Femtosecond laser-assisted astigmatic keratotomy versus toric IOL implantation for correcting astigmatism in cataract patients: a systematic review and meta-analysis with trial sequential analysis.

AIMS: To compare the refractive and visual outcomes of femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric intraocular lens (IOL) implantation for correcting astigmatism in cataract patients. METHODS: Studies were retrieved from the Ovid-Medline, EMBASE, Cochrane Central Register of Controlled Trials and Scopus which compared FSAK and toric IOL for astigmatism correction in cataract patients. Outcome measures included postoperative refractive cylinder, correction index, uncorrected distance visual acuity (UDVA), the proportion of patients achieving a residual refractive cylinder of 1.00 dioptre or less, target-induced astigmatism (TIA) and surgically induced astigmatism (SIA). The trial sequential analysis (TSA) was used to collect firm evidence supporting our conclusion. RESULTS: 9 studies encompassing 590 participants were analysed. The meta-analysis revealed that toric IOLs could result in less postoperative refractive cylinder and provide better UDVA compared with FSAK. The TSA disclosed strong evidence of lower postoperative refractive cylinder in the toric IOL group compared with that of the FSAK group. FSAK showed a smaller correction index and lower mean TIA and SIA compared with toric IOLs. CONCLUSIONS: For cataract patients, both FSAK and toric IOLs are effective methods for correcting astigmatism. However, toric IOLs offer less postoperative astigmatism and result in better postoperative UDVA compared with FSAK. In vector analysis of astigmatism, toric IOLs can also produce higher TIA and SIA. Additionally, neither method is associated with severe untreatable complications. Therefore, the conclusion is that toric IOLs are the preferred choice for astigmatism correction in cataract patients and FSAK serves as a viable alternative when toric IOLs are contraindicated.

Depression assessment using integrated multi-featured EEG bands deep neural network models: Leveraging ensemble learning techniques.

Mental Status Assessment (MSA) holds significant importance in psychiatry. In recent years, several studies have leveraged Electroencephalogram (EEG) technology to gauge an individual's mental state or level of depression. This study introduces a novel multi-tier ensemble learning approach to integrate multiple EEG bands for conducting mental state or depression assessments. Initially, the EEG signal is divided into eight sub-bands, and then a Long Short-Term Memory (LSTM)-based Deep Neural Network (DNN) model is trained for each band. Subsequently, the integration of multi-band EEG frequency models and the evaluation of mental state or depression level are facilitated through a two-tier ensemble learning approach based on Multiple Linear Regression (MLR). The authors conducted numerous experiments to validate the performance of the proposed method under different evaluation metrics. For clarity and conciseness, the research employs the simplest commercialized one-channel EEG sensor, positioned at FP1, to collect data from 57 subjects (49 depressed and 18 healthy subjects). The obtained results, including an accuracy of 0.897, F1-score of 0.921, precision of 0.935, negative predictive value of 0.829, recall of 0.908, specificity of 0.875, and AUC of 0.8917, provide evidence of the superior performance of the proposed method compared to other ensemble learning techniques. This method not only proves effective but also holds the potential to significantly enhance the accuracy of depression assessment.

Efficacy and safety of intravitreal faricimab for neovascular age-related macular degeneration: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to evaluate the visual, anatomical, and safety outcomes of the intravitreal faricimab, a novel vascular endothelial growth factor (VEGF)/angiopoietin-2 (Ang-2) bispecific agent, in neovascular age-related macular degeneration (nAMD) patients. The follow-up times in the included studies ranged from a minimum of 36 weeks to a maximum of 52 weeks. EMBASE, Ovid-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Scopus, the WHO ICTRP, ClinicalTrial.gov, the EU Clinical Trials Register, and Chinese Clinical Trial Registry (ChiCTR) were searched (The last literature search was performed on August 17, 2023) for randomized controlled trials (RCTs) comparing faricimab with control groups for neovascular age-related macular degeneration (nAMD). The risk of bias for eligible RCTs was independently assessed using the Cochrane Risk of Bias Tool by two authors (W.-T.Y. and C.-S.W.). The meta-analysis was conducted using Review Manager 5.4 software. The mean best corrected visual acuity (BCVA), central subfield thickness (CST), total choroidal neovascularization (CNV) area, and total lesion leakage were analyzed as continuous variables and the outcome measurements were reported as the weighted mean difference (WMD) with a 95% confidence interval (CI). The ocular adverse events and ocular serious adverse events were analyzed as dichotomous variables and the outcome measurements were analyzed as the odds ratios (ORs) with a 95% CI. Random-effects model was used in our study for all outcome synthesizing due to different clinical characteristics. Four RCTs with 1,486 patients were eligible for quantitative analysis. There was no statistically significant difference between intravitreal faricimab and anti-VEGF in BCVA [weighted mean difference (WMD) = 0.47; 95% CI: (- 0.17, 1.11)]. The intravitreal faricimab group showed numerically lower CST [WMD = - 5.96; 95% CI = (- 7.11, - 4.82)], total CNV area [WMD = - 0.49; 95% CI = (- 0.68, - 0.30)], and total lesion leakage [WMD = - 0.88; 95% CI = (- 1.08, - 0.69)] after intravitreal therapy compared with the intravitreal anti-VEGF group. There were no statistically significant differences between intravitreal faricimab and anti-VEGF in ocular adverse events (AEs) [pooled odds ratio (OR) = 1.10; 95% CI = (0.81, 1.49)] and serious adverse events (SAEs) [pooled OR = 0.84; 95% CI = (0.37, 1.90)]. The intravitreal bispecific anti-VEGF/angiopoietin 2 (Ang2) antibody faricimab with a extended injection interval was non-inferior to first-line anti-VEGF agents in BCVA. It was safe and had better anatomical recovery. Large, well-designed RCTs are needed to explore the potential benefit of extended faricimab for nAMD. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022327450).

Fighting the Pandemic with "Shields": Successful COVID-19 Securitization and Mask Policy in Taiwan.

Facemasks have been proven an effective non-pharmaceutical measure against coronavirus disease-19. Against the backdrop of global mask shortages, Taiwan distinguished herself from other countries in that Taiwan took a whole-of-nation approach to masks and mobilized the society quickly to become self-sufficient in masks. This paper argues that successful virus securitization as a threat to national security was what enabled Taiwan to effectively mobilize the private sector to carry out the state's will in ensuring adequate mask supply. Moreover, Taiwan securitized the virus more successfully than many other countries because the virus was connected to China, the nation's existing security threat.

The imperative of state capacity in public health crisis: Asia's early COVID-19 policy responses.

Preexisting political institutions influence governments' responses to public health crises in different ways, creating national variations. This article investigates how state capacity, a country's fundamental ability to organize bureaucracy and allocate societal resources, affects the timing and configuration of governments' COVID-19 policy responses. Through comparative case study analysis of five of China's neighboring countries early in the COVID-19 crisis, the paper shows that more-capable states (Singapore, South Korea, Taiwan) initiated crisis response faster, mobilized national resources more extensively, and utilized diverse policy tools when the virus risk level was still low. In contrast, low-capacity states (Thailand and Indonesia) were more reactive in handling the crisis, limited their focus to border-related measures, and were more constrained in the types of tools they could employ. The paper points to the importance of studying the COVID-19 response process rather than the outcome (i.e., confirmed cases/deaths) when unpacking the impacts of political institutions in public health crises.

Crafting Compliance Regime under COVID-19: Using Taiwan's Quarantine Policy as a Case Study.

One year after the World Health Organization declared COVID-19 a global pandemic, governments around the world adopt similar practices in containing the COVID-19 spread. Nevertheless, variation exists in the level of policy compliance, which directly contribute to policy success/failure across countries. As the pandemic continues, pandemic fatigue also decreases the public's willingness to comply. Increasing policy compliance during the remainder of pandemic has become a transnational concern. Using Taiwan's quarantine policy as an example, this article illustrates three aspects to craft an effective compliance regime to fight public health crises like COVID-19: (1) a comprehensive policy mix to reduce heterogeneous compliance barriers that impact different social groups; (2) constant and various policy communication with heterogeneous target audiences; and (3) leveraging and integrating street-level bureaucrats in the policy implementation stages. Taiwan's case provides several policy lessons for other countries: compliance regime is not driven by top-down enforcement but through the integration of policy design and implementation that remove all barriers for compliance. Taiwan's street level bureaucrats are the glue of the compliance regime. This article bears policy implications for policy makers around the world when aiming for increasing policy compliance.

Perioperative Pregabalin for Preventive Analgesia in Breast Cancer Surgery: A Meta-analysis of Randomized Controlled Trials.

OBJECTIVES: Pregabalin is a drug for neuropathic pain. Antipronociceptive properties of pregabalin have led to its recent use as an adjuvant to the multimodal postoperative pain regimen. This meta-analysis was conducted to evaluate the efficacy of perioperative pregabalin on acute and chronic postsurgical pain (CPSP) after breast cancer surgery. METHODS: A meta-analysis including 8 randomized controlled trials searched from MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted. Subgroup analysis was performed according to doses and timecourse of pregabalin administration. Review Manager 5.3 was selected to conduct the meta-analysis. RESULTS: Preoperative pregabalin in breast cancer surgery alleviated acute postoperative pain at rest 24 hours after surgery by 0.31 points on an 0 to 10 Numerical Rating Scale (95% confidence interval [CI] -0.57 to -0.05). Morphine consumption showed a decrease in postoperative use by 1.09 mg (95% CI: -1.61 to -0.57). The incidence of CPSP 3 months after surgery was reduced to 46% (95% CI: 0.25-0.85). Postoperative nausea and vomiting, dizziness, and sedation showed no overall significant reductions. However, a decrease in the incidence of postoperative nausea and vomiting and an increase in the incidence of dizziness were noted when patients received 300 mg of pregabalin before surgery. DISCUSSION: This study demonstrated that pregabalin showed more efficacy on chronic pain than acute pain after a breast cancer surgery. Further study based on doses and treatment course of pregabalin should be conducted to establish stronger evidence of treatment effects.

Collaborating with radiographers to address their work-related musculoskeletal discomfort.

The prevalence of musculoskeletal (MSK) symptoms in radiographers is high, similar to other healthcare occupations that involve high levels of physical exertion (e.g. patient handling; grasping and moving equipment). Reports of interventions to reduce MSK discomfort in radiographers are limited. A participatory approach was used to investigate daily challenges, needs, and opportunities for developing interventions to address exposures to many of the risk factors that contribute to MSK symptoms in radiographers. In this paper, we present the expressed needs of experienced radiographers (including assistance with patient handling, security, supportive design of equipment and work spaces), along with their evaluations of several intervention concepts intended to address some of those needs. We also report results from tests of three prototype interventions stemming from this participatory process that demonstrate the potential for new engineering control concepts to reduce the physical effort associated with some of the most common tasks radiographers perform.

Collaborating with mammographers to address their work-related musculoskeletal discomfort.

Mammographers are an understudied group of health care workers, yet the prevalence of musculoskeletal (MSK) symptoms in mammographers appears to be elevated, similar to many occupations in health care. In this study, we used a participatory approach to identify needs and opportunities for developing interventions to reduce mammographers' exposures to risk factors that lead to the development of MSK symptoms. In this paper, we present a number of those needs and several intervention concepts along with evaluations of those concepts from experienced mammographers. We include findings from a preliminary field test of a novel intervention concept to reduce the need to adopt awkward postures while positioning patients for a screening or diagnostic mammogram. Practitioner Summary: This paper discusses needs, opportunities and methods for working with mammographers in order to develop interventions to reduce their exposure to risk factors for work-related musculoskeletal discomfort. Results from a field test of a novel intervention to reduce mammographers' awkward work postures while positioning patients are presented.

Evaluation of jar lid design characteristics by older women with hand use limitations.

The study evaluated several lid design characteristics (diameter, height, top shape, side shape, and surface texture) by means of controlled laboratory testing with older women with hand function limitations. A subjective evaluation process was applied to examine main effects and interactions of lid design characteristics on usability, determined by participants' perceptions of effort and discomfort. Results showed that lid height was the most important design characteristic associated with usability. For 42 mm diameter lids, designs perceived as best were ones with taller height, hexagonal top shape, and convex side shape. For 28 mm diameter lids, the best designs were ones with taller height and hexagonal top shape. Additionally, when the smaller lid's side shape was flat, a serrate surface texture provided some advantages, particularly for subjects with more severe hand dysfunction. This information could be used by package designers to improve jar lid usability for a growing sector of consumers.

Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions.

For more than two decades, surveys of imaging technologists, including cardiac sonographers, diagnostic medical sonographers and vascular technologists, have consistently reported high prevalence of work-related musculoskeletal discomfort (WRMSD). Yet, intervention research involving sonographers is limited. In this study, we used a participatory approach to identifying needs and opportunities for developing interventions to reduce sonographers' exposures to WRMSD risk factors. In this paper, we present some of those needs. We include descriptions of two interventions, targeted for cardiac sonographers, that were developed, through an iterative process, into functional prototypes that were evaluated in pilot tests by practicing sonographers. One of these interventions is now in daily use. We would like other engineers and ergonomists to recognise this area of opportunity to apply their knowledge of biomechanics and design in order to begin to address the high prevalence of WRMSDs in sonographers, by working with sonographers to develop useful and usable interventions. Practitioner Summary: This paper discusses needs, opportunities and methods for working with sonographers in order to develop interventions to reduce their exposure to risk factors for work-related musculoskeletal discomfort. Results from field tests of two novel interventions targeting cardiac sonographers are also presented.

Preference of lid design characteristics by older adults with limited hand function.

INTRODUCTION: Although opening jars is problematic for older adults, little is known about the best interface design for jar lids. PURPOSE OF THE STUDY: To evaluate preferences in current and new lids for persons self-reporting difficulty with opening jars. METHODS: Participants were twenty-six older females with hand pain. Preference ratings were obtained for twenty-four current and forty-two new lid designs of different sizes, shapes, and textures. RESULTS: Current lids with taller heights, larger diameters, and textured sides were preferred. Texture compensated for limitations of shorter and smaller diameter lids. Preferred characteristics in new smaller diameter lids included taller height, non-circular top shapes, and concave side shapes. Taller height, regardless of shape, was preferred for new medium diameter lids. Least preferred for small and medium lids was the short height, traditional circular shape. CONCLUSIONS: The preferences of jar lids made by elderly females with hand pain support the recommendations commonly suggested by clinicians to increase the height, diameter, texture, and shape of jars, especially for lids smaller than 40 mm.

Empowering elderly women with osteoarthritis through hands-on exploration of adaptive equipment concepts.

The study investigated the participation experiences of elderly women with hand limitations in a maketools-inspired activity for improving bottle openability and verified the usefulness of the results from this approach. Participatory design was used to stimulate participants' hands-on fabrication of new bottle lid concepts. Air-dry modeling clay, Crayola Model Magic® (Crayola LLC, 1100 Church Lane Easton, PA 18044-0431), clay modeling tools sets and empty bottles were the tools used to explore feasible and user-envisioned ideal lids that could potentially reduce hand pain and improve function when opening bottles. Twenty-five elderly women fully participated in the study. They generated 36 bottle lid design concepts. Qualitative analysis identified inclusion of four primary design features as follows: 1) surface texture; 2) increased leverage through lid shape or diameters; 3) increased contact surface with palm/fingers through lid shape or height; and 4) facilitation of alternative grip types. The major limitations of the study were inclusion of only women participants and healthier persons living in a retirement community. Future research is needed to investigate the bottle lid preferences of men and persons with more severe hand function living in places other than independent living communities.