The COVID-19 pandemic has caused a huge impact towards the teaching and learning activities in medical schools. Due to the outbreak, the curricular activities were shifted to a mainly digitised ...version of learning format. The purpose of this paper is to present the study design and methodology of a population-based survey on the impact of COVID-19 among medical students. The survey aims to investigate the level of knowledge, attitudes and practices (KAP) on the COVID-19 pandemic, the online learning readiness and psychological status among medical students in Universiti Sains Islam Malaysia (USIM). A universal sampling method will be used that involve 475 medical students from Year 1 to Year 6 in USIM. The data collection will be conducted through an online survey. The questionnaire consists of three components: the study of KAP on COVID-19, the online learning readiness and psychological impact of COVID-19 pandemic. Both of the KAP and online learning readiness questionnaire will be adopted, adapted and validated from previous research and will be based on a local study. As for the depression, anxiety and stress, the Depression, Anxiety and Stress Scale (DASS) questionnaire will be used. Duration of data collection is expected to be one month, and findings are expected to be ready by three months from the last data collection date. The exposure variables include sociodemographic factors and years of study, while the outcomes are the KAP scores, online learning readiness level, and DASS scores. Relationships between the outcomes and associated factors will be analysed once data collection is completed.
Fenestrating a Fontan baffle has been associated with improved peri-operative outcomes in patients with univentricular hearts. However, longer-term potential adverse effects remain debated. We sought ...to assess the impact of a fenestrated Fontan baffle on adverse cardiovascular events including all-cause mortality, cardiac transplantation, atrial arrhythmias, and thromboemboli.
A multicenter North American retrospective cohort study was conducted on patients with a total cavopulmonary connection Fontan baffle, with and without fenestration. All components of the composite outcome were independently adjudicated. Potential static and time-varying confounders were taken into consideration, along with competing risks.
A total of 407 patients were followed for 10.4 (7.1-14.4) years, 70.0% of whom had fenestration of their Fontan baffle. The fenestration spontaneously closed or was deliberately sealed in 79.9% of patients a median of 2.0 years after Fontan completion. In multivariable analysis in which a persistent fenestration was modelled as a time-dependent variable, an open fenestration did not confer a higher risk of the composite outcome hazard ratio 1.18, 95% confidence interval (0.71 to 1.97), P=0.521. In secondary analyses, an open fenestration was not significantly associated with components of the primary outcome, i.e., mortality or transplantation, atrial arrhythmias, or thromboemboli. However, sensitivity analyses to assess the possible range of error resulting from imprecise dates for spontaneous fenestration closures could not rule-out significant associations between an open fenestration and atrial arrhythmias or thromboemboli.
In this multicenter study, no significant association was identified between an open fenestration in the Fontan baffle and major adverse cardiovascular events.
Display omitted
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
PDF
