Comparison of Video Laryngoscope (VL) and Intubating Laryngeal Mask Airway (I-LMA) for Endotracheal Intubation in a Manikin with Restricted Neck Motion.

Introduction: Intubating patients undergoing manual in-line stabilization (MILS) can make airway management more challenging. This study aimed to compare the outcomes of intubation with video-laryngoscope (VL) and Intubating Laryngeal Mask Airway (I-LMA) in manikin with restricted neck motion using MILS. Methods: In this comparative study, emergency medicine residents and paramedics were randomly allocated to two crossover sets. Then the intubation outcomes (success rate, time to successful intubation, and cervical spine movement) were compared between intubation with VL and I-LMA in a manikin model with restricted cervical spine mobility, achieved through MILS. Results: 64 participants with a mean age of 28.86 ± 4.03 (range: 24-47) years and a mean duration of intubation experience of 3.63 ± 1.35 years were studied (43.75% male, 81.3% emergency medicine resident). The intubation success rate was 62 out of 64 (96.88%) in the VL method and 52 out of 64 (81.25%) in the I-LMA method (p = 0.008). The mean time to successful intubation was 33.03±16.94 seconds in the VL method and 55.03±17.34 seconds in the I-LMA method (p < 0.001). The mean cervical range of motion (CROM) in flexion-extension was 4.38±1.82 degrees in the VL method and 4.13±3.20 degrees in the I-LMA method (p = 0.158). The mean CROM in rotation was 4.27±2.62 degrees in the VL method and 4.65±2.47 degrees in the I-LMA method (p= 0.258) and the mean CROM in lateral bending was 5.35±4.45 degrees in the VL method and 7.71±6.14 degrees in the I-LMA method (p = 0.010). Conclusion: In a manikin model with restricted cervical spine mobility, the utilization of VL significantly improved intubation success rates, reduced time to successful intubation, and limited CROM.

Smartphone video imaging: A versatile, low-cost technology for food authentication.

This study presents a low-cost smartphone-based imaging technique called smartphone video imaging (SVI) to capture short videos of samples that are illuminated by a colour-changing screen. Assisted by artificial intelligence, the study develops new capabilities to make SVI a versatile imaging technique such as the hyperspectral imaging (HSI). SVI enables classification of samples with heterogeneous contents, spatial representation of analyte contents and reconstruction of hyperspectral images from videos. When integrated with a residual neural network, SVI outperforms traditional computer vision methods for ginseng classification. Moreover, the technique effectively maps the spatial distribution of saffron purity in powder mixtures with predictive performance that is comparable to that of HSI. In addition, SVI combined with the U-Net deep learning module can produce high-quality images that closely resemble the target images acquired by HSI. These results suggest that SVI can serve as a consumer-oriented solution for food authentication.

Efetividade de um filme na ansiedade e medo de crianças em idade escolar submetidas a cirurgia / Effectiveness of an educational video in reducing anxiety and fear in school-aged children undergoing surgery / Eficacia de una película sobre la ansiedad y el miedo en escolares sometidos a cirugía

Resumo Enquadramento: A hospitalização e a cirurgia são consideradas pela criança como eventos ameaçadores e com repercussões no seu comportamento, nomeadamente ansiedade e medo. Objetivo: Avaliar a efetividade de um filme preparatório para procedimentos a realizar antes de uma cirurgia de ambulatório visando a redução da ansiedade e medo. Metodologia: Estudo randomizado, controlado, envolvendo 60 crianças (6-14 anos), submetidas a cirurgia de ambulatório. O grupo de intervenção visualizou um filme no período pré-operatório e o grupo de controlo recebeu os cuidados habituais. A efetividade do filme foi medida através da escala de ansiedade Children's Anxiety Meter-State e o medo pela escala Children's Fear Scale. Resultados: Não se observaram diferenças significativas (p > 0,05) entre o grupo de intervenção que visualizou o filme e o grupo de controlo que seguiu os cuidados pré-operatórios habituais. Conclusão: Importa avaliar de forma precisa se os custos envolvidos nesta intervenção compensam os benefícios. Sugere-se mais investigação nesta área, ajustando outros programas que se revelem mais efetivos neste contexto.

Abstract Background: Children often perceive hospitalization and surgery as threatening events that can lead to feelings of anxiety and fear. These feelings may affect their behaviors. Objective: To evaluate the effectiveness of an educational video in reducing anxiety and fear before outpatient surgery. Methodology: A randomized controlled study was conducted with 60 children (6 - 14 years old) undergoing outpatient surgery. The intervention group watched an educational video during the preoperative period, while the control group received standard preoperative care. The effectiveness of the video was measured using the Children's Anxiety Meter-State scale, and fear was measured using the Children's Fear Scale. Results: No significant differences (p > 0.05) were found between the intervention group that watched the video and the control group that received standard preoperative care. Conclusion: An accurate assessment of whether the costs of this intervention outweigh the benefits is essential. Further research is recommended, particularly in adapting other programs that have proven more effective in this context.

Resumen Marco contextual: La hospitalización y la intervención quirúrgica son percibidas por el niño como acontecimientos amenazantes que repercuten en su comportamiento, concretamente en la ansiedad y el miedo. Objetivo: Evaluar la eficacia de una película preparatoria para los procedimientos que deben realizarse antes de la cirugía ambulatoria con el fin de reducir la ansiedad y el miedo. Metodología: Estudio aleatorizado y controlado en el que participaron 60 niños (de 6 a 14 años) sometidos a cirugía ambulatoria. El grupo de intervención vio una película en el periodo preoperatorio y el grupo de control recibió los cuidados habituales. La eficacia de la película se midió con la escala Children's Anxiety Meter-State y el miedo con la Children's Fear Scale. Resultados: No hubo diferencias significativas (p > 0,05) entre el grupo de intervención que vio la película y el grupo de control que siguió los cuidados preoperatorios habituales. Conclusión: Es importante evaluar con precisión si los costes de esta intervención compensan los beneficios. Se sugiere seguir investigando en este ámbito, ajustando otros programas que resulten más eficaces en este contexto.

Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data.

BACKGROUND: Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. OBJECTIVE: This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. METHODS: We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. RESULTS: In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). CONCLUSIONS: As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.

Detecting thyroid nodules along with surrounding tissues and tracking nodules using motion prior in ultrasound videos.

Ultrasound examination plays a crucial role in the clinical diagnosis of thyroid nodules. Although deep learning technology has been applied to thyroid nodule examinations, the existing methods all overlook the prior knowledge of nodules moving along a straight line in the video. We propose a new detection model, DiffusionVID-Line, and design a novel tracking algorithm, ByteTrack-Line, both of which fully leverage the prior knowledge of linear motion of nodules in thyroid ultrasound videos. Among them, ByteTrack-Line groups detected nodules, further reducing the workload of doctors and significantly improving their diagnostic speed and accuracy. In DiffusionVID-Line, we propose two new modules: Freq-FPN and Attn-Line. Freq-FPN module is used to extract frequency features, taking advantage of these features to reduce the impact of image blur in ultrasound videos. Based on the standard practice of segmented scanning by doctors, Attn-Line module enhances the attention on targets moving along a straight line, thus improving the accuracy of detection. In ByteTrack-Line, considering the characteristic of linear motion of nodules, we propose the Match-Line association module, which reduces the number of nodule ID switches. In the testing of the detection and tracking datasets, DiffusionVID-Line achieved a mean Average Precision (mAP50) of 74.2 for multiple tissues and 85.6 for nodules, while ByteTrack-Line achieved a Multiple Object Tracking Accuracy (MOTA) of 83.4. Both nodule detection and tracking have achieved state-of-the-art performance.

Veteran comfort and satisfaction with comprehensive geriatric assessment via video telehealth to home.

BACKGROUND: The purpose of this project was to measure satisfaction with virtual comprehensive geriatric assessments (CGA) among older Veterans (OVs). METHODS: The CGA involved five different healthcare providers and four one-hour VA Video Connect (VVC) calls. Using specific enrollment criteria, OVs were recruited in four cohorts separated by time. After completing the CGA, participants were asked to complete a 10-statement telephone questionnaire. Before analyses, responses to each statement were dichotomized as Agree (Agree/Strongly agree) or Do not Agree (Neutral/Disagree/Strongly Disagree). Descriptive statistics and Binomial generalized linear models (GLMs) were used to analyze the data. RESULTS: All 269 enrolled OVs completed all components of the CGA. This included 79, 57, 61, and 72 Veterans in cohorts 1 to 4, respectively. Their average age was 76.0 ± 5.9 years, and they were predominately white (82%), male (94%), and residents of rural settings (64%). Of the 236 (88%) OVs who completed the telephone survey, 57% indicated they were comfortable using VVC and 57% expressed willingness to use VVC again; 44% felt that VVC was easier than going to in-person visits. The OVs in Cohort 1 were more likely to agree with these statements than those in the remaining cohorts, especially Cohorts 2 and 4. Differences in demographics partially explained some of these findings. The majority (89% or higher) of survey participants agreed with the remaining seven survey statements indicating they were satisfied with the CGA program. CONCLUSION: OVs were very satisfied with their participation in a program of CGA, although not necessarily the mode of delivery. The percentage of participants who indicated discomfort using VVC for the CGA visits appeared to increase with time. Further work is needed to determine which OVs would be the best candidates to use VVC to complete all or part of a CGA.

Prospective case-control study on pain intensity after the use of promethazine in patients undergoing videothoracoscopy.

Objective: Effective and secure pain management following video-assisted thoracoscopic surgery (VATS) is crucial for rapid postoperative recovery. This study evaluated analgesic and sedative effects of sufentanil and promethazine in patient-controlled intravenous analgesia (PCIA) post-thoracic surgery, along with potential adverse reactions. Methods: In this prospective, randomized, controlled, double-blind, clinical study, 60 patients (American Society of Anesthesiologists status I-III) undergoing VATS were enrolled. The patients were randomized into experimental (Group P) or control (Group C) groups. PCIA was administered post-general anesthesia using a double-blind method. Group P received sufentanil (3 µg/kg) + promethazine (1 mg/kg) + 0.9% sodium chloride solution (100 mL total), while Group C received sufentanil (3 µg/kg) + 0.9% sodium chloride solution (100 mL total). PCIA settings included a 1-mL bolus and 15-min locking time. The primary outcomes were the visual analog scale (VAS) at rest and during coughing and sedation (Ramsay) scores at 6, 12, 24, and 48 h. The secondary outcomes were rescue drug use rate, hemodynamic parameters (mean arterial pressure and heart rate), percutaneous oxygen saturation, respiratory rate, and occurrence of adverse reactions. Results: Group P exhibited lower resting and coughing VAS scores at 6, 12, 24, and 48 h, plus decreased incidence of nausea and vomiting within 48 h post-surgery compared with Group C (p < 0.05). No significant differences were observed in pruritus, sedation (Ramsay) scores, mean arterial pressure, heart rate, oxygen saturation, or respiratory rate between the two groups (p > 0.05). Discussion: The combination of sufentanil and promethazine for postoperative intravenous analgesia could effectively reduce adverse effects such as nausea and vomiting, contributing to postoperative pain relief.

Game-Based Assessment of Peripheral Neuropathy Combining Sensor-Equipped Insoles, Video Games, and AI: Proof-of-Concept Study.

BACKGROUND: Detecting peripheral neuropathy (PNP) is crucial in preventing complications such as foot ulceration. Clinical examinations for PNP are infrequently provided to patients at high risk due to restrictions on facilities, care providers, or time. A gamified health assessment approach combining wearable sensors holds the potential to address these challenges and provide individuals with instantaneous feedback on their health status. OBJECTIVE: We aimed to develop and evaluate an application that assesses PNP through video games controlled by pressure sensor-equipped insoles. METHODS: In the proof-of-concept exploratory cohort study, a complete game-based framework that allowed the study participant to play 4 video games solely by modulating plantar pressure values was established in an outpatient clinic setting. Foot plantar pressures were measured by the sensor-equipped insole and transferred via Bluetooth to an Android tablet for game control in real time. Game results and sensor data were delivered to the study server for visualization and analysis. Each session lasted about 15 minutes. In total, 299 patients with diabetes mellitus and 30 with metabolic syndrome were tested using the game application. Patients' game performance was initially assessed by hypothesis-driven key capabilities that consisted of reaction time, sensation, skillfulness, balance, endurance, and muscle strength. Subsequently, specific game features were extracted from gaming data sets and compared with nerve conduction study findings, neuropathy symptoms, or disability scores. Multiple machine learning algorithms were applied to 70% (n=122) of acquired data to train predictive models for PNP, while the remaining data were held out for final model evaluation. RESULTS: Overall, clinically evident PNP was present in 247 of 329 (75.1%) participants, with 88 (26.7%) individuals showing asymmetric nerve deficits. In a subcohort (n=37) undergoing nerve conduction study as the gold standard, sensory and motor nerve conduction velocities and nerve amplitudes in lower extremities significantly correlated with 79 game features (|R|>0.4, highest R value +0.65; P<.001; adjusted R2=0.36). Within another subcohort (n=173) with normal cognition and matched covariates (age, sex, BMI, etc), hypothesis-driven key capabilities and specific game features were significantly correlated with the presence of PNP. Predictive models using selected game features achieved 76.1% (left) and 81.7% (right foot) accuracy for PNP detection. Multiclass models yielded an area under the receiver operating characteristic curve of 0.76 (left foot) and 0.72 (right foot) for assessing nerve damage patterns (small, large, or mixed nerve fiber damage). CONCLUSIONS: The game-based application presents a promising avenue for PNP screening and classification. Evaluation in expanded cohorts may iteratively optimize artificial intelligence model efficacy. The integration of engaging motivational elements and automated data interpretation will support acceptance as a telemedical application.

The immediate, intermediate, and long-term effectiveness of audiovisuals for providing pre-treatment information to patients with cancer: A systematic review.

OBJECTIVE: To assess the effectiveness of audiovisuals in providing pre-treatment information to patients with cancer. Following the Six Function Model of Medical Communication, we distinguish between immediate, intermediate, and long-term outcomes. METHODS: A systematic search was performed in five electronic databases for quantitative studies comparing the addition of audiovisuals with standard care or alternative interventions. Quality was assessed using Cochrane's Risk of Bias 2. RESULTS: After abstract (n = 10,179) and full-text (n = 85) screening, 37 articles were included. Audiovisuals positively impacted patients' anxiety, knowledge, understanding, and physiological responses shortly after the consultation, particularly when video was compared with standard verbal care without audiovisual. Only five studies measured long-term outcomes, leaving the long-term effectiveness of audiovisuals unexplored. Majority of studies showed 'high risk of bias' (n = 34). CONCLUSION: Although caution is warranted because of the variability in study design and quality, the results suggest potential benefits of using audiovisuals alongside interpersonal communication. PRACTICAL IMPLICATIONS: More high-quality and longitudinal research is needed with emphasis on comparing counseling with and without usage of audiovisual tools. Healthcare providers can improve the short-term impact of information provision by using audiovisuals alongside standard care, but should carefully consider content, for whom, how, and timing.

Evaluating vertebrobasilar insufficiency and Meniere's disease: Insights from cervical vestibular evoked myogenic potential and video head impulse test.

Background and purpose:

This prospective study aimed to investigate diffe-rences in video head impulse test (vHIT) and cervical vestibular evoked myogenic poten-tial (cVEMP) findings between patients with vertebrobasilar insufficiency (VBI) and Meniere’s disease (MD) who experience episodic vertigo attacks.

A total of 27 patients with VBI and 37 patients with MD were enrolled into the study in a tertiary referral center. Inclusion criteria consisted of patients with a minimum of two previous vertigo attacks, unaccompanied by any neurological symptoms during an attack. All patients underwent horizontal canal h-vHIT and c-VEMP assessments following pure sound audiometric examinations. First, vHIT and cVEMP results for low and high flow sides in VBI patients were analyzed. Subsequently, data from the low-flow side in VBI patients and the affected side in MD patients were compared.

The mean vHIT values for low and high-flow volume sides in VBI patients were 0.68 and 0.88, respectively. In MD patients, mean vHIT values for affected and healthy sides were measured as 0.77 and 0.87, respectively. Abnormal results were observed in 66.7% of VBI patients and 51.4% of MD patients, with no statistically significant difference between the findings (p> 0.05). Upon examining the affected side, c-VEMP responses were absent in 41% of MD patients and 48% of VBI patients, with no statistically significant difference between the groups (p> 0.05).

vHIT and cVEMP assessments can be utilized as supplementary tools to radiologic investigations for the clinical diagnosis and follow-up of VBI. However, no significant differences were observed between vHIT and cVEMP findings in patients with MD and VBI.

Walking the Talk: "Reflexivity" to Advance Integration of Patient Reported Outcomes for Cancer Care Screening.

In this commentary, we propose the use of video-reflexive ethnography (VRE) as a means to support integration of patient-reported outcomes (PROs) in cancer care screening. As for any policy or intervention, the optimization of PROs depends on moving beyond their mere formal introduction, and depends on the integration of PROs in the everyday practice contexts of health care professionals (HPEs). The use of VRE allows for video-playback sessions among oncology professionals to support team-based learning and practice-change grounded in "reflexivity." Through a review of previous methods used to support organizational change in healthcare settings (e.g., policies, quality improvement initiatives, simulation sessions), we present some unsung advantages of VRE that can be applied to a complex integrated setting, such as cancer care. As opposed to other methods to create change, VRE does not dictate new measures, but rather supports "bottom-up" provider-initiated changes to health care practices and contexts, grounded in collaborative day-to-day practice. We argue that VRE optimizes PROs in cancer care by facilitating their effective and sustainable integration, to promote improved patient care.

Multimodal and multiscale feature fusion for weakly supervised video anomaly detection.

Weakly supervised video anomaly detection aims to detect anomalous events with only video-level labels. In the absence of boundary information for anomaly segments, most existing methods rely on multiple instance learning. In these approaches, the predictions for unlabeled video snippets are guided by the classification of labeled untrimmed videos. However, these methods do not account for issues such as video blur and visual occlusion, which can hinder accurate anomaly detection. To address these issues, we propose a novel weakly supervised video anomaly detection method that fuses multimodal and multiscale features. Firstly, RGB and optical flow snippets are input into pre-trained I3D to extract appearance and motion features. Then, we introduce an Attention De-redundancy (AD) module, which employs an attention mechanism to filter out task-irrelevant redundancy in these appearance and motion features. Next, to mitigate the effects of video blurring and visual occlusion, we propose a Multi-scale Feature Learning module. This module captures long-term and short-term temporal dependencies among video snippets to provide global and local guidance for blurred or occluded video snippets. Finally, to effectively utilize the discriminative features of different modalities, we propose an Adaptive Feature Fusion module. This module adaptively fuses appearance and motion features based on their respective feature weights. Extensive experimental results demonstrate that our proposed method outperforms mainstream unsupervised and weakly supervised methods in terms of AUC. Specifically, our proposed method achieves 97.00% AUC and 85.31% AUC on two benchmark datasets, i.e., ShanghaiTech and UCF-Crime, respectively.

A retrospective analysis of simultaneous bilateral uniportal thoracoscopic surgeries for multiple primary bilateral pulmonary nodules.

BACKGROUND: There are no standard treatment options for bilateral multiple pulmonary nodules requiring resection. This study aimed to summarize the experience of simultaneous bilateral uniportal video-assisted thoracoscopic surgery for the treatment of bilateral multiple primary pulmonary nodules. METHODS: The clinical data of 65 cases of simultaneous bilateral uniportal thoracoscopic surgery for bilateral multiple primary pulmonary nodules treated were retrospectively analyzed. These cases were treated within The Ninth Medical Center of PLA General Hospital between January 2018 and November 2020. Parameters related to the surgery, perioperative aspects, surgical techniques, pathology results, and postoperative complications were examined. RESULTS: All surgeries were conducted through uniportal video-assisted thoracoscopic surgery, with no instances of intraoperative conversion to thoracotomy. Fifty-three patients further underwent CT-guided Hookwire localization for the localization of pulmonary nodules. A total of 189 nodules were resected using multiple surgical procedures, with a malignancy rate of 86.2%. The average operation time was 226 ± 77.4 min, the average thoracic drainage duration was 3.1 ± 1.5 days, the average 24 h pleural drainage was 385.9 ± 157.4 mL, the average postoperative hospital stay was 8.6 ± 2.4 days, and the average blood loss was 77.2 ± 33.8 mL. Post-surgery, all patients were transferred to the ward safely within 12 h. 15.38% of patients have prolonged drainage time, and 12.31% of patients experience complications such as lung infection, arrhythmia, and venous thrombosis. CONCLUSION: The selected cases undergoing simultaneous bilateral uniportal video-assisted thoracoscopic surgery for the management of bilateral multiple primary pulmonary nodules demonstrated favorable outcomes. Our observations indicate the safety and feasibility of this procedure, providing an individualized and precise treatment approach for affected patients.

Open thoracotomy versus VATS versus RATS for segmentectomy: a systematic review & Bayesian network meta-analysis.

BACKGROUND: Recent trials suggest that more conservative resections such as segmentectomy are non-inferior to more radical approaches. Most segmentectomy can be safely performed using video-assisted thoracoscopic surgery (VATS). The clinical benefits of robotic-assisted thoracoscopic surgery (RATS) remain unclear. We aimed to perform a systematic review evaluating the outcome of open thoracotomy, VATS, and RATS for segmentectomy. METHODS: A systematic database search was conducted of original articles exploring the outcome of open versus VATS versus RATS segmentectomy in PubMed, EMBASE and SCOPUS. The primary outcome was 30-day mortality. Secondary outcomes were hospital readmission, air leak, and post-operative pneumonia respectively. RESULTS: 11 studies were included with a total patient sample size of 7280. There were no differences between the three approaches in terms of 30-day mortality, hospital readmission, air leak, and post-operative pneumonia. CONCLUSION: There are no significant differences between the three approaches in the clinical outcomes measured. While our analysis demonstrates the potential benefits of RATS, it is important to note that the steep learning curve associated with this technique may impact its wider adoption and efficacy in the community. Further randomised control studies are required to compare the short and long terms results of VATS and RATS approaches.

Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study.

BACKGROUND: Despite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study. METHODS: We analyzed cohort data of 9,538 adolescents (9-10 years at baseline in 2016-2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity. RESULTS: The sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents. CONCLUSIONS: Screen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems.

The Role of Mucociliary Clearance Function of Eustachian Tube as an Outcome Predictor for Type 1 Tympanoplasty.

OBJECTIVES: To evaluate the association between mucociliary function of the Eustachian tube using the Saccharin test preoperatively and its correlation with dynamic slow-motion video endoscopy on the outcome of Type-I Tympanoplasty in patients with inactive mucosal chronic otitis media. METHODOLOGY: Eighty patients diagnosed with inactive mucosal chronic otitis media who underwent Type-I Tympanoplasty were included in the study. Preoperative assessment of Eustachian tube function was conducted using the Saccharin test. Results of this test were categorized as normal, partial, or gross dysfunction. Dynamic slow-motion video endoscopy was performed to assess motion and pathological factors of the Eustachian tube. Results were evaluated based on a previously validated Visual Analogue Score (VAS). Patients were followed up postoperatively for 3 months. RESULTS: The proportion of patients with surgical failure at the end of the 1st and 3rd month postoperatively was significantly higher in cases of gross Eustachian tube dysfunction compared to those with normal and partial dysfunction (p-value < 0.0001 and p-value = 0.0001, respectively). Preoperative VAS scores in normal Eustachian tubes were significantly higher compared to those with partial dysfunction and gross dysfunction. CONCLUSION: The Saccharin test is a valuable tool for preoperative evaluation of mucociliary clearance of the Eustachian tube, and dynamic slow-motion video endoscopy serves as a useful adjunct in predicting the outcome of Type-I Tympanoplasty. Routine evaluation of mucociliary clearance function of the Eustachian tube should be included in the preoperative workup for patients undergoing Tympanoplasty to achieve optimal surgical outcomes.

Why do patients stay in hospital after enhanced recovery thoracoscopic wedge resection? A prospective observational study.

OBJECTIVES: This single-centre prospective observational study aimed to investigate reasons for prolonged hospitalization (over the median length of stay [LOS]) after enhanced recovery thoracoscopic (ERAS 3-port VATS) wedge resection. METHODS: All patients were evaluated twice daily by an investigator for reasons of hospitalization. Each reason was analysed individually. Predictors for prolonged hospitalization were identified using a multivariable backward stepwise logistic regression model. RESULTS: A total of 150 consecutive patients (lymphadenectomy 8.7%) were included from November 2022 to December 2023, with a median LOS of 1 (interquartile range 1-2) day. Of these, 55 patients (36.7%) experienced prolonged hospitalization. The main reasons included postoperative pain (16.0%), air leak (14.7%), and social factors (14.7%), followed by oxygen dependency (7.3%), gastrointestinal factors (5.3%), urinary factors (4.7%), pneumonia (1.3%), pleural effusion (1.3%), chylothorax (0.7%), atrial fibrillation (0.7%), confusion (0.7%), and fatigue (0.7%). Multivariable analysis revealed that an increase in percentage of predicted forced expiratory volume in 1 second (FEV1%pre) by 1% (odds ratio [OR] 0.41, P = 0.023) and percentage of predicted diffusing capacity for carbon monoxide (DLCO%pre) by 1% (OR 0.95, P = 0.002) decreased likelihood of prolonged hospitalization. Conversely, each additional pack-year (OR 1.01, P = 0.028) and living alone (OR 3.55, P = 0.005) increased the risk of prolonged hospitalization. CONCLUSIONS: Prolonged hospitalization (LOS > 1 day) after ERAS 3-port VATS wedge resection, with 8.7% lymphadenectomy, was mainly due to pain, air leak, and social factors. Smokers with decreased FEV1%pre or DLCO%pre and patient living alone were at increased risk.

Rupture of an Aneurysmal Pulmonary Sequestration Artery.

Pulmonary sequestration (PS) is a rare lung malformation seldomly accompanied by aneurysmal deformation of its arterial vasculature. This is a first report of aneurysmal PS presenting with acute aneurysmal rupture. The ruptured aneurysm was treated uneventfully by emergency endovascular coiling, and thoracoscopic hemothorax drainage.

Is YouTube a reliable source of education for the intravitreal injection procedure?

PURPOSE: This study aims to evaluate the quality of videos on YouTube that demonstrate the intravitreal injection (IVI) procedure as an educational tool. MATERIAL AND METHODS: A search on YouTube using the keywords "intravitreal injection", "intravitreal injection procedure", "eye injection", "eye injection procedure", "dexamethasone intraocular injection", and "anti-VEGF injection" was performed on January 10, 2023. Of the first 300 videos obtained, 70 met the inclusion criteria. The videos were evaluated for content and quality using the IVI procedure checklist score, DISCERN, modified Global Quality Score (GQS), Health on the Net Foundation (HON) code, and the Journal of American Medical Association (JAMA) scores. The quality of the videos was also compared with regard to the uploading source, such as a university or training hospital, educational channels, and individual medical doctors or healthcare professionals. RESULTS: The mean IVI procedure checklist score was 4.84±1.58, and 29 videos fulfilled more than 80% of the checklist items, indicating that only 41.4% of the videos conformed to the IVI procedure recommendations. The mean DISCERN, modified GQS, and JAMA benchmark scores were 34.75±10.46, 2.90±1.09, and 2.09±0.72, respectively, indicating poor overall video quality. The mean HON code score was 4.68±1.39, indicating moderate overall video quality. Videos uploaded by educational channels seem to be of better quality than those uploaded by others. CONCLUSIONS: The majority of evaluated YouTube videos on the IVI procedure appear to be of low quality as an educational tool. Videos uploaded by educational channels would be preferred to gain quality information about the IVI procedure.