ABSTRACT
BACKGROUND: Mental disorders have ranked among the top 10 prevalent causes of burden on a global scale. Generative artificial intelligence (GAI) has emerged as a promising and innovative technological advancement that has significant potential in the field of mental health care. Nevertheless, there is a scarcity of research dedicated to examining and understanding the application landscape of GAI within this domain. OBJECTIVE: This review aims to inform the current state of GAI knowledge and identify its key uses in the mental health domain by consolidating relevant literature. METHODS: Records were searched within 8 reputable sources including Web of Science, PubMed, IEEE Xplore, medRxiv, bioRxiv, Google Scholar, CNKI and Wanfang databases between 2013 and 2023. Our focus was on original, empirical research with either English or Chinese publications that use GAI technologies to benefit mental health. For an exhaustive search, we also checked the studies cited by relevant literature. Two reviewers were responsible for the data selection process, and all the extracted data were synthesized and summarized for brief and in-depth analyses depending on the GAI approaches used (traditional retrieval and rule-based techniques vs advanced GAI techniques). RESULTS: In this review of 144 articles, 44 (30.6%) met the inclusion criteria for detailed analysis. Six key uses of advanced GAI emerged: mental disorder detection, counseling support, therapeutic application, clinical training, clinical decision-making support, and goal-driven optimization. Advanced GAI systems have been mainly focused on therapeutic applications (n=19, 43%) and counseling support (n=13, 30%), with clinical training being the least common. Most studies (n=28, 64%) focused broadly on mental health, while specific conditions such as anxiety (n=1, 2%), bipolar disorder (n=2, 5%), eating disorders (n=1, 2%), posttraumatic stress disorder (n=2, 5%), and schizophrenia (n=1, 2%) received limited attention. Despite prevalent use, the efficacy of ChatGPT in the detection of mental disorders remains insufficient. In addition, 100 articles on traditional GAI approaches were found, indicating diverse areas where advanced GAI could enhance mental health care. CONCLUSIONS: This study provides a comprehensive overview of the use of GAI in mental health care, which serves as a valuable guide for future research, practical applications, and policy development in this domain. While GAI demonstrates promise in augmenting mental health care services, its inherent limitations emphasize its role as a supplementary tool rather than a replacement for trained mental health providers. A conscientious and ethical integration of GAI techniques is necessary, ensuring a balanced approach that maximizes benefits while mitigating potential challenges in mental health care practices.
ABSTRACT
PURPOSE: Dementia is common among patients with primary open angle glaucoma (POAG) and neovascular age-related macular degeneration (nAMD). This study compares visit frequency, diagnostic test utilization, and treatment patterns for POAG and nAMD among persons with vs. without dementia. METHODS: Optum's de-identified Clinformatics® Data Mart Database (January 1, 2000-June 30, 2022) was used for this study. Two cohorts were created from newly diagnosed POAG or nAMD patients. Within each cohort, an exposure cohort was created of newly diagnosed dementia patients. The primary outcome was the number of visits to an eye care provider. Secondary analyses for the POAG cohort assessed the number of visual field tests, optical coherence tomography (OCT), and glaucoma medication prescription coverage. The secondary analysis for the nAMD cohort included the number of injections performed. Poisson regression was used to determine the relative rates of outcomes. RESULTS: POAG patients with dementia had reduced rates of eye care visits (RR 0.76, 95% CI: 0.75-0.77), lower rates of testing utilization for visual fields (RR 0.66, 95% CI: 0.63-0.68) and OCT (RR 0.67, 95% CI: 0.64-0.69), and a lower rate of glaucoma prescription medication coverage (RR 0.83, 95% CI: 0.83-0.83). nAMD patients with dementia had reduced rates of eye care visits (RR 0.74, 95% CI: 0.70-0.79) and received fewer intravitreal injections (RR 0.64, 95% CI: 0.58-0.69) than those without dementia. CONCLUSIONS: POAG and nAMD patients with dementia obtained less eye care and less monitoring and treatment of their disease. These findings suggest that this population may be vulnerable to gaps in ophthalmic care.
ABSTRACT
BACKGROUND: Unanticipated postoperative thrombotic complications can occur in complex patients who receive preoperative epidurals. Therefore, it is imperative that we consider the risks and benefits of epidural management in the setting of therapeutic anticoagulation. We present a case of epidural catheter removal on a heparin infusion, due to the extreme risk of holding anticoagulation for any duration. CASE REPORT: A woman with hilar cholangiocarcinoma presented after uncomplicated hepatectomy, bile duct resection and hepaticojejunostomy, with a thoracic epidural for analgesia. On postoperative day 1, she developed a total portal vein thrombosis, requiring emergent open thrombectomy, transhepatic stenting and high-dose heparin infusion while the epidural was indwelling. The patient was deemed to have a profound risk of re-thrombosis if heparin were paused. Therefore, a multidisciplinary discussion between hepatobiliary surgery, critical care, neurosurgery, haematology, acute pain service and the patient's family ensued regarding epidural management. Options included catheter-directed thrombolytics to her stent while holding systemic anticoagulation, sterilely leaving the epidural catheter in place indefinitely, injecting prothrombotic agent into the epidural prior to removal, or removing the catheter without holding anticoagulation. Due to the risk of re-thrombosis in the portal vein and liver infarction, the heparin infusion was decreased to achieve the lowest therapeutic anti-Xa level, and the epidural was removed. The patient was continuously monitored in the intensive care unit without any adverse events. CONCLUSION: A multidisciplinary discussion is paramount to weigh the risk of epidural haematoma if a catheter is removed on therapeutic anticoagulation against catastrophic thrombosis if anticoagulation is paused.
ABSTRACT
BACKGROUND: The decline in global child mortality is an important public health achievement, yet child mortality remains disproportionally high in many low-income countries like Guinea-Bissau. The persisting high mortality rates necessitate targeted research to identify vulnerable subgroups of children and formulate effective interventions. OBJECTIVE: This study aimed to discover subgroups of children at an elevated risk of mortality in the urban setting of Bissau, Guinea-Bissau, West Africa. By identifying these groups, we intend to provide a foundation for developing targeted health interventions and inform public health policy. METHODS: We used data from the health and demographic surveillance site, Bandim Health Project, covering 2003 to 2019. We identified baseline variables recorded before children reached the age of 6 weeks. The focus was on determining factors consistently linked with increased mortality up to the age of 3 years. Our multifaceted methodological approach incorporated spatial analysis for visualizing geographical variations in mortality risk, causally adjusted regression analysis to single out specific risk factors, and machine learning techniques for identifying clusters of multifactorial risk factors. To ensure robustness and validity, we divided the data set temporally, assessing the persistence of identified subgroups over different periods. The reassessment of mortality risk used the targeted maximum likelihood estimation (TMLE) method to achieve more robust causal modeling. RESULTS: We analyzed data from 21,005 children. The mortality risk (6 weeks to 3 years of age) was 5.2% (95% CI 4.8%-5.6%) for children born between 2003 and 2011, and 2.9% (95% CI 2.5%-3.3%) for children born between 2012 and 2016. Our findings revealed 3 distinct high-risk subgroups with notably higher mortality rates, children residing in a specific urban area (adjusted mortality risk difference of 3.4%, 95% CI 0.3%-6.5%), children born to mothers with no prenatal consultations (adjusted mortality risk difference of 5.8%, 95% CI 2.6%-8.9%), and children from polygamous families born during the dry season (adjusted mortality risk difference of 1.7%, 95% CI 0.4%-2.9%). These subgroups, though small, showed a consistent pattern of higher mortality risk over time. Common social and economic factors were linked to a larger share of the total child deaths. CONCLUSIONS: The study's results underscore the need for targeted interventions to address the specific risks faced by these identified high-risk subgroups. These interventions should be designed to work to complement broader public health strategies, creating a comprehensive approach to reducing child mortality. We suggest future research that focuses on developing, testing, and comparing targeted intervention strategies unraveling the proposed hypotheses found in this study. The ultimate aim is to optimize health outcomes for all children in high-mortality settings, leveraging a strategic mix of targeted and general health interventions to address the varied needs of different child subgroups.
Subject(s)
Machine Learning , Public Health , Child , Humans , Infant , Child, Preschool , Guinea-Bissau/epidemiology , Cohort Studies , GeographyABSTRACT
BACKGROUND: This study aimed to evaluate the cost-effectiveness of a telehealth coaching intervention to prevent gestational diabetes mellitus (GDM) and to calculate the breakeven point of preventing GDM. METHODS: Data to inform the economic evaluation model was sourced directly from the large quaternary hospital in Brisbane, where the Living Well during Pregnancy (LWdP) program was implemented, and further supplemented with literature-based estimates where data had not been directly collected in the trial. A cost-effectiveness model was developed using a decision tree framework to estimate the potential for cost savings and quality of life improvement. A total of 1,315 pregnant women (49% with a BMI 25-29.9, and 51% with a BMI ≥ 30) were included in the analyses. RESULTS: The costs of providing routine care and routine care plus LWdP coaching intervention to pregnant women were calculated to be AUD 20,933 and AUD 20,828, respectively. The effectiveness of the LWdP coaching program (0.894 utility) was slightly higher compared to routine care (0.893). Therefore, the value of the incremental cost-effectiveness ratio (ICER) was negative, and it indicates that the LWdP coaching program is a dominant strategy to prevent GDM in pregnant women. We also performed a probabilistic sensitivity analysis using Monte Carlo simulation through 1,000 simulations. The ICE scatter plot showed that the LWdP coaching intervention was dominant over routine care in 93.60% of the trials using a willingness to pay threshold of AUD 50,000. CONCLUSION: Findings support consideration by healthcare policy and decision makers of telehealth and broad-reach delivery of structured lifestyle interventions during pregnancy to lower short-term costs associated with GDM to the health system.
ABSTRACT
BACKGROUND: The COVID-19 pandemic triggered unprecedented global vaccination efforts, with social media being a popular tool for vaccine promotion. OBJECTIVE: This study probes into Macao's COVID-19 vaccine communication dynamics, with a focus on the multifaceted impacts of government agendas on social media. METHODS: We scrutinized 22,986 vaccine-related Facebook posts from January 2020 to August 2022 in Macao. Using automated content analysis and advanced statistical methods, we unveiled intricate agenda dynamics between government and nongovernment entities. RESULTS: "Vaccine importance" and "COVID-19 risk" were the most prominent topics co-occurring in the overall vaccine communication. The government tended to emphasize "COVID-19 risk" and "vaccine effectiveness," while regular users prioritized vaccine safety and distribution, indicating a discrepancy in these agendas. Nonetheless, the government has limited impact on regular users in the aspects of vaccine importance, accessibility, affordability, and trust in experts. The agendas of government and nongovernment users intertwined, illustrating complex interactions. CONCLUSIONS: This study reveals the influence of government agendas on public discourse, impacting environmental awareness, public health education, and the social dynamics of inclusive communication during health crises. Inclusive strategies, accommodating public concerns, and involving diverse stakeholders are paramount for effective social media communication during health crises.
Subject(s)
COVID-19 , Social Media , Humans , COVID-19 Vaccines , Macau , Pandemics/prevention & control , COVID-19/prevention & control , GovernmentABSTRACT
OBJECTIVE: Amid ongoing medication safety concerns in China and limited research on public perceptions, this study investigates the correlations between media exposure, healthcare experiences, and individuals' perceptions of medication safety. It also examines individuals' reliance on information sources during safety crises. METHODS: A multistage stratified random sampling was employed with the gross sample containing 3090 Chinese adults aged 18-60 years. Data were analyzed using multiple linear regression. RESULTS: Social media exposure was found to negatively correlate with perceptions of current medication safety and its perceived improvement, while exposure to television and print media showed positive correlations. Positive healthcare experiences were associated with improved medication safety perceptions. Among various information sources, healthcare professionals were deemed most trustworthy during medication safety incidents. CONCLUSIONS: Media exposure and personal healthcare experiences significantly shape individuals' perceptions of medication safety in China, with healthcare professionals playing a crucial role in this context. Practiceimplications: Effective health crisis communication in China needs to be multifaceted, integrating traditional media and social media platforms to disseminate accurate information broadly. Additionally, healthcare professionals should be actively involved in crisis communication. Their role as trusted sources can be leveraged to clarify misconceptions, and reassure the public during medication safety incidents.
Subject(s)
Health Communication , Social Media , Adult , Humans , Media Exposure , Mass Media , China , Delivery of Health CareABSTRACT
BACKGROUND: We review the literature on the social impacts of diseases, defined as the social consequences of having a disease on the people around the patient, such as spouses, caregivers and offspring. The two objectives of this study are to summarise the social outcomes commonly associated with diseases and to compare the social impact across a range of diseases. METHODS: A systematic review of the social impact of disease in Nordic countries was conducted using PubMed, PsycINFO and Google Scholar (PROSPERO registration number CRD42022291796). All articles that met the inclusion criteria were reviewed. We tabulated all outcomes and diseases studied, and synthesised the evidence based on the perspectives of patients, spouse/caregiver and offspring. RESULTS: A total of 135 studies met the eligibility criteria, covering 76 diseases and 39 outcomes. From the patient's perspective, diseases impact divorce and marriage rates, social functioning, likelihood of committing a crime and being a victim of crime. From the caregiver's perspective, diseases affect their health-related quality of life and physical and psychological health. From the offspring's perspective, diseases impact their development, health and social adversities in later life. Diseases generally had negative social impacts, but there were some diseases associated with positive impacts. CONCLUSIONS: The review provides a useful summary and gross comparison of the social impact of different diseases. The social impact of diseases can be large and significant. Thus, it should be considered when policymakers are setting priorities across disease areas.
ABSTRACT
BACKGROUND: Economic burden studies can provide insights into the drivers leading to increasing healthcare costs. It can also provide a more holistic view of how diseases impact the welfare of patients and their families. Having concrete estimates of the economic burden across multiple diseases can help policymakers determine which diseases are economically more burdensome. This study aimed to review and summarise comprehensively economic burden studies across multiple diseases in the Nordic countries between 2000 and 2020. METHODS: According to the 2020 PRISMA statement, a systematic literature review was conducted in PubMed, CINAHL, Academic Search Premier and Global Health databases using key terms related to the economic burden of any disease in Denmark, Finland, Greenland, Iceland, Norway and Sweden. Grey literature was also reviewed. RESULTS: A total of 10,050 potential titles and abstracts were identified and screened, and 254 full-text papers that met the inclusion criteria were evaluated by two independent reviewers. Of these, 119 articles were included in a qualitative synthesis. Twenty-nine had clearly defined comparison groups, thus able to attribute the costs to the disease. Large variations concerning methodology and cost components were noted. Across diseases, the economic burden ranged from EUR 1668 per patient annually for chronic obstructive pulmonary disease to EUR 93,041 for multiple sclerosis. However, estimates varied widely, even within each disease. CONCLUSIONS: Our review highlights the need for more comparable economic burden studies. Future studies should focus on applying robust methodology and homogeneous cost-reporting methods to inform policymakers about which diseases are economically more burdensome.
Subject(s)
Cost of Illness , Health Care Costs , Humans , Norway , Scandinavian and Nordic Countries/epidemiologyABSTRACT
BACKGROUND: Generation Z (born 1995-2010) members are digital residents who use technology and the internet more frequently than any previous generation to learn about their health. They are increasingly moving away from conventional methods of seeking health information as technology advances quickly and becomes more widely available, resulting in a more digitalized health care system. Similar to all groups, Generation Z has specific health care requirements and preferences, and their use of technology influences how they look for health information. However, they have often been overlooked in scholarly research. OBJECTIVE: First, we aimed to identify the information-seeking preferences of older individuals and Generation Z (those between the ages of 18 and 26 years); second, we aimed to predict the effects of digital health literacy and health empowerment in both groups. We also aimed to identify factors that impact how both groups engage in digital health and remain in control of their own health. METHODS: The Health Information National Trends Survey was adopted for further use in 2022. We analyzed 1862 valid data points by conducting a survey among Chinese respondents to address the research gap. A descriptive analysis, 2-tailed t test, and multiple linear regression were applied to the results. RESULTS: When compared with previous generations, Generation Z respondents (995/1862, 53.44%) were more likely to use the internet to find out about health-related topics, whereas earlier generations relied more on traditional media and interpersonal contact. Web-based information-seeking behavior is predicted by digital health literacy (Generation Z: ß=.192, P<.001; older population: ß=.337, P<.001). While this was happening, only seeking health information from physicians positively predicted health empowerment (Generation Z: ß=.070, P=.002; older population: ß=.089, P<.001). Despite more frequent use of the internet to learn about their health, Generation Z showed lower levels of health empowerment and less desire to look for health information, overall. CONCLUSIONS: This study examined and compared the health information-seeking behaviors of Generation Z and older individuals to improve their digital health literacy and health empowerment. The 2 groups demonstrated distinct preferences regarding their choice of information sources. Health empowerment and digital health literacy were both significantly related to information-seeking behaviors.
Subject(s)
Health Literacy , Telemedicine , Humans , Adolescent , Young Adult , Adult , Information Seeking Behavior , Health Literacy/methods , Cross-Sectional Studies , Telemedicine/methods , Surveys and Questionnaires , Internet , Power, PsychologicalABSTRACT
Giant cell tumor of the tendon sheath (GCTTS) is a common mass in the digits, hands, and upper extremities. Diagnosis is made on clinical examination, adjunctive imaging, and distinct intraoperative findings. Surgical excision is the mainstay of treatment. GCTTS are typically found on flexor surfaces with the dorsal distal thumb being an unusual location. Any surgical approach to the digit should balance oncologic margins with preserving function. GCTTS have a tendency to recur and should be approached in a methodical manner with risk factors of recurrence in mind. This case report reviews the history of GCTTS, surgical approaches to the digit, and risk factors for recurrence to achieve success in the surgical management of these tumors.
ABSTRACT
BACKGROUND: The rise in health spending in the United States and the prevalence of multimorbidity-having more than one chronic condition-are interlinked but not well understood. Multimorbidity is believed to have an impact on an individual's health spending, but how having one specific additional condition impacts spending is not well established. Moreover, most studies estimating spending for single diseases rarely adjust for multimorbidity. Having more accurate estimates of spending associated with each disease and different combinations could aid policymakers in designing prevention policies to more effectively reduce national health spending. This study explores the relationship between multimorbidity and spending from two distinct perspectives: (1) quantifying spending on different disease combinations; and (2) assessing how spending on a single diseases changes when we consider the contribution of multimorbidity (i.e., additional/reduced spending that could be attributed in the presence of other chronic conditions). METHODS AND FINDINGS: We used data on private claims from Truven Health MarketScan Research Database, with 16,288,894 unique enrollees ages 18 to 64 from the US, and their annual inpatient and outpatient diagnoses and spending from 2018. We selected conditions that have an average duration of greater than one year among all Global Burden of Disease causes. We used penalized linear regression with stochastic gradient descent approach to assess relationship between spending and multimorbidity, including all possible disease combinations with two or three different conditions (dyads and triads) and for each condition after multimorbidity adjustment. We decomposed the change in multimorbidity-adjusted spending by the type of combination (single, dyads, and triads) and multimorbidity disease category. We defined 63 chronic conditions and observed that 56.2% of the study population had at least two chronic conditions. Approximately 60.1% of disease combinations had super-additive spending (e.g., spending for the combination was significantly greater than the sum of the individual diseases), 15.7% had additive spending, and 23.6% had sub-additive spending (e.g., spending for the combination was significantly less than the sum of the individual diseases). Relatively frequent disease combinations (higher observed prevalence) with high estimated spending were combinations that included endocrine, metabolic, blood, and immune disorders (EMBI disorders), chronic kidney disease, anemias, and blood cancers. When looking at multimorbidity-adjusted spending for single diseases, the following had the highest spending per treated patient and were among those with high observed prevalence: chronic kidney disease ($14,376 [12,291,16,670]), cirrhosis ($6,465 [6,090,6,930]), ischemic heart disease (IHD)-related heart conditions ($6,029 [5,529,6,529]), and inflammatory bowel disease ($4,697 [4,594,4,813]). Relative to unadjusted single-disease spending estimates, 50 conditions had higher spending after adjusting for multimorbidity, 7 had less than 5% difference, and 6 had lower spending after adjustment. CONCLUSIONS: We consistently found chronic kidney disease and IHD to be associated with high spending per treated case, high observed prevalence, and contributing the most to spending when in combination with other chronic conditions. In the midst of a surging health spending globally, and especially in the US, pinpointing high-prevalence, high-spending conditions and disease combinations, as especially conditions that are associated with larger super-additive spending, could help policymakers, insurers, and providers prioritize and design interventions to improve treatment effectiveness and reduce spending.
Subject(s)
Myocardial Ischemia , Neoplasms , Renal Insufficiency, Chronic , Humans , Adult , United States/epidemiology , Adolescent , Young Adult , Middle Aged , Multimorbidity , Chronic Disease , PrevalenceABSTRACT
BACKGROUND: Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns. METHODS: A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI). RESULTS: The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (bp = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (cp = 20%), while the direct-and-remainder path contributes the rest (cp = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential bp = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential bp = .32). CONCLUSIONS: Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.
Subject(s)
Diet, Healthy , Weight Loss , Humans , Adult , Body Mass Index , Nutritional Status , Personal Satisfaction , Feeding Behavior , EatingABSTRACT
BACKGROUND: People tend to overestimate their expectations for weight loss relative to what is achievable in a typical evidence-based behavioral weight management program, which can impact treatment satisfaction and outcomes. We are engaged in formative research to design a digital intervention that addresses binge eating and weight management; thus, understanding expectations among this group can inform more engaging intervention designs to produce a digital intervention that can achieve greater clinical success. Studies examining weight loss expectations have primarily focused on people who have overweight or obesity. Only one study has investigated weight loss expectations among people with binge eating disorder, a population that frequently experiences elevated weight and shape concerns and often presents to treatment with the goal of losing weight. OBJECTIVE: The aim of the study is to investigate differences in weight loss expectations among people with varying levels of binge eating to inform the design of a digital intervention for binge eating and weight management. Such an evaluation may be crucial for people presenting for a digital intervention, given that engagement and dropout are notable problems for digital behavior change interventions. We tested the hypotheses that (1) people who endorsed some or recurrent binge eating would expect to lose more weight than those who did not endorse binge eating and (2) people who endorsed a more severe versus a low or moderate overvaluation of weight and shape would have higher weight loss expectations. METHODS: A total of 760 adults (n=504, 66% female; n=441, 58% non-Hispanic White) completed a web-based screening questionnaire. One-way ANOVAs were conducted to explore weight loss expectations for binge eating status as well as overvaluation of shape and weight. RESULTS: Weight loss expectations significantly differed by binge eating status. Those who endorsed some and recurrent binge eating expected to lose more weight than those who endorsed no binge eating. Participants with severe overvaluation of weight or shape expected to lose the most weight compared to those with low or moderate levels of overvaluation of weight and shape. CONCLUSIONS: In the sample, people interested in a study to inform a digital intervention for binge eating and weight management overestimated their expectations for weight loss. Given that weight loss expectations can impact treatment completion and success, it may be important to assess and modify weight loss expectations among people with binge eating prior to enrolling in a digital intervention. Future work should design and test features that can modify these expectations relative to individuals' intended treatment goals to facilitate engagement and successful outcomes in a digital intervention.
ABSTRACT
Visual field tests, also known as perimetry tests, are used to assess progression of ophthalmic diseases such as retinitis pigmentosa (RP) by monitoring changes in a patient's visual field (VF). VF loss corresponds to damage at any point in the visual pathway, including the retina, such as in RP. Damage to different parts of this pathway corresponds to characteristic VF defects. Perimetry tests are subjective, as they are functional tests that help physicians identify abnormal fields as well as quantitatively assess VF sensitivity. The results may also be informative of a patient's visual function crucial for performing day-to-day activities. Automated perimetry tests are among the most commonly used, with the most common being automated static perimetry.
Subject(s)
Visual Fields , HumansABSTRACT
Retinitis pigmentosa (RP) is a heterogeneous group of hereditary retinal degenerations for which there is currently no cure. Studies investigating the use of gene therapy, gene editing, and stem cells as potential treatment strategies have shown promising results in animal models and some early clinical trials. Even still, major barriers still exist, including the ability to develop therapies that can target the wide range of mutational etiologies and phenotypic presentations that encompass RP. Additionally, effective screening and early diagnosis are crucial for maximum therapeutic potential, especially because many therapeutic agents require a baseline level photoreceptor function.
Subject(s)
Retinitis Pigmentosa , Humans , Retinitis Pigmentosa/genetics , Retinitis Pigmentosa/therapy , Genetic Therapy , Cell- and Tissue-Based TherapyABSTRACT
Background: The city-wide COVID-19 lockdown has resulted in psychological anguish, which may have an impact on dietary consumption. This study's dual goals are to show how Chinese food consumption was altered before and after the lockdown, and to examine the nutrient density for the psychologically affected group. Methods: A cross-sectional study involving 652 people from Mainland China, Taiwan, and Macao was conducted with the aid of a web-based questionnaire. Sociodemographic characteristics, related environmental factors, nutrient consumption, food recommendations, and psychological distress were all measured. 516 trustworthy data revealed that two nutrient-poor foods were consumed less frequently during the lockdown than they were before to the COVID-19 outbreak (i.e., salty snacks and alcoholic beverages). People who endured high levels of psychological distress in particular tended to consume more. Particularly, those who experienced high levels of psychological distress had a tendency to consume far more alcohol than people who only experienced low levels of stress. Comparing the time before the COVID-19 to the present, there has statistically been an increase in the frequency of family members recommending diets. According to research, by food advice, individuals who experience psychological distress should consume more nutrient-dense foods (78.7%) than nutrient-poor ones (61.9%). Thus, food advice plays a role in mediating the relationship between psychological distress and dietary decisions for nutrient-rich (b = 0.186, p < 0.001) or nutrient-poor (b = 0.187, p < 0.001) food groups. This study provides insights for lowering psychological distress through dietary consumption, where the exact mechanisms underlying these connections have not been thoroughly elucidated. It encourages nutrition research by recommending practical nutrition education from family and environmental activities. Chronic psychological anguish may have a crucial relationship to secure access to food and a balanced diet. Along with nutrition instruction, it is critical to develop skills in interventions such as food procurement and culinary knowledge.