Purpose: The purpose of this study was to explore the experiences of healthcare disparities in the individuals with acquired vision impairments. Methods: This study is a qualitative research using thematic analysis. Data were collected from January to March 2024 through one-on-one semi-structured interviews with a total of 11 individuals with acquired vision impairments. Results: The analysis revealed 5 main themes and 19 subthemes. The identified main themes were physical injury and aggravation, psychological tension, difficulty maintaining a healthy lifestyle, mastery of self-management and emergence of social requirements. Conclusion The findings of this study contribute to a deep understanding of the health management experiences of individuals with acquired vision impairments. Additionally, this study identifies their healthcare needs and provides directions for rehabilitation nursing and health promotion behaviors. It is necessary to explore methods for developing tailored health care programs for individuals with acquired vision impairments and to address their needs for physical environments and social systems.

Purpose: The purpose of this study was to explore the experiences of healthcare disparities in the individuals with acquired vision impairments. Methods: This study is a qualitative research using thematic analysis. Data were collected from January to March 2024 through one-on-one semi-structured interviews with a total of 11 individuals with acquired vision impairments. Results: The analysis revealed 5 main themes and 19 subthemes. The identified main themes were physical injury and aggravation, psychological tension, difficulty maintaining a healthy lifestyle, mastery of self-management and emergence of social requirements. Conclusion The findings of this study contribute to a deep understanding of the health management experiences of individuals with acquired vision impairments. Additionally, this study identifies their healthcare needs and provides directions for rehabilitation nursing and health promotion behaviors. It is necessary to explore methods for developing tailored health care programs for individuals with acquired vision impairments and to address their needs for physical environments and social systems.

Purpose: The purpose of this study was to explore the experiences of healthcare disparities in the individuals with acquired vision impairments. Methods: This study is a qualitative research using thematic analysis. Data were collected from January to March 2024 through one-on-one semi-structured interviews with a total of 11 individuals with acquired vision impairments. Results: The analysis revealed 5 main themes and 19 subthemes. The identified main themes were physical injury and aggravation, psychological tension, difficulty maintaining a healthy lifestyle, mastery of self-management and emergence of social requirements. Conclusion The findings of this study contribute to a deep understanding of the health management experiences of individuals with acquired vision impairments. Additionally, this study identifies their healthcare needs and provides directions for rehabilitation nursing and health promotion behaviors. It is necessary to explore methods for developing tailored health care programs for individuals with acquired vision impairments and to address their needs for physical environments and social systems.

Purpose: The purpose of this study was to explore the experiences of healthcare disparities in the individuals with acquired vision impairments. Methods: This study is a qualitative research using thematic analysis. Data were collected from January to March 2024 through one-on-one semi-structured interviews with a total of 11 individuals with acquired vision impairments. Results: The analysis revealed 5 main themes and 19 subthemes. The identified main themes were physical injury and aggravation, psychological tension, difficulty maintaining a healthy lifestyle, mastery of self-management and emergence of social requirements. Conclusion The findings of this study contribute to a deep understanding of the health management experiences of individuals with acquired vision impairments. Additionally, this study identifies their healthcare needs and provides directions for rehabilitation nursing and health promotion behaviors. It is necessary to explore methods for developing tailored health care programs for individuals with acquired vision impairments and to address their needs for physical environments and social systems.

Purpose: The purpose of this study was to explore the experiences of healthcare disparities in the individuals with acquired vision impairments. Methods: This study is a qualitative research using thematic analysis. Data were collected from January to March 2024 through one-on-one semi-structured interviews with a total of 11 individuals with acquired vision impairments. Results: The analysis revealed 5 main themes and 19 subthemes. The identified main themes were physical injury and aggravation, psychological tension, difficulty maintaining a healthy lifestyle, mastery of self-management and emergence of social requirements. Conclusion The findings of this study contribute to a deep understanding of the health management experiences of individuals with acquired vision impairments. Additionally, this study identifies their healthcare needs and provides directions for rehabilitation nursing and health promotion behaviors. It is necessary to explore methods for developing tailored health care programs for individuals with acquired vision impairments and to address their needs for physical environments and social systems.

Purpose: Sirolimus has emerged as a safe and effective treatment for complicated lymphatic malformations (LMs). We aim to prove the effectiveness and safety of sirolimus as a therapeutic option for patients with complicated LMs. Methods: Fifty-eight patients with complicated LMs treated with sirolimus for at least 6 months at multicenter between July 2018 and January 2023 were enrolled. All patients were administered oral sirolimus starting at 0.8 mg/m 2 every 12 hours, with target serum concentration levels of 8–15 ng/mL. Evaluation for clinical symptoms and LMs volume on MRI were reviewed to assess treatment response and toxicities. Evaluation of disease response was divided into 3 values:complete response, partial response (significant, moderate, and modest), and progressive disease. Results: The median age at the initiation of sirolimus treatment was 6.0 years (range, 1 month–26.7 years). The median duration of treatment was 2.0 years (range, 6 months–4.4 years). The most common lesions were head and neck (25 of 58, 43.1%). Forty-six patients (79.3%) demonstrated a reduction in LMs volume on MRI or improvement of clinical symptoms including 2 complete responses. The young age group and the patients who underwent few prior therapies showed better responses. None of the patients had toxicities attributable to sirolimus with a Common Terminology Criteria for Adverse Events grade of ≥3. Conclusion Oral sirolimus treatment brought a successful outcome without severe adverse effects. It could be the firstline therapy, especially for the young age group of complicated LMs, and an additional option for refractory lesions that did not respond to conventional treatment.

Purpose: This study aimed to evaluate the functional status and health service accessibility of the disabled children in Dar es Salaam, Tanzania. Methods: The research design for this study was a descriptive survey using convenience sampling using questionnaires. A total of 184 subjects were used to analysis. Data were analyzed using SPSS program version 22.0 to conduct independent t-tests, one-way ANOVA tests, χ2 tests, and multiple regressions. Results: The disabled children had more difficulty accessing health services compared to those without any disabilities. Factors negatively influencing health service accessability were inadequate drugs or medical equipment (t=2.18, p=.031), inability to afford transportation(t=3.00, p=.003), and inability afford the medical costs (t=2.54, p=.012). Also, Mother’s anxiety (β=-.50, p<.001) and child’s education experience (β=.22, p=.029) were identified as the influencing factors on the barriers to health care services. The relevant variables showed 30.5% influence (F=16.60, p<.001) on the barriers to health care services in disabled children. Conclusion The findings indicate that in order to enhance the disabled children‘s accessibility to health services, governmental support for transportation and medical costs are needed. In addition, it is necessary to promote the mental health of mothers raising children with disabilities.

Purpose: We analyzed the timing of inguinal hernia repair in premature infants in the neonatal intensive care unit (NICU) considering recurrence, incarceration, and other complications. Methods: In this multicenter retrospective review, premature infants (<37 weeks) in the NICU diagnosed with inguinal hernia between 2017 and 2021 were segregated into 2 groups based on the timing of inguinal hernia repair. Results: Of 149 patients, 109 (73.2%) underwent inguinal hernia repair in the NICU and 40 (26.8%) after discharge. Preoperative incarceration did not differ, but complications with recurrence and postoperative respiratory insufficiency were higher in the NICU group (11.0% vs. 0%, P = 0.029; 22.0% vs. 5.0%, P = 0.01). Multivariate analysis showed that the significant factors affecting recurrence were preoperative ventilator dependence and body weight of <3,000 g at the time of surgery (odds ratio [OR], 16.89; 95% confidence interval [CI], 3.45–82.69; P < 0.01 and OR, 9.97; 95% CI, 1.03–95.92; P = 0.04). Conclusion Our results suggest that when premature infants are diagnosed with inguinal hernia in the NICU, inguinal hernia repair after discharge may decrease the odds of recurrence and postoperative respiratory insufficiency. In patients who have difficulty delaying surgery, it is thought that surgery should be performed carefully in a ventilator preoperatively or weighed <3,000 g at the time of surgery.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM.Material and Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machinelearning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information. Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machinelearning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, P <0.001) and an infectious disease specialist (AUC 0.76; P = 0.03). Conclusion The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM.Material and Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machinelearning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information. Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machinelearning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, P <0.001) and an infectious disease specialist (AUC 0.76; P = 0.03). Conclusion The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.