BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

Objective To investigate the association between sleep behaviors （including bedtime， sleep quality， and nap duration） and academic performance among college students， as well as the regulatory effect of test anxiety and exercise habit on the association between sleep and academic performance. Methods A questionnaire survey was conducted to collect data. The grade of compulsory courses （with higher grades indicating better academic performance） was used as an ordinal dependent variable. All independent variables were coded by levels： for bedtime during exam and non-exam periods， higher levels indicated later bedtimes； for anxiety during the exam period， higher levels indicated more severe anxiety； for sleep quality during both exam and non-exam periods， higher levels indicated better sleep quality； for nap duration， higher levels indicated longer naps. Exercise habit was treated as a binary variable （yes/no）. Ordinal logistic regression （proportional odds model） was used for multivariable analysis， and OR and 95%CIwere calculated. In addition， sex-stratified models were established to investigate sex differences in the associations between these factors and academic performance. Results A total of 1 221 college students were included， among whom male students accounted for 33.7%. After controlling for confounding factors， bedtime during the exam period was significantly positively associated with the grade of compulsory courses， indicating that later bedtime was associated with a greater likelihood of achieving a higher grade （OR=1.32，95%CI 1.08‒1.62， P=0.007）. Sex was also an independent predictive factor， and the OR of achieving a higher grade in female students was 2.4 times that in male students （OR=2.41， 95%CI 1.90‒3.06， P<0.001）. Sleep quality during the exam period （OR=1.18，95%CI 0.99‒1.42， P=0.070） and exercise habit （OR=1.24， 95%CI 0.99‒1.55， P=0.064） showed marginally significant associations with grade. In contrast， bedtime during the non-exam period， nap duration， anxiety during the exam period， and self-rated sleep quality during the non-exam period showed no statistical significance （all P>0.05）. Sex-stratified analysis showed that among the male students， later bedtime during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.48， 95%CI 1.05‒2.09， P=0.025）， whereas higher anxiety during the exam period was associated with a lower likelihood （OR=0.79，95%CI 0.63‒0.98， P=0.032）； among the female students， better sleep quality during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.27， 95%CI 1.02‒1.57， P=0.033）， and bedtime during the exam period showed a positive association with academic performance， but without statistical significance （OR=1.25，95%CI 0.96‒1.62，P=0.091）. Conclusion The association between sleep behaviors and academic performance among college students varies with academic period and sex. Later bedtime during the exam period is associated with better academic performance， but this effect is observed only among male students. In addition， the academic performance of male students is negatively affected by test anxiety， whereas the academic performance of female students is positively associated with subjective sleep quality. Future interventions aimed at improving academic health should consider sex-specific strategies.
Anxiety ; Exercise

BACKGROUND AND OBJECTIVE

Pediatric post-operative congenital diaphragmatic hernia (CDH) patients have been shown to encounter reduced pulmonary function tests (PFT) potentially leading to respiratory symptoms. Strategies involving exercise have been used to improve PFT. This meta-analysis aims to determine the effectiveness of exercise in improving lung function in pediatric post-operative CDH patients.

METHODS

An electronic search was done on May 2023 in MEDLINE via Pubmed, Cochrane Library, Embase, ClinicalKey, Scopus, Google Scholar, and Herdin Plus, using the search terms "exercise" and "congenital diaphragmatic hernia" and "children" or "pediatric" and "pulmonary function" or "lung function". The study included pediatric patients in whom CDH has been surgically corrected, and excluded patients who were unable to perform the test maneuvers, have cardiopulmonary instability, and have serious associated anomalies. Randomized controlled trials (RCT) were identified and independently assessed by two review authors. Each RCT was independently assessed for bias by two review authors using the Cochrane Handbook for Systematic Reviews of Interventions. The RevMan 5.4 software was used for statistical analysis.

RESULTS

A total of 124 participants from three studies were included in the meta-analysis. The pooled mean difference showed a significantly higher mean functional vital capacity (FVC) (MD=6.12, 95%CI=3.91 to 8.33, p-value < 0.00001) and forced expiratory volume in 1 second (FEV1 ) (MD=6.25, 95%CI=3.39 to 9.10, p-value < 0.0001) in the study group compared to the control group.

CONCLUSION

Exercise may be effective in improving lung function in children with pediatric post-operative CDH. However, the study is limited by its small sample size, the lack of assessment of long-term outcomes, and the difference in exercise regimens used in each RCT. Further studies are recommended to determine the most optimal exercise regimen and to measure its effect on the other outcomes for this population.

Human ; Exercise ; Hernias, Diaphragmatic, Congenital ; Child ; Children

INTRODUCTION

The Bachelor of Science in Nursing (BSN) program spans four years and includes general education and professional courses. Student nurses attend lecture hours, clinical duties, and related learning experiences that might be affecting their time in attending to a healthy lifestyle. Health-promoting lifestyle is a multi-dimensional pattern of activities and perceptions that begins with self-motivation and assists in promoting self-improvement and health. The domains of health-promoting lifestyle are essential factors to further improve their way of dealing with daily challenges. Multiple factors can also influence student nurses’ lifestyles, including their separation from family, busy schedules, and dietary choices. A study highlights various factors affecting student nurses' lifestyles, underscoring the need for tailored health promotion strategies and curriculum enhancements. Research into these domains can better equip future healthcare leaders. Gender, year level, and living arrangements influence student nurses' lifestyles, prompting researchers to investigate the extent of health-promoting lifestyles among them and differences based on these factors. By addressing these domains and conducting further research, nursing education and practice can better prepare future healthcare leaders to promote health and lifestyle effectively within their communities.

OBJECTIVES

To determine the extent of health-promoting lifestyle among student nurses and identify the significant differences according to gender, year level, and living arrangement. 

METHODS

A quantitative, descriptive research design was used with 360 respondents, employing Yamane’s formula and quota sampling. The study adopted the Health-Promoting Lifestyle II questionnaire with a validity of 0.962.

RESULTS

Student nurses often engage in health promoting behaviors (mean=2.56). Male student nurses reported higher scores in health responsibility, physical activity, spiritual growth, and stress management compared to female students (p=0.40). Level IV students engaged in health-promoting activities more frequently than Level I students (p=0.74). Living arrangements did not significantly impact health-promoting lifestyles (p=0.99).

CONCLUSION

No significant difference in health-promoting lifestyles among student nurses. Respondents demonstrated the least health-promoting lifestyle behaviors in the domains of health responsibility, nutrition, and physical activity. In contrast, spiritual growth, interpersonal relations, and stress management attained the highest mean scores.

Human ; Physical Activity ; Exercise ; Interpersonal Relations ; Students, Nursing ; Life Style

The quest to decipher the determinants of human longevity has intensified with the rise in global life expectancy. Long-lived individuals (LLIs), who exceed the average life expectancy while delaying age-related diseases, serve as a unique model for studying human healthy aging and longevity. Longevity is a complex phenotype influenced by both genetic and non-genetic factors. This review paper delves into the genetic, epigenetic, metabolic, immune, and environmental factors underpinning the phenomenon of human longevity, with a particular focus on LLIs, such as centenarians. By integrating findings from human longevity studies, this review highlights a diverse array of factors influencing longevity, ranging from genetic polymorphisms and epigenetic modifications to the impacts of diet and physical activity. As life expectancy grows, understanding these factors is crucial for developing strategies that promote a healthier and longer life.
Humans ; Healthy Aging/physiology* ; Longevity/physiology* ; Epigenesis, Genetic ; Life Expectancy ; Exercise ; Aging/genetics* ; Diet ; Aged, 80 and over

At present, upper limb motor rehabilitation relies on specific rehabilitation aids, ignoring the initiative of upper limb motor of patients in the middle and late stages of rehabilitation. This paper proposes a fuzzy evaluation method for active participation based on trajectory error and surface electromyography (sEMG) for patients who gradually have the ability to generate active force. First, the level of motor participation was evaluated using trajectory error signals represented by computer vision. Then, the level of physiological participation was quantified based on muscle activation (MA) characterized by sEMG. Finally, the motor performance and physiological response parameters were input into the fuzzy inference system (FIS). This system was then used to construct the fuzzy decision tree (FDT), which ultimately outputs the active participation level. A controlled experiment of upper limb flexion and extension exercise in 16 healthy subjects demonstrated that the method presented in this paper was effective in quantifying difference in the active participation level of the upper limb in different force-generating states. The calculation results of this method and the active participation assessment method based on sEMG during the task cycle showed that the active participation evaluation values of both methods peaked in the initial cycle: (82.34 ± 9.3) % for this paper's method and (78.44 ± 7.31) % for the sEMG method. In the subsequent cycles, the values of both showed a dynamic change trend of rising first and then falling. Trend consistency verifies the effectiveness of the active participation assessment strategy in this paper, providing a new idea for quantifying the participation level of patients in middle and late stages of upper limb rehabilitation without special equipment mediation.
Humans ; Electromyography/methods* ; Upper Extremity/physiology* ; Fuzzy Logic ; Exercise Therapy/methods* ; Muscle, Skeletal/physiology* ; Male

Exercise intervention is an important non-pharmacological intervention for various diseases, and establishing precise exercise load assessment techniques can improve the quality of exercise intervention and the efficiency of disease prevention and control. Based on data collection from wearable devices, this study conducts nonlinear optimization and empirical verification of the original "Fitness-Fatigue Model". By constructing a time-varying attenuation function and specific coefficients, this study develops an optimized mathematical model that reflects the nonlinear characteristics of training responses. Thirteen participants underwent 12 weeks of moderate-intensity continuous cycling, three times per week. For each training session, external load (actual work done) and internal load (heart rate variability index) data were collected for each individual to conduct a performance comparison between the optimized model and the original model. The results show that the optimized model demonstrates a significantly improved overall goodness of fit and superior predictive ability. In summary, the findings of this study can support dynamic adjustments to participants' training programs and aid in the prevention and control of chronic diseases.
Humans ; Wearable Electronic Devices ; Exercise/physiology* ; Models, Theoretical ; Heart Rate/physiology* ; Exercise Therapy

OBJECTIVE: To investigate the load distribution on the more painful and less painful limbs in patients with mild-to-moderate and severe bilateral knee osteoarthritis (KOA) and explore the compensatory mechanisms in both limbs among bilateral KOA patients with different severity levels. METHODS: A total of 113 participants were enrolled between July 2022 and September 2023. This cohort comprised 43 patients with mild-to-moderate bilateral KOA (Kellgren-Lawrence grade 2-3), 43 patients with severe bilateral KOA (Kellgren-Lawrence grade 4), and 27 healthy volunteers (healthy control group). The visual analogue scale (VAS) score for pain, the Hospital for Special Surgery (HSS) score, passive knee range of motion (ROM), and hip-knee-ankle angle (HKA) were used to assess walking pain intensity, joint function, and lower limb alignment in KOA patients, respectively. Motion trajectories of reflective markers and ground reaction force data during walking were captured using a gait analysis system. Musculoskeletal modeling was then employed to calculate biomechanical parameters, including the peak knee adduction moment (KAM), KAM impulse, peak joint contact force (JCF), and peak medial/lateral contact forces (MCF/LCF). Statistical analyses were performed to compare differences in clinical and gait parameters between bilateral limbs. Additionally, one-dimensional statistical parametric mapping was utilized to analyze temporal gait data. RESULTS: Mild-to-moderate KOA patients showed the significantly higher HSS score (67.7±7.9) than severe KOA patients (51.9±8.9; t=8.747, P<0.001). The more painful limb in all KOA patients exhibited significantly greater HKA and higher VAS scores compared to the less painful limb ( P<0.05). While bilateral knee ROM did not differ significantly in mild-to-moderate KOA patients ( P>0.05), the severe KOA patients had significantly reduced ROM in the more painful limb versus the less painful limb ( P<0.05). Healthy controls showed no significant bilateral difference in any biomechanical parameters ( P>0.05). All KOA patients demonstrated longer stance time on the less painful limb ( P<0.05). Critically, severe KOA patients exhibited significantly higher peak KAM, KAM impulse, and peak MCF in the more painful limb ( P<0.05), while mild-to-moderate KOA patients showed the opposite pattern with lower peak KAM and KAM impulse in the more painful limb ( P<0.05) and a similar trend for peak MCF. CONCLUSION Patients with mild-to-moderate KOA effectively reduce load on the more painful limb through compensatory mechanisms in the less painful limb. Conversely, severe bilateral varus deformities in advanced KOA patients nullify compensatory capacity in the less painful limb, paradoxically increasing load on the more painful limb. This dichotomy necessitates personalized management strategies tailored to disease severity.
Humans ; Osteoarthritis, Knee/physiopathology* ; Range of Motion, Articular ; Male ; Female ; Middle Aged ; Biomechanical Phenomena ; Knee Joint/physiopathology* ; Pain Measurement ; Severity of Illness Index ; Aged ; Gait/physiology* ; Walking/physiology* ; Case-Control Studies ; Adult ; Weight-Bearing

OBJECTIVE: To explore the clinical efficacy of orthopedic manipulation combined with daoyin exercises in the treatment of chronic lumbar disc herniation under the guidance of the theory of "equal emphasis on muscles and bones". METHODS: A total of 60 patients with single-segment, unilateral chronic lumbar disc herniation from January 2023 to January 2024 were randomly divided into the traditional physical therapy group and the manipulation treatment group, with 30 cases in each group. Among them, 3 cases were lost to follow-up in the traditional physical therapy group and 2 cases in the manipulation treatment group. There were 27 cases in the traditional physical therapy group, including 15 males and 12 females, aged 25 to 65 years old with an average of (51.96±14.42) years;the course of disease ranged from 3 to 15 months with an average of (9.89±3.32) months;11 cases were on the left side and 16 cases on the right side;15 cases were at the L4, 5 segment and 12 cases at the L5S1 segment. They were treated with lumbar traction, medium-frequency electrical stimulation and ultrasonic therapy. There were 28 cases in the manipulation treatment group, including 14 males and 14 females, aged 24 to 68 years old with an average of (49.82±14.85) years old;the course of disease ranged from 3 to 14 months with an average of (9.61±3.05) months;15 cases were on the left side and 13 cases on the right side;17 cases were at the L4, 5 segment and 11 cases at the L5S1 segment. They were treated with orthopedic manipulation combined with daoyin exercises. The visual analogue scale (VAS), Oswestry disability index (ODI) and bilateral erector spinae muscle tone were compared between the two groups before treatment, after 2 weeks and 4 weeks of treatment. RESULTS: The two groups of patients were followed up and evaluated before treatment, 2 weeks and 4 weeks after treatment. The VAS of the manipulation treatment group and the traditional physical therapy group decreased from (5.46±0.99) and (5.41±1.05) points before treatment to (1.75±0.79) and (2.29±0.82) points after 4 weeks of treatment, respectively. Both groups were significantly improved after treatment compared with before treatment, and the differences were statistically significant (P<0.05);and the manipulation treatment group was better than the traditional physical therapy group at 4 weeks of treatment, with a statistically significant difference (P<0.05). The ODI of the manipulation treatment group and the traditional physical therapy group before treatment was (20.25±2.72) and (18.96±2.52) points, respectively, which decreased to (15.46±1.88) and (16.56±2.01) points after 2 weeks of treatment, and to (11.54±1.23) and (12.85±1.72) points after 4 weeks of treatment. Both groups were significantly improved after treatment compared with before treatment, and the differences were statistically significant (P<0.05), and the ODI in the manipulation treatment group was better than that in the traditional physical therapy group after treatment (P<0.05). There was no significant statistical difference in the displacement of erector spinae muscle tone between the healthy side and the affected side in both the manipulation treatment group and the traditional physical therapy group before treatment (P>0.05). After 2 weeks of treatment, the displacement values of erector spinae muscle tone on the healthy side in the manipulation treatment group and the traditional physical therapy group were (6.68±0.81) mm and (6.45±0.65) mm, respectively, and those on the affected side were (5.87±0.82) mm and (5.61±0.84) mm, respectively. After 4 weeks of treatment, the displacement values of erector spinae muscle tone on the healthy side in the manipulation treatment group and the traditional physical therapy group were (7.51±0.75) mm and (7.04±0.63) mm, respectively, and those on the affected side were (6.87±0.78) mm and (6.33±0.82) mm, respectively. The displacement values of erector spinae muscle tone on both the healthy and affected sides in both groups were significantly higher than those before treatment, and the differences were statistically significant (P<0.05);the displacement of erector spinae muscle tone in the manipulation treatment group after 4 weeks of treatment was better than that in the traditional physical therapy group, with a statistically significant difference (P<0.05). CONCLUSION Orthopedic manipulation combined with daoyin exercises can effectively improve the symptoms and lumbar function of patients with chronic lumbar disc herniation, and has more advantages in improving the tone of the erector spinae muscle.
Humans ; Male ; Female ; Middle Aged ; Adult ; Intervertebral Disc Displacement/physiopathology* ; Aged ; Lumbar Vertebrae/injuries* ; Exercise Therapy ; Chronic Disease/therapy* ; Manipulation, Orthopedic ; Combined Modality Therapy

INTRODUCTION: The survival rate for childhood cancer has increased with advances in medical care. Along with this comes the growing burden of long-term side effects of cancer treatment and cancer survivorship. Childhood cancer survivors are more likely to be sedentary and have a lower quality of life. Physical activity (PA) can promote health and well-being in childhood cancer survivors, but few studies have explored the role of parents of childhood cancer survivors (PCCS) in promoting PA. This qualitative study aims to explore the perceptions of PCCS in Singapore and the role they may have with regard to PA. METHODS: Participants were recruited through a local charity via email, social media and posters. One-hour semi-structured interviews were conducted online with seven parents. With consent, the interviews were recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Our study discussed thematically parents' accounts on (1) the barriers and enablers of PA and (2) the complications of cancer that potentially affect the levels of PA in childhood cancer survivors. Parents reported that childhood cancer negatively affects the quality of life and participation in PA. The determinants of participation in PA were multifaceted, and socioecological and health belief models were used to demonstrate how these factors were interlinked. CONCLUSION Participation in PA is influenced at an individual, family, community and societal level. The improved understanding facilitated by this research can be used to shape paediatric cancer care practices in Singapore and guide institutional or national policy interventions.
Humans ; Singapore ; Parents/psychology* ; Cancer Survivors/psychology* ; Qualitative Research ; Female ; Male ; Quality of Life ; Exercise ; Child ; Adult ; Neoplasms ; Adolescent ; Perception ; Middle Aged ; Interviews as Topic