METHODS: We searched all relevant medical literature, military reports, and travel industry documents on transfer of neurosurgical patients. This review was combined with a senior author's (M.J.) extensive relevant experience, to present important factors for neurosurgeons to consider during planning of aeromedical evacuation, highlighting potential preventable causes of deterioration en route.
RESULTS: Several criteria must be met for a transfer to be considered. The safe transfer of patients with craniospinal pathology requires efficient collaboration between the referring teams, the receiving units/departments, and the medical transfer service. Clear communication, qualified personnel, and appropriate transportation equipment must be available for the transfer. One must consider unique stressors during the air transfer, including the risk of hypoxia on certain types of flights. Vibration, loud noise, acceleration, and changes in barometric pressure en route may negatively affect the patient during transfer. Patient stabilization before transfer is a priority. Medical conditions that can potentially worsen in-flight should be corrected before transfer. The use of a checklist before departure is highly recommended and is included herein. The timing of transfer concerning the postoperative patient deserves special consideration.
CONCLUSIONS: Although there is little published information, this review provides useful criteria and parameters needed for safe aeromedical evacuation of neurosurgical patients.
METHODS: A qualitative study using interview approach was conducted in Hong Kong SAR and Malaysia. Thirty dental undergraduate students, each with one patient from the Faculty of Dentistry at The University of Hong Kong (n = 15) and Universiti Teknologi MARA (n = 15), were introduced to a digitally designed decision aid in missing tooth replacement prior to their treatment appointments. Semi-structured interviews were conducted with each student and patient, adhering to the interview protocol. Each interview was audio-recorded, transcribed, and subsequently coded to investigate the perceptions and potential advantages of this decision aid.
RESULTS: Thematic analysis identified three key themes from the dental students' perspective: communication, utilization, and satisfaction. From patients' perceptions, four central themes emerged: communication, treatment information, uncertainty, and utilization. Detailed examination of the data highlighted an enhancement in patients' confidence and trust in their dental care providers, as well as a marked increase in both student and patient satisfaction levels upon implementing this novel approach. The average satisfaction rates for students were 83 % for Hong Kong SAR and 82 % for Malaysia.
CONCLUSION: This patient-centered clinical decision aid helped to enhance communication between dental students and patients in both regions, ultimately leading to heightened patient satisfaction levels. Nonetheless, to address the present study's limitations, future studies should consider diversifying participant backgrounds, including patients without prior treatment discussions with students.
CLINICAL SIGNIFICANCE: Clinical decision aids are valuable tools in clinical teaching due to their enhancement of communication between clinicians and patients. They promote shared decision-making, leading to more personalized and evidence-driven treatment plans, ultimately improving patient care.
AIM: To analyze the burden of MD in the WPR from 1990 to 2021, along with associated risk factors, to reveal changing trends and emerging challenges.
METHODS: We used data from the Global Burden of Disease 2021, analyzing prevalence, incidence, and disability-adjusted life years (DALYs) of MD from 1990 to 2021. Statistical methods included age-standardisation and uncertainty analysis to address variations in population structure and data completeness.
RESULTS: Between 1990 and 2021, the prevalence of MD rose from 174.40 million cases [95% uncertainty interval (UI): 160.17-189.84] to 234.90 million cases (95%UI: 219.04-252.50), with corresponding DALYs increasing from 22.8 million (95%UI: 17.22-28.79) to 32.07 million (95%UI: 24.50-40.68). During this period, the burden of MD shifted towards older age groups. Depressive and anxiety disorders were predominant, with females showing higher DALYs for depressive and anxiety disorders, and males more affected by conduct disorders, attention-deficit hyperactivity disorder, and autism spectrum disorders. Australia, New Zealand, and Malaysia reported the highest burdens, whereas Vietnam, China, and Brunei Darussalam reported the lowest. Additionally, childhood sexual abuse and bullying, and intimate partner violence emerged as significant risk factors.
CONCLUSION: This study highlights the significant burden of MD in the WPR, with variations by age, gender, and nation. The coronavirus disease 2019 pandemic has exacerbated the situation, emphasizing the need for a coordinated response.
METHODS: We systematically searched PubMed, Web of Science, CINAHL, Embase, the Cochrane Library, PsycINFO, and 2 electronic databases to identify studies published up to October 2023 with data on the correlates of demoralization. Two researchers independently reviewed references, extracted data, and assessed data quality. Meta-analysis was performed using R4.1.1 software.
RESULTS: Thirty-eight studies were included in this meta-analysis. For the most studied sociodemographic correlates, demoralization was negatively correlated with income (z = -0.29, 95% CI: -0.51, -0.02), education (z = - 0.11, 95% CI: - 0.16, -0.05), and age (z = -0.45, 95%CI: -0.75, -0.01). For the most studied clinical correlates, demoralization was positively correlated with symptom burden (z = 0.37, 95% CI: 0.22, 0.50) and negatively correlated with quality of life (z = -0.40, 95% CI: -0.54, -0.24). For the most studied psychosocial correlates, demoralization was negatively correlated with social support (z = -0.39, 95% CI: -0.51, -0.26) and positively correlated with anxiety (z = 0.65, 95% CI: 0.56, 0.73), depression (z = 0.61, 95% CI: 0.54, 0.67), and suicidal ideation (z = 0.48, 95% CI: 0.34, 0.60).
SIGNIFICANCE OF RESULTS: Demoralization showed either positive or negative associations with sociodemographic, clinical, and psychological variables. More research is needed to explore the underlying mechanisms to develop effective interventions. This review provides information on the factors associated with demoralization in cancer patients, which can be used to inform strategies for clinical care providers.
METHOD: This was a prospective cohort interventional study involving 52 patients with primary pterygium divided equally into control and intervention groups. The intervention group received 0.5 mg ranibizumab two weeks prior to pterygium excision surgery. All participants had pterygium excision with autologous conjunctival graft under local anaesthesia. Excised pterygium tissues were evaluated for MVD and 8-OHdG. Each participant was monitored for recurrence up to 2 years after intervention. Pearson chi-square and Fisher exact tests were used to examine the differences between both groups.
RESULTS: The intervention group demonstrated significantly lower MVD (p
METHODS: We reported dengue cases among returning travelers (2010-2018) and computed dengue incidence per 100,000 travelers for each destination country. We compared officially reported dengue incidence per 100,000 inhabitants of the destination country with estimated incidence per 100,000 travelers, using Pearson's correlation coefficient.
RESULTS: Key findings revealed eight Southeast and South Asia countries as popular destinations for our sentinel sites, with Australia exhibiting the highest incidence (40.7 per 100,000 travelers). Dengue incidence variations were evident, with Malaysia showing a sharp increase over time. Correlation analysis showed strong links in Malaysia (r = 0.66-0.92) and weaker connections in India (r = -0.54-0.76) between dengue incidence among inhabitants and travelers.
CONCLUSION: Systematically collected dengue surveillance data from returning travelers can serve as a proxy for dengue incidence in the destination country and can be used to assess the robustness of the country's dengue surveillance.
METHODS: This single-center retrospective study collected data from patients treated with FD between January 2016 and March 2024, including patient characteristics, aneurysm features, postoperative DWI lesions, and clinical outcomes. Vessel status was assessed using CFSS: 1a (normal caliber and flow), 1b (normal caliber, reduced flow), 2a (reduced caliber, normal flow), 2b (reduced caliber and flow), and 3 (occlusion).
RESULTS: Thirty-nine patients with 41 aneurysms with 63 covered MCA branches were included. Immediately after FD deployment, 63.5% of covered branches retained normal caliber and flow (CFSS 1a) while the remaining branches with compromised caliber and flow (CFSS >1a) showed significant improvement following tirofiban administration. Intraoperative thromboembolic complications led to occlusion in three branches, all restored after tirofiban without clinical symptoms (P=0.003). At 6 months, 79% of covered branches showed normal flow with or without caliber reduction (CFSS 1a/2a). DWI lesions showed no significant correlation with caliber and flow changes and clinical symptoms.
CONCLUSIONS: FD treatment for MCA aneurysms leads to significant but primarily asymptomatic CFSS changes in covered cortical branches within the first 6 months. Intra-arterial tirofiban effectively improves vessel status in branches with higher CFSS (>1a). CFSS is valuable for tracking these changes and underscores the importance of long-term follow-up.