effective in controlling onset and progression of myopia in children. Environmental factors, genetic susceptibility or ethnic differences can affect the efficacy of these interventions. However, many questions remain unclear and even controversial for controlling myopia. China has the biggest population with myopia, especially for children myopia. Thus, it is of importance to present what achievements Chinese scientists have made in the field of myopia control in children. We summarize the current findings on myopia control in children from the Anyang Childhood Eye Study, including epidemiological data, clinical trials, systematic reviews and meta-analyses, and compare them with studies in other countries to find potential clues for controlling myopia in children.
Abstract: Between 2011 and 2013, two large-scale cohort epidemiology studies were launched in Shanghai: the SCALE study, which aimed to provide ocular public health services to cover the entire youth population in Shanghai, and the SCES, which was based on sample surveys and aimed to provide information on the prevalence and incidence of visual impairment and different types of refractive errors. A total of 910,245 children and adolescents were finally enrolled in the SCALE study; three possible methods for monitoring refractive error without mydriasis were tested, and the agreement between the refractive outcomes of three commonly used autorefractors were examined to ensure the accuracy of the results of the SCALE study. A total of 8,627 children were enrolled in the SCES, and the baseline prevalence of different refractive errors, different behaviors associated with 1 year myopic shifts, and the different patterns of 2-year myopia progression between internal migrant and local resident school children have been analyzed. In some subset samples of the SCALE study and the SCES, several refraction components such as choroidal thickness (ChT) and crystalline lens power were also measured, to further elucidate the relationships between the refraction components and myopia as well as the mechanism of myopia incidence and development. The three methods used in Shanghai to prevent and intervene with childhood myopia: increasing outdoor time, low concentration atropine, and use of orthokeratology lens are also addressed in this review.
Background: Understanding how individuals with autism spectrum disorder (ASD) learn is important for developing and implementing effective educational and behavioral interventions. Evidence suggests that individuals with ASD are relatively stronger in certain areas of perception (Simmons et al., 2009; Dakin and Frith, 2005); it therefore cannot be assumed that individuals with ASD learn using the same rules and strategies as neurotypicals (NT). Of particular interest, perceptual learning (PL) is a class of learning that is based upon changes induced by the repeated exposure and response to specific types of perceptual information. Such learning often includes feedback, indicating whether or not a response was correct during a trial within a PL task. The objectives of this study were to perform a pilot investigation of; (I) perceptual learning in adults with and without ASD using a low-level orientation discrimination task; and (II) the influence of feedback on accuracy in this task.
Methods: Eleven adults with ASD and fifteen NT adults, matched on Wechsler full-scale IQ and age (18–31 years), performed a low-level PL task. They were asked to indicate whether a grating was tilted to the left (i.e., counter-clockwise) or to the right (i.e., clockwise) relative to an oblique 45-degree reference orientation. Thresholds, defined by the minimal deviation in degrees needed to discriminate tilt orientation, were measured for each participant every 15 minutes, with each block consisting of 420 trials. To assess baseline performance, all participants completed a first block with no feedback. Participants were then randomly assigned to either feedback (NASD =6, NTD =8) or no feedback groups (NASD =5, NTD =7) and completed six subsequent testing blocks.
Results: PL was defined as the percent change in orientation discrimination threshold in each of the six testing blocks relative to baseline performance. No significant increase was found in performance as a function of testing block for any group; PL was therefore not evidenced under the conditions tested. ASD performance remained equal to that of baseline across testing blocks, whether or not trial-by-trial feedback was present. In contrast, NT performance was significantly increased when feedback was present.
Conclusions: NT individuals significantly benefited from feedback, while individuals with ASD did not. These results provide preliminary evidence for a divergent learning style in ASD and NT individuals. These pilot findings raise important questions regarding the impact of feedback during interventions, and at a more basic level, the atypical underlying perceptual and cognitive processes in individuals with ASD.
Background: It is well known that the pulvinar establishes reciprocal connections with areas of the visual cortex, allowing the transfer of cortico-cortical signals through transthalamic pathways. However, the exact function of these signals in coordinating activity across the visual cortical hierarchy remains largely unknown. In anesthetized cats, we have explored whether pulvinar inactivation affects the dynamic of interactions between the primary visual cortex (a17) and area 21a, a higher visual cortical area, as well as between layers within each cortical area. We found that pulvinar inactivation modifies the local field potentials (LFPs) coherence between a17 and 21a during a visual stimulation. In addition, the Granger causality analysis showed that the functional connectivity changed across visual areas and between cortical layers during pulvinar inactivation, the effects being stronger in layers of the same area. We observed that the effects of pulvinar inactivation arise at two different epochs of the visual response, i.e., at the early and late components. The proportion of feedback and feedforward functional events was higher during the early and the late phases of the responses, respectively. We also found that pulvinar inactivation facilitates the feedback propagation of gamma oscillations from 21a to a17. This feedback transmission was predominant during the late response. At the temporal level, pulvinar inactivation also delayed the signals from a17 and 21a, depending on the source and the target of the cortical layer. Thus, the pulvinar can not only modify the functional connectivity between intra and inter cortical layers but may also control the temporal dynamics of neuronal activity across the visual cortical hierarchy.
Methods: In vivo electrophysiological recordings of visual cortical areas, area 17 and 21a, in anesthetized cats, were then explored with temporal serial analysis (i.e., Fourier analysis, Coherence, Cross-correlation and Granger causality) of the local field potential.
Results: Inactivation of the thalamic nucleus modifies the dynamics of areas 17 and 21a. The changes observed depends on the source and the target of the cortical layer. The pulvinar inactivation arise at two different epochs of visual response.
Conclusions: The pulvinar modifies the functional connectivity between intra and inter cortical layers and may also control the temporal dynamics of neuronal activity across the visual cortical hierarchy.
Abstract: Presentations using PowerPoint or similar software are probably the most commonly used format that doctors use for teaching in medical school, during residency, at medical meetings and other continuous medical education (CME) activities. However, their effectiveness has been questioned by many. This article intends to provide, in a synthetized way, several recommendations that can help make presentation more effective.
Abstract: The teaching of professionalism, a key aspect of medical competence that regulates physician’s behavior towards patients, colleagues, society, and self, should be included in the curriculum of every training program. Studies suggest a variety of formats to teach and evaluate professionalism in residents, being role modeling, reflection, case discussions, and 360-degree assessments the most commonly used. However, little is published about the need to train faculty for teaching and evaluating professionalism, or how to improve institutional culture, so that principles that are indicated to teach in theory are also fulfilled in practice.
Abstract: Timely and widely available, social media (SM) platforms and tools offer new and exciting learning opportunities in medical education. Despite scarce, we sought for a body of consistent evidence allowing us to substantially approach the concept of SM and how physicians as learners and medical educators can use SM based-education to benefit their clinical practice and their patients’ outcomes. We correlate education theories with the progression of world-wide web phases and how this influences the process of teaching and learning. We mention some examples of SM tools already in use in healthcare education. Potential advantages and effectiveness SM in medical education, as well as limitations of SM and pre-requisites for its use are discussed. Our concluding remarks underline the good practices in effectively utilizing SM in healthcare education.
Abstract: Training in residency programs is highly competitive, it requires the formation of competent physicians that achieve the performance standards that were declared for their technical skills, attitudes and interpersonal abilities. The use of simulation and technology on the medical education has increased considerably. Particularly in ophthalmology the simulators used are: live models from animal or cadavers, mannequins, wet laboratories, simulated patients, part-task moles, laser or surgical models, and more recently, virtual reality (VR). VR places a person in a simulated environment that has a specific sense of self-location, where the participant interacts with the objects within the setting. Teaching with VR refers to the use of the available resources in technology and visualization of structures to improve the educational experience of medical students, residents and physicians in professional continuous development programs. Several authors highlight the benefits of assessing trainees with the tools, they argue that the key contribution of this model is in the formative assessment. Rather than evaluating and putting a score on student’s grades, VR provides a powerful experience for the acquisition of skills. A conclusion is the need to develop studies to document the effects that it has on knowledge, skills and behaviors, and to patient related outcomes.
