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Luminance and thresholding limitations of virtual reality headsets for visual field testing

by Changseok Lee, Liam Redden, Vivian Eng, Brennan Eadie

Purpose

To investigate the luminance capacity and achievable threshold levels of commercially employed virtual reality (VR) devices for visual field testing.

Methods

This two-part study included (1) a literature review of VR headsets used for perimetry with luminance data extracted from technical specifications in publications and manufacturers; and (2) empirical evaluation of three most employed VR headsets in the literature using a custom virtual testing environment.

Results

Three most employed VR devices for visual field testing were Pico Neo, Oculus Quest, and HTC Vive. The maximum reported luminance was 250 cd/m2 for the HTC Vive Pro. Information on luminance measurement was not consistently available, reporting only handheld luminance meters. Empirical measurements show that handheld luminance meters significantly overestimate luminance compared to standard spectroradiometers. Measured luminance varies significantly across aperture size and decreases for peripheral stimuli up to 30 degrees peripherally. Assuming conventional background of 10 cd/m2, the best performance with lowest possible thresholding was with HTC Vive at 16dB, corresponding to luminance of 80 cd/m2 centrally. Oculus Quest 2 and Pico Neo 3 had minimum threshold of 20dB.

Conclusion

Commercially available VR devices do not meet luminance requirements or threshold sensitivities for visual field testing. Current VR technology is not designed—nor has the capacity—to threshold at mid-to-low dB ranges, which limits accuracy in diagnosing and monitoring defects seen in glaucoma. Translational Relevance: This study highlights the technical limitations of current commercially available VR devices for visual field testing and significant variables in evaluating luminance performance in these devices.

Diagnostic performance of the Hightop Rapid Diagnostic Test for the detection of anti-Treponema pallidum antibodies in Cameroon: a laboratory-based cross-sectional and comparative study

Por: Taheu Ngounouh · C. · Nguwoh · P. S. · Fokam · J. · Essomba · R. G. · Halilou · I. · Al-Maye Bit Younouss · A. · Ibnou Moussa · N. · Yuosembom · E. · Pepa · S. · Mbarga Foe · M. · Orock Eta · E. · Mpiwouo Panyere · G. · Madie Tamo · C. · Ngantchui Tchuisseu · J. · Moussa · A. · Zotie
Objective

The study was conducted to assess the diagnostic performance of the Hightop Syphilis Rapid Diagnostic Test (RDT) in comparison with the ELISA test used as a reference method.

Design

A laboratory-based cross-sectional and comparative study was conducted to assess the diagnostic performance of the Hightop Syphilis RDT.

Setting

Blood samples obtained from adult participants in eight health facilities were analysed at the National Public Health Laboratory (NPHL), Ministry of Public Health, Yaounde, Cameroon.

Participants

From 29 April to 25 August 2023, 583 adult participants of both sexes (aged ≥21 years), including both syphilis positive and syphilis negative, were recruited consecutively in eight health facilities in eight regions of Cameroon.

Outcome measures

Blood samples were screened for the detection of anti-Treponema pallidum antibodies using the One Step Rapid Test (Qingdao Hightop Biotech), a non-treponemal test and ELISA (Biorex Diagnostics, UK), a treponemal test used as a reference method. Diagnostic performance of the Syphilis RDT was analysed using Epi Info V.7 and validated through online statistical tools such as StatPages, GraphPad, QuickCalcs and MedCalc software.

Results

Of the 583 samples tested, the Hightop Syphilis RDT revealed a sensitivity of 84.6% (95% CI: 74.8% to 91.1%) and specificity of 98.5% (95% CI: 97.5% to 99.1%). The positive predictive value (PPV) and negative predictive value (NPV) were 84.6% (95% CI: 74.8% to 91.1%) and 98.5% (95% CI: 97.5% to 99.1%), respectively. Regarding the stratification of diagnostic performance by clinical stage, the test showed a sensitivity of 100.0% (95% CI: 71.51% to 100.0%) and specificity of 99.06% (95% CI: 94.86% to 99.98%). The PPV and NPV were 91.67% (95% CI: 61.00% to 98.72%) and 100.0% (95% CI: 96.55% to 100.0%), respectively, in symptomatic individuals. Among asymptomatic individuals, sensitivity was 97.56% (95% CI: 87.14% to 99.94%) and specificity was 100.0% (95% CI: 99.14% to 100.0%). The PPV and NPV were 100.0% (95% CI: 91.19% to 100.0%) and 99.77% (95% CI: 98.40% to 99.97%), respectively.

Conclusions

The Hightop Syphilis RDT demonstrated adequate diagnostic performance, particularly among symptomatic individuals, supporting its utility as a reliable tool for syphilis detection in clinical settings.

What factors influence nutrition-related information-seeking behaviour among pregnant women attending antenatal care at public hospitals in Bahir Dar City, northwest Ethiopia: a cross-sectional study

Por: Bitacha · G. K. · Asemahagn · M. A. · Mekonnen · Z. A. · Chekol · T. M. · Ahmed · M. H. · Meshesha · N. A. · Guadie · H. A. · Dube · G. N.
Objective

This study aimed to assess the proportion of nutrition-related information-seeking behaviour and its associated factors among pregnant women attending antenatal care at public hospitals in Bahir Dar City, northwest Ethiopia, 2023.

Method

A cross-sectional quantitative supplemented with qualitative study design was conducted from March to April 2023 among 406 pregnant women. Pre-tested structured interviewer-administered and semistructured open-ended questionnaires were used to collect quantitative and qualitative data, respectively. Data were collected using the Kobo toolbox, and SPSS V.25 was used for analysis. Descriptive statistics were used to describe study subjects, and multivariate logistic regression analysis was employed to investigate the associated factors. The strength of associations was described using the OR with the corresponding 95% CI.

Result

The study included 406 pregnant mothers with a median age of 28 with an IQR of 8 and 212 (52.2%) from rural settings. Of the total respondents, 173 (42.6%; 95% CI 37.7 to 47.6) of pregnant mothers were nutrition-related information seekers. Educational status, residence, monthly income and nutrition information literacy were significantly associated with nutrition-related information-seeking behaviour.

Conclusion

The proportion of nutrition information seeking among pregnant mothers in Bahir Dar City public hospitals was low. Lower educational status, low nutrition information literacy level, being from a rural residence and low monthly income are significantly associated factors.

Recommendation

Awareness creation for pregnant mothers from rural areas and with low educational status and improving nutrition information literacy of pregnant mothers are important activities to improve their nutrition information-seeking behaviour.

AEROfen: protocol for a phase I, open-label, randomised crossover study evaluating the efficiency of nebulised fentanyl in healthy volunteers - comparing facial versus intranasal administration via pharmacometric modelling

Por: Follet · C. · Dumont · A. · Roussel · M. · Gillibert · A. · Boedard · C. · Quillard · M. · Ruault · S. · Vallin · F. · Donnadieu · N. · Nunes Ferreira · D. · Pereira · T. · Joly · L.-M. · Lvovschi · V. · Duflot · T.
Introduction

Pain accounts for approximately 80% of emergency department admissions. While intravenous morphine titration is commonly used for severe pain, non-invasive alternatives that bypass intravenous access are needed. Nebulised fentanyl, combined with pupillometry for objective monitoring of opioid impregnation, may offer a rapid and safe alternative for pain management.

Methods and analysis

This phase I, open-label, randomised, exploratory, crossover, single-centre prospective controlled trial will employ pharmacokinetic–pharmacodynamic (PK–PD) modelling to assess the variability in bioavailability of nebulised fentanyl administered via intranasal route versus facial aerosol. 20 healthy volunteers will receive three repeated administrations of fentanyl over two visits. At each visit, blood samples (n=11) will be collected for fentanyl quantification by liquid chromatography–tandem mass spectrometry, and pupillary unrest in ambient light (PUAL) measurements (n=9) will be recorded. The resulting data will be analysed using Monolix 2024R1 to model PK–PD relationships, perform Monte Carlo simulations and determine the optimal dosing and timing required to achieve a reduction of more than 30% in PUAL, while also evaluating safety, comfort and tolerance.

Ethics and dissemination

The study has been approved by the Ethic Committee Île-de-France VII (approval reference number: 000216, February 2024) and will be conducted in accordance with the Declaration of Helsinki. Informed consent will be obtained from all participants. Study findings will be disseminated through peer-reviewed publications, conference presentations and appropriate data-sharing platforms to support further research and clinical application.

Trial registration number

This trial is registered at ClinicalTrials.gov (Identifier: NCT06281951).

What drives clinic follow-up after traumatic spinal injury? An observational cohort study from Tanzania

Por: Ikwuegbuenyi · C. A. · Woodfield · J. · Sabas · R. R. · Inzerillo · S. · Willett · N. · Cadieux · M. · Zuckerman · S. L. · Waterkeyn · F. · Mangat · H. S. · Shabani · H. K. · Härtl · R.
Objectives

To evaluate factors associated with clinic follow-up after traumatic spinal injury (TSI) in Tanzania, focusing on demographic, injury-related and hospital variables. We hypothesised that socioeconomic and injury-specific factors would predict follow-up adherence.

Design

Retrospective observational cohort study.

Setting

Tertiary government referral centre for neurosurgery and orthopaedics in Dar es Salaam, Tanzania.

Participants

443 adults with TSI admitted between September 2016 and October 2021. Inclusion criteria included survival to discharge and availability of the discharge date. Patients with missing data were excluded.

Primary and secondary outcome measures

Primary outcomes were any clinic follow-up and 1-year follow-up post-discharge. Secondary outcome was time to loss of follow-up. Logistic regression was used to identify factors associated with follow-up, and Kaplan-Meier survival analysis assessed follow-up duration.

Results

Of 443 patients (85.8% male, median age 34 years), 52.4% returned for follow-up. Independent factors associated with return included private insurance (adjusted OR (aOR) 2.69, 95% CI 1.38 to 5.45, p=0.005), involvement in a road traffic accident (aOR 2.15, 95% CI 1.22 to 3.83, p=0.009), lumbar injuries (aOR 2.26, 95% CI 1.30 to 4.00, p=0.004), neurological improvement at discharge (aOR 3.52, 95% CI 1.72 to 7.64, p=0.001) and hospital stays shorter than 24 days (aOR 1.63, 95% CI 1.07 to 2.47, p=0.022). Among those who returned, only 25.4% completed 1 year of follow-up. Predictors of 1-year follow-up included being female (aOR 4.87, 95% CI 2.31 to 10.56, p

Conclusion

Follow-up after TSI in this low- and middle-income country setting is poor, with fewer than one in eight patients completing 1 year. Private insurance, injury mechanism, neurological improvement and female sex predicted follow-up. Targeted efforts are needed to improve long-term care engagement.

The Clinical Utility of Autofluorescence Imaging for Bacterial Detection in Wounds: A Systematic Review

ABSTRACT

This systematic review evaluated the clinical utility and diagnostic accuracy of autofluorescence imaging in detecting bacterial presence in wounds. A literature search was conducted in January 2025 across PubMed, Scopus, Cochrane, and EMBASE databases. Eligible studies included clinical trials and observational studies assessing autofluorescence imaging for wound bacterial detection. Seventeen studies were included; sixteen assessed the MolecuLight i:X device, and one evaluated PRODIGI. Autofluorescence imaging demonstrated higher accuracy than White Light and Clinical Signs and Symptoms-based assessment in detecting bacterial burden. Five studies highlighted its role in enhancing swabbing techniques, with fluorescence-guided sampling yielding higher bacterial counts than conventional methods. Ten studies reported significant bacterial reduction with autofluorescence-guided debridement. Six studies emphasized its role in refining treatment decisions and accelerating wound healing. Quality appraisal was undertaken using Evidence-Based Librarianship criteria, which deemed 10 studies valid, while 7 had limitations related to population representation. In conclusion, autofluorescence imaging enhances wound assessment by improving bacterial detection and may support more targeted clinical interventions. However, further research is needed to clarify its impact on infection control and long-term healing outcomes.

Repetitive transcranial magnetic stimulation as an adjunct to quadriceps strengthening exercise in knee osteoarthritis: a pilot randomised controlled trial

Por: Chang · W.-J. · Chiang · A. · Chowdhury · N. · Adie · S. · Naylor · J. M. · Finn · H. · Rizzo · R. R. N. · Gorgon · E. · OHagan · E. · Schabrun · S. M.
Objective

To examine the feasibility, safety and perceived patient response of a combined repetitive transcranial magnetic stimulation (rTMS) and quadriceps strengthening exercise intervention for knee osteoarthritis.

Methods

A two-arm, participant-blinded, therapist-blinded and assessor-blinded, randomised controlled trial with additional follow-up of pain and function at 3 months. Participants were randomised to receive active rTMS+exercise (AR+EX) or sham rTMS+exercise (SR+EX) twice weekly for 6 weeks while completing home exercises twice a week. Primary outcomes included recruitment rate, treatment attendance, dropouts, willingness to undergo therapy (11-point Numeric Rating Scale, ‘not at all willing’=0 and ‘very willing’=10), success of participant, therapist and outcome assessor blinding, adverse events and Global Perceived Effect Scale. Secondary outcomes were pain, function and measures of physiological mechanisms.

Results

86 people were screened, 31 (36%) were randomised, 28 (90%) completed the treatments and 3 (10%) dropouts at 3-month follow-up. Both groups had high treatment attendance (98.4% and 100%). All participants scored at least 7 on the willingness to undergo therapy scale. Blinding was successful. No adverse events were reported. At the postintervention assessment, 80% in the AR+EX group and 75% in the SR+EX group reported an improvement on the Global Perceived Effect Scale. Both groups demonstrated within-group improvements in pain at the postintervention assessment but not at the 3-month follow-up. Function improved only in the AR+EX group at the postintervention assessment.

Conclusions

Combined rTMS and quadriceps strengthening exercise intervention for knee osteoarthritis is feasible, safe and well-received. A full-scale trial is justified to assess the clinical benefits of this novel treatment.

Trial registration number

ACTRN12621001712897.

Association between serum neurofilament light chain levels and grip strength among US adults: a cross-sectional study using National Health and Nutrition Examination Survey data from 2013 to 2014

Por: Dilixiati · D. · Kadier · K. · Qiao · B. · Zhang · W. · Nuerdebieke · D. · Zebibula · A. · Yang · Y. · Rexiati · M.
Objective

We aimed to investigate the relationship between serum neurofilament light chain (NfL) and grip strength using data from the 2013–2014 US National Health and Nutrition Examination Survey (NHANES).

Design

Secondary analysis of cross-sectional, population-based data.

Setting

NHANES sample, 2013–2014.

Participants

We studied 1925 participants aged 20–75 years.

Outcome measures and analysis

We applied a multivariable generalised linear regression model, adjusted for several potential confounders, and restrictive cubic spline models to evaluate the association between serum NfL and grip strength. Subgroup analyses were conducted using stratified multivariable linear regression analysis.

Results

We included 1925 participants (average age: 44.8±0.44 years) from the NHANES database. Participants with higher serum NfL levels had a significantly higher prevalence of medical conditions (hypertension, diabetes, cardiovascular disorder, chronic kidney disease (CKD) and cancer) compared with those with lower NfL levels (all p

Conclusion

Our study demonstrates a strong, negative and linear correlation between elevated serum NfL levels and grip strength. Notably, our findings indicate that individuals aged between 60 and 75 years, those with physical inactivity and those with CKD exhibit a more pronounced reduction in grip strength with increasing serum NfL levels.

Incidence and predictors of tuberculosis among HIV-infected children after initiation of antiretroviral therapy in Ethiopia: A systematic review and meta-analysis

by Amare Kassaw, Worku Necho Asferie, Molla Azmeraw, Demewoz Kefale, Gashaw Kerebih, Gebrehiwot Berie Mekonnen, Fikadie Dagnew Baye, Shegaw Zeleke, Biruk Beletew, Solomon Demis Kebede, Tigabu Munye Aytenew, Lakachew Yismaw Bazezew, Muluken Chanie Agimas

Background

Globally, Tuberculosis (TB) is the main cause of morbidity and mortality among infectious disease. TB and Human Immune Virus (HIV) are the two deadly pandemics which interconnected each other tragically, and jeopardize the lives of children; particularly in Sub-Saharan Africa. Therefore, this review was aimed to determine the aggregated national pooled incidence of tuberculosis among HIV- infected children and its predictors in Ethiopia.

Methods

An electronic search engine (HINARI, PubMed, Scopus, web of science), Google scholar and free Google databases were searched to find eligible studies. Quality of the studies was checked using the Joanna Briggs Institute (JBI) quality assessment checklists for cohort studies. Heterogeneity between studies was evaluated using Cochrane Q-test and the I2 statistics.

Result

This review revealed that the pooled national incidence of tuberculosis among children with HIV after initiation of ART was 3.63% (95% CI: 2.726–4.532) per 100-person-years observations. Being Anemic, poor and fair ART adherence, advanced WHO clinical staging, missing of cotrimoxazole and isoniazid preventing therapy, low CD4 cell count, and undernutrition were significant predictors of tuberculosis incidence.

Conclusion

The study result indicated that the incidence of TB among HIV- infected children is still high. Therefore, parents/guardians should strictly follow and adjust nutritional status of their children to boost immunity, prevent undernutrition and opportunistic infections. Cotrimoxazole and isoniazid preventive therapy need to continually provide for HIV- infected children for the sake of enhancing CD4/immune cells, reduce viral load, and prevent from advanced disease stages. Furthermore, clinicians and parents strictly follow ART adherence.

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