Volumetric Resection and Complications in Nonfunctioning Pituitary Adenoma by Fully Endoscopic Transsphenoidal Approach along 15 Years of Single-Center Experience

Objective The aim of this study was to evaluate the rate of complications and the extent of resection (EOR) of nonfunctioning pituitary adenomas by endoscopic endonasal approach (EEA) in a 15-year learning curve. Methods A total of 100 patients operated by the same surgical team were divided chronologically into two, three, and four groups, comparing differences in EOR measured by a semiautomatic software (Smartbrush, Brainlab), rate of immediate postoperative complications, and the visual and hormonal status at 6 months. Results There were no significant differences over the years in rates of postoperative complications and in visual status at 6 months. A significant linear correlation between the EOR and the number of surgeries (rho = 0.259, p = 0.007) was found. The analysis was performed in three groups because of the remarkable differences among them; the EOR were: 87.2% (early group), 93.03% (intermediate group), and 95.1% (late group) (p = 0.019). Gross total resection was achieved in 30.3, 51.5, and 64%, respectively (p = 0.017); also, the rate of reoperation and the worsening of at least one new hormonal axis were worse in the early group. Consequently, the early group had a higher risk of incomplete resection compared with the late group (odds ratio: 4.2; 95% confidence interval: 1.5–11.7). The three groups were not different in demographic and volume tumor variables preoperatively. Conclusions The first 33 interventions were associated with a lower EOR, a high volume of residual tumor, a high reoperation rate, and a higher rate of hormonal dysfunction. We did not find differences in terms of postoperative complications and the visual status at 6-month follow-up.

Inclusive Adaptation of Existing Board Games for Gamers with and without Visual Impairments using a Spatial Augmented Reality Framework for Touch Detection and Audio Feedback

Board games allow us to share collective entertainment experiences. They entertain because of the interactions between players, physical manipulation of tokens and decision making. Unfortunately, most board games exclude people with visual impairments as they were not initially designed for players with special needs. Through a user-centered design process with an accessible game library and visually impaired players, we observed challenges and solutions in making existing board games accessible through handcrafted solutions (tactile stickers, braille labels, etc.). In a second step, we used Spatial Augmented Reality (SAR), to make existing board games inclusive by adding interactivity (GameARt). In a case study with an existing board game considered as not accessible (Jamaica), we designed an interactive SAR version with touch detection (JamaicAR). We evaluated this prototype in a user study with 5 groups of 3 players each, including sighted, low vision and blind players. All players, independent of visual status, were able to play the Augmented Reality game. Moreover, the game was rated positively by all players regarding attractiveness, play engrossment, enjoyment and social connectivity. Our work shows that Spatial Augmented Reality has the potential to make board games accessible to people with visual impairments when handcrafted adaptations fall short.

Touch-Avoidance and Touch-Seeking in Non-intimate Relationships: The Null Effects of Sightedness

People differ in their touch preferences and in the ways in which they touch others. People who are blind are particularly sensitive to tactile stimulation as a result of sensory compensation, and sense of touch can support their interpersonal communication. In the article presented here, we aimed to explore whether visual status predicts preferences for touch behaviors involving strangers; specifically, we examined touch-seeking and touch-avoidance in non-intimate interpersonal situations. Our study, whose participants comprised 43 individuals with congenital blindness, 53 individuals with adventitious blindness, and 47 sighted controls, showed that visual status does not predict touch-seeking or social touch-avoidance. We also observed similar gender differences in all participating groups, with women avoiding social touch more than men in non-intimate interpersonal situations involving strangers.

Self-Regulation of Driving Behavior Under the Influence of Cannabis: The Role of Driving Complexity and Driver Vision

Objective This study analyzed the self-regulation behaviors of drivers under the influence of cannabis and its relationship with road complexity and some driver traits, including visual deterioration. Background Cannabis is the illicit drug most often detected in drivers; its use results in significant negative effects in terms of visual function. Self-regulation behaviors involve the mechanisms used by drivers to maintain or reduce the risk resulting from different circumstances or the driving environment. Methods Thirty-one young, occasional cannabis users were assessed both in a baseline session and after smoking cannabis. We evaluated the visual function (visual acuity and contrast sensitivity) and driver self-regulation variables of both longitudinal and lateral control as the speed adaptation and standard deviation of lateral position (SDLP). Results Visual function was significantly impaired after cannabis use. Recreational cannabis use did not result in self-regulation, although some road features such as curved roads did determine self-regulation. Male participants adopted mean faster driving speeds with respect to the speed limit. Driver age also determined better lateral control with lower SDLPs. In addition, visual impairment resulting from cannabis use (contrast sensitivity) was linked with self-regulation by changes in longitudinal and lateral control. Conclusion Contrast sensitivity could be a good indicator of individual visual status to help determine how drivers self-regulate their driving both in normal conditions and while under the influence of cannabis. Application The findings provide new insights about driver self-regulation under cannabis effects and are useful for policy making and awareness campaigns.

Visual Outcome Predictors After Surgical Excision Of Meningiomas Compressing The Optochiasmatic Complex

Background Meningioma arising from locations in the vicinity of optic nerve or chiasm may affect the visual function which sometimes the presentation of such tumors. Decompression of the optic nerve or chiasm can give a chance to the visual function to recover. Methods 30 patients who had visual function affection and underwent meningioma excision are followed up for a period of one year with regular follow of their visual function periodically. Results In this study, females were more prevalent than males, 24 out of 30, age ranged from 24 to 72 years at the time of surgery, half the patients (15) presented with visual deterioration, the other patients presented with headache, seizure, proptosis or accidentally discovered. 22 patients improved concerning their visual function over time, 6 patients had stationary course and 2 patients deteriorated postoperatively. Conclusion Follow up of patients after surgical excision of meningioma compressing the anterior optic pathway showed gradual improvement in vision in follow up period up to one year, although the improvement in visual function showed a surge in early postoperative period, with continuous less steep improvement afterwards till the end of the observation period. Surgical excision of meningiomas compressing the anterior visual pathway give chance for recovery of visual function, more in younger patients, patients with shorter period of visual deterioration, patients with mild affection of the preoperative visual status. No statistically significant influence of tumor site, size, degree of excision and surgical approach on the postoperative visual outcome in this series.

Visual assessment of commercial drivers in the South West Region of Cameroon

Background Driving is a visually intensive task. In Cameroon, where the burden of road traffic deaths is high, visual assessment is not universally performed before the issuance of driver licenses. This study aims to assess the visual status of commercial drivers (CDs) in the southwestern region of Cameroon, and to find its relation to road traffic crashes (RTCs). Methods This work was a cross-sectional community-based study on CDs in Limbe and Buea. Questionnaires were used to assess sociodemographic parameters, the incidence of RTCs, and self-reported visual status. Visual acuity (VA) was measured using a standard Snellen chart at 6 m. Statistical analysis was performed using descriptive methods: frequencies, the paired Student’s t-test, and the chi-square test. Results Two hundred seven CDs were enrolled in this study, all of which were male, with a mean age of 41.8 ± 12.1 years. A total of 15.0% had undergone an eye exam prior to licensure, and 3.4% had undergone an eye exam within the past 10 years. The VA in the better-seeing eye of participants was less than 6/9 and 6/12 in 14.1 and 10.6% of CDs, respectively. Seventy-five percent of CDs with self-reported poor vision and 95% of CDs with VA < 0.5 had a history of RTCs compared to 55.8% of CDs with self-reported good vision and 55.7% of CDs with VA ≥ 0.5 (p < 0.05). Injuries from RTCs were more common in CDs with self-reported poor vision (81.1%) and in those with VA < 0.5 (90.5%) compared to CDs who self-reported good vision (55.8%) and those with VA ≥ 0.5 (55.7%) (p < 0.05). Conclusions A large proportion of CDs did not undergo a visual assessment before the issuance or renewal of their driver licenses. A substantial number of CDs had poor vision in their better-seeing eye and suffered from RTCs and related injuries, which suggests that the visual status of CDs in Cameroon is related to the gruesome number of road traffic crashes and deaths in the country. Therefore, concerned authorities should consider making vision tests a necessary requirement for the obtention of driver licenses.

Exploring 3D miniatures with action simulations by finger gestures: Study of a new embodied design for blind and sighted children

Tactile books for blind children generally contain tactile illustrations referring to a visual world that can be difficult to understand. This study investigates an innovative way to present content to be explored by touch. Following embodied approaches and evidence about the advantages of manipulations in tactile processing, we examined 3D miniatures that children explored using their middle and index fingers to simulate leg movements. This “Action simulations by finger gestures–ASFG” procedure has a symbolic relevance in the context of blindness. The aim of the present study was to show how the ASFG procedure facilitates the identification of objects by blind and sighted children. Experiment 1 examined the identification of 3D miniatures of action objects (e.g. the toboggan, trampoline) by 8 early blind and 15 sighted children, aged 7 to 12, who explored with the ASFG procedure. Results revealed that objects were very well identified by the two groups of children. Results confirmed hypotheses that ASFG procedures are relevant in the identification process regardless of the visual status of subjects. Experiment (control) 2 studied identification of tactile pictures of same action objects by 8 different early blind and 15 sighted children, aged 7 to 12. Results confirmed that almost all objects obtained lower recognition scores in tactile pictures than in 3D miniatures by both groups and showed surprisingly higher scores in blind children than in sighted children. Taken together, our study provides evidence of the contribution of sensorimotor simulation in the identification of objects by touch and brings innovative solutions in book design for blind people. Moreover, it means that only the ASFG procedure has a very inclusive potential to be relevant for a larger number of subjects, regardless of their visual skills.