Wide Age Range Research Articles

Physicians' and Patients' Expectations From Digital Agents for Consultations: Interview Study Among Physicians and Patients.

Physicians are currently overwhelmed by administrative tasks and spend very little time in consultations with patients, which hampers health literacy, shared decision-making, and treatment adherence. This study aims to examine whether digital agents constructed using fast-evolving generative artificial intelligence, such as ChatGPT, have the potential to improve consultations, adherence to treatment, and health literacy. We interviewed patients and physicians to obtain their opinions about 3 digital agents-a silent digital expert, a communicative digital expert, and a digital companion (DC). We conducted in-depth interviews with 25 patients and 22 physicians from a purposeful sample, with the patients having a wide age range and coming from different educational backgrounds and the physicians having different medical specialties. Transcripts of the interviews were deductively coded using MAXQDA (VERBI Software GmbH) and then summarized according to code and interview before being clustered for interpretation. Statements from patients and physicians were categorized according to three consultation phases: (1) silent and communicative digital experts that are part of the consultation, (2) digital experts that hand over to a DC, and (3) DCs that support patients in the period between consultations. Overall, patients and physicians were open to these forms of digital support but had reservations about all 3 agents. Ultimately, we derived 9 requirements for designing digital agents to support consultations, treatment adherence, and health literacy based on the literature and our qualitative findings.

Survival among patients receiving eteplirsen for up to 8 years for the treatment of Duchenne muscular dystrophy and contextualization with natural history controls.

Eteplirsen, approved in the US for patients with Duchenne muscular dystrophy (DMD) with exon 51 skip-amenable variants, is associated with attenuated ambulatory/pulmonary decline versus DMD natural history (NH). We report overall survival in a US cohort receiving eteplirsen and contextualize these outcomes versus DMD NH. US patients with DMD receiving eteplirsen were followed through a patient support program, with data collected on ages at eteplirsen initiation and death/end of follow-up. Individual DMD NH data were extracted by digitizing Kaplan-Meier (KM) curves from published systematic and targeted literature reviews. Overall survival age was analyzed using KM curves and contextualized with DMD NH survival curves; subanalyses considered age groups and duration of eteplirsen exposure. Overall survival time from treatment initiation was also evaluated. A total of 579 eteplirsen-treated patients were included. During a total follow-up of 2119 person-years, median survival age was 32.8 years. DMD NH survival curves extracted from four publications (follow-up for 1224 DMD NH controls) showed overall pooled median survival age of 27.4 years. Eteplirsen-treated patients had significantly longer survival from treatment initiation versus age-matched controls (age-adjusted hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.44-0.98; p < .05). Longer treatment exposure was associated with improved survival (HR, 0.15; 95% CI, 0.05-0.41; p < .001). Comparisons using different DMD NH cohorts to address common risks of bias yielded consistent findings. Data suggest eteplirsen may prolong survival in patients with DMD across a wide age range. As more data become available, the impact of eteplirsen on survival will be further elucidated.

Measuring health-related quality of life in children with suspected genetic conditions: validation of the PedsQL proxy-report versions.

Measuring health-related quality of life (HRQoL) of children with suspected genetic conditions is important for understanding the effect of interventions such as genomic sequencing (GS). The Pediatric Quality of Life Inventory (PedsQL) is a widely used generic measure of HRQoL in pediatric patients, but its psychometric properties have not yet been evaluated in children undergoing diagnostic GS. In this cross-sectional study, we surveyed caregivers at the time of their child's enrollment into GS research studies as part of the Clinical Sequencing Evidence Generating Research (CSER)consortium. To evaluate structural validity of the PedsQL 4.0 Generic Core Scales and PedsQL Infant Scales parent proxy-report versions, we performed a confirmatory factor analysis of the hypothesized factor structure. To evaluate convergent validity, we examined correlations between caregivers' reports of their child's health, assessed using the EQ VAS, and PedsQL scores by child age. We conducted linear regression analyses to examine whether age moderated the association between caregiver-reported child health and PedsQL scores. We assessed reliability using Cronbach's alpha. We analyzed data for 766 patients across all PedsQL age group versions (1-12months through 13-18years). Model fit failed to meet criteria for good fit, even after modification. Neither age group (categorical) nor age (continuous) significantly moderated associations between PedsQL scores and caregiver-reported child health. Cronbach's alphas indicated satisfactory internal consistency for most PedsQL scales. The PedsQL Generic Core Scales and Infant Scales may be appropriate to measure HRQoL in pediatric patients with suspected genetic conditions across a wide age range. While we found evidence of acceptable internal consistency and preliminary convergent validity in this sample, there were some potential problems with structural validity and reliability that require further attention.

Comparative analysis of post-mortem drug concentrations in cerebrospinal fluid and blood.

This study aimed to compare the concentration of various xenobiotics in both cerebrospinal fluid (CSF) and blood. We examined 175 autopsy cases covering a wide range of ages, causes of death, and drug ingestion histories, with cerebrospinal fluid and blood samples available for toxicological testing. Analytes studied included opioids, benzodiazepines, antidepressants, antipsychotics, and illicit substances such as cannabinoids, stimulants and new psychoactive substances, including synthetic cathinones and synthetic cannabinoids. We found that concentrations in CSF were generally lower than in blood. A significant correlation was observed between drug concentrations in CSF and blood for many analytes (p < 0.05). However, the strength and direction of the correlation varied considerably depending on the physicochemical properties of the drugs, suggesting that a 'one size fits all' model may not be applicable. The results indicate that cerebrospinal fluid (CSF) can be used to detect a variety of xenobiotics, particularly amphetamines, synthetic cathinones and synthetic cannabinoids, in cases where conventional biological materials are not available. Additionally, using the results obtained in the future can lead to a better understanding of pharmacokinetic processes and the effect of post-mortem redistribution. Further research is needed to refine our understanding of these relationships.

Origin and depositional background of the Holocene black soil in Northeast China: Evidence from grain-size analysis and optically stimulated luminescence dating

The fertile Holocene black soil of Northeast China make it a major grain producing region, however, this soil is increasingly vulnerable to erosion. Knowledge of the origin and depositional background of the black soil in Northeast China can provide a reference for the conservation of the soil resources of this region. To this end, we examined the grain-size characteristics of the Holocene black soil across the plains in Northeast China, and we conducted optically stimulated luminescence (OSL) dating of the underlying stratum. The western Holocene black soils have a bimodal grain-size distribution similar to that of the sandy loess deposits on the Chinese Loess Plateau. In contrast, the eastern Holocene black soils mostly have a trimodal grain-size distribution similar to that of reworked loess in flood plains. From west to east, the median grain size and the sand content gradually decrease from >120 μm to <20 μm and from >80 % to <20 %, respectively. This eastward fining trend is consistent with the prevailing westerly winds during the dust storm season, indicating a wind-blown origin for the black soil material which was transported primarily from the adjacent sandy lands. Furthermore, our OSL ages reveal that the underlying stratum of the Holocene black soil was primarily deposited during the last glacial period, with the relatively wide depositional age range of 2–65 ka. This suggests unstable geomorphological conditions in Northeast China prior to the formation of the black soil, which may have resulted from the enhanced erosion and decreased vegetation cover.

Perceived Neighbourhood Disorder, Alcohol Consumption and Alcohol-Related Problems in Chile.

Background: Alcohol misuse is one of the most important preventable public health risk factors. Empirical research shows that alcohol misuse is related to social and economic losses. Both theoretical and empirical evidence suggests that neighborhood disorder impacts alcohol-related behavior. However, there is limited literature in the context of developing countries. Objectives: The aim of this research is to estimate the association between perceived neighborhood disorder and (1) alcohol-related behavior and (2) alcohol-related problems in the context of the Chilean population. Our contribution focuses on the examination of the perception of disorder in urban neighborhoods and alcohol use patterns in a wide age range and sample of Chilean cities. Results: High levels of neighbor disorder perception are associated with higher levels of drinking and hazardous alcohol use. In addition, perceived neighborhood disorder is directly associated with probability of alcohol-related problems (ranging from 2% to 11%). Conclusions/Importance: The results are consistent with empirical and theoretical frameworks. This research could be used to better guide place-based policies in emerging countries with high levels of alcohol consumption to prevent alcohol risk behaviors and alcohol-related problems.

Effects of gene dosage and development on subcortical nuclei volumes in individuals with 22q11.2 copy number variations.

The 22q11.2 locus contains genes critical for brain development. Reciprocal Copy Number Variations (CNVs) at this locus impact risk for neurodevelopmental and psychiatric disorders. Both 22q11.2 deletions (22qDel) and duplications (22qDup) are associated with autism, but 22qDel uniquely elevates schizophrenia risk. Understanding brain phenotypes associated with these highly penetrant CNVs can provide insights into genetic pathways underlying neuropsychiatric disorders. Human neuroimaging and animal models indicate subcortical brain alterations in 22qDel, yet little is known about developmental differences across specific nuclei between reciprocal 22q11.2 CNV carriers and typically developing (TD) controls. We conducted a longitudinal MRI study in a total of 385 scans from 22qDel (n = 96, scans = 191, 53.1% female), 22qDup (n = 37, scans = 64, 45.9% female), and TD controls (n = 80, scans = 130, 51.2% female), across a wide age range (5.5-49.5 years). Volumes of the thalamus, hippocampus, amygdala, and anatomical subregions were estimated using FreeSurfer, and the linear effects of 22q11.2 gene dosage and non-linear effects of age were characterized with generalized additive mixed models (GAMMs). Positive gene dosage effects (volume increasing with copy number) were observed for total intracranial and whole hippocampus volumes, but not whole thalamus or amygdala volumes. Several amygdala subregions exhibited similar positive effects, with bi-directional effects found across thalamic nuclei. Distinct age-related trajectories were observed across the three groups. Notably, both 22qDel and 22qDup carriers exhibited flattened development of hippocampal CA2/3 subfields relative to TD controls. This study provides novel insights into the impact of 22q11.2 CNVs on subcortical brain structures and their developmental trajectories.

Binge-watching Uncovered: Examining the interplay of perceived usefulness, habit, and regret in continuous viewing

Binge-watching has become one of the most popular ways for people to spend their free time. Binge-watching refers to watching more than two episodes of a television show in a single sitting. This pattern of behavior can be seen in people of a wide range of ages, but it is particularly widespread among people of millennial age and younger. In this study, we propose a model that explains binge-watching engagement by theorizing and testing the association of social influence on perceived usefulness, regret on the continuous intention of binge-watching, and habit on continuous intention and binge-watching engagement. The authors evaluated the model using data collected from 225 respondents. The results supported the proposed hypotheses and confirmed that regret does not neutralize the positive – and strong – effect of perceived usefulness and habit on binge-watching.

Youth "Hanfu culture" in the context of the subcultural perspective of the development of Chinese street fashion

The development of the Hanfu Culture youth movement in China has been going on for more than ten years. The purpose of this study is to clarify the importance of the historical influence of ancient fashion on modern Hanfu costume and its perception by the youth of the country. The object of the study is social relations. An empirical survey using the example of young residents of Chengdu showed that fans of the "Hanfu culture" make up the absolute majority, and these are mainly women of a wide age range and Han youth with a higher cultural level with a good education. The author proves that the main goals of the Hanfu youth movement are: inheritance, dissemination and popularization of Hanfu culture; development and innovation of Hanfu culture. Based on the conducted surveys and tests, the author concludes that the rise of the youth "Hanfu culture" is mainly due to the following reasons: the awakening of national identity, inspired by the ongoing development of globalization; the increase in national consciousness caused by the emphasis on historical consciousness in domestic policy towards ethnic minorities. The following methods and methodology were used in the research process: Analysis of historical sources: historical documents, images, artifacts and literature; Questionnaires: among various population groups; Personal survey; Comparative analysis. The methodology included a comprehensive approach to the study of the historical context and its impact on modern fashion. The presented article explores the historical influence of ancient fashion on modern street fashion, taking into account questionnaires, personal survey and analysis of historical time periods and forms of Chinese Hanfu costume. The main conclusions of the study are to identify the significant influence of ancient fashion on modern street fashion trends, as well as to understand the importance of preserving historical heritage in modern fashion. A special contribution of the author to the research of the topic is an integrated approach to the analysis of historical data and opinions of various groups of society, which allowed us to get a more complete picture of the influence of ancient fashion on modern culture. The novelty of the research lies in the use of a combination of questionnaire methods, personal survey and analysis of historical forms to study this topic, which allowed us to obtain unique results and a deep understanding of the evolution of fashion.

The Magellan M2FS Spectroscopic Survey of High-redshift Galaxies: The Brightest Lyman-break Galaxies at z ∼ 6

We present a study of a sample of 45 spectroscopically confirmed, UV luminous galaxies at z ∼ 6. They were selected as bright Lyman-break galaxies (LBGs) using deep multiband optical images in more than 2 deg2 of the sky, and subsequently identified via their strong Lyα emission. The majority of these LBGs span an absolute UV magnitude range from −22.0 to −20.5 mag with Lyα equivalent width (EW) between ∼10 and ∼200 Å, representing the most luminous galaxies at z ∼ 6 in terms of both UV continuum emission and Lyα line emission. We model the spectral energy distributions of 10 LBGs that have deep infrared observations from Hubble Space Telescope, JWST, and/or Spitzer, and find that they have a wide range of stellar masses and ages. They also have high star formation rates ranging from a few tens to a few hundreds of solar mass per year. Five of the LBGs have JWST or HST images, and four of them show compact morphology in these images, including one that is roughly consistent with a point source, suggesting that UV luminous galaxies at this redshift are generally compact. The fraction of our photometrically selected LBGs with strong Lyα emission (EW > 25 Å) is about 0.2, which is consistent with previous results and supports a moderate evolution of the intergalactic medium opacity at the end of cosmic reionization. Using deep X-ray images, we do not find evidence of strong active galactic nucleus (AGN) activity in these galaxies, but our constraint is loose, and we are not able to rule out the possibility of any weak AGN activity.

The 730 nm picosecond titanium sapphire laser for treatment of café-au-lait macules in all skin types.

Café-au-lait macules (CALM) are benign birthmarks presenting as uniformly pigmented, well demarcated, brown patches that can be distressing to patients, especially when located in cosmetically sensitive areas. As with all pigmentary lesions in skin of color patients, CALMs have been particularly challenging to treat. Here we present the first case series characterizing treatment parameters and clinical outcomes utilizing the 730-nm picosecond titanium sapphire laser for the treatment of CALMs. This device provides an additional safe and effective treatment option for these challenging cases. We performed a retrospective review of patients treated at a single institution between April 2021 and December 2023. Clinical photographs were graded by 3 outside board-certified dermatologists using a 5-point visual analog scale. Fourteen patients (age range: 10 months-66 years, mean age: 27.4 years, Fitzpatrick skin types II-VI) were treated for CALM on the face (11) or body (3). On average, patients received 4.3 treatments, with treatment intervals ranging from 4 to 40 weeks. Treatment remains ongoing with the 730-nm picosecond laser for eight patients. Overall, patients were rated to have a mean improvement of 26%-50%. Two patients (FST III and VI) achieved 100% clearance after 4-5 treatment sessions. Our study included four patients whose CALM were of the smooth bordered "coast of California" subtype, three of whom had a mean improvement rating of only 1%-25%. The fourth patient had near complete resolution. Follow up for these patients has ranged from 6 weeks to 1.5 years. Of the patients treated, one patient experienced transient post-inflammatory hyperpigmentation and another transient post-inflammatory hypopigmentation, while a third patient experienced mild persistent guttate hypopigmentation. Three patients experienced partial recurrence indicating that maintenance treatments may be needed in some patients. The 730-nm picosecond titanium sapphire laser is a safe and efficacious treatment option, in the right morphologic setting, to improve the cosmetic appearance of CALMs in a wide range of ages and skin types. To our knowledge, this is the first reported treatment of CALMs with picosecond lasers in FST V and VI patients. Our study also supports prior studies which have found that CALM with smooth-bordered "coast of California" morphology have a poor response to laser therapy as compared to those with jagged or ill-defined bordered "coast of Maine" morphology.

Experience and impact of stigma in people with chronic hepatitis B: a qualitative study in Asia, Europe, and the United States

BackgroundPeople with chronic hepatitis B (CHB) commonly experience social and self-stigma. This study sought to understand the impacts of CHB-related stigma and a functional cure on stigma.MethodsAdults with CHB with a wide range of age and education were recruited from 5 countries and participated in 90-minute qualitative, semi-structured interviews to explore concepts related to CHB-associated stigma and its impact. Participants answered open-ended concept-elicitation questions regarding their experience of social and self-stigma, and the potential impact of reduced CHB-related stigma.ResultsSixty-three participants aged 25 to 71 years (15 from the United States and 12 each from China, Germany, Italy, and Japan) reported emotional, lifestyle, and social impacts of living with CHB, including prejudice, marginalization, and negative relationship and work experiences. Self-stigma led to low self-esteem, concealment of CHB status, and social withdrawal. Most participants stated a functional cure for hepatitis B would reduce self-stigma.ConclusionsCHB-related social and self-stigma are widely prevalent and affect many aspects of life. A functional cure for hepatitis B may reduce social and self-stigma and substantially improve the health-related quality of life of people with CHB. Incorporating stigma into guidelines along with infectivity considerations may broaden the patient groups who should receive treatment.

Assessment of the importance of platelet transfusion in patients with severe dengue: a systematic review

Introduction: Dengue is one of the most important vector-borne viral diseases in subtropical and tropical regions. The World Health Organization (WHO) 2009 classified dengue into three groups: dengue without alarm signs, dengue with alarm signs, and severe dengue. According to the type of dengue, various managements have been proposed. The authors suggest that a predictive factor to avoid a poor prognosis in this disease is to keep platelet levels stable in the patient to prevent a fatal outcome. The aim of this paper is to analyze the efficacy of transfusion of platelet agents in the outcome of patients with severe dengue and thrombocytopenia. Material and methods: A bibliographic search was carried out in the Medline, OVID, and Scielo databases from January 1, 2008, to April 31, 2023, using the MeSH terms. Results: 7 articles were included in the systematic review. A wide range in age was found (18 to 79 years). A minimal number of studies detail the comorbidities of patients in their enrollment. Regarding platelet transfusion, the average number of platelet units used in the transfusion case was 5 (2 - 14). Transfusions of ABO identical and compatible pooled platelets transfusion were found to be more successful in increasing platelets. Almost all of the patients included in the studies had platelets &lt;20,000 at enrollment. One study found a significant increase in platelets after transfusion, while the rest did not find it compelling. No mortality associated with platelet transfusion was recorded. Conclusions: Prophylactic platelet transfusion is not recommended as a routine measure in patients with severe dengue and thrombocytopenia. The uncertainty highlights need to reach a specific consensus establishing the appropriate indications for platelet transfusion and what type of patients with dengue virus would be beneficial.

Transfusion of blood components in pediatric age groups: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’

Pediatric transfusion is a complex area of medicine covering a wide age range, from neonates to young adults. Compared to adult practice, there is a relative lack of high-quality research to inform evidence-based guidelines. We aimed to adapt the pre-existing high-quality practice guidelines for the transfusion of blood components in different pediatric age groups to be available for national use by general practitioners, pediatricians, and other health care professionals. The guideline panel included 17 key leaders from different Egyptian institutions. The panel used the Adapted ADAPTE methodology. The panel prioritized the health questions and recommendations according to their importance for clinicians and patients. The procedure included searching for existing guidelines, quality appraisal, and adaptation of the recommendations to the target context of use. The guideline covered all important aspects of the indications, dosing, and administration of packed red cells, platelets, and fresh frozen plasma. It also included transfusion in special situations, e.g., chronic hemolytic anemia and aplastic anemia, management of massive blood loss, malignancies, surgery, recommendations for safe transfusion practices, and recommendations for modifications of cellular blood components. The final version of the adapted clinical practice guideline (CPG) has been made after a thorough review by an external review panel and was guided by their official recommendations and modifications. A set of implementation tools included algorithms, tables, and flow charts to aid decision-making in practice. This adapted guideline serves as a tool for safe transfusion practices in different pediatric age groups.

Integrating yoga into comprehensive cancer care: Starting somewhere

IntroductionThe rapid increase in cancer survivors in the United States (US) highlights the importance of survivors’ long-term care needs and symptom management. Given evidence that yoga supports cancer related symptoms, our aim was to develop and implement a community yoga program available for cancer survivors, family members, and staff involved in cancer care at a public comprehensive cancer center in the US. Given the wide age range and potential side effects from cancer treatment, we adapted the yoga program to meet the needs of cancer survivors. MethodsBeginning in May 2017, we offered sixty-minute gentle yoga sessions for all medically cleared cancer survivors and their family members, caregivers, and friends, as well as oncology staff. We aimed to evaluate acceptability, development, and implementation of an adaptive yoga program at our comprehensive cancer center using mixed methods. Classes were initially offered once a week, then increased to twice a week. A total of five service evaluations were sent approximately every six months between April 2018-October 2019 to evaluate participant satisfaction (n = 90 responses). Qualitative data were collected and analyzed using thematic analysis of participant satisfaction, allowing us to continuously monitor the yoga program and adjust to meet participants’ needs. ResultsBetween May 2017 and February 2020, 176 people attended our program. Ages ranged from 21 to 72 years, with an average age of 45 years. Based on these evaluations, 96 % (n = 86) of participants rated both the program and teachers excellent, and 4 % (n = 4) rated the program and teachers good. Qualitative themes highlighted positive aspects of the program, including accessibility, inclusivity, and adaptive yoga based on medical needs, skill level, and abilities. ConclusionsAdaptive yoga programs are well-accepted by cancer survivors and caregivers, and may contribute a solution to healthcare staff and physician burnout. It is essential to build a solid foundation of self-care and wellness programming for cancer survivors and to create and foster adaptive yoga classes. Next steps for our program include evaluating yoga within the clinical setting, including chemotherapy infusion centers, and further research on reduction in stress through yoga in cancer survivors.

Lassa fever vaccine use cases and demand: Perspectives from select West African experts

Lassa fever (LF) is a zoonotic viral hemorrhagic disease endemic to several West African countries. Approximately 300–500,000 cases occur annually across all ages with 10–20% case fatality rates. A LF vaccine is a recognized public health priority, with several candidates entering clinical trials. However, the perspectives of regional experts regarding critical vaccine properties, ideal delivery methods, and priority target populations remain unclear. Using a mixed methods approach with a standardized questionnaire, we individually interviewed 8 West African stakeholders, each with extensive knowledge and experience of LF. They strongly favored the use of a mass, proactive campaign strategy to immunize a wide age range of people in high-risk areas, including pregnant women and health care workers. We estimated that these and other plausible delivery scenarios could result in an initial demand of anywhere from 1 to 100 million doses, with most demand coming from Nigeria. These findings may help inform LF vaccine development and deployment efforts.

THE EFFECT OF LIMBAL RELAXING INCISIONS ON 1-WEEK POSTOPERATIVE IN K1 AND K2 VALUES

Introduction: Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification. Methods: This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1=flat keratometry and K2=steep keratometry) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI. Results: Five patients with the mean age 39.8 years (range: 22 to 76 years) and corneal astigmatism 3.12 D (range: 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329). Conclusion: This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subjects are required.

The Effect of Limbal Relaxing Incisions on 1-Week Postoperative K1 and K2 Values

Abstract&#x0D; Introduction &amp; Objectives : Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification.&#x0D; Methods : This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1 and K2) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI&#x0D; Results : Five eyes of Five patients with the mean age 39.8 years (range : 22 to 76 years) and corneal astigmatism 3.12 D (range : 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329).&#x0D; Conclusion : This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients, may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subject are required.

Development of the Children's English and Spanish Speech Recognition Test: Psychometric Properties, Feasibility, Reliability, and Normative Data.

The Children's English and Spanish Speech Recognition (ChEgSS) test is a computer-based tool for assessing closed-set word recognition in English and in Spanish, with a masker that is either speech-shaped noise or competing speech. The present study was conducted to (1) characterize the psychometric properties of the ChEgSS test, (2) evaluate feasibility and reliability for a large cohort of Spanish/English bilingual children with normal hearing, and (3) establish normative data. Three experiments were conducted to evaluate speech perception in children (4-17 years) and adults (19-40 years) with normal hearing using the ChEgSS test. In Experiment 1, data were collected from Spanish/English bilingual and English monolingual adults at multiple, fixed signal-to-noise ratios. Psychometric functions were fitted to the word-level data to characterize variability across target words in each language and in each masker condition. In Experiment 2, Spanish/English bilingual adults were tested using an adaptive tracking procedure to evaluate the influence of different target-word normalization approaches on the reliability of estimates of masked-speech recognition thresholds corresponding to 70.7% correct word recognition and to determine the optimal number of reversals needed to obtain reliable estimates. In Experiment 3, Spanish/English bilingual and English monolingual children completed speech perception testing using the ChEgSS test to (1) characterize feasibility across age and language group, (2) evaluate test-retest reliability, and (3) establish normative data. Experiments 1 and 2 yielded data that are essential for stimulus normalization, optimizing threshold estimation procedures, and interpreting threshold data across test language and masker type. Findings obtained from Spanish/English bilingual and English monolingual children with normal hearing in Experiment 3 support feasibility and demonstrate reliability for use with children as young as 4 years of age. Equivalent results for testing in English and Spanish were observed for Spanish/English bilingual children, contingent on adequate proficiency in the target language. Regression-based threshold norms were established for Spanish/English bilingual and English monolingual children between 4 and 17 years of age. The present findings indicate the ChEgSS test is appropriate for testing a wide age range of children with normal hearing in either Spanish, English, or both languages. The ChEgSS test is currently being evaluated in a large cohort of patients with hearing loss at pediatric audiology clinics across the United States. Results will be compared with normative data established in the present study and with established clinical measures used to evaluate English- and Spanish-speaking children. Questionnaire data from parents and clinician feedback will be used to further improve test procedures.

Reconstruction of the abdominal wall with component separation technique in patients with giant omphalocele

BackgroundSeveral techniques have been described to repair giant omphaloceles. Component Separation Technique (CST) is a surgical technique first reported in adults to repair large abdominal wall defects. The purpose of this study is to describe our experience using this technique in repairing large ventral hernias secondary to giant omphaloceles in children. MethodsNine patients with giant omphalocele were treated. The abdominal wall was reconstructed using CST, based on the enlargement of the abdominal wall by separate mobilization of the muscular layers. Patients were monitored for complications during admission, postoperative complications, and all patients were seen for follow-up. ResultsComponent separation technique was performed at a median age of 7.2 years. The median diameter of the hernia was 109.8 cm2. There was no mortality. Minor complications were seen (infection, skin necrosis, and hematoma). There were no recurrences after an average follow-up of 3.3 years (2 - 4 years). ConclusionsComponent separation technique is a valuable method for repairing large ventral hernias as a consequence of giant omphaloceles in children. Our series supports the use of CST in children, in a wide age range, from newborns for primary closure to adolescence in cases of giant ventral hernias secondary to omphaloceles with multiple previous surgeries. Level of EvidenceII