Paired opposite clear corneal incision : time-related changes of its effect and factors on which those changes depend.

PURPOSE To assess astigmatism induced by paired opposite clear corneal incision (OCCI) compared to single incisions and to investigate factors on which its effect depends. METHODS The study comprised 326 eyes from 326 patients. In patients with 1.0 D preoperative corneal astigmatism, a second, opposite clear corneal incision was made (OCCI group, n = 81). Both groups consisted of superior, temporal, and oblique subgroups according to the steepest meridian. Prior to the surgery, and after surgery, repeated keratometry was performed and surgically induced astigmatism (SIA) was calculated using vector analysis. RESULTS Two weeks after the surgery, the SIA was 0.67 ± 0.44 D in the CC group and 1.15 ± 0.65 D in the OCCI group; 9 weeks after the operation, it was 0.61 ± 0.43 D in the CC group and 0.99 ± 0.57 D in the OCCI group (p<0.001). The SIA showed no significant postoperative change in our groups. CONCLUSIONS Opposite clear corneal incision reliably induces about 1.0 D of corneal astigmatism on the steep meridian in proportion to the rate of preoperative astigmatism. Its magnitude is independent of the location of the incisions and its effect remains unchanged during the postoperative period

Influence of social media exposure on knowledge and behaviour of COVID-19 preventive measure:a cross sectional study

A lot of misinformation about COVID-19 on social media possibly hinder the practice of healthy behaviors that are essential to protect individuals. This situation is exacerbated by the lack of health literacy in Indonesia. This study aimed to determine the influence of social media information exposure on the knowledge and behavior of Indonesians in compliance with COVID-19 protocols. An online survey of 909 people was conducted from July 2nd to August 10th, 2020. The data collected were knowledge and behavior of preventing COVID-19, while independent variables were socio-demographic characteristics and exposure to social media information. Inclusion criteria were defined as follows: minimum age of 18 years and domiciled in the country during the data collection period. The analysis used for the data collected were univariate and multivariate. The result showed that gender, age, marital status, and social media presence significantly affect a person's knowledge about COVID-19 with a p-value of 0.05. Enforcement behavior of health and healthy living protocols is significantly influenced by the respondent’s gender, marital status, education level, the island of residence, and exposure to online information. The frequency of exposure to information affects people's knowledge and behavior to implement health protocols and healthy living in the COVID-19 era, and it is further influenced by socio-demographic characteristics

Three-dimensional transesophageal echocardiographic evaluation of pulmonary vein anatomy prior to cryoablation: validation with cardiac CT scan

Abstract Background Anatomical characteristics of the left atrium and the pulmonary veins (PVs) may be relevant to the success rate of cryoballoon (CB)-ablation for atrial fibrillation (AF). Cardiac computed tomography (CCT) is considered as the gold standard for preablation imaging. Recently, three-dimensional transesophageal echocardiography (3DTOE) has been proposed for preprocedural assessment of cardiac structures relevant to CB-ablation. The accuracy of 3DTOE has not been validated by other imaging modalities. Objective We prospectively evaluated the feasibility and the accuracy of 3DTOE imaging for the assessment of left atrial and PV structures prior to pulmonary vein isolation (PVI). In addition, CCT was used to validate the measurements obtained with 3DTOE. Methods PV anatomy of 67 patients (59.7% men, mean age 58.5 ± 10.5 years) was assessed using both 3DTOE and CCT scan prior to PVI with the Arctic Front CB. The following parameters were measured bilaterally: PV ostium area (OA), the major and minor axis diameters of the ostium (a > b) and the width of the carina between the superior and the inferior PVs. In addition, the width of the left lateral ridge (LLR) between the left atrial appendage and the left superior PV. Evaluation of inter-technique agreement was based on linear regression with Pearson correlation coefficient (PCC) and Bland–Altman analysis of biases and limits of agreement. Results Moderate positive correlation (PCC 0.5–0.7) was demonstrated between the two imaging methods for the right superior PV’s OA and both axis diameters, the width of the LLR and left superior PV (LSPV) minor axis diameter (b) with limits of agreement ˂50% and no significant biases. Low positive or negligible correlation (PCC < 0.5) was found for both inferior PV parameters. Conclusions Detailed assessment of the right superior PV parameters, LLR and LSPV b is feasible with 3DTOE prior to AF ablation. This 3DTOE measurements demonstrated a clinically acceptable inter-technique agreement with those obtained with CCT. Graphical Abstrac

Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes

Background In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. Methods In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. Results The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Conclusion Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare