Follow-up Study Research Articles

Vaccination status and long COVID symptoms among patients hospitalized with COVID-19: the WHF COVID-19 Long-term Study

Abstract Background COVID-19 vaccinations have been found to be effective in reducing the severity of COVID-19 infection and in-hospital deaths; however, insufficient evidence exists about the effect of vaccination on long term morbidity and mortality after hospitalization in patients from low- and middle-income countries. Methods The global WHF COVID-19 Long-Term Follow-up Study recruited 2,504 COVID-19 hospitalized patients from 26 collaborating sites in 16 countries between January 2022 - June 2023. Patients were followed up , at 1, 3, 6, and 9-12 months post-discharge to examine short- and long-term physical and psycho-social outcomes. A standardised questionnaire was used to collect data on demographics, pre-existing comorbidities, COVID-19 symptoms on admission, vaccination status, and outcomes at discharge, including persisting symptoms, new onset hypertension or diabetes, major adverse cardiovascular events (MACE), and mortality. We compared persistent long COVID symptoms, MACE, and mortality outcomes up to one year by COVID-19 vaccination status. Results The majority of study participants were Asians (78%), males (56%) with a mean (SD) age of 59.2 (19.9) years and from low- and middle-income (65%), upper middle-income (20%) and high-income (15%) countries. The most commonly reported comorbidities were hypertension: 54% and diabetes: 38%. Approximately two-thirds of the patients had received at least one dose of COVID-19 vaccination prior to hospitalization. Unvaccinated patients were more likely to present with dyspnea (60% vs 53%, p-value<0.001) and acute respiratory infection (15% vs 9%, p-value<0.001) during hospitalization. Unvaccinated patients also had twice the in-hospital mortality rate, compared with vaccinated patients (6% vs 3%, p-value<0.001). Unvaccinated patients had a greater incidence of MACE (23% vs 18%, p-value=0.016) during hospitalization and across all follow-up visits. Unvaccinated patients also had a higher mortality rate across all follow-up visits (mortality at one year post-discharge 14% vs 10%, p<0.001). At the 9-12 month follow-up, about a quarter of the patients had at least one long COVID symptom, but unvaccinated patients had a higher rate of long COVID symptoms, including fatigue (23% vs 14%, p<0.001), palpitations (17% to 7%, p-value<0.001), and anxiety (13% to 7%, p=0.002). Conclusions Our data highlight the long-term protective effect of COVID-19 vaccination on reducing morbidity and mortality among COVID-19 patients after hospital discharge. However, a substantial proportion of COVID-19 vaccinated patients still showed persistent long COVID symptoms (22%) and mortality (10%). Future research is needed to investigate individual- and health system-level factors contributing to poor health outcomes post-COVID-19 infection.

Impact of symptom-to-balloon time on long-term prognosis: a 3-year follow-up study in non-st-segment elevation myocardial infarction patients with complex lesions

Abstract Background Because no data are available, we compared clinical outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI), stratified based on the presence of complex lesions, according to symptom-to-balloon time (SBT, <48 h versus ≥48 h), undergoing newer-generation drug-eluting stents. Methods From the KAMIR (Korea Acute Myocardial Infarction Registry)-NIH dataset, a total of 4373 patients diagnosed with NSTEMI were enrolled and stratified into two groups: the complex group (2106 patients; SBT <48 h, 1365; SBT ≥48 h, 741) and the non-complex group (2267 patients, SBT <48 h, 1573; SBT ≥48 h, 694). The primary outcome was the 3-year all-cause death rate, and the secondary outcome was major adverse cardiac events (MACE), including cardiac death (CD), recurrent MI, and any repeat revascularization. Results The rates of all-cause death (adjusted hazard ratio [aHR], 0.656; p = 0.009) and cardiac death (aHR, 0.633; p = 0.037) in the complex group, and the rate of all-cause death (aHR, 0.773; p = 0.036) in the total study population, were significantly lower for patients with SBT <48 h than for those with SBT ≥48 h. In the non-complex group, all clinical outcomes were not significantly different between the SBT <48 h and SBT ≥48 h groups. In the SBT ≥48 h group, the complex group exhibits higher rates of all-cause death, any repeat revascularization, and MACE than those of the non-complex group Conclusions Reducing SBT was more effective in decreasing 3-year mortality in NSTEMI patients with a complex group compared to the non-complex group.

Prevalence and incidence of heart failure in patients with type 2 diabetes mellitus. Results of the prospective DIABET-IC study

Abstract Introduction Heart failure (HF) is one of the major health problems in our environment today. Type 2 diabetes mellitus (DM2) is an important cardiovascular risk factor and can increase the burden of HF through various mechanisms. The incidence of HF in DM2 has not been well studied. Purpose The aim of our study was to evaluate the prevalence and incidence of HF in patients with DM2 followed in hospital cardiology and endocrinology departments. Methods The DIABET-IC study is a longitudinal cohort, prospective, multicenter follow-up study that included 1,249 consecutive patients with DM2 in 2018-2019 in 30 Spanish centers in cardiology and endocrinology outpatient clinics. HF was diagnosed according to the clinical records and following the criteria of the European Society of Cardiology. The prevalence of HF at the inclusion visit was analyzed, as well as the incidence of HF (new diagnoses) during a 3-year follow-up. Results Mean age was 67.3±+9.9 years, with 31.7% of the patients being women. Cardiology clinics included 61.9% of patients and endocrinology clinics the remaining 38.1%. There was a previous history of coronary artery disease in 38.6%, hypertensive heart disease in 21% and atrial fibrillation in 31.9%. Cardiovascular and antidiabetic drugs prescribed at the baseline and 3-year visits are shown in figure 1. Figure 2 summarizes the results of the study. The prevalence of HF at the baseline visit was 39.2%, 490 cases (with reduced LVEF 17.3%, mildly reduced 8.1% and preserved 13.8%). After a follow-up of 1,935/100 persons-year of cases without baseline HF, 58 incident cases of HF were diagnosed, 7.6% (32 in the first year, 13 in the second and 13 in the third year of follow-up). The incidence rate was 3.01/100 person-years (95%CI: 2.30-3.92). Of these 58 cases, 23.7% were with reduced LVEF, 28.9% with slightly reduced LVEF and 47.4% preserved. The incidence was higher in patients followed by endocrinology (3.90 vs 2.90/100 persons-year; p=0.042). At the end of the 3-year follow-up, including baseline prevalence, 46.8% of all patients had HF. Conclusions The prevalence and incidence of HF in patients with DM2 are very high. The incidence of HF is around 3% per year, which is almost 8 times higher than the rate found in large studies in the general population. Approximately half of the new cases were HF with preserved LVEF, and the other half with LVEF < 50%. The use of new antidiabetic drugs, such as iSGLT2, which have been shown to reduce the incidence of HF, should be encouraged.

Characteristics of adolescents with acute alcohol intoxication in Belgium

Abstract Background Binge drinking and acute alcohol intoxication (AAI) are common in Belgian adolescents, posing a risk of serious health consequences. To develop cost-effective preventive measures for problematic alcohol use in adolescents in Belgium, more insight into the background of this group is necessary. Methods To gain more insight into the prevalence, medical characteristics and context of AAI, a retrospective multicentre hospital chart study was performed on adolescents aged 10 to 18 years with AAI in Antwerp, Belgium from 2015-2021. Furthermore, a prospective intervention study for adolescents with AAI in Antwerp was set up in 2023, of which the first results were not yet known at the time of submission. However, these results will be presented at the conference, if available. Results Over the study period, a total of 1032 admissions related to alcohol intoxication occurred in 1016 patients, with a median age of 16.6 years old and a median blood alcohol intoxication (BAC) of 1.95 g/L. There was combined drug use in 10% of the cases. Only 17% of the patients received additional care after admission. These findings did not significantly change over the study period. Multiple linear regression analyses indicated that after correcting for covariates, higher age, no combined drug use and decreased consciousness at admission were associated with more severe AAI cases (higher BAC). Conclusions AAI is prevalent among Belgian adolescents. Therefore, better-targeted preventive measures and policies are needed. Our findings could be taken into account when developing preventive measures. However, data addressing the demographics and context of AAI were mostly missing. Therefore, a prospective follow-up study was set up in Antwerp, which started in 2023 and is still ongoing. Furthermore, this study will investigate the feasibility and effectiveness of a follow-up intervention for this group of patients.

Incidence of blindness in open-angle glaucoma in Sweden: a long-term follow-up study

Background: Open-angle glaucoma (OAG) is a leading cause of irreversible blindness. There are no prospective studies on the risk of developing blindness in both eyes in individuals with definite OAG. Methods: A total of 354 patients with newly diagnosed OAG, who had participated in four studies conducted at the Eye Department in Tierp, Sweden, from 1979 to 2006, were included in the investigation. Using the World Health Organization’s criteria for blindness, medical records, glaucoma case records, and visual fields were reviewed to identify patients who developed bilateral blindness. Incidence proportions and incidence rates were estimated. To assess potential risk factors for blindness, standardised morbidity ratios (SMRs) were calculated. The effects of age and sex were also analysed using Cox proportional hazard models. Results: By the end of the study in August 2023, 33 cases of blindness caused by OAG had been found, corresponding to an incidence proportion of 9.3% (95% confidence interval [CI]: 6.5–12.8%). Within the first 20 years, 29 cases were detected, yielding a proportion of 8.2% (95% CI: 5.5–11.6%). The incidence rate was estimated to be 8.6 per 1,000 person-years (95% CI: 5.9–12.6 per 1,000 person-years). Glaucoma-related blindness was associated with male sex (SMR 2.33; 95% CI: 1.13–4.80). The hazard ratio was doubled for every 5 year of increasing age (2.21; 95% CI: 1.60–3.05). Conclusion: In this study of blindness in newly diagnosed OAG in a Swedish population, approximately one in 10 patients progressed to bilateral blindness caused by the disease. Old age and male sex were identified as significant risk factors.

Monitoring of the Analytical Performance of Four Different Blood Glucose Monitoring Systems: A Post-market Performance Follow-Up Study.

A sizeable minority of commercially available blood glucose monitoring (BGM) systems fail to satisfy regulatory accuracy requirements, such as ISO 15197:2013, after approval. This study assessed whether the BGMs tested could consistently meet these ISO requirements by investigating their accuracy in a non-standardized setting. In this 18-month post-market performance study, using the ISO criteria, healthcare professionals tested the accuracy of four CE-marked BGM systems (Roche Diabetes Care, Mannheim, Germany) on European adults with diabetes mellitus. ISOcriteria included 95% of blood glucose (BG) values being within ± 15mg/dl of a reference measurement for BG < 100mg/dl or ± 15% for BG ≥ 100mg/dl and, in the Parkes Consensus Error grid for type 1 diabetes comparing capillary BGM measurements versus reference method, 99% of BG values falling within zone A (no effect on clinical action or outcome) and zone B (altered clinical action with little or no effect on clinical outcome). BGM readings were obtained from 1650 participants, and the number of readings per BGM system was between 1712 and 2376. The percentage of BGM readings that fell within ISO 15197:2013 limits ranged from 99.4 to 99.9%. For all meter types, 100% of data points fell within zone A or zone B, and most data points for each meter (≥ 99.9%) were in zone A. All four CE-marked BGM models showed results within the accuracy limits defined by ISO 15197 in a non-standardized setting and thus consistently met regulatory accuracy requirements.

The incremetal predictive value of pulse wave velocity over score2 in the setting of primary cardiovascular prevention: a 6-year follow-up study

Abstract Background Arterial stiffness has been shown to be an independent additive predictor to several traditional risk factors regarding cardiovascular events. Purpose We studied in a prospective cohort whether arterial stiffness has an additive value to SCORE2 in predicting cardiovascular risk. Methods In 747 healthy subjects, we measured carotid-to-femoral pulse wave velocity (PWV), a marker of aortic stiffness. We prospectively documented the incidence of cardiovascular events (major adverse cardiovascular events [MACE]-death, stroke and myocardial infarction) during a 6-year follow-up period. Results Sixty MACE were recorded. Increased values of PWV predicted greater risk for MACE in a model including diabetes, smoking, hypertension, hyperlipidemia, sex and age (hazard ratio (HR)=1.09; 95%CI=1.03 – 1.14; p&amp;lt;0.001, Chi-square change = 8.05; p=0.004; c-statistic increased from 0.74 (0.66 – 0.81) to 0.77 (0.71 – 0.83), p=0.025). PWV was an independent and additive predictor of events when added in a model encompassing the SCORE2 and diabetes (HR=1.07; 95%CI=1.04 – 1.11; p&amp;lt;0.001, Chi-square change = 43.12; p&amp;lt;0.001, c-statistic increased from 0.73 (0.66 - 0.80) to 0.76 (0.70 - 0.82); p=0.014). Also PWV predicted significantly the occurrence of events in all subgroups of each risk factor (for smokers and non-smokers: HR=1.31 and HR=1.11 respectively; for participants with hypertension and participants without hypertension: HR=1.23 and HR=1.12 respectively; for participants with hyperlipidemia vs participants without hyperlipidemia: HR=1.19 and HR=1.12 respectively; for participants with diabetes and participants without diabetes HR=1.19 and HR=1.12 respectively) (p&amp;lt;0.05 for all subgroups). Conclusion PWV confers an additive prognostic value to SCORE2 in primary prevention.

Modulating Polymerase Activity Through Light-Oxygen-Voltage Domain Insertion.

Biochemical reaction networks adapt to environmental conditions by sensing chemical or physical stimuli and using tightly controlled mechanisms. While most signals come from molecules, many cells can also sense and respond to light. Among the biomolecular structures that enable light sensing, we selected a light-oxygen-voltage (LOV) domain in a previous study that tested the engineering of novel regulatory mechanisms into a nucleic acid polymerase. In this follow-up study, we studied the activities of previously selected variants in kinetic detail, and we generated additional LOV-polymerase fusion variants based on further insertion criteria. Our results provide mechanistic insights into how LOV domain insertion influences polymerase activity in a light-responsive manner: All active and photoresponsive enzyme variants studied by us to date were partially inhibited (i. e., "turned off") after irradiation with blue light at 470 nm, which can be explained by specific obstructions of the polymerase entry or exit structures (substrate entry channels or product exit channels, or both). Although the effects observed are moderate, we anticipate further engineering strategies that could be used to improve the extent of switchability and possibly to develop a "turn-on mode" insertion.

Myopia control with orthokeratology lenses. A 3-year follow-up study including a cross-over design: Clinical study Of Near-sightedness; TReatment with Orthokeratology Lenses 2 (CONTROL2 study).

The purpose of this study is to investigate 3-year efficacy of orthokeratology lenses (OKL) in controlling axial length progression in myopic Scandinavian children. Through a cross-over design of the control group to compare the treatment efficacy in younger versus older children, with the latter having higher cycloplegic spherical refractive error (cSEQ) at treatment initiation. Further, the study aimed to evaluate the safety of the treatment. This was a continuation of the randomized controlled study Clinical study Of Near-sightedness; TReatment with Orthokeratology Lenses (CONTROL study) in which the follow-up period of the original intervention group, that received OKL, was extended from 18 months to 36 months. Meanwhile, the original control group was crossed-over to OKL after the 18-month follow-up visit and treated for 18 months. Biometry was measured using Lenstar LS900, and contact lens complications were graded according to Efron Grading Scale for Contact Lens Complications (Efron score). Mixed models were used for statistical analysis. Nineteen subjects in the OKL group and 28 in the control group completed the CONTROL study. Hereof, 17 and 24 subjects from the OKL group and control group, respectively, agreed to participate in the CONTROL2 study. In the OKL continue group, the treatment efficacy did not decline during the 3-year study period (p-values for follow-up visits were all ≥0.82). There was no statistically significant difference between treatment efficacy when OKL treatment was initiated in younger versus older children (p-value ≥0.14 for all follow-up visits). Low-grade corneal staining was seen in several subjects at some point during the study, but here were no treatment-requiring or sight-threatening adverse events during the study period. The efficacy of myopia control by OKL was stable during 3 years of treatment. Similar treatment efficacies were found regardless of the age at treatment initiation. No severe adverse events occurred during the study period.

The Impact of Surgery-Related Emotional Distress on Long-Term Outcome After Colorectal Surgery: An Observational Follow-Up

Background: Preoperative emotional distress has been linked to adverse health outcomes, diminished quality of life, increased symptom burden after surgery, and poorer postoperative outcomes. Therefore, this study aimed to assess the impact of perioperative emotional distress on the long-term outcomes of patients undergoing colorectal surgery. Methods: We conducted a follow-up study of a previously conducted observational study of colorectal surgery patients who underwent surgery at the University Medical Centre Freiburg, Germany, between April 2018 and February 2020. Initially, all the patients completed a multidimensional mood questionnaire (MDMQ) preoperatively and on postoperative days 3, 6, and 9. From June to November 2021, these patients were contacted again to capture the results of MDMQ at least one year after surgery and to assess the rate of late complications, quality of life, dietary changes, and overall health. Results: Of the original 80 patients, 51 took part in the follow-up study (55% female, on average 59 years old), on average 30 months after the operation. The average mood results of the surgical patients returned to those of the normal population. Most patients (80%) did not feel that their quality of life was affected by the surgery. Satisfaction with the surgical outcome averaged 8.5 out of 10, while current health was rated at 6.8 out of 10. Emotional distress levels varied over time, with mood and arousal improving significantly postoperatively. Late complications were reported by 28% of the patients, but there were no significant differences in the MDMQ scores, health status, or satisfaction between those with and without complications. Conclusions: The results indicate that there is no association between the emotional strain measured by the MDMQ and the occurrence of late postoperative complications.

Research on the Application of New Media Technology in College Physics Teaching

Physics is a basic subject with a high degree of abstraction, and it is an indispensable and important course for science and engineering majors in universities. College physics teaching is mainly concentrated in the classroom, yet, in the limited teaching time, students find it difficult to fully understand the relevant teaching content, which not only affects their follow-up study but also greatly hits the student’s confidence in physics learning, thus, college physics teaching reform is imperative. This paper will briefly explain the relevant concepts of new media technology, then analyze the advantages of its application in college physics teaching, and finally explore the application strategies of new media technology in college physics teaching. This aims to improve the effect and quality of classroom teaching, improve students’ physics learning ability and level, and enhance the core literacy of disciplines by integrating new media technology into college physics teaching, as well as to lay a solid foundation for the study of professional knowledge.

Effects of pregnancy on the clinical course and treatment outcomes of Vogt-Koyanagi-Harada disease.

To describe the clinical course and treatment outcomes of Vogt-Koyanagi-Harada (VKH) disease during pregnancy. This retrospective study compares the clinical course and outcomes in pregnant and nonpregnant women with VKH. All VKH patients who were pregnant at presentation or on follow up and age-matched nonpregnant female controls during the study period (2013-2022) were included. Their best-corrected visual acuity (BCVA), clinical presentations, and treatment outcomes were analyzed. Among the 532 female VKH patients, nine (1.7%) were included. Thirty nonpregnant patients were included as control. At presentation, the mean age in the study group was 26 years ± 6.48 standard deviation (SD) compared to the control group (mean 25.1 years ± 3.04). The mean BCVA was comparable between the two groups at presentation (study group 1.35 logarithm of the minimum angle of resolution [logMAR] vs. control group 0.76 logMAR; P = 0.05) and the final follow-up (study group 0.65 logMAR vs. control group 0.35 logMAR; P = 0.15). Participants with anterior segment inflammation (study group 77.7% vs. control group 70%; P = 0.65), the disease stage (early-stage VKH: study group 88.8% vs. control group 73.3%; P = 0.33), and disease exacerbation (study group 33.3% vs. control group 26.6%; P = 0.69) were all comparable between the study and control groups. Following treatment, 66.6% and 46.6% of the study and control groups, respectively, had sunset glow fundus (P = 0.29). At the last follow-up, 44.4% and 26.6% of the study and control groups, respectively, had subretinal fibrosis (P = 0.31). Though pregnancy is an immunomodulatory state, the clinical course of VKH in pregnant patients can be similar to that of nonpregnant women and needs close monitoring and follow-up.

Long-Term Follow-Up Study of Necrotizing Pancreatitis

Long-Term Follow-Up Study of Necrotizing Pancreatitis

Factors Associated with the Development of Anti-drug Antibodies to TNFi and the Consequences for Axial Spondyloarthritis: A Two-year Follow-up Study.

To evaluate the development of anti-drug antibodies (ADAb) against tumor necrosis factor inhibitors (TNFi) therapy during a 2-year period and search the factors linked to patients with axial spondyloarthritis (axSpA). Biologic-naive patients with axSpA were included in this observational study. Serum drug levels and ADAb were measured at weeks 12, 24, 52, and 104 of treatment by enzyme-linked immunosorbent assay (ELISA). The development of ADAb and factors related to ADAb over time were investigated using generalized estimating equations (GEE). A total of 180 patients with axSpA (116 male, mean (±SD) 45.6 (±11.9) years) who started TNFi treatment (etanercept (32.2%), adalimumab (27.2%), golimumab (20.6%), infliximab (20%)) were included. In the etanercept treatment group, only 1 patient had ADAb at 12 weeks and 24 weeks. Anti-drug antibodies against TNFi drugs were present in the adalimumab group in 32.7% of patients and in the infliximab group in 21.2% of patients at 12 weeks, and the proportion of ADAb-positive patients were found to be stable throughout the follow-up for adalimumab- and infliximab-treated patients. In the golimumab group, one patient had ADAb against golimumab at 12 weeks and the proportion of ADAb-positive patients increased throughout follow-up. In longitudinal analysis, baseline age, TNFi type, longitudinal Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and ASDAS-CRP scores, serum C-eeactive protein (CRP) levels, presence of adverse events and treatment discontinuation were associated with the presence of ADAb. The development of ADAb against TNFi therapy is associated with younger age, high disease activity, the development of adverse events and more common treatment discontinuation in patients with axSpA during 2-year follow-up.

The influence of interaction and student characteristics in canine-assisted interventions

ABSTRACT Students in higher education face a multitude of life changes and challenges. In order to promote their mental health, the use of canine-assisted interventions (CAI) has gained increasing attention, yet one area that remains insufficiently studied is the influencing characteristics that may lead to the positive effects of CAIs. This study is a follow-up study to a previously published study, aiming to investigate qualitatively the factors that may influence the change in well-being during a CAI. In the present study, 27 students participated in a 15-min CAI in which they interacted freely with a dog. Using the Basler Befindlichkeitsskala, their well-being was assessed. Participants reported personal characteristics and evaluated the intervention to identify possible influencing characteristics. Additionally, the intervention process was videotaped and analysed. Results showed greater positive effects on well-being for students who did not own a dog, for whom the intervention was delivered by more experienced dog-human teams, and for whom the intervention was characterised by a high interaction intensity with a high proportion of ‘petting the dog’ while showing low interaction with the handler. Implications for the use of CAIs are discussed.

Recovery rate and predictors among children aged 6–59 months with severe acute malnutrition in Addis Ababa, Ethiopia: a retrospective follow-up study

IntroductionSevere acute malnutrition (SAM) is a critical public health concern in Ethiopia, contributing to high morbidity and mortality rates among children. Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rates (34%–88%) due to several context-specific factors. Understanding the factors influencing the recovery time can help inform targeted interventions and improve the overall management of SAM cases. Therefore, this study aimed to assess the time to recovery and predictors of children aged 6–59 months with severe acute malnutrition in Addis Ababa, Ethiopia, in 2023.MethodsAn institutional-based retrospective follow-up study was conducted among children aged 6–59 months who were admitted to Tirunesh Beijing Hospital (TBH), Addis Ababa, Ethiopia, from July 2019 to June 2023. The Kaplan–Meir estimate and survival curve were used to compare the time to recovery using a log-rank test among different characteristics. A Cox proportional hazard regression analysis model was used to identify significant predictors of time to recovery. Finally, a p-value of &amp;lt;0.05 was used to declare a significant association.ResultsThe median survival time to recovery was 17 (95% CI: 16.39–17.60) days, and the incidence rate of recovery from SAM was 37.8 per 1,000 child days. Moreover, exclusive breastfeeding [adjusted hazard ratio (aHR): 1.97, 95% CI: 1.45–2.68], amoxicillin provision (aHR = 1.62, 95% CI: 1.11–2.35), and deworming (aHR = 2.14, 95% CI: 1.48–3.09) were protective factors. However, complications at admission (aHR = 0.41, 95% CI: 0.23–0.73) and diarrhea during admission (aHR = 0.64, 95% CI: 0.45–0.91) were identified as risk factors of recovery from SAM.ConclusionThe time to recovery among the current study participants was low compared with the sphere standard. Besides, exclusive breastfeeding, complications at admission, diarrhea, amoxicillin provision, and deworming were independent predictors. Therefore, appropriate provision of routine medication and early management of medical comorbidity as per the national SAM management protocol can reduce the mortality of children with severe acute malnutrition significantly.

Audio-Vibratory You-Are-Here Mobile Maps for People with Visual Impairments

Self-localization and wayfinding are challenging tasks for people with visual impairments (PVIs), severely impacting independent mobility. Visual “You-are-here” (YAH) maps are useful for assisting local wayfinding of sighted users. They are used to self-localize and display points of interest, landmarks and routes in the surroundings. However, these maps are not always available and rarely accessible to PVIs. Relying on an iterative participatory design process with eight end-users with visual impairments, we created a proof of concept of a mobile audio-vibratory YAH map. Our design is based on either a tablet or a smartphone to ensure a small and portable solution. A user study with ten PVIs showed that the audio-vibratory YAH map that we designed provides the user with a good understanding of the surroundings and wayfinding cues. Surprisingly, the results show that the audio-vibratory YAH map prototype was as usable as the control condition (audio-tactile YAH map with a tactile overlay), with similar user satisfaction and cognitive load. A follow-up field study with two participants showed the effectiveness of the prototype for assisting in crossroad understanding. To conclude, our innovative design of a mobile audio-vibratory YAH map can overcome the portability and printing issues associated with tactile overlays and can be an appropriate solution for assisting the pedestrian navigation of PVIs.

A long-term follow-up study of gastric peroral endoscopic myotomy (G-POEM) in a large cohort of patients with postsurgical gastroparesis.

Postoperative gastroparesis occurs after surgeries which affect the upper digestive tract. Gastric peroral endoscopic myotomy (G-POEM) is a treatment for postoperative gastroparesis. The present study boasts the long-term efficacy and safety of G-POEM in a large cohort of patients. Gastroparesis Cardinal Symptom Index (GCSI) and Gastroesophageal Reflux Disease Questionnaire (GERDQ) were utilized for the assessment of postsurgical gastroparesis symptoms. Gastroscope was used to observe the anastomotic site. Three-dimensional ultrasound was used to measure the morphological structure of the gastric antrum and pylorus tube. Gastric emptying time was calculated by analyzing the volume change of gastric antrum. Significant clinical effectiveness of G-POEM was observed. The GCSI score, including each subscale score, showed significant decrease after G-POEM. Before G-POEM, there was a negative correlation between GCSI score and the inner diameter of pylorus, as well as a positive correlation with the length of pyloric tube. The similar results were found in the scores of nausea/vomiting and postprandial fullness/early satiety subscales. No correlation was observed between GCSI score and the emptying time, nor between the emptying time and the parameters of antrum morphology. After G-POEM, no correlation was found between GCSI (including subscales) score, the emptying time, and the parameters of antrum morphology. Patients who exhibited as clinical non-responders often accompanied with GERD symptoms. After G-POEM, the score of GERDQ decreased significantly. Either before or after G-POEM, no correlation was noticed between GERDQ scores, the emptying time and the parameters of antrum morphology. The technique of G-POEM was demonstrated as a minimally invasive approach with the long-term efficacy and safety in therapying postoperative gastroparesis.

Relationship between coping strategies and change in symptom severity in contamination-focused OCD patients during the COVID-19: a one-year follow-up

Objective To examine the relationship between coping strategies and the change in symptom severity in contamination-focused OCD patients during the COVID-19 pandemic over a one-year follow-up. Methods In March 2020, a one-year follow-up study was initiated with 56 contamination-focused OCD patients in Turkey. Coping strategies were evaluated using the COPE scale. OCD symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at the beginning and end of the year. The Fear of COVID-19 Scale was administered mid-year. Results One year post the onset of COVID-19, 68% of patients showed increased OCD symptom severity, while 32% displayed a decrease. Higher scores on the fear of COVID-19 scale and lower acceptance scores from COPE subscales were correlated with increased OCD symptom severity. Conclusions The COVID-19 pandemic has intensified OCD symptoms in a substantial proportion of patients, particularly those with heightened fears related to the pandemic, and reduced acceptance-based coping strategies. Tailored interventions emphasising adaptive coping mechanisms may benefit OCD patients in managing their symptoms during external stressors like pandemics.

Schizotypy 17 years on: Prediction of schizotypic individual differences in midlife.

The picture for the long-term prediction of schizotypic individual difference features in relation to schizotypy assessed earlier in life remains opaque. Whereas schizotypy assessed earlier in life, typically during the late teen years, has been shown to predict nonaffective psychotic illness as well as the presence of nonaffective psychotic features (Chapman et al., 1994; Lenzenweger, 2021), the presence in midlife (mid-30s) of nonpsychotic schizotypic features in those assessed for schizotypy earlier in life remains to be demonstrated. The current study, which reports on a 17-year follow-up study, addresses this void in the schizotypy literature. Seventeen years after an initial psychometric assessment for schizotypy, in a sample of emerging adults (age = 18) with no prior history of psychotic illness, Perceptual Aberration Scale scores predicted elevated schizotypal personality features, increased schizophrenia-related personality disorder features (particularly schizotypal and paranoid), and elevated schizophrenia proneness scores at age 35. This pattern of associations was maintained even after the removal of participants with a diagnosis of nonaffective psychosis. The associations also remained largely unchanged net of state anxiety levels at initial and later assessments. These results support the emergence or maintenance of schizotypic psychopathology features consistent with a model that views schizotypy as the underlying liability for schizotypic psychopathology phenotypes. The results also provide additional support for both the construct validity of the initial psychometric schizotypy measure (Perceptual Aberration Scale) as well as the validity of the psychometric high-risk paradigm. Longitudinal research remains an illuminating and informative approach to understanding the nature of schizophrenia-related psychopathology by utilizing time as an essential scientific lever. (PsycInfo Database Record (c) 2024 APA, all rights reserved).