392 research outputs found

    Differences in minimal disease knowledge of keratoconus patients: results from an international survey

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    Background/aims: The objective of this multicentre, multinational, prospective study was to assess the level of basic understanding that individuals with keratoconus possessed about their condition. Methods: We recruited 200 active keratoconus patients who were under regular review, and cornea specialists established a standard of 'minimal keratoconus knowledge' (MKK) that included an understanding of the definition, risk factors, symptoms and treatment options for the condition. We collected data from each participant regarding their clinical characteristics, highest level of education, (para)medical background and experiences with keratoconus within their social circle, and calculated the percentage of MKK attained by each patient. Results: Our findings revealed that none of the participants met the MKK standard, with the average MKK score being 34.6% and ranging from 0.0% to 94.4%. Furthermore, our study showed that patients with a university degree, previous surgical intervention for keratoconus or affected parents had a higher MKK. However, age, gender, disease severity, paramedical knowledge, disease duration and best-corrected visual acuity did not significantly affect the MKK score. Conclusions: Our study demonstrates a concerning lack of basic disease knowledge among keratoconus patients in three different countries. The level of knowledge exhibited by our sample was only one-third of what cornea specialists would typically anticipate from patients. This highlights the need for greater education and awareness campaigns surrounding keratoconus. Further research is needed to determine the most efficient approaches for enhancing MKK and subsequently improving the management and treatment of keratoconus.</p

    Telemedicine service for keratoconus monitoring: patient satisfaction and prospects for further expansion

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    Introduction: During the COVID-19 pandemic, keratoconus patient care moved from in-person clinics to virtual care. We surveyed patient satisfaction with the new virtual clinic model.  Methods: We assessed the views of keratoconus patients enrolled in the novel virtual service between June 1 and July 31, 2020, in individual structured telephone interviews using Likert questions.  Results: Of the 88 patients enrolled, the opinions of 69 patients could be evaluated (78.4%). Compared with previous in-person visits, mean waiting times for diagnostic examinations dropped from 43 (±32) min to 4 (±3) min (p Discussion: A novel virtual service to monitor keratoconus progression was well received and was associated with shorter waiting times. There was a strong interest on the part of patients to further develop the virtual keratoconus clinic.  Conclusions: This study demonstrates that keratoconus patients managed very well the conversion from in-person to virtual care. A solid majority of keratoconus patients also supported further expansion of the virtual consultations to a completely decentralized telemedicine model.</p

    Differences in minimal disease knowledge of keratoconus patients: results from an international survey

    No full text
    Background/aims The objective of this multicentre, multinational, prospective study was to assess the level of basic understanding that individuals with keratoconus possessed about their condition.Methods We recruited 200 active keratoconus patients who were under regular review, and cornea specialists established a standard of ‘minimal keratoconus knowledge’ (MKK) that included an understanding of the definition, risk factors, symptoms and treatment options for the condition. We collected data from each participant regarding their clinical characteristics, highest level of education, (para)medical background and experiences with keratoconus within their social circle, and calculated the percentage of MKK attained by each patient.Results Our findings revealed that none of the participants met the MKK standard, with the average MKK score being 34.6% and ranging from 0.0% to 94.4%. Furthermore, our study showed that patients with a university degree, previous surgical intervention for keratoconus or affected parents had a higher MKK. However, age, gender, disease severity, paramedical knowledge, disease duration and best-corrected visual acuity did not significantly affect the MKK score.Conclusions Our study demonstrates a concerning lack of basic disease knowledge among keratoconus patients in three different countries. The level of knowledge exhibited by our sample was only one-third of what cornea specialists would typically anticipate from patients. This highlights the need for greater education and awareness campaigns surrounding keratoconus. Further research is needed to determine the most efficient approaches for enhancing MKK and subsequently improving the management and treatment of keratoconus

    First observation and branching fraction measurement of the Λb0Dsp {\Lambda}_b^0\to {D}_s^{-}p decay

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    International audienceThe first observation of the Λb0Dsp {\Lambda}_b^0\to {D}_s^{-}p decay is presented using proton-proton collision data collected by the LHCb experiment at a centre-of-mass energy of s \sqrt{s} = 13 TeV, corresponding to a total integrated luminosity of 6 fb1^{−1}. Using the Λb0Λc+π {\Lambda}_b^0\to {\Lambda}_c^{+}{\pi}^{-} decay as the normalisation mode, the branching fraction of the Λb0Dsp {\Lambda}_b^0\to {D}_s^{-}p decay is measured to be B(Λb0Dsp)=(12.6±0.5±0.3±1.2)×106 \mathcal{B}\left({\Lambda}_b^0\to {D}_s^{-}p\right)=\left(12.6\pm 0.5\pm 0.3\pm 1.2\right)\times {10}^{-6} , where the first uncertainty is statistical, the second systematic and the third due to uncertainties in the branching fractions of the Λb0Λc+π {\Lambda}_b^0\to {\Lambda}_c^{+}{\pi}^{-} , DsKK+π {D}_s^{-}\to {K}^{-}{K}^{+}{\pi}^{-} and Λc+pKπ+ {\Lambda}_c^{+}\to p{K}^{-}{\pi}^{+} decays.[graphic not available: see fulltext

    bTUNED: transcutaneous tibial nerve stimulation for neurogenic lower urinary tract dysfunction

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    OBJECTIVE To present the protocol for a randomized controlled trial (RCT) evaluating the efficacy and safety of transcutaneous tibial nerve stimulation (TTNS) for refractory neurogenic lower urinary tract dysfunction (NLUTD). STUDY DESIGN AND RESULTS bTUNED (bladder and TranscUtaneous tibial Nerve stimulation for nEurogenic lower urinary tract Dysfunction) is an international multicentre, sham-controlled, double-blind RCT investigating the efficacy and safety of TTNS. The primary outcome is success of TTNS, defined as improvements in key bladder diary variables at study end compared to baseline values. The focus of the treatment is defined by the Self-Assessment Goal Achievement (SAGA) questionnaire. Secondary outcomes are the effect of TTNS on urodynamic, neurophysiological, and bowel function outcome measures, as well as the safety of TTNS. CONCLUSIONS A total of 240 patients with refractory NLUTD will be included and randomized 1:1 into the verum or sham TTNS group from March 2020 until August 2026. TTNS will be performed twice a week for 30 min during 6 weeks. The patients will attend baseline assessments, 12 treatment visits and follow-up assessments at the study end

    Resilience in patients with complex regional pain syndrome 1—A cross-sectional analysis of patients participating in a cross-sectional cohort study

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    Objective To assess the degree of resilience in patients with CRPS 1, to explore the relationship between resilience and patient-related outcome measurements and to describe a pattern of clinical manifestations associated with low resilience. Methods This study presents a cross-sectional analysis of baseline information collected from patients enrolled in a single center study between February 2019 and June 2021. Participants were recruited from the outpatient clinic of the Department of Physical Medicine &amp; Rheumatology of the Balgrist University Hospital, Zurich, Switzerland. We used linear regression analysis to explore association of resilience with patient reported outcomes at baseline. Further, we explored the impact of significant variables on the low degree resilience using logistic regression analysis. Results Seventy-one patients (females 90.1%, mean age 51.2 ± 12.9 years) were enrolled. There was no association between CRPS severity and the level of resilience. Quality of Life was positively correlated with resilience, as was pain self-efficacy. Pain catastrophizing was inversely correlated with the level of resilience. We observed a significant inverse association between anxiety, depression and fatigue and the level of resilience. The proportion of patients with a low resilience increased with higher level of anxiety, depression and fatigue on the PROMIS-29, without reaching statistical significance. Conclusion Resilience seems to be an independent factor in CRPS 1 and is associated with relevant parameters of the condition. Therefore, caretakers may screen the current resilience status of CRPS 1 patients to offer a supplementary treatment approach. Whether specific resilience training modifies CRPS 1 course, requires further investigations

    Randomised Controlled Trials Assessing the Clinical Value of Urodynamic Studies:A Systematic Review and Meta-analysis

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    Context The role of urodynamic studies (UDSs) in the diagnosis of lower urinary tract symptoms (LUTS) is crucial. Although expert statements and guidelines underline their value for clinical decision-making in various clinical settings, the academic debate as to their impact on patient outcomes continues. Objective To summarise the evidence from all randomised controlled trials assessing the clinical usefulness of UDS in the management of LUTS. Evidence acquisition For this systematic review, searches were performed without language restrictions in three electronic databases until November 18, 2020. The inclusion criteria were randomised controlled study design and allocation to receive UDS or not prior to any clinical management. Quality assessment was performed by two reviewers independently, using the Cochrane Collaboration's tool for assessing the risk of bias. A random-effect meta-analysis was performed on the uniformly reported outcome parameters. Evidence synthesis Eight trials were included, and all but two focused on women with pure or predominant stress urinary incontinence (SUI). A meta-analysis of six studies including 942 female patients was possible for treatment success, as defined by the authors (relative risk 1.00, 95% confidence interval: 0.93-1.07), indicating no difference in efficacy when managing women with UDS. Conclusions Although UDSs are not replaceable in diagnostics, since there is no other equivalent method to find out exactly what the lower urinary tract problem is, there are little data supporting its impact on outcomes. Randomised controlled trials have focussed on a small group of women with uncomplicated SUI and showed no added value, but these findings cannot be extrapolated to the overall patient population with LUTS, warranting further well-designed trials. Patient summary Despite urodynamics being the gold standard to assess lower urinary tract symptoms (LUTS), as it is the only method that can specify lower urinary tract dysfunction, more studies assessing the clinical usefulness of urodynamic studies (UDSs) in the management of LUTS are needed. UDS investigation is not increasing the probability of success in the treatment of stress urinary incontinence

    Search for CPCP violation using T^\hat{T}-odd correlations in B0ppˉK+πB^{0} \to p \bar p K^{+} \pi^{-} decays

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    A search for CPCP and PP violation in charmless four-body B0ppˉK+πB^{0} \to p \bar p K^{+} \pi^{-} decays is performed using triple-product asymmetry observables. It is based on proton-proton collision data collected by the LHCb experiment at centre-of-mass energies of 77, 88 and 1313 TeV, corresponding to a total integrated luminosity of 8.48.4 fb1^{-1}. The CPCP- and PP-violating asymmetries are measured both in the integrated phase space and in specific regions. No evidence is seen for CPCP violation. PP-parity violation is observed at a significance of 5.8 standard deviations.A search for CP and P violation in charmless four-body B0→pp¯K+π- decays is performed using triple-product asymmetry observables. It is based on proton-proton collision data collected by the LHCb experiment at center-of-mass energies of 7, 8 and 13 TeV, corresponding to a total integrated luminosity of 8.4  fb-1. The CP- and P-violating asymmetries are measured both in the integrated phase space and in specific regions. No evidence is seen for CP violation. P-parity violation is observed at a significance of 5.8 standard deviations.A search for CPCP and PP violation in charmless four-body B0ppˉK+πB^{0} \to p \bar p K^{+} \pi^{-} decays is performed using triple-product asymmetry observables. It is based on proton-proton collision data collected by the LHCb experiment at centre-of-mass energies of 77, 88 and 1313 TeV, corresponding to a total integrated luminosity of 8.48.4 fb1^{-1}. The CPCP- and PP-violating asymmetries are measured both in the integrated phase space and in specific regions. No evidence is seen for CPCP violation. PP-parity violation is observed at a significance of 5.8 standard deviation
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