Patient satisfaction and follow-up adherence to glaucoma case management clinic in China

AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.

Loss to Specialized Cardiology Follow-Up in Adults Living with Congenital Heart Disease

Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.

Factors associated with non-adherence to scheduled medical follow-up appointments among Cameroonian children requiring HIV care: a case-control analysis of the usual-care group in the MORE CARE trial

Background:A better understanding of why HIV-exposed/infected children fail to attend their scheduled follow-up medical appointments for HIV-related care would allow for interventions to enhance the delivery of care.The aim of this study was to determine characteristics of the caregiver-child dyad(CCD)associated with children’s non-adherence to scheduled follow-up medical appointments in HIV programs in Cameroon.Methods:We conducted a case-control analysis of the usual-care group of CCDs from the MORE CARE trial,in which the effect of mobile phone reminders for HIV-exposed/infected children in attending follow-up appointments was assessed from January to March 2013.For this study,the absence of a child at their appointment was considered a case and the presence of a child at their appointment was defined as a control.We used three multivariate binary logistic regression analyses.The best-fit model was the one which had the smallest chi-square value with the Hosmer-Lemeshow test(HLχ^(2)).Magnitudes of associations were expressed by odds ratio(OR),with a p-value<0.05 considered as statistically significant.Results:We included 30 cases and 31 controls.Our best-fit model which considered the sex of the adults and children separately(HLχ^(2)=3.5)showed that missing scheduled medical appointments was associated with:lack of formal education of the caregiver(OR 29.1,95%CI 1.1-777.0;p=0.044),prolonged time to the next appointment/follow-up(OR[1 week increase]1.4,95%CI 1.03-2.0;p=0.032),and being a female child(OR 5.2,95%CI 1.2-23.1;p=0.032).One model(HLχ^(2)=10.5)revealed that woman-boy pairs adhered less to medical appointments compared to woman-girl pairs(OR 4.9,95%CI 1.05-22.9;p=0.044).Another model(HLχ^(2)=11.1)revealed that man-boy pairs were more likely to attend appointments compared to woman-girl pairs(OR 0.23,95%CI 0.06-0.93;p=0.039).There were no statistical associations for the ages of the children or the caregivers,the study sites,or the HIV status(confirmed vs.suspected)of the children.Conclusion:The profile of children who would not attend follow-up medical appointments in an HIV program was:a female,with a caregiver who has had no formal education,and with a longer follow-up appointment interval.There is a possibility that female children are favored by female caregivers and that male children are favored by male caregivers when they come to medical care.

Essential role of postoperative follow-up in the management of clear cell sarcoma

Clear cell sarcoma(CCS)is a rare melanocytic soft tissue sarcoma known for itspropensity to metastasize to the lymph nodes and typically has an unfavorableprognosis.Currently,surgical resection is the primary treatment for localizedCCS,while radiotherapy and chemotherapy are preferred for metastatic cases.The roles of adjuvant chemotherapy,radiotherapy,and lymph node dissection arecontroversial.Although immunotherapy has emerged as a promising avenue inCCS treatment research,there are no established clinical standards for postoperativefollow-up.This editorial discusses a recent article by Liu et al,with afocus on current diagnostic modalities,treatment approaches,and the challengingprognosis associated with CCS.Our aim is to underscore the importance of longtermpatient follow-up in CCS management.

Visual analysis of shared medical appointments based on CiteSpace

Objective:Analyze the research hotspots and frontiers of shared outpatient service,and provide a reference for researchers in this field to carry out follow-up research.Methods:Search the Web of Science core collection database until 2022 and visually analyzekeywords in this field through CiteSpace5.8.R3 software,Results:A total of 261 iteratures were included.The research focuses mainly on advanced care planning,diabetes care,andgroup prenatal care,The research trend tends to be telemedicine and nursing provided by specialized nurses.Conclusion:Scholars can learn from the research hotspots of foreign shared medical appointments,pay attention to the research trend,expand its application scope in combination with China's national conditions,and further promote thedevelopment of shared medical appointments in China.

Long-term assessment of collagenase treatment for Dupuytren’s contracture:A 10-year follow-up study

BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.

Environmental Impact Assessment Follow-Up of Seismic Survey Offshore Activities in Brazil

Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.

Appointment scheduling with customer impatience based on operating cost model

An appointment scheduling problem is studied with the consideration of customer impatience.On the assumption that both the time of leaving queue and the time of service are exponentially distributed,in order to minimize the joint cost,the optimal appointment schedule of the fixed number of customers is studied.The joint cost function is composed of customers expected delay time and service availability time.The expected delay time of each customer in the queue is recursively computed in terms of customer interarrival time.Furthermore,the effect of impatience on the optimal schedule as well as the total operating cost is studied.The results show that as the impatience rate increases,the optimal interarrival time becomes shorter and the interarrival time of the last few customers gradually approaches that of the customers in the middle.In addition,impatient behaviors can increase the joint cost.

Design and Implementation of Clinic Appointment Registration System

Clinic Appointment Registration System is an important way to see a doctor, and it’s also a preliminary tool for storage and management of clinic medical records. This new system was developed using Visual Studio 2008 and C#.NET as the development environment and tools and Microsoft Access 2003 as the database to store the medical data based on Browse/Server (B/S) model. The system consists of several data operation functions including appointment registration, data management (e.g. addition, deletion and searching), data backup and recovery, etc., thus, achieve key research ob-jectives.

Appointment of Dr. Xue-Long JIANG as the Associate Editor-in-Chief of Zoological Research

We are very pleased to announce that we have invited Dr. Xue-Long JIANG to serve as the Associate Editor-in-Chief for Zoological Research （ZR）, effective from 1 March, 2016. Dr. JIANG, Professor and principle investigator from the Laboratory of Mammal Ecology and Evolution, Kunming Institute of Zoology, Chinese Academy of Sciences, has worked with ZR since 2006 as a member of the editorial board and has played an active and important role in maintaining ZR as a respected academic publishing platform. Currently, he also works as the Associate Editor-in-Chief of Acta Thefiologica Sinica, Mammal Research and as a senior editorial board member of Biodiversity Science.

Appointment of Dr. Wai-Yee Chan as the Associate Editor-in-Chief of Zoological Research

We are very pleased to announce that we have invited Dr. Wai-Yee Chan, Professor and Director of School of Biomedical Sciences, The Chinese University of Hong Kong, to serve as the Associate Editor- in-Chief for Zoological Research （ZR）, effective 1 September, 2016.

Quantum Algorithm for Appointment Scheduling

Suppose a practical scene that when two or more parties want to schedule anappointment, they need to share their calendars with each other in order to make itpossible. According to the present result the whole communication cost to solve thisproblem should be their calendars’ length by using a classical algorithm. In this work, weinvestigate the appointment schedule issue made by N users and try to accomplish it inquantum information case. Our study shows that the total communication cost will bequadratic times smaller than the conventional case if we apply a quantum algorithm in theappointment-scheduling problem.

The impact of out-of-pocket expenditures on missed appointments at HIV r care and treatment centers in Northern Tanzania

Background:Missed clinic appointments negatively impact clinic patient flow and health outcomes of people living with HIV(PLHIV).PLHIV likelihood of missing clinic appointments is associated with direct and indirect expenditures made while accessing HIV care.The objective of this study was to examine the relationship between out-of-pocket(OOP)health expenditures and the likelihood of missing appointments.Method:Totally 618 PLHIV older than 18 years attending two HIV care and treatment centres(CTC)in Northern Tanzania were enrolled in the study.Clinic attendance and clinical characteristics were abstracted from medical records.Information on OOP health expenditures,demographics,and socio-economic factors were self-reported by the participants.We used a hurdle model.The first part of the hurdle model assessed the marginal effect of a one Tanzanian Shillings(TZS)increase in OOP health expenditure on the probability of having a missed appointment and the second part assessed the probability of having missed appointments for those who had missed an appointment over the study period.Results:Among these 618 participants,242(39%)had at least one missed clinic appointment in the past year.OOP expenditure was not significantly associated with the number of missed clinic appointments.The median amount of OOP paid was 5100 TZS per visit,about 7%of the median monthly income.Participants who were separated from their partners(adjusted odds ratio[AOR]=1.83,95%confidence interval[CZ]:1.11-8.03)and those aged above 50 years(AOR=2.85,95%CI:1.01-8.03)were significantly associated with missing an appointment.For those who had at least one missed appointment over the study period,the probability of missing a clinic appointment was significantly associated with seeking care in a public CTC(P=0.49,95%CI:0.88-0.09)and aged between>25-35 years(P=0.90,95%CI:0.11-1.69).Conclusion:Interventions focused on improving compliance to clinic appointments should target public CTCs,PLHIV aged between>25-35 years,above 50 years of age and those who are separated from their partners.

An Extended Bailey-welch Rule with No-show and Walk-in For Outpatient Appointment Scheduling

In clinic＇s appointment scheduling system no-shows have been a significant and confirmed issue with a bad influence on patient accessibility and clinic efficiency. The problem of walk-in has often been seen as the opposite of no-show problem. In this work we revisit a walk-in admitting based approach to mitigate the bad influence of no-show without overbooking. First we establish a model which utilizes marginal benefit objective function to balance the interests of the clinic, the patient and the doctor, we prove that no-show and walk-in cancels out each other straightly has a bad property. Then we propose a new rule which is an extension of the well-known Bailey - Welch rule, the simulation results show that our rule has an improvement comparing with the common rule that cancels them out straightly.

Intensive follow-up vs conventional follow-up for patients with nonmetastatic colorectal cancer treated with curative intent:A metaanalysis

BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.

The natural course of bacillus Calmette-Guerin induced bladder lesions:A long-term follow-up study and systematic review

Objective:Bacillus Calmette-Gue´rin(BCG)instillation is the standard adjuvant treatment for intermediate-and high-risk non-muscle-invasive bladder cancer after transurethral resection.Nevertheless,its toxicity often causes bladder complications.On follow-up cystoscopy,post-BCG bladder lesions can be pathologically benign,urothelial carcinoma recurrence,or other types of bladder malignancy.Only a small number of case reports have been published on post-BCG bladder lesions.Their clinical features,natural course,and management remain unknown.Methods:We retrospectively studied cystoscopic videos and medical records of BCG-treated bladder cancer patients at our center.During a long-term follow-up,we took biopsies on tumor-like lesions and described their changes.In addition,we summarized previous studies on post-BCG bladder lesions by systematic literature searching and review.Results:We described a series of three cases with post-BCG bladder lesions mimicking tumor recurrence from a total of 38 cases with follow-up data for more than 5 years.Those lesions could last,grow,or disappear spontaneously,and remain pathological benign for years.In systematic review,we identified and analyzed a total of 15 cases with post-BCG bladder lesions with detailed clinical information.Eleven of the 15 were benign and have a good prognosis with nephrogenic adenoma being the most common pathological type.Conclusion:Based on previous studies and our experience,benign lesions after BCG instillation cannot distinguish with cancer recurrence by cystoscopy alone,even under narrow band imaging mode.Nonetheless,given most of them have a good prognosis,random biopsy or transurethral resection might be spared in the patients with long-term negative biopsy and urine cytology.

Reinforcement⁃Learning⁃Based Appointed⁃Time Prescribed Performance Attitude Control for Rigid Spacecraft

This paper addresses a geometric control algorithm for the attitude tracking problem of the rigid spacecraft modeled on SO(3).Considering the topological and geometric properties of SO(3),we introduced a smooth positive attitude error function to convert the attitude tracking issue on SO(3)into the stabilization counterpart on its Lie algebra.The error transformation technique was further utilized to ensure the assigned transient and steady state performance of the attitude tracking error with the aid of a well⁃designed assigned⁃time performance function.Then,using the actor⁃critic(AC)neural architecture,an adaptive reinforcement learning approximator was constructed,in which the actor neural network(NN)was utilized to approximate the unknown nonlinearity online.A critic function was introduced to tune the next phase of the actor neural network operation for performance improvement via supervising the system performance.A rigorous stability analysis was presented to show that the assigned system performance can be achieved.Finally,the effectiveness and feasibility of the constructed control strategy was verified by the numerical simulation.

Making an Appointment

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Stent-assisted coiling of intracranial carotid ophthalmic segment aneurysm segment aneurysms:Long-term follow-up from a single center

Background:To evaluate the efficacy of stent-assisted coiling(SAC)for the treatment of carotid ophthalmic segment aneurysm segment aneurysms(OSAs)of the internal carotid artery(ICA)through detailed long-term follow-up of a large patient cohort.Methods:We retrospectively analyzed 88 consecutive patients with OSAs between January 2009 and January 2020 at our center.Angiographic results were evaluated using the modified Raymond grading system and clinical outcomes were evaluated using the mRS scale.The primary endpoints were major aneurysm recurrence and poor clinical outcomes for at least 18 months of follow-up.The patients were asked to attend clinical follow-up assessments and possibly undergo DSA or MR via telephone.Results:We enrolled 88 patients with 99 OSAs treated with coiling,of whom 76 were treated with SAC.The coiling procedures were successful in all 88 patients.Overall,complications occurred in 8 patients(9.1%).No procedure-related mortality was observed.67(76.1%)experienced immediate aneurysm occlusion at the end of the procedure.Long-term angiographic follow-up(18 months)was available in 45/88 aneurysms(51%)(average 18.7±5.2 months).Four patients continued their follow-up for 5 years after initial aneurysm treatment.After a clinical follow-up time of 28.7 months(range,12-51 months),85 patients(95.5%)achieved favorable clinical outcomes(mRS scores of 0-2).Conclusions:This study indicates that SAC treatment is a safe and effective therapeutic alternative for ruptured and unruptured OSAs.The procedural risks are low with relatively long-term effectiveness.