The Dress: Transforming a web viral event into a scientific survey

Enabling teleophthalmology during the COVID-19 pandemic in the Province of Trento, Italy: Design and implementation of a mHealth solution

BACKGROUND

Due to the many restrictions imposed during the COVID-19 emergency, the normal clinical activities have been stopped abruptly in view of limiting the circulation of the virus. The extraordinary containment measures have had a dramatic impact on the undertaking and follow-up of ophthalmic outpatients.

OBJECTIVE

In order to guarantee proper monitoring and routine care, the Pediatric Ophthalmology equipe of Rovereto Hospital (North-East of Italy) supported by the Competence Center on Digital Health TrentinoSalute4.0, designed and implemented a digital platform, TreC Oculistica, enabling teleophthalmology. We report our innovative-albeit restricted-experience aiming at testing and maximizing the efficacy of remote ophthalmic and orthoptic visits.

METHODS

A multidisciplinary team created the TreC Oculistica platform and defined a teleophthalmology protocol. The system consists of a clinician web interface and a patient mobile application. Clinicians can prescribe outpatients with the App and some preliminary measurements to be self-collected before the televisit. The App conveys the clinician's requests (i.e. measurements) and eases the share of the collected information in a secure digital environment, promoting a new health care workflow.

RESULTS

Four clinicians took part in the testing phase (2 ophthalmologists and 2 orthoptists) and recruited 37 patients (mostly pediatric) in 3 months. Thanks to a continuous feedback between the testing and the technical implementation, it has been possible to identify pros and cons of the implemented functionalities, considering possible improvements. Digital solutions such as TreC Oculistica advance the digitalization of the Italian health care system, promoting a structured and effective reorganization of the workload supported by digital systems.

CONCLUSIONS

The study tested an innovative digital solution in the teleophthalmology context and represented the first experience within the Italian healthcare system. This solution opens up new possibilities and scenarios that can be effective not only during the pandemic, but also in the traditional management of public health services.

Influence of Main Ocular Variables in #TheDress Perception: An Ophthalmic Survey

The objective of this study is to study the influence of ocular variables in the perception of #thedress and to develop a logistic regression model that could help predict it. This is a cross-sectional study on 1,100 subjects. People who did not report one of the two main perceptions were excluded from the study. Dress perception was codified as 0 (white&gold) or 1 (black&blue). The association between dress perception and demographic and main ocular variables (age, gender, binocular visual acuity, grade of nuclear cataract, crystalline lens status [phakic/pseudophakic], spherical equivalent, and ocular health status) was tested using logistic regression. Receiver operation curves were used to test the predictive value of the model. Several variables were found to be related with dress perception. The best model included three variables-Age: adjusted odds ratio (OR) = 1.02 (1.01-1.03), p = 0.08; ocular refraction: adjusted OR = 1.07 (1.02-1.12), p = 0.009; and nuclear cataract grade: adjusted OR = 1.45 (1.05-1.99), p = 0.026. The predictive value of the model was low (area under the curve = 0.62). Older age, nuclear cataract grade, and hyperopia were associated with black&blue perception. The predictive capacity of the developed model was poor. Only a small proportion of the variability in the #thedress perception can be explained by ocular examination.

Color Judgments of #The Dress and #The Jacket in a Sample of Different Cultures

Two viral photographs, #The Dress and #The Jacket, have received recent attention in research on perception as the colors in these photos are ambiguous. In the current study, we examined perception of these photographs across three different cultural samples: Sweden (Western culture), China (Eastern culture), and India (between Western and Eastern cultures). Participants also answered questions about gender, age, morningness, and previous experience of the photographs. Analyses revealed that only age was a significant predictor for the perception of The Dress, as older people were more likely to perceive the colors as blue and black than white and gold. In contrast, multiple factors predicted perception of The Jacket, including age, previous experience, and country. Consistent with some previous research, this suggests that the perception of The Jacket is a different phenomenon from perception of The Dress and is influenced by additional factors, most notably culture.

A cross-sectional survey among physicians on internet use for epilepsy-related information

OBJECTIVE

We investigated views towards the Internet in a sample of Italian healthcare specialists involved in epilepsy field, to identify factors associated with the attitude of being influenced by information found on the Internet.

METHODS

This study was a self-administered survey conducted in a group of members of the Italian Chapter of the International League Against Epilepsy (ILAE) in January 2018.

RESULTS

184 questionnaires were analyzed. 97.8 % of responders reported to seek online information on epilepsy. The Internet was most frequently searched to obtain new information (69.9 %) or to confirm a diagnostic or therapeutic decision (37.3 %). The influence of consulting the Internet on clinical practice was associated with registration to social network(s) (OR: 2.94; 95 %CI: 1.28-6.76; p = 0.011), higher frequency of Internet use (OR: 3.66; 95 %CI: 1.56-9.21; p = 0.006) and higher confidence in reliability of online information (OR: 2.61; 95 %CI: 1.09-6.26; p = 0.031). No association was found with age, sex, years in epilepsy practice or easiness to find online information.

CONCLUSION

Internet is frequently used among healthcare professionals involved in the epilepsy to obtain information about this disease. The attitude of being influenced by the Internet for diagnostic and/or therapeutic decisions in epilepsy is independent on age and years of experience in epilepsy, and probably reflects an individual approach towards the Web.

Stripping #The Dress: the importance of contextual information on inter-individual differences in colour perception

In 2015, a picture of a Dress (henceforth the Dress) triggered popular and scientific interest; some reported seeing the Dress in white and gold (W&G) and others in blue and black (B&B). We aimed to describe the phenomenon and investigate the role of contextualization. Few days after the Dress had appeared on the Internet, we projected it to 240 students on two large screens in the classroom. Participants reported seeing the Dress in B&B (48%), W&G (38%), or blue and brown (B&Br; 7%). Amongst numerous socio-demographic variables, we only observed that W&G viewers were most likely to have always seen the Dress as W&G. In the laboratory, we tested how much contextual information is necessary for the phenomenon to occur. Fifty-seven participants selected colours most precisely matching predominant colours of parts or the full Dress. We presented, in this order, small squares (a), vertical strips (b), and the full Dress (c). We found that (1) B&B, B&Br, and W&G viewers had selected colours differing in lightness and chroma levels for contextualized images only (b, c conditions) and hue for fully contextualized condition only (c) and (2) B&B viewers selected colours most closely matching displayed colours of the Dress. Thus, the Dress phenomenon emerges due to inter-individual differences in subjectively perceived lightness, chroma, and hue, at least when all aspects of the picture need to be integrated. Our results support the previous conclusions that contextual information is key to colour perception; it should be important to understand how this actually happens.

Which are the colors of the dress? Review of an atypical optic illusion

OBJECTIVE

In 2015 the picture of a dress went viral on social media. A significant proportion of the population saw it as golden and white (G&W), while another significant proportion saw it as blue and black (B&B). The aim of this article is to review the related literature.

MATERIAL AND METHODS

Bibliographic search conducted in Pubmed and Google. The algorithm used was: (color OR colour) AND (dress OR #thedress). The search was limited to the years 2015-2017. No language restrictions were used. The references of the located articles were used to widen the search.

RESULTS

The search algorithm retrieved 23 articles related to the topic. Most of the works have been published in journals in the field of perception. Most works address the topic from the point of view of chromatic constancy. Genetic factors seem to have a low weight in the way the dress is perceived. There are few studies on the potential influence of ocular factors.

CONCLUSION

This illusion has gained little attention in ophthalmology journals. Although colour constancy is certainly involved, there is still no theory available to explain the dichotomous character of this optical illusion.

Neurology and the Internet: a review

Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

The dress and individual differences in the perception of surface properties

This study investigates systematic individual differences in the way observers perceive different kinds of surface properties and their relationship to the dress, which shows striking individual differences in colour perception. We tested whether these individual differences have a common source, namely differences in perceptual strategies according to which observers attribute features in two-dimensional images to surfaces or to their illumination. First, we reanalysed data from two previous experiments on the dress and colour constancy. The comparison of the two experiments revealed that the colour perception of the dress is strongly related to individual differences in colour constancy. Second, two online surveys measured individual differences in the perception of colour-ambiguous images including the dress, in colour constancy, in gloss perception, in the subjective grey-point, in colour naming, and in the perception of an image with ambiguous shading. The results of the surveys replicated and extended previous findings according to which individual differences in the colour perception of the dress are due to implicit assumptions about the illumination. However, results also showed that the individual differences for other phenomena were independent of the dress and of each other. Overall, these results suggest that the striking individual differences in dress colour perception are due to individual differences in the interpretation of illumination cues to achieve colour constancy. At the same time, they undermine the idea of an overall perceptual strategy that encompasses other phenomena more generally related to the interpretation of illumination and surface properties.

Health-care disparities stemming from sexual orientation of Italian patients with Multiple Sclerosis: A cross-sectional web-based study

Lesbian, gay, bisexual and transgender (LGBT) patients might experience unique difficulties and barriers to treatment of chronic diseases related to their sexual orientation. Thus, we investigated concerns experienced by LGBT patients with multiple sclerosis (MS). We conducted a web-based survey using a multi-choice questionnaire published in an Italian social-network (www.smsocialnetwork.com) for MS patients. The survey investigated: socio-demographic factors, lifestyle habits, MS-related health status and LGBT specific issues (e.g. friendliness to their sexual orientation and eventual homophobic behaviors in the MS Center). Among MS patients willing to use psychological services, LGBT patients were associated with a smaller number of psychological consultations, compared to heterosexuals (Coeff.=-0.449; p<0.001; 95%CI=-0.682 to -0.217). LGBT patients were more likely to change MS Center, compared to heterosexuals (OR=2.064; p=0.046; 95%CI=1.011-4.212). The number of MS Center changes was associated with MS Center friendliness (p=0.037; rho=-0.229) and with the occurrence of homophobic behaviors (p=0.036; rho=0.234). LGBT MS patients more frequently changed MS Center and had a reduced use of psychological services, compared to heterosexuals. The attitude towards LGBT MS patients might affect resource utilizations and LGBTs health status.

What Is the Correct Answer about The Dress' Colors? Investigating the Relation between Optimism, Previous Experience, and Answerability

The Dress photograph, first displayed on the internet in 2015, revealed stunning individual differences in color perception. The aim of this study was to investigate if lay-persons believed that the question about The Dress colors was answerable. Past research has found that optimism is related to judgments of how answerable knowledge questions with controversial answers are (Karlsson et al., 2016). Furthermore, familiarity with a question can create a feeling of knowing the answer (Reder and Ritter, 1992). Building on these findings, 186 participants saw the photo of The Dress and were asked about the correct answer to the question about The Dress’ colors (“blue and black,” “white and gold,” “other, namely…,” or “there is no correct answer”). Choice of the alternative “there is no correct answer” was interpreted as believing the question was not answerable. This answer was chosen more often by optimists and by people who reported they had not seen The Dress before. We also found that among participants who had seen The Dress photo before, 19%, perceived The Dress as “white and gold” but believed that the correct answer was “blue and black.” This, in analogy to previous findings about non-believed memories (Scoboria and Pascal, 2016), shows that people sometimes do not believe the colors they have perceived are correct. Our results suggest that individual differences related to optimism and previous experience may contribute to if the judgment of the individual perception of a photograph is enough to serve as a decision basis for valid conclusions about colors. Further research about color judgments under ambiguous circumstances could benefit from separating individual perceptual experience from beliefs about the correct answer to the color question. Including the option “there is no correct answer” may also be beneficial.