Background: The Sars-Cov-2 pandemic has accelerated the spreading of telemedicine, including TeleNeuroPsychology (TNP). Also in a non-pandemic scenario, TNP gives the advantage of reaching older subjects, which often ...Background: The Sars-Cov-2 pandemic has accelerated the spreading of telemedicine, including TeleNeuroPsychology (TNP). Also in a non-pandemic scenario, TNP gives the advantage of reaching older subjects, which often have mobility or transportation limitations. Previous studies on the feasibility, acceptability and reliability of TNP provide promising indications. However, it remains unclear how elderly populations in Italy welcome this practice, in particular when carried out “direct-to-home” (DTH neuropsychology—DTH-NP), hence without assistance in setting up, i.e., the videoconference, and which tests validated in Italian populations show good comparability between remote (either by voice phone call or videoconference) and face-to-face administration. Aims: Here we present a study protocol aimed at assessing: 1) the recruitment rate in a study on DTH neuropsychological assessment through voice calls or videoconference, 2) the feasibility and acceptability of a DTH neuropsychological assessment, 3) the comparability between DTH and face-to-face neuropsychological assessments. Methods: Fifty-eight older adults (65 - 85 years) were recruited among donors of the Abbiategrasso Brain Bank and will undergo both a face-to-face and a DTH neuropsychological assessment in a counterbalanced cross-over design (Group 1: remote session first;Group 2: face-to-face session first). Recruitment rate will be first evaluated. Then, the responses to an acceptability questionnaire will be compared between the two administration modalities. Finally, the DTH-face-to-face comparability will be evaluated as good reliability of a DTH neuropsychological assessment and agreement between scores obtained in the two modalities. Discussion and Conclusion: This study protocol aims at describing the procedures allowing a more reliable implementation of DTH-NP in the Italian clinical and research contexts. The inclusion of both phone-call and videoconference DTH neuropsychological assessment will give the opportunity to evaluate the feasibility of DTH-NP also in older adults with low digital skills. The results of the comparability analysis will offer the first evidence in the Italian context on which neuropsychological tests can be reliably delivered DTH, by phone call or videoconference.展开更多
AIM： To appraise the effect of treatment for diabetic macular edema（DME） in proliferative stage with sufficient panrentinal photocoagulation（PRP） therapy and intravitreal injections（IV） Conbercept and posterior...AIM： To appraise the effect of treatment for diabetic macular edema（DME） in proliferative stage with sufficient panrentinal photocoagulation（PRP） therapy and intravitreal injections（IV） Conbercept and posterior subtenon＇s triamcinolone acetonide（STTA） sequential therapy.METHODS： This prospective clinical randomized controlled trial of cross-over design was conducted in three phases. The participants included cases of DME in proliferative stage. They were divided into two groups and treated with PRP before enrollment. Group A were treated with IVConbercept 0.5 mg for one month in the 1^st phase. Group B were treated with STTA 40 mg（twice per two weeks）. The interventions were exchanged in the second phase（2mo） between the two groups. In the third phase（3-6mo） no other treatment was given. Best corrected visual acuity（BCVA）, central macular thickness（CMT） measured by OCT and complications were compared.RESULTS： After phase I： in Group A, BCVA improved from 0.201±0.17 to 0.37±0.24（F=5.88, P=0.004）. CMT changed from 449±155.10 to 304.1±84.70 μm（F=14.9, P〈0.01）. In Group B, BCVA changed from 0.195±0.19 to 0.26±0.20（F=0.76, P=0.41） while CMT changed from 463.82±152.92 to 366.00±115.40 μm（F=3.70, P〈0.03）. The improvement of BCVA was better in Group A（P〈0.05）. After phase II： in Group A, BCVA raised to 0.47±0.27（F=0.26, P〈0.01）, CMT reduced to 260.67±62.97 μm（F=-188.3, P〈0.01）; in Group B, BCVA raised to 0.51±0.26（F=0.31, P〈0.01）, CMT reduced to 261.93±50.15 μm（F=-201.9, P〈0.01）. But there were no difference between two groups（P〉0.05）. After phase III： in Group A, BCVA maintained 0.42±0.25（F=0.22, P=0.001）, CMT maintained 267.8±58.34 μm,（F=-0.27, P〈0.01）; in Group B, BCVA was 0.47±0.25（F=-0.27, P〈0.01）, CMT was 272.71±49.16 μm（F=-191.1, P〈0.01）. No serious complications happened in all phases.CONCLUSION： PRP＋Conbercept is better than PRP＋STTA in DME with proliferative stage but PRP＋Conbercept＋STTA sequential therapy may be a wiser choice for persistent effectiveness on anatomical as well as functional status.展开更多
文摘Background: The Sars-Cov-2 pandemic has accelerated the spreading of telemedicine, including TeleNeuroPsychology (TNP). Also in a non-pandemic scenario, TNP gives the advantage of reaching older subjects, which often have mobility or transportation limitations. Previous studies on the feasibility, acceptability and reliability of TNP provide promising indications. However, it remains unclear how elderly populations in Italy welcome this practice, in particular when carried out “direct-to-home” (DTH neuropsychology—DTH-NP), hence without assistance in setting up, i.e., the videoconference, and which tests validated in Italian populations show good comparability between remote (either by voice phone call or videoconference) and face-to-face administration. Aims: Here we present a study protocol aimed at assessing: 1) the recruitment rate in a study on DTH neuropsychological assessment through voice calls or videoconference, 2) the feasibility and acceptability of a DTH neuropsychological assessment, 3) the comparability between DTH and face-to-face neuropsychological assessments. Methods: Fifty-eight older adults (65 - 85 years) were recruited among donors of the Abbiategrasso Brain Bank and will undergo both a face-to-face and a DTH neuropsychological assessment in a counterbalanced cross-over design (Group 1: remote session first;Group 2: face-to-face session first). Recruitment rate will be first evaluated. Then, the responses to an acceptability questionnaire will be compared between the two administration modalities. Finally, the DTH-face-to-face comparability will be evaluated as good reliability of a DTH neuropsychological assessment and agreement between scores obtained in the two modalities. Discussion and Conclusion: This study protocol aims at describing the procedures allowing a more reliable implementation of DTH-NP in the Italian clinical and research contexts. The inclusion of both phone-call and videoconference DTH neuropsychological assessment will give the opportunity to evaluate the feasibility of DTH-NP also in older adults with low digital skills. The results of the comparability analysis will offer the first evidence in the Italian context on which neuropsychological tests can be reliably delivered DTH, by phone call or videoconference.
基金Supported by the Health and Family Planning Commission of Sichuan Province(No:17PJ536)
文摘AIM： To appraise the effect of treatment for diabetic macular edema（DME） in proliferative stage with sufficient panrentinal photocoagulation（PRP） therapy and intravitreal injections（IV） Conbercept and posterior subtenon＇s triamcinolone acetonide（STTA） sequential therapy.METHODS： This prospective clinical randomized controlled trial of cross-over design was conducted in three phases. The participants included cases of DME in proliferative stage. They were divided into two groups and treated with PRP before enrollment. Group A were treated with IVConbercept 0.5 mg for one month in the 1^st phase. Group B were treated with STTA 40 mg（twice per two weeks）. The interventions were exchanged in the second phase（2mo） between the two groups. In the third phase（3-6mo） no other treatment was given. Best corrected visual acuity（BCVA）, central macular thickness（CMT） measured by OCT and complications were compared.RESULTS： After phase I： in Group A, BCVA improved from 0.201±0.17 to 0.37±0.24（F=5.88, P=0.004）. CMT changed from 449±155.10 to 304.1±84.70 μm（F=14.9, P〈0.01）. In Group B, BCVA changed from 0.195±0.19 to 0.26±0.20（F=0.76, P=0.41） while CMT changed from 463.82±152.92 to 366.00±115.40 μm（F=3.70, P〈0.03）. The improvement of BCVA was better in Group A（P〈0.05）. After phase II： in Group A, BCVA raised to 0.47±0.27（F=0.26, P〈0.01）, CMT reduced to 260.67±62.97 μm（F=-188.3, P〈0.01）; in Group B, BCVA raised to 0.51±0.26（F=0.31, P〈0.01）, CMT reduced to 261.93±50.15 μm（F=-201.9, P〈0.01）. But there were no difference between two groups（P〉0.05）. After phase III： in Group A, BCVA maintained 0.42±0.25（F=0.22, P=0.001）, CMT maintained 267.8±58.34 μm,（F=-0.27, P〈0.01）; in Group B, BCVA was 0.47±0.25（F=-0.27, P〈0.01）, CMT was 272.71±49.16 μm（F=-191.1, P〈0.01）. No serious complications happened in all phases.CONCLUSION： PRP＋Conbercept is better than PRP＋STTA in DME with proliferative stage but PRP＋Conbercept＋STTA sequential therapy may be a wiser choice for persistent effectiveness on anatomical as well as functional status.
