The Impact of Study-at-Home During the COVID-19 Pandemic on Myopia Progression in Chinese Children

Background: To assess the impact of study-at-home during the COVID-19 pandemic on myopia development in Chinese schoolchildren.Methods: This historical cohort involved two groups with a total of 154 children. The exposed group was formed from 77 children aged 8 to 10 years who studied at home in the 7-month period during the COVID-19 pandemic (follow-up period: January – August 2020) and did not study at home in the 7-month period before the COVID-19 outbreak (baseline period: July 2019 – January 2020). Seventy-seven children who did not undergo study-at-home (baseline period: 7 months in 2015, follow-up period: 7 months in 2016) were included in the control group. Cycloplegic refraction, axial length and uncorrected visual acuity were measured 3 times. The questionnaire mainly focused on collecting visual habits.Results: Myopia progression was similar between the two groups in the baseline period. However, in the follow-up period the exposed group had a greater change in refraction toward myopia (−0.83 ± 0.56 D) than the control group (−0.28 ± 0.54 D; p < 0.001). In addition, the exposed group exhibited a significantly greater change in refraction toward myopia in the follow-up period (−0.83 ± 0.56 D) than in the baseline period (−0.33 ± 0.46 D; p < 0.001). Difference-in-difference analysis indicated that study-at-home accelerated the change in refraction toward myopia (t = −0.567; p < 0.001).Conclusions: During the COVID-19 pandemic study-at-home accelerated the change of refraction toward myopia in children.

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The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽

10.3390/pharmacy9020086 ◽

2021 ◽

Vol 9 (2) ◽

pp. 86

Author(s):

Fauna Herawati ◽

Yuni Megawati ◽

Aslichah ◽

Retnosari Andrajati ◽

Rika Yulia

Keyword(s):

Intervention Group ◽

Personal Control ◽

Control Group ◽

P Value ◽

Interactive Approach ◽

Community Based ◽

Tuberculosis Patients ◽

Level Of Knowledge ◽

The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

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Regression of cardiac amyloid deposits with novel therapeutics: reaching new frontiers in cardiac ATTR amyloidosis

European Heart Journal ◽

10.1093/ehjci/ehaa946.2117 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Chacko ◽

A Martinez-Naharro ◽

T Kotecha ◽

R Martone ◽

D Hutt ◽

...

Keyword(s):

Treatment Group ◽

Cardiac Amyloidosis ◽

T1 Mapping ◽

Group Versus ◽

Control Group ◽

Cardiac Amyloid ◽

Attr Amyloidosis ◽

Amyloid Load ◽

The Impact

Abstract Background Cardiac involvement is the main driver of outcome in ATTR amyloidosis. Advances in therapeutics hold potential in transforming the course of the disease but the impact on cardiac amyloid load is unknown. The aim of this study was to evaluate the impact of patisiran, a new double stranded RNA based gene silencing therapy and a stabilizer, diflunisal, on cardiac amyloid load as measured by CMR and T1 mapping, in patients with ATTR amyloidosis. Methods and results Thirty-two patients with hereditary cardiac amyloidosis were studied. Sixteen patients received treatment with patisiran, and sixteen control subjects did not receive any disease modifying treatment. Patients were assessed with echocardiogram, CMR, NT-proBNP and six-minute walk time measurements at baseline and at 1 year (Mean interval 11.45±3.08 months in treatment group, mean interval 12.82±5.06 months in the control group). CMR analysis comprised LV volumes, T1 mapping to measure the extracellular volume (ECV) occupied by amyloid, T2 mapping and late gadolinium enhancement imaging. At 1-year follow-up, there was a substantial reduction in cardiac amyloid burden, in keeping with cardiac amyloid regression in 45% of patients on treatment. Overall the treatment group showed a reduction in ECV at 1 year follow up compared to an increase in ECV at 1 year in the control group (−1.37%, 95% CI: −3.43 to 0.68% versus 5.02%, 95% CI: 2.86% to 7.18% respectively, p<0.001). The treatment group also showed an improvement in change in 6MWT at 1 year follow up compared to 6MWT at 1 year in the control group (−8.12 meters, 95% CI: −50.8 to 34.6 meters in the treatment group versus −132.27 meters, 95% CI: −216 to −48.6 meters in the control group, p=0.002). The treatment group showed a reduction in BNP at 1 year follow up compared to an increase in the control group (−567.87, 95% CI: −1288.90 to 153.15 in the treatment group versus 2004, 95% CI: 12.82 to 3995.45 in the control group, p<0.001). There was no significant difference from baseline and 1-year data between the control and treatment groups for the difference in echocardiographic parameters, native T1, T2. There was a significant reduction in the percentage of injected dose by 99Tc-DPD scintigraphy in treated patients at 1 year compared to baseline. Conclusions These findings provide the first compelling evidence of substantial cardiac amyloid regression in ATTR amyloidosis, as well as the potential for CMR to be used to track response in treated patients with ATTR cardiac amyloidosis. Combination therapy with transthyretin knock down and stabilizing agents may well be synergistic given enhanced stoichiometry of stabilizers in the face of much reduced plasma transthyretin concentration. Funding Acknowledgement Type of funding source: None

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Positive and Negative Affect Changes during Gender-Affirming Hormonal Treatment: Results from the European Network for the Investigation of Gender Incongruence (ENIGI)

Journal of Clinical Medicine ◽

10.3390/jcm10020296 ◽

2021 ◽

Vol 10 (2) ◽

pp. 296

Author(s):

Imke Matthys ◽

Justine Defreyne ◽

Els Elaut ◽

Alessandra Daphne Fisher ◽

Baudewijntje P. C. Kreukels ◽

...

Keyword(s):

Negative Affect ◽

Sex Steroids ◽

Hormonal Treatment ◽

Control Group ◽

First Year ◽

Positive And Negative Affect ◽

European Network ◽

Psychological Burden ◽

The Impact

Improving transgender people’s quality of life (QoL) is the most important goal of gender-affirming care. Prospective changes in affect can influence QoL. We aim to assess the impact of initiating gender-affirming hormonal treatment (HT) on affect. In the European Network for the Investigation of Gender Incongruence (ENIGI) study, we prospectively collected data of 873 participants (451 transwomen (TW) and 422 transmen (TM)). At baseline, psychological questionnaires including the Positive and Negative Affect Schedule (PANAS) were administered. The PANAS, levels of sex steroids and physical changes were registered at each follow-up visit during a 3-year follow-up period, starting at the initiation of hormonal therapy. Data were analyzed cross-sectionally and prospectively. Over the first three months, we observed a decline in positive affect (PA) in both TM and TW. Thereafter, PA reached a steady state in TW, whereas in TM there was also a second decline at 18 months. In both TM and TW there was no persisting difference comparing baseline to the 36-months results. Concerning negative affect (NA), we observed a decline during the first year in TM, which sustained during the second year and was not different anymore at 36 months compared to baseline. In TW though, we did not find any change of NA during the entire follow-up. Even if some of these results show significant differences, they should be considered with caution, since there was no control group and the absolute differences are small. No association between affect and the level of sex steroids was observed. Baseline QoL and psychological burden are related to affect independently from gender but are not necessarily good predictors of the evolution of one’s affect during the gender-affirming process. Further research is necessary to investigate these preliminary results.

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Impact of pharmacist-conducted anticoagulation patient education and telephone follow-up on transitions of care: a randomized controlled trial

BMC Health Services Research ◽

10.1186/s12913-021-06156-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lamis R. Karaoui ◽

Elsy Ramia ◽

Hanine Mansour ◽

Nisrine Haddad ◽

Nibal Chamoun

Keyword(s):

Tertiary Care ◽

Intervention Group ◽

Bleeding Event ◽

Transitions Of Care ◽

Control Group ◽

Published Data ◽

Post Discharge ◽

Readmission Rates ◽

The Impact

Abstract Background There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates. Methods This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge. Results Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups. Conclusions Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge. Trial registration Lebanon Clinical Trial Registry LBCTR2020033424. Retrospectively registered. Date of registration: 06/03/2020.

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Contemporary Surgical Management of Juvenile Nasopharyngeal Angiofibroma

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1725031 ◽

2021 ◽

Author(s):

Salomon Cohen-Cohen ◽

Kristen M. Scheitler ◽

Garret Choby ◽

Jeffrey Janus ◽

Eric J. Moore ◽

...

Keyword(s):

Surgical Management ◽

Intracranial Extension ◽

Preoperative Embolization ◽

Tumor Diameter ◽

Historical Cohort ◽

Nasopharyngeal Angiofibroma ◽

Estimated Blood Loss ◽

The Impact ◽

Previous Series

Abstract Objectives Juvenile nasopharyngeal angiofibromas (JNAs) are uncommon tumors with an evolving treatment paradigm. The objective of this study was to compare our prior experience reported in 2005 with our most contemporary series to compare practice improvements and the impact of expanded endonasal procedures. Design Retrospective review comparing a contemporary 22 patients with JNA who underwent surgical management between 2005 and 2019, compared with a historical cohort of 65 patients from the same center. Results The most common presenting symptom was epistaxis (68%). The median maximum tumor diameter was 4.4 cm. All patients underwent preoperative embolization. An endoscopic endonasal approach (EEA) was used in 18 patients (82%), compared with 9% in the series prior to 2005. Gross total resection was achieved in all patients. The median estimated blood loss was 175 and 350 mL for EEA and open (transfacial) cases, respectively. Only two patients (9%) required a blood transfusion compared with 52% on the previous series. The median follow-up was 19 months. The overall recurrence rate was 9% in this series and 24% in the previous series. No patient required radiation therapy in follow-up compared with 3% in our historical cohort. Conclusion There have been significant changes regarding the management of patients with JNA compared with the previous Mayo Clinic experience. The EEA has become the preferred route over the transfacial approaches to treat JNA in selected patients who do not have intracranial extension. Preoperative embolization has aided in reducing the postoperative transfusion rates.

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Impact of failed ab-interno trabeculectomy (trabectome) on subsequent XEN45 gel stent implantation in pseudophakic eyes

International Ophthalmology ◽

10.1007/s10792-021-01977-w ◽

2021 ◽

Author(s):

D. Kiessling ◽

C. Rennings ◽

M. Hild ◽

A. Lappas ◽

T. S. Dietlein ◽

...

Keyword(s):

Stent Implantation ◽

Open Angle Glaucoma ◽

Control Group ◽

Repeat Surgery ◽

Medication Score ◽

Significant Difference ◽

Ab Interno Trabeculectomy ◽

The Impact ◽

Ab Interno

Abstract Purpose To determine the impact of failed ab-interno trabeculectomy on the postoperative outcome of subsequent XEN45 gel stent (Allergan, CA, USA) implantation in pseudophakic eyes. Methods In this retrospective single-center study, we included 60 pseudophakic eyes from 60 participants who underwent XEN45 gel stent implantation. Thirty eyes each underwent primary stent implantation (control group) or had previously undergone a failed ab-interno trabeculectomy (trabectome group). The groups were matched at a 1:1 ratio based on the following criteria: preoperative and maximum Intraocular pressure (IOP), preoperative medication score, cup/disk-ratio, follow-up time, best-corrected visual acuity at baseline, age, and the proportion of patients classified as primary open angle glaucoma or exfoliation glaucoma. We defined a successful surgery by the following three scores: an IOP reduction > 20% and IOP at the longest follow-up < 21 mmHg (Score A) or < 18 mmHg (Score B) or IOP ≤ 15 mmHg and an IOP reduction ≥ 40% (Score C). One open conjunctival revision was allowed in all scores, and a repeat surgery was considered a failure. Results Following an average follow-up period of 22 ± 12 months, we observed a mean IOP reduction of 38%, from 23.5 ± 5.2–14.5 ± 5.0 mmHg. Comparative analyses between the groups did not reveal a significant difference in the postoperative IOP, postoperative medication score, side effects, revision rate, repeat surgery rate, or success rate. Conclusions Trabectome is a viable first-line procedure for medically uncontrolled glaucoma before filtering ab-interno microstent surgery is considered.

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Impact of non-contrast enhanced volumetric MRI-based feeder localization in the treatment of spinal dural arteriovenous fistula

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2016-012497 ◽

2016 ◽

Vol 9 (2) ◽

pp. 178-182 ◽

Cited By ~ 6

Author(s):

Santhosh Kumar Kannath ◽

Bejoy Thomas ◽

P Sankara Sarma ◽

Jayadevan Enakshy Rajan

Keyword(s):

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Definitive Treatment ◽

Spinal Angiography ◽

Vertebral Level ◽

Spinal Dural Arteriovenous Fistula ◽

Historical Cohort ◽

Contrast Enhanced ◽

The Impact

BackgroundThe preoperative localization of the feeder of spinal dural arteriovenous fistula (SDAVF) could simplify the diagnostic spinal angiographic procedure. Localization by non-contrast-enhanced MRI-based techniques is an attractive option. However, the usefulness of such an approach for evaluation of SDAVF has not yet been reported.ObjectiveTo study the impact of non-contrast MRI-based feeder localization, followed by targeted spinal angiography, in the evaluation of SDAVF before endovascular intervention.Materials and methodsProspectively collected data were analyzed and the level of the feeder was localized preoperatively. The procedural time for targeted spinal angiography was calculated and compared with that of a historical cohort, who underwent routine spinal angiographic examination before the study period. Follow-up MRI was carried out to assess the reliability of this model for detection of occasional metachronous lesions that might be missed with this approach.ResultsSeven patients underwent targeted spinal angiography during the study. The feeder level was accurately identified in five patients and was localized to one vertebral level in six patients. The correlation between MRI and DSA was statistically significant. The number of spinal levels assessed was fewer and overall procedure time was significantly shorter compared to historical cohort (58 min vs 162 min, respectively; p<0.001). Intervention was coupled with targeted angiography in two patients. Follow-up MRI demonstrated flow voids in one patient, who had recurrent fistula at one vertebral level below the previously embolized feeder.ConclusionsThe non-contrast MRI-based localization technique can reliably detect the level of feeder and help in therapeutic planning of SDAVF. The localization techniques potentially shorten the angiographic procedure and may facilitate simultaneous endovascular definitive treatment. Inclusion of follow-up MRI may be useful for detection of synchronous or metachronous lesions if a targeted approach is adopted. Additionally, this helps to identify failed endovascular therapy.

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Abstract P186: A Randomized Preschool Trial To Promote Cardiovascular Health In Colombia: 18 Month Follow Up.

Circulation ◽

10.1161/circ.125.suppl_10.ap186 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Jaime Céspedes ◽

German Briceño ◽

Michael Farkouh ◽

Rajesh Vedanthan ◽

Martha Leal ◽

...

Keyword(s):

Educational Intervention ◽

Cardiovascular Health ◽

Controlled Trial ◽

Intervention Group ◽

Educational Programs ◽

Control Group ◽

Active Lifestyle ◽

And Control ◽

The Impact

Introduction: Educational programs for children can increase uptake of healthy lifestyle behaviors. However, the impact of educational programs in preschool-aged children in low- and middle-income countries is not known. We conducted a five month educational intervention in preschool facilities (PF) in Bogota, Colombia, to assess changes in preschooler’s knowledge, attitudes and habits (KAH) towards healthy eating and living an active lifestyle. Methods: We conducted a cluster, randomized, controlled trial, and randomly assigned 14 PF in Bogota to a five-month educational intervention (7 PF) or to usual curriculum (7 PF). The intervention included classroom activities and use of printed material and videos. A total of 1216 pre-school children, 928 parents, and 120 teachers participated. A structured survey was used to evaluate changes in KAH with a weighted total score (WTS). The primary outcome was change in children's WTS, and the secondary outcomes were change in parents’ and teachers' WTS. The control PF were provided the intervention after the initial evaluation. To assess sustainability, we evaluated both intervention and control groups at 18 months. Results: At 6 months, children in the intervention group showed 10.9% increase in WTS vs. 5.3% in controls, p<0.001, after adjustment for cluster, sex, age and teachers' educational level. Among parents, the equivalent results were 8.9% and 3.1%, respectively, p< 0.001, and among teachers 9.4% and 2.5%, p=0.06. At the 18-month extended follow-up, both the intervention and control children showed a significant further increase in WTS, p<0.001 (Figure 1). In parents and teachers in the intervened group, there was no significant increase in WTS, p=0.7417, and p=0.1197. In the control group, there was an increase in WTS in teachers but not in parents, p=0.001, and p=0.4239. Conclusion: A preschool based intervention, aimed at changing KAH related to healthy diet and active lifestyle, is feasible, efficacious and sustainable up to 18 months in very young children in Colombia.

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Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty

10.21203/rs.3.rs-138081/v1 ◽

2021 ◽

Author(s):

Ahmed Negm ◽

Milad Yavarai ◽

Gian Jhangri ◽

Robert Haennel ◽

Allyson Jones

Keyword(s):

Physical Activity ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Intervention Group ◽

Young Patients ◽

Rehabilitation Program ◽

Control Group ◽

Total Hip ◽

The Impact

Abstract BackgroundThe increase rate seen in Total Hip Arthroplasty (THA) for younger patients has implications for future rehabilitation demands for primary and revision THA surgery. This study aims to determine the impact of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA) and function compared to age- and a sex-matched control group received usual postoperative care at 12-week post-THA. MethodsIn this quasi-experimental study, a cohort of THA candidates was recruited during their 6-week postoperative visit to their surgeons. The out-patient rehabilitation program consisted of 12 structured exercise classes (2 hrs/class) over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention. ResultsThe intervention group took significantly more steps/day at the follow-up compared to baseline. The intervention group had a higher mean change in the number of weekly PA bouts than the control group. Within the intervention groups, all HOOS subscales were significantly higher at the follow-up compared to baseline. ConclusionThe augmented rehabilitation program may have immediate effects on pain relief and symptom reduction for patients (≤60 years) following THA.

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Initial CT blend sign is not associated with poor outcome in patients following stereotactic minimally invasive surgery

10.21203/rs.3.rs-37415/v3 ◽

2021 ◽

Author(s):

Xu Yang ◽

Yan Zhu ◽

Linshan Zhang ◽

Likun Wang ◽

Yuanhong Mao ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Cardiac Complications ◽

Control Group ◽

Haematoma Expansion ◽

Poor Outcomes ◽

The Impact ◽

The Relationship

Abstract Background: The initial computed tomography (CT) blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a nonblend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS scores were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different between the two groups. The rate of rehaemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcomes in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.

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