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All other studied factors in this group of patients were not significantly associated with patient compliance. Conclusion VEGF suppression via the intravitreal route to treat DME is a long-term process that requires caregiver dedication but also proper patient compliance. Addressing real-life barriers in those patients may help guide future strategies to improve the treatment experience, lower the financial burden and contribute to better outcomes. Patients' perceptions of possible treatment outcomes at the short term may influence their long-term commitment to therapy. © 2020 Abu-Yaghi et al.Purpose To report the prevalence of subclinical keratoconus (KC), and KC suspects, in pediatric Egyptian population with astigmatic error ≥2 diopters (D), with the use of CSO Sirius tomographer. Methods A cross-sectional study that included all the children aged 6-18 years with an astigmatic error of ≥2 D who attended the pediatric ophthalmology clinic for routine checkups during the period between March 2017 and December 2017 was done. All subjects underwent comprehensive ophthalmic examination, and corneal imaging using CSO Sirius instrument, a pentacam with Scheimpflug technology. Results There were 547 subjects enrolled in our study. Mean age was 11.34 ± 3.03 (range 6-18) years. There were 278 subjects (50.8%) between 6 and 12 years, and 269 subjects (49.2%) between 12 and 18 years. Males represented 48.4% and females represented 51.6% of patients. Among all the subjects, there were 26 (4.8%) KC patients, 24 (4.4%) KC suspects, and 497 (90.9%) were normal. Conclusion Prevalence of subclinical KC among pediatric age group with astigmatism is relatively high, hence the importance of corneal tomography screening of children with astigmatic error ≥2 D. © 2020 Sidky et al.Background Adolescents have an increased risk of preterm birth (PTB) and sexually transmitted infections (STIs). We examined the prevalence and impact of STIs (gonorrhea, chlamydia, and trichomonas) on PTB and chorioamnionitis in pregnant adolescents. Methods This retrospective cohort study utilized the first pregnancy delivered at an urban hospital among patients ≤ 19 years old over a 5-year period. Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between STIs and PTB ( less then 37 weeks) and chorioamnionitis identified by clinical or placental pathology criteria. Results 739 deliveries were included. 18.8% (n = 139) of births were preterm. The overall prevalence of STIs during pregnancy was 16.5% (Chlamydia trachomatis 13.1%, n = 97; Trichomonas vaginalis 3.7%, n = 27; and Neisseria gonorrheae 3.1%, n = 23). Detection of C. trachomatis, T. vaginalis, or N. gonorrheae was not associated with increased PTB. While infection with N. gonorrheae and C. trachomatis did not increase the likelihood of any chorioamnionitis, infection with T. vaginalis significantly increased the likelihood of any chorioamnionitis diagnosis (aPR 2.19, 95% CI 1.26-3.83). Conclusion In this adolescent population with a high rate of PTB, in whom most received appropriate STI treatment, we did not find an association between STI during pregnancy and an increased rate of PTB. However, an infection with T. vaginalis was associated with an increased likelihood of chorioamnionitis. Early detection of STIs may prevent adverse pregnancy outcomes. Continued vigilance in STI screening during pregnancy, including consideration of universal Trichomonas vaginalis screening, is merited in this high-risk population. Copyright © 2020 Esther Fuchs et al.Background and Objectives In 2016 we published a stepwise evidence-based model (subsequently named SimSteps) for curriculum development (CD) of simulation-based courses. Selleckchem DL-Thiorphan The current study aimed to assess the uses, user friendliness, and perceived effectiveness of this model and its worksheet and to obtain suggestions for improvement. Methods We sent e-mail invitations for a 14-question web-based survey to 13 health professionals who requested the supplemental worksheet of the stepwise model and 11 authors who cited the model's publication in 14 articles. The survey included quantitative and qualitative items. Results Sixteen (67%) from seven countries and six professions responded. Ten (63%) used the model six for both course and faculty development, three for course development only, and one for faculty development only. Both users and nonusers found the model and worksheet applicable and user friendly and agreed that they guided use of a systematic, comprehensive approach to CD. 94% (15 of 16) agreed that they helped CDers integrate educational effectiveness criteria, develop more objective learners' assessment tools, and enhance validity for their courses. Sixty-nine percent (11 of 16) agreed that model and its worksheet helped CDers include nontechnical skills in courses. The highest reported role in enhancing program evaluation results was in the gain of knowledge (five of eight, 63%) and least was clinical outcomes (two of eight, 25%). All respondents would recommend the model and worksheet to a colleague. Conclusion Respondents find the stepwise model and its worksheet user friendly and helpful in developing simulation curricula of high educational standards. Future studies should include larger sample size, objective measures of impact, and longer-term follow-up. © 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons.Background and Objectives In patients with obstructing rectal cancers who require intestinal diversion before neoadjuvant therapy, minimizing diversion-related recovery and instituting early chemoradiation are critical to optimizing outcomes. Methods A novel, simple, safe, and inexpensive technique was developed for single-port laparoscopic diverting sigmoid loop colostomy in a low-resource environment. Results Ten consecutive patients with locally advanced rectal cancer underwent single-port, diverting sigmoid loop colostomy using a novel application of the EK glove port. Operative time averaged 59.5 min (range 40-75 min). There were no conversions to multiport laparoscopy or open surgery. There were no intraoperative or early postoperative surgical complications. All patients started chemoradiation therapy within 1 week of diverting colostomy. No surgical reinterventions were required. Conclusion Single-port laparoscopic diverting sigmoid loop colostomy utilizing an EK glove port is a novel, technically simple, safe, and cost-effective procedure, especially applicable to patients with obstructing rectal cancer who receive care in a low resource environment.