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Background: Hospital at Home (HaH) is an alternative care model that provides acute hospital-level services to patients at their homes. Despite its proven advantages and global experience, HaH did not gain significant traction in Israel until the COVID-19 pandemic. The issue was highlighted at the 2022 Dead Sea Conference on Health Policy. This study compares perceptions of HaH among the Israeli public and physicians, Jewish and Arab, identifying facilitators and barriers to its expansion in Israel. Methods: Two online surveys were conducted, one with 342 physicians and another with 424 members of the public aged 35+. Respondents were sampled based on age, gender, district of residence, and population group. Descriptive statistics and chi-square tests explored perceptions, and logistic regression analyzed multivariate relationships. Results: Results showed 39% of the public believed HaH care quality is as good as or better than hospitals, compared to 65% of physicians. 44% of the public felt HaH safety is as good or better, while 75% of physicians agreed. 58% of the public saw communication between patients/families and the healthcare professionals in HaH as good or better, contrasted with 91% of physicians. 78% of the public and 97% of physicians viewed HaH as a good alternative to hospitalization and would consider using it personally. Arab and lower-income respondents were less positive about HaH than Jewish and higher-income respondents. Community-based physicians preferred HaH more than hospital-based ones. Barriers to HaH expansion included lack of specialized manpower, resources, and awareness. Conclusions: The findings suggest that both the public and physicians show confidence in HaH, and it is gaining popularity among both. Policymakers could use these insights to expand HaH, focusing on increasing awareness, reducing family burden, tailoring services for diverse populations, involving hospital staff, and investing in resources and training. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate visual outcomes following the Smooth Incision Lenticular Keratomileusis (SILKTM) procedure for correction of myopic refractive errors with and without astigmatism, using the ELITATM Femtosecond Laser System.Patients and Methods: A prospective, multicenter, single-arm, open-label clinical study was conducted. Eighty-five myopic subjects (n = 170 eyes), aged 18 years or older, with manifest refractive spherical equivalent (MRSE) up to − 12.00 D and astigmatism up to − 6.00 D, were treated binocularly using the ELITA femtosecond laser and followed up for 6 months. Intended correction was emmetropia for all eyes. The primary outcome measures included post-operative uncorrected and corrected distance visual acuity (UDVA and CDVA). Secondary outcome measures included surgeon's rating for ease of lenticule extraction, predictability, safety, and stability.Results: A total of 170 eyes of 85 patients underwent SILK. Preoperative mean MRSE was − 4.14 D ± 1.32 D (range − 1.38 D to − 8.88 D) and the mean cylinder was − 0.77 D ± 0.62 D. Intraoperative surgeon ease of lenticule dissection was rated as grade 0 or 1 in 85.3% of eyes (no/only mild dissection needed). UDVA at 1 day, 1 week, 1 month, and 6 months was 20/20 or better in 65.9%, 85.4%, 91.5%, and 96% of eyes, respectively. No eyes lost any lines of CDVA at 6 months compared to the preoperative. The postoperative MRSE was stable over time, ranging from − 0.34 D ± 0.24 D at 1 month to − 0.33 D ± 0.23 D at 6 months. MRSE predictability (± 0.50 D) was 93.5% (129/138) at 3 months and 91.1% (113/124) at 6 months. No serious adverse events were noted.Conclusion: The SILK procedure with the ELITA Femtosecond Laser System is safe and effective for the treatment of myopic refractive errors with and without astigmatism. Fast visual recovery was demonstrated, with stability achieved by 3 months. [ABSTRACT FROM AUTHOR]

Background: Studies conducted in Israel and in other countries show that minority populations typically underuse telehealth services notwithstanding the advantages inherent in the use of these services. The goal of this study was to examine telehealth use patterns and the barriers to the use of telehealth services in the Arab population in Israel, which is a culturally and ethnically varied minority population with a unique language and culture. Methods: A telephone survey was conducted among a representative sample of the adult Arab population in Israel from October 29 to November 4, 2020. Of the randomly sampled 1,192 adult Israeli Arabs 501 participants responded to the entire questionnaire, representing a response rate of 42%. Results: The study found that the majority of the adult Arab population in Israel faced no technology or Internet accessibility barriers. Thus, the majority of adult Israeli Arabs (87%) use the Internet on a daily basis and have smartphones (96%) and an Internet connection (93%). However, although they have high technology and Internet accessibility, their use of telehealth services is mostly a telephone appointment with a doctor (66%). At the same time, significantly lower use rates were found with regard to advanced telehealth services delivered through the Internet, e.g., consultation with a health care provider by email or chat (34%) or video chat (8%) and ordering of medications (14%). It was found that Arab Christians are more likely to use digital services than Arab Muslims, even when background characteristics are statistically controlled. Lack of awareness was found to be the major barrier to the use of telehealth services, specifically advanced services such as ordering of medications (23%) and video medical consultation (15%). A high rate of women cited the unmet need for the discreet provision of telehealth services as a barrier to their use of the services. It was also found that the majority of the adult Arab population had no objection in principle to the use of email or chat (75%) or video chat (51%) for consultation with a health care provider. It was further found that facilitating factors promoting the use of telehealth services include previous acquaintance with the health care provider, a stable internet infrastructure, the provision of the services in the Arabis language, guidance in the use of the service, a recommendation by a health care provider, and the participation of a family member in the online medical consultation. Conclusions: The study findings highlight the need for the provision of accessible and customized telehealth services for minority populations. Whether delivered over the phone or through the Internet, the services have to be culturally (for Muslims and Christians) and linguistically (Arabic) adapted, guidance in the use of the services should be provided, and service marketing should be tailored to the target minority population. Specific solutions should be developed for the discreet provision of telehealth services for women, maintaining their privacy in online consultation with a health care provider, while the option of having a family member participate in the online medical consultation should be clearly indicated. In addition, awareness of telehealth services should be enhanced through promotional activities culturally adapted to the Arab society, for instance, through recommendation by the family doctor. [ABSTRACT FROM AUTHOR]

This document is a response to a letter from Dr. Alpins regarding a publication on the safety and effectiveness of the Smooth Incision Lenticular Keratomileusis (SILK™) procedure for correcting refractive errors. The authors of the publication disagree with Dr. Alpins' comments on their method and terminology for astigmatism analysis. They explain that they followed the recommended method and terminology from the American National Standards Institute (ANSI) and that their references were appropriate for comparing treatment results, not data analysis methods. The authors also disclose their affiliations and conflicts of interest. [Extracted from the article]

This document is a corrigendum for an article titled "Safety and Effectiveness of Smooth Incision Lenticular Keratomileusis (SILK™) Using the ELITA™ Femtosecond Laser System for Correction of Myopic and Astigmatic Refractive Errors." The authors have identified errors in Figure 3A and B, where the X and Y axes and other numbers should be shown as negative instead of positive. The correct Figure 3 is provided in the document. The authors apologize for these errors. [Extracted from the article]

Purpose: Investigator feedback was used to assess the clinical use of the LipiFlow® System with the new translucent Activator Clear to successfully complete LipiFlow® treatments. Patients and Methods: This was a prospective, open-label clinical investigation. A total of 88 eyes (44 subjects) were treated using the LipiFlow® System with the new Activator Clear. Subjects diagnosed with bilateral meibomian gland dysfunction (MGD) were enrolled in the study. Each investigator performed a complete LipiFlow® treatment with the translucent Activator on both eyes of each subject. Investigators completed a questionnaire assessing the clinical use of the Activator Clear on a 5-point scale (1 – very difficult or strongly disagree, 3 – neutral, 5 – very easy or strongly agree). Results: The new translucent Activator provided successful LipiFlow® treatments in 100% of cases, with 95% confidence interval of (96%, 100%). Additionally, the investigators agreed or strongly agreed that the translucent components of the Activator Clear made it easy to access and position the activator with confidence on the subject's eye. Conclusion: The overall investigators' impressions on usage and functionality of LipiFlow® System with the translucent Activator were very positive. The Activator Clear enables doctors with efficient and confident positioning around patient eyelids to ensure successful LipiFlow® treatment when used as indicated. [ABSTRACT FROM AUTHOR]

Optical coherence tomography (OCT)-based optical microangiography (OMAG) is a high-resolution, noninvasive imaging technique capable of providing three-dimensional in vivo blood flow visualization within microcirculatory tissue beds in the eye. Although the technique has demonstrated early clinical utility by imaging diseased eyes, its limited field of view (FOV) and the sensitivity to eye motion remain the two biggest challenges for the widespread clinical use of the technology. Here, we report the results of retinal OMAG imaging obtained from a Zeiss Cirrus 5000 spectral domain OCT system with motion tracking capability achieved by a line scan ophthalmoscope (LSO). The tracking LSO is able to guide the OCT scanning, which minimizes the effect of eye motion in the final results. We show that the tracking can effectively correct the motion artifacts and remove the discontinuities and distortions of vascular appearance due to microsaccade, leading to almost motion-free OMAG angiograms with good repeatability and reliability. Due to the robustness of the tracking LSO, we also show the montage scan protocol to provide unprecedented wide field retinal OMAG angiograms. We experimentally demonstrate a 12 x 16 mm2 retinal OMAG angiogram acquired from a volunteer, which is the widest FOV retinal vasculature imaging up to now in the community. [ABSTRACT FROM AUTHOR]

Background: Multifocal visual evoked potentials (mfVEP) measure local response amplitude and latency in the field of vision. Objective: To compare the sensitivity of mfVEP, Humphrey visual field (HVF) and optical coherence tomography (OCT) in detecting visual abnormality in multiple sclerosis (MS) patients. Methods: mfVEP, HVF, and OCT (retinal nerve fiber layer [RNFL]) were performed in 47 MS-ON eyes (last optic neuritis [ON] attack ≥6 months prior) and 65 MS-no-ON eyes without ON history. Criteria to define an eye as abnormal were: (1) mfVEP amplitude/latency - either amplitude or latency probability plots meeting cluster criteria with 95% specificity; (2) mfVEP amplitude or latency alone (specificity: 97% and 98%, respectively); and (3) HVF and OCT, mean deviation and RNFL thickness meeting p<0.05, respectively. Results: MfVEP (amplitude/latency) identified more abnormality in MS-ON eyes (89%) than HVF (72%), OCT (62%), mfVEP amplitude (66%) or latency (67%) alone. Eighteen percent of MS-no-ON eyes were abnormal for both mfVEP (amplitude/latency) and HVF compared with 8% with OCT. Agreement between tests ranged from 60% to 79%. mfVEP (amplitude/latency) categorized an additional 15% of MS-ON eyes as abnormal compared with HVF and OCT combined. Conclusions: mfVEP, which detects both demyelination (increased latency) and neural degeneration (reduced amplitude), revealed more abnormality than HVF or OCT in MS patients. [ABSTRACT FROM AUTHOR]

Multifocal visual evoked potentials provide a topographic measure of visual response amplitude and latency. The objective of this study was to evaluate the sensitivity and specificity of the multifocal visual evoked potential technique in detecting visual abnormalities in patients with multiple sclerosis. Multifocal visual evoked potentials were recorded from 74 patients with multiple sclerosis with history of optic neuritis (MS-ON, n = 74 eyes) or without (MS-no-ON, n=71 eyes), and 50 normal subjects (controls, n = 100 eyes) using a 60-sector pattern reversal dartboard stimulus (VERIS). Amplitude and latency for each sector were compared with normative data and assigned probabilities. Size and location of clusters of adjacent abnormal sectors (p<0.05) were examined. Mean response amplitudes were (±SE) 0.39±0.02, 0.53±0.02, and 0.60±0.01 for MS-ON, MS-no-ON, and control groups, respectively, with significant differences between all groups (p<0.0001). Mean latencies (ms; ±SE relative to normative data) were 12.7±1.3 (MS-ON), 4.3±1.1 (MS-no-ON), and 0.3±0.4 (controls); group differences again significant (p<0.0001). Half the MS-ON eyes had clusters larger than five sectors compared with 13% in MS-no-ON and 2% in controls. Abnormal sectors were distributed diffusely, although the largest cluster was smaller than 15 sectors in two-thirds of MS-ON eyes. Cluster criteria combining amplitude and latency showed an area of 0.96 under the receiver operating characteristic curve, yielding a criterion with 91% sensitivity and 95% specificity. We conclude that the multifocal visual evoked potential provides high sensitivity and specificity in detecting abnormalities in visual function in multiple sclerosis patients. [ABSTRACT FROM AUTHOR]